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Due to the COVID-19 pandemic, "smart working” (hereafter SW) has become the norm for millions of workers around the world. A new way of working for most workers and in particular in Italy, a country where the use of SW was extremely rare before the pandemic. The aim of this paper, was to highlights whether smart working, adopted to face and survive global crises, could be really a suitable tool to generate benefits for companies, society, reduce environmental impacts and guarantee autonomy and flexibility for workers as well as a balance between private life. The analysis was conducted on a sample of 2753 individuals based in Italy during the period January and February 2021 using PLS-SEM model. The contribution of this study to research is identified in clarifying the potential of SW to create sustainable Smart Cities. © 2022 Elsevier Inc.
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Mr. Editor: I have read carefully and with great interest, the article called Anxiety level of rst-year medical students from (1) a private university in Peru in times of Covid-19 by Saravia-Bartra et al. published in the journal of the Facultad de Medicina Humana URP where the grade of anxiety present among freshman medical students of a private university is presented. Let me complement the information given in this new article by exposing some factors that can predispose to this condition.
Sr. Editor: He leído con detenimiento y gran interés el artículo Nivel de ansiedad de estudiantes de medicina de primer año de una universidad privada del Perú en tiempos de Covid-191 de Saravia-Bartra y cols. publicado en la revista Facultad de Medicina Humana URP donde se da a conocer el grado de ansiedad presente en estudiantes de medicina del primer año de una universidad privada. Permítame complementar la información dada de este novedoso artículo exponiendo algunos factores que pueden predisponer esta condición.
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Introduction: Despite Karate being an ancient martial art, with inclusion in the Summer Olympic Games, there is a lack of information about the supplementation pattern of competitive athletes. Objective: To evaluate the consumption of dietary supplements of athletes participating in the first official face-to-face championship, to understand, clarify and guide possible inadequacies. Materials and Methods: 47 athletes participated by filling in anamnesis with anthropometry, weekly training pattern, championship awards, supplementary consumption, among others. For that, informed consent was requested, for later completion of an electronic form. Results: There was a higher percentage of athletes who do not use food supplements;among supplement users there is a predominance of females and, in addition to several supplements, the use of whey protein and creatine. There is an indication of a specific supplementary standard for each sex, but in general the prescribing source and objectives indicate risks of adverse effects due to lack of adequate professional guidance. Conclusion: Study with the novelty of collecting post -pandemic supplementary standard data from competitive athletes who concurrently won awards in the championship. However, these can have risks to health and income due to the lack of professional monitoring for supplementary consumption for income.
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Background: COVID-19 is a disease due to a new form of coronavirus called SARS-CoV2 which causes an acute infection with respiratory symptoms. This new virus is different from those that cause SARS (severe acute respiratory syndrome) or MERS (respiratory syndrome of Middle East). Clinical manifestations can range from asymptomatic infection to life-threatening disease. By November 2021, more than 250 million people have had confirmed covid-19 and more than four million have died worldwide. Literature data show increased mortality from COVID-19 in cancer patients (pts). Moreover, cancer pts often fail to respond adequately to the initial vaccination. The aim of our study was to evaluate, sex differences in safety and tolerability of m-RNA-1237 Moderna COVID- 19 vaccine booster dose (fourth dose) in oncology pts, focusing on the first week after vaccination. Material(s) and Method(s): We have retrospectively analyzed sex differences on safety and tolerability of m-RNA-1237 Moderna COVID-19 vaccine booster dose (fourth dose) in 37 cancer patients (pts). All pts were vaccinated in March 2022 while undergoing active cancer therapy. There were 21 men (56.7%), 16 women (43.2%) Mean age 70 years (range 48-82) We analyzed the following adverse events (AE): fever, joint pain, injection site pain, lymphadenopathies, chills, nausea and vomiting, headache, diarrhea. AE were analyzed and stratified in grades from G1 to G4 according to CTCAE scale. Result(s): Of 37 pts analyzed, 9 (24.3%) developed AE and all within one week of vaccination. All pts with AE were female All AE were G1 and G2.No pts presented G3-G4 AE. The AE found in the 9 pts were fever (100%) and injection site pain (100%) No pts had joint pain, lymphadenopathy, chills, nausea and vomiting, headache and diarrhea. Using the Fischer test we found that the difference in the two sexes between the development of adverse events related to vaccination was statistically significant (p 0.0001) Conclusion(s): Our results demonstrate that m-RNA-1237 Moderna COVID-19 vaccine second booster dose (fourth dose) is usually well tolerated among cancer pts: All AE were G1 and G2. No pts presented G3-G4 AE. In addition, despite the limited number of pts, we found a statistically significant difference between male and female pts in the development of adverse events related to vaccination.
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Introduction: Many pre- and post-marketing studies on Covid-19 vaccines investigated their safety in the overall population. Little information is available on cohorts with specific comorbidities. Few studies evaluate the safety in allergic subjects, in particular as related to the anaphylaxis risk. Objective(s): To investigate the association between anaphylaxis after Covid-19 vaccines and the history of hypersensitivity reactions to the most common allergens. Method(s): The Vaccine Adverse Event Reporting System (VAERS, January 2020-December 2021) was downloaded and cleaned. We focused on reports of Adverse Events Following Immunization (AEFIs) following COVID-19 vaccination in subjects>12 years old with history of allergy. We performed a descriptive analysis and calculated the Reporting Odds Ratio (ROR) to identify demographic characteristics and allergic histories disproportionally reported with anaphylaxis for each Covid-19 vaccine and the most recorded allergens. Result(s): We retrieved 183,860 AEFI reports recording any allergic history (864 anaphylaxis reports among cases vs 6,162 in Covid-19 reports without history of allergy). They concerned mostly women (81.3%) and adults (74.0%). Almost all reports were submitted in the US (99.7%) and 38.3% of them resulted in hospitalization. Covid-19 vaccines administered were Spikevax (49.3%), Comirnaty (42.1%), and Janssen (8.4%). The antigens most recorded as allergens were penicillins (49,407), sulfa drugs (37,365), opioids (26,398), seafood (12,039), latex (11,442), NSAIDs (11,319), cephalosporins (8,379), quinolones (8,023), macrolides (7,586). Seafood allergy resulted associated with anaphylaxis for Comirnaty (ROR = 2.80;95% CI 2.20-3.56), Spikevax (2.57;1.88-3.51), and Janssen (2.67;1.39-5.11). Latex allergy was associated with anaphylaxis for Comirnaty (ROR = 1.92;95% CI 1.45-2.55). Conclusion(s): We gathered evidence pointing towards a preferential development of anaphylaxis in patients with an history of hypersensitivity to seafood (for all Covid-19 vaccines) or latex (restricted to Comirnaty). Whether confirmed by further studies, this knowledge may drive a more practical anamnesis and a prompt management of anaphylactic reactions.
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Introduction: Many pre- and post-marketing studies on Covid-19 vaccines investigated their safety in the overall population. Little information is available on cohorts with specific comorbidities. Few studies evaluate the safety in allergic subjects, in particular as related to the anaphylaxis risk. Objective: To investigate the association between anaphylaxis after Covid-19 vaccines and the history of hypersensitivity reactions to the most common allergens. Methods: The Vaccine Adverse Event Reporting System (VAERS, January 2020-December 2021) was downloaded and cleaned. We focused on reports of Adverse Events Following Immunization (AEFIs) following COVID-19 vaccination in subjects > 12 years old with history of allergy. We performed a descriptive analysis and calculated the Reporting Odds Ratio (ROR) to identify demographic characteristics and allergic histories disproportionally reported with anaphylaxis for each Covid-19 vaccine and the most recorded allergens. Results: We retrieved 183,860 AEFI reports recording any allergic history (864 anaphylaxis reports among cases vs 6,162 in Covid-19 reports without history of allergy). They concerned mostly women (81.3%) and adults (74.0%). Almost all reports were submitted in the US (99.7%) and 38.3% of them resulted in hospitalization. Covid-19 vaccines administered were Spikevax (49.3%), Comirnaty (42.1%), and Janssen (8.4%). The antigens most recorded as allergens were penicillins (49,407), sulfa drugs (37,365), opioids (26,398), seafood (12,039), latex (11,442), NSAIDs (11,319), cephalosporins (8,379), quinolones (8,023), macrolides (7,586). Seafood allergy resulted associated with anaphylaxis for Comirnaty (ROR = 2.80;95% CI 2.20-3.56), Spikevax (2.57;1.88-3.51), and Janssen (2.67;1.39-5.11). Latex allergy was associated with anaphylaxis for Comirnaty (ROR = 1.92;95% CI 1.45-2.55). Conclusion: We gathered evidence pointing towards a preferential development of anaphylaxis in patients with an history of hypersensitivity to seafood (for all Covid-19 vaccines) or latex (restricted to Comirnaty). Whether confirmed by further studies, this knowledge may drive a more practical anamnesis and a prompt management of anaphylactic reactions.
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The unexpected and bursting arrival of the Covid-19 pandemic in a short time has overwhelmed the whole world, bringing changes in every aspect of life: social, work, economic, technological. The lifestyle and eating habits of the Italian population have also undergone significant changes. What happened during the lockdown period? How did the Italians react to the quarantine? How have their eating habits changed? What impact have these changes had on health?
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Background. One of the strategies suggested for the containment of SARS-CoV-2 pandemic is testing at risk populations with rapid turn-out of results, contact tracing and isolation of infected individuals, at least until vaccination programs have been completed. Molecular testing of naso-pharyngeal swabs (NPS) is considered gold-standard, but antigenic testing should offer the advantage of being more rapid. Aim. The aim of this study was to evaluate the clinical performance of two chemiluminescent immunoassays on laboratory automated platforms, LIAISON® SARS-CoV-2 Ag Assay (DiaSorin) and Elecsys SARS-CoV-2 Antigen (Roche), to detect SARS-CoV-2 N antigen in NPS. Patients and Methods. A total of 281 subjects were consecutively enrolled (116 M, 165 F) from three different cohorts: 14 were COVID-19 in-patients (Group 1), 149 were patients enrolled at the emergency unit (Group 2) while 118 were healthcare employees under SARS-CoV-2 periodic surveillance (Group 3). All subjects underwent NPS with eSwab Copan. Antigen and molecular testing were performed soon after collection. Results. Thirty subjects were SARS-CoV-2 positive at molecular testing. Liaison antigen was positive (>200 TCID50/ml) in 22/30 (Se=73.3%), equivocal (100-200 TCID50/ml) in 4/30 and negative (<100 TCID50/ml) in 4/30 subjects. Specificity was 61.8% since 60/157 negative samples had equivocal results. With Elecsys sensitivity was 75.9% and specificity 99.5%. ROC curves were performed to compare the two assays and to identify the best cut-off. The areas under the curves were not different (η2=0.14;Prob>η2=0.7077). The highest likelihood ratio for Liaison corresponded to 150 TCID50ml cut-off, while for Elecsys to 1 index value. With these thresholds sensitivity of these two assays were 86% and 87% respectively, with 99% specificity. The limitations in sensitivity were due to false negative results for samples with Ct values at molecular analysis higher than 25. No false negative case was recorded among those with Ct lower than 25. Conclusions. In conclusion NPS SARS-CoV-2 antigen testing with chemiluminescent immunoassays allows the rapid detection of positive samples with a sensitivity and specificity that meet the recommendations of the WHO for this type of testing.
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Background: In response to regulations related to the COVID 19 pandemic and to patient demand, an outpatient total mastectomy pathway has been implemented at the Léon Bérard Center (CLB). This study evaluates the implementation of this pathway in terms of postoperative complications and patient satisfaction. Materials and Methods: Observational, retrospective, uni-centric study comparing two care pathways: traditional hospitalization versus outpatient care, for a total mastectomy associated or not with an axillary lymph node procedure. In the outpatient care, a teleconsultation by the coordinating nurses (IDEC) was performed the day after the surgery (D1 postoperative). Patient satisfaction in the outpatient care protocol was assessed by means of a satisfaction questionnaire sent by e-mail, in person or by telephone. Results: Between January 2020 and March 2021, 314 total mastectomies, without immediate breast reconstruction, associated or not with an axillary lymph node procedure, were performed at CLB. Thirty-six patients (11.46%) benefited from the outpatient program. We matched them in age and ASA score with 36 patients who underwent total mastectomy in traditional hospitalization during the same period. The complication rate in our cohort was 54.2%, 30.6% of which were lymphoceles. The postoperative complication rate and the revision surgery rate were not significantly different between the 2 groups (p=0.509, p=0.614). Five patients (13.9%) in the outpatient protocol were converted to traditional hospitalization. No patient in the outpatient program was rehospitalized for a surgical complication. In 66.7% of cases, the teleconsultation on D1 post-operation was carried out between the patient, the IDEC and the nurse in the patient's home who was responsible for the rest of the management. The patients in the outpatient protocol responded to the satisfaction questionnaire in 83.3% of cases. The overall satisfaction rate was rated at 4 or 5 out of 5 in 72.2% of cases. Patients would recommend the outpatient program to a relative in 90% of cases. Conclusions: Our study highlights the feasibility of outpatient total mastectomy, with good patient satisfaction. Teleconsultation at D1 post-op facilitates the link between the surgical management center and the city, favoring continuity of care.
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The Covid-19 pandemic has forced the education system to a rapid and unprepared transition to distance learning, inducing many teachers to organize lessons via information and communication technologies (ICTs), albeit often without sufficient technological and organizational support. Our study aims to evaluate teachers’ and students’ experience with ICTs during the first lockdown, considering three categories of relevant factors: technical issues, attitudes and beliefs towards online learning, and metacognitive skills. Participants were 486 students and 83 teachers of a Northern Italy high school, who were administered a self-reported online questionnaire. Video-lessons and audio-lessons emerged as overlooked teaching modalities. The desktop was the less used device, teachers preferred the tablet, while students preferred the smartphone. In general, students displayed appreciation of distance learning, even if they wished for more interactive activities. Teachers’ level of metacognitive competence and self-efficacy were rather high. For students, the perception of the e-learning environment predicted positively the perception of distance education and negatively the experienced anxiety, with anxiety also being higher among females. For teachers, the evaluation of distance learning was positively predicted by their beliefs about ICTs. This demonstrates the importance of promoting positive ICTs beliefs to motivate teachers in engaging in distance learning. Moreover, higher perceived self-efficacy was associated with lower levels of anxiety, thus showing the need to engage in training activities enabling teachers to feel confident when using ICTs. © Italian e-Learning Association.
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Backgrond: During the first outbreak of COVID 19 pandemic, Piacenza was particularly affected since it counted over one hundred daily access in emergency department, of patients (pz) with SARS COV2 virus. This fact led to a reorganization of hospital activity consisting in the formation of 7 department devoting COVID 19 care and in temporarily postponing scheduled activities of various disciplines to prevent the spread of virus. Also Our Division of cardiology has kept only urgent clinical and interventional activity. With the use of remote monitoring (RM), we were able to check implantable cardiac devices (ICD) almost scheduled and we called ICD recipients in office only for urgent troubles. Methods: In our study we evaluated all ICD recipients that had a scheduled follow up in our electrostimulation clinic on the period from 23th February 2020 to 18 th May 2020 Results: In office scheduled controls during the period considered, involved 216 patients. 85% out of them was followed also with MR;after postponing in office visits, we requested control transmissions. In total we received 441 scheduled and with alert transmissions. Regarding alert transmission: 3 of them signaled ERI (elective replacement indicator), so the replacement of device has been planned;3 of them indicated noise in Ventricular Fibrillation zone related to lead malfunction, so we planned reimplantation of new ventricular lead;12 recorded ventricular arrhythmias (only one patient was called to visit in office for recurrent ventricular arrhythmias);1 of them signaled long lasting atrial fibrillation so we called him to begin anticoagulant therapy. We performed phone triage before confirming in office visit. None of the scheduled transmissions detected troubles. Only 1,8% of patients followed by remote monitoring came in hospital in that period. Conclusions: RM during phase 1 of the first wave of COVID 19 outbreak allowed us to reduce in office visits and to call in hospital only patients with real needs, decreasing the spread of the virus and maintaining identification of clinical and technical troubles.
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BACKGROUND AND AIMS: Data about HD patients and how to best dialyze them during the COVID-19 pandemic are scarce. The aim of the study is to describe the organizational model and clinical outcomes of patients confirmed COVID-19 needing renal replacement therapy, admitted in a COVID Hospital in Southern Italy during the first and second pandemic wave. METHOD: All the consecutive patients requiring chronic HD, during the first and second wave were considered. Due to local resources, we have implemented an organizational model based on the HD bedside with Genius system. The machine was prepared in the Dialysis Unit and then transferred to the COVID Hospital. After treatment, the monitor was sterilized and carefully cleaned with chlorine wipes and retransferred into the dialysis Unit to be prepared for the next dialysis. Demographic data, clinical symptoms at presentation, and laboratory results were extracted by the electronic medical record. Patients hospitalized during the first wave (FW) and second wave (SW) were compared. RESULTS: From March 10 through December 31 2020, we enrolled a cohort of 40 patients (37.5% F), with COVID-19 infection requiring HD;11 (27.5%) during first and 29 (72.5%) during second wave. The phenotype and clinical symptoms at the admission were not different between two groups. Compared to FW, the SW patients were younger (70.1±9.5 vs 77.3±5.9 years;p<0.03) with lower dialysis vintage (35±18 vs 60±48 months;p<0.05), and lower Charlson Comorbidity Index scores (2.8±1.8 vs 5.09±2.0;p<0.05). No differences were observed between the first and second wave as far as inflammatory markers IL6 (51.9±44.8 vs 55.45±40.52 pg/mL;ns) and C-reactive protein (4.74±3.8 vs 6.70±5.44 mg/L;ns) as well as the hospital stay (21.1±10 vs 24.4.8±10 days;ns) and in-hospital mortality (28.1% vs 18.2%;ns). Overall, 354 bedside treatments were performed;mean session time and mean weekly sessions were 3.64±0.40 hours, and 3.4±0.45 HD/week, with no differences between FW and SW patients. CONCLUSION: Our data show that the higher spread of Sars-cov2 during the second wave has infected younger and less comorbid HD patients, with no significant differences in clinical and laboratory parameters. Our organizational model based on the HD bedside with the Genius system, allowed a personalized treatment with efficacy and safety for the patients and staff.
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Detecting and tracking people is a challenging task in a persistent crowded environment as retail, airport or station, for human behaviour analysis of security purposes. Especially during the global spread of SARS-CoV-2 virus that has become part of everyday life in every country, it is important to be able to manage the flows inside and outside buildings indoors. This article introduces an approach to detect and count people when they cross a virtual line. The methods used are based on deep learning and in particular on convolutional neural networks, specifically MobileNetV3 which is used for the detection task and MOSSE filter which is used for the tracking phase. The hardware system assembled for people counting is inexpensive, as it is formed by Raspberry Pi4 and a Picamera module v2. These devices have already been installed in some supermarkets and museums in the center of Italy, precisely in the area of the Marche region. © Springer Nature Switzerland AG 2021.
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The COVID-19 pandemic forced immediate changes to clinical practice. The article presents some adaptations undertaken during the first outbreak in Mexico City, from March to June 2020. Key modifications were the telephone mode, the boundaries of personal space during the session, and the pace of the analysis. Regressive topics were recurrent, and some patients exhibited paranoid features related with contagion and vulnerability. Feelings of frustration, longing, and loneliness were pervasive, oftentimes accompanied by the symptoms of anxiety and depression, and an overall sense of timelessness was common. As the pandemic intensifies, fear and grief came closer. The experiences of the first outbreak might help other psychoanalysts navigate a complicated period.
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Introduction and Aim of the study: The unexpected COVID-19pandemic began in December 2019 in Wuhan and rapidly spreadworldwide, continues to challenge the medical community. The understanding of host characteristics at presentation could lead theway towards a better management. We analyzed data collectedform a cohort of patients admitted for Sars-CoV-2 infection to evaluate the determinants of disease severity.Materials and Methods: Data were collected retrospectively frommedical records of patients admitted at F. Miulli General HospitalCOVID department from February to May 2020. CD3, CD4, CD8,CD19, CD56, WBC, lymphocytes on admission were analyzed inrespect of on the basis of outcomes and need for resuscitation or not. A descriptive analysis was performed (t-test for continuousdata with normal distribution).Results: We studied 127 patients, 80 M, 47 F, mean age 66±15years. A statistically significant higher in CD3 (p <0.01-0.01), CD4(p<0.01-0.04), CD8 (p <0.01-0.0.05) and lower in lymphocytescount (p <0.01-0.001) decrease was observed in patients withfatal outcome and in ones who need for resuscitation (in bracketsthe respective p values). WBC counts only show a significant reduction in the recovery analysis (p<0.01-0.11).Conclusions: Our results confirm that a different immunologic profile can predict the clinical course of the disease. These evidencescould help to assess an individualize therapeutic management ofCOVID19 patients.