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Infectious diseases are one of the most common conditions impacting global health, being a matter of concern for health agencies due to their contagious capacity and periodic outbreaks of new diseases, such as the global pandemic COVID-19. Viruses are among the main causes of this illness and it is defined as obligate intracellular parasites for their need to have a host cell to live and reproduce, since they won't produce proteins and compete for nutrients and metabolites leading to the alteration of the host metabolome. The diagnosis of these viral infections can be done by detecting viral particles or components, isolating the virus in cell culture, or even by evaluating immune responses. In this context, metabolomics comes as a very useful tool that reflects all "omics" techniques and best represents the phenotype. Since water-soluble metabolites and lipids are the major molecular constituents of human plasma, their abnormalities are commonly observed during disease, which contributes to the understanding of physiology and pathology. Nuclear magnetic resonance (NMR) spectroscopy and mass spectrometry (MS) are the most widely used techniques in metabolomics. NMR spectroscopy has emerged as a valuable application due to its ability to identify compounds with simple sample preparation, in addition, to being a non-destructive, highly reproducible, and quantitative technique (primary ratio method). These features make NMR a valuable tool that is frequently used in metabolomics analysis, and nowadays used in the diagnosis of viral diseases. Therefore, in this chapter, we will address a short integrative description of viral diseases and diagnostics, metabolomics, and NMR concepts. Furthermore, we will explore the advances in NMR-based metabolomics applied in medicine, and finally, the viral diseases discriminated by NMR-based metabolomics. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023. All rights reserved.
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Purpose: To identify the managerial accounting practices used in retail organizations in the Eastern Region of the city of Porto Alegre (RS). In a complementary way, the effect of the Covid-19 pandemic and the importance attributed to financial reports and management instruments and data analysis systems for decision making are investigated. Methodology: Descriptive research with a quantitative approach, by means of a survey through a questionnaire carried out with owners/partners, administrators and employees of retail organizations in the region object of the study, totaling a non-probabilistic and accessibility sample of 26 companies. The questionnaire contemplated the profile of the respondents;management data;importance and use of management instruments and financial reports;and open questions to collect additional information. Results: Companies are on average micro-companies, with centralized decisions, little use of managerial instruments and understand accounting as a support to the tax area. The least used management tools are the Balanced Scorecard and product life cycle, and some companies do not even use basic operational and financial controls, such as inventories, accounts payable and receivable, and strategic planning. Still, they attach greater importance to managerial instruments than they use them. Contributions of the Study: based on the perception of importance of financial reports and management tools, low level of training of managers, little knowledge and use of management practices, it is inferred that the greater the complexity of management tools, the less importance attributed by managers to them. This was reflected in the face of the pandemic, there were few managerial changes to ensure business performance.
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Introduction. Patients with chronic kidney disease (CKD) and COVID-19 are at high risk of adverse outcomes due to the presence of comorbidities. However, it is still unclear whether dialysis therapy is associated with a worse prognosis in patients infected with SARSCoV- 2. The objectives were to assess mortality and risk factors associated with a worse prognosis of these patients (e.g., age, sex, comorbidities, Intensive Care Admission [ICU] admission, and need for invasive mechanical ventilation [IMV]). Methods. An observational, descriptive, retrospective study was conducted in the private healthcare maintenance organization (Unimed-BH) of Belo Horizonte and 33 surrounding cities in Brazil. We used data collected from the organization's database. We included adult inpatients with CKD on previous dialysis therapy who tested positive for COVID-19, from February 2020 to June 2021. Results. During the period, 16182 patients were admitted to Unimed-BH with a diagnosis of COVID-19. Of these, 333 (2%) had dialysis CKD. Male patients were 180 (54%), age ranged from 22.85 to 95.75 years and the mean was 60.91 years. Of the 333 patients, 109 (32.7%) were admitted to the ICU, and 56 (16.8%) required IMV. Among the 14 comorbidities analysed, the mean number of comorbidities was 6, with 93 (27.9%) dyslipidaemia, 74 (22%) diabetic, 270 (81%) hypertensive, 25 (7.5%) asthmatic, 42 (12.6%) with chronic pulmonary disease (CPD) and 122 (36.6%) with congestive heart failure (CHF). There were 66 (19.8%) deaths, 29 (43.9%) were male, the mean age was 60.8 years, and 23 patients (34.8%) were elderly (>60 years). Among the patients who died, 55 (83.3%) were in the ICU and 46 (69.7%) on IMV. The mean number of comorbidities was 9.27 being 16 (24.2%) dyslipidaemia, 44 (66.6%) diabetic, 60 (90.9%) hypertensive, 5 (7%) asthmatic, 10 (15%) with CPD and 32 (48.5%) with CHF. Conclusions. Dialysis patients appear more susceptible to unfavourable outcomes than the general population. Our findings are similar to those reported in the world literature which is still scarce. It is important to conduct more studies on this population.
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Introduction. Life expectancy is increasing worldwide. However, during the COVID-19 pandemic, people 100 years or more (centenaries) were challenged by a potentially fatal disease. We evaluated the outcome of centenaries hospitalized due to COVID-19 in a private healthcare system of Belo Horizonte/Brazil (Unimed-BH). Methods. Administrative data were collected from the hospital database. Patients were included if they had a severe adult respiratory syndrome due to coronavirus type 2 (SARS-CoV-2) ribonucleic acid identified by quantitative real-time reverse transcriptase polymerase chain reaction (RT-qPCR) or by the International Code of Disease- 10th review (ICD-10) hospitalization codes U07.1, B34.2, or B97.2. Results. From March 1 2020 to October 31 2021, 316.4 & plusmn;12.9 centenaries/month were registered. Eighteen hospitalizations due to COVID-19 were identified. Median age was 101.8 years (interquartile range [IQR]:100.7,103.0). Most patients were female (83%). There was a median of 6.0 morbidities per patient (IQR:5.3,7.8), range 2-12 morbidities, among 71 possible morbidities. The most described morbidities were systemic arterial hypertension (94%), dementia (61%), and congestive heart failure (61%). Median length of hospitalization was 6.5 days (IQR:3.3,8.0). No patient was dialyzed. Seven (39%) patients died during hospitalization, of whom 3 (17%) were admitted to the Intensive Care Unit and 2 (11%) were oxygenated by invasive mechanical ventilation. No other patients were admitted to the Intensive Care Unit or invasively mechanically ventilated. Conclusions. Although the hospitalization rate was low, the mortality rate during hospitalization was high among centenaries. Further research is required to evaluate the actual risks of centenaries to be infected by SARS-CoV-2 and the subsequent outcomes.
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This chapter presents a virtual discussion about the quantitative revolution's legacy for past, present, and future by various authors. This virtual discussion was written during a time when actual in-person discussions were difficult due to COVID-19 and when the notion of an in-person meeting, such as the workshop, seemed impossible. Auantitative methods should be employed as much as possible so that the results can be measured and compared. Each day, conclusions based exclusively on field observations and analysis of examples become more contested due to the high degree of subjectivism and the impossibility of measuring the degree of generalization of the examples taken. A place-based narrative on the arrival of the quantitative revolution among Brazilian geographers reveals the crucial role of an international network of human and nonhuman actors responsible for disseminating new theories, methods, and techniques in geographical investigations. © 2022 selection and editorial matter, Ferenc Gyuris, Boris Michel and Katharina Paulus;individual chapters, the contributors.
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Given the large number of COVID-19 cases around the world, a practical solution to decrease and relieve the queue of patients in the hospitals and in the health care systems is welcome. Fast and reliable diagnosis based on technological tools can support medical professionals to manage this bottleneck situation, such as the diagnostic based on image techniques, which allows non-intrusive procedures. In this paper, we propose a practical methodology using deep learning to detect and classify lungs affected by COVID-19 using Chest X-ray radiography. RetinaNet architecture is considered here. This architecture is an one-stage object detection using focal loss often applied with dense, small and imbalance objects. We consider a dataset with 2500 images for model training and 1000 images to validate the model. Besides, a set of 1000 images from two different datasets are applied to test the pipeline approach. The obtained results show a specificity score of 0.54, precision of 0.68, recall of 0.994, and mAP of 0.913. The high recall score explains that a patient with COVID-19 will be classified correctly. © 2021 IEEE.
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Patients with multiple myeloma (MM) have an increased risk for severe infections due to both the disease and anti-myeloma therapies. During the COVID-19 pandemic, case series of MM patients have demonstrated a poor outcome in those who required hospitalization due to COVID-19, and there are few data regarding those managed out of hospitals or risk factors for hospitalization. In Brazil, where the scenario is of restricted resources to treat MM patients and large numbers of COVID-19 cases and related death, the outcome can be even worse. Objective: To assess risk factors and outcomes of COVID-19 in Brazilian patients with MM. This retrospective case series investigated 81 MM patients with documented COVID-19, managed in and out-hospital, from 8 states, representing 4 of 5 regions in Brazil. This study has been conducted by “Grupo Brasileiro de Mieloma” (GBRAM), and the present analyses included cases from April 2020 to July 2021. Clinical features and risk factors were analyzed with the severity of COVID-19 and outcomes (hospital admissions, intensive care unit (ICU) admission, ventilatory support, and death). The frequency of MM treatment modification due to COVID-19 was also accessed. There were 81 MM patients (male 50%;median age 63 years;and ISS III at diagnosis 25%) diagnosed with COVID-19. At least one comorbidity was present in 47 (58%) patients: most frequently hypertension and diabetes (56% and 27%). Twenty-eight (35%) patients had more than one comorbidity. At COVID episode, 21 (26%) patients had an active disease or progression disease, and 40% received at least two prior lines of treatment. COVID-19 management required hospitalization in 49 (61%), ventilatory support in 30 (40%) and ICU in 28 (35%). Hospitalization was associated with age (p=0.008), presence of comorbidity (p=0.02), hypertension (p=0.02), presence of fever (p=0.005) and low respiratory symptoms (p=0.003). Ventilatory support was more frequent in patients with cardiac disease (p=0.05), receiving immunomodulatory (p=0.03), or monoclonal drugs (p=0.006). Patients receiving corticosteroids (p=0.02), immunomodulatory (p=0.06), or monoclonal drugs (p=0.06) in MM treatment had a higher frequency of ICU admission. By adjusted multivariate analysis, age, the clinical presentation with fever and low respiratory symptoms (p<0.001, p=0.05 and p=0.001, respectively) were independent associated with hospitalization;low respiratory symptoms and MM therapy including monoclonal drugs (p=0.07 and p=0.02) were associated with ventilatory support;therapy with corticosteroids and immunomodulatory drugs (p=0.019 and p=0.05) were associated with ICU admission. Overall mortality was 29%. Mortality rates were 47%, 68%, and 77% in hospitalized, ventilatory support, and ICU patients, respectively. By univariate analysis, age, ECOG performance status, and MM therapy including corticosteroids, were associated with increased mortality. By multivariate model, only ECOG performance status remained as an independent risk factor for death. ISS, prior lines of therapy, prior stem cell transplantation, and disease status at COVID-19 were not associated with any analyzed outcomes. MM patients who recovered from COVID had the current MM treatment delayed in 61% of cases. In this series, COVID-19 MM patients had a very high frequency of hospitalization, ventilatory support requirement, ICU admission, and deaths due to COVID-19. Although not associated with increased mortality, prior therapy drug classes were associated with severity of manifestation in our series. We also observed a high frequency of MM treatment delay in recovered patients, and the post-COVID clinical impact should be more explored. The high mortality observed reinforces the importance of preventing COVID-19, such as social distancing, wearing masks, and vaccination. Disclosures: De Queiroz Crusoe: Janssen: Research Funding. Hungria: Takeda: Honoraria;Amgen, BMS, Celgene, Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Support for attending meetings/tr vel;Abbvie: Honoraria;Sanofi: Honoraria, Other: Support for attending meetings/travel.
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Currently, efforts have been made to develop studies that seek to ascertain the impact of the blockage implemented to combat the spread of the coronavirus (COVID-19) in various economy sectors such as services, commerce, industry, civil construction, transportation and agriculture. Regarding the transport sector specifically, the blocks implemented in several countries around the world, to contain the virus, resulted in a significant reduction in the number of trips between points of origin and destination, with only the essential ones advised. This reduction should also impact on congestion and the number of traffic incidents. Thus, this chapter seeks to test the hypothesis that isolation, due to COVID-19, resulted in a significant drop in the occurrence of traffic incidents, through the performance of statistical analyzes. In addition, this possible reduction is discussed as being an important strategy to achieve several Sustainable Development Goals (SDGs). We used traffic incidents data in the Rio de Janeiro city made available by Traffic Engineering Company of the city. The results obtained through various statistical methods indicate that although the accident profile has not undergone significant changes, there was a sharp drop in the number of calls for traffic incidents, which can positively impact nine SDGs and 23 targets of the 2030 Agenda. It is also worth mentioning that although the blocking state is not permanent, the findings found can be used to improve the potential for mitigating traffic incidents in the future and help in a future planning of incident management. © 2021, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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The control of constitutionality of laws is used by most countries in which democracy is the form of government. With some specificities, these countries reinforce the supremacy of the Constitution, by allowing, as a rule, the Judiciary to control acts emanating from the Executive and Legislative Powers that contradict it. In times of pandemic caused by the new coronavirus (COVID-19), however, this attribution of the Judiciary is now in vogue. Thus, this article aims to problematize about the importance of this institute and how to make it compatible with the atypical moment that we are living in face of the numerous restrictions of fundamental rights, especially in the collective labor law, due to the Provisional Measure 936/2020 edited by the Federal Government, modified and converted into law number 14.020/2020. The rule introduces individual negotiation in the Brazilian legal system to the detriment of collective bargaining to face the impacts on the economy caused by the pandemic. This collision of fundamental rights was the object of an ADI in the STF and the situation was resolved by applying the principle of proportionality.