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1.
ACM/IEEE International Conference on Human-Robot Interaction (HRI) ; : 715-716, 2021.
Article in English | Web of Science | ID: covidwho-1769960

ABSTRACT

The Robots for Learning workshop series aims at advancing the research topics related to the use of social robots in educational contexts. This year's half-day workshop follows on previous events in Human-Robot Interaction conferences focusing on efforts to discuss potential benchmarks in design, methodology and evaluation of new robotics systems that help learners. In this 6th edition of the workshop, we will be investigating in particular methods from technologies for education and online learning. Since the past few months, online and remote learning has been put in place in several countries to cope with the health and safety measures due to the Covid-19 pandemic. In this workshop, we aim to discuss strategies to design robotics system able to provide embodied assistance to the remote learners and to demonstrate long-term learning effects.

2.
Blood ; 138:3906, 2021.
Article in English | EMBASE | ID: covidwho-1582273

ABSTRACT

The introduction of post-transplant cyclophosphamide (PTCy) has circumvented the need for T-cell depletion following haploidentical stem cell transplantation (SCT). By expanding the donor pool for patients from certain ethnic minorities, this has addressed to some degree an important health care disparity issue in SCT. However, a recent registry study showed increased incidence GvHD and inferior outcomes in patients receiving haploidentical SCT with PTCy, tacrolimus and mycophenolate mofetil for GvHD prevention as opposed to matched unrelated donor SCT with PTCy-based GvHD prevention. Seeking to improve the results of GvHD prevention in the setting of haploidentical SCT, we examined a combination of PTCy, abatacept and a short course of tacrolimus (CAST). Abatacept is a recombinant soluble fusion protein composed of the extracellular domain of cytotoxic T-lymphocyte associated antigen-4 (CTLA-4) fused to the Fc region of IgG1. Abatacept blocks CD28-CD80I86 axis and prevents T-cell co-stimulation. In early studies, abatacept has shown promising results when added to methotrexate and tacrolimus in matched and mismatched donor SCT. We initiated a phase Ib-II clinical trial for patients with hematological malignancies undergoing haploidentical SCT. Patients received G-CSF mobilized peripheral blood grafts from related haploidentical donors. GvHD prevention consisted of PTCy 50mg/kg IV on day +3 and +4 with forced hydration, abatacept 10mg/kg IV on day +5, +14 and +28 and tacrolimus. Tacrolimus was started on day +5 at 0.02mg/kg/day by continuous IV and adjusted thereafter to maintain a trough level of 5-12ng/mL. Tacrolimus taper was planned to begin on day +60 and complete by day +90 in the absence of GvHD. All patients received standard supportive care including levofloxacin until neutrophil engraftment, posaconazole until day +75, acyclovir for 1 year and, if CMV positive by serology, letermovir until day +100. Pneumocystis Jiroveci prophylaxis was started after neutrophil engraftment and continued until 6 months post-transplant. G-CSF was administered routinely until neutrophil engraftment. Since September 2020, 19 patients were enrolled. Three patients are too early in their post-transplant course and were excluded from this analysis. Patients' characteristics are summarized in the table. All but 2 patients received cryopreserved products. Median times to ANC and platelet engraftment were 18.5 days (14-30) and 28.5 (16-61). All 16 patients achieved full whole blood donor chimerism by day +30. There was no secondary graft failure. With a median follow-up was 149.5 days (41-308) with 10 patients having >120 days and 8 >180 days of follow-up, 4 patients developed skin acute GvHD (all grade I). No patient developed grade II-IV acute GvHD. Two patients developed skin chronic GvHD (limited, both moderate). Both cases were diagnosed following COVID-19 vaccination. Fifteen patients completed tacrolimus taper by day +90. Two patients received systemic steroids, one for treatment of cGvHD. The remaining patients required no further immunosuppressive therapy beyond day +90. CMV activation rate was 25%. One patient had EBV reactivation and required preemptive therapy with 2 weekly rituximab doses. There were no cases of adenovirus, HHV-6 virus or BK virus reactivation. Four patients developed renal insufficiency (3 in the setting of acute sepsis and 1 with thrombotic microangiopathy, which resolved after tapering off tacrolimus. One patient with adult T-cell leukemia/lymphoma relapsed and died. All other patients are alive and well. In summary, our preliminary results suggest that CAST with shortened course of tacrolimus is feasible and seems to offer very promising outcomes with low rates of acute GvHD. The study is accruing actively and the results of a larger cohort with longer follow-up will be presented at the meeting. If confirmed, by improving the outcomes of haploidentical SCT, this regimen may further address a health care disparity issue, offering almost every patient in need of allogeneic SCT an alternative donor op ion with equal outcomes. [Formula presented] Disclosures: Al-Homsi: Daichii Sanyko: Consultancy;Celyad: Other: Advisory Board. Abdul-Hay: Abbvie: Consultancy;Servier: Other: Advisory Board, Speakers Bureau;Jazz: Other: Advisory Board, Speakers Bureau;Takeda: Speakers Bureau;Amgen: Membership on an entity's Board of Directors or advisory committees. OffLabel Disclosure: Abatacept - off label use as GvHD prevention Cyclophosphamide - off label use as GvHD prevention

3.
Front Med (Lausanne) ; 8: 767291, 2021.
Article in English | MEDLINE | ID: covidwho-1555301

ABSTRACT

Background: The patients with coronavirus disease 2019 (COVID-19) associated with severe acute respiratory distress syndrome (ARDS) may require prolonged mechanical ventilation which often results in lung fibrosis, thus worsening the prognosis and increasing fatality rates. A mesenchymal stromal cell (MSC) therapy may decrease lung inflammation and accelerate recovery in COVID-19. In this context, some studies have reported the effects of MSC therapy for patients not requiring invasive ventilation or during the first hours of tracheal intubation. However, this is the first case report presenting the reduction of not only lung inflammation but also lung fibrosis in a critically ill long-term mechanically ventilated patient with COVID-19. Case Presentation: This is a case report of a 30-year-old male patient with COVID-19 under invasive mechanical ventilation for 14 days in the intensive care unit (ICU), who presented progressive clinical deterioration associated with lung fibrosis. The symptoms onset was 35 days before MSC therapy. The patient was treated with allogenic human umbilical-cord derived MSCs [5 × 107 (2 doses 2 days interval)]. No serious adverse events were observed during and after MSC administration. After MSC therapy, PaO2/FiO2 ratio increased, the need for vasoactive drugs reduced, chest CT scan imaging, which initially showed signs of bilateral and peripheral ground-glass, as well as consolidation and fibrosis, improved, and the systemic mediators associated with inflammation decreased. Modulation of the different cell populations in peripheral blood was also observed, such as a reduction in inflammatory monocytes and an increase in the frequency of patrolling monocytes, CD4+ lymphocytes, and type 2 classical dendritic cells (cDC2). The patient was discharged 13 days after the cell therapy. Conclusions: Mesenchymal stromal cell therapy may be a promising option in critically ill patients with COVID-19 presenting both severe lung inflammation and fibrosis. Further clinical trials could better assess the efficacy of MSC therapy in critically ill patients with COVID-19 with lung fibrosis associated with long-term mechanical ventilation.

4.
Front Genet ; 12: 679485, 2021.
Article in English | MEDLINE | ID: covidwho-1273335

ABSTRACT

Coronavirus disease 19 (COVID-19) has struck the world since the ending of 2019. Tools for pandemic control were scarce, limited only to social distance and face mask usage. Today, upto 12 vaccines were approved and the rapid development raises questions about the vaccine efficiency. We accessed the public database provided by each country and the number of death, active cases, and tests in order to evaluate how the vaccine is influencing the COVID-19 pandemic. We observed distinct profiles across the countries and it was related to the vaccination start date and we are proposing a new way to manage the vaccination.

5.
Transfus Med ; 2021 Jun 03.
Article in English | MEDLINE | ID: covidwho-1258987

ABSTRACT

OBJECTIVES: Evaluate the impact of ABO histo-blood group type on COVID-19 severity. BACKGROUND: ABO histo-blood type has been associated with different outcomes in infectious diseases. It has also shown a higher proportion of type A patients with SARS-CoV-2. In this observational study, extracted from an ongoing clinical trial on the efficacy of convalescent plasma transfused in COVID-19 patients, we describe the impact of ABO blood type on the risk of developing severe COVID-19. MATERIALS AND METHODS: Seventy-two consecutive patients (37 type A, 23 type O, 11 type B, 1 type AB) with severe (respiratory failure) COVID-19 were included. Control group was composed of 160 individuals randomly selected from the same populational basis. RESULTS: Blood group A was overrepresented (51.39%) in the patient group in relation to the control group (30%), whereas blood group O was less represented (31.94%) in patient than in control group (48%). Odds ratio (A vs. O) was 2.581 (1.381-4.817), CI 95%; p = 0.004. Also, blood group A patients appeared to have more severe disease, given by the scores of the Sequential Organ Failure Assessment and Simplified Acute Physiologic Score 3 (p = 0.036 and p = 0.058, respectively). CONCLUSION: Histo-blood type A is associated with a higher risk of developing severe COVID-19 in relation to blood type O.

6.
Journal of Sexual Medicine ; 18(3):S21-S21, 2021.
Article in English | Web of Science | ID: covidwho-1156337
7.
Int J Infect Dis ; 105: 579-587, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1126872

ABSTRACT

BACKGROUND: The progression and severity of COVID-19 vary significantly in the population. While the hallmarks of SARS-CoV-2 and severe COVID-19 within routine laboratory parameters are emerging, the impact of sex and age on these profiles is still unknown. METHODS: A multidimensional analysis was performed involving millions of records of laboratory parameters and diagnostic tests for 178 887 individuals from Brazil, of whom 33 266 tested positive for SARS-CoV-2. Analyzed data included those relating to complete blood cell count, electrolytes, metabolites, arterial blood gases, enzymes, hormones, cancer biomarkers, and others. FINDINGS: COVID-19 induced similar alterations in laboratory parameters in males and females. CRP and ferritin were increased, especially in older men with COVID-19, whereas abnormal liver function tests were common across several age groups, except for young women. Low peripheral blood basophils and eosinophils were more common in the elderly with COVID-19. Both male and female COVID-19 patients admitted to intensive care units displayed alterations in the coagulation system, and higher values for neutrophils, CRP, and lactate dehydrogenase. CONCLUSIONS: Our study uncovered the laboratory profiles of a large cohort of COVID-19 patients, which formed the basis of discrepancies influenced by aging and biological sex. These profiles directly linked COVID-19 disease presentation to an intricate interplay between sex, age, and immune activation.


Subject(s)
COVID-19/blood , Inflammation/etiology , SARS-CoV-2 , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , C-Reactive Protein/analysis , Female , Humans , Intensive Care Units , Male , Middle Aged , Sex Characteristics , Young Adult
8.
Atmospheric Chemistry and Physics ; 21(5):3555-3592, 2021.
Article in English | ProQuest Central | ID: covidwho-1123969

ABSTRACT

Social distancing to combat the COVID-19 pandemic has led to widespread reductions in air pollutant emissions. Quantifying these changes requires a business-as-usual counterfactual that accounts for the synoptic and seasonal variability of air pollutants. We use a machine learning algorithm driven by information from the NASA GEOS-CF model to assess changes in nitrogen dioxide (NO2) and ozone (O3) at 5756 observation sites in 46 countries from January through June 2020. Reductions in NO2 coincide with the timing and intensity of COVID-19 restrictions, ranging from 60 % in severely affected cities (e.g., Wuhan, Milan) to little change (e.g., Rio de Janeiro, Taipei). On average, NO2 concentrations were 18 (13–23) % lower than business as usual from February 2020 onward. China experienced the earliest and steepest decline, but concentrations since April have mostly recovered and remained within 5 % of the business-as-usual estimate. NO2 reductions in Europe and the US have been more gradual, with a halting recovery starting in late March. We estimate that the global NOx (NO + NO2) emission reduction during the first 6 months of 2020 amounted to 3.1 (2.6–3.6) TgN, equivalent to 5.5 (4.7–6.4) % of the annual anthropogenic total. The response of surface O3 is complicated by competing influences of nonlinear atmospheric chemistry. While surface O3 increased by up to 50 % in some locations, we find the overall net impact on daily average O3 between February–June 2020 to be small. However, our analysis indicates a flattening of the O3 diurnal cycle with an increase in nighttime ozone due to reduced titration and a decrease in daytime ozone, reflecting a reduction in photochemical production.The O3 response is dependent on season, timescale, and environment, with declines in surface O3 forecasted if NOx emission reductions continue.

10.
PLoS One ; 15(11): e0240793, 2020.
Article in English | MEDLINE | ID: covidwho-910484

ABSTRACT

OBJECTIVE: This study aimed to assess the performance of a commonly used ICU severity score (SAPS3) and determine whether an alternative scoring system may be more accurate across all age strata. METHODS: Retrospective cohort study in a general ICU in Brazil. A secondary analysis was performed with clinical and epidemiological data, present in the first 24 hours of unit admission. Then, a binary logistic regression, followed by cross-validation, was made to develop a novel prognostic tool. ICU mortality was the primary outcome evaluated. RESULTS: A total of 3042 patients were included over the study period between August 2015 and July 2018 with a median age of 67 ± 18.4 years. SAPS3 performed fairly in prediction of ICU mortality, particularly in the 80 years or older subset. Multivariable regression identified variables independently associated with mortality that were used to develop the Age Calibrated ICU Score (ACIS) tool that performed similarly to SAPS3 across age categories, being slightly superior in the very elderly population (AUC 0.80 vs 0.72). CONCLUSIONS: The ACIS offers a robust and simple tool to predict ICU mortality, particularly in an increasingly elderly critical care population.


Subject(s)
Critical Illness/therapy , Hospital Mortality , Hospitalization/statistics & numerical data , Intensive Care Units/statistics & numerical data , Aged , Aged, 80 and over , Brazil , Calibration , Cohort Studies , Critical Illness/classification , Critical Illness/mortality , Female , Humans , Intensive Care Units/standards , Logistic Models , Male , Middle Aged , Prognosis , Severity of Illness Index
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