ABSTRACT
This study aimed to evaluate the feasibility of using low-cost solutions to monitor and mitigate PM2.5 and PM10 concentrations in nursery and primary schools in Porto (Portugal). Three periods were considered: i) early 2020 (before COVID-19 pandemic), ii) early 2021 (during COVID-19 pandemic, with mitigation measures to prevent SARS-CoV-2 spread);and iii) in the middle of 2021 (additionally using a low-cost portable air cleaner). PM2.5 and PM10 were continuously monitored with a low-cost sensing device for at least two consecutive days in five classrooms. In general, the lowest PM concentrations were observed in the third period. Concentrations reduced up to 63% from the second to the third period. The application of low-cost solutions for monitoring and mitigating PM levels seems to be an effective tool for managing indoor air in schools. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.
ABSTRACT
Due to the COVID-19 pandemic, governments imposed several mobility restrictions which can be used to evaluate their impact on air quality and generate better-targeted policies to improve it. Therefore, this study aimed to define sustainable mitigation measures to reduce air pollution based on quantifying the impacts of the restrictions imposed during the COVID-19 pandemic on air quality in Portugal. Thus, hourly concentrations of PM10, PM2.5, NO2, O3, CO and SO2 were obtained from the Portuguese Air Quality Monitoring Network. Data was then divided into six periods (2020–2021) and compared with the corresponding historical periods (2015–2019). Furthermore, the satellite data of NO2, CO, and absorbing aerosol index (AAI) from the sentinel-5P TROPOMI was collected to complement the analysis conducted for the monitoring data. Overall, air quality improved in all study periods and areas, except in industrial sites. The satellite data corroborated the results herein achieved and thus validated the real effect of the measures adopted in the country during the pandemic on air quality. Sustainable policies to improve air quality could include remote (or hybrid) work whenever possible as a long-term measure and prohibition of travelling between municipalities when an extraordinary event of high air pollution is predicted or occurs. Other policies should be adopted for industrial areas. Given this, and as the restrictive mobility measures had a strong effect on reducing air pollution, the post-COVID era represents an opportunity for society to rethink future mobility and other emerging policies, that should favour softer and cleaner means of transportation. © 2022 The Authors. Sustainable Development published by ERP Environment and John Wiley & Sons Ltd.
ABSTRACT
Introduction Coronaviruses traditionally are considered to cause pulmonary diseases, often accompanied by gastrointestinal symptoms. Since the COVID-19 pandemic start in early 2020, there have been reports of a high prevalence of neuropsychiatric symptoms. Recent data show significant rates of neuropsychiatric diagnosis over the subsequent 6 months post-infection. Some of the data suggest the COVID-19 as a cause of new-onset psychotic symptoms in patients with no psychiatric history. Delusions, hallucinations, disorganized thoughts, and confusion were the most frequently reported psychotic features which low doses of antipsychotics seem to be helpful. Objectives Brief literature review about the relationship between COVID-19 and new-onset psychotic symptomatology. Methods Non-systematic review through PubMed research using the terms “COVID-19”, “SARS-CoV-2”, “pandemics”, “psychotic symptoms” and “psychosis”. Results The severity of the infection, especially in those with the need for hospitalization/intensive care, seems to have a clear effect on the gravity of subsequent neuropsychiatric symptoms, namely psychosis. Viral invasion of the central neural system, hypercoagulable states, and neuroinflammation are potential associated mechanisms. It’s important to consider the effect of therapies that may have the potential to cause psychosis (eg steroids). According to recent literature, around 0.9-4% of people exposed to the COVID-19 virus develop psychotic episodes, which is much higher than the incidence in the general population. Conclusions Post-COVID-19 related psychosis has been reported in different nations. The pathophysiology is yet not clear, although the hyperinflammatory response has been suggested as the main mechanism for the neuropsychiatric manifestations. Given the high number of case reports with similar presentations, it’s important to proceed with more investigations. Disclosure No significant relationships.
ABSTRACT
Introduction Since the COVID-19 pandemic start in early 2020, there have been reports of a high prevalence of neuropsychiatric symptoms. Cognitive impairment is being increasingly recognized as an acute and possibly long-term sequel of the disease. According to recent data, limited evidence point to SARS-CoV-2 having a preferential neurotropism for the frontal lobes, as suggested by behavioral and dysexecutive symptoms, frontotemporal hypoperfusion on MRI, EEG slowing in frontal regions, and frontal hypometabolism on 18F-FDG-PET. Nevertheless, there isn’t a specific biomarker. Objectives Brief literature review about the relationship between COVID-19, cognitive impairement onset and risk for dementia. Methods Non-systematic review through PubMed research using the terms “COVID-19”, “SARS-CoV-2”, “pandemics”, “cognitive impairement”, “dementia” and “risk factor”. Results Direct neuronal infection via angiotensin-converting enzyme 2 receptor (ACE2R), hyperinflammation, brain ischemia related to respiratory failure or thromboembolic strokes, and severe psychological stress are the mechanisms more associated with a deleterious effect on cognition. The relation between SARS-CoV-2 infection and neurodegenerative diseases is still unclear. However, the high expression of the ACE2R in the brain, may explain the acute brain damage and could also be the basis for later neurodegenerative changes. The potentially long-term nature of the deficits makes it important to do an early identification, management, rehabilitation and follow-up of the patients exhibiting cognitive symptoms. Conclusions Given the reports of brain damage by SARS-CoV-2, there are concerns that this damage may substantially increase the incidence of neurodegenerative diseases and promote dementia. Further long-term studies may be required to identify the relationships between SARS-CoV-2 infection and risk for dementia. Disclosure No significant relationships.
ABSTRACT
BACKGROUND AND AIMS: Patients on renal replacement therapy are reported to have altered humoral immunity, which is demonstrated by a decreased response to different vaccines. However, in kidney transplant (KT) patients, vaccines are even less immunogenic in terms of antibody response. Therefore, these patients have a higher risk of critical infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which makes them eligible for early vaccination. The aim of this study was to compare the humoral response after complete vaccination against SARS-CoV-2 between KT patients and peritoneal dialysis (PD) patients. METHOD: We conducted a single-center, retrospective study, which included 67 KT recipients and 49 prevalent PD patients. Patients were excluded if they had previously known SARS-CoV-2 infection or positive anti-nucleocapsid IgG or IgM antibodies. Completion of vaccination was defined as two doses of a messenger RNA vaccine (BNT162b2 messenger RNA vaccine [Pfizer-BioNTech] or messenger RNA- 1273 [Moderna]), two doses of viral vector vaccine ChadOx1 nCoV-19/AZD1222 (AstraZeneca) or one dose of JNJ-78 436 735 (Janssen) vaccine. Anti-spike (anti-S) IgG antibodies were measured, at least, 21 days after the completion of vaccination and before receiving a 'booster' dose. A value of anti-S >0.8 U/mL was considered positive. Immunogenicity of the vaccine, measured by anti-spike IgG antibodies, was compared between KT recipients and PD patients. RESULTS: The mean age of the population was 58.8 ± 13.6 years and 62.0% were males (similar between the two groups). The median interval between completion of vaccination and serologic analysis was 4.1 months in KT patients and 7.1 months in PD patients. In KT patients, the median anti-S level was 1.50 U/mL (IQR 0.0-27.3) versus 97.0 U/mL (IQR 34.5-447.0) in PD patients (P < .001). In the KT group, there were 31 (46.3%) non-responders (patients without detectable levels of anti-S), while in the second there were only two (4.1%). In KT patients, anti-S levels were not associated with time since transplant or immunosuppressive induction therapy. In PD patients, anti-S levels were not associated with time since the beginning of PD. In both groups, anti-S levels were not associated with age, gender, type of administered vaccine or interval between completion of vaccination and serologic analysis. CONCLUSION: We found a significant difference in humoral responses to the vaccine between PD and KT transplant patients with no previous exposure to SARSCoV- 2. In PD patients, the vaccine seemed to be effective. On the contrary, KT patients had a significantly weaker rising of anti-S titers, with a high proportion of patients not responding to the vaccine. This study emphasizes the negative impact of immunosuppression on humoral responses, reinforcing the need for a 'booster' dose in this group of patients.
ABSTRACT
BACKGROUND AND AIMS: Chronic kidney disease (CKD) patients, especially those on renal replacement therapy, have a higher risk of infection and worse clinical outcomes after coronavirus disease 2019 (COVID-19) than the general population. Thus, this population must be promptly immunized against COVID-19. We aimed to assess the humoral response after two doses of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) vaccine in peritoneal dialysis (PD) patients. We also aimed to identify potential factors associated with vaccine response and the prevalence of COVID-19 in a PD unit. METHOD: We conducted a single-center, retrospective study to evaluate the immunogenicity in terms of antibody response after COVID-19 vaccination. Three types of vaccine [BNT162b2 messenger RNA vaccine (Pfizer-BioNTech), messenger RNA-1273 (Moderna) and ChadOx1 nCoV-19/AZD1222 (AstraZeneca)] were administered in the PD unit. The detection of anti-spike IgG antibodies (with a cutoff of 0.8 U/mL) was done at least after 21 days of the two vaccine doses. We also evaluated the presence of COVID-19 infections, hospital admissions (including in intensive care unit) and deaths. RESULTS: This study enrolled 70 prevalent patients. We excluded patients with only one vaccine dose (n = 4), those who did not consent to the collection (n = 5) or were vaccinated before starting PD (n = 11). Among the 50 patients included, the mean age was 59 ± 15 years, 60% were male and the dialysis vintage was 22.1 (IQR 6-34.3) months. Six (12%) patients were receiving immunosuppressive therapy and 16 (32%) had diabetes. The mean interval between administration of the second vaccine dose and antibodies evaluation was 7.2 ± 0.7 months. Overall, after two doses, there was a significant increase in antibody level, with median of 1495 (IQR 37.8- 546.8) U/mL. Only two (4%) patients did not increase their antibody level (remained seronegative). History of immunosuppressive therapy was associated with no response after two doses (91.7% versus 8.3%, P = 0.012). There were two COVID-19 infections after the complete vaccination, with mild symptoms (one with hospital admission). Furthermore, there were no intensive care unit admissions or deaths. CONCLUSION: We found that immunization against COVID-19 was effective in generating an overall humoral response and in preventing severe disease in CKD patients on PD, which emphasizes the importance of the vaccination against COVID-19 in this population. These results also suggest the impact of the immunosuppressive therapy on vaccine response in PD patients.
ABSTRACT
BACKGROUND AND AIMS: Patients on maintenance hemodialysis (HD) experience a heavy burden of the disease and frequently report poor quality of life (QoL) scores.[1,2] During the coronavirus 2019 (COVID-19) pandemic, additional challenges were posed to this vulnerable group. Restriction policies affected social contact and physical activity, even leading to intradialytic exercise programs' suspension.[3] Few studies analyze the impact of the pandemic on the QoL of this population. Thus, we aimed to assess the QoL of HD-dependent patients during the pandemic. METHOD: This is a retrospective single-center study. Demographic data originated from electronical medical records. The health-related QoL EQ-5D-5L questionnaire, developed by the EuroQol Group in 2005 and widely used for various diseases, was applied and assessed the five following self-reported scores: health (0-100 points), mobility (1-5 points), self-care (1-5 points), usual activities (1-5 points), pain/discomfort (1-5 points) and anxiety/depression (1-5 points).[4] With the exception of health, higher scores relate to greater difficulties, as inverted scales. Patients undergoing regular HD who filled in the questionnaire during the pandemic and at least one year prior were included. IBM® SPSS ® 27 software was used for statistical analysis. RESULTS: A total of 71 patients were included with a predominance of the male gender (54.9%). The median age was 77 years (IQR = 18 years) and the median time on HD was 78 months (IQR = 99 months). Thirty patients had diabetes (42.25%). During the pandemic, 12 patients (16.9%) had COVID-19. Analyzing the different QoL scores, no difference was reported concerning health (mean score 67.89 ± 18.3 versus 65.23 ± 20.6;T = 1.059, P = 0.297, IC (95%) = (-2.1;7.6);d = 0.126), usual activities (mean score 1.8 ± 1.09 versus 1.97 ± 1.32;T (71)= -1.136, P = 0.260, d = -0.135), pain/discomfort [mean score 1.8 ± 0.95 versus 2.07 ± 1.13;T (71) = -0.894, P = 0.260, d = -0.374], and anxiety/depression [mean score 1.8 ± 0.82 versus 1.94 ± 1.04;T (71) = -1.055, P = 0.295, d = 0.125] comparing with the pre-pandemic period. There was a statistically significant decrease in mobility (mean score of 1.96 ± 1.09 versus 2.44 ± 1.34) with moderate size effect [T (71) = -3.525, P < 0.001, d = -0.418]. There was also a statistically significant decrease in self-care (mean score of 1.45 ± 0.86 versus 1.82 ± 1.43) with small size effect [T (71) = -2.983, P = 0.004, d = -0.354). There were no differences in any score when adjusting to diabetes or COVID-19. CONCLUSION: During the pandemic, most QoL scores appear to have been unaffected. Higher resilience among these patients and the support from caregivers and healthcare professionals might have contributed to better coping during this period. Nonetheless, mobility seems to have become compromised and movement restrictions could have accelerated this process. Therefore, even in such times, promoting physical activity may play a role in improving the QoL of HD-dependent patients.
ABSTRACT
Populists use constitutional change to perform three functions: deconstruct the former constitutional order, develop a substantial project rooted in criticism towards such order and consolidate their power. The great paradox that comes from these matters is that, while possibly facing populist legislative or executive powers, the constitutional courtrooms will be those that, at the end of the day, will defend political liberalism and the democratic system by interpreting the powers and rights in a political and legal field. How do the Courts apply the exercise of their political power? Can the constitutional jurisdiction exercise an “abusive judicial review” and legitimize undemocratic practices to consolidate the populist regime such as the criminalization of politics? This paper goes on to analyze the performance of the Federal Supreme Court (STF) in the responses to Allegations of non-Compliance with Fundamental Precepts (ADPFs) between March 2020 and February 2021 to verify if the political path of the exercise of power by the STF in the Covid-19 pandemic intends to consolidate or legitimize abusive practices of the powers or play an important role in the protection of democracy under the threat of regression. The investigation is based on the following elements: doctrine, documents, and official decisions issued by the STF and on the constitutions and case studies applied in the comparative field. The methodology emphasizes Comparative Law and can be defined as political-legal scientific research. © 2022 Centro Universitario de Brasilia. All rights reserved.
ABSTRACT
Three concurrent global environmental trends are particularly apparent: human population growth, urbanization, and climate change. Especially in countries such as Ethiopia in the Global South, all three are impacted by, and in turn have bearing upon, social justice and equity. Combined, these spatial and social factors reduce wellbeing, leading to increasing urgency to create urban environments that are more livable, resilient, and adaptive. However, the impacts on, and of, non-human urban residents, particularly on the ecosystem services they provide, are often neglected. We review the literature using the One Health theoretical framework and focusing on Ethiopia as a case-study. We argue for specific urban strategies that benefit humans and also have spillover effects that benefit other species, and vice versa. For example, urban trees provide shade, clean the air, help combat climate change, create more livable neighborhoods, and offer habitat for many species. Similarly, urban neighborhoods that attract wildlife have characteristics that also make them more desirable for humans, resulting in improved health outcomes, higher livability, and enhanced real-estate values. After summarizing the present state of knowledge about urban ecology, we emphasize components relevant to the developing world in general and pre- COVID-19 pandemic Ethiopia in particular, then expand the discussion to include social justice and equity concerns in the built environment. Prior to the ongoing civil war, Ethiopia was beginning to invest in more sustainable urbanization and serve as a model. Especially in light of the conflict and pandemic, much more will need to be done. Copyright © 2022 Perry, Gebresenbet, DaPra, Branco, Whibesilassie, Jelacic and Eyob.