Dry-spun carbon nanotube ultrafiltration membranes tailored by anti-viral metal oxide coatings for human coronavirus 229E capture in water.

Although waterborne virus removal may be achieved using separation membrane technologies, such technologies remain largely inefficient at generating virus-free effluents due to the lack of anti-viral reactivity of conventional membrane materials required to deactivating viruses. Here, a stepwise approach towards simultaneous filtration and disinfection of Human Coronavirus 229E (HCoV-229E) in water effluents, is proposed by engineering dry-spun ultrafiltration carbon nanotube (CNT) membranes, coated with anti-viral SnO2 thin films via atomic layer deposition. The thickness and pore size of the engineered CNT membranes were fine-tuned by varying spinnable CNT sheets and their relative orientations on carbon nanofibre (CNF) porous supports to reach thicknesses less than 1 µm and pore size around 28 nm. The nanoscale SnO2 coatings were found to further reduce the pore size down to ∼21 nm and provide more functional groups on the membrane surface to capture the viruses via size exclusion and electrostatic attractions. The synthesized CNT and SnO2 coated CNT membranes were shown to attain a viral removal efficiency above 6.7 log10 against HCoV-229E virus with fast water permeance up to ∼4 × 103 and 3.5 × 103 L.m-2.h-1.bar-1, respectively. Such high performance was achieved by increasing the dry-spun CNT sheets up to 60 layers, orienting successive 30 CNT layers at 45°, and coating 40 nm SnO2 on the synthesized membranes. The current study provides an efficient scalable fabrication scheme to engineer flexible ultrafiltration CNT-based membranes for cost-effective filtration and inactivation of waterborne viruses to outperform the state-of-the-art ultrafiltration membranes.

Feasibility and Acceptability of a US National Telemedicine Curriculum for Medical Students and Residents: Multi-institutional Cross-sectional Study.

BACKGROUND: Telemedicine use increased as a response to health care delivery changes necessitated by the COVID-19 pandemic. However, lack of standardized curricular content creates gaps and inconsistencies in effectively integrating telemedicine training at both the undergraduate medical education and graduate medical education levels. OBJECTIVE: This study evaluated the feasibility and acceptability of a web-based national telemedicine curriculum developed by the Society of Teachers of Family Medicine for medical students and family medicine (FM) residents. Based on the Association of American Medical Colleges telehealth competencies, the asynchronous curriculum featured 5 self-paced modules; covered topics include evidence-based telehealth uses, best practices in communication and remote physical examinations, technology requirements and documentation, access and equity in telehealth delivery, and the promise and potential perils of emerging technologies. METHODS: A total of 17 medical schools and 17 FM residency programs implemented the curriculum between September 1 and December 31, 2021. Participating sites represented 25 states in all 4 US census regions with balanced urban, suburban, and rural settings. A total of 1203 learners, including 844 (70%) medical students and 359 (30%) FM residents, participated. Outcomes were measured through self-reported 5-point Likert scale responses. RESULTS: A total of 92% (1101/1203) of learners completed the entire curriculum. Across the modules, 78% (SD 3%) of participants agreed or strongly agreed that they gained new knowledge, skills, or attitudes that will help them in their training or career; 87% (SD 4%) reported that the information presented was at the right level for them; 80% (SD 2%) reported that the structure of the modules was effective; and 78% (SD 3%) agreed or strongly agreed that they were satisfied. Overall experience using the national telemedicine curriculum did not differ significantly between medical students and FM residents on binary analysis. No consistent statistically significant relationships were found between participants' responses and their institution's geographic region, setting, or previous experience with a telemedicine curriculum. CONCLUSIONS: Both undergraduate medical education and graduate medical education learners, represented by diverse geographic regions and institutions, indicated that the curriculum was broadly acceptable and effective.

Difference in mortality rates in hospitalized COVID-19 patients identified by cytokine profile clustering using a machine learning approach: An outcome prediction alternative.

COVID-19 is a disease caused by the novel Coronavirus SARS-CoV-2 causing an acute respiratory disease that can eventually lead to severe acute respiratory syndrome (SARS). An exacerbated inflammatory response is characteristic of SARS-CoV-2 infection, which leads to a cytokine release syndrome also known as cytokine storm associated with the severity of the disease. Considering the importance of this event in the immunopathology of COVID-19, this study analyses cytokine levels of hospitalized patients to identify cytokine profiles associated with severity and mortality. Using a machine learning approach, 3 clusters of COVID-19 hospitalized patients were created based on their cytokine profile. Significant differences in the mortality rate were found among the clusters, associated to different CXCL10/IL-38 ratio. The balance of a CXCL10 induced inflammation with an appropriate immune regulation mediated by the anti-inflammatory cytokine IL-38 appears to generate the adequate immune context to overrule SARS-CoV-2 infection without creating a harmful inflammatory reaction. This study supports the concept that analyzing a single cytokine is insufficient to determine the outcome of a complex disease such as COVID-19, and different strategies incorporating bioinformatic analyses considering a broader immune profile represent a more robust alternative to predict the outcome of hospitalized patients with SARS-CoV-2 infection.

ACCIONES COLECTIVAS Y CONFLICTOS SOCIALES ALREDEDOR DE LOS TERRITORIOS Y BIENES COMUNES EN LA RURALIDAD COSTARRICENSE EN TIEMPOS DE PANDEMIA

Este artículo brinda una mirada sobre los conflictos sociales que se han mantenido en Costa Rica durante la pandemia producida por la Covid-19 (enero de 2020 y diciembre de 2021). Para esto se consideraron las acciones colectivas registradas y las experiencias del "Observatorio Comunitario de Acciones Colectivas", con lo que se logró identificar cuatro ejes de conflicto en este período: a) la demanda de derechos y defensa de los territorios indígenas, b) comunidades en defensa del agua y el ambiente, c) proyectos de ley que amenazan los bienes comunes, d) conflictos laborales y contaminación en la producción de monocultivos.Alternate :This paper provides a look at the social conflicts that have taken place in Costa Rica during the Covid-19 pandemic (January 2020 and December 2021). This study comes from the registered collective actions and the experiences of the "Community Observatory of Collective Actions." Based on this data, four axes of conflict were identified during this period: a) The demand for rights and defense of indigenous territories, b) Communities in defense of water and the environment, c) Draft laws that threaten common goods, d) Labor conflicts and pollution in the production of monocultives.

Difference in mortality rates in hospitalized COVID-19 patients identified by cytokine profile clustering using a machine learning approach: An outcome prediction alternative

COVID-19 is a disease caused by the novel Coronavirus SARS-CoV-2 causing an acute respiratory disease that can eventually lead to severe acute respiratory syndrome (SARS). An exacerbated inflammatory response is characteristic of SARS-CoV-2 infection, which leads to a cytokine release syndrome also known as cytokine storm associated with the severity of the disease. Considering the importance of this event in the immunopathology of COVID-19, this study analyses cytokine levels of hospitalized patients to identify cytokine profiles associated with severity and mortality. Using a machine learning approach, 3 clusters of COVID-19 hospitalized patients were created based on their cytokine profile. Significant differences in the mortality rate were found among the clusters, associated to different CXCL10/IL-38 ratio. The balance of a CXCL10 induced inflammation with an appropriate immune regulation mediated by the anti-inflammatory cytokine IL-38 appears to generate the adequate immune context to overrule SARS-CoV-2 infection without creating a harmful inflammatory reaction. This study supports the concept that analyzing a single cytokine is insufficient to determine the outcome of a complex disease such as COVID-19, and different strategies incorporating bioinformatic analyses considering a broader immune profile represent a more robust alternative to predict the outcome of hospitalized patients with SARS-CoV-2 infection.

Financial assessment of the community-based dental education program at the Indiana University School of Dentistry.

BACKGROUND: There is a gap in access to oral health services for millions of Americans residing in health professional shortage areas. The community-based dental education program at the Indiana University School of Dentistry is an innovative model that aims to improve access to oral health services in rural underserved Indiana. OBJECTIVE: With this study, our goal was to assess the financial implications of the program over a period of 3 years (2018-2021). METHODS: Proxy estimates for the revenue generated by students at the community clinic sites were calculated and compared against the implementation costs of the program as well as revenue lost by the school during the rotation period. Descriptive statistics were used to assess the quantitative impact of the program over the 3 years. RESULTS: The total of 7460 patients who were offered care as part of this program were mostly from the uninsured group or were covered under Medicaid. According to our cost-benefit analysis which was conducted during the peak of the coronavirus disease 2019 (COVID-19) pandemic, the total revenue of $1,777,097 was generated by students at the community sites through the 3-year period. The revenue generated was still more than the dollar amount invested in running the program, given the timeline of the study was when elective services were mostly suspended. CONCLUDE: We conclude community programs like these have an impact beyond the dollar value; they can be modeled to be cost-effective, improve access to oral health services for millions of Americans in underserved settings and at the same time provide a great learning experience for dental students.

Hybrid polymer/ionic liquid electrospun membranes with tunable surface charge for virus capture in aqueous environments

Although electrospun-based membranes may be engineered as efficient platforms for the capture of biomolecules in aqueous environments, the capability of such membranes to selectively capture viruses and proteins is often limited due to poor and constrained surface affinity for molecular bonding. In order to generate more efficient electrospun-based membranes, fine-tuning Van der Waals and ionic interactions is required to control chemical affinities with such contaminants and support advanced remediation solutions. Here, diallydimethylammonium chloride and poly(acrylonitrile) electrospun nanofibres were developed to enhance the adsorption of specific contaminant molecules compared to equivalently shaped pristine poly(acrylonitrile) nanofibre membranes. The results showed that the incorporation of the ionic liquid improved contact with water by forming super-hydrophilic nanofibres with narrow diameters and smaller pore size distributions, while also significantly changing the surface charge of the material and shifting the isoelectric point of the surface from 3 to 4.4. The specific surface area of the membranes was also increased by up to 4 times upon ionic liquid loading, which was found to support efficient coronavirus capture and filtration efficiency. This new strategy represents a promising way to control surface properties of virus filtration membranes towards efficient and targeted remediation solutions.

Priming With Rhinovirus Protects Mice Against a Lethal Pulmonary Coronavirus Infection.

Rhinoviruses (RV) have been shown to inhibit subsequent infection by heterologous respiratory viruses, including influenza viruses and severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). To better understand the mechanisms whereby RV protects against pulmonary coronavirus infection, we used a native murine virus, mouse hepatitis virus strain 1 (MHV-1), that causes severe disease in the lungs of infected mice. We found that priming of the respiratory tract with RV completely prevented mortality and reduced morbidity of a lethal MHV-1 infection. Replication of MHV-1 was reduced in RV-primed mouse lungs although expression of antiviral type I interferon, IFN-ß, was more robust in mice infected with MHV-1 alone. We further showed that signaling through the type I interferon receptor was required for survival of mice given a non-lethal dose of MHV-1. RV-primed mice had reduced pulmonary inflammation and hemorrhage and influx of leukocytes, especially neutrophils, in the airways upon MHV-1 infection. Although MHV-1 replication was reduced in RV-primed mice, RV did not inhibit MHV-1 replication in coinfected lung epithelial cells in vitro. In summary, RV-mediated priming in the respiratory tract reduces viral replication, inflammation, and tissue damage, and prevents mortality of a pulmonary coronavirus infection in mice. These results contribute to our understanding of how distinct respiratory viruses interact with the host to affect disease pathogenesis, which is a critical step in understanding how respiratory viral coinfections impact human health.

Metodología para la priorización de la entrega de ayudas humanitarias en el contexto de la pandemia covid-19, utilizando la herramienta QFD Fuzzy

El impacto de la disrupción causada por el covid-19 ha generado en los gobiernos locales múltiples retos relacionados con la toma de decisiones, tales como la priorización de familias afectadas de acuerdo con su nivel de vulnerabilidad, para garantizar una asignación equitativa de ayudas humanitarias. Este artículo propone un marco metodológico basado en el método de despliegue de función de calidad difuso (QFD Fuzzy) para priorizar familias afectadas por el covid-19, considerando variables como cobertura de poblaciones afectadas, tiempos de privación, eficiencia en costos y seguridad en la entrega. La metodología propuesta es probada utilizando datos sintéticos obtenidos de una muestra de 1000 familias, con el propósito de establecer el orden de atención de la población en una ciudad del centro del Valle del Cauca. Este documento establece una estrategia que ofrece a un gobierno mayor efectividad en la toma de decisiones para atender una emergencia sanitaria como la del covid-19, que apoya la intención humanitaria envuelta en esta gestión. Es necesario insistir, en todo caso, que no se trata de una metodología que pueda ser estática, por lo que se deben considerar de manera pertinente las variables que puedan surgir como indicadores de vulnerabilidad. Esto se presenta como una investigación futura complementaria.Alternate :The impact of the disruption caused by Covid-19 has generated in local governments, multiple challenges related to decision-making, such as prioritizing affected families according to their level of vulnerability to guarantee an equitable allocation of humanitarian aid. This article proposes a methodological framework based on the fuzzy quality function deployment method (QFD Fuzzy) to prioritize families affected by Covid-19 considering variables such as coverage of affected populations, deprivation times, cost efficiency and delivery security. The proposed methodology is tested using synthetic data obtained from a sample of 1000 families in order to establish the order of care of the population in a city in the Center of Valle del Cauca. This document establishes a strategy that offers a government greater effectiveness in making decisions to attend a health emergency such as COVID-19, which supports the humanitarian intention involved in this management. In any case, it is necessary to insist that it is not a methodology that can be static, for which it is necessary to force it to read in a pertinent way the new variables that may arise as indicators of vulnerability. This is presented as supplementary future research.Alternate :O impacto da interrupção causada pela Covid-19 gerou vários desafios relacionados à tomada de decisões nos governos locais, como priorizar as famílias afetadas de acordo com seu nível de vulnerabilidade, para garantir uma alocação equitativa da ajuda humanitária. Esse artículo propõe um marco metodológico baseado no método de desdobramento de função de qualidade difusa (QFD Fuzzy) para priorizar famílias afetadas pela Covid-19, considerando variáveis como cobertura de populações afetadas, tempos de privação, eficiência em custos e segurança na entrega. A metodologia proposta é testada a partir de dados sintéticos obtidos de uma amostra de 1000 famílias, a fim de estabelecer a ordem de atendimento à população de um município do centro do Vale do Cauca. Este documento estabelece uma estratégia que oferece a um governo maior eficácia na tomada de decisões para atender uma emergência de saúde como a Covid-19, que apoia a intenção humanitária envolvida nesta gestão. É necessário insistir, em qualquer caso, que não se trata de uma metodologia que possa ser estática, motivo pelo qual as variáveis que podem surgir como indicadores de vulnerabilidade devem ser consideradas de forma pertinente. Isso é apresentado como pesquisa complementar futura.

COVID-19 Vaccinations: Summary Guidance for Cancer Patients in 28 Languages: Breaking Barriers to Cancer Patient Information.

BACKGROUND: Covid-19 vaccination has started in the majority of the countries at the global level. Cancer patients are at high risk for infection, serious illness, and death from COVID-19 and need vaccination guidance and support. Guidance availability in the English language only is a major limit for recommendations' delivery and their application in the world's population and generates information inequalities across the different populations. METHODS: Most of the available COVID-19 vaccination guidance for cancer patients was screened and scrutinized by the European Cancer Patients Coalition (ECPC) and an international oncology panel of 52 physicians from 33 countries. RESULTS: A summary guidance was developed and provided in 28 languages in order to reach more than 70 percent of the global population. CONCLUSION: Language barrier and e-guidance availability in the native language are the most important barriers when communicating with patients. E-guidance availability in various native languages should be considered a major priority by international medical and health organizations that are communicating with patients at the global level.

Community-based Avitourism as a tool for Environmental Appropriation

Colombia is the country with the largest number of birds in the world, with approximately 1909 species, it also has 83 endemic species. However, the accelerated transformation of natural vegetation cover in Bogotá has affected native biodiversity in some cases irreversibly, originating development of agricultural and industrial activities and the growth of urban areas. Therefore, this research implements community-based avitourism strategies for the appropriation of environmental knowledge in the rural community of Ciudad Bolivar in Bogotá. Community-based avitourism is the activity carried out by bird watchers in the communities, where the communities have the opportunity to appropriate the knowledge of ornithological species and thus develop and provide touristic services as a complementary income to their local economy. To do this, there must be integration and distribution, as well as having trained personnel. This strategy contributes to local development, to achieve social benefits that help to preserve the habitat and biodiversity of its territory. This article has a qualitative approach, through participatory action with members of the community, its development was carried out in three phases, first the recognition of the ornithological species of the territory, second a participatory action research process, and finally, provide actions for the environmental appropriation of the community through a bird course. This allows the community to strengthen tourism based on environmental and sustainable practices, which achieves an ecological transformation for the communities and a greater social appropriation of knowledge.

Behavioural changes in transport and future repercussions of the COVID-19 outbreak in Spain.

COVID-19 (Coronavirus disease 2019) brought about a huge change in the behaviour and mobility of citizens in all parts of the world. This change was mainly a consequence of the strong measures of isolation and social distancing taken by the different governments in most countries through the world. The specific measures adopted in each country, in combination with the particular characteristics of the spread of the virus, generated differentiated, although similar, behavioural changes. This article presents the analysis of a survey carried out in Spain in March 2020, where citizens were asked about their mobility preferences before, during and after the lockdown due to the virus. In turn, questions were asked about the preferred modes of transport in each of the situations and the perception of safety on public transport in their current conditions. The mobility questions were differentiated between commuting to work or studies, shopping and leisure. The results show that public transport was the most affected transport mode, with a considerable increase in the use of the bicycle and walking trips. At the same time, changes were observed in the behaviour of shopping trips, including a considerable decrease on the use of large supermarkets. Citizens perceived great uncertainty in planning leisure trips, the consequence of which could be that a higher proportion of people not being able to carry out their planned trips.