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Academic demotivation is a determining factor in the risk of dropping out of school, it prevents the student from maintaining a behavior oriented to student achievement, low self-esteem and the formation of an erroneous self-concept;which became evident in the face of the changes in the educational context as a result of Covid-19. In view of the academic demotivation shown by the students when returning to face-to-face classes, the objective of the research was to design a methodological strategy for the development of the students' academic motivation in the face of the new normality. The sample consisted of 126 students, and the research approach was mixed. The method used was the survey, the results of which show that 54.76% of the students feel unmotivated to continue their studies. Based on the results obtained, a methodological strategy was designed for the development of students' academic motivation.
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OBJECTIVE: To determine the probability of hospitalization for chronic degenerative disease in patients with COVID-19. MATERIALS AND METHODS: A retrospective cohort in patients with COVID-19, confirmed by RT-PCR. Two study groups were integrated, the exposed group made up of 3 subgroups, exclusively diabetes mellitus, exclusively arterial hypertension and exclusively obesity;the unexposed group was the one in which any chronic comorbidity was ruled out. Relative risk, multiple logistic regression and probability calculation of the event (hospitalization) were used. RESULT(S): The relative risk for hospitalization in diabetes was of 3.59 (95%CI;2.44-5.29), 3.20 (95%CI;2.10-4.87) in hypertension and 2.56 (95%CI;1.72-3.81) in obesity. The multiple regression equation was y = -1358 + 2388 (diabetes mellitus) + 2005 (systemic arterial hypertension) + 1458 (obesity). The probability of hospitalization when there was no chronic disease was of 20.6%, when there was a chronic disease the probability fluctuated between 52.5% and 73.5%, when there were two chronic diseases it varied from 89.1% to 95.4%, and when there were three diseases the probability of hospitalization was of 98.9%. CONCLUSION(S): In the context of the probability of hospitalization when there is a chronic degenerative disease or it is absent, the research shows the difference in these two scenarios, as revealed by the more than 70 percentage points identified in the extreme scenarios, a condition that, led to the clinical field, reaffirms the presence of chronic degenerative disease as a risk factor for hospitalization.Copyright © 2023 Comunicaciones Cientificas Mexicanas S.A. de C.V.. All rights reserved.
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Background: Remdesivir (RDV) is a broad-spectrum nucleotide analog antiviral approved for the treatment of COVID-19 in patients who are hospitalized or non-hospitalized and at risk of progressing to severe disease. Here we present SARS-CoV-2 resistance analyses from the Phase 3 PINETREE trial. Method(s): PINETREE was a double-blind, placebo-controlled trial of nonhospitalized participants (N=562) with COVID-19 and >=1 risk factor for disease progression, randomized to receive RDV or placebo once-daily for 3 days. The whole genome of SARS-CoV-2 was sequenced from nasopharyngeal swabs collected at days 1 (baseline), 2, 3, 7, and 14 using next-generation sequencing. Emergent amino acid substitutions in SARS-CoV-2 from participants treated with RDV were tested in a replicon system to determine if they alter sensitivity to RDV. Result(s): Resistance analysis criteria included all participants in the RDV group and 50% in the placebo group with viral load above the lower limit of detection for the viral load assay. Of 281 participants who met these criteria, baseline and postbaseline sequencing data were available for 115/130 (88.5%) participants in the RDV group and 129/151 (85.4%) participants in the placebo group (Table 1). Among these, emergent substitutions in Nsp12 were observed in 8/115 (7.0%) in the RDV group and 7/129 (5.4%) in the placebo group. A total of 7 emergent amino acid substitutions in Nsp12 were observed in the RDV group, but not in the placebo group. Among these, only one substitution from one participant (A376V;first detected at day 14), showed reduced in vitro susceptibility to RDV, with a half-maximal effective concentration (EC50) fold-change of 12.6 compared with a wildtype reference. The participant achieved clinical recovery by day 14. None of the other substitutions impacted RDV susceptibility (EC50 fold-change <=1.4). Emergent substitutions in Nsp8, Nsp10, Nsp13, or Nsp14 were detected in 10/115 (8.7%) of participants in the RDV group and 10/129 (7.8%) in the placebo group, with substitutions in the RDV group showing similar susceptibility to RDV as the wildtype reference (EC50 fold-change <=2.3). Conclusion(s): Overall, emergent substitutions in the SARS-CoV-2 replication complex including Nsp12 were observed with similar frequency in the RDV and placebo groups, with only one participant developing a substitution associated with reduced in vitro RDV susceptibility, indicating a high barrier to the development of RDV resistance in COVID-19 patients.
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Background: Recent SARS-CoV-2 variants of concern (VOCs) have shown a progressive loss of sensitivity to monoclonal antibody therapeutics. Remdesivir (RDV) is a nucleotide analog prodrug that targets the viral RNA-dependent RNA polymerase (RdRp) Nsp12 and is approved to treat COVID-19 in hospitalized and non-hospitalized patients. Nsp12 is highly conserved across VOCs to date and RDV antiviral activity against previous VOCs (Alpha to Omicron BA.1) has been maintained. Here, we conduct a structural analysis of Nsp12 substitutions observed in recent Omicron subvariants (BA.2, BA.2.12.1, BA.4, BA.5 and BA.2.75) and assess RDV antiviral activity against clinical isolates and sitedirected mutants (SDMs) in a replicon system. Method(s): The prevalence of Nsp12 substitutions in Omicron subvariants was evaluated by analysis of sequences from the Global Initiative on Sharing Avian Influenza Data (GISAID) EpiCoV database. Structural analysis of identified substitutions was conducted on a prior cryo-electron microscopy-based model of the replication-transcription complex. Antiviral activity against subvariant clinical isolates was assessed by nucleoprotein ELISA in A549-hACE2-TMPRSS2 cells and by SDMs in the replicon system. Result(s): Genomic analysis of >1.4 million Omicron subvariant sequences revealed unique substitutions in Nsp12 compared to the ancestral WA1 strain. Besides P323L, present in all subvariants, G671S was observed in 95.9% of BA.2.75 sequences, F694Y was observed in <=1.9% of BA.4, BA.5 and BA.2.75 sequences, and Y521C was observed in 1.7% of BA.5 sequences. As anticipated, structural analysis of these substitutions showed no direct interaction with the incoming RDV nucleotide triphosphate or the viral RNA. Phenotyping of clinical isolates of Omicron subvariants BA.2, BA.2.12.1, BA.4, BA.5, and BA.2.75 consistently resulted in mean RDV EC50 values of 24.5 nM (BA.2) to 106.0 nM (BA.5). This represented 0.15-to 0.66-fold changes compared to WA1, indicating no loss of in vitro RDV antiviral activity against these VOCs. P323L, G671S, and F694Y were shown previously to have no impact on RDV antiviral activity. Similarly, the individual substitution Y521C showed no change in RDV susceptibility in the SARS-CoV-2 replicon system. Conclusion(s): RDV retained potent in vitro antiviral activity against all tested Omicron VOCs with potencies comparable to the WA1 isolate. These data support the continued use of RDV in patients infected with Omicron subvariants.
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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the current global pandemic of the COVID-19, which has persisted partly through the emergence of new variants. A non-infectious, convenient, and reproducible in vitro system is needed to assess drug susceptibility of new variants of concern and potential drug resistance mutations. Method(s): The SARS-CoV-2 replicon protocol was adapted and optimized based on {Zhang 2021}. The replicon RNA was produced by in vitro transcription of full-length replicon DNA assembled by ligation of plasmid fragments encoding for the SARS-CoV-2 non-structural proteins (Nsps), nucleoprotein and gaussia luciferase reporter protein. Wild-type and mutant replicon RNAs were transfected into Huh7-1CN cells by electroporation and treated with remdesivir (RDV). To determine EC50 values, luciferase activity was determined at 48 hours post transfection. A recombinant SARS-CoV-2 virus rescue system {Xie 2020} was used to generate matching Nsp mutants for comparison with the replicon system. Result(s): The selected substitutions reflective of Omicron BA.5 sub-lineage BF.7 variant: the triple mutants (Nsp12 (P323L) +Nsp13 (R392C) + Nsp14 (I42V), and a single Nsp12 L247F mutant as well as several specific Nsp12 mutations identified by in vitro resistance selection with RDV or RDV parent nucleoside analog GS-441524 were cloned into the replicon and tested for susceptibility to RDV. RDV inhibited the SARS-CoV-2 wild-type replicon with a mean EC50 value of 14.7 +/- 3.5 nM (N=9). The Nsp12 P323L substitution, a common polymorphism in all major variants of concern including Omicron, was fully susceptible to RDV with a 0.6-fold change in EC50 from the wild-type. The Omicron BF.7 triple mutants and L247F were also fully susceptible to RDV with 0.5- and 0.4-fold changes, respectively. Nsp12 substitutions F480L, V557L, V792I, S759A+V792I, and C799F resulting from in vitro resistance selections with RDV showed minimal to moderate levels of reduced susceptibility to RDV (1.8 to 18.3-fold change) (Table 1). The RDV EC50 fold changes correlated between the noninfectious replicon and recombinant infection virus system (Table 1). Conclusion(s): The replicon system is a convenient and reproducible model to test the susceptibility of SARS-CoV-2 mutant variants to RDV and potentially other antivirals. The common Nsp12 polymorphisms in all variants including the highly transmissible Omicron variant were fully susceptible to RDV.
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BACKGROUND // Unhealthy diet is the main contributor to childhood obesity. The aim of this study was to assess adherence to the mediterranean diet in a sample of adolescents and analyse adherence-related factors. METHODS // Cross-sectional descriptive study (June-October 2020), in a non-probabilistic sample of 473 patients with Substance Use Disorder, from the 8 Addiction Care Centers (CAD) of the Madrid City Council. Their demographic, habits and health characteristics, IgM and IgG for SARS-CoV-2, previous PCR, presence of symptoms, contact with COVID-19 cases were described, and multivariate analysis was performed using binary logistic regression. RESULTS // A total of 64.3% of participants displayed a medium level and 21.3% a high level of adherence to the mediterranean diet. High adherence was less frequent among teenage girls (17% [PR=0.63;p=0.02]), those whose mothers had not gone beyond primary school (16.3% [PR=0.58;p=0.07]), those who slept less than 8.5 h/day (16.8% [PR=0.54;p < 0.01]), and those who used a mobile telephone for more than 2.6 hours per day (12.2% [PR=0.56;p=0.02]). CONCLUSIONS // Adherence to the mediterranean diet is less than optimum in four out of five adolescents, and is lower in teenage girls whose mothers had not gone beyond primary school or who devote more time to mobile telephones and less time to sleeping. Our results highlight the importance of paying attention to sleeping habits and reducing the use of screens when seeking to improve mediterranean diet adherence among adolescents.
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Introduction: When the first case of COVID-19 was diagnosed in Cuba, a training setting had already been designed for students of all the majors in the field of medical sciences who, as part of their training, should internalize the responsibilities that medicine implies, which is not only limited to the acquisition of scientific and academic knowledge. Objective: To determine the medical sciences students from Camagüey's knowledge for performing active COVID-19 screening. Methods: An observational, descriptive and cross-sectional study was carried out in September 2021. The study universe was 2573 students, belonging to all the majors in the field of medical sciences who were involved in active COVID-19 screening within the Camagüey Municipality. A sample of 416 students was selected in eight health areas of this municipality, by using nonprobabilistic convenience sampling. A descriptive, qualitative, individual survey containing open and closed questions was elaborated and validated. Results: The sample was represented by the female sex in a 70.7 %, while the highest percentage belonged to the medical school (73 %). 55 % responded that they had a good training for carrying out active COVID-19 screening and 79.8 % recognized television as the most significant way for knowledge acquisition. 93.3 % considered that the clinical and epidemiological methods were significant to develop the activity. Conclusions: In the present research, the female sex predominated. Likewise, television was recognized as the best way for knowledge acquisition and most of the participants expressed the value of the clinical-epidemiological method for acquiring knowledge. It was considered that students should be provided with the tools for self-training to exploit the virtual setting and the active platforms even more. © 2023, Editorial Ciencias Medicas. All rights reserved.
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Introduction: Within the post-Covid syndrome, sleep disturbances are one of the most persistent symptoms, in which women are more 50% vulnerable than men to insomnia. Objective(s): To compare the prevalence of sleep disorders in post-Covid patients according to sex. Method(s): A cross-sectional observational study was carried out. The participants were 264 post-Covid patients evaluated 3 months after hospital discharge, divided into men (n=156, G1) and women (n=108, G2). A general sleep habits survey and the Berlin SAOS questionnaire were used for sleep assessment. Statistical analyses were performed using SPSS v25. Result(s): Mean age was G1: 54.16 +/-11.751 and G2: 54.23 +/- 13.319. There were differences (p<0.05) between both sexes in the following disorders (G1 vs G2): snoring (73.1% vs 58.3%), primary snoring (45.6% vs 28.6%), unrefreshing sleep more than 3 times a week (28.2% vs 43.5%), tiredness or fatigue during the day at least 3 times a week (30.1% vs 51.9%), sudden movements in extremities: (37.2% vs 22.2%), onset insomnia: (34.0% vs 53.7%), intermediate insomnia (36.5% vs 58.3%), final insomnia: (39.7% vs 55.6%). No differences (p>0.05) were found in pauses in breathing, teeth grinding, feeling of paralysis and feeling of choking, with a prevalence greater than 20% in all cases. Conclusion(s): In our study, the affectation of most sleep disorders are more frequent in the female sex, with the predominance of different types of insomnia (onset, intermediate and final);which could be related to affective disorders. In men, the most prevalent disorders were snoring and sudden movements, mostly linked to respiratory disorders.
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Introduction: Acute kidney injury (AKI) occurs in 0.5 to 25% of hospitalized COVID-19 patients. Clinical severity and renal involvement are due to inflammation, immune and endothelial dysfunction. On the other hand, risk factors such as age, comorbidities, mechanical ventilation requirement, hypovolemia and MAP <65 mm Hg are associated with AKI development. This study aim to evaluate the development of AKI and determine the relationship between serum creatinine and inflammatory. Method(s): A single center, retrospective study involving 166 patients under the diagnosis of moderate to severe COVID-19 infection in Hospital General Regional 110 Oblatos, Guadalajara, Mexico. A consecutive sample was approached. AKI was determined and classify when changes in serum creatinine met KDIGO definition. Demographics, clinical and biochemical data, risk factors for AKI and RRT prescription were assessed and reported during diagnosis and discharge. Outcome measures were renal recovery, mortality and causes of death. Differences were compared using 2-sample t test for continuous variables and chi-square for categorical variables. Relationship between creatinine changes and inflammation markers were assessed using Pearson correlation coefficients. All statistical tests were performed using SPSS 28.0 and a P < 0.05 level of significance. Result(s): Mean age 59 +/- 18.38 years. 60 cases (36%) were diagnose as AKI. 41% were in stage 1, whereas 35% and 24% made up stage 2 and 3, respectively. Changes in serum creatinine (SCr) correlated with gender (r=0.155, p 0.48), changes in hemoglobin (r= -0.384, p < 0.01), neutrophil/ lymphocyte ratio (NLR) (r= 0.229;p 0.003), serum phosphate (r= 0.555, p < 0.01), serum calcium (r= -0.210, p < 0.011), serum potassium (r= 0.555, p < 0.01), serum magnesium (r= 0.212, p < 0.012), D-dimer (r= 0.246, p 0.02) and (r= -0.322, p < 0.01). After adjusting model for cofounders, hospitalization length and age (OR: 3.03, CI 0.39, 11.56, p=0.033) trend to be a significant data, other cofounders in relation to the presence of AKI o changes in SCr were no significant with other potential outcomes. [Formula presented] Conclusion(s): The present study highlighted that the presence of AKI is associated the increased of inflammation, but the current evidence limits the outcomes in already none predictive factors. Further studies are needed to establish early strategies aimed to prevent AKI and its evolution in COVID-19 patients and pandemics ahead. No conflict of interestCopyright © 2023
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SARS-CoV-2 infection has been associated with multiple neurological manifestations. One such manifestation, which has been described since the early stages of the COVID-19 pandemic and is relevant for current neurological practice, is Guillain-Barre syndrome (GBS). The literature describes neurotoxic mechanisms of the virus itself and the possible pathways by which it may affect the peripheral nerves in experimental studies;however, we still lack information on the mechanisms causing the immune response that gives rise to GBS in the context of SARS-CoV-2 infection. Colombia is one of the Latin American countries worst affected by the pandemic, with the third-highest number of cases in the region;thus, it is essential to recognise GBS, as this potential postinfectious complication may severely compromise the patient's functional status in the absence of timely diagnosis and treatment. We present a series of 12 cases of GBS associated with SARS-CoV-2 infection from hospitals in 4 different Colombian cities and describe the clinical presentation, laboratory and electrophysiological study findings, and treatment.Copyright © 2022 Sociedad Espanola de Neurologia
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Rationale: Autopsy and biomarker studies suggest that endotheliopathy contributes to coronavirus disease (COVID-19)-associated acute respiratory distress syndrome. However, the effects of COVID-19 on the lung endothelium are not well defined. We hypothesized that the lung endotheliopathy of COVID-19 is caused by circulating host factors and direct endothelial infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Objectives: We aimed to determine the effects of SARS-CoV-2 or sera from patients with COVID-19 on the permeability and inflammatory activation of lung microvascular endothelial cells. Methods: Human lung microvascular endothelial cells were treated with live SARS-CoV-2;inactivated viral particles;or sera from patients with COVID-19, patients without COVID-19, and healthy volunteers. Permeability was determined by measuring transendothelial resistance to electrical current flow, where decreased resistance signifies increased permeability. Inflammatory mediators were quantified in culture supernatants. Endothelial biomarkers were quantified in patient sera. Measurements and Main Results: Viral PCR confirmed that SARS-CoV-2 enters and replicates in endothelial cells. Live SARS-CoV-2, but not dead virus or spike protein, induces endothelial permeability and secretion of plasminogen activator inhibitor 1 and vascular endothelial growth factor. There was substantial variability in the effects of SARS-CoV-2 on endothelial cells from different donors. Sera from patients with COVID-19 induced endothelial permeability, which correlated with disease severity. Serum levels of endothelial activation and injury biomarkers were increased in patients with COVID-19 and correlated with severity of illness. Conclusions: SARS-CoV-2 infects and dysregulates endothelial cell functions. Circulating factors in patients with COVID-19 also induce endothelial cell dysfunction. Our data point to roles for both systemic factors acting on lung endothelial cells and viral infection of endothelial cells in COVID-19-associated endotheliopathy.
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Comprehension of statistical tables (tally and frequency tables) was analysed with 78 Spanish 7-8-year old pupils from three schools. Using a mixed descriptive and exploratory approach, based on a conventional content analysis, an activity was designed and analysed based on data from the COVID-19 context, structured in four phases: initial dialogue, individual, small group and large group work. The focus of the analysis is on the construction of tables and their interpretation, together with transnumeration. The data reveal: 1) a good level of children interest, participation and capacity for reflection;2) most of the children were able to draw up tally tables and half of them were able to transnumerate the data into frequency tables, detecting some difficulties and errors both in the execution and in the subsequent interpretation. It is concluded that these results allow a better understanding of the development of statistical literacy in children and, consequently, provide relevant data for designing more efficient teacher training programmes. © 2023, Universidad Compultense Madrid. All rights reserved.
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During the spring of 2020, as Coronavirus Disease 2019 (COVID-19) infections rapidly spread across the globe, all sectors of healthcare, everywhere, would change in ways that were unimaginable. Early on, the ambulatory surgery space, being no exception, would suffer deep and impactful reductions in patient volume and revenue. Though actual care stoppages were short-lived, decreased ambulatory surgical patient volumes continued for a myriad of reasons, though in some cases, ambulatory surgery centers (ASCs) provided surgical care in limited numbers to patients who were "offloaded” from inpatient lists. Released on March 24, 2020, herein, we address the key perioperative issues as they relate to COVID-19 and ambulatory surgery including the many complexities and challenges of a new and rapidly changing virus, the impact of viral infection and vaccine development on perioperative outcomes, key ambulatory surgical approaches to COVID-19-related patient and staff safety, and finally, managing issues related to both supply chain (personal protective equipment (PPE) and other necessary equipment) and facility staffing. © 2022 Elsevier Ltd
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Aim/Introduction: The aim of the study was to assess the presence of lymph node uptake (LNU) in patients who had received a COVID-19 vaccine and to evaluate its association with patient characteristics, type of vaccines, and PET/CT radiotracers. Material(s) and Method(s): 361 patients who underwent a PET/CT scan with 18F-FDG (FDG), 68Ga-PSMA (PSMA), or 11C-Choline (CHOL) performed in two EARL PET/CT accredited centers, from May to July 2021, and who had received single or double dose of COVID-19 vaccine (mRNA-based and viral-vector) were selected. Data from age, tumor histology, type of vaccine, location of LNU and time from vaccination (time- Vacc) were prospectively collected. A retrospective analysis of scans was conducted evaluating the presence/absence of LNU (chisquare test). Additionally we performed a semiquantitative analysis (SUVmax of LNU), to explore possible differences according to type and number of vaccination doses, time-Vacc, patient age and tumor hystologies (independent t-tests). Result(s): From the 361 eligible subjects (median age: 67 years), 319 (88%) underwent PET/CT with FDG, 23 (6.3%) with PSMA, 19 (5,2%) with CHOL. 296 (82%) subjects received mRNA-based vaccine, 62 (17%) viral-vector (V-V) and 3 (1%) received mixed vaccines. Positive LNU was seen in 203 subjects (56.2%) independently of vaccine types (mRNA=59.68, V-V=55.7, p=0.74) and number of doses (1 dose: V-V=56.76%, mRNA=58.62 p=0.83;2 doses: mRNA=55%). Similar frequency of LNU positivity was observed using FDG and CHOL (57.6% and 57.8%, respectively), while with PSMA only 34.8% showed LNU positivity. LNU limited to ipsilateral axillar region was the most frequent location (global: 70.44%;FDG:69.6%;CHOL:63.6%;PSMA:100%), followed by both ipsilateral axillar and retropectoral region (global: 18.72%;CHOL: 36.4%). Positive LNU was less frequent in older patients (p=0.007), and ranged between 40 to 68% among the neoplastic pathologies, with the exception of multiple myeloma (15.8%;p=0.001). Positive LNU appeared in most cases in the first week post-vaccination (82%), persisted in second and third week (68.49%, 62.64%), and decreased after the fourth week (38.8%). Moreover, an inverse correlation between the time-Vacc and the SUVmax value calculated in the LNU using FDG (2.82 +/- 1.44;p=0.008) was observed. Conclusion(s): Patients referred to a FDG or CHOL PET scan due to diverse neoplastic diseases displayed high percentage of axillar LNU one week after COVID-19 vaccination, independently of vaccine type and number of doses. Our results also suggest a lower percentage of positive LNU in older subjects, patients with multiple myeloma, and when using PSMA-PET.
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ICT (information and communication technologies) have become a necessary educational resource and their use has become a daily occurrence in classrooms at different educational stages, even more so with the COVID-19 crisis. This relevance increases when it comes to disability, as ICTs become a tool for educational and social inclusion. Inclusion, technology, and teacher training are interrelated aspects, although they have hardly been analyzed in previous research. The aim of this paper is to analyze the situation regarding these aspects. To this end, a methodology based on uni- and bivariate analysis of six dimensions of a scale previously validated in other studies is used. The main results indicate that knowledge about disability and ICT is not sufficient;that knowledge about both aspects is greater among university teachers;and that in terms of gender and age differences, men and younger or less experienced teachers are more prepared and motivated. In short, the study is new in that it provides an accurate picture of the situation of teachers at all stages of education in technology and disability.
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Background. Remdesivir (RDV) is a broad-spectrum nucleotide analog prodrug approved for the treatment of COVID-19 in non-hospitalized and hospitalized adult as well as pediatric patients with clinical benefit demonstrated in multiple Phase 3 trials. Here we present SARS-CoV-2 resistance analyses from the Phase 3 ACTT-1 placebo-controlled clinical trial in hospitalized adults. Methods. Oro- or nasopharyngeal swab samples in ACTT-1 study were collected on Day 1, 3, 5, 8, 11, 15, and 29. All participants with >80th and 50% of participants with < 20th percentile of cumulative viral shedding underwent resistance analysis in both the RDV and placebo arm. The SARS-CoV-2 genome was sequenced using next generation sequencing. Phenotyping was conducted using virus isolation from clinical samples or generation of select site-directed mutants (SDMs) in a SARS-CoV-2 replicon system. Results. The majority of the sequencing data were obtained from participants with 80th percentile of cumulative viral shedding from the RDV and placebo arms as shown in Table 1. Among participants with both baseline and postbaseline sequencing data, emergent substitutions in nsp12 were observed in 12 of 31 participants (38.7%) treated with RDV and 12 of 30 participants (40.0%) in the placebo arm. The nsp12 substitutions that emerged in the RDV arm were only observed in one participant each, and the majority were present as mixtures with wildtype sequence. The following nsp12 mutations emerged in the RDV treatment group and were successfully phenotyped as clinical isolates or SDMs with low to no fold change in RDV susceptibility: A16V (0.8-fold), P323L+V792I (2.2-fold), C799F (2.5-fold), K59N (1.0-fold), and K59N+V792I (3.4-fold). V792I and C799F were identified previously in vitro in resistance selection experiments (Stevens Sci Transl Med 2022). In addition, for D684N and V764L identified in the RDV arm, the recovery of neither clinical isolates nor SDMs for phenotypic analysis were successful. Conclusion. The similar rate of emerging nsp12 substitutions in participants treated with RDV compared to placebo and the minimal to no change in RDV susceptibility among the treatment-emergent nsp12 substitutions support a high barrier to RDV resistance development in COVID-19 patients.
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Introduction: The results are presented of a research carried out in students from the University of Medical Sciences of Camagüey who were involved in the active COVID-19 screening in eight health areas of Camagüey Municipality. Objective: To determine the influence of active COVID-19 screening on the formation of values in students from the University of Medical Sciences of Camagüey. Methods: A survey was elaborated and applied to 416 intentionally selected students of medical sciences. The experience obtained in the active COVID-19 screening was assessed, as well as its influence in the students' performance as future health professionals, the human values strengthened in the task and the main tendencies that influenced such values formation. Results: In the sample studied, the female sex and the medical school were more representative. 82 % percent of the surveyed students recognized the importance of active screening for their performance as future health professionals. Responsibility was the value that was most strengthened, while the acquisition of new knowledge and skills was the tendency to stand out in more than 45 % of the respondents. Conclusions: Values formation from active COVID-19 screening has represented an effective experience in the comprehensive development of medical sciences students in Camagüey, since it has made it possible to confront the epidemic;in addition, it has allowed them to develop skills, as well as human and professional values of great importance for their future. © 2022, Editorial Ciencias Medicas. All rights reserved.
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Introduction: In early 2020, North American jurisdictions required households (e.g., romantic couples) to isolate together to help mitigate the spread of COVID-19. This study provides a first look at the interplay of depressive symptoms and conflict behaviors among isolating couples, including tests of predictions of the stress generation hypothesis. Methods: Mixed-gender couples residing in Canada (N = 711) completed online measures across two waves. We used the actor-partner interdependence mediation model, with Wave 1 depressive symptoms as the predictor, Wave 1 conflict enactment as the mediator, and Wave 2 depressive symptoms as the outcome. Results: Depressive symptoms showed stability across Wave 1 and 2. Wave 1 depressive symptoms showed associations with Wave 1 conflict enactment. For men (but not women), Wave 1 conflict enactment was associated with their own and their partner's Wave 2 depressive symptoms. For both partners, Wave 1 conflict enacted by men mediated the association between Wave 1 depressive symptoms and Wave 2 depressive symptoms. Discussion: Our study confirms and extends the stress generation hypothesis to the pandemic context, showing that depressive symptoms may partially contribute to conflict for isolating couples and that conflict behaviors enacted by men toward their partner can exacerbate depressive symptoms in both partners.