COVID-19, Microbiota, and Probiotics

Coronavirus 2, universally known as SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), was identified only a year ago as the causative agent of a new acute respiratory disease: the "coronavirus disease 2019" (COVID-19). The pathognomonic symptoms of COVID-19 are cough, fever, and dyspnea. To date, only two studies have been published to assess whether there are differences between the respiratory microbiota of healthy people and those with COVID-19, and in both cases the sample size was small. This chapter details these two studies. In any case, COVID-19 contains numerous aspects that constitute clear targets for the application of probiotics: the presence of diarrhea and other digestive symptoms in a high percentage of cases;modulation of the immune and inflammatory response to the virus;and so on. © 2023 John Wiley and Sons Ltd. Published 2023 by John Wiley and Sons Ltd.

Design of a cost-effective diagnosis tool for SARSCov-2 variant detection through a next generation sequencing (NGS) based strategy

Background/Objectives: Current pandemic situation, together with the continuous emergence of new SARS-CoV-2 variants reveal the need to develop a more versatile tool than PCR-based methods that allows both high throughput COVID-19 diagnostic and specific variant detection at reduced cost and fast turnaround times. Thus, with the aim of overcoming current test limitations and providing a strategy with these characteristics arises our novel next generation sequencing based approach. Method(s): The developed strategy works with RNA samples obtained from nasopharyngeal swabs. RNA samples are processed with our custom laboratory protocol and can be sequenced with any Illumina platform to generate results within a 24h timeframe. A tailored bioinformatic pipeline analyzes the data and generates a clinical-level report. Result(s): Clinical validation results have shown that the designed solution, sensitively and specifically identifies negative and positive samples that display a broad range in viral loads and readily identifies the following major SARS-CoV-2 variants of concern (VoC): Alpha, Beta, Gamma, Delta, Lambda and Omicron (BA.1 and BA.2). Conclusion(s): The versatility of our solution allows the capability of identifying the presence of other common respiratory viruses as well as identifying patients at risk through the identification of susceptibility human variants in the host. This, together with the possibility of easily adding new VoC as they emerge, will make VoC monitoring in entire populations feasible, providing a new perspective on the application of NGS methods in the field of clinical microbiology.

Perspective and experience of university students during Covid-19

After the huge and sudden change in the teaching-learning methodology at the University that the pandemic generated, we thought it necessary to study the perspective of the students on this experience. We carried out an exploratory survey from a qualitative approach, following an inductive logic of construction of categories from the data, with a sample of 67 students. Categories: personal sphere, positioning with respect to the institution, the teaching staff and ICT. For such analysis, we used the software Atlas.ti (Version 8.4). In conclusion, to improve similar situations, it is essential to include accompaniment and emotional support, in addition to reinforcing their resources and technological skills.

Does the Coronavirus Anxiety Scale Measure Coronaphobia the Same Way for Mourners With and Without Dysfunctional Grief?

Deaths from COVID-19 have exceeded 6.5 million people globally. Although many people are mourning the loss of loved ones to this deadly disease, little is known about the validity of measuring coronavirus-related anxiety with this particular group of people. Therefore, the objective of this study is to determine if the coronavirus anxiety scale (CAS) measures the coronaphobia construct the same way for mourners with and without dysfunctional levels of grief. The results indicated that the four-item version of the CAS has acceptable fit indices and is partially invariant between people with dysfunctional and non-dysfunctional grief. Moreover, the CAS demonstrated adequate criterion validity and reliability with this group of bereaved adults. In conclusion, the CAS can be used to measure anxiety due to COVID-19 in people who are going through dysfunctional and non-dysfunctional grieving processes. © The Author(s) 2023.

Interferon 1beta-1a ring prophylaxis to reduce household transmission of SARS-CoV-2

Introduction/Aim: Accumulating evidence indicates that an early, robust type 1 interferon (IFN) response to SARS-CoV-2 is critical for COVID-19 outcomes. Our objective was to examine the prophylactic potential of IFN treatment to limit viral transmission Methods: A cluster-randomised clinical trial was undertaken to determine effects of IFNbeta-1a treatment on SARS-CoV-2 household transmission (clinicaltrials.gov: NCT04552379). Index cases were identified from confirmed SARS-CoV-2 cases in Santiago, Chile, with 341 index cases and 831 household contacts enrolled. Households received 125 mug subcutaneous pegylated-IFNbeta-1a on days 1, 6, & 11 (172 households, 607 participants), or standard care (169 households, 565 participants). Primary outcomes included: (1) duration of viral shedding in infected cases (IC-INF), (2) transmission to treatment-eligible household contacts (EHC-ITT) at day 11. Result(s): Of 1172 individuals randomised, 53 individuals withdrew from the study (IFNbeta-1a = 35, SOC = 18). Eighty-two households (IFNbeta-1a = 36, SOC = 46) where the index case was SARS-CoV-2 negative on days 1 & 6, or with no SARS-CoV-2 negative contacts at recruitment, were excluded from exploratory analyses. Treatment with IFNbeta-1a: had no effect on duration of viral shedding in the IC-INF population (primary outcome 1), had no effect on transmission of SARS-CoV-2 at day 11 in the EHC-ITT population (primary outcome 2) but an effect was observed in a sensitivity analysis at day 6 (EHC-ITT: OR = 0.493, 95% CI = 0.256-0.949), reduced duration of hospitalisation in the IC-INF population and incidence of hospitalisation in per-protocol index cases (secondary outcome 3). In exploratory frequentist analysis, a significant effect of IFNbeta-1a treatment on SARS-CoV-2 transmission by day 11 (OR = 0.55, 95% CI = 0.36-0.99), and a Bayesian analysis identified a significant reduction in the odds of transmission (OR = -0.85, 95% credible interval = -1.59--0.16). Conclusion(s): Ring prophylaxis with IFNbeta-1a had no effect on duration of viral shedding but reduces the probability of SARS-CoV-2 transmission to uninfected, post-exposure contacts within a household.

DISABILITY AND COVID-19 TESTING: A CROSS-SECTIONAL RADx-UP STUDY

Background: Nearly 26% of adults in the U.S. live with disability and are more likely to experience chronic health conditions, barriers to healthcare, and severe COVID-19 illness. Therefore, COVID-19 testing of adults living with disability is important to consider. The purpose of this study was to explore relationships between disability and COVID-19 testing, infection, and related challenges. Method(s): A Rapid Acceleration of Diagnostics-Underserved Population (RADx-UP) project in Miami, FL determined disability with a modified version of the Washington Group General Disability Measure. HIV serostatus and COVID-19 vaccination were confirmed with medical records. COVID-19 testing and infection history were self-reported. Statistical analyses included chi-squared tests and multiple binary logistic regression;variance inflation factors were calculated to ensure absence of collinearity. Result(s): A total of 1,689 RADx-UP participants with an average age of 55+/-12.3, 51% male, 49% Black non-Hispanic, 23% living with HIV (86% virally suppressed), and 76% received at least one dose of a COVID-19 vaccine. Nearly 40% were disabled, 37% reported employment disability, and 21% were functionally disabled (disability that interferes with performance of daily activities). Despite recruitment from the same sources, PLWH, compared to those without HIV, were more likely to be disabled (52% vs 36%;p< 0.0001), report employment disability (63% vs 30%;p< 0.0001), and report functional disability (29% vs 18%;p< 0.0001). Those with employment disability were less likely to have ever been tested for COVID-19 compared to those without (81% vs 85%;p=0.026). Employment disability was also associated with lower odds of having ever tested positive for COVID-19 after adjustment for demographics, health insurance, HIV, COVID-19 vaccination, smoking, and lung disease (aOR, 0.62;95% CI, 0.43-0.90;p=0.013). Disability was associated with greater odds of transportation challenges (aOR, 2.33;95% CI, 1.76-3.08;p< 0.0001), illicit drug use (aOR, 1.92;95% CI, 1.49-2.47;p< 0.0001), and smoking (aOR, 1.74;95% CI, 1.39-2.17;p< 0.0001). Compared to those without, those with transportation challenges (14% vs 40%;p< 0.0001) and illicit drug use (18% vs 30%;p=0.001) were more likely to postpone medical care. Conclusion(s): Lower COVID-19 testing rates may contribute to underestimated COVID-19 positivity rates in adults living with disability. Challenges with transportation and substance abuse contribute to less engagement in care.

Thromboprophylaxis and anticoagulation in COVID-19.

The immunological reaction that facilitates the cytokine storm in the infection by the new coronavirus facilitates the appearance of microvascular, endothelial and direct cellular damage, which leads to a prothrombotic state and events of thromboembolism to different apparatus and systems as a complication. Therefore, the need to provide adequate prophylactic therapy or anticoagulant management in time and adequate dosage to these patients, as well as an individualized coagulation and hemostasis study. This document is intended to summarize in a practical way the evidence published to date and provide a broader view of the pathophysiological phenomena that occur in this hyperinflammatory state that has taught us a lot since its arrival.Copyright © 2022 Comunicaciones Cientificas Mexicanas S.A. de C.V.. All rights reserved.

Diagnosis by levels of organizational flexibility. Case study: Meat Company of Camaguey

The study of organizational flexibility in companies, as well as its dimensions, is an increasingly recurrent and relevant topic in business sustainability, whatever its size or nature, given the need to adapt to changes. The COVID19 pandemic was a filter between flexible and non-flexible companies, unable to reinvent themselves. This paper presents a study dedicated to understanding organizational flexibility by levels, using a meat products company as a case study. From there, the objective is planted: to evaluate the level of organizational flexibility as a capacity to adapt to changes in the environment. The evaluation is carried out through the contextualization and application of a methodological instrument, finding that it is viable, resulting in the assessment of flexibility at a medium level.

Implementation of mobile devices in higher education: Cases of good teaching practices

Mobile devices have become very prominent in education in recent years. Moreover, their use has intensified in the wake of the Covid-19 pandemic. In this sense, given the multitude of educational experiences, it is necessary to discern between a good use of the mobile device to carry out teaching practice. The purpose of this paper was to analyse learning strategies using mobile devices to provide models of good teaching practice. To this end, a cross-sectional study design was applied based on the distribution of an online survey including a standardised scale and an open-ended questionnaire. A total of 14 teachers, aged between 28 and 64 years (M = 48.42, SD = 10.67), participated in the study. The results obtained show that socio-demographic factors did not influence the development of good teaching practices with mobile devices. On the other hand, only five teachers identified themselves as agents of good teaching practices and the experience carried out in the classroom was collected. Finally, good teaching practices are a topic of interest in order to have practical models that can serve as a reference for other teachers and can be implemented at the University.

Fundamentals of a program for grief counseling and facing with post-Covid-19 losses

Background: when face-to-face activities restarted, the universities welcomed students who experienced losses related to Covid-19, caused or not by death, a situation that deserves to be addressed. Objective: to base, from the conceptual and methodological, a program aimed at teachers for grief counseling and facing with losses. Methods: a theoretical-reflexive analysis was carried out based on the systematization of publications in Spanish and English in the last three years. The terms: grief, university, coronavirus infections and counseling were introduced as descriptors. A screening of the eligible articles of the 76 found was carried out. A program for grief counseling and coping with post-Covid-19 losses was founded and prepared.Results: the program consists of three phases with general and specific indications, which can be modified by individualizing them. Evaluation instruments and intervention techniques are proposed.Conclusions: the program constitutes an adequate guidance instrument for teachers to help their students deal with grief.

Graphical-mathematical model to estimate CO2 concentration level as an indicator of SARS-CoV-2 transmission

The first documented cases of Coronavirus disease of 2019 (COVID-19) in Wuhan city (Hubei province, China) were caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), studies mention viral transmission is more common in indoor and poorly ventilated environments compared to outdoor environments or environments with abundant airflow. In this context, this research aimed to estimate, through a mathematical model by a Box-Behnken design, the time and occupancy required in a physical space to reach CO2 levels that exceed the risk level established as a safer condition of 700 ppm for SARS-CoV-2 transmission. According to the proposed mathematical model, it is possible to predict safe conditions. With this, it was found that natural ventilation is the best option to reduce CO2 concentration, considering the occupancy/m3 and time, allowing a constant airflow;the use of air conditioners to control the temperature in rooms without natural ventilation is suggested;notwithstanding, these types of equipment are not designed to reduce CO2 concentration. Thus, their use in rooms with open windows and doors leads to a shorter equipment lifetime, for this reason, its operation in special conditions, such as in rooms without natural ventilation should be considered

Technological heterogeneity and time-varying efficiency of sharing accommodation: Evidence from the Canary Islands

The production of services in the accommodation sharing industry is heterogeneous in the sense that listings with different strategic management could adopt distinct technologies. This paper analyses the time-varying efficiency of the peer-to-peer accommodation sector using the input distance stochastic frontier model with random coefficients to accommodate both multi-input and multi-output technology and the technological heterogeneity among listings. An empirical analysis is conducted based on data from Airbnb and HomeAway listings in the Canary Islands (Spain), before, during and after the COVID-19 lockdown (source: AirDNA), in the period January 2019-September 2020 (monthly data). The results show technological heterogeneity between listings and time-varying inefficiency which negatively depends on productivity. Moreover, multi-unit hosts are clearly more efficient than single-unit hosts. A mean efficiency of around 78% during the study period was estimated. © 2023 The Authors

Patterns of Progression and Treatment Discontinuation in a Real Life Latin American Prospective Cohort Study of Intermediate-Advanced Hepatocellular Carcinoma: Second Interim Analysis

Introduction and Objectives: Previously published regional real-world results of overall survival (OS) in Barcelona Clinic Liver Cancer (BCLC) B and C patients demanded a prospective cohort study nested in a systematic and continuous medical educational networking group. This study aimed to describe and evaluate the treatment decisions in patients with hepatocellular carcinoma (HCC) within BCLC B and C stages. Material(s) and Method(s): A multicenter prospective cohort study, conducted in different Latin American centers from Argentina, Brazil and Colombia, started on 15th May 2018 (delayed recruitment during COVID locked-down period). Patients within BCLC B or C stages were included. Survival, tumor progression and patterns of treatment suspension were evaluated. Result(s): At this second interim analysis (projected final analysis March 2023), 390 HCC BCLC-B or C patients were included (n=15 excluded);mean age 65 years, 75.6% males and 89.5% cirrhotic. Median OS since HCC diagnosis was 27.2 months. Among BCLC-B patients, the most frequent therapy was transarterial chemoembolization (TACE, 42.3%);51.8% using drug-eluting beads and 47.4% conventional TACE;with a median OS since 1st TACE of 41.9 months. Similar radiological responses after 1st TACE were observed between both modalities. Overall, 48.2% of the cohort received systemic therapy for HCC (n=188), 23.7% still on BCLC-B stage. The most frequent systemic treatments were Sorafenib (74.5%), atezolizumab bevacizumab (17.5%), and lenvatinib (12.2%), with a median OS since systemic therapy of 15.7 months. Lenvatinib or atezolizumab bevacizumab was used as the second line following sorafenib in 5 and 3 patients, respectively. The most common causes of systemic treatment discontinuation were tumor progression and liver function deterioration (15% to 36.4%). Patterns of tumor progression were not specifically associated with prognosis or treatment discontinuation. Conclusion(s): Liver function deterioration occurs in a third of patients following systemic therapies. The complexity of treatment decisions underly the need for a multidisciplinary team and the role of hepatologists.Copyright © 2023

Dialogic pedagogical gatherings in teaching the history of education: an online training experience

Dialogic Pedagogical Gatherings is a technique that has been previously used in different educational contexts. However, its implementation in virtual environ-ments is not so common. The present paper reflects an experience of this technique applied to the telematic training of Social Education students in a subject linked to the history of education. The results obtained were compared with other similar experiences in face-to-face format, evidencing that the Dialogic Pedagogical Gatherings have had good results in the online format, although there are elements of improvement for future implementations. © GKA Ediciones, authors.

Impacto de la pandemia de covid-19 en la educación universitaria intercultural en méxico. a teaching perspective

The COVID-19 pandemic has negatively impacted the health and living conditions of the world's population. In educational matters, social confinement forced the transition from a face-To-face modality to a virtual scheme supported by the use of information technologies and the Internet. This represented a challenge to access quality education at all levels, especially for the most vulnerable population groups, such as intercultural university education aimed at the indigenous population. Objective: To describe the perception that teachers of an intercultural university in southeastern Mexico have, regarding the impact that the adoption of a virtual and distance educational practice has had on the quality of education due to Covid-19. Methodology: Descriptive and cross-sectional quantitative research. The information was collected through the application of structured questionnaires consisting of 27 questions and 41 items, which were applied to a universe of 34 teachers from the seven degrees offered by the university. Results: It was found that the pandemic negatively affected the university intercultural educational process, accentuating the inequity in access to technological means for quality education. © 2022 Universidad de La Habana. All rights reserved.

Predictive indexes in prolonged weaning of mechanical ventilation due to tracheostomy in patients with COVID19 pneumonia

Introduction: In the pandemic, porlonged weaning(PW) of mechanical ventilation (wMV) of COVID patients in the intermediate respiratory care unit IRCU was performed. It was necessary to use predictive indexes for(wMV), which do not generate aerosolization of viral particles. Objetive: To develop a oredictive indexes for wMV and tracheostomy decannulation (TCHd) for COVID-19 pneumonia in IRCU. Method(s): The sample consists of 76 serial cases to the IRCU, in 2020 and 2021. Indexes were developed with an oxygenation variable (PaO2/FiO2) or (SatO2/FiO2), respiratory rate (RR) and corrected (C) in based alveolar ventilation (PCO2), the following indexes were developed as predictors of wMV;ventilation-oxygenation index IVOX= (PaFi/RR), IVOX corrected for PCO2 is IVOX-C=(IVOX x Oco2) and with SaFi the SIVOX-C= [(SaFi/RR) x PCO2]. The StatPlus 7.3 program forWindows was used of the Mann-Whitney U (M-WU) comparing their mean values, using binary logistic regression (BLR) and area under curve AUC ROC to compare their predictability. Result(s): Mean age 58,9 +/-14,4;male 53,7% and the stay in the IRCU was 16,7+/- 11 days, mortality of 28,3%(22);received MV (71,0%) 54. wMV was(70,4%)38 and TCHd was (67,3)35. The mean differrences in disconnected and non-diconnected from MV analyzed by M-WU are significante. An BLR model was built to analyze the predictive behavior ofIVOX, IVOX-C and SIVOX-C for wMV. It was observed that the three indexes are predictive, but IVOX-C and SIVOX-C have the highest predictive weight. In turn the AUC ROC was significance. Conclusion(s): The construction of a predictive indexes of wMV and TCHd in this sample the patients who reached the objective.

Serenity before the demystification of the scourge by Sars-CoV-2

The Pandemic caused by the SARS-CoV-2 virus generated multiple effects at the general level of the world population. Not only in the lethal implications it has for physical health, but also the psychological and emotional consequences that it has left throughout its evolution, since its appearance and categorization as a pandemic on March 11, 2020. This bibliographic review has In order to make a constructive analysis of the coronavirus, no longer seen as a disease that causes death, but with a view to demystifying that negative vision that was built on Covid-19, which is a disease that brought with it many negative implications and radical changes in our models of daily life, but that through advances in technology, medicine and our iron will to improve, as a species we managed to adapt and learned to go hand in hand with SARS-CoV-2, in a new postcovid society that seeks to regain its balance. For this, an exhaustive search was carried out in the available academic information search engines GoogleAcademic and PubMed, feeding the search engines through the words: Covid-19 and implications for health;SARS-CoV-2 and society;society-covid-health;emotional well-being and pandemic;level of emotional satisfaction and postcovid society;perspectives of the new post-pandemic life. The review allows us to highlight a different vision of the disease, no longer from a fatalistic perspective, but from a new evolutionary vision that has allowed us to overcome the self-imposed barriers of Covid-19 and achieve a more balanced society. © 2022 Instituto de Altos Estudios de Salud Publica. All rights reserved.

Systemic Corticosteroids in Patients with Bronchial Asthma: A Real-Life Study.

OBJECTIVES: The objective of the present study was to determine the use of systemic corti-costeroids (SCs) in patients with bronchial asthma using big data analysis. METHODS: We performed an observational, retrospective, noninterventional study based on secondary data captured from free text in the electronic health records. This study was per-formed based on data from the regional health service of Castille-La Mancha (SESCAM), Spain. We performed the analysis using big data and artificial intelligence via Savana® Manager version 3.0. RESULTS: During the study period, 103 667 patients were diagnosed with and treated for asthma at different care levels. The search was restricted to patients aged 10 to 90 years (mean age, 43.5 [95%CI, 43.4-43.7] years). Of these, 59.8% were women. SCs were taken for treatment of asthma by 58 745 patients at some point during the study period. These patients were older, with a higher prevalence of hypertension, dyslipidemia, diabetes, ob-esity, depression, and hiatus hernia. SCs are used frequently in the general population with asthma (31.4% in 2015 and 39.6% in 2019). SCs were prescribed mainly in primary care (59%), allergy (13%) and pulmonology (20%). The frequency of prescription of SCs had a direct impact on the main associated adverse effects. CONCLUSION: In clinical practice, SCs are frequently prescribed to patients with asthma, especially in primary care. Use of SCs is associated with a greater number of adverse events. It is necessary to implement measures to reduce prescription of SCs to patients with asthma, especially in primary care.