Telehealth Solutions for In-hospital Communication with Patients Under Isolation During COVID-19

The coronavirus disease 2019 (COVID-19) pandemic is a public health crisis that has quickly overwhelmed our healthcare system. It has led to significant shortages in personal protective equipment (PPE), ventilators, and intensive care unit beds across the nation. As the initial entry point for patients with suspected COVID illness, emergency departments (ED) have had to adapt quickly to prioritize the safety of patients and providers while still delivering optimal, timely patient care. COVID-19 has presented many challenges for the ED that also extend to all inpatient services. Some of these key challenges are the fundamental tasks of communicating with patients in respiratory isolation while minimizing PPE usage and enabling all patients who have been affected by hospitals’ visitor restrictions to connect with their families. We discuss the design principles behind implementing a robust in-hospital telehealth system for patient-provider and patient-family communication, provide a review of the strengths and weaknesses of potential videoconferencing options, and deliver concise, step-by-step guides for setting up a secure, low-cost, user-friendly solution that can be rapidly deployed

Seis islas temporales en Still — The Economy of Waiting

This article focuses on the analysis of the performative installation Still — The Economy of Waiting, work by German artist Julian Hetzel. This project addresses specific issues related to the mechanisms in labour productivity and work ethics. Taking as a starting point post-Fordist production models, Hetzel observes the current transformation of the idea of "work" into the notion of "occupation". While "labour and work" concepts have been oriented towards a productive model that pursues specific results and objectives, the concept "occupation" focuses on activity as a process, that is, its purpose is none other than to remain busy, thereby raising a temporary counter-model with which to generate a gap in the flow of capitalist circulation.El artículo se centra en el análisis de la instalación performática Still — The Economy of Waiting, obra del artista alemán Julian Hetzel. En dicho proyecto se abordan ciertas problemáticas asociadas a los mecanismos en la producción laboral y las éticas del trabajo. Tomando como punto de partida modelos de producción posfordistas, Hetzel observa la actual transformación de la idea de "trabajo" en la idea de "ocupación". Mientras que la idea de "labor y trabajo" han estado orientadas hacia un modelo productivo que persigue resultados y objetivos específicos, la idea de "ocupación" se centra en la actividad como proceso, es decir, su finalidad no es otra que la de permanecer ocupado, planteando con ello un contra-modelo temporal con el que generar una brecha en el flujo de la circulación capitalista

The competency-based mandate for emergency bedside sonography training and a tale of two residency programs

[no abstract available

Telehealth Solutions for In-hospital Communication with Patients Under Isolation During COVID-19

The coronavirus disease 2019 (COVID-19) pandemic is a public health crisis that has quickly overwhelmed our healthcare system. It has led to significant shortages in personal protective equipment (PPE), ventilators, and intensive care unit beds across the nation. As the initial entry point for patients with suspected COVID illness, emergency departments (ED) have had to adapt quickly to prioritize the safety of patients and providers while still delivering optimal, timely patient care. COVID-19 has presented many challenges for the ED that also extend to all inpatient services. Some of these key challenges are the fundamental tasks of communicating with patients in respiratory isolation while minimizing PPE usage and enabling all patients who have been affected by hospitals’ visitor restrictions to connect with their families. We discuss the design principles behind implementing a robust in-hospital telehealth system for patient-provider and patient-family communication, provide a review of the strengths and weaknesses of potential videoconferencing options, and deliver concise, step-by-step guides for setting up a secure, low-cost, user-friendly solution that can be rapidly deployed

Bedside Ultrasound Reduces Diagnostic Uncertainty and Guides Resuscitation in Patients With Undifferentiated Hypotension.

Objectives: Utilization of ultrasound in the evaluation of patients with undifferentiated hypotension has been proposed in several protocols. We sought to assess the impact of an ultrasound hypotension protocol on physicians\u27 diagnostic certainty, diagnostic ability, and treatment and resource utilization. Design: Prospective observational study. Setting: Emergency department in a single, academic tertiary care hospital. Subjects: A convenience sample of patients with a systolic blood pressure less than 90 mm Hg after an initial fluid resuscitation, who lacked an obvious source of hypotension. Interventions: An ultrasound-trained physician performed an ultrasound on each patient using a standardized hypotension protocol. Differential diagnosis and management plan was solicited from the treating physician immediately before and after the ultrasound. Blinded chart review was conducted for management and diagnosis during the emergency department and inpatient hospital stay. Measurements and Main Results: The primary endpoints were the identification of an accurate cause for hypotension and change in physicians\u27 diagnostic uncertainty. The secondary endpoints were changes in treatment plan, use of resources, and changes in disposition after performing the ultrasound. One hundred eighteen patients with a mean age of 62 years were enrolled. There was a significant 27.7% decrease in the mean aggregate complexity of diagnostic uncertainty before and after the ultrasound hypotension protocol (1.85-1.34; -0.51 [95% CI, -0.41 to -0.62]) as well as a significant increase in the absolute proportion of patients with a definitive diagnosis from 0.8% to 12.7%. Overall, the leading diagnosis after the ultrasound hypotension protocol demonstrated excellent concordance with the blinded consensus final diagnosis (Cohen k = 0.80). Twenty-nine patients (24.6%) had a significant change in the use of IV fluids, vasoactive agents, or blood products. There were also significant changes in major diagnostic imaging (30.5%), consultation (13.6%), and emergency department disposition (11.9%). Conclusions: Clinical management involving the early use of ultrasound in patients with hypotension accurately guides diagnosis, significantly reduces physicians\u27 diagnostic uncertainty, and substantially changes management and resource utilization in the emergency department

Nonsingular H-tensor and its criteria

H-tensor is a new developed concept in tensor analysis and it is an extension of H-matrix and M-tensor. Based on the spectral theory of nonnegative tensors, several equivalent conditions of nonsingular H-tensors are established in the literature. However, these conditions can not be used as a criteria to identify nonsingular H-tensors as they are hard to verify. In this paper, based on the diagonal product dominance and S diagonal product dominance of a tensor, we establish some new implementable criteria in identifying nonsingular H-tensors. The positive definiteness of nonsingular H-tensors with positive diagonal entries is also discussed in this paper. The obtained results extend the corresponding conclusions for nonsingular H-matrices and improve the existing results for nonsingular H-tensors

YAP1 subgroup supratentorial ependymoma requires TEAD and nuclear factor I-mediated transcriptional programmes for tumorigenesis

YAP1 fusion-positive supratentorial ependymomas predominantly occur in infants, but the molecular mechanisms of oncogenesis are unknown. Here we show YAP1-MAMLD1 fusions are sufficient to drive malignant transformation in mice, and the resulting tumors share histo-molecular characteristics of human ependymomas. Nuclear localization of YAP1-MAMLD1 protein is mediated by MAMLD1 and independent of YAP1-Ser127 phosphorylation. Chromatin immunoprecipitation-sequencing analyses of human YAP1-MAMLD1-positive ependymoma reveal enrichment of NFI and TEAD transcription factor binding site motifs in YAP1-bound regulatory elements, suggesting a role for these transcription factors in YAP1-MAMLD1-driven tumorigenesis. Mutation of the TEAD binding site in the YAP1 fusion or repression of NFI targets prevents tumor induction in mice. Together, these results demonstrate that the YAP1-MAMLD1 fusion functions as an oncogenic driver of ependymoma through recruitment of TEADs and NFIs, indicating a rationale for preclinical studies to block the interaction between YAP1 fusions and NFI and TEAD transcription factors