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1.
Hematology, Transfusion and Cell Therapy ; 43:S509-S510, 2021.
Article in Portuguese | EMBASE | ID: covidwho-1859704

ABSTRACT

Introdução: A anemia hemolítica autoimune (AHAI) tem sido associada a muitas patologias conhecidas, incluindo doenças autoimunes, linfoproliferativos e certas doenças infecciosas, principalmente nos casos por anticorpos a frio. Tem surgido alguns relatos de caso de doença por SARS-Cov2 (COVID-19) associado a AHAI;no entanto, essa potencial associação ainda não é clara. Aqui relatamos uma serie 3 casos de Síndrome de aglutininas a frio (CAS), associada a infecção por Covid-19. Relato de caso: Três pacientes, com idades de 53 a 65 anos, sendo 2 homens e 1 mulher, foram admitidos em nosso serviço de fevereiro a maio de 2021, devido a infecção por Covid-19. Dois apresentavam síndrome aguda de angústia respiratória, mas sem necessidade de ventilação mecânica. Todos apresentavam anemia macrocítica, com hemoglobina que variava de 6,5-9,1 g/dL, DHL aumentado (311-679), e 2 com Birrubina indireta aumentada (1,05-2,55). Todos apresentavam teste de antiglobulina direto fortemente positivo as custas de C3d, com amplitude térmica de 24°C, e título a frio de 64-256. Dois pacientes não apresentavam comorbidades, 1 paciente havia sido internado recentemente para correção cirurgica de Doença arterial Cronica. Dois pacinetes fora tranfundidos com CH, entrtanto nenhum tratamento específico para AHAI foi estabelecido. Uma paciente foi transferida e perdeu seguimento e dois pacientes recuperam totalmente do quadro, e mantém-se após 3 e 4 meses de infecção com Hb >12 g/dL, sem necessidade de tratamento. Discussão e conclusão: Doença resultante de infecção por Covid-19 está associada a várias anormalidades hematológicas, incluindo linfopenia, fênomenos trombo-embólicos, trombocitopenia imune, síndrome antifosfolipídeo. Tem surgido alguns relatos de casos no último ano, associando AHAI a infecção por covid-19 e sugerindo que a desregulação imunológica teria como a etiologia subjacente o SARS-CoV-2. Aqui, detalhamos uma série de 3 paciente com infecção sintomática por SARS-CoV-2 que apresentram anemia sintomática de leve a grave e a a investigação foi consistente com anemia hemolítica autoimune por anticorpos a frio secundária à infecção por covid-19 (CAS), diagnóstico raro em nosso meio.

2.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-333754

ABSTRACT

SARS-CoV-2, the etiological agent of COVID-19, was first described in Wuhan, China in December 2019 and has now spread globally. Ecuador was the second country in South America to confirm cases and Guayaquil was one of the first cities in the world to experience high mortality due to COVID-19. The aim of this study was to describe the lineages circulating throughout the country and to compare the mutations in local variants, to the reference strain. In this work we used the MinION platform (Oxford Nanopore Technologies) to sequence the whole SARS-CoV-2 genomes of 119 patients from all provinces of Ecuador, using the ARTIC network protocols. Our data from lineage assignment of the one hundred and nineteen whole genomes revealed twenty different lineages. All genomes presented differences in the S gene compared to the Wuhan reference strain, being the D614G amino acid replacement the most common change. The B.1.1.119 lineage was the most frequent and was found in several locations in the Coast and Andean region. Three sequences were assigned to the new B.1.1.7 lineage. Our work is an important contribution to the understanding of the epidemiology of SARS-CoV-2 in Ecuador and South America. HIGHLIGHTS: All 119 genomes showed mutations compared to the reference strain, which could be important to understand the virulence, severity and transmissibility of the virus.Until January 17, three sequences were assigned to the new B.1.1.7 lineage.Our findings suggest that there were at least twenty independent introductions of SARS-CoV-2 to Ecuador. ARTICLE SUMMARY LINE: We report 119 sequences of SARS-CoV-2 across all Ecuadorian provinces, 20 different lineages were found until January 17 th , including B.1.1.7.

3.
Mater Today Chem ; 25: 100924, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1799775

ABSTRACT

Due to the unprecedented and ongoing nature of the coronavirus outbreak, the development of rapid immunoassays to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its highly contagious variants is an important and challenging task. Here, we report the development of polyclonal antibody-functionalized spherical gold nanoparticle biosensors as well as the influence of the nanoparticle sizes on the immunoassay response to detect the SARS-CoV-2 spike protein by dynamic light scattering. By monitoring the increment in the hydrodynamic diameter (ΔDH) by dynamic light scattering measurements in the antigen-antibody interaction, SARS-CoV-2 S-protein can be detected in only 5 min. The larger the nanoparticles, the larger ΔDH in the presence of spike protein. From adsorption isotherm, the calculated binding constant (K D ) was 83 nM and the estimated limit of detection was 13 ng/mL (30 pM). The biosensor was stable up to 90 days at 4 °C. Therefore, the biosensor developed in this work could be potentially applied as a fast and sensible immunoassay to detect SARS-CoV-2 infection in patient samples.

4.
European Heart Journal Cardiovascular Imaging ; 23(SUPPL 1):i143, 2022.
Article in English | EMBASE | ID: covidwho-1795324

ABSTRACT

Introduction: The impact of acute infection by SARS-COV2 on the cardiovascular system has been previously reported in the literature, with a higher propensity in patients with more serious pattern of disease and pro-inflammatory status. Nevertheless, the long-term burden and sequels of COVID-19 on the cardiovascular system is still unknown. Purpose: To evaluate the long-term impact of COVID-19 on left ventricular function in patients with severe clinical presentation requiring intensive care hospitalization. Methods: This was a single-center observational, prospective study which included patients requiring admission to the Intensive Care Unit (ICU) due to COVID-19 infection from January to November 2020. All discharged patients were contacted to perform a clinical, electrocardiographic and echocardiographic evaluation and those who accepted were included on the protocol. Baseline and clinical characteristics were collected from clinical reports. For the global longitudinal strain (GLS) analysis all patients with significant wall motion abnormalities and valvular cardiopathy were excluded. Statistical analysis was performed with Mann-Whitney and a safety cut-off was established with ROC curve analysis. Results: A total of 43 patients were included (mean age 64 ± 12, 67.4% males). During SARS-COV2 infection 49% presented with severe ARDS and 51% with moderate, 35% required invasive mechanical ventilation, 14% noninvasive mechanical ventilation and 52% with high nasal flow cannula. On the follow-up analysis, fatigue was the most reported in symptom (52% patients) and the majority did not present other signs or symptoms suggestive of heart failure, with the mean NT-proBNP of 49 ± 389 pg/dL. The standard ECG and echocardiogram did not show significant changes with a mean LVEF of 58 ± 7.8 and mean TAPSE of 21 ± 4. The strain analysis showed low value of GLS (mean GLS of -17.14 ± 2.36) for a reference cut-off of -18%, suggesting subclinical left ventricular dysfunction in this subset of patients with preserved ejection fraction. Maximum CPR values during ICU did not correlate either with the extent of disease evolvement in CT (p= NS) or ARDS severity (p= NS). Nevertheless, maximum CPR correlated significantly with GLS reduction (R = 0.44, p = 0.019). A CPR value higher than iger30mg/ dL had 100% specificity for GLS reduction and a cut-off of 14gm/dL reported a sensitivity of 65% and specificity pf 75% for reduction in GLS. Conclusion: In our study, we reported subclinical impairment in left ventricular function detected with global longitudinal strain after serious infection with SARS-COV2. The detected myocardial dysfunction was related with higher inflammatory as expressed by CPR values. Longterm monitoring of these patients should be undertaken in order to timely detect late complications.

5.
Meng, B.; Ferreira, I. A. T. M.; Abdullahi, A.; Goonawardane, N.; Saito, A.; Kimura, I.; Yamasoba, D.; Gerba, P. P.; Fatihi, S.; Rathore, S.; Zepeda, S. K.; Papa, G.; Kemp, S. A.; Ikeda, T.; Toyoda, M.; Tan, T. S.; Kuramochi, J.; Mitsunaga, S.; Ueno, T.; Shirakawa, K.; Takaori-Kondo, A.; Brevini, T.; Mallery, D. L.; Charles, O. J.; Bowen, J. E.; Joshi, A.; Walls, A. C.; Jackson, L.; Cele, S.; Martin, D.; Smith, K. G. C.; Bradley, J.; Briggs, J. A. G.; Choi, J.; Madissoon, E.; Meyer, K.; Mlcochova, P.; Ceron-Gutierrez, L.; Doffinger, R.; Teichmann, S.; Pizzuto, M.; de Marco, A.; Corti, D.; Sigal, A.; James, L.; Veesler, D.; Hosmillo, M.; Lee, J. H.; Sampaziotis, F.; Goodfellow, I. G.; Matheson, N. J.; Thukral, L.; Sato, K.; Gupta, R. K.; Kawabata, R.; Morizako, N.; Sadamasu, K.; Asakura, H.; Nagashima, M.; Yoshimura, K.; Ito, J.; Kimura, I.; Uriu, K.; Kosugi, Y.; Suganami, M.; Oide, A.; Yokoyama, M.; Chiba, M.; Saito, A.; Butlertanaka, E. P.; Tanaka, Y. L.; Ikeda, T.; Motozono, C.; Nasser, H.; Shimizu, R.; Yuan, Y.; Kitazato, K.; Hasebe, H.; Nakagawa, S.; Wu, J.; Takahashi, M.; Fukuhara, T.; Shimizu, K.; Tsushima, K.; Kubo, H.; Kazuma, Y.; Nomura, R.; Horisawa, Y.; Nagata, K.; Kawai, Y.; Yanagida, Y.; Tashiro, Y.; Tokunaga, K.; Ozono, S.; Baker, S.; Dougan, G.; Hess, C.; Kingston, N.; Lehner, P. J.; Lyons, P. A.; Matheson, N. J.; Owehand, W. H.; Saunders, C.; Summers, C.; Thaventhiran, J. E. D.; Toshner, M.; Weekes, M. P.; Maxwell, P.; Shaw, A.; Bucke, A.; Calder, J.; Canna, L.; Domingo, J.; Elmer, A.; Fuller, S.; Harris, J.; Hewitt, S.; Kennet, J.; Jose, S.; Kourampa, J.; Meadows, A.; O’Brien, C.; Price, J.; Publico, C.; Rastall, R.; Ribeiro, C.; Rowlands, J.; Ruffolo, V.; Tordesillas, H.; Bullman, B.; Dunmore, B. J.; Fawke, S.; Gräf, S.; Hodgson, J.; Huang, C.; Hunter, K.; Jones, E.; Legchenko, E.; Matara, C.; Martin, J.; Mescia, F.; O’Donnell, C.; Pointon, L.; Pond, N.; Shih, J.; Sutcliffe, R.; Tilly, T.; Treacy, C.; Tong, Z.; Wood, J.; Wylot, M.; Bergamaschi, L.; Betancourt, A.; Bower, G.; Cossetti, C.; de Sa, A.; Epping, M.; Fawke, S.; Gleadall, N.; Grenfell, R.; Hinch, A.; Huhn, O.; Jackson, S.; Jarvis, I.; Krishna, B.; Lewis, D.; Marsden, J.; Nice, F.; Okecha, G.; Omarjee, O.; Perera, M.; Potts, M.; Richoz, N.; Romashova, V.; Yarkoni, N. S.; Sharma, R.; Stefanucci, L.; Stephens, J.; Strezlecki, M.; Turner, L.; de Bie, E. M. D. D.; Bunclark, K.; Josipovic, M.; Mackay, M.; Mescia, F.; Michael, A.; Rossi, S.; Selvan, M.; Spencer, S.; Yong, C.; Allison, J.; Butcher, H.; Caputo, D.; Clapham-Riley, D.; Dewhurst, E.; Furlong, A.; Graves, B.; Gray, J.; Ivers, T.; Kasanicki, M.; Le Gresley, E.; Linger, R.; Meloy, S.; Muldoon, F.; Ovington, N.; Papadia, S.; Phelan, I.; Stark, H.; Stirrups, K. E.; Townsend, P.; Walker, N.; Webster, J.; Scholtes, I.; Hein, S.; King, R.; Márquez, S.; Prado-Vivar, B.; Becerra-Wong, M.; Caravajal, M.; Trueba, G.; Rojas-Silva, P.; Grunauer, M.; Gutierrez, B.; Guadalupe, J. J.; Fernández-Cadena, J. C.; Andrade-Molina, D.; Baldeon, M.; Pinos, A..
Web of Science; 2021.
Preprint in English | Web of Science | ID: ppcovidwho-331154

ABSTRACT

The SARS-CoV-2 Omicron BA.1 variant emerged in late 2021 and is characterised by multiple spike mutations across all spike domains. Here we show that Omicron BA.1 has higher affinity for ACE2 compared to Delta, and confers very significant evasion of therapeutic monoclonal and vaccine-elicited polyclonal neutralising antibodies after two doses. mRNA vaccination as a third vaccine dose rescues and broadens neutralisation. Importantly, antiviral drugs remdesevir and molnupiravir retain efficacy against Omicron BA.1. We found that in human nasal epithelial 3D cultures replication was similar for both Omicron and Delta. However, in lower airway organoids, Calu-3 lung cells and gut adenocarcinoma cell lines live Omicron virus demonstrated significantly lower replication in comparison to Delta. We noted that despite presence of mutations predicted to favour spike S1/S2 cleavage, the spike protein is less efficiently cleaved in live Omicron virions compared to Delta virions. We mapped the replication differences between the variants to entry efficiency using spike pseudotyped virus (PV) entry assays. The defect for Omicron PV in specific cell types correlated with higher cellular RNA expression of TMPRSS2, and accordingly knock down of TMPRSS2 impacted Delta entry to a greater extent as compared to Omicron. Furthermore, drug inhibitors targeting specific entry pathways demonstrated that the Omicron spike inefficiently utilises the cellular protease TMPRSS2 that mediates cell entry via plasma membrane fusion. Instead, we demonstrate that Omicron spike has greater dependency on cell entry via the endocytic pathway requiring the activity of endosomal cathepsins to cleave spike. Consistent with suboptimal S1/S2 cleavage and inability to utilise TMPRSS2, syncytium formation by the Omicron spike was dramatically impaired compared to the Delta spike. Overall, Omicron appears to have gained significant evasion from neutralising antibodies whilst maintaining sensitivity to antiviral drugs targeting the polymerase. Omicron has shifted cellular tropism away from TMPRSS2 expressing cells that are enriched in cells found in the lower respiratory and GI tracts, with implications for altered pathogenesis.

6.
2021 IEEE International Geoscience and Remote Sensing Symposium, IGARSS 2021 ; 2021-July:8368-8371, 2021.
Article in English | Scopus | ID: covidwho-1746054

ABSTRACT

COVID-19 pandemic forced many countries to adopt lockdown measures, temporarily closing factories, diminish maritime traffic and reducing the mobility of people in the cities. Analysis from the Tropospheric Monitoring Instrument (TROPOMI) on board Europe's Sentinel-5P and Copernicus Atmosphere Monitoring Service (CAMS), for the first wave of COVID-19 in 2020, have shown a substantial improvement in air quality. More specifically, since lockdown until the end of April, Lisbon and Porto were at their lowest PM10 levels in 2 years, while Madrid had a significant drop with values considerably below 2018 levels but still close to 2019 values. In terms of NO2 levels, Lisbon had an historical minimum of the last 2 years during most of April 2020 and Madrid had 2-year lowest level since lockdown. Finally, the commercial port of Ponta Delgada (São Miguel, Azores) had a decrease in cruise ship calls during the pandemic, which reduced the number of daily cases with significant NO2 concentrations, comparing to 2019. © 2021 IEEE

7.
Anuario Iberoamericano de Justicia Constitucional ; 25(2):579-591, 2021.
Article in Spanish | Scopus | ID: covidwho-1716257
8.
9th International Conference on Technological Ecosystems for Enhancing Multiculturality, TEEM 2021 ; : 647-651, 2021.
Article in English | Scopus | ID: covidwho-1613100

ABSTRACT

The pandemic caused by COVID-19 had and still has implications in the social relationship between human beings and at the school level and families with school-age children and young people. The school had to quickly conceive an effective intervention plan regarding learning. Teachers, some with more, others with less training in Educational Technology, had to, in record time, modify their entire methodological plan of intervention with their students. This research team decided to study the implications of this pandemic in the educational context in the teaching community. This research focuses on the repercussions of the pandemic on teachers' emotional management and psychological well-being through an online questionnaire (Google Forms) administered between the beginning of the school term in September 2020 and March 2021. © 2021 ACM.

9.
2nd South American Conference on Industrial Engineering and Operations Management, IEOM 2021 ; : 1021-1033, 2021.
Article in English | Scopus | ID: covidwho-1589494

ABSTRACT

Detection tests for COVID-19 are important to mitigate its spread. However, it is not yet clear what are the best practices for its realization. This paper aims to propose best practices to avoid possible failures in the points of contact of the samples collection for Reverse Transcription Polymerase Chain Reaction (RT-PCR) process in an emergency department of a hospital for the care of patients who are suspected or diagnosed with the new coronavirus. For this purpose, we performed a process mapping of the RT-PCR collection process using the Service Blueprint tool to identify the points of contact between the patients and the hospital staff. Thus, we identified the possible failures in these points, with the process actors, and we prioritized them according to their perception about Gravity, Urgency, and Tendency matrix. Our results show that the most critical failures are related to the information and communication between the process actors and the patients. In this way, improvements were proposed related to the standardization, information material, continued training, development of specialized teams, creation of protocols, and use of information technology. © IEOM Society International.

10.
J Dent Res ; 101(2): 235, 2022 02.
Article in English | MEDLINE | ID: covidwho-1582765

Subject(s)
COVID-19 , SARS-CoV-2 , Aerosols , Humans
11.
Allergy: European Journal of Allergy and Clinical Immunology ; 76(SUPPL 110):475-476, 2021.
Article in English | EMBASE | ID: covidwho-1570424

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) was first identified in December 2019 in Wuhan, China. The WHO declared the outbreak a Public Health Emergency of International Concern in January 2020 and a pandemic in March 2020. Until March 28 2021, more than 125 million cases have been confirmed, with more than 2.7 million deaths attributed to COVID-19. On December 21, 2020, the EMA issued an Emergency Use Authorization for Pfizer-BioNTech COVID-19 vaccine to prevent COVID-19, to be administered in 2 separate doses 21 days apart. The aim of this study was to identify and describe the suspected allergic reactions to first dose of Pfizer-BioNTech COVID-19 vaccine in health care professionals of our center. We also aimed to know if these reactions interfered with the compliance of vaccination protocol. Method: All health care professionals that receipt the vaccine were included. A prospective study was carried out using an online questionnaire to access the demographic data, personal allergic history and description of reaction to the vaccine. Results: In our hospital, the vaccination began on December 29, 2020. A total of 3040 first doses were administered. A total of 2095 (69%) questionnaire responses were collected. It was reported 1649 (79%) adverse events. Among these, 16 (1%) were identified as suggestive allergic reaction. These reactions occurred in professionals, 13 cases (81%) female, with a median age of 41 years (28-52y). The median interval from vaccine administration to symptom onset was 6 hours (5 min-48h). Eight professionals had late cutaneous reactions: 6 had mild reactions and tolerated the second dose;and 2 had severe reactions and it was decided not to administer the vaccine. The other 8 professionals had immediate reactions: 7 performed allergological study that was negative. The second dose vaccine was administered with vigilance and it was observed cutaneous reaction similar to prior reaction in only one case. Conclusion: In our study population, only 0.8% (16 of 2095) had a suggestive allergic reaction to first dose of the Pfizer-BioNTech COVID-19 vaccine. Half of them had immediate reactions and only 1 professional had a reproducible episode with the second dose;the other had late reactions and only 2 (0.1%) professionals did not complete the vaccination protocol. We can conclude that this vaccine has a good safety profile. and that mild reactions do not interfere with compliance with vaccination schedule.

12.
European Heart Journal ; 42(SUPPL 1):2493, 2021.
Article in English | EMBASE | ID: covidwho-1554616

ABSTRACT

Introduction: CHA2DS2-VASc score is used to determine the thromboembolic risk, but its prognostic value has been demonstrated in several cardiovascular (CV) diseases. Except for female gender, many CV risk factors comprising this score are recognized as risk factors for mortality in COVID- 19. Cetinak G. et al demonstrated the ability of modified CHA2DS2-VASc (M-CHA2DS2-VASc) to predict mortality in COVID-19, which is based on changing gender criteria from female to male. Purpose: To evaluate the prognostic value of a M-CHA2DS2-VASc score to predict pulmonary embolism (PE) and mortality in pts with COVID-19 admitted at the emergency department (ED). Methods: Retrospective study of pts admitted to the ED between June 2020-January 2021, who underwent computed tomography pulmonary angiography (CTPA) due to PE suspicion. Pts were stratified into 3 MCHA2DS2- VASc risk groups: lower (0-1), intermediate (2-3) and high risk (≥4). Kruskal-Wallis and X-square test were used to compare score risk groups. Logistic regression was used to determine predictors of PE and mortality. ROC curve was performed to evaluate the discriminative power of the score. Results: We included 300 pts: median age 71 years, 59% male. Hypertension (59%) chronic kidney disease (CKD, 33%), dyslipidemia (32%) and diabetes (28%) were the most common comorbidities. PE was diagnosed in 46 pts (15%). We found no difference in PE incidence according to MCHA2DS2- VASc groups (p=0.531) and it showed no predictive value for PE (OR: 1.050, p=0.596). The AUC of M-CHA2DS2-VASc was 0.52, suggesting no discriminative power to predict PE. Regarding mortality, M-CHA2DS2-VASc score was higher in non-survivors COVID-19 pts than in survivors [4 (IQR 3-5) vs 2 (1-4), respectively, p<0.001]. A multivariate logistic regression analysis was performed for mortality based on M-CHA2DS2-VASC, troponin, CKD and smoking history, and only M-CHA2DS2-VASc was identified as an independent predictor of mortality (OR: 1.406, p=0.007). Kaplan-Meier showed that MCHA2DS2- VASc score was associated with mortality: the survival rate was 92%, 80% and 63% in the lower, intermediate and higher MCHA2DS2VASc score risk group (logrank test p<0.001;Fig. A). Most of the pts in the cohort were hospitalized (83%), but 21 pts (17%) discharged from the ED. Among these pts, 33% (n=17) had low risk, 37% (n=19) intermediate risk and 29% (n=15) high risk for mortality according to the M-CHA2DS2VASc score. The Kaplan-Meier individual survival analysis for hospitalized patients (Fig. B) and for those discharged from the ED (Fig. C) showed that M-CHA2DS2-VASc score had a good discriminative ability to predict short-term mortality for both groups (logrank test p<0.001 and p=0.007, respectively). Conclusion: Considering the lack of validated scores to predict mortality in COVID-19 pts, the M-CHA2DS2-VASc might be a simple tool to predict short-term mortality in these pts, irrespectively of the need for hospitalization or not.

14.
Pesquisa Odontologica Brasileira = Brazilian Oral Research ; 35:e109, 2021.
Article in English | MEDLINE | ID: covidwho-1533487

ABSTRACT

The COVID-19 pandemic has forced dentistry schools (DSs) to adapt their teaching techniques to digital platforms. Therefore, we aimed to evaluate distance classes in the Brazilian DS curriculum. After an online search of higher education institutions (HEIs) with DS on the e-Ministry of Education (MEC) platform, we included institutions with at least one graduated class to extract the age/localization of the DS, funding, number of authorized seats, MEC-grade, ENADE-score, and workload. HEIs' webpages were consulted to identify the curriculum, subjects offered in the distance education (DE) format, extracurricular programs, scientific events, postgraduate programs, and institutional YouTube channels. Chi-square/Fisher's tests plus binary logistic regression were performed (SPSS 20.0, p < 0.05). Of the 241 DSs evaluated, 82 (34.0%) offered distance classes, and a high prevalence was observed in the southeast region (p <0.001) and private HEIs (p = 0.001). HEIs with distance classes had lower ENADE scores (p = 0.004), lower workload (p = 0.007), and higher workload for optional subjects (p = 0.016), doctoral programs (p = 0.041), specialization courses (p = 0.017), and institutional YouTube channels (p < 0.001). Southern dental schools (p < 0.001), lower workload (p = 0.022), optional subjects (p = 0.033), and institutional YouTube channels (p = 0.005) were independently associated with distance classes. In one-third of the Brazilian DSs, distance classes and institutional YouTube channels were strongly associated variables. The association of distance learning with lower workload and low academic performance draws attention to the need for regulatory bodies for controlling the quality of DE.

15.
Radiotherapy and Oncology ; 161:S979-S980, 2021.
Article in English | Web of Science | ID: covidwho-1529200
16.
South European Society and Politics ; 2021.
Article in English | Scopus | ID: covidwho-1483291

ABSTRACT

Facing the first phase of the pandemic with exceptionally low casualties, Portugal was internationally praised as an outstanding example, particularly when compared to other Southern European countries. This article depicts how the pandemic crisis erupted in Portugal and how the Socialist government, the opposition and, to an important degree, the head of state responded to its demands, curbing the initial spread of the infection. The government ensured considerable levels of support from citizens and from other parties. The official opposition maintained its pragmatic and conciliatory tone during the confinement stages of the pandemic. It is argued that lower levels of political polarisation and a climate of cross-party collaboration are key factors in understanding the ‘Portuguese miracle’. © 2021 Informa UK Limited, trading as Taylor & Francis Group.

17.
Journal of the Neurological Sciences ; 429, 2021.
Article in English | EMBASE | ID: covidwho-1466691

ABSTRACT

Background and aims: Opicapone (OPC) proved to be effective in the treatment of end-of-dose motor fluctuations in Parkinson's disease (PD) patients. Non-motor symptoms have a substantial impact on health-related quality of life and are reported in approximately 90% of idiopathic PD patients. End-of-dose motor fluctuations and associated sleep disorders are commonly observed in PD patients who receive treatment with levodopa (L-dopa)/DOPA decarboxylase inhibitors (DDCI). This study aims to evaluate the effects of OPC treatment on sleep disorders in PD patients with ‘wearing-off’. Methods: Approximately 30 patients (aged ≥30 years) with idiopathic PD, treated with 3–8 daily doses of L-dopa/DDCI, with ‘wearing-off’ and sleep disorders will receive OPC 50 mg once daily during a 6-week evaluation period. L-dopa/DDCI daily dose, but not number of intakes, may be adjusted according to the patients' response in the first 2 weeks, and is kept unchanged afterwards (Fig. 1). As a pilot study, no formal sample size calculation was performed. [Formula presented] Results: The primary endpoint is change from baseline in total score of Parkinson's Disease Sleep Scale-2. Secondary endpoints include tolerability, functional motor and non-motor assessments (Movement Disorder Society-Non-Motor Symptoms Scale, Parkinson's Disease Questionnaire-8, Parkinson's Fatigue Scale, ON/OFF home diary), and Clinical and Patient Global Impression of Change scales. Study sites are in Germany and Portugal. First-patient-in is expected for early 2021 and last-patient-out for late 2021. Timelines might be impacted by the COVID-19 situation. Conclusions: This pilot study will provide preliminary data on the potential effect of OPC 50 mg once daily as adjunctive therapy to L-dopa/DDCI on PD-associated sleep disorders.

18.
Journal of the Neurological Sciences ; 429, 2021.
Article in English | EMBASE | ID: covidwho-1466690

ABSTRACT

Background and aims: Opicapone (OPC) proved to be effective in the treatment of end-of-dose motor fluctuations in Parkinson's disease (PD) patients. About 80–100% of PD patients show some degree of wearing-off within 10 years of levodopa (L-dopa) therapy. Approaches to optimize the L-dopa regimen include increasing the dose or ‘fractionating’ the total daily dose. This study aims to explore the potential of adjunctive OPC versus an additional dose of L-dopa/dopa decarboxylase inhibitor (DDCi) to optimize the L-dopa/DDCi regimen as first-line approach to treat wearing-off. Methods: Approximately 100 patients (aged ≥30 years) with idiopathic PD, treated with 3–4 daily oral L-dopa doses up to 600 mg, and signs of wearing-off (<2 years) will be equally randomized to receive OPC 50 mg once daily or an additional dose of 100 mg/25 mg L-dopa/DDCI during a 4-week open-label evaluation period (Fig. 1). [Formula presented] Results: Primary endpoint is the change from baseline in OFF-time. Secondary endpoints include tolerability, functional motor and non-motor assessments (Movement Disorder Society (MDS)-Unified Parkinson's Disease Rating Scale, MDS-Non-Motor Symptoms, Parkinson's Disease Questionnaire-8), and global impression of change scales (Clinical Global Impression of Change, Patient Global Impression of Change). As this is a descriptive/exploratory study, no formal sample size calculation was performed. Study sites are in Germany, Italy, Portugal, Spain, and the UK. First-patient-in is expected for 2021 and last-patient-out for late 2022. Timelines might be impacted by the COVID-19 situation. Conclusions: This study will evaluate the potential of adjunctive OPC versus an additional dose of L-dopa/DDCi as first-line approach to treat wearing-off in PD patients.

19.
Journal of the Neurological Sciences ; 429, 2021.
Article in English | EMBASE | ID: covidwho-1466689

ABSTRACT

Background and aims: Opicapone (OPC) proved to be effective in the treatment of end-of-dose motor fluctuations in Parkinson's disease (PD) patients. When OPC is co-administered with levodopa (L-dopa) and dopa decarboxylase inhibitor (DDCis), peripheral catechol-O-methyltransferase (COMT) is inhibited which increases L-dopa bioavailability. This study aims to explore the potential of OPC to enhance the clinical benefit of L-dopa/DDCi in patients with early-stage PD on stable treatment. Methods: Patients (aged 30–80 years) with idiopathic PD, treated with 3–4 daily oral doses of up to 500 mg L-dopa, with signs of treatable motor disability but no motor complications will be randomized (1:1) to receive OPC 50 mg once-daily or placebo during a 6-month double-blind evaluation period. The L-dopa/DDCi regimen should remain stable throughout the double-blind period. At the end of this period, patients may enter a 1-year, open-label period of OPC 50 mg treatment (Fig. 1);162 patients in each group are necessary to detect a minimum clinically-relevant magnitude of effect between arms. [Formula presented] Results: Change from baseline in the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III is the primary endpoint. Secondary endpoints include tolerability, functional motor and non-motor assessments (MDS-UPDRS, Non-Motor Symptoms Scale, Parkinson's Disease Questionnaire-39, Parkinson's Disease Sleep Scale-2), and global impression of change scales (Clinical-Global-Impression-of-Change, Patient-Global-Impression-of-Change). First-patient-in is expected for early 2021 and last-patient-out from double-blind period in late 2022. Timelines might be impacted by the COVID-19 pandemic situation. Conclusions: This study will evaluate the effect of OPC on motor symptoms when given as add-on to stable L-dopa/DDCi therapy in patients with early-stage PD.

20.
26th International Joint Conference on Industrial Engineering and Operations Management, IJCIEOM 2021 ; 367:327-335, 2021.
Article in English | Scopus | ID: covidwho-1437096

ABSTRACT

This article aims to analyze the perception and importance of biosafety actions in supermarkets. Besides, we want to understand how such actions can be classified under the perception of customers. For this, we established seven variables for the evaluation of biosafety. This research has an exploratory character because it analyzes biosafety actions and their effects under the perception of quality and customer satisfaction in a pandemic scenario. The results suggest that customers rate the actions as extremely important, but the perception of quality in carrying them out is reasonable. Six of the seven biosecurity measures were classified as one-dimensional attributes, indicating that customer satisfaction is proportional to performance. Item/action 6, which deals with the use of facial masks, was the action that obtained the best evaluation in matters of perception and importance. The Kano Model indicated that item/action 5, which deals with demonstrating the concern for customers’ health, is the one that most satisfies them. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.

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