Non-emergency Situations Research Articles

Lessons Learned from the Experiences of Domestic Violence Service Providers in Times of Crisis: Insights from a Central Asian Country.

Domestic violence is a widespread problem in both stable and crisis contexts. During crisis-driven periods, such as environmental, economic, political, and health emergencies, existing gender inequalities are exacerbated, and the risks of violence against women (VAW) are amplified. This qualitative study explores the experiences of professionals working in VAW organisations in a Central Asian country during the COVID-19 pandemic. By interviewing 45 professionals from social care organisations in Kazakhstan, this study aims to understand the impact of COVID-19 on the ability of VAW organisations to assist victims of domestic violence and comprehend the adjustments they made to support victims. The findings shed light on the challenges faced by VAW organisations, including reduced capacity, increased service demand, the shift to remote services, and funding cuts. The study highlights the critical role of these organisations in crises and urges the consideration of lessons learned to prevent VAW in emergency and non-emergency situations. In the Central Asian region, where domestic violence is persistent, this research offers valuable insights for interventions during and after crises. The study offers effective strategies for achieving Sustainable Development Goal 5.2, which aims to eliminate violence against women, and SDG 3.8, ensuring access to healthcare, psychological support, and safe environments.

Comparison of postoperative prognoses for resectable colorectal cancer with vs. without oncologic emergency using propensity score‑matched analyses: A single-center retrospective observational study.

While oncological emergencies in colorectal cancer present distinct challenges, existing literature offers conflicting evidence regarding long-term outcomes. Therefore, the present study compared the postoperative prognoses between patients with and without oncological emergencies. A retrospective evaluation was conducted on patients who had undergone radical surgery for pathological stages II and III colorectal cancer at a single center between January 2012 and December 2020. Patients were classified into the non-emergency and oncological emergency groups. The status of oncologic emergency was divided into obstruction and perforation. The outcomes were compared using propensity score matching. The primary objective was to compare the postoperative prognoses between non-emergency and oncological emergency situations. The secondary objectives included comparing prognoses between obstruction and perforation, identifying the type of recurrence depending on the status of oncologic emergency, and assessing the effect of adjuvant chemotherapy for oncologic emergencies. This study included 524 patients. After propensity score matching, the prognoses of oncological emergencies were worse compared with those without any emergency, whereas those of obstruction and perforation did not significantly differ. Regarding the type of recurrence, peritoneal dissemination in obstruction and local recurrence in perforation was more common compared with that in non-emergency cases. Adjuvant chemotherapy improved the recurrence-free survival for cases with oncological emergencies. The prognoses in cases with oncological emergencies could be worse compared with those without any emergency, whereas obstruction and perforation outcomes can be comparable. The administration of adjuvant chemotherapy should be strongly considered for oncological emergencies.

Implementing telemedicine with 5G technologies in a nursing home for reducing emergency admissions– study protocol of a mixed-methods study

BackgroundBy transmitting various types of data, telemedical care enables the provision of care where physicians and patients are physically separated. In nursing homes, telemedicine has the potential to reduce hospital admissions in nonemergency situations. In this study, telemedicine devices were implemented with the new 5G mobile communications standard in selected wards of a large nursing home in Northwest Germany. The main aim of this study is to investigate which individual and organizational factors are associated with the use of telemedicine devices and how users perceive the feasibility and implementation of such devices. Moreover, it is investigated whether the telemedical devices help to reduce the number of emergency admissions.MethodsTelemedicine devices are implemented over an 18-month period using a private 5G network, and all users receive training. This study uses qualitative and quantitative methods: To assess the individual and organizational factors associated with the use of telemedicine devices, survey data from employees before and after the implementation of these devices are compared. To assess the perception of the implementation process as well as the feasibility and usability of the telemedical devices, the nursing staff, physicians, medical assistants and residents are interviewed individually. Moreover, every telemedicine consultation is evaluated with a short survey. To assess whether the number of emergency admissions decreased, data from one year before implementation and one year after implementation are compared. The data are provided by the integrated dispatch centre and emergency medical services (EMS) protocols. The interview data are analysed via structured qualitative content analysis according to Kuckartz. Survey data are analysed using multivariable regression analysis.DiscussionLearnings from the implementation process will be used to inform future projects implementing telemedicine in care organizations, making the final telemedicine implementation and care concept available to more nursing homes and hospitals. Moreover, the study results can be used to provide use cases for appropriate and targeted application of telemedicine in nursing homes and to define the role of 5G technologies in these use cases. If the intervention is proven successful, the results will be used to promote 5G network rollout.Trial registrationGerman Clinical Trials Register – trial registration number: DRKS00030598.

Italian Speech-Language Pathologists and Telerehabilitation for Voice Disorders: A Survey on Satisfaction, Effectiveness, Limits, and Future Prospects.

Introduction: The aim of this study was to evaluate the distribution of virtual voice therapy during the coronavirus disease 2019 (COVID-19) lockdown in Italy via the collection of opinions of speech-language pathologists (SLPs). Methods: All SLPs who regularly carried out their professional activity in public hospitals, private hospitals, or private practices in Italy were asked to fill out an online survey consisting of two sections: (1) demographic information (age, gender, work setting, seniority, working time, and regular use of virtual voice therapy) and (2) opinions regarding telerehabilitation (motivation, personal satisfaction, effectiveness, and future needs and uses). Results: A total of 299 SLPs (mean age 39.1 ± 12.4 years) completed the survey. Overall, a regular use of virtual voice therapy was declared by 31.1% (93/299) of SLPs, with the highest prevalence for SLPs working in fully private facilities (46.7%; p < 0.001). Among all respondents, 25.4% had a highly positive opinion on the possible use of virtual voice therapy, even in nonemergency situations, and 55.8% planned to maintain this rehabilitation modality in the future. Discussion: Italian SLPs, regardless of age, had a positive impact with the new telerehabilitation practices. Investments in training and updating SLPs through specific courses would help to break down the strong barriers to telepractice acceptance, such as lack of familiarity with new technologies and lack of adequate preparation. Virtual voice therapy, which had never been experienced in such a way in Italy before the COVID-19 pandemic, promises to be a valuable future addition to the current traditional rehabilitation approaches.

Comparison of anesthesia methods for intra-arterial therapy of patients with acute ischemic stroke: an updated meta-analysis and systematic review

ObjectivesCurrently, there remains debate regarding the optimal anesthesia approach for patients undergoing intra-arterial therapy for acute ischemic stroke. Therefore, we conducted a comparative analysis to assess the effects of general anesthesia versus non general anesthesia on patient outcomes.MethodsThe research methodology entailed comprehensive searches of prominent databases such as the Cochrane Library, PubMed, Scopus, and Web of Science, covering the period from January 1, 2010, to March 1, 2024. Data synthesis employed techniques like risk ratio or standardized mean difference, along with 95% confidence intervals. The study protocol was prospectively registered with PROSPERO (CRD42024523079).ResultsA total of 27 trials and 12,875 patients were included in this study. The findings indicated that opting for non-general anesthesia significantly decreased the risk of in-hospital mortality (RR, 1.98; 95% CI: 1.50 to 2.61; p<0.00001; I2 = 20%), as well as mortality within three months post-procedure (RR, 1.24; 95% CI: 1.15 to 1.34; p<0.00001; I2 = 26%), while also leading to a shorter hospitalization duration (SMD, 0.24; 95% CI: 0.15 to 0.33; p<0.00001; I2 = 44%).ConclusionIschemic stroke patients who undergo intra-arterial treatment without general anesthesia have a lower risk of postoperative adverse events and less short-term neurological damage. In routine and non-emergency situations, non-general anesthetic options may be more suitable for intra-arterial treatment, offering greater benefits to patients. In addition to this, the neuroprotective effects of anesthetic drugs should be considered more preoperatively and postoperatively.

How to talk about dying? The development of an evidence-based model for communication with patients in their last days of life and their family caregivers

ObjectiveTo help healthcare professionals (HCP) act with more confidence when communicating about approaching death, we sought to develop a communication model for HCP to facilitate conversations with dying patients and family caregivers (FC) in nonemergency situations. MethodsWe used a four-phase integrative approach: (1) creation of a preliminary model based on a systematic literature review and expert knowledge, (2) review of the model draft by international palliative care experts, (3) review by key stakeholders, and (4) final appraisal by communication experts. ResultsAfter the clinical recognition of dying, the communication model provides a structure and practical communication aids for navigating the conversation based on three phases. It describes the content and relational level as core dimensions of effective conversations about approaching death and highlights the importance of HCP self-awareness and self-care when caring for the dying. ConclusionBased on systematic involvement of key stakeholders, the model supports clinicians navigating challenging conversations about approaching death with dying patients and their FC successfully and with more confidence. InnovationThis study expands the theoretical basis for communication about approaching death and offers a pragmatic model for educational interventions and clinical use.

Acute Chyloperitoneum with Small Bowel Volvulus: Case Series and Systematic Review of the Literature.

Introduction: Chyloperitoneum arises from lymph leakage into the abdominal cavity, leading to an accumulation of milky fluid rich in triglycerides. Diagnosis can be challenging, and mortality rates vary depending on the underlying cause, with intestinal volvulus being just one potential acute cause. Despite its rarity, our case series highlights chyloperitoneum associated with non-ischemic small bowel volvulus. The aims of our study include assessing the incidence of this association and evaluating diagnostic and therapeutic approaches. Material and Methods: We present two cases of acute abdominal peritonitis with suspected small bowel volvulus identified via contrast-enhanced computed tomography (CT). Emergency laparotomy revealed milky-free fluid and bowel volvulus. Additionally, we conducted a systematic review up to 31 October 2023, identifying 15 previously reported cases of small bowel volvulus and chyloperitoneum in adults (via the PRISMA scheme). Conclusions: Clarifying the etiopathogenetic mechanism of chyloperitoneum requires specific diagnostic tools. Magnetic resonance imaging (MRI) may be useful in non-emergency situations, while contrast-enhanced CT is employed in emergencies. Although small bowel volvulus infrequently causes chyloperitoneum, prompt treatment is necessary. The volvulus determines lymphatic flow obstruction at the base of the mesentery, with exudation and chyle accumulation in the abdominal cavity. Derotation of the volvulus alone may resolve chyloperitoneum without intestinal ischemia.

Chest Tube Size Selection: Evaluating Provider Practices, Treatment Efficacy, and Complications in Management of Thoracic Trauma.

The standard for managing traumatic pneumothorax (PTX), hemothorax (HTX), and hemopneumothorax (HPTX) has historically been large-bore (LB) chest tubes (>20-Fr). Previous studies have shown equal efficacy of small-bore (SB) chest tubes (≤19-Fr) in draining PTX and HTX/HPTX. This study aimed to evaluate provider practice patterns, treatment efficacy, and complications related to the selection of chest tube sizes for patients with thoracic trauma. A retrospective chart review was performed on adult patients who underwent tube thoracostomy for traumatic PTX, HTX, or HPTX at a Level 1 Trauma Center from January 2016 to December 2021. Comparison was made between SB and LB thoracostomy tubes. The primary outcome was indication for chest tube placement based on injury pattern. Secondary outcomes included retained hemothorax, insertion-related complications, and duration of chest tube placement. Univariate and multivariate analyses were performed. Three hundred and forty-one patients were included and 297 (87.1%) received LB tubes. No significant differences were found between the groups concerning tube failure and insertion-related complications. LB tubes were more frequently placed in patients with penetrating MOI, higher average ISS, and higher average thoracic AIS. Patients who received LB chest tubes experienced a higher incidence of retained HTX. In patients with thoracic trauma, both SB and LB chest tubes may be used for treatment. SB tubes are typically placed in nonemergent situations, and there is apparent provider bias for LB tubes. A future randomized clinical trial is needed to provide additional data on the usage of SB tubes in emergent situations.

One Health research ethics review processes in African countries: Challenges and opportunities

One Health research has gained attention over the past few decades due to its potential to improve health challenges across the globe. However, obtaining ethics approvals for timely implementation of One Health research is a challenge in some contexts. Our study was undertaken to describe various challenges faced by researchers, research ethics committees (RECs) and members of regulatory bodies in Africa. An online survey was conducted between March and June 2021. The effect of predictors, including respondents' role (e.g., REC member, regulator and/or One Health researcher), sex, education, age, and country, on the perception of challenges and opportunities when conducting and reviewing One Health research, was investigated using multivariable linear regression models. Participants with different roles did not perceive any of the examined challenges differently during review of One Health-related research; but female participants (p = 0.026) and those with ten or more years of experience (p = 0.0325) perceived insufficient One Health knowledge as less of a challenge. Professional role was an important predictor (p = 0.025) for the perception of the establishment of a mandatory One Health review system. Respondents with multiple roles perceived the creation of ad hoc committees for review of One Health research under emergency situations to be less important (p = 0.02); and REC members perceived the creation of such committees to be less feasible (p = 0.0697). Our study showed that perceptions of the importance and feasibility of opportunities for improvement of One Health research ethics review under emergency and non-emergency situations varied across professional roles. This emphasizes the need to consider such improvement strategies; and the need for continuous and timely evaluation for improvement of ethics review of One Health and emergency research in Africa.

Place Of First Trimester Ultrasound at The University Teaching Hospital of Bogodogo (UTH-B) in Burkina Faso

Objective: To describe the experience of the UTH-Bogodogo obstetrics and gynecology department in ultrasound determination of fetal sex in the first trimester of pregnancy. Patients and methods: This was a prospective descriptive study conducted over a 30-month period from February 1, 2021 to June 30, 2022 in the gynecological and obstetric ultrasound unit of the UTH-Bogodogo in Ouagadougou. The study sample consisted of 311 fetuses. The sample included all pregnant women who came for an obstetrical ultrasound scan in a non-emergency situation, whose gestational age was between the 11th and 14th week of amenorrhea, and who expressed a wish to know the fetal sex. The methods described by Mazza and Efrat were used to determine fetal sex. Patients were followed until delivery, after clinical verification of the sex of their newborns. Data were collected using an individual data collection form. Participation in the study was conditional on patients signing an informed consent form. Results: Fetal sex determination was possible in 280 of 311 fetuses, for a feasibility rate of 89.7%. In the remaining 31 cases, it was not possible to determine the fetal sex, as the position of the fetus did not allow a clear view of the genital bud. In terms of reliability, of the 238 fetuses monitored, fetal sex determination was correct in 204 fetuses, for a success rate of 85.7%. Accuracy was better when sex determination was performed after 12 weeks of amenorrhea. There was no significant difference in measurements between single and multiple fetuses. Conclusion: ultrasound determination of fetal sex at first birth could be an effective, simple, available and inexpensive option in developing countries.

PLACE OF FIRST TRIMESTER ULTRASOUND AT THE UNIVERSITY TEACHING HOSPITAL OF BOGODOGO (UTH-B) IN BURKINA FASO

AbstractObjective: To describe the experience of the UTH-Bogodogo obstetrics and gynecology department in ultrasound determination of fetal sex in the first trimester of pregnancy.Patients and methods: This was a prospective descriptive study conducted over a 30-month period from February 1, 2021 to June 30, 2022 in the gynecological and obstetric ultrasound unit of the UTH-Bogodogo in Ouagadougou. The study sample consisted of 311 fetuses. The sample included all pregnant women who came for an obstetrical ultrasound scan in a non-emergency situation, whose gestational age was between the 11th and 14th week of amenorrhea, and who expressed a wish to know the fetal sex. The methods described by Mazza and Efrat were used to determine fetal sex. Patients were followed until delivery, after clinical verification of the sex of their newborns. Data were collected using an individual data collection form. Participation in the study was conditional on patients signing an informed consent form.Results: Fetal sex determination was possible in 280 of 311 fetuses, for a feasibility rate of 89.7%. In the remaining 31 cases, it was not possible to determine the fetal sex, as the position of the fetus did not allow a clear view of the genital bud. In terms of reliability, of the 238 fetuses monitored, fetal sex determination was correct in 204 fetuses, for a success rate of 85.7%. Accuracy was better when sex determination was performed after 12 weeks of amenorrhea. There was no significant difference in measurements between single and multiple fetuses.Conclusion: ultrasound determination of fetal sex at first birth could be an effective, simple, available and inexpensive option in developing countries.

The Mountain Hall and the Smart Club: The Architecture of Emergency Reception in Norwegian Cities

Contemporary contingency planning is largely delinked from urban planning. However, the two domains intersect in critical ways. Contingency planning frames conditions for displaced persons in emergency situations but also affects the design of everyday urban spaces. Thus, the spatial output of emergency preparedness can encourage wellbeing and placemaking in both emergency and non-emergency situations. This article explores the built environments of contingency planning in Norwegian cities, paying particular attention to emergency reception.Furthermore, this article outlines the relationship between the policies of reception in displacement management and the spatial policies of placemaking. A study of Norwegian contingency planning history shows that the former evacuation shelter typology is being replaced by the more loosely defined concept of places of protection, similar to the retrofitted spaces commonly used as asylum centres. Newspaper clippings and document reviews are used to study two emergency reception structures: a Cold War multipurpose mountain hall close to the Norway–Russia border and a transformed 1970s warehouse near Oslo that currently houses the Norwegian national arrival facility for asylum-seekers. Comparing these two cases outlines the interaction between displacement management, contingency planning, and urban planning and contributes to conceptualising what we call contingency urbanism. We suggest that contingency urbanism can be useful in re-spatialising emergency architecture, re-linking contingency and urban planning, and pointing to placemaking opportunities in the duality of everyday life and a state of emergency.

Assessment and Monitoring of the Security of Information Resources as an Emergency Situation

Formulation of the problem: control (evaluation) and monitoring of the information protection system (IPS) effectiveness are an integral part of the protected information objects operation process (state information systems, information systems of personal data, significant objects of critical information infrastructure). Imperfection of the control and monitoring means of the IPS together with her the vulnerabilities often leads to computer incidents with protected informatization object subsequent failure and/or degradation of its. One of the effective ways to solve this problem is the organization and implementation of preventive measures. The purpose of the work is reducing the response time and elimination of consequences from a computer incident caused by IPS measures to control (evaluate) the effectiveness. An additional goal is to neutralize information security threats implemented by an external intruder using sociotechnical methods (fishing). Methods: generalization and analysis of the existing regulatory and methodological support for the actions of information security units to carry out control (evaluation) measures, as well as in case of emergency situations and the occurrence of computer incidents. Novelty: the novelty elements is consideration of the event on ISP effectiveness control (evaluation) as a non-emergency situation in the informatization object operation under protect. Result: the necessity of introducing a threat to information security new class – the threat of information resource performance disruption caused by IPS control (assessment) and monitoring of the effectiveness are proved. Practical significance: the results of the work can be used to ensure organizations information resources security when the Center for Information Protection and Special Communication FSS of and territorial security bodies in relation to them measures to assess their security and the ability of bodies (organizations) to resist threats to information security.

Physical distancing and its association with travel behavior in daily pre-pandemic urban life: An analysis utilizing lifelogging images and composite survey and mobility data

This study analyzed physical distancing in people’s daily lives and its association with travel behavior and the use of transportation modes before the COVID-19 outbreak. We used data from photographic images acquired automatically by lifelogging devices every 5 seconds, on average, from 170 participants of a 2-day wearable camera study, in order to identify their physical distancing status throughout the day. Using deep-learning computer vision algorithms, we developed three measures which provided a near-continuous quantification of the proportion of time spent without anyone else within a distance of approximately 13 meters, as well as the proportion of time spent without others within approximately 2 meters. These measures are then used as outcomes in beta regression and multinomial logit models to explore the association between the participant’s physical distancing and travel behavior and transportation choices. The multidisciplinary research approach to understand these associations accounted for a number of social, economic, and cultural factors that potentially influenced their physical isolation levels. We found that participants spend a significant amount of time physically separated from others, without anyone else within 2 meters. The use of public transportation, automobiles, active travel, and an increase in trip frequency, including trips to transportation facilities, reduced the extent of physical distancing, with public transportation having the most significant impact. Higher incomes, strong social networks, and a sense of belonging to the community reduced the tendency for physical distancing. In contrast, factors such as age, obesity, dog ownership, intensive use of the Internet, and being knowledgeable about climate change issues increased the likelihood of physical distancing. The paper addresses a crucial gap in our understanding of how these factors intersect to create the dynamics of physical distancing in non-emergency situations and highlights their planning and operational implications while showcasing the use of unique person-based physical distancing measures derived from autonomously collected image data.

Psychological evaluation of auditory warning signal for train horn

Air horns are commonly used to signal danger or caution during railroad operations. The main objectives of those auditory signals (i.e., whistle cords) are to "warn of danger," "call attention," and "notification of approach" in the situation before an accident occurs or "report an emergency" to those around after an accident occurs. Further, in case of using auditory signals in nonemergency situations (e.g., during the departure or arrival of a train), loud or unpleasant sounds should be avoided to the greatest possible extent, considering noise pollution in the environment. This study examined the nature of auditory signals for railroad vehicles through psycho-acoustic experiments using 11 types of auditory stimuli, including a "short, rapid horn sound" and a "long, slow horn sound." In the rating experiments, the auditory stimuli were presented via headphones to individual participants. The results indicated that upon initiating the auditory signal with an electronic horn sound (less unpleasant and dangerous impression) before blowing the air horn to alert perceived danger, the impressions of "warning," "caution," and "danger" tended to decrease, whereas those of "pleasantness," "quietness," and "relaxedness" tended to increase. The combined usage of electric and air horns can effectively provide auditory signals for maintaining the safety of railroad operations while addressing the associated noise pollution.

The Use of Operant Conditioning to Enhance the Management and Welfare of Captive Kingsnakes

Abstract Snakes have been kept and bred in captivity for decades very successfully, thanks to their ability to breed in minimalistic conditions. The history of published research in the operant conditioning of snakes and their learning capabilities is well evidenced. Many husbandry practices have been founded upon trial and error, with attitudes and husbandry of captive snakes steadily progressing. However, persistent attitudes towards the cognitive abilities of snakes may be contradictory to scientific literature, and thus directly impact upon the welfare of captive snakes. Recommendations are made here to tackle the problem. The case of captive kingsnakes with previous hyperreactivity and biting was resolved with target training by introducing clear communication to the snake as to when food is present. The snake was classically conditioned to associate the presence of the target with food; the presence of the target predicted food would follow. Once the meaning of the target for the snake was established, the presence of the target always indicated the presence of food. The snake learned activity during regular maintenance was not related to feeding; the absence of the target meant an absence of food. This training resulted in the desired behaviours during feeding and a reduction of the undesired behaviours outside of feeding. Operant conditioning was then used to teach the snake the target meant an opportunity to earn reinforcement contingent upon a shifting behaviour. The shifting behaviour was shaped in this case to remove the need to forcibly handle the snakes in non-emergency situations and to allow the snake to participate in their own care. Teaching cooperative care behaviours using operant conditioning leads to higher welfare states and closer towards “ a life worth living ”. Information © The Author 2023

Protecting the Autonomy of Patients with Severe Mental Illness Through Psychiatric Advance Directive Peer-Facilitation

Protecting the Autonomy of Patients with Severe Mental Illness Through Psychiatric Advance Directive Peer-Facilitation

Epidemiological Determinants of Patient Non-Conveyance to the Hospital in an Emergency Medical Service Environment.

The increasing prevalence of comorbidities worldwide has spurred the need for time-effective pre-hospital emergency medical services (EMS). Some pre-hospital emergency calls requesting EMS result in patient non-conveyance. Decisions for non-conveyance are sometimes driven by the patient or the clinician, which may jeopardize the patients' healthcare outcomes. This study aimed to explore the distribution and determinants of patient non-conveyance to hospitals in a Middle Eastern national Ambulance Service that promotes the transportation of all emergency call patients and does not adopt clinician-based non-conveyance decision. Using R Language, descriptive, bivariate, and binary logistic regression analyses were conducted for 334,392 multi-national patient non-conveyance emergency calls from June 2018 to July 2022, from a total of 1,030,228 calls to which a response unit was dispatched. After data pre-processing, 237,862 cases of patient non-conveyance to hospital were retained, with a monthly average of 41.96% (n = 8799) of the emergency service demands and a standard deviation of 5.49% (n = 2040.63). They predominantly involved South Asians (29.36%, n = 69,849); 64.50% (n = 153,427) were of the age category from 14 to 44 years; 61.22% (n = 145,610) were male; 74.59% (n = 177,424) from the urban setting; and 71.28% (n = 169,552) had received on-scene treatment. Binary logistic regression with full variables and backward methods identified the final models of the determinants of patient non-conveyance decisions with an Akaike information criterion prediction estimator, respectively, of (250,200) and (250,169), indicating no significant difference between both models (Chi-square test; p-value = 0.63). Despite exercising a cautious protocol by encouraging patient transportation to hospital, patient non-conveyance seems to be a problem in the healthcare system that strains the pre-hospital medical response teams' resources. Policies and regulations should be adopted to encourage individuals to access other primary care centers when required rather than draining emergency services for non-emergency situations.

Documentary Assessment of the Abilities of Kyrgyzstan's Research Ethics Committees During Public Health Emergency and Non-Emergency Situations.

Institutional Research Ethics Committees (RECs) play crucial roles in the impartial and competent review of scientific research, particularly during public health emergencies. In this report, we examined their ability and capacity to provide this basic service during public health emergencies and non-emergency situations. Our qualitative documentary analysis revealed that there are currently no legal regulations guiding the activities of Kyrgyz RECs during public health emergencies. In addition, major policy gaps exist in how RECs should operate in non-emergency circumstances. This lack of guidance highlights the urgent need to develop and implement ethical guidelines to meet the evolving needs of such emergencies. Our findings underscore the growing urgency of supporting capacity building of RECs to respond effectively to future pandemics and other public health crises.

Teaching Neuro Images : Burkitt dural lymphoma mimicking a subacute subdural hematoma

A 59-year-old woman with no history of trauma presented with severe headaches and right-sided weakness. A CT scan showed a left hemispheric isodense subdural collection thought to be consistent with a subacute subdural hematoma (figure 1A). The patient underwent a single parietal burr hole for evacuation, but the neurosurgeon found subdural fleshy tissue and performed a biopsy. Immediate postoperative MRI showed a homogeneous hypercellular subdural mass (figure 1, B–F).1 Pathology was consistent with Burkitt lymphoma (figure 2). Retrospectively, the homogeneous density of the collection argued against hematoma. In nonemergent situations, an atypical radiologic appearance of a subdural hematoma may suggest the need for further radiologic investigations before surgical evacuation.2