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For the past years, the world has been facing one of the worst pandemics of modern times. The COVID-19 outbreak joined a long list of infectious diseases that turned pandemic, and it will most likely leave scars and change how we live, plan, and manage the urban space and its infrastructures. Many fields of science were called into action to mitigate the impacts of this pandemic, including spatial and transport planning. Given the large number of articles recently published in these research areas, it is time to carry out an overview of the knowledge produced, synthesising, systematising, and critically analysing it. This article aims to review how the urban layout, accessibility and mobility influence the spread of a virus in an urban environment and what solutions exist or have been proposed to create a more effective and less intrusive response to pandemics. This review is split into two avenues of research: spatial planning and transport planning, including the direct and indirect impact on the environment and sustainability. © 2023 ICE Publishing: All rights reserved.
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Introduction: Colorectal cancer (CRC) screening is a critical preventative service and part of routine patient care. CRC is the second leading cause of cancer death in the US, and yet a third of the eligible population does not undergo routine screening. Endoscopy centers have been stretched thin by both COVID-19 and the recent drop in screening initiation age to 45. Fecal immunochemical testing (FIT), a sensitive and specific CRC screening modality, may be used to reach and risk-stratify more patients to increase the yield for detecting advanced neoplasia and cancer, reducing pressure on colonoscopy centers. Unfortunately, FIT is often suboptimal as patients inconsistently complete and return the test for analysis. Method(s): We performed a retrospective analysis of 5211 individuals at a single internal medicine clinic who had FIT ordered as part of USPSTF recommended care from 01/2017 through 12/2021. Starting in 01/2021 we instituted a dedicated patient navigator to support patients in completing FIT. Chi-square, Fisher exact test, and Student's t-tests were performed for descriptive analyses. Multivariable logistic regression was used to compare FIT kit drop off rates pre- and post-intervention, with the model adjusted by age, gender, race, ethnicity, language, and insurance status. Analysis was performed in SAS version 9.4. (Table) Results: The post-intervention period included 1181 (22.7%) patients. The predominant reasons cited for failure to complete testing were forgot (25%), too busy (13%), and lost kit (11%). Our intervention improved drop off rates from 46.4% to 51.3% at 2 weeks (OR 1.19, 95%CI 1.01-1.41), 56.7% to 73.7% at 1 month (2.14 [1.78-2.58]), 64.7% to 89.7% at 3 months (4.73 [3.66-6.12]), and 78.9% to 98.2% at 1 year (14.39 [8.25-25.12]). Overall, our intervention improved FIT kit drop off rates by 53.4% (1.53 [1.30-1.81]). FIT was positive in 4.9% (p=0.0529). (Figure) Conclusion(s): FIT can increase CRC screening rates, particularly in resource-limited settings, and may decrease the burden on endoscopy centers nationwide by improving the efficiency of colonoscopy in the average risk screening population. The addition of a dedicated patient navigator is a simple intervention that, by providing culturally competent care and personalized attention, improves completion rates and return time, allowing FIT to be a reliable method of screening. The ability to increase screening rates and prioritize patients for diagnostic colonoscopies will ultimately lead to earlier detection and treatment of CRC.
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The coronavirus disease 2019 (COVID-19) pandemic has drastically impacted life around the globe. As life returns to pre-pandemic routines, COVID-19 testing has become a key component, assuring that travellers and citizens are free from the disease. Conventional tests can be expensive, time-consuming (results can take up to 48h), and require laboratory testing. Rapid antigen testing, in turn, can generate results within 15-30 minutes and can be done at home, but research shows they achieve very poor sensitivity rates. In this paper, we propose an alternative test based on speech signals recorded at home with a portable device. It has been well-documented that the virus affects many of the speech production systems (e.g., lungs, larynx, and articulators). As such, we propose the use of new modulation spectral features and linear prediction analysis to characterize these changes and design a two-stage COVID-19 prediction system by fusing the proposed features. Experiments with three COVID-19 speech datasets (CSS, DiCOVA2, and Cambridge subset) show that the two-stage feature fusion system outperforms the benchmark systems of CSS and Cambridge datasets while maintaining lower complexity compared to DL-based systems. Furthermore, the two-stage system demonstrates higher generalizability to unseen conditions in a cross-dataset testing evaluation scheme. The generalizability and interpretability of our proposed system demonstrate the potential for accessible, low-cost, at-home COVID-19 testing. IEEE
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Background: The key impact of SARS-CoV-2 is its ability to cause a life-threatening infection in the lung. Aim(s): Using spatially resolved multiplex imaging the present study decodes the immunopathological complexity of severe COVID-19. Method(s): Autopsy lung tissue from 18 COVID-19 patients was used to map immune and structural cells in acute/exudative, intermediate and advanced diffuse alveolar damage (DAD) through multiplex immunohistochemistry and spatial statistical analyses. Cytokine profiling, viral, bacteria and fungi detection and transcriptome analyses were also performed. Result(s): All cases displayed concomitant patterns of DAD. The spatially resolved multiplex data revealed intricate patchworks of mm -size microenvironments representing distinct immunological niches. In-depth analysis of DAD areas revealed that the temporal/spatial DAD progression is associated with expansion of adaptive immune cells, macrophages, CD8 T cells, fibroblasts, angiogenesis and lymphangiogenesis. Viral load correlated positively with acute DAD and negatively with disease/hospital length. Cytokines correlated mainly with macrophages and CD8 T cells. Pro-coagulation and acute repair markers were enriched in acute DAD whereas intermediate/advanced DAD had a molecular profile of elevated humoral and innate immune responses and extracellular matrix production. Conclusion(s): Our unraveling of the spatio-temporal immunopathology in COVID-19 cases exposes the heterogeneous dynamics of acute viral infection and subsequent responses that occur side-by-side in the lungs. This complex disease feature has important implications for disease management and development of novel immunemodulatory treatments.
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Severe COVID-19 induces DAD, a condition with temporal-spatial heterogeneity. We determined the differentially expressed genes (DEGs) in the histological patterns of DAD. Twelve fatal COVID-19 cases were classified in acute DAD (n=5) and intermediate/advanced (IA) DAD (n=7). Autopsy lung RNA was extracted from COVID-19 and 4 control cases. RNA sequencing was performed on the Illumina NovaSeq 6000. Enrichment analysis was performed with clusterProfiler using Genome-wide annotation for Human R package. GO terms and KEGG pathways were considered enriched if adjusted p<=0.05. Principal component analysis showed that IA-DAD samples were grouped, while acute DAD samples were scattered. The differential expression analysis between these two groups and the control cases revealed: 261 DEGs in the acute DAD (143 Up- and 53 Down-regulated), 244 DEGs in the IA- DAD tissues (67 Up- and 116 Down-regulated), and 61 DEGs were shared between them (45 Up- and 16 Downregulated). Patients with acute DAD had up-regulated genes related to oxidative phosphorylation, blood coagulation, megakaryocytes differentiation/regulation, and platelet degranulation/activation. Patients with IA-DAD had DEGs related to immunoglobulins and extracellular matrix. The shared up-regulated DEGs between both patterns are involved in innate and adaptive immune responses. We selected 3 DEGs in each DAD pattern for validation by realtime PCR. There were no differences in acute DAD DEGs, but DEGs overexpressed in intermediate DAD (COL3A1, IGLV3-19, IGHV1-58) were significantly higher. Genes related to thrombotic events occur at the acute stage of DAD, whereas immunoglobulin production and remodeling occur at later stages of DAD.
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SARS-CoV2 infection induces a complex interaction between virus and host immune system, activating multiple inflammatory pathways and leading to hyperinflammation, diffuse alveolar damage (DAD), ARDS, and multiorgan failure. We aimed to correlate the quantification of viral load, inflammatory cells and cytokines in lung tissue of fatal COVID-19. We assessed inflammatory cells by multiplex immunohistochemistry, cytokines by Luminex xMAP Assay and viral load by real time PCR in autopsy lung tissue of 18 COVID-19 patients. Correlations were considered statistically significant if p<0.05. Macrophages correlated with IL-1beta (r=0.54), IL-10 (r=0.5), IFN-alpha2 (r=0.72), IFN-gamma (r=0.6), CCL20 (r=0.5), TGF-beta1 (r=0.6), TGF-beta2 (r=0.6). CD4+T cells correlated with CCL20 (r=0.6), MDC/CCL2 (r=0.53), CCL17 (r=0.5), IP-10 (r=0.6), CXCL9 (r=0.6). CD8+T cells correlated with IL-1beta (r=0.54), IL-4 (r=0.63), IL-6 (r=0.7), IL-8 (r=0.63), IL-10 (r=0.6), TNF-alpha (r=0.6), IFN-gamma (r=0.74), CCL20 (r=0.7), TGF-beta1 (r=0.7), TGF-beta2 (r=0.56), TGF-beta3 (r=0.54), MDC/CCL2 (r=0.7), CCL17 (r=0.64). Langerin dendritic cells (DC) correlated with symptom onset to death interval (r=0.6), hospitalization length (r=0.65), mechanical ventilation (MV) length (r=0.6), ICU stay (r=0.6), exudative DAD (r=-0.5), viral load (r=-0.6). Myeloid DC correlated with symptom onset to death interval (r=0.8), hospitalization length (r=0.8), MV length (r=0.8), ICU stay (r=0.8), exudative DAD (r=-0.5), viral load (r=-0.7). Viral load correlated with symptom onset to death interval (r=-0.7), hospitalization length (r=-0.8), MV length (r=-0.7), ICU stay (r=-0.8), exudative DAD (r=0.6). There is a complex temporal inflammatory modulation in severe COVID-19.
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During the COVID-19 pandemic, the misinformation problem arose again through social networks, like a harmful health advice and false solutions epidemic. In Brazil, one of the primary sources of misinformation is the messaging application WhatsApp. Thus, the automatic misinformation detection (MID) about COVID-19 in Brazilian Portuguese WhatsApp messages becomes a crucial challenge. Recently, some works presented different MID approaches for this purpose. Despite this success, most explored MID models remain complex black boxes. So, their internal logic and inner workings are hidden from users, which cannot fully understand why a MID model assessed a particular WhatsApp message as misinformation or not. Thus, in this article, we explore a post-hoc interpretability method called LIME to explain the predictions of MID approaches. Besides, we apply a textual analysis tool called LIWC to analyze WhatsApp messages’ linguistic characteristics and identify psychological aspects present in misinformation and non-misinformation messages. The results indicate that it is feasible to understand relevant aspects of the MID model’s predictions and find patterns on WhatsApp messages about COVID19. So, we hope that these findings help to understand the misinformation phenomena about COVID-19 in WhatsApp messages. © 2022, Springer Nature Switzerland AG.
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The objective of this work was to analyze the legitimate use of personal data, through digital technologies, for proposing public health policies in the context of the COVID-19 pandemic. The method used in this research was deductive;as for the means, the research was bibliographic and for the ends, qualitative. The conclusion reached was that the collection of personal data and the circulation of information in the health sector are satisfactory for combating pandemics, such as SARS-COV-2, and with the current entry into force of the General Data Protection Law, legal certainty in the planning of public policies in this sector will be greater provided that the guiding principles for the treatment of data are observed, and a supervisory body is established other guidelines and a dialogue for the effective protection of personal data. © 2021 Revista Civilistica. All rights reserved.
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Objective: Several therapies are being used or proposed for COVID-19, and many lack appropriate evaluations of their effectiveness and safety. The purpose of this document is to develop recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil. Methods: A group of 27 experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method. Results: Sixteen recommendations were generated. They include strong recommendations for the use of corticosteroids in patients using supplemental oxygen, the use of anticoagulants at prophylactic doses to prevent thromboembolism and the nonuse of antibiotics in patients without suspected bacterial infection. It was not possible to make a recommendation regarding the use of tocilizumab in patients hospitalized with COVID-19 using oxygen due to uncertainties regarding the availability of and access to the drug. Strong recommendations against the use of hydroxychloroquine, convalescent plasma, colchicine, lopinavir + ritonavir and antibiotics in patients without suspected bacterial infection and also conditional recommendations against the use of casirivimab + imdevimab, ivermectin and rendesivir were made. Conclusion: To date, few therapies have proven effective in the treatment of hospitalized patients with COVID-19, and only corticosteroids and prophylaxis for thromboembolism are recommended. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and promote economical resource use. © 2022 Associacao de Medicina Intensiva Brasileira - AMIB. All rights reserved.
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The COVID-19 pandemic has become a critical challenge for the higher education sector worldwide. Under such a circumstance, the exploration of the capacity of this sector to adapt to such a state of uncertainty has become of huge importance. In this chapter, the authors critically reflect on the Cape Verdean teaching experience during the early COVID-19 lockdown. This is an exploratory case study based on a qualitative approach with an aim to reflect on new practices of teaching under a pandemic emergency. Based on the teaching experience of teaching in Santiago University, they explain how this university has changed from a face-to-face to an online teaching system and stress the challenges and opportunities that appear from this transition process. This chapter concludes that this strategy has become an opportunity to the university since it consistently raised the number of international students cooperating with them and also that the more adaptive and resilient approaches to online teaching were also a success. © 2021 by IGI Global. All rights reserved.
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Brazil is a diverse country and the world's leading exporter of a number of agricultural commodities. Its agribusiness sector is performing an important role during the COVID19 pandemic. Data from the General Register of Employed and Unemployed (CAGED), released by the Ministry of Economy's Secretariat of Labor, reveal that agriculture is the only sector of Brazilian economic activity with positive results in terms of job creation in 2020. Moreover, despite the restrictions imposed by the crisis resulting from the COVID19 pandemic, the Brazilian Federal Government announced a 6% increase in the volume of resources for the 2020/2021 harvest, prioritizing investments for small and medium producers, financing the National Program for Strengthening Family Agriculture, with interest of 2.75% and 4% per year, for funding and marketing. Notwithstanding these developments, we argue that the high performance of the agricultural sector in Brazil and its diversity could help reduce the impacts of the COVID19 on the achievement of the SDGs by strengthening and encouraging sustainable agricultural initiatives. Thus, this document aims to present an overview about how some sustainable agricultural practices, already adopted in Brazil, have the potential to reduce the trade offs imposed by the COVID19 crisis and contribute to achieving the SDG targets. With the aim of supporting Brazilian agriculture during the pandemic, hot topics, like soil erosion and deforestation, must be addressed in new ways. This study meets the following Sustainable Development Goals stipulated by the United Nations (UN): SDG 2 Zero Hunger, SDG 3 Good Health and Well Being, SDG 6 Clean Water and Sanitation, SDG 13 Climate Action and SDG 15 Life on Land.
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This theoretical essay presents a brief literature review on the Business Model in Circular Economy (CE) and aims to answer the question: what would be the main aspects of the circularity to integrate Countryside Education in the current context of the COVID-19 pandemic in Brazil? In an essayistic manner, the study made it possible to reflect critically on the opportunities that CE can represent for Countryside Education. The results reveal converging aspects between Countryside Education and CE and that could be seen as a reference for solutions that deeply comprise the cause of socio-environmental problems currently present in the life and production in rural territories in Brazil.
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During the coronavirus pandemic, the problem of misinformation arose once again, quite intensely, through social networks. In many developing countries such as Brazil, one of the primary sources of misinformation is the messaging application WhatsApp. However, due to WhatsApp’s private messaging nature, there still few methods of misinformation detection developed specifically for this platform. Additionally, a MID model built to Twitter or Facebook may have a poor performance when used to classify WhatsApp messages. In this context, the automatic misinformation detection (MID) about COVID-19 in Brazilian Portuguese WhatsApp messages becomes a crucial challenge. In this work, we present the COVID-19.BR, a data set of WhatsApp messages about coronavirus in Brazilian Portuguese, collected from Brazilian public groups and manually labeled. Besides, we evaluated a series of misinformation classifiers combining different techniques. Our best result achieved an F1 score of 0.778, and the analysis of errors indicates that they occur mainly due to the predominance of short texts. When texts with less than 50 words are filtered, the F1 score rises to 0.857. © 2021, Springer Nature Switzerland AG.
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The coronavirus disease 2019 (COVID-19) is a major health emergency in today's time. In December 2019, a cluster of pneumonia cases in Wuhan, China was attributed to a novel coronavirus. The World Health Organization declared it as a pandemic. As the majority of the cases suffering from COVID-19 are mildly symptomatic or asymptomatic, it becomes a great challenge to identify the infected persons in the absence of extensive testing. In the hospital environment, it can infect several other vulnerable patients and healthcare providers, significantly impacting the hospital services. Anesthesiologists are at an increased risk of COVID-19 transmission from the patients, as they are frequently involved in several aerosol-generating procedures. It is not possible to identify asymptomatic COVID-19 patients solely based on history-taking during their first point of contact with the anesthesiologists at the preanesthetic checkup clinic. Most of the neurosurgical conditions are of urgent in nature and cannot be postponed for a longer duration. In view of this, the position statement and practice advisory from the Indian Society of Neuroanaesthesiology and Critical Care (ISNACC) provides guidance to the practice of neuroanesthesia in the present scenario. The advisory has been prepared considering the current disease status of the COVID-19 pandemic, available literature, and consensus from experts in the field of neuroanesthesiology. Since the pandemic is still progressing and the nature of the disease is dynamic, readers are advised to constantly look for updated literature from ISNACC and other neurology and neurosurgical societies.
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This research aims to examine the impact of the COVID-19 pandemic on the federal government's public budget. To this end, qualitative research with documentary analysis was adopted. The document analysis was divided into two phases: (i) Analysis of changes in the collection of federal taxes;and (ii) Analysis of changes in expenses through Provisional Measures. The results show that in relation to federal taxes, the Federal Government has postponed the maturity terms of Simples Nacional and MEI (DAS), PIS / PASEP, and COFINS. In addition to the reduction to zero of the IOF and IPI tax rate for products to combat COVID-19. Regarding expenses, the Federal Government authorized the opening of extraordinary credits in the amount of R $ 252.3 billion. This value represents a 4% increase in the expenses foreseen in the public budget. In principle, these expenses are aimed at helping people in vulnerable situations (50%), job protection and granting financing to companies (33%), and around 17% specifically for health. The research has implications for revealing that the state's participation in the economy needs to be notorious in the face of the COVID-19 crisis, either by safeguarding the essential rights to life, by safeguarding employment, and by seeking timely solutions.
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COVID-19 has caused dramatic effects on the world economy, business activities, and people. But digitization is also helping many companies to adapt and overcome the current situation caused by COVID-19. The growth in the use of technology in the daily lives of people and companies to face this exceptional situation is an evidence of the digital acceleration process. This exploratory study analyzes the impact of digital transformation processes in three business areas: labor and social relations, marketing and sales, and technology. The impact of digitalization is expected to be transversal to each area and will encourage the emergence of new digital products and services based on the principle of flexibility. Additionally, new ways of working will foster the demand for new talent regardless of people's geographical location. Moreover, cybersecurity and privacy will become two key elements that will support the integrated development of the Internet of Things technology solutions, artificial intelligence, big data, and robotics. IEEE