PREVALENCE AND CORRELATES OF SARS-CoV-2 VACCINE HESITANCY AMONG US PEOPLE WITH HIV

Background: People with HIV (PWH) have a higher risk of COVID-19 morbidity and mortality. SARS-CoV-2 vaccination is highly effective in preventing severe COVID-19, although medical mistrust may contribute to vaccine hesitancy among PWH. Method(s): PWH from 8 sites in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) completed the clinical assessment of patient-reported outcomes including a vaccine hesitancy instrument as part of routine care from 2/21-4/22. Participants were defined as vaccine hesitant if they had not yet received the SARS-CoV-2 vaccine and would probably or definitely not receive it. We assessed factors associated with SARS-CoV-2 vaccine hesitancy using logistic regression, and adjusted for demographics, unsuppressed viral load >200 copies/mL, calendar month and time on ART. Result(s): Overall, 3,278 PWH with a median age of 55 responded;19% were female sex at birth;93% were virally suppressed. At the time of survey, 27% reported they had not received the SARS-CoV-2 vaccine, of whom 27% (n=242;7% overall) reported vaccine hesitancy. Of these 242, 82% expressed concerns about vaccine efficacy;86% about side effects;38% reported distrust of healthcare, 53% reported concerns about vaccine contents (i.e. trackers, live virus);and 24% did not perceive risk from COVID-19. Factors associated with vaccine hesitancy included female sex (Adjusted Odds Ratio [AOR] 2.0;95% Confidence Interval (CI): 1.5-2.8;Table), Black vs. White race (AOR 1.8;95% CI: 1.3-2.5), age< 30 years (AOR 2.8;95% CI: 1.5-5.2), South/Midwest vs. Northeast region (AOR 1.7;95% CI: 1.2-2.4), years on ART (0.8;0.7-0.9) and unsuppressed viral load (AOR 2.2;95% CI: 1.4-3.5). Hesitancy decreased over time (AOR 0.9 per month;95% CI: 0.8-0.9). Vaccine side effects were the primary concern for women;vaccine contents for Black PWH and those who were unsuppressed;and lack of perceived COVID-19 risk for youth. Conclusion(s): Vaccine hesitancy was reported by approximately 7% of a U.S. multi-site cohort of PWH, and it was more prevalent among Black PWH, women, youth, those with unsuppressed viral loads, and residents of the South/ Midwest. The association between virologic non-suppression and vaccine hesitancy highlights the intertwined challenge of medical mistrust for both HIV and COVID-19. Although vaccine hesitancy decreased over time, renewed efforts will be needed to address concerns of PWH about the COVID-19 vaccine, given the ongoing need for revaccination with the evolution of the pandemic.

Viral Suppression Trajectories Destabilized after Covid-19 among Us People with Hiv

Background: Disruptions in clinical services during the COVID-19 pandemic could compromise past progress towards meeting U.S. Ending the HIV Epidemic (EHE) goals. We examined changes in the proportion with virologic suppression (VS) before and since the onset of COVID-19 in a multi-site U.S. cohort of people with HIV (PWH) using an interrupted time series design. Method(s): We assessed VS (< 200 copies/mL) trajectories 1/1/2018-1/1/2022, comparing trends before and after March 21, 2020 at 8 HIV clinics within the U.S. Center for AIDS Research Network of Integrated Clinical Systems (CNICS'). Hierarchical mixed-effects logistic regression and interrupted time series analyses examined changes in the trend (i.e., slope) of VS over time, and maximum likelihood estimation was used to account for missing VS data among those lost to follow-up (LTFU) post-COVID-19. Analyses were adjusted for demographics, site, CDC transmission group, CD4 nadir, VS, time on ART. Result(s): Data from 17,999 participants were included, providing a total of 120,918 VS assessments. Median age was 53 (interquartile range 42-61);19% were female sex at birth;the mean time on ART was 9.5 years;18% were unsuppressed at any point;17.7% were LTFU. Among the overall population, prior gains in VS slowed during COVID-19 (adjusted odds ratio [AOR] 0.93 per quarter-year;95% CI: 0.88-0.98;p=0.004;Figure). Greater impacts occurred among women (AOR 0.90;95% CI 0.81-0.99;p=0.05), persons with a history of injection drug use (PWID) (AOR 0.77 95% CI: 0.66-0.90;p=0.001), and Black PWH (AOR 0.90;95% CI: 0.84-0.96;p=0.001) in whom prior positive VS trends plateaued or began to reverse (Figure). VS remained lower among those with unstable housing (AOR 0.44;95% CI: 0.40-0.50;p< 0.001) but stayed unchanged from the pre-pandemic period. Conclusion(s): Previous gains in VS slowed during the COVID-19 pandemic among PWH in a multi-site network of U.S. HIV clinics. Known disparities in VS according to housing status remain unchanged, but VS disparities worsened for PWH who were women, PWID, or Black. Changes in VS trends could be related to socioeconomic impacts of the pandemic, insurance lapses, reduction of in-person clinic services, fear of coming to clinics, or other factors. Renewed investment in HIV public health and clinical services will be vital to achieve the U.S. EHE goals following COVID-19, with additional targeted interventions to support key populations with persistent or worsening disparities needed.

Improving ransomware detection based on portable executable header using xception convolutional neural network

All malware are harmful to computer systems;however, crypto-ransomware specifically leads to irreparable data loss and causes substantial economic prejudice. Ransomware attacks increased significantly during the COVID-19 pandemic, and because of its high profitability, this growth will likely persist. To respond to these attacks, we apply static analysis to detect ransomware by converting Portable Executable (PE) header files into color images in a sequential vector pattern and classifying these via Xception Convolutional Neural Network (CNN) model without transfer learning, which we call Xception ColSeq. This approach simplifies feature extraction, reduces processing load, and is more resilient against evasion techniques and ransomware evolution. The proposed method was evaluated using two datasets. The first contains 1000 ransomware and 1000 benign applications, on which the model achieved an accuracy of 93.73%, precision of 92.95%, recall of 94.64%, and F-measure of 93.75%. The second dataset, which we created and have made available, contains 1023 ransomware, grouped in 25 still active and relevant families, and 1134 benign applications, on which the proposed method achieved an accuracy of 98.20%, precision of 97.50%, recall of 98.76%, and F-measure of 98.12%. Furthermore, we refined a testing methodology for a particular case of zero-day ransomware attacks detection—the detection of new ransomware families—by adding an adequate amount of randomly selected benign applications to the test set, providing representative evaluation performance metrics. These results represent an improvement over the performance of the current methods reported in the literature. Our advantageous approach can be applied as a technique for ransomware detection to protect computer systems from cyber threats. © 2023 Elsevier Ltd

Learning Graphics in Supervised Teaching Practice in an Educational COVID-19 Context

The pandemic caused by COVID-19 has brought a sudden change in society and education. Thus, it was necessary to readapt the management of resources and knowledge already acquired to create new environments for the teaching and learning process. In this new paradigm, it was imperative not to give up and the watchword was to differentiate, as each child was an individual being with their own needs and motivations. On the other hand, it was vital to continue to promote educational experiences that articulated knowledge, with special emphasis on Mathematics, an unloved subject for many children. Based on these conceptions, in the Supervised Teaching Practice of the master's in teaching of the 1st CEB and of Mathematics and Natural Sciences in the 2nd CEB, it was important, in this distance learning period, to study what is the influence on the learning of the content on Statistics based on the child's real-life data. The methodology used was the case study which was implemented in a classroom and the technics implemented were the qualitative and interpretive. This teaching strategy was significant for the child, and a pedagogical differentiation promoted since different individual teaching activities applied for the use of new educational platforms. At the end, beneficial consequences for children were observed specifically on significant mathematical learning. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Both sides of the Atlantic: the impact of the pandemic on Real Estate Tourist Enterprises in Brazil and on Tourist Complexes (Resorts) in Portugal

This article aims to present a study of Real Estate Tourist Enterprises (ETIs) behavior in Brazil and their equivalents in Portugal, the Tourist Enterprises Resorts (CTR) face to the Covid-19 pandemic. The methodology used involved, in addition to the bibliographic review, a primary survey of ETIs in Brazilian case, consultation and georeferencing of the National Register of Tourist Enterprises (RNET), and information contained in the Geographic Information System of Tourism (SIGTUR), in Portuguese case. The conclusion in Portugal is that Covid-19 pandemic meant an opportunity for residential tourism and for these tourist developments, which registered a very significant increasing amount commercialization of residences integrated in tourist complexes, with a price increasing. In Brazilian case, the ETIs suffered from the impact of the pandemic, resulting in closed hotel units and exchange of flags, which signals a possible product retraction.

(Re)Learning to be a Professor at Public Universities in the Pandemic Period

Currently, changes caused by the covid-19 pandemic have affected all sectors of society, including the educational sector, such as higher education institutions. In this sense, this research aims to identify the perception of public university professors about remote activities in higher education. Therefore, descriptive and quantitative research was carried out using a survey-type data collection with 40 professors from public universities in Rio Grande do Norte State. The results indicate that professors are aware of the existing challenges, and also they have a good understanding of remote teaching. Through exploratory factor analysis, the items analyzed were grouped into four factors: Factor 1 (Format of remote classes), Factor 2 (Need and suitability for remote teaching), Factor 3 (Support and skills in digital media), and Factor 4 (Behavioral aspects), these being the main factors for triggering remote activities in higher education. It is also verified that the results presented in this study are in line with the findings of the current literature and meet the aspects related to the changes caused by the pandemic.

And me, teacher?!": Remote history teaching and the deficient inclusion scenario in rural and peripheral areas of the State of Para

This article aims to identify challenges regarding the teaching of history in the context of the new coronavirus pandemic, analyzing scenarios of deficient inclusion that involve public education in rural and peripheral areas in the interior of the State of Para. For this purpose, a qualitative research was developed. in the digital field (DESLANDES;COUTINHO, 2020), through which interpretive data were sought to signify experiences in teaching history developed at the State High School Dr. Padua Costa, in Santa Barbara do Para, in the second half of 2020 and in the first two months of 2021. The data obtained were analyzed following theoretical references aimed at teaching history. The results pointed to the need for sensitivity and effective participation of society in general, and the State in the construction of educational policies that mainly meet the needs of rural and peripheral populations, in order to offer an effectively citizen and democratic history teaching. © 2019 Inra Productions Animales. All rights reserved.

Predictors of mortality of covid-19 in chronic hemodialysis patients

BACKGROUND AND AIMS: Coronavirus disease 2019 (COVID-19) has affected the care of patients on chronic hemodialysis (HD). It has been reported that older adults and those with comorbidities, such as diabetes mellitus, hypertension, cardiovascular disease and chronic kidney disease are prone to develop severe disease and poorer outcomes. By virtue of their average old age, multiple comorbidities, immunosuppression and frequent contact with other patients in dialysis facilities, chronic HD patients are at particular risk for severe COVID-19 infection. The aim of this study was to compare clinical presentation, laboratory and radiologic data and outcomes between HD and non-HD COVID-19 patients and find possible risk factors for mortality on HD patients. METHOD: A single center retrospective cohort study including patients on HD hospitalized with a laboratory confirmed COVID-19 infection, from March 1st to December 31st of 2020 and matched them to non-dialysis patients (non-HD) (1:1). Data regarding patient baseline characteristics, symptoms, laboratory and radiologic results at presentation were collected, as well as their outcomes. Categorical variables are presented as frequencies and percentages, and continuous variables as means or medians for variables with skewed distributions. A paired Student's t-test was performed on parametric continuous values or Mann-Whitney for non-parametric continuous variables. Chi-squared test was performed for comparing categorical variables. Logistic regression was used to identify risk factors for mortality on HD patients. A p-value of less than 0,05 indicated statistical significance. RESULTS: A total of 34 patients HD patients were included, 70,6% male, mean age of 76,5 years, median time of dialysis of 3,0 years. Among them 85,3% were hypertensive, 47,1% diabetic, 47,1% had cardiovascular disease, 30,6% pulmonary chronic disease and 23,5% cancer. The most frequent symptoms were fever (67,6%), shortness of breath (61,8%) and cough (52,9%). At admission, 55,9% of patients needed oxygen supply, one required mechanic ventilation and was admitted to intensive care unit. Regarding laboratory data, the most common features were lymphopenia in 58,9% (median-795/uL), elevated LDH in 64,7% (median-255 U/L), raised C-reactive protein in 97,1% (median-6,3 mg/dlL, raised D-dimer in 95,8% (median 1,7 ng/mL), and all patients presented high ferritin (median 1658 ng/mL) and elevated Troponin T (median 130ng/mL). The majority presented with radiologic changes, particularly bilateral infiltrates in 29,4%. Concerning clinical outcomes, the median hospitalization time was 11 days and 13 patients (38,2%) developed bacterial superinfection. Mortality rate was 32,4%. When matched to 34 non-HD patients there was no statistical significant differences in sex, age and comorbidities. The HD group had a tendency to more ventilator support need (p=0,051), higher ferritin and troponin levels (p=<0,001 for both), whereas the non-HD group presented with greater levels of transaminases (p= 0,017). There was o significant difference in hospitalization time (median of 11 vs 7 days, p=0,222) neither in mortality (median of 32,4 vs 35,3%, p=0,798). When the logistic regression was performed, only bacterial superinfection was a predictor for mortality on hemodialysis patients (p=0,004). CONCLUSION: Our study compared outcomes for COVID-19 patients on chronic HD to non-dialysis patients and showed no difference in hospitalization time nor in death rate. In spite of these results, the mortality in patients on chronic HD is still not negligible, with up to 32% of in-hospital mortality. Bacterial superinfection is a predictive risk factor for mortality. Hence the importance of interventions to mitigate the burden of COVID-19 in these patients, by preventing its spread, particularly in hemodialysis centers.