Impact of the Coronavirus Disease 2019 Pandemic on an Emergency Department Service: Experience at the Largest Tertiary Center in Taiwan

Purpose

Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) is an emerging contagious pathogen that has caused community and nosocomial infections in many countries. This study aimed to evaluate the impact of Coronavirus disease 2019 (COVID-19) on emergency services of the largest medical center in Taiwan by comparing emergency department (ED) usage, turnover, and admission rates before the COVID-19 outbreak with those during the outbreak.

Materials and Methods

A retrospective cohort study was conducted in the ED of the largest tertiary medical center in Taiwan. Trends of adult, non-trauma patients who visited the ED during February-April 2019 were compared with those during February-April 2020. The number of visits, their dispositions, crowding parameters, and turnover rates were analyzed. The primary outcome was the change in ED attendance between the two periods. The secondary outcomes were changes in hospital admission rates, crowding parameters, and turnover rates.

Results

During the outbreak, there were decreased non-trauma ED visits by 33.45% (p < 0.001) and proportion of Taiwan Triage and Acuity Scale (TTAS) 3 patients (p=0.02), with increased admission rates by 4.7% (p < 0.001). Crowding parameters and turnover rate showed significant improvements.

Conclusion

Comparison of periods before and during the COVID-19 outbreak showed an obvious decline in adult, non-trauma ED visits. The reduction in TTAS 3 patient visits and the increased hospital admission rates provide references for future public-health policy-making to optimise emergency medical resource allocations globally.

Spatiotemporal shoreline dynamics of Marismas Nacionales, Pacific coast of Mexico, based on a remote sensing and GIS mapping approach

Within the last few decades, tropical coastal systems such as beaches, dunes, and mangrove forests have experienced high annual rates of loss worldwide due to natural and anthropogenic impacts. Historical remote sensing data have been used to map and monitor these fragile systems, as well as to track specific events through time. The purpose of this study was to examine coastal trends along Marismas Nacionales in Mexico, which is the largest wetland complex of the western coast of the Pacific Ocean. The opening of the Cuautla Canal in 1976 and the construction of several hydroelectric power dams have severely impacted this wetland system. Shoreline variability was estimated based on representative remote sensing images over half a century (1970 to 2019). Results indicate that, after 49 years, 805 ha of beach deposits have been lost in the Cuautla Canal and at the beach ridge region that should otherwise be an accretional coastal zone. Conversely, the southern section of the study site shows 406 ha of constant accretion during the same period due to the presence of the unobstructed San Pedro River. Our study highlights the adverse effects of engineering projects, such as inlets and hydroelectric dams throughout tropical coastal systems that have strongly depended on freshwater input from upstream rivers.

Evaluation of Land Cover Change and Agricultural Protection Sites: A GIS and Remote Sensing Approach for Ho Chi Minh City, Vietnam

Ho Chi Minh City (HCMC), economic center and most populous city of Vietnam faces a strong structural change since its market liberalization in the late 1980s. Big challenges occur in the form of uncontrolled urban sprawl due to rapid population growth with encroachment of agricultural land, which leads to environmental and climatic issues like urban heat island effects, air pollution and flooding events. Remote Sensing and Geographic Information Systems (GIS) provide new computer-based technologies for urban planners which can greatly ease the monitoring of agricultural loss as well as improve decision making for future land management. In the first part of this study, land cover change dynamics are thoroughly assessed using moderate and high spatial resolution satellite imagery (Landsat and SPOT) over the period 2010–2017 in 22 districts of HCMC. In the second part, the land cover classification results of 2017 provide the initial map for a GIS-based Multi-Criteria-Decision-Analysis (MCDA) of potential agricultural protection sites. Therefore, criteria of climate adaptation and ecological service are established and embedded in the GIS-compatible Compromise Programming Model (CP). With the use of Analytic Hierarchy Process (AHP) by Thomas L. Saaty and additional expert knowledge, appropriate weighting factors have been affiliated. The results show that agricultural land decreased by more than two thirds in the period considered. However, particularly the western rural districts Bình Chánh and Hóc Môn still offer a great amount of valuable agricultural land suitable for protection. The proposed method can serve as a scientific framework for planning departments of fast growing cities to zone agricultural land for protection on an early planning stage in order to ensure sustainable land use development in the future.

Introduction: History of SH2 Domains and Their Applications

The Src Homology 2 (SH2) domain is the prototypical protein interaction module that lies at the heart of phosphotyrosine signaling. Since its serendipitous discovery, there has been a tremendous advancement in technologies and an array of techniques available for studying SH2 domains and phosphotyrosine signaling. In this chapter, we provide a glimpse of the history of SH2 domains and describe many of the tools and techniques that have been developed along the way and discuss future directions for SH2 domain studies. We highlight the gist of each chapter in this volume in the context of: the structural biology and phosphotyrosine binding; characterizing SH2 specificity and generating prediction models; systems biology and proteomics; SH2 domains in signal transduction; and SH2 domains in disease, diagnostics, and therapeutics. Many of the individual chapters provide an in-depth approach that will allow scientists to interrogate the function and role of SH2 domains.