Communicable diseases

Chapter 5 looks at defining communicable diseases and understanding and the impact on both animal and human health and how vital it is for veterinary nurses. This chapter does this in a clear and systematic way. It considers both emerging communicable diseases (such as COVID-19) and re-emerging diseases that reappear after a period of absence and the factors that contribute to this. © CAB International 2023. All rights reserved.

Pharmaceutically Active Compounds in Water Bodies—Occurrence, Fate, and Toxicity

The presence of pharmaceutically active compounds (PhACs) in water bodies has been considered an issue of global concern due to their high consumption and release into the environment, especially under pandemic conditions such as current COVID-19 situations. Additionally, the appearance of antibiotic-resistant bacteria (ARBs) and antibiotic resistance genes (ARGs) threatens the effectiveness of the pharmaceuticals developed to treat certain diseases. To address this problem, there have been efforts to develop efficient and cost-effective (waste)water treatment methods or to upgrade the existing facilities to regenerate clean water resources. According to the reports available in the literature, the effectiveness of these methods is highly dependent on the applied technology and the type and concentration of the PhACs. The efficiency of these systems can also determine the environmental and ecotoxicological effects expected from the release of these compounds. This chapter aims to summarize and discuss the available literature on the occurrence, environmental concentrations, fate, and possible effects of typical PhACs when introduced into receiving environments. The existing research gaps have also been discussed, and recommendations have been provided for further studies. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Phone calls against social isolation during the Covid-19 lockdown

Context. During the Covid-19 lockdown, the southeastern France pension fund launched a phone call campaign to maintain social contacts with retirees living alone. A study was carried out among the pension fund's workers to explore their views on the campaign, and how retirees experienced lockdown. Methods. Qualitative study based on structured interviews with 19 workers between June 16 and July 2, 2020. Results. From the workers' point of view, retirees mainly suffered from a lack of physical and emotional contact with their families, and from a lack of physical activity affecting their quality of life and their autonomy. The workers reported a strong mobilization of friends and relatives (family, neighbors) and, in some areas, of local stakeholders. This campaign allowed the workers to feel useful, to rediscover humanity in their jobs, and to better understand the needs of older people. They regretted a lack of both technical and psychological preparation. Discussion. This study highlights several areas of improvement for this kind of campaign (target audience, training, collaboration between actors). © Caisse nationale d'assurance vieillesse. Tous droits réservés pour tous pays.

The Determining Factors for the Entry of Small Investors into the Brazilian Stock Exchange

This study aims to verify the determining factors for the entry of small investors in the Brazilian Stock Exchange. For this, a questionnaire sent to respondents by electronic means was used. 698 valid responses were obtained. Homogeneity Analysis (HOMALS) was used to identify the association between the profile of investors and the determining factors for investors to enter the Stock Exchange. Through the results, it was found that the most important determining factors are: the possibility of obtaining extra income in the future, the fall in the price of shares, the low yield of savings and the drop in the SELIC rate. The factors that have less influence are: advertisements and encouragement from relatives and friends. In addition, almost half of the respondents agree that they see the Stock Exchange as an option to make quick money. It was identified that people with less knowledge about the market and a moderate risk profile disagree that the Stock Exchange is an opportunity to make quick money and that the more aggressive the investor's profile, the stronger the view that the fall in the price of shares is an opportunity for investments on the Stock Exchange. Differences were identified between the factors that determined the decision to invest in the Stock Exchange of investors who entered before and after the COVID-19 pandemic in Brazil. This study helps to fill the gaps in empirical research on the reasons that make small investors choose to invest in the Stock Exchange. It also contributes to the formulation of investment strategies and commercial strategies for those interested in increasing the number of Individual investors on the Stock Exchange..

Versatile gene delivery targeting via Ultrasound and gas Microbubbles

The COVID-19 crisis and the rapid development of highly effective mRNA vaccines opened a new era for gene therapy. While viral vectors were for a long time the only tool for efficient delivery, new non-viral vectors have recently emerged, spawning new opportunities (indications, tissues, etc.). A new one is set to take off thanks to its safety profile, its specificity toward tissues, and its versatility toward both genetic materials and indications. Gas-filled microbubbles (MB), clinically used as ultrasound (US) contrast agents, have proven their benefits in various animal models and clinical applications for targeted delivery of drugs/genes. Herein, we disclose the development of new MB formulations allowing the delivery of various genetic materials at a specific location under the control of an ultrasound probe. We set forth a study to elicit the expression of a foreign enzyme in a liver mouse model. To this aim, MB were systemically co-injected with a Luciferase pDNA (6 to 65 mug) in the tail vein, then Ultrasound were delivered at MB arrival in the liver. The effective pDNA transfection was observed by bioluminescence 24 hours after treatment. Mice were divided into three groups: pDNA alone;pDNA with US;pDNA with US and MBs (n >= 5). The use of our MB allowed increasing the signal up to 5 folds in comparison to the US alone. These results highlight the potential of MB plus US to efficiently deliver locally genetic material without any safety concerns.

Programa Doadores Herois: Reconhecendo Doadores Fidelizados

A captacao de doadores e uma ferramenta valiosa que cria um vinculo entre o doador, o banco de sangue e a missao de salvar vidas. O presente programa de captacao e reconhecimento de doadores fidelizados, foi baseado no conceito de Marketing Social para fomentar uma mudanca de comportamento e mobilizar de doadores. Objetivou-se implementar o Programa Doadores Herois, visando fortalecer o relacionamento com doadores, fideliza-los e torna-los multiplicadores de campanhas de doacao de sangue. Trata-se de um estudo de pesquisa-acao com abordagem intervencionista e foco na disseminacao da cultura de doacao de sangue voluntaria, demonstrando quanto os doadores herois sao importantes para salvar vidas. O programa consiste em reconhecer os doadores com 10 doacoes ou mais por meio da entrega de um certificado de solidariedade presencialmente e por meios digitais, assim como solicitar a contribuicao deles na promocao da doacao de sangue, sendo multiplicadores das campanhas. A enfermeira responsavel faz a gestao do numero de doacoes de cada pessoa, por meio do sistema de informacoes hemoterapicas HEMOPLUS, entra em contato com os doadores via whatsapp, informando que eles fazem parte do grupo de "doadores herois", explica quantas vidas ja salvaram aproximadamente, envia o certificado de solidariedade como uma forma simbolica de agradecimento e reconhecimento, assim como questiona se o doador tem interesse de ser multiplicador de campanhas de doacao. Todos os doadores com mais de 10 doacoes que comparecem para uma nova doacao, sao identificados no ato do cadastro e e confeccionado o certificado para a entrega durante a doacao, realizados registros fotograficos e publicacao no instagram ihhs_aracaju_sergipe. Por fim, os doadores herois sao convidados a preencher o link da capsula do tempo do IHHS, que consiste numa iniciativa de o doador registrar o seu sentimento no momento do recebimento do certificado de solidariedade, onde acaba refletindo sobre quantas vidas ja salvou e o quanto isso e importante. A capsula sera aberta em 2026, numa comemoracao especifica convidando os doadores para participarem e abrirem conosco, assim como fazerem a leitura das suas mensagens (https://abre.ai/capsulatempoihhs). Resultados e Discussao: Antes da implementacao do Programa Doadores Herois o indice de doadores fidelizados era de 33% e apos aumentou para 52% (p>0,01). Atualmente o IHHS possui 261 (100%) doadores herois, destes 102 (39%) participam ativamente das campanhas e 95 (36,4%) ja preencheram a capsula do tempo. O Programa Doadores Herois foi reconhecido pela Organizacao Nacional de Acreditacao como um dos pontos fortes da Instituicao, bem e motivo constante de elogio pelos doadores, que muitas vezes se emocionam junto com a equipe no momento da entrega do certificado. O programa foi apresentado para a populacao no jornal local, ganhando destaque e visibilidade, contribuindo para uma imagem positiva da doacao de sangue, motivando outras pessoas a se tornarem doadores. Com o advento da pandemia do novo coronavirus, as doacoes de sangue diminuiram muito, uma vez que, o combate a propagacao da COVID-19 contempla o isolamento social. Conclusao: O Programa Doadores Herois traz beneficios para os pacientes que aguardam transfusao, pois permite uma melhor manutencao do estoque de sangue, permitindo o pronto atendimento das solicitacoes. Constatou-se a eficacia do programa, pois apos a sua implementacao houve um aumento significativo de doadores fidelizados e melhoria do acesso a informacao sobre doacao de sangue para a populacao. Copyright © 2022

Atendimento a Doadores De Celulas Progenitoras Hematopoieticas Em Centros De Hemoterapia: A Experiencia Do Grupo Gsh No Cuidado Aos Doadores Do Redome

Objetivo: No ano de 2020, em decorrencia da reducao significativa da capacidade de atendimento a doadores alogenicos nao aparentados pelos hospitais parceiros do Registro Brasileiro de Doadores de Medula Ossea (REDOME) e com a restricao de internacoes eletivas para comportar as internacoes dos pacientes para tratamento da COVID-19, surge a oportunidade de um modelo inovador de avaliacao de doadores alogenicos nao aparentados no Brasil, o atendimento exclusivamente realizado por um servico privado de hemoterapia. Nesse cenario, o presente trabalho busca demostrar a seguranca do procedimento de doacao de celulas progenitoras hematopoieticas (CPH) ambulatorial em servicos de hemoterapia. Materiais e metodos: O atendimento a esses doadores e realizado nos Complexos de Hemoterapia do Grupo GSH nas cidades de Sao Paulo, Rio de Janeiro e Brasilia, onde ja havia equipe com experiencia em avaliacao e coleta de CPH por aferese de doadores alogenicos. Os possiveis doadores sao selecionados e encaminhados pelo REDOME para avaliacao e coleta de CPH de acordo com a demanda do registro. Todo o processo de orientacoes, avaliacao clinica e laboratorial, mobilizacao e coleta de CPH por aferese foi realizada no banco de sangue, um ambiente preparado para o atendimento a doadores e sob a coordenacao de um medico hemoterapeuta. Resultados: No periodo de 01/08/2020 a 01/08/2022 foram avaliados 48 doadores encaminhados pelo REDOME sendo 1 deles um doador aparentado que, devido as restricoes de viagem impostas pela pandemia, realizou a doacao no Brasil para que o irmao fosse transplantado no exterior. A idade dos doadores nao aparentados variou de 23 a 49 (mediana 35 anos) e 44% eram do sexo feminino. Vinte e cinco (52%) foram considerados inaptos para a coleta de celulas em regime ambulatorial e desses, 19 (76%) o motivo da inaptidao foi o acesso venoso periferico incompativel com o procedimento de aferese. Esses doadores foram encaminhados pelo REDOME para outros servicos para realizar a coleta em regime hospitalar. Vinte e tres doadores foram aptos e submetidos a 25 procedimento de aferese. O volume sanguineo processado medio foi de 13,3 litros (variando de 7,8 a 17 litros) com tempo maximo de procedimento de 300 minutos. Nenhum doador apresentou reacao adversa moderada ou grave, em 28% dos procedimentos o doador apresentou hematoma no local da puncao venosa e em 25% dos procedimentos houve perda de acesso com necessidade nova puncao para conclusao da coleta. Dois doadores apresentaram sintomas de hipocalcemia durante a coleta de celulas que regrediram com reducao do fluxo de extracao e aumento da velocidade de reposicao do calcio. Conclusao: Assim como em estudos previamente publicados, a analise dos dados demonstra que o procedimento de coleta de CPH alogenica por aferese apresenta baixo risco de eventos adversos quando o doador e adequadamente selecionado o que possibilita a realizacao do procedimento com seguranca no ambiente de banco de sangue, onde o doador encontra maior conforto e e acompanhado por profissionais treinados e habituados com cuidados a doadores, o que reduz a probabilidade de haver sub-identificacao dos riscos para o doador e aumenta a seguranca do procedimento. Copyright © 2022

Health public crisis impact on non-life insurance: the case of COVID-19

The insurance industry plays a crucial role in developing a country’s economy, thus becoming one of the main focuses when studying the possible impacts of the current public health crisis. Accordingly, the main objective of this study is to investigate the COVID-19 impact on non-life insurance profitability of the Portuguese insurance sector. This study also intends to assess the explaining factors of insurance companies’ profitability on the period between 2004/2020. The methodology implemented was a multiple linear regression, using a panel data model with random effects. The sample consists of a total of 238 observations from 14 non-life insurers over 17 years. The results revealed that COVID-19 positively impacted the profitability of the insurance companies presented. However, this impact was only significant on the return on assets. Furthermore, the results showed an inverse and meaningful relationship between the profitability ratios and the variables leverage and loss ratio. Copyright © 2022 Inderscience Enterprises Ltd.

Psychiatry training goes virtual: the experience of the first online edition of the EPA Research Summer School

Introduction: The European Psychiatric Association (EPA) Summer School allows psychiatric trainees and early career psychiatrists (ECPs) from all over Europe to meet, network, and learn together. After the 2020 edition being cancelled due to COVID-19, the 10th edition in 2021 focused for the first time on research and was conducted remotely. Objective(s): To provide an overview and feedback about the first Virtual EPA Research Summer School as a new way to encourage international networking during COVID-19. Method(s): The School was organized by the EPA Secretary for Education, and 4 Faculty members. It started with a breaking the ice session one week before and then a two-days meeting on 23-24 September 2021 using an online video-platform. This was preceded by all the 21 participants (from 18 different countries) recording a short 4-minute video presentation, which was uploaded and shared with other participants and Faculty. Result(s): Participants were divided on a voluntary basis into three working groups: 1) Drug repurposing: overcoming challenges in pharmacoepidemiology 2) Psychopathological research in psychiatry;3) How to conduct a cross-sectional survey?. The Summer School program was composed of plenary sessions with lectures by the Faculty members, discussion sessions, and working groups time. At the end, each group presented a summary of the work done to the rest of the participants. Conclusion(s): Although the remote format limits social interactions during the Summer School, overall participants' high satisfaction and productivity indicate that not only online formats, but also the topic of research might be covered in future editions.

COVID-19 Psychiatric Inpatient Unit- experience and challenges

Introduction: On January 2021 the Department of Psychiatry became the only unit exclusively dedicated to COVID patients with severe mental illness in acute decompensation. Only patients in risk of rapid medical deterioration were excluded and forwarded to intensive care. Objective(s): Discussion of this unprecedented experience. Method(s): Analysis of 28 patients hospitalized during 3 months with both an acute psychiatric disorder and an SARS-CoV-2 infection;description of the multidisciplinary intervention made. Result(s): Our samplewas characterized by a majority of patients with an acute psychotic episode derived from a schizophrenia spectrum disorder (42%) or a bipolar affective disorder (21%). Only 3% of the patients had a diagnosis of severe major depressive disorder. And 10% of patients developed severe respiratory symptoms requiring oxygen or urgent transfer to COVID medical wards. Most patients presented periods of psychomotor agitation, lack of impulse control and self-aggression. Psychopharmacological and psychotherapeutic interventions had to be adapted to these unusual conditions. Most of them had already gone through a period of isolation in the buffer ward created to exclude false negatives, which promoted atypical deliriums and symptoms of post-traumatic stress. The psychiatric team was faced with the emergent need to adapt an intervention model based on trust to a model that had to prioritize physical safety. Conclusion(s): The pandemic experience was transformative forall who lived through it. From the challenge perspective, it may have been enriching. But the maintained confrontation with the antithesis of therapy, defined by "caring, supporting, communicating, approaching", was devastating in ways that we consider essential to be debated.

Outcomes of Kidney Transplant Recipients in Singapore With COVID-19 Infection With Delta and Omicron Variants

Background: Kidney transplant recipients (KTR) are at higher risk for breakthrough COVID-19 infections and progression to severe disease. Herein, we compare the outcomes of KTR infected with the Delta and Omicron variants. Method(s): We performed a retrospective, single-centre study of all SARS-CoV-2-infected KTR confirmed by PCR from 17/09/21 to 30/04/22. At diagnosis, anti-metabolite doses were halved with further reductions of immunosuppression with increasing disease severity. Treatment for KTR not requiring supplemental oxygen (SuppO2) on admission was guided by SARS-CoV-2 spike antibody (SpAb), Roche Cobas SARSCoV-2-S assay. Sotrovimab 500mg IV was given if SpAb<100 U/mL. With community emergence of Omicron subvariant BA.2, sotrovimab was replaced by tixagevimab/ cilgavimab (EVUSHELDTM) 600mg IM in KTR with SpAb<250 U/mL or remdesivir if SpAb>250 U/mL. KTR with SuppO2 were treated with dexamethasone +/-remdesivir and immunomodulator therapy (baricitinib or tocilizumab). Characteristics and outcomes between KTR with Delta and Omicron were compared. Result(s): Clinical characteristics and outcomes are summarized in Table 1. Baseline demographics were similar between groups. Vaccination rates increased over time in concert with government vaccine programs and communications by our team. KTR with Omicron had higher vaccination rates, higher likelihood of SpAb>250 U/mL, and were less likely to have AKI, SuppO2, ICU stay, and mortality (p<0.05 for all). Of 16 KTR with Omicron with SuppO2, 5 were unvaccinated and only 1/16 had SpAb>250 u/mL. Conclusion(s): Severe disease was less frequent in KTR with Omicron likely due to improved vaccination rates, higher SpAb, and virus characteristics. However, KTR remain at risk for severe disease especially if unvaccinated or if SpAb is low.

International comparison of the impact of COVID on adherence with supportive care focused Choosing Wisely recommendations (CWR)

Background: The reorganization of cancer care delivery during the COVID pandemic had the potential to catalyze improvement in CWR adherence by reducing provision of low value care to minimize in-person visits and mitigate potential issues with staff and resource shortages. We evaluated the impact of COVID on adherence with CWR for supportive care, relevant to colorectal and anal cancer patients with stage IV disease at Princess Margaret Cancer Centre (PM) in Canada and AC Camargo Cancer Center (AC) in Brazil. Method(s): Eligible patients had a new patient consult 02/2020- 12/2020 (COVID) or the same period in 2019 (control). Performance on individual CWR in the 6 months following initial consultation was calculated as the proportion of eligible patients meeting the recommendation. Result(s): The PM and AC cohorts each consisted of 100 patients;demographic and disease characteristics of COVID and control cohorts were similar within each centre. Marginally fewer patients received surgery during COVID (PM: 38.3 vs 49.1%, p = 0.28;AC: 54.8 vs 55.2%, p = 0.97). At PM, more patients received radiation therapy during COVID (36.2 vs 24.5%, p = 0.21), whereas the opposite occurred at AC (7.1 vs 17.2%, p = 0.14). A higher proportion of both PM and AC patients treated during COVID died within 6 months of initial consult than in 2019 (PM: 10.6 vs 7.5%, p = 0.015;AC: 21.4 vs 8.6%, p = 0.029). Adherence to selected CWR is summarized below;whereby a higher proportion means higher concordance with CWR. Conclusion(s): There was low overall adherence to CWR across both centers with no significant changes to patterns of care for patients with stage IV disease during the COVID-19 pandemic.

Impact of Immunosuppression on T-cell Responses After mRNABased Sars-CoV-2 Vaccination

Purpose: Administration of mRNA-based SARS-CoV-2 vaccines confers protection from SARS-CoV-2 infection and reduces its severity in the general population. It has been suggested that mounting a coordinated adaptive immune response characterized by production of neutralizing antibodies and SARS-CoV-2 spike proteinspecific T-cells correlates with protection from infection. Studies in organ transplant recipients have demonstrated suboptimal responses after 2 doses of SARS-CoV-2 vaccination;however, the impact of different immunosuppressive regimens (IS) on T-cell responses is not well described. This study prospectively evaluated the impact of IS on T-cell responses in a kidney transplant (KTx) population and compared these to 26 healthy controls. Method(s): In this single-centre, prospective study, 92 KTx on follow-up at our centre were enrolled after informed consent. T-cell responses were evaluated before and after each of 2 doses of BNT162b2 SARS-CoV-2 vaccine administered 21 days apart: before each dose, 10-14 days after Dose1 and 21-24 days after Dose2. The study population included 69.6% Live-Donor and 30.4% Deceased-Donor KTx. Longitudinal assessment of the quantity of spike-specific T-cells was performed by stimulating whole blood with peptides covering the SARS-CoV-2 spike protein, followed by cytokine (IFN-gamma, IL-2) measurement (JCI, Tan et al, 2021). KTx were stratified by maintenance IS into 4 groups and T-cell responses compared between groups. Result(s): As shown (Figures 1A, 1B), in comparison to healthy controls, KTx displayed poor spike-specific T-cell responses as measured by IFN-gamma and IL-2 release. Percent responders were significantly lower for KTx vs. healthy controls: 6.5% vs. 92.3% after Dose1 (P<0.00001) and 27.2% vs. 100% after Dose2 respectively. There was a significant impact of different IS regimens (Figure 1C);percent responders after Dose2 were 19%, 43%, 40% and 71% for KTx receiving CNI-MPA-Pred, CNI-Aza-Pred, mTORi and Other regimens respectively (P=0.013). Conclusion(s): Our results highlight the critical role of IS on T-cell responses to SARS-CoV-2 vaccination. In the context of the COVID-19 pandemic, monitoring T-cell and antibody responses over time after vaccination, modulating IS and modifying vaccination strategies are clearly needed to protect this vulnerable population.

Adverse Renal Events After BNT162b2 Pfizer/BioNTech COVID-19 Vaccine in Kidney Transplant Recipients

Purpose: Adverse events of a novel mRNA vaccine are not well described in Kidney Transplant Recipients(KTR), especially the risk of immune activation or recurrent glomerulonephritis(GN), which has been described in native GN after COVID-19 vaccines. Method(s): In this single-center prospective study, 147 KTR were enrolled after informed consent and administered 2 doses of Pfizer/BioNTech vaccine 21 days apart. Follow-up was 3 weeks after Dose2. Result(s): Mean age of KTR was 51 years;55.1% male;65.3% Chinese, 19% Malay, 11.6% Indian;69.5% Living donor, 29.9% Deceased donor, 0.7% Pancreas-kidney transplants;71.5% had biopsy-proven or presumptive chronic GN(CGN), 12.9% diabetic nephropathy, 15.6% other causes. 11(7.5%) KTR had delayed Dose2 administered at median 29 days(range 24-93) after Dose1. 7(4.8%)were delayed due to renal events: rise in creatinine(n=3), or proteinuria(n=2), or both creatinine and proteinuria with allograft biopsy showing acute T-cell and antibody-mediated rejection(n=1), new BK viraemia(n=1). Other reasons were possible anaphylaxis(n=1), intercurrent infection(n=2), and inability to attend due to quarantine(n=1). 27 KTR had new microhaematuria(MH) after Dose1;9 persisted after Dose2. Additional 18 had new MH after Dose2. Of 45 KTR with new MH, 7 had underlying IgAN, 5 had other biopsy-proven-CGN and 22 had presumed CGN, suggesting 34/45 with possible immune activation. 12 KTR had new onset proteinuria (rise in urine protein:creatinine ratio (UPCR) <=30 to >30mg/mmol);5/7 who developed a rise after Dose1 remained elevated;additional 5 had a rise after Dose2. 7 KTR had rise in proteinuria from UPCR <=100 to >100mg/mmol. Conclusion(s): Subclinical changes in allograft monitoring parameters are frequent after COVID-19 mRNA vaccines with up to 40.1% of KTRs showing rises in creatinine, proteinuria or new MH. Although overt recurrent GN and acute rejection are infrequent, high vigilance and monitoring for these occurrences should be undertaken in KTRs receiving mRNA vaccines.

Outcomes of Kidney Transplant Recipients with Covid-19 in Singapore Treated with Sotrovimab in the Era of the Delta Variant

Purpose: Kidney transplant recipients (KTRs) are at higher risk for severe COVID- 19 caused by the severe acute respiratory syndrome coronavirus-2 (SARS646 All Infections (Excluding Kidney & Viral Hepatitis) I CoV-2). Sotrovimab decreases the risk of disease progression in the general population, but efficacy and safety in KTRs is unknown. Herein, we describe our experience in treating COVID-19 infected KTRs with sotrovimab. Method(s): We performed a retrospective, single-center cohort study of KTRs diagnosed with COVID-19 by polymerase chain reaction from 07/15/21-11/30/21. KTRs with COVID-19 were admitted to the hospital to expedite evaluation and treatment. KTRs with COVID-19 were eligible for sotrovimab if they 1) were not requiring oxygen at admission, 2) were unvaccinated or if SARS-CoV-2 spike antibody (SAb) after vaccination was <100 U/mL, and 3) duration of symptoms/day of illness (DOI) was <=7 days. COVID-19 disease requiring oxygen therapy was treated with remdesevir + dexamethasone. Immunomodulator therapy (baricitinib or tocilizimab) was given for rapidly progressive disease requiring high-flow oxygen or ICU care. Baseline characteristics, treatments, and outcomes including oxygen supplementation, ICU admission, and mortality were manually ed and evaluated. Result(s): In all, 36 KTRs were diagnosed with COVID-19 - mean age 59 years, 72% male, 67% Chinese, 64% diabetic and 17% obese;72% were deceased donor and 28% were living donor KTRs presenting a mean 11 years from transplant. The majority (69%) were vaccinated with >=2 doses of mRNA-based SARS-CoV-2 vaccines, 22% received 3 doses, and 15% were unvaccinated. Among KTRs who received >=2 doses, SAb was reactive in 36% and >100 U/mL in 16%. In all, 14 (39%) required oxygen, 11 (31%) required ICU admission, 5 (14%) were mechanically ventilated, and 4 (11%) died (Table). Sotrovimab was given to 27 eligible KTRs at median DOI 2 (range 0-6). Of these, 8 (30%) required oxygen, 5 (19%) required ICU admission, 2 (7%) were mechanically ventilated, and 1 died (4%). KTRs receiving sotrovimab at DOI <=3 vs >3 were less likely to require oxygen (p=0.01) or ICU admission (p=0.02). Sotrovimab was well tolerated with one associated adverse event (self-limiting diarrhea). Conclusion(s): KTRs remain at high risk for severe COVID-19. Sotrovimab administered early in the disease course is associated with a lower rate of severe COVID-19. Outcomes of KTRs with COVID-19 overall and among those receiving sotrovimab by day of illness (Figure Presented).

Accessibility in Spanish Universities, evaluation through their

This research analyzes the announcements issued by Spanish universities during the COVID-19 pandemic relating to students with special needs, to offer a new vision, complementary to existing audits conducted on university websites about technical accessibility compliance. The study approaches the evaluation of accessibility from the point of view of organizational support. The identified measures are mapped onto Universal Design Learning guidelines to give them context and to analyze their coverage. The research shows a landscape with an uncoordinated and uncollaborative approach, with negative consequences in the tackling of remote emergency teaching.. © 2022 ACM.

Impact of COVID-19 pandemic on breast cancer neoadjuvant therapy: a retrospective institutional analysis

Background: COVID-19 pandemic motivated a reorganization of healthcare institutions, which may have led to a negative impact on cancer patients' treatment. This study compared the pathological response (PR) rate to neoadjuvant chemotherapy (NACT) in breast cancer (BC) patients who underwent treatment before (BCv) and during (DCv) the COVID-19 pandemic at our institution.