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1.
European Journal of Obstetrics & Gynecology and Reproductive Biology ; 270:E28-E28, 2022.
Article in English | Web of Science | ID: covidwho-1798265
2.
Indian Journal of Clinical Biochemistry ; 36(SUPPL 1):S142, 2021.
Article in English | EMBASE | ID: covidwho-1767675

ABSTRACT

Background &Objective : Multi-Drug Resistant Tuberculosis (MDRTB) and depression act synergistically that magnify the burden of disease. The present study aims to understand the differences in depression scale using Patient Health Questionnaire-9 (PHQ-9) over the time during the COVID-19 pandemic which may cause mental and psychological changes in the patients with MDRTB. Method: A total of 155 treatment naive adults and adolescents MDRTB are enrolled in an ongoing cohort. Each participant completes PHQ-9 to assess depression at baseline, 2 weeks, 1, 2, 3, 4, 5, 6, 12, 18, 24 months of treatment and post treatment 6 and 12 months. Differences in the PHQ9 scores for visits before COVID-19, during 1st lockdown, in unlock phase and 2nd lockdown were assessed by Chi-squared test and t-test and p<0.05 were considered statistically significant. Results: Out of 155 participants with median age of 27 years' 102 (65.8%) were females A significant difference was seen in the overall PHQ-9 scores across each time period (p<0.001). Also, significant changes were seen in overall PHQ-9 scores before COVID-19 and 1st lockdown (p<0.001), during unlock phase, 2nd lockdown (p<0.001) and without lockdown and during 1st and 2nd lockdowns (p<0.001). During 1st lockdown and unlock phase (p=0.165), there were no significant differences seen in the PHQ-9 scores. Conclusion: In this ongoing study, changes in the overall depression scale were significantly associated with COVID-19 lockdown, during unlock phase and 2nd lockdown phase. PHQ-9 screening can be useful for patients who may benefit from additional support and counselling during the treatment during COVID-19 pandemic.

3.
Indian Journal of Clinical Biochemistry ; 36(SUPPL 1):S149, 2021.
Article in English | EMBASE | ID: covidwho-1767667

ABSTRACT

Background &Objective : SARS-CoV-2 pandemic is causing high morbidity and mortality burden worldwide with unprecedented strain on health care systems. Data on the prevalence of the SARS-CoV-2 antibody is expanding with growing research. The initial data on antibodies was available for nucleocapsid target proteins however with advancing research and development of vaccines against the Spike RBD domain of the virus, antibody assays are being focussed to the Spike RBD proteins. The current study aims to understand the prevalence of Anti-Spike SARS cov2 antibodies. Method: A commercially available assay targeting the SPIKE RBD domain of the virus using a chemiluminescent microparticle immunoassay was used for the qualitative and quantitative determination of IgG antibodies to SARS-CoV-2 in a total of 260 individuals. Results: A total of 260 individuals were screened which included 147 males and 113 females with a mean age of 51+16 years. A positive seroprevalence was observed in 85.3% (222/260) individuals. Vaccination details were available for 225 individuals wherein 194 were seropositive. Around 12% did not show presence of antibodies (26/211) even after 21 days of vaccination. A few non-vaccinated individuals were seropositive due to prior history of Covid infection. However, 7 individuals with past history of Covid infection and 2 post vaccination were negative for antibodies. Conclusion: Serological testing plays a vital role in understanding and ultimately combating viral outbreaks and can help identifying individuals with an adaptive immune response to SARSCoV-2, indicating recent or prior infection. A high prevalence of positive spike antibodies is observed in most individuals.

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Open Forum Infectious Diseases ; 8(SUPPL 1):S576-S577, 2021.
Article in English | EMBASE | ID: covidwho-1746340

ABSTRACT

Background. Brazillian authorities reported a total of 16.3 million cases and 454. 000 deaths during COVID-19 pandemic in Brazil by may 2021. It became necessary to educate healthcare professionals on diagnosis and treatment of the syndrome. Game based learning surfaced as an effective alternative, since it promotes critical thinking and problem solving skills. A team of Brazilian and Peruvian students, physicians, designers and programmers gathered to create a decision based computer game that simulates a hospital scenario and allows medical students to analise, make decisions and receive feedback. This work describes the creative process and showcase the initial version of the software. Methods. Professors and students of Medicine, Information Technology (IT), Design and Architecture from Brazil and Peru assembled a team in order to develop the computer game. Clinical cases were created by the medical students and professors, comprising medical procedures for the treatment and management of COVID 19, and a video game script was developed exploring gamification principles of challenge, objectivity, persistence, failure, reward and feedback. Algorithms (image 1) were created, under supervision of professors of Medicine, to define possible courses of action and outcomes (e.g. gain or loss of points, improvement or worsening of the patient). Students of Design created artistic elements, and IT students programmed with a game engine software. This fluxogram, written in portuguese, describes in detail all the possible courses of actions that can be exercised by the player. It is created by a team of Professors of Medicine and medical students, in accordance with evidence-based guidelines. Primarily, this document guides the programmers and designers throughout the development phase of the game. Results. Initially, an expandable minimum viable product was obtained. The game, visualized on image 2, consists in a non-playable character and a playable character (i.e. doctor), with a scenario and a dialogue script simulating a clinical examination of a COVID 19 patient. The player can interact with certain elements within the game, e.g. the computer and other characters, to retrieve test results or start dialogues with relevant information. Hospital scenario and dialogue window between doctor (player in black) and patient (non playable character) are displayer in the game engine software (Unity 2D). On the bottom half of the screen, the dialogue box allows the player to collect the patient's medical history. The player can interact with certain elements to obtain relevant information to make decision and progress in the game. Conclusion. The game allows medical students to practice diagnosis and treatment of COVID 19. Future versions will include assessment reports of player's actions, and a new score system will be implemented. New diseases will be incorporated in the gameplay to match the variety of scenarios offered by real hospitals and patients. Artificial intelligence will be employed to optimize gameplay, feedback and learning.

6.
ASME 2021 International Mechanical Engineering Congress and Exposition, IMECE 2021 ; 9, 2021.
Article in English | Scopus | ID: covidwho-1708139

ABSTRACT

This study presents a research experience with engineering students at undergraduate and graduate levels, during the summer of 2020 at the School of Engineering, University of Minho, Portugal. Following the first pandemic event in Portugal, from March to May 2020, the Foundation for promoting Science and Technology (FCT) has opened a call for research projects among students and researchers at different Universities. The main aim of these projects was to motivate students to return physically to the campus during a summer course, and to promote a research environment among them. i9Masks was one of the projects approved by the University of Minho and its main objective was the development of innovative masks in a silicone elastomer for the protection of COVID-19 with the use of state-of-the-art technologies. The development of masks was at the time a very hot topic as well as a fashionable subject for research. Considering the results obtained, from the final works presented by students, a very positive balance of the experience was achieved. The i9Masks project was a useful learning experience for engineering education, particularly in Portugal, where the opportunity to participate in this type of "learning by doing" experience is very small. Copyright © 2021 by ASME

8.
Einstein (Sao Paulo, Brazil) ; 19:eAO6254, 2021.
Article in English, Portuguese | Scopus | ID: covidwho-1614543

ABSTRACT

OBJECTIVE: To evaluate the severity of COVID-19 in cancer patients to describe clinical and epidemiological factors associated with poor outcomes (mortality and need of intensive care unit admission or mechanical ventilation). METHODS: Retrospective data from patients with cancer and laboratory diagnosis of COVID-19, obtained between March 16 and May 29, 2020, were retrieved out of a cancer center database. Data analyzed included patient history, age, sex, comorbidities, types of cancer and anticancer therapy. RESULTS: This sample comprised 105 patients aged 18-92 years, 80.9% of whom were females. Dyspnea was the most prevalent initial symptom (30.4%) among patients who died (p<0.0001). Overall, 57.1% of patients had metastatic disease and 60% had poor performance status (Eastern Cooperative Oncologic Group ≥2) at the time of COVID-19 diagnosis. The overall mortality rate was 40.95%. Mortality rates were higher in male patients and those with poor performance status (p<0.0001). CONCLUSION: This cohort is one of the largest Brazilian studies describing clinical and epidemiological features of patients with cancer and concurrent COVID-19. Findings of this study emphasize the vulnerability of cancer patients in the current pandemic, and indicate high mortality from COVID-19 among male cancer patients and cancer patients with poor performance status. This analysis may assist the selection of patients who may benefit from strict isolation and eventual discontinuation of anticancer therapy to reduce exposure to infection.

9.
Australasian Journal of Regional Studies ; 27(2):221-236, 2021.
Article in English | Web of Science | ID: covidwho-1576109

ABSTRACT

To examine the realities of COVID-19 on enterprise development in regional Australia, this paper discusses the findings of a study which examined the capacity of a remote community to exploit changes occurring in the marketplace. The study identified that barriers to entrepreneurship which existed pre-COVID-19 remain, with COVID-19 acting as a driver and barrier. To exploit changes in the marketplace, experienced entrepreneurs have higher levels of entrepreneurial self-efficacy (ESE) connected to innovating and adapting. However, nascent and experienced entrepreneurs require support to develop other areas of ESE. A conceptual framework is developed to support enterprise development.

10.
Pediatric Diabetes ; 22(SUPPL 30):86-87, 2021.
Article in English | EMBASE | ID: covidwho-1570994

ABSTRACT

Introduction: The rate of diabetic ketoacidosis (DKA) in new-onset type 1 diabetes mellitus (T1D) is multifactorial. There seems to be an inverse relationship between T1D's incidence and DKA's frequency. DKA has been reported to be more common among young children. Recently, the COVID-19 pandemic has posed additional challenges as to diagnosing T1D. Objectives: We aimed to assess the rate of DKA and associated risk factors in pediatric new-onset T1D in a large pediatric diabetes center in Portugal. Methods: Retrospective analysis of data of patients referred to a level III pediatric hospital between January 1st, 2013 and December 31th, 2020 (8 years). Results: We included 276 children and adolescents with a median age of 9,6 years, 20,1% under 5 years old. A mean incidence of 35 new cases/year was observed, with an upward trend. Newonset T1D cases under 5 years old raised progressively, having more than tripled throughout the study period (n=3 in 2013 vs. n=10 in 2020). In total, 38% children and adolescents presented with DKA, ranging from 23,3% in 2013 to 43,2% in 2020, while remaining stable (37,2%-40,9%) in the period in-between. Overall, DKA was considered severe in 24,8% of cases, ranging from 6% in 2017 to 47% in 2020. 20 (7,2%) patients were admitted to the intensive care unit. DKA at presentation was more frequent in the age group under 2 years old (p=0,016), in which 80% of patients presented with DKA. Non-DKA presentation was associated with family history of T1D (p=0,005). Conclusions: Our study shows an upward trend in T1D's incidence in children under 5 years old and a high DKA rate at disease onset, which was more frequent in patients under 2 years of age. In the first year of COVID-19 pandemic, 43% of DKA was considered severe. It is urgent to implement educational programs to promote earlier diagnosis. Broader studies are required to provide a representative national landscape of the epidemiology of T1D in pediatric population in Portugal.

11.
Pediatric Diabetes ; 22(SUPPL 30):49, 2021.
Article in English | EMBASE | ID: covidwho-1570993

ABSTRACT

Introduction: On 12th March 2020, a national lockdown was imposed in Portugal, as a response to rising COVID-19 cases. Since then healthcare access patterns were deeply modified. Objectives: In this study, we tried to understand what shifted from prior years in new-onset type 1 diabetes mellitus (T1D). Methods: It was performed a retrospective analysis of patients referred to a level III pediatric hospital from March 2020 until March 2021. Patients admitted during the same period in the 3 previous years were set as control group. Results: Since lockdown imposition, 44 children and adolescents were diagnosed T1D, contrasting with prior mean incidence of 32 cases/ year. Median age was 9,9 years (min. 0,5 - max. 15,8). Children under 2 years-old represented 4,9% of cases, contrasting with only 2,1% in previous years. All subjects were tested for SARS CoV-2 but only 2 were positive. When comparing to prior years, subjects presenting with less than one week of symptoms almost doubled in 2020, (19,5% vs. 10,4%), and a higher rate of diabetic ketoacidosis (DKA) was also observed (53,7%, vs. 38,5%). DKA severity was also higher (40,9% vs. 21,6%;p=0,02 and 14,6% subjects required admission to intensive care unit. Conclusions: Similarly to other reports, a higher number of new-onset T1D was observed, with a comparable increase in severity. In contrast to what might have been expected, DKA prevalence and severity was not necessarily linked to delayed diagnosis. We estimate that such severity may be related to a higher proportion of younger patients. While the role of SARS CoV-2 exposure in pancreatic islet cells destruction is still under investigation, antibody assessment and detailed contact history could help to explain the increased prevalence and severity of new-onset T1D during the pandemic period.

12.
Internationalisation at home: A collection of pedagogical approaches to develop students' intercultural competences ; : 1-272, 2021.
Article in English | Scopus | ID: covidwho-1551638

ABSTRACT

The internationalisation of higher education has accelerated in recent years. Internationalisation at most higher education institutions mainly takes the form of study abroad. This immersion in an intercultural environment is believed to foster the development of academic and non-academic skills, thus improving graduates employability. Regardless of the geographical area, higher education institutions (HEI) have therefor put student mobility at the heart of their academic projects. However, the context has changed: the Covid-19 health crisis has led to a freezing of international mobility. Alternative solutions to traditional mobility must be found. With this book, we intend to contribute to reflections on how to develop intercultural sensitivity and intercultural competences among students through Internationalisation at Home. For this purpose, in the eight chapters of the book, we present some pedagogical methods that facilitate the creation of a context conducive to interculturality and the acquisition of plural skills by students at home. Some authors examine how these competences can be assessed. Finally, we propose a framework explaining how a combination of activities within an institution can foster the development of students' intercultural competences. Regardless of the approaches chosen by the teachers observed, they answered similar questions. These questions set a framework for reflections on efficient approaches to supporting the development of students' intercultural skills in an Internationalisation at Home context. © P.I.E. PETER LANG s.a. All rights reserved.

14.
23rd International Symposium on Computers in Education, SIIE 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1526336

ABSTRACT

The COVID-19 Pandemic affected institutions, students, and faculty around the world. As if it wasn't already evident that technologies were gaining more space on the educational policy agenda, the decision by governments to close educational institutions made it imperative to move to online using distance learning strategies, mainly technological solutions. In this paper, we analyzed an online course created to help Portuguese teachers from different educational levels. This course aimed to support teachers transitioning from face-to-face to online and provide them with an experience as distance student. The information shared by participants, as well as satisfaction questionnaire allowed us to realize two things. On one hand, that the difficulties experienced in Portugal are similar to those identified in previous studies, on the other hand to identify specific needs by education level. We conclude that pedagogical training on distance learning methodologies and hybrid contexts is emerging, should be continued and should integrate governments and educational institutions' strategy. © 2021 IEEE.

15.
Journal of the American Society of Nephrology ; 32:130-131, 2021.
Article in English | EMBASE | ID: covidwho-1490222

ABSTRACT

Background: There are no objective criteria for the discontinuation of renal replacement therapy (RRT) in patients who have acute kidney injury (AKI). It is unknown if Kinetic Estimated Glomerular Filtration Rate (KeGFR) can be used as assessment of renal recovery in patients who underwent RRT. Methods: All critical patients in Hospital das Clínicas during September 2020 to May 2021 who started hemodialysis due to AKI and remained free of RRT for at least 2 consecutive days were included. Patients who stopped RRT due to decision for exclusive palliative care or hemodynamic instability were excluded. Patients were divided in two groups: Success group (free from RRT for 7 consecutive days after their last RRT session) and failure group. Discontinuation day was defined as the second day without RRT. Variables were expressed as median (25th and 75th percentile) and categorical data as percentage. Mann Whitney test was used. Statistical significance was defined as p<0.05. Results: 72 patients were enrolled. COVID19, ischemia-reperfusion and sepsis were the main causes of AKI (37%;28,7%;24,6%, respectively), with no difference in prevalence between groups. Success group (n=47) presented higher KeFGR on the day of discontinuation (keGFR1) and in the day after (keGFR2) when compared to failure group (n=25): KeGFR1: Success: 18.76ml/min vs. failure: 10.21ml/min, p=0.05. KeGFR2: Success: 29.38ml/min vs. failure: 16.03ml/min, p<0.05. Success group had lower non renal SOFA score at discontinuation (4 vs. 6;p<0.05) and higher urine output (1600 vs. 725;p<0.05) when compared to failure group. There was no difference in diuretic use. Conclusions: KeGFR is higher in patients who succeed in stopping RRT and it may be an useful tool for decision-making. Supported by FAPESP.

16.
Journal of the American Society of Nephrology ; 32:352, 2021.
Article in English | EMBASE | ID: covidwho-1489365

ABSTRACT

Background: The hemodialysis non tunneled catheter (HDC) is the most common access of starting renal replacement therapy. Malposition of catheter is associated with delays in treatment. Agitated saline bubble-enhanced ultrasound (SBUS) has become a new method to visualize the HDC position. Delayed appearance of microbubbles (≥2-second) in the right atrium indicates malposition. Our objective is to analyze the accuracy of SBUS between right and left internal jugular vein (IJV) HDC insertion, comparing to chest radiography (standard method). Methods: From December 2019 to May 2021, we evaluated 145 hospitalized patients submitted to HDC insertion in IJV. We compared SBUS with chest radiography (CR);the time spent to perform the CR;complications;patient characteristics;catheter blood flow and quality of dialysis. Results: Total of 145 patients were analyzed, the median age was 62 years old [50.5-70], and there was no statistical difference between the site of insertion. In RIJV, 91% catheters were placed. AKI was more frequent than CKD (75% vs 25%), except when the site was LIJV (46% vs 54%, p<0.05). AKI-related COVID-19 was the most common etiology (54%). The confirmation of catheter placement by SBUS was correlated with position by CR (All: r=0.6603, p<0.0001;RIJV: r=0.7044, p<0.0001;LIJV: r=0.6396, p=0.0769). SBUS was highly accurate in identifying adequate location of HDC, especially in RIJV (All: 97.9%;RIJV: 99.2%;LIJV: 84.6%, p< 0.05). The time of the catheter insertion to perform radiography was 191 minutes [83.5-287]. Adequate syringe blood flow and an effective hemodialysis session was more frequent in RIJV catheter (99.2% vs 53.8%, p<0.05;96.8% vs 72.7%, p <0.05, respectively). Complications occurred only in 4.2%, without statistical difference between catheter sites. Conclusions: Comparing with chest radiography, agitated saline bubble-enhanced ultrasound was more accurate in identifying adequate placement of RIJV than LIJV hemodialysis catheters.

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Journal of the American Society of Nephrology ; 32:70, 2021.
Article in English | EMBASE | ID: covidwho-1489307

ABSTRACT

Background: In COVID-19, as in SARS, the degree of kidney injury can have major implications for the clinical outcomes. Early reports indicate that, among patients with COVID-19, AKI is common and is associated with worse outcomes. However, COVID-19-related AKI among ICU patients in Brazil has not been well described. Methods: This was a retrospective observational study of the electronic health records of patients with COVID-19-related AKI admitted to the Hospital das Clínicas in the city of São Paulo, Brazil, between March and August of 2020. We applied only KDIGO criteria 2 and 3. We used logistic regression to analyze risk factors for the composite outcome of mortality or RRT. Results: Among the 694 patients with COVID-19-related AKI, the mean age was 63 years and mortality was 66.4%;41% needed vasoactive drugs, 66% needed mechanical ventilation, and 72% needed dialysis. Univariate analysis showed the following risk factors for mortality and RRT at admission: male sex;diabetes;CKD;vasoactive drug use;mechanical ventilation;acidemia;elevated lactate, magnesium, potassium, creatinine, C-reactive protein, creatine phosphokinase, total bilirrubin;proteinuria;hematuria;and increased fractional excretion of potassium (n=98) and sodium (n=110). The factors that remained significant in the multivariate analysis were male sex, vasoactive drug use, serum magnesium >2.5 mg/dL and oliguria (24-h urine output <500 mL). Conclusions: In ICU patients with COVID-19-related AKI, in Brazil and elsewhere, in-hospital mortality is high. The exact mechanism by which hypermagnesemia increases mortality in such patients merits further study.

18.
PLoS ONE ; 16(2), 2021.
Article in English | CAB Abstracts | ID: covidwho-1410659

ABSTRACT

We analyze the trade-offs between health and the economy during the period of social distancing in Sao Paulo, the state hardest hit by the COVID-19 pandemic in Brazil. We use longitudinal data with municipal-level information and check the robustness of our estimates to several sources of bias, including spatial dependence, reverse causality, and time-variant omitted variables. We use exogenous climate shocks as instruments for social distancing since people are more likely to stay home in wetter and colder periods. Our findings suggest that the health benefits of social distancing differ by levels of municipal development and may have vanished if the COVID-19 spread was not controlled in neighboring municipalities. In turn, we did not find evidence that municipalities with tougher social distancing performed worse economically. Our results also highlight that estimates that do not account for endogeneity may largely underestimate the benefits of social distancing on reducing the spread of COVID-19.

19.
Revista Da Associacao Medica Brasileira ; 67(3):474-478, 2021.
Article in English | MEDLINE | ID: covidwho-1381318

ABSTRACT

INTRODUCTION: The rapid advance of Coronavirus disease 2019 (Covid-19) has led to the incessant search for therapeutic and prophylactic measures to fight the pandemic. Because it is a viral infection, the safest long-term prophylactic form, in addition to social distance and hygiene, is the vaccine. OBJECTIVE: Thus, this study aimed at conducting a review of the efficacy and landscape of Covid-19 vaccines. METHODS: The following electronic databases were used MEDLINE via PubMed, SCIELO, LILACS, NEJM, and Clinical Trials. Our study includes the 7 vaccines (phase 3) that reported an efficacy rate for Covid-19, including characteristics inherent to each one of them. RESULTS: Preliminary studies have shown that, although an efficacy >=70% is necessary to eliminate the infection, a prophylactic vaccine with efficacy <70% will still have an important impact and can contribute to the elimination of the virus, provided that appropriate measures of social distancing remain. CONCLUSIONS: The effectiveness of the vaccines obtained in this study varied between 50.38 and 95%, data that may represent a reduction in serious cases, hospitalizations, sequels, and deaths caused by Covid-19, respecting the panorama presented in this article.

20.
13th International Symposium on Project Approaches in Engineering Education and 18th Active Learning in Engineering Education Workshop, PAEE/ALE 2021 ; 11:429-435, 2021.
Article in English | Scopus | ID: covidwho-1369868

ABSTRACT

The outbreak of COVID-19 had a great impact on education with the sudden shift from traditional to online learning. As a result, the difficulties experienced by students increased, professors had to adapt the teaching method of the contents and experimental activities were all transmitted from a screen, making this a difficult task for everyone. In this context, the resumption of in-person activities is of great importance to surpass the difficulties that this pandemic crisis has brought to students learning. Motivated by this necessity, the Foundation for Science and Technology (FCT), proposed a program called “Summer with Science”. This program aimed to develop presential activities with the participation of students, professors, and researchers in the summer of 2020, that involved innovative solutions related to the COVID-19 pandemic. i9Masks was one of the interesting projects that emerged from this initiative and it consisted of developing transparent facial masks for preventing the virus’ dissemination. This project joined students of different engineering and biological sciences at any level in a Higher Education Institution to learn science. In order to understand the impact of this course on student’s motivation to conduct research, in the present study, a questionnaire was used to collect the data from the students who participated in the i9Masks summer project. The same questionnaire was applied to non-participants as a control group. After the data are gathered, the results were evaluated, and it was observed that effectively this course had a great and positive impact on student’s perspective on research activities. Significant differences were observed regarding the attitudes towards research between participants and non-participants. © 2021 University of Minho. All rights reserved.

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