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Introduction: Immunogenicity has emerged as a challenge in the development of vaccines against coronavirus disease of 2019 (COVID-19). Immunogenicity is a determinant of the efficacy and safety of vaccines. This systematic review and associated meta-analysis summarized and characterized the immunogenicity of COVID-19 vaccines in randomized controlled trials (RCTs). Methods: Relevant RCTs were systematically sourced from different medical databases in August 2021. The risk ratios and mean differences with 95% confidence intervals were calculated. Results: Of 2,310 papers, 16 RCTs were eligible for review. These RCTs involved a total of 26,698 participants (15,292 males and 11,231 females). The pooled results showed a significant difference in the geometric mean titer between the vaccinated and control groups in favor of the vaccine group after 1 and 2 months of follow-up, for the young age group (18 -< 55y), and with different doses (P < 0.001). The difference in the older age group (>55y) was insignificant (P = 0.24). The seroconversion rate of spike neutralizing antibodies favored the vaccine groups 1 or 2 months after vaccination (P < 0.001). The seroconversion rate of the vaccine group was significantly different (P < 0.001) from that of the control group. Conclusions: Vaccination elicits immunogenicity in the follow-up period for all age groups and at low and large doses. Therefore, people should be encouraged to receive vaccines currently being offered. A boost dose has been asserted for the elderly.
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Technostress-the difficulty of adapting to technologies-is a psychosocial condition that can affect one's emotional state and certainly seems to be affecting today's society. This is no longer a concept that is exclusive to workers whose work activities are directly related to technology;it now also affects millions of students in education. Digital migration forced by compulsory confinement has led to technostress in students all over the world, with consequences such as rejection, denial, fear, uncertainty and a series of other problems that affect students' mental state and integrity. These conditions in turn lead to a decrease in the quality of education, as students become fatigued, tired, or bored by having to spend so much time in front of information and communication technologies. The purpose of this chapter is to measure the level of technostress in higher education students who have been forced to change from on-site to the online educational models. It is also intended to compare the perception of the same students regarding these two educational models, in order to detect variants that affect their academic performance. The research uses a four-dimensional construct, in addition to analysing students' perception of each educational model through a fifth dimension. The results show that for students, the forced change from on-site to online education has posed a great challenge, resulting in negation, rejection, and addiction, among other conditions, which together account for a high level of technostress. © 2022 Emerald Publishing Limited. All rights reserved.
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Heart transplant recipients are at a very high risk of adverse outcomes after SARS-CoV-2 infection. There is no clear guidance on how to manage immunosuppression (IS) on heart transplant patients with COVID-19;in most studies IS was decreased or held. At our center, however, we deliberately maintained IS with the premise that this would result in a reduced inflammatory response to COVID-19. In this study we present our single center experience of heart transplant recipients infected with COVID-19 in whom IS was maintained. Retrospective analysis from June 2020 to February 2022 of heart transplant recipients followed at our center that tested positive for COVID-19. Patient demographics, comorbidities, baseline IS, hospitalization, ICU need, O2 requirement, mechanical support requirement and mortality were recorded. During the study period, 581 transplants were followed at our center, we documented 65 cases of COVID-19 (Table 1). The average age was 58 years, 75% male, 51% Caucasian. 50% had DM, 69% HTN and 48% CKD. Median time since OHT was 4.6 years. 71% of the patients were on dual IS. All patients remained on their baseline immunosuppression. Of the 65 patients, 37% required hospitalization, 9% ICU-level of care. Median LOS was 5.5 days. Mortality was 8%, there were no events of rejection or allograph dysfunction. Our data suggest that maintenance of therapeutical levels of IS in patients with COVID-19 is safe in heart transplant recipients. Our outcomes were comparable to those of the existing literature. Larger studies are needed to further validate our results. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Purpose: Reducing our carbon footprint (CF) or decarbonizing is a sustainable development goal. Although there has been an increase in research on this topic, little is known about the status of CF research within universities. The purpose of this paper is to identify the initiatives implemented in universities aimed at reducing CF in their efforts toward creating a Green Campus. Design/methodology/approach: Using a bibliometric method, the status of this field of research was examined for the purpose of identifying the main publications and the most central researchers in terms of productivity and citations. Also, by using an exploratory factor analysis (EFA), the regions of the world with the most active research, as well as the direction of research, were identified. Findings: The survey identified the region that published the most on the subject in the past 10 years, as well as the most relevant authors in the publications. Through this factor analysis, it was possible to identify, among the 105 publications analyzed, four distinct factors (clusters) with different thematic strands that appear to define a difference between the related studies on this topic. These factors were identified as campus management: supply and consumption operations;greenhouse gases emissions assessment: CF calculation;university air travel;sustainable food systems. The changes in people's attitudes and in the use of university spaces during the COVID-19 pandemic in relation to the CF was also noted as a point that can be investigated in future research. As well as the reflection of the reduction in academic air travel and the "forced” occurrence of online events during the same period. Originality/value: The paper aims to innovate by applying the multidimensional scaling method and EFA to scientific articles on the topic of decarbonizing campuses and identifying the clusters that constitute this field of study. The research seeks to contribute to current metric knowledge on the topic and to the creation of a specific research agenda. © 2022, Emerald Publishing Limited.
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Objetivos: Alteracoes em parametros laboratoriais sao descritos na infeccao por SARS-Cov-2. O objetivo deste trabalho foi analisar o comportamento de parametros do hemograma em relacao a infectividade do virus determinada pelo numero de ciclos (CT) do PCR, realizados em um laboratorio de referencia no periodo de fevereiro a junho de 2020. Material e metodos: Foram incluidos 1.218 portadores de SARS-Cov-2 detectados por RT-PCR (plataformas Roche 6800, Cepheid, protocolo Charite e kit Xgen), e 828 controles (sindromes gripais com RT-PCR negativo para SARS-Cov-2). O hemograma foi realizado no equipamento XN-10 (SYSMEX) com revisao em lamina e foram analisados os seguintes parametros: nivel de hemoglobina (Hb), numero de eritroblastos, leucocitos totais, neutrofilos, linfocitos, eosinofilos, desvio a esquerda (presenca de metamielocitos), numero de linfocitos atipicos e niveis plaquetarios. Os pacientes foram divididos em grupos a partir do CT: grupo 1 (1 a 20), grupo 2 (21 a 30), grupo 3 (31 a 40) e grupo 4 (> 40). Para comparacao entre grupos foram utilizados os testes ANOVA ouKruskal-Wallis e comparacoes multiplas pelos testes de Tukey e Dunn. Resultados: Das 1.218 amostras de infectados, 322 pertenciam ao grupo 1 (alta carga viral), 554 ao grupo 2 (moderada carga viral), 328 ao grupo 3 (baixa carga viral) e 14 ao grupo 4 (muito baixa carga viral). Houve diferenca significativa entre todos os parametros de hemograma com excecao do numero de eritroblastos em relacao a todos os grupos (controle e infectados em diferentes grupos de CT). A taxa de Hb foi menor nos grupos 2 e 3 em relacao ao controle. O numero de leucocitos foi menor no grupo 1 e 2 em relacao ao controle, e o numero de neutrofilos e leucocitos foram menores no grupo 1 em relacao a 2 e 3. O numero de linfocitos foi menor em 1, 2 e 3 em relacao ao controle, sendo menor no grupo 1 e 2 em relacao ao 3. O numero de eosinofilos foi menor nos grupos 1, 2 e 3 em relacao ao controle sendo menor nos grupos 1 e 2 em relacao a 3 e 4. A contagem plaquetaria dos grupos 1 e 2 foi menor em relacao ao grupo controle e apresentaram menores taxas em relacao aos demais grupos de infectados. Discussao: Os parametros laboratoriais do hemograma mostraram padrao semelhante ao observado em varias infeccoes virais com queda de Hb, leucocitos, eosinofilos e plaquetas nas fases com maior carga viral, com posterior recuperacao destes parametros. Entretanto, salienta-se que o grupo controle foi constituido por pacientes com sindrome gripal nao SARS-Cov-2, e, assim, e possivel considerar que o grupo de infectados peloSARS-Cov-2mostrou alteracoes mais significativas do hemograma desde o momento de alta carga viral ate a recuperacao em relacao ao grupo controle SARS-Cov-2 negativo. Estes dados refletem a fase inicial da pandemia durante a qual as linhagens predominantes foram B.1.1.28 e B.1.1.33 e na ausencia de imunizacao vacinal. Conclusao: Concluimos que ao se comparar os resultados laboratoriais de pacientes infectados pela primeira cepa do virus SARS-Cov-2, esses apresentaram maiores tendencias a queda dos parametros hematologicos durante o periodo com maior CV em comparacao a infeccoes por outros agentes etiologicos causadores de sindrome gripal. Copyright © 2022
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This paper reviewed the literature on the topics of organizational redesign, digital transformation, strategic planning, process management, administrative simplification, continuous improvement, redesign and automation, and also considered the activities developed to implement organizational redesign in the quarantine declared by the Peruvian state as a result of COVID 19, with the purpose of proposing a method for organizational redesign towards digital transformation in public entities, with a strategic and operational approach. For the implementation of the strategic approach, the institutions that functionally depend on the Ministry of Education were involved, considering the current situation in relation to the operational and territorial capacities of each region, to develop the strategic and process design. Likewise, for the implementation of the operational approach, the results of the virtual course on process management for administrative simplification 2 were used, involving several institutions that proposed and implemented improvements towards the digitization of processes, promoting digital transformation. The results of the present work consider the effective time of the administrative procedures and the cost of implementation. The effective time of the procedures was reflected in a reduction of 11% and 52% in the reduction of the cost of the procedures. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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COVID-19 infection occurs mainly in mild and severe forms, the latter requiring hospitalization and respiratory support due to complications such as severe acute respiratory syndrome (SARS), the clinical course of which has been widely described;however, the alteration of laboratory profiles has not been precisely established. A retrospective study was carried out to determine biochemical parameters and blood counts in 32 patients with moderate and severe COVID-19, confined at the "Raul Maldonado Mejia" Basic Hospital in Cayambe, Ecuador, and to evaluate their usefulness as indicators of severity. Medical records were reviewed., obtaining clinical, biochemical and hematometric data. A higher proportion of moderate and severe COVID cases was observed in men, and the severe form in both genders, with an average age between 45-73 years. The most frequent comorbidities were: arterial hypertension (HTA), type 2 diabetes mellitus (DM2), congestive heart failure (CHF) and obesity. The biochemical and blood count parameters with the worst prognosis for severity were: elevation of lactate dehydrogenase (LDH) activity, alanine aminotransferase (ALT), aspartate aminotransferase (AST), C-reactive protein (CRP) levels, prothrombin time (PT) prolonged, total leukocyte count, ne index utrophil/lymphocyte (INL) and decreased lymphocytes. Biochemical parameters (LDH, CRP, ALT, AST), coagulation (PT) and blood counts (leukocyte count, lymphocytes and INL) can be useful indicators of severity in patients with COVID-19, allowing early identification of patients with moderate disease and avoid the development of the most severe form of the disease and its complications.
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This research analyzes the Job Satisfaction in the Footwear sector in the State of Guanajuato, Mexico, in Times of COVID-19 Pandemic (JSFTPfootware). A participation of 231 collaborators, affected by the COVID pandemic, were considered in the study;as well as the variables of “wor-king conditions” and “a safe and healthy company”, as determinants of JSFTPfootware. To carry out the analysis, a system of structural equations was modeled that yielded a good fit to validate the dependence between the indicated variables and JSFTPfootware. It was determined em-ployees perceive as essential elements in their working conditions, the economic stability, the growth opportunity and the communication spaces. Their also belief that to be in a safe and healthy company, implies adequate management and infraestructure, being factors that influence their job satisfaction. © 2022, Revista Portuguesa de Estudos Regionais.All Rights Reserved.
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Objectives: To compare the number of deaths that occurred in the state of Amazonas and in Brazil, from March 16th to August 20th 2020, using the variables skin color, sex, place of death, age group and association with COVID-19, and secondly, to verify whether between 2019 and 2020, in the period from March 16th to August 20th, there was a significant change in the number of deaths from diseases not associated with COVID-19. Methods: We searched the databases of the Brazilian public agency "Transparency Portal" for the data on deaths that occurred in the state of Amazonas and Brazil in the period from March 16th to August 20th, 2019 and 2020. The absolute frequencies and percentages of the variables studied were used for statistical analysis. Results: COVID-19 was responsible for an 11.01% increase in deaths in Brazil;however, this rate quadrupled in the state of Amazonas. In relation to age group, there was a similar percentage between Amazonas and the national average. The stratified analysis showed significant differences between genders and races, with higher death rates in men and people of brown/black skin. The number of deaths at home increased significantly, especially those from causes not associated with COVID-19. Conclusions: The national drop in deaths from diseases not associated with COVID between March and August 2020 in Brazil is misleading and may be due to the result of misreported causes of death.
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In December 2019, an outbreak of pneumonia cases emerged in Wuhan, China, which evolved into the COVID-19 pandemic. The purpose of the work is to design a community prevention strategy in the indigenous population of zone 3 at the starting point of the epidemiological characterization carried out. A longitudinal and prospective experimental explanatory study was conducted with deliberate intervention, descriptive and inferential statistical methods were used. It was identified that the age of 60 years or more pre- dominated in the subjects surveyed, which represented 9,7%, and the other risk group located at ages under 18 years, were located 17 for 4,5% of the sample, although the figure of both age groups of risk is not high, it is necessary to work with the indigenous population at the community level, ischemic heart disease, high blood pressure, diabetes mellitus and bronchial asthma were also identified as a risk. As social factors, extreme poverty, living alone, overcrowding and poor accessibility to health services. The community prevention strategy of Covid-19 in the indigenous population will favor the epidemiological control of the pandemic with probable economic and social impact added, which will guarantee a rational use of resources focused on the most vulnerable population.
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Introduction: The university population may be vulnerable to self-medication due to COVID-19 due to their greater exposure to social networks and their tendency to imitate self-medication practices of their social environment. Objective: Assess the characteristics and factors associated with self-medication due to COVID-19 in undergraduate university students of a Peruvian university. Methods: An analytical cross-sectional study (October 1st to November 14, 2020) in which 166 surveys were analyzed among students of the National University of Central Peru selected through a probabilistic sampling stratified by faculties. The factors associated with self-medication were evaluated by Poisson regression of robust variances, in this way the prevalence ratios and corresponding confidence intervals were obtained. Results: 14.5% of the students self-medicated due to COVID-19 and the main reasons were sore throat (45.8%), fever (37.5%) and disease prevention (29.2%). The most commonly used drugs were paracetamol (70.8%), aspirin (62.5%) and influenza drugs (62.5%). Some participants (20.8%) reported experiencing side effects after taking medications such as aspirin, ivermectin, dexamethasone, and chlorine dioxide. The perception that self-medication is harmful to health (PR: 0.41;CI: 0.20-0.84) and having doctors as a source of drug information (PR: 0.46;CI: 0.21-0.99) were associated with self-medication due to COVID-19. Approximately 15 out of every 100 students in the studied population self-medicated due to COVID-19. Likewise, those who perceived self-medication as harmful to health and who had doctors as a source of drug information self-medicated less. Conclusions: The results allow us to characterize the problem of self-medication due to COVID-19 in university students, while offering information for the approach of strategies that reduce its negative impact.
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Background. Epicardial adipose tissue (EAT) is a highly inflammatory depot of fat, with high concentrations of IL-6 and macrophages, which can directly reach the myo-pericardium via the vasa vasorum or paracrine pathways. TNF-α and IL-6 diminish cardiac inotropic function, making EAT inflammation a potential cause of cardiac dysfunction. Methods. A retrospective cohort study assessing EAT Thickness and Density from CT scans, without contrast, from adult patients during index admission for COVID-19 infection at Mount Sinai Medical Center from March 2020 to January 2021. A total of 1,644 patients were screened, of which 148 patients were included. Follow-up completed until death or discharge. The descriptive analysis was applied to the general population, parametric test of normality for comparisons between groups. Kaplan survival analysis was conducted after survival distribution was confirmed significant. It was followed by the assumption of normality by Q-Q Plot, prior to performing a multiple regression analysis in the vulnerable group using a K-Matrix input for cofounders. A log-rank test was conducted to determine differences in the survival distributions for the different ranges of EAT thickness. Results. A total of 148 Participants were assigned to two groups based on epicardial adipose tissue in order to classify them as increased or decreased risk of cardiovascular risk: >5mm (n = 99), < 5mm (n = 49). The survival percentage was higher in the group with no EAT inflammation compared to the group with EAT inflammation (95.0% and 65%, respectively). Participants with EAT >5mm had a median day of hospital stay of 18 (95% CI, 16.86 to 29.92). The survival distributions for the two categories were statistically significantly different, χ2(2) = 6.9, p < 0.01. A Bonferroni correction was made with statistical significance accepted at the p < 0.025 level. There was a statistically significant difference in survival distributions for the EAT >5 mm vs EAT < 5 mm, χ2(1) =6.953, p = 0.008. Conclusion. There was an association with increased EAT thickness and increased mortality. These findings suggest that EAT thickness can be used as a prognostic factor and as a risk factor for increased mortality in patients with COVID-19.
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Intro: Cardiac involvement in COVID-19 infection is common. Epicardial adipose tissue functions as an inflammatory depot, and a thickness (EAT-T) >5mm is associated with increased cardiovascular risk. The present study assessed the significance of increased EAT-T in patients with COVID-19. Methods: A retrospective cohort study of 149 consecutive patients diagnosed with COVID-19 between March 2020 to January 2021 was performed. Inclusion criteria were lab-confirmed COVID19 infection and having a Chest CT scan without contrast during hospitalization. EAT-T was measure in right ventricle free wall (Figure 1). Characteristic of patients and comparisons were analyzed by T-Test and Chi-square. Log-linear analysis and cumulative logistic regression was carried out to predict effect between EAT-T and mortality Results: The mean age was 67 ± 15 years, 65% were male, and time from onset of symptoms was 7 ± 5 days. Forty-seven (31.5%) patients required mechanical ventilation, and 34 (22.8%) required vasopressors. Medical therapy included convalescent plasma (36%), Remdesivir (28%), Tocilizumab (46%), Enoxaparin (64%), and Dexamethasone (39%). There were 36 (24.2%) inhospital deaths, with a greater incidence amongst patients with an EAT-T > 5 mm versus ≤ 5 mm (95 vs 5%, p=.001). Notably, age was not significantly different on patients with in-hospital mortality (69 vs 66 years, p=0.5), and higher EAT-T by 2.17 mm on patient with acute respiratory distress syndrome (p=.001) and 10.9 mm in myocardial infarction (p=.02). In multivariable analysis an EAT-T >5mm was associated with an increased risk of mortality (OR 12.3, 95% CI 3-55, p=.001). In the presence of EAT-T > 5 mm, no effect was observed by chronic kidney disease, hypertension, coronary artery disease, dyslipidemia, or body mass index (p >0.5). Conclusions: In patients with COVID-19, an EAT-T > 5 mm is associated with increased risk of inhospital mortality and may provide important risk stratification.
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Portuguese-speaking countries are at different levels in the process of promoting environmental education and sustainability. In recognition of the political and cultural ties within a considerable diversity of socio-economic conditions, a pioneering study was developed in 2017 to map and establish a diagnostic of Environmental Education’s (EE) realities and “sustainability norms legislation” in the Lusophone nations. Three years later, the EE2CPLP survey, implemented in 2020, builds upon and streamlines the first edition, considering the current context marked by Agenda 2030 and the impacts and concerns regarding the COVID-19 pandemic. Thus, the survey was divided into three main sections: (1) Contexts and EE approaches in the CPLP countries;(2) Place and role of children and youth in the field of EE and (3) Coronavirus pandemic environment, against the backdrop of Agenda 2030. In the following chapter, we will address EE’s cross-cutting nature, its selective traditions (i.e., positivist, normative, and pluralist) and its role for sustainable development and the 2030 Agenda. Looking for the perspective of stakeholders and experts in Environmental Education (EE) and sustainability, we will assess the perceived impact of the current health crisis, which compounds the climate crisis, exacerbating the socio-economic issues within Portuguese-speaking countries. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.