MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN ACROSS 16 LATIN AMERICAN COUNTRIES: A MULTICENTER STUDY FROM THE REKAMLATINA NETWORK

BackgroundMultisystem Inflammatory Syndrome in Children (MIS-C) is one of the most feared complications following SARS-CoV2 infection in children and adolescents. Few multinational multicenter studies from Latin America have been published.ObjectivesTo describe the clinical presentation, management, and outcomes of MIS-C in Latin America.MethodsObservational, prospective and retrospective, multicenter study to gather information from 84 participating centers across 16 Latin American countries, between August January 1, 2020 and June 30, 2022.ResultsOf the 1,239 reported cases of MIS-C, 84.2% were previously healthy. The most frequent clinical manifestation in our studied population was abdominal pain (N=804, 64.9%), followed by conjunctival injection (N=784, 63.3%). The median days of fever at the time of hospital admission was 5 and a significant number of subjects required admission to an intensive care unit (N=589, 47.8%). A total of 538 (47.2%) patients had an abnormal initial echocardiogram. Most of the subjects (N= 1,096, 88.7%) were treated with intravenous immunoglobulin (IVIG), while 76.7% (N= 947) were treated with steroids, of which 10.6% (N= 100) did not receive IVIG. The death rate attributed to MIS-C was 4.88%, with a rate of 3.39% for those initially diagnosed with MIS-C and 8.85% for those whose admission diagnosis was not MIS-C (P= 0.00001).ConclusionOne of the most significant findings from our study was the death rate, especially in those not initially diagnosed with MIS-C, in whom it was higher. This highlights the importance of increasing awareness and making an earlier diagnosis of MIS-C in Latin America.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

Project (e)mergency Remote Instructional Skills Enhancement (e-RISE): Implications to Nursing Education in Times of a Global Health Crisis

The COVID-19 pandemic urged higher learning institutions to initiate an agile response to ensure quality online teaching and learning. In response to the challenges of transitioning from traditional to online teaching and learning during the COVID-19 pandemic, the researchers explored the lessons uncovered from the (e)mergency Remote Instructional Skills Enhancement (e-RISE), an intervention that comprised a series of faculty mentoring sessions towards full adoption of an online platform for professional nursing courses. This action research utilized the Look, Think, Act cycle of Stringer (1996) involving eleven nurse faculty as participants. Using thematic analysis, various themes were revealed such as advancing technological knowledge and competence, accepting personal limitations, values acquisition, and teacher empowerment. Firstly, the technological knowledge and competence of the nurse faculty require further improvement. Secondly, the acceptance of personal limitations in terms of putting up online learning modules implies the need to enhance pedagogy and design. Values acquisition in terms of life skills was also dominant in response to the need to change and adapt during the pandemic -challenged teaching and learning. As another significant finding, reverse mentoring is highly recommended to sustain Project e -RISE. To make remote teaching and learning more feasible, effective, and efficient, teacher empowerment must be prioritized. Generally, the study findings suggest that Project e -RISE may be adopted by institutions of higher learning as a sustainable mechanism to capacitate the nurse faculty in their migration from traditional to remote teaching.

Development of a Platform for Learning Cybersecurity Using Capturing the Flag Competitions

Currently, cybersecurity is a topic of great importance for society. With the increase in the use of technology and the digitization of many activities, the number of cyber threats to which individuals and organizations are exposed has increased. In addition, the COVID-19 pandemic has accelerated the digitization of many processes, further increasing the risk of cyberattacks. One of the main causes of these problems is the lack of cyber security awareness, as many people and organizations do not have a proper understanding of cyber threats and the measures, they must take to protect themselves. As a solution to the lack of cybersecurity knowledge, this work proposes the development of a Capture the Flag platform for learning about cybersecurity. The objective is to provide a tool that allows the education of future professionals in this field and covers the existing demand for this type of specialist. The platform is made up of two sections, one for learning and the other for CTF. The first section allows teachers to contribute to the teaching of their students using challenges. The second section allows one to carry out competitions with effective results when acquiring knowledge and experience. The platform is evaluated using questionnaires and surveys to measure whether the platform fulfills its purpose. © 2023 by the authors.

Hazard communication through telephone interpreters during the pandemic in Spain: the case of COVID-19 tracer calls

This contribution addresses the telephone calls from coronavirus tracers to patients mediated by interpreters through the analysis of a series of real conversations during the communication of PCR tests results, hazards of this situation, hygiene instructions, lockdown orders, and related health issues. The focus will be on culture-related aspects of the communication related to the perception of risk and the asymmetry of knowledge, as reflected on the discourse of the tracers and the responses from patients (many of them immersed in situations of helplessness, unemployment, mental disorders, indigence or simply defiance against legal and health restrictions), as well as on the mechanisms that interpreters use to bridge communication. Critical incident analysis will be used as a methodological approach to select, analyse, and reflect on examples, to be able, not only to offer objective results about the characteristics of the discourse and the nature of the mechanisms used by interpreters, but also to provide criticism and suggestions for the interpreting practice. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

Remote interpreting in Spain after the irruption of COVID-19: A mapping exercise

Remote interpreting, particularly telephone interpreting, was implemented in Spain less than 20 years ago and, since then, it has become increasingly common. Its use has even increased during the last months, due to COVID-19 circumstances and the subsequent growth of telecommuting. This paper aims at mapping remote interpreting services in Spain. With that purpose, structured qualitative interviews were conducted with representatives of the six main Spanish companies offering these services. The results show a diffusion of telephone interpreting across the country and an incipient presence of video-link interpreting. Nevertheless, more attention to quality performance and working conditions should be paid. © 2022 Universidad de Cordoba,Servicio de Publicaciones. All rights reserved.

Learning analytics as a tool for interpreting the effect of the pandemic on the final grade in Chemistry I course at the State Distance University of Costa Rica

Due to Covid-19, educational institutions had to change traditional educational practices to virtual modality, representing significant challenges on the planning, mediating, and evaluating processes. Learning analytics are a set of innovative tools in the pedagogical area, in which the use of data can contribute to the improvement of courses and educational policies. This work aims to carry out a descriptive reflection of the learning analytics evaluating the effect of the pandemic on the overall performance of the subject. For this purpose, a quantitative investigation was carried out by studying the grades in the subject of Chemistry I during the 2018-2021 period at the UNED, Costa Rica. The overall performance and approval of the subject experienced an increase in the average grade during the period 2020-2021. In addition, some significant differences were found between the mean grades according to the demographic regions of the country. However, it is necessary to make efforts in order to measure the quality of the learning achieved in the subject and the degree of satisfaction of the students according to the learning objectives that have been achieved in the course.

Technological performance of cucumber and squash as an opportunity for post-COVID-19 economic recovery

Cucumber (Cucumis sativus) and zucchini (Cucurbita pepo) are produced on small farms in the Andean tropics. Previously, the only identified use was for salads but, in the last five years, diverse applications have developed. Smoothies, juice and other combined beverages based on cucumber are new products in the food industry. Likewise, dehydrated cucumber and zucchini slices could be a new snack. In particular, transformed vegetables that have healthy kinds of bioactive and phytoterapeutic components could be used in small, local, commercial markets post-COVID-19. Fresh vegetables are not easily marketable, especially with post-COVID-19 limitations in affected latitudes, but dehydrated cucumber and zucchini offer simple processing lines in the farmer-producer-transformer-consumer chain. “Junk food” sees high consumption by children and young people, resulting in poor nutrition and predisposition for obesity and other non-communicable illnesses in future adults. Healthy snacks are required for a radical change in food habits. Fresh cucumber and zucchini slices were dehydrated with two methods: direct convection and irradiance, providing crisp slices. Osmotic dehydration was applied with NaCl2 solutions, from 1 to 3%. Natural flavors, pepper and paprika and sea salt spices, were included in the osmotic solutions to make the flavor of the slices more attractive for consumers. The slice thickness varied from 0.3 to 0.5 cm, providing the most desirable product. The slices flavored with paprika or pepper were accepted by the panel without differences for the zucchini slices, while, for the cucumber slices flavored with sea salt spices, thin slices were preferred because of the texture. According to the results, cucumber and zucchini possess technological aptitude for producing crisp slices with good organoleptic characteristics. Simple technological processing lines should be implemented in medium and small sized food companies, thereby contributing to economic recovery under post-COVID-19 vulnerable commercial production conditions in the tropics. © 2022 International Society for Horticultural Science. All rights reserved.

Resilience and mediation: mechanisms to resolve family conflicts in times of the SARS-CoV-2 pandemic

The article analyzes the importance of resilience and the usefulness of family mediation as an effective method of family conflict resolution in times of the SARS-CoV-2 pandemic. To meet the objective, an exploratory descriptive analysis was conducted comparing the official figures of complaints of domestic violence published by the National Police of Colombia during the years 2019 and 2020, in the period from January to February and those occurring after March 11, 2020, the date on which the World Health Organization (WHO), classified the epidemic outbreak of SARS-CoV-2 as a pandemic and in coherence with the mandatory preventive isolation in the country. The study was carried out based on the characteristics of the perpetrators, the type of weapons used, and the distinctive elements of the reports before and after the measure. The studies agree that the global health emergency is a completely new condition that will be overcome, based on the contributions of different disciplines that emphasize the importance of the consequences on individual and family mental health, overcoming the intervention focused on prevention and treatment;to move towards an intervention oriented towards conflict resolution. From this perspective, family mediation is configured as a strategy that enhances positive personal and family development. The findings allow us to generate proposals that promote family mediation as an effective method for conflict resolution, prevention, and reduction of violence, with the benefits of resilience. © 2022 Academia Nacional de Medicina. All rights reserved.

Real-Time Estimation of Alternative Stress Index for Low-Cost, Mechanical Ventilators for Emergency Use

Stress index is a useful indicator in mechanical ventilation to assess improper ventilation settings. It can indicate tidal overdistension or tidal recruitment, which are two major mechanisms of ventilator-induced lung injury. However, it's implementation require dedicated hardware and software and is not a widespread parameter used in commercial ventilators. In this work, an alternative, simple way to visually inspect the concavity of the pressure-time curve during mechanical ventilation is presented, by calculating the pressure difference of the pressure-time curve. This proves useful when implemented in low-cost emergency devices, such as those designed to cope with the COVID-19 pandemic, because of the reduced computational load required to perform its calculation. The method was implemented in a low-cost emergency mechanical ventilator and tested with an artificial lung for a proof-of-concept. Results show that this alternative method can be effectively used to qualitatively assess the concavity of the pressure-time curve.

Combining hands-on and virtual experiments for enhancing fluid mechanics teaching: A design-based research study

Fluid Mechanics courses comprise both theoretical and laboratory modules. In developing nations, computer-assisted techniques are not commonly applied in Fluid Mechanics instruction. Forced by the COVID-19 pandemic, South American universities are, however, using them for online teaching. This contribution presents an 8-semester (2016–2019) educational intervention over an undergraduate Fluid Mechanics course. It mainly blends physical (hands-on) and virtual experiments (computer fluid dynamics-based simulations) for the laboratory module, which are complemented by flipped classroom-based prompts for the theoretical module. The intervention follows design-based research as a research method and is guided via conjecture mapping and fidelity of implementation standards. Our results suggest that the intervention improves fluid mechanics laboratory instruction, although improvements depend upon the participation of other educational actors such as teaching assistants and laboratory technicians to some extent. Laboratory report grades (the assessment instrument) follow the Gompertz probability distribution. Following UNESCO standards, a portion of the intervention output is shared as open educational resources. This contribution encourages upscaling the educational intervention through the formation of cooperative clusters to build common-pool Fluid Mechanics resources. Learning scientists have underlined the need to better understand laboratory instruction processes. They have been addressed in very few instances in developing countries. We believe that this study has the potential to provide valuable insights on the matter. © 2022 Wiley Periodicals LLC.

INTRACELLULAR SARS-COV-2 FOUNDIN THE SPERMATOZOA OF CONVALESCENT MEN WITH NEGATIVE PCR SEMEN SAMPLES REVEALED BY ELECTRON MICROSCOPY

INTRODUCTION AND OBJECTIVE: SARS-CoV-2 can invade different testicular cell types, such as spermatogonia, spermatids, Sertoli, and Leydig cells. We investigated the viral presence inside the sperm of negative PCR infected men up to 3 months after discharge from the hospital. METHODS: This cross-sectional study included 13 of a 26 moderate-to-severe SARS-CoV-2 infected men cohort (mean 34.3 ± 6.5 years;range: 21-50 years old). Patients were enrolled 30 to 90 days after the diagnosis. Semen samples were obtained by masturbation and processed within one hour according to WHO guidelines. All patients were PCR negative for the virus in the ejaculate. Samples were liquefied for 30 min at room temperature in 0.1M phosphate buffer before centrifuging at 500 g for 10 min. The supernatant was removed, and pellets were fixed in 2,5% v/v glutaraldehyde in 0.1M phosphate buffer for 2h at 4°C, post-fixed in 1% OsO4 for 1h at 4°C, stained overnight in 1% aqueous uranyl acetate. Then, the pellets were dehydrated sequentially in 30%, 70%, and 100% ethanol and embedded in epoxy resin. Ultrathin sections (70nm) were obtained in an ultramicrotome, collected on nickel grids, and double-stained by uranyl acetate and lead citrate. Micrographs were obtained with a Jeol JEM 1010 electron microscope (Tokyo, Japan, 80 kV). RESULTS: We identified viruses inside spermatozoa in 9/13 patients up to 90 days after discharge from the hospital. Moreover, in all 13 men, a type of DNA-based extracellular traps, probably in a cfDNAdependent manner, like described in the COVID-19 systemic inflammatory response. FIGURE: High magnification electron micrograph of a spermatozoon with the nucleus (nu) displaying the typical condensed chromatin. The remained cytoplasm contains several viral particles (ranging in diameter from 90 to 110 nm). The inset corresponds to a higher magnification of the boxed area containing two virions, showing the SARS-CoV-2 characteristics: viral envelope (white arrowhead), nucleocapsids (black arrowhead), and spike-like projections (white arrow). CONCLUSIONS: Although SARS-CoV-2 is not found in the infected men's semen, it was intracellularly present in the spermatozoa. The potential implications for assisted conception should be addressed. (Figure Presented).

ELEVATED ROS LEVELS AND DNA FRAGMENTATION IN SPERM FROM CONVALESCENT MEN IN SARS-COV-2 INFECTION

INTRODUCTION AND OBJECTIVE: Current evidence has proven the systemic nature of COVID19, including its involvement in the male reproductive tract. We aimed to investigate seminal parameters of moderate-to-severe COVID-19 men during the convalescence phase. METHODS: This cross-sectional study included 18 to 50-yearold men with confirmed moderate-to-severe COVID-19. Patients were enrolled 15 to 45 days after the diagnosis. After a urologist's initial clinical evaluation, semen samples were obtained by masturbation and processed within one hour. Semen analysis was performed using the World Health Organization (WHO) manual (6th edition). Sperm function tests were conducted in an andrology laboratory, including Reactive oxygen species (ROS), DNA fragmentation, lipid peroxidation, and Creatine Kinase (CK) analysis. An essential endocrine evaluation was performed. Patients with a history of disorders that could impair testicular function were excluded. A group of pre-vasectomy baseline samples was used as a control group. Statistical analysis was performed using R version 4.0.5. One-tailed and paired T-tests were used for comparisons between groups. RESULTS: The sample size was 26 men (mean 34.3±6.5 years;range: 21-50 years). Sperm concentration (mean 38.74±32, P <0.01) and total motile count (mean 55.3±66.8, P <0.01) were significantly reduced in the COVID-19 group. The DNA fragmentation (mean 41.1±29.2) and ROS (mean 4.84±8.7) were significantly higher in post-infection patients. Other parameters such as WHO/ Kruger morphology and progressive motility were also reduced in the disease group, albeit not statistically significant. Total testosterone (mean 409.2±201.2) was lower in the convalescent men. All semen samples were negative for SARS-CoV-2 using the PCR analysis. CONCLUSIONS: Our findings indicate that male reproductive injury can be a relevant component of SARS-CoV-2 systemic infection. High DNA fragmentation and ROS, hallmarks of tissue injury, might signal a direct testicular involvement. The morphological and functional damage could represent significant impairment of the male reproductive health if persistent after convalescence.

Prophylactic use of nasalferon against COVID-19 in healthcare workers. Early surveillance study

Introduction: In Cuba, the nasal application of recombinant human IFN-alpha- 2b (nasalferon) began in personnel at risk in order to prevent SARS-CoV-2 infection. Objective: To characterize the safety in those subjects exposed to the use of Nasalferon at the Surgical Medical Research Center and to explore the effect of the prophylactic use of the drug against acute respiratory symptoms mainly caused by SARS-CoV-2. Material and Methods: Monocentric, prospective, open, and early surveillance epidemiological study conducted in healthcare workers who were administered Nasalferon. Surveillance was performed using the Prescription-Related Adverse Event Monitoring Surveillance method. The main variable was the presence of adverse events. Secondarily, the effect of the drug in preventing virus infection was explored. For the analysis of the main variable, the proportion of subjects who experienced each of the adverse events was estimated. In addition, the frequency distribution of the type of event, intensity, severity, and causality or imputability were estimated. Results: A total of 86 subjects were included;50 of them experienced 15 types of adverse events. No severe or serious events were reported. Headache, leukopenia, decay, and arterial hypertension were classified as moderate ones. During the whole duration of the treatment and until a month after it, none of the subjects included in the study presented COVID-19 or other viral acute respiratory symptoms. Conclusions: Nasalferon proved to be a safe and tolerable drug and the included subjects did not present acute respiratory symptoms related or unrelated to COVID-19.

Social network addiction and academic procrastination in Peruvian adolescents in times of coronavirus Covid-19

The aim of this study was to determine the relationship between social network addiction and academic procrastination in times of coronavirus (COVID-19) in regular basic education (RBE) students of a public educational institution (IE) in Peru. The population consisted of 1,255 students of both sexes, between 12 and 17 years of age, and non-probabilistic, convenience-induced sampling was used. The SPSS V.25 program was used for statistical analysis;also, two questionnaires with a validity and reliability greater than 90 were applied. However, Somers' Gamma and D coefficients were also used to detect the degree and direction of association. The results show a high and highly significant correlation between social network addiction and academic procrastination (r=0.710;p=0.01). As described above, addiction has had an increase in confinement times corresponding to increased procrastination.

How COVID-19 changed telephone interpreting in Spain

Before the COVID-19 pandemic, telephone interpreters in Spain were used to communicating administrative issues, medical instructions, and even humanitarian social assistance rendered by social workers and psychologists. However, since March 2020 these interactions have been heavily replaced by conversations mediated by telephone interpreters related to severe acute respiratory syndrome (SARS) coronavirus infection. This contribution describes the provision of telephone interpreting during the COVID-19 pandemic using the information reported by the interpreters of the company Dualia Teletraducciones as a case study. It focuses on healthcare-related services and clients, offering data related to the frequency of use of telephone interpreting, the most common languages used, and the evolution of clients and services (Emergency Rooms, tracers, pandemic hotels, etc.). This article also describes the hiring, training and quality monitoring processes, including the main tools developed to facilitate remote interpreting during the pandemic. © John Benjamins Publishing Company.

[Post-covid syndrome after icu admission. Parameters related to a better physical recovery after 4 months.]

OBJECTIVE: Post-COVID syndrome can impact against every sphere of daily live. The objective of this work was to detect the factors correlated with a better or worse physical recovery four months after hospital discharge from a hospitalization in ICU due to COVID-19. METHODS: Prospective descriptive study of 125 patients valued by the Rehabilitation Service during hospitalization in ICU, from March 12th to December 31st, 2020. Data from 76 patients was analysed with clinical follow up after 1, 2 and 4 months of hospital discharge. Variables on personal, hospitalary, functional symptoms/signals and physical recovery were analysed with mean +/- standard deviation, counting (percentage), T-student test and Fisher test. RESULTS: After one month, fatigue was observed in 60 (80%) patients and dyspnoea in 47 (62%). After two months, fatigue in 37 (55%), dyspnoea in 25 (33%), shoulder pain in 33 (43%), average QuickDASH was 22.7 (11.3-50), Sit-to-Stand Test in 30 seconds 11.5 (10-13) and 6-minute walk test 390 meters (326-445). In the fourth month, 25 (53%) had returned to work and had an average of the physical recovery of 79.1%+/-18.3%. There was no correlation between physical recovery >=75% and the first month data, but there certainly was a correlation between some second month variables, such as fatigue (p=0.001), dyspnoea (p=0.035), QuickDASH (p=0.001) and 6-minute walk test (p=0.021). CONCLUSIONS: Symptoms (fatigue and dyspnoea) and functional scales (QuickDASH and 6-minute walk test) after 2 months predict a better/worsen physical recovery after 4 months of hospital discharge.

Influence of sex on disease severity in children with multisystem inflammatory syndrome and covid-19 in latin america

Data from adult studies show that COVID-19 is more severe in men than women. However, no data are available for the pediatric population. For this reason, we performed this study aiming to understand if sex influenced disease severity and outcomes in a large cohort of Latin-American children with COVID-19 and multisystem inflammatory syndrome (MIS-C). We found that a higher percentage of male children developed MIS-C (8.9% vs 5% in females) and died (1.2% and 0.4% in females), although on multivariate adjusted analyses the only statistically significant difference was found in need of hospitalization, with females less frequently admitted compared with boys (25.6% vs 35.4%). This data are preliminary and need further independent studies to better assess the role of sex. © 2021, Il Pensiero Scientifico Editore s.r.l.. All rights reserved.

Predictive models for COVID-19 cases, deaths and recoveries in Algeria.

This study was conducted to predict the number of COVID-19 cases, deaths and recoveries using reported data by the Algerian Ministry of health from February 25, 2020 to January 10, 2021. Four models were compared including Gompertz model, logistic model, Bertalanffy model and inverse artificial neural network (ANNi). Results showed that all the models showed a good fit between the predicted and the real data (R2>0.97). In this study, we demonstrate that obtaining a good fit of real data is not directly related to a good prediction efficiency with future data. In predicting cases, the logistic model obtained the best precision with an error of 0.92% compared to the rest of the models studied. In deaths, the Gompertz model stood out with a minimum error of 1.14%. Finally, the ANNi model reached an error of 1.16% in the prediction of recovered cases in Algeria. .

Puerto Rico Health System Resilience After Hurricane Maria: Implications for Disaster Preparedness in the COVID-19 Era

Background: Every year, Puerto Rico faces a hurricane season fraught with potentially catastrophic structural, emotional and health consequences. In 2017, Puerto Rico was hit by Hurricane Maria, the largest natural disaster to ever affect the island. Several studies have estimated the excess morbidity and mortality following Hurricane Maria in Puerto Rico, yet no study has comprehensively examined the underlying health system weaknesses contributing to the deleterious health outcomes. Methods: A qualitative case study was conducted to assess the ability of the UPR health system to provide patient care in response to Hurricane Maria. An established five key resilience framework and inductive analysis was used to identify factors that affected health system resilience. Thirteen Emergency Medicine Physicians, Family Medicine Physicians, and Hospital Administrators in a University of Puerto Rico (UPR) Community Hospital were interviewed as part of our study. Results: Of the five key resiliency components, three domains were notably weak with respect to UPR's resiliency. Prior to the Hurricane, key personnel at the UPR hospital were unaware of the limited capacity of back-up generators at hospitals and were ill-prepared to transfer ICU patients to appropriate hospitals. Post Hurricane, the hospital faced self-regulation challenges when triaging the provision of Hurricane-related emergency services with delivering core health services, in particular for patients with chronic conditions. Finally, during and after the Hurricane, integration of patient care coordination between the UPR hospital ambulances, neighboring hospitals, and national and state government was suboptimal. The two remaining resiliency factors, addressing diverse needs and system adaptiveness in a time of crisis, were seen as strengths. Conclusions: Hurricane Maria exposed weaknesses in the Puerto Rican health system, notably the lack of awareness about the limited capacity of backup generators, poor patient care coordination, and interruption of medical care for patients with chronic conditions. As in other countries, the current COVID epidemic is taxing the capacity of the Puerto Rico health system, which could increase the likelihood of another health system collapse should another hurricane hit the island. Therefore, a resilience framework is a useful tool to help health systems identify areas of improvement in preparation for possible natural disasters.