Impact of the COVID-19 Pandemic on Food Insecurity in Puerto Rico

This survey (n = 1,356) reports food insecurity (FI) in Puerto Rico (PR) at 38% before, and 40% since, the COVID-19 pandemic. Odds for FI increased for households with annual income <=$15k vs. >=$60k (OR: 3.52;95% CI: 1.20, 10.36);experiencing an income reduction (OR: 2.22 (1.55, 3.18));participating in the United States Department of Agriculture Nutrition Assistance Program (OR: 1.75 (1.14, 2.70));higher food acquisition anxiety (OR: 1.45 (1.29, 1.64));increased home availability of fruit-flavored drinks (OR: 1.52 (1.04, 2.22)), whereas increased fruit availability was protective (OR: 0.63 (0.43, 0.93)). Results heighten the need to examine FI strategies in PR.Copyright © 2021 Taylor & Francis Group, LLC.

Covid-19 pandemic impact in pediatricians: stress factors and their consequences

Previous studies have demonstrated that the COVID-19 pandemic has had negative psychological consequences on healthcare professionals, however, specific data on pediatricians are scarce. Ob-jective: To evaluate anxiety among pediatricians after the first COVID-19 wave as well as to identify possible related risk factors. Material and Method: A cross-sectional multicentric survey study was designed and sent to Spanish pediatricians through the Asociacion Espanola de Pediatria's e-mail lists. Demographic, socio-familial, occupational, emotional self-perception, psychosomatic symptoms, smoking, alcohol, and psychotropic drugs use data were collected. The State-Trait Anxiety Scale (STAI) was included, and its association with qualitative and quantitative variables of the sample was studied. Results: 440 surveys were registered. 42.2% of the participants expressed moderate-intense anxiety symptomatology according to the Anxiety-State scale and 26.9% on the Anxiety-Trait scale. Isolation at home was associated with a higher score on both scales. A change in the work situation of the cohabitant resulted in a higher score on the Anxiety-State scale. 41.1% of the respondents clas-sified the psychological impact suffered as mild, 50% as moderate, and 8.9% as severe. Up to 71.8% of the participants manifested some psychosomatic symptoms, with a linear association between the concurrence of symptoms and higher scores on the two scales. Conclusions: After the first pandemic wave, pediatricians have suffered anxiety, causing physical and emotional discomfort. Personal sit-uations were the main source of concern. Likewise, the presence of several somatic symptoms was associated with higher levels of anxiety.

Impact of the Covid-19 Pandemic on the Adherence of Hiv Patients

Background and Importance In 2020 Spain was involved in the SARS-CoV-2 pandemic. This situation entailed in the dispensing of drugs from pharmacy services to patients' homes. This way of reaching the patient facilitated the access to antiretroviral treatment (ART) in this difficult situation. However, due to the social stigmas, certain patients did not consent to access this dispensing system. Aim and Objectives The objective is to study how adherence to antiretroviral treatment was affected in HIV-positive patients during the months of the first alarm state in Spain (March 14 to June 21 2020);because during those period ART was home dispensation. Material and Methods Observational retrospective study, included patients HIV-positive who received ART during the first alarm state in Spain during COVID-19 pandemic and in the same period of 2019. Collected data were: sex, age and variables related to pharmacological treatment (ART in the selected periods, number of dispensations made, galenic units dispensed). To measure adherence, an indirect method was used, comparing the dispensations made in the hospital pharmacy of the hospital of Leon during the studied period and the same dates of the previous year. % adherence = [dispensed galenic units/planned galenic units] x100 Results We analyse 444 patients with a median age of 54 years (45-59) being 77.93% (n=346) men. During the study period 83 patients (18.69%) changed their ART. 38.55% (n=32) carried out a simplification of ART in 2020 (from a treatment based on several pharmaceutical forms to a treatment based on a single one). The mean adherence in the periods studied in 2019 and 2020 was 91.89% (CI 90.44-92.90) and 90.25% (CI 87.61- 92.90), respectively. In 2019, 67.12% (n=298) of patients had adherence greater than 95%, compared to 86.71% (n=385) in 2020. For 38 patients there are no medication dispensations during the 2020 period. Of the majority (n=27) the reason for the absence is unknown;6 were not disposed of from the hospital of Leon for spending the confinement outside the city;4 have died and 1 did not accept home dispensation. Conclusion and Relevance The implementation of home dispensing could have positively influenced adherence in HIVpositive patients. It is necessary to evaluate in the future that the implementation of new telepharmacy programmes can have a positive influence on adherence.

Air pollution and meteorological variables' effects on COVID-19 first and second waves in Spain.

The aim of this research is to study the influence of atmospheric pollutants and meteorological variables on the incidence rate of COVID-19 and the rate of hospital admissions due to COVID-19 during the first and second waves in nine Spanish provinces. Numerous studies analyze the effect of environmental and pollution variables separately, but few that include them in the same analysis together, and even fewer that compare their effects between the first and second waves of the virus. This study was conducted in nine of 52 Spanish provinces, using generalized linear models with Poisson link between levels of PM10, NO2 and O3 (independent variables) and maximum temperature and absolute humidity and the rates of incidence and hospital admissions of COVID-19 (dependent variables), establishing a series of significant lags. Using the estimators obtained from the significant multivariate models, the relative risks associated with these variables were calculated for increases of 10 µg/m3 for pollutants, 1 °C for temperature and 1 g/m3 for humidity. The results suggest that NO2 has a greater association than the other air pollution variables and the meteorological variables. There was a greater association with O3 in the first wave and with NO2 in the second. Pollutants showed a homogeneous distribution across the country. We conclude that, compared to other air pollutants and meteorological variables, NO2 is a protagonist that may modulate the incidence and severity of COVID-19, though preventive public health measures such as masking and hand washing are still very important. Supplementary Information: The online version contains supplementary material available at 10.1007/s13762-022-04190-z.

Impact of the COVID-19 on the epidemiology of maxillofacial fractures surgically treated in a Cuban university hospital

Introduction: COVID-19 pandemic has had a significant impact on people's behavior. Aim: To evaluate the impact of the COVID-19 on the epidemiology of maxillofacial fractures surgically treated in a Cuban university hospital. Methods: This research involved a 4-year descriptive, comparative, retrospective and cross-sectional study. Patients surgically treated between March 1 and December 31, 2020 (COVID-19 period) were compared with those who had undergone surgery between the same date in the years 2017-2019 (non-pandemic period). Age, sex, residence, year, month, alcohol consumption at the time of trauma, etiology, fractures types, and number of fractures per patient were recorded. Results: A decline in patients with maxillofacial fractures in 2020 (n=25) was observed when compared to equivalent periods in the three previous years (2017: n=37;2018: n=31;2019: n=41), respectively, with an annual average reduction of 31.19 %. Interpersonal violence was found to be the paramount etiological factor for maxillofacial fractures during the comparison periods (2017-2019);however, road traffic accident prevailed in the 2020 (n=12;48 %). There was a small increase in the number of alcohol-related fractures (56 % in 2020 vs 46.34 %, 41.94 %, and 51.35 % in 2019, 2018, and 2017, respectively). Conclusion: COVID-19 impacted on the epidemiology maxillofacial fractures surgically treated in this Cuban university hospital. © 2023, Editorial Ciencias Medicas. All rights reserved.

Covid-19 pandemic impact in pediatricians: stress factors and their consequences

Previous studies have demonstrated that the COVID-19 pandemic has had negative psychological consequences on healthcare professionals, however, specific data on pediatricians are scarce. Ob-jective: To evaluate anxiety among pediatricians after the first COVID-19 wave as well as to identify possible related risk factors. Material(s) and Method(s): A cross-sectional multicentric survey study was designed and sent to Spanish pediatricians through the Asociacion Espanola de Pediatria's e-mail lists. Demographic, socio-familial, occupational, emotional self-perception, psychosomatic symptoms, smoking, alcohol, and psychotropic drugs use data were collected. The State-Trait Anxiety Scale (STAI) was included, and its association with qualitative and quantitative variables of the sample was studied. Result(s): 440 surveys were registered. 42.2% of the participants expressed moderate-intense anxiety symptomatology according to the Anxiety-State scale and 26.9% on the Anxiety-Trait scale. Isolation at home was associated with a higher score on both scales. A change in the work situation of the cohabitant resulted in a higher score on the Anxiety-State scale. 41.1% of the respondents clas-sified the psychological impact suffered as mild, 50% as moderate, and 8.9% as severe. Up to 71.8% of the participants manifested some psychosomatic symptoms, with a linear association between the concurrence of symptoms and higher scores on the two scales. Conclusion(s): After the first pandemic wave, pediatricians have suffered anxiety, causing physical and emotional discomfort. Personal situations were the main source of concern. Likewise, the presence of several somatic symptoms was associated with higher levels of anxiety. Copyright © 2022, Sociedad Chilena de Pediatria. All rights reserved.

Covid-19 Vaccine Protection against Mortality in Patients with Oxygen: A Multicontinental Study

INTRODUCTION: The COVID-19 vaccines have effectiveness above 90% for avoiding hospitalization. However, 5% of vaccinated patients require hospitalization with a mortality ratio between 15% to 24%, similar to the one reported for unvaccinated hospitalized patients. These vaccinated patients belong to the most sensitive groups with a high comorbidity burden. The similarity in the mortality ratio between vaccinated and unvaccinated patients has been used to make claims against the vaccine's efficacy. A thoughtful analysis, taking into account the comorbidities of each group, on how vaccination protects patients with moderate or severe illness, is missing. METHOD(S): We perform a multi-continental retrospective cohort study in 111 hospitals in Spain and 37 in Argentina. We included hospitalized patients who received oxygen therapy older than 18 years with COVID-19. To assess the relation between COVID-19 vaccine status and death, we performed a logistic regression adjusting by confounders. Also, as a sensitivity analysis, we perform a propensityscore matching. Additionally, we studied the Population Attributable Risk (PAR). RESULT(S): Between January 2020 and May 2022, we included 21,479 patients, 717 (3 3%) were vaccinated. Hospitalized vaccinated patients with oxygen therapy had a higher proportion of comorbidities. The overall mortality in vaccinated patients was 20 9%, and 19 5% in unvaccinated patients. The crude Odds Ratio was 1 07 (IC95% 0 89-1 29;p=0 41), while the adjusted was 0 73 (IC95% 0 56-0 95;p=0 02) in the complete case analysis (6,352 patients) and 0 77 (CI 95% 0 54-0 97;p=0 02) in the complete dataset after multiple imputations. These observations were robust to the sensitivity analysis. The adjusted PAR reduction was 4 3% (95%CI 1%-5%). Therefore, as the death proportion in unvaccinated patients was 19 6% (95%CI 19%-20 1%), if they were vaccinated the expected death proportion would have been 15 3% (95%CI 12 9%-18%;p< 0 01). CONCLUSION(S): Even with the high protection of the COVID-19 vaccine, patients with a high burden of comorbidities will be hospitalized in future pandemic waves. In this study, we observed that the COVID-19 vaccines significantly reduce the probability of death even when lung inflammation has already been initiated, with moderate or severe COVID-19 disease.

Global Indicators for Measuring the Learning of the Active Students

Education 4.0 is a model to meet the demands of Industry 4.0. This is achieved by developing competencies during the learning process that will later be used in Industry 4.0. The structural model proposed in this work has four components: Cloud Computing infrastructures (applied in the COVID-19 confinement period), active hybrid methodologies (applicable in face-to-face, online, and blended learning mode), technologies (through a technological ecosystem), and horizontal 4.0 competencies. One of the main factors differentiating industrial innovation from educational innovation in teaching is its scope. While the scope of industrial innovation is global (market sector), that of educational innovation in teaching is local (in the subject itself). This approach has several effects on educational innovation in teaching compared to industrial innovation: there is a great deal of repetition of experiences, the advances are not immediately incorporated into other educational contexts, and the impact is local. This paper analyzes evidence to rethink the scope of educational innovation in teaching, developing it under a global vision but applying it locally. The study was carried out utilizing a survey of teachers from different educational levels (university and non-university) and different countries. They were asked about the impact of student inactivity on learning and the indicators that, in their opinion, allow measuring the success of educational innovation to promote active learning. The responses indicate that the education sector has a shared vision of the impact of inactivity on learning and of the measurement indicators. The conclusion is that innovation applied to a specific academic subject can be approached globally across the entire education sector. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Creation of a brief group intervention to reduce caregivers burden in an intensive home treatment unit

Introduction: Intensive home-treatment (IHT) for people experiencing a mental health crisis has been progressively established in many European countries as an alternative to in-ward treatment. However, the management of acute episodes at home can cause burden in the caregivers of these patients. Objective(s): To create a brief group intervention (BGI) to reduce burden in the caregivers of the patients admitted to an IHT unit. Method(s): A preliminary version of the BGI (BGI 1.0) was designed based on literature's review. It consisted of 4 sessions of 90 minutes (one per week), on-line (COVID-19), focused on caregivers burden, stress and self-care, communication skills, and self-compassion. All the caregivers of the patients admitted for IHT from 10/01/2020 to 06/01/2021 were offered the BGI 1.0. At the end of the intervention, participants (caregivers and therapists) were asked about their opinion on its contents and usefulness. Result(s): A total of 31 caregivers received the BGI 1.0. Most of them felt satisfied with the intervention. Opinions varied as to which contents should be expanded orincluded. The therapists thought that the number of sessions should be increased to take a closer look at some contents or to include new ones. They also believed that the on-line format hindered the adherence and the interaction between the participants. Conclusion(s): The BGI 1.0 seems to be a good starting point to design the final version of the intervention. However, an exhaustive assessment of the construct of burden in a larger sample of caregivers should be performed prior to its design.

Mechanisms of primary and secondary resistance to RET inhibitors in patients with RET-positive advanced NSCLC

Background: RET fusions are found in 1-2% of patients (pts) with advanced non-small cell lung cancer (aNSCLC). Targeted therapy with RET inhibitors (RETi) significantly improved prognosis. Molecular mechanisms of resistance are still incompletely characterized. Methods: This multicentric retrospective study included 24 centres. Eligible pts had a RET+ aNSCLC, were treated with a RETi and had at least one molecular profile by next-generation sequencing (NGS), performed before and/or after RETi, on tissue and/or plasma samples. Primary resistance under RETi was defined as disease progression (PD) within 6 months of therapy. Results: 95 patients were included with 112 biopsies: 93 at baseline, 19 at PD. 17 patients had paired NGS (baseline and PD). Median age was 65 years (range 56-72);62% were female, 54% were never smokers, 17% had brain metastasis (BM) at diagnosis. 55 patients received pralsetinib, 36 selpercatinib, 4 other RETi. Overall, median PFS under RETi was 17.1 months (95%CI 12.6-28). Primary resistance to RETi occurred in 22 (23%) patients. Primary resistant versus durable responders to RETi had non-adenocarcinoma histology in 9% vs 46% (p=0.61), smoking history in 57% vs 40% (p=0.21), BM in 5% vs 21% (p=0.1), TP53 mutations in 37% vs 22% (p=0.23). KRAS G12V mutation and SMARCA4 alterations were found only in poor responders (4.5% vs 0%, p=0.2;and 25% vs 0%, p=0.04, respectively). Among biopsies at PD (N=19, 13 liquid and 6 tissue biopsies), 7/13 (54%) liquid biopsies failed due to insufficient ctDNA. In 12 evaluable pts, 3 (25%) acquired secondary RET mutations (2 G810S and 1 S904F), 3 (25%) had novel RET rearrangements (2 in intron 11, 1 RET-DOCK1, 1 RET-CSGALNACT2) and 3 (25%) pts had off-target alterations (2 MET and 1 MYC amplification). Three pts (25%) developed novel TP53 mutations, while 3 (25%) had no novel identifiable alterations at PD. Conclusions: SMARCA4 and KRAS co-mutations may have a role in primary resistance to RETi. Secondary RET mutations, novel RET rearrangements and MET/MYC amplifications were identified after treatment with RETi. More than half of pts had insufficient ctDNA at PD, making tissue biopsy essential to identify resistance mechanisms. Legal entity responsible for the study: Institut Gustave Roussy. Funding: Has not received any funding. Disclosure: V. Fallet: Financial Interests, Personal, Advisory Board: AstraZeneca, BMS, Takeda, Roche, Pfizer, Sanofi, Sandoz, Jansen;Financial Interests, Personal, Invited Speaker: AstraZeneca, BMS, Takeda, Pfizer, MSD;Financial Interests, Personal, Expert Testimony: GSK, Boehringer. C. Audigier-Valette: Financial Interests, Personal, Advisory Role: AbbVie, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Ipsen, Eli Lilly, Novartis, Pfizer, and Roche. A. Russo: Financial Interests, Personal, Advisory Board: Pfizer, AstraZeneca, MSD, Novartis;Financial Interests, Personal, Writing Engagements: AstraZeneca, Novartis. A. Calles Blanco: Financial Interests, Personal, Advisory Board: AstraZeneca, Boehringer Ingelheim, Pfizer, Roche, Lilly, Merck Sharp & Dohme, Novartis, Bristol-Myers Squibb, Takeda, Sanofi;Financial Interests, Personal, Other, Speaker honoraria: Bayer;Financial Interests, Institutional, Research Grant, Drug-only for Investigator-initiated trial: Merck Sharp & Dohme. P. Iranzo Gomez: Financial Interests, Personal, Advisory Role: Bristol-Myers Squibb Recipient, F. Hoffmann, La Roche AG, Merck Sharp & Dohme, Boehringer Ingelheim, MSD Oncology, Rovi, Yowa Kirin, Grunenthal Pharma S.A., Pfizer. M. Tagliamento: Financial Interests, Personal, Other, medical writer: Novartis, Amgen;Financial Interests, Personal, Invited Speaker, travel/accommodation: Roche, Bristol-Myers Squibb, AstraZeneca, Takeda. L. Mezquita: Financial Interests, Personal, Advisory Board: Takeda, AstraZeneca, Roche;Financial Interests, Personal, Invited Speaker: Roche, BMS, AstraZeneca, Takeda;Financial Interests, Personal, Research Grant, SEOM Beca Retorno 2019: BI;Financial Interests, Personal, Research Grant, ESMO TR Research Fellowship 2019: BMS;Financial Interests, Institutional, Research Grant, COVID research Grant: Amgen;Financial Interests, Institutional, Invited Speaker: Inivata, Stilla. C. Lindsay: Financial Interests, Institutional, Principal Investigator: Roche, Amgen, BI;Financial Interests, Personal, Advisory Role: CBPartners, Amgen. S. Ponce: Financial Interests, Institutional, Principal Investigator: Merck Sharp and Dohme, F. Hoffmann-La Roche, Foundation Medicine, PharmaMar. Personal fees: Merck Sharp and Dohme, Bristol-Myers Squibb, F. Hoffmann-La Roche, Foundation Medicine, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Pfizer, Amgen, Celgene.;Financial Interests, Personal, Advisory Board: Merck Sharp and Dohme, Bristol-Myers Squibb, F. Hoffmann-La Roche, Foundation Medicine, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Pfizer, Amgen, Celgene.;Non-Financial Interests, Personal, Other: Merck Sharp and Dohme, Bristol-Myers Squibb, F. Hoffmann-La Roche. M. Aldea: Financial Interests, Personal, Invited Speaker, travel/accommodation: Sandoz. All other authors have declared no conflicts of interest.

COVID-19 Welcomes a New Variable That Influences Consumer Behavior: Anxiety

COVID-19 has generated a context full of questions about the effects of mental health in the economic or social sphere. Significant changes in consumer behavior have been investigated. As consumers reduced their purchases in physical establishments and increased online purchases, retailers took measures to minimize health risks, but also to retain consumers. The objective of this research is to identify the intellectual structure of the research field on anxiety and consumption, including the main lines of research in the area, the sources of knowledge, and the connection points that are helping to spread this knowledge. To do this, this research uses a bibliometric methodology based on co-citations. This research concludes that academics must incorporate anxiety in their models and that companies must take this variable into account in the design of their business strategies. We have to legitimize anxiety as one more variable influences on consumer behavior. © 2022 by IGI Global. All rights reserved.

Flipping the model: A novel approach to expand access and increase capture of ovarian cancer patients for genetic testing

Background Genetic testing for ovarian cancer patients is essential to consideration of PARP inhibitor therapy. To improve access, we piloted a Genetic Testing Station (GTS) which allowed patients to have a drop-in, same-day genetic testing visit facilitated by Genetic Counselor Assistants (GCAs) under the supervision of Genetic Counselors (GCs). Methods The GTS was implemented in December 2018 and operated through February 2020. Gynecologic Oncologist offered ovarian cancer patients a same-day GTS visit with a GCA, where the patient received education via videos designed by GCs. The patient also provided consent, a brief family history, and a sample for a standardized 133-gene panel. Results were provided by a telehealth or clinic visit with a GC. We compared uptake of genetic testing post-GTS, and also time from referral to delivery of testing results. Patients were retrospectively identified by querying the medical record for ovarian cancer patients seen 12 months prior to and 18 months after GTS implementation. Results A total of 482 patients pre-GTS were compared to 625 patients post-GTS. Genetic testing increased from 68.5% to 75.66665% (p = 0.012) after implementation of the GTS, with the majority of the increase in patients with epithelial histologies (80% vs 89% in pre-GTS vs post-GTS, p = 0.005). Time from referral to genetic testing to obtaining results was evaluated in the post-GTS cohort, comparing patients who had traditional counseling to those who utilized the GTS. The time to obtaining results was shorter in the GTS group at 21 days (95% CI [10, 34]) compared to 56 days (95% CI [41,76]) in the traditional genetic counseling group. Discussion The GTS reduces barriers to care and facilitates discussion of precision treatment and prevention strategies with patients and their families in a timely fashion while optimizing Genetic Counselor clinic time. Post-COVID, access improvement remains integral to improving uptake of genetic testing.

Education 4.0-based Method to Improve Learning: Lessons Learned from COVID-19

Education 4.0 is a model to meet the demands of Industry 4.0. This is achieved by developing competencies during the learning process that will later be used in Industry 4.0. The structural model proposed in this paper has four components: Cloud Computing infrastructures (applied in COVID-19 lockdown period), active hybrid methodologies (applicable in face-to-face, online, and blended learning mode), technologies (through a technological ecosystem), and horizontal 4.0 competences. These competencies have been acquired by integrating the active hybrid methodology with technologies. In the experience carried out, students have cooperatively used 4.0 competencies such as identifying, searching, evaluating, retrieving, creating, and using knowledge during the learning process. Likewise, the students have designed the technological system that classifies and manages all the knowledge created. Measured results show that the proposed Education 4.0 model has led to improvements in learning outcomes and has favoured peer-to-peer learning. The application of the 4.0 competencies has generated a 4.0 product which is the knowledge system to classify, organize, and use all the knowledge produced by the students through their learning experience in an academic subject.

Do Air Pollution and Meteorological Variables Have a Bearing on COVID-19 Mortality? Benchmarking of Time Series between the First and Second Waves in Nine Spanish Provinces

Some pollutants like PM10, NO2 and O-3 are detrimental to people's health, as numerous studies have shown, and they are related to short-term and long-term mortality. A sample of 9 out of the 52 Spanish provinces was studied. Generalized linear models (GLM) with a Poisson link function were developed during the time periods corresponding to the first and second waves of the daily average values of the independent variables (PM10, NO2 and O-3, as atmospheric pollutants, and meteorological variables such as the daily maximum temperature and the absolute humidity) versus the dependent variable (COVID-19 mortality rate, or CMR) during said first and second waves. Statistically significant lags between the independent variables and the dependent variable were established. The associated relative risks were calculated from the estimators obtained in the GLMs, with increases of 10 mu g/m(3) for atmospheric pollutants, 1 degrees C for the maximum temperature and 1 g/m(3) for the absolute humidity. The results show that NO2 has a stronger relationship with the CMR than the other air pollutants. The meteorological variables examined did not show a robust relationship between both waves, which indicates that they played a minor role in the CMR. In conclusion, air pollutants such as to NO2 and PM10 had a statistically significant relationship with the CMR, although it is limited and subordinate to other factors such as the public health measures that were taken, the presence of comorbidities and the age of the patient.

Impact of COVID-19 infection on a physically active population: evaluation functional using the Cardiopulmonar Exercise Test (CPET)

Introduction: An increase it is being seen in patients who are referred for consultation due to dyspnea persistent after having overcome COVID19. The cause for this sequel is still not entirely clear, but our group has observed -in another study- that the consumption of oxygen (VO2) determined by cardiopulmonar exercise test (CPET) in these patients is low with respect to its predicted (p50). The objective of the present work was to demonstrate this hypothesis against to a control group with similar characteristics, who have not suffered from COVID19. Methods: We conducted a prospective study with military personnel who are part of a corps of army elite. All subjects have performed the same training daily during the last 2 years. They were divided into 3 groups: the first (G1) made up of those who had not suffered from the COVID19 disease;a second group (G2) that had suffered from it, but did not report impairment of functional class (CF);and a third group (G3) who maintained dyspnea persistent 3 months after suffering from the disease. Analytical with NT-proBNP, echocardiogram, basal spirometry, and CPET were performed. None required hospital admission. Results: 36 subjects were included, distributed as follows: G1 (n = 14), G2 (n = 15), G3 (n = 7). The 3 groups had a similar age and BMI. None of the subjects presented alterations in baseline spirometry, neither structural heart disease in the echo, and nor relevant analytical alterations, being NT-proBNP less than 125 pg/ml in all of them. In relation to the response variables cardiovascular, statistical differences (p = 0.03) were observed in peak oxygen consumption predicted among the three groups (% predicted peak VO2), being significantly lower in the G3 subjects. In addition, a trend was observed -in absolute values- of peak VO2 to be lower in G3 -not significant probably due to the small sample size-. They were not objectified significant differences in PulseO2, nor in OUES. No patient presented alterations in the ventilatory efficiency parameters, or in final BR. Conclusions: In our sample, patients who remained with persistent dyspnea after COVID-19, have a lower functional capacity compared to healthy subjects of the same characteristics, and with respect to subjects who after COVID19 do not present any symptoms. This subjective deterioration of the FC can be objectively quantified using CPET, thus reaffirming its value in this context. (Figure Presented).

AEROSOL AND DROPLET GENERATION IN UPPER AND LOWER GASTROINTESTINAL ENDOSCOPY: WHOLE PROCEDURE AND EVENTBASED ANALYSIS

AIM: We aimed to characterise aerosol and droplet generation in gastrointestinal endoscopy. METHODS: This prospective observational study included patients undergoing routine per-oral gastroscopy (POG, n = 36), trans-nasal endoscopy (TNE, n = 11) and lower gastrointestinal (LGI) endoscopy (n = 48). Particle counters took measurements near the appropriate orifice (two models used, diameter ranges 0.3-25 μm and 20-3000 μm). Quantitative analysis was performed by recording specific events and subtracting the background particles. RESULTS: POG produced 2.06x the level of background particles (P < 0.001), and 2.13x the number of particles compared to TNE. LGI procedures produce significant particle counts (P < 0.001), with a rate of 8.8x106/min/m3 compared to 13.0x106/min/m3 for POG. Events significant relative to the room background particle count were: POG- throat spray (112.3x, P < 0.01), oesophageal extubation (36.7x, P < 0.001), coughing/gagging (30.7x, P < 0.01);TNE- nasal spray (32.8x, P < 0.01), nasal extubation (25.6x, P < 0.01), coughing/gagging (23.3x, P < 0.01);LGI- rectal intubation (3.5x, P < 0.05), rectal extubation (11.8x, P < 0.01), application of abdominal pressure (4.9x, P < 0.05). These all produced particle counts larger than or comparable to volitional cough. CONCLUSIONS: Gastrointestinal endoscopy performed via the mouth, nose or rectum all generates significant quantities of aerosols and droplets. As the infectivity of procedures is not established, we therefore suggest adequate Personal protective equipment (PPE) is used for all GI endoscopy where there is a high population prevalence of COVID-19. Avoiding throat and nasal spray would significantly reduce particles generated from UGI procedures.

University degrees adapted to new social frameworks

For years, many studies has been stressing the importance of incorporating new technologies and tele-education in universities across the globe. However, the implementation of new methodologies that take advantage of educational innovation supported by new technological tools has been slow and gradual. The new reality to which we have been exposed due to the health emergency caused by COVID-19 has hastened the incorporation of these methodologies hastily and has highlighted the lack of resources or training that universities suffer from to face the changes that have occurred. There is a clear need to modernize educational methodologies in higher education to bring it closer to the new generations and their needs, implementing more flexible models that provide transversal competencies. This work proposes a methodology based on social networks as a tool for support and connection between teachers and students. In addition, we explored different combinations of accessible software that allowing us to conclude the steps to follow for the successful implementation of social networks in the classroom. Copyright © 2021 for this paper by its authors. Use permitted under Creative Commons License Attribution 4.0 International (CC BY 4.0).

Analysis of the university teaching influenced by the COVID-19 context: some lessons learned

The health crisis caused by the SARS-COV-2 virus produced a drastic change in teaching in March 2020, when face-to-face teaching was forced to become online teaching. It led to changes in teaching methodologies, teaching materials and evaluation methods. The objective of this study is to determine which of these changes in the on-site university have been positive and should be sustained over time. To this end, a survey has been carried out among the students of different courses of the degrees taught at the E.T.S.I. Minas y Energía (E.T.S.I.M.E) of Universidad Politécnica de Madrid that allows us to know how the pandemic has influenced the use of didactic materials, what type of teaching modalities students prefer, and what resources they use the most during the study. Although class notes and slides remain the preferred resources among students, they showed great interest in class recordings. Other traditional materials, such as bibliography or tutoring, are less used by students. As for teaching methodologies, opinion is polarized. Therefore, it is necessary to make an effort to efficiently combine tele-teaching methodologies and didactic resources to face-to-face teaching, generating asynchronous resources without detriment to traditional face-to-face activities. Copyright © 2021 for this paper by its authors. Use permitted under Creative Commons License Attribution 4.0 International (CC BY 4.0).

A participative system methodology to model pest dynamics in an agricultural setting

Purpose: This study aims to identify the most relevant causal factors and the feedback loops of the dynamics between Tuta absoluta incidence in tomato crops and farmers' reactions to the problem. The authors seek to develop a conceptual model based on farmers' know-how to address crop damage by T. absoluta at a local and regional levels in order to determine how to confront this problem in the tomato-growing region of Sáchica, Colombia. Design/methodology/approach: Community-Based System Dynamics (CBSD) is a participatory research methodology in which a group of stakeholders identifies relevant variables and the cause-effect relations among them which are then arranged into a causal loop diagram. The authors implemented this methodology in a workshop, focused on the farmers' insights related to the pest situation at the local and regional level, to achieve a causal loop diagram that explained pest dynamics and their potential management. Findings: The relevant factors for the presence of T. absoluta, seen in the causal loop diagram, vary regionally and locally. At the local level, the pest impacts tomato production, farmers' well-being and their cash flow, while at the regional level, it affects market dynamics and environment and promotes regional coordination among farmers. Farmers propose product innocuity as a key regional objective. They also proposed establishing a planting calendar and census of greenhouses to control the pest throughout the region and the tomato supply. Research limitations/implications: First, the synthesized model could not be validated with the farmers due to the COVID 19 epidemic. However, the authors held sessions with experts to analyze each result. Second, decision-makers from the local government did not participate in the workshop. Nevertheless, the approach of the workshop was aimed at understanding the mental models of the farmers since they are the ones who decide how pests are managed. Finally, even though farmers showed interest in projects aimed at proposing area-wide, long-term and wide pest control strategies, there is a risk that they will not adopt the proposed changes, due to risk aversion. Originality/value: CBSD has not been applied to agricultural systems to analyze impacts from pests at the local and regional levels. The results of this study contribute to designing future interventions for pest control in the region, along with the factors which may turn out to be “side effects” or unwanted results. To design pest control interventions at a regional level, a sound understanding of the variables or factors that control the system dynamics at various levels is required. This study represents the first step towards that end. © 2022, Emerald Publishing Limited.