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3.
17th European Conference on Technology Enhanced Learning, EC-TEL 2022 ; 13450 LNCS:492-499, 2022.
Article in English | Scopus | ID: covidwho-2048157

ABSTRACT

Many researchers consider that blended or hybrid learning implies a meaningful combination of online and face-to-face activities. Before the COVID-19 pandemic, studies had shown promising results of blended learning to improve student performance. However, the design and implementation of effective combinations is far from trivial, considering students’ differences regarding their demographics and self-regulatory capacities. This paper presents a survey study developed in an Engineering school of a Latin American university that transitioned from online learning to a hybrid format in mid-2021. Quantitative data was collected throughout an online questionnaire applied to a convenience sample of 1,124 students. Subgroup differences were identified by means of exploratory factor analysis and clustering. Two different subgroups emerged from the data: those who prefer online learning and those who prefer face-to-face activities. This difference is particularly observed in students from different cohorts and regions of origin: students who are closer to graduation preferred online activities, as well as students who come from regions outside the campus location. Students’ preferences varied regarding feedback delivery and collaboration with peers, which are usually synchronous activities. Further implications are discussed to inform instructional design of blended and hybrid approaches beyond COVID-19. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

4.
Emergencias ; 34(5):361-368, 2022.
Article in Spanish | Scopus | ID: covidwho-2044827

ABSTRACT

Objective. To characterize phenotypes of prehospital patients with COVID-19 to facilitate early identification of at-risk groups. Methods. Multicenter observational noninterventional study of a retrospective cohort of 3789 patients, analyzing 52 prehospital variables. The main outcomes were 4 clusters of prehospital variables describing the phenotypes. Secondary outcomes were hospitalization, mechanical ventilation, admission to an intensive care unit, and cumulative mortality inside or outside the hospital on days 1, 2, 3, 7, 14, 21, and 28 after hospitalization and after start of prehospital care. Results. We used a principal components multiple correspondence analysis (factor analysis) followed by decomposition into 4 clusters as follows: cluster 1, 1090 patients (28.7%);cluster 2, 1420 (37.4%);cluster 3, 250 (6.6%), and cluster 4, 1029 (27.1%). Cluster 4 was comprised of the oldest patients and had the highest frequencies of residence in group facilities and low arterial oxygen saturation. This group also had the highest mortality (44.8% at 28 days). Cluster 1 was comprised of the youngest patients and had the highest frequencies of smoking, fever, and requirement for mechanical ventilation. This group had the most favorable prognosis and the lowest mortality. Conclusions. Patients with COVID-19 evaluated by emergency medical responders and transferred to hospital emergency departments can be classified into 4 phenotypes with different clinical, therapeutic, and prognostic characteristics. The phenotypes can help health care professionals to quickly assess a patient’s future risk, thus informing clinical decisions. © 2022, Saned. All rights reserved.

5.
Lessons from COVID-19: Impact on Healthcare Systems and Technology ; : 263-287, 2022.
Article in English | Scopus | ID: covidwho-2027812

ABSTRACT

Machine learning (ML) and artificial intelligence (AI) approaches are prominent and well established in the field of health-care informatics. Because they have a more productive ability to predict, they are successfully applied in several health-care applications. ML approaches are needed thanks to the unsatisfactory experience of the novel virus, considerable ambiguity, complicated social circumstances, and inadequate accessible data. Several approaches have been applied as a tool to combat and protect against the new diseases. The COVID-19 outbreak has rapid growth, so it is not easy to predict the patients and resources within a specified time. ML is a strong approach in the fighting against the pandemic such as COVID-19. It is found significant to predict the susceptible, infected, recovered, or exposed persons and can assist the control strategies to block the spread of infections. This study critically examines the appropriateness and contribution of AI/ML methods on COVID-19 datasets, enhancing the understanding to apply these methods for quick analysis and verification of pandemic databases. © 2022 Elsevier Inc. All rights reserved.

6.
Annals of the Rheumatic Diseases ; 81:1091, 2022.
Article in English | EMBASE | ID: covidwho-2009181

ABSTRACT

Background: Many measurement tools are designed to assess disease activity for Rheumatoid Arthritis (RA) patients. One of the most used tools is the Disease Activity Score-DAS28 which assesses the number of painful joints, erythrocyte sedimentation, and a patient's global assessment. The assessment is performed by a clinician and requires laboratory exams. Unfortunately, from March to August 2019, Colombia had one of the strictest responses to the COVID-19 pandemic according to the COVID-19 stringency Index(1). One of the main restrictions was the preventive isolation of older populations, especially those with comorbidities. These restrictions challenged the rheumatology practice because face-to-face consultations were not possible. Due to the above, measurements like the PAS-II score should be used to assess disease activity during the pandemic. Objectives: To describe disease activity according to the Patient Activity Score-PAS-II score patients with RA and compare its results to the most recent DAS28 assessment before the COVID-19 pandemic. Methods: We conducted a descriptive study;patients were followed during the COVID-19-lockdown in a video consultation. The PAS-II score was applied to assess disease activity as an alternative to the DAS28 assessment. The patients were part of an educational program, clinical charts were reviewed to collect the study variables. We collected demographic data and DAS28 before the pandemic started. We present a descriptive analysis of DAS28 severity and the results obtained by the PASS-II score. Results: The educational program enrolled 250 participants;196 patients had complete data. 93% of participants were women, mean age was 64 years IQR (54-67). 43% of participants were married or had a civil union, 26% were single, 20% divorced, and 11% were widowed. Regarding educational level, 25% had fnished elementary school and 39% high school;the remaining 36% had higher education. When we compared the last DAS28 assessed by a rheumatologist between January, and March 2019, 67% of patients were in remission, while in July 2019, the PASS-II score reported that 7% of patients were in remission and 75% had low or minimal activity. Figure 1-Table 1. Conclusion: The PASS score is a helpful tool to assess disease activity in patients with RA, especially in situations where the patient cannot see a rheumatologist in a face-to-face consultation;however, patients in severe disease activity should not delay the consultation with a clinician. As other studies have demonstrated, patient-reported outcome measures should be adopted in clinical practice as an alternative for treat-to-targe strategies(2). Further studies should be conducted to assess the impact of the pandemic in countries with high levels of restrictions in the course of RA.

7.
Annals of the Rheumatic Diseases ; 81:1668-1669, 2022.
Article in English | EMBASE | ID: covidwho-2008860

ABSTRACT

Background: Persistent symptoms after acute COVID have been described previously. Main symptoms reported are fatigue, arthralgias, myalgias and mental sickness. Defnition and methods vary widely.1 Objectives: To asses prevalence and related factors to long COVID in a retrospective cohort of patients with rheumatic diseases from Argentina. Methods: A total of 1915 patients were registered from August 18th, 2020 to July 29th, 2021. Patients > 18 years old, with rheumatic disease and confrmed infection by SARS-CoV-2 (antigen or RT-PCR) were included. Those dead, with unknown outcome, wrong date or missing data were excluded. Demographic data, comorbidities, rheumatic disease, and characteristics of SARS-CoV-2 infection were recorded. Long COVID was defned according to NICE guidelines (persistent symptoms for more than 4 weeks, without alternative diagnosis). Long COVID symptoms were defned by rheumatologist. Severity of infection was clas-sifed according to WHO ordinal scale. We used descriptive statistics, univariate model (Student's test, chi square test, ANOVA) and multivariate logistic regression analysis. Results: 230 (12%) had long COVID. Median age was 51 (IQR 40-61]) years, 82% were females, 51% were not caucasian. Median of education was 13.3 years (IQR 12-16), 79 % had private health insurance and 55 % were employed. Nearly half (n=762, 46%) had comorbidities, the most prevalent was hypertension (n=396, 24%). The most frequent rheumatic diseases were rheumatoid arthritis (n=719, 42%) and systemic lupus ery-thematosus (n=280, 16 %). Most were in low activity/remission (79%), used Conventional DMARD (n=773 patients, 45%) and steroids (n=588, 34%) at low dose (n=415, 71%). Main laboratory findings were abnormal D-di-mer (n=94, 28%) and leukopenia (n=93, 26%). Most patients had a WHO ordinal scale < 5 (n=1472, 86%). Median of hospitalization at intensive care unit (ICU) was 8 days [IQR 5, 13]. Treatment for SARS-CoV-2 infection (steroids, anticoagulation, azithromycin, convalescent plasma) was used in 461 (27%) patients. Most of long COVID (n= 152, 69%) reported 1 symptom, the most frequent was fatigue (n= 55, 22%). Figure 1. Univariate analysis is presented in Table 1. In multivariate logistic regression analysis non-caucasian ethnicity OR 1.44 (1.07-1.95), years of education OR 1.05 (1-1.09), treatment with cyclophosphamide OR 11.35 (1.56-112.97), symptoms of COVID-19 OR 13.26 (2.75-242.08), severity scale WHO ≥ 5 OR 2.46 (1.68-3.57), and ICU hospitalization days OR 1.09 (1.05-1.14) were factors associated to long COVID. Conclusion: Prevalence of long COVID was 12%. Non-caucasian ethnicity, higher education, treatment with cyclophosphamide, symptoms of COVID-19, severe disease and ICU hospitalization days were related to long COVID.

8.
Annals of the Rheumatic Diseases ; 81:927-928, 2022.
Article in English | EMBASE | ID: covidwho-2008837

ABSTRACT

Background: Comorbidities, particularly cardio-metabolic disorders, are highly prevalent in patients with psoriatic arthritis (PsA) and they were associated with an increased risk of atherosclerotic cardiovascular disease, which have been associated with higher morbidity and mortality. Whether PsA enhances the risk of SARS-CoV-2 infection or affects the disease outcome remains to be ascertained. Objectives: To describe the sociodemographic, clinical and treatment characteristics of patients with PsA with confrmed SARS-CoV-2 infection from the SAR-COVID registry and to identify the variables associated with poor COVID-19 outcomes, comparing them with those with rheumatoid arthritis (RA). Methods: Cross-sectional observational study including patients ≥18 years old, with diagnosis of PsA (CASPAR criteria) and RA (ACR/EULAR 2010 criteria), who had confrmed SARS-CoV-2 infection (RT-PCR or serology) from the SAR-COVID registry. Recruitment period was between August 13, 2020 and July 31, 2021. Sociodemographic variables, comorbidities, and treatments were analyzed. To assess the severity of the infection, the ordinal scale of the National Institute of Allergy and Infectious Diseases (NIAID)1 was used, and it was considered that a patient met the primary outcome, if they presented criteria of categories 5 or higher on the severity scale. For this analysis, Chi2 test, Fisher's test, Student's test or Wilcoxon test, and binomial logistic regression using NIAID>=5 as dependent variable were performed. Results: A total of 129 PsA patients and 808 with RA were included. Clinical characteristics are shown in Table 1. Regarding PsA treatment, 12.4% of PsA were receiving IL-17 inhibitors, 5.4% IL12-23 inhibitors, one patient apremilast and one abatacept. The frequency of NIAID≥5 was comparable between groups (PsA 19.5% vs RA 20.1%;p=0.976). (Figure 1). PsA patients with NIAID≥5 in comparison with NIAID<5 were older (58.6±11.4 vs 50±12.5;p=0.002), had more frequently hypertension (52.2% vs 23%;p=0.011) and dyslipidemia (39.1% vs 15%;p=0.017). In the multivariate analysis, age (OR 1.06;95% CI 1.02-1.11) was associated with a worse outcome of the COVID-19 (NIAID≥5) in patients with PsA, while those who received methotrexate (OR 0.34;95% CI 0.11-0.92) and biological DMARDs (OR 0.28;95% CI 0.09-0.78) had a better outcome. Conclusion: Although PsA patients have a higher frequency of cardiovascular and metabolic comorbidities than those with RA, the COVID-19 severity was similar. Most of the patients had mild SARS-CoV-2 infection and a low death rate.

9.
Cirugia Cardiovascular ; 29(4):258, 2022.
Article in Spanish | Es | ID: covidwho-2003932

ABSTRACT

Introducción: La pandemia COVID-19 ha podido tener influencia en la incidencia de endocarditis infecciosa nosocomial (EIN). Objetivos: Describir la incidencia, características y evolución de la EIN durante la pandemia COVID-19. Material y métodos: Estudio retrospectivo unicéntrico incluyendo las EIN definidas, según los criterios de Duke, desde marzo 2020 hasta marzo 2021. Se dividieron a los pacientes en ingreso por COVID-19 (grupo COVID) o por otros motivos (grupo no COVID). Se comparó la incidencia de EIN con el mismo periodo de 2019-2020. Resultados: Durante el periodo de estudio se diagnosticaron 22 EIN, 7 (31,8%) en COVID, 15 (68,2%) en no COVID. La incidencia fue 9,7 casos/10.000 ingresos (22/22.596). La incidencia en el mismo periodo 2019-2020 fue 4,6/10.000 (10/21.668), siendo la diferencia significativa (OR 1,91, IC95% 1,03-3,96, p = 0,038). Durante el periodo 2020-2021, la incidencia de EIN en COVID fue 24,6/10.000 (7/2.846) frente a 7,5/10.000 (15/19.750) en no COVID, siendo la diferencia significativa (OR 3,23 IC95% 1,32-7,95, p < 0,001). La mediana de edad fue 75 años (RIQ 68-80), siendo varones 68,2%. La mediana de Índice de Charlson fue 5 (RIQ 4-6). Un 36,4% presentaban válvula protésica, mientras un 22,7% valvulopatías significativa no protésica. Los pacientes COVID habían recibido más frecuentemente inmunosupresores (71,4% vs. 13,3%, p = 0,014), sin otras diferencias entre grupos. El foco primario fue considerado vascular en 86,4% (19/22;10 por vía periférica (VP), 5 por catéter venoso central (CVC), 4 no se pudo diferenciar origen entre VP o CVC). 3 pacientes presentaron foco no vascular (1 genitourinario, 2 gastrointestinal). No hubo diferencias entre grupos. Las manifestaciones fueron: fiebre 95,5%;insuficiencia cardiaca 68,2%;embolismos 45,5%;ictus 40,9%;insuficiencia renal 40,9%;bacteriemia persistente 38,1%;y shock séptico 14,3%. Los pacientes no COVID presentaron con más frecuencia clínica subaguda (0 vs. 46,7%, p = 0,042), sin otras diferencias estadísticamente significativas. La etiología fue: estafilococos coagulasa negativo 6 (27,3%);Enterococcus faecalis 6 (27,3%);Staphylococcus aureus 4 (18,2%);Candida albicans 3 (13,6%). En 3 casos no hubo aislamiento microbiológico (13.6%). No hubo diferencias entre grupos. La mortalidad a 30 días fue 45,5%, siendo la EIN o sus complicaciones la causa en todos los casos salvo 1 (no COVID). No hubo diferencias de mortalidad entre grupos (28,6% vs. 53,3%, p = 0,381). Conclusiones: La incidencia de EIN ha aumentado durante la pandemia, especialmente en pacientes ingresados por COVID-19. El foco primario de las EIN fue predominantemente vascular. Afectaron frecuentemente a pacientes con comorbilidad y patología valvular previa. Las manifestaciones, etiología y evolución fueron similares en COVID y no COVID, destacando una elevada frecuencia de eventos embólicos, especialmente ictus. Las EIN asocian elevada morbimortalidad y es importante extremar las medidas de prevención.

10.
Gaceta Medica de Caracas ; 130:S459-S469, 2022.
Article in English | Scopus | ID: covidwho-1995013

ABSTRACT

Introduction: Unlike many Latin American countries, Venezuela has not had an official record of COVID-19 vaccine doses administered during the pandemic. This paper is the first report on COVID-19 vaccination coverage using household sample surveys. M ethods: The paper systematizes preliminary reports with results of questions included in national surveys conducted in Venezuela in June, August, September, November, and December 2021, to estimate COVID-19 vaccination coverage. All surveys were conducted in population centers of 1 000 and more inhabitants. In each survey, 1 200 persons aged 18 years and older were interviewed in their homes. Results: Full coverage (two doses of COVID-19 vaccine) increased from 8.1 % of the total population in August to 50 % in the 18 years and older age group in December 2021. The age group with consistently higher coverage is 50 years and older. At the end of 2021, the full coverage of this population group was 72.3 %. Full coverage is higher in the Metropolitan District of Caracas (MDC). Refusal to vaccinate, within the unvaccinated population, decreased from 25 % in August to 9.6 % in November 2021. The most frequent reason for not wanting to be vaccinated is distrust of the vaccine (34.1 %). The Sinopharm and Sinovac vaccines (together) were the most frequently administered (72.7 %). Discussion: Venezuela has registered vaccination coverage against COVID-19, which places it among the lowest-performing countries in the region. Complete vaccination coverage against COVID-19 had not exceeded 50 % of the population aged 18 years and older by the end of 2021. Conclusions: The failure in Venezuela to develop a high-performing COVID-19 vaccination program has conditioned both the management of the pandemic and the weighing of its effects. © 2022 Academia Nacional de Medicina. All rights reserved.

12.
17th Iberian Conference on Information Systems and Technologies, CISTI 2022 ; 2022-June, 2022.
Article in Spanish | Scopus | ID: covidwho-1975675

ABSTRACT

The COVID-19 pandemic caused a digital transformation for educational institutions, causing many of them, including music conservatories, to not have the same teaching effectiveness as before. This article analyses the learning of musical content through a before and after comparison of the implementation of an intelligent tutoring system in the preparatory programme Formación Básica I at the Carlos Valderrama Conservatory in Trujillo-Peru;the type of research was applied, pre-experimental, also, a survey was used as a tool for data collection, which was validated by expert judgement. In order to create the intelligent tutoring system, the Mobile-D methodology was used, which has the following phases: Exploration, Initialisation, Production, Stabilisation and Testing, in addition, software development tools were used such as: Ionic, Angular, HTML and CSS, as well as Dialogflow and Kommunicate services, finally, the Model View Controller (MVC) software architecture pattern was used. © 2022 IEEE Computer Society. All rights reserved.

14.
Revista de Obstetricia y Ginecologia de Venezuela ; 82(2):179-188, 2022.
Article in Spanish | Scopus | ID: covidwho-1876636

ABSTRACT

Objective: To evaluate the outpatient activities of high obstetric risk during the COVID-19 pandemic. Methods: Retrospective, descriptive review of epidemiological, clinical/paraclinical factors and treatment of 102 medical records from the High Obstetric Risk clinic of the Jesus Maria Casal Ramos Araure/Acarigua University Hospital from March 11, 2020 to March 11, 2021. Results: In the year, 346 controls were carried out, 244 successive controls, 23% adolescents, 19% elderly and 58% of reproductive age;77% with some degree of formal education;57% of the municipality of Araure, the most common reason for referral in 25% want not to reproduce and 23% in previous cesarean sections;high blood pressure was the most frequent family and personal history and comorbidity;64% had a lower average gain of 6 Kgs;52% of patients were anemic on their exams, requiring iron supplements or transfusions;betamethasone was the most widely used inducer of lung maturation and amoxicillin/clavulanic antibiotic. 2 patients positive for human immunodeficiency virus, 1 primary syphilis and 2 COVID-19 were monitored and treated on an outpatient basis: 1 mild in the 1st trimester and 1 moderate in the 3rd trimester. There were no maternal deaths in the sample. Conclusion: The high obstetric risk consultation is the most effective form of articulation between the surrogate, the health services and the community that guarantees a healthy pregnancy, the place to give birth, as well as a dignified and respected treatment throughout the process. © 2022 Sociedad de Obstetricia y Ginecologia de Venezuela. All rights reserved.

15.
Journal of the American College of Cardiology ; 79(9):2046-2046, 2022.
Article in English | Web of Science | ID: covidwho-1848861
16.
13th International Multi-Conference on Complexity, Informatics and Cybernetics, IMCIC 2022 ; 1:63-68, 2022.
Article in English | Scopus | ID: covidwho-1836703

ABSTRACT

The exponential growth of technology has caused changes in all areas of knowledge, and education has not been an exception. This paper shows the methodology used in a public university in northeastern Mexico for the transformation of the face-to-face modality to the digital modality based on the health contingency of COVID 19. The methodology used for the development of this proposal was design thinking. The suggested technologies are the Microsoft Teams, Forms, and Turnitin platforms, and the proposed teaching strategies are the flipped classroom, active learning, and inquiry-based learning. The proposed methodology consists of 6 steps that are the framing of the course, the exposure to the contents of the subject, the asynchronous seminar-type session for the discussion of the exposed topics, the elaboration of the integrative PIA learning product divided into advances with their respective feedback. synchronous and the dissemination of the products in magazines, congresses, or seminars. The case shows the experience of implementing the digital strategy. © 2022 IMCIC 2022 - 13th International Multi-Conference on Complexity, Informatics and Cybernetics, Proceedings. All rights reserved.

18.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-333875

ABSTRACT

INTRODUCTION: Infection with SARS-CoV-2 is typically compared with influenza to contextualize its health risks. SARS-CoV-2 has been linked with coagulation disturbances including arterial thrombosis, leading to considerable interest in antithrombotic therapy for Coronavirus Disease 2019 (COVID-19). However, the independent thromboembolic risk of SARS-CoV-2 infection compared with influenza remains incompletely understood. We evaluated the adjusted risks of thromboembolic events after a diagnosis of COVID-19 compared with influenza in a large retrospective cohort. METHODS: We used a US-based electronic health record (EHR) dataset linked with insurance claims to identify adults diagnosed with COVID-19 between April 1, 2020 and October 31, 2020. We identified influenza patients diagnosed between October 1, 2018 and April 31, 2019. Primary outcomes [venous composite of pulmonary embolism (PE) and acute deep vein thrombosis (DVT);arterial composite of ischemic stroke and myocardial infarction (MI)] and secondary outcomes were assessed 90 days post-diagnosis. Propensity scores (PS) were calculated using demographic, clinical, and medication variables. PS-adjusted hazard ratios (HRs) were calculated using Cox proportional hazards regression. RESULTS: There were 417,975 COVID-19 patients (median age 57y, 61% women), and 345,934 influenza patients (median age 47y, 66% women). Compared with influenza, patients with COVID-19 had higher venous thromboembolic risk (HR 1.53, 95% CI 1.38-1.70), but not arterial thromboembolic risk (HR 1.02, 95% CI 0.95-1.10). Secondary analyses demonstrated similar risk for ischemic stroke (HR 1.11, 95% CI 0.98-1.25) and MI (HR 0.93, 95% CI 0.85-1.03) and higher risk for DVT (HR 1.36, 95% CI 1.19-1.56) and PE (HR 1.82, 95% CI 1.57-2.10) in patients with COVID-19. CONCLUSION: In a large retrospective US cohort, COVID-19 was independently associated with higher 90-day risk for venous thrombosis, but not arterial thrombosis, as compared with influenza. These findings may inform crucial knowledge gaps regarding the specific thromboembolic risks of COVID-19.

19.
Journal of Clinical Lipidology ; 16(1):e25, 2022.
Article in English | EMBASE | ID: covidwho-1778237

ABSTRACT

Lead Author's Financial Disclosures: Nothing to disclose. Study Funding: Piper Biosciences. Background/Synopsis: The effectiveness of a plant sterol gummy supplement was studied in a South-Asian (SA) patient population with low to moderate cardiovascular disease (CVD) risk as defined by an Atherosclerotic Cardiovascular Disease (ASCVD) Risk Score of < 7.5%, and a low density lipoprotein (LDL)-C level of 120-189 mg/dl. Statin therapy is often not recommended to patients with ASCVD score < 7.5% even in the presence of risk accelerators such as SA ethnicity, to which the 2018 National Lipid Association (NLA) guidelines call attention. Objective/Purpose: Phytosterols are known to lower LDL-C and are included in NLA and other global guidelines. This study aimed to establish their impact on LDL-C levels in 'borderline' risk SAs. Methods: 50 SAs were recruited during the COVID 19 pandemic, mainly from a preventive cardiology clinic dedicated to reducing SA heart disease risk. Eligible subjects had a 10-year CV risk score (ASCVD) <7.5% and LDL-C level of 120-193mg/dl at study enrollment. Subjects intolerant of or refusing statins were also recruited. The study was administered with a fully decentralized design, leveraging mailed supplements, televisits, remote lab collection, and SMS-based communications. Upon completing baseline labs and surveys, subjects were provided a 90-day supply of 1400mg phytosterol gummy supplements in individual packets (Piper Biosciences, Los Altos, CA) to be ingested twice daily. Subjects were instructed to continue current lifestyle habits and report major dietary pattern deviations. The primary endpoint was LDL-C reduction at 3 months. Pre- and post-study surveys were administered to assess diet and lifestyle. Results: 33 of the 50 subjects successfully completed the protocol. A significant overall reduction in LDL-C of 5.8% was observed (p=0.03) (Table 1, Figure 1). Subgroup A (n=27) completed the protocol with no significant dietary variation, demonstrating a significant LDL-C reduction of 6.5% (p=0.002), as well as a total cholesterol (TC) reduction of 4.4% (p=0.01). There was no significant change in other metrics, including BMI, fasting glucose, or HbA1C. Patients who completed the protocol but reported worsening dietary habits (Subgroup B, n=6) showed an average increase in LDL-C of 6% (p=0.2) and in TC of 8% (p=0.002). Survey responses indicate that 94% of subjects would be interested in long-term supplementation if recommended by physician and 80% would prefer taking it proactively to manage cholesterol levels. Conclusions: Plant sterols are an effective and sustainable means to lower LDL-C in middle-aged SAs, whose CV risk is often underestimated. To our knowledge this study represents the first demonstration of phytosterol effectiveness in the highest coronary disease risk population globally.

20.
Embase; 2021.
Preprint in English | EMBASE | ID: ppcovidwho-331973

ABSTRACT

Background: Recent strides in computational structural biology have opened up an opportunity to understand previously uncharacterised proteins. The under-representation of transmembrane proteins in the Protein Data Bank highlights the need to apply new and advanced bioinformatics methods to shed light on their structure and function. This study focuses on a family of transmembrane proteins containing the Pfam domain PF09335 ('SNARE_ASSOC'/ ‘VTT ‘/’Tvp38’/'DedA'). One prominent member, Tmem41b, has been shown to be involved in early stages of autophagosome formation and is vital in mouse embryonic development as well as being identified as a viral host factor of SARS-CoV-2. Methods: We used evolutionary covariance-derived information to construct and validate ab initio models, make domain boundary predictions and infer local structural features. Results: The results from the structural bioinformatics analysis of Tmem41b and its homologues showed that they contain a tandem repeat that is clearly visible in evolutionary covariance data but much less so by sequence analysis. Furthermore, cross-referencing of other prediction data with covariance analysis showed that the internal repeat features two-fold rotational symmetry. Ab initio modelling of Tmem41b and homologues reinforces these structural predictions. Local structural features predicted to be present in Tmem41b were also present in Cl-/H+ antiporters. Conclusions: The results of this study strongly point to Tmem41b and its homologues being transporters for an as-yet uncharacterised substrate and possibly using H+ antiporter activity as its mechanism for transport.

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