Building learning through graphic organizers in higher education

In recent years, technology applied to education has advanced by leaps and bounds;Pressured by the Covid-19 pandemic, it has been necessary to move from face-to-face to virtual, which has required teachers to show the full potential of digital tools, such as visual organizers. The objective of the research was the interpretation of the utility of graphic organizers (GO) for the acquisition of learning in higher education students. The methodology used was qualitative, a type of basic research of hermeneutic design;Through interviews with teachers with expertise in GO, interviews were conducted with teachers with extensive experience in the use of GO, processing the information with AtlasTi. As a result, the relevance of using the GO in higher education teaching was obtained, while emerging categories were obtained that will allow the best interpretation of the study variable. It is concluded that the use of GO has a positive significance in the assimilation of new knowledge to achieve significant learning. © 2022, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.

Simultaneous systemic thrombosis as a manifestation of COVID-19.

BACKGROUND: The current COVID-19 pandemic mainly affects the respiratory system;however, with the increase in cases worldwide, there is evidence of compromise at the cardiovascular level, which can manifest as acute myocardial infarction, myocarditis, pericarditis, myopericarditis, heart failure, cardiogenic shock, vasculitis, deep vein thrombosis, pulmonary embolism, ischemic stroke, acute arterial insufficiency, arrhythmias, and sudden death. CLINICAL CASE: A 70-year-old male patient who simultaneously presented multisystemic thrombosis manifested by cerebral vascular event, pulmonary thromboembolism, acute myocardial infarction and acute arterial insufficiency in the context of SARSCoV-2 pneumonia. CONCLUSION(S): In patients with COVID-19 there is a high thrombogenic potential secondary to blood stasis, hypercoagulability and endothelial dysfunction, which worsens the prognosis and increases mortality, mainly in patients who require ICU stay, so an adequate thromboprophylactic or anticoagulant scheme and follow-up in the convalescent phase must be provided to detect sequelae associated with COVID-19.Copyright © 2022 Comunicaciones Cientificas Mexicanas S.A. de C.V.. All rights reserved.

Proteomic determinants of disease, mortality and sequelae in COVID-19 patients requiring invasive mechanical ventilation

Introduction: The molecular mechanisms linked to the pathology of severe COVID-19 and its outcomes are poorly described. Aim(s): To analyze the proteomic profile of bronchial aspirates (BAS) samples from critically ill COVID-19 patients in order to identify factors associated with the disease and its prognosis. Method(s): Multicenter study including 74 critically ill non-COVID-19 and COVID-19 patients. BAS was obtained by bronchoaspiration after invasive mechanical ventilation (IMV) initiation. Proximity extension assay (PEA) technology was used for proteomic profiling. Random forest (RF) statistical models were used to predict the variable importance. Result(s): After adjusting for confounding factors, CST5, NADK, SRPK2 and TGF-alpha showed differences between COVID-19 and non-COVID-19 patients. Reduced levels of ENTPD2 and PTN were observed in non-survivors, even after adjustment. AGR2, NQO2, IL-1alpha, OSM and TRAIL, were the top five strongest predictors for ICU mortality and were used to build a prediction model. PTN (HR=4.00) ENTPD2 (HR=2.14) and the prediction model (HR=6.25) were associated with higher risk of death. In survivors, FCRL1, NTF4 and THOP1 correlated with lung function (DLCO levels) 3-months after hospital discharge. Similar findings were observed for Flt3L and THOP1 and radiological features (TSS). The proteins identified are expressed in immune and non-immune lung cells. A poor control of viral infectivity and an inappropriate reparative response seems to be linked to the disease and fatal outcomes, respectively. Conclusion(s): In critically ill COVID-19 patients, specific proteomic profiles are associated with the pathology, mortality and lung sequelae.

Proteomic profiling of severe lung diffusion impairment in the recovery stage of COVID-19-induced ARDS

Background: Around 80% of patients who developed COVID-19-driven ARDS present lung ailment. There is a lack of knowledge of the mechanisms that mediate the pulmonary outcomes. Aim(s): To characterize the factors linked to diffusion impairment in survivors of severe COVID-19. Method(s): Prospective cohort study including 87 COVID-19-induced ARDS survivors. A complete pulmonary evaluation was performed 3 months after hospital discharge. 364 proteins were quantified using the proximity extension assay (PEA). Partial least square-discriminant analysis (PLS-DA) and random forest (RF) were used for multivariable analyses. Result(s): Moderate to severe diffusion impairment (DLCO<60% predicted) was observed in the 30% of the cohort. 15 proteins were differentially detected [false discovery rate (FDR)<0.05] in the univariate analysis. Pleiotrophin showed the highest differences (fold change=2.22 and FDR=0.001). In continuous analysis, proteins were inversely and independently associated with DLCO, and in some cases showed a robust dose-response relationship. PLS-DA and RF identified proteomic profiles related to the severity of diffusion capacity. Clusters identified were enriched in mediators of cell proliferation and differentiation, tissue remodeling, angiogenesis, coagulation, inflammation, immune response and fibrosis. Proteins are expressed in immune and non-immune lung cells. Conclusion(s): In survivors of COVID-19-driven ARDS, lung dysfunction is linked to plasma factors involved in injury and repair mechanisms. The host proteomic profile provides a novel understanding of post-acute sequelae and may be source of therapeutic strategies and biomarkers.

Mortality incidence for SARS-COV-2 non-survivor infected in Colombia: A potential vaccination priority guide based on Comorbidities

The SARS-CoV-2 vaccination plan development in Colombia, set to begin in February 2021, included a comprehensive assessment of the spread to set population priorities in rank-ordered phases. In Phase 3 of the plan, populations between 16 and 59 years with a set of specific comorbidities will be vaccinated. Our study aims to evaluate the comorbidities incidence in the survival probability to assess the population at most risk if infected and assist in the assignation on this phase. In this study, multivariate Cox regression and Kaplan-Meier curves were performed to determine risk predictors of mortality for 610 reports of up to 15-day decay non-survivor SARS-CoV-2 infected in Colombia. After implementation, higher hazard ratios were associated with diabetes. Kaplan-Meier curves indicate that patients with diabetes that have an older age and hypertension are at a higher risk of earlier death. © IEOM Society International.

Pulmonary function and radiological features in survivors of critical COVID-19: A 3-month prospective cohort

Background More than 20% of hospitalized patients with coronavirus disease 2019 (COVID-19) develop acute respiratory distress syndrome (ARDS) requiring intensive care unit (ICU) admission. The long-term respiratory sequelae in ICU survivors remain unclear. Aim: To perform a detailed characterization of the long-term pulmonary sequelae in critical COVID-19 survivors. Study Design and Methods Consecutive patients with COVID-19 requiring ICU admission were recruited and evaluated 3 months after hospitalization discharge. The follow-up comprised symptom and quality of life, anxiety and depression questionnaires, pulmonary function tests, exercise test (6-minute walking test (6MWT)) and chest computed tomography (CT). Results 125 ICU patients with ARDS secondary to COVID-19 were recruited between March and June 2020. At the 3-month follow-up, 62 patients were available for pulmonary evaluation. The most frequent symptoms were dyspnea (46.7%), and cough (34.4%). Eighty-two percent of patients showed a lung diffusing capacity of less than 80%. The mean distance in the 6MWT was 401±93 mts. CT scans were abnormal in 70.2% of patients, showing reticular lesions in 49.1% and fibrotic patterns in 21.1%. Patients with more severe alterations on chest CT had worse pulmonary function and presented more degrees of desaturation in the 6MWT. Factors associated with the severity of lung damage on chest CT were age and prone position during the ICU stay. Interpretation Pulmonary structural abnormalities and functional impairment are highly prevalent in surviving ICU patients with ARDS secondary to COVID-19 3 months after hospital discharge. Pulmonary evaluation should be considered for all critical COVID-19 survivors 3 months post discharge.

Nature tourism on the colombian—ecuadorian Amazonian border: History, current situation, and challenges

Global conflicts can severely affect a nation’s tourism activities. Tourism can also be seriously affected by health problems such as epidemics or pandemics. It is important to establish strategies to be prepared for adverse situations. The objective of this study focused on analyzing nature tourism from a post-conflict and post-COVID-19 situation in the Amazonian border of Colombia (Department of Putumayo) and Ecuador (Province of Sucumbíos), which will contribute to establishing future strategic management scenarios. In order to respond to this objective, a systematic bibliographic review was carried out, accompanied by fieldwork (interviews). The results indicate that in the face of adverse situations, the tourism industry has the capacity to be resilient. The success of its recovery will be directly proportional to its capacity to create policies and strategies that allow it to take advantage of natural resources and turn them into an opportunity for the socioeconomic development of its population. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Coping, resilience, and emotional wellbeing in pharmacy students during the COVID-19 pandemic

Introduction: In March 2020, the World Health Organization declared the COVID-19 outbreak a pandemic impacting the mental wellbeing of the general public. Pharmacy students may experience greater stress during this pandemic due to interruptions in classes or rotations, concerns regarding personal/family health, and social isolation from peers. These changes may result in behavior shifts, difficulty concentrating, and increased use of negative coping strategies. The extent to which these factors affect overall student wellbeing during a pandemic is largely unknown. Research Question or Hypothesis: The purpose of this study was to assess coping, resilience, personal characteristics, and emotional wellbeing among pharmacy students during the COVID-19 pandemic. Study Design: This was a cross-sectional study of three pharmacy programs in California, Florida, and North Carolina, after the onset of the COVID-19 pandemic via an online, anonymous 71-item questionnaire using REDCap software during May-July 2020. Methods: The Emotional Wellbeing in Healthcare Professions Students Questionnaire (EWB-Q) assessed coping, personal resilience, personal characteristics in pharmacy students and determined emotional wellbeing vis-à-vis these factors. Linear regression and descriptive statistics analyses were conducted using SPSS v.26. Results: Multiple linear regression indicated levels of coping strategies, personal resilience, and ethnicity (Hispanic vs. non-Hispanic) explained a significant amount of the variance (approximately 30%) in emotional wellbeing scores of pharmacy students (N = 104). A significant regression equation was found, F(2,76) = 11.785, P < .000, R2 = .317, R2 adjusted = .291). No differences were noted between students in didactic coursework vs. rotations. Greater use of coping strategies, higher levels of resilience, and identifying as Hispanic were significant predictors of increased emotional wellbeing. Conclusion: Student mental health continues to be of importance, especially during crises and pandemics. Therefore, pharmacy programs should cultivate emotional wellbeing of their students. Campus-based initiatives may be needed to encourage healthy coping behaviors and bolster students' personal resilience to better prepare them for providing front-line patient care in the future.