Decisiones gubernamentales para contener la pandemia y sus efectos en el comercio mundial de mercancías

El brote y rápida propagación del coronavirus (COVID-19) profundizó la desaceleración del comercio internacional, puesto que las decisiones tomadas por los gobiernos para contener la propagación del virus perjudicaron la actividad económica al ralentizar la producción o incluso detenerla por completo. El objetivo de este artículo es analizar el nivel de severidad de las medidas restrictivas de salud pública aplicadas por los gobiernos para contener la pandemia del COVID-19 y los efectos de estas decisiones en el comercio mundial de mercancías. Como indicador de la severidad de las medidas aplicadas por los países se utiliza el índice de rigurosidad, calculado diariamente con base en la puntuación de nueve métricas, cuyos valores oscilan entre 0 y 100;así como las tasas de crecimiento interanual del comercio mundial de mercancías. Los resultados revelan que la mayoría de los países registraron los confinamientos más estrictos y prolongados cuando no había vacunas, y al mismo tiempo experimentaron fuertes caídas, en diversos grados, en las tasas de crecimiento del comercio de mercancías. En conclusión, se observa que, a medida que avanzaban las campañas de vacunación, se acercaba más el final del confinamiento, así como la recuperación de la actividad económico-comercial y del empleo.Alternate :The outbreak and rapid spread of the coronavirus (COVID-19) deepened the slowdown in international trade, as decisions taken by governments to contain the spread of the virus hurt economic activity by slowing production or even stopping it altogether. The objective of this article is to analyze the level of severity of the restrictive public health measures applied by governments to contain the COVID-19 pandemic and the effects of these decisions on world merchandise trade. The strictness index is used as an indicator of the severity of the measures applied by the countries, calculated daily based on the score of nine metrics, whose values range between 0 and 100;as well as the annual growth rates of world merchandise trade. The results reveal that most countries recorded the strictest and longest lockdowns when there were no vaccines, simultaneously experiencing sharp declines, to varying degrees, in their merchandise trade growth rates;In conclusion, it is observed that, as the vaccination campaigns progressed, the end of the confinement was closer, as was the recovery of economic-commercial activity and employment.

Household income is associated with functional outcomes in a multi-institutional cohort of patients with ischemic stroke and COVID-19.

OBJECTIVES: The COVID-19 pandemic has heightened awareness of health disparities associated with socioeconomic status (SES) across the United States. We examined whether household income is associated with functional outcomes after stroke and COVID-19. MATERIALS AND METHODS: This was a multi-institutional, retrospective cohort study of consecutively hospitalized patients with SARS-CoV-2 and radiographically confirmed stroke presenting from March through November 2020 to any of five comprehensive stroke centers in metropolitan Chicago, Illinois, USA. Zip-code-derived household income was dichotomized at the Chicago median. Logistic regression was used to examine the relationship between household income and good functional outcome (modified Rankin Scale 0-3 at discharge, after ischemic stroke). RESULTS: Across five hospitals, 159 patients were included. Black patients comprised 48.1%, White patients 38.6%, and Hispanic patients 27.7%. Median household income was $46,938 [IQR: $32,460-63,219]. Ischemic stroke occurred in 115 (72.3%) patients (median NIHSS 7, IQR: 0.5-18.5) and hemorrhagic stroke in 37 (23.7%). When controlling for age, sex, severe COVID-19, and NIHSS, patients with ischemic stroke and household income above the Chicago median were more likely to have a good functional outcome at discharge (OR 7.53, 95% CI 1.61 - 45.73; P=0.016). Race/ethnicity were not included in final adjusted models given collinearity with income. CONCLUSIONS: In this multi-institutional study of hospitalized patients with stroke, those residing in higher SES zip codes were more likely to have better functional outcomes, despite controlling for stroke severity and COVID-19 severity. This suggests that area-based SES factors may play a role in outcomes from stroke and COVID-19.

Website quality in digital media: literature reviewon general evaluation methods and indicators and reliability attributes

Introducción: En el contexto de la pérdida de confianza hacia los contenidos en internet, la desinformación, las noticias falsas y la crisis financiera que afecta a la prensa a escala global, se revisan los estudios que proponen instrumentos dedicados a evaluar los sitios web de los medios digitales. Objetivos: Identificar y caracterizar los trabajos focalizados en el análisis de cibermedios, examinar sus métodos e indicadores, y revisar si estos consideran atributos de fiabilidad. Metodología: Se examina la producción científica sobre calidad web mediante una revisión bibliográfica sistematizada sobre 83 publicaciones recuperadas desde las principales bases de datos. También se detectan parámetros de calidad en general y menciones a aspectos web con implicaciones éticas o sociales. Resultados y discusión: Se constata que las herramientas específicas para medir la calidad web de los medios digitales son escasas y que entre los métodos de evaluación predomina el análisis experto mediante inspección heurística por sobre los estudios de usuario. El parámetro más estudiado es la interactividad, entendida como espacio de participación, seguida por la usabilidad o facilidad de uso, la arquitectura de información y el contenido, entre otros. Además, se detectan muy pocas menciones a asuntos deontológicos -como enlaces engañosos, protección de datos o corrección de informaciones- y casi nulas referencias a directrices, estándares y políticas internacionales. Conclusiones: Numerosos trabajos abordan indicadores específicos de los medios digitales, pero existen pocos protocolos de análisis para los sitios web que los sustentan. Hay un amplio margen de mejora en los estudios de la calidad web en cibermedios, en cuanto a considerar no solo asuntos técnicos sino también parámetros propios del rigor periodístico y la credibilidad informativa.Alternate :Introduction: In the context of the loss of confidence towards Internet content, misinformation, fake news, and the financial crisis affecting the press globally, the studies that propose instruments dedicated to evaluating digital media websites are reviewed. Objectives: Identify and characterize the works focused on digital media, examine their methodologies and indicators, and check if they consider reliability attributes among them. Methodology: Scientific production on web quality is examined through a systematic review of 83 articles retrieved from the main databases, detecting parameters of web quality in general, and mentions of web aspects with ethical or social implications. Results and discussion: As part of the findings, it has been found that specific tools for the evaluation of digital media are scarce and that among the evaluation methods, expert analysis through heuristic inspection predominates over user studies. The most studied parameter is interactivity, understood as a space for participation, followed by usability, accessibility, and personalization, among others. In addition, there are very few references to deontological matters and almost no references to international guidelines, standards, and policies. Conclusions: Numerous studies address specific indicators of digital media, but there are few analysis protocols for websites that support them. There is, therefore, a wide margin of improvement in the studies of website quality in digital media, incorporating not only technical issues but also considering parameters of journalistic rigor and informative credibility.

Acute telestroke evaluations during the COVID-19 pandemic.

We sought to analyze the effect of COVID-19 on telestroke requests and to characterize patients remotely evaluated for acute ischemic stroke (AIS) during this time. This study is a retrospective database review of all telestroke requests at one academic vascular neurology center telestroke network with seven remote sites in the USA between March 15 and April 30, 2020. Data were compared with historical cohort spanning same time frame in 2019 using parametric or nonparametric methods as appropriate. Among telestroke requests, characteristics of age, gender, race/ethnicity, National Institutes of Health Stroke Scale (NIHSS), primary diagnosis of AIS or transient ischemic attack (TIA), and number of patients receiving intravenous alteplase (IV-rtPA) and endovascular therapy (ET) were recorded. There was a 53% decrease in telestroke evaluation requests in 2020 from 2019 (p < 0.00001). Mean NIHSS in 2020 was 9.1 (SD ± 8.4) and mean NIHSS in 2019 was 7.2 (SD ± 7.3) (p = 0.122). Among patients with primary diagnosis of suspected AIS or TIA, mean age was 60.5 years in 2020 (SD ± 17.5) and mean age of 67.0 years in 2019 (SD ± 16.0) (p = 0.038). A significant lower number of telestroke evaluations were performed with a higher mean NIHSS overall and a lower mean age among AIS/TIA-suspected patients. Higher NIHSS and severity in all telestroke evaluations reflect neurological manifestations of AIS and mimics, possibly influenced by COVID-19. The younger age of those with suspected AIS or TIA reflects thrombotic complications in atypical stroke populations.

International registry of dermatological manifestations secondary to COVID-19 infection in 347 Hispanic patients from 25 countries.

BACKGROUND: The infection by coronavirus disease 2019 (COVID-19) has been associated with multiple cutaneous manifestations, although characterization of them in Hispanic patients with darker skin phototypes is lacking. The objective of this study is to characterize the clinical dermatological manifestations associated with COVID-19 infection in cases with few or without general symptoms in patients from Latin America. METHODS: Cross-sectional study using a questionnaire that was made for health professionals (physicians with a specialty in dermatology) to investigate dermatological lesions associated with COVID-19 infection in patients from 25 countries of Latin America. The survey was active from June 9 to July 30, 2020. RESULTS: In this study, information was collected from a total of 347 patients. We found a female gender predominance: 179/347 (51.6%). The mean age at presentation was 40.87 years. The most frequent dermatological manifestations were maculopapular rash and urticarial lesions, followed by papulovesicular lesions, vesicular lesions, chilblain-like lesions, papular lesions, ecchymosis, petechial purpura, pityriasis rosea-like lesions, pruritus, palmoplantar dysesthesias, transient livedo, acral necrosis, palpable purpura, livedo racemosa, and retiform purpura. As far as we know, there are no previous reports of pruritus and palmoplantar dysesthesias. CONCLUSIONS: This registry emphasizes skin manifestations as an important criterion for establishing the diagnosis of COVID-19 infection in Latin American countries. This information will be useful for the early identification of suspected cases by health professionals (dermatologists and nondermatologists) and will allow contact tracing to mitigate the impact on health systems at different levels.

Acute Ischemic Stroke and COVID-19: Experience From a Comprehensive Stroke Center in Midwest US.

Background: COVID-19 has been associated with increased risk of venous and arterial thromboembolism including ischemic stroke. We report on patients with acute ischemic stroke and concomitant COVID-19 in a diverse patient population. Methods: This is a retrospective analysis of patients hospitalized with acute ischemic stroke (AIS) and COVID-19 to our comprehensive stroke center in Chicago, IL, between March 1, 2020, and April 30, 2020. We reviewed stroke characteristics, etiologies, and composite outcomes. We then compared our cohort with historic patients with AIS without COVID-19 admitted in the same time frame in 2019 and 2020. Results: Out of 13 patients with AIS and COVID-19, Latinos and African-Americans compromised the majority of our cohort (76.8%), with age ranging from 31-80 years. Most strokes were cortical (84.6%) and more than 50% of patients had no identifiable source, and were categorized as embolic stroke of unknown source (ESUS). A trend toward less alteplase administration was noted in the COVID-19 stroke patients compared to the non-COVID group from 2020 and 2019 (7.1 vs. 20.7% p 0.435 and 7.1 vs. 27.2% p 0.178). Endovascular thrombectomy was performed in 3 (23%) patients. Systemic thrombotic complications occurred in 3 (23%) COVID-19 AIS patients. Median National Institutes of Health Stroke Scale and modified Rankin Scale at discharge were 11 (IQR 4-23) and 4 (IQR 3-4), respectively. In the logistic regression model corrected for age and sex, COVID-19 was associated with discharge to mRS > 2 (p 0.046, OR 3.82, CI 1.02-14.3). Eight patients (63.8%) were discharged home or to acute rehabilitation, and two deceased from COVID-19 complications. Conclusion: AIS in the setting of COVID-19 is associated with worse outcomes, especially among African-American and Latino populations. Large vessel disease with ESUS was common suggesting an increased risk of coagulopathy and endothelial dysfunction as a potential etiology.