In this article, our goal is to provide researchers with a non-western perspective concerning the COVID-19 pandemic through a qualitative study of older adults living in Iwate, a prefecture in Japan that has only recently (27 July 2020) reported its first confirmed COVID-19 cases and which has experienced comparatively few cases since. Because they live in an environment with few COVID-19 cases, the individuals in this study provide an interesting perspective of the pandemic as it is unfolding in rural Japan and our focus here is on documenting the circumstances and ideas of elder residents of Iwate Prefecture to understand individual experiences of this population. Our intention here is to provide data and tentative analysis that may be useful in developing more complex cross-cultural studies related to the lived experience of COVID-19 among older people.

The purpose of the map and dashboard is twofold. First, Microsoft’s Power BI software presents a reasonably easy means by which many can make reasonably robust data visualizations with minimal expertise in mapping and programming languages. Unlike some competing data visualization and online mapping software packages that require specialized software or skills, ordinary citizens and students, new to data collection and management can create an appealing dashboard-style presentation within a few minutes with minimal guidance. Familiarity with the function and logic of spreadsheet software seems to be the only prerequisite. Many businesses, colleges, and universities already provide access to the Microsoft Office suite of software, further extending the appeal of using Power BI. The COVID-19 dashboard featuring case data by date, city, county, and / or neighborhood in Southern California was created in less than one-half hour using a connection to publicly available data shared by the Los Angeles Times via GitHub. The map allows visitors to select individual communities from a map, which prompts dynamically linked graphs and tables to display data for only that community. The second purpose of this dashboard is to allow users to rapidly analyze local data trends, perhaps following school openings / closings, changes in the status of businesses, or social protests movements. Epidemiologists have expressed concern over the effects of the protest marches and untimely changes in rules regarding businesses and schools on COVID-19 rates. Compounding the need for such a map are concerns about differential COVID-19 infection rates in communities of color, whose citizens were already at an elevated risk of death from COVID-19. This map and dashboard demonstrates that these concerns were not unfounded.

Background Internal medicine (IM) residents lack confidence in rheumatology. Due to the wide variety of topics in rheumatology, identifying the most important subjects to learn during training is vital to create future interventions to increase confidence and knowledge. The preferred teaching modality for both attendings/fellows and residents is not known. Methods An electronic survey was distributed to all IM residents, rheumatology fellows, and rheumatology faculty at the University of Chicago during the 2020–2021 academic year. Residents reported self-confidence levels on 10 rheumatology topics, while rheumatology attendings/fellows were asked to rank these from most to least important to learn during IM residency. All groups were asked preferred teaching modality. Results Median confidence level [interquartile range] among residents for caring for patients with rheumatological conditions was 6 [3.6–7.5] for inpatient and 5 [3.7–6.5] for outpatient settings (10 being very confident). Attendings and fellows identified the most important topics to learn during the rheumatology rotation as ordering and interpreting autoimmune serologies and musculoskeletal exam. Both attendings/fellows and residents preferred bedside teaching in the inpatient setting and case-based learning in the outpatient setting. Conclusions While some disease-specific topics such as autoimmune serologies were identified as important rheumatology topics for IM residents to learn, more practical topics like musculoskeletal exam skills were also deemed important. This highlights the need for comprehensive interventions that focus on more than standardized exam topics alone to improve rheumatology confidence in IM residents. There are different preferences of teaching styles in various clinical settings.

Background Internal medicine (IM) residents lack confidence in rheumatology. Due to the wide variety of topics in rheumatology, identifying the most important subjects to learn during training is vital to create future interventions to increase confidence and knowledge. The preferred teaching modality for both attendings/fellows and residents is not known. Methods An electronic survey was distributed to all IM residents, rheumatology fellows, and rheumatology faculty at the University of Chicago during the 2020–2021 academic year. Residents reported self-confidence levels on 10 rheumatology topics, while rheumatology attendings/fellows were asked to rank these from most to least important to learn during IM residency. All groups were asked preferred teaching modality. Results Median confidence level [interquartile range] among residents for caring for patients with rheumatological conditions was 6 [3.6–7.5] for inpatient and 5 [3.7–6.5] for outpatient settings (10 being very confident). Attendings and fellows identified the most important topics to learn during the rheumatology rotation as ordering and interpreting autoimmune serologies and musculoskeletal exam. Both attendings/fellows and residents preferred bedside teaching in the inpatient setting and case-based learning in the outpatient setting. Conclusions While some disease-specific topics such as autoimmune serologies were identified as important rheumatology topics for IM residents to learn, more practical topics like musculoskeletal exam skills were also deemed important. This highlights the need for comprehensive interventions that focus on more than standardized exam topics alone to improve rheumatology confidence in IM residents. There are different preferences of teaching styles in various clinical settings.

Background Systemic lupus erythematosus is an autoimmune disease that can have cutaneous and systemic manifestations. Lupus panniculitis, also known as lupus mastitis, is a subset of chronic cutaneous lupus erythematosus that involves inflammation of the subcutaneous fat. The pathogenesis of lupus mastitis is not fully understood. Diagnosis involves a combination of skin manifestations, imaging, and pathologic confirmation. Treatment typically includes steroids and antimalarials, with more severe disease requiring additional immunosuppressive medications. This report highlights a case of lupus mastitis treated with rituximab and a possible relationship between this disease process and thrombotic disease. Case presentation A 48-year-old African American female with systemic lupus erythematosus and antiphospholipid syndrome presented with new breast lesion. Mammography revealed calcifications and increased density with coarse trabecular pattern. Breast biopsy showed features of cutaneous lupus and occlusive vasculopathy. The patient was diagnosed with lupus mastitis and treated with anticoagulation, rituximab, mycophenolate mofetil, and quinacrine with resolution of her symptoms. Conclusion This patient experienced improvement in her breast symptoms with combination therapy including rituximab. There are only two other cases reported in literature of patients with lupus mastitis responding to rituximab, highlighting the possible role of B cell depleting therapy for those who have contraindications to standard treatments for lupus mastitis. While the pathophysiology of lupus mastitis is thought to be immune driven, some literature suggests that associated thrombosis commonly seen may be due to a physiologic overlap similar to antiphospholipid syndrome. The possible relationship between antiphospholipid syndrome and lupus mastitis and the use of antiplatelet and anticoagulation therapy is discussed and may warrant further investigation.