Impact of government evaluation and accreditation processes on the research output of universities in developing countries: an X-ray of the young Ecuadorian academia

Ecuador is a unique case study, where strict evaluation and accreditation processes have been recently established (i.e., early-2010s) mainly based on the experience of their peers and that of developed countries. Interestingly, the development of quality assurance indicators for research output received special attention. The current study systematically explored the research output of the Ecuadorian higher education institutions (HEIs) after only one decade of being subjected to multiple rigorous evaluation and accreditation processes. Peer-reviewed documents in the Scopus Database from 2006 to 2021 were statistically analyzed in terms of the number of documents produced (i.e., books, book chapters, journals, and conference proceedings), citations, H-index, quartiles, and impact factors (i.e., SRJ, SNIP, and Cite Score), at both country and single-university levels. The influence of the multiple evaluation processes and external factors (e.g., relaxation of regulations, COVID) on the research output trends were comprehensively and chronologically discussed. Accordingly, a statistical answer to the following research questions was attempted: where is the Ecuadorian research output currently standing after these evaluation and accreditation measures? Furthermore, where is it heading? This investigation would assist in creating and adjusting policies targeting sustainable research in HEIs in Ecuador and other countries in similar early research development. Copyright © 2023 Gutiérrez, Yaguarema, Ayala, Zambrano R and Gutiérrez.

HEPATITIS B NUCLEOCAPSID PARTICLE AS IMMUNOPOTENTIATOR OF INNATE AND ADAPTIVE IMMUNITY FOR NASAL VACCINES CIGB 2020 AND MAMBISA AGAINST COVID-19

Intro The concept of training immunity originally developed for other diseases has gained attraction during the epidemic. Several clinical trials and epidemiological analyses of populations previously immunized with BCG and other vaccines were the focus of scientific discussions. Here we show the activation of innate immunity markers both at mucosal and systemic levels with a mucosal vaccine CIGB2020 (HeberNasvacTM) containing virus-like particles (HBsAg) and nucleocapsid particle (HBcAg) of the hepatitis B virus. Moreover, the immune potentiating capacity of the HBcAg combined with RBD protein was used to formulate a specific mucosal vaccine candidate against SARS-CoV-2 (MambisaTM). Methods With CIGB 2020 (100µg HBsAg and 100 µg HBcAg) were conducted two proof of concept trials in human volunteers and a Phase I-II open, randomized, and controlled trial in 46 volunteers older than 60 years, symptomatic or close contact of COVID-19 patients. The volunteers were randomly assigned to the treatment group or not treated group. The nasal spray was administered to the treatment group on days 0, 7, and 14 together with daily sublingual administrations. Mucosal and serum samples were collected on days 0, 4, and 8. With MambisaTM vaccine (50µg RBD and 40 µg HBcAg) was conducted one proof of concept trial and a Phase I-II open and randomized trial in 1131 volunteers 19 to 60 years old, evaluating three different devices for nasal administration. All the volunteers gave written informed consent. Findings CIGB2020 activates interferon-induced genes and TLR 3, 7, and 8 at the level of oropharyngeal mucosa and PBMC. Monocyte and lymphocyte populations were also activated. One dose of the MambisaTM vaccine induces high levels of specific IgG. The serum and mucosal antibodies show RBD-ACE2 binding inhibition capacity and neutralization activity. Conclusion Nasal immunization exhibits advantages in inducing immunity at the level of the nasopharyngeal mucosa in addition to the systemic response.

Cuban Vaccines Abdala and Mambisa against Covid-19

Intro: With the first case of COVID-19 in Cuba on March 11, 2020, the Center for Genetic Engineering and Biotechnology in Havana began an extensive vaccine program. Two vaccines based on RBD recombinant protein were developed, one for systemic administration "Abdala" and one mucosal vaccine "Mambisa". Abdala received the EUA in July 2021 and "Mambisa" completed its clinical development as a booster dose for convalescent subjects. Method(s): Two doses (25 and 50 microg) and two schedules (0-14-28 and 1-28-56 days) were evaluated in phase I clinical trials with volunteers 19 to 54 years old. The phase II and III clinical trials were also double-blind, randomized, and placebo-controlled, and included respectively 660 and 48,000 volunteers from 19 to 80 years. The anti-RBD titers were evaluated using a quantitative ELISA system developed at the Center for Immunoassay, Havana Cuba, and ELECSYS system from Roche. The RBD to ACE2 plate-based binding competitive ELISA was performed to determine the inhibitory activity of the anti-RBD polyclonal sera on the binding of the hFc-ACE2 coated plates. The neutralization antibody titers were detected by a traditional virus microneutralization assay (MN50). Finding(s): The Abdala vaccine reached 92.28% efficacy. The epidemic was frankly under control in Cuba after the vaccine introduction having reached the highest levels of cases and mortality in July 2021 with the dominance of the Delta strain. The peak of the Omicron wave, unlike other countries, did not reach half of the cases of the Delta wave with a significant reduction in mortality. The mucosal vaccine candidate "Mambisa" completed its clinical development as a booster dose for convalescent subjects reaching the trial end-point. Conclusion(s): Vaccine composition based on RBD recombinant antigen alone is sufficient to achieve high vaccine efficacy comparable to mRNA and live vaccine platforms. The vaccine also protects against different viral variants including Delta and Omicron strains.Copyright © 2023

Hospital environment cleaning and disinfection in times of covid-19. Guidelines and reflections

In this pandemic times, faced with a variant of coronavirus called severe acute respiratory syndrome coronavirus 2 (sars cov2), we face a conjuncture of dilemmas and hypotheses about the causes of transmission of the microorganism when approved guideline for cleaning and disinfection in the hospital environment are not enough to consider a suitable surface, was in part to the lack of quantitative evidence that allow us to support or detract the effect of a disinfectant due to its misuse or wrong application. objective. to determine the effectiveness of four disinfectants applied with local cleaning and disinfection standards in the hospital environment. material and methods. observational study carried out in four hospitalization areas of two different health care centers. Cleaning and/or disinfection is carried out with three methods: spraying, friction and electromagnetic. Luminescence-based atp was used to quantify living cells results. friction on surfaces with hydrogen peroxide impregnated towels had a decrease up to 88% in relative light units (rlu) compared to spraying with other disinfectants. In rooms with previous cleaning, with spraying, the rlu had a 50% reduction, however, in sink faucets and dispensers, the simple use of nebulization was enough to reduce rlus more than 90%. Anesthesia equipment in three rooms, had the highest amount of organic material (bacteria, viruses, etc.) and the spraying reduced the rlus more than 95%.

Training professionals through clinical simulation during the first covid-19 wave

In this article, we share the experience in training healthcare professionals from the Hospital General Universitario of Ciudad Real (HGUCR) through theoretical-practical training with clinical simulation, and the evaluation of its results. Sessions were set with high and low complexity simulation for 40 persons and in reduced groups. The evolution of needs led to an increase in the number of sessions, and the suppression of the Advanced Simulation Room. A 64-session program was held between March and April 2020, in morning and afternoon shifts and for groups of 15 persons, with participation by 41.5% (n= 852) of the healthcare staff from the Integrated Care Management of Ciudad Real. The evaluation questionnaire was answered by 91 persons, who reported high satisfaction with the activity (4.32 scores over 5 at overall level);they valued particularly its utility for work, the clarity of the information, and the practical aspect of the session (simulation). Likewise, 80.6% reported an increase in confidence, and 65.9% reported a reduction in anxiety regarding management of patients with COVID. Even though other causes should be analysed, the proportion of contagion among professionals (10%) was similar to that among the general population. The availability of training spaces with simulation and professionals trained in the design of this type of activities represents a useful and flexible resource for any healthcare demands that might arise. © 2021 DAE Editorial, Grupo Paradigma. All rights reserved.

Low muscle mass in COVID-19 critically-ill patients: Prognostic significance and surrogate markers for assessment.

INTRODUCTION: Low muscle mass is a common condition in the critically ill population and is associated with adverse clinical outcomes. The primary aim of this study was to analyze the prognostic significance of low muscle mass using computed tomography (CT) scans in COVID-19 critically ill patients. A second objective was to determine the accuracy and agreement in low muscle mass identification using diverse markers compared to CT as the gold standard. METHODS: This was a prospective cohort study of COVID-19 critically ill patients. Skeletal muscle area at the third lumbar vertebra was measured. Clinical outcomes (intensive care unit [ICU] and hospital length of stay [LOS], tracheostomy, days on mechanical ventilation [MV], and in-hospital mortality) were assessed. Phase angle, estimated fat-free mass index, calf circumference, and mid-upper arm circumference were measured as surrogate markers of muscle mass. RESULTS: Eighty-six patients were included (mean age ± SD: 48.6 ± 12.9; 74% males). Patients with low muscle mass (48%) had a higher rate of tracheostomy (50 vs 20%, p = 0.01), prolonged ICU (adjusted HR 0.53, 95%CI 0.30-0.92, p = 0.024) and hospital LOS (adjusted HR 0.50, 95% CI 0.29-0.86, p = 0.014). Bedside markers of muscle mass showed poor to fair agreement and accuracy compared to CT-assessed low muscle mass. CONCLUSION: Low muscle mass at admission was associated with prolonged length of ICU and hospital stays. Further studies are needed to establish targeted nutritional interventions to halt and correct the catabolic impact of COVID-19 in critically ill patients, based on standardized and reliable measurements of body composition.

Rupture of membranes self-assessment

Objective: An accurate tool to self-assess rupture of membranes (ROM) could decrease the need for hospital visits during the COVID pandemic. Our objectives were to evaluate the agreement between patients’ and researchers’ interpretation of a test for ROM using a modified FDA approved device and to evaluate patients’ level of difficulty interpreting the test. Study Design: A prospective cohort study of women complaining of leakage of fluid at ≥20 weeks gestation. Women wore sanitary pads with a modified lateral flow alpha-fetoprotein immunoassay strip to detect ROM. The strip was obtained from the FDA approved ROM Plus kit (Laborie/Clinical Innovations). Another set of pads was instilled with their urine. Patients and investigators interpreted the tests as positive (2 bars), negative (1 control bar), and other (not activated [no bars] or invalid [partial or unclear bars]). Cohen’s kappa was used to measure the agreement between patients and researchers. Difficulty interpreting the test was graded by patients on a scale of 1-10 (1 = least difficult, 10 = most). Results: Twenty-one women were recruited: 19 had ROM confirmed by clinical assessment, and 2 had ROM ruled out. Fifty-four pads were tested (women could wear more than 1 pad). Of the 26 worn by women with confirmed ROM, 20 (76.9%) were positive, none (0%) were negative, 3 [11.5%] were invalid and 3 [11.5%] were not activated. Of the 24 urine instilled pads from women with confirmed ROM, 4 (16.7%) were positive, 18 (75%) were negative and 2 (8.3%) were not activated. The women with ROM ruled out had non-activated tests (2 dry worn pads) and their urine instilled on 2 additional pads showed negative results. Cohen’s kappa was 0.85.Weighted kappa 0.88. The mean level of difficulty interpreting the test was 1.64. Conclusion: The modification of the FDA approved test did not result in false positive or negative results and 81.5% gave definitive results. Patients and researchers had a near perfect agreement interpreting the test. Women can easily interpret this self-test. [Formula presented] [Formula presented]

Relevance of the mass media in prevention, education and contextual management of covid-19

The purpose of this research was to determine the relevance of the media in the prevention, education and contextual management of COVID-19. Methodology: descriptive non-experimental transectional research. An international survey validated by experts was applied, surveying 1082 people during a month. The countries with the highest participation were Peru, Colombia, Mexico, the United States and Russia. The data was processed using SPSS version 25. 64.7% of the respondents affirmed that the means were decisive in preventing the pandemic;59.1% recognized the importance of the media for awareness and prevention of the pandemic, and 64% valued the importance of the media for the contextual management of the pandemic;demonstrating a significant relationship between the variables. Contributions: the need for strategic, prudent, ethical and socially responsible communication that benefits citizens in a pandemic situation is highlighted. © 2021 United World Center of Research Innovation and Publication. All rights reserved.

BBIBP-CorV/Sinopharm COVID-19 vaccine-induced humoral response in frontline workers

With the arrival of the vaccine against COVID-19, the decrease in cases of SARS-CoV-2 infection was evidenced. The objective of the study was to quantify the production of neutralizing antibodies (An) and immunoglobulin G (S-IgG) in frontline workers immunized with two doses of the BBIBP-CorV/Sinopharma vaccine. A cross-sectional analytical observational study was carried out in health personnel immunized with the inactivated vaccine (BBIBP-CorV). Their blood samples were collected three months after the second dose, to measure antibody responses (An, S-IgG). Of a total of 172 people evaluated, 110 (64%) people already had COVID-19 before entering the study, An titers were greater than 10 AU/mL in 60.5% of those vaccinated and 89, 3% showed S-IgG greater than 50 AU/mL. Workers older than 60 years were the group that did not develop enough antibodies. The correlation of An and S-IgG was positive (r=0.84) (p<0.001). The administration of two doses of the inactivated BBIBP-CorV/Sinopharma vaccine caused a notable An and S-IgG response, except in those over 60 years of age. © 2022 Instituto de Altos Estudios de Salud Publica. All rights reserved.