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1.
Acta Colombiana de Cuidado Intensivo ; JOUR
Artigo em Espanhol | EuropePMC | ID: covidwho-2092686

RESUMO

Introducción: Uno de los grandes retos durante la pandemia por la COVID-19 fue el manejo del soporte ventilatorio. La Oxigenación por Membrana Extracorpórea (ECMO) fue la principal estrategia para el manejo del síndrome de dificultad respiratoria aguda refractaria. Objetivo: El objetivo de este proyecto fue evaluar las características de los pacientes con COVID-19 que requirieron soporte con ECMO. Materiales y métodos: Estudio de cohorte retrospectivo, multicéntrico, de pacientes adultos que requirieron de (ECMO) en los centros participantes. Se registraron características clínicas y paraclínicas. Se realizó comparación entre los pacientes sobrevivientes y no sobrevivientes. Además, se analizó el tiempo transcurrido desde el inicio de los síntomas hasta la colocación de ECMO, el tiempo desde la ventilación mecánica y la canulación. Resultados: Se incluyeron 26 pacientes en el análisis. La mortalidad durante ECMO fue del 42,3% (n = 11) y la hospitalaria global fue del 65,3% (n = 17). La cohorte de pacientes no fue diferente, en términos de características sociodemográficas y predicadores de mortalidad al ingreso a UCI entre los sobrevivientes y no sobrevivientes. Se realizó ECMO móvil en 10 pacientes, mientras que 16 fueron canulados in situ en los centros participantes. La mediana de tiempo desde el inicio de los síntomas hasta ECMO fue de 14, 5 días (RIC 10, 7 - 21, 5), 11 días (RIC 9,5-15,5) en el grupo de supervivientes y 17 días (RIC 12, 5 - 27 ) en los no supervivientes. La mediana de tiempo de VMI fue de 28, 5 (RIC 13 - 38, 25) días. La presión de conducción (12 vvs 10 cmH2O;p<0.01), la complacencia (37,2 vs 21,4 ml/cmH20;p<0,01), y el poder mecánico (17,4 vs 11,3 J/min;p=0,051) del sistema respiratorio mostraron diferencias estadísticamente significativas al comparar sobrevivientes y no sobrevivientes, durante el 3er día de soporte con ECMO. Conclusiones: En nuestra cohorte, la mortalidad tras ECMO y a los 30 días de estancia hospitalaria fue del 42,3% similar a la data recogida por la Extracorporeal life support organisation (ELSO) COVID-19. En este estudio se proporcionó información sobre pacientes que requirieron ECMO durante la primera ola de COVID-19 en Argentina.

2.
Acta Colombiana de Cuidado Intensivo ; JOUR
Artigo em Espanhol | ScienceDirect | ID: covidwho-2085840

RESUMO

Resumen Introducción: Uno de los grandes retos durante la pandemia por la COVID-19 fue el manejo del soporte ventilatorio. La Oxigenación por Membrana Extracorpórea (ECMO) fue la principal estrategia para el manejo del síndrome de dificultad respiratoria aguda refractaria. Objetivo: El objetivo de este proyecto fue evaluar las características de los pacientes con COVID-19 que requirieron soporte con ECMO. Materiales y métodos: Estudio de cohorte retrospectivo, multicéntrico, de pacientes adultos que requirieron de (ECMO) en los centros participantes. Se registraron características clínicas y paraclínicas. Se realizó comparación entre los pacientes sobrevivientes y no sobrevivientes. Además, se analizó el tiempo transcurrido desde el inicio de los síntomas hasta la colocación de ECMO, el tiempo desde la ventilación mecánica y la canulación. Resultados: Se incluyeron 26 pacientes en el análisis. La mortalidad durante ECMO fue del 42,3% (n = 11) y la hospitalaria global fue del 65,3% (n = 17). La cohorte de pacientes no fue diferente, en términos de características sociodemográficas y predicadores de mortalidad al ingreso a UCI entre los sobrevivientes y no sobrevivientes. Se realizó ECMO móvil en 10 pacientes, mientras que 16 fueron canulados in situ en los centros participantes. La mediana de tiempo desde el inicio de los síntomas hasta ECMO fue de 14, 5 días (RIC 10, 7 - 21, 5), 11 días (RIC 9,5-15,5) en el grupo de supervivientes y 17 días (RIC 12, 5 - 27 ) en los no supervivientes. La mediana de tiempo de VMI fue de 28, 5 (RIC 13 - 38, 25) días. La presión de conducción (12 vvs 10 cmH2O;p<0.01), la complacencia (37,2 vs 21,4 ml/cmH20;p<0,01), y el poder mecánico (17,4 vs 11,3 J/min;p=0,051) del sistema respiratorio mostraron diferencias estadísticamente significativas al comparar sobrevivientes y no sobrevivientes, durante el 3er día de soporte con ECMO. Conclusiones: En nuestra cohorte, la mortalidad tras ECMO y a los 30 días de estancia hospitalaria fue del 42,3% similar a la data recogida por la Extracorporeal life support organisation (ELSO) COVID-19. En este estudio se proporcionó información sobre pacientes que requirieron ECMO durante la primera ola de COVID-19 en Argentina. Introduction: One of the great challenges during the COVID-19 pandemic was the management of ventilatory support. Extracorporeal membrane oxygenation (ECMO) was the main strategy for the management of refractory acute respiratory distress syndrome. Objective: Retrospective, multicentre cohort study of adult patients who required Extracorporeal Membrane Oxygenation (ECMO) in participating centres. Clinical and paraclinical characteristics were recorded. A comparison was made between surviving and non-surviving patients. In addition, time from symptom onset to ECMO placement, time from mechanical ventilation, and cannulation were analysed. Material and methods: Retrospective, multicentre cohort study of adult patients who required Extracorporeal Membrane Oxygenation (ECMO) in participating centres. Clinical and paraclinical characteristics were recorded. A comparison was made between surviving and non-surviving patients. In addition, time from symptom onset to ECMO placement, time from mechanical ventilation, and cannulation were analysed. Results: Twenty-six patients were included in the analysis. Mortality during ECMO was 42.3% (n = 11) and overall hospital mortality was 65.3% (n = 17). The patient cohort did not differ in terms of sociodemographic characteristics and predictors of mortality at ICU admission between survivors and non-survivors. Mobile ECMO was performed in 10 patients, while 16 were cannulated in situ at the participating centres. The median time from symptom onset to ECMO was 14.5 days (IQR 10.7-21.5), 11 days (IQR 9.5-15.5) in the survivor group, and 17 days (IQR 12, 5-27) in non-survivors. The median IMV time was 28.5 (IQR 13 - 38.25) days. Driving pressure (12 vs 10 cmH2O;p<.01), compliance (37.2 vs 21.4 ml/cmH20;p<.01), and mechanical power ( 17.4 vs 11.3 J/min;p=.051) o the respiratory system showed statistically significant differences when comparing survivors and non-survivors, during the 3rd day of ECMO support. Conclusion: In our cohort, mortality after ECMO and after 30 days of hospital stay, was 42.3%, similar to that stated on the extracorporeal life support organisation (ELSO) COVID-19 registry dashboard. Information about patients with COVID-19 who required ECMO during the first wave in Argentina was provided in this analysis.

3.
Front Psychol ; 13: 906108, 2022.
Artigo em Inglês | MEDLINE | ID: covidwho-2080250

RESUMO

At the 2019 and 2021 International Conference on Environmental Psychology, discussions were held on the future of conferences in light of the enormous greenhouse gas emissions and inequities associated with conference travel. In this manuscript, we provide an early career researcher (ECR) perspective on this discussion. We argue that travel-intensive conference practices damage both the environment and our credibility as a discipline, conflict with the intrinsic values and motivations of our discipline, and are inequitable. As such, they must change. This change can be achieved by moving toward virtual and hybrid conferences, which can reduce researchers' carbon footprints and promote equity, if employed carefully and with informal exchange as a priority. By acting collectively and with the support of institutional change, we can adapt conference travel norms in our field. To investigate whether our arguments correspond to views in the wider community of ECRs within environmental psychology, we conducted a community case study. By leveraging our professional networks and directly contacting researchers in countries underrepresented in those networks, we recruited 117 ECRs in 32 countries for an online survey in February 2022. The surveyed ECRs supported a change in conference travel practices, including flying less, and perceived the number of researchers wanting to reduce their travel emissions to be growing. Thirteen percent of respondents had even considered leaving academia due to travel requirements. Concerning alternative conference formats, a mixed picture emerged. Overall, participants had slightly negative evaluations of virtual conferences, but expected them to improve within the next 5 years. However, ECRs with health issues, facing visa challenges, on low funding, living in remote areas, with caretaking obligations or facing travel restrictions due to COVID-19 expected a switch toward virtual or hybrid conferences to positively affect their groups. Participants were divided about their ability to build professional relationships in virtual settings, but believed that maintaining relationships virtually is possible. We conclude by arguing that the concerns of ECRs in environmental psychology about current and alternative conference practices must be taken seriously. We call on our community to work on collective solutions and less travel-intensive conference designs using participatory methods.

6.
BMJ Supportive and Palliative Care ; 11:A38-A39, 2021.
Artigo em Inglês | EMBASE | ID: covidwho-2032476

RESUMO

Background In response to the COVID-19 pandemic, the hospice moved to digital approaches. Whilst tele-rehabilitation has shown benefits for various chronic health conditions (Bhatt, Patel, Anderson, et al., 2019;Zanaboni, Hoaas, Lien, et al., 2017;Hwang, Bruning, Morris, et al., 2017), there is a gap in the literature on telehealth interventions for palliative rehabilitation. Aim To evaluate digital delivery of a palliative rehabilitation programme and obtain perceptions of users and staff. Methods All members of the Fatigue and Breathlessness (FAB) follow-on group (n=19) were invited to complete a questionnaire on the experience of transitioning to Zoom sessions. Descriptive statistics were produced using the statistical software package, Stata (Version 15;StataCorp, 2017). Qualitative data were analysed using an inductive thematic analysis framework (Braun & Clarke, 2006). Three members of the rehabilitation team were interviewed about encountered benefits and challenges. Results Thirteen members completed the questionnaire (68%) and all were positive about the transformed sessions. Eight respondents (62%) felt that the Zoom sessions were 'no different' or 'better' than in-person sessions. No adverse events were reported. Themes from open-ended comments included patient-level effects such as maintained exercise and social contact when in isolation and removed travel requirements. At the service level, there was improved access but technological challenges. Most respondents (9, 69%) suggested keeping the option of Zoom for flexibility and 46% (6) wanted both staff-led and self-led elements. The rehabilitation team felt their rapid response and team working enabled efficient transition to Zoom. This included risk assessments, particularly for those living alone. With help, users quickly learned and the virtual delivery provided opportunities to try new activities. At times, staff found the 'silent audience' challenging. The rehabilitation team felt the approach may only work with groups with existing rapport. Conclusions The hospice rehabilitation team now provide concurrent sessions at home via Zoom and in the hospice. These access options provide choice, appear to be acceptable and offer flexibility around changing condition status and personal factors.

7.
One Health ; 15: 100429, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: covidwho-2004396

RESUMO

SARS-CoV-2, the virus responsible for COVID-19 in humans, can efficiently infect a large number of animal species. Like any virus, and particularly RNA viruses, SARS-CoV-2 undergoes mutations during its life cycle some of which bring a selective advantage, leading to the selection of a given lineage. Minks are very susceptible to SARS-CoV-2 and owing to their presence in mass rearing, they make a good model for studying the relative importance of mutations in viral adaptation to host species. Variants, such as the mink-selected SARS-CoV-2 Y453F and D614G or H69del/V70del, Y453F, I692V and M1229I were identified in humans after spreading through densely caged minks. However, not all mink-specific mutations are conserved when the virus infects human populations back. Many questions remain regarding the interspecies evolution of SARS-CoV-2 and the dynamics of transmission leading to the emergence of new variant strains. We compared the human and mink ACE2 receptor structures and their interactions with SARS-CVoV-2 variants. In minks, ACE2 presents a Y34 amino acid instead of the H34 amino acid found in the human ACE2. H34 is essential for the interaction with the Y453 residue of the SARS-CoV-2 Spike protein. The Y453F mink mutation abolishes this conflict. A series of 18 mutations not involved in the direct ACE2 interaction was observed in addition to the Y453F and D614G in 16 different SARS-CoV-2 strains following bidirectional infections between humans and minks. These mutations were not random and were distributed into five different functional groups having an effect on the kinetics of ACE2-RD interaction. The interspecies transmission of SARS-CoV-2 from humans to minks and back to humans, generated specific mutations in each species which improved the affinity for the ACE2 receptor either by direct mutation of the core 453 residue or by associated compensatory mutations.

8.
Journal of Business and Technical Communication ; 36(4):524-534, 2022.
Artigo em Inglês | ProQuest Central | ID: covidwho-1993261

RESUMO

Successfully adapting to organizational changes during the COVID-19 pandemic crisis necessitated the effective deployment of technical communication texts delineating the expectations and structures for guiding behavior and interactions. A dearth of system-wide familiarity with changes in modalities has disrupted expectations and impacted engagement. During acute events, business and technical communicators will probably not be the initial source of transition messaging. Instead, this task will fall on managers, faculty, and other front-line communicators. The authors present pragmatic recommendations for adapting familiar discourses, semiotics, and mental scripts so that communicators can more effectively intervene during crises to ease organizational transitions and decrease uncertainty.

9.
J Clin Med ; 11(15)2022 Aug 03.
Artigo em Inglês | MEDLINE | ID: covidwho-1969335

RESUMO

COVID-19 mRNA vaccinations have recently been implicated in causing myocarditis. Therefore, the primary aim of this systematic review and meta-analysis was to investigate the clinical characteristics of patients with myocarditis following mRNA vaccination. The secondary aims were to report common imaging and laboratory findings, as well as treatment regimes, in these patients. A literature search was performed from December 2019 to June 2022. Eligible studies reported patients older than 18 years vaccinated with mRNA, a diagnosis of myocarditis, and subsequent outcomes. Pooled mean or proportion were analyzed using a random-effects model. Seventy-five unique studies (patient n = 188, 89.4% male, mean age 18-67 years) were included. Eighty-six patients had Moderna vaccines while one hundred and two patients had Pfizer-BioNTech vaccines. The most common presenting symptoms were chest pain (34.5%), fever (17.1%), myalgia (12.4%), and chills (12.1%). The most common radiologic findings were ST-related changes on an electrocardiogram (58.7%) and hypokinesia on cardiac magnetic resonance imaging or echocardiography (50.7%). Laboratory findings included elevated Troponin I levels (81.7%) and elevated C-reactive protein (71.5%). Seven patients were admitted to the intensive care unit. The most common treatment modality was non-steroid anti-inflammatory drugs (36.6%) followed by colchicine (28.5%). This meta-analysis presents novel evidence to suggest possible myocarditis post mRNA vaccination in certain individuals, especially young male patients. Clinical practice must therefore take appropriate pre-cautionary measures when administrating COVID-19 mRNA vaccinations.

10.
Ann Surg ; 276(5): 746-752, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: covidwho-1961268

RESUMO

OBJECTIVE: To explore the prospects of academic e-learning by evaluating our long-standing internet-based surgical learning program and to assess the impact of training on the presentation skills of our residents. The eventual goal is to search whether such models could be further developed by the European Surgical Association (ESA). BACKGROUND: E-learning has become a major educational trend particularly during the COVID-19 pandemic. For more than a decade, our academic tertiary center has released weekly video-lectures covering the entire abdominal-surgical curriculum for residents. All lessons were prepared under the supervision of specialized experts and recorded and edited by a professional film team before being released on a dedicated YouTube channel ( https://www.usz.ch/surgical-resident-lectures ). METHODS: To date, our channel includes 120 presentations with more than 619,000 views. We conducted a survey among online users with a medical background and tested the benefits and potential for improvements of local stakeholders to collect individual reviews. RESULTS: A total of 708 users from 106 countries participated in the survey. Continuing medical education (49%), specific questions (38%), and exam preparation (33%) were the main motivations for video viewing. The preferred topics were current guidelines (69%), latest research topics (59%), and complex surgical conditions (52%). Ninety-four percent of our local audience reported a positive learning experience. CONCLUSION: E-learning can improve local academic training and promote the global visibility of strong academic centers. Providing free and unrestricted expertise via social media is a novel and groundbreaking opportunity that fills a global education gap by dissemination of surgical education on an unprecedented scale. Expert associations such as the ESA may adopt similar formats and foster their perception as true beacons of knowledge.


Assuntos
Instrução por Computador , Cirurgiões , COVID-19/epidemiologia , Currículo , Humanos , Pandemias , Cirurgiões/educação
11.
Diabetes ; 71, 2022.
Artigo em Inglês | ProQuest Central | ID: covidwho-1923981

RESUMO

Introduction: In times of economic crisis, there have been sharp increases in levels of food insecurity. During the COVID-pandemic, the USDA reported that food insecurity remained stable at 15% in America from 20to 2020. This national average may not reflect the heightened risk of rural areas and counties with known socioeconomic disadvantages. Objective: To evaluate food insecurity in a rural county with documented poor health outcomes and assess the impact of the COVID-pandemic. Methods: We performed a cross-sectional survey of all households in Sullivan County, a rural county that has the second-worst health outcomes among all counties in New York State. The survey included two screening questions that have been validated to identify households with food insecurity. The questions were asked in reference to 2019, before the pandemic, and for 2020, during the pandemic. Respondents were also asked to fill out household and demographic questions. To help mitigate non-response bias, statistical raking was performed using age, sex, race/ethnicity, and health insurance strata. We also performed geospatial analysis within the county to identify significant clusters of food insecurity. Results: Of 4,725 survey responses analyzed, 26% of households reported food insecurity in 2019, which increased to 35% in 2020. We identified high levels of food insecurity in 58% of Black households and 58% of Hispanic households in 2020. Food insecurity in 2020 was also present in 58% of unmarried households with children and in 64% of households insured by Medicaid. Nearest neighbor analyses revealed that hotspots of food insecurity were primarily located in or near urban clusters within this rural county. Conclusion: Our countywide health survey of a particularly at-risk rural county identified significant increases in food insecurity during the COVID-pandemic. Economic responses to future pandemics may need to focus on bolstering food security among single households with children and those insured by Medicaid.

12.
Frontiers in psychology ; 13, 2022.
Artigo em Inglês | EuropePMC | ID: covidwho-1918746

RESUMO

At the 2019 and 2021 International Conference on Environmental Psychology, discussions were held on the future of conferences in light of the enormous greenhouse gas emissions and inequities associated with conference travel. In this manuscript, we provide an early career researcher (ECR) perspective on this discussion. We argue that travel-intensive conference practices damage both the environment and our credibility as a discipline, conflict with the intrinsic values and motivations of our discipline, and are inequitable. As such, they must change. This change can be achieved by moving toward virtual and hybrid conferences, which can reduce researchers’ carbon footprints and promote equity, if employed carefully and with informal exchange as a priority. By acting collectively and with the support of institutional change, we can adapt conference travel norms in our field. To investigate whether our arguments correspond to views in the wider community of ECRs within environmental psychology, we conducted a community case study. By leveraging our professional networks and directly contacting researchers in countries underrepresented in those networks, we recruited 117 ECRs in 32 countries for an online survey in February 2022. The surveyed ECRs supported a change in conference travel practices, including flying less, and perceived the number of researchers wanting to reduce their travel emissions to be growing. Thirteen percent of respondents had even considered leaving academia due to travel requirements. Concerning alternative conference formats, a mixed picture emerged. Overall, participants had slightly negative evaluations of virtual conferences, but expected them to improve within the next 5 years. However, ECRs with health issues, facing visa challenges, on low funding, living in remote areas, with caretaking obligations or facing travel restrictions due to COVID-19 expected a switch toward virtual or hybrid conferences to positively affect their groups. Participants were divided about their ability to build professional relationships in virtual settings, but believed that maintaining relationships virtually is possible. We conclude by arguing that the concerns of ECRs in environmental psychology about current and alternative conference practices must be taken seriously. We call on our community to work on collective solutions and less travel-intensive conference designs using participatory methods.

14.
Viruses ; 14(7)2022 Jun 28.
Artigo em Inglês | MEDLINE | ID: covidwho-1911664

RESUMO

Molecular mimicry between viral antigens and host proteins can produce cross-reacting antibodies leading to autoimmunity. The coronavirus SARS-CoV-2 causes COVID-19, a disease curiously resulting in varied symptoms and outcomes, ranging from asymptomatic to fatal. Autoimmunity due to cross-reacting antibodies resulting from molecular mimicry between viral antigens and host proteins may provide an explanation. Thus, we computationally investigated molecular mimicry between SARS-CoV-2 Spike and known epitopes. We discovered molecular mimicry hotspots in Spike and highlight two examples with tentative high autoimmune potential and implications for understanding COVID-19 complications. We show that a TQLPP motif in Spike and thrombopoietin shares similar antibody binding properties. Antibodies cross-reacting with thrombopoietin may induce thrombocytopenia, a condition observed in COVID-19 patients. Another motif, ELDKY, is shared in multiple human proteins, such as PRKG1 involved in platelet activation and calcium regulation, and tropomyosin, which is linked to cardiac disease. Antibodies cross-reacting with PRKG1 and tropomyosin may cause known COVID-19 complications such as blood-clotting disorders and cardiac disease, respectively. Our findings illuminate COVID-19 pathogenesis and highlight the importance of considering autoimmune potential when developing therapeutic interventions to reduce adverse reactions.


Assuntos
COVID-19 , Cardiopatias , Anticorpos Antivirais , Antígenos Virais , Autoimunidade , Humanos , Mimetismo Molecular , SARS-CoV-2 , Glicoproteína da Espícula de Coronavírus/genética , Trombopoetina , Tropomiosina/metabolismo
15.
PLoS Comput Biol ; 18(6): e1010271, 2022 06.
Artigo em Inglês | MEDLINE | ID: covidwho-1910466

RESUMO

While deep learning models have seen increasing applications in protein science, few have been implemented for protein backbone generation-an important task in structure-based problems such as active site and interface design. We present a new approach to building class-specific backbones, using a variational auto-encoder to directly generate the 3D coordinates of immunoglobulins. Our model is torsion- and distance-aware, learns a high-resolution embedding of the dataset, and generates novel, high-quality structures compatible with existing design tools. We show that the Ig-VAE can be used with Rosetta to create a computational model of a SARS-CoV2-RBD binder via latent space sampling. We further demonstrate that the model's generative prior is a powerful tool for guiding computational protein design, motivating a new paradigm under which backbone design is solved as constrained optimization problem in the latent space of a generative model.


Assuntos
COVID-19 , RNA Viral , Humanos , Imunoglobulinas , Proteínas/química , SARS-CoV-2
16.
Med Sci (Paris) ; 38(6-7): 600-607, 2022.
Artigo em Francês | MEDLINE | ID: covidwho-1908317

RESUMO

Since the beginning of the COVID-19 pandemic, the question of the origin of this virus has been the subject of a vivid controversy. It is the question of the "origin" itself which is biased. Darwin showed that there is no determined origin to any animal or plant species, simply an evolutionary and selective process. The same is true for viruses, there is no origin, but an evolutionary process. Viruses circulate from host to host, animals or humans. Pandemic viruses are already circulating in humans and evolving before the onset of disease. This evolutionary process then continues and gives rise to successive variants. The solution is not to target the disease or the putative causative agent but rather to address the process of disease emergence.


Title: Le virus SARS-CoV-2 n'a pas « d'origine ¼. Abstract: Depuis le début de la pandémie de COVID-19, la question de l'origine de ce virus fait l'objet d'une vive polémique. C'est la question de « l'origine ¼ qui est biaisée. Darwin a montré qu'il n'y a pas d'origine déterminée à aucune espèce animale ou végétale, simplement un processus évolutif et sélectif. Il en est de même pour les virus, il n'y a pas d'origine, mais un processus évolutif. Les virus circulent d'hôte à hôte, animaux ou humains. Les virus pandémiques circulent déjà chez l'homme et évoluent avant l'apparition d'une maladie. Ce processus évolutif se poursuit et donne naissance à des variants successifs. La solution n'est pas de cibler la maladie ou le possible agent causal, mais plutôt de cibler le processus d'émergence de la maladie lui-même.


Assuntos
COVID-19 , SARS-CoV-2 , Animais , Humanos , Pandemias
17.
Am J Surg ; 224(1 Pt A): 131-135, 2022 07.
Artigo em Inglês | MEDLINE | ID: covidwho-1899505

RESUMO

BACKGROUND: Tertiary surveys can help identify missed injuries, but how and when to conduct them remains uncertain. This study aimed to evaluate the outcomes of a policy requiring tertiary survey completion within 24 h post-admission. METHODS: A retrospective review was performed with a pre-intervention time-period of 8/1/2019-1/31/2020, where tertiary surveys were performed prior to discharge (n = 762). During the post-intervention time-period of 8/1/2020-1/31/21 tertiary surveys were performed within 24 h of admission (n = 651). RESULTS: Missed injury (1.6% [n = 12] vs. 1.5% [n = 10]; p = 0.953) and mortality rates (3.1% vs. 3.7%, p = 0.579) were similar between the pre- and post-intervention groups. Tertiary survey completion rates were higher (86.8% vs. 80.2%; p = 0.001) and exams performed earlier (1[1-1] vs. 1 [1-2] day, p < 0.001) in the post-intervention group. For those with missed injuries, time to injury identification and number of injuries identified on tertiary survey was unchanged. CONCLUSION: Requiring tertiary surveys within 24 h of admission can help identify and correct missed injuries, but standardization of the tertiary survey process and documentation may be as important as the timing.


Assuntos
Traumatismo Múltiplo , Centros de Traumatologia , Erros de Diagnóstico , Documentação , Humanos , Estudos Retrospectivos
18.
J Am Coll Emerg Physicians Open ; 1(4): 592-596, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: covidwho-1898682

RESUMO

Objectives: The purpose of this study was to assess coinfection rates of coronavirus disease 2019 (COVID-19) with other respiratory infections on presentation. Methods: This is a retrospective analysis of data from a 2 hospital academic medical centers and 2 urgent care centers during the initial 2 weeks of testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), March 10, 2020 to March 23, 2020. Testing was targeted toward high-risk patients following US Centers for Disease Control and Prevention guidelines. Demographics include age group and sex. Laboratory test results included SARS-CoV-2, rapid influenza A/B, and upper respiratory pathogen nucleic acid detection. Patient demographics and coinfections are presented overall and by test results with descriptive statistics. Results: Complete laboratory results from the first 2 weeks of testing were available for 471 emergency department patients and 117 urgent care center patients who were tested for SARS-CoV. A total of 51 (8.7%) patients tested positive for COVID-19 with only 1 of these patients also testing positive for another respiratory infection. One of the patients positive for COVID-19 also tested positive for influenza A. Among the 537 patients who were screened and tested negative for COVID-19, there were 33 (6.1%) patients who tested positive in the upper respiratory pathogen nucleic acid detection test. Conclusion: In our study investigating coinfections among 51 patients testing positive for COVID-19, 1 patient also tested positive for influenza A. Although we found limited coinfections in our emergency department and urgent care center patient populations, further research is needed to assess potential coinfection in patients with COVID-19.

19.
J R Soc Interface ; 19(188): 20210668, 2022 03.
Artigo em Inglês | MEDLINE | ID: covidwho-1886535

RESUMO

The effectiveness of non-pharmaceutical interventions, such as mask-wearing and social distancing, as control measures for pandemic disease relies upon a conscientious and well-informed public who are aware of and prepared to follow advice. Unfortunately, public health messages can be undermined by competing misinformation and conspiracy theories, spread virally through communities that are already distrustful of expert opinion. In this article, we propose and analyse a simple model of the interaction between disease spread and awareness dynamics in a heterogeneous population composed of both trusting individuals who seek better quality information and will take precautionary measures, and distrusting individuals who reject better quality information and have overall riskier behaviour. We show that, as the density of the distrusting population increases, the model passes through a phase transition to a state in which major outbreaks cannot be suppressed. Our work highlights the urgent need for effective interventions to increase trust and inform the public.


Assuntos
Influenza Humana , Comunicação , Surtos de Doenças , Humanos , Influenza Humana/epidemiologia , Pandemias/prevenção & controle , Saúde Pública
20.
Journal of Business and Technical Communication ; : 10506519221105493, 2022.
Artigo em Inglês | Sage | ID: covidwho-1886873

RESUMO

Successfully adapting to organizational changes during the COVID-19 pandemic crisis necessitated the effective deployment of technical communication texts delineating the expectations and structures for guiding behavior and interactions. A dearth of system-wide familiarity with changes in modalities has disrupted expectations and impacted engagement. During acute events, business and technical communicators will probably not be the initial source of transition messaging. Instead, this task will fall on managers, faculty, and other front-line communicators. The authors present pragmatic recommendations for adapting familiar discourses, semiotics, and mental scripts so that communicators can more effectively intervene during crises to ease organizational transitions and decrease uncertainty.

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