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The present work addresses the challenges of pedagogical practice in the period of the covid-19 pandemic, it aims to verify the training process and the challenges faced by teachers and pedagogical coordinators in the face of a "new" teaching modality, Emergency Remote Teaching, also addressing the difficulties expressed by those responsible for the students in the learning process. Thus, questionnaires were applied to teachers, coordination and parents of students from Elementary I classes in a school in the urban area of Breves-Para, seeking to access their perception about remote teaching and how it was applied. With the research, it is clear that the challenges of teachers go far beyond training and professional qualification, involving the creation and application of public policies aimed at improving the public educational system, with investment in equipment and technological resources.
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Recently, with the coronavirus pandemic, the eating habits of the population have been modified, observing the search for healthy diet. In this sense, the consumption of fruits and vegetables has increased, and the hygiene is a fundamental step in quality control, since fruits and vegetables can be consumed in natura. The objective of the work was to elaborate a review about the main chemical sanitizers used in the sanitization of fruits and vegetables. The study is a review based on scientific publications, using the combination of the following descriptors: hygiene, fruits and vegetables, sanitizers and sanitizing. It was possible to verify that the most used sanitizer in the sanitization of fruits and vegetables is chlorine and its derivatives, in concentrations from 100 to 200 ppm, normally for 15 minutes. Ozone could destroy numerous microorganisms and for its sanitizing effect it is necessary to have a longer exposure time, on average up to 30 minutes. When using organic acids (acetic, citric, lactic and peracetic acid), the concentrations vary up to 2% and the average exposure time is a few minutes, which can be used in combination or not. However, its use is not always effective. It is concluded that the application of each type of sanitizer varies according to its concentrations, pH, exposure time to the treatment and the type of fruit or vegetable to be sanitized.
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Background: Covid-19 is associated with an increased risk of pulmonary embolism (PE) therefore, should the cut off d-dimer value be adjusted for these patients? Material(s) and Method(s): Retrospective and observational study to understand if there is a d-dimer cut-off that could guide clinics to perform a thoracic computed tomography angiography (CTA) in patients with covid-19. The population was covid-19 patients admitted to covid-19 dedicated wards of a University Hospital Centre for one year. Result(s) and Conclusion(s): 725 (52%) patients with covid-19 had a d-dimer value dosed during the first 5 days of the disease. Those, 63 (9%) did a CTA with a diagnosis of 16 (25%) PE. Gender was equally represented, median age was 70 years (ID=3.49) and the majority (94%) survived. Thirteen (81%) patients with PE had a d-dimer value above 2500 ng/mL (OR=9.244, 95% CI 2.248-9.837), with 7 (54%) with values over 10000 ng/mL, but in 3 (9%) it was under 1500 ng/mL. Seventy-three (63%) of patients with a d-dimer over 1500 ng/mL did not had a thoracic CTA performed. In our population PE was not a frequent outcome. The results are influenced by the low number of thoracic CTA performed because, even tough the cut-off d-dimer value used at our hospital to perform a thoracic CTA to exclude PE is 1500 ng/mL, most patients with that d-dimer value did not take the exam and so PE could not be excluded. Although in most PE cases the d-dimer value was above 2500 ng/mL, the results of our study cannot verify if that is a better cut-off value.
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Background: The COVID-19 pandemic has had a dramatic impact on clinical practice, amounting to more emergency department and intensive care unit (ICU) admissions. Due to their frequent multiple comorbidities, management in the ICU is challenging. Early studies suggest that cardiac injury is frequent in hospitalized patients with COVID-19, and it is plausible that these patients have a higher risk of cardiac dysrhythmias. Purpose: To determine the prevalence of dysrhythmias in ICU patients with COVID-19 pneumonia, identify major predictors and determine the impact on in-hospital mortality. Methods: A retrospective study of 98 consecutive patients with COVID-19 Pneumonia admitted to the ICU of a tertiary hospital in 2020. The main outcome was dysrhythmias (including significant bradycardia, high/slow ventricular rate or new-onset atrial fibrillation (AF) or atrial flutter, other supraventricular tachycardias, ventricular tachycardia and ventricular fibrillation). Significant bradycardia was defined as heart rate lower than 40 or need of treatment. Sociodemographic variables and clinical data were retrieved for each patient, severity scores at admission (Apache II, SOFA and SAPS II), number of days on mechanical ventilation or high-flow oxygen and placement on Venovenous Extracorporeal Membrane Oxygenation (ECMO) or prone position were recorded. Statistical comparison was made between groups, including logistic regression adjusting for confounding variables. Results: The most frequent arrhythmia was significant sinus bradycardia (28, 28.5%) followed by high ventricular rate AF (14, 14.2%). Patients who had dysrhythmias were older (66.24 ± 10.13 vs 60.85 ± 12.69 years, p 0.024), more severe (SAPS II score 42.55 ± 11.08 vs 35.98 ± 11.26, p 0.006), had more atrial fibrillation (AF) (p 0.022), had higher maximum C-reactive protein (mCRP) (6.56 ± 2.68 vs 6.24 vs 2.86, p 0.009), were mechanically ventilated for a longer time (15.64 ± 13.18 vs 8.92 ± 8.85 days, p 0.004), had longer intubation time (14.52 ± 9.39 vs 8.70 ± 8.21 days, p 0.002) and had higher usage of dexamethasone (p 0.042) and prone position (p 0.016). When adjusted for confounding variables, prone was the most significant predictor (OR 2.800;95% CI 1.203-6.516) followed by use of dexamethasone (OR 2.484;95% CI 1.020-6.050). Days intubated, days on mechanical ventilation, age, mCRP and SAPS II on admission were also predictors of dysrhythmia. Regarding mortality, patients with arrhythmic events had a tendency for greater in-hospital death (OR 2.440;95% CI 0.950-6.310;p 0.065). Conclusions: COVID-19 ICU patients are a subset of patients at risk of cardiac arrhythmias. Use of prone position was the main contributor to these events, but clinical history, severity and treatment may also play an important role. Efforts must be made to optimize ventilatory support and treatment in order to reduce the risk of dysrhythmias. (Figure Presented).
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Background: The COVID-19 pandemic has shifted tremendously the paradigm of hospital care and treatment of cardiovascular (CV) patients. According to most recent evidence, due to its multisystemic impact, COVID-19 may lead to an increased risk of cardiac arrhythmias with subsequently increased morbimortality. Purpose: Determine the prevalence of tachyarrhythmias in patients admitted with COVID-19, possible predictors and impact on in-hospital mortality. Methods: A retrospective study of 3475 consecutive patients with COVID-19 pneumonia admitted to our hospital between February 2020 and November 2021 were included. The main outcome was tachyarrhythmias (high ventricular rate (HVR) or new-onset atrial fibrillation (AF), HVR or new-onset atrial flutter (AFL), other supraventricular tachycardias (SVT), ventricular tachycardia (VT) and ventricular fibrillation (VF)). Secondary outcome was in-hospital mortality. Sociodemographic variables and clinical data were recorded. Statistical comparison was made between groups, including logistic regression to determine odds ratios (OR). Results: A total of 215 patients presented HVR AF (6.31%), 79 of which with new-onset AF (36.74%). 8 patients had HVR AFL (0.23%), 5 VT (0.15%), 4 VF (0.12%) and only 3 patients had a SVT identified (0.09%). Patients with tachyarrhythmias were significantly older (77. 74 ± 11.25 68.94 ± 17.51 years, p <0.001) and had more hypertension (p 0.034), heart failure (HF) (p <0.001), severe valvular heart disease (VHD) (p 0.007), coronary artery disease (CAD) (p 0.031), chronic kidney disease (CKD) (p 0.048) and paroxysmal AF (if previously diagnosed (p 0.001). There were no significant differences regarding gender, dyslipidemia, diabetes, cerebrovascular disease and obstructive sleep apnoea (OSA). Patients with HF had the highest risk of tachyarrhythmia (OR 3.539;95% CI 2.666-4.698;p <0.001), followed by severe VHD (OR 1.990;95% CI 1.192-3.365;p 0.009) and CAD (OR 1.575;95% CI 1.040-2.386;p 0.032). Older patients or patients with hypertension or CKD were also at an increased risk. Also of note, patients previously diagnosed with paroxysmal AF were more likely to have episodes of HVR AF than the ones with persistent or permanent AF (OR 1.819;95% CI 1.272-2.602;p 0.001) Regarding the secondary outcome, patients with tachyarrhythmias during hospital stay had an odd almost 3 times higher of death (OR 2.820;95% CI 2.151-3.695;p <0.001). Conclusions: Tachyarrhythmias is a common complication in COVID-19 patients during hospital stay that is significantly linked to higher in-hospital mortality. Patients presenting with high CV disease burden are at particularly significant risk and should be carefully managed. Odds-ratio of tachyarrhythmias (Figure Presented).
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The emergence of the COVID-19 pandemic brought into evidence some of the challenges of deploying and managing user studies out-of-the-lab. Satisfying new health guidelines required adapting to remote and contactless procedures, which in turn impacted recruitment, participant involvement, and technology delivery and configuration. Such challenges are endemic to many user studies. However, the emergence of the pandemic forced us to confront them head on in two distinct multidevice deployment studies. Changing research design, deployment strategies, and study management allowed us to reflect on some of the core challenges for all field related technological interventions and provided insight into how researchers might conduct more responsive, flexible, and robust studies outside the lab more broadly. Our reflections suggest simple but important ways that researchers can design flexibility, responsiveness, and empathy into all future user studies in- the-wild.
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As the number of mobile devices has increased, software development teams have focused on releasing mobile applications, allowing users to carry out transactions, access information and improve their lifestyle more efficiently. Nevertheless, even when providing useful means for carrying out daily tasks, users report dissatisfaction or frustration when using these applications. For energy companies, mobile applications that fail to provide both usefulness and ease of use may reduce their adoption and an increase in the company’s workload, as users will require company workers to solve problems they could solve on their own. In this paper, we report how we applied exploratory testing and ad-hoc usability inspection to identify improvement opportunities during the development of a mobile application that would allow users to measure their power consumption, supporting social distancing in the context of the COVID-19 pandemic. After identified a set of functional and usability problems, the development team redesigned the application, which was perceived as both useful and easy to use from the point of view of the managers that requested it. Also, we report lessons learned that are useful for practitioners willing to replicate this experience. © 2021, Springer Nature Switzerland AG.
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Background: COVID-19 was first considered a pandemic on the 11th of March of 2020 by the World Health Organization. Its impact comprised not only the direct consequences of the disease but a decrease in the follow-up and interventions of patients with cardiovascular (CV) disease. In Portugal and the World, the consequences of this complex paradigm shift on emergent pacemaker implantation rates during and after this pandemic is largely unknown. Purpose: We sought to analyse the impact of COVID-19 pandemic on emergent pacemaker implantation rate and patient profile in a tertiary hospital during the first Portuguese lockdown and subsequent post-lockdown period. Methods: We retrospectively reviewed the clinical profile of patients who had pacemakers implanted in our hospital in an urgent/emergent setting from March 18, 2020 to May 17, 2020 (lockdown) and May 19 to July 17, 2020 (post-lockdown). This data was then directly compared to the homologous periods from the year before (H1 and H2, respectively). Results: A total of 180 patients submitted to emergent pacemaker implantation were included. The cohort was comprised of 29 patients who had a pacemaker implanted during lockdown, 60 post-lockdown, 38 in H1 (+31% vs lockdown) and 53 in H2. Average age and gender proportion were similar for all groups. When comparing lockdown and post-lockdown periods, the number of cases significantly increased in the second period (+106.9%) and there was a tendency for a higher number of temporary pacemaker use (3.4% vs 16.7%;p=0.076). Patients admitted during lockdown were 7.57 times more likely to present with hypotension/shock (odds ratio (OR) 7.57;p=0.013). Regarding lockdown and its homologous 2019 period, there was a decrease in the number of patients admitted (-23.7%). Again, there was a higher tendency for hypotension on presentation during lockdown (p=0.054). In comparison to its homologous 2019 period, post-lockdown saw a slight increase in the number of patients (+13.2%) and more patients presented with bradycardia (16.7% vs 3.8%;p=0.026). Also of note, no patients were admitted to the emergency department during lockdown for anomalies detected on ambulatory tests (Holter, electrocardiogram or implanted loop recorder). Conclusion: During lockdown, clinical presentation was generally more severe, with a greater number of patients presenting with hypotension/ shock. In addition, there appears to be a lockdown effect on emergent bradyarrhtmias admissions in the post-lockdown period with a profound impact: higher admission rates and more severe presentations including a higher need of temporary pacemaker. Patients with symptoms suggestive of bradyarrhythmias should be advised to present promptly regardless of the pandemic. (Figure Presented).
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To mitigate financial loss and follow the recommended sanitary measures due to the COVID-19 pandemic, self-reading, a method in which a consumer reads and reports his own energy consumption, has been presented as an efficient alternative for power companies. In such context, this work presents a solution for self-reading via chatbot in chatting applications. This solution is under development as part of a research and development (R&D) project. It is integrated with a method based on image processing that automatically reads the energy consumption and recognizes the identification code of a meter for validation purposes. Furthermore, all processes utilize cognitive services from the IBM Watson platform to recognize intentions in the dialog with the consumers. The dataset used to validate the proposed method for self-reading contains examples of analogical and digital meters used by Equatorial Energy group. Preliminary results presented accuracies of 77.20% and 84.30%, respectively, for the recognition of complete reading sequences and identification codes in digital meters and accuracies of 89% and 95.20% in the context of analogical meters. Considering both meter types, the method obtains an accuracy per digit of 97%. The proposed method was also evaluated with UFPR-AMR public dataset and achieves a result comparable to the state of the art. © 2021, Brazilian Society for Automatics--SBA.
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The COVID-19 outbreak resulted in an emergency of projects developed, shared and produced by makers, fablabs and open source enthusiasts. These projects are often released in design sharing platforms, e.g. Thingiverse, Github and Instructables under open source licenses. It is often argued that the release of such projects holds potential for enhancing collaboration, continuous development and design dissemination. These arguments have been subject of recent studies on the structure of maker/Open Design communities and sharing platforms. This study aims to contribute to the on-going debate on the potentialities of such communities. We adopt an explorative approach to (i) identify the influence of the COVID-19 outbreak on the activity volume of Thingiverse, the object of our study, (ii) analyze the designs metadata and its network patterns, and (iii) identify interaction patterns based on real-world localities. Based on our findings we comment on the importance of the maker/Open Design communities to tackle critical situations and highlight the current limitations for a wider dissemination of open source designs. Our findings may contribute to build better tools for designers and enthusiasts of the maker/open culture as well as to studies on collaborative development. © 2020 Universidade do Vale do Rio dos Sinos. All rights reserved.