Teleconsultation in respiratory medicine - A position paper of the Portuguese Pulmonology Society.

The COVID-19 pandemic crisis, among so many social, economic and health problems, also brought new opportunities. The potential of telemedicine to improve health outcomes had already been recognised in the last decades, but the pandemic crisis has accelerated the digital revolution. In 2020, a rapid increase in the use of remote consultations occurred due to the need to reduce attendance and overcrowding in outpatient clinics. However, the benefit of their use extends beyond the pandemic crisis, as an important tool to improve both the efficiency and capacity of future healthcare systems. This article reviews the literature regarding telemedicine and teleconsultation standards and recommendations, collects opinions of Portuguese experts in respiratory medicine and provides guidance in teleconsultation practices for Pulmonologists.

Reduction of the Nutritional Diagnosis of Eutrophy Among Brazilian Adolescents, Evaluation from 2010 to 2021

Introduction: Identifying the nutritional diagnosis of adolescents is crucial for developing public health strategies that promote the adequate development of this population. Objective(s): To analyze the temporal trends of the BMI of Brazilian adolescents (10 to 19 years old) between 2010 and 2021. Method(s): Descriptive ecological study. Data obtained from e-SUS Primary Care. The prevalence rate of the categories was obtained: severe thinness (ST), thinness (T), eutrophic (E), overweight (OW), obesity (OB), and severe obesity (SOB), and the trend was calculated by segmented linear regression, the variations annual percentages (APCs). In addition, time-series analysis was performed in the Joinpoint Regression Program. Result(s): In the analysis of the country as a whole, the BMI showed a decreasing character in the categories 'ST' (APC:-2.7;p=0.029) and 'E' (APC:-3.8;p=0.008). BP' (APC: 3.0;p<0.031), 'OB' (APC: 9;1;p<0.001) and 'SOB' (APC: 29.6;p=0.012). The highest annual percentage reduction (APC-) of 'E' occurred between 2019 and 2020 (67.78% -> 64.17%). The highest APC+ of 'OW', 'OB' and 'SOB' occurred between 2019 and 2020 ('SB': 18.25% ->19.97%;'OB':7.91% ->10.46%;'SOB':1.8% -> 2.41%). 'ST' was stationary in the Northeast and decreasing in the others 'T' showed an increasing character in the Northeast, Southeast, and South. In all regions, 'E' had a decreasing trend, while we observed an increasing character in the prevalence of 'OW', 'OB' and 'SOB'. Conclusion(s): The growing trend of the 'OW', 'OB' and 'SOB' categories in the last 12 years evidence exposure to risk factors harmful to the development of this population, such as the intake of hypercaloric foods and a sedentary lifestyle. In addition, the increase in 'MA' in some regions highlights the country's socioeconomic inequalities and differences in nutritional profile. The most considerable reduction in 'E' and the most significant increase in 'OW' and 'OB' in the 2019-2020 period can be attributed to the Covid-19 pandemic's impact on the habits of this population.

Understanding Stakeholders’ Perspectives Towards Serious Games for Vocational Training for People with Intellectual Disabilities in Macau

People with intellectual disabilities need vocational training and support in order to be able to get into the work market and maintain their workplace. In Macau SAR, China, the vocational training ecosystem still operates in fully classic, in-person, fashion, which means it is susceptible to pandemic situations such as COVID-19. This causes a big disruption to the training when isolation measures are in place. Our goal is to study the introduction of serious games for vocational training of people with disabilities in Macau. This work presents a study to assess the training benefits of serious games and usability factors, understand the acceptability and adoption factors/benefits of serious games for vocational training for people with intellectual disabilities and associated stakeholders in Macau. © 2022, IFIP International Federation for Information Processing.

Design of a Simulator for Ventricular Assistance Devices

Recent research shows that the number of patients with heart disease is still bigger than Covid 19 disease. Some indicators in Brazil indicate about 400,000 deaths per year. Because of heart disease, heart failure is responsible for the main cause of hospitalization of patients over 65 years of age. Part of these patients eventually developed one or more severe disease because of heart disease, leaving as clinical alternatives, treatments, and more aggressive procedures such as heart transplantation. The current scenario for patients waiting for a heart transplantation is actually aggravated each day by the pandemic. Other problem is the organ rejection that is 15% of mortality rate. Then a clinical alternative that can provide support and improve the life quality of patients with heart failure is the mechanical circulatory assistance devices. This kind of device is aiding and/or substitutes in cardiovascular function and it is recognized by the medicine showing satisfactory results over the years. However, the homologation of this kind of device to clinical use is hard and these devices need to be submitted to exhaustive tests, in distinct phases. “In Vitro” validations are applied, a test performed in simulators, whether they physical, computational or hybrid and “In Vivo”, a test that is performed on animals. After these validations, clinical evaluations are started for equipment approval. In this context, the objective of this work is to present the design, construction and functioning of a physical fluid dynamic simulator, which allows testing in ventricular assist devices, with the ability to reproduce the variations of systolic and diastolic blood pressure, as well as the other phenomena related to the functioning of the cardiovascular system. For the project, we used a review of the historical line of the simulators, concepts of hydraulics, anatomy of the human cardiovascular system, heart diseases and PID control algorithms from the theoretical basis. The construction of the physical plant is finished and some tests are made presenting excellent results. The simulator is equipped with two tanks, one proportional control valves, recirculation systems, two level control sensors, blood flow meters, an Microcontroller with a PID control algorithm and a man machine interface developed in android platform. The tests demonstrated the full functioning of the simulator, with the automatic stabilization of the levels, pressure and flow. The tests were made based on the patient body conditions and the variation parameters were observed of the ventricular assist device response. Then the some heart disease were simulated with the modulation of the valve and the monitoring of the ventricular assist device flow as a function of the setpoint change, all these parameters inserted and monitored through a cellular application. (Figure Presented).

Beyond Masks: On the Generalization of Masked Face Recognition Models to Occluded Face Recognition

Over the years, the evolution of face recognition (FR) algorithms has been steep and accelerated by a myriad of factors. Motivated by the unexpected elements found in real-world scenarios, researchers have investigated and developed a number of methods for occluded face recognition (OFR). However, due to the SarS-Cov2 pandemic, masked face recognition (MFR) research branched from OFR and became a hot and urgent research challenge. Due to time and data constraints, these models followed different and novel approaches to handle lower face occlusions, i.e., face masks. Hence, this study aims to evaluate the different approaches followed for both MFR and OFR, find linked details about the two conceptually similar research directions and understand future directions for both topics. For this analysis, several occluded and face recognition algorithms from the literature are studied. First, they are evaluated in the task that they were trained on, but also on the other. These methods were picked accordingly to the novelty of their approach, proven state-of-the-art results, and publicly available source code. We present quantitative results on 4 occluded and 5 masked FR datasets, and a qualitative analysis of several MFR and OFR models on the Occ-LFW dataset. The analysis presented, sustain the interoperable deployability of MFR methods on OFR datasets, when the occlusions are of a reasonable size. Thus, solutions proposed for MFR can be effectively deployed for general OFR. © 2022 IEEE.

FocusFace: Multi-task Contrastive Learning for Masked Face Recognition

SARS-CoV-2 has presented direct and indirect challenges to the scientific community. One of the most prominent indirect challenges advents from the mandatory use of face masks in a large number of countries. Face recognition methods struggle to perform identity verification with similar accuracy on masked and unmasked individuals. It has been shown that the performance of these methods drops considerably in the presence of face masks, especially if the reference image is unmasked. We propose FocusFace, a multi-task architecture that uses contrastive learning to be able to accurately perform masked face recognition. The proposed architecture is designed to be trained from scratch or to work on top of state-of-the-art face recognition methods without sacrificing the capabilities of a existing models in conventional face recognition tasks. We also explore different approaches to design the contrastive learning module. Results are presented in terms of masked-masked (MM) and unmasked-masked (U-M) face verification performance. For both settings, the results are on par with published methods, but for M-M specifically, the proposed method was able to outperform all the solutions that it was compared to. We further show that when using our method on top of already existing methods the training computational costs decrease significantly while retaining similar performances. The implementation and the trained models are available at GitHub.

Surgical training during the COVID-19 pandemic – a single institution’s trainee survey

Background: Few studies have assessed the impact of COVID-19 on surgical training in low- and middle-income countries. The aim of this study was to survey the effect of the COVID-19 pandemic on postgraduate surgical training, research and registrar wellbeing in South Africa. Methods: A cross-sectional study was conducted as an online survey from 5 October 2020 to 1 December 2020. The study population was registrars from all surgical disciplines at the Faculty of Medicine and Health Sciences of Stellenbosch University. The survey consisted of 26 multiple-choice and five open-ended qualitative questions on the impact of COVID-19 on physical and mental wellbeing, skills acquisition and postgraduate research. Results: Of 98 surgical registrars, 35 (36%) responded. Twenty-three (65.7%) reported missed planned surgical rotations, 30 (85.7%) decreased surgical training time, and 22 (62.9%) reported a perceived decrease in training quality. Simulated skills training was only available to eight (22.9%) participants. Twenty-four (68.6%) experienced burnout and/or depression symptoms during the pandemic. Twenty-seven (77.1%) reported that postgraduate research was unaffected by the pandemic. Conclusion: During the COVID-19 pandemic, surgical trainees at this institution reported a decrease in the quality of surgical training and skills acquisition and a negative impact on their mental wellbeing.

My Eyes Are Up Here: Promoting Focus on Uncovered Regions in Masked Face Recognition

The recent Covid-19 pandemic and the fact that wearing masks in public is now mandatory in several countries, created challenges in the use of face recognition systems (FRS). In this work, we address the challenge of masked face recognition (MFR) and focus on evaluating the verification performance in FRS when verifying masked vs unmasked faces compared to verifying only unmasked faces. We propose a methodology that combines the traditional triplet loss and the mean squared error (MSE) intending to improve the robustness of an MFR system in the masked-unmasked comparison mode. The results obtained by our proposed method show improvements in a detailed step-wise ablation study. The conducted study showed significant performance gains induced by our proposed training paradigm and modified triplet loss on two evaluation databases. © 2021 Gesellschaft fur Informatik (GI). All rights reserved.

THE IMPACT of SARS-COV-2 in VASCULAR SURGICAL ACTIVITY in A TERTIARY HOSPITAL

Introduction/Objectives: The Corona Virus Disease 0/2019 (COVID-19) has taken a major toll on the public health system, with restrictions in all clinical activity, from consultations and exams to number and type of surgeries. Patients apprehension to resort to medical aid and hospitals leads to late admissions and, in our perception, more severe presentations of the underlying pathology, namely, in Chronic limb threatening ischemia (CLTI). Need for testing prior to non-emergent surgery causes larger delays in the referral of patients, and this, added to the reduction of surgical times andlCU availability, potentially results in worse outcomes. The aim of this study was to objectively evaluate the type pathology that was treated during the emergency state and to compare the outcome of the surgical procedures with the same period of 2018 and 2019. Methods: A retrospective analysis of the patient charts from patients submitted to surgery in the months of March and April of the year 2020 was conducted and compared to the same period on the previous two years. The primary endpoint was death at 30 days or during hospital stay and the secondary endpoints were pathology classification, grade of ischemia, amputation, amputation level, type of surgery (endovascular, conventional or hybrid), time of hospital stay and reintervention. Results: There were 98 patients submitted to surgery in the COVID period (CP), compared to 286 in the Non-COVID period (NCP). There was no significant difference in the age (70 years (17-98) in the CP vs. 69 (17-92) in the NCP, p=.i3) or sex profile of the patients (76% male (n=74) in the CP vs. 70% (n=i96) in the NCP, p=.26). There was no statistical differ¬ence in mortality (5% (n=5) in the CP vs. 5% (n=i3) in the NCP, p=.88). There was a statistically significant decrease in conventional surgery (43% (n=u2) in the CP vs. 57% (n=i6 4) in the NCP, p=.04), but no statistically significant difference in length of hospital stay(io (0-77) days in the CP vs. 7 (0-118) in the NCP, p=.6), and reintervention (18% (n=i8) in the CP vs. 16% (n=45) in the NCP, p=.s8). PAD corresponded to 75% (n=73) of the admissions in the CP vs. 48% (n=i37) in the NCP, p=.02. CLTI corresponded to 99% (n=70) of the PAD population in the CP, vs. 93% (n=n 4) in the NCP, p=.i, with a significant increase in the number of patients presenting with Rutherford Grades 5 and 6 (81% (n=57) in the CP, vs. 68% (n=77) in the NCP, p=.03). There was a non-significant decrease in amputation rate (35% (n-25) vs. 40% (n=49J, P-49) and increase of major limb amputation (52% (0=13) vs. 39% (n=i9), p=.27). The second mostfrequent pathology was aneurysmal aortic and iliac disease, but there was a statistically significant reduction in the number of patients treated (5% (n=s) in the CP vs. 13% (n=36) in the NCP, p=.os). All aortic aneurysms treated in 2020 were ruptured (100% (n=s) vs. 42% (n=is) in the NCP, p=o.2). There was no significant difference in mortality in urgent aortic aneurysm repair between groups (60% (n=3) in the CP vs. 47% (n-7) in the NCP, p-.77). Conclusions: COVID-19 restrictions manifested mainly in the type of pathology treated and the number of patients operated on. The gravity of the underlying pathology, manifested by more serious wounds and advanced CLTI at presentation, did not increase mortality nor was reflected on limb amputations rates. Aortic and iliac aneurismal disease was the second most common pathologytreated but with a significant decrease in total number of cases and no significant difference in mortality.

Beliefs and Values Towards Sustainable Development in the Age of Covid-19

Sustainable development is a relatively new concept, nurtured by both public and private international organizations. It remains to be seen whether the concept has become rooted within societies, or if it is mainly a tool of public policy and the political elites. This contribution looks at the various dimensions of the beliefs and values regarding the concept of sustainable development, by collecting data and reviewing the relevant literature on the issue. The pandemic of Covid-19, that started in early 2020, in China, may have been a turning point, and we question if this has increased the societal dimension of sustainable development, by forcing a change of lifestyles. However, the obligation to reduce consumption and pollution is not the same as sharing values on sustainable development or, more generally, being concerned about the impact of human activities on the environment. In order to assess the changes of paradigms in the beliefs and values towards sustainable development, the article looks at the way the states, and the civil societies, including the business sector, have changed and adapted their positions on this issue before and following the pandemic. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

My Eyes Are up Here: Promoting Focus on Uncovered Regions in Masked Face Recognition

The recent Covid-19 pandemic and the fact that wearing masks in public is now mandatory in several countries, created challenges in the use of face recognition systems (FRS). In this work, we address the challenge of masked face recognition (MFR) and focus on evaluating the verification performance in FRS when verifying masked vs unmasked faces compared to verifying only unmasked faces. We propose a methodology that combines the traditional triplet loss and the mean squared error (MSE) intending to improve the robustness of an MFR system in the masked-unmasked comparison mode. The results obtained by our proposed method show improvements in a detailed step-wise ablation study. The conducted study showed significant performance gains induced by our proposed training paradigm and modified triplet loss on two evaluation databases. © 2021 IEEE.

Sars-CoV-2 Infection in Lung Transplant Patients - Single Center Experience in Portugal

Introduction Lung transplant (LT) patients are immunosuppressed and it is yet to be determined if immunosuppression plays a role in SARS-CoV-2 infection. Due to this lack of information about COVID-19 in solid transplant patients, case series are of utmost importance. We report two cases of LT patients with COVID-19 at our LT center. Case Report We report a 60-year-old man submitted to a bilateral LT due to COPD in January 2020. Immunosuppression: basiliximab as induction and prednisolone, mycophenolate mofetil and tacrolimus as maintenance therapy. He was discharged 47 days post-operatively. Six months after LT, as routine screening to an elective endoscopy for previously controlled Barret's esophagus, RT-PCR of naso-pharyngeal swabs detected SARS-CoV-2 RNA, assuming the diagnosis of COVID-19. He was hospitalized for monitoring despite being asymptomatic. Oxygen saturation was always higher than 97% at room air. Leukocyte was 5.730 × 10

Social networks as a tool for brands to communicate: The use of instagram during the covid – 19 pandemic

The use of social networks by the main Spanish brands as a tool to communicate their contents is discussed in this article. This analysis is focused on the use of Instagram during the lockdown period caused by the crisis of COVID-19. The main purpose wich are the characteristics used by the different brands took. The analysis the messages, images and other available resources found in Instragran, shows that in their publications brands convey not only their commercial aspect, but also a human and emotional side. This has been confirmed by the use of static images and no typical hashtags related to this crisis as well as the use of messages of support, encourageme nt and tranquillity uploaded by its employees in their publications. © 2021, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.

Predictors of the intention to maintain social distancing

This research aimed to develop an Intention to Maintain Social Distancing Scale (IMSDS) based on the Theory of Planned Behavior (TPB). The model establishes that the variables attitudes, subjective norms and perceived behavioral control are predictors of the intention to maintain social distancing (IMSD). The methodological design was an online survey with non-probabilistic sampling. The survey included 786 Brazilian participants, mostly residents of the southern region of the country. The TBP variables explained 85% of the IMSD variation: subjective norms (β = 0.69), attitudes (β = 0.24) and perceived behavioral control (β = 0.06). These results provide evidence of what are the underlying beliefs that influence the IMSD. This evidence is relevant to public and private organizations in the process of developing strategies to promote and engage the population in adopting the behavior of “maintaining social distancing” in Brazil. In the discussions, the practical implications are presented, pointing out the limitations of the research and the possibilities for future studies on IMSD. © 2020, Fundacao Getulio Vargas. All rights reserved.