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Arterial dissection is an uncommon complication of reversible cerebral vasocon-striction syndrome (RCVS). We describe the case of a 35-year-old woman with a migraine history who presented with recurrent thunderclap headache and focal neurological signs, including right hemiataxia. She had been diagnosed with COVID-19 disease two weeks earlier. Neuroimaging revealed multifocal stenosis of the posterior circulation arteries and dissection of the right superior cerebellar artery. She improved significantly throughout her one-week hospitalization and maintained only mild ataxia. The interplay between COVID-19 disease, RCVS, and arterial dissection requires further investigation.Copyright © Author(s) (or their employer(s)) and Sinapse 2022.
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Objective: To analyze and compare COVID-19 patient characteristics, clinical management and outcomes between the peak and plateau periods of the first pandemic wave in Portugal. Methods: This was a multicentric ambispective cohort study including consecutive severe COVID-19 patients between March and August 2020 from 16 Portuguese intensive care units. The peak and plateau periods, respectively, weeks 10 - 16 and 17 - 34, were defined. Results: Five hundred forty-one adult patients with a median age of 65 [57 - 74] years, mostly male (71.2%), were included. There were no significant differences in median age (p = 0.3), Simplified Acute Physiology Score II (40 versus 39;p = 0.8), partial arterial oxygen pressure/fraction of inspired oxygen ratio (139 versus 136;p = 0.6), antibiotic therapy (57% versus 64%;p = 0.2) at admission, or 28-day mortality (24.4% versus 22.8%;p = 0.7) between the peak and plateau periods. During the peak period, patients had fewer comorbidities (1 [0 - 3] versus 2 [0 - 5];p = 0.002) and presented a higher use of vasopressors (47% versus 36%;p < 0.001) and invasive mechanical ventilation (58.1 versus 49.2%;p < 0.001) at admission, prone positioning (45% versus 36%;p = 0.04), and hydroxychloroquine (59% versus 10%;p < 0.001) and lopinavir/ ritonavir (41% versus 10%;p < 0.001) prescriptions. However, a greater use of high-flow nasal cannulas (5% versus 16%, p < 0.001) on admission, remdesivir (0.3% versus 15%;p < 0.001) and corticosteroid (29% versus 52%, p < 0.001) therapy, and a shorter ICU length of stay (12 days versus 8, p < 0.001) were observed during the plateau. Conclusion: There were significant changes in patient comorbidities, intensive care unit therapies and length of stay between the peak and plateau periods of the first COVID-19 wave. © 2023 Associacao de Medicina Intensiva Brasileira - AMIB. All rights reserved.
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Re-enactment events are widely recognized to play an important role in individual, regional, or even national attractions, raising a community's cultural heritage identity and boosting local tourism development. The aim of this paper is to share the importance of experiences based on Historical Reconstruction and Recreation and analyze the consequences of cancellation of this type of events. The paper consists of six blocks to present a literature review, definitions of event tourism, medieval tourism events and analyses of the effects of cancellation of historical re-enactments and events in Portugal and in the world. We have selected the most important medieval re-enactment that takes place in Santa Maria da Feira, widely recognized by attendees and visitors, as well as by locals as the most significant of its kind in Portugal. The data is organized in the results of the survey conducted between June and September 2020, on the perceptions of residents, participants, and visitors to understand the various impacts of the cancellation of Historic Re-enactments in Portugal. Data analysis points out an unequal potential of these events. Conclusions seek to make suggestions for post-COVID-19 tourism recovery and define some future paths. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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The aim of this paper is to share the future of historic re-enactments in Portugal, the case of Santa Maria da Feira on historical reconstruction and recreation, and analyze the consequences of cancelation of this types of events. Recently, there has been a great expansion in the re-enactment of history in Portugal, so it is well worth debating the phenomenon in order to be better acquainted with it and to disseminate the associated instruments. The renewal of the State of Emergency in Portugal, on April 2020 and 2021, forced the cancelation of the largest historical re-enactment in Europe, which takes place in Santa Maria da Feira. In the list of the exceptional and temporary measures adopted by the government, in the context of the combat of COVID-19, is included the non-holding of mass events. In thousands of localities, like Santa Maria da Feira, there has been a suspension of many business operations which directly or indirectly depend on the economy fueled by visitors, and it is by no means certain that they will all reopen. The consequences of global immobility induced by The COVID-19 crisis resulted in worldwide immobility, which rather all confused those involved in the promotion and research of tourism. Probably, this pandemic will create a psychological change and during the first year many tourists will prefer to travel to nearby destinations in their own country, or to countries where the pandemic has not been too intense (if there is such a country in a few months…). However, the tourism industry has recovered before from such periods of crisis, epidemics included, which shows how resilient it is and capable of mitigating abrupt shifts in demand or supply. One should create the conditions for small local businesses to adapt, through a flexible approach to the demands of the market. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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The cross-border network can be understood as a process of effective articulation and collaboration between researchers and university institutions in the three countries that form the triple border between Brazil, Colombia, and Peru. Its fundamental objective is to systematize information, research, monitor, and publicize results on the pandemic in a joint way, that is, to think of these localities and border municipalities of the three countries as a single cross-border region. This perspective of research and data analysis aims to break with the methodological nationalism so present in research in international border areas. This poses a number of challenges in systematizing joint information, as the institutions of each nation-state develop different methodologies and different time frames for the publication of official data, in addition to problems of underreporting in some cases. These difficulties became very present in the process of producing bulletins from covid 19 in the region, as evidenced here during the dialogue with the researchers.
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Introdução: A Trombocitopenia Imune (TI) pós vacina é um fenômeno já relatado com outros imunizantes já introduzidos no calendário vacinal. Com a atual pandemia da infecção pelo coronavírus (COVID-19) houve também uma corrida para desenvolvimento de agentes capazes de imunizar e dessa forma proteger a população da infecção. O mecanismo pelo qual ocorre a TI pós vacina é imunológico, com desenvolvimento de anticorpos contra plaquetas. O tempo médio para desenvolvimento da TI na infecção por COVID foi de 13 dias, na reação pós vacinal variou em uma série de casos de 1-23 dias. Nosso estudo vem relatar um quadro de TI após 9 dias da vacinação com AstraZeneca. Relato: Trata-se de paciente adulto, sexo masculino,53 anos, previamente hígido, intercorrendo 9 dias após vacinação, imunizante AstraZeneca, com petéquias em MMII, tronco e purpura úmida, o que o levou a procurar atendimento médico. Sendo internado no dia 04 de julho com plaquetopenia isolada. Exames: Hb:14,30 Htc:41,50 VCM:92 HCM:31,80 GB:14210 (Seg:11652—Linf:1421) Plaquetas: 3000. Investigadas infecções latentes que poderiam ser a etiologia do processo, contudo negativas. Iniciado corticoterapia em dose 1 mg/Kg/dia, sem resposta adequada. Prescrito Imunoglobulina venosa (IGV), no 4°dia de internação, na dose 1 g/kg/dia por 2 dias, sem resposta. Mantido prednisona 1 mg/kg/dia e repetido no 25°dia, a IGV, com resposta clínica. Durante o período o paciente foi investigado para fenômenos trombogênicos, associado a Trombocitopenia Trombótica induzida por Vacina (TTIV) não pontuando para síndrome (Fibrinogênio não consumido, VHS e PCR dentro do valor normal de referência, LDH normal, D-dímero: normal, anticorpo anti fator 4 plaquetário ainda pendente). Discussão: No caso da COVID-19 foi descrita TI com diversos mecanismos: destruição imunológica;destruição direta pela infecção, redução da produção da trombopoetina. O mecanismo pós vacina é imunomediada. A TTIV ocorre de 4 a 28 dias após a vacinação contudo haveria fenômeno trombótico associado, o que não ocorreu com nosso paciente. A demora a resposta terapêutica é similar a TI pós Covid-19.
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The SARS-CoV-2 virus spread rapidly, infecting over a hundred million people worldwide;thus, it has been called the COVID-19 pandemic, in which it is very important to wear a protective mask, wash hands properly, obey social distance rules, and use disinfectants to protect ourselves against infection. Therefore, the consumption of cleaning agents such as disinfectants, surface cleaners, and bleach has increased during the pandemic. Misuse of these substances such as drinking or gargling of cleaners and excessive use has led to many poisoning cases and even deaths. In addition, quarantine and stay-at-home orders during the pandemic caused people to could not socialize and feel dissociated. Moreover, due to the economic problems, many people became unemployed, which affected substance abuse and alcohol consumption frequency, thus poisoning cases as well. This article aimed to review how the COVID-19 was affected the disinfectant or cleaner-induced poisoning cases and the public health impacts between the drug or substance abuse due to pandemic. © 2022, Hacettepe University, Faculty of Pharmacy. All rights reserved.
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About seven months after the start of the COVID-19 pandemic, the first vaccine against the disease was approved for emergency use. Since then, twenty-three more vaccines have been approved, while more than three hundred are in development. Despite being one of the fastest vaccines ever created, several questions about it remain open. Computational models can be useful to answer some of these questions. This paper aims to evaluate whether a computer model previously used to reproduce the effects of the yellow fever vaccine in the body is also capable of reproducing the effects of a distinct vaccine: ChAdOx1 nCoV-19. Preliminary results show that the model is a promising tool to achieve this goal since it was able to reproduce the antibody curves observed in individuals vaccinated with ChAdOx1 nCoV-19. © 2021 IEEE.
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The first case of Corona Virus Disease (COVID-19) was registered in Wuhan, China, in November 2019. In March, the World Health Organization (WHO) declared COVID-19 as a global pandemic. The effects of this pandemic have been devastating worldwide, especially in Brazil, which occupies the third position in the absolute number of cases of COVID-19 and the second position in the absolute number of deaths by the virus. A big question that the population yearns to be answered is: When can life return to normal? To address this question, this work proposes an extension of a SIRD-based mathematical model that includes vaccination effects. The model takes into account different rates of daily vaccination and different values of vaccine effectiveness. The results show that although the discussion is very much around the effectiveness of the vaccine, the daily vaccination rate is the most important variable for mitigating the pandemic. Vaccination rates of 1M per day can potentially stop the progression of COVID-19 epidemics in Brazil in less than one year. © 2021, Springer Nature Switzerland AG.
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Access to drinking water is essential for life, and an adequate and constant distribution of water is necessary during the occurrence of contagious diseases and pandemic situations. Currently, COVID-19, caused by the SARS-COV-2 coronavirus, has spread throughout the world, and in Brazil, more than 5,300,000 cases and 157,000 deaths had been reported by 26th October 2020. Water is regarded as one of the most important resources in a pandemic, in order to provide the necessary sanitary conditions. Thus, the present study aims to analyse changes in hygiene behaviour in relation to the recommendations of the World Health Organisation and the impact on water consumption before and during the pandemic. The survey was conducted using a questionnaire, which was delivered online to 149 participants between June and July 2020. The results pointed to changes in hygiene behaviour, with a consequent effect on water consumption.
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This work aims to analyze the social vulnerability of students in the disciplines taught in distance education in the context of the COVID-19 pandemic. This is a theoretical study, reflective analysis on the various issues of social vulnerability, focusing on how students experience distance learning within the social isolation obligation context. The following points are based on literature review with discussion: Distance learning as a realistic response on the fight against social isolation and social vulnerability, on higher education students, while aiming to avoid losing any semester topics. As a result, it is important to highlight the student's requirements in terms of preparation with information and communication technologies and, especially, those in a situation of social vulnerability who do not have all the necessary resources to access contents taught in this teaching modality, at a distance. There must be a perception of diversity, accessibility and the principles of inclusion so that the demands of students in situations of social vulnerability can be met in an equitable way. © Proceedings of the 14th IADIS International Conference e-Learning 2020, EL 2020 - Part of the 14th Multi Conference on Computer Science and Information Systems, MCCSIS 2020. All rights reserved.
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The aim of this article is to present an online assessment system for tasks/papers and/or handwritten or digital exams. Initially teachers or students scan and load the work on the platform. The teachers then classify the work and distribute the results using the web-based platform. The system in question is optimized for three fundamental dimensions: speed, consistency and flexibility. The primary innovation that allows improvements in the three dimensions is a dynamic and efficient evolution for each question in the assessment. This system, which has been in existence for four years, used by professors from numerous institutions has led to an increase in the number of users confined due to the COVID-19 pandemic. Results are presented as data reported by users to the system as feedback on the time saved in carrying out the task of correcting/classifying. The use of this system also pleased the students, both in terms of carrying out assignments/evaluations, and in terms of disclosure of classifications. Teachers contacted in a system questionnaire indicated saving 30% or more compared to the traditional workflow. The authors also found the classification uniform to an individual response regardless of the number of teachers to be in charge of corrected. © 2020 Owner/Author.
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By November 2020, the Coronavirus disease 2019 (COVID-19) has infected more than 50 million people worldwide, causing more than 1.2 million deaths. This new contagious disease is not well understood, and the scientific community is trying to comprehend better the interactions of the causative agent of the disease, SAR2-CoV-2, and the immune response to identify its weak points to develop new therapies to impair its lethal effects. Mathematical and computational tools can help in this task: the multiscale interactions among the various components of the human immune system and the pathogen are very complex. In this work, we present a simple system of five ordinary differential equations that can be used to model the immune response to SARS-CoV-2. The model parameters and initial conditions were adjusted to cohort studies that collected viremia and antibody data. The results have shown that the model was able to reproduce both viremia and antibodies dynamics successfully. © 2020 IEEE.
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The Covid-19 pandemic and the worldwide lockdown have brought about profound changes to the way in which fieldwork is done. During a time particularly marked by social distancing, how do social scientists cope with the need to alter their methodologies with fields in transition? This essay reflects upon the changes caused by the pandemic, both in the field and in the methodologies adopted by the authors – all in different phases of their PhD research. Drawing from their research areas, it focuses on two main thematic axes, both deeply affected by the current situation: international mobilities (of commodities and people) and education (in Portugal and abroad). © 2020 by the author.
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In this study we present an overview of the dissemination of the new Coronavirus (SARS-Cov-2) in the municipalities of the Alto Solimoes micro-region in the state of Amazonas, Brazil. The data used comes from the Monitoring System of cases of COVID-19 infection in the municipalities of the State of Amazonas, and from the Monitoring System of cases of COVID-19 among indigenous peoples in Brazil, which are organized in the database and WebSig coordinated by researchers from the federal universities of Rio Grande do Sul and Amazonas, and the university of the State of Amazonas. We systematize and analyze information from municipal and state public agencies responsible for preventing and combating the pandemic, giving special attention to data on indigenous health, present in the bulletins of the Special Secretary of Indigenous Health, but, which are questioned by reports made by indigenous organizations. By comparing these data with the geographical, political and socio-economic characteristics of the Alto Solimoes micro-region, the numbers of new coronavirus infections and of deaths resulting from complications of the disease, we forecast a scenario of vulnerability and risk for the population, especially for the indigenous peoples. The ineffectiveness of public health policies in the context of the pandemic reveals a worsening of situations in which the services and actions of health professionals are deficient, which favours the spread of the virus in a cross-border context.
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Objective: the aim of this article is to discuss the implications of the connection between safety and bioethical issues for evidence-based care during the COVID-19 pandemic. Method: reflective analysis with the guiding question: “How can professional and patient safety be linked to bioethical issues during the COVID-19 pandemic?” Results: the COVID-19 pandemic has challenged countries around the world, mainly due to the collapse of the health system that could threaten the safety of patients and healthcare providers. Connecting worker safety to patient safety is imperative for safe care during the COVID-19 pandemic. Aspects related to professional qualification and the provision and proper use of personal protective equipment permeate an environment of economic and political crisis that accentuates tensions and can interfere in decision-making, greatly affecting the results of the care provided. This article presents reflections and recommendations to support healthcare providers in making decisions that involve bioethical issues during the care process in times of scarce resources generated by the COVID-19 pandemic. © 2021, Universidade Federal de Santa Catarina. All rights reserved.