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Intro: In Australia, the main methods to diagnose COVID-19 are through rapid antigen tests (RATs) and through nucleic acid amplification testing (NAAT, including polymerase chain reaction) on healthcare worker (HCW)-collected combined nose/throat swabs. With self-collection widely used by the public for RATs, the aim of this study was to evaluate the performance of self-collected samples using commercial NAAT for SARS-CoV-2. Method(s): Consenting participants aged 14 years and older were provided with a self-collection pack containing instructions and either a FLOQSwab (Copan) or a Rhinoswab (Rhinomed). Participants collected their own nasal sample unsupervised prior to having a HCW-collected combined nose and throat swab taken for standard of care NAAT. Paired self-collected and HCW samples were tested on the cobas SARS-CoV-2 assay (Roche) and the Aptima SARS-CoV-2 assay (Hologic). Finding(s): We demonstrated comparable sensitivity, specificity, and agreement between self-collected nasal and Rhinoswab samples, compared to HCW- collected samples tested using the cobas SARS-CoV-2 and Aptima SARS-CoV-2 assays. In our study the clinical performance of self-collected specimens was comparable to HCW-collected samples, with both self-collect nasal and Rhinoswab samples resulting in 90-95% sensitivity, and in most cases >95% specificity. Discussion(s): Without the availability of samples for NAAT the ability to perform genomic testing is limited, reducing surveillance and public health investigations. We showed that genomic sequencing from self-collected samples can correctly identify the virus lineage and that the main determination of successful genomic testing is a high viral load rather than collection method. Conclusion(s): These data support self-collection as an accessible method for community testing for COVID-19 and introduces a novel collection device, the Rhinoswab as an alternative to the standard nasal swab. The testing method of self-collection can be expanded from the widely used RATs to NAAT and genomic testing which may inform the management and public health response to the COVID-19 pandemic.Copyright © 2023
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During the COVID-19 pandemic, universities worldwide were forced to close, causing a shift from presential to remote classes. This situation motivated teachers to find suitable tools to evaluate students remotely, fairly, and accurately. However, currently available systems are either survey or exercise evaluation based, not suitable for competency-based assessments. Faced with this context and limitations of available evaluation systems, we developed TestsOverSSH, a system to devise, deliver, and automatically correct assessments performed in a Command Line Interface (CLI) environment. Unique assessments are generated per student when they access the proposed system via Secure SHell (SSH). TestsOverSSH is composed of shell scripts that orchestrate a series of tools and services that come pre-installed in Linux distributions. It can be used to construct multiple-choice or direct answer questions while also requiring students to perform tasks in the environment per se, namely computer programming or CLI manipulation-related assignments. We present examples of the question types in this system, explaining question formats and operating guidelines. Since the assessments are directly performed in the system, logs and command history can be easily retrieved while keeping information within student devices uncollected. We performed evaluations using this system in a real context and obtained student feedback through a custom survey and the System Usability Scale (SUS). Survey results and SUS score suggest that TestsOverSSH is an intuitive evaluation tool, with eased access and usage, making it applicable for e-learning. © The Author(s). 2023.
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The article presents an account of the experience carried out during the COVID-19 syndemic, from the implementation actions of agroforestry systems aimed at productive inclusion, health and quality of life in the Koyakati Village - Mae Maria Indigenous Land -, in Bom Jesus do Tocantins-southeast of Para. These actions are part of the ArticulaFito project and result from a diagnosis of the national production base of medicinal plants and socio-biodiversity products, where the need for recovery and conservation of degraded areas was identified as a factor of fragility of productive relations, especially with regard to territories of populations and traditional communities, pressured by predatory production models that negatively impact the ways of life and health of these populations. The Value Links-B methodology was applied in the diagnosis with a view to drawing up an action plan aimed at the challenges diagnosed in the chain of Brazil nut (Bertholletia excelsa Bonpl.), a species categorized as threatened with extinction due to population decline. Then, it indicates the agroforestry systems, to guarantee the adequate management of the native agroextractive species and, in this way, to conserve biodiversity, as well as guarantee the access to the raw material. The implementation actions of the Agroecological Experimentation Unit (UEA) are described here, with the objective of strengthening production systems and, thus, generating employment and income, in order to improve health indicators in these territories.
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Introduction: Since the emergence of COVID19, a broad spectrum of presentation has been described, from the absence of symptoms to critical illness. Some studies show that increased levels of interleukin-6 (IL-6) are correlated with increased mortality and disease severity. Objective(s): To establish the value of IL-6 as an early predictor of severity in SARS-CoV2 infection. Method(s): Prospective study with IL-6 assay as part of the initial study of patients with SARS-CoV2 infection, between 20/10/2021 and 31/01/2022. Two groups were created (I: without hospitalization;II: with hospitalization). Exclusion criteria: chronic respiratory disease, rheumatologic disease and/or inflammatory bowel disease;time between dosing and hospitalization >=72h. Statistics (SPSS v28): Mann Whitney test, AUROC, Spearman correlation. Result(s): Sample of 117 patients (after excluding 10). Group I: 80 patients, 38 (47.5%) were male;mean age of 46.40 +/- 18.85 years old (18-88). Group II: 37 patients, 24 (64.9%) were male;mean age of 72.35 +/- 15.39 years old (29-96). Mean hospital stay of 19.49 +/- 17.02 days;9 (24.3%) were admitted to the ICU. Significantly higher IL-6 values in group II (p<0.001), showing good discriminating power regarding the probability of hospitalization (AUC=0.888;p<0.001) and a statistically significant (p=0.02) positive correlation (0.380) with the length of stay. The optimal cut-off value of IL-6 to establish the need for hospitalization, in our sample, was 12.4 pg/mL (Sensitivity: 97%;Specificity: 69%;Youden index: 0.66). Conclusion(s): IL-6 levels were significantly higher in patients requiring hospitalization and correlated with length of hospital stay. Larger studies are needed to validate its use in risk stratification.
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The purpose of this research is to demonstrate how retailers have used the digital transformation to mitigate the negative effects of COVID-19. As this research aims to understand a real-life phenomenon for which there is very limited knowledge, we created the opportunity to empirically explore the digital transformation in the retail industry during COVID-19 pandemic. In general terms, the research follows a qualitative, descriptive, and exploratory case study design. The results have shown that retailers should focus on technological innovations, adapt their business models, manage their distribution channels, and strengthen their customer-centric strategy. Moreover, it is necessary to emphasize that while smart retail is gradually standing out in the sector, there are also some factors that have not been overcome, such as lack of digital culture, training, and digital leadership. Despite these identified difficulties, the adoption of a digital strategy will allow a differentiating, safe and secure shopping experience, which today is one of the decisive factors for the survival of companies. The COVID-19 pandemic had social and economic effects in all industries – retail was no exception. In turn, the digital technologies already used by companies began to contribute to retailers being able to respond more quickly to customer needs, having been fundamental in fighting the COVID-19 pandemic. To the best of the authors' knowledge, this research is one of the first to explore this topic, bringing new contributions to theory and managerial practice. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Introduction: The COVID-19 pandemic, caused by SARS-CoV-2, showed a rapid increase in the number of cases and deaths in the five continents, with a major impact in the public health and the economy of the countries. The effects of COVID-19 have highlighted an increase in existing inequalities in society. A global mobilization for the development and rapid production of vaccines was needed to meet the emergency demand caused by COVID-19. Objective: To discuss actions carried out by Fiocruz in the challenges imposed by the emergency to combat the disease, in addition to analyzing and discussing the partnership established between Bio-Manguinhos/Fiocruz and AstraZeneca, through Technological Order (ETEC), aiming at the verticalized Technology Transfer (TT) of the CHADOX1 NCOV-19 vaccine. Method: A documentary analysis of a descriptive nature and qualitative approach was carried out, based on the search for scientific articles on the subject, and institutional documents, as well as a thorough procedural analysis of ETEC, formalized between Fiocruz and AstraZeneca. Results: Although the National Policy for Technological Innovation in Health (PNITS) describes three viable legal instruments for formalizing partnerships, ETEC was the most adequate to meet the demands imposed by the health emergency of COVID-19, reinforcing the importance of using the State's purchasing power as an instrument for strengthening the State Health Care System (SUS) within the scope of the Health Industrial Complex. Conclusions: Even considering the health emergency caused by COVID-19, Bio-Manguinhos/Fiocruz managed to establish a partnership with AstraZeneca, aiming at the TT for the national verticalized production of the COVID-19 vaccine, for the attendance of SUS acute accent s demand. The legal instrument chosen for the formalization of the partnership was ETEC, the first used in the public health area, which proved feasible to be reproduced in future partnerships aiming at the internalization of technologies of national interest. From the absorption of this technology, Bio-Manguinhos will be able to develop new vaccines of HM's interest using the same technology.
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Introduction. Patients receiving serial outpatient infusion treatment for lymphoma or breast cancer (BC) with potentially cardio-toxic chemotherapeutic regimens may experience declines in left ventricular ejection fraction (LVEF) and exercise capacity. This study sought to determine if a physical activity intervention (PAI) administered during cancer treatment could attenuate deterioration of exercise capacity and LVEF. Methods. Across two NCI funded cancer centers, we randomized (2:1) 34 participants to a homebased PAI or healthy living education intervention (HLI) within 6 weeks of initiating curative therapies for stage I-IV Hodgkin's, non-Hodgkin's lymphoma, or stage I-III BC (NCT01719562). Training programs were tailored by treatment and functional status and adapted for remote delivery during COVID-19. Exercise capacity was determined via cardiopulmonary exercise test (peak VO2 [ml/kg/min]) and LVEF (%) was determined by magnetic resonance imaging at baseline, 3, and 6 months. Separate linear mixed-effects regression models controlling for baseline values examined changes in peak VO and LVEF by time and treatment group. Results. Demographics were similar between the two arms (PAI vs. HLI, 52.4 [16.3] vs. 56.8 [12.7] years of age [SD];69% vs. 75% white;and 57.7% vs. 50% female). Peak VO 2increased at 3 (+1.15 ml/kg/min [CI: -1.46 - 3.77]) and 6 months (+3.88 ml/kg/min [CI: 0.79 - 6.96]) in the PAI arm, while the HLI arm increased slightly at 3- (+0.67 ml/kg/min [CI: -5.14 - 6.48]) but not 6 months (-0.83 ml/kg/min [CI: -5.99 - 4.33]). LVEF declined slightly at 3 months in the PAI (-2.29% [CI: -4.83 - 0.25]) but not HLI arm (3.05.% [CI: -2.49 - 8.60]), while at 6 months, the PAI arm had returned to baseline LVEF (-0.58% [CI: -4.30 - 3.14]) and the HLI arm declined slightly (-1.76% [CI: -7.23 - 3.71]). Conclusions. This pilot RCT suggests the importance and utility of home-based physical activity during cancer treatment in protecting against expected declines in exercise capacity and LVEF. These results highlight the need for larger randomized trials that examine the effects of lifestyle interventions administered during treatment to improve quality of life and to support long term cardiovascular health in cancer survivors.
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Introduction. This article discusses some anthropological and sociological slight reflections about the uses and the abuses of the political exceptionality in the Covid-19 pandemic. The relevance is connected with questions about the "New Norm", permeated with the daily destructiveness of antisocial metabolic practices of an even more predatory capitalism, whose social control cannot regulate violent neoliberal extraction in a mode of accumulation. Aim and tasks. The purpose of the article is to study the gradual resumption of interrupted social activities as a policy measure to combat the New Coronavirus Pandemic is placed from the perspective of its economic and ecologic rationalities as well as from the perspective of the new moral, emotional, cognitive, and behavioral demands directed to the common social actor and agent of big and small cities. Results. The article substantiates the context of the so-called "new norm", permeated by the daily destructiveness of antisocial metabolic practices of even more predatory capitalism in a violent neoliberal form. Therefore, due to this discrepancy between legality and legitimacy, the level of authoritarianism and further growth of inequality and indifference among people increases. In the context of the Covid-19 pandemic, there is a mismatch between legality and legitimacy, as well as the legitimization of the interests of individual actors in the market as opposed to the adoption of legislation and for pro-capital interests. The principles of legitimacy were limited by bureaucratic rationality and the genocidal legalism of neoliberal politics. Conclusions. The pandemic has disrupted economies, has mainly punished the poorest and most underserved and has destabilized governments of various ideological nuances. Participants at all levels of the economy will suffer the most severe and immediate consequences of all losses. This is the controversial logic of capital and one of its main contradictions is revealed.
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Introduction: COVID-19 is a problem for the humanity. Since now, 526.534.751 of confirmed cases. The world campain vaccination started in the end of 2020. Until now, we had almost 12 bilions people vaccinated. We never had in the world a massive vaccination campain like that. Considering that medications and vaccines can present adverse events, some cases of glomerulopathies were described. Case Description: We describe 50 yea-old white male patient who was obese and presented hypertension well controlled with Six months before admission, routine blood and urine tests were normal. He received two doses of Coronavac (Sinovac, China) inactivated virus vaccine for Covid-19 (28 day interval between dosses). On December 2021, he received a third dose (booster) Covid-19 vaccine from Pfizer-BioNtech (RNA). One day later, he began to experience high fever lasting one day, severe and progressively chest pain. The patient was hospitalized with pericarditis and AKI KDIGO 1. Corticosteroids and support measures were taken leading to an improvement in the cardiac condition. Two weeks later, renal function progressively worsened, and hematuria and proteinuria ensured. Investigation was negative for autoimmune diseases, serum levels C3 and C4 were normal, and viral serologies were negative. The creatinine level rised to 5 mg/dL (440 mmol/L). A pulse of 1 g methylprednisone was initiated for 3 days. Renal biopsy showed necrotizing glomerulonephritis, with fibrocellular crescents and immune paucity. Two doses of Rituximab 1g was added and prednisone 1 mg/kg and azathioprine were used as maintenance regimen. After 4 months of treatment, the patient presented partial recovery of renal function with a creatinine of 1.7 mg/dL (150 mmol/L). Discussion(s): Glomerulopathies related to Covid infection and vaccines are scarce. Rocatello et al reported 17 cases of post-vaccination glomerulopathies, most of which were of minimal change disease with no case of necrotizing pauci immune-negative being related. Few cases were reported with positive ANCA-related necrotizing GN, and in the present case the patient had all negative antibodies. A causal relationship cannot be stated, but with mass vaccination, cases of rare adverse effects must be monitored and reported to better clarify their mechanisms and evolution.
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Introduction: The COVID-19 pandemic led to the development of numerous adaptations in the healthcare systems in order to minimize the risk of infection for patients and healthcare professionals. One of the main difficulties related to Sleep-related breathing disorders, namely Obstructive Sleep Apnea (OSA), was the initiation of noninvasive ventilation (NIV), as this procedure carries a high risk of transmission through aerosol generation. In our hospital, patients previously initiated NIV at the Sleep Disorders Clinic. However, due to the pandemic, this had to be suspended and NIV initiation began to take place at the patient's home. Our objective was to evaluate the difference in adherence to NIV when this therapy was initiated in-hospital or at home. Method(s): Retrospective study, evaluating the differences in NIV adherence between patients with OSA that initiated NIV in-hospital (previously to the pandemic) or at home (post-pandemic). Statistical analysis was performed using an independent samples t-test on SPSS Statistics version 27. Result(s): From the patients that had OSA diagnosed through polysomnography level 3, we selected 114, of which 60 initiated NIV inhospital and 54 initiated NIV at home. In both groups, the majority of patients were male (76,7% in the inhospital NIV initiation group and 70,4% in the home NIV initiation group), with a mean age of 60,9 +/- 10,4 years and 61,3 +/- 10,6 years, respectively. Most patients had severe OSAS (78,3% and 75,9%, respectively) and had a body mass index (BMI) >= 30 (76,6% and 81,5%, respectively). In the first-month post NIV initiation, mean adherence was 88,3% in patients that had in-hospital initiation and 85,0% in patients with home NIV initiation. In the sixth month was 89,2% and 85,9%, respectively, and after 1 year was 96,7% and 82,50%, respectively. No statistical difference was found between adherence in all periods (p > 0,05). Conclusion(s): Our work suggests that home initiation of NIV in OSAS patients has non-inferior results in terms of patients' adherence and is a possibility to maintain in the future. This will allow reallocation of human resources to other areas in Sleep Disorders that are understaffed.
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Introduction: Diaphragmatic hernias (DH) in most cases are the consequence of a diaphragmatic trauma causing a missed injury. Less frequently, DHs are congenital. Case Presentation: A 52 years old patient came to our attention due to a worsening severe dyspnea. A chest CT scan were performed, showing an extensive left-side DH.We present the video of the surgical procedure. The patient mentioned a severe left hemithorax trauma occurred almost twenty years before due to a motorbike accident. Possibly, a diaphragmatic injury was not diagnosed at the time. Subsequently, a Covid-19-related chronic cough resulting in a persistently increased intra abdominal pressuremayhave caused the herniation of abdominal viscera. The surgical procedure was laparoscopic. The whole greater omentum and most of the transverse colon were herniated and, after a thorough adhesiolysis between the herniated tissues and the left diaphragmatic crus, the DH was reduced. It was confirmed the presence of a 8 cm defect of the left hemidiaphragm, it was repaired with a absorbable continuous suture. A 08x10 cm Bio-A patch was positioned over. The herniated tissues were meticulously examined and showed no signs of damage. Conclusion(s): Diaphragm's injuries are unfortunately difficult to diagnose in an acute setting, thus remaining often unbeknownst to the surgeon. Some patients never develop any symptoms because of such missed diaphragmatic injuries. Some others instead, due to an increase in the intra abdominal pressure, may develop symptomatic DHs. In the latter case, surgical management becomes mandatory.
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As long as the COVID-19 pandemic is still active in most countries worldwide, rapid diagnostic continues to be crucial to mitigate the impact of seasonal infection waves. Commercialized rapid antigen self-tests proved they cannot handle the most demanding periods, lacking availability and leading to cost rises. Thus, developing a non-invasive, costless, and more decentralized technology capable of giving people feedback about the COVID-19 infection probability would fill these gaps. This paper explores a sound-based analysis of vocal and respiratory audio data to achieve that objective. This work presents a modular data-centric Machine Learning pipeline for COVID-19 identification from voice and respiratory audio samples. Signals are processed to extract and classify relevant segments that contain informative events, such as coughing or breathing. Temporal, amplitude, spectral, cepstral, and phonetic features are extracted from audio along with available metadata for COVID-19 identification. Audio augmentation and data balancing techniques are used to mitigate class disproportionality. The open-access Coswara and COVID-19 Sounds datasets were used to test the performance of the proposed architecture. Obtained sensitivity scores ranged from 60.00% to 80.00% in Coswara and from 51.43% to 77.14% in COVID-19 Sounds. Although previous works report higher accuracy on COVID-19 detection, this research focused on a data-centric approach by validating the quality of the samples, segmenting the speech events, and exploring interpretable features with physiological meaning. As the pandemic evolves, its lessons must endure, and pipelines such as the proposed one will help prepare new stages where quick and easy disease identification is essential.
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HaliTeddies are made of carnosic acid present in rosemary and aim to inhibit the action of halitosis causing bacteria. A need for this product was identified due to the mandatory use of facial masks because of COVID-19, which has had a negative outcome when it comes to breathe malodour. A vegan gummy bear product was selected as the best idea to satisfy this need since it is an appealing approach for a younger audience of 15-to 49-year-olds. The strategy for production includes rosemary being bought from a national producer, whereas extraction of the active principle, production, and packaging is done at the production facilities. Lastly, an economic analysis has shown that this project requires an investment of 7 M€. The product would be sold at pharmacies at a retail price of 11.99 €. This analysis has shown that HaliTeddies may be considered to be a profitable and viable business. © 2022, Universidade do Porto - Faculdade de Engenharia. All rights reserved.
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This research aimed to measure and analyze the agribusiness labor market in Minas Gerais state, to verify potential effects of the covid-19 crisis. In 2020, the population employed in agribusiness was 3.9% lower than in 2019, according to microdata by the Continuous National Household Sample Survey (PNAD-Continua) and, in a complementary way, data from the annual report on social information (RAIS) and from the Center for Advanced Studies on Applied Economics (CEPEA). All agribusiness segments, except for the primary segment, showed a decrease in the number of employed workers. The quarterly analysis shows that the biggest decreases occurred in the first two quarters of 2020 and that, although small, some recovery had been seen in the fourth quarter. The most affected job positions workers were those of workers with a formal contract, as well as those without a formal contract and the employers;however, an increase in the number of the self-employed was observed. Workers with lower instruction level were also one of the most affected groups. Creating employment generation programs in the sector, as well as programs that provide the maintenance of the employees and that afford assistance to informal workers and to those who became unemployed during the pandemic are some examples of public policies that may mitigate the negative effects of the crisis.
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Society and the economy, which should be increasingly based on knowledge and learning, require an innovative and integrated university;with a level of relevance that allows it to train a professional whose modes of action have a positive impact on society. In Cuban universities, the practice of sport and physical activity have as a fundamental objective to contribute to the integral and harmonious formation of the future sports professional, improving health and correcting pathologies practically in their entirety. On the other hand, the Covid-19 pandemic has imposed a modification in the ways of acting, bringing with it a greater use of technologies, thus causing people to assume prolonged and sedentary postures;likewise, the intense hours of mental work have caused changes in life habits and psychological discomfort. Since these aspects may have an impact on physical conditions, this contribution makes an assessment of the social importance of healthy habits and lifestyles during Covid-19 in university environments, with emphasis on the development of physical activity.
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Introduction: The European Open Platform for Prescribing Education (EurOP2E) aims to improve and harmonize European clinical pharmacology and therapeutics education by facilitating international collaboration and sharing open educational resources. The COVID-19 pandemic has forced teachers to switch to online teaching, highlighting the need for high-quality online teaching materials. Objectives: The goal of this study was to establish the resources needed to sustain prescribing education during the pandemic and thereafter. Methods: A nominal group technique study was conducted with prescribing teachers from several European countries and combined with thematic analysis. Results: In four meetings, 20 teachers from 15 countries ranked 35 teaching materials. Ten themes were identified: prescribing scenarios;interactivity & gamification;re-usable materials;online case discussions;practical aspects of prescribing;teaching the teacher;knowledge multimedia;topical issues;personalized & evidence-based prescribing;and essential formularies. Conclusion: By making teaching materials related to the learning outcomes of CPT, format of teaching and resource and faculty development openly available, EurOP2E will help to make high-quality prescribing education available to all. The role of the platform will range from facilitating collaboration to educating the teachers and/or providing ready-touse teaching materials.
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Fashion is a waste industry, but it is in a phase of change and transition to sustainability, including consciousness around the excessive use of natural resources to produce inputs for clothing and accessories. In this article, we focus on the problem of waste and sustainable innovations for the fashion industry, adopting ethical and linear solutions to the principles of a circular economy that abandons the current production process of extraction, production and disposal, consuming finite resources already in Imminent risk of raw materials, a fact that came to light during the Covid-19 pandemic. The circular economy is the process that may assist in this transition, the method consists of the circularity of the products, the reuse and proper management of waste generated during each stage of development of a product. The buttons are essential items for clothing, an ancient invention that maintains its function and form to this day. The only change in the production of this accessory was the material employed in production, if in the early days the materials were natural;Currently plastic is the main raw material. Its impact on the environment is ignored, despite the amount existing in relation to each piece of clothing that is discarded incorrectly in urban waste containers. In this article, the problem was addressed around current materials and proposed the development of biodegradable buttons from eating waste. The study was based on the foundations of the circular economy and the design thinking methodology for new product development, rapid prototyping was used as a means of materializing research, resulting in an experimental product. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.