ABSTRACT
The objective of this research is to develop a monthly indicator that synthesizes the economic acti-vity of the construction sector in Valle del Cauca, as a tool for analyzing the production cycle and as a single, public measure that contributes to decision-making. Dynamic factorial models, the Kalman filter and the Litterman method are used, also employed in the Monthly Index of Economic Activity (IMAE), in order to capture signals, changes in the productive cycle of construction and compile the sectoral economic facts that affect production. In the results, the dynamics of the sectoral and economic variables are observed that explain the behavior of the sector in Valle del Cauca during 2009-2020. A change of slope is observed in 2020, as a direct consequence of the crisis generated by COVID-19 and the restrictive measures taken by the government to contain its advance.
ABSTRACT
In this summer program, preservice teachers are recruited to work with children from the community and are mentored closely by two faculty members who are literacy education professors. This allows the candidates to learn from faculty mentors and their peers, a proven model for effective field experiences. Despite the research being done on remote learning due to COVID-19, the factors dictating the necessity of caring classrooms-such as systemic inequities and mental health's impact on student achievement-are more prevalent than ever and missing from the literature. The findings of the qualitative case study indicate the need for intentional work in preservice programs on creating caring digital classrooms. The findings also indicate the immediacy of the mental health concerns for children learning digitally due to COVID-19.
ABSTRACT
Background: With the COVID-19 vaccine now available, there have been occasional reports of post-vaccination neurological complications. Case presentation: In this report, we present a case of neuromyelitis optica spectrum disorder (NMOSD) that developed one month after the patient received the second dose of BIBP COVID-19 vaccine (SARS-CoV-2-Vaccine [Vero Cell] Inactivated). The patient presented with itching, numbness in the hand and right side of the face, as well as nausea, vomiting, and hiccups. Brain MRI revelead lesions in the area postrema, medulla, and bilateral hypothalamus, which are typical of NMOSD. Serum antibodies to anti-AQP4 and anti-MOG were negative. Conclusion(s): The pathogenesis of NMOSD development after vaccination is still unknown. NMOSD is generally aggressive and disabling, it is important for the neurologist to be attentive to the highly variable clinical presentation after COVID-19 vaccination for early diagnosis and effective treatment.Copyright © 2023
ABSTRACT
The objective of this research is to develop a monthly indicator that synthesizes the economic acti-vity of the construction sector in Valle del Cauca, as a tool for analyzing the production cycle and as a single, public measure that contributes to decision-making. Dynamic factorial models, the Kalman filter and the Litterman method are used, also employed in the Monthly Index of Economic Activity (IMAE), in order to capture signals, changes in the productive cycle of construction and compile the sectoral economic facts that affect production. In the results, the dynamics of the sectoral and economic variables are observed that explain the behavior of the sector in Valle del Cauca during 2009-2020. A change of slope is observed in 2020, as a direct consequence of the crisis generated by COVID-19 and the restrictive measures taken by the government to contain its advance.
ABSTRACT
Introduction: post-COVID-19 syndrome is the set of signs and symptoms that develop during or after an infection compatible with COVID-19, that persist for more than 12 weeks and are not explained by an alternative diagnosis. Background: to characterize the clinical-epidemiological behavior of the post-COVID-19 syndrome in patients at the Andres Ortiz Polyclinic. Method: a descriptive and cross-sectional observational study was carried out from October to December 2021, in a population of 51 subjects that was studied in its entirety. The analysis was descriptive. Results: patients with 50-59 years (n = 20;39.2%), female (n = 32;62.7%) predominated. The most frequently affected organ system was the respiratory (n = 19;37.2%), while the symptoms were: chronic fatigue (n = 15;29.4%), shortness of breath (n = 11;21.5%) and cough (n = 8, 15.6%). Among the patients with respiratory (n = 30), cardiovascular (n = 24) and neurological (n = 10) diseases, the most frequent were, respectively: pulmonary fibrosis (n = 17;56.7%), cardiac arrhythmias (n = 11;45.8%) and peripheral neuropathies (n = 5;50%). Conclusions: post-COVID-19 syndrome occurred mainly between the ages of 50 and 59, in female patients, with symptoms of chronic fatigue, shortness of breath and cough, as well as pulmonary fibrosis, cardiac arrhythmias and peripheral neuropathies as main comorbidities.
ABSTRACT
This paper presents and evaluates a hypothetical learning trajectory by which students bridge the transition from elementary to university-level instruction regarding the concept of vector. The trajectory consists of an instructional sequence of five tasks and begins with a problem in context. Each task is carried out with the support of a Virtual Interactive Didactic Scenario, accompanied by exploration and guided learning sheets, in which the problem is introduced through the simulation of the movement of a robotic arm. This proposal was implemented at the beginning of the SARS-CoV-2 pandemic using various digital media. Two teaching experiments were carried out with engineering students at a Mexican public university. We present the hypothetical learning trajectory that should be followed toward solving the task, and contrast it in each case with the students' actual learning trajectory. The results show that more than 70 % of the students successfully transitioned from the geometrical vector representation of elementary physics to the algebraic one. © 2023 Elsevier Inc.
ABSTRACT
Conference tourism is of growing importance for destinations, although has been severely impacted by the travel and venue capacity restrictions caused by COVID-19. The main aim of this study is to analyse the motivation of conference tourism demand from a gender-based perspective. Data were gathered using an online survey instrument developed on the basis of a literature review. A total of 265 responses received were subjected to exploratory factor, ANOVA and logistic regression analyses. The sample was composed of 52.5% men and 47.5% women and the average age of respondents was 44.25 (SD = 9.87). The results indicated five motivating factors for attending conferences: Destination and leisure, academic and professional development, networking, travelability and cost. Significant gender differences were found in the first four factors. Female attendees at conferences considered these factors more important than male attendees did. The implications of these findings for conference organisers are discussed. © The Author(s) 2022.
ABSTRACT
Video-based online meetings and, ultimately, the amount of private information that is shared-intentionally or accidentally-increased as a result of the COVID-19 pandemic. For example, online teaching might reveal lecturers' private environment to students or business meetings might provide insights about employees' family relationships. This raises the need to understand users' perception towards privacy intrusion during online video conferences to inform concepts that better protect meeting participants' privacy. We present the results of an online survey (N = 140) in which we investigate user stories of privacy-invasive situations in their homes during such meetings. Our results show that online meetings reveal private information that would not have become available during physical meetings. This often involves third parties (e.g., children, spouse, colleague), who might not even be aware of this. We discuss potential means to support users in protecting their and others' privacy before, during, and after video-based online meetings. © 2022 ACM.
ABSTRACT
Background. Secondary infections are common among severe COVID-19 patients, increasing complications and mortality risk. These infections are not well characterized in Latin America and the Caribbean. Methods. A cross-sectional observational study of adult patients with COVID-19 admitted to the hospital Fundacion Valle del Lili in Cali-Colombia from March 2020 to March 2021. Demographic data, clinical characteristics, laboratory parameters, and clinical outcomes were collected. We describe secondary infection, antibiotic therapy, and antibiotic resistance profiles. Secondary infection was defined if the diagnosis occurred >=48 hours after hospital admission for COVID-19. Results. A total of 2138 patients with COVID-19 were analyzed;350 (16.3%) presented secondary infection. 60% were male;the median age was 65 years [IQR: 55-72]. Glucocorticoid therapy was indicated in 335 patients (96.3%). 281 received high doses and 54 low doses. Bacterial infections were the most common, affecting 81.3 % of patients, followed by fungal (14.4%) and viral (4.3%) infections. Most bacterial isolates were orotracheal secretion, blood, urine, and bronchoalveolar lavage fluid culture. The three most frequently identified bacteria were Klebsiella pneumoniae, Staphylococcus aureus, and Pseudomonas aeruginosa. Most of the initial isolates were not antibiotic-resistant (75-89.7%). Empiric antibiotic therapy was indicated in 346 patients (98.9%), 268 received carbapenems (76.6%), 267 Vancomycin (76.3%), and 233 cefepime (66.6%). Of the 350 patients, 327 (93.4%) required management in the intensive care unit, and overall mortality was 35.4% (124/350). Conclusion. Our results showed a lower frequency of secondary infection than previous reports;However, a high frequency of broad-spectrum antibiotics usage was found despite a high prevalence of non-resistant bacteria. Further studies are needed to establish the best approach for antibiotics therapy.
ABSTRACT
Background. Differences in access to specialized medical care services and their overcrowding due to the pandemic could impact clinical outcomes. Availability of newer treatments, vaccination, and emergence of newer SARS-CoV-2 variants could also explain these differences. Methods. We performed a single-centered, observational study comparing clinical outcomes of COVID-19 admitted to the emergency department among the first three waves of the pandemic defined as June to August 2020, November 2020 to January 2021, and May to July 2021, respectively. The primary outcomes included intensive care unit admission, invasive mechanical ventilation requirement, hospital length of stay, and hospital mortality categorized by age groups. Effective COVID 19 antiviral therapy and monoclonal antibodies are not available in Colombia. Vaccination was available after March 2021. Results. Out of a total of 2264 patients were admitted. Fifty-six percent were male, with a median age of 58 years [IQR, 45-70]. A significant increase of patients was seen after each wave: 530 in the first, 568 in the second, and 1166 in the third-wave worsening hospital overcrowding. Patients from the third wave were significantly younger (59 vs. 62 vs. 56 years, p < 0.01). Patients from the first wave had higher proportion of intensive care unit admission (62.83% vs. 51.23% vs. 52.23%, p< 0.01), invasive mechanical ventilation (39.25% vs. 32.22% vs. 31.22%, p< 0.01), and length of hospital stay (9 vs 7 vs 7 days, p< 0.01). Overall, no difference was found inmortalityamong waves (18.4%vs 19% 18.8%, p = 0.974). However, patients of 70-79 and >= 80 had a lower mortality during the third wave (24.4% vs 33.3% vs 19%, p=0.018), (30.6% vs 29.6% vs 23.6%, p=0.018). Vaccination was very low in all the age groups but was higher in elderly patients. Conclusion. Overall mortality did not increase between infection waves, although there was an increase in cases during the third wave. We found a significant decrease in mortality among the elderly. Major efforts of medical teams succeed in containing COVID 19 mortality.
ABSTRACT
Background. Dengue fever and COVID-19 co-infection constitute a significant public health concern in Latin America, becoming a clinical challenge to distinguish these two entities in early stages of the disease. Clinical outcomes of coinfected hospitalized patients have not been well established. Methods. A cross-sectional study was conducted. We included suspected patients diagnosed with COVID-19/dengue co-infection admitted at Hospital Fundacion Valle del Lili, Cali - Colombia, from March 2020 to March 2021. All dengue patients had positive NS1 and/or IgM dengue antibodies. SARS-CoV-2 infection was confirmed by RT-PCR or antigen rapid test from nasopharyngeal swab. Laboratory and clinical data were recollected from the clinical laboratory database, clinical charts, and institutional COVID-19 registry. Results. A total of 90 COVID-19 patients were included. 72 patients were confirmed only with COVID-19, and 18 with dengue co-infection. Most patients were male: 46 (63.9%) vs. 13 (72.2%). None of these study patients were vaccinated against COVID-19 or dengue. The median time from symptoms onset and the diagnosis was five days, and fever was the most common symptom for both groups. There were significant differences between COVID-19 patients and coinfected patients regarding presence of dyspnea (22.2% vs. 61.1%;p=0.003), desaturation (13.4% vs. 53.3%;p=0.002) and a higher neutrophil/lymphocyte ratio (NLR) (3.84 vs. 5.59;p = 0.038). The co-infection was associated with a worse presentation of the COVID-19 infection (p=0.002), an increased requirement of initial supplemental oxygen therapy (p=0.007), mechanical ventilation (p=0.0004), ICU management at the admission (p=0.002), and ICU final management (p=0.002). Overall mortality in patients with co-infection was 44.4% vs. 6.9% in only COVID-19 infected patients (p< 0.001). Conclusion. Despite the pandemic era, the possibility of co-infection of these two entities must be considered. Admitted coinfected patients were associated with worse clinical outcomes and higher mortality. According to our results, patients with co-infection present with severe respiratory symptoms and an elevated NLR. The impact of the Covid 19 vaccination on this coinfection is unknown.
ABSTRACT
Background: Environmental contamination is suspected to play a key role in transmission of Candida auris in healthcare facilities. We recently showed that environmental surfaces near C. auris-colonized patients are commonly recontaminated within hours after disinfection. Clinical factors contributing to environmental contamination are not well characterized. Methods: We conducted a multi-regional (Chicago, IL;Irvine, CA) prospective study of environmental contamination associated with C. auris colonization at six long-term care facilities (LTCF) and 1 acute-care hospital (ACH). On day of sampling, 5 participant body sites were cultured once, followed by routine daily room cleaning by facility staff, then targeted disinfection of high-touch surfaces with hydrogen peroxide wipes by research staff. Surfaces were cultured for C. auris using pre-moistened sponge-sticks and neutralizer immediately pre- and post-disinfection, and 4, 8, and 12 hours post-disinfection. We calculated the odds of surface recontamination after disinfection as a function of body site colonization with C. auris using generalized estimating equations to account for clustering among multiple surfaces within timepoints, patients, and facilities. Models included an interaction between facility type and colonization. Results: C. auris was cultured from ≥1 body site in 41 participants (12 ACH and 29 LTCF patients, 205 body sites) on day of sampling. Proportion of body sites colonized did not vary by facility type (Table). Although environmental contamination rates were similar prior to disinfection [ACH 38% (n=60 samples) vs LTCF 29%, (n=145 samples), p=0.209)], the proportion of surfaces recontaminated between 4–12 hours after disinfection was higher in ACH vs LTCF (n=574 samples) (Figure). Number of body sites colonized with C. auris was associated with higher odds of environmental recontamination [ACH: OR 2.16 (95% CI 1.63–2.88), p< 0.001;LTCF: OR 1.40 (95% CI 1.07–1.84), p=0.015;Interaction ACH vs LTCF p< 0.001].Figure.Percent of Environmental Surfaces Recontaminated with C. auris within 12 hours of Cleaning by Facility Type Conclusion: The number of body sites colonized was associated with odds of C. auris environmental contamination. Differences in environmental recontamination by facility type may be related to greater provider-patient interactions in ACH as a driving factor. Disclosures: Gabrielle M. Gussin, MS, Medline: Conducted studies in which hospitals and nursing homes received contributed antiseptic and/or environmental cleaning products;Stryker: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products;Xttrium Laboratories: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products Raveena D. Singh, MA, Medline: Conducted studies in which hospitals and nursing homes received contributed antiseptic and/or environmental cleaning products;Stryker: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products;Xttrium Laboratories: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products Raheeb Saavedra, AS, Medline: Conducted studies in which hospitals and nursing homes received contributed antiseptic and/or environmental cleaning products;Stryker: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products;Xttrium Laboratories: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products Nicholas M. Moore, PhD, D(ABMM), Abbott Molecular: Grant/Research Support;Cepheid: Grant/Research Support Susan S. Huang, MD, MPH, Medline: Conducted studies in which hospitals and nursing homes received contributed antiseptic and/or environmental cleaning products;Molnlyke: Conducted clinical studies in which hospitals received contributed antiseptic product;Stryker: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products;Xttri m Laboratories: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic product Mary K. Hayden, MD, Sanofi: Member, clinical adjudication panel for an investigational SARS-CoV-2 vaccine.
ABSTRACT
Introduction: Status epilepticus (SE) is a neurologic emergency with high-mortality rates that requires early diagnosis and prompt treatment to improve the patient's chances. A SE is called refractory (RSE) when seizures are uncontrollable despite intravenous (IV) benzodiazepine in addition to anti-epileptic drugs (AED). If seizures continue despite IV-AED and/or IV-anesthetics, that is designated as super-RSE (SRSE). Recently, new-onset RSE (NORSE) has been described. The current armamentarium of AEDs, immunomodulation-drugs and non-pharmacological therapies available, including neuromodulation techniques, has been used to treat RSE. Lately, the use, efficacy, and safety of repetitive-transcranial-magnetic-stimulation (rTMS) are well known. Method(s): In October 2020, a 23-year-old male with a low level of consciousness and clinical SE was admitted to an intensive care unit. A febrile peak, the previous week, was the only pertinent data. SARS-CoV2 test was negative, although it became positive a week later. While in the hospital, SE therapeutic protocol was followed (antivirals, antibiotics, and AEDs, anesthetics, including cortical electrical silence pentothal-induced, immunomodulation drugs (tocilizumab, anakinra), and ketogenic diet) without achieving seizure control. Despite the lack of continuous electroencephalography (EEG) monitorization, daily EEGs were recorded and a diffuse slow-wave cortical activity led the way to bihemispheric fronto-temporal (FT) seizures;left-FT SE was also registered. On the 49th day, the decision was made to administer rTMS. Previously, the epileptiform zone had been located in the right-FT region. He received ten sessions of low-frequency (1-Hz) rTMS in a middle point between C4/T4. No side effects were reported. Result(s): After the first sessions, the patient's level of consciousness improved, and the EEG showed progressive improvement of the cortical slowing and the epileptiform activity over the following days. By the time of discharge, EEG activity was almost normal with some epileptiform discharge still present on the EEG record. Conclusion(s): To our knowledge, a few case series have been published on the use of low-frequency rTMS as a therapeutic approach in SE. Low-frequency rTMS applied over the active epileptogenic focus may swap the cortical excitability toward an inhibitory direction by inducing synaptic plasticity through a long-term depression mechanism, which translates into SE suppression. We cannot confirm that rTMS was the only reason for the positive outcome in this particular patient. However, the outstanding improvement of the EEG activity since the administration of rTMS, accompanied by the progressive recovery of the level of consciousness, means that this technique should be taken into account as a potential therapeutic option in the early onset of SE given its efficacy, and its harmless characteristics. Copyright © 2022
ABSTRACT
Introduction: Multiple sclerosis drugs (DMTs) were expected to increase the incidence and risk of severe infection for SARSCoV- 2 and to decrease the response to the vaccine, but has it been the case? Objectives: 1) To evaluate the relationship between the use of DMTs and the incidence and severity of SARS-CoV-2 infection. 2) To evaluate the relationship between the use of DMTs and the incidence and severity of SARS-CoV-2 infection after vaccination. Aim(s): To demonstrate that treatment with DMTs does not increase the incidence and risk of severe illness or the response to vaccination due to SARS-CoV-2 infection. Method(s): Retrospective cohort study of 472 adults with MS in a MS Unit between March, 2020 and March, 2022. All DMTs were prescribed prior to COVID-19 testing. Variables: Demographics data, DMTs, SARS-CoV-2 test results, severity of the infection (hospitalized and death), infection after vaccination. Result(s): Among 472 patients with MS, 120 patients (25.4%) had SARS-CoV-2 infection (Incidence in the general population of Catalonia: 22.7%);83 (26%) were women;mean age: 49 years (44.5 yrs for infected;50.6 yrs for not infected);there was no significant difference in the incidence of infection between 66 (29.3%) of the 213 treated and 52 (21.8 %) of the 259 untreated patients (p=0,059). There was also no significant difference in hospitalization between the 4 treated (5.9 %) and 3 untreated (2.5 %) patients. None of them died. There wasn't a significant difference between post-vaccination incidence of infection between the 26 treated (41.3%) and 16 untreated (36.4%) patients either. Conclusion(s): The use of DMTs was not associated with an increase in incidence or severity of SARS-CoV-2 infection, and a favorable vaccine-induced SARS-CoV-2 response was observed. Further research is needed to determine the possible protective role of MS drugs on risk and severity of SARS-CoV-2 and the mechanisms that underlie these findings.
ABSTRACT
Advances in the knowledge of the particularities of COVID-19 in the neonatal period have led to some changes in the recommendations for clinical practice, reasons that motivated us to present this article with the aim of updating the aspects related to the care of newborns with suspected or confirmed COVID-19 after a year of pandemic. Neonatal SARS-CoV-2 infection can be congenital or intrapartum or postpartum acquired. The incidence of SARS-CoV-2 positive infants in COVID-19-positive women near delivery is 1.8-2.7%. About 55% of neonates with COVID-19 have clinical manifestations. Of special interest, due to its severity, is the fetal inflammatory response syndrome or neonatal multisystem inflammatory syndrome, of rare presentation. The possibility of occurrence of congenital and intrapartum neonatal infection justifies the implementation of actions for its diagnosis and prevention. Breastfeeding in children of women with COVID-19 should be maintained. During cardiopulmonary resuscitation and respiratory care, compliance with strict protective measures is required. COVID-19 has particularities in the newborn with respect to other ages. The clinical evaluation of the newborn with suspected COVID-19 should take into account the multiple patterns that link the various alterations that occur in the mother-child day by day in the perinatal period, with a view to optimizing the diagnosis, classification and treatment of this disease in the neonatal period. © 2021, Editorial Ciencias Medicas. All rights reserved.
ABSTRACT
The COVID-19 pandemic has significantly increased the use of online tools in the conduct of multilateral environmental negotiations. Although scholars have recognized that information and communication technologies have gradually been reshaping traditional diplomatic practice, such technologies are not considered to be transformative of diplomatic practice itself. However, owing to the COVID-19 pandemic states have had to rush into unprecedented and unpredictable forms of digital cooperation that are poorly understood. To illuminate this uncharted area, our research applies combined digital and critical policy ethnography to two online dialogues within the framework of ongoing negotiations under the United Nations Convention on the Law of the Sea toward a new treaty for the protection and sustainable use of marine biodiversity beyond national jurisdiction. Digital critical policy ethnography conducted at two online sites enables us to study the political effects of emerging international practices. We re-interpret digital diplomacy in terms of "communities of practice" developing across, and connecting physical and digital sites. Virtual communications amongst state and non-state actors mirror traditional forms of diplomacy whilst introducing new practices that may change conventional forms of international treaty-making. We propose the term digital multilateralism to capture these new forms and conclude that it can have two effects: deepen the background knowledge of actors that form a community of practice and create new inequalities.
ABSTRACT
Background: The risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) is higher than individuals from the general population due to chronic infammation. Current CV risk screening and management strategies underestimate the actual CV risk in RA. Thus, an adequate CV risk stratifcation has special relevance in RA to identify patients at risk of CV disease. Objectives: To assess the incidence of cardiovascular events in a RA cohort after a 2 years follow-up. Methods: A cohort study was performed in which inclusion criteria were adult RA patients and matched adults in terms of age, sex and CV risk factors (controls). Population over 75 years old, patients with established CV disease and/or stage III chronic kidney disease were excluded. Controls with other infam-matory diseases, pregnant women or any malignancy were also excluded. This study was performed from July-2019 to January-2022. CV risk assessment included risk factors collection and US evaluation consisted in detection of plaques and measurement of the intima-media thickness in both right and left carotid. Results: Overall, a total of 200 cases and 111 healthy controls were enrolled in the study. Demographical and clinical variables were comparable between cases and controls and are shown in Table 1. US study revealed a higher IMT in both right and left carotid arteries with greater presence of plaques in patients than in controls (CI 95% [1.542;3.436], p<0.001). Plaques were found in both carotid arteries in the 32% of cases and 9.91% of controls. The longer duration of RA was related to a higher presence of carotid plaques (95% [1.015;1.056], p<0.001). Eight patients (4%) presented a cardiovascular event, and one of them died (0.5%). The events consisted in 2 angina pectoris, 3 transient ischemic attack, 1 acute myocardial infarction, 1 lacunar stroke and 1 cardiac arrest. Six out those 8 patients demonstrated bilateral plaque presence at baseline. Two patient caused loss of follow up due to death related to Covid-19. Not a single cardiovascular event was reported in the control group. Conclusion: Our results shows that cardiovascular events are increased in RA patients and US study may be useful in predicting an event.