ABSTRACT
Two years after the shock undergone by the Italian school ecosystem—due to the lock-down imposed by the COVID-19 at beginning of March 2020—the effects generated by the resulting fully digital immersion have been investigated by a survey administered to a representative sample of school teachers and principals. The analysis of the outcomes, together with their comparison with similar investigations performed in May 2020 and March 2021, shows that the activities carried out in the last two years—from emergency teaching to integrated teaching and, finally, to teaching in a “new normal” condition—have triggered an apparently fast innovation process with beneficial effects on the e-maturity of the system, on the educational processes and on the state of the individual well-being. Although some symptoms of normalization start to be glimpsed, and despite the workload increase induced by the adoption of technologies, the system seems ready to carry out an optimization of the educational processes to include a stable use of didactic activities augmented by technologies and, more in general, of forms of integrated on-line learning. As a corollary, emerges the relevance attributed, in a plebiscite manner, to continuous training (LLL) on learning technologies and digital pedagogy, as well as the need to implement permanent forms of smart working to thin the organizational processes. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
ABSTRACT
Background: liver injury has been reported at variable rate during COVID-19 outbreak, but the impact of pre-existing liver damage and related etiology has not been detailed so far Methods: we studied the reciprocal impact of COVID-19 and viral or metabolic pre-existing advanced liver diseases in patients consecutively admitted at 3 Italian hospitals during the COVID-19 emergency In this preliminary analysis we analyzed the results of patients enrolled in the observational study from February 28th to April 10th 2020;further analyses will be presented at the meeting Simultaneously, we investigated the prevalence of COVID-19 in patients with all HCV genotypes and any stage of fibrosis or HCV genotype 3 and cirrhosis prospectively enrolled in two real world studies on sofosbuvir/velpatasvir pangenotypic treatment recently published by our collaborative group Results: in the observational study, prevalence of HCVAbs and HBsAg positivity, among 332 COVID-19 infected patients matched recently reported national data Demographic and laboratory results in the table Overall 27 4% and 24 3%, respectively showed increased ALT and AST levels Only 10 patients (3 0%) had HCVAbs, 1 with detectable HCV-RNA, the remaining with spontaneously or treatment-induced HCVRNA clearance The frequency of HCVAbs among subjects with increased ALT at baseline (6.6%) was significantly higher than in patients with normal liver enzymes (1 8%) (p=0 038) Pre-existing cirrhosis was reported in 10, 7 had non viral origin cirrhosis, 70% of non viral origin died Overall mortality was 27 1% Cirrhosis, older age, low white blood cell (WBC) and lymphocyte count were independent predictors of death (OR=6 14, 95%CI 1 11-34 15, p=0 038;OR=1 05, 95%CI 1 03-1 07, p=0 0001, OR=1 10, 95% CI 1 01-1 16;OR=1 06, 95%CI 0 39-0 90, p=0 015) Among HCV patients recently treated with pangenotypic regimen, only 1 (0 07%) with cirrhosis in the pangenotypic study and 2 (1%) in the GT3 cirrhosis study reported COVID-19 ascertained infection, all of them recovered Conclusion: in the observational study, prevalence of HCVAbs is low among patients with COVID-19 Pre-existing cirrhosis is associated with high mortality Whether patients recently cured for HCV infection had a smaller exposure or were less vulnerable to COVID-19 as compared to patients with cirrhosis of metabolic origin deserves further investigation.