Teaching web development courses using flipped classroom and Discord: a two-year experience in the Peruvian context during the COVID-19 pandemic

The Flipped Classroom methodology encourages students to interact with content in multiple ways and professors, who provide active learning strategies to create a super engaging group space that can extend beyond the classroom walls. The purpose of the study was to generate learning scenarios that ensure the good performance of students to achieve the skills in two programming courses at a private university in Peru, making its implementation sustainable over the years. The educational proposal presented in this research made use of the flipped classroom methodology and the Discord platform as an agile means of communication. The results are very encouraging because it allowed students to participate in their own learning in an active and self-directed way so that they self-regulate their own learning path individually and in groups;based on flipped classroom and successfully deployed on the Discord platform. © 2023 IEEE.

Recessions and flattening of the yield curve (1960–2021): A two-way road under a regime switching approach

The one-way relationship that goes from the term spread to recessions has been widely studied. However, the relationship between term spread and the business cycle, in addition to being bidirectional, is conditioned by the cyclical phase itself. To demonstrate this, we have modelled the bidirectional relationship between term spread and the business cycle by extracting two interrelated latent Markov variables: the first, drawn from four activity indicators, replicates the phases of the US business cycle;the second, from the term spread of the yield curve, identifies two regimes: an ordinary regime (positive slope) and a flattening regime. By analyzing both the transition between these regimes and forecasted probabilities, we find that this bidirectional relationship is not symmetrical. That is, the term spread signals a change in the business cycle regime while the cyclical factor only signals the beginning of the ordinary regime of the term spread, not its ending. To illustrate the model, we confirm the beginning of the COVID-19 recession in March of 2020, and the corresponding start of the ordinary regime in the term spread. © 2022 The Author

Impact of the COVID-19 Pandemic on a Cancer Fast-Track Programme.

INTRODUCTION: The COVID-19 pandemic has disrupted many aspects of clinical practice in oncology, particularly regarding early cancer diagnosis, sparking public health concerns that possible delays could increase the proportion of patients diagnosed at advanced stages. In 2009, a cancer fast-track program (CFP) was implemented at the Clinico-Malvarrosa Health Department in Valencia, Spain with the aim of shortening waiting times between suspected cancer symptoms, diagnosis and therapy initiation. OBJECTIVES: The study aimed to explore the effects of the COVID-19 pandemic on our cancer diagnosis fast-track program. METHODS: The program workflow (patients included and time periods) was analysed from the beginning of the state of alarm on March 16th, 2020 until March 15th, 2021. Data was compared with data from the same period of time from the year before (2019). RESULTS: During the pandemic year, 975 suspected cancer cases were submitted to the CFP. The number of submissions only decreased during times of highest COVID-19 incidence and stricter lockdown, and overall, referrals were slightly higher than in the previous 2 years. Cancer diagnosis was confirmed in 197 (24.1%) cases, among which 33% were urological, 23% breast, 16% gastrointestinal and 9% lung cancer. The median time from referral to specialist appointment was 13 days and diagnosis was reached at a median of 18 days. In confirmed cancer cases, treatment was started at around 30 days from time of diagnosis. In total, 61% of cancer disease was detected at early stage, 20% at locally advanced stage, and 19% at advanced stage, displaying time frames and case proportions similar to pre-pandemic years. CONCLUSIONS: Our program has been able to maintain normal flow and efficacy despite the challenges of the current pandemic, and has proven a reliable tool to help primary care physicians referring suspected cancer patients.

E-gene RT-PCR crossing point value and other biochemical parameters as useful markers of death risk in COVID-19 patients

The identification of laboratory markers which predict the outcome of COVID-19 patients is a great concern. Real-time reverse transcriptase–polymerase chain reaction (RT-PCR) has been used to confirm the clinical diagnosis. The aim of this study is to evaluate laboratory parameters of COVID-19 patients as well as to evaluate the RT-PCR crossing point (Cp) value and correlate blood test abnormalities and the Cp value with patients survival. Two hundred thirty patients with positive RT-PCR of SARS-CoV-2 were included in the study. Molecular diagnosis of SARS-CoV-2 was performed by RT-PCR (LightMix, TibMolbiol, Germany). Clinical information, biochemical parameters and Cp values were collected in an anonymized database and variables were analyzed with SPSS v25.0 (IBM Corporation, Armonk, NY, USA). No-survivors were significantly older (>65 years old) than survivors (p=0.007). A higher prevalence of cardiovascular comorbidities in patients who died than in those who survived was found (p=0.002). Statistically significant differences were obtained comparing RT-PCR Cp values for the E-gene of patients who died and those who survived, being lower (<=28) those of patients who died (p=0.004). No-survivors had significantly higher levels of CRP (>100) (p=0.007). E-gene Cp values <=28, which correlate with a high number of copies of SARS-CoV-2, as well as several demographical and biochemical parameters (Age above 65 years old, CRP levels >100 mg/L or cardiovascular comorbidities) could be useful markers of death risk in these patients. © 2021 International Federation of Clinical Chemistry and Laboratory Medicine. All rights reserved.

Análisis de letalidad por COVID-19 en pacientes con demencia neurodegenerativa Case fatality of COVID-19 in patients with neurodegenerative dementia

Introducción La población anciana es la más amenazada por COVID-19, con mayores tasas de mortalidad. El objetivo de este trabajo es analizar la letalidad en una cohorte de pacientes de COVID-19 con demencia degenerativa. Métodos Hicimos un estudio descriptivo de casos-control de una muestra de pacientes diagnosticados con demencias neurodegenerativas primarias. Resultados De los 88 pacientes incluidos en el estudio, 24 pacientes con COVID-19 fallecieron: 10/23 (43,4%) eran pacientes con diagnóstico de demencia y 14/65 (21,5%) pacientes del grupo control, una diferencia estadísticamente significativa. Discusión La letalidad por COVID-19 entre los pacientes con demencia degenerativa primaria es significativamente mayor en comparación con otros pacientes con edades medias y comorbilidades similares, según nuestro estudio.

Predictors of Hospitalization Due to Coronavirus Disease 2019 (COVID-19) at a Veterans Affairs Medical Center

Background. During the COVID-19 pandemic, the Veterans Affairs Long Beach Healthcare System (VALB HCS) saw a surge of patients with a positive SARS-CoV-2 test. There is a lack of guidance on triaging patients with COVID-19 in the clinical literature. To address this need, our study evaluated factors that predicted hospitalization of patients due to COVID-19. Methods. This was a retrospective cohort study of patients with a positive SARSCoV-2 test and medical evaluation at the VALB HCS between August 1 and December 31, 2020. SARS-CoV-2 positive patients admitted to the hospital for a non-COVID-19 related diagnosis were excluded. At the time of initial evaluation, demographic, clinical, and laboratory data, and PCR cycle threshold were collected and compared between patients admitted to the hospital and those managed in the community. A multiple logistic regression analysis was conducted to evaluate predictors for hospitalization due to COVID-19. Results. Of 748 patients, 94 were admitted to the hospital and 654 were community-managed. The outcomes from the logistic regression analysis indicated that the model explained 58.8% of variance and was a significant predictor of hospitalization (X2 [8, 737] = 277.5, p< 0.0001). Patients with self-reported shortness of breath (OR=12.14, 95% CI=6.43-22.92) or diarrhea (OR=2.78, 95% CI=1.33-5.84) were more likely to be hospitalized, whereas patients with sore throat (OR=0.095, 95% CI=0.017-0.53) or body ache (OR=0.42, 95% CI=0.20-0.89) were less likely to be hospitalized than patients not having such symptoms. Every unit increase in patients' age and temperature increased the likelihood of hospitalization by 7.6% and 62.7%, respectively. Every unit increase in patients' diastolic pressure and SpO2% decreased the likelihood of hospitalization by 6.1% and 3.6%, respectively. Conclusion. Our findings indicate that patients with shortness of breath, diarrhea, temperature, and old age were more likely to be hospitalized due to COVID-19. The results may help providers in clinical decision making regarding whether to admit the patient or not. These findings may be especially helpful when hospital bed availability is limited.

Impact of the COVID-19 pandemic in the cancer fast-track programme

Background: The COVID-19 pandemic has disrupted many aspects of clinical practice in oncology, particularly in making timely cancer diagnosis. Our public health system has been concerned about potential delays leading to a higher proportion of patients with advanced stages. Our cancer diagnosis fast-track program (CFP) in the Clinic-Malvarrosa Health department in Valencia (Spain) is connecting primary care (PC) with different specialists to speed cancer diagnosis and treatment upon well founded suspicion. A 10-year evaluation of our CFP has recently been published. The aim of this analysis was to investigate the impact of the COVID-19 pandemic on the CFP. Methods: We analysed the programme flow during the state of emergency starting on March 16, 2020 for one year. Results: During that year, 975 suspected cancer cases were submitted to the CFP. The submissions only decreased during the times of highest COVID-19 incidence and stricter lockdown (March, April and October 2020). However, referrals were slightly higher than in the two previous years (average 877). Of those 975 patients, 817 were seen by the corresponding specialist. A cancer diagnosis was confirmed in 197 (24.1%) with 33% urological, 23% breast, 16% gastrointestinal and 9% lung cancer. Median time from referral to the specialist visit was 13 (interquartile range, 8 to 22 days) days and a diagnosis was reached in a median of 18 days (interquartile range, 10 to 30 days). In cancer patients, treatment was started in around 30 days (interquartile range, 13.5 to 51 days) from the time of diagnosis. Sixty-one percent of cancers were found in an early stage, 20% in a locally advanced stage, and 19% in an advanced stage. These intervals and proportions were similar to the previous years. Conclusions: Our programme has proven to be a reliable tool to help PC physicians referring patients with cancer suspicion cancer, maintaining its normal flow and efficacy despite the current pandemic. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

Case fatality of COVID-19 in patients with neurodegenerative dementia

INTRODUCTION The elderly population is the group most threatened by COVID-19, with the highest mortality rates. This study aims to analyse the case fatality of COVID-19 in a cohort of patients with degenerative dementia. METHODS We conducted a descriptive case-control study of a sample of patients diagnosed with primary neurodegenerative dementia. RESULTS Twenty-four of the 88 patients with COVID-19 included in the study died: 10/23 (43.4%) patients diagnosed with dementia and 14/65 (21.5%) controls;this difference was statistically significant. DISCUSSION Our results suggest that case fatality of COVID-19 is significantly higher among patients with primary degenerative dementia than in other patients with similar mean ages and comorbidities. Resumen INTRODUCCIÓN La población anciana es la más amenazada por COVID-19, con mayores tasas de mortalidad. El objetivo de este trabajo es analizar la letalidad en una cohorte de pacientes de COVID-19 con demencia degenerativa. MÉTODOS Hicimos un estudio descriptivo de casos-control de una muestra de pacientes diagnosticados con demencias neurodegenerativas primarias. RESULTADOS De los 88 pacientes incluidos en el estudio, 24 pacientes con COVID-19 fallecieron: 10/23 (43,4%) eran pacientes con diagnóstico de demencia y 14/65 (21,5%) pacientes del grupo control, una diferencia estadísticamente significativa. DISCUSIÓN La letalidad entre los pacientes con demencia degenerativa primaria por COVID-19 es significativamente mayor en comparación con otros pacientes con edades medias y comorbilidades similares, según nuestro estudio.

Case fatality of COVID-19 in patients with neurodegenerative dementia. / Análisis de letalidad por COVID-19 en pacientes con demencia neurodegenerativa.

INTRODUCTION: The elderly population is the group most threatened by COVID-19, with the highest mortality rates. This study aims to analyse the case fatality of COVID-19 in a cohort of patients with degenerative dementia. METHODS: We conducted a descriptive case-control study of a sample of patients diagnosed with primary neurodegenerative dementia. RESULTS: Twenty-four of the 88 patients with COVID-19 included in the study died: 10/23 (43.4%) patients diagnosed with dementia and 14/65 (21.5%) controls; this difference was statistically significant. DISCUSSION: Our results suggest that case fatality of COVID-19 is significantly higher among patients with primary degenerative dementia than in other patients with similar mean ages and comorbidities.

Miller-Fisher syndrome after SARS-CoV-2 infection.

INTRODUCTION: On March 11th, 2020, the WHO declared the SARS-Cov-2 pandemic. Syndromes have been detected in relation to COVID-19 such as encephalitis, acute necrotizing hemorrhagic encephalopathy and cerebrovascular complications. There are also cases of peripheral nervous system involvement. METHODS: Our case would be the 3rd patient with MFS associated with COVID-19 as far as we know. RESULTS: We present a 51 years old female diagnosed with MFS two weeks after COVID-19. RTPCR to SARS-CoV-2 was negative but IgG was positive. CONCLUSION: Most of the cases were mild or moderate with typical signs and symptoms. All were treated with IV immunoglobulin with good response in most cases. Despite the short evolution time of the cases surviving the current pandemic, the description of cases of post-infectious neurological syndromes suggests that this is probably not an infrequent complication in the subacute stage of Covid-19 disease.

Impact of SARS-CoV-2 infection on neurodegenerative and neuropsychiatric diseases: a delayed pandemic? / Influencia de la infección SARS-CoV-2 sobre enfermedades neurodegenerativas y neuropsiquiátricas: ¿una pandemia demorada?

INTRODUCTION: SARS-CoV-2 was first detected in December 2019 in the Chinese city of Wuhan and has since spread across the world. At present, the virus has infected over 1.7 million people and caused over 100 000 deaths worldwide. Research is currently focused on understanding the acute infection and developing effective treatment strategies. In view of the magnitude of the epidemic, we conducted a speculative review of possible medium- and long-term neurological consequences of SARS-CoV-2 infection, with particular emphasis on neurodegenerative and neuropsychiatric diseases of neuroinflammatory origin, based on the available evidence on neurological symptoms of acute SARS-CoV-2 infection. DEVELOPMENT: We systematically reviewed the available evidence about the pathogenic mechanisms of SARS-CoV-2 infection, the immediate and lasting effects of the cytokine storm on the central nervous system, and the consequences of neuroinflammation for the central nervous system. CONCLUSIONS: SARS-CoV-2 is a neuroinvasive virus capable of triggering a cytokine storm, with persistent effects in specific populations. Although our hypothesis is highly speculative, the impact of SARS-CoV-2 infection on the onset and progression of neurodegenerative and neuropsychiatric diseases of neuroinflammatory origin should be regarded as the potential cause of a delayed pandemic that may have a major public health impact in the medium to long term. Cognitive and neuropsychological function should be closely monitored in COVID-19 survivors.