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The soviet social theorist Mikhail M. Bakhtin developed the theory of the carnivalesque as a logic of exaggeration, inversion and irony. Beyond carnival events themselves, Bakhtin proposed this logic as a creative instance to foresee openings within an assumed normality. The conceptual gaze of the ‘carnivalesque' helps to rethink the reconfiguration of actors and practices around mobility, borders and migration during the initial lockdowns of the COVID-19 pandemic. This impasse worked as a corona-carnival in the midst of the current mobility regime. The use of ‘carnivalesque' in this article is not related to the playful aspects of carnival as a parade, but to the potential of the carnivalesque impasse for envisioning alternatives, which are not necessarily emancipatory but deeply ambivalent, grotesque and unfinished. That carnivalesque momentum, marked by social norms placed on pause, is captured in artistic and linguistic production, acting as a collective legacy for imagining futures otherwise. This paper compiles some keywords which emerged during the corona-carnival impasse, each holding hopeful and dystopian glimpses of possible alterations to the status-quo. These linguistic productions question assumed notions and practices of migration management, opening the social imagination to other ways of engaging with human mobilities. © The Author(s) 2023.
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This article reflects on the actions carried out by six conductor-teachers of children and youth orchestras- considered factors of social change- working with virtual learning during the COVID-19 pandemic in Mexico. A qualitative approach was conducted through the autobiographical method in the paradigm of learning ecologies to identify the challenges and motivations of two different orchestral programs during lockdown. The teaching needs derived from the transformations that occurred in learning environments and the chal-lenges that led to new teaching strategies were identified and interpreted as elements of the new learning ecologies.
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Introduction: The covid pandemic has become a unique phenomenon in world history with great impact on mental health. Objective(s): A great growth of anxious depressive pathology in relation to the Covid situation has appeared with the need to increase the psychiatric approach in the general population Methods: A 58-year-old woman with no personal medical story of interest is referred to the high-resolution Covid program due to severe depressive symptoms: intense apathy, abulia, anhedonia, weight loss, insomnia and important social distancing after the beginning of the confinement due to the Covid Pandemic. 4 psychotherapy sessions are performed, with a maximum duration of 45 minutes. It is necessary to add antidepressant medication with sertraline up to 100mg to improve psychotherapeutic work. Result(s): A complete recovery of symptoms is achieved even their severity with normalization of daily life. Conclusion(s): Small psychotherapeutic interventions have been shown, even with critically ill patients, to be very effective in helping patients regain their baseline status.
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The experimental part of teaching chemistry in a series of laboratory activities complements the fundamental learning of the various topics covered in a chemistry course. However, alternatives are necessary when situations arise where it is impossible to have a chemistry laboratory. Conducting home experiments can be of great help in teaching various chemistry topics, as they can be used in tasks, research scenarios, and alternative laboratory practices. They can be applied to different levels of teaching depending on their orientation and the contents they address. In the absence of a laboratory to conduct chemistry practice experiments due to Covid-19 faculty and student confinements at home, we developed feasible practices to do at home with ordinary homemade materials that were not risky or dangerous. We selected solutions with desired colligative properties. Thirty engineering students taking two university chemistry laboratory classes participated, coming from programs in the chemical area such as chemical engineering and biotechnology engineering, among others. The teaching-learning process was conducted remotely via Zoom. The students appreciated the in-home practices. Motivated to understand the topics, they performed well on the exams and the laboratory reports and issued high opinions of the classes in the student survey. © 2022 University of Minho. All rights reserved.
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OBJECTIVE: To determine if the use of corticosteroids was associated with Intensive Care Unit (ICU) mortality among whole population and pre-specified clinical phenotypes. DESIGN: A secondary analysis derived from multicenter, observational study. SETTING: Critical Care Units. PATIENTS: Adult critically ill patients with confirmed COVID-19 disease admitted to 63 ICUs in Spain. INTERVENTIONS: Corticosteroids vs. no corticosteroids. MAIN VARIABLES OF INTEREST: Three phenotypes were derived by non-supervised clustering analysis from whole population and classified as (A: severe, B: critical and C: life-threatening). We performed a multivariate analysis after propensity optimal full matching (PS) for whole population and weighted Cox regression (HR) and Fine-Gray analysis (sHR) to assess the impact of corticosteroids on ICU mortality according to the whole population and distinctive patient clinical phenotypes. RESULTS: A total of 2017 patients were analyzed, 1171 (58%) with corticosteroids. After PS, corticosteroids were shown not to be associated with ICU mortality (OR: 1.0; 95% CI: 0.98-1.15). Corticosteroids were administered in 298/537 (55.5%) patients of "A" phenotype and their use was not associated with ICU mortality (HR=0.85 [0.55-1.33]). A total of 338/623 (54.2%) patients in "B" phenotype received corticosteroids. No effect of corticosteroids on ICU mortality was observed when HR was performed (0.72 [0.49-1.05]). Finally, 535/857 (62.4%) patients in "C" phenotype received corticosteroids. In this phenotype HR (0.75 [0.58-0.98]) and sHR (0.79 [0.63-0.98]) suggest a protective effect of corticosteroids on ICU mortality. CONCLUSION: Our finding warns against the widespread use of corticosteroids in all critically ill patients with COVID-19 at moderate dose. Only patients with the highest inflammatory levels could benefit from steroid treatment.
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Objective To determine if the use of corticosteroids was associated with Intensive Care Unit (ICU) mortality among whole population and pre-specified clinical phenotypes. Design A secondary analysis derived from multicenter, observational study. Setting Critical Care Units. Patients Adult critically ill patients with confirmed COVID-19 disease admitted to 63 ICUs in Spain. Interventions Corticosteroids vs. no corticosteroids. Main variables of interest Three phenotypes were derived by non-supervised clustering analysis from whole population and classified as (A: severe, B: critical and C: life-threatening). We performed a multivariate analysis after propensity optimal full matching (PS) for whole population and weighted Cox regression (HR) and Fine-Gray analysis (sHR) to assess the impact of corticosteroids on ICU mortality according to the whole population and distinctive patient clinical phenotypes. Results A total of 2017 patients were analyzed, 1171 (58%) with corticosteroids. After PS, corticosteroids were shown not to be associated with ICU mortality (OR: 1.0;95% CI: 0.98–1.15). Corticosteroids were administered in 298/537 (55.5%) patients of “A” phenotype and their use was not associated with ICU mortality (HR = 0.85 [0.55–1.33]). A total of 338/623 (54.2%) patients in “B” phenotype received corticosteroids. No effect of corticosteroids on ICU mortality was observed when HR was performed (0.72 [0.49–1.05]). Finally, 535/857 (62.4%) patients in “C” phenotype received corticosteroids. In this phenotype HR (0.75 [0.58–0.98]) and sHR (0.79 [0.63–0.98]) suggest a protective effect of corticosteroids on ICU mortality. Conclusion Our finding warns against the widespread use of corticosteroids in all critically ill patients with COVID-19 at moderate dose. Only patients with the highest inflammatory levels could benefit from steroid treatment.
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Background: The world and Cuba in the last two years have been affected by Covid-19. It is of vital importance for Public Health to have statistical studies of infected cases, prognostic equations of the same and possible peaks of the disease, with a view to applying the appropriate measures to combat the pandemic. Objective: The objective of the work is to carry out statistical studies on the data of confirmed cases in the province of Cienfuegos, in the period from March 2020 to August 2021. Methods: The Applied Mathematics Research Group of the University of Cienfuegos carried out a statistical study of the databases of patients confirmed with Covid-19, in the 8 municipalities of the province of Cienfuegos, from March 2020 to August 2021. applied descriptive statistics on the accumulated confirmed cases, age, sex, doses of vaccines received and the probable dates of the highest pandemic peak. The Gompertz, Weibull and Loglogistic logistic population growth models were used to obtain forecast equations for confirmed cases. The basic reproduction numbers Ro and effective Rt were calculated. Results: Knowledge of the adjustment equations in the municipalities of the province of Cienfuegos allows health and government authorities to design strategies to reduce effective reproduction and their monitoring increases the effectiveness of the measures taken. There is an adequacy of the models presented with respect to the predicted and real values, which allows their reliability for the forecasts made. Conclusions:The logistic, Weibull and Gompertz population growth models used to obtain forecast equations in the province of Cienfuegos of confirmed cases of COVID-19, allow future monitoring, control and projection of the behavior of the pandemic according to significant indicators in Cienfuegos.
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Tuberculous meningitis (TBM) is the most severe and disabling form of tuberculosis (TB), with at least 100,000 cases per year and a mortality rate of up to 50% in individuals co-infected with human immunodeficiency virus type 1 (HIV-1). To evaluate the efficacy and safety of an intensified anti-tubercular regimen and an anti-inflammatory treatment, the INTENSE-TBM project includes a phase III randomised clinical trial (TBM-RCT) in four countries in sub-Saharan Africa (SSA). Within this framework, we designed a comprehensive capacity-building work package ensuring all centres had, or would acquire, the ability to conduct the TBM-RCT and developing a network of skilled researchers, clinical centres and microbiology laboratories. Here, we describe these activities, identify strengths/challenges and share tools adaptable to other projects, particularly in low- and lower-middle income countries with heterogeneous settings and during the coronavirus disease 2019 (COVID-19) pandemic. Despite major challenges, TBM-RCT initiation was achieved in all sites, promoting enhanced local healthcare systems and encouraging further clinical research in SSA. In terms of certified trainings, the achievement levels were 95% (124/131) for good clinical practice, 91% (39/43) for good clinical laboratory practice and 91% (48/53) for infection prevention and control. Platform-based research, developed as part of capacity-building activities for specific projects, may be a valuable tool in fighting future infectious diseases and in developing high-level research in Africa.
The INTENSE-TBM project aimed to design a comprehensive work-package on capacity building, ensuring all centres would acquire the ability to conduct a phase III randomised clinical trial on TBM in sub-Saharan Africa, to reduce tuberculous meningitis mortality and morbidity in patients with/without HIV-1 co-infection. Therefore, the INTENSE-TBM project is an example of how an international clinical research consortium can provide opportunities to enhance local capacity building and promote centres without previous experience in clinical research. This article provides practical approaches for implementing effective capacity-building programmes. We highlight how to overcome limitations imposed by the COVID-19 pandemic to successfully complete clinics, laboratory set-ups and personnel training, so as to optimise resources and empower African institutions on a local level. At the same time, our experience shows how capacity-building programmes can deliver long-lasting impact that extends beyond the original aims of the project (e.g. HIV and TB), and support local health systems in fighting other infectious disease (e.g. COVID-19). Research projects in low- and lower-middle income countries with heterogeneous settings could stand to benefit the most.
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On 14 March 2020, in the face of the health crisis caused by COVID-19, the Spanish government declared a state of alarm in the whole of Spain, which, in different phases and degrees, entailed the confinement of the population and the suspension of economic activity not considered essential. This decision has been analysed from multiple perspectives, including the territorial one, but perhaps the one that has remained most invisible has been the rural perspective. This paper aims to analyse the impact of the pandemic and the first confinement in rural areas, by comparison with urban and semi-urban areas. In order to achieve this aim, the results of a survey of 2,920 interviews, carried out throughout Spain in May 2020, will be analysed. As we will see, contrary to what was initially expected, rural areas did not behave significantly differently from urban areas. What the statistical analysis shows is that it is the semi-urban environment that was worst affected by the initial impact of the pandemic.
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Introduction: Randomized trials demonstrated ~95% efficacy of SARS-CoV-2 spike messenger RNA (mRNA) vaccines. Patients (pts) after allogeneic hematopoietic cell transplant (HCT) have a variable period of immune deficiency and the impact of diagnosis, treatment regimens, GvHD, and immunosuppression on vaccine (vacc) immunogenicity is unknown. Methods: We performed a retrospective analysis of 149 consecutive pts (Table) who received a SARS-CoV-2 vacc between 12/17/2020, and 5/21/21, and were tested for anti-SARS-CoV-2 S1/S2 antibodies. Serology testing was performed with the Liaison® SARS-CoV-2 S1/S2 IgG assay (DiaSorin) with ≥15 AU/mL defined as a positive result. Pts with prior COVID-19 infection were excluded. Pts received mRNA-1273/Moderna (n= 46), BNT162b2/Pfizer-BioNTech (n= 100) or Jannsen vacc (n= 3). Reactogenicity was not investigated. Demographic and treatment variables were tested for prediction of vaccine response using Chi-square test or Fisher's exact test for categorical variables and two-sample t test for continuous variables. Univariate and multivariable logistic regression analyses with backward selection using Akaike information criterion (AIC) were used to examine interdependence of those variables and odds ratios (OR) with 95% confidence intervals (CI). Results: Pts underwent HCT from a related HLA matched sibling (n=36), related haploidentical (n= 23), or matched/mismatched unrelated donor (n= 89). 93% received fludarabine in the HCT conditioning regimen (data not shown). All pts received a calcineurin inhibitor (CNI) and 76 pts received ATG for GvHD prophylaxis. All pts achieved at least mixed donor lymphoid engraftment (data not shown). Median time from HCT to 1st vaccination was 26 months (range, 3-258 months). Median age at time of vaccination was 61 years (range, 24-78) and 75 (50%) were female. Serology was tested at a median of 37 days (range, 6-119 days) after the second vacc dose. Serology was tested <14 days in 3 pts;all were seropositive. No pt developed COVID-19 during the period of observation. 101 pts (67%) tested positive for anti-SARS-CoV-2 S1/S2 antibodies (vacc responders). Of the responders, the median time from HCT to 1st vacc was 45.5 months (range, 3-258, SD 39.78). Among the 23 pts between 3-9 months after HCT, 26% (n=6) had a positive antibody response, but all were receiving ongoing immunosuppression at time of vaccination. 29% (n=29) vacc responders were receiving prednisone (pred) in the management of cGvHD at the time of vaccination. 48 pts did not mount an antibody response (vacc non-responders). Of the non-responders, 30 pts were receiving cGvHD treatment at the time of vacc, 31 pts were taking pred, and 20 pts were taking CNIs. In univariate analysis, we found a history of prolonged use of pred (>8 weeks) and/or CNIs, on current treatment for cGvHD at time of vacc, and receipt of rituximab in the preceding 12 months predicted for lack of response (Table). Active use of pred and treatment with pred >8 weeks in the preceding 12 months prior to vacc predicted vacc non-response [OR 0.221;95% CI (0.106 - 0.456);p<0.001] and [OR 0.408;95% CI (0.197 - 0.844);p=0.016] in univariate analysis, respectively, however, active use of pred was predictive [OR 0.07;95% CI (0.016-0.304;p<0.001] while pred treatment >8 weeks was not [OR 2.00;95% CI (0.55-7.298;p=0.293] in multivariable analysis. Other significant predictors for non-response in the multivariable analysis include pt use of ruxolitinib [OR, 0.233, 95% CI, (0.067-0.808);p=0.022], and rituximab within 1 year [OR, 0.026, 95% CI, (0.007-0.099);p<0.001]. Discussion: In this study, we found that 67% allogeneic HCT pts developed anti-SARS-CoV-2 S1/S2 antibodies after SARS-CoV-2 vaccination. Predictors of non-response after adjustment for potential confounders, were factors that are expected to suppress immune response including active use of immunosuppressive medications. Consistent with prior studies, anti-CD20 therapy likely impairs humoral response to vaccination. Ruxolitinib also appears to impair response. owever, a proportion of pts being actively treated for cGvHD responded to vaccination and these pts should still be encouraged to receive vaccination in consideration of the COVID-19 mortality risk. Many questions remain including the protective benefit of immune response, the duration of response, and the potential value of booster vaccinations in non-responders. [Formula presented] Disclosures: Rowley: ReAlta Life Sciences: Consultancy.
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Covid-19 accelerated the transformations that have been taking place in the international life since 2008. These have been materialized in, a competition between economic giants, a weakening in the world governance, a reconfiguration of capitalism with technology and a breakdown of the trust of societies in democracy This has led to a new reconfiguration of material capacities, institutions and ideas, and demonstrates that what the world is currently experiencing is the closing of a historical cycle and the weakening of the hegemonic structure of the United States. Based on this panorama, the opportunities and challenges presented by the new emerging countries are analyzed in the light of the concept of power, illustrated by critical theory.
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Context. In the COVID-19 pandemic, higher education was one of the most affected in adapting the teaching-learning process to comply with social distance measures. In this context, this research reports how we combined two active methodologies in Software Engineering Emergency Remote Teaching. Objective. Therefore, this study aims to report the experiences obtained from the application of gamified study guides in Software Engineering (SE) between November 2020 and April 2021. Method. We combined flipped classroom, an active methodology already known by them, with Gamification to improve students' acceptance and engagement. We created six gamified study guides for the SE flipped classes. 51 students participated in the classes, 12 students from the Computer Technician course and 39 students from the Computer Science Bachelor course. Each study guide had a group of checkpoints to organize the content in levels. Results. At the end of the application, we observed 83.6% of the participating students maintained their engagement. According to self-declaration, 85% felt motivated by the approach adopted, with 75.9% considering that the class format presented enhanced their learning. We also observed a positive impact on learning gain in an average of 18.3% in their grades. Final Considerations. We concluded that using Gamification and Flipped Classroom has positive impacts on learning and acceptance, although the COVID-19 pandemic and the ERT negatively affect students' motivation. © 2021 ACM.