Elicitation, analysis and mitigation of systemic pandemic risks

The Covid-19 pandemic has disrupted the health care system and affected all sectors of society, including critical infrastructures. In turn, the impact on society's infrastructures has impacted back on the health care sector. These interactions have created a system of associated risks and outcomes, where the outcomes of risks are risks themselves and where the resulting consequences are complex vicious cycles. Traditional risks assessment methods cannot cope with interdependent risks. This paper describes a novel risk systemicity approach to elicit and mitigate the systemic risks of a major pandemic. The approach employed the internet-based software strategyfinder™ in workshops to elicit relevant risk information from sixteen appropriately selected experts from the health care sector and major sectors impacted by and impacting back on the health care sector. The risk information was processed with powerful analytical tools of strategyfinder to allow the experts to prioritise portfolios of strategies attacking the vicious cycles. © 2021 Information Systems for Crisis Response and Management, ISCRAM. All rights reserved.

Evaluation of a Series of Overdentures Made in a Higher Education Dental Institution in Southern Brazil

AIM AND OBJECTIVE: This study aimed to evaluate the epidemiological profile, oral health self-perception index, and level of satisfaction of users of complete implant-supported overdentures that had been used for at least 1 year and were made at the School of Dentistry of the University of Passo Fundo, Rio Grande do Sul, Brazil (FO/UPF), between 2014 and 2019. MATERIALS AND METHODS: The sample consisted of 30 patients with overdentures, who were selected from the dental records filed at the institution. Data on general health and the dental implants involved (brand, type of prosthetic connection, number of implants, and additional overdenture retention system) were collected from the medical records. The 30 patients were invited to answer the Oral Health Impact Profile-14 (OHIP-14) and visual analog scale (VAS) questionnaires, and due to the coronavirus disease 2019 pandemic, it was possible to contact 15 patients. RESULTS: Most of the prostheses studied were mandibular overdentures, and 66.66% of the cases were retained by the O-ring system. As for the oral health self-perception of the individuals, it was concluded that male patients had a lower mean overall score (p = 0.047) and functional domain (p = 0.042) in the OHIP-14. The number of implants and the installation arch interfered with functional domain and psychological capacity (p <0.05). The VAS showed that women have greater esthetic satisfaction with prostheses (p = 0.048) and that the bar-clip retention system is more satisfactory than the O-ring (p = 0.017). CONCLUSION: Despite the limitations of overdentures, it was noted that, when properly indicated, they are a viable option for oral rehabilitation on implants. CLINICAL SIGNIFICANCE: Oral rehabilitation well-indicated with overdentures, especially those retained by the bar-clip system, results in an improvement in the patients' quality of life.

Setting the social monitoring framework for nature-based solutions impact: Methodological approach and pre-greening measurements in the case study from clever cities milan

Nature-based solutions (NBS) are currently being deployed in many European Commission Horizon 2020 projects in reaction to the increasing number of environmental threats, such as climate change, unsustainable urbanization, degradation and loss of natural capital and ecosystem services. In this research, we consider the application of NBS as a catalyst for social inclusivity in urban regeneration strategies, enabled through civic participation in the co-creation of green interventions with respect to social cohesion and wellbeing. This article is focused on a social monitoring framework elaborated within the H2020 CLEVER Cities project, with the city of Milan as a case study. Firstly, we overviewed the major regeneration challenges and expected co-benefits of the project, which are mainly human health and wellbeing, social cohesion and environmental justice, as well as citizen perception about safety and security related to the NBS implementation process. Secondly, we examined the relevance of using NBS in addressing social co-benefits by analyzing data from questionnaires against a set of five major indicators, submitted to citizens and participants of activities during pre-greening interventions: (1) Place, use of space and relationship with nature, (2) Perceived ownership and sense of belonging, (3) Psychosocial issues, social interactions and social cohesion, (4) Citizen perception about safety and security, and lastly, we analyzed (5) knowledge about CLEVER interventions and NBS benefits in relation to socio-demographics of the questionnaires’ respondents. Thirdly, we cross-referenced a wind-rose multi-model of co-benefits analysis for NBS across the regeneration challenges of the project. Because of the COVID-19 emer-gency, in this research we mainly focused on site observations and online questionnaires, as well as on monitoring pre-greening scenarios in three Urban Living Labs (ULLs) in Milan, namely CLEVER Action Labs. Lastly, this study emphasizes the expected social added values of NBS impact over long-term urban regeneration projects. Insights from the pre-greening surveys results accentuate the importance of the NBS interventions in citizens’ perceptions about their wellbeing, general health and strong sense of neighborhood belonging. A wider interest towards civic participation in co-management and getting informed about NBS interventions in the Milanese context is also noted. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Pulmonary embolism in patients with COVID-19 pneumonia: When we have to search for it?

BACKGROUND: COVID-19 is still a global challenge in regard for management and therapy. Pulmonary embolism (PE) seems to have a higher prevalence in COVID-19 instead of non-COVID patients. Clinical and laboratory parameters related with PE are still unknown. METHODS: We conducted a retrospective unicentre study in Alto Vicentino Hospital between March 1st, 2020, and January 31st, 2021 in patients admitted for COVID-19 tested with a RT-PCR nasal swab. Data about patients studied with computed tomography pulmonary angiogram (CTPA) because of PE suspicion were collected, as their clinical and laboratory parameters too. RESULTS: 2621 patients were admitted for COVID-19 in Alto Vicentino Hospital between March 1st, 2020, and January 31st, 2021 and in 267 of them a CTPA was performed finding 50 PE (18.7%). Only non-Caucasian race (OR = 5.44; 95% CI 1.22-24.35; p = 0.027) and previous VTE (OR = 5.3; 95% CI 1.09-26.17; p = 0.039) were found to be independently associated with PE. CONCLUSION: PE is a frequent complication of COVID-19 and clinician need high degree of suspicion because clinical and laboratoristic parameters cannot drive diagnosis.