Genomic evolution of SARS-CoV-2 variants of concern under in vitro neutralising selection pressure following two doses of the Pfizer-BioNTech BNT162b2 COVID-19 vaccine (preprint)

Aims: To explore viral evolution during in vitro neutralisation using next generation sequencing, and to determine whether sera from individuals immunised with two doses of the Pfizer BioNTech vaccine (BNT162b2) are as effective at neutralising the SARSCoV2 variant of concern (VOC) Delta (B 1.617.2) compared to the earlier lineages Beta (B.1.351) and wildtype (lineage A.2.2) virus. Methods: Using a live virus SARSCoV2 neutralisation assay in Vero E6 cells we determined neutralising antibody titres (nAbT) in 14 participants (vaccine naive (n=2) and post second dose of BNT162b2 vaccination (n=12), median age 45 years [IQR 29 to 65], median time after second dose = 21 days [IQR 19 to 28] against three SARSCoV2 strains: wild-type, Beta and Delta. The determination of nAbT was performed by visual inspection of cytopathic effect (CPE) and inhouse quantitative reverse transcriptase real time quantitative polymerase chain reaction (RTqPCR) to confirm SARS-CoV-2 replication. A total of 110 representative samples including inoculum, neutralisation breakpoints at 72 hrs, negative and positive controls underwent genome sequencing using the Respiratory Viral Oligo Panel version 2 (RVOP) (Illumina Inc. (San Diego, United States of America)) viral enrichment and short read sequencing using (Illumina Inc. (San Diego, United States of America)),(Figure 1). Results: There was a significant reduction in nAbT observed against the Delta and Beta VOC compared with wildtype, 4.4 fold (p = >0.0006) and 2.3 fold (p = 0.0140), respectively (Figure 2). Neutralizing antibodies were not detected in one vaccinated immunosuppressed participant nor the vaccine naive participants (n=2). The highest nAbT against the SARS-CoV-2 variants investigated was obtained from a participant who was vaccinated following SARSCoV2 infection 12 months prior (Table S1). Limited consensus level mutations occurred in the SARS-CoV-2 genome of any lineage during in vitro neutralisation, however, consistent minority allele frequency variants (MFV) were detected in the SARS-CoV-2 polypeptide, spike (S) and membrane protein. Discussion: Significant reductions in nAbT post vaccination were identified, with Delta demonstrating a 4.4 fold reduction. The reduction in nAbT for the VOC Beta has been previously documented, however, limited data is available on vaccine evasion for the Delta VOC, the predominant strain currently circulating worldwide at the time. Studies in high incidence countries may not be applicable to low incidence settings such as Australia as nAbT may be significantly higher in vaccine recipients previously infected with SARSCoV2, as seen in our cohort. Monitoring viral evolution is critical to evaluate the impact of novel SARSCoV2 variants on vaccine effectiveness as mutational profiles in the sub-consensus genome could indicate increases in transmissibility, virulence or allow the development of antiviral resistance.

Impact of COVID-19 on recorded blood pressure screening and hypertension management in England: An analysis of monthly changes in Quality and Outcomes Framework indicators in OpenSAFELY (preprint)

Background: Cardiovascular disease management in primary care in England was disrupted during the COVID-19 pandemic. Objective: We aim to describe the impact of the COVID-19 pandemic on blood pressure screening and hypertension management, based upon a national quality of care scheme (Quality and Outcomes Framework, QOF) across key demographic, regional, and clinical subgroups. To this end, we translate complex clinical quality of care schemes from text descriptions into reusable analytic code. Methods: With the approval of NHS England, a population based cohort study was conducted on 25.2 million patient records in situ using OpenSAFELY-TPP. We included all NHS patients registered at general practices using TPP software between March 2019 and March 2023. Individuals that were eligible for blood pressure screening and with a diagnosis of hypertension were identified according to the QOF 2021/22 business rules. We examined monthly changes in recorded blood pressure screening in the preceding 5 years in patients aged [≥] 45, recorded hypertension prevalence, and the recorded percentage of patients treated to target (i.e., [≤] 140/90 mmHg for patients [≤] 79 years and [≤] 150/90 mmHg for patients [≥] 80 years) in the preceding 12 months, within demographic, regional, and clinical subgroups as well as the variation across practices. Results: The overall percentage of patients aged [≥] 45 who had blood pressure screening recorded in the preceding 5 years decreased from 90% in March 2019 to 85% in March 2023. Recorded hypertension prevalence was relatively stable at 15% throughout the study period. The percentage of patients with a record of hypertension treated to target in the preceding 12 months reduced from a maximum of 71% in March 2020 to a minimum of 47% in February 2021 in patients aged [≤] 79 years, and from 85% in March 2020 to a minimum of 58% in February 2021 in patients aged [≥] 80 years before recovering. Blood pressure screening rates in the preceding 5 years remained stable in older age groups, patients with a record of learning disability, or care home status. Conclusions: There was substantial disruption to hypertension management QOF indicators during the pandemic, which can likely be attributed to a general reduction of blood pressure screening. OpenSAFELY can be used to continuously monitor monthly changes in national quality of care schemes to identify changes in key clinical subgroups early and support prioritisation of recovery from disrupted care caused by COVID-19.

Multisystem Inflammatory Syndrome in Children

Multisystem inflammatory syndrome in children (MIS-C) is an uncommon but emerging syndrome related to SARS-CoV-2 infection. While the presentation of MIS-C is generally delayed after exposure to the virus that causes coronavirus 2019, both MIS-C and Kawasaki disease (KD) share similar clinical features. Multisystem inflammatory syndrome in children poses a diagnostic and therapeutic challenge given the lack of definitive diagnostic tests and a paucity of evidence regarding treatment modalities. We review the clinical presentation, diagnostic evaluations, and management of MIS-C and compare its clinical features to those of KD.

IMPACT OF VIRTUAL INTERPROFESSIONAL COVID-19 DISASTER SIMULATION TABLETOP EXERCISE (VICTER) WORKSHOP ON DISASTER PREPAREDNESS AMONG INTERPROFESSIONAL TRAINEES IN A TERTIARY CARE TEACHING HOSPITAL IN INDIA

INTRODUCTION: Disaster planning is of significant importance for the healthcare professional and the healthcare setting. Hospital-based disaster protocols form the cornerstone of disaster response. There is a paucity of data on disaster preparedness training using the virtual tabletop exercise (VTTX) module for interprofessional education from in-hospital and prehospital settings. With the coronavirus disease 2019 (COVID-19) pandemic, we have seen a paradigm shift of education strategies to the virtual realm. Here we attempt to study the impact of an online tabletop exercise workshop on the knowledge and confidence of disaster preparedness among Interprofessional trainees. MATERIAL AND METHODS: Interprofessional trainees from medical, dental, nursing, respiratory therapy, and paramedic domains who consented were included in this study. Institutional ethics committee approval was received and the study was registered with the clinical trials registry India (CTRI), before initiation. The VTTX module has been adapted from the World Health Organization (WHO) COVID-19 training resources. Three international experts from the disaster medicine domain validated the module, questionnaire, and feedback. Wilcoxon signed-rank test was used to compare the parameters (Knowledge and confidence level) pre and post-workshop. RESULTS: A total of 76 candidates with a mean age was 21.67 ± 2.5 (range:19-36) were part of the workshop. Comparison of the median scores and interquartile range of confidence level and knowledge respectively before [38 (29.25-45.75), 9 (7-11)] and after [51.50 (45-60), 11 (10-12)] the workshop showed vital significance (p-value < 0.001). All participants gave positive feedback on the workshop meeting the objectives. The majority agreed that the workshop improved their self-preparedness (90%) and felt that the online platform was appropriate (97.5%) CONCLUSIONS: This study sheds light on the positive impact of the online VTTX based workshop on disaster preparedness training among interprofessional trainees. Disaster preparedness training using available online platforms may be effectively executed with the VICTEr workshop even during the COVID-19 pandemic. The VICTEr workshop serves as a primer for developing online modules for effective pandemic preparedness training in interprofessional education. Copyright © 2023 Via Medica.

The effect of consumer lockdown on the relationship between environmental beliefs and pro-environmental behaviors

This study investigates the disruptive effect of the COVID-19 lockdown on the relationship between environmental beliefs and pro-environmental behaviors. We used a survey conducted in the four major cities of Colombia before COVID-19 arrived in December 2019 and then repeated it in October 2020, after most of the major restrictions on mobility and economic activity had been lifted. The survey captured ecocentric and anthropocentric beliefs using the New Ecological Paradigm (NEP) and Pro Environmental Behaviors (PEBS) using 18 questions about energy and water savings, recycling, and sustainable purchasing. In the 2020 survey, we included a measure of the severity of the individual's experience of disruption, including economic, family, and health-related aspects. Controlling for demographic variables, we analyzed (1) descriptive changes in NEP and PEBS, (2) the moderating effect of the disruption on the effect of NEP on PEBS, (3) the direct effect of disruption severity on PEBS, and (4) the moderating effect of severity on the effect of NEP on PEBS in 2020. We found that disruption caused by the lockdown crisis decreased anthropocentric beliefs and slightly increased ecocentric beliefs. This disruption also modified the effects of NEP on PEBS, thereby ameliorating the capacity of NEP to activate PEBS. The severity of experience moderated most of these effects. We discuss the implications of our results for the theory of environmental beliefs and pro-environmental behaviors and offer recommendations to reverse the potential negative effect of the COVID-19 crisis on the promotion of sustainable consumption.

Direct costs of hospital care according to coinfection in adult COVID-19 patients

Objective: To estimate the direct costs of hospital care according to coinfection in adult COVID-19 patients. Material(s) and Method(s): A retrospective follow-up study of adult patients hospitalized for COVID-19 between March and August 2020 at the San Vicente Foundation Hospitals (Medellin and Rionegro, Colombia). Patients whose diagnosis of SARS-Cov2 pneumonia was confirmed by RT-PCR test were included. Death from any cause and length of stay were considered outcome variables. Costs were estimated in 20 20 US dollars. Result(s): 365 patients with an average age of 60 years (IQR: 46-71), 40% female, were analyzed. 60.5% required an Intensive Care Unit (ICU). All-cause mortality was 2.87 per 100 patient-days. Patients admitted to the ICU who developed coinfection had an average length of stay of 27.8 days (SD:17.1) and an average cost of $23,935.7 (SD: $16,808.2);patients admitted to the ICU who did not develop a coinfection had an average length of stay of 14.7 days (SD:8.6) and an average cost of $9,968.5 (SD: $8,054.0). Conclusion(s): A high percentage of patients required intensive care, and there was a high mortality due to COVID-19. In addition, a higher cost of care was observed for those patients who developed coinfection and were admitted to ICU.Copyright © 2023 Asociacion Colombiana de Infectologia. All rights reserved.

TEST ON JUDICIAL ACTIVISM IN SOCIETY IN A CRISIS AGGRAVATED BY PANDEMIA: NECESSARY REFLECTIONS ON RECOMMENDATION 62/2020, NATIONAL COUNCIL OF JUSTICE (CNJ)

After experiences of significant violations of the essential rights to the person as a human being that marked, especially in the 18th and 19th centuries, taking as a landmark the post-World War II, there is an expansion of rights and instruments for their effectiveness, both internally, or international. In this context, a different state stance was demanded: of power centered on an authoritarian monarch followed by the non-interventionist to the State of Social Welfare where the promotion, expansion and instrumentation of rights became essential. In Brazil, with the democratization of the country and the promulgation of a Constitution, the essential foundation of which is the dignity of the human person, the realization of fundamental rights and the respect for separation come to permeate the entire legal system. In that same step, before the legislative option of providing for indeterminate legal concepts plus the "doctrine of the enforcement of fundamental rights”, it allowed the judicial protagonism to expand in the country, more commonly called "judicial activism” which, a priori, has a negative and needs to be contained. With the social and economic crisis aggravated by the covid-19 pandemic, this activist role of the Judiciary is also present, so reflections need to be made. Thus, the present study will be dedicated to the analysis of judicial activism in the context of a pandemic crisis, pointing out positive and negative aspects, based on a qualified doctrinal review and Recommendation 62/2020, by CNJ. © 2022, Universidade do Estado do Rio de Janeiro. All rights reserved.

An Analysis of The Trend of Incidences and Fatality of Pulmonary Tuberculosis in East Java from 2015-2020: A Lesson From COVID-19

Background: Pulmonary tuberculosis is still a public health problem, and surveillance data analysis has not been done much. Recently a global pandemic of COVID-19 has the potential in disturbing TB elimination programs and treatment. This study aims to comprehensively analyse the incidence rate (IR) and Case Fatality Rate (CFR) of pulmonary tuberculosis in East Java from 2015–2020 and during COVID-19 and the strategies for optimizing tuberculosis disease control. Methodology: The study analyzed annual surveillance data using an analytical descriptive design. The Variables were analyzed with Spearman correlation with a level of evidence of 95% (p<0.05). Results: The prevalence of pulmonary tuberculosis in East Java fluctuated from 2015–2020. In 2020 and during the COVID-19 pandemic, the number of cases and morbidity rates increased. Statistic results confirm the presence of a significant correlation between the values of Incidence rate (IR) and Case Fatality rate (CFR) (p = 0.032), IR and Treatment Success Rate (TSR) (p = 0.020), and CFR and TSR (p = 0.002). Population density is not correlated with the number of new cases (p = 0.667). Treatment rates have increased to 51%;cure and treatment rates have decreased to 76% and 89%, respectively, and there was a 4% increase in mortality during COVID-19. Conclusions: COVID-19 has tremendously affected the treatment of pulmonary TB cases in East Java, Indonesia by increasing the incidence rate and decreasing the fatality rate. The pandemic promotes fear in the community to check their medical status and improve the quality of their health in East Java. © The Authors retain the copyrights of this article, with first publication rights granted to Medsci Publications.

Challenges for exercising health advocacy to hospitalized children during the COVID-19 pandemic

Objective: To analyze the challenges for exercising health advocacy to hospitalized children during the COVID-19 pandemic.Methods: This is an online descriptive-exploratory qualitative study. Participants were 28 nursing professionals enrolled in the subject Nursing in Health Care for Children and Adolescents in a graduate program at a federal university in northeastern Brazil. Data collection took place in June 2021 through a conversation wheel and press conference. As instruments, we used Google forms and a semi-structured script. The study was approved by the Research Ethics Committee. As an analysis method, Discursive Textual Analysis (DTA) was used. For data organization, Atlas.ti 8.4.15 software (Qualitative Research and Solutions) was used.Results: Two categories emerged: 1) Impacts of the pandemic on pediatric care and advocacy: child isolation and a health care scenario where children were placed in the background were observed. 2) Existing barriers that worsened with the health crisis: work overload, precarious structure and difficulty in working conditions were identified, which led to violations of children's rights and aggravated the overview of difficulties in the provision of pediatric services.Conclusion: The challenges for exercising health advocacy for hospitalized children during the pandemic, evidenced by the impacts and barriers to care, have expanded health teams' work, making the exercise of advocacy in pediatric care even more difficult. It is necessary to rethink and adjust access and care policies after the pandemic to ensure that child care is not restricted.

Cross-Sectional Study on COVID-19 Prevention and Vaccination Status of Veterinary Colleges in Southeast Nigeria

COVID-19 vaccination and compliance with the established prevention protocols are integral to curbing the spread of the COVID-19 virus;however, there is a paucity of information on compliance with these measures among veterinary schools within southeast Nigeria. To fill this gap, we evaluated the vaccination status and individual's perception of the preventive measures against COVID-19 infections. A cross-sectional study using a self-reported internet-based questionnaire was employed to obtain responses from students and staff of the veterinary colleges in southeast Nigeria. Multivariate binary logistic regression analysis was used to identify significant factors associated with vaccination status and compliance with the COVID-19 prevention protocols by the respondents. A total of 183 individuals participated in the online survey. Although 75% (138/183) of the respondents revealed a willingness to take the COVID-19 vaccine, only 25.1% (46/183) of the respondents had received one or more doses of the COVID-19 vaccine. We observed that male respondents (28 ± 4.4% (95% CI 19-37)) had a higher percentage of vaccinated individuals than female respondents. Furthermore, the academic staff of the veterinary colleges were 39.70 (95% CI 2.50-630.65;p=0.01) times more likely to get vaccinated than undergraduate students. The educational status of the respondent greatly contributed to the willingness to get vaccinated, and individuals within the age bracket of 31 to 40 years were 10.2 ± 1.07 (95% CI 1.33-92.25;p=0.03) times less likely to comply with the COVID-19 prevention protocols. Although a high proportion of the respondents had a good perception of the COVID-19 prevention protocols, only 25.1% of the members of the veterinary colleges in southeast Nigeria had been vaccinated. Therefore, there is a need to create better awareness channels to improve the vaccination status of members of veterinary colleges in southeast Nigeria. © 2023 M. E. Sanda et al.

Music therapy in COVID-19 patients

Background: Music therapy can be used to influence the physical and emotional state of patients diagnosed with COVID-19. An exploratory systematic review was carried out including observational studies and clinical trials, Pubmed and Scopus were the databases used to carry out the literature search. In addition, clinical trial registries from the World Health Organization International Clinical Trials Registry Platform are included. Objective: To explore the available medical literature on the clinical impact of music therapy in patients diagnosed with COVID-19. Development: Of 39 documents found in the search, two articles are included: a clinical trial and a case report, with a total population of 41 patients. Medical evidence is found to support the favorable clinical impact on oxygen saturation, physical rehabilitation and symptoms associated with stress in patients diagnosed with COVID-19 with and without the need for ventilatory support. Conclusions: Music therapy is a useful tool in the non-pharmacological treatment and rehabilitation of patients with COVID-19. However, new clinical studies with a larger number of sample populations and follow-up times using music therapy in this disease are necessary. © 2023, Editorial Ciencias Medicas. All rights reserved.

Procalcitonin as a Prognostic Marker of Complicated Appendicitis

Introduction: Acute appendicitis is the most common cause of acute abdominal pain as well as one of the most frequently performed procedures in general surgery. Different prognostic laboratory markers have been studied to identify patients with complicated appendicitis and it is unknown whether the level of procalcitonin in adults could be used as a predictive marker. From a cut-off point, Does procalcitonin have predictive value for complicated appendicitis? Methods: Prospective, observational study. Patients from the Civil Hospital of Guadalajara with a diagnosis of Appendicitis, presurgical laboratory studies and Procalcitonin, and undergo appendectomy in this institution. A calculated sample was obtained based on the surgeries performed annually. Result(s): 80 appendicectomies were performed in the 12-month period (2021;COVID pandemic) obtaining: 37 patients with uncomplicated appendicitis (Phase I and II) 43 patients with complicated appendicitis (Phase III and IV) The procalcitonin levels of both groups were analyzed to demonstrate differences between them, Mann-Whitney U test gives us as a result a p value <0.05. For the cut-off point at the most suitable procalcitonin level for this sample we decided to use the Yauden index method in the analysis of the ROC curve: it is observed that the cut-off point with a sensitivity of 72.1% and a specificity of 81.1% for the sample is 0.305. Conclusion(s): Procalcitonin has been shown to be a useful marker for discriminating the severity of appendicitis and that the best cutoff point for this sample is 0.3 ng/dl.

Serving a sentence in Italy: Old and new challenges

The Italian system of the enforcement of the sentences has been shaped, since the enter into force of the Italian Constitution in 1948, on the rehabilitation principle but the path towards a real implementation of this pivotal goal is still ongoing. Moreover, conditions like the ones strictly linked to permanent prison overcrowding and reduced economical resources for the implementation of prison and probation staff stand as elements that slow down the achievement of the expected outcomes. In this complicated framework, people that committed a crime can count on a well structured system of alternative measures that have been improved and reinforced during the last twenty years. Despite the ongoing efforts for a better application of such measures, there are still specific issues linked, above all, to the most vulnerable people (foreigners and persons at the margins of the society) that are in the position to experiment substantial discrimination in regard to their lack of the fundamental elements asked by the law for the application of an alternative sanctions. To overcome the many problems still unresolved, the Italian prison and probation system is attaching great importance to the role of restorative justice, as a useful tool for achieving constitutional objectives. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022. All rights reserved.

(Co-)learning and (Co-)evaluation in Scholarly Ecosystem: Challenges and Opportunities in the Covid-19 Era

The study aims at exploring the influence of global coronavirus pandemic on teaching, learning and evaluation processes involved in Higher Education (HE) by analysing the way in which knowledge exchange is reframed through ICTs and technology. Through the interpretative lens of Service Dominant logic, the chapter rereads HE as an ecosystem and investigates theoretically: (1) the transformations introduced in information management, technology adoption, resource integration, value co-creation and co-learning processes to challenge the sanitary emergency;(2) the way in which the adoption of this transformation can redefine the rules, practices and institutions in Higher education system. The results identify the different tech-nological touchpoints that can be implemented in teaching, learning and evaluation to boost co-learning and the different mechanisms that can foster the emergence of social change and innovation. © Springer Nature Switzerland AG 2022.

A Qualitative Investigation of the Impact of the Sars-Cov-2 Pandemic on Goal Attainment Scaling in a Clinical Research Setting

Objectives: Goal Attainment Scaling (GAS) quantifies the effect of interventions on individuals' personal goals. Goals that are meaningful to individual patients are set by GAS interviewers (physicians/academics, experienced in clinical research/trials) in collaboration with patients and/or their caregivers. The SARS-CoV-2 pandemic presented a major challenge to health care worldwide. We investigated how the SARS-CoV-2 pandemic affected the use and implementation of GAS in clinical/research settings. Method(s): Eleven GAS interviewers in Canada, the US, UK and Australia with current/past experience working with patient-caregivers to identify goals and build scales to measure goal attainment as an outcome were interviewed using a semi-structured approach. They described how the pandemic affected GAS use in clinical/research settings. Interviews were recorded and transcribed, then themes were identified and coded in Nvivo 12. Result(s): Most GAS interviews were moved to the virtual environment during the pandemic (9/11). GAS interviewers identified few negative impacts. Some goals required modification (e.g. going to the gym or shops). Pandemic stress impacted both interviewers and interviewees. Even so, most GAS interviewers (8/11) emphasized positive impacts of the pandemic. These were: 1) the virtual environment meant patients were more readily available as they did not need to travel;2) because interviewers did not have to travel, patient recruitment could be expanded into more remote geographical areas;3) researchers could recruit and retain more participants and collect data more quickly;and 4) interviewers commented they became more open to technology because of the pandemic (9/11). Conclusion(s): Despite the challenges of the SARS-CoV-2 pandemic for health care, most GAS interviewers found that the impacts were largely positive for using GAS in clinical/research settings. The ability to deploy GAS through a virtual platform could facilitate the uptake of GAS as a patient-centric outcome measure.Copyright © 2023

Biochemical mechanisms in the severe prognosis of pa- tients with diabetes mellitus infected by SARS-CoV-2 virus: literature review

Diabetes mellitus (DM) is a metabolic disease characterised mainly by signs and symptoms derived from increased serum glucose or hyperglycemia. The coronavirus disease 2019 (COVID-19) pandemic affected the entire world with reports of severe prognosis in diabetic patients infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and high hospital admissions in the intensive care unit (ICU) compared to non-diabetic patients. The objective of the bibliographic review was to evaluate and describe some of the biochemical mechanisms that lead to severe prognosis in patients with DM infected by the SARS-CoV-2 virus through a systematic search for information in different databases. The results showed that the high ICU admission with a severe prognosis of diabetic patients infected by the virus was due to excessive inflammation that causes acute respiratory distress syndrome, cytokine storm, severe pneu-monia, impaired immunity, and hyperglycemia. The virus enters the cell mainly through the endocytic and non-endosomal pathway;the central cellular receptors involved in the mechanisms are insulin receptors (IR), glucose transporter type 2 (GLUT-2), dipeptidyl peptidase-4 (DPP4), glucose transporter type 4 (GLUT-4), glucose converting enzyme angiotensin 2 (ACE2), and the serine transmembrane protease co-receptor 2 (TMPRSS2) essential for viral propagation. The increased susceptibility to devel-oping COVID-19 in diabetic patients is due to the overexpression of ACE2, and serious complications are increased at the microvascular and macrovascular levels, such as nephropathies, neuropathies, and cardiovascular diseases.

Adverse effects post vaccination against COVID-19 in adolescents

Introduction: immunization against Covid-19 can attract short or long-term effects, these can be mild (headache, pain at the puncture site), moderate (nausea, vomiting, diarrhea, rash, fever (>38°), pruritus, lymph node inflamation) or serious (facial paralysis, facial swelling, anaphylaxis, changes in heart rhythm, coagulation disorders, arterial hypertension, transverse myelitis, Guillan Barre syndrome), in the following study will be revealed the effects produced after the application of the vaccine against COVID-19 in adolescents. Objective: to identify the adverse effects after the application of the third dose of the vaccine against COVID-19 in high school students of the Joaquín Lalama Educational Unit. Method: cross-sectional study, with a quantitative approach, of a cross-sectional non-experimental design with a descriptive correlational scope. The study population are adolescents from 14 to 19 years old, high school students of the Joaquín Lalama Educational Unit. For data collection, the questionnaire called COVID-19 Side effects and vaccination was used. For the processing and analysis of the information, the IBPM SPSS statistical platform will be used, as well as tables for its correct interpretation. Results: after the analysis of the surveys applied to adolescents, it was found that there were no serious adverse effects in a large part of the population, but there were mild adverse effects, data similar to other studies carried out by other authors. © 2023, Publicacion de la Asociacion Salud, Ciencia y Tecnologia. All rights reserved.

An Analytical Approach for Dispatch Operations of Emergency Medical Services: A Case Study of COVID-19

: Emergency medical services (EMS) aims to deliver timely ambulatory care to incidents in communities. However, the operations of EMS may contend with suddenly increasing demands resulting from unexpected disasters such as disease outbreaks (e.g., COVID-19) or hurricanes. To this end, it usually requires better strategical decisions to dispatch, allocate, and reallocate EMS resources to meet the demand changes over time in terms of demographic and geographic distribution of incidents. In this study, we focus on the operation of the EMS resources (i.e., ambulance dispatch) in response to a demand disruption amid the COVID-19 pandemic. Specifically, we present a analytical framework to (1) analyze the underlying demographic and geographic patterns of emergency incidents and EMS resources;(2) develop a mathematical programming model to identify potential demand gaps of EMS coverage across different districts;and (3) provide a remedial reallocation solution to the EMS system with the existing ambulance capacity. The proposed method is validated with emergency response incident data in New York City for the first COVID-19 surge from March to April 2020. We found that it takes a long incident response time to scenes which reflects unexpected incident demands during COVID-19 surge. To cover such disruptive demands, ambulances need to be reallocated between service districts while meeting the response time standard. The proposed framework can be potentially applied to similar disruptive scenarios in the future and other operational systems disrupted by other disasters. Highlights: We propose an analytical framework using optimization modeling and simulation techniques for EMS resource allocation in response to a demand disruption amid the COVID-19 pandemic.We propose mathematical programming models to identify potential demand gaps of EMS coverage across different districts.We provide a remedial reallocation solution to the EMS system with the existing ambulance capacity. © 2023, The Author(s).

Integrating the United Nations' sustainable development goals into virtual exchange

This chapter focuses on how to integrate synchronous computer-mediated communication (SCMC)-based virtual exchanges into coursework in teacher preparation programs in higher education. During their 6-week virtual exchange, participants met with partner(s) to discuss their ideas about the United Nations' Sustainable Development Goals (SDGs). In addition to recording their SCMC sessions, participants also completed online worksheets to reflect on their SDG discussion. By focusing on creating activities that coincide with the United Nations' SDGs in a virtual exchange, results showed that participants raised their awareness about the SDGs and created a critically sensitive critical lens, which impacted their learning. In addition to developing content knowledge, these programs were able to internationalize the higher education curriculum through virtual exchange. Students were able to discover things about themselves, their partners, their coursework, and the SDGs with "new eyes." With the recent rush to digital transformation caused by COVID-19, synchronous virtual exchange programs appear to be even more valuable as collaborative learning models. © Springer Nature Switzerland AG 2021. All rights reserved.