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Finally, future perspectives on the design of new interventions are described.

With the outbreak of coronavirus disease 2019 (COVID-19), the workload of the Iran's health-care system along with the Pre-hospital Emergency Service (PHES) increased significantly so that Iranian fledgling emergency system had never experienced such a crisis. With regard to the importance of the function of PHES as the front-line staff of Iran's health system and its role in controlling the recent epidemic crisis, this study was conducted to identify the challenges of PHES function in the face of COVID-19 pandemic.

The study was conducted with qualitative approach through content analysis in 2021. Semi-structured interviews were used to collect data. Sampling was purposive and continued until data saturation. After 24 interviews, the data were saturated. The extracted codes were thoroughly prepared as a data pool. After encoding all available data, the related codes were categorized into a single theme. After extracting the themes, a network of themes, related to the research topic, was drawn, and then, s to maintain the staff's physical and mental health during the pandemic and the possible crises ahead.Highly quantitative metabolomics studies of complex biological mixtures are facilitated by the resolution enhancement afforded by 2D NMR spectra such as 2D 13C-1H HSQC spectra. Here, we describe a new public web server, COLMARq, for the semi-automated analysis of sets of 2D HSQC spectra of cohorts of samples. The workflow of COLMARq includes automated peak picking using the deep neural network DEEP Picker, quantitative cross-peak volume extraction by numerical fitting using Voigt Fitter, the matching of corresponding cross-peaks across cohorts of spectra, peak volume normalization between different spectra, database query for metabolite identification, and basic univariate and multivariate statistical analyses of the results. COLMARq allows the analysis of cross-peaks that belong to both known and unknown metabolites. After a user has uploaded cohorts of 2D 13C-1H HSQC and optionally 2D 1H-1H TOCSY spectra in their preferred format, all subsequent steps on the web server can be performed fully automatically, allowing manual editing if needed and the sessions can be saved for later use. The accuracy, versatility, and interactive nature of COLMARq enables quantitative metabolomics analysis, including biomarker identification, of a broad range of complex biological mixtures as is illustrated for cohorts of samples from bacterial cultures of Pseudomonas aeruginosa in both its biofilm and planktonic states.

Neonatal infants are at increased risk for motor development disorders.

To compare General Movements (GMs) classification between three neonatal risk groups, correlate the GMs Assessment (GMA) with a standardized developmental neurological examination (SDNE) and determine risk factors for abnormal GMs.

Monocentric observational study with three risk groups (children with operated congenital heart disease (CHD) n=26, with operated congenital gastrointestinal malformations (CGM) n=17 and with fetal operated myelomeningocele (MMC) n=12 who underwent inpatient video-based examination. GMA was evaluated according to Hadders-Algra classification and divided into 4 categories normal optimal (NO), normal suboptimal (NS), mildly abnormal (MA), definitely abnormal (DA).

The distribution was as follows CHD 80.8% NS, 19.2% MA, CGM 5.9% NO, 64.7% NS, 29.4% MA, MMC upper extremities 100% NS, lower extremities 33.3% NS, 33.3% MA and 33.3% DA (group comparison Kruskal-Wallis 10.729,

=0.003). GMA correlated significantly with SDNE (Spearman



=0.869,

<0.001). Binary logistic regression analysis showed that only gestational age (Chi

=11.93,

<0.001) correlated with abnormal GMs.

The majority of children showed normal GMs. Children with MMC and those with lower gestational age showed an increased risk of abnormal GMs. The GMA and SDNE represent complementary "bedside tools" to detect early motor abnormalities.

The majority of children showed normal GMs. Children with MMC and those with lower gestational age showed an increased risk of abnormal GMs. The GMA and SDNE represent complementary "bedside tools" to detect early motor abnormalities.

Improvement of disease-specific knowledge in pediatric patients with inflammatory bowel disease (IBD) using a digital app and individualized teaching from physician to patient.

We developed an app for Android Software called KARLOTTA (Kids + Adolescents Research Learning On Tablet Teaching Aachen) with a game of skill and IBD questionnaire with visual feedback and high scores. Randomized controlled study as a pilot project with 30 IBD patients, aged 10-18 years. The intervention group used the KARLOTTA app on a tablet before every consultation during a 12-month period. Outcome parameters were an increase in knowledge, changes in quality of life and analysis of the feedback questionnaires for patient and physician. The statistical analysis was carried out with the

-test, Mann-Whitney-U test and descriptive analysis.

KARLOTTA was played 55 times by 14 patients. In all patients (100%) gaps in knowledge could be discovered and specific teaching took place. In the KARLOTTA group, 11 of 14 patients (79%) had an increase in knowledge, in the control group 7 of 15 patients (47%), p-value of 0.08 with the

-test. There were no differences in results for quality of life. The app could be used without any problems in 87% of the appointments.

The KARLOTTA app reveals individual gaps in knowledge, provides tailor-made physician-patient teaching and can be easily implemented in the outpatient clinic.

The KARLOTTA app reveals individual gaps in knowledge, provides tailor-made physician-patient teaching and can be easily implemented in the outpatient clinic.Primary squamous cell carcinoma (PSCC) of the stomach is a rare oncologic disease with a reported incidence of only 0.04%. Therefore, there are no evidence-based recommendations for treatment. We present the case of a 73-year-old patient with PSSC. Multivisceral resection had to be performed to achieve tumor-free resection margins. Preoperative investigations, surgical treatment, histologic criteria and findings, and follow-up are presented.Emergency upper gastrointestinal endoscopy in a 45 years old man with a complicated medical history obtained a small ulcer in the gastric corpus bedded in a round impression of 4 cm in diameter and no active bleeding during investigation. We decided to perform an immediate angio-CT-examination of thorax and abdomen. Gastric ulcer and impression were induced by a partially thrombosed aneurysm of the splenic artery. Emergency angiography with percutaneous transluminal implantation of a covered stent into the splenic artery completely bridged the aneurysm. The patient resolved and left the hospital after 12 days. Literature review shows that currently an immediate switch from endoscopy to vascular surgery is the best option in such cases. Emergency endoscopists have to identify the so called herald lesion as what it is and to initiate further diagnostic steps at once, since the second bleeding is mostly fatal. This may increase the prognosis significantly to 20-90 % survival. Unfortunately, in a current survey 50 % of gastroenterologists felt themselves not good informed about this fact and would probably not have done the correct decisions.Head Injury Assessment (HIA) is the screening tool for head injury during a rugby game. The purpose of this study was to investigate the epidemiology of HIA in the Japan Rugby Top League (JRTL). The incidences of HIA, defined concussion (per 1,000 player-hours) and repeated concussions were evaluated in three seasons (2016-17, 2017-18, 2018-19; total 360 games). The HIA incidence rates were 12.7 (95% confidence interval 9.5-15.9), 20.8 (16.8-24.9), and 25.0 (20.5-29.5) in each season. HIA-1 criteria 2, which is applied for suspected concussion cases, was performed for 46 cases in the 2016-17 season, 81 cases in the 2017-18 season, and 88 cases in the 2018-19 season. The concussion incidence rates were significantly greater in the 2017-18 season (9.6/1000 player-hours, 95% confidence interval 6.8-12.4) and the 2018-19 season (14.4, 11-17.8) compared to the 2016-17 season (4.8, 2.8-6.8). The number of repeated concussion cases in the same season was 1 in the 2016-17 season and 4 in both the 2017-18 and 2018-19 seasons. This study confirmed significantly higher HIA and concussion incidence rates over time. Although the HIA system might have been established in the three seasons in JRTL, comprehensive management needs to be improved to prevent repeated concussions.

In late 2019, a novel coronavirus was detected in Wuhan, China, that caused a pandemic by September 2021, resulting in 224,180,411 cases and more than 4,600,000 deaths worldwide. In response to the pandemic, the Autonomous Kurdistan Regional Government of Iraq (KRG) imposed strict infection control measures at its borders for all travelers from neighboring countries, wherein each traveler was subjected to a mandatory reverse transcription polymerase chain reaction (RT-PCR) test on arrival to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected travelers. The aim of this study is to determine the rate of infection with SARS-CoV-2 among the travelers entering Kurdistan region through Ibrahim Al-Khalil crossing point with Turkey as a predictor for the upcoming infection waves.

The data of RT-PCR tests to detect SARS-CoV-2 in all travelers arriving at the Ibrahim Al-Khalil Border Crossing between Iraq and the Republic of Turkey were reviewed from August 21, 2020 to August 21, 2021.

It was found that there were 9873 cases of SARS-CoV-2 infections among 1,082,074 travelers during the study period.

This study shows the importance of mass testing of travelers at border crossings to control the spread of SARS-CoV-2 infection.

This study shows the importance of mass testing of travelers at border crossings to control the spread of SARS-CoV-2 infection.

Intestinal ultrasound is increasingly used for primary diagnosis, detection of complications and monitoring of patients with Crohn's disease and ulcerative colitis. Standardization of reporting is relevant to ensure quality of the methodology and to improve communication between different specialties. The current manuscript describes the features required for optimized reporting of intestinal ultrasound findings in inflammatory bowel disease (IBD).

An expert consensus panel of gastroenterologists, radiologists, pathologists, paediatric gastroenterologists and surgeons conducted a systematic literature search. In a Delphi- process members of the Kompetenznetz Darmerkrankungen in collaboration with members of the German Society for Radiology (DRG) voted on relevant criteria for reporting of findings in intestinal ultrasound. Based on the voting results statements were agreed by expert consensus.

Clinically relevant aspects of intestinal ultrasound (IUS) findings have been defined to optimize reporting and to standardize terminology. Minimal requirements for standardized reporting are suggested. The statements focus on description of disease activity as well as on complications of IBD. PD173074 in vitro Attributes of intestinal inflammation are described and illustrated by exemplary images.

The current manuscript provides practical recommendations on how to standardize documentation and reporting from intestinal ultrasound findings in patients with IBD.

The current manuscript provides practical recommendations on how to standardize documentation and reporting from intestinal ultrasound findings in patients with IBD.