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Due to the COVID-19 pandemic, digital interactions ceased to be "just another form of communication”;indeed, they became the only means of social interaction, mediated and driven by information and communication technologies (ICTs). Consequently, working in a digital context switched from being a phenomenon to be studied to the primary means of socializing and the primary workspace for researchers. This study explores four different methodologies to question how discursive interactions related to power and newsworthiness may be addressed in digital contexts. The multimodal approach was reviewed through the affordances of critical discourse analysis, issue ownership and salience, morphological discourse analysis, and protest event analysis. It starts by theoretically addressing concepts of multimodality and phenomenology by focusing on the implications of both perspectives. It examines publications and interactions in digital contexts in Ecuador from March 2017 to December 2020 within three political phenomena. The results of the analysis of these publications and interactions suggest that when analyzing political participation and newsworthiness, the virtual becomes a subjective space. Moreover, qualitative research is one of the primary ways to combine multimodality with other forms of discourse analysis. This paper concludes that perceptions, practices, and meanings assigned to social online representations can be better analyzed through multimodality, which tackles the intertwined characteristics of virtual discourses. © 2023 by the authors.
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BackgroundMultisystem Inflammatory Syndrome in Children (MIS-C) is one of the most feared complications following SARS-CoV2 infection in children and adolescents. Few multinational multicenter studies from Latin America have been published.ObjectivesTo describe the clinical presentation, management, and outcomes of MIS-C in Latin America.MethodsObservational, prospective and retrospective, multicenter study to gather information from 84 participating centers across 16 Latin American countries, between August January 1, 2020 and June 30, 2022.ResultsOf the 1,239 reported cases of MIS-C, 84.2% were previously healthy. The most frequent clinical manifestation in our studied population was abdominal pain (N=804, 64.9%), followed by conjunctival injection (N=784, 63.3%). The median days of fever at the time of hospital admission was 5 and a significant number of subjects required admission to an intensive care unit (N=589, 47.8%). A total of 538 (47.2%) patients had an abnormal initial echocardiogram. Most of the subjects (N= 1,096, 88.7%) were treated with intravenous immunoglobulin (IVIG), while 76.7% (N= 947) were treated with steroids, of which 10.6% (N= 100) did not receive IVIG. The death rate attributed to MIS-C was 4.88%, with a rate of 3.39% for those initially diagnosed with MIS-C and 8.85% for those whose admission diagnosis was not MIS-C (P= 0.00001).ConclusionOne of the most significant findings from our study was the death rate, especially in those not initially diagnosed with MIS-C, in whom it was higher. This highlights the importance of increasing awareness and making an earlier diagnosis of MIS-C in Latin America.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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Notorious is that, over just over 100 years, marketing has undergone changes, especially in the conceptual area, causing confusion in the correct use of expressions and use of these expressions. Knowing how to differentiate societal marketing from social marketing it is important for them to be used in order to achieve the objectives that are conceptually proposed to them. Societal marketing focuses on accepting a product, while social marketing is focused on a cause that can produce a change in social behavior. Given the problem of the pandemic that has plagued the world since December 2019, the importance of social marketing in the attempt to cause changes in the behavior of citizens. This theoretical essay aims to show the importance of social marketing in the face of the PANDEMIC of COVID-19. It also aims to clearly conceptualize societal marketing and social marketing, as well as to show the social problem caused by the new corocavirus.
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Introduction: Acute kidney injury (AKI) is a frequent and severe complication of COVID-19 infection in ICU patients. We propose a structured data-driven methodology and develop a model to predict the use of renal replacement therapy for patients on respiratory support with Covid-19 in 126 ICUs from 42 Brazilian hospitals. Method(s): Adult ICU patients (March 2020-December 2021) with confirmed SARS-CoV-2 infection and need of ventilatory support at D1 admission in the ICU. Main outcome was the need of RRT. We estimated 3 prediction models: Logistic Regression (LR), Random Forest (RF) and XGB Boosting. Models were derived in the training set and evaluated in the test set following an 80/20 split ratio, and models' parameters were selected using fivefold cross-validation. We evaluated and selected the best model in terms of discrimination (AUC) and calibration (Brier's Score). Variable importance was estimated for each predictor variable. Result(s): 13,575 ICU patients with need of respiratory support, of which 1828 (14%) needed RRT. ICU and hospital mortality were respectively 15.7%, 20.3% (non-RRT) and 54.3%, 69% (RRT). Mean age was 63.9 and 55.3 years (RRT vs non-RRT). Mean ICU LOS was 27.8 vs. 12 days, in RRT vs non-RRT. RF and XGB models both showed higher discrimination performance compared to LR (95% confidence interval [95% CI]: 0.84 [0.81-0.85] and 0.83 [0.80-0.85] vs 0.78 [0.75-0.80]). RF and XGB models presented similar calibration (Brier's Score: ([95% CI]: 0.09 [0.09- 0.10] and 0.09 [0.09-0.10]), also better than in LR (0.11 [0.10-0.12]). The final model (RF) showed no sign of under or overestimation of predicted probabilities in calibration plots. Conclusion(s): The need of RRT among patients on respiratory support diagnosed with Covid-19 was accurately predicted through machine learning methods. RF and XGB based models using data from general intensive care databases provides an accurate and practical approach for the early prediction of use of RRT in COVID-19 patients.
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Chronic respiratory diseases affect both the upper and lower airways. The main components of the respiratory system are the rib cage, airways, and the pulmonary interstitium. The airway originates in the trachea, a structure located in the mediastinum, which splits into two parts to form the main bronchus (right and left bronchi). The bronchi gradually divide into secondary bronchi, bronchioles, alveolar ducts, and alveoli. Acute or chronic respiratory diseases are present in all age groups, with many different forms of clinical presentation. In general, the most common diseases are asthma, chronic obstructive pulmonary disease, respiratory allergies, occupational lung diseases, pulmonary hypertension, sinusitis, pharyngitis, bronchitis, tuberculosis, cold, and influenza (flu). Among the acute illnesses, infections of the upper respiratory tract, flu, and pneumonia are particularly prominent, and since 2019, we could include in this group the COVID-19 with the beginning of the pandemic of this disease. For chronic diseases, diseases of the lower respiratory tract are the most common, such as bronchitis, emphysema, and asthma. © 2023 Elsevier B.V.
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Introduction: IL-6 has been correlated as a prognostic biomarker for worsening sepsis and COVID-19 as well as positive fluid balance for duration of mechanical ventilation [1, 2]. Method(s): We performed a retrospective cohort study to analyze the correlation between high levels of serum IL-6 and positive fluid balances in the first 24 h of ICU arrival with mechanical ventilation days. We included adult patient records of critical COVID-19 during 2020 from the High Specialty Regional Hospital Bicentenario 2010, all patients were intubated, received treatment according to guidelines inforced in that time. We obtained mean and standard deviation for continuous variables and frequencies for categorical variables, calculated Kolmogorov-Smirnov for non-parametric test and Spearman correlation, OR for severe hypoxemia, RRT. Result(s): We analyzed 102 patient records, 72% were male, mean age 54.8 years (SD 19.4), tracheostomy was performed in 8.8% of cases, mean APACHE II 16.7 (SD 8.4), values of inflammatory markers were C-reactive protein 108 mg/dl (SD 95), IL-6 118 pg/ml (SD 240), mean paO2/FiO2 was 150 mmHg (SD 82), 93% were on vasopressors, fluid balance mean was 1542 ml (SD 839), severe hypoxemia was present on 62.7% (P/F below 150 mmHg), prono was used in 47.1%, with an overall mortality occurred in 69%. We found no correlation between serum IL-6 levels and positive fluid balance with mechanical ventilation days and outcomes (rs -0.11 p = 0.23, Fig. 1). Elevated serum IL-6 + positive fluid balance at 24 h ICU arrival was associated with severe hypoxemia (OR 2.82, CI 95% 1.14-6.97, x2 p = 0.022), OR for discharge was non-significant (0.48 CI 0.19-1.20 p = 0.11), RRT (1.09 CI 95% 0.27-4.37, p = 0.9). Conclusion(s): In our study no correlation was found between serum IL-6 levels, positive fluid balance and mechanical ventilation days, but there was a significant association with severe hypoxemia.
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Objective: to know the specific procedures and care provided to pregnant women, puerperal women and newborns in times of a pandemic and to analyze changes in prenatal care, labor, delivery and the postpartum period during the coronavirus pandemic. Methods: this is a qualitative, descriptive and exploratory study involving 26 women. The interviews were conducted via the Google Forms platform, with closed and open questions. Results: Two categories emerged from the study: 1) Influence of social isolation on the emergence of mental disorders;2) Adaptations with loss of sexual and reproductive, social and labor rights. Conclusion: mental health and sexual and reproductive, social and labor rights were shown to be more vulnerable in women who experienced pregnancy and postpartum in the coronavirus pandemic.
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Covid-19 has made families search for ways to assist their children in their online studies, so their learning should not be interrupted. The present article aimed to identify the difficulties faced in the teaching-learning process from the homes. Symptoms such as depression and stress caused by the lack of social interaction could be identified. During the analysis of the results, three categories were conceived: apprehension regarding the students' health (physical and/or mental), concern about the child's learning, and how to motivate students in the remote teaching period. From the data generated, it was possible to obtain elements for the elaboration of an orientation guide with the intention of helping other families. The results obtained suggest possible ways to guide and motivate pupils and how it has become important during online teaching, as well as the support and welcoming of the educational institutions to which the students belong.
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Studies that assess food insecurity and its association with the consumption of fruits, legumes, and vegetables (FLV) can help identify groups and risk factors of inadequate food consumption, in order to propose assertive nutritional interventions. The aim of this study was to describe FLV consumption by children in different food security situations. This is an exploratory cross-sectional study, conducted with parents/guardians of 44 children from zero to four years old. The short version of the Brazilian Food Insecurity Scale and a Food Frequency Questionnaire were applied to parents/guardians via a telephone interview. The children were 2.6 years old on average, 56.8% were female, 67.5% were eutrophic, and 70.5% of the families were in a situation of food insecurity. For households in a situation of food security, the median consumption of FLV was 213.4 g/day (P25=97.89;P75=425.91). As for those in a situation of food insecurity, the median FLV was 105.4 g/day (P25=33.58;P75=205.16). It was concluded that the consumption of FLV by children from families in a situation of food security is higher than that of children in a situation of food insecurity, who are strongly influenced by the offer of cheap food with low nutritional quality. Public policies are needed to favor the guarantee of access to FLV of quality and at an affordable cost for all families.
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On November 17, 2019, the first known case of COVID-19 in the world emerged. It was diagnosed in the Chinese province of Hubei, Wuhan (observer, 2019). Little or nothing was known until then, but the virus quickly spread around the world. More than three months after the first cases appeared in Wuhan, China, COVID-19 was no longer considered an epidemic and was, for the first time, declared by the WHO as a pandemic on March 13, 2020 (Publico, 2020). The world never thought to live a drama of this dimension, airplanes stopped, desert cities, schools closed, with students studying at distance and almost all people working from home. Given its transferability, there was a need for higher education schools to reorganize and implement contingency plans in order to mitigate the spread of the disease. In this work, we intend to show how this implementation in situ was achieved, so that the classes return to a possible normality, taking into account the imposed conditions. A comparing between the case of a national educational establishment and those of another country was made.
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Remote controlled laboratories had a great push during the COVID-19 pandemic. In fact, they were already out there but lacking in visibility. This external trigger pushed the academy to face a global challenge to start offering remote experiments more consistently and maturely. Instituto Superior Técnico (IST) has been offering several remote experiments since 2000 but with the need for an update due to technological aging. As such, the framework for remote experiments in education (FREE) was created based on new web technologies. In addition to the most diverse experiments that had already been developed, FREE includes two experiments that aimed at advanced-level physics students: the Langmuir probe and the electromagnetic (EM) cavity. Both allow users to configure the various parameters and to access the results in real time or check back later. All this access is done using a browser (on a PC or mobile phone) without the need to install additional software. The results of an experimental execution are stored in a database and are downloadable, allowing users to do various analyses and to determine the corresponding plasma density and temperature. In this paper, we will introduce how FREE was used in the implementation of both experiments and give an insight into their didactic approach, such as: (i) how to perform an experimental execution, (ii) the typical data set obtained with, and (iii) the corresponding analysis necessary for the user to retrieve information from it. © 2023 Pedro A. Mendes Rossa et al., published by Sciendo.
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In December 2019, in Wuhan, China, an outbreak of a respiratory disease was reported, and the causative agent of which was discovered to be the new coronavirus. This disease spread rapidly around the world, and in March 2020, the WHO declared a state of pandemic. According to the WHO situation in October report, more than 41,570.883 were affected, and 1,134.940 deaths had occurred. Thus, the urgency to find therapeutic targets to prevent viral replication and a vaccine to protect against the disease became a great challenge for researchers around the world. A French group began using, in patients, a drug that had already been approved for human use, hy-droxychloroquine (HQ) alone or in combination with azithromycin. The use of a drug already approved by regulatory agencies can enable treatment strategies to be put in place rapidly;however, even though in vitro may indicate success, this is not always guaranteed. For HQ, some studies have shown a satisfactory response in patients, while in many others, the result was not positive and patients actually died. Furthermore, many adverse effects of HQ have been described. In this re-view, we will briefly discuss how this therapy became an option for the treatment of SARS-CoV-2 infection. We will address the use of HQ in different pathologies and COVID-19 specifically;de-scribing the doses used, as well as the main adverse effects. The take-home message is that more ef-forts are still required to conclude the efficacy of HQ against COVID-19, however, most of the studies carried out currently are showing that the use of HQ does not bring benefits during treatment of COVID-19.Copyright © 2021 Bentham Science Publishers.
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Even after virus elimination, coronavirus disease 2019 (COVID-2019) leaves numerous sequelae. Growing evidence demonstrates that massive release of proinflammatory cytokines, which drives COVID-19 progression, severity, and mortality, remains elevated after acute phase of COVID-2019, playing a central role in the disease' sequelae. In this way, bronchial epithelial cells are the first cells hyperactivated by coronavirus-2 (SARS-Cov-2) leading to massive cytokine release, triggering leukocytes and other cells hyperactivation, mediating COVID-19 sequelae. So, proinflammatory cytokines are initiated by the host. Thus, this in vitro study tested the hypothesis that ImmuneRecovTM, a protein blend, could inhibit the hyperactivation of human bronchial epithelial cells (BEAS-2B) induced by SARS-Cov-2. BEAS-2B (5x104/mL/well) cells were co-cultivated with 1ml of blood of a SARS-Cov-2 infected patient for 4 hours and protein blend (1ug/mL) was added in the first minute of the co-culture. After 4 hours, the cells were recovered and used for analysis of cytotoxicity by MTT and for mRNA expression of IL-1beta, IL-6, IL-10. The supernatant was used to measure cytokines. SARS-Cov-2 incubation resulted in increased levels of IL-1beta and IL-6 by BEAS-2B cells (p<0.001). Treatment with the protein blend resulted in reduced levels of pro-inflammatory IL1beta and IL-6 (p<0.001), and increased the levels of anti-inflammatory IL-10 (p<0.001). Protein blend reduced SARS Cov-2-increased the mRNA expression of IL-1beta and IL-6, and increased the expression of IL-10 and IFN-gamma. In conclusion, protein blend presents important anti-inflammatory effects in the context of SARS-Cov-2 infection.
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The pandemic pushed companies to rethink competitive strategies and the innovation ecosystem structure. Then, we studied four small organizations from different industries through interviews, observations, and documentation. We offer five key findings: First, the crisis affected the cases in distinct ways, benefiting those in the healthcare sector. Second, innovation ecosystems provided opportunities for digitalization to keep businesses running. Third, resilience and initiative from the ecosystem leaders were crucial in responding to the crisis. Fourth, shifts in competition and cooperation favored survival. Lastly, the competitive strategy and ecosystem goals set before the pandemic have not changed, but how to achieve them. © 2023 Elsevier B.V.
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Following the outbreak of the coronavirus epidemic in early 2020, municipalities, regional governments and policymakers worldwide had to plan their Non-Pharmaceutical Interventions (NPIs) amidst a scenario of great uncertainty. At this early stage of an epidemic, where no vaccine or medical treatment is in sight, algorithmic prediction can become a powerful tool to inform local policymaking. However, when we replicated one prominent epidemiological model to inform health authorities in a region in the south of Brazil, we found that this model relied too heavily on manually predetermined covariates and was too reactive to changes in data trends. Our four proposed models access data of both daily reported deaths and infections as well as take into account missing data (e.g., the under-reporting of cases) more explicitly, with two of the proposed versions also attempting to model the delay in test reporting. We simulated weekly forecasting of deaths from the period from 31/05/2020 until 31/01/2021, with first week data being used as a cold-start to the algorithm, after which we use a lighter variant of the model for faster forecasting. Because our models are significantly more proactive in identifying trend changes, this has improved forecasting, especially in long-range predictions and after the peak of an infection wave, as they were quicker to adapt to scenarios after these peaks in reported deaths. Assuming reported cases were under-reported greatly benefited the model in its stability, and modelling retroactively-added data (due to the "hot” nature of the data used) had a negligible impact on performance. © 2022 The Author(s)
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The role of steroid hormones against infectious diseases has been extensively studied. From immunomodulatory action to direct inhibition of microorganism growth, hormones D3 (VD3) and 17beta-estradiol (E2), and the genetic pathways modulated by them, are key targets for a better understanding pathogenesis of infectious respiratory diseases (IRD) such as tuberculosis (TB) and the coronavirus disease-19 (COVID-19). Currently, the world faces two major public health problems, the outbreak of COVID-19, accounting for more than 6 million so far, and TB, more than 1 million deaths per year. Both, although resulting from different pathogens, the Mtb and the SARS-CoV-2, respectively, are considered serious and epidemic. TB and COVID-19 present similar infection rates between men and women, however the number of complications and deaths resulting from the two infections is higher in men when compared to women in childbearing age, which may indicate a role of the sex hormone E2 in the context of these diseases. E2 and VD3 act upon key gene pathways as important immunomodulatory players and supporting molecules in IRDs. This review summarizes the main roles of these hormones (VD3 and E2) in modulating immune and inflammatory responses and their relationship with TB and COVID-19.Copyright © Sociedade Brasileira de Genetica.