Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 11 de 11
Filter
1.
World Journal of Critical Care Medicine ; 11(4):246-254, 2022.
Article in English | MEDLINE | ID: covidwho-2025161

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) can be associated with life-threatening organ dysfunction due to septic shock, frequently requiring intensive care unit (ICU) admission, respiratory and vasopressor support. Therefore, clear clinical criteria are pivotal for early recognition of patients more likely to need prompt organ support. Although most patients with severe COVID-19 meet the Sepsis-3.0 criteria for septic shock, it has been increasingly recognized that hyperlactatemia is frequently absent, possibly leading to an underestimation of illness severity and mortality risk. AIM: To identify the proportion of severe COVID-19 patients with vasopressor support requirements, with and without hyperlactatemia, and describe their clinical outcomes and mortality. METHODS: We performed a single-center prospective cohort study. All adult patients admitted to the ICU with COVID-19 were included in the analysis and were further divided into three groups: Sepsis group, without both criteria;Vasoplegic Shock group, with persistent hypotension and vasopressor support without hyperlactatemia;and Septic Shock 3.0 group, with both criteria. COVID-19 was diagnosed using clinical and radiologic criteria with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive RT-PCR test. RESULTS: 118 patients (mean age 63 years, 87% males) were included in the analysis (n = 51 Sepsis group, n = 26 Vasoplegic Shock group, and n = 41 Septic Shock 3.0 group). SOFA score at ICU admission and ICU length of stay were different between the groups (P < 0.001). Mortality was significantly higher in the Vasoplegic Shock and Septic Shock 3.0 groups when compared with the Sepsis group (P < 0.001) without a significant difference between the former two groups (P = 0.713). The log rank tests of Kaplan-Meier survival curves were also different (P = 0.007). Ventilator-free days and vasopressor-free days were different between the Sepsis vs Vasoplegic Shock and Septic Shock 3.0 groups (both P < 0.001), and similar in the last two groups (P = 0.128 and P = 0.133, respectively). Logistic regression identified the maximum dose of vasopressor therapy used (AOR 1.046;95%CI: 1.012-1.082, P = 0.008) and serum lactate level (AOR 1.542;95%CI: 1.055-2.255, P = 0.02) as the major explanatory variables of mortality rates (R 2 0.79). CONCLUSION: In severe COVID-19 patients, the Sepsis 3.0 criteria of septic shock may exclude approximately one third of patients with a similarly high risk of a poor outcome and mortality rate, which should be equally addressed.

2.
Br J Nutr ; : 1-26, 2022 Mar 14.
Article in English | MEDLINE | ID: covidwho-1740370

ABSTRACT

The aim of this study was to ascertain the level of occupational stress before and during the COVID-19 pandemic, how it changed, and its association with health outcomes of hospital workers in the Recôncavo of Bahia, Brazil. A longitudinal study was conducted with 218 hospital workers over 18 years old. A semi-structured questionnaire was used for collecting sociodemographic, occupational, lifestyle, anthropometric, and health data. The main exposures were occupational stress, assessed through Job Content Questionnaire and classified according to the Demand-Control Model and reported shift work. Health outcomes considered were nutritional status assessed by Body Mass Index (BMI), Waist Circumference (WC), and Body Fat Percentage (BF%); health self-perception; and cardiovascular risk factors. We used McNemar chi-squared or Wilcoxon tests to compare levels of exposure and outcome variables before and during the pandemic, and odds ratios to evaluate associations between changes in occupational stress and shiftwork with health outcomes. During the pandemic, participants reported increased occupational stress and shift work, lower self-perceived health, and had higher BMI and cardiovascular risk factors, compared with before the pandemic. No association was observed between change in occupational stress and health outcomes. However, increased amount of shift work was related to increased BMI in the overall sample (OR 3.79, CI95% 1.40-10.30), and in health workers (OR 11.56; CI95% 2.57-52.00). These findings support calls to strengthen labour policies to ensure adequate working conditions for hospital workers in context of the COVID-19 pandemic.

3.
4th International Conference of the Portuguese Society for Engineering Education, CISPEE 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1735789

ABSTRACT

In a multimodal world the contact time between the teacher and the students is not always sufficient to ensure the effectiveness of the learning process. For the assimilation of concepts, students often endeavor on a search for the materials that best suit their learning needs. With the application of new technologies in teaching, study materials and support platforms are increasingly abundant and diverse. Additionally, recommendation algorithms overwhelm students with several options, sometimes hard to resist and select, especially after the COVID-19 restrictions, where the amount of connected time as increased. In this context, it is important for the teacher, to know which methods and materials the students use when they are autonomously developing their knowledge and skills. A survey was conducted within a group of engineering students at a Portuguese higher education institution with the main goal of characterizing the study habits and the materials that students. The obtained results are here reported and analyzed and compared with previous results from pre-pandemic study. © 2021 IEEE.

4.
34th SIBGRAPI Conference on Graphics, Patterns and Images, SIBGRAPI 2021 ; : 239-246, 2021.
Article in English | Scopus | ID: covidwho-1707726

ABSTRACT

Since the COVID-19 pandemic, the use of facial masks in public spaces or during people gatherings has become common. Therefore, journalists, reporters, and interviewees frequently use a mask, following the public health measures to contain the pandemic. However, using a mask while speaking or conducting a presentation can be uncomfortable for viewers. Furthermore, the usage of a mask prevents lip reading, which can harm the speech comprehension of people with hearing impairment. Thus, this work aims at artificially removing masks in videos while recovering the lip movements using the audio and uncovered face features. We use the audio to infer the lip movement in a way it matches with the uttered phrase. From the audio, we estimate landmarks representing the mouth structure. Finally, the landmarks (i.e. uncovered and estimated) are the input in a generative adversarial network (GAN) that reconstructs the full face image with the mouth in a correct shape. We present quantitative results in the form of evaluation metrics and qualitative results in the form of visual examples. © 2021 IEEE.

5.
34th SIBGRAPI Conference on Graphics, Patterns and Images (SIBGRAPI) ; : 239-246, 2021.
Article in English | Web of Science | ID: covidwho-1691667

ABSTRACT

Since the COVID-19 pandemic, the use of facial masks in public spaces or during people gatherings has become common. Therefore, journalists, reporters, and interviewees frequently use a mask, following the public health measures to contain the pandemic. However, using a mask while speaking or conducting a presentation can be uncomfortable for viewers. Furthermore, the usage of a mask prevents lip reading, which can harm the speech comprehension of people with hearing impairment. Thus, this work aims at artificially removing masks in videos while recovering the lip movements using the audio and uncovered face features. We use the audio to infer the lip movement in a way it matches with the uttered phrase. From the audio, we estimate landmarks representing the mouth structure. Finally, the landmarks (i.e. uncovered and estimated) are the input in a generative adversarial network (GAN) that reconstructs the full face image with the mouth in a correct shape. We present quantitative results in the form of evaluation metrics and qualitative results in the form of visual examples.

6.
International Joint Conference on Neural Networks (IJCNN) ; 2021.
Article in English | Web of Science | ID: covidwho-1612796

ABSTRACT

Forecasts can help in the decision-making process. Epidemiological forecasts are no different, they can help to evaluate the scenario and possible direction of disease spread, for guiding possible interventions. In this work, Echo State Networks (ESNs) are evaluated for COVID-19 (Coronavirus Disease 2019) cases and deaths forecasting ten days ahead. The chosen locations for the experiment are five states in Brazil, namely Sao Paulo (SP), Bahia (BA), Minas Gerais (MG), Rio de Janeiro (RJ), and Ceara (CE), the states with the most COVID-19 cases as of December 31, 2020. The results are evaluated using performance indexes RMSE (Root-mean-square error), MAE (Mean absolute error), and MAPE (Mean absolute percentage error). Results are compared with a common forecasting technique called ARIMA (Autoregressive Integrated Moving Average). The error signals are compared using Wilcoxon Signed-Rank Test, to evaluate the difference statistically. ESNs presented overall good results for a ten day horizon forecast regarding used performance metrics, but for the number of cases, ARIMA outperformed ESNs regarding RMSE, MAE, and MAPE in all but one state. For the number of deaths however, ESNs outperformed ARIMA in most states when the MAE is taken into account. ESNs are shown to be a solid forecasting model when compared with ARIMA, presenting comparable results and in some cases outperforming it.

7.
European Heart Journal ; 42(SUPPL 1):1517, 2021.
Article in English | EMBASE | ID: covidwho-1554003

ABSTRACT

Introduction/Purpose: COVID19 can be associated with life-threatening organ dysfunction due to septic shock, frequently requiring ICU admission, respiratory and vasopressor support. Therefore, clear clinical criteria are pivotal to early recognition of patients more likely to have poor outcomes, needing prompt organ support. Although most patients with severe COVID19 meet the Sepsis-3.0 criteria for septic shock, it has been increasingly recognized that, in this population, hyperlactatemia is frequently absent, possibly leading to an underestimation of illness severity and mortality risk. Purpose: This study aimed to identify the proportion of patients with COVID19 with hypotension despite adequate volume resuscitation, needing vasopressors to have a MAP>65mmHg, with and without hyperlactatemia, in ICU, and describe its clinical outcomes and mortality rate. Methods: We performed a single-center retrospective cohort study. All adult patients admitted to ICU with COVID19 were eligible and were further divided in 3 groups according to hyperlactatemia (lactate >2mmol/L) and persistent hypotension with vasopressor therapy requirement: (1) sepsis group (without both criteria), (2) vasoplegic shock (with persistent hypotension with vasopressor therapy requirement without hyperlactatemia) and (3) septic shock 3.0 (with both criteria). COVID19 was diagnosed using clinical and radiologic criteria with a SARS-CoV-2 positive RT-PCR test. Qui-square test was used for categorical variables and Kruskal-Wallis and logistic regression were used on continuous variables for statistical assessment of outcomes between groups. Kaplan-Meier survival curve and logrank test were also obtained. Results: 103 patients (mean age 62 years, 71% males) were included in the analysis (N=45 sepsis, N=25 vasoplegic shock;N=33 septic shock 3.0). SOFA score at ICU admission and ICU length of stay were different between groups (p<0.001). Ventilator-free days and vasopressor-free days were also different between sepsis vs vasoplegic shock and septic shock 3.0 groups (both p<0.001 and p<0.001, respectively), and similar in vasoplegic vs septic shock 3.0 groups (p=0.387 and p=0.193, respectively). Mortality was significantly higher in vasoplegic shock and septic shock 3.0 when compared with sepsis group (p<0.001) without difference between the former two groups (p=0.595). Log rank test of Kaplan-Meier survival curves were also different (p=0.07). Logistic regression identified the maximum dose of vasopressor therapy used (OR 1.065;CI 95%: 1.023-1.108, p=0.02) and serum lactate level (OR 1.543;CI 95%: 1.069-2.23, p=0.02) as the major explanatory variables of mortality rates. Conclusions: In severe COVID19 patients, the Sepsis 3 criteria of septic shock may exclude patients with a similarly high risk of poor outcomes and mortality rate, that should be equally approached. (Table Presented).

8.
Studies in Systems, Decision and Control ; 366:821-858, 2022.
Article in English | Scopus | ID: covidwho-1516835

ABSTRACT

The coronavirus disease (COVID-19), according to the World Health Organization, by July 15th, 2021, has infected more than 188 million people, and more than 4 millions have died from it in the worldwide. It is important to forecast the incidence of cases in a short-term horizon to help the public health system develop strategic planning to deal with the COVID-19. In this chapter, several artificial intelligence (AI) models including extreme gradient boosting, extreme learning machine, long short-term memory, and support vector regression are used stand-alone, and coupled with the ensemble empirical mode decomposition (EEMD) employed to decompose the time-series into intrinsic mode functions and residual signals. All AI techniques are evaluated in the task of forecasting daily incidence COVID-19 cases in ten Brazilian states, with a high number of cases by September 4th, 2020, with seven and fourteen-days-ahead. Previous COVID-19 incidence cases and urban mobility information were employed as systems input for all forecasting models. The models’ effectiveness are evaluated based on the performance criteria. In general, the EEMD approach outperformed the compared models regarding the accuracy in 65% of the cases. Regarding the exogenous variables, urban mobility information indeed plays a key role in the forecasting task. Therefore, due to the efficiency of evaluated models to forecasting cumulative COVID-19 cases up to fourteen-days-ahead, the adopted models can be recommended as promising for forecasting and can be used to assist in development of public policies to mitigate the effects of COVID-19 outbreak. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

10.
Revista Praxis Educacional ; 17(47):22, 2021.
Article in Portuguese | Web of Science | ID: covidwho-1395621

ABSTRACT

With the Covid-19 pandemic, teacher education has raised broad discussion in academia, as student learning takes on new contours in the face of the remote teaching alternative, which can have a substantial impact on the personal and professional dimensions of the subject in formation. Given this context, this article aims to analyze, in the light of Freire's conceptions, the implications of the pandemic context for a group of postgraduate students of the Specialization in Early Childhood Education, at a public university in Bahia. To do so, we adopted a qualitative approach, with 26 participants. In the production of data, we used a questionnaire with 17 questions, being 05 closed and 12 open. The data reveal that although graduate students have pointed out some negative aspects of the pandemic, such as increased spending on technological resources and the internet, a feeling of impotence, insecurity, fear, and exhaustion;on the other hand, they saw opportunities to develop creativity, overcome challenges, study close to the family, learn and develop new skills. We conclude that the current pandemic scenario in Brazil requires immediate public educational policies to support teachers and students, as well as offering initial or continuing teacher training that address the learning needs of the teaching profession in situations of uncertainty and social change, political, economic, emotional, among others.

11.
Clinical Cancer Research ; 26(18 SUPPL), 2020.
Article in English | EMBASE | ID: covidwho-992068

ABSTRACT

The Covid-19 pandemic presents itself as one of the greatest health challenges on a global scale. Brazil has thehighest number of cases and deaths in Latin America, given these underestimates. Teófilo Otoni is the polemunicipality of the northeast macroregion of Minas Gerais (MG) and its health network is a reference for 448,438inhabitants. The study aims to assess the current panorama of Covid-19 in the city of Teófilo Otoni, its futureperspective, and the impacts on mortality. For the preparation of this study, data were collected on Covid-19 inTeófilo Otoni according to official bulletins issued daily by the Health Department of the State of Minas Gerais. Adescriptive analysis of the data was carried out via a map with spatialization of the cases, and, for the numericalsimulation of the evolution of the cases, the epidemiologic mathematical model S.I.R (Susceptible, Infected andRecovered) was used, combining the Code Blocks software combined with Matlab. The northeastern macroregionhas high levels of illiteracy, many rural residents, and the presence of indigenous communities in situations of socialvulnerability. Thus, in this region are found about 54% of the municipalities classified among the 100 worst MunicipalHuman Development Indexes in MG. Although a reference, Teófilo Otoni, until April 12, had only 7 beds of intensivecare units (ICU) for Covid-19.The first confirmed case of the disease in the city occurred on April 22 and themunicipality followed the recommendations of the Ministry of Health, launched on April 6, to adopt the SelectiveSocial Distancing, since there were not more than 50% of the ICU beds occupied, thus helping the Expanded SocialDistancing that was being carried out. However, the cases increased, and on May 22 the city decreed the closure ofnonessential trade, intensifying the distance measures. Until June 8, Teófilo Otoni had 372 confirmed cases and 10deaths from Covid-19, which is worthy of the simulations of the research project “Covid-19/UFVJM Bulletin,” since298 and 535 infected were expected in the first week of this month, considering the contact rate close to reality(70%). However, by another analysis, the numbers are high, since the expectation for the first week of June, withhorizontal isolation, was between 5 and 6 cases. In addition, it is imperative to highlight that deaths in the regiontend to increase, since, on June 7, the two main hospitals in the city had 100% of their beds occupied. It appearsthat Teófilo Otoni is in a situation of public calamity, since the health network is not prepared to receive all patientsreferred with Covid-19 and who require ICU, which corresponds to about 3% (13,453) of cases. This reinforces theneed to analyze epidemiologic data, expand the region's hospital network, and improve mitigation measures, as theforecasts can supplement public policies to contain the progress of the disease.

SELECTION OF CITATIONS
SEARCH DETAIL