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Aim: The aim of this research was to evaluate the impact of a telerehabilitation program on physical fitness, muscle strength, and levels of depression and anxiety in post-COVID-19 patients. Methods: Thirty-two individuals recovered from COVID-19 (48.20±12.82 years) were allocated into either a telerehabilitation (TG n=16) or control (CG n=16) group. Physical fitness, handgrip strength, depression and anxiety levels were assessed before and after an 8-week intervention. Results: There was a significant improvement in muscle strength in both groups. Physical fitness significantly increased compared to the CG at the end of the intervention. Levels of anxiety and depression significantly decreased after the intervention when compared to the CG. Conclusion: Eight weeks of functional telerehabilitation training is a viable and efficient way to rehabilitate patients affected by COVID-19, as it improved physical conditioning and mental health. © 2023, University Library System, University of Pittsburgh. All rights reserved.
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Introduction: Orosomucoid also named Alpha-1 Acid Glycoprotein(AGP) is a major acute-phase protein and is increased in response to systemic injury and inflammation. AGP has been described as an inhibitor of neutrophil migration on sepsis, particularly its immunomodulation effects. The AGP biological functions are not understood in Coronavirus disease 2019 (COVID-19). Hypothesis: We hypothesize that plasmatic AGP is upregulated in severe Covid-19 patients and is involved in the regulation of netosis. Therefore, we sought to investigate the role of AGP in plasmatic from COVID-19 severe infection patients and neutrophils infected with Severe Acute Respiratory Syndrome Coronavirus-2 (SarsCov-2). Method(s): Epidemiological data and AGP, interleukin-6 (IL-6), C-reactive protein (PCR), lactate, and other laboratorial parameters were measured in blood samples from 52 subjects hospitalized in the ICU with clinically SarsCov-2 infection confirmed by RT-PCR. To evaluate the role of AGP in netosis in neutrophils, blood samples from health patients (n=13) were collected, and neutrophils were separated and infected with Sars-Cov-2 (Moi=1). Those neutrophils were treated with AGP (10mug/ml) or vehicle for 18 hours and netosis was analyzed by flow cytometry (n=10) and immunofluorescence (IF;n=10). Early and late netosis, respectively, were characterized by negative or positive FVS and positive Sytox. The neutrophil extracellular traps (NETs) were investigated by myeloperoxidase (MPO), neutrophil elastase (NE), and DAPI by IF and quantified Netquant/Matlab software. This study was approved by Ethics Committee -CAAE: 30816620.0.0000.5440. Result(s): AGP increased in severe Covid-19 patients (p<0.05). A positive correlation between AGP with IL-6 and C-reactive protein (respectively, p=0.005, p=0.002) and a negative correlation between AGP and lactate (p=0.004) were found it. Together, AGP treatment downregulated early (35,7%) and late (43,5%) netosis in neutrophils infected with SarsCov-2. Confocal analysis by MPO, NE e DAPI showed NETs released by neutrophils infected with Sar-Cov-2 decreased when neutrophils were treated with AGP (p<0.05). Conclusion(s): Our data showed increased AGP in COVID-19 infection and contributed to netosis regulation.
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Aim: Since the early phases of the COVID-19 pandemic, health systems tried to adapt to ensure the continuity of care of oncological patients. This study aimed to describe the impact of SARS-CoV- 2 on rectal cancer screening and staging. Method(s): A two-year (March 2019 to March 2021) retrospective study concerning rectal cancer patients from a referral center was conducted. Patients clinical data from pre-COVID (March 2019 -February 2020) and COVID time (March 2020 -March 2021) was compared. Descriptive and inferential analysis was performed (Chi-Square test). Result(s): One hundred and sixty-five patients were discussed at the multidisciplinary meetings during the 2-year study period (mean age 69 years [+/- 11.1];M: 64%;F:36%). Upon comparative analysis both pre-COVID and COVID patients were found to have similar demographic characteristics, however during the pandemic a higher proportion of patients presented with low rectal cancers (36% vs. 42%;P = 0.1). Moreover, during the COVID period, fewer patients (minus 26%;npre-covid= 95 vs. ncovid = 70) were referred to the hospital, and a larger number of patients presented in Stage IV of the disease (17,9% (n = 17) in pre COVID period vs. 28,6% (n = 20) in COVID period (P = 0.07)). Lastly, the authors run a comparative sub-analysis between the above results and data from the 3 years prior to the pandemic (2017-2019) and still came across with lesser rectal cancer referrals during the pandemic year. Conclusion(s): Our data clearly shows that, during the COVID period, fewer patients received in-hospital care and a higher number were referred in Stage IV. This represents a red flag for the community and should alert the government to implement public health policies to reestablish colorectal cancer standard of care.
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Objetivo: O presente estudo tem por objetivo relatar caso de infeccao aguda por citomegalovirus associada a glomerulonefrite rapidamente progressiva no paciente em terapia de manutencao para leucemia pro mielocitica aguda. Relato de caso: Paciente masculino de 25 anos, sem comorbidades, em seguimento no servico de hematologia da UNIFESP por quadro de Leucemia Pro Mielocitica Aguda (diagnostico em julho/2021), em protocolo de manutencao desde janeiro/2022 com 6-mercaptopurina, metotrexato e ATRA, em remissao morfologica e molecular, evolui com quadro de febre diaria ha 10 dias associada a odinofagia e tosse, com linfopenia, sem alteracoes ao exame fisico e rastreio infeccioso ambulatorial negativo. Solicitadas pesquisas de Citomegalovirus, Parvovirus, Epstein-Barr e SARS-Cov-2, suspensos os farmacos do protocolo de manutencao e indicada internacao hospitalar. Sem melhora do quadro relatado acima, paciente evoluiu com pancitopenia associada a um aumento de DHL e ferritina, sem figuras de hemofagocitose no aspirado de medular, alem de sindrome nefrotica e lesao renal rapidamente progressiva KDIGO III com indicacao de dialise. Visto tambem que nao haviam esquizocitos em sangue periferico, alteracoes no coagulograma ou outras disfuncoes organicas. Constatadas sorologias IgM e IgG positiva para CMV alem de carga viral serica elevada para CMV, confirmando a infeccao aguda por CMV associada a glomerulonefrite rapidamente progressiva. A biopsia renal demonstrou podocitos com alteracoes degenerativas, ausencia de depositos glomerulares e infiltrado linfocitario intersticial. Apos tratamento adequado com ganciclovir paciente evoluiu com melhora da febre e retorno da funcao renal de base. Discussao: Em individuos imunocompetentes a infeccao assintomatica pelo citomegalovirus e comum, e quando ocorrem sintomas ha um quadro clinico semelhante a mononucleose infecciosa, que pode cursar com sintomas de vias aereas superiores associados a linfadenopatia, esplenomegalia e linfopenia. No contexto clinico dos pacientes imunossuprimidos e mais comum que ocorra uma reativacao viral que pode levar a lesao organica aguda com acometimento de orgao unico ou lesao multissitemica. E descrito em literatura que a infeccao por citomegalovirus associada a lesao renal aguda exclusiva esta mais associada ao contexto do paciente imunossuprimido pos transplante renal em uso de drogas com maior potencial imunossupressor, diferentemente do caso relatado. Conclusao: A partir das manifestacoes clinicas e do rastreio infeccioso direcionado as infeccoes oportunistas que acometem o paciente imunossuprimido foi possivel associar o quadro de glomerulonefrite rapidamente progressiva a infeccao aguda por CMV, quadro pouco conhecido na pratica clinica, visto a predilecao para doenca invasiva em sistema nervoso central, retina, trato gastrointestinal e trato respiratorio. Alem disso, notou-se que nesse caso o tratamento com Ganciclovir foi efetivo neste tipo de apresentacao clinica, visto o retorno da funcao renal de base apos o tratamento adequado. Copyright © 2022
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Introduction: The SARS-CoV-2 pandemic killed over 6 million people worldwide. Children were described to have predominantly mild or asymptomatic infections and to be less exposed to the virus, at least for the initial variants. In the present study, we describe how SARS-CoV-2 can silently infect tonsils and adenoids in children undergoing adenotonsillectomy. Method(s): In this cross-sectional study we assessed children who underwent adenotonsillectomy between October 2020 and September 2021 in a secondary hospital in Brazil. All the caregivers denied any symptom of acute viral upper airway infection in the month prior to surgery. Briefly, nasal cytobrush (NC), nasal wash (NW) and tonsillar tissue fragments posttonsillectomy were tested by RT-PCR, immunohistochemistry (IHC), in situ immunofluorescence (IF), and flow cytometry. Result(s): A total of 48 children (18 females, median age 5.5 years) were enrolled. None of them had been vaccinated against COVID-19 at the time of surgery. Only 2 had a history of previous COVID-19 diagnosis, 3 and 5 months, respectively, before surgery. SARS-CoV-2 RNA was detected in 25% (12) of patients-20% in palatine tonsils, 16.27% in the adenoids, 10.41% in NC, and 6.25% in NW. IHC labeling showed viral nucleoprotein presence in both adenoids and palatine tonsils, in epithelial surface and lymphoid cells from extrafollicular and follicular regions. In 5 out of 7 patients, in situ IF showed the expression of ACE2 and TMPRSS2 and viral spike protein in the tonsillar tissue. Flow cytometry revealed that SARS-CoV-2 is predominantly observed in CD123+ dendritic cells (10.57% of all tested sites), followed by CD14+ monocytes (6.32%). Conclusion(s): According to these results, the prevalence of SARS-CoV-2 infection seems to be higher than expected and underdiagnosed in children at this age group. Palatine tonsils and adenoids are important sites of infection and may be a reservoir for the virus. Nevertheless, it is still unclear the impact of these results on virus transmission.
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This study aims to verify the situation of school Physical Education classes in the COVID-19 pandemic context from the perspective of the pedagogical practice of Physical Education teachers. It uses a quantitative approach through survey research, using a questionnaire as an instrument, completed by 439 participants. The data reveal that 72.6% of teachers assured that their schools had never worked with digital platforms before, and 65.1% of those had never participated in any course on technologies. WhatsApp (45.8%) and YouTube (26.1%) were used as the main digital platforms for classes. Thus, student adherence in this period was far from ideal, yet WhatsApp groups promoted more rapprochement between schools and families.
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Covid-19 brought disruptions and uncertainties at a global scale. Municipalities were forced to show immediate adaptive capacity to counter the effects of the pandemic shock. The record of their performance is critical to improve future responses and more resilient regions. This article does the inventory of the measures adopted in the CIM-RC, by municipalities, during the first wave of the pandemic in Portugal. Their adaptive capacity in fostering conditions of adaptation and adaptability to the pandemic shock reveals local resilience, in spite of some differences between more urban and more rural municipalities. Taken together, the three categories of adopted measures - sanitary, economic and social measures - exhibit more tenuous traces of resilience associated with the neighborhood effect than those of category-by-category analysis. No polarizing effects deriving from the main urban centers were observed. © 2022,Revista Portuguesa de Estudos Regionais.All Rights Reserved
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The inhibitory activity of thirty-one sesquiterpenes identified from Brazilian essential oils (Copaifera langsdorffii Desf., Croton cajucara Benth. and Siparuna guianensis Aublet.) were analyzed by in silico molecular docking. The compounds were characterized by gas chromatography-mass spectrometry (GC-MS) and gas chromatography with flame-ionization detection (GC-FID), and then, applied against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) proteins and human angiotensin-converting enzyme 2 (hACE2). Applying molecular docking and AutoDock Vina software, a total of 496 individual interactions were detected for sesquiterpenes along with SARS-CoV-2 proteins and hACE2 human angiotensin converting enzyme-2 protein. The findings showed considerable binding affinity of sesquiterpenes with the tested macromolecules. In that, beta-selinene from C. langsdorffii displayed the best energy (-7.2 kcal mol(-1)) and showed strong interactions with the amino acids of the SARS-CoV-2 M-Pro protein. Spathulenol from C. cajucara strongly interacted with human ACE2, with a binding energy of -7.1 kcal mol(-1). Meanwhile, gamma-eudesmol from S. guianensis presented the lowest binding energy (-7.5 kcal moL(-1)) by interacting with the SARS-CoV-2 M-Pro complex. Additionally, measurements were performed aiming to evaluate the best sesquiterpenes binding interactions with the main proteins and its homologue files. According to results, these Brazilian essential oils hold antiviral potential being a rich source for further in vitro and in vivo studies focusing on herbal therapeutic adjuvants against SARS-CoV-2 infections.
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Background: Though various computerized tomography (CT) severity scores have been described for risk prognostication for coronavirus disease 2019 (COVID-19), most are challenging to calculate and have variable inter-observer agreement. The objective of this study was to develop a simple CT severity score (CT-SS) with good inter-observer agreement and assess its correlation with clinical outcome.
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With the Covid-19 pandemic, classroom teaching activities were suspended and distance learning was seen as an alternative for students at all levels of education, to continue their learning. This study aims to know the perceptions of teachers and families regarding distance learning. The study had the participation of two teachers and two families, from two primary schools in the north of Portugal. Through a qualitative methodology using the interview, as an instrument of data collection, an attempt was made to emphasize the participants’ points of view and the meaning they have on the subject. The main results demonstrate that although distance learning allows flexible management of the timetable and greater autonomy for students, it can be unfavorable in terms of the development of socio-emotional skills. The difficulties felt point to the lack of monitoring by students, time management and the lack of technological skills. The investment in teacher training in this area was considered as a suggestion for improvement. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Inefficient supply chain management could jeopardize or limit an effective vaccination campaign as well as the immunization programs. As we face a COVID-19 pandemic outbreak and population immunization is the best solution, it is critical to map the vaccine supply chain management to identify risks and opportunities for the Industrial Engineering and Operations Management researchers and practitioners. This paper aims to map the field, applying descriptive bibliometric analysis. The application of a string search in the science index Web of Science resulted in a sample of 808 documents. We used the Bibliometrix R for data processing. The scientific production of the domain has been rising since 2006. The few high productivity authors focus on Health Sciences and Immunology studies even though the results unfold a growing interest by academics from Engineering, Business and Economics, Operations Research, and Management Sciences domains. Vaccine and other health sciences journals are the most productive and present a higher impact. The authors’ keywords dynamics analysis shows a resettling of technical terms as “stabilization” and “formulation” to supply chain management keywords as “logistics”. Evidence points out the need for more Industrial Engineering and Operations Management research to increase vaccine distribution effectiveness. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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The Covid-19 pandemic brought with it a set of impacts and consequences, some of which of a typology and dimension still to be known and properly measured. The set of communicational practices and media consumption is no exception, having been observed during the March / April 2020 confinement a significant change in the patterns usually identified in the Portuguese society. Podcasting, as a format intrinsically related with aspects such as portability and ease of access and consumption, faces in this context a very significant communicational reframing process, insofar as the relevant dimensions of its consumption are strongly associated with the paradigms of mobility. This is, however, only a relative dimension of the change that the format is going through, being simultaneous to the growing interest in platformized and closed models of content distribution and to the growing relevance of the social dimension of audio and, in particular, of the voice as an instrument to sociability. This article explores the materialization of the change observed in the format due to the pandemic. Starting from the observation of media consumption trends in Portugal, we seek to reflect on how the format is thought, developed and operationalized by the production sphere. To this end, the dynamics of podcast consumption in Portugal are observed, using a representative sample of the population, and the consumption patterns by gender and source in pre-pandemic (December 2018) and post-pandemic (December 2020) periods. The analysis carried out allows us to see that podcasting will have organically acquired a new configuration with confined communicability. From the production point of view, the pandemic has not halted the exponential growth on the supply side both in terms of content diversity and quantity and of increased competition within the existing format. © 2021 Obercom. All rights reserved.
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Objective: The objectives of this study were to measure the global impact of the pandemic on the volumes for intravenous thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with two control 4-month periods. Background: The COVID-19 pandemic led to widespread repercussions on the delivery of health care worldwide. Design/Methods: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by ICD-10 codes and/or classifications in stroke center databases. Results: There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95%CI,-11.7 to-11.3, p<0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95%CI,-13.8 to-12.7, p<0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95%CI,-13.7 to-10.3, p=0.001). There were greater declines in primary compared to comprehensive stroke centers (CSC) for stroke hospitalizations (-17.3% vs-10.3%, p<0.0001) and IVT (-15.5% vs-12.6%, p=0.0001). Recovery of stroke hospitalization volume (9.5%, 95%CI 9.2-9.8, p<0.0001) was noted over the two later (May, June) versus the two earlier (March, April) months of the pandemic, with greater recovery in hospitals with lower COVID-19 hospitalization volume, high volume stroke center, and CSC. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. SARS-CoV-2 infection was noted in 3.3% (1,722/52,026) of all stroke admissions. Conclusions: The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months, with greater recovery in hospitals with lower COVID-19 hospitalizations, high volume stroke centers, and CSCs.
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The use of digital educational resources has expanded considerably, including in the context of the COVID-19 pandemic. In the educational materials used in these resources, the Microcontent (MC) format predominates, with its fragmented and small information units. So, we ask: can the LongForm (LF) format, which allows the presentation of dense and extensive content, be a viable alternative to MC, when applied to complex educational content, specific to undergraduate courses? The LF, hypothetically, can offer better support for higher distance education courses. To answer the question, an educational activity, elaborated in both formats, was applied to 67 students from a university of Minas Gerais state, in Brazil. The observation of student activity revealed their preferences: MC has shown to be good for building learning with smaller materials in both size and content complexity, but LF was more appropriated when dealing with complex, dense, multimedia-requiring contents to facilitate understanding. It was confirmed that the LF presents itself as a viable alternative for online studying because it is constituted by a single virtual space where larger texts and varied multimedia resources can be inserted to enrich the educational material and to offer the full content for students. © 2021 Universidad de Murcia. All rights reserved.
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The development of accurate, reliable, inexpensive and fully recyclable analytical platforms is of utmost relevance to several fields from medical diagnosis to environmental screening. Surface-enhanced Raman spectroscopy (SERS) is a compelling detection method with high specificity and sensitivity. In this work, a microwave-assisted synthesis method was used for fast and uniform in situ growth of gold nanoparticles (AuNPs) onto nanocellulose (NC) membranes, through a seed-mediated process. The as-prepared membranes were fully optimized and its application as SERS platforms was demonstrated. A direct comparison with other cellulose-based substrates showed the superior characteristics of NC such as high mechanical strength, high surface area and lower porous content. An Enhancement Factor (EF) up to ~106 was obtained using rhodamine 6G (R6G) 10−6 M as probe molecule and a remarkable shelf life of at least 7 months was achieved, with no special storage requirements. Preliminary results on the label-free detection of spike protein from SARS-CoV-2 virus are shown, through direct measurements on the optimized SERS membrane. We believe that this work evidences the effectiveness of in situ seed-mediated microwave-assisted synthesis as a fabrication method, the high stability of AuNPs and the superior characteristics of NC substrates to be used as SERS platforms. © 2021 Elsevier B.V.
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On March 19, 2020, a State of Emergency was declared in Portugal as a way to contain the spread of the COVID-19. Restriction measures were adopted, limiting the mobility of the population. This paper presents preliminary results of an online survey to Portuguese households on the impact of COVID-19 lockdown on food purchase, storage, management, and waste generation. A total of 841 questionnaires were collected. The main changes observed were in food purchasing behavior, as 77 percent stated that they had reduced the frequency of grocery shopping, and 68 percent had bought more in local shops than before. Regarding food waste generation, the majority (60 percent), stated that during lockdown they threw away the same amount of food as before. 36 percent answered less than before, reporting that they had adopted strategies to reduce food waste. Vegetables, milk, and fruit were the goods with the highest reduction of food waste. © 2020, Society for Human Ecology. All rights reserved.