Change in prostate cancer staging patterns in the post-COVID-19 era

Introduction & Objectives: In 2020, the COVID-19 pandemic brought innumerous challenges to healthcare systems, with reallocation of professionals and suspension of normal activity. This led to a more difficult patient access to primary care, with postponed routine examinations and delayed referrals to specialized consultations. We are now experiencing the results of such delays, with patients arriving later at specialized outpatient appointments. Our objectives were to compare pathological staging patterns of prostate cancer between pre and post-COVID-19 years. Material(s) and Method(s): At a tertiary center, we gathered all pathological data from prostate biopsies (PB) and radical prostatectomy (RP) from 01-01-2019 to 30-06-2022, and compared pathological specimens between 2019 and post-COVID-19 years (2021 and 2022). Result(s): We collected data from 850 PB and 401 RP. During the first pandemic year (2020), we observed a 34.5% and 24.4% reduction in PB and RP (192 PB in 2020 vs 293 in 2019;96 RP in 2020 vs 127 in 2019), respectively. In 2021 and first semester of 2022, the number of PB and RP returned to pre-pandemic values. In post-pandemic years (2021 and 2022) (PPY) PB resulted in less ISUP1 tumors (20.6% in PPY vs 26.62% in 2019) and more poorly differentiated tumors (21.6% ISUP34 in PPY vs 15.7% in 2019), with a 75% increase in cribriform pattern detection. Regarding RP specimens, we identified a 150% increase in high-grade tumors (ISUP34: 9.9% In PPY vs 3.9% in 2019) and 66% increase in extraprostatic extension (54.3% in PPY vs 36.2% in 2019). Nodal involvement was detected in 4.6% (n=15) in PPY compared to 3.9% (n=5) in 2019. Conclusion(s): We are currently observing a change in prostate cancer disease characteristics compared to pre-pandemic years, with patients arriving with higher-grade tumors and more locally advanced featuresCopyright © 2022 European Association of Urology. Published by Elsevier B.V.

Tracheostomy outcomes in COVID-19 and non-COVID-19 critical patients

Introduction: Tracheostomy is a common surgical procedure in the setting of acute respiratory failure. And improves outcomes for critically patients requiring prolonged mechanical ventilation. Initially avoided due to it's high risk to biosafety, tracheostomy soon became a routine procedure in the critical support of critical ill patients affected by COVID-19. The aim of this review was to compare tracheostomy done in COVID-19 and non-COVID-19 pneumonias in an UCI. Method(s): This retrospective, observational study included 78 patients (23 female, 55 male;age range: 23-90 years, mean age: 66) with severe pneumonia who were admitted to the intensive care unit (ICU) of Hospital Beatriz Angelo (Portugal) between 01/03/2012 until 31/12/2021, to whom a tracheostomy was performed. Patients underwent orotracheal intubation with invasive mechanical ventilation, followed by percutaneous or open surgical tracheotomy. Indications, timing of the procedure, and time needed to complete weaning and decannulation, as well as complications, were reported and compared between patients with COVID-19 (N = 38) and non-COVID-19 (N = 40) pneumonias. Result(s): In both groups, weaning from difficult ventilation was the most common indication for the procedure, followed by prolonged mechanical ventilation in the COVID-19 group (42%) and protection of the airway/secretions management in the non-COVID-19 group (22.5%). Timing of the procedure was 14.6 and 16.4 days after mechanical ventilation in the COVID-19 and non-COVID group, respectively. The non-COVID-19 group reported more days to decannulation (39.3 vs 15.1 days) as well as more days to wean off from mechanical ventilation (20.3 vs 14.1 days) and more major complications (12.5% vs 2%). Hospital discharge rate was similar in both groups (COVID-19 with 42.1% and 42.5% to non-COVID-19). Conclusion(s): Although the differences between both groups are multifactorial, it's useful for self-evaluation observations, as well as sharing practices and outcomes for further analysis.

Ergonomics in "Remote Work" Activities: A Workstation Adaptation Case Study in Brazil

The coronavirus disease 2019 (COVID-19) pandemic decreed by the outbreak of the new coronavirus culminated in the need to implement jobs in the homes of employees who had to adhere to the "remote work" style, due to social isolation actions in Brazil. Many of the employees started to work in the absence of adequate working conditions in their homes, impacting the three dimensions of ergonomics, i.e., physical, organizational and cognitive. The objective of this chapter is to report the adjustments made in a workplace after the change of modality from face-to-face (f2f) activities to "remote work" after the beginning of the pandemic in 2020, aiming to adopt actions aimed at ergonomics. The research was carried out with a professional in the area of Environmental and Sanitary Engineering who started remote work in March 2020. The work is of a qualitative nature, using photos to illustrate the changes occurring before and after the installation of the equipments and reports on strategies to improve working conditions in the "remote work". The cost of physical adaptations was also computed. The most reported complaints collected by the professional were back pain, neck, forearm, wrist and eye pain, in addition to mental fatigue. The necessary equipment and furniture were acquired for the physical adaptation of the workspace. Issues of working hours, days off, means of communication were also addressed, but aspects of cognitive and organizational ergonomics must have the participation of the entire work group to achieve effective results. The accompaniment of a specialized technical professional would be important for the establishment of further assertive actions, seeking the productivity and quality of life of the employee.

‘Your luck is our luck': Covid-19, the radical right and low polarisation in the 2022 Portuguese elections

In the 2022 Portuguese legislative elections, held nearly two years after the pandemic hit the country, the incumbent Socialists improved their position, being now able to govern with an absolute majority, while populist radical right Chega experienced considerable growth. Was the pandemic a relevant factor for vote choice in these elections? The main goal of this article is to shed light on this matter. In addition to portraying this election's background and results, we describe the degree of COVID-19-related polarisation in Portugal, analyse the salience of the pandemic in the campaign and measure the relative impact of pandemic-related perceptions vs other variables on voting behaviour. Our findings reveal that, although there was little politicisation of the pandemic and the incumbent enjoyed high levels of support among both political elites and public opinion, Chega, which was less involved in rallying around the flag, arguably sent signals that made COVID-19-related assessments relevant in terms of voting behaviour. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

Quality of life and psychosocial risks of nurses involved in the battle against the COVID-19 pandemic.

Objective: The present investigation aims to understand the impact of providing care to people with suspected or confirmed SARS-CoV-2 infection on nurses' quality of life and psychosocial risk factors and to identify associations with their sociodemographic characteristics. Method(s): An exploratory-descriptive study was carried out through the World Health Organization Quality of Life Instruments - Bref and Copenhagen Psychosocial Questionnaire scales, with a total of 127 valid responses. Data were processed in SPSS, using descriptive statistics and crosstabs. Result(s): The mean values of quality of life did not reach 70 points and 22 psychosocial risk factors were identified in intermediate and high degree. Some sociodemographic characteristics seem to be associated with these results. Conclusion(s): The nurses of the sample were significantly affected by the provision of care in the context of the pandemic.Copyright © 2022, Fundacion Index. All rights reserved.

Remote Leadership: A (Re)qualification of School Leaders in Portugal

The COVID-19 pandemic brought about new challenges to schools' organization leaderships and to school leaders. This study, of qualitative nature, aims at understanding the impact occurred in the area of school management, in pandemic times, from the leaders' perspective, in Portugal. The investigation question is: what prevailed during the remote school management of the leader's team amidst the COVID-19 pandemic time? The sample is a video, with 2 min and 47 s, done by the Leader of a Cluster of Schools, in the North of Portugal, within the context of activities related to affection, promoted by the group of Schools' Libraries, entitled "Month of Affections”, when COVID-19 lockdown was mandatory. The content analysis was done using the webQDA® software. All ethical rules were accounted for. The main results are: (i) adaptation and remote management;(ii) challenges to leadership and (iii) vision for the future. It was concluded that, due to the mandatory social distance, the Leader chose for an active and creative virtual presence (re)qualifying his leadership. The concept of this remote leadership kept the organizational balance, leading his co-workers to achieve the defined objectives. The remote leadership will have to be a dialogical field in the Public Policies of the Ministry of Education and Science in Portugal. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Political Disaffection and Digital Political Participation in Latin America: A Comparative Analysis of the Period 2008–2020

One of the issues facing the field of political behaviour analysis in recent years has been the transformation of political participation among citizens, in a context of increasing change, profoundly marked by the spread of a new digital paradigm. Network society has brought with it new forms of political participation, where different types of participatory citizenship coexist in a process of increasing interaction which, in turn, creates new morphologies, and where online and offline modes are reciprocal, generating new patterns of behaviour. Of these different types of participatory citizenship, that of the disaffected is perhaps among the most important in recent years and, in particular, since the start of the so-called "Great Recession” around 2008, and the subsequent global COVID-19 crisis. This recent context can be characterised by a significant increase in political disaffection, resulting from a loss of trust in institutions and from the constant distancing of a certain section of the citizenry from politics as a coded punishment of those governments and institutions they see as ineffective. This paper provides an analysis of citizenship types in Latin America, particularly that of the disaffected, describing their relationship to the following of political information through digital media and social networks, and identifying patterns of evolution and development in some of the trends. Results show that a clear distinction exists between the different types of citizenship and associated forms of participation, both online and offline, while also describing differences in both political perceptions and attitudes, and between areas or regions in Latin America. Likewise, important differences are found according to citizen type in relation to the following of different social networks, especially among citizens categorised as critical or disaffected. © 2023 by the authors.

Oncological emergencies in lung cancer patients during 2019 and SARS-CoV-2 pandemic year

Lung cancer (LC) is frequently related to oncological emergencies (OE). We performed a retrospective analysis to characterize OE in LC from 2019 to 2020 and to determine the effects of SARS-CoV-2 pandemic. T-test or Mann- Whitney was used to compare independent continuous variables. Comparison between proportions was tested through Chi-square. The association between clinical variables and 6-months mortality was tested through uni and multivariable logistic regression.82 patients were admitted due to OE. The median age was 66 years old and 73.1% were male. The two most frequent OE were brain metastasis (45.1%) and vena cava syndrome (15.8%). OE was the first manifestation of LC in 45.2% of cases and only 24.4% were alive 6 months after the OE. Neurological OE was associated with lower risk of 6-months mortality compared to cardiovascular and respiratory OE, regardless of gender, age, stage, histology, smoking status and cancer treatment [OR 0.255 (CI 0.72-0.90), p=0.035)]. SCLC had shorter time between diagnosis and OE compared to NSCLC (p=0.016), as well as patients with distant metastasis compared to local disease (p=0.02) and in those without previous cancer treatment (p<0.001). When comparing patients admitted with OE in 2019 and 2020, there were no differences in the following variables: 6-months mortality (p=0.741), OE as first manifestation of LC (p=0.913), time between diagnosis and OE (p=0.670), stage (p=0.276) and type of OE (p=0.733). In this study, SCLC, metastatic disease and no previous cancer treatment were associated with lesser time until OE and brain metastasis was associated with better prognosis. There were no differences in relevant clinical variables between 2019 and 2020.

COVID-19 non-pharmaceutical interventions: data annotation for rapidly changing local policy information.

Understanding the scope, prevalence, and impact of the COVID-19 pandemic response will be a rich ground for research for many years. Key to the response to COVID-19 was the non-pharmaceutical intervention (NPI) measures, such as mask mandates or stay-in-place orders. For future pandemic preparedness, it is critical to understand the impact and scope of these interventions. Given the ongoing nature of the pandemic, existing NPI studies covering only the initial portion provide only a narrow view of the impact of NPI measures. This paper describes a dataset of NPI measures taken by counties in the U.S. state of Virginia that include measures taken over the first two years of the pandemic beginning in March 2020. This data enables analyses of NPI measures over a long time period that can produce impact analyses on both the individual NPI effectiveness in slowing the pandemic spread, and the impact of various NPI measures on the behavior and conditions of the different counties and state.

Is Virtual Therapy Effective for Pediatric Eating Disorder Patients? An Exploratory Study

Objectives: As a result of the COVID-19 pandemic, in-person pediatric eating disorder treatment was moved to a virtual format. The study explored the early treatment response and effectiveness of family-based treatment (FBT) delivered virtually. Method(s): Twenty patients were included in the study;10 patients who received virtual treatment during the pandemic were compared to 10 patients who received in-person treatment prior to the pandemic. All patients completed an in-person interdisciplinary comprehensive assessment and received a DSM-5 eating disorder diagnosis. Patients were included in the study if they were 90% or lower than an estimated target weight (ETW) at treatment start and FBT was recommended. The study examined patient weight restoration at 1-, 3-, and 6-months posttreatment start. Independent sample t tests assessed group differences, and a Fisher's exact test was used to evaluate the association between treatment group and weight restoration. Result(s): Weight restoration did not significantly differ between treatment groups (virtual vs in-person) at any time point. Weight gain between the virtual (M = 1.99 kg;SD = 1.25) and in-person (M = 1.51 kg;SD = 0.86) groups was similar at 1 month (p =.48). The percentage of estimated target weight (%ETW) was also not significantly different between the groups at 3 and 6 months (p >.05). Further, there was no association between treatment group and remission weight at 6 months (p >.05) (70% of patients in each group reached at least 95% of an ETW). Conclusion(s): The COVID-19 pandemic emphasized an already recognized need for increased access to evidence-based pediatric eating disorder treatments. Results suggest that pediatric eating disorder patients may benefit from family therapy delivered via a virtual platform. Study results are considered exploratory. Future research should utilize a randomized controlled design, larger sample, the inclusion of an eating pathology measure, and longer follow-up. EA, TVM, FT Copyright © 2022

LICOR: Beyond the Design System. A Proposal to Empower Teams to Develop Software in Compliance with the Principles of Accessibility, Usability, and Privacy by Design in the Extreme Contexts and Challenging Domains Post-COVID-19

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.

ASSESSMENT OF FEAR AND STRESS BY THE ELDERLY IN THE NEW CORONAVIRUS PANDEMIC: A CROSS-SECTIONAL STUDY

Objective: to identify the main fears and level of stress regarding the New coronavirus pandemic in the aged. Method: cross-sectional, analytical study based on a non-probability sample by convenience composed of 25 elderly users of a public square in the municipality of Belém, Pará, Brazil, conducted from January to June 2021. The sociodemographic questionnaire, New coronavirus fear scale, and perceived stress scale were applied. The parametric t-test (p<0.05) was used. Results: the average age was 67.6 years, predominantly female (72%). It was evidenced that the elderly presented a moderate level of fear (p0.001) related to the fear of COVID-19 (t=0.26). Moderate level of perceived stress (p0.001) related to irritability caused by the out-of-control situation (t=0.00) prevailed. Conclusion: perceiving fear and stress in the elderly contributes to the development of actions by professionals to promote mental health in times of pandemic. © 2022, Universidade Federal do Parana. All rights reserved.

Colorectal Surgery During the First Wave of Covid-19 Pandemic: How the Coronavirus Affected Our Practice

Objective: The COVID-19 has quickly climbed to a global pandemic and hospitals had to adjust in order to manage the resources available. The aim of this article was to expose our experience and the means used to avoid delay in treating oncologic patients. Methods: Collection of data from all patient who underwent elective colorectal surgery for neoplasia during the state of emergency (between March 16th and May 16th 2020) and compared the surgical outcomes with the outcomes of the previous year. Results: A total of 28 patients received colorectal surgery from March 16th and May 16th 2020. Laparoscopy using the Air-Seal® was the most practiced approach (Pearson Chi-Square 0.014;p value 0.905). The complication rate was not statistically different from the previous year (Pearson Chi-Square 2.640;p value 0.104) as well as the rate of major complications (Pearson Chi-Square 0.754;p value 0.385). During the peak of infections, there was no increase in the number of days of hospitalization comparing to the previous year (p value 0.279). There was no delay in the oncologic surgical treatment (p value 0.010). Conclusion: We were able to demonstrate that it is possible to treat cancer patients during pandemic without compromising its possibility of cure. © 2022 Celsius Publishing House. All rights reserved.

Impact of covid-19 and the accumulation of games of the brazilian championship teams of serie A in 2021

The COVID-19 pandemic has hit everyone in the world in the last two years. All areas of life were affected, including football. Brazilian football, as it could not fail to be, had to be reformulated in a matter of months and the athletes were the hardest hit. We saw championships starting in one year and ending in another and requiring even more from football athletes. Characterized as quantitative analysis, based on the calendars provided by the State Football Federations, Brazilian Football Confederations and South American (CONMEBOL), the aim of this study was to analyze the impact of COVID-19 on the calendar and the accumulation of games to which the teams were submitted. When analyzing the numbers, we saw teams reaching more than 130 games in a row, with just over three and a half days of recovery between matches which, physiologically, is absurd. We conclude, then, that there was a huge demand on the athletes of Brazilian football. Teams seeking to improve their financial issues, being submitted to four, five championships in parallel, without bringing adequate rest to players and committees, who see their training plans being exchanged for a model without any preparation for athletes, disregarding what is studied in terms of excess load, detraining and recovery. Finally, this season, there would be the opportunity for a valuation of smaller teams in terms of winning titles, giving more visibility to players and more time for the main teams to prepare for the main competitions of the calendar.

Digital surveillance tools for contact tracking of infected persons by SARS-CoV-2

Background: In times of pandemic, case management and tracking people with contact can be differential elements for controlling the spread. The objective of this review was to evaluate the digital tools used to track contacts of people infected with SARS-CoV-2.

Impact of SARS-CoV-2 (COVID-19) on the mental health of healthcare professionals: a systematic review

Background: In times of this global pandemic situation, population's mental health is compromised, especially in those groups that are at the forefront of defense against the virus such as healthcare professionals. The objective of this study was to analyze the impact of the SARS-CoV-2 outbreak on healthcare professionals' mental health.

PERFIL DE EXCLUSÃO DE TRIAGEM NA DOAÇÃO DE SANGUE DOS POSTOS DE COLETA DA COLSAN DA CIDADE DE SÃO PAULO

Objetivos: Analisar quais os principais motivos de exclusão de triagem dos possíveis doadores de sangue. Material e métodos: Trata-se de um estudo observacional e retrospectivo, de abordagem quantitativa e qualitativa. As informações foram extraídas da base de dados da Associação Beneficente de Coleta de Sangue (COLSAN). Foram acessados e tabulados os dados da quantidade total de candidatos à doação de sangue, quantidade de candidatos aptos, quantidade de candidatos inaptos e motivo da inaptidão entre os anos de 2016 e 2020 das diversas unidades de coleta. Não houve a necessidade de procedimentos éticos em pesquisa, pois não envolveu diretamente seres humanos, tratando-se de estudo secundário. Resultados: Foram relatados 723.808 candidatos à doação de sangue no período de 2016 a 2020, sendo que 97.166 (12,74%) foram bloqueados durante a triagem. As principais causas para a inaptidão foram hematócrito/hemoglobina baixos (11,29%), uso de medicamentos contraindicados para a doação de sangue (10,88%), tatuagem/acupuntura/perfuração do lobo da orelha recente (10,27%), cirurgia recente (8,05%) e infecção/febre (7,38%). Discussão: Entre 2016 e 2020, 762.808 candidatos à doação de sangue foram entrevistados e triados, sendo o ano de 2019 com maior número de candidatos e 2020 com menor número de candidatos (já que a pandemia da Covid-19 afetou o fluxo de doação). As causas de exclusão se reptem durante os anos analisados, como hemoglobina baixa, uso de medicamentos contraindicados para doação, tatuagem/acupuntura ou perfuração de lobo da orelha recente, cirurgia recente, infecção ou febre no momento da triagem, relação sexual de risco e vacinação recente. Estas são as principais causas de exclusão durante os anos analisados totalizando aproximadamente 59% de todas as exclusões. A pesquisa da hemoglobina e do hematócrito se tornou requisito obrigatório para a doação de sangue desde a aprovação pela legislação do MERCOSUL. Comumente, o que impede a doação de sangue não é o uso do medicamento, mas a patologia associada à medicação do doador. O motivo pelo qual o terceiro é um impeditivo temporário para a doação de sangue é o uso de agulhas sem poder comprovar que as mesmas estavam assépticas, classificando o candidato em situação de risco para contaminação por vírus, devendo esperar um ano após o procedimento para doar. Cirurgia recente é um obstáculo para doação pelo tempo necessário do organismo do doador de completa recuperação. Já o candidato que apresentar febre, resfriado, dor de garganta ou qualquer indicativo de infecção na última semana está impedido de doar sangue até duas semanas após o término do tratamento por causa do risco de viremia e bacteremia que podem contaminar o hemocomponente a ser doado. A exclusão por atividade sexual de risco está relacionada ao risco de contração de infecções sexualmente transmissíveis. A vacinação recente é o critério de exclusão que deu um salto de incidência entre os anos de 2017, o que impede a doação são: interferências no resultado das sorologias por reação cruzada e a circulação do microorganismo da vacina que permanece no doador por um tempo, mesmo que atenuado. Conclusão: Os principais critérios de exclusão, portanto, são causas temporárias, relacionadas com o estado do doador.

Rethinking the away rotation

Learning Objectives: Through a virtual elective 1. Provide a remote virtual education opportunity for EM bound students during times of disruption 2. Demonstrate our academic mission, program strengths, and introduce a variety of faculty to prospective applicants 3.Recruit high-quality EM bound applicants : Background: Emergency Medicine (EM) applicants and residencies benefit from away rotations by giving applicants exposure to different program leadership, diverse clinical environments, and providing programs face-time with qualified interested applicants. COVID has suspended this practice. Through a virtual elective, we were able to convey our academic mission and cultivate an interest in our program for interview season. Educational Objectives: 1.Provide a remote virtual education opportunity for EM bound students during times of disrupted clinical exposure 2.Demonstrate our academic mission, program strengths, and introduce a variety of faculty to prospective applicants 3.Recruit high-quality EM bound applicants Curricular Design: We met the disruption with a virtual 1-week clerkship designed as an away elective for visiting students. The content was developed based on feedback from institutional education experts and a literature review of the implementation of a virtual classroom. Each day consisted of small group case-based didactics, virtual hands-on learning, digital hands-on simulation, and social interaction with program leadership. To encourage active participation and add variety to the virtual format, a “care-package” with materials to perform an at-home splinting lab was mailed to students. In addition, students were encouraged to forage for wound care and splinting materials in their own homes to improvise with during a wilderness medicine session. To foster a sense of community and simulate in-person interpersonal interactions we dedicated 3 hours to meet with the chief residents and Program Director. Impact: We accepted four students into the elective, all interested, and all applied for an interview. Despite the lack of contact in the clinical setting, this proved to be a worthwhile educational experience for the students and has the potential to be an alternative recruitment tool during an era where social distancing is imperative.