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This chapter uses discourse analysis to study the statements made by two main players of the Mexican government: President Andrés Manuel López Obrador and Hugo López-Gatell, the Undersecretary for Health Prevention and Promotion. This analysis also discusses the ¡Quédate en casa! audiovisual advertisement campaign and its main character: the heroine SuSana Distancia. It suggests that the government's advertisement campaigns failed to promote the importance of health care and joint responsibility among the community;this is reflected in the number of people infected and deaths in Mexico. This study is made up of six parts: the first introduces the importance of a strategic communication plan;the second discusses the frame of reference;the third describes the analysis method and the corpus study configuration;the fourth includes the results;the fifth ponders the analysis;and the sixth includes the conclusions. The main findings are that the Mexican government never had the intention of promoting the use of masks as an essential measure. Two spots taught the population how to wear a mask;however, the discourse of both the Undersecretary and the President was that wearing a mask was not an essential measure to control infections. © Springer Nature Switzerland AG 2023. All rights reserved.
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The idea of Open Government, centered on the pillars of transparency, collaboration and participation, has been embedded in many governments to strengthen the creation of democratic governments in accordance with the demands that are immersed in information societies today and that act based on to the principles of accountability, transparency and access to information of general interest. In this sense, through a documentary methodology, the objective of the article is to theoretically describe the influence of Open Government framed governance and sustainable development. Public administration in today's world demands flexibility, creativity, effectiveness, efficiency, participation, cooperation and co-responsibility. Open government is transversal to the 2030 Agenda, because SDG 16 proposes to configure a new public governance framework and a renewed state architecture that allow the promotion of peaceful and inclusive societies for sustainable development, facilitate access to justice for all and build effective, accountable and inclusive institutions at all levels.
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OBJECTIVE: To evaluate the reasons for COVID-19 vaccine hesitancy during pregnancy. DESIGN: We used regular expressions to identify publicly available social media posts from pregnant people expressing at least one reason for their decision not to accept COVID-19 vaccine. SETTING: Two social media platforms - WhatToExpect and Twitter. SAMPLE: A total of 945 pregnant people in WhatToExpect (1017 posts) and 345 pregnant people in Twitter (435 tweets). METHODS: Two annotators manually coded posts according to the Scientific Advisory Group for Emergencies (SAGE) working group's 3Cs vaccine hesitancy model (confidence, complacency and convenience barriers). Within each 3Cs we created subthemes that emerged from the data. MAIN OUTCOME MEASURES: Subthemes were derived according to the people's posting own words. RESULTS: Safety concerns were most common and largely linked to the perceived speed at which the vaccine was created and the lack of data about its safety in pregnancy. This led to a preference to wait until after the baby was born or to take other precautions instead. Complacency surrounded a belief that they are young and healthy or already had COVID-19. Misinformation led to false safety and efficacy allegations, or even conspiracy theories, and fed into creating confidence and complacency barriers. Convenience barriers (such as availability) were uncommon. CONCLUSION: The information in this study can be used to highlight the questions, fears and hesitations pregnant people have about the COVID-19 vaccine. Highlighting these hesitations can help public health campaigns and improve communication between healthcare professionals and patients.
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COVID-19 , Social Media , Female , Pregnancy , Humans , COVID-19 Vaccines/therapeutic use , COVID-19/prevention & control , Vaccination Hesitancy , VaccinationABSTRACT
A contribution of Lung Surfactant (LS) inactivation to COVID-19-related ARDS (cvARDS) has been argued, but not been clearly demonstrated to date. In the present study, we have characterised the extent of lung neutrophil infiltration along with the surface-active properties and protein composition of LS in bronchoalveolar lavages (BALs) collected from 12 cvARDS patients. A control group of 9 subjects without respiratory diseases was also enrolled. BAL cell sorting was performed by flow cytometry. The adsorption of LS at the air-liquid interface was assessed by Surfactant Adsorption Test (SAT), whereas the level of surfactant hydrophobic proteins was measured by Western Blot analysis. Results were normalised by phosphatidylcholine (PC) total amount. Significant increase in neutrophil [61.3(47.5-84.6)% vs 1.6(0.9-4.9)%, p<0.0001] and decrease in macrophage percentages [13.6(6.1-28.9)% vs 90.8(87.1-92-6)%, p<0.0001] of total BAL cells were detected in cvARDS patients. A lower overtime LS adsorption/accumulation at the air-liquid interface was also observed in those patients compared to the control group from 60min onward [14003(10232-19736) vs 24501(16386-28489) RFU, p=0.0471]. Moreover, cvARDS patients under the acute phase showed the lowest surfactant activity at the end of SAT (12191(11588-20159) RFU, p=0.048). An increase in both SP-B and SP-C/PC was also evident in cvARDS BALs. Here, we report for the first time on the reduction of LS surface-active properties during the acute period and even under the recovery phases of cvARDS. This may confirm how LS inactivation may be involved in both early and late consequences of severe cvARDS.
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Introduction and Objectives: Cirrhosis and acute liver failure have a high mortality rate and liver transplantation is the only treatment that has shown improvement in the survival of these patients, being 90% in the first year after transplantation and 80% in five years. Currently, in our center there are 95 patients on the liver transplant waiting list, being the largest in the country. The availability of an organ is of key importance and is directly related to the morbidity and mortality of our patients. This study aimed to determine direct and indirect variables that affect mortality on the waiting list in our transplant center. Material(s) and Method(s): We did a retrospective observational study in which we reviewed the clinical charts of the 116 patients who died in the liver transplant list between 2015 and 2021. We described the stage of cirrhosis, its complications and the cause of death. For the analysis of the results, we performed a statistical description. Result(s): Between 2015 and 2021, 116 patients died on the liver transplant waiting list. The cause of cirrhosis was autoimmune disease in 42%of the patients, 75% were CHILD C and 39.7% had MELD >25. The main cause of death was an infection, and the main complications of cirrhosis were ascites (84.5%), encephalopathy (59.5%) and variceal hemorrhage (39.7%). Between 2020 and 2021, COVID-19 infection was documented in 16.7% of deceased patients. Conclusion(s): Infection in patients on the waiting list is the main cause of death before transplantation. It has been documented in the literature that one-year mortality, according to the Meld score, is 30% and 50% for scores of 20-29 and 30-39, respectively. Because of this reason, liver transplantation is the only alternative to impact the survival of these patients. The pandemic contingency affected the care of patients with terminal liver disease, reducing the number of transplants performed because of the lower donation rate. Being pioneers in Colombia of living donor transplantation, it was possible to mitigate the low availability of organs during the Covid-19 pandemic, and in 2020 -2021, 38% of the transplants performed in our center were from a living donor.Copyright © 2023
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As a result of the global health crisis caused by the COVID-19 pandemic, the need for applications that allow for remote patient monitoring has increased. In this chapter, we propose and discuss the development of an IoT-based web application for arrhythmia detection. The application is implemented on the Xiaomi™ MiBand5 band to monitor patient heart rate and other biomedical signals. The data is stored in the Google Fit™ platform and analyzed using a set of rules to detect possible arrhythmia. The application is able to detect arrhythmia thanks to: (a) its synchronization with the wearable device (i.e. smart band) and (b) real-time patient monitoring. Also, the application provides follow-up to patients through a series of alerts and recommendations. We conducted a case study to describe the main functionalities and components of the application. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Aim: COVID-19 is mostly well known because of its respiratory pathology, nevertheless several ischemic complications have been reported during the pandemia. The aim of this report is to present 9 cases of acute intestinal ischemia in patients with concomitant SARS-COV- 2 bilateral pneumonia. Method(s): We present a case series collected from a retrospective database, that includes 9 patients with intestinal ischemia and bilateral COVID 19 pneumonia diagnosed during the years 2020 and 2022 at the "Hospital Universitario Nuestra Senora de Candelaria." Results: Of the 9 patients, 6 were men with a mean age of 63 years, 5 of them unvaccinated and 2 with partial dose. All presented with bilateral covid pneumonia requiring admission and intubation at the intensive care unit. During admission, after a hemodynamic worsening with increasing lactate, acute intestinal ischemia was diagnosed on a CT scan (7 non occlusive and 2 occlusive ischemia of the SMA). 7 of them underwent damage control surgery of whom only 2 survived. The remaining 3, died hours after diagnosis, not undergoing surgical treatment due to poor short-term prognosis. Conclusion(s): The severe inflammatory response along with a hypercoagulable state secondary to COVID 19 is responsible for many severe ischemic diseases such as intestinal ischemia. These can go unnoticed in intubated critically ill patients, or with concomitant respiratory disease due to the absence of obvious clinical manifestations. Given its high mortality, it is essential to take this differential diagnosis into account, to obtain an early diagnosis and treatment.
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Aim: The COVID-19 pandemic has drastically impacted the surgical world. Proctology has been severely affected by the reorganisation of healthcare systems over the last year. We present the COVID-19 infection screening protocol that we have carried out in our Major Ambulatory Surgery (MAS) unit for proctological procedures. Method(s): Analysis of the cases operated between April-20 and February-21 in the MAS unit following the protocol established for screening against COVID-19 for both, patients and staff, system alerts and solutions to outbreaks. Screening of patients is carried out by PCR test 48h prior to the intervention, outside the unit and extracted by trained staff. If positive, the intervention is postponed for 40-60 days or until a negative PCR is obtained. Screening of all staff is carried out weekly with a PCR test and 24-48 hours before any professional enters in the unit. If a positive case is detected, it is isolated for a week until negative PCR is obtained and all contagions are tested on days 0, 4 and 8. If an outbreak of less than 3 professionals is detected, they are isolated and follow-up continues. In case of 4 or more, activity in the unit is stopped until PCR is negative. Result(s): 2068 procedures were performed in the MAS unit of which 202 were proctological interventions: 38.6% perianal fistulas, 20.8% haemorrhoids, 12.9% anal dysplasia, 9.4% fissures and 18.32% other pathologies. 48 positive cases of patients were detected and the intervention was postponed without prejudice to the patients. Five alerts were detected in the staff screening, with a maximum of 3 professionals infected in one outbreak. The affected cases were removed from the unit until a negative PCR test was obtained. At no time did the MAS unit have to be closed due to infection. Conclusion(s): Our COVID-19 screening for patients and professionals has been effective and has allowed us to continue our healthcare practice during the pandemic, without the need to close the unit due to outbreaks.
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As a result of the global health crisis caused by the COVID-19 pandemic, the need for applications that allow for remote patient monitoring has increased. In this chapter, we propose and discuss the development of an IoT-based web application for arrhythmia detection. The application is implemented on the Xiaomi™ MiBand5 band to monitor patient heart rate and other biomedical signals. The data is stored in the Google Fit™ platform and analyzed using a set of rules to detect possible arrhythmia. The application is able to detect arrhythmia thanks to: (a) its synchronization with the wearable device (i.e. smart band) and (b) real-time patient monitoring. Also, the application provides follow-up to patients through a series of alerts and recommendations. We conducted a case study to describe the main functionalities and components of the application. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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The areas of data science and data engineering have experienced strong advances in recent years. This has had a particular impact on areas such as healthcare, where, as a result of the pandemic caused by the COVID-19 virus, technological development has accelerated. This has led to a need to produce solutions that enable the collection, integration and efficient use of information for decision making scenarios. This is evidenced by the proliferation of monitoring, data collection, analysis, and prediction systems aimed at controlling the pandemic. To go beyond current epidemic prediction possibilities, this article proposes a hybrid model that combines the dynamics of epidemiological processes with the predictive capabilities of artificial neural networks. In addition, the system allows for the introduction of additional information through an expert system, thus allowing the incorporation of additional hypotheses on the adoption of containment measures.
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Introduction: The COVID-19 pandemic modifies the info-communicative environment of cyber users. Cuba, in particular, presents a remarkable level of technological development inserted in the Internet social platform, Twitter. This support plays a key role in the debate about issues related to the Cuban medical delegations due to their confrontation with the virus at the international level, which contributes to the formation of a favorable global opinion. The aforementioned point is expressed from the online conversations and their speeches in this site. Objective: To characterize the info-communicative environment on Twitter during the online conversations about Cuban medical brigades between December 31, 2020 and January 18, 2021. Material and Methods: The hermeneutic theoretical method is used for the description of the results of the statistical processing of content, structure and use on the Web, corresponding to a transdisciplinary approach through the application of Data Mining Technique as an instrument of the unsupervised algorithm SSA-UO for sentiment analysis on Twitter. Results: The characteristics of the info-communicative environment on Twitter during the online conversations about Cuban medical delegations evidence a predominance of positive polarity. Conclusions: Retweets, mentions and the publication of links influence the particularities of the debate on the topic in the microblogging sphere.
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Introduction L'atteinte pulmonaire de la CoVID-19 et de la grippe est la principale raison d'admission des patients (pts) en réanimation. Les taux de co-infection et de surinfection chez les pts à risque de PAVM (VM > 48h) justifient de comparer leur devenir chez des pts atteints de CoVID-19 ou de grippe. Matériels et méthodes Une cohorte multicentrique française impliquant 11 services de réanimation a inclus 379 pts CoVID-19 (PCR SARS-CoV-2 positive) à risque de PAVM (VM > 48h) entre février 2020 et octobre 2021 et 93 pts à risque de PAVM atteints de grippe de 2008 à 2021 (recherche de virus grippal positive). Parmi les pts à risque PAVM (VM > 48H), les données démographiques, maladies chroniques, comorbidités, scores SAPSII et SOFA, paramètres biologiques, documentations microbiologiques, types de ventilation, autres supports d'organes, durée d'hospitalisation et mortalité à J60 ont été recueillis prospectivement. Résultats Les pts COVID-19 à risque de PAVM étaient plus souvent des hommes (79 % versus 58 %, p<0.01), plus âgés (63a versus 58a, p=0.05), avaient plus souvent un IMC > 30 Kg/m2 (38 % versus 26 %, p=0,02), un antécédent cardiovasculaire (28 % versus 19 % p<0,01) et une insuffisance respiratoire chronique (29 % versus 13 % p<0,01). Le motif d'admission était principalement une détresse respiratoire aiguë dans les 2 groupes de pts : 72 % des 379 pts COVID-19 ont été ventilés mécaniquement dans les 48H suivant l'admission et 90 % des 93 pts grippés (p=0,01) ; 29 % des pts COVID-19 et 19 % des pts grippés ont reçu des corticoïdes (p=0,03). Chez 379 pts CoVID-19, 234 épisodes de PAVM ont été identifiés contre 36 chez 93 pts grippés. La densité d'incidence de type 1 était de 32 pts avec au moins 1 PAVM / 1000 jours de VM chez les pts CoVID-19 contre 17 pour les pts grippés. La densité d'incidence de type 2 était de 25 épisodes de PAVM / 1000 jours de VM chez les pts CoVID-19 contre 13 pour les pts grippés. Les causes de PAVM étaient des cocci à gram positif (CGP) chez 65 (28 %) pts CoVID-19, 2 (6 %) (p<0,01) chez des pts grippés ; parmi les CGP des pts COVID-19, 10 % SARM, 50 % SAMS, 10 % pneumocoques. Chez les pts CoVID-19, 195 (83 %) BGN ont été isolés lors de PAVM, dont 142 (61 %) entérobactéries (32 % étaient résistantes à au moins une C3G), 57 (24 %) Pseudomonas aeruginosa. Pour les pts grippés, 18 (50 %) BGN (p<0,01) isolés de PAVM, dont 10 (28 %) entérobactéries (14 % résistantes à une C3G), et 9 (25 %) Pseudomonas aeruginosa. La durée de séjour en réanimation ne différait pas entre les groupes : 16j. La mortalité à J60 était de 45 % pour les pts CoVID-19 et de 23 % (p<0,01) pour les pts grippés. Elle était plus fortement corrélée à la survenue d'une PAVM chez les pts COVID-19 que chez les pts grippés (HR : 3,1 (1,1 – 9), p<0,01). Conclusion La mortalité à J60 et l'incidence des PAVM sont plus élevées chez les patients CoVID-19 que chez les pts grippés avec une surmortalité fortement accrue liée aux PAVM chez les pts CoVID-19, surtout associées à des entérobactéries, résistantes dans près d'un tiers des cas à au moins une C3G. Aucun lien d'intérêt
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In a health crisis, info-communicative scenarios for decision-making/action-taking are modified by public opinion in social media, impacting health. The study aims to characterize the symbolic construction of public opinions about Cuba’s cooperation amidst the COVID-19 health crisis, reflected in discourses and their symbols on Twitter between December 31, 2020, and January 18, 2021. Related tags include #CubaporlaVida, #CubaporlaSalud, #CubaCoopera, #CubaViva, #CubaSalvaVidas, and #ConunaNuevaSonrisa, accumulating 84,581 tweets. The perspective used is transdisciplinary to integrate the knowledge of social and computer sciences, while the approach is mixed to use polarity metrics. We used data mining on the web to delve into the content-structure-use link and critical analysis of multimodal discourse with a socio-cognitive approach to relate ideological structures. The instrument employed is Stela 5.2 software. The results reflect a polarized discourse, with a predominance of positive and neutral affinities, and the use of retweets, mentions, and metadata to amplify the message. Users directed their questions to political, media, and institutional accounts to talk about the subject. © 2022 Universidad de La Sabana. All rights reserved.
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A framework that allows the incorporation of community structure into epidemiological compartmental models has been developed. The models resulting from this process are compartmental models as well, which are related to the base models. This work includes an existence and uniqueness theorem, showing that, under certain conditions on the mobility, epidemiological models in which f(t,X) is continuous in time and Lipschitz continuous on the compartments induce unique community models;and a homogeneous mixing limit, showing that under high mobility conditions the base model is recovered in the global population. Applications of the SIR model and the impact of the community structure on the estimation of their effective parameters are discussed in detail. An open computational implementation of this framework is available to the scientific community. It allows modeling community distribution using mobility data, as shown with Spain data during the 2020 state of alarm.
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Several studies have estimated the effects of lockdowns, owing to Covid-19, on production and employment on a national level but few on a regional level. Thus, using a regional input output matrix for Colombia, and by means of a variation of a hypothetical extraction method, the regional effects on production and employment on account of lockdown are estimated. It was found that the negative repercussions on the economy impact production which decreases by 8.2%, leading to a reduction in employment of 3.5 million jobs, this the result of the heterogeneity of effects between departments.