In-hospital diagnosis of tuberculosis (TB)in non-HIV patients: the impact of the COVID-19 pandemic

Introduction: The COVID-19 pandemic brought unprecedented consequences to healthcare systems, deeply affecting the efforts on TB prevention, case detection and management. Aim(s): To evaluate the impact of the COVID-19 pandemic on in-hospital diagnosis of tuberculosis in non-HIV patients. Method(s): Single-center retrospective study comparing adult hospitalised patients with TB not associated with HIV infection, admitted from March 2018 to June 2019 (pre-pandemic) with those admitted from March 2020 to June 2021 (pandemic). Result(s): From a total of 100 cases, 58 and 42 were admitted in the pre and pandemic periods, respectively. Patients tended to be younger in the pre-pandemic group (54.5 years vs 63.0 years) but in both groups, most were male (75.9% vs 78.6%). Immunosuppression status was significantly higher in the pre-pandemic group (p=0.002). Bilateral lesions were more frequent in the second period (p=0.035) and a significant increase in disseminated tuberculosis cases in immunocompetent patients (p=0.009) was observed in the pandemic group. Concerning patients with negative sputum smears at presentation and patients with numerous (>50/field) bacilli, a statistically significant difference was not achieved (p=0.055). During the pandemic period, the length of stay was longer (median, 19.5 days [IQR 9.75-51.00] vs. 40.5 days [IQR 13.25-67.25]) and mortality was lower (12.1% vs 4.8%). Conclusion(s): In the pandemic period, less immunocompromised patients hospitalized with TB were seen, there was an increase in extended pulmonary forms, a significant rise of disseminated tuberculosis in immunocompetent patients and a tendency to find a greater proportion of numerous bacilli on smears.

Multiplier effects of social protection: a SVAR approach for Brazil

Based on a Structural VAR approach, we estimated fiscal multipliers for social benefits in Brazil for 1997–2018. Our results suggest that social benefits have relatively large multiplier effects, even when compared to public investment. The multipliers are also larger in the full sample, which includes the country's 2014–16 economic crisis than in the period 1997–2014. In particular, our results show that spending one unit on social expenditures generates a final change in GDP of almost three after two years. The higher estimated multipliers in the full sample appear in the response of household consumption and private investment to shocks in total social expenditures and for different types of social benefits (e.g. cash transfers, unemployment insurance, and pensions). In a context in which the expansion of social protection became prominent as a response to structural changes in the labor market and the Covid-19 pandemic, our paper reinforces its potential role in the short-run economic recovery. © 2022 Informa UK Limited, trading as Taylor & Francis Group.

AFMC: An alignment framework for multiple computing services and providers

The Hirschberg algorithm is commonly used for protein sequence alignment, which is a very important task in bioinformatics. This article presents the AFMC framework for using the Hirschberg method to perform sequence alignment in multiple cloud computing services of different models, such as Infrastructure-as-a-Service and Function-as-a-Service (FaaS). Experiments were carried out in which several instances of AWS EC2, Azure VMs and Google Compute Engine as well as varied configurations of AWS Lambda, Azure Function, and Google Cloud Function were used to pairwise align COVID-19 spike proteins. The services were submitted to different levels of simultaneity to align the genetic sequences. The findings reveal that there is a tradeoff between predicted execution time and cost for this application, for example, FaaS-oriented cloud service models generally took less time to process the workloads. On the other hand, it was observed that, as the level of concurrence increased, there was a marked augmentation in cost. In this context, a framework that provides multi cloud solutions for bioinformatics such as AFMC is essential. © 2023 John Wiley & Sons, Ltd.

Outcomes Of Centenaries Hospitalized Due To COVID-19 In A Private Healthcare System

Introduction. Life expectancy is increasing worldwide. However, during the COVID-19 pandemic, people 100 years or more (centenaries) were challenged by a potentially fatal disease. We evaluated the outcome of centenaries hospitalized due to COVID-19 in a private healthcare system of Belo Horizonte/Brazil (Unimed-BH). Methods. Administrative data were collected from the hospital database. Patients were included if they had a severe adult respiratory syndrome due to coronavirus type 2 (SARS-CoV-2) ribonucleic acid identified by quantitative real-time reverse transcriptase polymerase chain reaction (RT-qPCR) or by the International Code of Disease- 10th review (ICD-10) hospitalization codes U07.1, B34.2, or B97.2. Results. From March 1 2020 to October 31 2021, 316.4 & plusmn;12.9 centenaries/month were registered. Eighteen hospitalizations due to COVID-19 were identified. Median age was 101.8 years (interquartile range [IQR]:100.7,103.0). Most patients were female (83%). There was a median of 6.0 morbidities per patient (IQR:5.3,7.8), range 2-12 morbidities, among 71 possible morbidities. The most described morbidities were systemic arterial hypertension (94%), dementia (61%), and congestive heart failure (61%). Median length of hospitalization was 6.5 days (IQR:3.3,8.0). No patient was dialyzed. Seven (39%) patients died during hospitalization, of whom 3 (17%) were admitted to the Intensive Care Unit and 2 (11%) were oxygenated by invasive mechanical ventilation. No other patients were admitted to the Intensive Care Unit or invasively mechanically ventilated. Conclusions. Although the hospitalization rate was low, the mortality rate during hospitalization was high among centenaries. Further research is required to evaluate the actual risks of centenaries to be infected by SARS-CoV-2 and the subsequent outcomes.

Adherence to protective mechanical ventilation in COVID-19 versus non-COVID-19-associated acute respiratory distress syndrome: Comparison between two prospective cohorts.

OBJECTIVE: To compare adherence to protective mechanical ventilation (MV) parameters in patients with acute respiratory distress syndrome (ARDS) caused by COVID-19 with patients with ARDS from other etiologies. DESIGN: Multiple prospective cohort study. SETTING: Two Brazilian cohorts of ARDS patients were evaluated. One with COVID-19 patients admitted to two Brazilian intensive care units (ICUs) in 2020 and 2021 (C-ARDS, n=282), the other with ARDS-patients from other etiologies admitted to 37 Brazilian ICUs in 2016 (NC-ARDS, n=120). PATIENTS: ARDS patients under MV. INTERVENTIONS: None. MAIN VARIABLES OF INTEREST: Adherence to protective MV (tidal volume ≤8mL/kg PBW; plateau pressure ≤30cmH2O; and driving pressure ≤15cmH2O), adherence to each individual component of the protective MV, and the association between protective MV and mortality. RESULTS: Adherence to protective MV was higher in C-ARDS than in NC-ARDS patients (65.8% vs. 50.0%, p=0.005), mainly due to a higher adherence to driving pressure ≤15cmH2O (75.0% vs. 62.4%, p=0.02). Multivariable logistic regression showed that the C-ARDS cohort was independently associated with adherence to protective MV. Among the components of the protective MV, only limiting driving pressure was independently associated with lower ICU mortality. CONCLUSIONS: Higher adherence to protective MV in patients with C-ARDS was secondary to higher adherence to limiting driving pressure. Additionally, lower driving pressure was independently associated with lower ICU mortality, which suggests that limiting exposure to driving pressure may improve survival in these patients.

Dificuldades Encontradas Pelas Ligas De Hematologia Do Brasil

Introducao: As ligas academicas possuem papel decisivo na vida do estudante, pois, por meio delas, o individuo explora a sua autonomia, criticidade e comprometimento. Alem disso, o aluno procura as ligas tambem para suprir a necessidade de experiencia clinica e de qualificacao profissional. E notorio que muitas ligas enfrentam obstaculos em suprir as demandas dos participantes, seja em funcao da dificuldade de encontrar professores para ministrar aulas, da realizacao de pesquisas ou da disponibilidade de projetos de extensao. O objetivo desse trabalho e, portanto, discutir os principais obstaculos que as Ligas de Hematologia do Brasil enfrentam. Metodologia: Foi realizada uma pesquisa quantitativa por meio da aplicacao de questionarios online direcionados a ligas academicas de hematologia do Brasil, no ano de 2020. O questionario foi destinado a 44 ligas, sendo a taxa de resposta de 72,7%. Esta pesquisa foi aprovada pelo comite de etica da instituicao proponente sob o CAAE 24510719.2.0000.0029. Os dados foram analisados pela ferramenta Excel 2013, para analise descritiva e foram codificados, de forma a garantir o sigilo dos participantes. Resultados: Ao ser questionado as ligas sobre a publicacao de trabalhos em congressos, 78,1% afirmaram que fazem esse tipo de publicacao. Das 32 ligas analisadas, 75% possuem atividade de extensao, sendo 91,7% com contato direto com os pacientes. Alem disso, 71,9% possuem dificuldades em promover um projeto de extensao, por conta de diferentes motivos. Dessas ligas analisadas, 93,8% tem professor orientador e 40,6% tem dificuldades em encontrar professores dispostos a ministrar aulas sobre o assunto. Discussao: Na extensao universitaria, parte do tripe ensino-pesquisa-extensao, as Ligas de Hematologia conseguem desenvolver alguma atividade de extensao na grande maioria, no entanto encontram dificuldades na elaboracao dos projetos, possivelmente por falta de professores orientadores para auxiliar nas atividades e a necessidade de recursos e estrutura para a realizacao desses. A falta do professor orientador hematologista pode tambem estar relacionada ao menor numero de medicos especialista em hematologista no Brasil, que, apesar de terem aumentado nos ultimos anos de acordo com a Demografia Medica de 2018, ainda sao poucos em comparacao a outras especialidades. Para as atividades de ensino e pesquisa o advento das atividades online, durante a Pandemia da COVID-19, pode ter sido fator positivo que possibilitou as Ligas a realizacao de aulas online com especialistas de outras cidades e estados, alem de orientacao de trabalhos a distancia, mas, para confirmar tal relacao, novos estudos seriam necessarios. Conclusao: As Ligas, apesar de enfrentarem obstaculos, mantem atividades nos pilares de pesquisa, ensino e extensao, principalmente com regularidade de aulas e publicacoes cientificas, sendo, portanto, necessario mais estudos que possam analisar as causas especificas dos problemas. Copyright © 2022

Personality and adherence to the COVID-19 vaccine: the role of agreeableness and openness traits

Aim: This study aimed to verify the relationship between personality traits and commitment to vaccination against COVID-19. Material and methods: The sample consisted of 595 Brazilian adults aged 18-72 years, who answered the Big Five Inventory 2 Short (BFI-2-S) and a COVID-19 Vaccine Questionnaire. Results and discussion: Higher scores in agreeableness and openness were associated with a higher probability of adhering to the vaccination program, and higher scores in extroversion and lower scores in agreeableness were associated with poor adherence to the vaccination, anti-vaccine movement, and conspiracy beliefs against the vaccine (p <= .01). These results show the agreeableness and openness traits seem to be crucial for adherence to the vaccination program. Conclusion: The findings indicate the importance of acknowledging agreeableness and openness traits as relevant in the adherence to the public policies programs against the COVID-19 pandemic.

Distance education in higher education: Modern applications and management courses

Distance education became a reality, increasingly based on higher education. The pandemic context (COVID-19) that devastated many countries and the whole world in general proved this reality and presented a different proposal in education and even in people's lives. It has changed the educational system, and there has been much discussion about e-learning and remote teaching in digital learning environments, yet they are quite different terms. This chapter aims to study what exists to date about distance learning in higher education, with a special focus on business administration courses. To get the full benefit of online learning, new strategies and learning methodologies are applied, and information and communication technology can play a fundamental role here. © 2022, IGI Global.

SCHOOL WHEN THERE’S NO SCHOOL: THE COVID-19 PANDEMIC FROM THE CHILDREN’S POINTS OF VIEW

This article discusses the meanings of school for children between 8 and 12 years old amid class suspension over the COVID-19 pandemic. The comprehension of the children’s points of view is based on the recognition of their rights and their ability to participate in social life, as demonstrated by childhood studies in the social sciences. We analyze survey data collected from 2.021 children in Belo Horizonte Metropolitan Region (Brazil). Results indicate that children understand school as a place which has a wide range of functions, among which learning, care, and sociability are included. © 2022, Centro de Estudos Educacao e Sociedade - CEDES. All rights reserved.

Exercise and lifestyle education program for people living with diabetes and prediabetes in Brazil: a pilot randomized trial

Background: Lifestyle changes are crucial to preventing diabetes and its cardiovascular complications, including maintaining a physically active lifestyle. Morever, patient education is essential to promote diabetes self-management and health condition control. However, programs that combine physical exercise and lifestyle education are still poorly implemented in low- and middle-income countries, such as Brazil. The Diabetes College Brazil Study is a pioneer randomized clinical trial (RCT) designed to promote behavioral changes in adults with diabetes and prediabetes. PURPOSE: To test the feasibility, acceptability, and preliminary effectiveness of Diabetes College Brazil Study interventions (Exercise (Ex) vs. Exercise and Lifestyle Education (ExLE)) as part of the preparation for the development of the RCT. Methods: This pilot randomized trial (NCT03914924) had two parallel arms: ExLE program (12 weeks of exercise and educational interventions) and Ex program (12 weeks of exercise intervention only) (Figure 1). Feasibility (eligibility, recruitment, retention, completeness of RCT variables measures and participation rates), acceptability (satisfaction with interventions), and preliminary effectiveness of interventions (comparison of RCT variables measured in pre-and post-assessments) were evaluated. The preliminary effectiveness of the interventions was analyzed from the values of the difference between post-and pre-intervention measures (Δ post-pre) using both per-protocol (PP) and intention to treat (ITT) analysis for the comparison between groups (Ex vs. ExLE). The value 0 was imputed to replace the missing data in the analysis that followed the ITT principle. The results were reported as estimates of effect (95% confidence interval (CI) of the difference) for variables with normal distribution. RESULTS: Thirty-seven individuals participated in the study (ExLE: n = 18, 56.9±9.5 years old, 55.6% female, 5.6% prediabetes;Ex: n = 19, 59.5±7.3 years old, 52.6% female, 21.1% prediabetes). Eligibility, recruitment and retention rates were 16%, 100% and 82% respectively. The completeness of RCT variables measures was higher in the pre-intervention assessment. Missing data in the post-intervention assessment were mainly related to modifications in research procedures due to the COVID-19 pandemic. Participation rates in supervised exercise sessions and education classes were 76% and 71%, respectively (total sample). Interventions were highly acceptable to participants. There was a trend towards better results in the ExLE than Ex for most variables, mainly for physical activity level and quality of life (Table 1). Conclusion: The interventions are feasible and acceptable to participants. The results of this trial indicate the potential clinical benefit of lifestyle educational intervention associated with exercise intervention for people with diabetes and prediabetes. (Figure Presented).

Personality and adherence to the COVID-19 vaccine: the role of agreeableness and openness traits

Aim: This study aimed to verify the relationship between personality traits and commitment to vaccination against COVID-19. Material and methods: The sample consisted of 595 Brazilian adults aged 18-72 years, who answered the Big Five Inventory 2 Short (BFI-2-S) and a COVID-19 Vaccine Questionnaire. Results and discussion: Higher scores in agreeableness and openness were associated with a higher probability of adhering to the vaccination program, and higher scores in extroversion and lower scores in agreeableness were associated with poor adherence to the vaccination, anti-vaccine movement, and conspiracy beliefs against the vaccine (p ≤ .01). These results show the agreeableness and openness traits seem to be crucial for adherence to the vaccination program. Conclusion: The findings indicate the importance of acknowledging agreeableness and openness traits as relevant in the adherence to the public policies programs against the COVID-19 pandemic. © 2022 Polish Psychiatric Association. All rights reserved.

Differences of venous thromboembolism (Vte) events in COVID-19 and non-COVID-19 hospitalized patients

Background : Although the novel coronavirus disease 2019 (COVID-19) has been associated with an increased risk of venous thromboembolism (VTE), different VTE incidences are reported according to the population profile. Aims : To compare risk factors, prophylaxis regimens, laboratory data, incidence and mortality rates of VTE associated with COVID-19 and non-COVID-19 patients, hospitalized in an institution with best practices in thromboprophylaxis. Methods : We retrospectively analyzed all confirmed cases of VTE (pulmonary embolism [PE] and/or deep vein thrombosis [DVT]) reported in electronic medical records diagnosed at admission, during hospitalization or readmitted to the hospital within 90 days after discharge, between January/2020 and February/2021. Characteristics of VTE events associated with COVID-19 and VTE associated with other diseases (non-COVID patients), were compared. Results : Over the study period, 177 patients presented VTE events (63.8% male, mean age 63.8 ± 18.9 years, 38.4% confirmed COVID-19;85% critically ill patients). Clinical characteristics were summarized in Table 1. In contrast to non-COVID group, COVID-19 patients were predominantly male (78% vs. 55%;P = 0.002) and older (66 vs. 61 years old ;P = 0.034), had less clinical risk factors for VTE, and developed VTE more frequently during hospital stay, despite using higher doses of enoxaparin (Tables 1 and 2). Mortality rate was higher in the COVID group (38.2% vs. 5.5%;P < 0.0001). Additionally, COVID group presented higher D-Dimer levels (17481 ± 26278 UI/ ml vs. 7291 ± 11708 UI/ml;P = 0.004), but similar C-reactive protein levels (12.5 ± 11.8 vs.13.8 ± 79.2;P = 0.892). Regarding critically ill patients, COVID-19 was associated with an increased risk of VTE compared to non-COVID group (5.6% [34/602] vs. 0.5% [20/3690], unadjusted OR = 10.98 [95% CI 6.3-19.2;P < 0.00001]) (Table 2). Conclusions : Despite of having less clinical risk factors for VTE and using greater doses of enoxaparin, COVID-19 patients had higher incidence of In-hospital VTE and higher mortality rate. These findings suggest that a hypercoagulability state could be induced by the coronavirus itself. .

Use of D-dimer as a predictor of venous thromboembolism events (VTE) in COVID-19 patients

Background : D-Dimer (DD) values are often elevated in coronavirus disease 2019 (COVID-19), but its role as a diagnostic test of VTE is controversial. Aims : To analyze the performance of DD in the VTE events diagnosis in a cohort of COVID-19 patients. Methods : We retrospectively analyzed, from March/2020 to February/2021, all cases of proven COVID-19 submitted to a compression ultrasound (CUS) or CT pulmonary angiogram (CTPA) to investigate deep venous thrombosis [DVT] and/or pulmonary embolism [PE]. DD levels were recorded at hospital admission and at the day (±24 h) of each imaging studies. DD levels were categorized into 3 groups according to terciles, in order to determine VTE risk. ROC curve analysis was used to determine optimal DD cut-off to predict VTE. Results : From 717 COVID-19 admissions, we identified 169 patients (median age 65 years [20-103], 66% male) submitted to a 208 imaging studies (74 CTPA, 134 CUS). In the overall cohort, 54 (32%) patients had VTE diagnosis according to 62 positive exams (39 CUS and 23 CTPA). Confirmed VTE patients had higher median levels of DD at admission (2364 vs. 831 ng/mL;P = 0.004) and at the day of exam (7013 vs. 1378 ng/mL;P < 0.0001). The AUROC for DD and VTE at admission and at the day of imaging study was 0.72 (95%CI,0.63-0.81) and 0.80 (95%CI,0.73-0.87), respectively. The best DD cut-off point to predict VTE was 2000 ng/mL (86% sensitivity, 63% specificity). Greater values of DD were associated with an increased rate of VTE diagnosis: group I≤1200 ng/mL: 7.6%;group II-1201-5000 ng/mL: 35.8% and group III>5000 ng/mL: 60.3% ( P < 0.001). The OR of group II and III vs. group I was 6.8 (95%CI 2.4-19.3;P < 0.0001) and 18.5 (95%CI6.6-52.0;P < 0.0001), respectively. Conclusions : In a cohort of hospitalized COVID-19 patients, DD test was a good discriminator of VTE events. Serial measurements of DD could help physicians to initiate anticoagulation therapy in COVID-19 patients suspected of VTE diagnosis.

Society Against Chance: netwoRk Theory and the new Coronavirus pandemic

In this brief work, we try to present in a didactic way some fundamentals of the so-called network theory, more specifically the concepts of “small world effect”, “giant component” and “percolation”, which help in understanding the fast spread of the new coronavirus pandemic. As a theory organized based on dialogue between different disciplines, such as physics, mathematics, biology and sociology itself, we believe it is essential to expand the contact of social scientists with the main concepts and empirical findings in this transdisciplinary field. © 2021. All Rights Reserved.

Celebrating 45 Years of the Brazilian Society of Automatics

The Brazilian Society of Automatics, Sociedade Brasileira de Automatica (SBA) in Portuguese, celebrated its 45th anniversary during the XXIII Congresso Brasileiro de Automatica (CBA) in a virtual platform due to the global pandemic of coronavirus COVID-19. In this paper, the authors have summarized its activities since 2002. The previous activities before 2002 were presented in Revista Controle & Automacao da SBA. This magazine became Journal of Control, Automation and Electrical Systems after 2012 published by Springer.

Stay home? Forced evictions and Covid-19

The purpose of this paper is to verify if the Supreme Court, Superior Court of Justice, Federal Court of Appeals of the 2nd Circuit and the Rio de Janeiro State Tribunal considered the Covid-19 pandemic when judging repossession and possession lawsuits between 02/06/2020 and 06/02/2021, and whether international standards on forced eviction were observed. After analyzing 291 decisions, we observed that the pandemic was not mentioned in the majority of the decisions and that international parameters were ignored.