Enhanced Monitoring System to Better Monitor High-Risk COVID-19 Patients.

Telemedicine (TM) is a useful tool to extend medical care during a pandemic. TM was extensively utilized in Singapore during the COVID-19 pandemic as part of the Nation's COVID-19 healthcare strategy. Patients were risk stratified to prioritize limited healthcare resources and the Telemedicine Allocation Reconciliation System (TMARS) was adapted to monitor and manage limited TM resources. High-Risk patients (Protocol 1) had an escalation rate of 4.87%, compared to the non-High-Risk patients' 0.002% and TM doctors spent an average of six hours to complete one tele-consultation. In order to optimize the efficiency of the TM system, an enhanced monitoring system was implemented in March 2022. The intent was to focus monitoring efforts on the High-Risk patients. High-Risk patients reporting sick for the first time were prioritized to receive tele-consultations through this system. With the aid of a data-driven dashboard, the Operations Control and Monitoring team (OCM) was able to closely monitor the performance of the various TM providers (TMPs), sent them timely reminders and re-assigned patients to other TMPs when the requisite turnaround time was not met. Implementing the enhanced monitoring system resulted in a significant reduction in the average time taken to provide tele-consultations. After 3 months of implementation, the percentages of consultations completed within two hours were raised from 75.7% (February 2022) to 96.8% (May 2022), greatly increasing productivity and efficiency.

Acne agminata: dermoscopic features and a short review.

Acne agminata is a rare idiopathic inflammatory dermatosis. Treatment is variable with no clear consensus. We herein report a case of a 31-year-old man with sudden onset papulonodular eruptions on his face over two months. Histopathological examination revealed superficial granuloma composed of epithelioid histiocytes and scattered multinucleated giant cells, confirming acne agminata. Dermoscopy showed focal orangish structureless areas with follicular openings with white keratotic plugs. He achieved complete clinical resolution with oral prednisolone in 6 weeks. We also reviewed the literature regarding the reported treatment regimens used.

Eco-friendly synthesis for MCM-41 nanoporous materials using the non-reacted reagents in mother liquor.

Nanoporous materials such as Mobil composite material number 41 (MCM-41) are attractive for applications such as catalysis, adsorption, supports, and carriers. Green synthesis of MCM-41 is particularly appealing because the chemical reagents are useful and valuable. We report on the eco-friendly synthesis of MCM-41 nanoporous materials via multi-cycle approach by re-using the non-reacted reagents in supernatant as mother liquor after separating the solid product. This approach was achieved via minimal requirement of chemical compensation where additional fresh reactants were added into the mother liquor followed by pH adjustment after each cycle of synthesis. The solid product of each successive batch was collected and characterized while the non-reacted reagents in supernatant can be recovered and re-used to produce subsequent cycle of MCM-41. The multi-cycle synthesis is demonstrated up to three times in this research. This approach suggests a low cost and eco-friendly synthesis of nanoporous material since less waste is discarded after the product has been collected, and in addition, product yield can be maintained at the high level.