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Objective: to evaluate the effectiveness of Ivermectin and Atazanavir compared to placebo in the time to resolution of symptoms and duration of illness due to COVID-19. Method: observational, prospective, longitudinal, descriptive and analytical cohort study with symptomatic outpatients, followed for 06 months in two Basic Health Units for COVID-19 care in Teresina-Piaui, Brazil, from November to April 2021 identified by 1:1:1 random sampling. Reverse transcription polymerase chain reaction (RT-PCR) tests were performed for laboratory confirmation of suspected infection with the new coronavirus and sociodemographic and clinical evaluation. Results: of the 87 randomized patients, 62.1% (n=54) were male, with a mean age of 35.1 years, had a partner (53.9%), low income (50.6%), eutrophic (40.7%) and without health comorbidities (78.2%). There was no difference between the median time to resolution of symptoms, which was 21 days (IQR, 8-30) in the atazanavir group, 30 days (IQR, 5-90) in the ivermectin group compared with 14 days (IQR, 9-21) in the control group. At day 180, there was resolution of symptoms in 100% in the placebo group, 93.9% in the atazanavir group, and 95% in the ivermectin group. The median duration of illness was 8 days in all study arms. Conclusion: Treatment with atazanavir (6 days) and ivermectin (3 days) did not reduce the time to symptom resolution or the duration of illness among outpatients with mild COVID-19 compared to the placebo group. The results do not support the use of ivermectin and atazanavir for the treatment of mild to moderate COVID-19.
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Background: In 2018 we reported the emergence of the new HIV-1 recombinant CRF94-02BF2 involved in a large transmission cluster of 49 French MSM mostly infected in 2016-2017. This CRF94 raised concerns of enhanced virulence. Prevention actions were undertaken in the area and population affected. This study reported the molecular and epidemiological evolution of this CRF94 until June 2022. Method(s): In 2021-2022, French sequence databases were screened for patients infected with HIV-1 subtype CRF94 or similar strain. HIV subtyping was confirmed by phylogenetic analysis of genes encoding both protease and reverse transcriptase (1070bps), and integrase (696bps) using IQ-Tree. Five whole genomes, related but distinct from CRF94, were obtained with the DeepChek assay Whole Genome kits. Recombination breakpoints were estimated using RDP4 and SimPlot. Mann-Whitney and LogRank tests were used for statistical analyses to compare patients' characteristics. Result(s): In June 2022, 49 new HIV-1 sequences were collected: 14 clustered with the 49 previous CRF94, 32 formed a new cluster next to but distinct from CRF94, and 3 strains could not be classified. Analysis of 5 whole genomes from the new cluster revealed a new recombinant, the CRF132-94B, mainly consisting of CRF94 which recombined with subtype B in the POL and accessory genes. Vif gene changed from the F2 to the B subtype. Both CRF94 and 132 clusters involved >95% of MSM, mostly infected < 1 year before diagnosis. However, there were differences: 97% were diagnosed in 2013-2019 for CRF94 vs 90% in 2020-2022 for CRF132. At time of diagnosis, 33% of patients infected with CRF94 knew the Prep vs 95% for CRF132. In the cluster CRF94, patients were older (34 vs 30 years, p=0.02), had higher viral loads (5.42 vs 4.42 log10 copies/Ml;p< 0.001), a lower CD4 cell counts (358 vs 508 /mm3, p=0.002). On treatment, the patients with the CRF94 reached viremia < 50 copies/Ml significantly later than those infected with CRF132 (p=0.0002). The prevention activities targeting the CRF94 cluster could explained the few patients infected with this strain after 2018. The CRF132 is mainly located in another Paris region area, but no specific transmission place has been identified. Conclusion(s): After 2019, the CRF94 spread seems greatly slowed down but the very close CRF132-94B has given birth to a new highly active cluster in 2020- 2022, despite the COVID social-distancing and a strong knowledge of the Prep. CRF132 appears to be less virulent perhaps due to the Vif gene change. Identified breakpoints positions of the new HIV-1 CRF132-94B. GenBank accession numbers of the five references : ON901787 to ON901791.
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Paper aims: This paper presents the literature findings of the Covid-19 vaccines supply chain, its main challenges and best practices, which are compared and verified empirically. Originality: The questionnaire developed in this study provides new empirical data about the Covid-19 vaccines supply chain, especially regarding the impacts of the Covid-19 pandemic in the chain, as these events are still recent. Research method: A questionnaire was sent by e-mail to specialists working with the Covid-19 vaccine supply chain in South America. Each response was compared to the literature findings. Main findings: Despite the challenges faced by vaccination programs, some countries have achieved good results due to strategies adopted at the beginning of their immunization campaigns. The empirical research confirmed that literature findings match business reality, although some empirical results vary depending on the scenario of the country regarding the impacts of the pandemic. Implications for theory and practice: This paper summarizes the Covid-19 vaccine supply chain and its challenges, best practices of the most successful countries regarding the immunization process, providing a better understanding of the pandemic scenario. Some empirical data corroborate the literature, and some discrepancies allow the formulation of suppositions that may be tested in future studies © This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
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This article has as its central theme the legal regulation of the exercise of telemedicine, especially from the context created in the COV1D-19 pandemic. In this sense, the study addresses the legal mechanisms and guidelines given by the Federal Council of Medicine (CFM) for the adoption of the practice. As a result, several questions arise regarding the work situation of health professionals who use telemedicine as a work mechanism. The article, therefore, will explain the importance of adopting telemedicine, as well as the problems that arise through it. Copyright © 2023 Beatriz Sena Figueirêdo, Flávia de Paiva Medeiros de Oliveira.
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Pathophysiological characteristics of obesity includes chronic inflammation. Complications in the respiratory tract are related to bodily problems, which lead to a restriction of lung function due to reduced volume, inducing an increase in respiratory work. SARS-CoV-2 has a high potential for contamination by respiratory secretions and, therefore, obesity is one of the main risk factors for complications. The relations between obesity and SARS-CoV-2 are complex, since the immunological agents that are activated by these processes are ubiquitous. It is well-known that network analysis can generate results about the dynamics of complex biological phenomena, such as signalling networks, neural networks, immunological networks, and so on. Here we propose and analysis and interpretation of the complex relationships between obesity and COVID-19 in a meta-analysis study using complex network modelling and the theoretical knockouts technique. In a complex network of this kind, vertices are considered as immunological agents and their relation as directed edges. We built two networks: one related to COVID-19 and obesity (synergy) and another only with COVID-19. In both networks, we have performed the knockout of all 52 vertices. These knockouts indicated that, besides the Infected Host Cell and COVID viral particle, IL-17;CD40, AR and AL channels;and Th17, were the most relevant agents in this complex network. Overall, our study indicated the superior role and importance of IL-17 in this context. Such result corroborates with the role of IL-17 in identification and prognosis of Acute Respiratory Discomfort Syndrome (ARDS).
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The emotional impact of the COVID-19 pandemic and ensuing social restrictions has been profound, with widespread negative effects on mental health. We made use of the natural language processing and large-scale Twitter data to explore this in depth, identifying emotions in COVID-19 news content and user reactions to it, and how these evolved over the course of the pandemic. We focused on major UK news channels, constructing a dataset of COVID-related news tweets (tweets from news organisations) and user comments made in response to these, covering Jan 2020 to April 2021. Natural language processing was used to analyse topics and levels of anger, joy, optimism, and sadness. Overall, sadness was the most prevalent emotion in the news tweets, but this was seen to decline over the timeframe under study. In contrast, amongst user tweets, anger was the overall most prevalent emotion. Time epochs were defined according to the time course of the UK social restrictions, and some interesting effects emerged regarding these. Further, correlation analysis revealed significant positive correlations between the emotions in the news tweets and the emotions expressed amongst the user tweets made in response, across all channels studied. Results provide unique insight onto how the dominant emotions present in UK news and user tweets evolved as the pandemic unfolded. Correspondence between news and user tweet emotional content highlights the potential emotional effect of online news on users and points to strategies to combat the negative mental health impact of the pandemic. © 2023 Simon L. Evans et al.
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During the pandemic, people were asked to stay at home, which increased the demand for software. The quality of the software is improving as a result of this trend. In response, companies have accelerated their digitization processes to provide better quality software that is more accessible, user-friendly, and secure. Since the pandemic, software development teams around the world have struggled to meet deadlines during uncertain times. This poster addresses the difficulties developers and designers face in developing and managing digital health software. This is due to the growing appeal of low and no-code platforms that are becoming more accessible and user-friendly to non-programmers. The goal of this project is to develop and evaluate a prototype digital health component library known as LICOR. This software development kit contains integrated digital components designed specifically for the digital health industry. It helps even non-experts create effective digital health products. The design approach was developed by combining various theories and techniques such as design system principles, domain-oriented design, micro front-ends, and microservices. The methodology is based on the design-based research approach, which combines theoretical research with working and coded software artifacts to enable real-world testing. We are interested in contributions from the community and would be happy to discuss ethical concerns, bias, and illiteracy in digital health with academics. Finally, we discuss future research opportunities and the difficulties of connecting the design phase with the development phase in digital health software development. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Objective: analyse non-pharmacological measures of prevention of the Covid-19 adopted by health professionals in the Primary Attention to Health in family coexistence.Methods: transversal and analytical study performed with 229 health professionals of the Primary Attention. Data were collected through a virtual questionnaire in the platform SurveyMonkey. The data analysis was performed by the Chi-Square Test, exact of Fisher and logistic regression.Results: most of the professionals used hygiene measures of hands, environment cleaning, food hygiene, use of tissue masks and physical distancing of relatives. Male single/divorced health professionals have smaller chance to adopt environment cleaning, food hygiene and use of tissue masks.Conclusion: the adoption of non-pharmacological measures against Covid-19 by health professionals in family coexistence is essential for reducing contamination risk among their relatives.
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The work shows an application of Geodesign for metropolitan region of Florianópolis, at Santa Catarina state, Brazil, with focus on reducing carbon emissions considering the future scenarios of 2035 and 2050. The research took place with students from the discipline of Multipurpose Land Registry and Territorial Planning related to doctoral course of the Post-Graduate Program in Territorial Planning and Social-environmental Development (Programa de Pós-Graduação em Planejamento Territorial e Desenvolvimento Socioambiental – PPGPLAN) from the State University of Santa Catarina - UDESC in the year 2021. The students had different training and performances, but all to a greater or lesser degree had experience in urban planning, with 25% knowing the methods and concepts of Geodesign. Due to the conditions of social distancing imposed by the COVID-19 pandemic, the lessons activities took place remotely. Four official weekly meetings and also daily communication were established to carry on the activities, which were performed by WhatsApp, email or even by extra on-line meeting. To assist decision-making on the GISColab Platform, a spreadsheet was created using Excel software that ensured the organization and systematization of proposals, as well as supporting the spatialization of policies and projects. Due to the students’ professional experience, the biggest challenge was shown in the proposition of ideas that corroborated with the initial goal, that was especially focused on territorial planning integrated in multifactorial parameters. In this sense, remote meetings fulfilled the role of initiating remote participatory discussion, sharing ideas and decisions for proposals adopted and approved in groups, but revealed the lack of specialized critical thinking, difficulties in developing territorial planning and defending ideas based on action and reaction that GISColab platform provides. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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The experience of purchasing a good is highly influenced by various technologies that have not only impacted the shopping experience but have also significantly changed the way brands work on their digital presence. Augmented reality, a technology that delivers multisensory experiences that merge the real world with the digital, discussed in this article, is gaining presence in retail. The multidisciplinary teams of companies in this field, often through their branders and brand managers, have proposed creating and promoting distinctive technological experiences that put the user/customer at the centre. This trend has taken hold in physical retail and increasingly in online retail, which has experienced an unpredictable surge prior to the pandemic associated with COVID19. This paper aims to provide a literature review to understand better the state of the art of Augmented Reality (AR) in the retail space and its evolution in recent years and to identify the brands that have invested the most in this technology. Using SCOPUS and Web of Science as a research base, the work presented here shows that although research in this area already exists, it is perhaps still in an introductory phase in this field and is still looking for greater maturity in the use of AR in the consumer experience. © 2022 IEEE Computer Society. All rights reserved.
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CoVID-19 is a devastating disease that affects different organs and systems in the human body and is caused by the SARS-CoV-2 virus. This disease had its beginnings in China and has raged around the world, characterizing a pandemic that is difficult to control due to the high transmission capacity of the virus between people. Studies with plants with anti-protozoan activity have been the object of studies for the treatment of CoVID-19, since some of these plants have an antiviral effect. The aim of this study was to conduct a review of the literature on the use of medicinal plants with antimalarial activity as a possible strategy in CoVID-19 therapy. Dozens of plants with antimalarial activity stood out for having antivirals and, considering the diversity of active compounds present in these plants, it is possible to think of these plants as a potential source of new biologically active compounds that could potentially be applicable in therapy against CoVID-19. © 2022 International Scientific Organization. All Rights Reserved.
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Background: As a care tool for the elderly population, caregivers must have knowledge about the prevention of COVID-19 to minimize the transmission of SARS-CoV-2. Objective: Describe the process of construction and validation of educational leaflet content for caregivers of the elderly on covid-19 prevention measures. Methods: Methodological study developed in three stages. The first stage corresponds to the literature review;the second involved the construction of the brochure and the last stage was content validation by a committee of twenty-three experts who judged the objectives, structure/presentation and relevance of the brochure from a validated 3-point Likert scale. Items with positive opinions by more than 80.0% were considered adequate. Results: The leaflet was prepared containing six pages, with information on the new coronavirus, forms of transmission, signs and symptoms, protection of the disease, alteration of the routine of daily care, the importance of hand hygiene, surfaces and food;correct use of mask;care for the caregiver or family member;emotional health and how to proceed in case of suspicion of COVID-19. Only one evaluation round was required;the content validity index was 1.0 and the agreement between judges was statistically significant in all domains of the scale (p<0.006). Conclusion: This study provides an educational leaflet with validated content, configuring a capable component to improve the knowledge of caregivers about prevention measures against COVID-19 in the elderly. © 2021 Faculdade de Medicina de Ribeirao Preto - U.S.P.. All rights reserved.
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The social isolation established as a measure to contain the advancement of Covid-19 forced educational institutions, in conformity with Portaria 343/2020, of the Ministry of Education, to replace the classes in person with remote teaching. All levels and modalities of education were affected, generating discussions about distance education and remote teaching. In this paper, we sought to analyze the context of different educational levels and highlight their realities and problems, to reflect on the lessons for public policies in Brazilian education. Therefore, a bibliographic research was carried out as the first step to map the theme. The paper includes the analysis of articles by Brazilian scholars who are references in the studies of education, and of official documents and publications from entities linked to the educational field, such as ANPED, ANDES and MIEIB. We conclude that the context of the pandemic is serving as a justification for reforming Brazilian education, resulting in a process of legitimization of distance education that opens up the serious and historical problems of social inequality, which requires the strengthening of the public character of education and social public policies.
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Media has played an important role in public information on COVID-19. But distressing news, e.g., COVID-19 death tolls, may trigger negative emotions in public, discouraging them from following the news, which, in turn, can limit the effectiveness of the media. To understand people’s emotional response to the COVID-19 news, we have investigated the prevalence of basic human emotions in around 19 million user responses to 1.7 million COVID-19 news posts on Twitter from (English-speaking) media across 12 countries from January 2020 to April 2021. We have used Latent Dirichlet Allocation (LDA) to identify news themes on Twitter. Also, the Robustly Optimized BERT Pretraining Approach (RoBERTa) model was used to identify emotions in the tweets. Our analysis of the Twitter data revealed that anger was the most prevalent emotion in user responses to the news coverage of COVID-19. That was followed by sadness, optimism, and joy, steadily over the period of the study. The prevalence of anger (in user responses) was higher for the news about authorities and politics while optimism and joy were more prevalent for the news about vaccination and educational impacts of COVID-19 respectively. The prevalence of sadness in user responses, however, was the highest for the news about COVID-19 cases and deaths and the impacts on the families, mental health, jails, and nursing homes.We also observed a higher level of anger in the user responses to the (COVID-19) news posted by the USA media accounts (e.g., CNN Politics, Fox News, MSNBC). Optimism, on the other hand, was found to be the highest for Filipino media accounts. Author
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Introdução/Objetivo: A resistência antimicrobiana é considerada hoje uma ameaça global pela OMS e um desafio constante na prática médica intra-hospitalar. Bactérias resistentes aos carbapenêmicos, principalmente via produção de carbapenemases, frequentemente são relacionadas a infecções graves e com limitado arsenal terapêutico. Dessa forma, objetivou-se neste estudo a caracterização de microorganismos isolados conforme o perfil de resistência aos carbapenêmicos no Centro de Medicina Tropical de Rondônia (CEMETRON). Métodos: Estudo retrospectivo no CEMETRON no primeiro semestre de 2021. Avaliação dos resultados de culturas provenientes do banco de dados não nominal do Serviço de Controle de Infecção Hospitalar. Para as análises estatísticas utilizamos o SPSS® versão 25.0. Resultados: No primeiro semestre de 2021 o CEMETRON teve 303 culturas positivas, destas, 153 bactérias Gram negativas, sendo incluídas 61 (39,9%) resistentes a pelo menos um carbapenêmico. A topografia mais prevalente foi o aspirado traqueal (52,5%), seguido por sangue (18,0%) e urina (14,8%). Em ordem de prevalência tivemos 38 (62,3%) Klebsiella pneumonie, 12 (19,7%) Acinetobacter baumannii, cinco (8,2%) Pseudomonas aeroginosa, quatro (6,6%) Escherichia coli, uma (1,6%) Burkholderia cepacia e uma (1,6%) Serratia marcescens. Das 61 culturas incluídas, 19 (31,1%) foram avaliadas quanto a presença de gene de resistências enzimática, sendo 11 Klebsiella pneumonie, seis Acinetobacter baumanni, uma Pseudomonas aeroginosa e uma Serratia marcescens. Foram detectados genes enzimáticos de resistência em seis das 19 (31,6%) bactérias testadas, sendo quatro KPC detectáveis em Klebsiella pneumonie, dois OXA-51 e um OXA-58 detectáveis em Acinetobacter baumanni. Conclusão: Nosso estudo demonstra uma grande incidência de bactérias resistentes aos carbapenêmicos, quase 40% das culturas com bactérias Gram negativas no período. Importante ressaltar que a maioria dessas culturas eram de aspirado traqueal, o que pode estar relacionado com o atual cenário da pandemia de COVID-19, onde as infecções pulmonares secundárias são as mais prevalentes em UTIs. É de fazer notar a detecção de produtores de carbapenemases de classe A e D cujas terapias envolvem o uso de novos inibidores de beta-lactamases (p. ex. ceftazidima-avibactam) que não estão disponíveis na maioria dos hospitais da rede pública, nos restando terapias com menor índice de sucesso (p. ex. polimixina) comparados a medicação de primeira escolha.
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Smartphones have been an alternative resource in emergency remote learning. In this paper, we introduce the Opi application, an educational game aimed at students from the 1st to the 5th grade of elementary school. The application was developed with the objective of contributing to the engagement and motivation of children in the context of remote classes during the Covid-19 pandemic, in addition to promoting the participation of parents in the process. The main functionalities and characteristics of Opi are described from a mobile game-based learning framework. We report the usability evaluation carried out with children and parents, listing the problems found and the suggestions and feedback. It ends with some lessons learned on the design and evaluation for children in the context of the pandemic and of mobile game-based learning. © 2021 ACM.
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During the current year of 2020, the outbreak of the COVID-19 highlighted the vulnerabilities of the cultural sector. The forced closing of the cultural equipment’s was widely reported and afterwards it became gradually evident the consequences that remained while these spaces progressively reopened. The present study that I am presenting combined a wide range of observations that were already made that assessed this phenomenon. As a variable I will use the number of visits that were registered in the cultural equipment’s under the tutelage of the Town Hall of Tomar. © 2021, Ponteditora. All rights reserved.
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The fast transformation of the urban centers, pushed by the impacts of climatic changes and the dramatic events of the COVID-19 Pandemic, will profoundly influence our daily mobility. This resulted scenario is expected to favor adopting cleaner and flexible modal solutions centered on bicycles and scooters, especially as last-mile options. However, as the use of bicycles has rapidly increased, cyclists have been subject to adverse conditions that may affect their health and safety when cycling in urban areas. Therefore, whereas cities should implement mechanisms to monitor and evaluate adverse conditions in cycling paths, cyclists should have some effective mechanism to visualize the indirect quality of cycling paths, eventually supporting choosing more appropriate routes. Therefore, this article proposes a comprehensive multi-parameter system based on multiple independent subsystems, covering all phases of data collecting, formatting, transmission, and processing related to the monitoring, evaluating, and visualizing the quality of cycling paths in the perspective of adverse conditions that affect cyclist. The formal interactions of all modules are carefully described, as well as implementation and deployment details. Additionally, a case study is considered for a large city in Brazil, demonstrating how the proposed system can be adopted in a real scenario.