Acute aortic dissection mimicking as ureteral calculus

AbstractAcute aortic dissection is an uncommon but life-threatening emergency, which is often missed in up to 38% of patients on initial evaluation, and in up to 28% of patients the diagnosis is made at autopsy. Painless aortic dissection has been reported, but is relatively uncommon. The mortality rates are estimated at 50% by 48 hours and increase by 1% per hour if undiagnosed. We report a case of atypical aortic dissection who presented to ER with subtle unspecific renal colicky like pain as a primary symptom, which had made the prompt diagnosis very challenging and difficult

Impact of the COVID-19 pandemic on medical-seeking behavior in older adults by comparing the presenting complaints of the emergency department visits

Abstract Background The outbreak of the coronavirus disease 2019 (COVID-19) has caused a catastrophic event worldwide. Since then, people’s way of living has changed in terms of personal behavior, social interaction, and medical-seeking behavior, including change of the emergency department (ED) visiting patterns. The objective of this study was to analyze the impact of the COVID-19 pandemic on the ED visiting patterns of the older people to explore its variable expression with the intention of ameliorating an effective and suitable response to public health emergencies. Methods This was a retrospective study conducted in three hospitals of the Cathay Health System in Taiwan. Patients aged ≥ 65 years who presented to the ED between January 21, 2020, and April 30, 2020 (pandemic stage), and between January 21, 2019, and April 30, 2019 (pre-pandemic stage) were enrolled in the study. Basic demographics, including visit characteristics, disposition, and chief complaints of the patients visiting the ED between these two periods of time, were compared and analyzed. Results A total of 16,655 older people were included in this study. A 20.91% reduction in ED older adult patient visits was noted during the pandemic period. During the pandemic, there was a decrease in ambulance use among elderly patients visiting the ED, with the proportion decreasing from 16.90 to 16.58%. Chief complaints of fever, upper respiratory infections, psychological and social problems increased, with incidence risk ratios (IRRs) of 1.12, 1.23, 1.25, and 5.2, respectively. Meanwhile, the incidence of both non-life-threatening and life-threatening complaints decreased, with IRRs of 0.72 and 0.83, respectively. Conclusion Health education regarding life-threatening symptom signs among older adult patients and avocation of the proper timing to seek medical attention via ambulance were crucial issues during the pandemic

Plasma-Assisted Synthesis of High-Mobility Atomically Layered Violet Phosphorus

Two-dimensional layered materials such as graphene, transition metal dichalcogenides, and black phosphorus have demonstrated outstanding properties due to electron confinement as the thickness is reduced to atomic scale. Among the phosphorus allotropes, black phosphorus, and violet phosphorus possess layer structure with the potential to be scaled down to atomically thin film. For the first time, the plasma-assisted synthesis of atomically layered violet phosphorus has been achieved. Material characterization supports the formation of violet phosphorus/InN over InP substrate where the layer structure of violet phosphorus is clearly observed. The identification of the crystal structure and lattice constant ratifies the formation of violet phosphorus indeed. The critical concept of this synthesis method is the selective reaction induced by different variations of Gibbs free energy (Δ<i>G</i>) of reactions. Besides, the Hall mobility of the violet phosphorus on the InP substrate greatly increases over the theoretical values of InP bulk material without much reduction in the carrier concentration, suggesting that the mobility enhancement results from the violet phosphorus layers. Furthermore, this study demonstrates a low-cost technique with high compatibility to synthesize the high-mobility atomically layered violet phosphorus and open the space for the study of the fundamental properties of this intriguing material as a new member of the fast growing family of 2D crystals