Blue Light and Eye Damage: A Review on the Impact of Digital Device Emissions

The pandemic and lockdown caused by COVID-19 accelerated digitalization. Personal digital devices, emitting high-energy light, namely in the blue wavelength, have raised concerns about possible harmful effects on users' eyes. Scientific research history has shown a relationship between exposure to blue light and changes in ocular structures. The main goal of this review is to examine frequent and prolonged exposure to blue radiation from computers, tablets and smartphones and its consequences on vision and ocular structures. Bibliographic research was carried out on changes induced by blue light in ocular structures, the cornea, the crystalline lens and the retina based on the following scientific databases: BioOne Complete™;Google Scholar™;Paperity™;PubMed™;and ScienceOpen™. The most significant studies on blue light and ocular damage were selected and reviewed. The most relevant bibliographic data were analyzed and summarized and some gaps in the theme of blue light from digital devices were identified. The experimental need to acquire additional new data is suggested. The hypothesis that continued use of digital devices enriched with blue light may interfere with the biological tissues of the cornea, crystalline lens, or retina is not clarified in the available scientific evidence. Therefore, additional studies are needed to answer this problem. © 2023 by the authors.

Circadian misalignment is associated with COVID-19 infection

Background: Circadian system contributes to the regulation of inflammatory processes, but the role of circadian misalignment as a risk factor for contracting Covid-19 has up to now been poorly studied. The aim of this study was to explore the relationship between circadian misalignment (chronic disturbance of the circadian system) and the risk of Covid-19 infection in a population of subjects suspected of contact or infection with SARS-CoV-2. Method(s): Cross-sectional single-center study conducted during a period without lockdown in winter 2021. Recruitment took place in a Covid-19 outpatient testing center. Subjects between 18 and 45 years old were included whether they were symptomatic or not, healthcare workers or not, in contact with a Covid-19 case or not. To determine social jetlag, a proxy of circadian misalignment, they were asked about their usual sleep-wake behaviors. Usual sleep duration and sleep-wake timing were explored on workdays and free days. Social jetlag was defined as at least 2 h shift of circadian alignment (defined as the difference between mid-sleep on workdays and mid-sleep on free days, midsleep as the median between bedtime and rise time). Result(s): One thousand fourteen subjects were included (sampling rate: 10.8%, 39% men, mean age 28 +/- 8) with 56 subjects positive for Covid-19 (positivity rate: 5.5%). Usual mean sleep duration was equivalent in both groups (7 h47 versus 7 h49, p = 0.733). Social jetlag greater than 2 h comprised 33.3% of subjects in the Covid-19 group versus 20.6% in the control group (p = 0.026). After adjustment on age, gender, BMI and work schedules, subjects presenting with social jetlag greater than 2 h had a 2.07-fold higher likelihood to test positive than subjects who had identical sleep-wake timing on workdays and free days (OR = 2.07, 95%CI = [1.12e3.80], p = 0.024). Conclusion(s): Circadian misalignment not only is present in subjects infected by Covid-19 but could also be responsible for a higher likelihood of being infected. The chronobiological impact on the immune system or a higher likelihood of being exposed to social contacts during nocturnal activities could explain our findings, which need to be confirmed in a future large cohort study. Regular sleep-wake timing could ultimately become a target for preventing Covid-19 infection.

Evaluation of the implementation of the Remote Education Program in Minas Gerais during the pandemic: What do users say?

This paper assesses the users’ perception about the implementation of the Remote Education Program (Reanp) formulated by the government of the state of Minas Gerais. A total of 388 comments from teachers, students and guardians were monitored and analyzed in relation to 36 posts on the official Facebook page of the State Department of Education, published between May and October 2020. The data reveal that the implementation of the program and its complexity can contribute to the intensification of regional and social inequality, in addition to pointing to the exclusion of a significant number of users. Tensions are evident in relation to technologies, resources and artifacts, access asymmetries that compromise teaching work and student performance. The users’ perceptions about the implementation of Reanp indicates that the emergence of the policy led to vertical and improvised actions, increased levels of discretion, inducing different levels of commitment and motivation. © 2022, Arizona State University. All rights reserved.

CIRCADIAN MISALIGNMENT IS ASSOCIATED WITH COVID-19 INFECTION

Introduction: Sleep disturbances are frequently reported in patients infected by Covid-19, but the role of sleep-wake behaviors as a risk factor to contract Covid-19 has up to now poorly been studied. The aim of this study was to explore the relationship between usual sleep-wake behaviors and the risk of Covid-19 infection in a population of subjects suspect of contact or infection with SARS-CoV-2. Methods: Cross-sectionnal monocentric study set during a nonconfined period in winter 2021. Recruitment took place in a Covid-19 ambulatory screening platform. Subjects between 18 and 45 years old were included whether they were symptomatic or not, healthcare workers or not, in contact with a Covid-19 case or not. They were asked about their usual sleep-wake behaviors. Usual sleep duration and sleep timing were explored during workdays and free days. Circadian misalignment was defined as at least 2 hours shift of circadian alignment (defined as the difference between mid-sleep during workdays and mid-sleep during free days, mid sleep as the middle between bedtime and getting up time). Results: One thousand eighteen subjects were included in our study (acceptance rate: 10.8%, 39% of men, mean age of 28± 8). Habitual mean sleep duration was equivalent in both groups (7h47 vs 7h49, p=0.733). Circadian misalignment greater than 2 hours concerned 33% of subjects in the Covid-19 group versus 20% of the control group (p=0.026). After adjustment on age, gender, BMI and work schedules, subjects presenting a circadian misalignment superior to 2 hours had 2.07 more chances to be tested positive than subjects which respected on identical sleep-wake timing between workdays and free days (OR=2.07, 95%CI= [1.12-3.80], p=0.024). Conclusion: Altered sleep not only is present in subjects infected by Covid-19 but could be responsible of a higher change to be infected. Chronobiological impact on immune system and higher chances to be exposed to social contacts could explain our findings which deserve to be confirmed through a future large cohort study. Ultimately regular sleep-wake pattern could constitute a privileged prevention target to fight Covid-19 infection.

The impact of COVID-19 on delivering intravitreal therapy to patients with diabetic macular edema

Purpose : To evaluate the effectiveness of our treatment guideline for intravitreal injections (IV), which was implemented in diabetic macular edema (DME) patients. Methods : Retrospective analysis of medical case reports in patients who had an IV appointment at Centro Hospitalar e Universitário do Porto. The first aspect of this analysis was the impact of COVID-19 on treatment appointments by comparing the lockdown period (22 March 2020 - 2 May2020) with the same period in 2019. The second aspect quantified the number of DME patients with delayed treatments based on a COVID-19 treatment guideline (see Figure 1). The impact of delayed appointments was assessed based on best-corrected visual acuity (BCVA) and central foveal thickness (CFT) prior to COVID-19 and then immediately after a missed appointment at the outset of COVID-19 and 6 months after the pandemic began. Results : In 2019, 693 medical retina patients received an IV. During the same period in 2020, 272 maintained their IV appointment, 391 patients experienced a delay and 80 patients missed their IV. 132 DME patients (mean age 70.6 ± 9.7 years;59.1% females) had a delayed IV and were subsequently evaluated following a missed appointment and then 6 months after lockdown began. Prior to COVID-19, mean BCVA was 61.9±19.0 ETDRS letters and CFT was 361±140 μm. Then, immediately after the COVID-19 lockdown and the missed appointment, BCVA and CFT were 59.4±21.1 ETDRS letters and 355±132 μm, respectively. These then improved to 67.7±15.6 ETDRS letters and 314±84 μm, respectively, 6 months after the onset of COVID-19. In the appointment after the delayed IV, a clinical decision was taken to increase the time between IV in 50.8% of patients;to shorten it in 4.5%;in 39.0% it could be kept the same;and, in 5.7%, therapy was switched. Conclusions : These data show that during the enforced COVID-19 lockdown, about half of all our IV appointments were delayed. This had an immediate impact on DME patient's vision as demonstrated by the small reduction in BCVA, which was reversed after reimplementation of DME treatment according to the standard of care, with BCVA and CFT improvement. This highlights the importance of treatment guidelines but also the value of longer duration treatments that can be used to minimize the potential negative impact of interruptions to DME therapy.

Adherence to anti-hypertensive treatment on the COVID-19 pandemic

Objective: To evaluate the adherence to antihypertensive treatment during the COVID-19 pandemic and associated variables. Design and method: Cross-sectional study was performed with outpatient, from a Hospital in São Paulo, Brazil. Inclusion criteria were: age >18 years old, telephone number, in treatment for at least six months. Pregnant women were excluded. The period defined to characterize the assessment of social distance due to the COVID-19 pandemic was from March, 24 until August, 31. Hypertensive patients were interviewed by telephone. The adherence to treatment was assessed by Morisky and Green scale and the BP control was systolic BP <140 mmHg and diastolic BP <90 mmHg. Biosocial data, habits and lifestyles and attitudes towards social distancing measures were evaluated. The study was approved by the Research Ethics Committee. The significance level was p<=0.05. Results: The sample was 281 hypertensive patients: 62.3% women;66 (14) years old;348,7 (255,8) $USA monthly income;43.8% completed high school;60.5% white;47.0% married;and 59.1% retired. It was found that 58.7% were adherent to antihypertensive treatment and BP control was 51.6%. The systolic BP was 138.5 (22.7) mmHg and diastolic BP was 77.3 (14.4) mmHg. As for drug treatment, 55.2% of hypertensive patients received the drugs sent by the hospital pharmacy via mail, 63.9% reported that during the COVID-19 pandemic there was a problem in receiving the drugs and 10% was without antihypertensive sometime at home. The variables associated with treatment adherence were: race black (OR 0.40;95% CI: 0.21-0.73), education elementary school II (OR 2.97;95% CI: 1.24-7.06), stayed without antihypertensive at home someday from quarantine (OR 0.40;95% CI: 0.17-0.95) and diastolic BP (OR 0.98;CI: 0.96-0.99). During the period of the pandemic evaluated, it was also observed that 77.6% reported leaving home, 13.5% had contact with people with the disease and 91.8% reported not feeling safe to leave the house after the end of quarantine. Conclusions: The rate of non-adherence to antihypertensive treatment during the COVID-19 pandemic was high and was associated with unfavorable biosocial variables.

Activating Templar Heritage: Tourism, Narrative Strategies and Information Technologies

While fairly established in several western countries, military tourism is still in a grey area in Portugal. In order to bolster the notion that this concept can be a major contributor to tourism activation, an Information System is being developed with the Templar Order as basis. This project is a direct result of the work of the Polytechnic Institute of Tomar (Portugal), the Templars Route European Federation and Tomar’s local government. It uses the Rapid Application Development methodology and resorts mostly to a client-server web application, using web standards such as HTML, CSS and JS, and it’s operated by the PHP program language and SGBD Mysql for data persistence. The IS fills a void as far as military tourism heritage platforms are concerned. It’s user friendly design and architecture make for a pleasant research experience while the inclusion of more updated and historical narratives along with storytelling strategies increase its appeal among a non-academic audience. The recent COVID-19 outbreak brought about the need to adapt the original model to an ever-increasing virtual culture trend. © 2021, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.