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1.
Music Therapy Perspectives ; 2023.
Article in English | Web of Science | ID: covidwho-2189400

ABSTRACT

The coronavirus disease (COVID-19) pandemic disrupted education, peer interactions, and social access for a large percentage of learners and created increased stress and workloads for parents, particularly in families of autistic children, who lost access to specialized services. Providing parents with resources to support their children at home became a necessity. This exploratory study investigated the feasibility of a parent coaching model of music interventions through virtual sessions in a low-resource country. Eight families participated in six 1-hr weekly sessions where the music therapist shared music interventions for young autistic children through videoconferencing. Results show that parent coaching in a virtual setting is feasible, useful, and acceptable for parents. All parents improved in their ability to modify the environment to address child's needs, adequately respond to their child's communication attempts, and provide opportunities for engagement and natural reinforcement. Parents found the coaching important, useful, and supportive. Initial recommendations for practice include providing guidelines for safe sessions;adapting to family needs, strengths, and culture;relaying information quickly and concisely;and ensuring that parents can access local services to continue their parenting journey.

2.
J Am Acad Child Adolesc Psychiatry ; 61(10):S269, 2022.
Article in English | PubMed Central | ID: covidwho-2061390
3.
35th IEEE International Symposium on Computer-Based Medical Systems, CBMS 2022 ; 2022-July:7-12, 2022.
Article in English | Scopus | ID: covidwho-2051939

ABSTRACT

In recent years and due to COVID-19 pandemic, drug repurposing or repositioning has been placed in the spotlight. Giving new therapeutic uses to already existing drugs, this discipline allows to streamline the drug discovery process, reducing the costs and risks inherent to de novo development. Computational approaches have gained momentum, and emerging techniques from the machine learning domain have proved themselves as highly exploitable means for repurposing prediction. Against this backdrop, one can find that biomedical data can be represented in terms of graphs, which allow depicting in a very expressive manner the underlying structure of the information. Combining these graph data structures with deep learning models enhances the prediction of new links, such as potential disease-drug connections. In this paper, we present a new model named REDIRECTION, which aims to predict new disease-drug links in the context of drug repurposing. It has been trained with a part of the DISNET biomedical graph, formed by diseases, symptoms, drugs, and their relationships. The reserved testing graph for the evaluation has yielded to an AUROC of 0.93 and an AUPRC of 0.90. We have performed a secondary validation of REDIRECTION using RepoDB data as the testing set, which has led to an AUROC of 0.87 and a AUPRC of 0.83. In the light of these results, we believe that REDIRECTION can be a meaningful and promising tool to generate drug repurposing hypotheses. © 2022 IEEE.

4.
Annals of Oncology ; 33:S904-S905, 2022.
Article in English | EMBASE | ID: covidwho-2041538

ABSTRACT

Background: CSCC is highly immune-responsive;a prior pilot study demonstrated a high rate of pathologic complete response (pCR) or major pathologic response (MPR, ≤10% viable tumor), using cemiplimab anti-programmed death 1 (PD-1) therapy in the neoadjuvant setting. Here, we present the primary analysis of a confirmatory, open-label, multicenter, Phase 2, single-arm trial of neoadjuvant cemiplimab in pts with resectable Stage II–IV (M0) CSCC. Methods: Pts received cemiplimab 350 mg IV q3W for up to 4 doses before surgery. The primary endpoint was pCR rate per independent central pathologic review (ICPR). Key secondary endpoints included MPR rate per ICPR, objective response rate (ORR;complete response [CR] + partial response [PR]) per RECIST v1.1, investigator-assessed pCR and MPR, safety and tolerability. Results: At data cutoff date of 01 Dec 2021, 79 pts were enrolled (67 male;median age 73.0 yrs [range, 66.0–81.0];ECOG performance status 0 (n=60) and 1 (n=19) with stage II (n=5), III (n=38), or IV(M0) (n =36) disease;62 pts received all 4 doses (median number of doses given (Q1:Q3), 4 (4:4);70 pts underwent surgery. The study met its primary endpoint: pCR was observed in 40 (50.6%) pts (95% confidence interval [CI], 39.1–62.1%). MPR was observed in an additional 10 (12.7%) pts (95% CI, 6.2–22.0%). ORR was 68.4% (95% CI, 56.9–78.4) (5 CR, 49 PR, 16 stable disease, 8 progressive disease (PD), 1 non evaluable. Reasons 9 pts did not have surgery: 3 responders declined surgery, 2 lost to follow-up or noncompliance, 2 had inoperable PD, 2 due to AE. Fourteen (17.7%) pts experienced Grade ≥3 AE. Four pts died due to AEs: 1 exacerbation of cardiac failure, 2 myocardial infarctions, and 1 COVID-19 pneumonia. The most common AEs regardless of attribution (all grades) were fatigue (30.4%), rash maculo-papular (13.9%), diarrhea (13.9%) and nausea (13.9%). Conclusions: The pCR + MPR of 63.3% by ICPR in pts with Stage II–IV (M0) CSCC is the highest observed in a multicenter anti-PD-1 neoadjuvant monotherapy study for any solid tumor type. The safety profile of neoadjuvant cemiplimab is consistent with previous anti-PD-1 monotherapy experience. Ongoing follow-up will describe disease-free survival. Clinical trial identification: NCT04154943. Editorial acknowledgement: Medical writing support was provided by John G Facciponte, PhD, of Prime, Knutsford, UK, funded by Regeneron Pharmaceuticals, Inc., and Sanofi. Legal entity responsible for the study: Regeneron Pharmaceuticals, Inc., and Sanofi. Funding: Regeneron Pharmaceuticals, Inc., and Sanofi. Disclosure: N. Gross: Financial Interests, Personal, Research Grant: Regeneron Pharmaceuticals, Inc.;Financial Interests, Personal, Advisory Board: PDS Biotechnology, Shattuck Labs and Genzyme;Financial Interests, Personal, Advisory Role: PDS Biotechnology, Shattuck Labs and Genzyme. D.M. Miller: Financial Interests, Personal, Advisory Role: Castle Biosciences, EMD Serono, Merck KGaA, Merck Sharpe & Dome, Pfizer, Regeneron, Sanofi Genzyme;Financial Interests, Personal, Ownership Interest: Checkpoint Therapeutics;Financial Interests, Personal, Research Grant: Kartos Therapeutics, NeoImmune Tech, Inc., Regeneron Pharmaceuticals, Inc. N. Khushanlani: Financial Interests, Personal, Research Grant: Regeneron Pharmaceuticals, Inc., Bristol Myers Squibb, HUYA Bioscience International, Merck, Novartis, GlaxoSmithKline, Celgene, Amgen;Financial Interests, Personal, Advisory Board: EMD Serono, Regeneron Pharmaceuticals, Inc., Genentech, AstraZeneca (data safety monitoring committee), Merck, Array Biopharma, Jounce Therapeutics, Immunocore, Bristol Myers Squibb, HUYA Bioscience International;Financial Interests, Personal, Other, honoraria: Sanofi;Financial Interests, Personal, Stocks/Shares: Bellicum Pharmaceuticals, Mazor Robotics, Amarin, Transenetrix. V. Divi: Financial Interests, Institutional, Research Grant: Genentech. E.S. Ruiz: Financial Interests, Personal, Advisory Board: Genentech, Leo Pharmaceuticals, Regeneron Pharmaceuticals, Inc., Sanofi;Financial Int rests, Personal, Advisory Role, consulting fees: Genentech, Leo Pharmaceuticals, Regeneron Pharmaceuticals, Inc., Sanofi;Financial Interests, Personal, Member of the Board of Directors: Checkpoint Therapeutics. E.J. Lipson: Financial Interests, Personal, Other, Advisory board and consulting fees: Bristol Myers-Squibb, Eisai, Genentech, Immunocore, Instil Bio, MacroGenics, Merck, Natera, Nektar Therapeutics, Odonate Therapeutics, OncoSec, Pfizer, Rain Therapeutics, Regeneron, Sanofi;Financial Interests, Institutional, Research Grant: Bristol Myers Squibb, Merck, Regeneron. F. Meier: Financial Interests, Personal, Other, Travel support, speaker’s fees or advisor’s honoraria: Bristol Myers Squibb, Merck Sharp & Dohme, Novartis, Pierre Fabre, Roche and Sanofi;Financial Interests, Personal, Research Grant: Novartis and Roche. P.L. Swiecicki: Financial Interests, Institutional, Research Grant: Ascentage Pharma, Pfizer;Financial Interests, Personal, Advisory Board: Prelude Therapeutics, Elevar Therapeutics, Regeneron Pharmaceuticals. J.L. Atlas: Financial Interests, Personal, Advisory Role: Regeneron Pharmaceuticals, Inc., Sanofi, and Bristol Myers Squibb. J.L. Geiger: Financial Interests, Institutional, Research Grant: Alkermes, Debio, Merck, Regeneron Pharmaceuticals, Inc., and Roche/Genentech;Financial Interests, Personal, Advisory Role: Exelixis, Merck and Regeneron Pharmaceuticals, Inc. A. Hauschild: Financial Interests, Personal and Institutional, Other, Institutional grants, speaker’s honoraria and consultancy fees: Amgen, Bristol Myers Squibb, Merck Sharp & Dohme, Novartis, Pierre Fabre, Provectus and Roche;Financial Interests, Institutional, Other, Institutional grants and consultancy fees: EMD Serono, Philogen and Regeneron Pharmaceuticals, Inc.;Financial Interests, Personal, Advisory Role: OncoSec Medical. J.H. Choe: Financial Interests, Personal, Advisory Role: Exelixis, Coherus Biosciences, Regeneron Pharmaceuticals, Inc. B.G.M. Hughes: Financial Interests, Personal, Advisory Role: AstraZeneca, Bristol Myers Squibb, Eisai, Merck Sharp & Dohme, Pfizer and Roche;Financial Interests, Institutional, Research Grant: Amgen. S. Yoo: Financial Interests, Personal, Full or part-time Employment: Regeneron Pharmaceuticals, Inc.;Financial Interests, Personal, Stocks/Shares: Regeneron Pharmaceuticals, Inc. K. Fenech: Financial Interests, Personal, Full or part-time Employment: Regeneron Pharmaceuticals, Inc.;Financial Interests, Personal, Stocks/Shares: Regeneron Pharmaceuticals, Inc. M.D. Mathias: Financial Interests, Personal, Full or part-time Employment: Regeneron Pharmaceuticals, Inc.;Financial Interests, Personal, Stocks/Shares: Regeneron Pharmaceuticals, Inc. H. Han: Financial Interests, Personal, Full or part-time Employment: Regeneron Pharmaceuticals, Inc.;Financial Interests, Personal, Stocks/Shares: Regeneron Pharmaceuticals, Inc. M.G. Fury: Financial Interests, Personal, Full or part-time Employment: Regeneron Pharmaceuticals, Inc.;Financial Interests, Personal, Stocks/Shares: Regeneron Pharmaceuticals, Inc. D. Rischin: Financial Interests, Institutional, Research Grant: Regeneron Pharmaceuticals, Inc., Genentech, Sanofi, Kura Oncology, Roche, Merck Sharp & Dohme, Merck KGaA, Bristol Myers Squibb, GlaxoSmithKline, ALX Oncology;Financial Interests, Personal, Advisory Role: Merck Sharp & Dohme, Regeneron Pharmaceuticals, Inc., Sanofi, GlaxoSmithKline, Bristol Myers Squibb;Financial Interests, Personal, Advisory Board: Merck Sharp & Dohme, Regeneron Pharmaceuticals, Inc., Sanofi, GlaxoSmithKline, Bristol Myers Squibb. All other authors have declared no conflicts of interest.

7.
Music Therapy Perspectives ; : 12, 2022.
Article in English | Web of Science | ID: covidwho-1927344

ABSTRACT

Translation of research to practice is essential for competent practitioners but requires skills and experience in reading and understanding research. Course-based undergraduate research experiences (CUREs) may be a means of developing research skills for all students in a course. For successful CUREs, faculty evaluate students' research skill development and decide on a project that appropriately promotes student learning. In this case, we chose an open-ended project. We then evaluated the experiences of music students (music therapy, music performance, and music digital media) as they participated in a virtual CURE during the COVID-19 pandemic. Results of a sequential explanatory mixed-methods design with two surveys and open-ended responses of the whole group (n = 22) and a focus group with a volunteer subsample of students (n = 7) indicated important gains in understanding research articles, writing a scholarly paper, understanding the relevance of research to their coursework, and developing communication and teamwork skills. Student suggestions for improvement included clarification of the expectations and timelines, particularly in a virtual setting, and better distribution of effort during the semester. Overall, a virtual CURE may support student research skill development and help them become more effective research consumers.

8.
European Stroke Journal ; 7(1 SUPPL):541-542, 2022.
Article in English | EMBASE | ID: covidwho-1928120

ABSTRACT

Background and aims: Madrid was one of the epicentres of the COVID-19 pandemic in Spain. The entire healthcare system was severely affected by the first wave of the pandemic. We aimed to assess the extent to which the acute stroke care chain was impacted. Methods: Using the stroke code (SC) cohort of SUMMA 112 (the main emergency medical service in the region), we compared all patients in the first wave of the pandemic and in the same period of the previous year. Subsequently, we collected all anonymized records from the main hospital administrative database (minimum basic data set at hospital discharge). We used ambulance response times, concordance between pre-hospital and hospital diagnosis, hospital times, and mortality to evaluate the SC protocol. The study was approved by the Ethics Committee of the Community of Madrid. Results: 966 SC were analysed (514 pre-pandemic and 452 during the first wave). Pre-hospital attention times were longer (39 vs. 35 minutes), patients stayed longer in the emergency room before admission (7.5 vs. 6.1 hours), the concordance between pre-hospital and in-hospital diagnostic suspicion did not change significantly (86% vs. 89%) and mortality decreased (9% vs 13%) during the first wave of the pandemic Conclusions: During the first wave of the pandemic, there were delays in care, especially in the on-scene time. Improvements in training might have prevented it. The high qualification of pre-hospital teams enabled them to maintain their diagnostic accuracy. The reduction in mortality needs further exploration.

9.
Adcomunica-Revista Cientifica De Estrategias Tendencias E Innovacion En Communicacion ; - (23):119-140, 2022.
Article in Spanish | Web of Science | ID: covidwho-1918056

ABSTRACT

During the COVID-19 pandemic and the infodemic that accompanied it, digital literacy proved to be a preventive approach with the possibility of offering future guidance to contemplate the negative influences of digital media in the post-pandemic context. However, this emphasis on the potentialities of digital literacy requires, at the same time, a review of its traditional assumptions, in order to optimize its characteristics in the future context. One of the central aspects of this review is related to the inclusion of the interference that cognitive biases have in the use of contemporary digital media, in which misinformation and misinformation proliferate. A clear example of this during the pandemic has been the spread of multiple conspiracy theories. Starting from here, the objective of this article will be to analyze the possible contribution of metacognition, when it is understood as a fundamental component of digital literacy.

11.
Medicina ; 82(1):47-54, 2022.
Article in Spanish | GIM | ID: covidwho-1864015

ABSTRACT

The use of high-flow nasal therapy (HFNT) in patients with severe acute respiratory failure (SARF) due to COVID-19 pneu monia (NCOVID-19) is debated. Given the lack of beds in Intensive Care Units in the Public Health System of the Province of Neuquen, their use was implemented in general wards. This restrospective multicenter study was carried out to describe the experience of using HNFT in patients with SARF due to NCOVID-19. The primary outcome was the frequency of successful weaning from HFNT and in-hospital mortality (IHM). Two hundred ninety-nine patients were analyzed;120 (40.1%) were successfully withdrawn from HFNT. This failed in 59.8% (179), 44.1% (132) required invasive mechanical ventilation (IMV), and 15.7% (47) was not candidates for intubation. A ROX index 5 at 6 h after initiation was associated with the success of HFNT (OR 0.26 [IC 95% 0.15-0.46] p<0.0001). The general IHM was 48.5% (145/299), 70.4% (93/132) in patients with IMV, 4.2% (5/120) died after successful weaning from HFNT and 100% (47/47) in the group not candidates for intubation. Patients with TNAFO had a statistically significant decrease in MIH and days of hospitalization. TNAFO in general wards achieved a decrease in the use of IMV, with a reduction in mortality and days of stay in hospitalized for NCOVID-19 with SARF.

12.
Cancer Research ; 82(4 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1779456

ABSTRACT

Amplification and/or overexpression of HER2 in breast cancer (BCa) patients is associated with aggressive disease and poor prognosis. Herceptin® (trastuzumab), a monoclonal antibody targeting HER2, has an established role in the treatment of HER2 positive BCa. Addition of trastuzumab to anthracycline-and taxane-based neoadjuvant treatment in women with HER2-positive BCa has resulted in improvements in pathological complete response (pCR, a strong predictor for long-term clinical outcome), event-free survival (EFS) and overall survival (OS). This study is designed to compare efficacy (pCR) and safety between the originator Herceptin and the proposed trastuzumab biosimilar EG12014. The study is conducted during the COVID-19 pandemic (last patient in: March 2020, last patient last visit: planned Jan 2022) in Belarus, Chile, Colombia, Georgia, India, Russia, South Africa, South Korea, Taiwan, and the Ukraine. Methods: Neoadjuvant phase: 807 patients were randomized (1:1) into 2 arms receiving epirubicin (90 mg/m 2) and cyclophosphamide (600 mg/m2) every 3 weeks for 4 cycles, followed by EG12014 (arm 1) or Herceptin (arm 2) (both at loading dose: 8 mg/kg and maintenance dose: 6 mg/kg) and paclitaxel (175 mg/m2) every 3 weeks Sfor 4 cycles. Subsequently, the patients underwent surgery, and primary endpoint (pCR [ypT0/is ypN0]) was assessed. Adjuvant phase: After surgery, the patients received EG12014 or Herceptin (both at loading dose: 8 mg/kg and maintenance dose: 6 mg/kg) to complete 12 months of overall trastuzumab treatment. COVID-19 infections in the study population were not expected to affect primary endpoint analysis;thus, no sensitivity analysis was performed regarding COVID-19 status (symptomatic/asymptomatic). Differences between the 2 arms regarding delays in study treatments and procedures due to COVID-19 were assessed. Results (at interim data base lock, blinded as study is ongoing): Study population: the mean age was 50 years, the majority were white Europeans with tumor stage II, estrogen receptor positive and progesterone receptor negative. The median time from date of first diagnosis was 0.5 months. Primary endpoint pCR (ypT0/is ypN0) was reached with relative risk ratio (RR) for the full analysis set: 0.992 (90% CI 0.880 to 1.118) between the 2 treatment arms. Secondary pCR endpoints (defined as ypT0 ypN0 and ypT0/is) were also reached, with RR between the treatment arms: 0.917 and 0.992, respectively. Objective clinical response prior to surgery was similar for the 2 treatment arms: 83.8% and 83.6%, respectively. EFS, OS, safety endpoints (e.g., adverse events [most frequently reported: alopecia], serious adverse events, and deaths), and toxicity assessments, supported similarity between EG12014 and Herceptin. Sixty-two patients (7.7%) were infected with COVID-19;the infections were equally distributed between the 2 treatment arms. COVID-19 did not cause any discontinuations or deaths in the study. Among all reported COVID-19 events, 13 (21%) were asymptomatic, 11 (18%) were graded as 3 (severe), and 1 (1.6%) was graded as grade 4 (life threatening). Conclusion: EG12014 has shown equivalent efficacy to Herceptin in regard to clinical response (pCR) and has also demonstrated a similar safety profile. The impact of the COVID-19 pandemic has been comparable between the two treatment arms. The influence of the pandemic on this clinical study has been relatively low considering timing and the participating countries.

13.
Universitas-Revista De Ciencias Sociales Y Humanas ; - (36):19-41, 2022.
Article in Spanish | Web of Science | ID: covidwho-1761337

ABSTRACT

This article aims to analyze the use of Twitter as a communication channel by the president of El Salvador, Nayib Bukele (@nayibbukele), an outsider, who is also considered the 'millennial'president of that nation and who strongly employs this digital platform for the dissemination of its government policies. The present analysis is landed and justified in the context of COVID-19, characterized by the taking of restrictive confinement measures at the regional and local level, with a strong struggle between the executive and the Salvadoran legislative apparatus, as well as the impact of the virus on all corners of the globe. As a temporality, the April June quarter of 2020 is taken, for a total corpus of 766 messages. Through content analysis, the role of the political actor in a health crisis, the presence of struggles with the political class, the construction of the category of people applied to the Central American nationality, the polarization present in their agenda and others are analyzed. Elements of interest within the construction of the 'us-them'dichotomy in a digital environment. As the main finding, it is obtained that Bukele is framed within two characterizations;the first coupled with confronting political and social actors (mainly the legislative apparatus), an environment strongly marked by polarization;and the second, where he connects with citizens through charisma and the use of a close and positive language, in which cases polarization becomes an absent element and integration is called for.

14.
Cancer Epidemiology Biomarkers and Prevention ; 31(1 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1677424

ABSTRACT

Introductory sentences indicating the purposes of the study: We used boot camp translation (BCT), a validated community based participatory strategy, to elicit input from diverse stakeholders (i.e., patients and clinic staff) to develop messaging and patient education materials for follow-up colonoscopy after abnormal fecal testing. BCT is a process that engages participants in translating health information into ideas, messages, and materials that are understandable and relevant to patients. Brief description of pertinent experimental procedures: Colorectal cancer is the second-leading cause of cancer death in the United States, and screening rates are disproportionately low among Latinos. Mailed fecal immunochemical test (FIT) outreach programs have been shown to improve colorectal cancer screening rates in federally qualified health centers (FQHCs), with improvements ranging from 22% - 45%. Patients with an abnormal FIT result have an increased risk of having colorectal cancer, and the risk increases if the necessary follow-up colonoscopy is delayed. Unfortunately, rates of follow-up colonoscopy among adults with an abnormal FIT result are low in FQHCs. As part of the Participatory Research to Advance Colon Cancer Prevention (PROMPT) study, a partnership with a Los Angeles-based FQHC that provides medical services to over 300,000 patients annually (82% Latino), we used BCT to gather input from patients and staff to develop messaging and materials for patients in need of a follow-up colonoscopy after abnormal FIT. Due to the COVID-19 pandemic, we conducted BCT using a digital platform. Eligible patient participants were Latino, ages 50 to 75 years, Spanish-speaking, and willing to participate in three virtual sessions. Recruitment and BCT materials were developed in English and Spanish, but all three sessions were held in Spanish consistent with patient preferences. The sessions included presentations on colorectal cancer screening, effective messaging to improve Latino screening participation, and brainstorming sessions to obtain feedback on messaging and materials. Summary of the new unpublished data: A total of 10 adults (7 patients and 3 clinic staff) participated in the BCT sessions. Key themes learned were 1) increasing awareness about the colonoscopy procedure (why it is important, what the procedure is, how to prepare), 2) using simple and clear wording, including statistics, and using family as a motivator, and 3) providing different patient outreach modalities to broaden reach, such as patient-facing fact sheets, videos in clinic or sent by text. Statement of the conclusions: Using BCT, we successfully incorporated feedback from Spanish-speaking Latino patients to design culturally relevant materials to promote follow-up colonoscopy after abnormal FIT results. Targeted efforts are needed to improve rates of follow-up colonoscopy among patients with abnormal FIT results in FQHC settings. (Final materials, including patient-facing fact sheets and screenshots from short videos, will be showcased in the poster.).

15.
Areas-Revista Internacional De Ciencias Sociales ; - (42):105-113, 2021.
Article in Spanish | Web of Science | ID: covidwho-1667642

ABSTRACT

Social participation is closely linked to well-being and healthy aging, generating physical and psychological benefits. However, older people tend to lower levels of participation and social interaction after retirement although many others continue to militate and participate in non-profit organisations and social movements. The pandemic caused by COVID-19 has had a strong impact at the social and health level, with the elderly being the main victims, not only due to the high mortality rates but because the social distancing measures imposed for their protection have led to a worsening of social isolation and the feeling of loneliness of our elders. It is urgent to create safe spaces to increase levels of social participation.

16.
Medicina (Argentina) ; 82(1):47-54, 2022.
Article in Spanish | EMBASE | ID: covidwho-1647588

ABSTRACT

The use of high-flow nasal therapy (HFNT) in patients with severe acute respiratory failure (SARF) due to COVID-19 pneu-monia (NCOVID-19) is debated. Given the lack of beds in Intensive Care Units in the Public Health System of the Province of Neuquén, their use was implemented in general wards. This restrospective multicenter study was carried out to describe the experience of using HNFT in patients with SARF due to NCOVID-19. The primary outcome was the frequency of successful weaning from HFNT and in-hospital mortality (IHM). Two hundred ninety-nine patients were analyzed;120 (40.1%) were successfully withdrawn from HFNT. This failed in 59.8% (179), 44.1% (132) required invasive mechanical ventilation (IMV), and 15.7% (47) was not candidates for intubation. A ROX index ≥ 5 at 6 h after initiation was associated with the success of HFNT (OR 0.26 [IC 95% 0.15-0.46] p<0.0001). The general IHM was 48.5% (145/299), 70.4% (93/132) in patients with IMV, 4.2% (5/120) died after successful weaning from HFNT and 100% (47/47) in the group not candidates for intubation. Patients with TNAFO had a statistically significant decrease in MIH and days of hospitalization. TNAFO in general wards achieved a decrease in the use of IMV, with a reduction in mortality and days of stay in hospitalized for NCOVID-19 with SARF.

17.
18.
Sophia(Ecuador) ; - (30):175-195, 2021.
Article in English | Scopus | ID: covidwho-1598422

ABSTRACT

The traditional vision of critical thinking (CT) founded on a rationalist approach has been questioned since the end of the last century by the ‘second wave’ of CT, which, despite not being a fully defined movement, has included aspects such as imagination, creativity and cooperative work in its understanding and in its application to teaching. At the same time, current perspectives in moral psychology such as the ‘social intuitionist’ model proposed by Jonathan Haidt, represent a challenge to the rationalist model of morality that many of the canonical normative ethics suppose. Since both CT and the moral foundation represent essential factors in the teaching of ethics, it is made explicit that the latter also needs to be revised. That is why the present work analyses a perspective of CT alternative to the traditional one based on the potential contribution of metacognition and the social intuitionist model, in order to open new lines of research to update the moral foundation that is assumed in the teaching of ethics. To delve into this, the relevance and applicability of metacognition in the teaching of ethics will be exemplified with situations related to the current Covid-19 pandemic. © Universidad Politécnica Salesiana del Ecuador.

19.
European Neuropsychopharmacology ; 53:S419, 2021.
Article in English | EMBASE | ID: covidwho-1592736

ABSTRACT

Background. Notwithstanding predictions of increase in suicide risk related to the current pandemic [1,2], as was the case in previous pandemics [3], so far there is no clear evidence of increased rates of suicide, self-harm, suicide attempts, or suicidal thoughts associated with the COVID-19 pandemic [4]. An increase in suicide deaths after the initial decline in the pandemic ourbreak has been described in Japan [5]. Objective. We assessed the impact of the COVID-19 outbreak on trends in suicide mortality and suicidal behavior (SB) in Cantabria (Spain). Methods. Data collection: suicide mortalities by the Institute of Forensic Medicine of Cantabria (IML) and SB (suicidal ideation, or suicide attempt defined as any self-injurious act with at least some intent to die) by Emergency Department (ED) visits using triage data from the electronic health care records of University Hospital Valdecilla (HUMV, reference hospital for all psychiatric emergencies in Cantabria, Spain). Collection period: January-2015 to December-2020. Data are analyzed in three different COVID-19 pandemic periods (outbreak and lockdown: March–June;return to quasi-normality and second wave: July-September;third wave: October-December) compared to those same quarters of the previous five years. Since we exclusively used available aggregate data in this study, formal ethical review was not required. Results. Since 2015, there has been an increasing trend of admissions to the ED of HUMV for SB, having almost tripled between 2015-2019 (88 vs 249). During 2020, visits for SB decreased by more than 30% in comparison with the previous year (173 vs 249). This decline started in March with the onset of the covid-19 pandemic. Previously in the first quarter of the year there were 35% more consultations for SB than 2019. On the contrary, during lockdown (second quarter) SB visits were one third of those in the same period of 2019. Although the third and fourth quarters of 2020 see a doubling of visits compared to the containment period, the number of visits in both quarters is between 60-65% of those in 2019. In 2020, suicides have dropped compared to 2019, both in absolute numbers (46 vs. 52) and rates per-100,000 inhabitants (7.89 vs. 8.95). In the first quarter of 2020 there were 19 suicides (7 more versus 2019), but during lockdown there were only 8 (12 less than in the same period 2019). Conclusions. In Cantabria (Spain), no increase in suicide or SB has been observed related to the pandemic. Conversely, in 2020 we found a decrease in both, consultations for SB and deaths by suicide, compared to 2019. The decrease in suicides and SB has been observed in all periods of Covid-19 pandemic (outbreak and lockdown;quasi-normality and second wave;third wave). Suicide data are difficult to collect in real time and the economic effects of the pandemic are still evolving. Preventive strategies will need to be developed to cope the possible increase in suicide and SB when current social protective measures are discontinued.No conflict of interest

20.
Blood ; 138:186, 2021.
Article in English | EMBASE | ID: covidwho-1582217

ABSTRACT

Introduction: The severity of acute clinical outcomes and mortality in hematologic malignancy (HM) patients infected by SARS-CoV-2 was exhaustively documented in the first weeks of the pandemic. A consistent increased mortality compared to non-cancer patients was observed across studies. In this study we aimed to estimate survival in COVID-19 HM patients by type of malignancy, to describe acute and post-acute clinical outcomes, and to compare outcomes in early and later pandemic periods. Methods: In this population-based registry study sponsored by the Madrid Society of Hematology (Asociación Madrileña de Hematología y Hemoterapia), we collected de-identified data on clinical characteristics, treatment and acute and post-acute outcomes in adult patients with hematologic malignancies and confirmed SARS-CoV-2 infection within the Madrid region of Spain. Our case series included all eligible patients admitted to 26 regional health service hospitals and 5 private healthcare centers between February 28, 2020 and February 18, 2021 with a coverage of 98% on a population of 6.6 million inhabitants. The study outcomes were all-cause mortality, severity of disease (WHO), oxygen support, ICU admission, and follow-up symptoms and signs and complications. Survival probabilities were estimated with the actuarial method and reported overall and stratified by type of malignancy and for two study periods (early cohort,-COVID-19 diagnosis from February 28 to 31 May, 2020, and later cohort, up to February 18, 2021). Results: Of the 1408 patients reported to the HEMATO-MADRID COVID-19 registry, 1166 were included in the present analyses;839 (72%) had a lymphoid malignancy, including 325 (28%) with non-Hodgkin lymphoma, 50 (4%) with Hodgkin lymphoma and 263 (23%) with multiple myeloma;and 327 (28%) had a myeloid malignancy, including 115 (10%) with myelodysplastic syndrome, 92 (8%) with acute myeloid leukemia (AML) and 87 (7%) with Philadelphia chromosome (Ph)-negative myeloproliferative neoplasms. Overall COVID-19 clinical severity was classified as critical in 19% of patients, severe in 36%, moderate in 22%, and mild in 22%;10% were admitted to an ICU;8% were on mechanical ventilation and 19% on noninvasive ventilation. Mild disease increased between early and later period from 15% to 38% of patients;severe disease decreased from 42% to 24%, p<0.001. COVID-19 treatment with steroids increased from 38% to 59%, p<0.001. At follow-up, 22% reported persistent symptoms related to COVID-19 at 2 months, 16% at 4 months and 14% at 6 months. 381 of 1166 (33%) patients died. Overall 30-day survival was 68%;2 and 3-month overall survival probabilities were 56% and 53%, respectively. Survival was more favorable for patients with myeloproliferative neoplasms (82%, 69% and 65% at 30-days, 2 and 3 months, respectively) than for those with lymphoid malignancies (68%, 56% and 54%) or myelodysplastic syndrome/acute myeloid leukemia (61%, 51%, 46%), p=001. 285 (37%) patients died in the early period vs 96 (24%) in the later, p<0.001, but median (interquartile range) follow-up time was much higher in the early vs later, 45 (20-116) days vs. 26 (11-86), respectively. Overall survival was not different between periods, p=0.5 (hazard ratio [95%C], 0.93 [0.73-1.17]). In the later cohort, 30 and 60-day survival probabilities were 71% and 56% vs. 67% and 56% in the early cohort Conclusions. A population-based registry in Spain provided strong evidence that although COVID-19 severity decreased over year 1 of the pandemic, mortality remained high, and survival was stable over time in the group of patients with hematological malignancy infected by SARS-Coc-2. A relevant proportion of the infected patients (1 in 6) referred persistent symptoms attributable to COVID-19. The improved clinical management of severe COVID-19 in non-cancer patients that followed the dissemination of evidence-based recommendations did not translate in more favorable survival in patients with hematological malignancies. Research is needed to address the specific characteristics nd improve the clinical management of this vulnerable population. Disclosures: Martinez-Lopez: Novartis: Consultancy, Speakers Bureau;BMS: Consultancy, Research Funding, Speakers Bureau;Janssen: Consultancy, Speakers Bureau;Incyte: Consultancy, Research Funding, Speakers Bureau;Roche: Consultancy, Research Funding, Speakers Bureau;Astellas: Research Funding, Speakers Bureau. Jiménez-Yuste: Pfizer: Consultancy, Honoraria, Research Funding;Grifols: Consultancy, Honoraria, Research Funding;CSL Behring: Consultancy, Honoraria, Research Funding;Sanofi: Consultancy, Honoraria, Research Funding;Bayer: Consultancy, Honoraria, Research Funding;NovoNordisk: Consultancy, Honoraria, Research Funding;BioMarin: Consultancy;Sobi: Consultancy, Honoraria, Research Funding;Octapharma: Consultancy, Honoraria, Research Funding;Takeda: Consultancy, Honoraria, Research Funding;F. Hoffmann-La Roche Ltd: Consultancy, Honoraria, Research Funding. Kwon: Gilead: Honoraria.

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