[Epidemiological characterization of COVID-2019 in Mexican pregnant women: a cohort study]

Background: COVID-19 in pregnancy can increase the risk of complications due to the cardiorespiratory and immunological changes typical of pregnancy. Objective: To report the epidemiological characterization of COVID-19 in Mexican pregnant women. Material and methods: Cohort study on pregnant women with a positive COVID-19 test, which were followed until delivery and one month later. Results: 758 pregnant women were included in the analysis. Mothers' mean age was 28.8 +/- 6.1 years;the majority were workers 497 (65.6%) and with an urban origin (482, 63.6%);the most common blood group was O with 458 (63.0%);478 (63.0%) were nulliparous women and more than 25% had some comorbidities;the average gestation weeks at infection were 34.4 +/- 5.1 weeks;only 170 pregnant women (22.4%) received vaccination;the most frequent vaccine was BioNTech Pfizer (96, 60%);there were no serious adverse events attributed to vaccination. The mean gestational age at delivery was 35.4 +/- 5.2 weeks;85% of pregnancies were cesarean section;the most frequent complication was prematurity (406, 53.5%), followed by preeclampsia (199, 26.2%);there were 5 cases of maternal death and 39 cases of perinatal death. Conclusions: COVID-19 in pregnancy increases the risk of preterm birth, preeclampsia, and maternal death. Vaccination against COVID-19 in this series showed no risk for pregnant women and their newborns. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.

Quest for financial inclusion via digital financial services (Fintech) during COVID-19 pandemic: case study of women in Indonesia

Based upon an extended Technology Acceptance Model (TAM), this study aims to investigate the factors influencing the behavioral intention to adopt Fintech from the perspective of Indonesian women. The research data were collected from 409 Indonesian female respondents and analyzed using the SEMinR statistical data analysis tool. Structural equation modeling (SEM) was used to assess this research's measurement model and structural model. The result shows that perceived usefulness, perceived ease of use, user innovativeness, attitude, trust, and brand image significantly positively impact behavioral intention to adopt Fintech among Indonesian women. Meanwhile, perceived ease of use, financial literacy, and government support are found to have indirect relationships with behavioral intention. In addition, moderation analysis revealed that the saving habits of women during the COVID-19 pandemic reduced the relationship between their innovativeness and behavioral intention to adopt Fintech. Based on these results, we recommend practical suggestions to the government, policymakers, and aspiring Fintech service providers further to enhance women's empowerment through digital financial inclusion. © 2023, The Author(s).

Use of Audiovisual Strategies as a Complementary Resource for Practical Courses in Biomedical Engineering

In recent years, the education has been influenced by the implementation of new learning strategies due to the confinement caused by the spread of COVID-19. Teachers adopted audiovisual resources that allow them to teach their classes remotely. However, the transition to this modality has been sudden, forced, and evolving “on the fly" in response to the pedagogical adaptations. A structured implementation of audiovisual media in education is required, since it represents an important part of access to information in our times. For this goal, we propose strategies for the development of complementary offline and online audiovisual content to help teach practical courses in a Biomedical Engineering bachelor program. In particular, we present content created for a Medical Imaging Systems course. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Pneumomediastinum in COVID-19 Patients: A series of 10 cases

Coronavirus disease 2019 is a current public health problem that has caused more than 100,000 deaths in Colombia and around 4.13 million deaths worldwide. The acute respiratory distress syndrome secondary to this viral infection can lead to a series of complications such as pneumomediastinum, which is rare but potentially fatal and is related to mechanical ventilation. We present a case series of 10 patients who were admitted to the intensive care unit requiring invasive mechanical ventilation and developed pneumomediastinum. Largest case series reported to date. © 2022 Asociación Colombiana de Medicina Crítica y Cuidado lntensivo

Higher Immunogenicity of a Third Heterologous Dose with BNT262b2 Mensanger RNA Vaccine Compared to a Homologous Dose in Kidney Transplant Recipients Fully Vaccinated with Inactivated Whole- Virion CoronaVac Vaccine

Purpose: This study aims to compare the immunogenicity of a third dose of the heterologous BNT262b2 mRNA vaccine versus the homologous inactivated wholevirion CoronaVac vaccine in adult kidney transplant recipients (KTR). Method(s): This prospective, single-center, phase 4 interventional study included KTR aged 30-69 years, with more than 30days of transplantation, and no previous confirmed COVID-19. The patients received the 3rd heterologous (BNT162b2 mRNA) or homologous dose, at least four weeks after the standard two-dose schedule of CoronaVac vaccine, at the transplant center. Antibody response immediately before and after the 3rd dose was assessed by the AdviseDx SARS-CoV-2 IgG II assay. For those positive assays, neutralizing anti-SARS-CoV-2 antibodies were assessed through the cPassTM SARS-CoV-2 Neutralization Antibody Detection Kit. Result(s): There were 307 patients in the heterologous group and 777 patients in the homologous group. KTR in the heterologous group were older (median age 54 vs. 50 years,p<0.0001), with a lower prevalence of diabetes (7% vs. 11%,p=0.032), lower percentage of deceased donors (60% vs. 68%,p=0.006) and longer time since transplant (median 11 vs. 6 years,p< 0.0001).Immediately before the 3rd dose, seroprevalence for IgG antibodies (36% vs. 34%,p=0.597) and the median antibody titers among those seroprevalent (246 AU/mL vs. 268 AU/mL,p=0.279) were similar. At a median of 25 days after the heterologous and 35 days after the homologous 3rddose vaccine, seroconversion rate was higher in the heterologous group (49% vs. 32%,p<0.0001), resulting in a higher seroprevalence rate (67% vs. 55%,p=0.0003). Overall, 42% remained seronegative after the third dose. The median antibody titers after booster among those seroprevalent patients was higher in those in whom the 3rd heterologous vaccine was administered (7,771 AU/mL vs 599 AU/mL,p<0.0001). The analysis of the neutralizing activity is ongoing. Conclusion(s): This prospective interventional study suggests that a 3rd heterologous dose is associated with a higher seroconversion rate and median antibody titers compared to a homologous dose in kidney transplant recipients fully vaccinated with inactivated whole-virion CoronaVac vaccine. In addition, 42% of subjects did not produce humoral immune response after the third dose, urging the development of alternative strategies.

The High Incidence of Long-COVID-19 in Kidney Transplant Recipients: A Longitudinal Cohort Study

Purpose: This study aimed to investigate the clinical consequences at 3 months after symptom onset among kidney transplant recipients surviving COVID-19. Method(s): This is an ongoing single-center observational prospective study including adult kidney transplant recipients who were diagnosed and survived after COVID-19 between 03/20/2020 and 05/31/2021. Patients who lost their graft were excluded. The patients are scheduled to receive a telephone contact at 3 months after symptom onset from the clinical research team. The call consisted of a structured questionnaire of symptoms with binary answers (yes or no). The questionnaire included the following symptoms: headache, dizziness, anosmia/ageusia, weakness, myalgia, inappetence, diarrhea, and dyspnea, which could be presented before and/or after the COVID-19 diagnosis. Those patients with at least one symptom presented only after the disease, were defined as having Long-COVID-19. Subsequently, the clinical research team included a question about the work status. Adjusted multivariable logistic regression models were used to identify the risk factors associated with Long-COVID-19. Result(s): There were 1,731 patients with COVID-19, with 455 deaths and 36 graft losses. Of the remaining 1,240 patients, 454 (36%) didn't answer our calls, yielding a final cohort of 786 patients. Of them, 217 (28%) developed Long-COVID-19. The incidence of each symptom at 3 months was: dyspnea (7%), myalgia (12%), weakness (11%), headache (10%), dizziness (7%), diarrhea (4%), inappetence (4%) and anosmia/ageusia (3%). About 1% of our patients needed domiciliary O2. Of those who we obtained the working status (n=239), 95 (40%) were employed before COVID-19 and 79 of them (83%) had returned to their original work at 3 months. After COVID-19 diagnosis, 44% of the patients were hospitalized (31% in ICU), 35% used supplemental O2, and 5% required mechanical ventilation. Fever (53%), shiver (39%), nausea (3%), anosmia/ageusia (59%), hospitalization (67%), and adverse cardiovascular events (3%), such as thrombosis or myocardial infarction, were risk factors associated with subsequent development of Long-COVID-19, using adjusted multivariable logistic regression. Conclusion(s): The incidence of Long-COVID-19 at 3 months was 28% and was associated with reduced quality of life and return to work. Several COVID-19 associated symptoms and disease severity markers were associated with Long- COVID-19.

Change in the Use of Fractionation in Radiotherapy Used for Early Breast Cancer at the Start of the COVID-19 Pandemic: A Population-Based Cohort Study of Older Women in England and Wales.

AIMS: Adjuvant radiotherapy is recommended for most patients with early breast cancer (EBC) receiving breast-conserving surgery and those at moderate/high risk of recurrence treated by mastectomy. During the first wave of COVID-19 in England and Wales, there was rapid dissemination of randomised controlled trial-based evidence showing non-inferiority for five-fraction ultra-hypofractionated radiotherapy (HFRT) regimens compared with standard moderate-HFRT, with guidance recommending the use of five-fraction HFRT for eligible patients. We evaluated the uptake of this recommendation in clinical practice as part of the National Audit of Breast Cancer in Older Patients (NABCOP). MATERIALS AND METHODS: Women aged ≥50 years who underwent surgery for EBC from January 2019 to July 2020 were identified from the Rapid Cancer Registration Dataset for England and from Wales Cancer Network data. Radiotherapy details were from linked national Radiotherapy Datasets. Multivariate mixed-effects logistic regression models were used to assess characteristics influential in the use of ultra-HFRT. RESULTS: Among 35 561 women having surgery for EBC, 71% received postoperative radiotherapy. Receipt of 26 Gy in five fractions (26Gy5F) increased from <1% in February 2020 to 70% in April 2020. Regional variation in the use of 26Gy5F during April to July 2020 was similar by age, ranging from 49 to 87% among women aged ≥70 years. Use of 26Gy5F was characterised by no known nodal involvement, no comorbidities and initial breast-conserving surgery. Of those patients receiving radiotherapy to the breast/chest wall, 85% had 26Gy5F; 23% had 26Gy5F if radiotherapy included regional nodes. Among 5139 women receiving postoperative radiotherapy from April to July 2020, nodal involvement, overall stage, type of surgery, time from diagnosis to start of radiotherapy were independently associated with fractionation choice. CONCLUSIONS: There was a striking increase in the use of 26Gy5F dose fractionation regimens for EBC, among women aged ≥50 years, within a month of guidance published at the start of the COVID-19 pandemic in England and Wales.

Peruvian consumer responses to the use of technologies in the context of COVID-19

The pandemic caused by COVID-19 has led many states, in an attempt to control the spread of the virus, to decree social immobilization, which meant the introduction of restrictions on the free movement of people and the opening of shops. This led them to seek new marketing channels for purchases. Among these, ICTs have been important. This is the focus of the analysis in this document. Through surveys and interviews, information was obtained, divided into four age groups, which showed that an important part of the population has had to resort to ICTs to acquire goods and/or pay for services. This change in the way of acquiring had different particularities according to the age group analyzed, with a greater change in the oldest group (56 to 74 years old). It can be concluded that the massification of these tools has generated a change in the ways of acquiring products, and this is likely to transcend the pandemic and these channels will be maintained and strengthened in the future. © 2021, IGI Global.

An interactive 3D interface for a virtual Chilean artisan fairs

Craft fairs are spaces where artisans can exhibit their artistic pieces and interact with the public, however this activity is always affected by external factors, such as weather, stoppages, health situation (due to covid-19), among others. This proposal is an innovative contribution to this problem that makes technology available to support this sector. Through a Web platform that incorporates a 3D interface, the craftsman will reach his audience without having to leave his home, since it simulates the environment of a craft fair where you can browse and see the crafts in its 360°, admiring each detail as if the user were in person. The technological infrastructure includes a catalog of all the pieces offered by the artisans and contact details. A filter facilitates the search for parts according to established criteria. The proposal has validations and various functional tests that show the technical feasibility and usability tests that demonstrate its usefulness and ease of use. © 2021 IEEE.

Recommendations for the approach of coinfection and superinfection. (Pautas nacionales para la atenci..n de pacientes adultos con COVID-19.) [Spanish]

This study aims to discuss guidelines for coinfection and superinfection for COVID-19. Regarding secondary infection in hospitalized patients, pulmonary superinfection is common in severely ill patients, particularly pneumonia associated with ventilation (VAP), which can occur in one out of every three patients. Current evidence does not support the routine use of empirical antibiotics in the treatment of confirmed COVID-19 infection at the time of admission, with the exception of critically ill patients with suspected clinical-imaging criteria or immunosuppression. However, a recent meta-analysis reports that 71.9% of patients hospitalized with COVID-19 received antibiotics, despite the fact that only 6.9% of these were associated with bacterial co-infections. In patients with sequelae of acute COVID-19 or persistent COVID-19, those exposed to corticosteroid therapy, or those re-admitted to the ICU, other microorganisms (mycobacteria and fungal infections) should be considered. Coinfections, particularly bacterial ones, occur in 10%-20% of patients hospitalized for COVID-19. In Uruguay we do not have national data, and as of April 2021, no co-infections have been reported in critically ill patients (PAHO/PAHO, Weekly Report). Sometimes, defining this situation makes it possible to establish whether the patient could benefit from the use of specific therapies such as tocilizumab, long-term high-dose or low-dose corticosteroids.

High-flow nasal therapy in severe respiratory failure due to SARS-CoV-2

The use of high-flow nasal therapy (HFNT) in patients with severe acute respiratory failure (SARF) due to COVID-19 pneu-monia (NCOVID-19) is debated. Given the lack of beds in Intensive Care Units in the Public Health System of the Province of Neuquén, their use was implemented in general wards. This restrospective multicenter study was carried out to describe the experience of using HNFT in patients with SARF due to NCOVID-19. The primary outcome was the frequency of successful weaning from HFNT and in-hospital mortality (IHM). Two hundred ninety-nine patients were analyzed;120 (40.1%) were successfully withdrawn from HFNT. This failed in 59.8% (179), 44.1% (132) required invasive mechanical ventilation (IMV), and 15.7% (47) was not candidates for intubation. A ROX index ≥ 5 at 6 h after initiation was associated with the success of HFNT (OR 0.26 [IC 95% 0.15-0.46] p<0.0001). The general IHM was 48.5% (145/299), 70.4% (93/132) in patients with IMV, 4.2% (5/120) died after successful weaning from HFNT and 100% (47/47) in the group not candidates for intubation. Patients with TNAFO had a statistically significant decrease in MIH and days of hospitalization. TNAFO in general wards achieved a decrease in the use of IMV, with a reduction in mortality and days of stay in hospitalized for NCOVID-19 with SARF.

[Coinfections by SARS-CoV-2 and other respiratory viruses and their clinical outcome]

Background: SARS-CoV-2 is a coronavirus described for the first time in China, in December 2019. This virus can cause a disease with a very variable spectrum that ranges from asymptomatic cases to deaths. The most severe cases are normally associated with comorbidities and with the age of the patient. However, there are patients who are not part of these risk groups and develop severe cases. Objetive: To determine the association between coinfections by SARS-CoV-2 and other respiratory viruses and their clincal outcome. Material and methods: RT-qPCR was performed to determine the presence of 16 respiratory viruses in 103 confirmed COVID-19 cases. Demographic and comorbid data were collected, and statistical analyzes were performed to determine associations with severity. Results: Of the 103 analyzed cases, 14 (13.6%) presented a coinfection, of these, 92% did not require hospitalization, even in those cases in which the patient presented advanced age and some comorbidities. Conclusions: These results suggest that coinfection of SARS-CoV-2 and other respiratory viruses is not related to a more severe form of COVID-19 and, in some cases, depending on the virus involved, it could even lead to a better prognosis. These findings lay the foundations for the development of new studies that could determine the biological mechanism of this phenomenon.

Covid-19 in Ecuador: Radiography of Hospital Distribution Using Data Science

Exploring the behavior and impact that the Covid-19 pandemic is causing on the supply of hospital services in the main cities of Ecuador is the urgent aspiration of national and local authorities and society in general. Therefore, this work evaluates the distribution and area of influence of hospitals suitable for care of critically ill patients. For the study, advanced computational techniques were used, the data were obtained from Open Street Maps OSM and the Ministry of Public Health. In this work, it is possible to chain the process of extraction of statistical data of fatality product of Covid-19, the geolocation and distribution of the Health Centers (HC) of Quito, Guayaquiñl and Cuenca. Then, based on this information, it is verified how the hospital supply capacity and the balanced distribution of HC affect the number of deaths caused by the pandemic. Concluding that Guayaquil has the highest number of deaths and has the lowest rate of HC and a more unequal distribution;on the other hand, Cuenca has the lowest number of deaths and the highest HC rate with a more balanced distribution of HC. © 2021 IEEE.

Towards a New Learning Experience through a Mobile Application with Augmented Reality in Engineering Education

With the rise of information technology and digitization, education has been faced with the need to adopt new learning models using technology to create innovative educational methodologies. In addition, due to pandemic restrictions and in order to help contain the spread of the virus (COVID-19), all educational institutions have been forced to switch immediately to online education. The application of augmented reality (AR) in education provides important benefits, such as increased engagement and interactivity, and can help to minimize the negative effects of the disruption of face-to-face education. Therefore, this paper focuses on describing the effect of an augmented reality mobile application (NetAR) that was developed for engineering students as a complement to traditional education. To achieve this objective, an experimental group and a control group were established to work with the application for three weeks for three hours a day. Moreover, there are a number of usability issues with AR that may impact learning effectiveness and motivation. Therefore, the usability of the application was evaluated with the IBM Computer System Usability Questionnaire (CSUQ) tool. The usability results show that users are satisfied with NetAR, and the statistical data from the control group indicate that the application positively affects learning.