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Introduction: The COVID-19 pandemic and preventive measures led to changes in the quality and quantity of sleep, impacting mental health. Objectives: To understand how the pandemic and confinement interfered with the routines and/or sleeping habits of children and adolescents and influenced mental health. Methodology: A literature review on MEDLINE was conducted, with the research question: What are the changes in the routines or sleep habits of children and adolescents during the pandemic? Results and discussion: From the 370 articles analysed, 35 were selected. Due to confinement and online learning, the number of hours of sleep increased. However, the quality of sleep decreased due to decreased physical activity, an unbalanced diet, and increased time in front of screens. Consequently, there was a negative influence on mental health. Conclusion: The increase in sleep disorders and their influence on mental health was observed, with the need to develop awareness and literacy strategies addressing this area.
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Intro The concept of training immunity originally developed for other diseases has gained attraction during the epidemic. Several clinical trials and epidemiological analyses of populations previously immunized with BCG and other vaccines were the focus of scientific discussions. Here we show the activation of innate immunity markers both at mucosal and systemic levels with a mucosal vaccine CIGB2020 (HeberNasvacTM) containing virus-like particles (HBsAg) and nucleocapsid particle (HBcAg) of the hepatitis B virus. Moreover, the immune potentiating capacity of the HBcAg combined with RBD protein was used to formulate a specific mucosal vaccine candidate against SARS-CoV-2 (MambisaTM). Methods With CIGB 2020 (100µg HBsAg and 100 µg HBcAg) were conducted two proof of concept trials in human volunteers and a Phase I-II open, randomized, and controlled trial in 46 volunteers older than 60 years, symptomatic or close contact of COVID-19 patients. The volunteers were randomly assigned to the treatment group or not treated group. The nasal spray was administered to the treatment group on days 0, 7, and 14 together with daily sublingual administrations. Mucosal and serum samples were collected on days 0, 4, and 8. With MambisaTM vaccine (50µg RBD and 40 µg HBcAg) was conducted one proof of concept trial and a Phase I-II open and randomized trial in 1131 volunteers 19 to 60 years old, evaluating three different devices for nasal administration. All the volunteers gave written informed consent. Findings CIGB2020 activates interferon-induced genes and TLR 3, 7, and 8 at the level of oropharyngeal mucosa and PBMC. Monocyte and lymphocyte populations were also activated. One dose of the MambisaTM vaccine induces high levels of specific IgG. The serum and mucosal antibodies show RBD-ACE2 binding inhibition capacity and neutralization activity. Conclusion Nasal immunization exhibits advantages in inducing immunity at the level of the nasopharyngeal mucosa in addition to the systemic response.
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Intro: With the first case of COVID-19 in Cuba on March 11, 2020, the Center for Genetic Engineering and Biotechnology in Havana began an extensive vaccine program. Two vaccines based on RBD recombinant protein were developed, one for systemic administration "Abdala" and one mucosal vaccine "Mambisa". Abdala received the EUA in July 2021 and "Mambisa" completed its clinical development as a booster dose for convalescent subjects. Method(s): Two doses (25 and 50 microg) and two schedules (0-14-28 and 1-28-56 days) were evaluated in phase I clinical trials with volunteers 19 to 54 years old. The phase II and III clinical trials were also double-blind, randomized, and placebo-controlled, and included respectively 660 and 48,000 volunteers from 19 to 80 years. The anti-RBD titers were evaluated using a quantitative ELISA system developed at the Center for Immunoassay, Havana Cuba, and ELECSYS system from Roche. The RBD to ACE2 plate-based binding competitive ELISA was performed to determine the inhibitory activity of the anti-RBD polyclonal sera on the binding of the hFc-ACE2 coated plates. The neutralization antibody titers were detected by a traditional virus microneutralization assay (MN50). Finding(s): The Abdala vaccine reached 92.28% efficacy. The epidemic was frankly under control in Cuba after the vaccine introduction having reached the highest levels of cases and mortality in July 2021 with the dominance of the Delta strain. The peak of the Omicron wave, unlike other countries, did not reach half of the cases of the Delta wave with a significant reduction in mortality. The mucosal vaccine candidate "Mambisa" completed its clinical development as a booster dose for convalescent subjects reaching the trial end-point. Conclusion(s): Vaccine composition based on RBD recombinant antigen alone is sufficient to achieve high vaccine efficacy comparable to mRNA and live vaccine platforms. The vaccine also protects against different viral variants including Delta and Omicron strains.Copyright © 2023
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Objectives: COVID-19 is an acute respiratory infection caused by the new coronavirus that has spread around the world, becoming an international public health emergency. Studies have shown a high prevalence of psychiatric symptoms such as depression, anxiety and post-traumatic stress disorder in patients after the infection, a situation that can be evenmore pronounced in patients with chronic diseases such as Immune-mediated rheumatic diseases (IRMD). The aim of this study is to evaluate the psychological impact of the COVID-19 infection and pandemic on patients with IRMD as well as to describe the epidemiological profile of the selected population. Method(s): A longitudinal cohort observational study was carried out with a comparison group, based on the analysis of data from patients of Project Reumacov, organized by de Brazilian Society of Rheumatology, in Manaus/ Amazonas. Data regarding the psychological impact was obtained through the application of DASS-21 forms, which evaluated levels of depression, anxiety and stress. Possible answers were divided into four categories according to the frequency of the symptoms presented, such as Not applicable;Present for a short time;Present for a significant amount of time or Present most of the time. Result(s): In total, 283 patients were included in the study. The mean age was 44 years and the majority of the patients were female. The most frequent diagnosis was systemic lupus erythematosus, followed by rheumatoid arthritis. Of the patients included, 270 answered the DASS-21 questionnaire, being 152 in the Case group (patients with COVID-19) and 118 in the Control group (patients without COVID-19). There was a significant statistic correlation between high levels of depression, anxiety and stress and the presence of COVID-19 related symptoms. Conclusion(s): Our study demonstrated that high levels of stress, depression and anxiety were associated to the coronavirus infection. It is, however, difficult to determine whether this scenario is a result of a physiological response to the infection or a consequence of the social context of a pandemic. This knowledge may contribute to a better understanding of COVID-19 infection and its repercussions as well as to highlight the necessity of a multidisciplinary approach aimed at the mental health of patients with rheumatic diseases.
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Objectives: Patients with Systemic Lupus Erythematosus (SLE) are predisposed to serious infections due to immunocompromise, comorbidities, immunomodulatory and/or immunosuppressive therapy, as well as the lack of these medications faced by patients dependent on the Sistema Unico de Saude (SUS) during the COVID-19 pandemic. Studies revealed a low risk of worsening disease activity after vaccination against SARS-CoV-2 and safety in the continuity of immunomodulatory therapy during the vaccination stages. Thus, immunization against COVID-19 is an important pillar in reducingmorbidity and mortality related to infectious conditions and SLE. This study had the objective to understand the disease activity in SLE patients after vaccination against COVID-19. Method(s): This is an observational, longitudinal, ambidirectional study with follow-up of subgroups of patients with immune-mediated rheumatic diseases immunized with vaccines made available by the Programa Nacional de Imunizacao (Butantan Institute, Pfizer/BioNTech, BioManguinhos/Fiocruz and Janssen). Data from the SLE disease activity index 2000 (SLEDAI-2 K) and sociodemographic data were collected and stored via an online platform, with a comparison of the index before and after each dose. This study was approved by the local Research Ethics Committee, and it is associated to the SAFER Project from Brazilian Society of Rheumatology. Result(s): A total of 223 patients were included, of which 83% were female and 39% had SLE, 36.7 +/- 11.76 years old. Regarding the disease activity, at inclusion the mean PGA score(SD) was 2,61 +/- 2,77. After the 1st dose it was 1.38 +/- 2.17, after the 2nd dose it was 2,35 +/- 2,99, after the 3rd dose it was 2,19 +/- 2,58 and after the 4th dose 1.18 +/- 1.88. The mean SLEDAI-2 K score at inclusion was 7,27 +/- 9,70, after the 1st dose it was 2,75 +/- 5,29, after the 2nd dose it was 4,73 +/- 6,40, after the 3rd dose 3,33 +/- 5,51 and after the 4th dose 2.12 +/- 4.27. 6% of the patients referred worsening disease activity after the 1st dose, 14,3%after the 2nd dose, and no patient reportedworsening of disease activity after the 3rd and 4th doses. Conclusion(s): Vaccination did not contribute toworsening disease activity of the SLE patientss studied, according to the indices used to assess disease activity.
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Objectives: Immunization against SARS-CoV-2 is an effective strategy to reduce morbidity and mortality in the face of the COVID-19 pandemic. People with Immune-mediated Rheumatic Diseases (IMRD) also benefited from this campaign. However, there is a limited amount of data on the outcome of vaccination in these patients, in terms of those who were infected by the virus. This study had the objective to evaluate the rate of COVID-19 cases in patients with IMRD after vaccination against SARS-CoV-2. Method(s): Observational, longitudinal and ambidirectional study with follow-up of subgroups of patients with IMRD immunized with vaccines made available by the National Immunization Plan (inactivated adsorbed vaccine registered by the Instituto Butantan (IB), recombinant vaccines registered by Bio Manguinhos/ Fiocruz and by Janssen, and Pfizer/BioNTech). Sociodemographic data and questionnaires on flu syndrome, laboratory confirmation of infection and need for hospitalization and outcomes were collected and stored via an online platform. This study is associated to the SAFER Project from the Brazilian Society of Rheumatology and it was approved by the local Research Ethics Committee. Result(s): A total of 223 patients aged over 18 years, mean age 42.79 +/- 15.18 years, were included. All were within the inclusion/exclusion criteria, with 83% being female. The main IMRD included were systemic lupus erythematosus (39%) and rheumatoid arthritis (33.6%). After the 1st dose, 1.45% of patients had COVID-19, 50% sought health services (emergency care), without the need for hospitalization and after the 2nd dose, 1.5% had the disease, of which none sought health services, required hospitalization or had a negative outcome. After the 3rd dose,: 2.9%were infected with SARS-CoV-2 one month later, 15.6% two to three months later and 5.5% four to six months later, all with laboratory confirmation;only 4% presenting any serious complication;there were no deaths. After the 4th dose, 9.1%of patients had COVID-19, of which 40%were hospitalized, without the need for assisted ventilation;half of these patients had a serious complication, but there no deaths. Conclusion(s): In this study, we observed the effectiveness of the vaccine in preventing severe cases of COVID-19 and complications of SARS-CoV-2 infection.
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Objectives: Chronic Inflammatory Immune-mediated Diseases (CIMD) can cause pain and severe discomfort to the patient, leading to significant reductions in his/her quality of life. Vaccination against COVID-19 has proven to be an efficient method in preventing cases and serious repercussions. However, there is insufficient evidence on the safety of these vaccines in the CIMD population. Objective(s): To assess disease activity in adolescent patients with CIMD after vaccination against SARS-CoV-2. Method(s): Observational, longitudinal, ambidirectional study with follow-up of groups of adolescent patients with CIMDwho received the vaccine provided by the National Immunization Program -Pfizer/BioNTech. Sociodemographic and clinical disease activity data were collected before and after each vaccine dose. Data were stored through an online platform (REDCap). This study is associated to the SAFER Project from the Brazilian Society of Rheumatology and was approved by the local Research Ethics Committee. Result(s): Nineteen adolescents aged between 12 and 17 years were included, all of whom met the inclusion/exclusion criteria. Of the total, 31.6% have Juvenile Idiopathic Arthritis (JIA)-14.33 +/- 2.25 years of age, whose subtypes included persistent oligoarticular JIA (16.7%), Polyarticular Rheumatoid Factor (RF) negative (33.3%), Polyarticular RF positive (16.7%) and Systemic (33.3%);68.4% have Systemic Lupus Erythematosus (SLE) -14.77 +/- 1.96 years of age. Regarding JIA patients, at inclusion, the mean disease activity assessed by the physician was 3 +/- 3.83 and 3.25 +/- 3.77 as assessed by the patient. After the 1st dose, the mean activity assessed by the physician was 2.8 +/- 3.9 and after the 2nd dose it was 3 +/- 4.24. Themean activity after the first dose as assessed by the patient was 3.2 +/- 3.96, and after the 2nd dose it was 2.8 +/- 3.11. In the SLE patients, at inclusion, the mean degree of disease activity was 1.92 +/- 1.83 and of the SLEDAI-2 K was 4.67 +/- 5.14. After the 1st dose, the mean disease activity was 1.11 +/- 1.96, and after the 2nd dose, it was 2.25 +/- 2.76. After the 1st dose, the SLEDAI-2 K was 1.11 +/- 1.76, and after the 2nd dose it was 4.25 +/- 5.28. No reports of worsening of disease activity after the vaccine were found. Conclusion(s): The vaccination proved not to contribute to worsening of clinical activity of rheumatic diseases in adolescents, without significant changes in SLE assessment indices and in the personal and medical assessment of JIA patients.
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Objectives: In the Chronic Inflammatory Immune-mediated Diseases (CIMD), infections mainly occur in the respiratory tract and their occurrence is related to drug-induced immunosuppression, underlying diseases and comorbidities. To reduce this morbidity and mortality, vaccination is an effective means of prevention. However, the available studies on SARS-CoV-2 vaccines have not addressed this group of patients with CIMD, and there are still many doubts regarding the indications, adverse effects, safety and efficacy of these vaccines. Objective(s): to evaluate the adverse effects of vaccines against SARS-CoV-2 in adolescent patients with CIMD. Method(s): Research associated to the SAFER Project from Brazilian Society of Rheumatology. It is an observational, longitudinal, ambidirectional study, with follow-up of groups of vaccinated adolescent patients with CIMD, vaccine by Pfizer/BioNTech. Sociodemographic data were collected, stored on an online platform, and adverse events were presented by filling in diaries issued for each patient. This study was approved by the local Research Ethics Committee. Result(s): We included 19 adolescents, aged between 12 to 17 years, who met the inclusion and exclusion criteria. The mean age was 14.63 +/- 2.01 years. Of these, 68.4% were female. In relation to CIMD, 31.6% have Juvenile Idiopathic Arthritis and 68.4% have Systemic Lupus Erythematosus. All were vaccinated with the Pfizer vaccine. In the 1st dose, the main adverse effects presented were Pain at the injection site (85.7%), Headache (42.9%), Tiredness (33.3%) and Edema and skin induration at the injection site (26, 7%). After the 2nd dose, the only adverse effect reported was Pain at the injection site (57.1%), with no other complaints. Conclusion(s): The adverse effects reported are of mild tomoderate reactogenicity;no serious adverse events were reported.
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In December 2019 an outbreak of a new disease happened, in Wuhan city, China, in which the symptoms were very similar to pneumonia. The disease was attributed to SARS-CoV-2 as the infectious agent and it was called the new coronavirus or Covid-19. In March 2020, the World Health Organization declared a worldwide pandemic of the new coronavirus. We have already counted more than 110 million cases and almost 2.5 million deaths worldwide. In order to assist in decision-making to contain the disease, several scientists around the world have engaged in various efforts, and they have proposed a lot of systems and solutions for tracking, monitoring, and predicting confirmed cases and deaths from Covid-19. Mathematical models help to analyze and understand the evolution of the disease, but understanding the disease was not enough, it was necessary to understand the problem in a quantitative way to lead the decision-making during the pandemic. Several initiatives have made use of Artificial Intelligence, and models were designed using machine learning algorithms with features for temporal and spatio-temporal investigation and prediction of cases of Covid-19. Among the algorithms used are Support Vector Machine (SVM), Random Forest, Multilayer Perceptron (MLP), Graph Neural Networks (GNNs), Ecological Niche Models (ENMs), Long-Short Term Memory Networks (LSTM), linear regression, and others. And these had good results, and to analyze them, the Root Mean Squared Error (RMSE), Log Root Mean Squared Error (RMSLE), correlation coefficient, and others were used as metrics. Covid-19 presents a huge problem to public health worldwide, so it is of utmost importance to investigate it, and with these two approaches it is possible to track not only how the disease evolves but also to know which areas are at risk. And these solutions can help in supporting decision-making by health managers to make the best decisions for the disease that is in the outbreak. This chapter aims to present a literature review and a brief contribution to the use of machine learning methods for temporal and spatio-temporal prediction of Covid-19, using Brazil and its federative units as a case study. From canonical methods to deep networks and hybrid committee-based, approaches will be investigated. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
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Cyber-Physical Systems: AI and COVID-19 highlights original research which addresses current data challenges in terms of the development of mathematical models, cyber-physical systems-based tools and techniques, and the design and development of algorithmic solutions, etc. It reviews the technical concepts of gathering, processing and analyzing data from cyber-physical systems (CPS) and reviews tools and techniques that can be used. This book will act as a resource to guide COVID researchers as they move forward with clinical and epidemiological studies on this outbreak, including the technical concepts of gathering, processing and analyzing data from cyber-physical systems (CPS). The major problem in the identification of COVID-19 is detection and diagnosis due to non-availability of medicine. In this situation, only one method, Reverse Transcription Polymerase Chain Reaction (RT-PCR) has been widely adopted and used for diagnosis. With the evolution of COVID-19, the global research community has implemented many machine learning and deep learning-based approaches with incremental datasets. However, finding more accurate identification and prediction methods are crucial at this juncture. © 2022 Elsevier Inc. All rights reserved.
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Background: The COVID-19 pandemic crisis has brought about changes in the lives of higher education students that may influence their psychological well-being. Objective: To analyze the association between nursing students’ coping strategies and their psychological well-being during the COVID-19 quarantine. Methodology: Cross-sectional, descriptive-correlational study using a convenience sample of 136 students. Data were collected online using the Portuguese version of the Échelle de Mesure des Mani-festations du Bien-être Psychologique and the Brief COPE. Results: Students in the last years of their undergraduate studies used the instrumental support (p = 0.015) and emotional support (p = 0.009) coping strategies more often and had higher levels of psychological well-being (p = 0.012). Psychological well-being is associated with household income changes (p = 0.024), as well as with religion (r = 0.36;p ≤ 0.01), positive reframing (r = 0.47;p ≤ 0.01), and humor (r = 0.37;p ≤ 0.01) coping strategies. Conclusion: Students’ coping strategies seem to be associated with their psychological well-being during the COVID-19 quarantine. © 2021, Escola Superior de Enfermagem de Coimbra. All rights reserved.
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The use of renal replacement therapies in patients with SARS-COV2 infection accounts for up to 20% of patients admitted to the intensive care unit. Therefore, for an adequate dialysis therapy, the placement of an adequate catheter is imperative. In patients who develop a severe SIRA, the American and European guidelines recommend the prone position to improve pulmonary ventilation, so the placement of an catheter, becomes a great challenge, the use of technology such as ultrasound, helps reduce complications, however, when it is not available, the importance of an anatomical knowledge is vital for success. A 62-year-old male, with non-productive cough, asthenia, adynamia, adding, increasing dyspnea, even meriting ventilator mechanical support, with high ventilatory parameters, Therefore, as an added therapeutic measure, the patient was pronated, presenting ventilatory improvement. After 6 days of stay in the intensive care unit, renal compromise is added with evolution of oliguric AKIN 3 acute kidney injury, requiring initiate renal replacement therapy so it is decided to place a temporary catheter to start therapy. Because the patient's requirement to remain in pronation position, it is decided to place a temporary double- lumen catheter in that position, after not having an ultrasound available, the use of anatomical reference is chosen. The challenges that doctors have faced over the last few months, due to the recent coronavirus, have required new protocols and procedures to which techniques and procedures have had to be adapted to obtain better results, and improve the health status of each of the patients. A review of this case was carried out to refer the importance of anatomical knowledge, that the nephrologist, in the interventional area, is of utmost importance for reducing complications and increasing the success rate in each of their procedures.
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Diabetes is a life-long condition that is well-known in the 21st century. Once known as a disease of the West, the rise of diabetes has been fed by a nutrition shift, rapid urbanization and increasingly sedentary lifestyles. In late 2019, a new public health concern was emerging (COVID-19), with a particular hazard concerning people living with diabetes. Medical institutes have been collecting data for years. We expect to achieve predictions for pathological complications, which hopefully will prevent the loss of lives and improve the quality of life using data mining processes. This work proposes a comparative study of data mining techniques for early diagnosis of diabetes. We use a publicly accessible data set containing 520 instances, each with 17 attributes. Naive Bayes, Neural Network, AdaBoost, k-Nearest Neighbors, Random Forest and Support Vector Machine methods have been tested. The results suggest that Neural Networks should be used for diabetes prediction. The proposed model presents an AUC of 98.3% and 98.1% accuracy, an F1-Score, Precision and Sensitivity of 98.4% and a Specificity of 97.5%. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
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This paper was made during social distancing, when the COVID-19 contaminations increases in Brazil, counting 27.276 deaths on May 29th of 2020, besides several not accounted cases and recent alteration in accounting methods. In this context, to write about something which is in course is challenging and, why not to say, risky, because the lack of deep analyses. It is also a singular opportunity to talk about the intends of the social and economic project in course in Brazil at and the combat actions to the virus pandemic by the federal government. Therefore, we want to demonstrate the current contradictions of neoliberalism - within the Brazilian political-ideological project - in view of the exposure of social, economic and spatial vulnerabilities and inequalities in urban spaces (cities) to fight COVID-19. The methodology used consists of a bibliographic review based on scientific journals and newspaper articles. Lastly, this article emphasizes the need to redefine the urban dynamic facing the unitary logic of the capital - labor, because we should not understand social distancing as a privilege. We are assertive in believing that social distancing is a right, which for now is being denied and placed as a class privilege.