Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 135.288
Filter
1.
Paidéia (Ribeirão Preto, Online) ; 32: e3208, 2022. tab
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1833842

ABSTRACT

Abstract The National Policies of Humanization and Permanent Health Education (PHE) have shown advances and setbacks in their historical process. Some concepts from the theoretical framework of institutional analysis can contribute in these themes, such as the concept of analyzer. This article discusses the analyzers identified in an intervention research with professionals who work as supporters of humanization and/or articulators of PHE in municipalities of the state of São Paulo. The theoretical-methodological framework is the institutional analysis, socio-clinical line, focusing on the work of the analyzers. The intervention groups were composed of 30 participants. We highlight three analyzers: (1) the COVID-19 historical analyzer; (2) the time analyzer; (3) the silence analyzer. These analyzers evidence tensions such as: the peripheral place of primary care, discomfort in the face of "not knowing" and/or lethargy in the face of imposed non-doing, and the paradox of creating and interrupting both care actions and support for the teams.


Resumo As Políticas Nacionais de Humanização e Educação Permanente em Saúde têm mostrado em seu processo histórico avanços e retrocessos. Alguns conceitos do referencial teórico da análise institucional podem contribuir nesses temas, como o conceito de analisador. O objetivo do presente estudo foi discutir os analisadores identificados em uma pesquisa-intervenção, com profissionais que exercem a função de apoiadores de humanização e/ou de articuladores de educação permanente em saúde em municípios paulistas. O quadro teórico-metodológico é a análise institucional, linha sócio-clínica, sendo destacado, o trabalho dos analisadores. Participaram 30 pessoas dos grupos de intervenção. Destacamos três analisadores: (1) o analisador histórico Covid-19; (2) o analisador tempo; (3) o analisador silêncio. Esses analisadores iluminaram tensões como: o lugar periférico da atenção básica, o desconforto frente ao "não saber" e/ou a letargia ante o não-fazer imposto e o paradoxo de criar e interromper tanto ações de cuidado, como de suporte às equipes.


Resumen Las Políticas Nacionales de Humanización y Educación Permanente en Salud han mostrado avances y retrocesos en su proceso histórico. Algunos conceptos del marco teórico del análisis institucional pueden contribuir a estos temas, como el concepto de analizador. El objetivo de este artículo fue discutir los analizadores identificados en una investigación-intervención, con profesionales que actúan como apoyadores de la humanización y/o articuladores de la educación permanente en salud en municipios de São Paulo. El marco teórico-metodológico fue el del análisis institucional, línea socioclínica, destacándose el trabajo de los analizadores. Participaron 30 personas en los grupos de intervención. Se destacan tres analizadores: (1) el analizador histórico Covid-19; (2) el analizador de tiempo; (3) el analizador de silencio. Estos analizadores iluminan tensiones como: el lugar periférico de la atención primaria, el malestar ante el "no saber" y/o el letargo ante el no hacer impuesto y la paradoja de crear e interrumpir tanto las acciones asistenciales como de apoyo a los equipos.


Subject(s)
Humans , Primary Health Care , Unified Health System , Education, Continuing , Humanization of Assistance , COVID-19 , Health Services Research
2.
J Inflamm Res ; 14: 6293-6303, 2021.
Article in English | MEDLINE | ID: covidwho-1833962

ABSTRACT

BACKGROUND: The clinical spectrum of COVID-19 is extremely variable. Thus, it is likely that the heterogeneity in the genetic make-up of the host may contribute to disease severity. Toll-like receptor (TLR)-4 plays a vital role in the innate immune response to SARS-CoV-2 infection. The susceptibility of humans to severe COVID-19 concerning TLR-4 single nucleotide polymorphisms (SNPs) has not been well examined. OBJECTIVE: The goal of this research was to investigate the association between TLR-4 (Asp299Gly and Thr399Ile) SNPs and COVID-19 severity and progression as well as the cytokine storm in Egyptian patients. METHODS: We genotyped 300 adult COVID-19 Egyptian patients for TLR-4 (Asp299Gly and Thr399Ile) SNPs using PCR-restriction fragment length polymorphism (PCR-RFLP). We also measured interleukin (IL)-6 levels by enzyme-linked immunosorbent assay (ELISA) as an indicator of the cytokine storm. RESULTS: The minor 299Gly (G) and 399Ile (T) alleles were associated with a significant (P < 0.001) positive risk of severe COVID-19 (OR = 3.14; 95% CI = 2.02-4.88 and OR = 2.75; 95% CI = 1.66-4.57), their frequency in the severe group were 71.8% (84/150) and 70.7% (58/150), respectively. We detected significant differences between TLR-4 (Asp299Gly, Thr399Ile) genotypes with regard to serum levels of IL-6. Levels of IL-6 increased significantly with the presence of the mutant 299Gly (G) and 399Ile (T) alleles to reach the highest levels in the Gly299Gly (GG) and the Ile399Ile (TT) genotypes (170 pg/mL (145-208.25) and 112 pg/mL (24-284.75), respectively). CONCLUSION: The TLR-4 (Asp299Gly and Thr399Ile) minor alleles 299Gly (G) and 399Ile (T) are associated with COVID-19 severity, mortality, and the cytokine storm.

3.
Egypt J Intern Med ; 33(1): 37, 2021.
Article in English | MEDLINE | ID: covidwho-1833420

ABSTRACT

BACKGROUND: In this pandemic of COVID-19, the highest amount of infective material, biomedical waste is generated in hospitals and it is frequently handled by the healthcare workers irrespective of cadres. Hence the awareness of healthcare workers in regards with biomedical waste (BMW) management is crucial in this pandemic. This study is therefore conducted to assess the knowledge, attitude and practices in BMW management among health care workers in our institution. RESULTS: A total of 280 subjects consisting of doctors, nursing staff and group D workers were included in the study after obtaining informed consent. The knowledge among healthcare workers was satisfactory, but comparatively group D workers were lagging behind. Overall they all have a good attitude towards BMW management but practices on BMW management needs improvement mostly among group D workers. CONCLUSIONS: There have to be regular training programmes on biomedical waste management and its hazards for all the healthcare workers including group D workers. Along with educational intervention, strict implementation of biomedical waste management guidelines with its monitoring at all levels is also very much essential.

4.
Int J Educ Technol High Educ ; 18(1): 59, 2021.
Article in English | MEDLINE | ID: covidwho-1833377

ABSTRACT

The COVID-19 pandemic required an abrupt shift from face-to-face to online instruction for many students in higher education in the United States. Prior research has raised some concerns about both equitable access to online courses, and the quality of instruction in online courses compared to face-to-face courses. This survey study included a retrospective pretest approach to comparing students experiences before and after the transition to online instruction. The sample of 1731 students ranged across all available topics of study and all class standings from first-year students to doctoral students at a R1: Doctoral Universities-Very High Research Activity university according to the Carnegie classifications. Quality of instruction was addressed through the three principles of Universal Design for Learning. Students reported that most areas of quality of instruction were poorer after the transition, with having Engagement dropping by the largest effect size. However, Representation showed a small effect of improvement following the transition. Students who preferred online instruction reported less loss of instructional quality. Similarly, students eligible for disability services also reported less loss of instructional quality. Doctoral students reported significantly poorer access on multiple measures compared to all four years of undergraduate students' standings. Results are discussed in terms of patterns, exceptions, effect sizes, and recommendations for future research. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s41239-021-00296-5.

5.
Glob Qual Nurs Res ; 8: 23333936211051705, 2021.
Article in English | MEDLINE | ID: covidwho-1833234

ABSTRACT

People with developmental disabilities (DD) are devastatingly impacted by COVID-19, yet no studies have explored the experiences of developmental disability nurses during the pandemic. In April 2020, as part of a multiple method study, we used manifest content analysis to evaluate nurses' 287 open-ended responses to our online survey question: "What is the experience of being a developmental disability nurse while encountering challenges to meeting basic care needs during the early COVID-19 pandemic?" We identified four themes: living with fear and stress, helping others to understand and cope, navigating a changing landscape, and being left out. Findings reinforce the need for accessible health information for people with developmental disability, guidelines relevant to developmental disability nursing settings, emotional support for developmental disability nurses, and education of health care professionals about the contribution of the developmental disability nurse in supporting the holistic well-being of people with DD.

6.
BMJ Open ; 11(1): e045889, 2021 01 17.
Article in English | MEDLINE | ID: covidwho-1832434

ABSTRACT

BACKGROUND: The COVID-19 pandemic has had a major impact on delivery of social support services. This might be expected to particularly affect older adults and people living with dementia (PLWD), and to reduce their well-being. AIMS: To explore how social support service use by older adults, carers and PLWD, and their mental well-being changed over the first 3 months since the pandemic outbreak. METHODS: Unpaid dementia carers, PLWD and older adults took part in a longitudinal online or telephone survey collected between April and May 2020, and at two subsequent timepoints 6 and 12 weeks after baseline. Participants were asked about their social support service usage in a typical week prior to the pandemic (at baseline), and in the past week at each of the three timepoints. They also completed measures of levels of depression, anxiety and mental well-being. RESULTS: 377 participants had complete data at all three timepoints. Social support service usage dropped shortly after lockdown measures were imposed at timepoint 1 (T1), to then increase again by T3. The access to paid care was least affected by COVID-19. Cases of anxiety dropped significantly across the study period, while cases of depression rose. Well-being increased significantly for older adults and PLWD from T1 to T3. CONCLUSIONS: Access to social support services has been significantly affected by the pandemic, which is starting to recover slowly. With mental well-being differently affected across groups, support needs to be put in place to maintain better well-being across those vulnerable groups during the ongoing pandemic.


Subject(s)
COVID-19/psychology , Caregivers/psychology , Dementia/psychology , Health Facility Closure , Social Work , Adult , Aged , Aged, 80 and over , Anxiety/epidemiology , COVID-19/prevention & control , Depression/epidemiology , Female , Humans , Longitudinal Studies , Male , Mental Health , Middle Aged , Social Support , United Kingdom/epidemiology , Young Adult
7.
Pediatr Int ; 2021 Oct 01.
Article in English | MEDLINE | ID: covidwho-1832223

ABSTRACT

BACKGROUND: Cystic fibrosis (CF) is a chronic disease causing recurrent respiratory tract infections. Viral respiratory tract infections are more severe in CF. The first case of COVID-19 was seen in our country on March 11, 2020 and nationwide school closure and lockdown were implemented. School closure and home confinement might have adverse effects on children's physical and mental health. In this study, we aimed to compare the effect of COVID-19 pandemic on psychological reactions of CF patients and healthy controls. METHODS: This is a controlled cross-sectional study including 7-18 year-old children with CF. The survey included questions regarding family environment and peer relations, self care and psychological reactions to COVID-19 pandemic. The questionnaire was applied to children via telephone call under parental supervision. RESULTS: We evaluated 132 CF patients and 135 their healthy peers. Mean age was 11.5±2.9 years in CF group and 11.8±3.2 years in control group (p=0.98). There were 55 girls (41.7%) in CF group and 81 girls (60%) in control group (p=0.027). The socioeconomic status of families was similar. CF patients were found to be less anxious for family members having the risk of COVID-19, less upset for school closure, less anxious about the COVID-19 pandemic (p<0.001, 0.02, 0.01 respectively). CONCLUSION: CF patients seem to show more resilience in coping with the pandemic. Appropriate psychological support should be provided to them and resilience strategies in coping with the pandemic should be nurtured.

8.
Pacing Clin Electrophysiol ; 2021 Mar 15.
Article in English | MEDLINE | ID: covidwho-1832218

ABSTRACT

In the era of coronavirus disease 2019 (COVID-19), the management of cardiac implantable electronic devices infections with concomitant viral infection has not been completely defined yet. In this explorable context, we report the first experience of a Cardiac resynchronization therapy with defibrillator (CRT-D) implantation after transvenous lead extraction for endocarditis in a COVID-19 patient. We describe both the measures and procedures implemented to reduce the cross-infection in the operating room and our clinical practice to improving procedure effectiveness on patient care.

10.
BJOG ; 129(2): 256-266, 2022 01.
Article in English | MEDLINE | ID: covidwho-1831884

ABSTRACT

BACKGROUND: Pregnant women have been identified as a potentially at-risk group concerning COVID-19 infection, but little is known regarding the susceptibility of the fetus to infection. Co-expression of ACE2 and TMPRSS2 has been identified as a prerequisite for infection, and expression across different tissues is known to vary between children and adults. However, the expression of these proteins in the fetus is unknown. METHODS: We performed a retrospective analysis of a single cell data repository. The data were then validated at both gene and protein level by performing RT-qPCR and two-colour immunohistochemistry on a library of second-trimester human fetal tissues. FINDINGS: TMPRSS2 is present at both gene and protein level in the predominantly epithelial fetal tissues analysed. ACE2 is present at significant levels only in the fetal intestine and kidney, and is not expressed in the fetal lung. The placenta also does not co-express the two proteins across the second trimester or at term. INTERPRETATION: This dataset indicates that the lungs are unlikely to be a viable route of SARS-CoV2 fetal infection. The fetal kidney, despite presenting both the proteins required for the infection, is anatomically protected from the exposure to the virus. However, the gastrointestinal tract is likely to be susceptible to infection due to its high co-expression of both proteins, as well as its exposure to potentially infected amniotic fluid. TWEETABLE ABSTRACT: This work provides detailed mechanistic insight into the relative protection & vulnerabilities of the fetus & placenta to SARS-CoV-2 infection by scRNAseq & protein expression analysis for ACE2 & TMPRSS2. The findings help to explain the low rate of vertical transmission.


Subject(s)
Angiotensin-Converting Enzyme 2/genetics , COVID-19 , Gene Expression Profiling , Placenta/metabolism , Serine Endopeptidases/genetics , Adult , COVID-19/epidemiology , COVID-19/genetics , COVID-19/transmission , Databases, Nucleic Acid , Disease Susceptibility/metabolism , Female , Fetal Research , Gene Expression Profiling/methods , Gene Expression Profiling/statistics & numerical data , Genetic Testing/methods , Gestational Age , Humans , Immunohistochemistry , Infectious Disease Transmission, Vertical , Pregnancy , Protective Factors , Ribonucleoproteins, Small Cytoplasmic/analysis , SARS-CoV-2/physiology
11.
BJOG ; 129(2): 248-255, 2022 01.
Article in English | MEDLINE | ID: covidwho-1831883

ABSTRACT

OBJECTIVE: To evaluate the impact of Covid-19 vaccination (Pfizer-BioNTech BNT162b2) during the third trimester of pregnancy on maternal and neonatal outcomes. DESIGN: A multicentre, retrospective computerised database. POPULATION: Women who gave birth at >24 weeks of gestation in Israel, between January and April 2021, with full records of Covid-19 disease and vaccination status. METHODS: Women who received two doses of the vaccine were compared with unvaccinated women. Women who were recorded as having disease or a positive Covid-19 polymerase chain reaction (PCR) swab during pregnancy or delivery were excluded from both study groups. Univariate analysis was followed by multivariate logistic regression. MAIN OUTCOME MEASURES: Composite adverse maternal outcomes. Secondary outcomes were vaccination rate and composite adverse neonatal outcomes. RESULTS: The overall uptake of one or both vaccines was 40.2%; 712 women who received two doses of the Covid-19 vaccine were compared with 1063 unvaccinated women. Maternal composite outcomes were comparable between the groups; however, women who received the vaccine had higher rates of elective caesarean deliveries (CDs) and lower rates of vacuum deliveries. An adjusted multivariable logistic regression analysis demonstrated that Covid-19 vaccination was not associated with maternal composite adverse outcome (aOR 0.8, 95% CI 0.61-1.03); a significant reduction in the risk for neonatal composite adverse outcomes was observed (aOR 0.5, 95% CI 0.36-0.74). CONCLUSIONS: In a motivated population covered by a National Health Insurance Plan, we found a 40.2% rate of vaccination for the Covid-19 vaccine during the third trimester of pregnancy, which was not associated with adverse maternal outcomes and, moreover, decreased the risk for neonatal adverse outcomes. TWEETABLE ABSTRACT: Covid-19 vaccine during pregnancy is safe for both mother and fetus.


Subject(s)
COVID-19 , Vaccination , /administration & dosage , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/adverse effects , Cohort Studies , Female , Humans , Infant, Newborn , Israel/epidemiology , Patient Safety , Pregnancy , Pregnancy Outcome/epidemiology , Pregnancy Trimester, Third , Retrospective Studies , SARS-CoV-2 , Treatment Outcome , Vaccination/methods , Vaccination/statistics & numerical data
12.
Cardiovasc Res ; 2021 Dec 02.
Article in English | MEDLINE | ID: covidwho-1831091

ABSTRACT

AIMS: Since its emergence in early 2020, the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) has reached pandemic levels, and there have been repeated outbreaks across the globe. The aim of this two-part series is to provide practical knowledge and guidance to aid clinicians in the diagnosis and management of cardiovascular disease (CVD) in association with COVID-19. METHODS AND RESULTS: A narrative literature review of the available evidence has been performed, and the resulting information has been organized into two parts. The first, reported here, focuses on the epidemiology, pathophysiology, and diagnosis of cardiovascular (CV) conditions that may be manifest in patients with COVID-19. The second part, which will follow in a later edition of the journal, addresses the topics of care pathways, treatment, and follow-up of CV conditions in patients with COVID-19. CONCLUSION: This comprehensive review is not a formal guideline but rather a document that provides a summary of current knowledge and guidance to practicing clinicians managing patients with CVD and COVID-19. The recommendations are mainly the result of observations and personal experience from healthcare providers. Therefore, the information provided here may be subject to change with increasing knowledge, evidence from prospective studies, and changes in the pandemic. Likewise, the guidance provided in the document should not interfere with recommendations provided by local and national healthcare authorities.

13.
Clin Infect Dis ; 2021 Aug 10.
Article in English | MEDLINE | ID: covidwho-1831036

ABSTRACT

BACKGROUND: SARS-CoV-2 viral RNA (vRNA) is detected in the bloodstream of some patients with COVID-19 ("RNAemia") but it is not clear whether this RNAemia reflects viremia (i.e., virus particles) and how RNAemia/viremia is related to host immune responses and outcomes. METHODS: SARS-CoV-2 vRNA was quantified by ultra-sensitive RT-PCR in plasma samples (0.5-1.0 ml) from observational cohorts of 51 COVID-19 patients including 9 outpatients, 19 hospitalized (non-ICU), and 23 ICU patients, and vRNA levels compared with cross-sectional indices of COVID-19 severity and prospective clinical outcomes. We used multiple imaging methods to visualize virions in pelleted plasma. RESULTS: SARS-CoV-2 vRNA was detected in plasma of 100%, 52.6% and 11.1% of ICU, non-ICU, and outpatients respectively. Virions were detected in plasma pellets by electron tomography and immunostaining. Plasma vRNA levels were significantly higher in ICU > non-ICU > outpatients (p<0.0001); and for inpatient, plasma vRNA levels were strongly associated with higher WHO score at admission (p=0.01), maximum WHO score (p=0.002) and discharge disposition (p=0.004). A plasma vRNA level >6,000 copies/ml was strongly associated with mortality (HR: 10.7). Levels of vRNA were significantly associated with several inflammatory biomarkers (p<0.01) but not with plasma neutralizing antibody titers (p=0.8). CONCLUSIONS: Visualization of virus particles in plasma indicates that SARS-CoV-2 RNAemia is due, at least in part, to viremia. The levels of SARS-CoV-2 RNAemia quantified by ultrasensitive RT-PCR correlate strongly with disease severity, patient outcome and specific inflammatory biomarkers but not neutralizing antibody titers.

14.
JMIR Form Res ; 4(10): e22043, 2020 Oct 23.
Article | MEDLINE | ID: covidwho-1834119

ABSTRACT

BACKGROUND: The COVID-19 pandemic has had numerous worldwide effects. In the United States, there have been 8.3 million cases and nearly 222,000 deaths as of October 21, 2020. Based on previous studies of mental health during outbreaks, the mental health of the population will be negatively affected in the aftermath of this pandemic. The long-term nature of this pandemic may lead to unforeseen mental health outcomes and/or unexpected relationships between demographic factors and mental health outcomes. OBJECTIVE: This research focused on assessing the mental health status of adults in the United States during the early weeks of an unfolding pandemic. METHODS: Data was collected from English-speaking adults from early April to early June 2020 using an online survey. The final convenience sample included 1083 US residents. The 71-item survey consisted of demographic questions, mental health and well-being measures, a coping mechanisms checklist, and questions about COVID-19-specific concerns. Hierarchical multivariable logistic regression was used to explore associations among demographic variables and mental health outcomes. Hierarchical linear regression was conducted to examine associations among demographic variables, COVID-19-specific concerns, and mental health and well-being outcomes. RESULTS: Approximately 50% (536/1076) of the US sample was aged ≥45 years. Most of the sample was White (1013/1054, 96%), non-Hispanic (985/1058, 93%), and female (884/1073, 82%). Participants reported high rates of depression (295/1034, 29%), anxiety (342/1007, 34%), and stress (773/1058, 73%). Older individuals were less likely to report depressive symptomology (OR 0.78, P<.001) and anxiety symptomology (OR 0.72, P<.001); in addition, they had lower stress scores (-0.15 points, SE 0.01, P<.001) and increased well-being scores (1.86 points, SE 0.22, P<.001). Individuals who were no longer working due to COVID-19 were 2.25 times more likely to report symptoms of depression (P=.02), had a 0.51-point increase in stress (SE 0.17, P=.02), and a 3.9-point decrease in well-being scores (SE 1.49, P=.009) compared to individuals who were working remotely before and after COVID-19. Individuals who had partial or no insurance coverage were 2-3 times more likely to report depressive symptomology compared to individuals with full coverage (P=.02 and P=.01, respectively). Individuals who were on Medicare/Medicaid and individuals with no coverage were 1.97 and 4.48 times more likely to report moderate or severe anxiety, respectively (P=.03 and P=.01, respectively). Financial and food access concerns were significantly and positively related to depression, anxiety, and stress (all P<.05), and significantly negatively related to well-being (both P<.001). Economy, illness, and death concerns were significantly positively related to overall stress scores (all P<.05). CONCLUSIONS: Our findings suggest that many US residents are experiencing high stress, depressive, and anxiety symptomatology, especially those who are underinsured, uninsured, or unemployed. Longitudinal investigation of these variables is recommended. Health practitioners may provide opportunities to allay concerns or offer coping techniques to individuals in need of mental health care. These messages should be shared in person and through practice websites and social media.

15.
JMIR Form Res ; 4(10): e19876, 2020 Oct 20.
Article in English | MEDLINE | ID: covidwho-1834118

ABSTRACT

BACKGROUND: The COVID-19 outbreak was first reported to the World Health Organization on December 31, 2019, and it was officially declared a public health emergency of international concern on January 30, 2020. The COVID-19 outbreak and the safety measures taken to control it caused many psychological issues in populations worldwide, such as depression, anxiety, and stress. OBJECTIVE: The objectives of this study were to assess the psychological effects of the lockdown due to the COVID-19 outbreak on university students in the United Arab Emirates (UAE) and to investigate the students' awareness of mobile mental health care apps as well as their attitudes toward the use of these apps. METHODS: A two-part self-administered web-based questionnaire was delivered to students at United Arab Emirates University. The first part of the questionnaire assessed the mental state of the participants using the 12-item General Health Questionnaire (GHQ-12), while the second part contained questions investigating the participants' awareness of and attitudes toward mental health care apps. Students were invited to fill out the web-based questionnaire via social media and mailing lists. RESULTS: A total of 154 students participated in the survey, and the majority were female. The results of the GHQ-12 analysis showed that the students were experiencing psychological issues related to depression and anxiety as well as social dysfunction. The results also revealed a lack of awareness of mental health care apps and uncertainty regarding the use of such apps. Approximately one-third of the participants (44/154, 28.6%) suggested preferred functionalities and characteristics of mobile mental health care apps, such as affordable price, simple design, ease of use, web-based therapy, communication with others experiencing the same issues, and tracking of mental status. CONCLUSIONS: Like many groups of people worldwide, university students in the UAE were psychologically affected by the lockdown due to the COVID-19 outbreak. Although apps can be useful tools for mental health care delivery, especially in circumstances such as those produced by the outbreak, the students in this study showed a lack of awareness of these apps and mixed attitudes toward them. Improving the digital health literacy of university students in the UAE by increasing their awareness of mental health care apps and the treatment methods and benefits of the apps, as well as involving students in the app creation process, may encourage students to use these tools for mental health care.

16.
Frontiers in Aging Neuroscience ; 14, 2022.
Article | ProQuest Central | ID: covidwho-1834467

ABSTRACT

Background: Handwriting is an acquired complex cognitive and motor skill resulting from the activation of a widespread brain network. Handwriting therefore may provide biologically relevant information on health status. Also, handwriting can be collected easily in an ecological scenario, through safe, cheap, and largely available tools. Hence, objective handwriting analysis through artificial intelligence would represent an innovative strategy for telemedicine purposes in healthy subjects and people affected by neurological disorders. Material and Methods: One-hundred and fifty-six healthy subjects (61 males;49.6±20.4 years) were enrolled and divided according to age into three subgroups: younger adults (YA), middle-aged adults (MA), and older adults (OA). Participants performed an ecological handwriting task that was digitalized through smartphones. Data underwent the DBNet algorithm for measuring and comparing the average stroke sizes in the three groups. A convolutional neural network (CNN) was also used to classify handwriting samples. Lastly, receiver operating characteristic (ROC) curves and sensitivity, specificity, positive, negative predictive values (PPV, NPV), accuracy and area under the curve (AUC) were calculated to report the performance of the algorithm. Results: Stroke sizes were significantly smaller in OA than in MA and YA. The CNN classifier objectively discriminated YA vs. OA (sensitivity=82%, specificity=80%, PPV=78%, NPV=79%, accuracy=77%, and AUC=0.84), MA vs. OA (sensitivity=84%, specificity=56%, PPV=78%, NPV=73%, accuracy=74%, and AUC=0.7), and YA vs. MA (sensitivity=75%, specificity=82%, PPV=79%, NPV=83%, accuracy=79%, and AUC=0.83). Discussion: Handwriting progressively declines with human ageing. The effect of physiological ageing on handwriting abilities can be detected remotely and objectively by using machine learning algorithms.

17.
Frontiers in Immunology ; 13:884211, 2022.
Article in English | MEDLINE | ID: covidwho-1834411

ABSTRACT

Stagnating COVID-19 vaccination rates and vaccine hesitancy remain a threat to public health. Improved strategies for real-time tracking and estimation of population-level behavior regarding vaccinations are needed. The aim of this study was to evaluate whether online search trends for COIVD-19 and influenza mirror vaccination rates. State-level weekly fraction of online searches for top vaccination-related search terms and CDC vaccination data were obtained from June 1, 2020, to May 31, 2021. Next, trends in online search and vaccination data for COVID-19 and influenza were analyzed for visual and quantitative correlation patterns using Spearman's rank correlation analysis. Online searches in the US for COVID-19 vaccinations increased 2.71-fold (95% CI: 1.98-3.45) in the 4 weeks after the FDA emergency authorization compared to the precedent 4 weeks. In March-April 2021, US online searches reached a plateau that was followed by a decline of 83.3% (95% CI: 31.2%-135.3%) until May 31, 2021. The timing of peaks in online searches varied across US states. Online searches were strongly correlated with vaccination rates (r=0.71, 95% CI: 0.45 - 0.87), preceding actual reported vaccination rates in 44 of 51 states. Online search trends preceded vaccination trends by a median of 3.0 weeks (95% CI: 2.0-4.0 weeks) across all states. For influenza vaccination searches, seasonal peaks in September-October between 2016-2020 were noted. Influenza search trends highly correlated with the timing of actual vaccinations for the 2019-2020 (r=0.82, 95% CI: 0.64 - 0.93) and 2020-2021 season (r=0.91, 95% CI: 0.78 - 0.97). Search trends and real-world vaccination rates are highly correlated. Temporal alignment and correlation levels were higher for influenza vaccinations;however, only online searches for COVID-19 vaccination preceded vaccination trends. These findings indicate that US online search data can potentially guide public health efforts, including policy changes and identifying geographical areas to expand vaccination campaigns.

18.
Frontiers in Immunology ; 13:875236, 2022.
Article in English | MEDLINE | ID: covidwho-1834410

ABSTRACT

A variety of methods have been explored to increase delivery efficiencies for DNA vaccine. However, the immunogenicity of DNA vaccines has not been satisfactorily improved. Unlike most of the previous attempts, we provided evidence suggesting that changing the injection site successively (successively site-translocated inoculation, SSTI) could significantly enhance the immunogenicity of DNA vaccines in a previous study. To simplify the strategy and to evaluate its impact on candidate SARS-CoV-2 vaccines, we immunized mice with either a SARS-CoV-2 spike-based DNA vaccine or a spike protein subunit vaccine via three different inoculation strategies. Our data demonstrated that S protein specific antibody responses elicited by the DNA vaccine or the protein subunit vaccine showed no significant difference among different inoculation strategies. Of interest, compared with the conventional site fixed inoculation (SFI), both successive site-translocating inoculation (SSTI) and the simplified translocating inoculation (STI) strategy improved specific T cell responses elicited by the DNA vaccine. More specifically, the SSTI strategy significantly improved both the monofunctional (IFN-gamma+IL-2-TNF-alpha-CD8+) and the multifunctional (IFN-gamma+IL-2-TNF-alpha+CD8+, IFN-gamma+IL-2-TNF-alpha+CD4+, IFN-gamma+IL-2+TNF-alpha+CD4+) T cell responses, while the simplified translocating inoculation (STI) strategy significantly improved the multifunctional CD8+ (IFN-gamma+IL-2-TNF-alpha+CD8+, IFN-gamma+IL-2+TNF-alpha+CD8+) and CD4+ (IFN-gamma+IL-2-TNF-alpha+CD4+, IFN-gamma+IL-2+TNF-alpha+CD4+) T cell responses. The current study confirmed that changing the site of intra muscular injection can significantly improve the immunogenicity of DNA vaccines.

19.
Frontiers in Immunology ; 13:868020, 2022.
Article in English | MEDLINE | ID: covidwho-1834408

ABSTRACT

Objectives: Comparative analysis between different monoclonal antibodies (mAbs) against SARS-CoV-2 are lacking. We present an emulation trial from observational data to compare effectiveness of Bamlanivimab/Etesevimab (BAM/ETE) and Casirivimab/Imdevimab (CAS/IMD) in outpatients with early mild-to-moderate COVID-19 in a real-world scenario of variants of concern (VoCs) from Alpha to Delta. Methods: Allocation to treatment was subject to mAbs availability, and the measured factors were not used to determine which combination to use. Patients were followed through day 30. Viral load was measured by cycle threshold (CT) on D1 (baseline) and D7.Primary outcome was time to COVID-19-related hospitalization or death from any cause over days 0-30. Weighted pooled logistic regression and marginal structural Cox model by inverse probability weights were used to compare BAM/ETE vs. CAS/IMD. ANCOVA was used to compare mean D7 CT values by intervention. Models were adjusted for calendar month, MASS score and VoCs. We evaluated effect measure modification by VoCs, vaccination, D1 CT levels and enrolment period. Results: COVID19-related hospitalization or death from any cause occurred in 15 of 237 patients in the BAM/ETE group (6.3%) and in 4 of 196 patients in the CAS/IMD group (2.0%) (relative risk reduction [1 minus the relative risk] 72%;p=0.024). Subset analysis carried no evidence that the effect of the intervention was different across stratification factors. There was no evidence in viral load reduction from baseline through day 7 across the two groups (+0.17, 95% -1.41;+1.74, p=0.83). Among patients who experienced primary outcome, none showed a negative RT-PCR test in nasopharyngeal swab (p=0.009) and 82.4% showed still high viral load (p<0.001) on D7. Conclusions: In a pre-Omicron epidemiologic scenario, CAS/IMD reduced risk of clinical progression of COVID-19 compared to BAM/ETE. This effect was not associated with a concomitant difference in virological response.

20.
Frontiers in Immunology ; 13:860891, 2022.
Article in English | MEDLINE | ID: covidwho-1834406

ABSTRACT

Immunosuppressant conditions such as hematological malignancies increase the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. It has been described in the literature that patients on anti-CD20 maintenance therapies for lymphoid malignancies are susceptible to having recurrent flares together with viral replication or reinfections, although these cases are scarce. These patients are not well represented in randomized controlled trials, and as a consequence, the evidence for the use of certain treatments in this scenario is lacking. We present two cases of patients with B-cell lymphoma on remission and treated with rituximab on maintenance. They developed at least 1 flare of coronavirus disease 2019 (COVID-19) after acute infection and always after receiving rituximab. RT-PCR was positive in the nasopharyngeal swab and also in plasma. Patients were treated during flares with remdesivir, hyperimmune plasma, and corticosteroids. These two cases showed the unresolved problem of COVID-19 in immunosuppressant patients and showed that despite the vast amount of information available on SARS-CoV-2, information in this subgroup of patients is lacking.

SELECTION OF CITATIONS
SEARCH DETAIL