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Introduction: This study aims to assess the association of inflammatory markers with the clinical progression of patients diagnosed with COVID-19. Material(s) and Method(s): Critically ill patients with COVID-19 were included. Prealbumin, lactate dehydrogenase (LDH), transferrin, procalcitonin, ferritin, D-dimer, troponin T and C-reactive protein (CRP) were monitored. A comparison was performed between patients regarding their need for mechanical ventilation, duration of hospital and intensive care unit stay, discharge, mortality, complications, and response to treatment in order to reveal potential correlations. Result(s): A total of 107 patients were enrolled in the study. D-dimer levels on the 3rd and 6th days were significantly higher in the exitus group. Prealbumin and transferrin levels measured at baseline and on days three and six were significantly lower in the exitus group compared to the surviving group (p< 0.05). In the exitus group, the procalcitonin, CRP, LDH, troponin T, and ferritin levels were significantly higher on days zero, three, and six as compared to the surviving group (p< 0.05). Conclusion(s): Our results suggest that inflammatory markers may be useful as early indicators of mortality in COVID-19 patients.Copyright © 2023 Bilimsel Tip Yayinevi. All rights reserved.
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Background: According to data from the World Health Organization updated to September 30, 2022, SARS-CoV-2 is a viral disease, that infected six hundred million people and claimed six and a half million victims in all over the world. Some authors describe the alteration of blood parameters in pediatric age following COVID-19 such as: anomalies of the leukocyte formula, CK-MB and LDH enzymes, C reactive protein (PCR) and procalcitonin (PCT). Based on these studies we wanted to focus on two cardiac biomarkers: type B natriuretic peptide (BNP) and high sensitivity cardiac troponin (cTnT-hs). In order to suggest a strategy aimed at preventing the possible occurrence of cardiovascular complications in children we monitored them in patients with specific anti-SARS-CoV-2 immunoglobulins (IgG). Method(s): From November 2020 to December 2021, 53 children with positive IgG to SARS-CoV-2 by immunochromatographic method were tested for BNP and cTnT-hs. Samples collected in potassium EDTA tubes were tested for BNP by a fluorescence immunoassay. cTnT-hs was determined with an electrochemiluminescence sandwich test, which employs two specific monoclonal antibodies directed against cardiac troponin. The BNP cutoff is 100 pg/mL for patients aged 1 to 14 years, while that of cTnT-hs is 14 ng/L. All patients were monitored from hospitalization to discharge. Result(s): At least one of the two biomarkers resulted pathologic in 35 (66%) patients, while 18 (34%) were negative. The 35 pathologic cases were distributed as follows: 12 were simultaneously positive for cTnT-hs and BNP;13 were only positive for BNP, and 10 only positive for cTnT-hs. Sick children had a BNP mean value of 634 pg/mL at hospitalization, and of 94 pg/mL at discharge. For cTnT-hs, the initial mean value was 46 ng/l and the final was 17 ng/L. Twelve children with both altered values were monitored for a longer time, as they returned negative more slowly. Repeated dosages of the two analytes from hospitalization to discharge, showed a constant decrease over the time. After about ten days from the first dosage, both parameters returned to values near to the relative cutoffs. Conclusion(s): Measuring BNP and cTnt-hs can be useful for screening and monitoring pediatric patients positive for anti-SARSCoV-2 IgG.Copyright © 2022 EDIZIONI MINERVA MEDICA.
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Myocarditis can lead to myocardial infarction in the absence of coronary artery obstruction. We report a case of probable myocarditis, complicated by myocardial infarction with non-obstructive coronary arteries. A 19-year-old man presented with chest pain typical of myocarditis. He was a smoker but was otherwise well. Electrocardiogram revealed diffuse ST-elevation and echocardiography revealed a thin, akinetic apex. Troponin-T levels on admission were raised leading to an initial diagnosis of myocarditis being made. However, late gadolinium enhancement study on cardiac magnetic resonance imaging demonstrated transmural enhancement typical of ischaemia. Coronary angiogram was normal, leading to a likely diagnosis of myocardial infarction with non-obstructive coronary arteries. It is important to highlight that coronary assessment remains important when working up for myocarditis, as myocardial infarction with non-obstructive coronary arteries can often complicate myocarditis in cases of normal angiography. Another important lesson was on how cardiac magnetic resonance imaging provided vital evidence to support underlying ischaemia despite normal coronary angiogram, leading to a diagnosis of myocardial infarction with non-obstructive coronary arteries. Myocardial infarction with non-obstructive coronary arteries remains a broad 'umbrella' term and cardiac magnetic resonance imaging, as well as more invasive coronary imaging techniques during angiography, can further assist in its diagnosis. Our case provides a reminder that myocardial infarction with non-obstructive coronary arteries, although increasingly recognised, remains under-diagnosed and can often overlap with peri-myocarditis, highlighting the need to employ multi-modality imaging in guiding management.Copyright © The Author(s) 2021.
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PrepaTec Morelia students returned to face-To-face classes in January-May 2022 semester after just over a year in the online class format, because of confinement due to the COVID-19 pandemic, it was a priority to implement activities that promoted the integration, physical activity, and emotional health of the students. This is how, given the popularity generated among adolescents by the South Korean series "The Squid Game"where several traditional games are presented, the idea of implementing similar activities with traditional Mexican games to promote the integration and emotional well-being of the students rose. The games that were chosen were: Jumping Rope. Elastic Skipping, Freeze Tag, Red Light, Green Light, Hopscotch, Marbles, Yoyo, Spinning Top, Cup-And-Ball and Play Tig. The project was applied in the Tutoring and Wellbeing VI class with a total of 124 students between the ages of 17 and 19 who were in their last year of high school. With one week per week for a total of 8 sessions. A survey with the question: What emotions did you experience when playing and interacting with your classmates The results showed that 84.6% of the students experienced a feeling of happiness, followed by 72.6% who said they felt also energetic. In the satisfaction survey within the satisfaction survey with 5-point Likert scale where 5 is very satisfactory and 1, the result was 3.94 with a standard deviation of 1.03, which confirms the importance of generating activities not only focused on the academic area, because without a doubt one of the great lessons learned from the pandemic is that mental health care as part of the optimal personal development of the human being and learning for life. © 2022 Owner/Author.
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Ventricular tachycardia (VT) is a type of broad complex tachycardia originating from a focus in the ventricle. It is one of the four important rhythms which can lead to cardiac arrest. Accurate and timely diagnosis of true VT is the cornerstone for proper management in the emergency department (ED). We present an interesting case of an electrocardiographic artifact mimicking VT, which led to a diagnostic dilemma in the ED.Copyright © 2023 Rehman, Albaroudi, Akram, Ahmad, licensee HBKU Press.
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Electric drives have been used in several applications, such as electric vehicles, industry 4.0, and robotics. Thus, it is mandatory to promote updated electric drive courses that allow students to design novel solutions in these engineering areas. However, traditional undergraduate courses that only cover theoretical aspects and do not allow students to interact and produce practical results through experimentation are insufficient today. The students are not exposed to educational innovation, so they have difficulties proposing original solutions. On the other hand, conventional theoretical and laboratory courses in which students follow specific directions for achieving predefined goals do not allow students to create novel solutions and integrate the innovation process as a standard methodology. Moreover, beginning in 2020, the COVID-19 pandemic forced professors to implement digital tools and materials to continue education intensively. This proposed course presents an alternative to promote practical and theoretical knowledge in students. Besides, engineering students must create innovative solutions to increase the quality of life in rural and urban communities, which calls for novel experimental approaches. Electric drives are fundamental elements in electric systems and industrial processes proposed to save energy or control electric machines. In addition, industries urge specialized engineers who can tackle complex industrial problems. The proposed educational methodology can be implemented in manufacturing, agriculture, robotics, and aerospace. Hence, low-cost devices to validate the proposed solutions became used by students to achieve novel solutions using electric drives. This paper describes an undergraduate course called "Digital Control of Electric Machines" (electric drives) and its implementation of the Tec21 Educational Model of Tecnologico de Monterrey, V Model, MATLAB/ Simulink, low-cost hardware, and complex thinking. The content of the course begins with electric machine models and power electronics that allow students to move from the basic to the advanced industrial electric drive problems in a friendly manner. In addition, the V-model and Modelo Tec 21 are used as fundamental pillars of the leading innovative structure of the proposed course. The results showed that students mastered several soft and hard skills to accomplish complex design goals, including controlling an electric rapid prototype vehicle.
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Pandemics such us COVID-19 are significant outbreaks of infectious diseases, which can spread higher healthy threats, and seriously rise morbidity and mortality over wide populations and cause important economic, social, and political troubles. COVID-19 has triggered high risks among human beings. For that, the infected humans working in manufacturing and logistics systems can lead to complex issues beyond the industrial networks. Smart logistics (SL) systems remain a promising area to form a safe working environment. SL promotes the use of automated assets based on networked sensors which are controlled by suitable intelligent decision-making algorithms. Using SL technologies smooths the release of the whole production process disruption, due to COVID-19, by interconnecting the good and service flows to decrease the severity of the actual industrial chain disruption. Our study presents a novel smart logistics framework to strengthen the production process recovery and build an evaluation model to assess the impacts of SL technologies. We form an optimization model, which allows the planning of SL resources allocation according to the market demands and regarding the severity of the Covid-19 pandemic. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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The Ageing experience and increased longevity presents innovation opportunity for emergent technology, e.g., mobile and wearable. In turn, these technologies can enhance quality of life and independence as we age;however, they can also increase social inequalities and exclusion. The Covid-19 pandemic affected how we interact, communicate engage and interact with people and also technologies. People - across the generations were impacted and disrupted, motivating new behaviours in how they conducted everyday tasks and activities. Co-Design approaches have previously revealed successful collaborations between older adults, students, researchers, designers and other disciplines as a means to define unmet needs. Edinburgh Napier University provided funding to the PI (Principal Investigator) as a means to mobilise a 'Creative Cross-Education Team' (CCET) consisting of undergraduate students, research assistants (post-graduate researchers) and other staff colleagues of the University. The CCET worked with members from 'Tap into IT' (a local charity based in Edinburgh with a remit and focus on enhancing and enabling digital technology access for older adults). Two CoDesign workshops were conducted online titled 'Express' & 'Create.' The aim of these workshops was to explore, identify and define unmet needs/gaps expressed by older adult participants as a catalyst to create and generate future conceptual technology opportunities. The workshops were framed around Instrumental Activities of Daily Living (IADLs). The team were broken into groups whereby they were encouraged to collectively collaborate, Express and Create with the participants. This multi-generational and transdisciplinary approach created a democratized outlook where each contributor added value through expression, commentary and creativity. The findings have generated themes which are the basis for new opportunity through education and research with a focus on future technology opportunities. © Proceedings of the 24th International Conference on Engineering and Product Design Education: Disrupt, Innovate, Regenerate and Transform, E and PDE 2022. All rights reserved.
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Catatonia is an undertreated and underdiagnosed neuropsychiatric syndrome whose prognosis is benign if treated early, thus avoiding possible complications and compromising the health of patients. The latest epidemiological studies indicate a prevalence of catatonia of 9.2%, being frequent in medical pathologies (especially neurological ones), as well as in psychiatric pathologies. The use of validated scales is recommended for its diagnosis, to be able to measure the severity and response to treatment. Once catatonia has been identified, it is necessary to perform a protocolized diagnostic study of the underlying aetiology («Catatonia Workup»). Treatment of choice is benzodiazepines and electroconvulsive therapy. In recent years, new therapeutic alternatives such as non-invasive transcranial magnetic stimulation have emerged. In this review we propose several initiatives to promote the dissemination and knowledge of catatonia in the clinical setting. Resumen La catatonia es un síndrome neuropsiquiátrico infratratado e infradiagnósticado cuyo pronóstico es benigno si se trata de forma precoz, evitando así posibles complicaciones y el compromiso de la salud de los pacientes. Los últimos estudios epidemiológicos señalan una prevalencia de catatonia del 9,2%, siendo frecuente tanto en las enfermedades médicas (especialmente en las neurológicas), como en las psiquiátricas. Es recomendable el uso de escalas validadas para su diagnóstico y poder medir la gravedad y la respuesta al tratamiento. Una vez identificada la catatonia, es necesario realizar un estudio diagnóstico protocolizado de la etiología subyacente («Catatonia Workup»). El tratamiento de elección son las benzodiacepinas y la terapia electroconvulsiva. En los últimos años, han surgido nuevas alternativas terapéuticas no invasivas, tales como la estimulación magnética transcraneal. En esta revisión, proponemos varias iniciativas para fomentar la difusión y el conocimiento de la catatonia en el ámbito clínico.
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Our senses act as sensors that allow us to receive the information of the reality that we perceive, either in isolation or because of their crossing. During the block’s challenge called: Formal Representation of Space (FRS), the aim is for higher education students to enjoy an immersive and experimental experience in understanding space through sensory perceptions, taking the students through its material and virtual representation by drawing techniques, both analogue and virtual;putting into practice themes of geometry, perspective, technologies in art, models, and prototypes. The block is based in Challenged-based learning (CBL) and the challenge in Competency-based learning that “Tec-21” offers to the first year Creative Studies professional students. The group is formed from students of several areas such as Architecture, Industrial Design, Educative Innovation, Hispanic Letters, Journalism, Musical Production, Digital Art, Communication, which lead to conformed multidisciplinary teams. The project consists of designing a Sensorial Booth (SB), an installation that seeks to generate a space in which the perception of the environment can be highlighted through the senses in a playful and interactive way. The main objective is to involve the students in a real challenge while acquiring knowledge through a creative project, as well as interacting with a real space of a real institution, which is one of the main purposes of the CBL. Beyond the creative experience that led to the process of conceptualization and materialization 1:1 scale of the Sensorial Booth, prior to confinement by COVID-19, the students realized the importance of giving a comprehensive and memorable sensory experience to people without the need to be connected to a device, while immersing in the reflection of reconnecting with themselves and with the natural environment that surrounded this installation. Regarding to the learning experience, the students enjoyed the challenged offered by the Educational Innovation programme, Block Tec21, doing the most they enjoy, creating, using technology, working with real materials, and collaborating with real former partners. © PDE 2021.
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Introduction: The coronavirus disease 2019 (COVID-19) pandemic has necessitated the use of new technologies and new processes to care for hospitalized patients, including diabetes patients. This was the basis for the "GER-e-TEC COVID study," an experiment involving the use of the smart MyPredi TM e-platform to automatically detect the exacerbation of glycemic disorder risk in COVID-19 older diabetic patients. Methods: The MyPredi TM platform is connected to a medical analysis system that receives physiological data from medical sensors in real time and analyzes this data to generate (when necessary) alerts. An experiment was conducted between December 14th, 2020 and February 25th, 2021 to test this alert system. During this time, the platform was used on COVID-19 patients being monitored in an internal medicine COVID-19 unit at the University Hospital of Strasbourg. The alerts were compiled and analyzed in terms of sensitivity, specificity, positive and negative predictive values with respect to clinical data. Results: 10 older diabetic COVID-19 patients in total were monitored remotely, six of whom were male. The mean age of the patients was 84.1 years. The patients used the telemedicine solution for an average of 14.5 days. 142 alerts were emitted for the glycemic disorder risk indicating hyperglycemia, with an average of 20.3 alerts per patient and a standard deviation of 26.6. In our study, we did not note any hypoglycemia, so the system emitted any alerts. For the sensitivity of alerts emitted, the results were extremely satisfactory, and also in terms of positive and negative predictive values. In terms of survival analysis, the number of alerts and gender played no role in the length of the hospital stay, regardless of the reason for the hospitalization (COVID-19 management). Conclusion: This work is a pilot study with preliminary results. To date, relatively few projects and trials in diabetic patients have been run within the "telemedicine 2.0" setting, particularly using AI, ICT and the Web 2.0 in the era of COVID-19 disease.
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Bruton tyrosine kinase (Btk) is expressed in B-lymphocytes, myeloid cells and platelets, and Btk-inhibitors (BTKi) are used to treat patients with B-cell malignancies, developed against autoimmune diseases, have been proposed as novel antithrombotic drugs, and been tested in patients with severe COVID-19. However, mild bleeding is frequent in patients with B-cell malignancies treated with the irreversible BTKi ibrutinib and the recently approved 2nd generation BTKi acalabrutinib, zanubrutinib and tirabrutinib, and also in volunteers receiving in a phase-1 study the novel irreversible BTKi BI-705564. In contrast, no bleeding has been reported in clinical trials of other BTKi. These include the brain-penetrant irreversible tolebrutinib and evobrutinib (against multiple sclerosis), the irreversible branebrutinib, the reversible BMS-986142 and fenebrutinib (targeting rheumatoid arthritis and lupus erythematodes), and the reversible covalent rilzabrutinib (against pemphigus and immune thrombocytopenia). Remibrutinib, a novel highly selective covalent BTKi, is currently in clinical studies of autoimmune dermatological disorders. This review describes twelve BTKi approved or in clinical trials. By focusing on their pharmacological properties, targeted disease, bleeding side effects and actions on platelets it attempts to clarify the mechanisms underlying bleeding. Specific platelet function tests in blood might help to estimate the probability of bleeding of newly developed BTKi.
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INTRODUCTION: We tested the MyPredi™ e-platform which is dedicated to the automated, intelligent detection of situations posing a risk of decompensation in geriatric patients. OBJECTIVE: The goal was to validate the technological choices, to consolidate the system and to test the robustness of the MyPredi™ e-platform through daily use. RESULTS: The telemedicine solution took 3,552 measurements for a hospitalized patient during her stay, with an average of 237 measurements per day, and issued 32 alerts, with an average of 2 alerts per day. The main risk was heart failure which generated the most alerts (n=13). The platform had 100% sensitivity for all geriatric risks, and had very satisfactory positive and negative predictive values. CONCLUSION: The present experiment validates the technological choices, the tools and the solutions developed. LEARNING POINTS: Patients with chronic conditions can be monitored with telemedicine systems to optimise their management, particularly during the COVID-19 pandemic.The goal was to validate the technological choices, to consolidate the system and to test the robustness of the MyPredi™ e-platform, through daily use in an elderly patient.The present experiment demonstrates the relevance of the technological choices, the tools and the solutions developed.