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The aim of this study is to learn about the experiences of university teachers during and after emergency remote teaching (ERT), which emerged in the context of isolation due to the Covid-19 pandemic. Its methodology has a qualitative, non-experimental, cross-sectional and descriptive design with a phenomenological approach. As results, the university professors consulted consider that during the ERT, the time dedicated to work increased, both due to meetings outside the timetable and to the creation of educational materials. They express having to use their own resources to teach their subjects online and also detail that there is a lack of technological training. The teachers also commented that they suffered health problems, such as visual weakness, body aches, stress, anxiety and depression. In conclusion, teachers face the situation by updating themselves in information and educational technologies, being flexible and adapting. A limitation of this study is that the sample was obtained with a non-probabilistic method by convenience, in 35 Mexican Institutions of Higher Education (IESM), so it is difficult to generalize these results to all Mexico.
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Objectives: To know and explore from convalescent plasma donators' voices the experience in the blood donation process at a social security hospital. Methods: Qualitative study with a phenomenological design. The investigation was carried out in 01 hospitals of the social security of Peru. Semi-structured interviews were carried out. Results: Eleven donors of convalescent plasma were interviewed. The main motivations for donating were being able to contribute to national research and supporting patients affected by COVID-19. Fears focus on the possible risk of contagion within the hospital. Donors emphasised the attention and support of health personnel alongside the donation procedure. The main expectations and suggestions point towards greater dissemination of donation campaigns with special emphasis on safety. Likewise, an improvement in the time of the donation procedure (from enrolment to the extraction of convalescent plasma), and the implementation of friendly spaces to encourage future blood donation campaigns were highlighted. Conclusions: The experience of the convalescent plasma donors was positive. However, improvements must be made in terms of processes and infrastructure to ensure future successful blood donation campaigns.
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Aim: The aim of this study was to determine severity in patients who have had SARS-CoV2 pneumonia. Method(s): A cohort of 802 patients from our post-COVID multidisciplinary unit treated at least 30 days after being discharged from hospital was analyzed. Patients were divided into three groups: group 1 (admission to the Intensive Care Unit or Intermediate Respiratory Care Unit), group 2 (admission to conventional hospitalization), and group 3 (outpatient management without hospitalization). Symptoms, quality of life, daily physical activity, emotional state, biomarkers of systemic inflammation and KL-6 levels were evaluated. Result(s): A total of 802 patients with a median (interquartile range) age 59 (48-70 years) at diagnosis were reviewed, of whom 439 (54.8%) were women. Dyspnea was reported by 351 (66.%) patients and 142 (36.4%) had a grade more than 2 on the mMRC scale. Likewise, 106 (20.1%) presented dry cough and 233 (44.5%) asthenia. There were significant differences between groups 2 and 3 in: dyspnea (p=0.04), myalgia (p=0.04) and asthenia (p=0.01). Group 1 had a higher score in the TTO and VAS rates of the EuroQuoL scale compared to group 2. Finally, the KL6 levels in groups 1, 2 and 3 were: 381.50 (304 - 511.75) U/ml, 372 (249 - 483) U/ml and 298 (231.5 - 398) U/ml, respectively. Statistically significant differences were observed between the 3 groups (p=0.001) and in the post-hoc analysis, lower levels of KL-6 were observed in group 3 compared to the other two groups. Conclusion(s): There is evidence to affirm that KL6 levels in post-COVID patients are related to the severity of the acute episode.
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The coronavirus disease of 2019 (COVID-19) generated a crisis;however, it also gave us an opportunity to imagine the future and build a better world. Moreover, as we are convinced of the importance of understanding the lessons of history when facing both current and future challenges, this chapter seeks to present a concise overview of global crises since the end of the nineteenth century and to show crises for which we ignored the warning signs and wakeup calls, the consequences of said crises and how we managed to recover and thrive in several cases. Ultimately, we seek to justify the capacity of humanity to build a sustainable future-ideally, a regenerative future. © 2022 Emerald Publishing Limited.
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HEMOCOVID-19 is a multi-center trial aiming to assess the microvascular and endothelial health of severe COVID-19 patients in the intensive care using near-infrared spectroscopy. Here, we present the preliminary results, showing that peripheral microcirculatory alterations are associated with the severity of acute respiratory distress syndrome. © 2022 The Author(s).
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With the current goal of reaching a 100% electrification rate of the world population, the importance of PV/battery or solar home systems (SHS) grows as the one of the most viable solution for the most remote and scattered communities. Their modularity and capacity to harvest local resources is particularly relevant for that purpose. The stochasticity of solar energy and of the demand can however lead to energy shortages in the most critical periods of the day, while an over-sized system represents an important increase in the levelized cost of energy (LCOE). To capture these dynamics and the tradeoff between installed capacity and lost load probability (LLP), 16 different demand scenarios are modeled and analyzed. An optimal size for SHS is determined using a linear programming model with different levels of LLP in each scenario. The Demand time series are constructed using a stochastic demand generator that simulates the behavior of each appliance on a household. The information to create the base-case scenario was obtained with field surveys of a rural community in Cochabamba, Bolivia (Raqaypampa). Each scenario has different combinations of appliances, including the intensive use of radio to comply with guidelines of remote education (due to the COVID-19 crisis). The result shows that there is a high reduction of the LCOE in the lower range of LLP. This reduction reaches a breaking point where a higher LLP does not represent a significant further reduction of the LCOE. An empirical mathematical formulation is proposed to calculate this inflection point and a Pareto front plotted to assess the tradeoff between quality of service and LCOE. © ECOS 2021 - 34th International Conference on Efficency, Cost, Optimization, Simulation and Environmental Impact of Energy Systems.
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Objective: We aim to describe the evolution in the number of clinical studies sponsored by Institut d'Investigació Biomèdica Sant Pau (IIBSP) before and during the COVID-19 pandemic period (2019-2021). Besides, we aim to quantify the monitoring activities carried out by Sant Pau Clinical Trials Unit (SP-CTU) and by external clinical research organizations (CRO) in the same period. Material and/or methods: A database was designed to record and follow-up all independent studies sponsored by IIBSP and monitored by SP-CTU. In the same way, the Documentation and Archive Management Area of Sant Pau (AGDAC) registered the monitoring activities carried out by external CROs. A descriptive analysis of the number and types of clinical studies, and monitoring activities was made. Results: The evolution in the number of clinical studies sponsored by IIBSP was 91 in 2019, 121 in 2020 and 93 in 2021. Clinical trials represented the 11%, 13.2% and 10.7%, whereas observational studies supposed 57.1%, 54.6% and 57%, and biomedical research projects 31.9%, 32.2% and 32.3% respectively, during the evaluated years. Regarding the number of monitoring visits, in 2019 was 82 for SP-CTU and 1919 for external CROs;whereas in 2020 the number of monitoring visits was 50 for SP-CTU and 1431 for external CROs. Finally, in 2021, the number of monitoring visits was: 92 for SP-CTU and 1731 for external CROs. Conclusions: The number of clinical studies sponsored by IIBSP was higher during the first year of COVID-19 pandemic compared to the year before and the year after, probably due to the unmet medical need for COVID-19 knowledge base and therapies. Conversely, a clear reduction of monitoring activities for both independent sponsored and pharmaceutical industries sponsored studies was observed during the first year of the pandemic period, with an important recovery the following year. These data support the need to encourage remote monitoring.
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6ER-022 Table 1Odds ratio results from logistic regression analysisFactor OR Lower 95% CI Upper 95%CI Factor OR Lower 95% CI Upper 95%CI A02B 1.46 0.427 4.991 N02B 0.814 0.513 1.291 A10B 1.246 0.816 1.904 N03A 0.715 0.443 1.154 A11C 0.875 0.535 1.431 N05A* 0.353 0.137 0.91 A12A 1.192 0.73 1.948 N05B 0.98 0.649 1.482 B01A* 1.95 1.004 3.824 N06A 1.002 0.671 1.497 C03C 1.088 0.72 1.642 R03A 0.997 0.628 1.583 C07A 1.206 0.8 1.818 R03B 0.881 0.541 1.435 C10A 0.988 0.626 1.561 Total prescribed drugs* 1.182 1.078 1.297 H02A 0.875 0.431 1.778 Gender 1.011 0.651 1.57 M05B 1.016 0.581 1.776 Age 1.022 0.991 1.054 N02A 0.819 0.524 1.279 CI, confidence interval;OR, odds ratio. *p<0.05.Conclusion and relevanceIn this preliminary analysis of 930 PEP, B01A (antithrombotic drugs) and a number of total prescribed drugs were SS factor associated with a higher risk of admission, meanwhile N05A (antipsychotics) showed a protective trend.References and/or acknowledgementsConflict of interestNo conflict of interest
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Throughout history, various infectious diseases have been presented, which, over time, have been eradicated and/or controlled by vaccines and drugs, however, this does not leave the population exempt from outbreaks or new infectious diseases;in fact, with the emergence and worldwide spread of the coronavirus disease 2019 (COVID-19) caused by the SARS-CoV-2 virus, the lack of policies within companies for a correct management of contagion control between its members, causing the work stoppage for indefinite periods, as shown in the studies carried out by the National Institute of Statistics and Geography (INEGI) in the Survey on the Economic Impact Generated by COVID-19 in Companies (ECOVID-IE). Currently there are tools that allow the detection and control of some diseases, however, they are not applicable to any environment and, above all, most of them are only useful for infectious diseases and specific contexts. That is why the objective of this article is to show the analysis of the requirements of a system that allows monitoring the contagions of infectious diseases that occur within a company, using a graph-oriented base, two mobile applications and a Web application, to provide timely information to the management of the company. © 2021 IEEE.
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Latin America has been severely affected by the COVID-19 pandemic. The COVID-19 burden in rural settings in Latin America is unclear. We performed a cross-sectional, population-based, random-selection SARS-CoV-2 serologic study during March 2021 in the rural population of San Martin region, northern Peru. In total, 563 persons from 288 houses across 10 provinces were enrolled, reaching 0.2% of the total rural population of San Martin. Screening for SARS-CoV-2 IgG antibodies was done using a chemiluminescence immunoassay (CLIA), and reactive sera were confirmed using a SARS-CoV-2 surrogate virus neutralization test (sVNT). Validation of the testing algorithm using prepandemic sera from two regions of Peru showed false-positive results in the CLIA (23/84 sera;27%) but not in the sVNT, highlighting the pitfalls of SARS-CoV-2 antibody testing in tropical regions and the high specificity of the two-step algorithm used in this study. An overall 59.0% seroprevalence (95% confidence interval [CI], 55 to 63%) corroborated intense SARS-CoV-2 spread in San Martin. Seroprevalence rates between the 10 provinces varied from 41.3 to 74.0% (95% CI, 30 to 84%). Higher seroprevalence was not associated with population size, population density, surface area, mean altitude, or poverty index in Spearman correlations. Seroprevalence and reported incidence diverged substantially between provinces, suggesting regional biases of COVID-19 surveillance data. Potentially, limited health care access due to environmental, economic, and cultural factors might lead to undetected infections in rural populations. Additionally, test avoidance to evade mandatory quarantine might affect rural regions more than urban regions. Serologic diagnostics should be pursued in resource-limited settings to inform country-level surveillance and vaccination strategies and to support control measures for COVID-19. IMPORTANCE Latin America is a global hot spot of the COVID-19 pandemic. Serologic studies in Latin America have been mostly performed in urban settings. Rural populations comprise 20% of the total Latin American population. Nevertheless, information on COVID-19 spread in rural settings is scarce. Using a representative population-based seroprevalence study, we detected a high seroprevalence in rural populations in San Martin, northern Peru, in 2021, reaching 41 to 74%. However, seroprevalence and reported incidence diverged substantially between regions, potentially due to limited health care access or test avoidance due to mandatory quarantine. Our results suggest that rural populations are highly affected by SARS-CoV-2 even though they are sociodemographically distinct from urban populations and that highly specific serological diagnostics should be performed in resource-limited settings to support public health strategies of COVID-19 control.
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The use of high-flow nasal therapy (HFNT) in patients with severe acute respiratory failure (SARF) due to COVID-19 pneu-monia (NCOVID-19) is debated. Given the lack of beds in Intensive Care Units in the Public Health System of the Province of Neuquén, their use was implemented in general wards. This restrospective multicenter study was carried out to describe the experience of using HNFT in patients with SARF due to NCOVID-19. The primary outcome was the frequency of successful weaning from HFNT and in-hospital mortality (IHM). Two hundred ninety-nine patients were analyzed;120 (40.1%) were successfully withdrawn from HFNT. This failed in 59.8% (179), 44.1% (132) required invasive mechanical ventilation (IMV), and 15.7% (47) was not candidates for intubation. A ROX index ≥ 5 at 6 h after initiation was associated with the success of HFNT (OR 0.26 [IC 95% 0.15-0.46] p<0.0001). The general IHM was 48.5% (145/299), 70.4% (93/132) in patients with IMV, 4.2% (5/120) died after successful weaning from HFNT and 100% (47/47) in the group not candidates for intubation. Patients with TNAFO had a statistically significant decrease in MIH and days of hospitalization. TNAFO in general wards achieved a decrease in the use of IMV, with a reduction in mortality and days of stay in hospitalized for NCOVID-19 with SARF.
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We present the HEMOCOVID-19 study spanning four countries and eight hospitals where near-infrared spectroscopy is utilized to evaluate microvascular and endothelial health of severe COVID-19 patients at the intensive care. © 2021 SPIE. All rights reserved.
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The aim of this research is to analyze the economic, political and cultural expressions of the women who make up the self-managed, feminist and dissident Tianguis in the city of Oaxaca, Mexico. The research is qualitative and is based on the techniques of ethnographic studies. The tianguis is formed by the loss of jobs brought about by the COVID-19 pandemic and recovers the original form of market organization by physically concentrating producers and buyers, where money as a means of exchange is gradually being replaced by barter. The hegemonic, capitalist and patriarchal system extends its domination in a subtle and imperceptible way in society, is built from the bottom up, but it also shows the intolerant and repressive nature of institutional power. This is the only way to explain why the authorities of the municipality of Oaxaca de Juárez violently evicted and recovered the public space occupied by the tianguistas. The study shows that women have had to resist and take a political stance in the absence of agreements with the municipal authorities to be able to continue trading and selling their goods. © 2021, Universidad del Zulia. All rights reserved.
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This paper shows a selection of the most relevant articles in congenital heart diseases published since the end of the last year. The COVID-19 pandemic represents a significant challenge for the care of patients with congenital heart diseases. Multiple guidelines and consensus have been published (pulmonary hypertension, multimodality imaging during follow-up, ultrasound examination of the fetal heart and management of arrhythmias) and will be very useful for the standardization of the management of these complex patients. We highlight contributions related to risk stratification for sudden cardiac death and advanced heart failure therapies for patients with congenital heart disease. In this regard, the long waiting lists for pediatric heart transplantation are being reduced due to the progress in the management of potential donors. Finally, percutaneous interventions at any age and surgical techniques, with a particular focus on aortic valve leaflet reconstruction techniques in children and young adults, continue to develop and explore new paths previously unexpected.
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Introduction: Reports have revealed that people susceptible to severe forms of COVID-19 are older adults with comorbidities;However, the pediatric population has also been affected, considering children with underlying conditions such as onco-hematological conditions to be high risk. We present a cases series in a third level hospital. Material and methods: We conducted a retrospective study in children under the age of 16 years with a diagnosis of acute leukemia and infection with the SARS-CoV2 virus. Descriptive statistics with means and percentages were used. To show differences between the groups, Chi-square test, Student t test and Mann-Whitney U test were used depending on the type of variable and its distribution. Results: SARS-CoV2 virus infection was confirmed in 15 children diagnosed with acute leukemia, at different stages of treatment. The mean age was 7.5 years, 8 male and 7 female, 11 of them diagnosed with acute B-cell lymphoblastic leukemia, one with acute T-cell lymphoblastic leukemia and 3 with acute myeloid leukemia. The mean days of hospital stay at the diagnosis of COVID-19 was 22. Thirteen of the children had fever and neutropenia. 7 patients died. There was a statistically significant correlation with the outcome in patients who presented a prolongation of aPTT, an increase in D-dimer, an increase in liver enzymes and severe respiratory distress with the need for mechanical ventilation. Conclusion: The risk of death in children with leukemia and COVID-19 was associated with prolonged aPTT, increased D-dimer, increased liver enzymes, respiratory distress, and the need for mechanical ventilation.