Evaluation of UV-C Radiation Efficiency in the Decontamination of Inanimate Surfaces and Personal Protective Equipment Contaminated with Phage ϕ6.

To help halt the global spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), appropriate disinfection techniques are required. Over the last years, the interest in Ultraviolet-C (UV-C) radiation as a method to disinfect inanimate surfaces and personal protective equipment (PPE) has increased, mainly to efficiently disinfect and prevent SARS-CoV-2 from spreading and allow for the safe reuse of said equipment. The bacteriophage ϕ6 (or simply phage ϕ6) is an RNA virus with a phospholipid envelope and is commonly used in environmental studies as a surrogate for human RNA-enveloped viruses, including SARS-CoV-2. The present study investigated the use of two new UV irradiation systems ((2)2.4W and (8)5.5W)) constituted by conventional mercury UV-C lamps with a strong emission peak at ~254 nm to potentially inactivate phage ϕ6 on different surfaces (glass, plastic, stainless steel, and wood) and personal protective equipment, PPE, (surgical and filtering facepiece 2, FFP2, masks, a clear acetate visor, and disposable protective clothing). The results showed that both UV-C systems were effective in inactivating phage ϕ6, but the UV-C sterilizing chamber (8)5.5W had the best disinfection performance on the tested surfaces. The inactivation effectiveness is material-dependent on all surfaces, reaching the detection limit of the method at different times (between 60 and 240 s of irradiation). The glass surface needed less time to reduce the virus (30 s) when compared with plastic, stainless, and wood surfaces (60 s). The virus inactivation was more effective in the disposable surgical and FFP2 masks (60 and 120 s, respectively) than in the disposable vest and clear acetate visor (240 s). Overall, this study suggests that UV-C lamps with peak emission at ~254 nm could provide rapid, efficient, and sustainable sanitization procedures to different materials and surfaces. However, dosage and irradiation time are important parameters to be considered during their implementation as a tool in the fight against human coronaviruses, namely against SARS-CoV-2.

The influence of technological innovations on international business strategy before and during COVID-19 pandemic

In the last two years, the world has gone through an unprecedented change in the most diverse dimensions (social, economic, and even political), leading that society had to adapt very quickly to the contingencies imposed by COVID-19. All organizations (independent of their area of activity) had to adjust their processes to respond, efficiently and effectively, to these constraints. In this context, companies with concerns in internationalization (those that are already internationalized and those in an internationalization process) have had to resort to technologies to support the change in their modus operandi. The digital transformation (until now had an essential role in the transformation of organizations, but which was in a relatively slow implementation process) started to perform, in an accelerated way, the base of work for the heads of the organizations to be able to respond to these challenges. In this context, the transformation of the business model, supported by digital technology, has been documented as one of the strategies used to respond to disruptive environmental changes, particularly technologies that help companies identify new business practices. This study aims to find evidence of the importance of integrating and influencing technological innovations in the practice of international business strategy before and during COVID-19 pandemic. The results show the influence of the digitalization on the business strategies.

Correction to the article "Viscoelastic Tests in the Evaluation of Haemostatic Disorders in SARS-CoV-2 Infection", Published on Acta Med Port 2021 Jan;34(1):35-46.

On page 36, in the fifth sentence of right-side column, where it reads: "Direct thrombin inhibitors (DTI) (argatroban, bivalirrubin) are used in COVID-19 infected patients with significantly lower antithrombin levels,24 or if heparin induced thrombocytopenia (HIT) occurs."It should read: "Direct thrombin inhibitors (DTI) (argatroban, bivalirudin) are used in COVID-19 infected patients with significantly lower antithrombin levels,24 or if heparin induced thrombocytopenia (HIT) occurs."Article published with errors: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14784.

COVID-19 and Cardiovascular Disease: Direct Consequences and Lines of Investigation

SARS-COV-2 infection has left no one unscathed or indifferent. It has had profound implications for personal daily lives and health, but also at a broader economic and social level. In terms of cardiovascular disease, COVID-19 had a huge impact. Much remains unknown and the information is often contradictory. This article aims to point out lines of investigation that may be useful to find answers about the link between SARS-COV-2 infection and cardiovascular disease. We explore the known direct effects of the disease, addressing the pathophysiological mechanisms, whether it is the direct cell aggression, inflammatory storm, thrombotic angiopathy, hypoxia or lipoprotein dysfunction.

Viscoelastic Tests in the Evaluation of Haemostasis Disturbances in SARS-CoV2 Infection.

COVID-19 associated coagulopathy is a dysfunction of severe SARS-CoV-2 infection, characterized by significantly increased fibrinogen, D-dimer and C reactive protein and normal to near-normal prothrombin time, activated partial thromboplastin time and platelet count. Hypercoagulopathy and hypofibrinolysis coexist and are detected by viscoelastic tests. These features, when associated with immobilization and intrinsic risk factors (age, obesity, comorbidities, drugs) of the patient, can trigger thromboembolic events, despite thromboprophylaxis. The lungs are the first and most severely damaged organ. To date, most patients have exhibited hypercoagulability on viscoelastic tests not detected by standard coagulation tests. A high rate of thrombotic events was reported, suggesting that it should be considered as a cause of clinical deterioration in intensive care and potentially other clinical settings. In advanced stage, COVID-19 associated coagulopathy, fibrinogen and platelet count can decrease significantly, depending on the severity of clinical status resembling consumptive coagulopathy. In this stage, bleeding events can occur, especially if the patient is under extracorporeal membrane oxygenation (ECMO). Viscoelastic tests are very useful tools to assess hypercoagulability and hypofibrinolysis (not detectable by standard coagulation tests) in critically ill SARS-CoV-2 patients with COVID-19 associated coagulopathy and look like very promising tools for anticoagulation management. However, further research needs to be carried out to determine whether abnormal viscoelastic tests alone or in combination with other clinical or laboratory findings can identify patients at increased thrombotic risk. Clinical trials to evaluate hypercoagulability using viscoelastic tests and the need for personalized dosage of anticoagulation in SARS-CoV-2 patientsare quickly emerging.

A coagulopatia associada à COVID-19 é uma disfunção associada à infeção SARS-CoV-2 grave, caraterizada por aumento significativo do fibrinogénio, D-dímeros e Proteína C reativa, e por valores normais/muito pouco alterados do tempo de protrombina, tempo de tromboplastina parcial ativado, e número de plaquetas. A hipercoagulabilidade e a hipofibrinólise coexistem e são detetadas por testes viscoelásticos. Quando associadas à imobilização e aos fatores de risco intrínsecos do doente (idade, obesidade, comorbilidades, drogas) potenciam eventos tromboembólicos, apesar da tromboprofilaxia. Os pulmões são o órgão inicialmente e mais gravemente afetado. Até à data, a maioria dos doentes apresentou hipercoagulabilidade nos testes viscoelásticos, não detetada pelos testes de coagulação de rotina, e foi reportada uma elevada taxa de eventos trombóticos, sugerindo que esta deveria ser considerada uma das causas de deterioração clínica, não só em cuidados intensivos. Na coagulopatia associada à COVID-19 avançada, o número de plaquetas e o fibrinogénio podem diminuir significativamente, dependendo da gravidade clínica da infeção, assemelhando-se o quadro a uma coagulopatia de consumo. Nesta fase pode haver hemorragia, especialmente se o doente estiver sob extracorporeal membrane oxygenation. Os testes viscoelásticos afiguram-se muito úteis para avaliar a hipercoagulabilidade e a hipofibrinólise em doentes críticos SARS-CoV-2 com coagulopatia associada à COVID-19, parecendo também promissores para a gestão da anticoagulação. No entanto, é necessária mais investigação para determinar se testes viscoelásticos alterados, individualmente ou quando combinadoscom outros resultados clínicos/laboratoriais, podem identificar os doentes com risco trombótico acrescido. Estão a emergir rapidamente ensaios clínicos para avaliação da hipercoagulabilidade por testes viscoelásticos e da necessidade de personalização da anticoagulação em doentes SARS-CoV-2.

Fighting COVID-19 in salvador: Cooperation and conflict in intergovernmental relationship

The purpose of this paper is to analyze the intergovernmental relationship between the Government of the State of Bahia and the Municipality of Salvador, and the measures put in place by these entities to fight COVID-19. This paper also reflects on the Federal Government's relationship with the federative units during the fight against the pandemic. It analyzes the extent to which intergovernmental relations are based on verticalization, cooperation or conflict. The paper concludes that, despite being led by politicians from groups and parties that are historically antagonistic, the governments of the State of Bahia and the city of Salvador have been adjusting actions and cooperating among themselves to implement policies to face the health crisis. Going in a completely different direction, the Federal Government of Brazil is building relationships with federal state governors characterized by verticalization attempts and conflicts.