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Ecuador is a unique case study, where strict evaluation and accreditation processes have been recently established (i.e., early-2010s) mainly based on the experience of their peers and that of developed countries. Interestingly, the development of quality assurance indicators for research output received special attention. The current study systematically explored the research output of the Ecuadorian higher education institutions (HEIs) after only one decade of being subjected to multiple rigorous evaluation and accreditation processes. Peer-reviewed documents in the Scopus Database from 2006 to 2021 were statistically analyzed in terms of the number of documents produced (i.e., books, book chapters, journals, and conference proceedings), citations, H-index, quartiles, and impact factors (i.e., SRJ, SNIP, and Cite Score), at both country and single-university levels. The influence of the multiple evaluation processes and external factors (e.g., relaxation of regulations, COVID) on the research output trends were comprehensively and chronologically discussed. Accordingly, a statistical answer to the following research questions was attempted: where is the Ecuadorian research output currently standing after these evaluation and accreditation measures? Furthermore, where is it heading? This investigation would assist in creating and adjusting policies targeting sustainable research in HEIs in Ecuador and other countries in similar early research development. Copyright © 2023 Gutiérrez, Yaguarema, Ayala, Zambrano R and Gutiérrez.
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Introduction: Central venous-to-arterial carbon dioxide tension ( PvaCO2) can be useful for monitoring adequacy of tissue perfusion in patients with ARDS supported with veno-venous Extracorporeal Membrane Oxygenation (VV-ECMO). However, in theory, the unavoidable mixing of venous blood with blood after the oxygenator can affect PvaCO2 values by increasing central venous oxygen saturation and substantially decreasing CO2 concentration. This study aimed to evaluate acute changes in PvaCO2 after VV-ECMO installation and determine its association with patient outcomes. Method(s): Retrospectively evaluated coronavirus disease 2019 (COVID-19) ARDS patients with at least one concurrent arterial and central venous blood gas analysis before and after VV-ECMO installation as standard care. The primary outcome was intensive care unit (ICU) mortality at 28 days. Result(s): 29 patients were enrolled in the study. All the patients had a 25 F drainage multistage femoral cannula and a 21 F internal jugular infusion cannula. The median distance between the central venous sampling point and the tip of the infusion cannula was 39 [23-73] mm. No statistically significant changes in PvaCO2frelative changes calculated. After were observed 24-48 h after VV-ECMO installation (5 [4-7] mmHg to 6.5 [5-8.2] mmHg, p = 0.12). Hemoglobin concentration decreased 24 to 48 h after VVECMO installation (10.7 [9.5-12.7] g/dl to 9.6 [8.8-11.6] g/dl, p < 0.01) but neither central venous (75 [70-81]% to 73 [67-78]%, p = 0.46) nor arterial oxygen saturation (95 [92-97]% to 95 [93-96]%, p = 0.81) changed significantly. Elevated PvaCO2 after VV-ECMO installation had a good predictive value for 28 day ICU mortality (calculated area under the ROC curve 0.81) (Fig. 1 veno-venous). Conclusion(s): VV-ECMO support appears to have little effect on the PvaCO2 calculation. PvaCO2 can be used to evaluate patients with ARDS supported with VV-ECMO, as persistently elevated values can be associated with poor outcomes.
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The present study was designed to analyse community participation in the co‑management of the UNESCO Global Geopark of El Hierro (The Canary Islands, Spain) after its first revalidation process in 2018 (where this aspect figured as central, pending attention) and previous to the 2022 revalidation. The study was carried out at the height of the crisis caused by the Covid‑19 pandemic and was planned to detect whether in the later process of regeneration, the island should finally tackle the co‑management principle central to the socio‑ ‑geological model of the UNESCO GLOBAL Geopark for resilience, and if the community itself perceived the need to take control of their own destiny and destination, above all in its aspect of geotourism. The preliminary results show clearly that the Global Geopark is considered to be important by the community and that there is also a strong desire for greater participation and implication than at present. © PASOS. Revista de Turismo y Patrimonio Cultural.
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Background: The COVID-19 disease has represented one of the most important threats to health. The most severe form is acute respiratory distress syndrome (ARDS). The inflammatory response can cause hematologic changes.
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Introduction: The SARS-CoV-2 is the denomination of the new betacoronavirus, which was discovered and isolated for the first time in Wuhan, China, at the end of December 2019, and it is the causal agent of the sanitary emergency of the COVID-19 pandemic. Experimental studies have shown susceptibility to infection in pets (dogs and cats). Objective: To present the current information available on SARS-CoV-2 in animals under the care of humans that have been officially reported in the sanitary registries of the World Animal Health Information System (WAHIS) of the World Organization for Animal Health. Materials and methods: We conducted a narrative review using Medline/ PubMed, Scopus, and Web of Sciences, and official documents of the World Organisation for Animal Health. The search terms used were as follows: “coronavirus”, “SARS coronavirus 2019”, “SARS-CoV”, “SARS-CoV-2 in dog and/or cat” “pets SARS-CoV-2”. Results: The studies reviewed in this manuscript highlight those positive cases in cats and dogs for SARS-CoV-2 have been associated with an exposure to positive COVID-19 people. In the available evidence, 55.17 % of the total cases of animals that were positive for SARS-CoV-2 were associated with people with COVID-19 who had the disease at home, possibly due to maintaining a longer exposure to the humans. Conclusion: Regarding the zoonotic aspects, it is important to clarify that although several animal species have been infected by SARSCoV-2, none of them has been scientifically proven to represent a risk of direct transmission between positive animals and other humans or to play an epidemiological role in the disease © 2022, Revista Lasallista de Investigacion.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 and Aim: The pandemic caused by the SARS-CoV-2 virus has generated a social, economic, health and educational collapse of unsuspected dimensions, paralyzing teaching in dental schools around the world and modifying their clinical protocols. To evaluate the knowledge of the students of the University Clinic of Dentistry of the University of Oviedo (CLUO) about the infection by SARS-CoV-2. Methods: A descriptive observational study was carried out through a survey made in “GOOGLE FORMS.” Five sections were included: demographic data, questions about the acquisition of knowledge about COVID-19, questions about general knowledge of COVID-19, questions about knowledge of COVID-19 in dentistry and resolution of clinical COVID-19 cases. Results: A total of 110 surveys were collected. The predominant age range was 18 to 28 years (82.7%) and female the predominant sex (72.6%). Television and the internet were the media where they were first informed about the pandemic. The general knowledge about Covid-19 of the surveyed students (67.93% correct) was higher than the specific knowledge (COVID-19 in dentistry) (27.5% correct). At the clinical cases, the area of less knowledge about the specific COVID-19 management was those applied to Periodontology. Conclusions: Our results indicate that the students had a moderate knowledge about COVID-19, suggesting the need to increase basic training on infection control and promote workshops on protection measures based on the risks inherent to the specific dental practice.
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We share school leaders' perspectives on Zoom videos concerning the needs of immigrant and refugee families in Title I schools. In these videos, participants crafted and shared personal narratives about their leadership experiences during the COVID-19 era of education. Rooted in participatory design research methods, the process of designing these videos were both a research project and an intervention to assist families and school leaders to better understand each other. We present a close analysis of administrators' perspectives and describe how our codesigned video methodology enabled participants to coconstruct new meanings of school-community relationships during the pandemic through a radical care framework. We conceptualize these reimaginings as aperturas-cracks in the dominant family engagement paradigm that allow us to collectively work towards transformative ends which we term community-centered school leadership. We conclude the article with recommendations for how both school leadership and research can approach and reimagine family engagement postpandemic.
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OBJECTIVES: Compare 30-day mortality rate following a proximal femur fracture (PFF) and SARS-CoV-2 infection versus a PFF and no SARS-CoV-2 infection. DESIGN: Retrospective comparative study. SETTING: Three university hospitals in Biscay province (Basque Country, Spain). PATIENTS: 77 patients over 65 years-old with PFF (AO 31-A and 31-B). INTERVENTION: Study conducted between 9 March and 15 April 2020. The COVID-19 group included only patients with SARS-CoV-2 infection, confirmed by a positive RT-PCR test. MAIN OUTCOME MEASUREMENTS: 30-Day mortality rate and risk factors for mortality. RESULTS: Of a total 77 patients, 10 were diagnosed with SARS-CoV-2 infection. Mean age was 85 years. Patients with SARS-CoV-2 infection had higher BMI (29.53 kg/m2) compared to patients without infection (24.09 kg/m2) (p = 0.001). No significant differences were found between both groups in terms of the Charlson Comorbidity Index, ASA score, use of oral anticoagulants or presence of cognitive impairment. Seven of the 10 patients in the COVID-19 group developed (viral) pneumonia, as compared to one single case (1/67) of (bacterial) pneumonia in the control group (p < 0.001). Thirty-days mortality was higher (p = 0.03) in COVID-19 patients (40%) than in those in the control group (11.9%). In the multivariate analysis, age ≥ 91 years-old, ASA class IV and BMI > 25 kg/m2 were significant predictors of 30-day mortality. All deaths in the COVID-19 group occurred while the patients were hospitalized. CONCLUSIONS: SARS-CoV-2 infection in patients with a PFF was seen to result in higher rates of early mortality, with COVID-19-related pneumonia being the leading direct cause of mortality. LEVEL OF EVIDENCE: Level III study.
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The teaching-learning process in an Engineering thermodynamics course benefits from laboratory components as experiential learning activities. Unfortunately, the COVID-19 pandemic brought difficulties for the use of experiential learning in lab-based topics. This work describes the results from implementing an at-home non-traditional laboratory, where the students had to design and build a prototype to conduct experiments and analyse results. Results indicate positive learning outcomes and both acceptance and satisfaction from the students;the students had a mean mark of 89.22;comparatively, the previous year in-person overall mean mark was 87.98. Moreover, from a conducted student experience survey, in terms of overall satisfaction, the obtained score was 9 out of 10, while when the module was taught in-person the average score was 9.1. © 2022 IEEE.
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Introduction: The severe acute respiratory syndrome of the new coronavirus (SARS-CoV-2) is the causal agent of the health emergency due to the COVID-19 pandemic. Although humans are the main susceptible host, experimental studies and reported cases of natural infection have evidenced scenarios of SARS-CoV-2 reverse zoonosis in animals. Objective: To evaluate the natural infection of SARS-CoV-2 in cats and dogs of owners diagnosed with COVID-19 in the Aburra Valley, Antioquia, Colombia. Materials and methods: The circulation of SARS-CoV-2 was evaluated by RT-qPCR and RT-PCR in samples of nasopharyngeal and oropharyngeal smears from cats and dogs whose owners had latency due to COVID-19 infection. The positive cases were verified by amplifying fragments of the RdRp, N and E genes;and the RdRp amplicon was sequenced and phylogenetically analyzed. Results: Six cats and three dogs were confirmed cases of natural infection for SARS-CoV-2 from 80 tested animals. The animals did not show clinical signs;and their owners, who suffered from the infection, reported only mild signs of the disease without clinical complications. In the analysis of one of the sequences, a single nucleotide polymorphism (SNP) was found with a change in position 647 substituting the amino acid serine (S) for an isoleucine (I). The cases occurred in the municipalities of Caldas, Medellin and Envigado. Conclusions: It is inferred that natural infection in cats and dogs is associated with direct contact with a COVID-19 patient.
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Training for industrial operations is an important task in different aspects related to safety, technical and operational topics, that are developed in university specialties. These issues are a priority process of learning and training for the use of machine tool workshop equipment. Likewise, the application of the industrial innovation paradigms of the different topics of Industry 4.0 are a necessity for technical and training development in engineering students, with augmented reality being one of the most important concepts of said industrial trend. This study shows the process of the development and validation study of a digital model of a conventional C&J CQ6125V lathe, based on augmented reality, with the aim of contributing to the educational process in the machine tool workshop at the Mexican University UPAEP. Given the need for Hybrid learning activities, caused by the SARS-COV-2 pandemic, where students considered models of Face-to-Face and Online activities, it was used in machine tool workshop courses as an alternative training and a learning instrument of laboratory teams. This application based on software for mobile devices was developed taking into account training considerations for the recognition of the essential elements of the lathe and the safety characteristics in its use, through the identification of its moving parts, using an interface easy to use for students involved in the machine tool shop. Once access to the augmented reality application was facilitated to interested parties, a survey was conducted on a non-probabilistic sample of engineering students to diagnose the essential operational functions of the application. The results stand out that the augmented reality exercise has an average higher than a value of four in Likert's scale for the number of components shown, the identification of the components from color codes and the animation of the lathe mechanisms. As well as the availability for installation and management of the application. The improvement findings of the students in the engineering areas show the need to improve the graphics to represent the real components of the lathe and the training parameters of the machine tool described. © 2022 IMCIC 2022 - 13th International Multi-Conference on Complexity, Informatics and Cybernetics, Proceedings. All rights reserved.
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This paper focuses on analyzing the differences between women and men in terms of employment, temporary employment and the influence of educational level, in a period covering both the 2008 and the COVID-19 crisis. It also studies the evolution and changes in labor regulations in the Spanish labor market, in order to identify the influence of new regulations on the labor market situation. The analysis is mainly based on Pearson correlations between the different indicators: percentage of employed people in the labor force, the temporary employment rate and the education rate of employed population (IEPO). The results of the analysis allow us to conclude that a higher level of education favors the attainment and maintenance of employment, especially among women. However, although the 2008 crisis has particularly affected those with lower education rate, as it has progressed, those with higher levels of education have also lost their employment. On the other hand, the data shows that temporary employment is associated with low levels of education, both for men and women. However, it has not been possible to demonstrate an increase in temporary employment during the crisis period, since, on the contrary, there has been a decrease in the temporary employment rate, probably due to the destruction of employment among those with temporary contracts, in both the 2008 economic crisis and the COVID-19 crisis. Finally, the growth in the rates of temporary employment and the total employment has been driven mainly by periods of economic expansion.
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NOVEL INTRODUCTION: With the presence of COVID-19 in all human activities, the medical world has faced a radical change in the way that medical practice develops all around the world. A necessary cog in the physician's life is the teaching-learning process that is lived daily in the clinical setting during medical residencies. The new reality that is being contemplated warrants a new way of thinking, acting, teaching, and learning. OBJECTIVE: To identify challenges and opportunities for the physician's formation in medical residencies ever since the onset of the pandemic. AUTHOR'S POSITIONING: One of the essential tools that a human being must have to survive any given crisis is his/her capability to adapt and modify conducts in order to better respond to uncertainty. The system under which physicians with specialties have developed throughout the years was sufficient for that specific reality under which it was first conceived;however, as time went by and with the current emergency, this is no longer efficient nor sufficient. Therefore, it's necessary to analyze the education model and reevaluate the competences required to instruct in a specialist. CONCLUSIONS: The clinical formation, particularly, represents a new opportunity to design, plan and implement the education process with a social responsibility sense and innovation through a new and different approach. In this new proposal, both education and health institutions work collaboratively in the generation of excellent medical specialists, not only in the cognitive aspect, but also, in the human aspect.
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Background and objectives: Despite myocardial injury being related to excess mortality in acute COVID-19 infection, its impact on imaging findings remains unclear. This study aimed to characterize transthoracic echocardiographic (TTE) findings in patients admitted with COVID-19 infections and its impact on management and prognosis. Methods: A prospective observational cohort study was performed among 66 COVID-19 patients who were admitted to a tertiary center between March 1 and May 25, 2020 and underwent TTE. High-sensitivity troponin I (hs-cTnI) data, echocardiographic assessment of right and left ventricular (LV) functional parameters, strain, and myocardial work analysis were obtained. Results: 2025 patients were admitted with COVID-19 and in 200 a complete TTE study was performed. Due to poor image quality, only 66 studies were included in the final analysis. The median age was 62 years (IQR, 55-70) and 59.1% of patients were males. The most common comorbidity was hypertension (47%), followed by smoking history (30.3%), atrial fibrillation (9.1%), and chronic obstructive pulmonary disease (7.9%). More than half of the patients (39, 59%) were admitted to the ICU, and half of them (33, 50%) required invasive mechanical ventilation. TTE was mainly indicated because of concerns for systemic conditions (50%) and evaluation of hemodynamic assessment (30%). Thirty-six patients (54.5%) had an abnormal TTE result and 57% had elevated hs-cTnI levels. The most common cardiac abnormality was LV diastolic dysfunction in 33% of the patients, followed by right ventricular dysfunction (12%) and LV dysfunction (6%) (Figure 1). LV GLS was reduced in 48.5% of the cases. Myocardial work performance indices were all reduced in patients with an abnormal TTE (GWI 30%, GCW 30%, GWW 40%, and GWE 40%), although differences were not significant (P>0.2 for all parameters). Patients with an abnormal TTE were older and presented a higher cardiovascular risk profile. There were no significant differences in the levels of D-dimer, NTproBNP, and hs-cTnI between patients with and without diastolic dysfunction, RV, or LV dysfunction (P>0.3 for all parameters). Using Spearman rank correlation, there was an inverse relationship between hs-cTnI and LV strain and myocardial work analysis. TTE results impacted clinical management in 60 patients, mainly de-escalation of medical treatment (Figure 2). Abnormal TTE results did not impact in-hospital outcomes. Conclusions: Severe echocardiographic abnormalities are uncommon in hospitalized patients with COVID-19 infections, presenting mostly with subclinical myocardial changes, such as diastolic dysfunction, reduced LV GLS, and myocardial work indices, both associated with high-sensitivity troponin I elevation. An echocardiographic study should be limited to rule out long-term ICU complications or to evaluate hemodynamic instability. Although TTE was a valuable tool for guiding management, it had no significant impact on prognosis. (Figure Presented).
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Introduction: The COVID-19 brought physical isolation affecting the usual development of academic activities. The physiotherapy career took on a greater challenge, as many of its contents require a practical component of intercorporality. Thus, the objective of this article is to describe the pedagogical experience around project-based learning for clinical reasoning about spinal pain during quarantine in physiotherapy students from University of La Sabana. Methods: A Project was created in according to the health demands of people performing telework or virtual study, because of the risk of cervical-back-low back pain associated with the workplace and postural habits. The Project had 3 phases, a diagnosis, the second to develop educational material, a final of disclosure. Results: Faced with the COVID-19 quarantine, physiotherapy students had to adapt to different challenges in order to achieve meaningful learning from virtuality;this allowed the development of skills for clinical reasoning, based on the methodology of project-based learning through the formation of work teams that used ICTs to create dissemination materials related to spinal pain. Conclusion: Project-based learning mediated by ICTs for the clinical reasoning of spinal pain in physical therapy students resulted as a positive experience for development of academic content to acquire learning competencies. © 2021 Elsevier España, S.L.U.