Post-infection recovery time by COVID-19, in civil servants, from a Colombian Private University

Objective: To estimate the recovery time of the employees of a university infected by COVID 19 in the period from March 2020 to June 2021. Materials and methods: An observational study was carried out in which sixty-three employees confirmed with COVID-19 participated, they were characterized through the anamnesis and post-infection physical assessment with the bioimpedance method. Data analysis was done in the statistical package Stata 19.0 for Windows. Results: the average age was 42 years, 54% belonged to the female sex, the socioeconomic stratum with the highest prevalence was three with 52%, 44% of the participants had some alteration in body weight, and a protein percentage down 54%. Conclusion: The average recovery time of officials after infection by COVID 19 was 10 days, factors that impact recovery time were identified and ratified, such as age over 60 years, socioeconomic level 1,2 and 3, the low percentage of protein and the high percentage of fat. © 2023 Federacion Espanola de Docentes de Educacion Fisica. All rights reserved.

Causes of academic dropout in higher education in Andalusia and proposals for its prevention at university: A systematic review

Introduction: One of the main problems facing the university system is the high student dropout rate due to a number of variables, accentuated by the COVID-19 pandemic. This is a problem not only in Spanish universities but is prevalent worldwide. It is therefore important to understand and analyze the underlying reasons for dropout so that it can be addressed and mechanisms implemented to limit dropout in higher education to the greatest extent possible. Method: A systematic review was carried out summarizing the results of studies and reports on university dropout in Spain and specifically in the universities of the Autonomous Community of Andalusia. The review was conducted in accordance with the PRISMA statement by searching the scientific databases Scopus and Web of Science, limiting the search to articles published between 2010 and 2022. Results: The main publications in both Spain and the Autonomous Community of Andalusia were identified. The review included the main causes of university dropout indicated in each of the selected studies and the proposals to reduce it, including educational policies, the rise of distance education, academic failure in basic educational stages, and social, personal, psychological, and economic variables. Conclusion: There is a lack of research on university dropout, with only 25% of Spanish universities having carried out research on this subject in the last 12 years. The studies analyzed conclude that the most frequent causes of university dropout are associated with low academic performance, poor social support in the new academic environment, low socio-economic status, pessimism, and lack of motivation, together with other less significant factors such as poor relationships with teachers, lack of vocation, work incompatibility, and previous academic performance. Further research on the causes of university dropout and its prevention is needed both before university entrance, by providing meaningful information to secondary school students, and during the university stay, through institutional and teaching policies that improve family support and social roots, produce positive academic experiences, favor associationism, and encourage activities that improve planning and time management, together with cognitive learning strategies, motivational strategies and the use of advanced learning materials [such as Information and Communication Technology (ICT) tools]. Copyright © 2023 de la Cruz-Campos, Victoria-Maldonado, Martínez-Domingo and Campos-Soto.

Lung Perfusion SPECT/CT in Suspected Chronic Thromboembolic Pulmonary Hypertension: Impact on Classification of Pulmonary Hypertension and Therapeutic Decision

Aim/Introduction: Chronic thromboembolic pulmonary hypertension (CTEPH) is a difficult entity to diagnose due to its association with other etiologies causing pulmonary hypertension (PHT), mainly cardiological disease. Our aim is to analyse the value of pulmonary perfusion SPECT/CT in the presence of suspected CTEPH and to evaluate its impact on the diagnosis and subsequent therapeutic approach. Material(s) and Method(s): Retrospective series of 108 patients with suspected CTEPH who were performed a lung perfusion SPECT/CT in the presence of perfusion defects on planar images between March 2020-April 2022. Variables such as age, sex, scintigraphic result, other radiological findings, correlation with catheterisation and CT angiography, type of PHT (according to Dana Point Consensus Classification of Pulmonary Hypertension, California 2008) and therapy of choice after scintigraphy were analysed. Result(s): Mean age: 69 +/- 12 years (25-90). 54% women. In 55 patients(51%) CTEPH was ruled out by SPECT/CT(-), although other radiological findings were observed (13% chronic parenchymal pathology/post-COVID-19 infection, 7% cardiomegaly, 5% pleural effusion, 4% infiltrates consistent with COVID-19 infection,2% pulmonary nodule suspicious of malignancy). 6 of the 18 patients with catheterisation(33%) had a pulmonary capillary pressure(PCP) suspicious for CTEPH(<=15mmHg), which was ruled out after negative scintigraphy. In the 53(49%) confirmed CTEPH by SPECT/ CT(+), 28 with other radiological findings(36% chronic pulmonary pathology/post-COVID-19,11% pulmonary nodule suspicious of malignancy,11% infiltrates consistent with COVID-19 infection). 10 of 15 patients(67%) with CT angiography(-). 55% of the patients with catheterisation(11/20) presented with a PCP not suspicious of CTEPH(>=15mmHg), and were finally diagnosed with CTEPH after positive SPECT. In patients without CTEPH after SPECT(-), PHT was classified into the following types:37 with PHT type-II/left heart disease(6 candidates for valve replacement),9 type-III/pulmonary disease and/or hypoxaemia, 5 mixed type-II+III, 2 type-I (1 portal hypertension in cirrhotic patient and 1 scleroderma), 2 type-V (1 obstruction of tumour origin and 1 chronic renal failure). of the patients who were confirmed to have CTEPH, 19(36%) had purely embolic PHT(type-IV), with 5 being candidates for endacterectomy/ angioplasty, and the remaining 34(64%) had mixed PHT(24 type-II+IV, 5 type-III+IV, 5 type-II+III+IV), with 35% being candidates for surgery. Conclusion(s): Lung perfusion SPECT/CT imaging is a very useful test for the classification of pulmonary hypertension leading to better therapeutic management of these patients. The greatest efficiency is seen with a negative result as the embolic origin is excluded with excellent reliability, thus avoiding more aggressive and/or difficult-to-manage therapies. In addition, low-dose CT provides additional information of great clinical relevance.

Clinical features, coagulation and inflammatory biomarkers associated with poor in-hospital outcomes in a Honduran population with RT-PCR confirmed COVID-19

Background: SARS-COV-2, in most cases, only generates a mild acute respiratory disease. However, patients with severe disease show an exaggerated response of the immune system, creating a pro-inflammatory state, which could cause abnormalities in the coagulation system that increases mortality. Latin American countries, specially those with limited resources, have few studies about clinical features, coagulation and inflammatory biomarkers that could be useful at admission to assess poor outcomes. Objective: The objective of this study is to describe the clinical features, coagulation, and inflammatory biomarkers, and identify risk factors at admission that are associated poor outcomes in Honduran population. Methods: A cohort study was conducted. 210 patients were included, which 105 died during hospitalization due to COVID-19 and 105 were discharged alive, between September 2020 and January 2021. Clinical and laboratorial data was retrospectively collected. Results: 57,6% of the population were male. The median age was 58 years. The median time between symptom onset and hospital admission was 6 days. D-dimer median was higher in the dead group compared with the alive group. Poor prognosis factors in the Cox multivariable model were male gender, age, symptom's duration, obesity and an elevated d dimer at admission. Conclusion: In low-middle income countries, the assessment of these clinical and laboratory tools, especially in those with risk factors for prothrombotic states, could help clinicians to correctly stratify disease prognosis, establish a baseline to evaluate further evolution, and also predict outcomes, thus improving patient management. © 2022

Quantification and mapping of domestic plastic waste using GIS/GPS approach at the city of Guayaquil

A significant contributor to the waste stream is the domestic single-use plastic used in households, being the final disposal in most cases the local landfill. There is a significant opportunity to promote resource recovery and efficiency through the introduction of circular economy strategies. However, the knowledge and management of post-consumer plastic waste in the country is poor, and there is a lack of an efficient collection and sorting system. In this context, spatial information on domestic plastic waste generation (DPWG) is essential for recycling decision-making. The integration of Geographic Information Systems (GIS) and the Global Positioning System (GPS) shows an opportunity to collect, mapping, and analyse spatial DPWG issues. Thus, this paper had a double objective. The first was to assess the evolution of eight different types of plastic waste in the city's households and their daily per capita generation between 2019 and 2021. The second objective was to provide a complete geo-referenced information on the quantities and typologies of domestic plastic waste (DPW) produced in Guayaquil and analyse how the flows have shifted throughout the years. The results showed that PET is the most generated, recording 97.76% and 100.00 % of the households who generate this type of plastic for 2019 and 2021, respectively, with an average of 13.08 and 15.13 g/day/c. Following, we had HDPE, PP and PVC occupying the second, third and fourth place for 2019 with 5.86, 3.05, 2.54 g/day/c, respectively. On the other hand, for 2021, PP (7.43 g/day/c), HDPE (5.92 g/day/c), and LDPE (3.99 g/day/c) occupied the second, third and fourth, respectively. According to the spatial maps, the DPW increment is in most of the popular zones. These popular zones are neighborhoods with a considerable quantity of population and limited basic services. Most of these people live in extreme poverty, being a possible relation between the COVID-19 lockdown and the increasement of DPW. © 2022 Elsevier B.V.. All rights reserved.

Chapter 9 - Particulate vaccines against SARS-CoV-2

The ongoing COVID-19 pandemic requires the development of effective vaccines consisting of formulations able to induce safe and neutralizing humoral and cellular responses, particularly in the respiratory system. Since nanomaterials can serve as efficient antigen delivery carriers and immunostimulatory agents, their exploration and use in vaccinology have led to the production of nanovaccines, specifically, conjugates comprising antigens, nanocarriers, and adjuvants that can render highly effective immunization agents. This chapter covers vaccines under development and in present use, general considerations on nanomaterials that can be used as nanocarriers, and recently reported nanovaccines targeting SARS-CoV-2 that result in attractive immunization models already implemented in test animals and generating promising immune-protective effects. A revision of such developments is presented here, identifying improvements to these approaches. Moreover, we include perspectives on the development of anti-SARS-CoV-2 vaccines taking advantage of such precedents.

Technology and abstraction: Complex skills development through video games

This study aims to propose supervised machine learning models to predict the abstraction ability in students as an early warning mechanism through both the technology use and the video game use. The methodology used was mixed with a prescriptive and predictive design;118 tests were carried out by Chilean pedagogy students. For analysis, several variables were correlated: age, modality, academic semester and six predictive models. The results show three relevant findings;First, regarding the relation abstraction/ age, in the Satisfactory and No abstraction, the distribution is homogeneous in every age. Second, the relationship abstraction/modality shows a 50% pattern for all the abstraction categories. Third, the relation abstraction/academic semester shows that most students from the seventh semester have no capacity for abstraction. The study concludes the abstraction level is low, showing that 61,1% of the students do not have a higher cognitive level. Two out of six of the supervised machine learning models are suggested to predict early warning, decision tree and random forest since they have a 100% accuracy. Therefore, through the use of technology and the video game it is possible to ensure higher cognitive level development, by the use of several planned strategies in covid-19 times concentrated in the first two tears of pedagogy training. © 2021 North Caucasian Institute of Mining and Metallurgy, State Technological University. All rights reserved.

Psychosocial effects of COVID-19 pandemic in Bolivia. Preliminary results

IntroductionThe global health crisis due to Coronavirus Disease 2019 (COVID-19) and related containment measures have led to changes in daily life and, therefore, social and psychological impacts on the population.ObjectivesTo explore the psychological and social impact of COVID-19 in the general population of Bolivia.MethodsCross-sectional study was implemented using an anonymous and self-administered online questionnaire. Adult people were invited to participate through social networks between May to June 2020. The questionnaire included sociodemographic information, coping strategies, changes in income and working conditions and psychological distress (K10 Scale).ResultsA total of 878 adults living in Bolivia answered the questionnaire. Most people considered COVID-19 as a quite/very serious health problem that affects the entire population, without distinction. 65% reported to accomplish lock down measure, however, one of the main reasons for non-compliance is the need to go out to work. Half of participants (50%) reduced worked hours and 18% modified their employment contract. However, 70% reduced household income. A considerable percentage (62%) reported psychological distress (46% with moderate or severe). It was higher in women, young people and among those with lower household income. In addition, social networks and watching series and movies were the main coping strategies reported.ConclusionsThe COVID-19 pandemic has a considerable impact on psychological and social level. The negative impact was greater in some population groups such as women, young people, and those with a lower socioeconomic level, which may further increase inequities.

Psychological well-being and employment status during the COVID-19 pandemic

IntroductionSeveral restrictive measures have been implemented to reduced COVID- 19 impact with unknown consequences on people daily life.ObjectivesThe primary objective is to asses the psychosocial impact and employment status changes since lockdown COVID-19 measures in Chile.MethodsCross-sectional study was implemented using an anonymous and self-administered online questionnaire. Adult people were invited to participate through social networks between May to June 2020. The questionnaire included sociodemographic information, coping strategies, changes in income and working conditions and psychological distress (K10 Scale).Results3102 participants over 18 years answered the questionnaire. 69.9% reported psychological distress mainly women (82.2%), members of the public health system (59%), dependent workers (39.8%), people who suffered income reduction (36.8%)., and those who changed their employment status (26.4%). Participants who presented income reduction were 1.83 times more likely to present psychological distress than those without changes (p <0.001)ConclusionsPandemic crisis had impacted population health, especially in some specifics groups that could be targeted for future interventions.

Using Digital Tools to Advance Alzheimer's Drug Trials During a Pandemic: The EU/US CTAD Task Force.

The 2020 COVID-19 pandemic has disrupted Alzheimer's disease (AD) clinical studies worldwide. Digital technologies may help minimize disruptions by enabling remote assessment of subtle cognitive and functional changes over the course of the disease. The EU/US Clinical Trials in Alzheimer's Disease (CTAD) Task Force met virtually in November 2020 to explore the opportunities and challenges associated with the use of digital technologies in AD clinical research. While recognizing the potential of digital tools to accelerate clinical trials, improve the engagement of diverse populations, capture clinically meaningful data, and lower costs, questions remain regarding the stability, validity, generalizability, and reproducibility of digital data. Substantial concerns also exist regarding regulatory acceptance and privacy. Nonetheless, the Task Force supported further exploration of digital technologies through collaboration and data sharing, noting the need for standardization of digital readouts. They also concluded that while it may be premature to employ remote assessments for trials of novel experimental medications, remote studies of non-invasive, multi-domain approaches may be feasible at this time.

Invasive aspergillosis in COVID-19 patients in an intensive care unit in Mexico City

Background: An elevated incidence of invasive pulmonary aspergillosis (IPA) in patients with COVID-19 without traditional risk factors for IPA has been recently reported around the world. This co-infection has been described in patients requiring treatment in an intensive care unit. The risk factors for its development are still unclear. Methods: We conducted a nested case-control study using the COVID-19 registry of the ARMII study group, based in the Centro Médico ABC, a private hospital in Mexico City. We included all patients that required admission to the intensive care unit (ICU) from March 12 to June 15, 2020, and excluded patients without serum galactomannan measurements or bronchial secretion cultures. We used the modified definition of IPA proposed by Schauwvlieghe et al for IPA in influenza patients. The control group was formed by patients with ruled-out IPA (negative galactomannan and secretion cultures). We compared both groups to identify risk factors for IPA using the chi-squared test or the Mann-Whitney U test as applicable. Results: Out of a total 239 patients, 54 met the inclusion criteria. We identified 13 patients with IPA (24.07%) that met the definition of IPA (2 with positive cultures and 11 with positive galactomannan) and 41 without IPA. Only three patients with IPA had important comorbidities (COPD, chronic kidney disease, and HIV). Patients with IPA tended to have a higher median age (64.6 vs 53.59, p=0.075) and a higher serum glucose at their arrival (145 vs 119, p=0.028). All patients with IPA presented to the hospital with ARDS (100% vs 72.5%, p=0.034), but ultimately did not have a higher requirement for mechanical ventilation (100% vs 82.93%, p=0.110). There were no statistical significant differences in use of Tocilizumab, use of glucocorticoids, mortality (23.07% vs 17.50%, p=0.563) or length of stay. Conclusion: It has been previously described that patients with acute respiratory disease syndrome triggered by viral infection, like the influenza virus, are prone to invasive aspergillosis even in the absence of underlying immunodeficiency. The use of antifungals to prevent aspergillosis in COVID-19 patients should be assessed because of the gravity presented in the patients with this co-infection.

Elevated HScore is Associated with Poor Clinical Outcomes in COVID-19, Even in the Absence of Secondary Hemophagocytic Lymphohistiocytosis. (preprint)

Introduction: Patients with Coronavirus Disease 2019 (COVID-19) frequently experience a hyperinflammatory syndrome, that leads to unfavorable outcomes. This condition resembles Secondary Hemophagocytic Lymphohistiocytosis (sHLH) described in neoplastic, rheumatic and other infectious diseases. However, it has not been prospectively studied on these patients. A scoring system (HScore) has been validated for sHLH, and recently proposed to evaluate hyperinflammation in COVID-19. Methods: 143 patients aged [≥]18 years admitted because of COVID-19 were enrolled in a prospective, single-center, cohort study. HScore was calculated within the 72 hours since admission. The incidence of sHLH during hospitalization was evaluated. Additionally, the relationship between HScore [≥]130 points and either the requirement of mechanical ventilation or 60-days mortality was explored. Results: The median age of enrolled patients was 57 (21-100), and 63.6% were male. The median HScore was 96 (33-169). One patient was diagnosed with sHLH (incidence 0,7%), due to a HScore of 169. After adjusting for age, sex, comorbidities and obesity, HScore [≥]130 was independently associated with the composite clinical outcome (HR 2.13, p=0.022). Conclusion: sHLH is not frequent among COVID-19 patients. HScore can efficiently predict the risk for poor outcomes.

Tracheotomies in critical patients during the COVID-19 pandemia. Preliminary study of our experiences at La Paz University Hospital of Madrid

The outbreak caused by the SARS-CoV-2 virus is currently very active in Spain. Many infected people still require to be hospitalized. Around 10-15 % of hospitalized patients require intensive care, where they are intubated for a prolonged period, needing tracheotomies some weeks after the intubation. We will be conducting an observational study of the tracheotomies performed by our oral and maxillofacial Department to COVID-19 patients on intensive care units between March 17th and April 17th, 2020. This study will be analyzing the patients’ epidemiological and clinical aspects, surgical technique employed, surgical time, type of cannula used, postoperative complications and the patients’ clinical monitoring. A total of 22 patients underwent open elective tracheotomy. There were twenty-two males and three females aged between 40 and 77 (mean: 64,9 years-old). In all cases tracheotomy was carried out due to pulmonary process caused by COVID-19 bilateral pneumonia. Two patients presented pneumothorax in the immediate postoperatory care as a complication, one perished during the procedure and another did so after arriving to the Intensive Care Unit after the tracheotomy surgery. Even though tracheotomy is a ruled surgical technique, the special characteristics of COVID-19 patients make of this procedure a critical situation, mainly due to lung instability and quick desaturation of the patients. This requires the surgery to be carried out by experienced physicians in order to reduce operative time and to be able to react to any eventualities that may arise. © 2020 SECOM.

Cutaneous susceptibility to SARS-CoV-2 infection according to the expression of viral entry factors in the skin

Introduction: Reports of dermatological manifestations in patients with COVID-19 suggest a possible cutaneous tropism of SARS-CoV-2;however, the capacity of this virus to infect the skin is unknown.