Resource tiered reviews – a provisional reporting checklist

AFJEM is committed to publishing review articles that will benefit acute care providers, independent of the resources available to them. As a result we have compiled a checklist aimed specifically at best evidence in the resource-restricted setting (Table 1). The aim is to guide authors in producing a report which is a combination between a clinical guideline and a systematic review. Best available evidence, using a transparent and systematic approach to find and evaluate relevant studies, is still key; but with additional focus on resource availability. In effect it will be more rigorous than a narrative review but less time-consuming than a systematic review or meta-analysis. In order to apply the content to different resource levels, authors are advised to start by describing the very best evidence available; then assume the resources for this level are not available and describe the next tier of evidence until all options are exhausted. For example, if we return to our patient with chest pain: the recommended treatment for a patient with STEMI is primary percutaneous coronary intervention; if this treatment is not available, then thrombolytics should be considered; if that is not available then antiplatelet therapy and anticoagulation should be used, and so on and so forth

The giant deep-sea octopus Haliphron atlanticus forages on gelatinous fauna

Feeding strategies and predator-prey interactions of many deep-sea pelagic organisms are still unknown. This is also true for pelagic cephalopods, some of which are very abundant in oceanic ecosystems and which are known for their elaborate behaviors and central role in many foodwebs. We report on the first observations of the giant deep-sea octopus Haliphron atlanticus with prey. Using remotely operated vehicles, we saw these giant octopods holding medusae in their arms. One of the medusae could be identified as Phacellophora camtschatica (the egg-yolk jelly). Stomach content analysis confirmed predation on cnidarians and gelatinous organisms. The relationship between medusae and H. atlanticus is discussed, also in comparison with other species of the Argonautoidea, all of which have close relationships with gelatinous zooplankto

A descriptive analysis of the effect of the national COVID-19 lockdown on the workload and case mix of patients presenting to a district-level emergency centre in Cape Town, South Africa

Background. The global COVID-19 pandemic caused many countries to institute nationwide lockdowns to limit the spread of the disease.Objectives. To describe the effect of the national COVID-19 lockdown in South Africa (SA) on the workload and case mix of patients presenting to a district-level emergency centre.Methods. The electronic patient tracking and registration database at Mitchells Plain Hospital, a district-level hospital in Cape Town, was retrospectively analysed. The 5-week lockdown period (27 March - 30 April 2020) was compared with a similar period immediately before the lockdown (21 February - 26 March). A comparison was also made with corresponding time periods during 2018 and 2019. Patient demographics, characteristics, diagnoses and disposition, as well as process times, were compared.Results. A total of 26 164 emergency centre visits were analysed (8 297 in 2020, 9 726 in 2019, 8 141 in 2018). There was a reduction of 15% in overall emergency centre visits from 2019 to 2020 (non-trauma 14%, trauma 20%). A 35% decrease was seen between the 2020 lockdown period and the 5-week period before lockdown (non-trauma 33%, trauma 43%), and the reduced number of visits stayed similar throughout the lockdown period. The median age increased by 5 years during the 2020 lockdown period, along with an 8% decrease in patients aged <12 years. High-acuity patients increased by 6% and the emergency centre mortality rate increased by 1%. All process times were shorter during the lockdown period (time to triage –24%, time to consultation –56%, time to disposition decision –29%, time in the emergency centre –20%).Conclusions. The SA national COVID-19 lockdown resulted in a substantial decrease in the number of patients presenting to the emergency centre. It is yet to be seen how quickly emergency centre volumes will recover as lockdown measures are eased

Signalling C-Type lectin receptors, microbial recognition and immunity

This work was supported in part by the Wellcome Trust, Medical Research Council (UK) and the University of Cape Town. J.C. Hoving is a Carnegie Corporation postdoctoral researcher at the University of Cape Town. We apologize of all our colleagues whose important contributions we could not cite due to space constraints.Peer reviewedPublisher PD