Sedentary Behaviour and Physical Activity Levels during Second Period of Lockdown in Chilean's Schoolchildren: How Bad Is It?

OBJECTIVE: The objective of this study was to compare the levels of sedentary behaviour and physical activity in relation to sociodemographic variables of Chilean schoolchildren before and during the COVID-19 pandemic. METHODS: This retrospective study considered a non-random sample of 83 boys and 232 girls, and their respective parents, who attended public schools (n = 119) and private schools (n = 196) in Chile. A self-report instrument was applied that included sociodemographic variables, sedentary behaviour (SB), and physical activity (PA) in the second period of the pandemic in 2021. RESULTS: The main results show that pre-pandemic SB had significant differences when compared between sexes, except for television time. During the pandemic, there was no significant difference in television time or telephone time. There were no significant differences by sex before and during the pandemic. When comparing the SB scores, video game time in boys decreased (p < 0.001), as did video game time in girls (p < 0.001), and computer time in boys (p < 0.001) and girls (p < 0.001). Telephone time increased in boys (p < 0.001) and girls (p < 0.001), as did television time (p < 0.001). Likewise, PA increased in boys (Δ + 9.51min) and girls (Δ + 3.54 min) during the pandemic (p < 0.001). CONCLUSIONS: Both PA and SB underwent changes according to sex before and during the second period of the COVID-19 pandemic in Chilean schoolchildren.

Mental health in Chilean higher education students during the COVID-19 pandemic: A longitudinal study.

OBJECTIVE: The COVID-19 pandemic has required important changes in the lifestyles and quality of life of higher education students, generating emotional distress. This study sought to evaluate a predictive model of emotional distress and positive mental health through measures of posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) in Chilean higher education students during the pandemic. METHOD: To this end, 502 students (67.8% female), aged 18-44 years, were surveyed at two time points during the pandemic, separated by 6 months. Potential predictors included emotional regulation strategies, perceived social support, sociodemographic characteristics, factors related to the pandemic, and students' experiences related to online classes. RESULTS: Findings indicated that PTSS levels were generally stable across the two time points, but PTG levels increased. In addition, emotional regulation strategies (suppression, cognitive reappraisal), perceived social support, and female gender predicted both PTSS and PTG 6 months later; students' number of hours of screen time for school also influenced PTG. CONCLUSIONS: Findings enhance understanding of the processes contributing to PTSS and PTG in higher education students. The need to improve quality of life and mental health in higher education students, including individual- and institutional-level strategies, is discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Prognostic Significance of Lung and Cava Vein Ultrasound in Elderly Patients Admitted for Acute Heart Failure: PROFUND-IC Registry Analysis.

INTRODUCTION: Heart failure is an extremely prevalent disease in the elderly population of the world. Most patients present signs and symptoms of decompensation of the disease due to worsening congestion. This congestion has been clinically assessed through clinical signs and symptoms and complementary imaging tests, such as chest radiography. Recently, pulmonary and inferior vena cava ultrasound has been shown to be useful in assessing congestion but its prognostic significance in elderly patients has been less well evaluated. OBJECTIVES: This study aims to compare the clinical and radiological characteristics and predictive values for mortality in patients admitted for heart failure through the determination of B lines by lung ultrasound and the degree of collapsibility of the inferior vena cava (IVC). Secondarily, the study aims to assess the prediction of 30-day mortality based on the diameter of the IVC by means of the ROC curve. METHODS: This is an observational cohort study based on data collected in the PROFUND-IC study, a nationwide multicentric registry of patients admitted with decompensated heart failure. Data were collected from these patients between October 2020 and April 2022. RESULTS: A total of 482 patients were entered into the PROFUND-IC registry between October 2020 and April 2022. Bedside clinical ultrasound was performed during admission in 301 patients (64.3%). The number of patients with more than 6 B-lines on lung ultrasound amounted to 194 (66%). Statistically significant differences in 30-day mortality (22.1% vs. 9.2%; p = 0.01) were found in these patients. The sum of patients with IVC collapsibility of less than 50% amounted to 195 (67%). Regarding prognostic value, collapsibility data were significant for the number of admissions in the last year (12.5% vs. 5.5%; p = 0.04), in-hospital mortality (10.1% vs. 3.3%, p = 0.04) and 30-day mortality (22.6% vs. 8.1%; p < 0.01), but not for readmissions. Regarding the prognostic value of IVC diameter for 30-day mortality, the area under the ROC curve (AUC) was 0.73, with a p < 0.01. The curve cut-off point with the highest sensitivity (70%) and specificity (70.3%) was for an IVC value of 22.5 mm. In the logistic regression analysis, we observed that the variable most associated with patient survival at 30 days was the presence of a collapsible inferior vena cava, with more than 50% OR 0.359 (CI 0.139-0.926; p = 0.034). CONCLUSIONS: The subgroups of patients analyzed with more than six B lines per field and IVC collapsibility less than or equal to 50%, as measured by clinical ultrasound, had higher 30-day mortality rates than patients who did not fall into these subgroups. IVC diameter may be a good independent predictor of 30-day mortality in patients with decompensated heart failure. Comparing both ultrasound variables, it seems that in our population, the assessment of the inferior vena cava may be more associated with short-term prognosis than the pulmonary congestion variables assessed by B lines.

Applications of machine learning approaches to combat COVID-19: A survey

Machine learning (ML) and artificial intelligence (AI) approaches are prominent and well established in the field of health-care informatics. Because they have a more productive ability to predict, they are successfully applied in several health-care applications. ML approaches are needed thanks to the unsatisfactory experience of the novel virus, considerable ambiguity, complicated social circumstances, and inadequate accessible data. Several approaches have been applied as a tool to combat and protect against the new diseases. The COVID-19 outbreak has rapid growth, so it is not easy to predict the patients and resources within a specified time. ML is a strong approach in the fighting against the pandemic such as COVID-19. It is found significant to predict the susceptible, infected, recovered, or exposed persons and can assist the control strategies to block the spread of infections. This study critically examines the appropriateness and contribution of AI/ML methods on COVID-19 datasets, enhancing the understanding to apply these methods for quick analysis and verification of pandemic databases.

Outcomes of neonates born to women with Covid-19.

Not available.

Polymorphisms in ACE, ACE2, AGTR1 genes and severity of COVID-19 disease.

BACKGROUND: Infection by the SARS-Cov-2 virus produces in humans a disease of highly variable and unpredictable severity. The presence of frequent genetic single nucleotide polymorphisms (SNPs) in the population might lead to a greater susceptibility to infection or an exaggerated inflammatory response. SARS-CoV-2 requires the presence of the ACE2 protein to enter in the cell and ACE2 is a regulator of the renin-angiotensin system. Accordingly, we studied the associations between 8 SNPs from AGTR1, ACE2 and ACE genes and the severity of the disease produced by the SARS-Cov-2 virus. METHODS: 318 (aged 59.6±17.3 years, males 62.6%) COVID-19 patients were grouped based on the severity of symptoms: Outpatients (n = 104, 32.7%), hospitalized on the wards (n = 73, 23.0%), Intensive Care Unit (ICU) (n = 84, 26.4%) and deceased (n = 57, 17.9%). Comorbidity data (diabetes, hypertension, obesity, lung disease and cancer) were collected for adjustment. Genotype distribution of 8 selected SNPs among the severity groups was analyzed. RESULTS: Four SNPs in ACE2 were associated with the severity of disease. While rs2074192 andrs1978124showed a protector effectassuming an overdominant model of inheritance (G/A vs. GG-AA, OR = 0.32, 95%CI = 0.12-0.82; p = 0.016 and A/G vs. AA-GG, OR = 0.37, 95%CI: 0.14-0.96; p = 0.038, respectively); the SNPs rs2106809 and rs2285666were associated with an increased risk of being hospitalized and a severity course of the disease with recessive models of inheritance (C/C vs. T/C-T/T, OR = 11.41, 95% CI: 1.12-115.91; p = 0.012) and (A/A vs. GG-G/A, OR = 12.61, 95% CI: 1.26-125.87; p = 0.0081). As expected, an older age (OR = 1.47), male gender (OR = 1.98) and comorbidities (OR = 2.52) increased the risk of being admitted to ICU or death vs more benign outpatient course. Multivariable analysis demonstrated the role of the certain genotypes (ACE2) with the severity of COVID-19 (OR: 0.31, OR 0.37 for rs2074192 and rs1978124, and OR = 2.67, OR = 2.70 for rs2106809 and rs2285666, respectively). Hardy-Weinberg equilibrium in hospitalized group for I/D SNP in ACE was not showed (p<0.05), which might be due to the association with the disease. No association between COVID-19 disease and the different AGTR1 SNPs was evidenced on multivariable, nevertheless the A/A genotype for rs5183 showed an higher hospitalization risk in patients with comorbidities. CONCLUSIONS: Different genetic variants in ACE2 were associated with a severe clinical course and death groups of patients with COVID-19. ACE2 common SNPs in the population might modulate severity of COVID-19 infection independently of other known markers like gender, age and comorbidities.

Renal histopathology in critically ill patients with Septic Acute Kidney Injury(S-AKI).

PURPOSE: To describe the kidney histopathology of patients with S-AKI and correlate the histological findings with AKI severity, presence of septic shock, and the degree of multiple organic dysfunction (MOD) using the SOFA score. MATERIALS AND METHODS: This was a prospective, observational, and analytical study of a cohort of critically ill patients with S-AKI who died from sepsis at the "Hospital Español" intensive care unit (ICU). Kidney necropsies were performed within 2 h after death. RESULTS: We considered twenty (20) patients, with all of them exhibiting S-AKI stage 3 at the same time. In renal histopathology analysis, nonspecific tubulointerstitial (TI) lesions were found in almost all patients (95%). The more frequently found nonspecific TI lesions involved leukocyte infiltration (85%). Necrotic TI lesions were found in 6 patients (30%), and necrotic tubular cell casts were the most frequent lesions (50% of patients). It was not possible to demonstrate an association between the presence of necrotic TI lesions and factors such as the APACHE II score, the global SOFA score, ICU stays, AKI length and renal replacement therapy (RRT). CONCLUSIONS: The main histopathological findings in kidney necropsies in patients with S-AKI KDIGO 3, showed nonspecific TI lesions, and TI necrosis was only observed in 30% of the cases; therefore, S-AKI cannot be considered to be synonymous with acute tubular necrosis (ATN).

On the evolution of the COVID-19 epidemiological parameters using only the series of deceased. A study of the Spanish outbreak using Genetic Algorithms.

We propose a methodology for estimating the evolution of the epidemiological parameters of a SIRD model (acronym of Susceptible, Infected, Recovered and Deceased individuals) which allows to evaluate the sanitary measures taken by the government, for the COVID-19 in the Spanish outbreak. In our methodology the only information required for estimating these parameters is the time series of deceased people; due to the number of asymptomatic people produced by the COVID-19, it is not possible to know the actual number of infected people at any given time. Therefore, among the different time series that quantify the pandemic we consider just the number of deceased people to minimize the square sum of errors. The time series of deaths considered runs from March to the end of September and is divided into four sub-periods reflecting the different isolation measures taken by the Spanish government. The parameters that we can estimate are the time from the beginning of the disease, the transmission rate, and the recovery rate; these last two ratios are estimated in each of the different sub-periods. In this way the model considered has 2x4+1=9 parameters that are estimated jointly over the whole period from the data of deceased. Given the complexity of the model, to estimate the parameters that minimize the square sum of errors, a Genetic Algorithm is used. Our methodology confirms the effectiveness of the sanitary measures taken by the Spanish government showing a dramatic reduction in the basic reproductive number R 0 during confinement; also, a further increase in R 0 after the end of the alarm state decreed by the government on June 21 was detected. Our results also point out that the Patient Zero in the COVID-19 Spanish outbreak emerged between the end of December and early January, at least four weeks before January 31st, that was the moment when the Spanish authorities reported the first positive case.

Changes in Active Behaviours, Physical Activity, Sedentary Time, and Physical Fitness in Chilean Parents during the COVID-19 Pandemic: A Retrospective Study.

Strategies to reduce the spread of coronavirus disease 2019 (COVID-19) have caused different behavioural modifications in all populations. Therefore, this study aimed to determine changes in active commuting, moderate-to-vigorous physical activity (MVPA), physical fitness, and sedentary time during the COVID-19 pandemic in Chilean parents. Eighty-six fathers (41.30 ± 6.82 years) and 294 mothers (40.68 ± 6.92 years) of children from different schools from Valparaíso, Chile, participated. Inclusion criteria were adults with schoolchildren who were resident in Chile during the research period. Convenience sampling was used as a non-probabilistic sampling technique. Respondents completed a self-reported online survey about active commuting, MVPA, self-perceived physical fitness, and sedentary time July-September 2020 during the first pandemic period. Comparisons between before and during the pandemic were performed using t-tests and covariance analysis (ANCOVA), establishing a significance level at p < 0.05. Most participants stayed at home during the pandemic, whereas active and passive commuting significantly decreased in both fathers and mothers (p < 0.001). MVPA and physical fitness scores reduced considerably (p < 0.05), while sedentary time significantly increased (p < 0.05), independent of the sex of parents and children's school type. Differences by age groups and the number of children were more heterogeneous, as younger parents showed a larger decrease in MVPA (p < 0.05) and physical fitness score (p < 0.05). Additionally, parents with one child showed a larger decrease in sedentary time (p < 0.05) than those with two or more children. The COVID-19 pandemic significantly affected healthy behaviours. Hence, health policies should promote more strategies to mitigate the long-term health effects of the pandemic on Chilean parents.

Associations Between Movement Behaviors and Emotional Changes in Toddlers and Preschoolers During Early Stages of the COVID-19 Pandemic in Chile.

Background: There is limited evidence about emotional and behavioral responses in toddlers and preschoolers during the novel coronavirus (COVID-19) pandemic, particularly in Latin America. Objective: To assess associations between changes in movement behaviors (physical activity, screen time and sleeping) and emotional changes in toddlers and preschoolers during early stages of the pandemic in Chile. Methods: A cross-sectional study conducted from March 30th to April 27th, 2020. Main caregivers of 1- to 5-year-old children living in Chile answered an online survey that included questions about sociodemographic characteristics, changes in the child's emotions and behaviors, movement behaviors and caregivers' stress during the pandemic. Multiple linear regressions were used to assess the association between different factors and emotional changes in toddlers and preschoolers. Results: In total, 1727 caregivers provided complete data on emotional changes for children aged 2.9 ± 1.36 years old, 47.9% girls. A large proportion of toddlers and preschoolers in Chile experienced emotional and behavioral changes. Most caregivers reported that children "were more affectionate" (78.9%), "more restless" (65.1%), and 'more frustrated' (54.1%) compared with pre-pandemic times. Apart from changes in movement behaviors, factors such as child age, caregivers' age and stress, and residential area (urban/rural) were consistently associated with changes in emotions and behaviors. Conclusion: The pandemic substantially affected the emotions and behaviors of toddlers and preschoolers in Chile. The findings suggest that supportive actions for caregivers may have a positive impact not only on adults but also on children. Mental health promotion programs should consider multilevel approaches in which the promotion of movement behaviors and support for caregivers should be essential pieces for future responses.

Sociodemographic Predictors of Changes in Physical Activity, Screen Time, and Sleep among Toddlers and Preschoolers in Chile during the COVID-19 Pandemic.

The aim was to examine the sociodemographic predictors associated with changes in movement behaviors (physical activity, screen time, and sleep) among toddlers and preschoolers during the early stages of the coronavirus disease 2019 pandemic in Chile. Caregivers of 1- to 5-year-old children completed an online survey between 30 March and 27 April 2020. Information about the child's movement behaviors before (retrospectively) and during the pandemic, as well as family characteristics were reported. In total, 3157 participants provided complete data (mean children age: 3.1 ± 1.38 years). During early stages of the pandemic, time spent in physical activity decreased, recreational screen time and sleep duration increased, and sleep quality declined. Toddlers and preschoolers with space to play at home and living in rural areas experienced an attenuated impact of the pandemic restrictions on their physical activity levels, screen time, and sleep quality. Older children, those whose caregivers were aged ≥35-<45 years and had a higher educational level, and those living in apartments had greater changes, mainly a decrease in total physical activity and increase in screen time. This study has shown the significant impact of the pandemic restrictions on movement behaviors in toddlers and preschoolers in Chile.

Group Membership and Social and Personal Identities as Psychosocial Coping Resources to Psychological Consequences of the COVID-19 Confinement.

The confinement imposed by measures to deal with the COVID-19 pandemic may in the short and medium term have psychological and psychosocial consequences affecting the well-being and mental health of individuals. This study aims to explore the role played by group membership and social and personal identities as coping resources to face the experience of the COVID-19 confinement and radical disruption of social, work, family and personal life in a sample of 421 people who have experienced a month of strict confinement in the Region of Madrid. Our results show that identity-resources (membership continuity/new group memberships, and personal identity strength) are positively related to process-resources (social support and perceived personal control), and that both are related to better perceived mental health, lower levels of anxiety and depression, and higher well-being (life satisfaction and resilience) during confinement. These results, in addition to providing relevant information about the psychological consequences of this experience, constitute a solid basis for the design of psychosocial interventions based on group memberships and social identity as coping resources.

Group Membership and Social and Personal Identities as Psychosocial Coping Resources to Psychological Consequences of the COVID-19 Confinement

The confinement imposed by measures to deal with the COVID-19 pandemic may in the short and medium term have psychological and psychosocial consequences affecting the well-being and mental health of individuals. This study aims to explore the role played by group membership and social and personal identities as coping resources to face the experience of the COVID-19 confinement and radical disruption of social, work, family and personal life in a sample of 421 people who have experienced a month of strict confinement in the Region of Madrid. Our results show that identity-resources (membership continuity/new group memberships, and personal identity strength) are positively related to process-resources (social support and perceived personal control), and that both are related to better perceived mental health, lower levels of anxiety and depression, and higher well-being (life satisfaction and resilience) during confinement. These results, in addition to providing relevant information about the psychological consequences of this experience, constitute a solid basis for the design of psychosocial interventions based on group memberships and social identity as coping resources.

Técnica quirúrgica de la traqueostomía percutánea en el paciente con COVID-19

Generalidades. Desde diciembre de 2019 se detectó una nueva infección respiratoria, causada por el virus denominado SARS-CoV-2, decretada posteriormente como pandemia, lo cual ha exigido al personal de salud replantear la forma de prestar sus servicios en salud y garantizar la auto-protección con recursos que han sido insuficientes incluso en los países más desarrollados.Dado que la transmisión del SARS-CoV-2 ocurre a través de aerosoles expulsados de la vía aérea, que pueden ser inhalados o llevados a las mucosas por contacto con las manos contaminadas, se requiere minimizar la posibilidad de contagio para los equipos de atención en salud.Objetivos. Brindar herramientas a los cirujanos que les permitan elegir la técnica con menor probabilidad de exposición a aerosoles. Describir el paso a paso de la técnica quirúrgica de la traqueostomía percutánea, enfati-zando en el control sobre la generación de aerosoles en pasos críticos.Aspectos técnicos. La técnica completamente percutánea con kit de traqueostomía permite un mejor sello entre tejidos y dispositivos. Los escenarios más frecuentes para realizar una traqueostomía son: el paciente intubado con ventilación mecánica y el paciente con falla en la intubación que requiere una intervención de emergencia.Conclusión. El alto contagio del COVID-19 al practicar intervenciones en la vía aérea nos obliga a hacer énfasis en las estrategias que reduzcan la formación de aerosoles y permitan la contención de los mismos durante la realización de traqueostomíasBackground: Since December 2019, a new respiratory infection was detected, caused by the virus called SARS-CoV-2, later decreed as a pandemic, which has required health personnel to rethink the way of providing their health services and guarantee the self-protection with resources that have been insufficient even in the most developed countries. As the transmission of SARS-CoV-2 occurs through aerosols expelled from the airway, which can be inhaled or brought to the mucosa by contact with contaminated hands, it is necessary to minimize the possibility of contagion for the health care teams.Objectives: Provide tools to surgeons that allow them to choose the technique with the least probability of exposure to aerosols. Describe the step-by-step of the percutaneous tracheostomy technique, emphasizing control about the generation of aerosols in critical steps.Technical aspects: The fully percutaneous technique with a tracheostomy kit allows a better seal between tissues and devices. The most frequent scenarios for performing a tracheostomy are an intubated patient with mechanical ventilation and a patient with failure of intubation that requires emergency intervention.Conclusion: The high contagion of COVID-19 when practicing airway interventions forces us to emphasize strategies that reduce the formation of aerosols and allow them to be contained during tracheostomies