PiBOT: Design and Development of a Mobile Robotic Platform for COVID-19 Response

The present paper undertakes the design, development, and implementation of an autonomous, flexible robotic platform (PiBOT), capable of monitoring the environment, analyzing data and generating metrics in real-time;additionally, the PiBOT can interact with the people around it as a collaborative robot. The 2021 version is focused on the prevention of COVID-19 infections by identifying faults to the preventive measures such as social distancing and the use of face masks. For this, the robot generates physical alerts for compliance. This project intends to make a robotic system capable of patrolling and analyzing human behavior in the context of a university, helping students to develop new technologies and solutions to post-pandemic scenarios. The PiBOT implementation would include Computer Vision, Web Interfaces, Navigation, Augmented Reality, Autonomous and Collaborative Robot Development, and Robotic Suspension Design. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

A Phase I/II Dose-Escalation Multi-Center Study to Evaluate the Safety of Infusion of Natural Killer Cells or Memory T Cells As Adoptive Therapy in Coronavirus Pneumonia and/or Lymphopenia: (RELEASE NCT04578210)

Background: Adoptive cell immunotherapies for opportunistic virus in immunocompromised patients using haploidentical memory T cells have shown to be safe and effective. Since severe cases of COVID-19 present a dysregulated immune system with T cell lymphopenia and a hyper-inflammatory state we have proposed that a similar strategy could be proven to be efficient for COVID-19 patients. This is a study protocol of an open-label, multicenter, double-arm, randomized, dose-finding phase I/II clinical trial to evaluate the feasibility, safety, tolerability, and efficacy of the administration of a single dose of allogenic SARS-CoV-2 specific memory CD45RA - T cells and Natural Killer (NK) cells in COVID-19 patients with lymphopenia and pneumonia. The aim of the study is to find efficient treatments for patients with moderate/severe COVID-19. Identification of Specific memory T cells and NK cells: i)Memory T Cells: we first determined the existence of SARS-CoV-2 specific T cells within the CD45RA - T memory cells of the blood of convalescent donors. Memory T cells can respond quickly to the infection and provide long-term immune protection to reduce the severity of the COVID-19 symptoms without inducing classically T cell alloreactivity. Also, CD45RA - memory T cells confer protection for other pathogens the donors encountered in their life. ii)NK cells: we determined the phenotype of NK cells after COVID-19 and the main characteristic of SARS-CoV-2 specific NK population in the blood of convalescent donors, as it has been shown for cytomegalovirus infections. Also, NK cells confer protection for other pathogens the donors encountered in their life. Pilot Phase I- Safety, feasibility, and dose escalation: Between September and November 2020 a phase 1, dose-escalation, single-center clinical trial was conducted to evaluate the safety and feasibility of the infusion of CD45RA - memory T cells containing SARS-CoV-2 specific T cells as adoptive cell therapy against moderate/severe cases of COVID-19. Nine participants with pneumonia and/or lymphopenia and with at least one human leukocyte antigen (HLA) match with the donor were infused. The first three subjects received the lowest dose (1x10 5 cells/kg), the next three received the intermediate dose (5x10 5 cells/kg) and the last three received the highest dose (1x10 6 cells/kg) of CD45RA - memory T cells. Clinicaltrials.gov registration: NCT04578210. Findings: All participants' clinical status measured by National Early Warning Score (NEWS) and 7-category point ordinal scales showed improvement six days after infusion. No serious adverse events were reported. Inflammatory parameters were stabilized post-infusion and the participants showed lymphocyte recovery two weeks after the procedure. Donor microchimerism was observed at least for three weeks after infusion in all patients. Interpretation: This study provides preliminary evidence supporting the idea that treatment of COVID-19 patients with moderate/severe symptoms using convalescent SARS-CoV-2 specific CD45RA - memory T cells is feasible and safe. We did not find dose-liming toxicity. The Recommended Phase 2 dose was 1x10 6 CD45RA - T cells. Phase II- Efficacy: Between January 2021 and July 2021 patients have been enrolled based on the matched with the HLA genotype of the convalescent donors and following the protocol inclusion/exclusion criteria. The primary outcome is the incidence of patient recovery at day 14, defined as normalization of fever and oxygen saturation or lymphopenia recovery. Secondary outcomes are the time to normal level of lymphocytes, the proportion of patients showing clinical improvement at day 7, time to first negative SARS-CoV-2 PCR, the incidence of treatment-related adverse events, duration of hospitalization, time to discharge, time to improvement by one category a 7-point ordinal scale or NEWS score, the proportion of patients requiring intensive care unit, and all-cause mortality. In addition, lymphocyte recovery by multiparametric flow cytometry and donor chimerism by real-time PCR in the e perimental arm was monitored weekly during the first month. This study provides preliminary evidence supporting the idea that treatment of COVID-19 patients with moderate/severe symptoms using convalescent CD45RA - memory T cells is safe and feasible. The phase II clinical trial is ongoing to demonstrate efficacy. [Formula presented] Disclosures: Soria: Celgene: Other: Fees;Gilead: Other: Fees;AbbVie: Other: Fees.

Phase I dose-escalation single centre clinical trial to evaluate the safety of infusion of memory T cells as adoptive therapy in COVID-19 (RELEASE).

BACKGROUND: Effective treatments are still needed to reduce the severity of symptoms, time of hospitalization, and mortality of COVID-19. SARS-CoV-2 specific memory T-lymphocytes obtained from convalescent donors recovered can be used as passive cell immunotherapy. METHODS: Between September and November 2020 a phase 1, dose-escalation, single centre clinical trial was conducted to evaluate the safety and feasibility of the infusion of CD45RA- memory T cells containing SARS-CoV-2 specific T cells as adoptive cell therapy against moderate/severe cases of COVID-19. Nine participants with pneumonia and/or lymphopenia and with at least one human leukocyte antigen (HLA) match with the donor were infused. The first three subjects received the lowest dose (1 × 105 cells/kg), the next three received the intermediate dose (5 × 105 cells/kg) and the last three received the highest dose (1 × 106 cells/kg) of CD45RA- memory T cells. Clinicaltrials.gov registration: NCT04578210. FINDINGS: All participants' clinical status measured by National Early Warning Score (NEWS) and 7-category point ordinal scales showed improvement six days after infusion. No serious adverse events were reported. Inflammatory parameters were stabilised post-infusion and the participants showed lymphocyte recovery two weeks after the procedure. Donor microchimerism was observed at least for three weeks after infusion in all patients. INTERPRETATION: This study provides preliminary evidence supporting the idea that treatment of COVID-19 patients with moderate/severe symptoms using convalescent CD45RA- memory T cells is feasible and safe. FUNDING: Clinical Trial supported by Spanish Clinical Research Network PT17/0017/0013. Co-funded by European Regional Development Fund/European Social Fund. CRIS CANCER Foundation Grant to AP-M and Agencia Valenciana de Innovación Grant AVI-GVA COVID-19-68 to BS.

Experience of tele consulting care for health care professionals and patients with rheumatoid arthritis, in the health emergency due to covid-19

Objectives: Rheumatoid arthritis (RA) is a disease highly vulnerable to COVID-19, a factor that caused an impact on everyday practice and the implementation of tele care assistance. Our goal was to understand the experiences of RA patients and health care professionals (HCP) in the implementation of a non-face-to-face multidisciplinary consultation model in the health emergency caused by COVID-19. Methods: Qualitative descriptive exploratory study. Semi-structured interviews (telephone or video-based depending on the participant preferences) were carried out that analyzed the experiences of RA patients and HCP who cared for them in a specialized center in Bogotá (Colombia). All interviews were audio-recorded, with prior informed consent of the participants, and were conducted by researchers trained in qualitative designs. Inclusion criteria: Adult RA patients evaluated in the tele consultation modality on at least two occasions, patients treated in the face-to-face consultation modality on at least two occasions and health professionals who have carried out at least 25 tele consultations, in the context of the health emergency due to COVID-19. It was analyzed following the Taylor-Bogdan proposal. Results: 36 interviews were conducted, 29 (80.5%) corresponded to RA patients (69% were attended by tele consultation and 31%, through face-toface consultation);and 7 (19.4%) corresponded to HCP. Characteristics of participants are shown in table 1 and 2. Four categories emerged configuring the experience of the subjects (patients and professionals) in a scenario of high vulnerability and uncertainty derived from the COVID-19 pandemic: Factors present in communication, information and communications technology (ICT) management, family support and interaction, and adherence to treatment. In patients, mental health, pain, functional dependence, and quality of life, were the most affected dimensions. Resilience mechanisms such as adaptation and self-care measures emerged to minimize risks from pandemic. Conclusion: Clinical and social conditioning factors were identified, which may determine the relevance of tele consultation. The implementation of tele consultation should be accompanied by the training of HCP, digital literacy and investment in technological infrastructure to overcome barrier access. It is important to promote assertive communication processes in the professional-patient relationship mediated by ICT.

Digital media use differs between transgender and cisgenderyouth

Background: Transgender, nonbinary, and gender diverse (TNG) youth often describe exploring identities andcommunities online. Studies of cisgender youth connect increased digital technology use with loneliness anddecreased body image. Digital technology use in adolescent school experiences has increased over time, andsuddenly youth across the U.S. are in completely digital school environments due to the COVID-19 pandemic.With educational systems employing and encouraging these tools, it is critical to understand the technologyuse of TNG youth and how this affects their health. Objective: To compare features of digital technology use of cisgender and TNG youth, as well as interactions of this use with well-being. Methods: Using Qualtrics panels, we surveyed a nationally representative sample of adolescents (ages 13-18) and their parents about digitaltechnology use. Youth assessment included the Adolescent Digital Technology Interactions and Importance(ADTI) scale, with subscales assessing the purpose of technology use, and the short Problematic and RiskyInternet Use Screening Scale (PRIUSS-3). Health-related measures included validated instruments assessing body image, parental support, loneliness, well-being, fear of missing out (FOMO), and parent social media use.We compared ADTI scores between gender groups with analysis of covariance. Generalized estimatingequation (GEE) analysis was conducted to compare the proportions of subjects at risk for problematic internetuse (PRIUSS-3 >3). All comparisons were adjusted for age and parent social media use. Pearson's correlationanalyses evaluated the correlations between parent support, body image, loneliness, well-being, and FOMOvs. ADTI and PRIUSS-3 scores. Results: Among 4575 adolescent-parent pairs, there were 53 (1.16%) TNG youth.TNG youth showed higher probabilities of problematic internet use than cisgender peers (0.91 vs. 0.69,p=0.004). TNG youth had signicantly higher scores for use of technology to explore identity/go outside one'soffline environment (ADTI 2) compared to cisgender youth (mean 18.45 vs. 15.76, p = 0.0085). Parental supportcorrelated positively with ADTI 2 scores for TNG youth (0.05), though correlated negatively with ADTI 2 scoresfor cisgender youth (-0.22, p=0.043). In a pattern different from cisgender peers, problematic internet usescores for TNG youth correlated positively with body image (0.26 vs. -0.17, p = 0.0025) and well-being (0.33 vs.-0.08, p = 0.0019). Conclusion(s): TNG youth are at increased risk for problematic internet use compared tocisgender peers, though motivations for digital technology use may differ. TNG youth are more likely to usedigital technology to explore identity and go outside one's offline environment. Correlation of digital usemeasures with positive body image and well-being also suggests that this population may uniquely benetfrom digital experiences, which may challenge current denitions of problematic internet use in thispopulation. Future research, screening and intervention efforts should address both positive and problematicdigital technology use among TNG youth. Demographics of Cisgender and TNG Youth Participants Comparison of Correlation Coefficients of ParentSupport, Body Image, Loneliness, Well-being, and Fear of Missing Out versus Digital Technology Interactionsand Problematic Internet Use Outcomes for Transgender/Nonbinary and Cisgender Youth.

Policy responses to COVID-19 in Latin American countries: A universal basic income?

The wide socioeconomic impact of the COVID-19 pandemic in the world has led to several political initiatives to minimize it, both in developed and developing countries. One that has gained some notoriety is the idea of transferring cash to citizens with a broader scope in terms of universality and inclusiveness - or a Universal Basic Income (UBI) - than what these types of programs have typically had in the past. This article describes the implications that adopting a UBI policy could have in Latin American countries (LAC), based both on the UBI’s analytical considerations and the weak starting socioeconomic conditions that these countries would face in adopting a UBI policy. We conjecture that, given these initial restrictions, the full implementation of a UBI program in the region does not seem feasible at this time;and that, given the profound impact and slow recovery they face in front of the pandemic’s impact, a compromise between a UBI and a less universal and unconditional cash transfer could meet both the need to face the economic emergency in the short term, as well as the financial capacity to address it. © 2020 Academia Nacional de Medicina. All rights reserved.