Inpatient Transition to Virtual Care During COVID-19 Pandemic

Introduction: During the coronavirus disease 2019 (COVID-19) outbreak, novel approaches to diabetes care have been employed. Care in both the inpatient and outpatient setting has transformed considerably. Driven by the need to reduce the use of personal protective equipment and exposure for patients and providers alike, we transitioned inpatient diabetes management services to largely "virtual" or remotely provided care at our hospital. Methods: Implementation of a diabetes co-management service under the direction of the University of North Carolina division of endocrinology was initiated in July 2019. In response to the COVID-19 pandemic, the diabetes service was largely transitioned to a virtual care model in March 2020. Automatic consults for COVID-19 patients were implemented. Glycemic outcomes from before and after transition to virtual care were evaluated. Results: Data over a 15-week period suggest that using virtual care for diabetes management in the hospital is feasible and can provide similar outcomes to traditional face-to-face care. Conclusion: Automatic consults for COVID-19 patients ensure that patients with serious illness receive specialized diabetes care. Transitioning to virtual care models does not limit the glycemic outcomes of inpatient diabetes care and should be employed to reduce patient and provider exposure in the setting of COVID-19. These findings may have implications for reducing nosocomial infection in less challenging times and might address shortage of health care providers, especially in the remote areas

Actin-based dynamics during spermatogenesis and its significance*

Actin can be found in all kinds of eukaryotic cells, maintaining their shapes and motilities, while its dynamics in sperm cells is understood less than their nonmuscle somatic cell counterparts. Spermatogenesis is a complicated process, resulting in the production of mature sperm from primordial germ cell. Significant structural and biochemical changes take place in the seminiferous epithelium of the adult testis during spermatogenesis. It was proved that all mammalian sperm contain actin, and that F-actin may play an important role during spermatogenesis, especially in nuclear shaping. Recently a new model for sperm head elongation based on the acrosome-acroplaxome-manchette complex has been proposed. In Drosophila, F-actin assembly is supposed to be very crucial during individualization. In this mini-review, we provide an overview of the structure, function, and regulation characteristics of actin cytoskeleton, and a summary of the current status of research of actin-based structure and movement is also provided, with emphasis on the role of actins in sperm head shaping during spermiogenesis and the cell junction dynamics in the testis. Research of the Sertoli ectoplasmic specialization is in the spotlight, which is a testis-specific actin-based junction very important for the movement of germ cells across the epithelium. Study of the molecular architecture and the regulating mechanism of the Sertoli ectoplasmic specialization has become an intriguing field. All this may lead to a new strategy for male infertility and, at the same time, a novel idea may result in devising much safer contraception with high efficiency. It is hoped that the advances listed in this review would give developmental and morphological researchers a favorable investigating outline and could help to enlarge the view of new strategies and models for actin dynamics during spermatogenesis