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BackgroundSystemic lupus erythematosus (SLE) is an autoimmune disease, which presents an immune disorder that leads to the production of autoantibodies with potential involvement of multiple organs. Infections are one of the most frequent causes of hospitalization and death in lupus patients, and SARS-CoV-2 infection has been a global threat since March 2020. Immunization of these patients has been strongly recommended, although vaccine evaluation studies have not included this profile of patients.ObjectivesTo evaluate the immunogenicity and safety after 2 doses of the vaccine against SARS-CoV2 in patients with SLE.MethodsSubgroup of SLE patients from the prospective multicenter cohort of patients with immune-mediated diseases "SAFER” – Safety and Efficacy on COVID-19 Vaccine in Rheumatic Disease, a phase IV study. Vaccination against SARS-CoV-2 took place with vaccines approved by Brazilian regulatory bodies CoronaVac (Inactivated SARS-CoV-2 Vaccine), ChadOx-1 (AstraZeneca) and BNT162b2 (Pfizer-BioNTech) and this project followed in line with the guidelines of the National Immunization Plan in Brazil. Patients aged 18 years or older with a previous diagnosis of SLE (according to the 2019 ACR/EULAR criteria) were included. Patients were evaluated by telephone contact and in a face-to-face visit on the 28th day after each dose. Patients were followed up by means of blood collection for measurement of IgG antibody against SARS-COV-2 by chemiluminescence and disease activity assessed using SLEDAI-2K score.ResultsA total of 367 individuals with SLE were included, of whom 207 received 2 doses of CoronaVac, 128 received 2 doses of ChadOx-1 and 32 received 2 doses of BNT162b2. 90% of the subjects were female with a mean age of 37 years. About 42% (154) of the individuals included did not have any other associated comorbidity. 50% (182) of patients were using oral glucocorticoids and azathioprine was the most frequent immunosuppressive therapy. Regarding disease activity parameters, 38% (140) of patients had zero SLEDAI-2K at baseline and 41% (147) had zero SLEDAI-2K 28 days after the 2nd dose. Anti-DNA positivity was 30.7% (16/52) at inclusion and 32.6% (17/52) 28 days after the 2nd dose. Complement consumption was present in 18% (10/55) at inclusion and in 14.5% (8/55) 28 days after the 2nd vaccine dose. The geometric mean titers of IgG antibodies against SARS-COV-2 increased in the different vaccine groups, log 2.27 BAU/mL at inclusion and log 5.58 BAU/mL 28 days after the 2nd dose. Antibody titers after second dose varied between different vaccines, 4.96 BAU/mL CoronaVac, 6.00 BAU/mL ChadOx-1 and 7.31 BAU/mL BNT162b2 vaccine, p < 0.001. Only 3.54% (13/367) patients had covid-19 infection after the 15th day of the second dose of immunization, 9 of them having received 2 doses of CoronaVac, 4 of them of ChadOx-1 and none of them receiving BNT162b2, with p-value of 0.63.ConclusionThis study suggests that vaccines against SARS-COV-2 are safe in SLE patients. Induction of immunogenicity occurred in different vaccine regimens. Only 3.5% of individuals had COVID-19 infection with no difference between the types of vaccines evaluated. Future analyzes to explore the association of the effect of immunosuppressive medication, as well as the impact of booster doses and longer follow-up on clinical outcome will be performed.References[1]Mason A, et al. Lupus, vaccinations and COVID-19: What we know now. Lupus. 2021;30(10):1541-1552.[2]Furer V, Eviatar T, Zisman D, et al. Immunogenicity and safety of the BNT162b2 mRNA COVID-19 vaccine in adult patients with autoimmune inflammatory rheumatic diseases and in the general population: A multicentre study. Ann Rheum Dis. 2021;80(10):1330-1338.[3]Izmirly PM, Kim MY, Samanovic M, et al. Evaluation of Immune Response and Disease Status in SLE Patients Following SARS-CoV-2 Vaccination. Arthritis Rheumatol. Published online 2021.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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Background: Implantation of the double J stent is a common procedure in urology. The function of this device is to maintain the flow of urine from the ureteropelvic junction to the urinary bladder when the ureter is blocked or partially blocked for some reason. Once in place, the stent may cause low back pain, hematuria, symptoms of urinary irritation, a reduction in labor capacity, infection and calcification which are side effects that are easy to manage. However, severe complications can occur, such as the insertion of the stent into the circulatory system, such as the vena cava, which, although uncommon, is one of the most severe and difficult to manage. This work reports the case of a patient with the accidental insertion of a double J stent into the inferior vena cava.Case Description: An 80-year-old female patient with repeated urinary tract infections using a double J stent due to stenosis of the right distal ureter distal presenting retroperitoneal fibrosis secondary to previous radiotherapy. The patient had Lynch syndrome, ovarian and uterine cancer, colorectal cancer, and nephrolithiasis. She had been submitted to multiple previous surgeries. Due to the possibility of viral infection by COVID 19, chest computed tomography was performed, which suggested the insertion of the double J stent in the inferior vena cava, confirmed by abdominal computed tomography. As the distal end of the stent was within the bladder, the decision was made to remove the stent by cystoscopy, with the implantation of a new stent using fluoroscopic control for the confirmation of its trajectory. No intraoperative or postoperative complications occurred and the patient is currently in outpatient follow-up.Conclusions: Situations such as this require caution during the implantation of the drainage device, with the occurrence of resistance indicating the need to discontinue the procedure and perform a new assessment with imaging exams. No intraoperative or postoperative complications occurred and the patient is currently in outpatient follow-up.
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This book discusses the applications and optimization of emerging smart technologies in the field of healthcare. It further explains different modeling scenarios of the latest technologies in the healthcare system and compares the results to better understand the nature and progress of diseases in the human body, which would ultimately lead to early diagnosis and better treatment and cure of diseases with the help of distributed technology. Covers the implementation models using technologies such as artificial intelligence, machine learning, and deep learning with distributed systems for better diagnosis and treatment of diseases. Gives in-depth review of technological advancements like advanced sensing technologies such as plasmonic sensors, usage of RFIDs, and electronic diagnostic tools in the field of healthcare engineering. Discusses possibilities of augmented reality and virtual reality interventions for providing unique solutions in medical science, clinical research, psychology, and neurological disorders. Highlights the future challenges and risks involved in the application of smart technologies such as cloud computing, fog computing, IOT, and distributed computing in healthcare. Confers to utilize the AI and ML and associated aids in healthcare sectors in the post-Covid 19 period to revitalize the medical setup. Contributions included in the book will motivate technological developers and researchers to develop new algorithms and protocols in the healthcare field. It will serve as a vast platform for gaining knowledge regarding healthcare delivery, health- care management, healthcare in governance, and health monitoring approaches using distributed environments. It will serve as an ideal reference text for graduate students and researchers in diverse engineering fields including electrical, electronics and communication, computer, and biomedical fields. © 2023 selection and editorial matter, Preeti Nagrath, Jafar A. Alzubi, Bhawna Singla, Joel J. P. C. Rodrigues and A. K. Verma;individual chapters, the contributors.
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For the past years, the world has been facing one of the worst pandemics of modern times. The COVID-19 outbreak joined a long list of infectious diseases that turned pandemic, and it will most likely leave scars and change how we live, plan, and manage the urban space and its infrastructures. Many fields of science were called into action to mitigate the impacts of this pandemic, including spatial and transport planning. Given the large number of articles recently published in these research areas, it is time to carry out an overview of the knowledge produced, synthesising, systematising, and critically analysing it. This article aims to review how the urban layout, accessibility and mobility influence the spread of a virus in an urban environment and what solutions exist or have been proposed to create a more effective and less intrusive response to pandemics. This review is split into two avenues of research: spatial planning and transport planning, including the direct and indirect impact on the environment and sustainability. © 2023 ICE Publishing: All rights reserved.
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Objective: to investigate the relationship between procalcitonin in the differential diagnosis of bacterial coinfection in COVID-19 patients. Method: a cross-sectional retrospective study conducted between February and March 2021 in the Intensive Care Unit of a public hospital from southern Brazil by filling in a form. Descriptive statistical analyses were performed, as well as of association between variables. Results: of the 231 patients, 28.14% presented infection (63.20% in the lungs), 25% had bacteria isolated, 77.49% used antimicrobials and, in 14.72% of the cases, procalcitonin > 2 ng/mL. There was a significant association between antimicrobial use and infection (p=0.001), isolation of bacteria (p<0.001), topography of the infection (p<0.001) and procalcitonin values (p<0.001). Procalcitonin use showed an association with bacterial infection (p<0.001), isolation of bacteria (p<0.001), antimicrobial use (p=0.001) and death (p<0.001). Conclusion: procalcitonin can reduce empirical antimicrobial use and stimulate detection and identification of pathogens, taking into account the clinical and epidemiological data. © 2023, Universidade Federal do Parana. All rights reserved.
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Background: Advances in computational methodologies have enabled processing of large datasets originating from imaging studies. However, most imaging biomarkers suffer from a lack of direct links with underlying biology, as they are only observationally correlated with pathophysiology. Purpose(s): To develop and validate a novel AI-assisted image analysis platform, by applying quantitative radiotranscriptomics that quantifies cytokinedriven vascular inflammation from routine CT angiograms (CTA) performed as part of clinical care in COVID-19. Method(s): We used this platform to train the radiotranscriptomic signature C19-RS, derived from the perivascular space around the aorta and the internal mammary artery in routine chest CTAs, to best describe cytokinedriven vascular inflammation, defined using transcriptomic profiles from RNA sequencing data from human arterial biopsies (A). This signature was validated externally in 358 clinically indicated CT pulmonary angiograms from patients with or without COVID-19 from 3 different geographical regions. Result(s): First, 22 patients who had a CTA before the pandemic underwent repeat CTA <6 months post COVID-19 infection (B). Compared with 22 controls (matched for age, gender, and BMI) C19-RS was increased only in the COVID-19 group (C). Next, C19-RS was calculated in a cohort of 331 patients hospitalised during the pandemic, and was higher in COVID-19 positives (adjusted OR=2.97 [95% CI: 1.43-6.27], p=0.004, D). C19-RS had prognostic value for in-hospital mortality in COVID-19, with HR=3.31 ([95% CI: 1.49-7.33], p=0.003) and 2.58 ([95% CI: 1.10-6.05], p=0.028) in two testing cohorts respectively (E, F), adjusted for clinical factors and biochemical biomarkers of inflammation and myocardial injury. The corrected HR for in-hospital mortality was 8.24 [95% CI: 2.16-31.36], p=0.002 for those who received no treatment with dexamethasone, but only 2.27 [95% CI: 0.69-7.55], p=0.18 in those who received dexamethasone subsequently to the C19-RS based image analysis, suggesting that vascular inflammation may have been a therapeutic target of dexamethasone in COVID-19. Finally, C19-RS was strongly associated (r=0.61, p=0.0003) with a whole blood transcriptional module representing dysregulation of coagulation and platelet aggregation pathways. Conclusion(s): We present the first proof of concept study that combines transcriptomics with radiomics to provide a platform for the development of machine learning derived radiotranscriptomics analysis of routine clinical CT scans for the development of non-invasive imaging biomarkers. Application in COVID-19 produced C19-RS, a marker of cytokine-driven inflammation driving systemic activation of coagulation, that predicts inhospital mortality and identifies people who will have better response to anti-inflammatory treatments, allowing targeted therapy. This AI-assisted image analysis platform may have applications across a wide range of vascular diseases, from infections to autoimmune diseases.
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BACKGROUND: Inflammatory bowel disease (IBD) flares are common and unpredictable. Disease monitoring relies on symptom reporting or single timepoint assessments of stool, blood, imaging, or endoscopy-these are inconvenient and invasive and do not always reflect the patient perspective. Advances in wearable technology allow for passive, continuous and non-invasive assessment of physiological metrics including heart rate variability (HRV), the measure of small time differences between each heartbeat, a marker of autonomic nervous system function. Our group has previously demonstrated that changes in autonomic function precedes an IBD flare, can predict psychological state transitions and even identify inflammatory events including SARS-CoV-2 infection. To develop algorithms that can predict IBD flares using wearable device signatures, we launched a national wearable device study called The IBD Forecast study. To assess data quality and feasibility, the first 125 Apple Watch users to enroll were evaluated. METHOD(S): The IBD Forecast study is a prospective cohort study enrolling anyone >=18 years of age in the United States (US) with IBD who is willing to (1) use a commercially available wearable device, (2) download our custom eHive app and (3) answer daily survey questions. HRV metrics (mean of the standard deviations of all the NN intervals [SDNN]) were analyzed using a mixed-effect cosigner model that incorporated body mass index, age, and sex. SDNN is a time domain HRV index that reflects both sympathetic and parasympathetic nervous system activity and is calculated from the variance of intervals between adjacent QRS complexes (the normal-to-normal [NN] intervals). Clinical flare was assessed with daily Patient Reported Outcome (PRO)-2 surveys (flare;PRO-2 Crohn's disease >7, PRO-2 ulcerative colitis >2). Inflammatory flare was assessed via patient reported C-reactive protein (CRP), with inflammatory flare defined as >5 mg/L. RESULT(S): The first 125 study participants were enrolled across 29 states in the US (Table 1). Circadian features of changes of HRV were modelled (Figure 1). The mesor, or midline of the circadian pattern of the SDNN was higher in those with clinical flare (mean 44.43;95% CI 41.25-47.75) compared to those in clinical remission (mean 43.03;95% CI 39.94-46.22) (p<0.004). The mesor of the circadian pattern of the SDNN was lower in those with an inflammatory flare (mean 38.16;95% CI 30.86-45.72) compared to those with normal inflammatory markers (mean 49.51;95% CI 43.12-56.26) (p<0.001). CONCLUSION(S): Longitudinally collected HRV metrics from a commonly worn commercial wearable device can identify symptomatic and inflammatory flares. This preliminary analysis of a small proportion of the IBD Forecast Study cohort demonstrates the feasibility of using wearable devices to identify, and may potentially predict, IBD flares. [Formula presented] [Formula presented]Copyright © 2023
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Vaccination remains a main weapon against Coronavirus Disease 2019 (Covid-19). Although its efficacy is reduced in the immunocompromised population, we felt empirically that outcomes of Covid-19 in lung transplant recipients (LTRs) were better after widespread vaccination than in earlier phases of the pandemic. We aimed to compare outcomes of unvaccinated and vaccinated LTRs infected with SARS-CoV-2. All LTRs followed in our hospital were reviewed and those with a positive polymerase chain reaction test were included. We analysed disease severity (using World Health Organization criteria) and mortality rates in unvaccinated and fully vaccinated patients (pts). Twenty-four pts were included, two-thirds of which were male, with a mean age of 51 years. Main diagnoses were hypersensitivity pneumonitis (25%), chronic obstructive pulmonary disease (16,7%), idiopathic pulmonary fibrosis (12,5%) and cystic fibrosis (12,5%). Lung transplant was bilateral in 79,2% of pts, unilateral in 16,7% and lobar in one pt (4,1%). The most common immunosuppression regimen was tacrolimus, mycophenolate-mofetil and prednisolone. Thirteen pts were unvaccinated and 11 were vaccinated at time of infection, with a mean time since transplant of 746 and 1641 days, respectively. In the unvaccinated group 69,2% had mild disease, 30,8% had severe disease and mortality was 25%. No deaths occurred among fully vaccinated pts;disease was mild in 72,7%, moderate in 18,2% and severe in 9,1%. Neither the difference in severity (p=0,156) or mortality (p=0,089) reached statistical significance, presumably due to the small sample size. Nevertheless, we confirmed that, in our centre, vaccinated LTRs had better overall outcomes than unvaccinated pts.
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Introduction: Organizing pneumonia due to COVID-19 (OP) has been described more frequently. The burden and most adequate therapeutical strategy are yet to be determined. Objetive: descriptive analysis of patients diagnosed with OP in an intensive care unit (ICU). Method(s): We reviewed all admissions in a polyvalent ICU in 2021 and selected those with the diagnosis of OP (established after review of thoracic computed-tomography images by a thoracic radiologist). Statistical analysis was performed with IBM SPSS Statistics 25. Discussion/results: There were 117 admissions because of acute respiratory failure due to COVID-19 (male=77.8%). OP diagnosis was made in 39 patients (pts). Mean age at diagnosis was 49.6 years old. Obesity was present in 46.2% and high blood pressure in 30.8%. The mean length of stay in the ICU was of 31.9 days however it was 11,4 days in pts without OP. Mortality rate was 25.6%. OP diagnosis was made about 22.7 days after COVID-19 diagnosis. Extracorporeal-membrane-oxygenation was needed in 27 pts (6 pts died) with runs ranging from 2 to 87 days. Only 6 pts did not receive initial dexamethasone for unknown reasons. Pts with hemodynamic compromise and severe ARF would receive 1g of methylprednisolone followed by 1 mg/kg/day. It was given to 27 pts and only 2 of these died (p<0.05);8 of those who started methylprednisolone with no pulse (n=12) died. Six months after, 3 pts still needed supplementary oxygen. Every patient described subjective idea of irretrievable quality-of-life. Conclusion(s): Pulse of methylprenisolone seems to reduce mortality in severe OP. When OP is present length of stay increases significantly which inevitably has more impact in quality of life.
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BACKGROUND: Inflammatory bowel disease (IBD) flares are common and unpredictable. Disease monitoring relies on symptom reporting or single timepoint assessments of stool, blood, imaging, or endoscopy-these are inconvenient and invasive and do not always reflect the patient perspective. Advances in wearable technology allow for passive, continuous and non-invasive assessment of physiological metrics including heart rate variability (HRV), the measure of small time differences between each heartbeat, a marker of autonomic nervous system function. Our group has previously demonstrated that changes in autonomic function precedes an IBD flare, can predict psychological state transitions and even identify inflammatory events including SARS-CoV-2 infection. To develop algorithms that can predict IBD flares using wearable device signatures, we launched a national wearable device study called The IBD Forecast study. To assess data quality and feasibility, the first 125 Apple Watch users to enroll were evaluated. METHOD(S): The IBD Forecast study is a prospective cohort study enrolling anyone >=18 years of age in the United States (US) with IBD who is willing to (1) use a commercially available wearable device, (2) download our custom eHive app and (3) answer daily survey questions. HRV metrics (mean of the standard deviations of all the NN intervals [SDNN]) were analyzed using a mixed-effect cosigner model that incorporated body mass index, age, and sex. SDNN is a time domain HRV index that reflects both sympathetic and parasympathetic nervous system activity and is calculated from the variance of intervals between adjacent QRS complexes (the normal-to-normal [NN] intervals). Clinical flare was assessed with daily Patient Reported Outcome (PRO)-2 surveys (flare;PRO-2 Crohn's disease >7, PRO-2 ulcerative colitis >2). Inflammatory flare was assessed via patient reported C-reactive protein (CRP), with inflammatory flare defined as >5 mg/L. RESULT(S): The first 125 study participants were enrolled across 29 states in the US (Table 1). Circadian features of changes of HRV were modelled (Figure 1). The mesor, or midline of the circadian pattern of the SDNN was higher in those with clinical flare (mean 44.43;95% CI 41.25-47.75) compared to those in clinical remission (mean 43.03;95% CI 39.94-46.22) (p<0.004). The mesor of the circadian pattern of the SDNN was lower in those with an inflammatory flare (mean 38.16;95% CI 30.86-45.72) compared to those with normal inflammatory markers (mean 49.51;95% CI 43.12-56.26) (p<0.001). CONCLUSION(S): Longitudinally collected HRV metrics from a commonly worn commercial wearable device can identify symptomatic and inflammatory flares. This preliminary analysis of a small proportion of the IBD Forecast Study cohort demonstrates the feasibility of using wearable devices to identify, and may potentially predict, IBD flares. (Table Presented).
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Aim/Introduction: Neurological sequelae of Covid-19 have been widely documented by anatomic and functional methods [1,2]. Brain metabolism studies using 18F-FDG PET/CT during the subacute phase of the disease have also been published [1]. On the other hand, there is a lack of information about the influence of SARS-Cov2 infection on brain metabolism during the acute phase of the disease. The aim of this study was to identify and quantify changes in brain metabolism during the acute onset of Covid-19. Material(s) and Method(s): We studied 23 patients (13 women, median age 55.5[33-78] years) hospitalized with positive nasopharyngeal swab test (RT-PCR) for Covid-19 and requiring supplemental oxygen. Dedicated PET/CT images of the brain were acquired for 10 minutes, 1h after injection of 4.4 MBq/kg of 18F-FDG. Visual analysis was performed by two nuclear medicine specialists and one radiologist. Quantitative analysis was performed using dedicated software. 18F-FDG uptake in multiple brain regions was evaluated and the standard deviation (SD) of brain uptake in each region was automatically calculated in comparison with a group of normal subjects. More than 2 SD above or below the control group was considered significant in each area. Result(s): Serum C-reactive protein at admission ranged from 6.43 to 189.0 mg/L (mean 97.0 +/- 55.5 mg/L). The mean supplemental oxygen demand was 2.8 +/- 1.5 L/min. PET/CT images were acquired between 4 and 20 days of symptoms (mean 12.9 +/- 3.8 days). The images showed increased glycolytic metabolism in basal ganglia and relatively reduced brain metabolism in cortical regions. Basal ganglia metabolism was bilaterally increased in 18/23 (78.3%) and normal in 5 (21.7%) patients. Lenticular nucleus presented increased metabolism in 21/23 (91.3%) and was normal in 2 (8.7%) patients. Frontal and parietal lobes metabolism was respectively reduced in 9/24 (37.6%) and 8/23 (34.8%) patients. The whole brain metabolism was normal in 20/23 (86.9%) patients. Olfactory cortex metabolism was normal in 18/23 (78.3%) patients. Conclusion(s): Brain metabolism is clearly affected during the acute phase of SARS-Cov2 infection. The most frequent finding was increased basal ganglia metabolism, with most patients presenting marked lenticular nucleus hypermetabolism. Frontal and parietal lobes presented reduced metabolism in some patients. Interestingly, olfactory cortex is not affected in most patients, suggesting that anosmia, reported by some patients, is not related to the direct involvement of the brain by the disease.
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MOOCs can be used to provide specialized and continuing medical education in times of Covid-19. The procedure to evaluate the satisfaction of this MOOC aimed at primary care health professionals for the detection and management of suicidal risk had descriptive statistics, Cronbach's Alpha, and CHAID analysis (Chi-square Automatic Interaction Detector) to find the factor that most influenced the satisfaction of this course. This evaluation was complemented with thematic analysis. CHAID analysis of this MOOC course, the satisfaction of 53% Excellent was explained by the Course Content Assessment with a value of P <.001. The results of the thematic analysis were that 75% of the learning obtained corresponds to the general objective of the course. 53% of the most relevant topics of this MOOC were considered useful and of interest to their profession. Health professionals liked the final interview and the practical cases, they requested more real cases to better manage the risk of suicide. The achievement of the objective of this MOOC helps to contribute to the prevention of suicide. We can learn that this type of course is feasible at a technological level and that it requires a great commitment or interest from health professionals to carry it out satisfactorily in times of Covid-19. © 2022 IEEE.
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This article offers an anthropological and ethnographic perspective on how the COVID-19 pandemic affected and shaped rural community social behaviour in Kayo village during Japan's first official state of emergency, April 7th to May 6th, 2020. It draws from observations and informal conversations with villagers during this period. First, it discusses the researcher's experience of living in a rural village in northern Okinawa during the state of emergency and addresses the position of the ethnographer during the pandemic. It explores the Japanese concept of uchi/soto (inside/outside), to discuss the insider/outsider dynamics that characteriseeveryday social life in Okinawa. Secondly, it engages with Marshall Sahlins's (2013) idea of kinship as 'social mutuality' to consider how the pandemic invites us to rethink interpersonal relationships, space negotiation, and social boundaries, and how the latter are reconstructed and negotiated according to the new situation (emergency state). The example of Okinawa rural communities shows how rural populations can reconceptualise their environment and practices during the pandemic. It allows us to understand how notions of space, accessibility and kinship are reshaped into subtle boundaries between locals and outsiders in order toregulate access.
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This article offers an anthropological and ethnographic perspective on how the COVID-19 pandemic affected and shaped rural community social behaviour in Kayo village during Japan's first official state of emergency, April 7th to May 6th, 2020. It draws from observations and informal conversations with villagers during this period. First, it discusses the researcher's experience of living in a rural village in northern Okinawa during the state of emergency and addresses the position of the ethnographer during the pandemic. It explores the Japanese concept of uchi/soto (inside/outside), to discuss the insider/outsider dynamics that character-ise everyday social life in Okinawa. Secondly, it engages with Marshall Sahlins' (2013) idea of kinship as 'social mutuality' to consider how the pandemic invites us to rethink interpersonal relationships, space negotiation, and social boundaries, and how the latter are reconstructed and negotiated according to the new situation (emergency state). The example of Okinawa rural communities shows how rural populations can reconceptualise their environment and practices during the pandemic. It allows us to understand how notions of space, accessibility and kinship are reshaped into subtle boundaries between locals and outsiders in order to regulate access. © 2022 Jamila Rodrigues.
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Oxygen therapy is one of the critical treatments employed in epidemics, pandemics, and natural calamities. Recent covid pandemic worldwide witnessed many deaths due to improper management, delayed delivery, and wastage of medical oxygen. Therefore, efficient utilization of available oxygen is very important. To monitor and manage oxygen, several hospitals employ IoT-based systems. Scalability is an essential feature in such monitoring systems in order to cater to the needs of a sudden surge in the number of patients requiring oxygen. The most commonly employed technique to monitor and manage an oxygen cylinder uses a pressure sensor where scaling up is an issue. Therefore, in this paper, a scalable solution that efficiently measures and monitors the available oxygen in the cylinder is proposed. The approach measures oxygen level using a weight sensor module and raises alerts during critical conditions such as low oxygen level and blockage or leakage of oxygen. The proposed system is a cost-effective, plug-and-play system that aids rapid deployment thereby providing timely care to the patients. Also, it does not require any change in the existing infrastructure making it suitable for a resource-constrained environment. The proposed system supports a web-based dashboard and mobile app that can be remotely accessed. © 2022 IEEE.
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Introduction: Since the first outbreak, the Covid-19 pandemic has had and still has several implications worldwide, particularly in severe mentally ill patients, leading to multiple challenges in their management. Objective(s): We aim to assess the impact and implications of the Covid-19 pandemic on patients with Schizophrenia Spectrum Disorders (SSD) and the treatment recommendations available. Method(s): We conduct an integrative review using PubMed database. Search terms included: "psychosis" AND "COVID-19 pandemic", "schizophrenia and COVID-19", "severe mental illness" AND "COVID-19". The search period was between 1st January 2020 and 31th July 2021. Result(s): Studies postulated that people with SSD are at a higher risk of COVID-19 infection with a poorer medical and social outcome which is attributed to factors such as higher rates of disadvantageous lifestyle behaviours, medical comorbidities, antipsychotic medication metabolic effects, psychosocial adversities, smaller social networks and poor engagement with general health services. The Covid-19 pandemic also demanded adjustments in treatment guidelines and monitoring, particularly in patients with SSD on Clozapine. Many studies address the importance of psychiatric care and treatment during the pandemic. They emphasize rapid implementation of measures to decrease the risk of COVID-19 transmission and maintain continuity care and research. An individualized and flexible approach is needed to promote safety of SSD patients. Conclusion(s): Particular attention is required by clinicians to help SSD patients face the current pandemic situation. Future epidemiological studies are needed in order to better understand the impact of theCOVID-19 pandemic in this population and provide proper care.
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The present study is an integrative review, which aimed to understand the damage to the mental health of the elderly population caused by the COVID-19 pandemic. Scientific evidence on the psychological impacts of the SARS-CoV-2 pandemic on the world's elderly population was based on one of the methods of disease prevention, through social isolation, where the elderly population became more vulnerable to loneliness, feeling of abandonment, fear of death and loss, among others. Among the most important impacts found are anxiety, depression, stress, behavioral changes, early grief, and untreated chronic pain, reaching the extreme that is suicide. The relevance of this work is due to the importance of knowing and studying the mental health of the elderly during the COVID-19 pandemic, in order to help in the psychological treatment of patients in need. The integrative review technique was performed, which is a study that aims to gather other similar studies, evaluate them and gather them in analysis in order to create a new content. For the search for information, file bases such as Scientific Electronic Libraby Online (SciELO), the Portal of Electronic Journals of Psychology (PePSIC), MEDLINE, PubMed, Google Scholar were used.
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This article portrays the different temporal phases (past, present and future) in the real estate sector, focusing its purpose on digital marketing as one of the main and most important tools in the lives of professionals in the sector. This type of marketing, combined with the impact of the COVID-19 pandemic, has been influencing the demand and supply of properties in the current market.
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Background: COVID-19 pandemic brought pressure to Portuguese National Health Service (NHS). We aim to assess pandemic impact on diagnosis and management of breast cancer (BC) in a high-volume Portuguese comprehensive cancer centre, which was classified as a COVID-free institution by public health authorities.