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Objective: Evaluate the impact of real life use of remdesivir (RDV) as treatment for hypoxemic SarsCoV2 Pneumonia. Method(s): Of 1155 consecutive adult subjects hospitalised with SarsCov2 infection, we selected only those with cumulative evidence of: 1. positive PCR test;2. Radiologically confirmed pneumonia;3. Hypoxemia and need of supplementary O2 (>= 24%). We compared those treated with RDV versus those receiving Standard of Care (SoC), in terms of mortality, length of hospital stay and secondary effects of treatment. Result(s): 843 subjects were treated with RDV and 312 with SoC. In the RDV group, 97.1% patients were also receiving Dexamethasone (DEXA) and mean age was 69.7 (+/-14.4) years with 61.8% male prevalence, as opposed to the SoC group that registered 73.9 (+/-14.5) years and 49.7% male prevalence. Both groups had similar prevalence of Diabetes, Hypertension and Chronic Lung Disease;Overweight was more prevalent in the RDV group whereas Immunosuppressant conditions and Smoking were more frequent in the SoC subjects. Concerning the proposed outcomes: a) RDV patients had a mean Hospital Stay 4.25 days inferior than SOC subjects (p=0.002);b)The relative risk of death during hospital stay in the RDV group was 0.47 [0.38;0.60] when compared to those in the SoC group;c) 9 subjects in the SoC group (0.03%) and 12 patients in the RDV group (0.014%) had secondary effects attributable to treatment drugs, all resolved with treatment interruption. Conclusion(s): The use of RDV with DEXA in SARSCoV-2 Hypoxemic Pneumonia significantly reduced mortality and hospital stay, and registered no significant side effects in a real life cohort of consecutively enrolled patients.
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Covid-19 pandemic has been the cause of the most significant global revolution in recent times. The attack from an invisible enemy had caught the world unprepared since its first reported outbreak from Wuhan, China, in 2019. As a result, challenges arising from that of unimaginable proportions soon followed suit, and the world felt the impact of those challenges on so many levels. Most of the economy's industries had been greatly affected, with the construction industry being one of the hardest hit. Sarawak's construction industry is not spared either, as several construction site clusters resulting from workers' quarters popped up from the circle. The scenario creates awareness of the importance of improving the quality of workers' quarters. The Sarawak State Government, through its Ministry of Public Health, Housing and Local Government, had formulated a guideline for Local Authorities on the temporary permit application for workers' quarters' building within construction sites. The response of the permit is studied using a qualitative approach through a case study of workers' quarters within construction sites in the jurisdiction of Kuching City South as the primary research method. The study is mainly based on observation and literature review and discusses the permit implementation response among the construction industry players. The findings from this paper conclude that the implementation of the permit could be observed further to capture a greater level of compliance and accountability to improve the quality of workers' quarters for occupational safety and the general health of labourers. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Introduction: SARS-CoV-2 infection may lead to the development of the novel coronavirus disease (COVID-19). Scarce data is available regarding safety and efficacy of SARS-CoV-2 vaccination in IBD patients, which may present differences between subgroups. Lower immunological response could require an additional booster injection. Aims & Methods: Prospective study including adult patients with IBD after complete vaccination against SARS-COV-2 infection with BioNTech vaccine. Patients with previous SARS-COV-2 infection were excluded. A control group with healthy individuals matched for age and sex was also analyzed. Blood samples were collected 30 days after complete vaccination to quantify IgG antibody titers against SARS-CoV-2 in both groups. Result(s): Final sample included 81 IBD and 32 non-IBD patients, 55(48.7%) of them females, with a mean age of 40.2+/-13.0 years. From IBD patients, 58(71.6%) had CD and 23(28.4%) UC. IBD patients had significantly lower median anti-SARS-COV-2 IgG levels when compared to the control group (6479, IQR-10053 vs 13061, IQR-15539 AU/mL;p=0.003). Regarding IBD medication, significant lower levels of SARS-COV-2 IgG antibodies when compared to controls where observed in patients under thiopurines (5423, IQR-10260 AU/mL;p=0.011);methotrexate (834, IQR-4155 AU/mL;p=0.002);infliximab (5294, IQR-10392 AU/mL;p=0.001);and corticosteroids (548, IQR-n/a AU/mL;p=0.001). The incidence of SARS-CoV-2 infection after vaccination was also significantly higher in each of these treatments - healthy controls 25% vs thiopurines 50% (p=0.025), infliximab 43.8% (p=0.048), methotrexate 75% (p=0.041) and corticosteroids 100% (p=0.027). Conclusion(s): IBD patients under Immunomodulators, infliximab and corticosteroid treatment presented significantly lower anti-SARS-COV-2 IgG levels 30 days following complete vaccination when compared to healthy controls. These findings could support the benefit of an additional booster injection in this population.
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Background: The severe acute respiratory syndrome coronavirus, 2 (SARS-COV-2) infection may lead to the development of the novel coronavirus disease, 2019 (COVID-19). Currently, little to no data is available regarding safety and efficacy of SARS-COV-2 vaccination in Inflammatory Bowel Disease (IBD) patients, which may present differences between subgroups, as these patients may exhibit impaired innate and adaptive immune system responses. Lower immunological response could, in this specific population, require an additional booster injection. Methods: We conducted a prospective study including adult patients with Crohn's disease (CD) and Ulcerative Colitis (UC) who have undergone complete vaccination against SARS-COV-2 infection with BioNTech® vaccine. Patients with previous SARS-COV-2 infection were excluded. Medical data regarding age, sex, IBD classification and current medication for IBD were collected. A control group with healthy individuals matched for age and sex was also analyzed. Blood samples were collected, 30 days after complete vaccination to quantify IgG antibody titers for SARS-COV-2 in both groups (IBD and non-IBD). Results: Our final sample included, 81 IBD and, 32 non-IBD patients, 55 (48.7%) of them females, with a mean age of, 40.2±13.0 years. From the IBD patients, 58(71.6%) had CD and, 23(28.4%) had UC. IBD patients had significantly lower anti-SARS-COV-2 IgG levels when compared to the control group (8950±9366 vs, 14834±11679 AU/mL;p=0.003). Regarding IBD medication, significant lower levels of SARS-COV-2 IgG antibodies when compared to control patients were found in patients under thiopurines (9074±9779 AU/mL;p=0.011);methotrexate (1987±2568 AU/mL;p=0.002);infliximab (7208±7276 AU/ mL;p=0.001);and corticosteroids (1065±933 AU/mL;p=0.001). Additionally, patients under combined therapy (infliximab plus thiopurines) presented with significantly lower antibodies titers when compared to patients treated with thiopurines in monotherapy (8130±11048 vs, 10563±5680 AU/mL;p=0.039). No significant differences were found in IBD patients under salicylates (10195±7371 AU/mL;p=0.226);adalimumab (15644±21467 AU/mL;p=0.336);vedolizumab (10464±9087 AU/mL;p=0.286) and ustekinumab (11366±10016 AU/mL;p=0.390). Conclusion: IBD patients presented with significantly lower anti- SARS-COV-2 IgG levels, 1 month after complete vaccination against SARS-COV-2 infection compared to healthy controls. Thiopurines, methotrexate, infliximab and corticosteroid treatment were associated with significantly lower antibodies levels. These findings may express the benefit of an additional booster injection in this population.
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Fluid Mechanics is a fundamental core course in mechanical engineering curricula that covers the motion of fluids (liquids and gases), internal flows (flows in pipes/ducts), external flows (flow around vehicles and aircraft, river flow, etc.), and flow vector fields which require higherorder math skills to master. We have taught the undergraduate fluid mechanics course in hybrid modality with active in-class learning before the COVID-19 pandemic. Once the COVID-19 pandemic required the instruction to move to the remote format in the middle of the Spring2020 semester, we have started a new open Courseware website and a new YouTube channel and hosted 200+ lecture videos totaling 45 hours of undergraduate fluid mechanics class and prerequisite differential equations content and continued the active learning exercises via synchronous remote sessions. This paper discusses how the transition was accomplished and how the synchronous remote sessions were handled for continued active learning exercises for 100+ students enrolled in the class in spring 2020 and beyond. We also distributed a survey on students and inquired about how the student perception and learning effectiveness of active remote learning exercises vs. active in-class exercises. The students overall appreciated the availability of lecture videos and preferred to watch the lecture videos directly from YouTube as opposed to the Learning Management system. The majority of students found the effort to be more for remote instruction, as they found more responsibility has been placed on them. As a result, around 80% of students either preferred in-class active learning or were not sure for the Spring2020 semester. The percentage of students preferring online instruction increased for the Summer 2020 and Fall2020 semesters. As an example, just slightly over 50 percent of the students preferred in-class instruction as of the Fall2020 semester. © American Society for Engineering Education, 2021
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BACKGROUND: Commercial availability of serological tests to evaluate immunoglobulins (Ig) targeting severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has grown exponentially since the start of the coronavirus disease 2019 (COVID-19) outbreak. Thorough validation of these tests is important before use as epidemiological tools to infer seroprevalence in specific populations and as diagnostic tools to complement molecular approaches (e.g., quantitative reverse transcription-polymerase chain reaction). METHODS: Commercial serological tests from 11 suppliers were assayed side-by-side using 126 samples from SARS-CoV-2-infected inpatients and 36 from healthy and HIV-infected individuals. RESULTS: The majority of the tests assayed have >95% specificity. For the sensitivity calculation, samples were stratified by days since symptoms onset; sensitivity peaks at 16-21 days for IgM and IgA (maximum 91.2%, Euroimmun) and, dependant on the test, at 16-21 or >21 days for IgG (maximum 94.1%, Snibe). Data from semiquantitative tests show that patients with a severe clinical presentation have lower levels of Ig targeting SARS-CoV-2 at <10 days since symptoms onset and higher levels at >21 days, compared to patients with a non-severe presentation. CONCLUSIONS: This study highlights the heterogeneity of sensitivity and generally high specificity of the serological tests and establishes a basis for their usefulness to complement diagnostic techniques and population seroprevalence studies.