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Introduction: Research has revealed high rates of mental health problems in university students before and during the COVID-19 pan-demic, with effects on poor sleep quality;however, perceived social sup-port appears to act as a protective factor. Objective: To assess the impact of mental health (anxiety, depression, and stress) on sleep quality, cross-sectionally and longitudinally, before and during the COVID-19 pandemic in Chilean university students, verifying whether perceived social support could act as a moderator in this relationship. Material and Methods: 1,619 university students in 2019 and 1,862 in 2020 answered questionnaires aimed at measuring depression, anxiety, stress, sleep quality, and perceived social support. Longitudinal analysis was per-formed with a fraction of the sample that responded in both years (n = 325). The scores of the instruments for both years were contrasted using a transition matrix and a multiple regression model. Results: High prevalence rates of mental health problems were found, with moderate and severe symptoms increasing in 2020. Sleep problems and the perception of low social support worsened. All mental health variables were found to predict sleep quality except for social support;longitudinally, the severity of poor sleep quality and depression increased. No significant moderation effects were found between perceived social support and the rest of the variables. Conclusions: The effect of the pandemic on mental health is complex, re-quiring concrete actions to provide students with psychological support. © 2023, Universidad de Murcia Servicio de Publicaciones. All rights reserved.
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Background: Pancreatic Ductal Adenocarcinoma (PDAC) has historically been an important diagnostic and therapeutic challenge. The multidisciplinary approach and new diagnostic techniques' implementation have modified this process. Method(s): We conducted a retrospective analysis based on clinical data of patients with PDAC between the years 2010 to 2021, analyzing the diagnosis and initial treatment evolution. Result(s): 673 patients between 2010-2021 with a suspected diagnosis of pancreatic adenocarcinoma were reviewed. Most of them were metastatic (n=362;53.8%), followed by locally advanced unresectable (n=166;24.7%) and resectable or borderline resectable (n=145;21.5%). Regarding the pathological diagnosis, it was not possible in 62 patients (9.2%), varying over time from 21.2%in 2010-2012 to 1% in 2019-2021 (p<0,0001). Moreover, the number of biopsies has decreased with a mean number of biopsies to obtain a pathological diagnosis of 1.55 (2010-2012) vs 1.31 (2019-2021). During this last period, most of the diagnoses were made by cytological analysis (61.4%;n=121). Specifically in the 2019-2021 patients subgroup, we found that 18 NGS (9,1%) were performed in this period (solid tumor), with 4 patients having actionable mutations (22.2%;3 KRAS G12C). Germline (g) mutational panels were carried out in 89 patients, finding only 9 positive cases (10.1%), being 3 of them gBRCA1/2 mutated (3,4%). In our study, a decrease in palliative management was evidenced over time. In 2010-2012, 28,8% of patients received exclusively palliative care against 9,6% in 2019-21 (p, 0.0001). An increase in PDAC diagnosis was observed since 2010, 44 patients/year in 2010-12 vs. 66 patients/year in 2019-21 (including COVID-19 pandemic period). All previous results are summarized. Conclusion(s): The diagnosis of PDAC has changed throughout the last decade, increasing the percentage of patients with a pathological diagnosis without increasing the number of invasive procedures. The number of patients suitable for anti-cancer therapy has also increased among time. In our cohort, the implementation of molecular testing would change the therapeutic approach in more than 20% of patients.
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The objective of the article is to know the impact of the four financial dimensions on the probability of financial inclusion (IF) of remittance recipients. A Probit model helps to reflect this association, its marginal effects are estimated using the data available from the module on international remittances of the ENIF 2015 Survey. The results reflect the importance of the "use" of financial instruments for the FI of the recipients, much more than having high income;while financial access and knowledge has a varying effect. One recommendation derived from the analysis is that in the post-Covid horizon, progress can be accelerated to increase banking penetration of remittance recipients. The limitation for this type of analysis is the availability of data, since the latest version of the ENIF eliminated the section on international remittances;however, the originality of the study lies in analyzing the recipients and their proximity to the financial system. Receiving remittances does not necessarily imply participating in the system, recipients are conditioned to different degrees by financial use and access, and attention must be paid to this. © 2022 Instituto Mexicano de Ejecutivos de Finanzas. All right reserved.
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Introduction: The need to identify new knowledge and introduce it to respond to the problems of researchers, professors and managers acquires great importance in research-development-innovation projects linked to health technologies, due to their impact on the lives of the global population. Objective: To develop an information search procedure that allows retrieving quality, pertinent and relevant information from the health field. Methods: The methodology of knowledge generation and management was applied. The exploration was carried out on the websites, Google Academic, World Health Organization and World Industrial Property Organization, and the keywords were identified to establish the strategy and the computer resources to be used. The procedure obtained was subsequently applied to the COVID-19 case study. Results: A procedure was obtained for the search for information on health technologies, which consists of search fields, time period, tools and computer resources already identified, this allows to recover quality, pertinent and relevant information from the health field. The application of the procedure to the COVID-19 case allowed its validation in the identification of sources of information specific to this subject. Conclusions: The procedure allows direct access to specialized sites with a recovery of higher quality information and, at the same time, is part of a version of the methodology of management and generation of knowledge. © 2022, Editorial Ciencias Medicas. All rights reserved.
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Background: Rituximab (anti-CD20 Ab) is the cornerstone of the treatment of non-Hodgkin B lymphomas. Infusion-related reactions (IRR) are the most common adverse effects. To reduce them, intravenous premedication with antihistamine and acetaminophen is administered prior to rituximab. If no IRR after first infusion, subsequent infusions time takes 3-6 hours. Many centers use the rapid 90-minute infusion (off-label). Since 2017 subcutaneous rituximab formulation is available, that takes 5 minutes of administration. Nevertheless, in order to reduce cost, due to approval of biosimilars, some health providers continue using intravenous rituximab. On the other hand, with COVID pandemic, an effort to reduce visits and day-care hospitals stays has been made. In the current situation, it would be convenient to reduce day-care stay and the nursing care burden. We wanted to evaluate the safety of an ultrarapid infusion of biosimilar rituximab in a total time of 30 minutes by analyzing IRR and adverse events (AE). Methods: Since November 2021, 3 cohorts of ultrafast infusion have been studied as follows: One cohort (Cohort 1) with intravenous premedication with dexchlorpheniramine and acetaminophen, followed by rituximab infusion over 1 hour, and 2 cohorts with rituximab infusion over 30 minutes: Cohort 2: with intravenous premedication, and cohort 3 with oral premedication. IRR and adverse events have been independently reviewed and graded using Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0 (November 27, 2017). Results: 34 patients have been included receiving 48 rituximab infusions (16 infusions in each cohort). Median age was 64 years old (range: 51-91). Diagnostic of NHL were as follows: large b cell: 10;follicular: 13;marginal: 7;mantle cell: 1, Waldeström: 1;Ritcher transformation: 2. Rituximab infusion was in monotherapy (21), and in combination (27) with: bendamustine: 9, CHOP: 17, GEMOX: 1. Considering safety, no IRR has been observed in cohort 1 (1 hour infusion), and 1 IRR grade II in cohort 3 (30 minutes, oral premedication). Other AE were: hypertension grade I and hypotension grade I, both in cohort 2. Conclusions: Ultrarapid rituximab infusion is safe. Oral premedication is feasibly allowing a total infusion time of 30 minutes. This infusion rate alleviates day-care burden saving between 75-90% of time in each rituximab infusion, reduce day-care stay and is comfortable for the patients.
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Background: Lifestyle changes are crucial to preventing diabetes and its cardiovascular complications, including maintaining a physically active lifestyle. Morever, patient education is essential to promote diabetes self-management and health condition control. However, programs that combine physical exercise and lifestyle education are still poorly implemented in low- and middle-income countries, such as Brazil. The Diabetes College Brazil Study is a pioneer randomized clinical trial (RCT) designed to promote behavioral changes in adults with diabetes and prediabetes. PURPOSE: To test the feasibility, acceptability, and preliminary effectiveness of Diabetes College Brazil Study interventions (Exercise (Ex) vs. Exercise and Lifestyle Education (ExLE)) as part of the preparation for the development of the RCT. Methods: This pilot randomized trial (NCT03914924) had two parallel arms: ExLE program (12 weeks of exercise and educational interventions) and Ex program (12 weeks of exercise intervention only) (Figure 1). Feasibility (eligibility, recruitment, retention, completeness of RCT variables measures and participation rates), acceptability (satisfaction with interventions), and preliminary effectiveness of interventions (comparison of RCT variables measured in pre-and post-assessments) were evaluated. The preliminary effectiveness of the interventions was analyzed from the values of the difference between post-and pre-intervention measures (Δ post-pre) using both per-protocol (PP) and intention to treat (ITT) analysis for the comparison between groups (Ex vs. ExLE). The value 0 was imputed to replace the missing data in the analysis that followed the ITT principle. The results were reported as estimates of effect (95% confidence interval (CI) of the difference) for variables with normal distribution. RESULTS: Thirty-seven individuals participated in the study (ExLE: n = 18, 56.9±9.5 years old, 55.6% female, 5.6% prediabetes;Ex: n = 19, 59.5±7.3 years old, 52.6% female, 21.1% prediabetes). Eligibility, recruitment and retention rates were 16%, 100% and 82% respectively. The completeness of RCT variables measures was higher in the pre-intervention assessment. Missing data in the post-intervention assessment were mainly related to modifications in research procedures due to the COVID-19 pandemic. Participation rates in supervised exercise sessions and education classes were 76% and 71%, respectively (total sample). Interventions were highly acceptable to participants. There was a trend towards better results in the ExLE than Ex for most variables, mainly for physical activity level and quality of life (Table 1). Conclusion: The interventions are feasible and acceptable to participants. The results of this trial indicate the potential clinical benefit of lifestyle educational intervention associated with exercise intervention for people with diabetes and prediabetes. (Figure Presented).
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This paper presents an exploratory analysis of a of 117 news stories on the effects of the COVID-19 pandemic on education and reading habits and skills. The news stories were published in the Spanish-speaking press between March 2020 and May 2021 and compiled through the Factiva database. The analysis combined critical discourse with corpus linguistics methods. The results show that compulsory digitalization, which has affected the development of reading skills, has led to new problems relating to uneven access to connectivity and technology, as well as problems relating to endemic inequalities that have affected teachers, students and families alike.
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Background: Quarantines may exacerbate the presence of emotional symptoms or anxiety. Aim: To explore the relation between time spent in lockdown and development of depressive and anxiety symptoms. Material and Methods: A survey including the GAD anxiety and PHQ-9 depression scores was answered online by 1,488 subjects aged 36 +/- 14 years (74% women), invited to participate through social networks. Both scores are validated for the Chilean population. Results: Most responders had a private health insurance system. Sixty seven percent had clinically significant depressive symptoms and 39% had anxiety symptoms. Spending four or more weeks of lockdown (quarantine) was associated with 1.6 times higher risk of developing depressive symptoms and 2.9 times higher risk of developing anxiety symptoms. Difficulties in access to health care increased 3.3 times the risk of developing depression. Suffering a respiratory disease increased 2.39 times the risk of developing anxiety. Conclusions: There was a direct association between depressive and anxious symptoms, and the time spent of quarantine.
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The exponential increase in the number of COVID-19 infections around the world has prompted governments, in conjunction with medical and scientific communities, to recommend a social distance of at least two meters between people, to avoid increasing the number of infections. With the purpose of determining compliance with the measure of social distancing, a pilot test is carried out through video image processing for the people detection in open spaces in the central area of the city of Cucuta, Colombia. The proposed method consists of the analysis of information from videos of people with static background, taken from a height of 4.5 meters, in addition to location of centroids by the method of moments and distance estimation by the euclidean method, this, by means of Python programming language. As a result, it is obtained a success in the people detection of 92.43 % and that 84.21 % of those who circulated through the video frame and transit in the central zone of the city of Cucuta, Colombia, do not comply with the social distance of two meters recommended by the scientific community and exposed in the municipal circular 023 of 2020.
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The objective of this article is to present a computational estimate from a statistical physics approach and its contributions to Covid-19 in Colombia. Based on the daily data of contagions, recoveries and deaths, during the months of March to July, the estimation of the behavior of the epidemic was made using the nonlinear regression method with adjustment of curves by minimum squares. Highlighting the benefits that this method presents in the study of physical phenomena, it was used in the present research developing two types of modeling: exponential and Gaussian, and with these some predictions were made. The coefficients of determination of the exponential model were: 0.9641 for contagions, 0.9400 for recoveries and 0.9788 for deaths, and those of the Gaussian model were: 0.9799 for contagions, 0.9606 for recoveries and 0.9894 for deaths, showing a good correlation between the models and the real behavior of the pandemic, being the Gaussian one, the most approximate. This was also evidenced by comparing the prognosis of both models with the actual data for the first 13 days of August, concluding that the pandemic is beginning to mitigate, and the curve is flattening out. © 2020 Published under licence by IOP Publishing Ltd.
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Due to the global alert about the risk of contagion and propagation of Covid-19, a situation that has changed in the educational processes, this has forced the system to migrate towards a more dynamic and connected model of teaching and learning, which has allowed not to interrupt and to continue with the training processes, in a remote and assisted way. In this research, the profile of the engineering and science student is analyzed, and its relationship with the learning of physics in this crisis. For this purpose, the technique of simple random sampling of a certain population was applied, a research instrument was designed and validated by pairs of experts, its reliability was established based on Cronbach's Alpha test, and the instrument was applied to 354 students of the faculty of engineering and basic sciences, of the Universidad Francisco de Paula Santander, located in the city of Cúcuta, Colombia, during a 15-day time window, the analysis of the data and variables is carried out from the design of a mathematical model of logistic regression, where the dependent variable represents the feeling of emotional affect by the obligatory social isolation. The results indicated that the students feel emotionally affected in 88.56% generating implications in the learning of physics and in their academic performance, especially those who comply the profile: being female, single, not having received training in the use of digital platforms, without academic difficulties but who feel that their academic performance has been affected. © Published under licence by IOP Publishing Ltd.