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1.
Canadian Journal of Latin American & Caribbean Studies ; JOUR(3):415-435, 47.
Article in Portuguese | ProQuest Central | ID: covidwho-2106906

ABSTRACT

RESUMENDurante el período de pandemia (COVID-19), oficialmente reconocido en marzo 2020, hubo un aumento de casos de violencia de género en países como Chile y Argentina. Sólo unos meses antes, en noviembre 2019, el colectivo chileno LASTESIS había salido al espacio público precisamente para denunciar la violencia en contra de las mujeres, ello con su “Un violador en tu camino”. Como acto artístico-político, la performance permitió elucidar y divulgar tanto a nivel local como internacional la teorización feminista de carácter decolonial, estableciendo un diálogo directo, por ejemplo, con la obra de Rita Segato. Mediante un proceso de retroalimentación, la propuesta se ha transformado en un himno de empoderamiento de carácter social e inclusivo. Inscripto en una perspectiva feminista-decolonial, este artículo contextualiza la performance y examina las réplicas del Movimiento de Sordes Feministas Argentina (MOSFA), de la Colectiva NiUnaMenos Tilcara-Maimara de Jujuy (Argentina) y de la diáspora latinoamericana en Auckland (Nueva Zelanda). Se sostiene que, al irse corporeizando como un nuevo espacio de resistencia feminista, decolonial y contestario de la violencia de género, la performance denuncia el feminicidio a nivel local e internacional, visualizando y problematizando el femigenocio.

2.
Bulletin of Latin American Research ; JOUR(3):341-343, 41.
Article in English | ProQuest Central | ID: covidwho-2088144

ABSTRACT

As Latin America emerges scathed from the COVID-19 pandemic, the political pendulum appears to turn once again towards its longstanding calls for greater social inclusion. Inequality, inflation and continuous resource extraction without sufficient inclusiveness – in the forms of mining, expanding export-oriented agriculture or, increasingly, exclusionary approaches to sustainable development through renewable energy projects or the bioeconomy – have all driven social discontent. The region saw remarkable socio-economic progress during the 2000s, but those achievements largely relied on extensive natural resource exploitation in a development strategy sometimes dubbed neo-extractivism. Unequal access to decision-making and skewed distribution of benefits and burdens then fostered significant discontent as well as counter-reactions in many Latin American countries. The end of the so-called pink tide of more progressive governments and the emergence of right-wing populism have only made things tenser in the past years. It might be too early to speak of a new tide of socio-economic progress for the region, but rising commodity prices and the election of various left-leaning presidents since 2020 do give out signals reminiscent of the start of the century. However, it remains to be seen what this new political and economic cycle of Latin America entails for the environment, inclusiveness, and human rights.

3.
Bulletin of Latin American Research ; JOUR(1):3-5, 41.
Article in English | ProQuest Central | ID: covidwho-2088143

ABSTRACT

As Latin America emerges scathed from the COVID-19 pandemic, the political pendulum appears to turn once again towards its longstanding calls for greater social inclusion. Inequality, inflation and continuous resource extraction without sufficient inclusiveness – in the forms of mining, expanding export-oriented agriculture or, increasingly, exclusionary approaches to sustainable development through renewable energy projects or the bioeconomy – have all driven social discontent. The region saw remarkable socio-economic progress during the 2000s, but those achievements largely relied on extensive natural resource exploitation in a development strategy sometimes dubbed neo-extractivism. Unequal access to decision-making and skewed distribution of benefits and burdens then fostered significant discontent as well as counter-reactions in many Latin American countries. The end of the so-called pink tide of more progressive governments and the emergence of right-wing populism have only made things tenser in the past years. It might be too early to speak of a new tide of socio-economic progress for the region, but rising commodity prices and the election of various left-leaning presidents since 2020 do give out signals reminiscent of the start of the century. However, it remains to be seen what this new political and economic cycle of Latin America entails for the environment, inclusiveness, and human rights.

4.
Bulletin of Latin American Research ; JOUR(4):505-507, 41.
Article in English | ProQuest Central | ID: covidwho-2088142

ABSTRACT

The focus of this Special Section stems from research presented in the 2019 PILAS Conference held at the University of York. The conference theme ‘Communities of Knowledge, Communities of Action’ sought to bridge the gap between scholarly research and Latin American activism. The collegial exchange of ideas between a new generation of engaged and innovative researchers at the conference represented a critical alternative to the traditional isolation of academia – a reality that has since been exacerbated and magnified by the impact of the Coronavirus pandemic. This Special Section of the Bulletin of Latin American Research seeks to offer a platform that will advance these new epistemologies and propel the voices of a new generation of engaged scholars.

5.
Emerg Infect Dis ; 28(11): 1-8, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2089722

ABSTRACT

During 2020-2021, countries in Latin America and the Caribbean reported clinical emergence of carbapenemase-producing Enterobacterales that had not been previously characterized locally, increased prevalence of carbapenemases that had previously been detected, and co-production of multiple carbapenemases in some isolates. These increases were likely fueled by changes related to the COVID-19 pandemic, including empirical antibiotic use for potential COVID-19-related bacterial infections and healthcare limitations resulting from the rapid rise in COVID-19 cases. Strengthening antimicrobial resistance surveillance, epidemiologic research, and infection prevention and control programs and antimicrobial stewardship in clinical settings can help prevent emergence and transmission of carbapenemase-producing Enterobacterales.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Pandemics , Latin America/epidemiology , beta-Lactamases/genetics , Bacterial Proteins/genetics , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Bacteria
6.
The Americas ; JOUR(4):712-714, 79.
Article in English | ProQuest Central | ID: covidwho-2087104

ABSTRACT

The authors take a holistic approach to the estallido artístico, covering wall art but also music, performance, and other means of creative expression. [...]they make a great case for the profound and organic relationship between art and activism that exists in Chile. [...]Gordon-Zolov and Zolov also tell us that the Piñera government took advantage of the COVID-19 lockdowns of 2020 to cover up much of this artwork. [...]the book does the important work of documenting and archiving an arts and social movement with its 146 full-color illustrations. [...]Gordon-Zolov and Zolov themselves recognize this limitation early on in their book. [...]I have little doubt that the disruption to public transportation caused by el estallido made poblaciones less accessible to them.

7.
New Microbes New Infect ; 49: 101041, 2022.
Article in English | MEDLINE | ID: covidwho-2086595

ABSTRACT

Introduction: Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has spread globally, becoming a long-lasting pandemic. Dengue is the most common arboviral disease in tropical and subtropical regions worldwide. COVID-19 and dengue coinfections have been reported, associated with worse outcomes with significant morbidity and mortality. Therefore, this study aims to determine the epidemiological situation of COVID-19 and dengue coinfection in Latin America. Methods: A systematic literature review was performed using PubMed, Scopus, Embase, Web of Science, LILACS, and BVS databases from January 1, 2020, to September 4, 2021. The key search terms used were "dengue" and "COVID-19". Results: Nineteen published articles were included. The studies were case reports with a detailed description of the coinfection's clinical, laboratory, diagnostic, and treatment features. Conclusion: Coinfection with SARS-CoV-2 and dengue virus is associated with worse outcomes with significant morbidity and mortality. The similar clinical and laboratory features of each infection are a challenge in accurately diagnosing and treating cases. Establishing an early diagnosis could be the answer to reducing the estimated significant burden of these conditions.

8.
Inform Med Unlocked ; 34: 101102, 2022.
Article in English | MEDLINE | ID: covidwho-2086316

ABSTRACT

Electronic health records (EHRs) have proven their effectiveness during the coronavirus disease (COVID-19) pandemic. However, successful implementation of EHRs requires assessing nurses' attitudes as they are considered the first line in providing direct care for patients. This study assessed Jordanian nurses' attitudes and examined factors that affect nurses' attitudes toward using EHRs. A cross-sectional, correlational design was used. A convenient sample of 130 nurses was recruited from three major public hospitals in Jordan. All Participants completed the Nurses' attitudes Towards Computerization (NATC) Questionnaire. The overall nurses' attitude was positive; the mean was 61.85 (SD = 10.97). Findings revealed no significant relationship between nurses' attitudes toward using EHRs and nurses' age, gender, education level, previous computer skills experience, years of work experience, and years of dealing with EHRs. However, the work unit was found to have a significant correlation with nurses' attitudes toward using EHRs. Therefore, nurse administrators should arrange for the conduct of educational workshops and continuous training programs considering the needs of the nurses.

9.
Apuntes-Revista De Ciencias Sociales ; JOUR(92):151-182, 49.
Article in Spanish | Web of Science | ID: covidwho-2082365

ABSTRACT

One of the main challenges that the COVID-19 pandemic brought was the continuity of education. In this context, this work focuses on analyzing the practice of higher education in the discipline of Engineering and its related academic programs with a future perspective, motivated by the limitations and challenges imposed by the pandemic. To ensure high-quality education, it was relevant to give continuity to the education of students, maintaining active, experiential, student-centered learning experiences that are relevant to developing their skills, despite their remote interaction and frequent technological deficiencies. and educational resources. Thus, this work proposes a conceptual scheme to guide the design and reflection of learning experiences with a post-pandemic perspective. This scheme is composed of six dimensions of innovation and educational leadership for higher education: environment, impact and linkage, educational models and value chain, educational strategies, teaching formats, infrastructure and learning resources, accreditations and learning evaluation. Additionally, this document presents initiatives that exemplify this effort within the MIT Supply Chain And Logistics Excellence network for Latin America and the Caribbean (MIT SCALE LAC), led by the Center for Transportation and Logistics from the Massachusetts Institute of Technology. These initiatives refer to learning experiences in universities in Bolivia, Mexico, and Peru that have sought to maintain active learning in the context of the pandemic, with a link to the contemporary challenges of organizations, communities, and the society in general in which they live. students immersed.

10.
J Infect ; 2022 Oct 20.
Article in English | MEDLINE | ID: covidwho-2082953

ABSTRACT

This review summarizes the recent Global Meningococcal Initiative (GMI) regional meeting, which explored meningococcal disease in North America. Invasive meningococcal disease (IMD) cases are documented through both passive and active surveillance networks. IMD appears to be decreasing in many areas, such as the Dominican Republic (2016: 18 cases; 2021: 2 cases) and Panama (2008: 1 case/100,000; 2021: <0.1 cases/100,000); however, there is notable regional and temporal variation. Outbreaks persist in at-risk subpopulations, such as people experiencing homelessness in the US and migrants in Mexico. The recent emergence of ß-lactamase-positive and ciprofloxacin-resistant meningococci in the US is a major concern. While vaccination practices vary across North America, vaccine uptake remains relatively high. Monovalent and multivalent conjugate vaccines (which many countries in North America primarily use) can provide herd protection. However, there is no evidence that group B vaccines reduce meningococcal carriage. The coronavirus pandemic illustrates that following public health crises, enhanced surveillance of disease epidemiology and catch-up vaccine schedules is key. Whole genome sequencing is a key epidemiological tool for identifying IMD strain emergence and the evaluation of vaccine strain coverage. The Global Roadmap on Defeating Meningitis by 2030 remains a focus of the GMI.

11.
Vaccine ; 40(49): 7158-7166, 2022 Nov 22.
Article in English | MEDLINE | ID: covidwho-2082722

ABSTRACT

COVID-19 vaccine hesitancy is currently-one of the main obstacles to worldwide herd immunity and socioeconomic recovery. Because vaccine coverage can vary between and within countries, it is important to identify sources of variation so that policies can be tailored to different population groups. In this paper, we analyze the results from a survey designed and implemented in order to identify early adopters and laggers in six big cities located in Argentina, Colombia, Chile, Ecuador, Peru, and Dominican Republic. We find that trust in government and science, accurate knowledge about the value of vaccination and vaccine effects, and perceived risk of getting sick is associated with a higher probability to get vaccinated. We also identify potential laggers such as women and populations with high education but low knowledge about vaccines. We discuss specific strategies to promote vaccination among these populations groups as well as more general strategies designed to gain trust. These findings are specific to the context of Latin America insofar as the underlying factors associated with the choice to be vaccinated vary significantly by location and in relation to individual-level factors.

12.
SSRN;
Preprint in English | SSRN | ID: ppcovidwho-346138

ABSTRACT

This study shows that the trend of declining gender gaps in labor market indicators in Latin America in previous decades did not change significantly in most countries during the COVID-19 pandemic. However, a closer look at the dynamics during the 2019–2021 period shows that (i) women were harder hit in terms of employment losses during the 2020 economic shock;(ii) despite the labor market recovery, women in 2021 often remained less likely to work than they did in 2019;nevertheless, (iii) in a subset of countries the gender gap in employment rates widened. However, relative to the value of their 2019 wages, the accumulated income losses were considerably greater for women than for men in most cases. This can create scarring effects for the future through greater vulnerability, lower incomes, and reduced probabilities of job insertion. The groups of women hit hardest by the shock were those with less than a tertiary education, those in the 14-24 year-old age group, those living in urban areas, and those working in the tertiary sector.

13.
Front Med (Lausanne) ; 9: 877764, 2022.
Article in English | MEDLINE | ID: covidwho-2080166

ABSTRACT

Background: The Latin American and Caribbean (LAC) region has been one of the regions most affected by the COVID-19 pandemic, with countries presenting some of the highest numbers of cases and deaths from this disease in the world. Despite this, vaccination intention is not homogeneous in the region, and no study has evaluated the influence of the mass media on vaccination intention. The objective of this study was to evaluate the association between the use of mass media to learn about COVID-19 and the non-intention of vaccination against COVID-19 in LAC countries. Methods: An analysis of secondary data from a Massachusetts Institute of Technology (MIT) survey was conducted in collaboration with Facebook on people's beliefs, behaviors, and norms regarding COVID-19. Crude and adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95%CI) were calculated to evaluate the association between the use of mass media and non-vaccination intention using generalized linear models of the Poisson family with logarithmic link. Results: A total of 350,322 Facebook users over the age of 18 from LAC countries were included. 50.0% were men, 28.4% were between 18 and 30 years old, 41.4% had a high school education level, 86.1% lived in the city and 34.4% reported good health condition. The prevalence of using the mass media to learn about COVID-19 was mostly through mixed media (65.8%). The non-intention of vaccination was 10.8%. A higher prevalence of not intending to be vaccinated against COVID-19 was found in those who used traditional media (aPR = 1.36; 95%CI: 1.29-1.44; p < 0.001) and digital media (aPR = 1.70; 95%CI: 1.24-2.33; p = 0.003) compared to those using mixed media. Conclusion: We found an association between the type of mass media used to learn about COVID-19 and the non-intention of vaccination. The use of only traditional or digital information sources were associated with a higher probability of non-intention to vaccinate compared to the use of both sources.

14.
Journal of Scientometric Research ; 11(2):171-182, 2022.
Article in English | Web of Science | ID: covidwho-2072096

ABSTRACT

This study aims to present exploratory and descriptive research about Latin America's online information search and Twitter activity and the repercussions of chloroquine, hydroxychloroquine, and ivermectin, which were at the time considered promising alternatives to prevent or treat COVID-19. From the perspective of Webmetrics and Altmetrics -data were collected and analysed from Twitter around indexed outputs by titles with one of these three drugs and from Google Trends (Relative Search Interest) in Latin American countries. The results demonstrated that there might be parallels between Google Search and Twitter activity. The results also showed that ivermectin was, among the three selected drugs, the most searched in Google Search and higher activity on Latin America's Twitter accounts.

15.
Heart, Vessels and Transplantation ; 6(3), 2022.
Article in English | EMBASE | ID: covidwho-2067558

ABSTRACT

The SARS-CoV2 virus has infected over 545 million people and has claimed over 6 million lives globally by the end of June 2022. The global case fatality rate ranged from 5.5% in Mexico, 2.1-2.5% in South Africa, Brazil, Guatemala, Russia, 1.1-1.5% in the United States, Canada, India and Chile, 0.5-0.9% in Western European countries, 0.3% in Japan, 0.2% in Taiwan to 0.1% in Australia. Among hospitalized COVID-19 patients, the prevalence of pre-existing cardiovascular diseases was approximately 10%. The prevalence of cardiovascular diseases among COVID-19 non-survivors and COVID-19 patients requiring intensive care unit admission were approximately 20-30%. In a multicenter study of 8910 COVID-19 patients from 169 hospitals in Asia, Europe and North America, presence of pre-existing coronary artery disease, chronic heart failure and cardiac arrhythmia was associated with increased mortality of 10.2%, 15.3% and 11.5% respectively, compared with 5-6% mortality in those without the above co-morbidities. The systemic inflammation caused by SARS-CoV-2 could lead to a wide spectrum of cardiovascular complications including acute cardiac injury, acute coronary syndrome, coronary artery dissection, acute myocarditis, cardiomyopathy, chronic heart failure, cardiac arrhythmia, pulmonary embolism, cardiogenic shock, circulatory failure or even cardiac arrest. Copyright © 2022 Heart, Vessels and Transplantation. All right reserved.

16.
Int J Environ Res Public Health ; 19(19)2022 Oct 01.
Article in English | MEDLINE | ID: covidwho-2066010

ABSTRACT

In Latin American cities, the built environment is facing crucial challenges in the 21st century, not only in terms of the redesign of the physical environment, but also how to remodel public spaces as healthier places for walking and social interaction. The objective of this article is to evaluate the effects of the built environment on walking perceptions in a central neighbourhood in the intermediate city of Valdivia, Chile. The methodology integrates quantitative and qualitative methods to explore which elements of the physical built environment ease and hinder walkability. Depthmap software and Simpson's Diversity Index are used to evaluate connectivity and diversity of land uses at street level. Additionally, the People Following method and 26 walking interviews are conducted using the Natural Go-Along technique to analyse pedestrians' perceptions about their mobility environment. The results show that the factors that promote walkability mainly include streets with high connectivity values, wide pavements, diversity of greening, and facade characteristics of buildings with architectural heritage causing tranquillity, longing, and happiness. On the contrary, factors that inhibit walkability are related to poor-quality and narrow sidewalks, cars parked on sidewalks, dirty streets, and motorized traffic and vehicular noise causing negative emotions in walking perceptions such as tiredness, anger, disgust, discomfort, and insecurity, with negative effects on the well-being of residents that vary according to age and gender. Finally, recommendations are oriented to improve public spaces in central areas in southern Chile, to address moving towards more liveable and inclusive environments and support well-being through urban design in these types of context.


Subject(s)
Environment Design , Walking , Built Environment , Chile , Humans , Residence Characteristics , Walking/psychology
18.
American Journal of Transplantation ; 22(Supplement 3):646-647, 2022.
Article in English | EMBASE | ID: covidwho-2063459

ABSTRACT

Purpose: To understand the outcomes and changes in disease severity of COVID-19 in Solid Organ Transplant (SOT) recipients over time in the context of therapeutic advances. Method(s): We performed a multicenter, prospective cohort study of all SOT recipients diagnosed with COVID-19, across 9 transplant programs in Canada, from March 2020-November 2021. Baseline characteristics, demographics, treatment and disease severity outcomes were collected. The primary outcome was need for supplemental oxygen. Factors associated with the primary outcome and changes in outcomes over time were analyzed. Pandemic time periods were divided into four time frames coinciding with 4 waves in North America. Result(s): We enrolled 509 SOT recipients with confirmed COVID-19 during the study period. The risk factors associated with oxygen requirement are outlined in Table 1. Severe disease and mortality were greatest in lung transplant recipients compared to other organ types (15/48 (31.3%) lung deaths vs 63/461(13.7%) nonlung organs, (p=0.001). There was no influence of 2-dose vaccination and 3 patients were infected after 3-dose vaccine. Disease with alpha or delta variant was not associated with increased oxygen requirement. In a subgroup analysis of participants requiring oxygen (n=190), remdesivir was associated with less death (p=0.035). Over the pandemic period (Figure 1), there were no significant changes in the proportion of patients requiring oxygen, ICU admission, ventilatory support or death. (Table Presented) Conclusion(s): COVID-19 is especially severe in lung transplant recipients and immunosuppression plays a significant role. The outcomes associated with COVID-19 in SOT have not appreciably changed over time despite the emergence of novel variants and changes in therapeutic regimens.

19.
American Journal of Transplantation ; 22(Supplement 3):404-405, 2022.
Article in English | EMBASE | ID: covidwho-2063344

ABSTRACT

Purpose: Transplantation has been disrupted dramatically by COVID-19 due to reallocation of healthcare resources and concerns from early reports of increased mortality rates (20-30%) in solid organ transplant recipients. Across the transplant population, up to 90% of patients are several years post-transplant and managed by primary care practitioners. Hence, it is important to understand if transplantation truly conveys additional risk and to differentiate predictors of outcomes associated with COVID-19 disease. Method(s): The international COVID-19 transplant registry, www.c19txr.org, centralized global tracking of outcomes for transplant patients. COVID-19 cases were defined by positive PCR nasal swab. Seventeen countries and 57 centers participated (Jan 1-Dec 20, 2020). Data analysis was performed at two timepoints, differentiating global lockdowns. Result(s): There were 1619 kidney, 157 heart, 50 lung, 127 liver and 49 multi-visceral patients with COVID-19. Patient demographics are shown in Table 1. Of all cases, 8.7% required hospitalization, 3.9% required ventilation, and 2.2% of grafts failed (kidney only). Overall mortality was 7.1% at a median of 17.2 days after diagnosis. The risk of mortality in year 1 post-transplant was 34.3% (n=49) and 14.7% (n=21) within 90 days of T-cell depleting induction therapy. The need for dialysis led to 11% increase in mortality. A significant decrease in mortality rates was observed from 6.2% to 2.6% in patients with COVID-19 before and after July 2020 respectively;however, this differed by geographical location. Patients were asymptomatic in 19.7% of cases and 78.6% developed IgG and/or IgM antibodies (Table 2). Conclusion(s): Global registry data suggests overall risk of COVID-19, antibody response to infection and the associated mortality post-transplant mirror the general population. However, findings show higher risk of mortality within 90 days of T-cell depleting agents and within year 1 post-transplant, supporting modulation of immunosuppression during acute infection for these high-risk individuals. Racial data has shown disadvantaged groups experience higher mortality. The mortality data described here is consistent with geographical census statistics, with North and South America having a larger African population than Europe or Asia. (Table Presented).

20.
Cardiology in the Young ; 32(Supplement 2):S56-S57, 2022.
Article in English | EMBASE | ID: covidwho-2062107

ABSTRACT

Background and Aim: The considerable overlap in case definition and clinical features between patients with COVID-19 associated Multisystem Inflammatory Syndrome in Children (MIS-C) and Kawasaki disease (KD) suggests shared pathogenesis. We sought to compare demographic, clinical presentation, management and outcomes of patients by COVID-19 status. Method(s): The International KD Registry (IKDR) began enrolling patients with clinical features of either acute MIS-C or KD or fever with hyperinflammation beginning in January 2020. The IKDR is unique regarding broad patient selection and includes sites from North, Central and South America, Europe, Asia and the Middle East. Patient groups stratified by COVID-19 status were compared. Result(s): As of October 6, 2021, 1330 patients were registered from 31 sites. COVID status was POSITIVE for 59% (confirmed household COVID-19 contact and/or positive SARS-CoV-2 PCR or serology), POSSIBLE for 4% (suggestive clinical features but some negative tests or absent exposure), NEGATIVE for 23%, and UNKNOWN (no known exposure and testing not com-pleted) for 14% (TABLE). Most of the UNKNOWN patients were from early in the COVID-19 pandemic before MIS-C was defined and before COVID-19 serologic testing was widely used. POSITIVE and POSSIBLE patients were older, had fewer KD clinical criteria, greater gastrointestinal symptoms, were more likely to present with shock and require ICU admission and inotropic support. POSSIBLE patients had greater days from symptom onset to first immune modulation treatment, with no differences between groups regarding days from admission to first treatment. Most patients in each group received intravenous immune globu-lin, with POSITIVE and POSSIBLE patients more likely to have received steroids and anakinra. NEGATIVE and UNKNOWN patients had higher maximal coronary artery Z scores, with a trend to having higher categories of aneurysm involvement. Conclusion(s): While there was considerable overlap in presentation, management and outcomes between COVID-19 POSITIVE/POSSIBLE (presumed MIS-C) and COVID NEGATIVE/UNKNOWN patients (presumed KD), COVID-19 POSITIVE/POSSIBLE patients had more severe presentations and required more intensive management, although coronary artery outcomes trended to be less severe. Patient recruitment con-tinues, and in-depth comparison of laboratory features and appli-cation of machine learning approaches to patient differentiation and prediction of optimal management pathways are forthcoming.

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