Declaration of Cuernavaca

The National Public Health Institutes (NPHI), members of the Latin American Regional Network of the International Association of National Institutes of Public Health, met face to face at the headquarters of the National Institute of Public Health of Mexico, in the City of Cuernavaca, from October 5 to 7, 2022, with the participation of the directors or their representatives of the NPHIs of Bolivia, Brazil, Colombia, Costa Rica, El Salvador, Mexico, Peru and Suriname and representatives of the South American Sub regional Program (SAM), and the Central American Sub regional Program (CAM) of the Pan American Health Organization (PAHO), the Organization of the Amazon Cooperation Treaty (OTCA), the Andean Health Agency/Hipolito Unanue Agreement (ORAS/CONHU) and the Central American Integration System (SICA/COMISCA), analyzing the role of the NPHI in combating health inequities;in confronting the global climate and environmental crisis;combating hunger, food insecurity and malnutrition;successes and challenges in responding to the Covid-19 pandemic;strengthening and continuous improvement of integrated disease surveillance and preparedness for health emergencies;as well as the various existing regional and sub-regional health cooperation programs, noticing that: 1. In the current scenario, the dominating development model is a generator of growing social inequalities, which determine serious inequities in the health conditions of our peoples. 2. Likewise, the current model of production and consumption, adopted at the global level, has increased hunger, food insecurity and malnutrition that possibly constitute nowadays the main health problem in our region. 3. The environmental crisis, which is also a product of the current global development model, has a significant impact on human and animal health and the interaction between both. 4. The NPHIs have played a role of major relevance in confronting the Covid-19 pandemic, not fully applying, however, their full potential for research and for proposing national plans for the disease control. 5. Health surveillance systems, in most of our countries, suffer from significant fragmentation between various sectors and within the health sector itself, implying, in any case, reactive actions that do not allow for anticipating the emergence of new pathologies or health emergencies. 6. The various regional and sub regional cooperation agencies and programs offer an enormous capacity for synergies and mutual cooperation.

A Psychometric Analysis of the Spanish Version of the Grief Impairment Scale: A Screening Tool of Biopsychosocial Grief-Related Functional Impairment in a Salvadoran Sample.

The objective of this study was to translate and psychometrically evaluate a Spanish version of the Grief Impairment Scale (GIS) using a sample of bereaved adults from El Salvador (N = 579). The results confirm the unidimensional structure of the GIS, and solid reliability, item characteristics, and criterion-related validity, where the GIS scale significantly and positively predicts depression. However, this instrument only showed evidence of configural and metric invariance between different sex groups. Overall, these results support the Spanish version of the GIS as a psychometrically sound screening tool for health professionals and researchers to use in their clinical work.

Are societies in conflict more susceptible to believe in COVID-19 conspiracy theories? A 66 nation study

Conspiracy theories widely influence our social and political lives. A recent example is the broad impact such theories had on government's efforts to halt the spread of the COVID-19 pandemic. In that context, public's compliance and willingness to get vaccinated was found to be substantially and negatively affected by the belief in conspiracy theories, among various factors. In the present study, we tested whether some countries are more susceptible to conspiracy theories than others. We examined, for the first time, the idea that the degree of intensity of conflict predicts the degree of belief in COVID-19 conspiracy theories. A multilevel analysis across 66 countries (N = 46,450) demonstrated that people living in countries with higher conflict intensity tended to be more susceptible to COVID-19 conspiracy beliefs. These findings are the first large-scale comparative evidence of the profound psychological effects of conflicts on the involved societies. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Impact Statement The belief in COVID-19 conspiracy theories has severe implications on public's health. Thus, it is important to better understand the reasons behind such beliefs. The present study provides new information which helps to better understand the contexts in which conspiracy belief thrive. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Pandemic populism and permanent campaigning: How Central American presidents build political legitimacy on Facebook

This article examines how Carlos Alvarado and Nayib Bukele, presidents of Costa Rica and El Salvador, respectively, employed Facebook throughout 2020 to communicate about the COVID-19 pandemic. The study draws on content analysis of 1584 posts made by both presidents on Facebook throughout 2020. The article argues that Alvarado and Bukele turned the pandemic into a means to build political legitimacy in their specific political context through two main strategies: populist communication and permanent campaigning. Whereas Alvarado relied on these strategies to demonstrate that he was in control of the country amid mounting backlash, Bukele infused both strategies with a religious imaginary to attack political opponents and perform the role of El Salvador's messiah. This analysis broadens the understanding of the relationship between populist communication and permanent campaigning in two main ways. First, by employing a comparative approach to identify singularities and differences in the ways that presidents built political legitimacy during the pandemic in a largely under-examined region (Central America). Second, by situating findings within a wide temporal perspective that included posts in an entire calendar year and comparisons with Alvarado's and Bukele's presidential campaigns. © The Author(s) 2022.

Can the New Left Deliver Change in Latin America?

The intense Latin American electoral cycle of 2020–22 coincided with deteriorating socio-economic conditions in the wake of the COVID-19 pandemic and increasing frustration with the status quo. Anti-incumbent sentiment coupled with demands for more inclusive and fair economic models prompted a pronounced shift to the left in the region, although with many different shades of ‘pink'. But an increasingly polarised and fragmented political and social environment is testing the ability of new governments to deliver change, as shown by the popular rejection of a new constitution in Chile. A more limited fiscal space is also constraining these governments' effectiveness. Nevertheless, political alignment among countries with important stakes in global climate-change mitigation and thwarting drug trafficking could produce more cohesive foreign-policy stances and increased regional leverage.

Mobile Robots for COVID-19 Pandemic: A State of the Art

This paper aims to show how technology and automation have supported the fight against the covid-19 pandemic and how have contributed to assistance and personal interaction, the state of the art and some of the models that are being used in common applications that have a risk of contact or transmission are presented. Finally, the use of technology in the health area in El Salvador is discussed. © 2022 IEEE.

Impact of visiting restrictions for the dying during the COVID-19 pandemic on healthcare professionals' quality of life around the world (the CO-LIVE study)

Aims: The COVID-19 pandemic forced a trade-off between the interests of all versus those of individuals. Therefore, many healthcare organisations applied visiting restrictions, also for dying patients.Our aim was to explore, in an international context, if visiting restrictions for dying patients had an impact on the quality of life of healthcare professionals. Method(s): From April 2020 to June 2021, an open online survey was conducted among healthcare professionals in 14 countries;Belgium, Czech Republic, Norway, Slovenia, the Netherlands, United Kingdom, Argentina, Brazil, Chile, Colombia, El Salvador, Uruguay, Indonesia and Japan. The survey consisted of validated and purposively designed measures of perceived quality of care (CODE) and staff QoL. Data were analysed descriptively and inferentially, with regression analysis conducted for all countries, and the results pooled and analysed in a multilevel analysis using Cochrane Review Manager. Result(s): Among 2925 respondents (mean age 42 years), 2385 (81.8%) were female, 1601 (54.9%) were nursing staff, and 1560 (53.3%) worked in hospitals. Approximately half of the patients reported on were men (n = 1470, 50.4%) and 1202 (41.4%) were COVID-19 positive. In all countries, the majority of respondents rated medical and nursing care for the patient as sufficient (n = 2468, 84.6%, and n = 2426, 83.2%, respectively). In 1559 cases (53.9%), visitors were allowed with limitations during the last 2 days of the patient's life, and in 468 cases (16.2%) no visits were allowed at all. Most respondents rated their QoL during the past week as 4 or higher out of 7. Mean QoL was lowest in Brazil (M 3.94, SD 1.34) and highest in Indonesia (M 5.80, SD 1.21). Regression analyses showed that no or limited visiting in the last days of life, was associated with lower QoL scores of healthcare professionals compared with those who reported that visiting was unrestricted (OR 0.63, 95%CI 0.48-0.83, p<0.001). Heterogeneity between countries was high. Conclusion(s): Our results suggest that visiting restrictions are associated with QoL of healthcare professionals. It may be that restrictions resulted in staff feeling unable to provide the desired level of care, and in turn affected their role perception and QoL.

Repatriación en Latinoamérica durante la pandemia: drama humanitario y derechos humanos

El artículo analiza las medidas gubernamentales implementadas por Chile y El Salvador durante la pandemia, para gestionar la repatriación de los connacionales y ciudadanos residentes que quedaron varados en el extranjero producto del cierre de fronteras, decisión impuesta por los gobiernos a nivel mundial como medida de contención de la crisis sanitaria generada por el covid-19 en sus territorios. La restricción al libre tránsito de las personas a través de las fronteras provocó en varios países de la región un drama humanitario adicional a los devastadores efectos de la crisis sanitaria global, por lo que el presente trabajo examina dicha problemática desde la cobertura otorgada por los medios de comunicación latinoamericanos a los procesos de repatriación de chilenos y salvadoreños como casos de estudio, mediante un análisis documental de tipo cualitativo de las noticias sobre las principales dificultades y consencuencias generadas por dicho drama humanitario. Una conclusión importante del estudio reconoce la relevancia de la capacidad administrativa, logística y comunicacional que deben desarrollar las misiones diplomáticas de los países latinoamericanos, así como la preeminencia de los derechos humanos en las relaciones internacionales para enfrentar más responsablemente la crisis migratoria ocasionada por el cierre de fronteras por razones sanitarias.Alternate : The article analyzes the government measures implemented by Chile and El Salvador during the pandemic, to manage the repatriation of nationals and resident citizens who were stranded abroad as a result of border closure, a decision imposed by governments worldwide as a containment measure of the health crisis generated by covid-19 in their territories. The restriction of the free movement of people across borders caused in several countries of the region a humanitarian drama in addition to the devastating effects of the global health crisis, so this work examines this problem from the coverage provided by the media from Latin American communication to the repatriation processes of Chileans and Salvadorans as case studies, through a qualitative documentary analysis of the news on the main difficulties and consequences generated by said humanitarian drama. An important conclusion of the study recognizes the relevance of the administrative, logistical and communicational capacity that the diplomatic missions of Latin American countries must develop, as well as the preeminence of human rights in international relations to more responsibly face the migratory crisis caused by the closure of borders for health reasons.

REACTIVATION OF EPSTEIN-BARR VIRUS AND CYTOMEGALOVIRUS INFECTION IN PATIENTS WITH COVID-19

SESSION TITLE: Studies on COVID-19 Infections Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/18/2022 01:30 pm - 02:30 pm PURPOSE: Latent Epstein-Barr virus (EBV) and cytomegalovirus (CMV) are commonly reactivated in critically ill patients with severe infections. This study aimed to evaluate the proportion of reactivation of EBV and CMV and its impact on length of stay, need for ventilation, and Ichikado CT scores in patients with coronavirus disease 2019 (COVID-19). METHODS: A retrospective study was conducted comprising adult patients admitted to our hospital with COVID-19 infection from June 2021 to September 2021. Patients were divided into groups: virus-free, EBV-only, CMV-only, and EBV and CMV detected. Primary outcomes were length of stay, need for ventilation, and Ichikado CT score. Descriptive statistics, one-way ANOVA, Games-Howell, and Kruskal-Wallis tests were used. RESULTS: 189 patients were included with a median age of 51 years [41 – 66], 80 (42.3%) were female and 109 (57.7%) were male. CD4(+) counts were lower in all viral reactivation groups. EBV-only (157 cell/µl [93 – 279.2] ), CMV-only (82.5 cell/µl [65.5 – 323.7] ), both viruses (62.5 cell/µl [47.5 – 135.5]) and virus-free (221 cell/µl [117 – 318]), (H(3) = 12.029, p = < 0.01). A significant increase in the Ichikado CT score was seen in the viral reactivation groups. EBV 186.5 [43.6], CMV 177.5 [41.6], both-viruses group 204 [50.3] vs. virus-free 161 [45.8],( H(3) = 15.770, p = < 0.01). There was an increase in days of hospitalization when comparing the virus-free and the viral reactivation groups. EBV (9 days [5.5-15.5]), CMV (17 days [3-33]), both viruses (23 days [8-31]) vs. virus-free (5 days [3.5-9]), (H(3) = 15.487, p = < 0.01). Regarding the need for assisted ventilation, there was no difference between groups. 7 (9.1%) patients in the virus-free group, 29 (29.9%) patients in the EBV group, 2 (33.3%) patients in the CMV group, and 2 (22.2%) patients in the both-viruses group needed mechanical ventilation (X2 (3, N=189) = 11.699, p= 0.08). Additionally, a statistically significant decrease in albumin levels on admission was found in the EBV-only patients compared to the virus-free group, (3.4 g/dL [0.44] vs 3.75 g/dL [0.46], F(3,185) = 5.483, p = < 0.01). CONCLUSIONS: Viral reactivation is associated with lower CD4(+) count, an increase in length of stay, and higher Ichikado CT scores. CLINICAL IMPLICATIONS: EVB and CMV reactivation is associated with low CD4(+) counts and longer hospital stay. DISCLOSURES: No relevant relationships by David Akinwale No relevant relationships by Angelica Almaguer No relevant relationships by Sushen Bhalla No relevant relationships by Ailine Canete Cruz No relevant relationships by Ndiya Emeaba Speaker/Speaker's relationship with johnson and johnson Please note: approx year 2000 Added 03/31/2022 by Joseph Gathe, value=Honoraria clinical research relationship with gilead Please note: since 1990 Added 03/31/2022 by Joseph Gathe, value=Grant/Research clinical research relationship with ansun Please note: 2020 Added 03/31/2022 by Joseph Gathe, value=Grant/Research Support clinical research relationship with regeneron Please note: 2020 Added 03/31/2022 by Joseph Gathe, value=Grant/Research Support No relevant relationships by Jesus Salvador Gonzalez Lopez No relevant relationships by Najia Hussaini No relevant relationships by Claudia Ramirez No relevant relationships by Salim Surani No relevant relationships by Daryelle Varon No relevant relationships by Joseph Varon No relevant relationships by Mohamed Ziad

LOW CD8+ COUNT CORRELATION WITH INFLAMMATORY MARKERS IN ACUTE COVID-19

SESSION TITLE: Biological Markers in Patients with COVID-19 Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/18/2022 01:30 pm - 02:30 pm PURPOSE: Severe COVID19 patients present with low CD8(+) T cell counts. A reduced number of T-cells seems to be correlated with high serum IL-6 and IL-10 levels, and a marked inflammatory state. This study aimed to assess if low CD8(+) counts were associated with inflammation markers, length of stay, and Ichikado CT scores in COVID-19 patients. METHODS: A retrospective study of adult patients admitted to our hospital with COVID-19 infection from June 2021 to September 2021. CD8(+) count was obtained, and patients were divided into less than 150 cells/μl and more than 150 cells/μl. Ferritin, c-reactive protein (CRP), erythrocyte sedimentation rate (ESR), troponin, Lactate dehydrogenase (LDH), and d-Dimer values were also recorded. Primary outcomes were hospital length of stay (LOS), Ichikado CT score, and correlation of CD8(+) count and inflammatory markers. Descriptive statistics, and Mann-Whitney-U methods were utilized. RESULTS: 264 patients were included, median age was 50 years [41-61]. 143 (54.2%) patients were male. There was a statistically significant difference when assessing hospital LOS in patients with CD8(+) counts <150 cells/μl vs > 150 cells/μl (9 days [5-16] vs 5 days [4-9], U=(134, 84)=3742, z=-4.174, p<0.01). The Ichikado CT score was significantly different between groups (190 [150-220] vs [130-190], U=(128,80)=3394, z=-4.094, p<0.01). IL-6 and IL-10 values were higher in those patients with CD8(+) less than 150 μl, when compared to higher CD8(+) counts. IL-10 value was (23.8pg/ml [13.6-43.3] vs (6.6pg/ml [9.4-29.2]), U=(131,78)=3711.5, z=-3.305, p<0.01), and for IL-6 (23.8pg/ml [7.6-88.3] vs (11.9 [4.1-32.1]), U=(125,75)=3473.5, z=-3.064, P<0.01). Ferritin was increased in patients with CD8(+) counts lower than 150 cells/μl compared to more than 150 cells/μl (845.3ng/ml [381.6-1600] vs 480ng/ml [232.6-988.7], U=(133,83)=3939.5, z=-3.550, p=<0.01). Similarly, CRP (83mg/L [46.3-136.7] vs 60.2 mg/L [33.25-100.72], U=(134-82)=4208, z=-2.885, p=<0.01), d-Dimer (1.76mg/L [0.53-7] vs 0.64 mg/L [0.35-1.72], U= (134,84)=3635.5, z=-4.396, p<0.01), and LDH (555IU/L [361-849.2] vs 375.5IU/L [273.2-531.2], U=(122,72)=2740,z=-4.373,p<0.01). Troponin and ESR were not significantly different, median troponin (0.022ng/ml [0.011-0.039] vs 0.012ng/ml [0.007-0.032], U=(111,70)=3218, z=-1.944,P=0.052) and median ESR (78mm/hr [57.2-105] vs 76.5 mm/hr [55-108.7], U=(134,84)=5603, z=-0.055,P=0.95). CONCLUSIONS: CD8(+) counts below 150 cells/μl are associated with increased inflammatory markers, a longer hospital stay, and higher Ichikado CT scores. CLINICAL IMPLICATIONS: CD8(+) count below 150 cells/μl is other indicator of disease severity in COVID-19 DISCLOSURES: No relevant relationships by David Akinwale No relevant relationships by Angelica Almaguer No relevant relationships by Sushen Bhalla No relevant relationships by Ailine Canete Cruz No relevant relationships by Ndiya Emeaba Speaker/Speaker's relationship with johnson and johnson Please note: approx year 2000 Added 03/31/2022 by Joseph Gathe, value=Honoraria clinical research relationship with gilead Please note: since 1990 Added 03/31/2022 by Joseph Gathe, value=Grant/Research clinical research relationship with ansun Please note: 2020 Added 03/31/2022 by Joseph Gathe, value=Grant/Research Support clinical research relationship with regeneron Please note: 2020 Added 03/31/2022 by Joseph Gathe, value=Grant/Research Support No relevant relationships by Jesus Salvador Gonzalez Lopez No relevant relationships by Najia Hussaini No relevant relationships by Claudia Ramirez No relevant relationships by Salim Surani No relevant relationships by Daryelle Varon No relevant relationships by Joseph Varon No relevant relationships by Mohamed Ziad

ELEVATED CREATINE PHOSPHOKINASE IN PATIENTS WITH COVID-19

SESSION TITLE: Biological Markers in Patients with COVID-19 Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/18/2022 01:30 pm - 02:30 pm PURPOSE: Common markers of inflammation in COVID-19 include erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and ferritin. We aimed to find an association between creatine Phosphokinase (CPK) and other inflammatory markers and enzymes, and their effect on length of hospital stay, and the Ichikado CT scores. METHODS: Retrospective study of the data of 264 adult patients admitted to our hospital between June and September 2021, with COVID-19. Patients were divided into groups with CPK of greater or less than 200mg/dL. Each was assessed for its association with CRP, ESR, ferritin, and lactate dehydrogenase (LDH), length of hospital stay, and Ichikado CT score. Descriptive statistics, Mann Whitney-U were used to address statistical significance. RESULTS: 264 patients were included, median age was 51.95 years [41-63]. 143(53.2%) were male. The median highest CRP value in patients with CPK of <200 mg/dL was (55 mg/L [24-96.4] vs 97.4 mg/L [50.1-139]) in those with CPK of >200 mg/dL, (U=(131,118) =5097, z=-4.638, p<0.01). The median highest ESR with CPK of <200 mg/dL was (72 mm/hr [51.0-102.5] vs 89 mm/hr [60-109]) in those with CPK of >200 mg/dL, (U= (133,119) =6862.5, z=-1.820, p=0.069). The median highest ferritin value in those with CPK of <200 mg/dL was (388.5 ng/mL [187.1-804.4] vs 1046 ng/mL [462.1-1600]) in those with CPK of >200 mg/dL, (U=(132,118) =4156.5, z=6.3985, p<0.01). The median highest phosphate level in patients with CPK of <200 mg/dL was (3.6 mg/dL [3.3-4.2] vs 3.8 mg/dL [3.4-5.2]) in those with CPK of >200 mg/dL,(U=(133,119) =6487.5, z=-2.471, p=0.013). The median highest LDH level in patients with CPK of <200 mg/dL was (352 IU/L [271.5-459] vs 673.5 IU/L[411.7-980.2]) in those with CPK of >200 mg/dL, (U=(113,106) = 2201, z =-8.084, p<0.01). The median highest Ichikado CT score in patients with CPK of <200 mg/dL was (150[130-190] vs 190[140-222.5]) in those with CPK of >200 mg/dL,(U= (142,209) =5188, z=-4.482, p<0.01). The length of hospital stay in patients with CPK of<200 mg/dL was (5 days [3-8] vs 9 days [5-17]) in those with CPK of >200 mg/dL, (U=(144,120) = 5533, z =-5.049, p<0.01). CONCLUSIONS: CPK has a statistically significant association with CRP and ferritin levels but not ESR. Imaging disease severity at presentation (Ichikado CT score) was associated with higher CPK levels. CLINICAL IMPLICATIONS: CPK is another marker of disease severity in COVID-19. DISCLOSURES: No relevant relationships by David Akinwale No relevant relationships by Angelica Almaguer No relevant relationships by Sushen Bhalla No relevant relationships by Ailine Canete Cruz No relevant relationships by Ndiya Emeaba Speaker/Speaker's relationship with johnson and johnson Please note: approx year 2000 Added 03/31/2022 by Joseph Gathe, value=Honoraria clinical research relationship with gilead Please note: since 1990 Added 03/31/2022 by Joseph Gathe, value=Grant/Research clinical research relationship with ansun Please note: 2020 Added 03/31/2022 by Joseph Gathe, value=Grant/Research Support clinical research relationship with regeneron Please note: 2020 Added 03/31/2022 by Joseph Gathe, value=Grant/Research Support No relevant relationships by Jesus Salvador Gonzalez Lopez No relevant relationships by Najia Hussaini No relevant relationships by Claudia Ramirez No relevant relationships by Salim Surani No relevant relationships by Joseph Varon No relevant relationships by Daryelle Varon No relevant relationships by Mohamed Ziad

LOW CD4+ COUNT CORRELATION WITH INFLAMMATORY MARKERS IN ACUTE COVID-19

SESSION TITLE: Biological Markers in Patients with COVID-19 Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/18/2022 01:30 pm - 02:30 pm PURPOSE: A significant reduction of CD4(+) cells and marked inflammatory activity in moderate and severe COVID-19 cases are seen, both associated with a poor prognosis. This study aimed to assess the association of low CD4(+) counts with inflammatory markers, length of stay, and ICKIKADO scores in COVID-19 patients. METHODS: A retrospective study of adult patients admitted to our hospital with COVID-19 infection from June 2021 to September 2021. CD4(+) count was obtained and patients were divided into two categories: less than 200 cells/μl and more than 200 cells/μl. Ferritin, c-reactive protein (CRP), erythrocyte sedimentation rate (ESR), troponin, Lactate dehydrogenase (LDH), and d-Dimer values were also recorded. Primary outcomes were hospital length of stay (LOS), Ichikado CT scores, and correlation of CD4(+) count and inflammatory markers. Descriptive statistics, and Mann-Whitney-U methods were used. RESULTS: 264 patients were included, median age was 50 years [41-61]. 143(54.2%) were male. There was a statistically significant difference in LOS for patients with CD4(+) counts <200 cells/μl vs > 200 cells/μl CD4(+) (9 days [5-18]vs 6 days [4-9]), U=(111,107)=4330, z=-3.466, p <0.01). The Ichikado CT score was significantly different between groups (190[150-220]vs 160[128.7-192.5], U=(106,102)=3706.5, z=-3.923, p<0.01). IL-10 values and IL-6 values were higher in those patients with CD4(+) less than 200 cells/μl, as compared to higher CD4(+) counts. median IL-10 was (25.2 pg/ml [17-72.45 ] vs 15.7 pg/ml [9.4-26.8 ], U=(109,100)=3463, z=-4.550, p<0.01), and median IL-6 was (23 pg/ml [10.5-99] vs 12 pg/ml [3.77-39], U=(104, 96)=3444.5, z=-3.785, p<0.01). Ferritin was increased in patients with CD4(+) counts lower than 200 cells/μl when compared to counts more than 200 cells/μl (850.2 ng/mL [373.3-1600] vs 541.5 ng/mL [245.1-1034.6], U=(110,106) =4543.5, z=-2.813, p=<0.01). CRP had a similar pattern (82 mg/L[49.5-138.2] vs 60.8 mg/L[30-114.2]), U=(111,105)=4478, z=-2.940, p=<0.01), d-Dimer (2.2 mg/L[0.55-7.14] vs 0.7mg/L[0.37-1.75], U=(111,107)=3992.5, z=-4.180, p<0.01), LDH (630 IU/L[371-888] vs 381 IU/L[276-520.2], U=(102,92)=2631.5,z=-5.227, p<0.01) and troponin (0.024 ng/mL[0.012-0.048] vs 0.012 ng/mL[0.007-0.027], U=(91,90)=2925, z=-3.321,P<0.01). The only inflammatory marker that was not statistically significant different was ESR (86 mm/hr[60-110] vs 72 mm/hr[50-100], U(111-107)=5113, z=-1.773,P=0.076). CONCLUSIONS: CD4(+) counts below 200 cells/μl are associated with increased inflammatory markers, a longer hospital stay, and higher Ichikado CT scores. CLINICAL IMPLICATIONS: CD4(+) count below 200 cells/μl is other indicator of disease severity in COVID-19 DISCLOSURES: No relevant relationships by David Akinwale No relevant relationships by Angelica Almaguer No relevant relationships by Sushen Bhalla No relevant relationships by Ailine Canete Cruz No relevant relationships by Ndiya Emeaba Speaker/Speaker's relationship with johnson and johnson Please note: approx year 2000 Added 03/31/2022 by Joseph Gathe, value=Honoraria clinical research relationship with gilead Please note: since 1990 Added 03/31/2022 by Joseph Gathe, value=Grant/Research clinical research relationship with ansun Please note: 2020 Added 03/31/2022 by Joseph Gathe, value=Grant/Research Support clinical research relationship with regeneron Please note: 2020 Added 03/31/2022 by Joseph Gathe, value=Grant/Research Support No relevant relationships by Jesus Salvador Gonzalez Lopez No relevant relationships by Najia Hussaini No relevant relationships by Claudia Ramirez No relevant relationships by Salim Surani No relevant relationships by Daryelle Varon No relevant relationships by Joseph Varon No relevant relationships by Mohamed Ziad

Root Causes of Migration, Development, and US Aid to Northern Triangle States

For decades, governments have sought to deter migration by investing in the development of migrant-sending communities, despite macroeconomic data that shows that development can increase emigration. However, emerging research suggests that well-designed aid can promote rootedness in home communities. The US Agency for International Development (USAID) has increasingly attempted to use development to deter migration from the Northern Triangle states of Central America. Is this policy sound?This paper argues that development should not be instrumentalized to discourage people from migrating. It examines migration and development policies from the lens of Catholic social teaching, which recognizes the need for states to respect the agency of individuals. This is particularly important when it comes to complex and consequential decisions like whether to migrate. The Catholic Church recognizes both a right to migrate, when necessary, and the responsibility of states, particularly wealthy nations, to help people realize the right not to migrate;that is, to thrive in their home communities. The paper argues for US government assistance to alleviate poverty and invest in human capital in Central America, but independently of efforts to deter migration. Prioritizing aid to potential migrants risks reducing its effectiveness. The United States should instead pursue a whole-of-government strategy that emphasizes the right relationships with aid recipients, and that prioritizes and empowers the poor and marginalized. The paper is strongly influenced by the author's 15 years of work for Catholic agencies on migration and development, more than one-half of those with Catholic Relief Services.

Advantages and challenges of e-learning in architecture: The case of Colombia and El Salvador

The recommendations of physical and social isolation established by the World Health Organization-WHO to face the COVID-19 pandemic implied the physical closure of establishments and institutions, including educational institutions. UNESCO reported a world crisis in education, in which 91% of students worldwide were deprived of their right to education. This article seeks to analyze the effects of migration to virtual education on architecture students in Colombia and El Salvador. The methodology used was a virtual survey administered to 293 students of the Universidad de la Costa (Colombia) and 142 students of the Universidad Centroamericana José Simeón Cañas (El Salvador). From the results, it is possible to affirm that, although the virtual modality has meant a great opportunity to transcend to new stages of university teaching, the economic limitations for most students in Latin America, particularly in the cases analyzed, as well as the digital gap that exists in certain areas, posed and continue to pose a profound challenge for the educational system in the context of the Covid-19 pandemic. © The author;licensee Universidad de la Costa - CUC

2020 American Community Survey: Use with Caution, An Analysis of the Undercount in the 2020 ACS Data Used to Derive Estimates of the Undocumented Population

This paper analyzes and provides estimates of the undercount of the foreign-born in the US Census Bureau’s 2020 American Community Survey (ACS). It confirms that a differential undercount occurred in the 2020 ACS. In particular, noncitizens that arrived from Central American countries after 1981 had undercount rates of 15–25 percent, but undercount of noncitizens that arrived from European countries in the same period was not detectable by the methods described in this paper. The Center for Migration Studies of New York (CMS) and others use ACS data to derive annual estimates of the US undocumented population. The Census Bureau recently reported that the total population count for the 2020 Census was consistent with the count for recent censuses, despite the Covid-19 pandemic and the Trump administration’s interference in the 2020 Census. Nonetheless, the accuracy of 2020 ACS data for the noncitizen population that arrived after 1981 remains a major concern given the fear generated by the Trump administration’s abusive rhetoric and anti-immigrant policies. The estimates set forth in this paper were derived by analyzing trends in annual ACS data for 2016–2020 compiled from the IPUMS website (Ruggles et al. 2021). Decennial census data cannot be used for this purpose because data on country of birth, citizenship, and year of immigration are not collected in the census. However, it is reasonable to believe that the 2020 census and the 2020 ACS experienced similar challenges because they were conducted under comparable conditions. The patterns of undercount of noncitizens described here for the 2020 ACS are likely mirrored in the 2020 census and will reduce federal funding and representation to affected cities and states for the next decade.

The present and future of rural youth in the SICA region in the COVID-19 scenario: analysis of gender, opinions, values, expectations, experiences and life projects

This study was carried out, between March and May 2021, in El Salvador, Guatemala and Honduras, to: (a) collect information and analyse the opinions, values, experiences and behaviours of rural youth in these three countries of the SICA region in relation to the COVID-19 pandemic and its impact at different levels: education, work, health, violence, gender relations, citizen/political participation and associativism, environment, climate change and natural disasters;(b) investigate, in particular, how this pandemic influences the expectations and future projects of young people at a personal, educational and work level;and (c) analyse the information gathered from a gender and intersectional analysis that allows identifying and systematizing the differences and inequalities between the genders in all the selected aspects. The study also inquired about the opinions and explanations of rural youth about different aspects of the COVID 19 pandemic, among others, ideas about its "origin", the consequences at the social and environmental levels, and prioritized means of obtaining information, with the purpose of highlighting the frameworks of meaning that are built on this stage.

Maintaining Quality of Palliative Care in a Global Pandemic: Experiences of Health Care Professionals From 14 Countries During the COVID-19 Pandemic (the CO-LIVE Study)

Background/aims: During the COVID-19 pandemic, measures imposed by governments and healthcare institutions to limit spreading of the disease may have negatively impacted the quality of care for dying patients. Our aim was to provide insight into similarities and differences between countries in the experiences of healthcare workers caring for patients in their last days of life during the COVID-19 pandemic. Methods: An open online survey study, consisting of purposively designed measures of perceived quality of care for dying patients, was conducted among healthcare workers from April 2020 to June 2021 in Belgium, Czech Republic, Norway, Slovenia, the Netherlands, United Kingdom, Argentina, Brazil, Chile, Colombia, El Salvador, Uruguay, Indonesia and Japan. Descriptive statistics were calculated. Results: A total of 3112 healthcare workers from 14 countries completed the questionnaire. The number of respondents per country ranged from 44 respondents in El Salvador, to 764 respondents in the Netherlands. The percentage of respondents who indicated that treatment and care for dying patients had been limited due to the pandemic ranged from 13% in Norway to 88% in Slovenia. Nevertheless, the majority of health care professionals considered the quality of medical care sufficient to meet the patient's needs, with percentages ranging from 73% in the Czech Republic to 99% in Colombia. Nursing care was also considered sufficient by the majority of health care professionals, with percentages ranging from 59% in Argentina to 96% in Chile. Conclusions: Preliminary results show important differences between countries in the impact of the COVID-19 pandemic and related measures on end-of-life care. Although in all countries the majority of healthcare workers reported sufficient quality of medical and nursing care, there were large differences in perceived limitations in treatment and care due to the pandemic.

More than a third of SACA countries (South and Central America) do not have coverage of insulin, supplies and lab exams

Background: The IDF Diabetes Atlas 2019 points out that SACA is the region with the highest percentage of health expenditures on diabetes, 19.4%. The total number of individuals with diabetes in the region is 31.6 million, which means a prevalence of 9.4%. Countries with the largest percentage of expenditures are Cuba (24.3%), Brazil (24.2%), and Costa Rica (21.3%), while the lowest estimates are for Argentina (5.0%) and Uruguay (6.1%). Aim: Identify if insulin, oral medicines, supplies (syringes, test strips, needles, etc.) and lab exams are fully provided (free of charge) in those countries and if there is an association between percentage of expenditures on diabetes and care provision. Method: A digital online survey with 12 multiple choice questions was shared by e-mail and WhatsApp with all IDF members organizations in the SACA region. It was open for answers between April 4th and May 5th, during the COVID-19 pandemic. The question of interest for this was specifically about access to medicines and lab exams. Mean diabetes-related expenditure (USD) per person with diabetes (20–79 years) was based on IDF Diabetes Atlas 2019 data. Wilcoxon signed-rank test was used to compare expenditures of countries providing free supplies with those without free medical supplies. Results: The questionnaire was answered by 16 of the 18 IDF SACA region countries. Colombia and El Salvador were the only countries with no response. Most of the countries reported free access to oral medicines (69%), insulins (63%), supplies (syringes, needles, test strips, etc. - 56%) and lab exams (63%). Honduras was the only country where free access started because of the COVID-19 pandemic. Associations between expenditures and provision of free oral medicines, insulins, medical supplies or exams were not statistically significant, i.e. free provision of any of the four items was not associated with higher expenditures. Discussion: Our study revealed that expenditure does not determine whether medicines, supplies and exams are provided for free or not. We hypothesize that countries spending less in providing these essential items for free are still spending similar amounts due to the high costs of treating diabetes chronic complications caused by lack of access to insulin, oral medicines, supplies and lab exams. At the same time that most of the SACA countries already count on full coverage of essential diabetes medicines and supplies, such as insulin, metformin, test strips, and exams, there are still 6 countries (Bolivia, Cuba, Dominican Republic, Ecuador, Peru and Puerto Rico) lacking coverage of 3 out of four or of all essential items. It is especially worrisome that 100 years after the discovery of insulin more than a third of the countries in SACA regions still do not count on full provision of this essential life-saving medicine.

Cervical Cancer Prevention in El Salvador: Gains to Date and Challenges for the Future.

Cervical cancer is preventable through vaccination, early detection, and the treatment of pre-cancerous lesions. However, global inequalities mean that the disease remains a leading cause of cancer death around the world, with over 80% of new cases and 90% of deaths occurring in low- and middle-income countries (LMICs). In El Salvador, joint efforts between the Ministry of Health (MoH) and the non-profit organization Basic Health International (BHI) have been in place since 2008, with the goal of reducing the country's disease burden. While the World Health Organization's (WHO) call to action to eliminate cervical cancer provided worldwide momentum to implement new public health initiatives, the COVID-19 pandemic disrupted ongoing programs and jeopardized plans for the future. The purpose of this manuscript is to describe the progress that El Salvador has achieved in improving cervical cancer prevention, the impact of the pandemic on current strategies, and potential solutions that can help the country meet the WHO's strategic targets by 2030 to accelerate the elimination of cervical cancer.

Beatificación de Rutilio Grande y otros tres siervos de Dios de El Salvador

El artículo discute la ceremonia de Beatificación de Rutilio Grande y otros tres siervos de Dios de El Salvador, con un enfoque en un decreto sobre el martirio durante la pandemia de Covid-19. El artículo también se centra en la promoción humana, la libertad de culto y las doctrinas políticas de la iglesia.