The Effect of Sociodemographic Factors on COVID-19 Mortality in Costa Rica: A Geographic Approach

Introduction: The coronavirus disease (COVID-19) has spread among the population of Costa Rica and has had a great global impact. However, there are important geographic differences in mortality from COVID-19 among world regions and within Costa Rica.Objective: To explore the effect of some sociodemographic factors on COVID-19 mortality in the small geo-graphic divisions or cantons of Costa Rica.Methods: We used official records and applied a classical epidemiological Poisson regression model and a geographically weighted regression model.Results: We obtained a lower Akaike Information Criterion with the weighted regression (927.1 in Poisson regression versus 358.4 in weighted regression). The cantons with higher risk of mortality from COVID-19 had a denser population;higher material well-being;less population by health service units and are located near the Pacific coast.Conclusions: A specific COVID-19 intervention strategy should concentrate on Pacific coast areas with denser population, higher material well-being and less population by health service units.

Management Tools for Process Mapping and Modeling in Assembly Industry

In a highly globalized world affected by economic policies and a latent COVID-19 pandemic, companies need to organize or reorganize to achieve efficient operations. The correct management of organizations has led their administrators to adopt resourceful management models that guide their activities towards fulfilling their objectives. Thus, management tools have been presented as an effective alternative to control processes and activities. According to a previous study, the main tools that allow process mapping and modeling are Business Process Management (BPM), Business Process Reengineering (BPR), and Event Process Chain (EPC). This article analyzes their characteristics based on compatibility and affinity with four case studies dedicated to the assembly industry using this previous study. In addition, the advantages and disadvantages of the three tools related to the possible adaptability in the four companies are studied. This work uses qualitative qualification matrices, which answer specific questions, determine the potential improvement of organizational management, and create a methodology for mapping and modeling processes. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Increasing teleconsultation utilisation for pre-operative anaesthesia evaluation in the COVID-19 pandemic era: a qualityimprovement project

The COVID-19 pandemic has accelerated the growth of telemedicine. Advantages include patient convenience, reduced waiting time, minimising hospital commute and the risk of virus transmission and healthcare cost-savings [1]. Compared with other specialties, anaesthesiology is less engaged with telemedicine- based clinical work and challenges in implementation exist [2]. To align with the Ministry of Health, Singapore COVID-19-safe management measures, pre-anaesthetic assessment via video consultation (VC) workflow was implemented in Sengkang General Hospital, Singapore, in December 2020;however, the referral rate amongst our surgical colleagues remained low. Therefore the aim was to increase the number of VCs by 50% within 12 months (from June 2021) and evaluate patients' experiences. Methods Eligibility criteria included low-risk surgeries (duration < 4 h) with minimal expected blood loss, patients aged 21-65 years, ASA status 1 or 2, body mass index < 35 and the patient's ability to use the Zoom video-conferencing application. Post-consultation, patients were invited to complete an electronic patient satisfaction survey. The main reasons for the low VC referral rate were identified based on ground engagement and feedback. Two plan-do-study-act (PDSA) cycles were conducted to address these issues. PDSA cycle 1 (June 2021): to increase awareness amongst surgeons, surgical champions were engaged to promote VC within their departments;however, the VC referral rate remained low. Therefore, a second PDSA cycle was undertaken. PDSA cycle 2 (October 2021): to increase patient and staff awareness by placing posters publicising VC and enlisting the help of Patient Service Associates (PSAs) to screen for patient eligibility. This led to a significant increase in VC referrals. The current workflow will be evaluated for sustainability. Results Pre-intervention, the average number of monthly VCs was 3, and remained unchanged during PDSA cycle 1. This was increased to 14 during PDSA cycle 2. Discussion VC referrals have increased after the modified workflow, achieving high patient satisfaction and no surgical cancellations. Future work includes developing an automated VC workflow for low-risk surgeries. (Figure Presented).

The effects of quarantine on anxiety and emotional symptoms. Results of an online survey

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.

Management Tools for Process Mapping and Modeling in Assembly Industry

In a highly globalized world affected by economic policies and a latent COVID-19 pandemic, companies need to organize or reorganize to achieve efficient operations. The correct management of organizations has led their administrators to adopt resourceful management models that guide their activities towards fulfilling their objectives. Thus, management tools have been presented as an effective alternative to control processes and activities. According to a previous study, the main tools that allow process mapping and modeling are Business Process Management (BPM), Business Process Reengineering (BPR), and Event Process Chain (EPC). This article analyzes their characteristics based on compatibility and affinity with four case studies dedicated to the assembly industry using this previous study. In addition, the advantages and disadvantages of the three tools related to the possible adaptability in the four companies are studied. This work uses qualitative qualification matrices, which answer specific questions, determine the potential improvement of organizational management, and create a methodology for mapping and modeling processes. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Comparison of Convolutional Neural Network Architectures for COVID-19 Diagnosis

Convolutional neural networks (CNNs) have shown great potential to solve several medical image classification problems. In this research, thirty-two CNN architectures were evaluated and compared to perform COVID-19 diagnosis by using radiographic images. A collection of 5,953 frontal chest X-ray images (117 patients diagnosed with COVID-19, 4,273 with Pneumonia not related to COVID-19, and 1,563 Normal or healthy) was used for training and testing those thirty-two architectures. In this article, the implemented metrics were according to the conditions of an imbalanced dataset. Seven of the thirty-two models evaluated achieved an excellent performance classification (>= 90%) according to the Index of Balanced Accuracy (IBA) metric. The top three CNN models selected in this research (Wide_resnet101_2, Resnext101_32x8d, and Resnext50_32x4d) obtained the highest classification precision value of 97.75%. The overfitting problem was ruled out according to the evolution of the training and testing precision measurement. The best CNN model for COVID-19 diagnosis is the Resnext101_32x8d according to the confusion matrix and the metrics achieved (sensitivity, specificity, F1-score, G_mean, IBA, and training time of 97.75%, 96.40%, 97.75%, 97.06%, 94.34%, 76.98 min, respectively) by the CNN model.

MEDIIK: Design and Manufacturing of an Emergency Ventilator against COVID-19 Pandemic

Herein we describe the modular design and manufacturing of an emergency ventilator based on cyclical compression of a resuscitation bag to face the COVID-19 pandemic. This was done to mitigate the staggering conditions to supply these medical devices under challenging scenarios of need and logistics. The design is based on international standards and commissions for medical electrical equipment, particular requirements for basic safety, electromagnetic compatibility, and essential performance of critical care and emergency ventilators. The modular design is capable of providing four ventilation modes: volume/pressure mandatory ventilation and volume/pressure assisted ventilation. After testing with artificial lungs, calibration, and validation instruments it was found that the main ventilation parameters achieved are: maximum tidal volume of 700 mL, maximum pressure of 50 cmH2O, inspiration/expiration ratio up to 1:4 at 30 breaths per minute. The MEDIIK designation is derived from the mayan word ik' which means wind. © 2021 ACM.

Policies to control the COVID-19 pandemic in Costa Rica

The objective of this paper is to present a series of policies for the control of the COVID-19 pandemic by the Costa Rican authorities. An exhaustive review of the pandemic control policies was made in the official government media, mainly the Ministry of Health and the Costa Rican Social Security Fund and some collective media. The first wave of the pandemic in Costa Rica was quite mild, allowing the government to address it with a series of quite effective suppression and mitigation measures, which had the unrestricted support of the population. The second wave grew aggressively, causing social discontent due to the economic impact. Due to the ineffectiveness of the “hammer and dance” strategy, the Costa Rican government has rethought that strategy, lifting certain restrictions while recognizing the risk involved in terms of the increase in cases of COVID-19 in cases and deaths. © 2020 Academia Nacional de Medicina. All rights reserved.