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1.
ESMO Open ; 7(2): 100448, 2022 04.
Article in English | MEDLINE | ID: covidwho-1763725

ABSTRACT

BACKGROUND: Androgen-deprivation therapy (ADT) has been associated with cognitive decline, but results are conflicting. This study describes changes in cognitive performance in patients with prostate cancer, according to ADT, during the first year after prostate cancer diagnosis. PATIENTS AND METHODS: Patients with prostate cancer treated at the Portuguese Institute of Oncology of Porto (n = 366) were evaluated with the Montreal Cognitive Assessment (MoCA), before treatment and after 1 year. All baseline evaluations were performed before the coronavirus disease 2019 (COVID-19) pandemic and 69.7% of the 1-year assessments were completed after the first lockdown. Cognitive decline was defined as the decrease in MoCA from baseline to the 1-year evaluation below 1.5 standard deviations of the distribution of changes in the whole cohort. Participants scoring below age- and education-specific normative reference values in the MoCA were considered to have cognitive impairment. Age- and education-adjusted odds ratios (aORs) were computed for the association between ADT and cognitive outcomes. RESULTS: Mean MoCA scores increased from baseline to the 1-year evaluation (22.3 versus 22.8, P < 0.001). Cognitive decline was more frequent in the ADT group, and even more after the onset of the COVID-19 pandemic (aOR 6.81 versus 1.93, P for interaction = 0.233). The 1-year cumulative incidence of cognitive impairment was 6.9% (9.1% before and 3.7% after the pandemic onset), which was higher among patients receiving ADT, but only after the pandemic (aOR 5.53 versus 0.49, P for interaction = 0.044). CONCLUSIONS: ADT was associated with worse cognitive performance of patients with prostate cancer, mostly among those evaluated after the first COVID-19 lockdown.


Subject(s)
COVID-19 , Cognitive Dysfunction , Prostatic Neoplasms , Androgen Antagonists/adverse effects , Androgens , Cognitive Dysfunction/complications , Cognitive Dysfunction/etiology , Communicable Disease Control , Humans , Male , Neon , Pandemics , Prospective Studies , Prostatic Neoplasms/complications , Prostatic Neoplasms/drug therapy
3.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-316891

ABSTRACT

Without a vaccine, the fight against the spreading of the coronavirus has focused on maintaining physical distance. To study the impact of such measures on inter-municipality traffic, we analyze a mobile dataset with the daily flow of people in Portugal in March and April 2020. We find that the reduction in inter-municipality traffic depends strongly on its initial outflow. In municipalities where the mobility is low, the outflow reduced by $10-20\%$ and this decrease was independent of the population size. Whereas, for municipalities of high mobility, the reduction was a monotonic increasing function of the population size and it even exceeded $60\%$ for the largest municipalities. As a consequence of such heterogeneities, there were significant structural changes on the most probable paths for the spreading of the virus, which must be considered when modeling the impact of control measures.

4.
Technologies ; 9(4):13, 2021.
Article in English | Web of Science | ID: covidwho-1627246

ABSTRACT

The aim of this article is to characterize the impacts of Smart Additive Manufacturing (SAM) on industrial production, digital supply chains (DSCs) and corresponding digital value chains (DVCs), logistics and inventory management. The method used consists of a critical review of the literature, enriched by the authors' field experience. The results show that digital transformation of manufacturing is affecting business models, from resource acquisition to the end user. Smart manufacturing is considered a successful improvement introduced by Industry 4.0. Additive Manufacturing (AM) plays a crucial role in this digital transformation, changing the way manufacturers think about the entire lifecycle of a product. SAM combines AM in a smart factory environment. SAM reduces the complexity of DSCs and contributes to a more flexible approach to logistics and inventory management. It has also spurred the growth and popularization of customized mass production as well as decentralized manufacturing, rapid prototyping, unprecedented flexibility in product design, production and delivery, and resource efficiency and sustainability. SAM technology impacts all five Fletcher's stages in DVCs. However, the need for clear definitions and regulations on 3D printing of digital files and their reproduction, as well as product health, safety, and integrity issues, cannot be ignored. Furthermore, investment in this technology is still expensive and can be prohibitive for many companies, namely SMEs.

7.
Journal of Clinical Rheumatology ; 27(SUPPL 1):S19, 2021.
Article in English | EMBASE | ID: covidwho-1368233

ABSTRACT

Objectives: To determine the main risk factors associated with COVID-19 in SLE patients. Methods: The Reuma CoV Brazil is a multicenter, observational, prospective cohort designed to monitor immune-mediated rheumatic diseases patients during SARS-CoV-2 pandemic in Brazil. SLE adult patients according to SLE SLICC criteria classification (2012), with and without (control group-CG) COVID-19 diagnosis were matched. Demographic data, managing of COVID-19, comorbidities, clinical characteristics (disease activity: Patient Report Outcomes-PROs, Physician Global Assessment and SLEDAI-2 K)were collected. Results: From May 2020 to January 2021, 604 SLE patients were included, 317 (52.4%) with COVID-19 and 287 (47.6%) in the CG. Both groups were homogeneous and comparable regarding sex and comorbidities. SLE patients with COVID-19 declared a lower level of social isolation (49.5% vs. 61.9%;p = 0.002), worked more commonly in health professions (10.4% vs. 3.5%;p = 0.002), presented more frequently joint (32.5% vs. 22.0%;p = 0.004) and hematological manifestations (18.0% vs. 11.5%;p = 0.025). SLEDAI-2 K did not differ among groups prior and after COVID-19 infection. However, considering the mean duration of COVID-19 symptoms (12.1 ± 8.8 days), infected patients had more severe disease activity's PROs after resolution of COVID-19 symptoms (2.9 ± 2.9 vs. 2.3 ± 2.6;p = 0.031). The hospitalization rate was 20.5% (n = 65), of whom 23 (7.2%) needed intensive care unit and 14 (4.4%) patients died. Hypertension [5,26 (1,9714,07);p = 0.001] and recently cyclophosphamide pulses [39,21 (4,17-368,53);p = 0.001] were associated with hospitalization and patients who received telemedicine medical care presented 72% less chance of hospitalization [0.28 (0.09-0.83);p = 0.023). Conclusion: COVID-19 was associated with a lower level of declared social isolation and more severe disease activity perception after SARS-CoV-2 infection according to PROs. Hypertension and cyclophosphamide were associated with hospitalization and telemedicine can be a useful tool for SLE patients with COVID-19. These data should be considered to perform public health policy and national guidelines to manage SLE patients during the pandemic, as well as to prioritize some special groups for the immunization program.

8.
Journal of Clinical Rheumatology ; 27(SUPPL 1):S114, 2021.
Article in English | EMBASE | ID: covidwho-1368218

ABSTRACT

Objectives: The engagement of undergraduate medical students (MS) in clinical research may lead to improvement in scientific method critical analysis, better performance as young physicians, awareness of innovation, and the development of leadership skills and teamwork perspectives (1). This study evaluated changings in daily routine and the awareness of patients' realities reported by MS participating on a research project involving rheumatic patients in Brazil during the COVID-19 pandemic. Methods: A secondary analysis of a web-based cross-sectional survey (2) including MS participating of Mário Pinotti II study (MPII) (3) was performed. Demographic characterization and the description of the MS impressions of the impact of participating of MPII are reported. Results: A total of 228 (58%) MS involved in MPII responded to the survey: 151 (66%) were women with (Mean(SD)) 22.8 (2.8) years of age, most were studying in public (N = 135 (59%)) medical schools, from 10 Brazilian states. Figures 1 and 2 summarizeMS' reports on the impact of participating of MPII on their daily routine and increased awareness of patient's realities. Conclusion: MS participating on the MPII study reported a better understanding of rheumatic patients' fears and uncertainties during the COVID-19 pandemic, including hydroxychloroquine shortage, lack of medical appointments and an unmet need related to more adequate information addressed to the rheumatic diseases. Furthermore, the close interaction among rheumatic patients, faculty, rheumatologists, and otherMShave provided a significant improvement in their feelings of usefulness during the pandemic and could contribute to their future professional activities.

9.
Annals of the Rheumatic Diseases ; 80(SUPPL 1):909-910, 2021.
Article in English | EMBASE | ID: covidwho-1358867

ABSTRACT

Background: The role of chronic use of hydroxychloroquine (HCQ) in rheumatic disease (RD) patients during the SARS-CoV-2 pandemic is still subject of discussion. Objectives: To compare the occurrence of COVID-19 and its outcomes between RD patients on HCQ use with individuals from the same household not taking the drug during community viral transmission in an observational prospective multicenter study in Brazil. Methods: Participants were enrolled and monitored through 24-week (From March 29th to Sep 30th, 2020) regularly scheduled phone calls performed by trained medical professionals. Epidemiological and demographic data, as well as RD disease activity status and current treatment data, specific information about COVID-19, hospitalization, need for intensive care, and death was recorded in both groups and stored in the Research Electronic Data Capture (REDCap) database. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. The statistical analysis was performed using IBM-SPSS v.20.0 software. Group comparisons were made using the Man-Whitney, Chi-Square and Fisher Exact Test, as well as multivariate regression models adjusted to confounders. Survival curves were performed using Kaplan-Meier analysis. Results: A total of 10,427 participants mean age (SD) of 44.04 (14.98) years were enrolled, including 6004 (57.6%) rheumatic disease patients, of whom 70.8% had systemic lupus erythematosus (SLE), 6.7% rheumatoid arthritis (RA), 4% primary Sjögren's syndrome (pSS), 1.8% mixed connective tissue disease (DMTC), 1% systemic sclerosis (SSc) and others (15.9), including overlap syndromes. In total, 1,132 (10.8%) participants fulfilled criteria for COVID-19, being 6.7% RD patients and 4.1% controls (p=0.002). A recent influenza vaccination had a protective role (p<0.001). Moderate and severe COVID-19 included the need for hospitalization, intensive care, mechanical ventilation or death. Infection severity was not different between groups (p=0.391) (Table 1). After adjustments for multiple confounders, the main risk factors significantly associated with COVID-19 were higher education level (OR=1.29 95%CI 1.05-1.59), being healthcare professionals (OR=1.91;95%CI 1.45-2.53), presence of two comorbidities (OR=1.31;95%CI 1.01-1.66) and three or more comorbidities associated (OR=1.69;95%CI 1.23-2.32). Interestingly, age ≥=65 years (OR=0.20;95%CI 0.11-0.34) was negatively associated. Regarding RD, the risk factors associated with COVID-19 diagnosys were SLE (OR= 2.37;95%CI 1.92-293), SSc (OR=2.25;95%CI 1.05-4.83) and rituximab use (OR=1.92;95%CI 1.13-3.26). In addition, age ≥=65 years (OR=5.47;95%CI 1.7-19.4) and heart disease (OR=2.60;95%CI 1.06-6.38) were associated with hospitalization. Seven female RD patients died, six with SLE and one with pSS, and the presence of two or more comorbidities were associated with higher mortality rate. Conclusion: Chronic HCQ use did not prevent COVID-19 in RD compared to their household cohabitants. Health care profession, presence of comorbidities LES, SSc and rituximab were identified as main risk factors for COVID-19 and aging and heart disease as higher risk for hospitalization. Our data suggest these outcomes could be considered to manage them in clinical practice.

10.
Annals of the Rheumatic Diseases ; 80(SUPPL 1):1448, 2021.
Article in English | EMBASE | ID: covidwho-1358707

ABSTRACT

Background: Mental health was widely affected during the new coronavirus pandemic. In addition, some measures adopted by most countries in order to contain the virus spread, such as isolation and social distancing, leading to the interruption of routine activities, including partial or complete interruption of face-to-face classes may be associated with increased stress, depression and anxiety among undergraduate medical students (1). From March to September, 2020, the Brazilian Society of Rheumatology carried out the Mario Pinotti II Project (MPII), a prospective, multicenter, observational cohort study designed to monitor the COVID-19 in patients with rheumatic disease on hydroxychloroquine, using periodic telephone calls performed by undergraduate medical students (2). Objectives: To compare the mental health status of medical students who were participating from the MPII with theirs colleagues not involved in this project. Methods: A web-based survey via google forms platform was developed by a panel composed of undergraduate medical students, rheumatologists, medical school professors, and a psychology professor. It included details on demographic and life habits data and domains regarding depression, anxiety and stress, using the DASS-21 (Depression, Anxiety & Stress Scale), Brazilian version. Data collection occurred from July 20th to August 31st, 2020. Statistical analysis was performed using the SPSS version 20.0. Univariate and multivariate linear regression analysis were performed to verify associations with the DASS-21, defined as dependent variable. A p-value < 0.05 was deemed as significant. This study was approved by the Institutional Research Ethics Committee. Results: A total of 684 undergraduate medical students were included in this study, of whom 228 as MPII volunteers (VG) and 456 as control group (CG). Median age was 23 years (IQ 21-24) and the CG was older than the VG (p<0.03). Most of them were white (68.8%) and women (63%). There were no significant differences regarding comorbidities, ethnicity, smoking status, alcohol intake and physical activity. Older age, male gender, participation of MPII study, absence of a worsening in sleep pattern during the pandemic and a lower number of prior comorbidities were associated with lower DASS21 scores, suggesting a better mental health (Table 1). Conclusion: Several aspects may be involved with mental health, including increased emotional maturity, gender and sleep pattern. Although with marginal independent association, medical students with participation in the MPII study had better mental health than their student colleagues not engaged with this research. Our data pointed out that voluntary participation in a research project which foresees interaction by telephone contact with rheumatic patients, professors, rheumatologists, and colleagues is associated with better mental health.

11.
Clinical & Experimental Rheumatology ; 07:07, 2021.
Article in English | MEDLINE | ID: covidwho-1305088

ABSTRACT

OBJECTIVES: To evaluate the incidence of COVID-19 and its main outcomes in rheumatic disease (RD) patients on hydroxychloroquine (HCQ) compared to household cohabitants (HC). METHODS: This is a 24-week nationwide prospective multi-centre cohort with a control group without RD and not using HCQ. All participants were monitored through scheduled phone interviews performed by health professionals. Details regarding COVID-19 symptoms, and epidemiological, clinical, and demographic data were recorded on a specific web-based platform. COVID-19 was defined according to the Brazilian Ministry of Health criteria and classified as mild, moderate or severe. RESULTS: A total of 9,585 participants, 5,164 (53.9%) RD patients on HCQ and 4,421 (46.1%) HC were enrolled from March 29th, 2020 to September 30th, 2020, according to the eligibility criteria. COVID-19 confirmed cases were higher in RD patients than in cohabitants [728 (14.1%) vs. 427 (9.7%), p<0.001] in a 24-week follow-up. However, there was no significant difference regarding outcomes related to moderate/ severe COVID-19 (7.1% and 7.3%, respectively, p=0.896). After multiple adjustments, risk factors associated with hospitalisation were age over 65 (HR=4.5;95%CI 1.35-15.04, p=0.014) and cardiopathy (HR=2.57;95%CI 1.12-5.91, p=0.026). The final survival analysis demonstrated the probability of dying in 180 days after a COVID-19 diagnosis was significantly higher in patients over 65 years (HR=20.8;95%CI 4.5-96.1) and with 2 or more comorbidities (HR=10.8;95%CI 1.1-107.9 and HR=24.8;95%CI 2.5-249.3, p=0.006, respectively). CONCLUSIONS: Although RD patients have had a higher COVID-19 incidence than individuals from the same epidemiological background, the COVID-19 severity was related to traditional risk factors, particularly multiple comorbidities and age, and not to underlying RD and HCQ.

12.
Revista Interamericana de Bibliotecologia ; 43(3), 2020.
Article in Portuguese | Scopus | ID: covidwho-854773

ABSTRACT

This reflection study is exploratory and descriptive. As a objective, we sought to verify elements that make it possible to assess the credibility of the information available on the Web. To meet the proposed objective, a literature review was applied in order to identify publications that deal with the topics: fake news, Post-truth, Infodemia, Misinformation, Checking and Credibility of information. It is concluded that the fact-checking method was considered valid in the content accreditation, since it starts from checking the entire informational context, going through validation steps, which allows the transparency of the method and the sources checked. Due to a large amount of information available on the internet, the practice of content checking has become necessary for the verification and certification of publications, relevant to the public interest, combating fake news and the movement of infodemia, and disinformation in today's society. © 2020 Escuela Interamericana de Bibliotecologia. All rights reserved.

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