Hyponatremia as a Prognostic Factor for Mortality in COVID-19 at The National Hospital "Dos de Mayo", Lima Peru

Introduction: Hyponatremia is the most common electrolyte disorder in hospitalized patients. It's more common in patients who were hospitalized with a diagnosed of pneumonia, which worsen the prognosis of the general condition. The infection in patients with SARS-CoV-2, can present hyponatremia, which would affect in a negativity way the recovery of them with mild, moderate or severe respiratory symptoms. Objective: Establish if hyponatremia is a prognostic factor of mortality in patients with covid-19 diagnosis.Material and methods: The sample consisted of 185 medical records of patients with a COVID-19 diagnosis, which has been seen between June 2020 and February 2021 an observational, cohort and retrospective study. We recorded epidemiological, demographic, clinical, biochemical and radiological variables of SARS-CoV-2 infection and hyponatremia at the time of diagnosis during hospitalization. Descriptive analysis was used for main variables, Chi square tests, OR calculation and confidence interval were used to assess the statistical association of the variables. Finally, a logistic regression analysis was performed to evaluate confusing variables. Results: 160 patients have hyponatremia (34.9% mild, 26.7% moderate and 40% severe) and none of them had a previous diagnosis of SIHAD (Syndrome of inappropriate antidiuretic hormone secretion) consigned in their clinical histories. The increase of mortality was consigned (viewed) in patients with severe hyponatremia compared with moderate and mild hyponatremia diagnosed at hospital admission (20.8% mild hyponatremia, 21.6% moderate and 46.4% severe, p=0. 03) Conclusion: Severe hyponatremia at hospital admission was associated with elevated mortality in SARSCoV-2 patients.Presentation: No date and time listed

Breathing Curriculum for Stress Reduction in High School Students: A Feasibility Randomized Controlled Trial

Methods: This cluster-randomized pilot compared 5-minute slow DB with treatment-as-usual among four 12th-grade public high school classes. Students individually participated in the curriculum after school during COVID-19-related hybrid teaching, with DB 3 times/week and breath science education once/week. Feasibility was based on overall compliance and qualitative assessments. Preliminary effectiveness was measured with the State-Trait Anxiety Inventory (STAI) and a timed-exhale carbon dioxide tolerance test (CO2TT). Descriptive statistics and repeated analysis of variance were performed to quantify and compare cross-sectional and temporal outcomes between classes and time periods. Human subjects research approval was granted through WCG-IRB. Results: Forty-two students consented to participate. Intervention and effectiveness assessments' compliance varied from 29-91% across classes and weeks, and decreased on average 40% from baseline to follow-up. Compliance of ease/ tolerability assessments ranged from 41% to 86%, and averaged 55% for open-ended assessments. Usefulness, ease and tolerability ratings for the DB ranged from 1.63±0.74 to 2.88±0.35 on scales of 0-3 (“not at all” - “very much”);and from 2.24±0.84 to 2.60±0.55 for effectiveness assessments. Students reported enjoying the DB, CO2TT, and breath science;some found the extended exhales challenging and the curriculum and assessments time-consuming. Outcome measures demonstrated trends towards improvements (e.g., improved STAI and CO2TT before-to-after breathing exercises), but were not statistically significant. Background: Nearly 1 in 3 US adolescents meet the criteria for anxiety, an issue that has worsened with the COVID-19 pandemic. We developed a video-based, 5-week, slow diaphragmatic breathing (DB) stress-reduction curriculum for high school students and evaluated its feasibility and preliminary effectiveness. Conclusion: Implementation of this 5-week slow breathing curriculum was feasible and tolerable to this cohort. Compliance, tolerability, and effectiveness may be improved with in-class participation. Future research on simple and accessible slow-breathing exercises is warranted to address today's adolescent stress-management crisis.

Improving Explainability of Image Classification in Scenarios with Class Overlap: Application to COVID-19 and Pneumonia

Trust in predictions made by machine learning models is increased if the model generalizes well on previously unseen samples and when inference is accompanied by cogent explanations of the reasoning behind predictions. In the image classification domain, generalization can be assessed through accuracy, sensitivity, and specificity. Explainability can be assessed by how well the model localizes the object of interest within an image. However, both generalization and explainability through localization are degraded in scenarios with significant overlap between classes. We propose a method based on binary expert networks that enhances the explainability of image classifications through better localization by mitigating the model uncertainty induced by class overlap. Our technique performs discriminative localization on images that contain features with significant class overlap, without explicitly training for localization. Our method is particularly promising in real-world class overlap scenarios, such as COVID-19 and pneumonia, where expertly labeled data for localization is not readily available. This can be useful for early, rapid, and trustworthy screening for COVID-19. © 2020 IEEE.

Management of digital strategic communication of the main companies in the tourist and gastronomic sector of Ecuador

In times of uncertainty, companies must rethink their strategic communication and take advantage of the possibilities of the digital environment. The research identified the management of communication 2.0 in the main companies of the tourist and gastronomic sector of Ecuador on Twitter. For the quantitative analysis, the communication index 2.0 on social media (Twitter) was measured. Qualitatively, the generated content was analyzed: direct advertising, indirect advertising and valuable content through metrics and Web analytics tools. Finally, the triangulation of information allowed to describe communication 2.0. The study shows that there is a deficient management of communication strategies 2.0 in companies in the tourism and gastronomy sector of Ecuador, a deficiency that is aggravated by the pandemic (COVID-19), so that the challenges are demanding in order to maintain the business, boost economic income, and above all, meet the expectations and needs of tourist 2.0. © AISTI 2020.