Triage Nurse-Activated Emergency Evaluation Reduced Door-to-Needle Time in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis.

Methods: This was a retrospective analysis in a general hospital emergency department in Beijing, China. 212 adult AIS patients treated with thrombolysis who failed to use EMSs were included. In addition to DNT, door-to-vein open time (DVT), door-to-blood sample deliver time (DBT), and 7-day NIHSS scores were evaluated. Results: 137 (64.6%) patients were in the triage nurse-activated group and 75 (35.4%) patients were in the doctor-activated group. The DNT of the triage nurse-activated group was significantly reduced compared with the doctor-activated group (28 (26, 32.5) min vs. 30 (28, 40) min, p=0.001). DNT less than 45 min was seen in 95.6% of patients in the triage nurse-activated group and 84% of patients in the doctor-activated group (p=0.011, OR 3.972, 95% CI 1.375-11.477). In addition, DVT (7 (4, 10) min vs. 8 (5, 12) min, P=0.025) and DBT (15 (13, 21) min vs. 19 (15, 26) min, p=0.001) of the triage nurse-activated group were also shorter than those of the doctor-activated group (p < 0.05). The 7-day NIHSS scores were not statistically different between the two groups. Conclusions: Triage nurse-activated urgent emergency evaluation could reduce the door-to-needle time, which provides a feasible opportunity to optimize the emergency department service for AIS patients who failed to use emergency medical services.

BMI, Blood Pressure, and Plasma Lipids among Centenarians and Their Offspring.

BACKGROUND: The burden of cardiovascular diseases (CVDs) is increasing substantially due to population growth and aging. Determining effective prevention and understanding the underlying mechanisms remain desirable pursuits for increasing the quality of life. As centenarians and their offspring may have genetic advantages, they may present with healthier cardiovascular-related profiles. METHODS: We launched a cross-sectional household-based survey of centenarian families, including 253 centenarians, 217 centenarian offspring, and 116 offspring spouses without centenarian parents from county-level Chinese longevity city Rugao. Among offspring and offspring spouses were the following arrangements: 101 paired offspring and offspring spouses who lived together, 116 unpaired offspring, and 16 unpaired spouses. We investigated their cardiovascular-related health status including waist circumference, body mass index (BMI), blood pressure, and plasma lipids and compared results among centenarians, centenarian offspring, and offspring spouses. RESULTS: Centenarians ranged from 99 to 109 years with a median age of 100 years. Centenarian offspring, with a median age of 70 years, and offspring spouses, with a median age of 69 years, shared similar age. Results of blood pressure, plasma lipid levels, and BMI displayed no significant difference between centenarian offspring and offspring spouses. However, centenarians appeared to have lower waist circumference, BMI, TC, LDL-C, TG, and diastolic blood pressure but higher levels of systolic blood pressure (p < 0.05). Multivariate analysis showed the prevalence of obesity, hypertension, and dyslipidemia was similar between centenarian offspring and offspring spouses, while centenarians appeared to have a lower prevalence of obesity and a higher prevalence of hypertension (p < 0.05). CONCLUSIONS: Centenarians and centenarian offspring did not present healthier BMI, blood pressure, or plasma lipids than offspring spouses. Further research on longevity and cardiovascular diseases are desirable.

Learning Communities Engage Medical Students: A COVID-19 Virtual Conversation Series.

Context Challenges to medical education have been pervasive during the COVID-19 pandemic, and medical students, in particular, have faced numerous obstacles as a result. One of the greatest losses for medical students was the inability to gather with their peers and a lost sense of community. The Learning Community (LC) program at Wayne State University School of Medicine (WSU SoM) expanded our offerings through the use of the Zoom platform to increase a sense of connectedness among medical students. The first initiative of its kind at WSU SoM, the Virtual Conversation series enabled students to share their pandemic challenges while also connecting with physicians on the COVID-19 frontlines.  Students were offered eight online sessions with physicians and residents who were able to share insight regarding (1) how to succeed as a medical student on rotation during COVID-19, (2) potential implications of the pandemic on residency applications, (3) the utility of telemedicine, (4) tips for patient encounters, and (5) realities of serving as a physician during a global health crisis.  Methods Residents and clinical physicians on the COVID-19 frontlines participated in 40-minute discussions with WSU SoM students through Zoom. Electronic Qualtrics surveys were distributed to medical student attendees of the Virtual Conversation series and responses were received via Likert scale, open text, and ranking questions. Results Qualtrics results demonstrated 55% of medical students (n=55) reported they learned new information about the COVID-19 pandemic from the perspective of physicians. Additionally, 62% of medical students described the Virtual Conversation series as 'extremely useful'. Conclusion The Virtual Conversation series emphasizing different medical aspects of COVID-19 provided a unique benefit to medical students' understanding of the current landscape of healthcare, the anticipation of their future roles as physicians, connectedness with their community, and opportunity to practice flexibility as they begin to apply online learning with real-world situations in the health system.