COVID-19 vaccine acceptance in older Syrian refugees : Preliminary findings from an ongoing study

Funding source This work was supported by ELRHA’s Research for Health in Humanitarian Crisis (R2HC) Programme, which aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises. R2HC is funded by the UK Foreign, Commonwealth and Development Office (FCDO), Wellcome, and the UK National Institute for Health Research (NIHR). The views expressed herein should not be taken, in any way, to reflect the official opinion of the NRC or ELRHA. The funding agency was not involved in the data collection, analysis or interpretation.Peer reviewedPublisher PD

Proportion of At-Risk Alcohol Consumers According to the New French Guidelines: Cross-Sectional Weighted Analyses From the CONSTANCES Cohort

Objective: To estimate the proportion of the participants of the French national population-based CONSTANCES cohort exceeding the new low-risk drinking guidelines according to sociodemographic and clinical factors.Methods: From 34,470 participants with follow-up data in 2019, among volunteers aged 18–69 years and invited to enroll in the CONSTANCES cohort in 2016 and 2017, weighted prevalence and odds ratios with 95% confidence intervals (CI) exceeding the guidelines using logistic regressions were presented stratified for age, gender, education, occupational grade, employment, income, marital status, pregnancy, work stress, depression, alcohol dependence, binge drinking, cannabis use, smoking status, e-cigarette use, cardiovascular diseases, and cancer.Results: The guidelines were exceeded more by men at 60.2% (95%CI: 59.3%–61.0%) than by women at 36.6% (95%CI: 35.9%–37.4%). Exceeding the guidelines increased with age, socioeconomic status, smoking, vaping, using cannabis, binge drinking, and alcohol dependence. Being depressed was associated with exceeding the guidelines in women. Even though pregnant women were less likely to exceed the guidelines, 7.6% (95%CI: 5.4%–10.6%) were at-risk drinkers.Conclusion: These findings highlight the need to implement effective prevention measures for at-risk alcohol use among the French population

Prospective evaluation of entrainment mapping as an adjunct to new-generation high-density activation mapping systems of left atrial tachycardias

BACKGROUND Identification of atrial tachycardia (AT) mechanism remains challenging. OBJECTIVE We sought to investigate the added value of entrainment maneuvers (EM) when using new high-density activation mapping (HDAM) technologies for the identification of complex left ATs. METHODS Thirty-six consecutive complex ATs occurring after ablation of persistent atrial fibrillation were prospectively analyzed. The AT mechanism was diagnosed in 2 steps by 2 experts: (1) based on H DAM only (Coherent module, CARTO, Biosense Webster Inc., Irvine, CA) and (2) with additional analysis from EM. RESULTS EM resulted in atrial fibrillation in 1 patient, who was excluded from the analysis. Ten of 11 single loop macroreentries identified by HDAM were confirmed by EM. Only 4 of 14 double loop macroreentries identified by HDAM wereconfirmed by EM (in 10 patients, EM unmasked passive activation of one of the visual cir- cuits). One sole microreentry circuit identified by HDAM was confirmed by EM. A combination of macro- and microreentry circuits was visualized in 3 ATs using H DAM. However, EM revealed passive activation of the visual macroreentrant loop in 2 of these 3 cases. By using HDAM in 6 of 35 ATs (17%), no univocal mechanism could be identified, whereas EM finally enabled the diagnosis of 5 microreentry circuits and 1 macroreentrant AT. All the diagnoses made from EM in addition to HDAM were confirmed by ablation. CONCLUSION Entrainment maneuvers are still useful during mapping of complex left ATs, mostly to differentiate active from passive macroreentrant loops and to demonstrate microreentry circuits

Structures and reactivity of peroxy radicals and dimeric products revealed by online tandem mass spectrometry

Organic peroxy radicals (RO2) play a pivotal role in the degradation of hydrocarbons. The autoxidation of atmospheric RO2 radicals produces highly oxygenated organic molecules (HOMs), including low-volatility ROOR dimers formed by bimolecular RO2 + RO2 reactions. HOMs can initiate and greatly contribute to the formation and growth of atmospheric particles. As a result, HOMs have far-reaching health and climate implications. Nevertheless, the structures and formation mechanism of RO2 radicals and HOMs remain elusive. Here, we present the in-situ characterization of RO2 and dimer structure in the gas-phase, using online tandem mass spectrometry analyses. In this study, we constrain the structures and formation pathway of several HOM-RO2 radicals and dimers produced from monoterpene ozonolysis, a prominent atmospheric oxidation process. In addition to providing insights into atmospheric HOM chemistry, this study debuts online tandem MS analyses as a unique approach for the chemical characterization of reactive compounds, e.g., organic radicals.Peer reviewe

Webquest como recurso tecnológico didático para capacitação de colaboradores em instituição hospitalar

Neste estudo objetivou-se avaliar a utilização daWebquestcomo recurso tecnológico didático para capacitação quanto às Metas Internacionais de Segurança do Paciente em uma instituição hospitalar. Estudo quantitativo, transversal, realizado em hospital público de ensino, no Sul do Brasil. De 895 colaboradores, participaram da pesquisa 679 (76%), vinculados à diretoria de enfermagem, sendo enfermeiros, técnicos em enfermagem, auxiliares de enfermagem, técnicos administrativos e auxiliares operacionais zeladores que foram capacitados quanto as metas de segurança. Foram avaliados 11 itens em cada meta aplicada, dentre eles apenas estrutura física, quantidade de textos, tempo destinado à capacitação, cores e design,aplicação na prática e objetividade dos textosforam referidoscomo regular ou ruim por um a 3% dos colaboradores. O recurso foi considerado satisfatório como estratégia para educação permanente, possibilitando a identificação de fragilidades do processo, passíveis de melhoria, para aprimoramento da metodologia Webquestem instituição hospitalar

Automatic segmentation of right ventricle in cardiac cine MR images using a saliency analysis

PURPOSE: Accurate measurement of the right ventricle (RV) volume is important for the assessment of the ventricular function and a biomarker of the progression of any cardiovascular disease. However, the high RV variability makes difficult a proper delineation of the myocardium wall. This paper introduces a new automatic method for segmenting the RV volume from short axis cardiac magnetic resonance (MR) images by a salient analysis of temporal and spatial observations. METHODS: The RV volume estimation starts by localizing the heart as the region with the most coherent motion during the cardiac cycle. Afterward, the ventricular chambers are identified at the basal level using the isodata algorithm, the right ventricle extracted, and its centroid computed. A series of radial intensity profiles, traced from this centroid, is used to search a salient intensity pattern that models the inner-outer myocardium boundary. This process is iteratively applied toward the apex, using the segmentation of the previous slice as a regularizer. The consecutive 2D segmentations are added together to obtain the final RV endocardium volume that serves to estimate also the epicardium. RESULTS: Experiments performed with a public dataset, provided by the RV segmentation challenge in cardiac MRI, demonstrated that this method is highly competitive with respect to the state of the art, obtaining a Dice score of 0.87, and a Hausdorff distance of 7.26 mm while a whole volume was segmented in about 3 s. CONCLUSIONS: The proposed method provides an useful delineation of the RV shape using only the spatial and temporal information of the cine MR images. This methodology may be used by the expert to achieve cardiac indicators of the right ventricle function

Olimpíada de qualidade e segurança em hospital universitário público sentinela

Introduction: The quality of health care aims to ensure safe and free from unnecessary harm care to the customer. Objective: Describe the experience of the Risk Management sector at the quality and safety awareness event in a sentinel public university hospital. Method: This is a descriptive experience report study that used the active methodology called Gamification to promote patient quality and safety. The event was held in April 2018, in a high-complexity university hospital located in northern Paraná, inserted in the SentinelHospitals Network of the National Health Surveillance Agency. Results: Approximately 325 people were involved among health professionals, administrative technicians, teachers, residents, academics and external community who participated in the various proposed activities. Nine challenges were made for the dissemination of knowledge on the subject. Concurrent with the activities, the judging committee met to assess the challenges and score points, displayed on the scoreboard posted in the hospital hall. The award of the winning team was a lunch at a renowned restaurant, and for the others, certificates and medals. Conclusion: The use of games and dynamics is a pedagogical tool that provides learning and collaborates in the dissemination of the theme of quality and safety, as well as provides interaction between employees. At the end of the event, the participants’ satisfaction survey was applied, being rated between excellent and good by 90% of respondents.Introdução: A qualidade da assistência à saúde tem como finalidade garantir uma assistência segura e livre de danos desnecessários ao cliente. Objetivo: Descrever a experiência do setor de Gerência de Risco no evento de sensibilização sobre a qualidade e segurança em hospital universitário público sentinela. Método: Estudo descritivo, do tipo relato de experiência, que utilizou a metodologia ativa denominada gamificação, para promoção da qualidade e da segurança do paciente. O evento foi realizado em abril de 2018, em umhospital universitário de alta complexidade localizado no norte do Paraná, inserido na Rede de Hospitais Sentinelas, da Agência Nacional de Vigilância Sanitária. Resultados: Houve a participação de aproximadamente 325 pessoas, entre profissionais de saúde, técnicos administrativos, docentes, residentes, acadêmicos e comunidade externa que participaram das diversas atividades propostas. Foram realizados nove desafios para disseminação do conhecimento sobre a temática. Concomitante às atividades, a comissão julgadora se reunia para avaliação dos desafios e contabilização de pontos, divulgados no placar afixado no hall do hospital. A premiação do time vencedor foi um almoço em restaurante renomado e, para os demais, foram entregues certificados e medalhas. Conclusões: O uso de jogos e dinâmicas constituiu-se em uma ferramenta pedagógica que proporciona o aprendizado e colabora na disseminação da temática de qualidade e segurança, além de proporcionar a interação entre os colaboradores. Ao término do evento foi aplicada uma pesquisa de satisfação aos participantes, e ele foi classificado como ótimo e bom por 90% dos respondentes

Clinical Outcomes and Predictors of Thirty-Day Readmissions of Hypertriglyceridemia-Induced Acute Pancreatitis

Background: Hypertriglyceridemia (HTG) is a well-established cause of acute pancreatitis often leading to significant morbidity, mortality, and healthcare burden. This study aimed to describe the rate, reasons, and predictors of HTG-induced acute pancreatitis (HTG-AP) in the USA. Methods: This retrospective study analyzed the Nationwide Readmissions Database (NRD) for 2018 to determine all adults (≥ 18 years) readmitted within 30 days of an index hospitalization of HTG-AP. Hospitalization characteristics and adverse outcomes for 30-day readmissions were highlighted and compared with index admissions of HTG-AP. Furthermore, independent predictors for 30-day readmissions of HTG-AP were also identified. P values ≤ 0.05 were considered statistically significant. Results: In 2018, the rate of 30-day readmission of HTG-AP was noted to be 13.5%. At the time of readmission, AP (45.2%) was identified as the most common principal diagnosis, followed by chronic pancreatitis (6.3%) and unspecified sepsis (4.8%). Compared to index admissions, 30-day readmissions of HTG-AP had a higher proportion of patients with Charlson Comorbidity Index (CCI) scores ≥ 3 (48.5% vs. 33.8%, P < 0.001). Furthermore, we noted higher rates of inpatient mortality (1.7% vs. 0.7%, odds ratio (OR): 2.55, 95% confidence interval (CI): 1.83 - 3.57, P < 0.001), mean length of stay (LOS) (5.6 vs. 4.1 days, OR: 1.5, 95% CI: 1.2 - 1.7, P < 0.001), and mean total healthcare charge (THC) ($56,799 vs.$36,078, OR: 18,702, 95% CI: 15,136 - 22,267, P < 0.001) for 30-day readmissions of HTG-AP compared to index admissions. Independent predictors for 30-day all-cause readmissions of HTG-AP included hypertension, protein energy malnutrition (PEM), CCI scores ≥ 3, chronic kidney disease and discharge against medical advice. Conclusions: AP was the principal diagnosis on presentation in only 45.2% patients for 30-day readmissions of HTG-AP. Compared to index admissions, 30-day readmissions of HTG-AP had a higher comorbidity burden, inpatient mortality, mean LOS and mean THC