Healthcare Recommender System Based on Medical Specialties, Patient Profiles, and Geospatial Information

The global outburst of COVID-19 introduced severe issues concerning the capacity and adoption of healthcare systems and how vulnerable citizen classes might be affected. The pandemic generated the most remarkable transformation of health services, appropriating the increase in new information and communication technologies to bring sustainability to health services. This paper proposes a novel, methodological, and collaborative approach based on patient-centered technology, which consists of a recommender system architecture to assist the health service level according to medical specialties. The system provides recommendations according to the user profile of the citizens and a ranked list of medical facilities. Thus, we propose a health attention factor to semantically compute the similarity between medical specialties and offer medical centers with response capacity, health service type, and close user geographic location. Thus, considering the challenges described in the state-of-the-art, this approach tackles issues related to recommenders in mobile devices and the diversity of items in the healthcare domain, incorporating semantic and geospatial processing. The recommender system was tested in diverse districts of Mexico City, and the spatial visualization of the medical facilities filtering by the recommendations is displayed in a Web-GIS application.

Influenza D Virus: A Review and Update of Its Role in Bovine Respiratory Syndrome.

Bovine respiratory disease (BRD) is one of the most prevalent, deadly, and costly diseases in young cattle. BRD has been recognized as a multifactorial disease caused mainly by viruses (bovine herpesvirus, BVDV, parainfluenza-3 virus, respiratory syncytial virus, and bovine coronavirus) and bacteria (Mycoplasma bovis, Pasteurella multocida, Mannheimia haemolytica and Histophilus somni). However, other microorganisms have been recognized to cause BRD. Influenza D virus (IDV) is a novel RNA pathogen belonging to the family Orthomyxoviridae, first discovered in 2011. It is distributed worldwide in cattle, the main reservoir. IDV has been demonstrated to play a role in BRD, with proven ability to cause respiratory disease, a high transmission rate, and potentiate the effects of other pathogens. The transmission mechanisms of this virus are by direct contact and by aerosol route over short distances. IDV causes lesions in the upper respiratory tract of calves and can also replicate in the lower respiratory tract and cause pneumonia. There is currently no commercial vaccine or specific treatment for IDV. It should be noted that IDV has zoonotic potential and could be a major public health concern if there is a drastic change in its pathogenicity to humans. This review summarizes current knowledge regarding IDV structure, pathogenesis, clinical significance, and epidemiology.

The first year of COVID-19 vaccine roll-out in Africa: challenges and lessons learned.

Introduction: in the first year following the introduction of COVID-19 vaccines, only 6.8% of the total population in the 47 countries in the WHO African Region have received full vaccination. In an emergency context, the intra-action review helps countries to assess their progress and document what has worked and not worked. Methods: we reviewed and identified the key lessons and challenges documented in the reports from intra-action review of COVID vaccine roll out in 22 African countries. Results: all countries documented high level political commitment, but a serious shortage of COVID-19 vaccines and funding. Seven countries identified gaps in microplanning because of lack of funding or due to the unpredictability in the type and volume of vaccine supplies. The shortage of operational funding also affected training of health workers and hampered the expansion of service delivery. The countries implemented multi-channel communications and social mobilisation activities, alongside social media engagement and social listening. However, country capacity was limited in terms of timely responding to infodemics. Hesitancy among health workers and the general population was a challenge in most of the countries. Conclusion: countries have gained valuable experiences exploring various COVID-19 vaccination delivery models, including implementing the integration of COVID-19 vaccination within routine health care programs. There is a need to regularly monitor or do studies measuring public perceptions towards COVID-19 vaccination in order to drive the demand generation efforts, as well as use evidence in addressing hesitancy.

The first year of COVID-19 vaccine roll-out in Africa: challenges and lessons learned

Introduction in the first year following the introduction of COVID-19 vaccines, only 6.8% of the total population in the 47 countries in the WHO African Region have received full vaccination. In an emergency context, the intra-action review helps countries to assess their progress and document what has worked and not worked. Methods we reviewed and identified the key lessons and challenges documented in the reports from intra-action review of COVID vaccine roll out in 22 African countries. Results all countries documented high level political commitment, but a serious shortage of COVID-19 vaccines and funding. Seven countries identified gaps in microplanning because of lack of funding or due to the unpredictability in the type and volume of vaccine supplies. The shortage of operational funding also affected training of health workers and hampered the expansion of service delivery. The countries implemented multi-channel communications and social mobilisation activities, alongside social media engagement and social listening. However, country capacity was limited in terms of timely responding to infodemics. Hesitancy among health workers and the general population was a challenge in most of the countries. Conclusion countries have gained valuable experiences exploring various COVID-19 vaccination delivery models, including implementing the integration of COVID-19 vaccination within routine health care programs. There is a need to regularly monitor or do studies measuring public perceptions towards COVID-19 vaccination in order to drive the demand generation efforts, as well as use evidence in addressing hesitancy.

Translating knowledge into innovation capability: An exploratory study investigating the perceptions on distance learning in higher education during the COVID-19 pandemic - the case of Mexico

The COVID-19 pandemic represented a significant challenge to higher education and forced academic institutions worldwide to abruptly shift to remote teaching. Higher education institutions are continuously confronted with the difficulties of creating satisfactory online learning experiences that adhere to the new norms. This paper presents a study concerning the perceptions of the quality and efficiency of the educational process in higher education concerning distance learning at the Instituto Politécnico Nacional of Mexico during the COVID-19 pandemic. The data analysis identified the level of satisfaction with distance learning education separately for students and professors and the lived experience for future education models. Data analysis consisted of a stepwise regression model to identify the most important variables related to the satisfaction aspect of e-learning for students and professors. The main findings are associated with the perception of one's own skills as the most crucial variable to define the aspects of e-learning satisfaction. Therefore, these skills involve the knowledge of e-learning platforms and the adoption rate of new technologies. The study found that the students emphasized that the variable "low sense of community" negatively impacts e-learning due to the loss of personal contact with the academic workspace. The key contribution of our research is a knowledge translation into a sustainable innovation capability model.

Global patterns of antigen receptor repertoire disruption across adaptive immune compartments in COVID-19.

Whereas pathogen-specific T and B cells are a primary focus of interest during infectious disease, we have used COVID-19 to ask whether their emergence comes at a cost of broader B cell and T cell repertoire disruption. We applied a genomic DNA-based approach to concurrently study the immunoglobulin-heavy (IGH) and T cell receptor (TCR) ß and δ chain loci of 95 individuals. Our approach detected anticipated repertoire focusing for the IGH repertoire, including expansions of clusters of related sequences temporally aligned with SARS-CoV-2-specific seroconversion, and enrichment of some shared SARS-CoV-2-associated sequences. No significant age-related or disease severity-related deficiencies were noted for the IGH repertoire. By contrast, whereas focusing occurred at the TCRß and TCRδ loci, including some TCRß sequence-sharing, disruptive repertoire narrowing was almost entirely limited to many patients aged older than 50 y. By temporarily reducing T cell diversity and by risking expansions of nonbeneficial T cells, these traits may constitute an age-related risk factor for COVID-19, including a vulnerability to new variants for which T cells may provide key protection.

Overview of coronavirus pandemic

During the last months of 2019, numerous cases of respiratory illness such as pneumonia and acute respiratory distress syndrome were described in Wuhan, the capital city of Hubei province in China. At the same time, several research groups identified and reported the etiological agent, that included within the Coronaviridae family and the order Nidovirales, named SARS-CoV-2. Subsequently, the pathological and clinical status caused by the pathogen is commonly known as Coronavirus disease 2019 (COVID-19). In a short period, the outbreak of emerging spread across the world. Therefore the World Health Organization declared a public health emergency of international concern on January 30, 2020, and as a pandemic on March 11, 2020. Many different public health and epidemiological studies have been published since the COVID-19 outbreak, but fatality rates (those that relate the number of cases to mortality) are difficult to assess with certainty. Mean and median case-fatality rates worldwide are near to 3% and 2%, respectively. The median infection fatality calculated from serologic prevalence varies from 0.00% to 1.63% but is mostly estimated between 0.27% and 0.9%. These indexes are influenced by geographic location, socioeconomic status, sex, age, and health conditions, among others.

Remote Healthcare Program in Mexico in the Context of the COVID-19 Pandemic.

OBJECTIVES: Given the challenge of limiting the transmission of coronavirus disease 2019 while simultaneously continuing to provide medical care for other chronic and degenerative diseases and monitor therapy, a remote medical advice and guidance program was created to help individuals receive health services at their homes. METHODS: A descriptive, cross-sectional, and observational study was performed from April 13, 2020 to April 19, 2021 among Petroleos Mexicanos (PEMEX) health services beneficiaries. Mobile text messages were used to assign patients throughout Mexico to a doctor, who coordinated a video call with the nursing service for advice and remote care. RESULTS: In total, 17,472 calls were registered, with an average duration of 10.28 minutes. Almost half (49.4%) of the people who requested attention through the remote program were workers, 31.5% were workers' relatives, and 19.1% were retired workers. The average age of the program users was 50.66 ± 18.02 years. A total of 144 doctors from 28 different specialties participated. In this program, 7,163 calls were made because of respiratory symptoms, 1,514 for therapeutic monitoring (prescriptions), and 8,183 because of other diseases, including mental health. CONCLUSIONS: Remote healthcare programs have shown the potential to support the health system. This program is the first to deploy real-time video calls with a health team utilizing institutional electronic clinical records in Mexico. The implementation of this pandemic management program impacted the number of consultations given remotely, resulting in effective triage.

Understanding Teacher Digital Competence in the Framework of Social Sustainability: A Systematic Review

Due to the global COVID-19 pandemic, ICT has been urgently introduced in education systems in a generalised manner. In this context, it is essential for teachers to master a spectrum of basic digital competencies and manifest digital leadership in the classroom. In addition, it is necessary to consider the relationship between digital competence development and social sustainability, that is, social and cultural heritage, and to what extent they contribute to improving social cohesion and living conditions in a community. This study presents a systematic review of research on teacher digital competence and social sustainability based on the PRISMA model and a review of 22 studies indexed in SCOPUS. The review reveals that most are intended to measure the digital competence level of teachers, usually in compulsory stages of the educational system and through quantitative studies based on virtual questionnaires comprised of closed-ended questions. However, the studies tend to ignore questions related to social sustainability (access to resources, heritage culture, intergenerational transmission, employability, or gender equality). It is therefore urgent to develop research committed to a sustainable society that is oriented towards social justice.

Safety and immunogenicity of one versus two doses of the COVID-19 vaccine BNT162b2 for patients with cancer: interim analysis of a prospective observational study.

BACKGROUND: The efficacy and safety profiles of vaccines against SARS-CoV-2 in patients with cancer is unknown. We aimed to assess the safety and immunogenicity of the BNT162b2 (Pfizer-BioNTech) vaccine in patients with cancer. METHODS: For this prospective observational study, we recruited patients with cancer and healthy controls (mostly health-care workers) from three London hospitals between Dec 8, 2020, and Feb 18, 2021. Participants who were vaccinated between Dec 8 and Dec 29, 2020, received two 30 µg doses of BNT162b2 administered intramuscularly 21 days apart; patients vaccinated after this date received only one 30 µg dose with a planned follow-up boost at 12 weeks. Blood samples were taken before vaccination and at 3 weeks and 5 weeks after the first vaccination. Where possible, serial nasopharyngeal real-time RT-PCR (rRT-PCR) swab tests were done every 10 days or in cases of symptomatic COVID-19. The coprimary endpoints were seroconversion to SARS-CoV-2 spike (S) protein in patients with cancer following the first vaccination with the BNT162b2 vaccine and the effect of vaccine boosting after 21 days on seroconversion. All participants with available data were included in the safety and immunogenicity analyses. Ongoing follow-up is underway for further blood sampling after the delayed (12-week) vaccine boost. This study is registered with the NHS Health Research Authority and Health and Care Research Wales (REC ID 20/HRA/2031). FINDINGS: 151 patients with cancer (95 patients with solid cancer and 56 patients with haematological cancer) and 54 healthy controls were enrolled. For this interim data analysis of the safety and immunogenicity of vaccinated patients with cancer, samples and data obtained up to March 19, 2021, were analysed. After exclusion of 17 patients who had been exposed to SARS-CoV-2 (detected by either antibody seroconversion or a positive rRT-PCR COVID-19 swab test) from the immunogenicity analysis, the proportion of positive anti-S IgG titres at approximately 21 days following a single vaccine inoculum across the three cohorts were 32 (94%; 95% CI 81-98) of 34 healthy controls; 21 (38%; 26-51) of 56 patients with solid cancer, and eight (18%; 10-32) of 44 patients with haematological cancer. 16 healthy controls, 25 patients with solid cancer, and six patients with haematological cancer received a second dose on day 21. Of the patients with available blood samples 2 weeks following a 21-day vaccine boost, and excluding 17 participants with evidence of previous natural SARS-CoV-2 exposure, 18 (95%; 95% CI 75-99) of 19 patients with solid cancer, 12 (100%; 76-100) of 12 healthy controls, and three (60%; 23-88) of five patients with haematological cancers were seropositive, compared with ten (30%; 17-47) of 33, 18 (86%; 65-95) of 21, and four (11%; 4-25) of 36, respectively, who did not receive a boost. The vaccine was well tolerated; no toxicities were reported in 75 (54%) of 140 patients with cancer following the first dose of BNT162b2, and in 22 (71%) of 31 patients with cancer following the second dose. Similarly, no toxicities were reported in 15 (38%) of 40 healthy controls after the first dose and in five (31%) of 16 after the second dose. Injection-site pain within 7 days following the first dose was the most commonly reported local reaction (23 [35%] of 65 patients with cancer; 12 [48%] of 25 healthy controls). No vaccine-related deaths were reported. INTERPRETATION: In patients with cancer, one dose of the BNT162b2 vaccine yields poor efficacy. Immunogenicity increased significantly in patients with solid cancer within 2 weeks of a vaccine boost at day 21 after the first dose. These data support prioritisation of patients with cancer for an early (day 21) second dose of the BNT162b2 vaccine. FUNDING: King's College London, Cancer Research UK, Wellcome Trust, Rosetrees Trust, and Francis Crick Institute.

Author Correction: A dynamic COVID-19 immune signature includes associations with poor prognosis.

A Correction to this paper has been published: https://doi.org/10.1038/s41591-020-01186-5.

Acute Immune Signatures and Their Legacies in Severe Acute Respiratory Syndrome Coronavirus-2 Infected Cancer Patients.

Given the immune system's importance for cancer surveillance and treatment, we have investigated how it may be affected by SARS-CoV-2 infection of cancer patients. Across some heterogeneity in tumor type, stage, and treatment, virus-exposed solid cancer patients display a dominant impact of SARS-CoV-2, apparent from the resemblance of their immune signatures to those for COVID-19+ non-cancer patients. This is not the case for hematological malignancies, with virus-exposed patients collectively displaying heterogeneous humoral responses, an exhausted T cell phenotype and a high prevalence of prolonged virus shedding. Furthermore, while recovered solid cancer patients' immunophenotypes resemble those of non-virus-exposed cancer patients, recovered hematological cancer patients display distinct, lingering immunological legacies. Thus, while solid cancer patients, including those with advanced disease, seem no more at risk of SARS-CoV-2-associated immune dysregulation than the general population, hematological cancer patients show complex immunological consequences of SARS-CoV-2 exposure that might usefully inform their care.

A dynamic COVID-19 immune signature includes associations with poor prognosis.

Improved understanding and management of COVID-19, a potentially life-threatening disease, could greatly reduce the threat posed by its etiologic agent, SARS-CoV-2. Toward this end, we have identified a core peripheral blood immune signature across 63 hospital-treated patients with COVID-19 who were otherwise highly heterogeneous. The signature includes discrete changes in B and myelomonocytic cell composition, profoundly altered T cell phenotypes, selective cytokine/chemokine upregulation and SARS-CoV-2-specific antibodies. Some signature traits identify links with other settings of immunoprotection and immunopathology; others, including basophil and plasmacytoid dendritic cell depletion, correlate strongly with disease severity; while a third set of traits, including a triad of IP-10, interleukin-10 and interleukin-6, anticipate subsequent clinical progression. Hence, contingent upon independent validation in other COVID-19 cohorts, individual traits within this signature may collectively and individually guide treatment options; offer insights into COVID-19 pathogenesis; and aid early, risk-based patient stratification that is particularly beneficial in phasic diseases such as COVID-19.