Emergency department presentation changes due to the coronavirus disease pandemic in Nova Scotia,Canada

Multiple studies have reported decreased emergency department(ED)patient volumes during the coronavirus disease(COVID-19)pandemic,[1-6]including areas most affected by the virus.[7]Most existing studies have investigated general trends in ED presentations and have not examined the impact of COVID-19 on different types of EDs,specific ED patient groups,or illness presentations.

Effectiveness of Short Message Service Support on Adherence to Chemotherapy Treatment among Patients Attending Cancer Treatment Facilities in Kenya

Introduction: Cancer is a chronic debilitating disease that unnerves patients, communities, and nations. At some point in cancer patient’s disease experience, chemotherapy is used, and the patient is expected to adhere to treatment to improve survival and quality of life. Methods: This multisite Cluster Randomized Trial (CRT) evaluated the effectiveness of mobile phone Short Message Service (SMS) support on the adherence to treatment schedules among adult cancer patients in Kenya. Data was collected using questionnaires. Ethical approvals were obtained from relevant Ethical Review Boards (ERBs). Results: The mean adherence was 83%. There was a significant difference between treatment arms in relation to the adherence. The intervention arm had a higher mean adherence difference, M = 3.913, 95% CI 2.632-5.193, t (402) = 6.006, p ≤ 0.001), with Cohen’s d = 0.60. Although not significant, (χ2dd = 0.151, df = 1, p = 2.064), more women were perfect adheres than males. Perfect adherers were satisfied with SMS support (χ2dd = 7.620, df = 1, p = 0.06), were in the intervention arm (χ2dd = 22.942, df = 1, p ≤ 0.001), and had trust in the care provider (χ2dd = 10.591 p ≤ 0.001). SMS support was not significant in the multivariate analysis but had an estimated effect size of 0.958 (z = 1.424, p = 0.154, CI = 0.242-3.781), indicating that mean adherence was slightly better in the presence of the intervention. Conclusions: SMS-support intervention has demonstrated superiority in influencing adherence. Further, health system-related factors have a significant influence on the adherence to chemotherapy treatment. Interventions to re-design health systems that are responsive to unmet care needs of cancer patients must be explored. .

Combining BPANN and wavelet analysis to simulate hydro-climatic processes a case study of the Kaidu River, North-west China

Using the hydrological and meteorological data in the Kaidu River Basin during 1957-2008, we simulated the hydro-climatic process by back-propagation artificial neural network （BPANN） based on wavelet analysis （WA）, and then compared the simulated results with those from a multiple linear regression （MLR）. The results show that the variation of runoff responded to regional climate change. The annual runoff （AR） was mainly affected by annual average temperature （AAT） and annual precipitation （AP）, which revealed different varia- tion patterns at five time scales. At the time scale of 32-years, AR presented a monotonically increasing trend with the similar trend of AAT and AP. But at the 2-year, 4- year, 8-year, and 16-year time-scale, AR presented non-linear variation with fluctuations of AAT and AP. Both MLR and BPANN successfully simulated the hydro- climatic process based on WA at each time scale, but the simulated effect from BPANN is better than that from MLR.

Engineering of Materials for Respiratory Protection:Salt-Coated Antimicrobial Fabrics for Their Application in Respiratory Devices

CONSPECTUS:The development of a highly effective,low-cost method for protection against direct transmission through infectious media associated with respiratory diseases has been considered to be a major challenge in the management of the pandemic outbreak.Currently,filtration in respirators and masks depends on the mesh size,raising safety concerns about direct contact with the virus-laden layers of masks and respirators during use and disposal.Also,conventional medical face masks and respirators are recommended for single use only because long-term use and reuse of masks increase the risk of contact transmission of pathogens.As a result,mask reusability has gained much attention in addressing the global problem of respirator and mask shortages during the COVID-19 pandemic.Furthermore,coinfection by influenza,SARSCoV-2,and bacteria has been an ongoing issue in the current COVID-19 pandemic.In our response to the increasing demand for more convenient forms of disease control,our group has investigated antimicrobial technologies for respiratory devices against pandemic/epidemic diseases and developed two universal antimicrobial coating technologies:(1)nonwashable,reusable salt-coated fabrics and(2)washable,photopolymerizable polymer-coated fabrics which efficiently inactivate infectious viruses by contact with the filter.This is an opportune time to assess research efforts toward antimicrobial face mask technology for its expected impact on society and the economy.

2002～2005年期间萨斯喀彻温省儿科三级医疗中心因呼吸道合胞病毒感染住院的儿童病例分析(英文)

中文概呼吸道合胞病毒（RSV）是2岁以下儿童呼吸道感染最常见的病原体，也是引起婴儿病毒感染所致死亡的主要原因。到目前为止，尚未见加拿大萨斯喀彻温省RSV流行病学的研究报道。本研究的目的是描述2002年7月至2005年6月期间在萨斯喀彻温省的两个儿科三级医疗中心，即皇家大学医院（RUH）和萨斯卡通和里贾纳总医院（RGH），因RSV感染住院的儿童的流行病学特点及疾病严重程度，其中部分患儿有帕利珠单抗（palivizumab）预防史。 在上述2个医疗中心住院时间≥24h的儿童（年龄：从出生到16岁11个月）经实验室病毒鉴定确诊为RSV感染的儿童纳入本研究。在RUH中心，患儿鼻咽部分泌物经直接荧光抗体（DFA）检测阳性者确诊为RSV感染。如果DFA为阴性，则对该标本进行病毒培养。在RGH中心，所有患儿鼻咽部分泌物标本均进行DFA检测和病毒培养。确诊后对患儿的健康记录进行回顾性分析，内容包括患儿的人口统计信息、转诊模式、帕利珠单抗预防史、感染严重程度及转归。目前尚无统一的感染严重程度的判断标准，本研究根据住院时间、是否需要小儿重症监护及持续时间、是否机械通气等进行评估。在研究期间，萨斯喀彻温省的帕利珠单抗预防的标准与加拿大儿科学会（CPS）的建议一致。 2002年7月至2005年6月3年期间，总共有590名RSV儿童（包括324名男童）住院治疗，共602次住院记录，其中12名儿童住院1次以上。入院时患儿中位实足年龄为5.3个月，平均住院时间为4.0d（范围：〈1d至121.2个月）。82.4％的患儿出生时胎龄≥36周，7.5％为33-35周，9.5％≤32周。RSV感染住院情况呈现季节性模式，其中大部分发生在三月和六月。患儿最常见的临床表现为细支气管炎（70.2％），38.1％表现为肺炎，17.3％为上呼吸道感染，0.5％表现为哮吼（患儿可能同时有1个以上的临床表现）。478例（81.0％）为RSV轻度至中度感染，110例（18.6％）为重度感染。25.1%的患儿有继发性细菌感染。共有39例（6.7％）需要入住儿科重症监护病房（PICU），中位入住时间为5.0d。其中，22例重症患儿（56％）需要机械通气（通气时间中位数6.0d），14例重症患儿（36％）有继发性细菌感染。与入住普通病房的患儿比较，PICU患儿大多有如下情况：入院时年龄较小（P〈0.01），有潜在的肺部疾病（P〈0.01）或先天性心脏疾病（P=0.01），有两个或更多潜在的疾病（P〈0.01），与其他儿童共同居住（P=0.02）。在本研究过程中，2例儿童死亡，但均与RSV感染无关。 本研究有22例患儿在入院前接受过帕利珠单抗预防RSV感染，其中18例已完成至少2个月的剂量，17例（77％）有1个或以上的慢性疾病，14例（64%）出生时胎龄不超过32周。入院时中位实足年龄为5.6个月（范围0-27.5个月），中位住院时间为9.5d（范围2-271d）。大多数儿童（17/22）为轻度至中度RSV感染。 小结：RSV在萨斯喀彻温省保持较高的发病率，男性、实足年龄小于1岁的足月儿或晚期早产儿发病率较高。细支气管炎是最常见的临床表现。大多数患儿呈轻度至中度感染，但约7％的患儿需要重症监护。较小的实足年龄、潜在的肺部或心脏疾病或多个潜在疾病等因素均有可能导致患儿需要重症监护。此外，与其他孩子同住也有可能是导致患儿需要重症监护的一个因素。需要重症监护的患儿往往胎龄大于35周。虽然部分接受过帕利珠单抗预防的患儿也感染了RSV，但是其大部分患儿的病情为轻度至中度。这些曾接受过帕利珠单抗预防的患儿更可能有潜在疾病，并且出生时胎龄往往小于32周。在本研究中，无一例因RSV感染而引起的死亡病例。本研究尚浅，需要开展更深入的研究，以进一步确定RSV患儿，特别是PICU患儿以及曾接受过帕利珠单抗预防却仍然受到RSV感染的患儿的特征。