ABSTRACT
The pandemic caused by the SARS-CoV-2 virus has caused in the scientific community the need to collaborate as well as promoting Open Science practices, including the open data paradigm to stimulate resing. In this article a set of outreach articles published in The Conversation are analyzed together with some Open Science services and tools to carry out an analysis of their content and context, including information about their authors, institutions and disciplines. This information can be analyzed to better understand the entire research life cycle while facilitating the discovery of relationships at the article, topics or experts.
ABSTRACT
Background : COVID-19 is associated with an intense inflammatory response and an increased risk of thrombosis. High levels of D-dimer (DD), fibrinogen (Fg), von Willebrand factor (vWF) and factor VIII (FVIII) was reported among patients with severe disease. Aims : We aimed to characterize the relationship between vWF and other coagulation factors and clinical outcome among inpatients with severe COVID-19. Methods : We conducted a cross-sectional study of COVID-19 inpatients admitted in Mexico National Institute of Cardiology between April and December 2020. Patients with severe COVID-19 diagnosis who were admitted to the Intensive Care Unit were included. Blood samples were collected and processed according to the standardized institutional procedures. For patients who had anticoagulation therapy with heparin, anti-Xa level was determined. Patient's demographic and clinical characteristics, inflammatory and coagulation markers, and clinical outcome (thrombosis, mechanical ventilation, and death) were retrieved from the electronic medical records. Descriptive statistics and multivariate models were performed to assess associations between coagulation factors and clinical outcome. Results : A total of 58 patients were included during the study period. The mean age was 53.7 +14 years and 75.9% were men. Overall, 84.2% required mechanical ventilation, 25% had thrombosis (pulmonary embolism and/or deep vein thrombosis). Both vWFAg and vWFRCo were increased;the median value was 362.2% and 297.3% respectively. Among patients who died, a significantly increase in VWF measured by both methods was found. Of the 58 patients, 38 (65.5%) had mechanical ventilation and 22 (57.9%) died. Mortality was significantly higher among patients with mechanical ventilation (57.9% vs 42.1%;P < 0.001. Conclusions : In this study, we determined the levels of antigenic and RCo vWF in 58 patients with moderate-severe COVID-19. The vWF was markedly increased among patients with severe clinical presentation. Both antigenic and functional vWF were significantly associated with mechanical ventilation and death.
ABSTRACT
Background : Heparin-induced thrombocytopenia (HIT) is an antibody-mediated reaction against the heparin-platelet factor 4 complex (H-PF4). Incidence in patients with extracorporeal circulation membrane (ECMO) is unknown. Aims : We describe a case of HIT confirmed during ECMO support in a COVID-19 patient. Methods : N/A A 48 year-old man with severe COVID-19 confirmed by RT-PCR for SARS-CoV2, was admitted to intensive care unit (ICU). After 21 days of the diagnosis he required mechanical ventilation support and V-V ECMO. Since his admission he received anticoagulation with enoxaparin 80 mg SC every 12 h, when ECMO started, he continued anticoagulation with intravenous infusion of 700 U/hour of unfractionated heparin (UFH). On the third day of infusion, there was a decrease in platelets > 50% (nadir 25,000/mm3 ), it was documented 6 points in a 4T HIT score having a probability 64% for HIT. It was confirmed by functional test with platelet aggregometry induced by UFH using the Born method. UFH was suspended and fondaparinux 7.5 mg SC every 24 h. We made serial measurements of anti-Xa (Stago ® ). Therapeutic response to HIT was documented at day 9 from the start of fondaparinux, without requiring an ECMO membrane change. Conclusions : The diagnosis of HIT was made by clinical suspicion, using the 4T HIT score and later confirmation platelet aggregometryUFH induced. The usual pharmacological treatment is based on argatroban, bivalirudin, and lepirudin. To our knowledge, there is only one case reported with fondaparinux as treatment in ECMO. Determination of plasma levels by antiXa activity was used to guide dosing because previous studies have reported bleeding rates between 10 to 22% with fondaparinux. This is a success case of fondaparinux as treatment for HIT in an ICU patient with ECMO support, and the first one in the clinical context of severe COVID -19 infection.
ABSTRACT
The year 2020 will be remembered as the year in which a human, health, social and economic tragedy was experienced as a result of the COVID-19 virus. Education faced a scenario not experienced before and like the rest of society it was doomed to severe confinement. The confinement was followed by a partial reincorporation of the students and in both scenarios digital technology played a fundamental role. The formative work was forced to adopt digital methodologies with the urgency that the situation required and the teaching staff had to adapt as they go. Bimodality, synchronous education, online classes are now common terms that accompany the complex teaching work. The study that we present analyzes the starting point of Spanish and European teachers regarding attitudes and training levels in ICT, as well as the possible variations after the outbreak of the pandemic. For this, the data collected in the Teaching And Learning International Study, TALIS 2018, regarding the use of Information and Communication Technologies, have been compared, together with the data provided by the Digital Education Action Plan 2021-2027 by through the Open Public Consultation. It can be concluded that although the teachers, before COVID-19 crisis, had high participation levels on ICT training, they did not value the need to be trained with the same recognition as once the pandemic began. Even so, we propose the need for a pedagogical approach in digital training that goes beyond technical learning by proposing didactic strategies that allow the equidistance between face-to-face and virtual training. © 2021 Univ Nacional de Educacion a Distancia (UNED). All rights reserved.