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In-person mobility has traditionally been taken for granted as an element of academic collaboration. The COVID-19 pandemic disrupted this status quo, introducing new challenges, especially across Africa, Asia and Latin America, where local economies and higher education systems have been disproportionately affected, exacerbating existing inequities. Low and unequal vaccination rates in these regions will likely continue to influence academic mobility. Given that international travel is set to remain complicated and expensive, African, Asian and Latin American academics' preference for North America and Europe as destinations for mobility is likely to shift, with new academic mobility ecosystems emerging. Indeed, strong institutions and countries in these regions are becoming new hubs for intra-regional mobility and collaboration. The future of academic mobility and collaboration in Africa, Asia and Latin America is thus likely to include alternative destinations and virtual mobility, with the possibility of lower levels of international cooperation as the perceived value of mobility comes into question. These changes call for creative, long-term plans by institutions as well as governments. They present opportunities to promote mobility within regions, as well as South-South mobility in order to increase higher education's social relevance. © International Network for Higher Education in Africa, University of Kwazulu-Natal. All rights reserved.
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The paper presents new annotated corpora for performing stance detection on Spanish Twitter data, most notably Health-related tweets. The objectives of this research are threefold: (1) to develop a manually annotated benchmark corpus for emotion recognition taking into account different variants of Spanish in social posts;(2) to evaluate the efficiency of semi-supervised models for extending such corpus with unlabelled posts;and (3) to describe such short text corpora via specialised topic modelling. A corpus of 2,801 tweets about COVID-19 vaccination was annotated by three native speakers to be in favour (904), against (674) or neither (1,223) with a 0.725 Fleiss' kappa score. Results show that the self-training method with SVM base estimator can alleviate annotation work while ensuring high model performance. The self-training model outperformed the other approaches and produced a corpus of 11,204 tweets with a macro averaged f1 score of 0.94. The combination of sentence-level deep learning embeddings and density-based clustering was applied to explore the contents of both corpora. Topic quality was measured in terms of the trustworthiness and the validation index. © 2023 The Author(s)
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The aim of the study was to investigate whether the COVID-19 pandemic and related measures had an influence on colorectal cancer (CRC) presentation, management, and outcomes; it was a retrospective monocentric study. CRC patients undergoing surgery during the COVID-19 pandemic (1 March 2020-28 February 2022) (group B) were compared with patients operated on in the previous two years (1 March 2018-29 February 2020) in the same unit (group A). The primary outcome was to investigate whether there were differences in concern regarding the stage at presentation, as a whole and after dividing groups based on cancer location (right colon cancer, left colon cancer, rectal cancer). Secondary outcomes included differences in the number of patients admitted from emergency departments and emergency surgeries between periods, and differences in the postoperative outcomes. A subanalysis within the pandemic group was conducted on the same outcomes, dividing the aforementioned group based on pandemic trends. Two hundred and eighty (280) were operated on during the study period: 147 in group A and 133 in group B. Stage at presentation was similar between groups; however, the subgroups analysis showed that in the pandemic group, the number of early-stage left colon cancer occurrences almost halves, yet not significantly. Emergency department referral was more common in group B (p-value: 0.003); in group B, they also had longer operations and there was a more frequent use of ostomy. No differences in the number of postoperative complications nor in the postoperative outcomes were found. Patients with CRC were more frequently referred through the emergency department during the COVID-19 pandemic and left-sided cancers appear to be generally diagnosed at a more advanced stage. Postoperative outcomes showed that high specialized colorectal units can deliver standard high-level treatment under high-pressure external conditions.
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The article investigates the controversies that emerge with the production of the CoronaVac vaccine, the first Covid-19 vaccine available in Brazil, on June 11th, 2020. Based on Actor-Network Theory, this study is inspired by virtual ethnography. We thus privilege digital documents from government agencies and medical entities, specialized publications, publications in Facebook groups, and the writing of a virtual field diary. Our investigation ends with the approval of the CoronaVac and Oxford/AstraZeneca vaccines by the National Health Surveillance Agency (Anvisa). We identify the construction of factoids by groups that were critical of social distancing measures, basing themselves on the use of purportedly scientific arguments. The alliances established between doctors and the federal government through the Ministry of Health challenged the vaccine as a technoscientific artifact, and advocated for drugs that were part of the so-called “early treatment” as the “cure” for the pandemic in Brazil. © 2022, Brazilian Anthropology Association. All rights reserved.
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Background/aims: Palliative care training has arisen as a protector of professionals' burnout. Also coping with death has repeatedly been related to burnout, with higher levels in such a competence resulting in lower levels of burnout. In this same line, stress management training, in its different forms, has also been related to lower levels of burnout. Because the COVID-19 pandemics has increased the risk of burnout in palliative care providers, the role of education and training as protectors is of interest. The aim of this research is to describe how training was related to palliative care professionals' burnout during the COVID-19 pandemics. Methods: This study has a cross-sectional design. Data of 241 Spanish palliative care professionals were gathered after one year of COVID-19 pandemics (April-May, 2021). 224 professionals reported their levels of burnout. Results: 86.16% professionals reported having received specific training in palliative care, 74.55% in coping with death, and 62.95% in stress management. 23.2% of professionals suffered from high emotional exhaustion, 39.0% reported high depersonalization, and only 17% informed of low personal accomplishment. When burnout was related to training, higher levels of depersonalization and lower levels of personal accomplishment were found in those who did not received specific palliative care training, compared to those who did. Those who had received coping with death training showed lower levels of burnout, in the three dimensions: lower emotional exhaustion, lower depersonalization, and higher personal accomplishment. Finally, stress management training did also affect professionals' levels of burnout: professionals who had received such training reported lower levels of emotional exhaustion and depersonalization. Conclusions: Training in palliative care, coping with death, and stress management have protected Spanish palliative care professionals from suffering burnout during the pandemics.
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Background/aims: COVID-19 pandemics has been a real challenge for palliative care professionals. They have been exposed to the front line of the pandemics, and have suffered from the lack of access to adequate protective equipment;the feeling of inadequate support;prolonged working hours and unexpected changes in the type of work;the concern about becoming infected or infecting their relatives;the lack of access to updated information on constantly changing guidelines for action;or the uncertainty about disease containment. Additionally, COVID-19 has been a challenge for patients' dignified deaths. The aim of this research is to describe COVID-19-related experiences have affected Spanish palliative care professionals during the pandemics. Methods: This study has a cross-sectional design. Data of 241 Spanish palliative care professionals were gathered after one year of COVID-19 pandemics (April-May, 2021). Analyses included descriptive statistics. Results: 32% of the professionals (n= 77) reported absence of adequate protective equipment during the pandemics. More than a half (58.5%;n= 141) declared a significant increase in their workload during the pandemics, and more than 40% reported a deterioration in the teamwork. Almost all the participants had treated COVID-19 patients during the pandemics (89.6%;n= 215). Out of them, 192 reported patients dying with COVID-19. In these cases, only 83 (43.9%) reported that the death process of COVID-19 patients has been accompanied by a family member, and 62 professionals (32.6%) felt that adequately accompanied their COVID-19 patients in their dying process and that they had a dignified death. Conclusions: COVID-19 pandemics has affected both the quality of work and the quality of care of Spanish palliative care professionals. Patients' dignity in the dying process was not accomplished according to the perception of one in three professionals.
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The severity of lung involvement on chest tomography (CT) images in COVID-19 patients may have a prognostic value. This study assesses the type, severity and frequency of the different images of lung CT in hospitalized patients with COVID-19, and the differences in clinical characteristics and in-hospital outcomes, according to the CT severity score. This represents an observational study (retrospective cohort) of hospitalized patients with COVID-19. The ISARIC-WHO form was used to collect data. The type of lung lesions, affected lobes, and total CT severity score were determined at hospital admission. The first, second and third quartiles of the total CT score were calculated to divide the sample into four equal parts (Q1, Q2, Q3 and Q4). A total of 556 patients were included, 336 men (60.4%) and 220 women (39.6%), with a mean age of 61.9 +/- 15.8 years;and 532 of them had CT scan at admission. Patients in the more severe quartiles had more days of symptoms evolution (Q1 6.4 +/- 3.5, Q2 7.9 +/- 4.1, Q3 8.2 +/- 4.1, Q4 8.1 +/- 4.4), desaturation (Q1 95.3 +/- 3.7, Q2 94.4 +/- 3.1%, Q3 91.7 +/- 4.8%, Q4 86.5 +/- 9.1%), alterations of inflammatory markers, hospital stay (Q1 6.4 +/- 2.9, Q2 7.4 +/- 4.1, Q3 9.6 +/- 5.8, Q4 13.1 +/- 10.4 days), admission to ICU (Q1-2.5%, Q2-5.8%, Q3-12.5%, Q4-49.1%), mortality (Q1-3.8%, Q2-4.5%, Q3-9.4%, Q4-33.3%), mixed CT lesions (ground glass opacity-consolidation), linear opacities, crazy-paving pattern, reverse halo sign, and bronchiectasis. The total CT score significantly correlated with leukocyte, neutrophil and lymphocyte counts, and with other inflammatory markers. Semi-quantitative evaluation of pulmonary involvement in the initial chest CT can help to establish the severity of the case and predict relevant clinical outcomes in COVID-19 patients.
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Background: The Covid-19 pandemic has increased pressure on health systems, forcing professionals to make critical decisions in adverse environments. Combined with the fact that their patients often have no therapeutic options, healthcare workers are experiencing a consequent sense of failure. Aims: To study compassionate care in palliative care professionals after the first wave of the pandemic in Spain. Methods: Design. Data were collected in May 2020. Data collection. 57 professionals participated. Analysis. Statistical analyses included descriptive information of COVID and compassionate care experiences. Results: The majority of the participants were women (66.7%). Mean age was 46.15 years old (SD=10.75). Most participants worked with Covid patients (n=35;62.5%). When compared to professionals not working with Covid, they showed lowers levels of compassion satisfaction, positive self-compassion and well-being, and higher levels of burnout, compassion fatigue and negative self-compassion. Among the professionals treating Covid patients, 28 had patients who had died. Only 13 affirmed the dying process had been accompanied by a family member, 9 believed they adequately accompanied their patients in the process, and 11 that it was a dignified death. Professionals feeling their Covid patients' deaths were dignified deaths showed higher levels of compassion satisfaction, positive self-compassion and well-being, and lower levels of burnout, compassion fatigue and negative self-compassion. Conclusion: Although our results are mainly descriptive, because of the small sample size, they point out that palliative care professionals in the frontline of Covid-19 could suffer from problems of self-compassion, quality of life and well-being. This is even more likely in those who felt the patients' death were non-dignified deaths.
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Background: There is little information on the prevalence of bacterial coinfection and use of antibiotics in hospitalized CO-VID-19 patients. The present study assesses the frequency of in-hospital antibiotic prescription, the bacterial cultures im-plementation and the clinical characteristics of patients with COVID-19 according to the use of antibiotics. Methods: Ret-rospective, observational study of hospitalized patients with COVID-19. The ISARIC-WHO form was used for data col-lection. Results: 145 patients were included, 95 men and 50 women, with a mean age 63.8±16.0 years. 79/145 (54.5%) patients received antibiotics, 52/145 (35%) had samples for culture and 49/145 (33.8%) were blood cultures. Pathogenic bacteria were isolated only in 7% of the patients. The patients with antibiotics had worse oxygenation, chest tomography and inflammatory markers, more admission to ICU, deaths, and prolonged hospital stay. Conclusion: Our results do not support the initial widespread use of antibiotics in hospitalized COVID-19 patients without knowing the pathogen and its susceptibility.
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Background: There is limited information about the variations of the clinical characteristics and outcomes in hospitalized patients with COVID-19 during the pandemic. No study has evaluated these changes in our region. Objective: To assess the clinical characteristics and outcomes of adult hospitalized patients with COVID-19 during the first year of the pandemic. Methods: This is a retrospective, observational study. Medical charts of hospitalized patients with COVID-19 at the Hospital Centro Médico de Caracas were reviewed to obtain information about their clinical characteristics. Results: A total of 454 patients were included, 278 men (61 %) and 176 women (39 %), with an average age of 61.97±15.95 years, previous duration of symptoms 7.38 ± 4.01 days, chest CT score 11.49±5.80, and hospital stay 8.30±5.11 days. 59.8 % of the patients had severe-critical disease, 40.2 % mild-moderate, 15.86 % were admitted to the ICU, 81.2 % were discharged and 9.5 % had died. The curve of hospitalized cases was bimodal, identifying two waves: The first between July-September 2020 (peak in August with 59 cases), the second larger and longer between December 2020 and April 2021 (peak in March 2021 with 140 cases). The length of hospital stay remained stable over one year, while mortality decreased progressively (highest value in August 2020, 26.4 % and the lowest in March 2021, 5.4 %). Conclusion: The results show the behavior of hospitalized patients with COVID-19 during a year of the pandemic in our population. It is reasonable that the decline in mortality rate is the result of changes in the age of patients, the disease severity, and provision of care during the pandemic. © 2021 Academia Nacional de Medicina. All rights reserved.
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Hyperglycemia, with or without diabetes, is associated with complications in hospitalized patients with COVID-19. There is no information regarding this problem in our region. This study was aimed to compare the characteristics and in-hospital clinical course of patients with a probable diagnosis of COVID-19, with and without hyperglycemia during the hospitalization. This is a retrospective, observational study of clinical records review of hospitalized patients with COVID-19. The ISARIC-WHO form was used for data collection. Hyperglycemia was defined as a fasting value >= 140 mg/dL according to standard glycaemia targets in hospitalized patients. A total of 148 patients were included, 97 (65.5%) men and 51 (34.5%) women, with a mean age of 64.1 +/- 16.1 years;of which 42/148 (28.4%) patients reported previous diabetes, 60/148 (40.5%) patients had hyperglycemia during the hospitalization and 32/60 (53.3%) of these cases did not report previous diabetes. The patients with hyperglycemia were older, received more frequently systemic corticosteroids (96.6 vs 82.6%;p=0.01), and antibiotics (68.3 vs 44.3%;p=0.01), had worse baseline oxygenation parameters (SpO(2) 88.1 +/- 1,1.7%;vs 92.8 +/- 5.5%;p=0.02, PaO2/FiO(2), 194.4 +/- 119.7 vs 270.9 +/- 118.3;p<0.001), higher total lung severity score in the chest CT (14.9 +/- 5.7 vs 11.1 +/- 6.3;p<0.001) and higher levels of baseline inflammatory markers (CRP 6.73 +/- 3.61 vs 5.08 +/- 4.21;p<0.01, LDH 342.9 +/- 118.4 vs 296.5 +/- 161.4;p=0.01 and Ferritin 687.7 +/- 373.2 vs 542.6 +/- 395.3;p=0.01). Mortality (34.5 vs 10.7%;p<0.001) and admission to ICU (43.3 vs 7.9%;p<0.001) were higher in patients with hyperglycemia. Hyperglycemia in hospitalized patients with COVID-19 is a marker of severe disease and poor prognosis.
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Background: Acute respiratory distress syndrome (ARDS) is a severe critical condition with a high mortality that is currently in focus given that it is associated with mortality caused by coronavirus disease 2019 (COVID-19). Neutrophils play a key role in the lung injury characteristic of non-COVID-19 ARDS and there is also accumulating evidence of neutrophil mediated lung injury in patients who succumb to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: We undertook a functional proteomic and metabolomic survey of circulating neutrophil populations, comparing patients with COVID-19 ARDS and non-COVID-19 ARDS to understand the molecular basis of neutrophil dysregulation.
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Global citizenship education is full of contradictions and tensions. Neither the global nor citizenship are neutral concepts, and both come with long histories of violence, oppression and exclusion. While global citizenship education has often been discussed from a policy- or institution-level perspective, it is necessary to examine closely the practices that bring this concept to life at the course and individual instructor level, as well as beyond the classroom. In this article, I provide a first-person, first-hand analysis of the shortcomings of implementing global citizenship education in universities through the practice of internationalisation at home (IaH). I analyse a campus environment where US and international students lived and learned together, until they were separated by the COVID-19 pandemic, which brought a new perspective to the (im)possibilities of global citizenship within higher education. In doing so, I search for a pedagogy of dwelling or inhabiting as a possible way of enacting Global Citizenship Education. © 2021 Informa UK Limited, trading as Taylor & Francis Group.
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Objectives. To determine changes in the clinical characteristics and in-hospital outcomes of patients hospitalized for COVID-19 in a private hospital in Caracas during two years of the pandemic. Materials and Methods. Retrospective, observational study of patients hospitalized for COVID-19. We evaluated the correspondence between waves of hospital admissions and circulating variants of SARS-CoV-2 in the general population of the Capital District and Miranda state. Results. A total of 1025 patients (569 men and 456 women) were included, with a mean age of 62.9 SD: 16.2 years. Four waves of hospital admissions were identified: first (March-No-vember 2020) 150/1025 (14.6%) cases;second (December 2020 to May 2021) 415/1025 (40.5%) cases;third (June-December 2021) 344/1025 (33.6%) cases;fourth (January-February 2022) 116/1025 (11.3%) cases. The mean age was higher in the fourth wave (first: 64.0±15.7, second: 61.4±15.8, third: 62.1±16.5, and fourth wave: 68.5±16.4), while the proportion of male patients (first: 66.7%, se-cond: 58.8%, third: 50.3%, and fourth wave: 44.8%), patients with severe-critical illness (first: 65.3%, second: 57%, third: 51.7%, and fourth wave: 44.8%), in-hospital stay (first: 9.1±6.0, second: 9.0±7.3, third: 8.8±7.7, and fourth wave: 6.9±5.0 days), ICU admissions (first: 23.3%, second: 15.7%, third: 14.0%, and fourth wave: 11.2%;p=0.027) and mortality (first: 21. 8%, second: 10.7%, third: 9.1%, and fourth wave: 7.1%;p<0.001) progressively decreased over time. Conclusions. The results show lower frequency of severe cases and improvement of in-hospital outcomes in two years of the pandemic. Changes in circulating variants, improvements in disease management and vaccination are likely to have influenced these results. © 2022, Instituto Nacional de Salud. All rights reserved.