Human Anti-Ace2 Monoclonal Antibodies as Pan-Sarbecovirus Prophylactic Agents

Background: Human monoclonal antibodies from convalescent individuals that target the SARS-CoV-2 spike protein have been deployed as therapeutics against SARS-CoV-2. However, nearly all of these antibodies have been rendered obsolete by SARS-CoV-2 variants that evolved to resist similar, naturally occurring antibodies. Moreover, Most SARS-CoV-2 specific antibodies are inactive against divergent sarbecoviruses Methods: By immunizing mice that carry human immunoglobulin variable gene segments we generated a suite of fully human monoclonal antibodies that bind the human ACE2 receptor (hACE2) rather than the viral spike protein and were engineered to lack effector functions such as ADCC. Result(s): These ACE2 binding antibodies block infection by all hACE2 binding sarbecoviruses, including emergent SARS-CoV-2 variants, with a potency that of the most potent spike binding therapeutic antibodies. Structural and biochemical analyses revealed that the antibodies target an hACE2 epitope that engages SARS-CoV-2 spike. Importantly, the antibodies do not inhibit hACE2 enzymatic activity, nor do they induce ACE depletion from cell surfaces. The antibodies exhibit favorable pharmacology in human ACE2 knock in mice and provide near complete protection of hACE2 knock-in mice against SARS-CoV-2 infection. Conclusion(s): ACE2 binding antibodies should be useful prophylactic and treatment agents against any current and future SARS-CoV-2 variants, as well as hACE2-binding sarbecoviruses that might emerge as future pandemic threats.

USING MACHINE LEARNING TECHNIQUES TO SUPPORT THE EMERGENCY DEPARTMENT

This research lays down foundations for a stronger presence of machine learning in the emergency department. Using machine learning to make predictions on a patient???s situation can increase patient???s health and decrease the waiting time. This paper explores to what extent it is possible to accurately predict ER outcome. These predictions will be based on routinely available ER data from a Dutch hospital. The data set used is representative for any Dutch Hospital. Prediction performance is compared between ML predictors. Using random forest and stacked ensemble gathered the best results. This research found that for more than half of the adult patients, the algorithm can very accurately predict hospitalization, with similar results for children and during the COVID-19. Moreover, it is investigated which characteristics and events contribute to the direction of the patient. Finally, several plans are introduced to substantially improve the ER process, for example by quickly reviewing patients selected by the algorithms. These might lead to an ER process that is significantly quicker, with more accurate diagnosis.

UNVEILING CONTEXTS AND REITERATING PRINCIPLES IN SCHOOL MANAGEMENT IN TOCANTINS IN TIMES OF PANDEMIC

The article addresses the theme of school management in the state of Tocantins, aiming to raise reflection on challenges and lessons learned that stood out in school management in Tocantins during the new Coronavirus pandemic period from 2020 to mid-2021. it bases on a critical perspective using bibliographical and document review. In the pandemic scenario, the school needed to reinvent its, so the management area should guarantee the fundamental means for quality learning. The new challenges made the problems that already existed in education even more difficult. The context of the pandemic revealed challenging scenarios and re-presented lessons/principles that are part of the normative framework, permeated by the dispute of corporate projects. In this field full of provocations, it is possible to understand that the principle of democratic management is one of the mediating elements of an emancipatory education for a democratic society.

Palliative care for patients with cardiovascular disease and COVID-19 in a major referral hospital

Introduction: COVID-19 disease has a wide spectrum of severity, ranging from asymptomatic to severe acute respiratory syndrome. Although the estimated mortality is around 3% in the general population, individuals with comorbidities such as cardiovascular disease (CVD) may develop worse virus-related outcomes and have higher mortality rates. Furthermore, triage systems in pandemics may have low sensitivity to the need for palliative care, leaving many patients without appropriate end-of-life support. Purpose: The aim of this study was to evaluate the palliative care offered to patients with CVD and COVID-19 in a major referral hospital in Brazil. Methods: Descriptive and retrospective study of adult patients with CVD and COVID-19 admitted to a major referral hospital in Brazil. Medical records of patients with CVD and COVID-19 were reviewed. Patients were screened for the need for palliative care through the Supportive and Palliative Care Indicators Tool (SPICT). Pearson's chi-squared tests were performed and p < 0.05 was considered statistically significant. Results: The sample was composed of 526 (53.6%) males and 456 (46.4%) females. Median [IQR] age was 65 [55-73] years old. Regarding department of admission, 194 (19.8%) patients were admitted to the wards, 359 (36.5%) to the emergency room (ER), and 429 (43.7%) to the intensive care unit (ICU). Regarding SPICT criteria, 285 (29%) were at risk of deteriorating and dying. Palliative care was offered to 82 (8.4%) patients. From the patients who met SPICT criteria (n = 285), only 64 (22.5%) had access to palliative care during hospitalization. Patients who received palliative care were more likely to be ≥60 years old, to meet SPICT criteria, and to die (p < 0,001) (Table). Sex and department of admission were not associated with the likelihood of receiving palliative care (Table). Regarding outcomes, 356 patients died (36.3%), 573 were discharged (58.3%), and 53 (5.4%) were transferred to another unit. From the patients who died (n = 356), only 65 (18.3%) had access to palliative care. Conclusions: In our study, there was a high mortality rate in patients with CVD and COVID-19, although a considerable proportion of them did not have access to palliative care before dying. It is important to give further attention to the end-of-life support offered to patients with CVD and COVID-19. (Figure Presented).

Palliative care for 317 cancer patients with COVID-19 in a major public hospital in South America

Background: Cancer patients are at higher risk of developing severe COVID-19 and worse virus-related outcomes. In addition, low- and middle-income countries may be even more impacted by COVID-19, and not offer appropriate end-of-life support to many patients. The aim of this study was to evaluate the palliative care offered to cancer patients with COVID-19 in a major referral hospital in South America. Methods: Descriptive and retrospective study in Hospital das Clínicas, Faculty of Medicine of the University of São Paulo, Brazil. This hospital is considered one of the major referral and public hospitals in South America. Medical records of adult cancer patients admitted for COVID-19 were reviewed. Patients were screened for the need for palliative care through Supportive and Palliative Care Indicators Tool (SPICT). Data was analyzed using Stata 14. Results: The sample was composed of 317 Latino patients, of which 155 (48.9%) were male and 162 (51.1%) were female. Median [IQR] age was 68 [56-81] years old. In addition, 119 (37.5%) were admitted to the wards, 110 (34.7%) to the emergency room, and 88 (27.8%) to the intensive care unit. Patients admitted to the wards were more likely to receive palliative care (46.7% vs. 32.9%;p=0.016). A total of 107 (33.7%) patients had access to palliative care. Regarding SPICT criteria, 260 (82.0%) were at risk of deteriorating and dying. Of the patients who met SPICT criteria, 98 (37.7%) had access to palliative care during hospitalization. Regarding outcomes;155 patients (48.9%) died, 128 (40.4%) were discharged, and 34 (10.7%) were transferred to another unit. Of the patients who died, 72 (46.5%) did not have access to palliative care. Conclusions: In our study, there was a high mortality rate in Latino cancer patients with COVID-19, although a considerable percentage of them did not have access to palliative care before dying. It is important to give further attention to the end-of-life support offered to cancer patients with COVID-19, especially in underserved communities and among racial/ethnic minorities.

A model for pandemic control through isolation policy

In this paper we model the dynamics of a spreading pandemic over a country using a new dynamical and decentralised differential model with the main objective of studying the effect of different policies of social isolation (social distancing) over the population to control the spread of the pandemic. A probabilistic infection process with time lags is introduced in the dynamics with the main contribution being the proposed model to explicitly look at levels of interaction between towns and regions within the considered country. We believe the strategies and findings here will help practitioners, planners and Governments to put in place better strategies to control the spread of pandemics, thus saving lives and minimizing the impact of pandemia on socio-economic development and the populations livelihood.

The practicum in times of Covid-19: Knowledge developed by future physical education teachers in virtual modality

The Covid-19 pandemic has put enormous pressure on the educational system in all its teaching and learning activities, and in the specific case of the practical training of teachers. This study seeks to investigate through qualitative research with a comprehensive interpretive approach, the training of the practicum of Physical Education teachers in Chile, considering the knowledge and experiences, in the context of virtual classrooms during the Covid-19 pandemic. Semi-structured interviews and focus groups were used to collect the data;and were analyzed with the content analysis technique. As result, it can be observed that the students manifest diverse experiences in their practicum process, with difficulties inherent to the remote work condition, such as difficulty in communication with students and school teachers, problems in didactic and evaluation processes, and adaptation to context. It is necessary to discuss the access of students and teachers to technologies, as well as the training of physical education teachers in areas of didactic and assessment in contexts where face-to-face is difficult. © 2021 The authors and IJLTER.ORG. All rights reserved.

Judicialization of the right to education: democratic management in times of COVID-19

The United Nations Educational, Scientific and Cultural Organization - Unesco, revealed that the pandemic caused by COVID-19 affected more than 90% of the world's students due to the temporary closure of schools (Unesco, 2020). The Federal Constitution of 1988 guarantees the right of all to quality education and recognizes it as a subjective public right, as established by articles 205, 206 and its items VI and VII, both of CF / 88 (Brazil, 1988). The present article, of a documental theoretical nature, presents a qualitative approach and uses the Gramscian theory (Gramsci, 1982) to analyze the democratic educational management, as well as the quality standard of education (Cabral, 2008), which made it possible to verify the influence of capitalist ideology in the Brazilian educational process. Due to the citizens' lack of knowledge about the judicial system (Sadek, 2010) this study aims to discuss the right to education and present the judicialization of that right as a tool of democratic management (Ferreira, 2008) considering the historical context that comprises the decade of 1980 to 2020, in which the guarantee of this right has been increasingly undermined due to the crisis caused by the pandemic of COVID-19.

Right to Education: Democratic Management end Public Policies in Time of Pandemic/Covid-19 in the State of Tocantins

The article aims to analyze democratic management as a principle of the right to education in the State of Tocantins, in times of Pandemic Covid-19. The discussion aims to elucidate public policies aimed at quality educational services in the public network - covering urban and rural education - and the state system's actions to guarantee the right to education in the exercise of democracy. The research is based on dialectical historical materialism, having as reference the bibliographic and documental research and normative collection issued, mainly, by the Ministry of Education, National Council of Education, Tocantins State Government and State Council of Education and data from CONVIVA. With critical attention, it points out the non-existence of educational policies and the State Education System's commitment to the situation of educational crisis and especially to the right to education in terms of democratic management.

Repercussions of the covid-19 pandemic in children and mothers with congenital zika syndrome

Objective: To analyze the repercussions of the COVID-19 pandemic in mothers-children with Congenital Zika Syndrome. Methods: This is a mixed exploratory sequential study (QUAL-> QUAN), carried out with 44 mothers of children with Congenital Zika Syndrome who answered an online questionnaire applied between April and May 2020. Qualitative data were subjected to thematic content analysis and quantitative data to statistics descriptive, with application of paired Student's t test. Data integration was performed according to the joint display technique. Results: Physical distancing reconfi gures the mother-child routine, limits the development of activities in the domestic environment, changes habits, increases caregivers' burden (p<0.05), implies changes in sleep patterns and generates signs of stress and anxiety. Mothers are concerned about the decrease in family income and strive to perform stimulation exercises and school activities in the domestic environment after the interruption of professional rehabilitation care and the closing of schools. Conclusion: The COVID-19 pandemic had an impact on the increase in new tasks of caring for the child and the home environment, as well as raising the levels of care burden for mothers, which can result in important changes in their physical and mental health. © 2021 Departamento de Enfermagem/Universidade Federal de Sao Paulo. All rights reserved.