ABSTRACT
Objectives: To evaluate the outcomes and risk factors associated with mortality of patients cannulated on ECMO in the context of covid infection during the pandemics in a newly implemented ECMO center Methods: This was a unicentric observational retrospective study performed at Real Hospital Portugues, in Recife, state of Pernambuco, Brazil. All consecutive patients with laboratory confirmed SARS-CoV-2 infection cannulated for VV-ECMO or VA-ECMO for severe ARDS from march 2020 to december 2021 were included retrospectively. Patients recieving ECMO for isolated refratory cardiogenic shock were excluded. Descriptive statistics and association tests were used to analyze characteristics, management and patient outcomes during that period. Result(s): In our cohort of 47 ECMO for covid associated ARDS (CARDS), 39 patients (83%) were admitted by our emergency department. 8 patients (17%) had been transferred from other hospitals as soons as they had been cannulated. 32 patients (68%) were male, median age was 50 years (18-69). Mean body mass index was 31 (21,4-46,3). 37 patients (78%) had at least 1 comorbidity. Major bleeding occurred in 34 (72%) patients. Venous thromboembolism and hemolysis ocurred in 19 (40%) and 13 (23%) patients, respectively. When we compared treatments before ECMO initiation (imunoglobulin, tocilizuman, nitric oxide, neuromuscular blockade and proning), proning was associated with better survival (RR 0,67 IC 0,46-0,97 p 0,029). The mean duration in mechanical ventilation until ECMO cannulation was 9,69 days and mean time in ECMO was 23 days. The 90- day mortality was approximately 72%. Conclusion(s): The only variable associated with a better chance of survival was proning before ECMO. Our mortality (72%) is higher than reported from a recent meta-analysis of 1986 ECMO patients implanted during the first pandemic year(37,1%). However it is similar to a German populational registry of covid patients receiving VV-ECMO (73%). Althought it;s impossible to make causal inferences with such a design and sample sizes, we believe that describing the experience of smaller and newly implemented ECMO centers serves as motivation to improve quality and also to plan for future episodes of pressure on health system.
ABSTRACT
Due to the suspension of in-person classes caused by the COVID-19 pandemic, educational institutions had to adapt to remote teaching. Thus, videoconferencing tools were adopted to make it possible. However, using these tools can impact the remote teaching experience. In this paper, we present an investigation about the Google Meet and Zoom. We considered teacher and students profiles concerning Usability, a quality attribute that allows assessing the ease of use of user interfaces, and the User Experience (UX), which provides a holistic view focusing on subjective aspects such as affect and emotions. The purpose of Usability and UX is to understand the impacts of the tools on the quality of the remote teaching experience. Our results indicate that besides the tools, the interaction between teacher and student, in the context of synchronous classes, impacts the remote teaching experience, being an essential aspect of discussion and enabling further investigations within the technology-supported education community. Copyright © 2022 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved.
ABSTRACT
We tested the capabilities of urban greenhouse gas (GHG) measurement networks to detect abrupt changes in emissions, such as those caused by the roughly 6-week COVID-19 lockdown in March 2020 using hourly in situ GHG mole fraction measurements from six North American cities. We compared observed changes in CO2, CO, and CH4 for different mole fraction metrics (diurnal amplitude, vertical gradients, enhancements, within-hour variances, and multi-gas enhancement ratios) during 2020 relative to previous years for three periods: pre-lockdown, lockdown, and ongoing recovery. The networks showed decreases in CO2 and CO metrics during the lockdown period in all cities for all metrics, while changes in the CH4 metrics were variable across cities and not statistically significant. Traffic decreases in 2020 were correlated with the changes in GHG metrics, whereas changes in meteorology and biology were not, implying that decreases in the CO2 and CO metrics were related to reduced emissions from traffic and demonstrating the sensitivity of these tower networks to rapid changes in urban emissions. The enhancements showed signatures of the lockdowns more consistently than the three micrometeorological methods, possibly because the urban measurements are collected at relatively high altitudes to be sensitive to whole-city emissions. This suggests that urban observatories might benefit from a mixture of measurement altitudes to improve observational network sensitivity to both city-scale and more local fluxes.