Study of the adaptability to change and proactive behavior of students in a university context in face of the COVID-19 health emergency

The objective of this study is to analyze the variables of adaptability to change and organizational behavior of the students of the Tecnologico Nacional de Mexico Campus Coatzacoalcos, in the state of Veracruz-Mexico. The research has a qualitative and quantitative approach, it is a cross-sectional study with a single cut in time, developed in the period corresponding to the month of November 2021 and June of this year. The method used is hypothetical-deductive. A non -probabilistic sampling was determined with the convenience technique, obtaining the participation of 513 students from the different careers offered at the institution. A measurement instrument was applied that analyzes the perception of the eight dimensions to be studied: need for change, leadership and management, attitude to change, communication, adaptation to change, proactive behavior oriented towards the organization, proactive behavior oriented towards others and behavior proactive proactive towards oneself. Through a parametric test, Kolmogorov-Smirnov hypothesis testing and Whitney's Mann's U, male and female students adapt to change in the institution and that males are more likely to have change-oriented behavior that the women.

COVID-19 Associated Pulmonary Aspergillosis (CAPA) at a Hospital in Nicaragua: Prevalence and Risk Factors for Mortality

Background. COVID-19 associated pulmonary aspergillosis (CAPA) is a newly recognized clinical entity. Alterations in the mucociliary clearance, epithelial damage, lymphopenia, and the use of steroids and monoclonal antibodies could be contributing factors for the development of CAPA. The aim of this study was to detemine the prevalence of probable CAPA and risk factors for mortality in patients with COVID-19 admitted in one of the main hospitals in Nicaragua. Methods. This is a retrospective cohort study of patients admitted with the diagnosis of COVID-19 in the Hospital Dr. Fernando Velez Paiz of Managua, Nicaragua. The criteria of probable CAPA was established using the consensus of ECMM/ISHAM. Serum Aspergillus galactomannan lateral flow assay (IMMY) was determined in patients with suspect of CAPA. An optical index > 0.5 was considered positive. Different clinical and laboratory variables, and clinical outcomes were evaluated. Results. A total of 325 patients were included in the study. Ninety-one patients were diagnosed with probable CAPA thatmeans a prevalence of 28%. The mean age was 56.6 +/- 15.0 years old. The most important identified comorbidities were arterial hypertension (44.2%), diabetes mellitus (29.4%), and COPD (14.8%). Lymphopenia was a remarkable finding (56% of the patients). The most frequent radiological pattern in the chest CT scan were: "crazy paving" (56.0%), ground glass opacities (28.5%), and diffuse reticulonodular infiltrates (10.9%). The mortality rate in the patients with CAPA was 42.9%. The risk factors associated with mortality in the patients with CAPA were: admission to Intensive Care Unit (ICU) (OR: 17.3;CI95%: 3.6-81.9), any chronic medical condition (OR: 9.28;CI95%: 1.13-75.90), COPD (OR: 6.41;CI95%: 1.64-24.90), use of steroids (OR: 5.03, CI95%: 1.55-16.30), lymphopenia < 1,500/mL (OR: 4.92;CI95%: 1.94-12.40), "crazy paving" pattern in CT (OR: 4.92;CI95%: 1.94-12.40), and diabetes mellitus (OR: 3.60, CI95%: 1.41-9.15). Risk factors identified for mortality in patients with COVID-19 associated pulmonary aspergillosis (CAPA). Conclusion. The prevalence of probable CAPA in this study is relatively high. The mortality was of 42.9%. Risk factors for mortality were admission to ICU, chronic medical conditions (COPD and diabetes mellitus), use of steroids, lymphopenia, and radiological "crazy paving" pattern in the chest CT-scan.

Outbreak of Ralstonia pickettii Bacteremia Caused by Contaminated Hydromorphone in a Universitary Hospital in Bogota, Colombia

Background. Ralstonia pickettii are aerobic non fermenter gram negative bacilli isolated in water and soil. It is related to nosocomial infection outbreaks and considered an opportunistic pathogen. There have been outbreaks reports due to contaminated water systems and sterile drug solutions which mainly occurs during manufacturing. We present the report of an outbreak of R. pickettii bacteremia secondary to a contamination of hydromorphone vials. Methods. In February 2021 an outbreak of R. pickettii bacteremia was identified. All isolates were from blood cultures with slow growth, thus indicating the culturing of liquid inputs, intravenous administration solutions and commonly used drugs among patients including hydromorphone. Mass spectrometry (MALDI-TOF) was used for the identification and automated microdilution to determine sensitivity to antimicrobials of the isolates and clonality analysis of genetic relationships was carried out using the DICE coefficient, UPGMA algorithm Results. During the outbreak, 19 patients with R. pickettii bacteremia were identified The global attack rate was 1,9%. 11/19 (58%) were women and 13/19 (68%) of the isolations were from inward patients and 6/19 (32%) were from intensive care unit. Factors that could contribute to the appearance of the outbreak were underlying pathology, 2 patients with a diagnosis of diabetes mellitus, 10 patients with a diagnosis of arterial hypertension, 5 patients with obesity, 6 patients with heart disease, additionally 7 patients with a diagnosis of SARS COV 2 and 6 patients with the use of corticosteroids. The global attack rate was 1,9% and mortality was 31.5% (6 patients). R. pickettii was identified from two batches of hydromorphone by MALDI-TOF and the clonality study concluded that the isolates analyzed, were clonal with a 100% similarity. The associated mortality rate was 5/29 (26.3%). Conclusion. We confirmed an outbreak of R. pickettii due to the contamination of two hydromorphone badges in Colombia. It is crucial to acknowledge the importance of infection control and surveillance during the COVID-19 pandemic as well as maintaining adequate quality control of medication production in order to avoid presenting this kind of outbreaks.

Ischemic and non-ischemic heartbeat classifier for portable automatic detection systems

This article presents a new heartbeat classifieroriented to an automatic cardiac ischemia detection system aimedat the medical control of the population with cardiac disorders (ahigher risk group of severe COVID-19). The algorithm focuses ondistinguishing ischemic heartbeats from non-ischemic based onmethods and techniques proposed by medical experts in cardiacischemia diagnoses. The proposed algorithm was tested with 80 electrocardiogram recordings obtained from the Long-term STdatabase of Physionet with a 100,112 heartbeat population. Theheartbeat population contains different types of non-ischemiccases. The algorithm exhibits a sensitivity of 98.7 percent andspecificity of 97.23 percent. The digital synthesis, in a 180nmCMOS process with a dynamic power consumption of 13.15 microWatt demanding an area of 490x400 micrometers, attests to thealgorithm benefits.

Political institutions and pandemic management: Massive pcr testing

A strand of the political economy literature expects political institutions to matter in the management of catastrophes (famines, pandemics, etc.), with democratic regimes being held as more effective than their authoritarian peers. The COVID-19 pandemic offers an interesting setting to test this expectation, in particular with regards to the crucial massification of SARS-CoV-2 testing. Evidence from 85 countries reveals a curvilinear relationship between democracy and testing, with low and high levels of democracy associated with the massification of testing, and medium levels —anocracies— associated with low testing. The variance is also partially explained by GDP per capita and government effectiveness. © 2020, Universidad Externado de Colombia. All rights reserved.

Guía de recomendación ached-schge para el funcionamiento de las unidades de endoscopia durante el brote de coronavirus (COVID-19)

The outbreak of COVID-19 disease has recently spread from its original place in Wuhan, Hubei province, China, to the entire world, and has been declared to be a pandemic by the World Health Organization in March 2020. All countries in America, in particular Chile, show an important increase in COVID-19 cases and deaths. The clinical manifestations of COVID-19 are a broad spectrum, from asymptomatic mild disease, to severe respiratory failure, shock, multiorgan dysfunction and death. Thus, high clinical suspicion and appropriate structure risk stratification are needed. Health care teams in endoscopy units, are at an increased risk of infection by COVID-19 from inhalation of droplets, mucosae contact, probably contamination due to contact with stools. Endoscopic aerosolized associated infections have also been reported. Different societies'recommendations, have recently placed digestive endoscopy (especially upper) among the high risk aerosol generating procedures (AGPs). In addition, live virus has been found in patient stools. On top of this, the infected health professionals may transmit the infection to their patients. Health care infection prevention and control (HCIPC), has been shown to be effective in assuring the safety of both health care personnel and patients. This is not limited to the correct use of personal protective equipment (PPE), but is based on a clear, detailed and well communicated HCIPC strategy, risk stratification, use of PPE, and careful interventions in patients with moderate and high risk of COVID-19. A conscientious approach regarding limited resources is important, as the simultaneous outbreak in all countries heavily affects the availability of health supplies. The Chilean Gastroenterology Society (SChGE) and Digestive Endoscopy Association of Chile (ACHED) are joining to provide continued updated guidance in order to assure the highest level of protection against COVID-19, for both patients and health care workers. This guideline will be updated online as needed. El brote de la enfermedad denominada COVID-19, se ha extendido desde su origen en Wuhan, provincia de Hubei, China, a todo el mundo. La Organización Mundial de la Salud lo declaró pandemia en marzo de 2020. Todos los países de América, en especial Chile, presentan incremento de casos y fallecidos. Las manifestaciones clínicas de COVID-19 van desde una enfermedad leve, hasta insuficiencia respiratoria severa, shock, disfunción orgánica y muerte. Se necesita una alta sospecha clínica y una adecuada estratificación del riesgo. El equipo de salud en las unidades de endoscopia, tiene un mayor riesgo de COVID-19 que otras unidades clínicas y de apoyo diagnóstico, dada la mayor exposición a inhalación de gotas, contacto posible con mucosas y contaminación por contacto con deposiciones. Recomendaciones de diferentes sociedades colocan la endoscopia digestiva (especialmente la esofagogastroscopia o endoscopia digestiva alta, EDA) entre los procedimientos generadores de aerosoles (PGA) de alto riesgo. Además, se han encontrado virus viables en las deposiciones de los pacientes. Potencialmente, los profesionales de la salud infectados podrían contagiar a los pacientes. Se ha demostrado que la prevención y control de infecciones asociadas a la atención de salud (IAAS), son efectivos para garantizar la seguridad tanto del personal de salud, como de los pacientes. Esto no es solamente el correcto uso del equipo de protección personal (EPP), sino que se basa en una clara estrategia de IAAS, bien comunicada, con estratificación de riesgo, uso de EPP e intervenciones correctas en pacientes con riesgo moderado y alto. Es relevante un enfoque sobre los limitados recursos, dado la simultaneidad del brote en todos los países, que afecta la disponibilidad de insumos. La Sociedad Chilena de Gastroenterología (SChGE) y la Asociación Chilena de Endoscopia Digestiva (ACHED) publican esta guía actualizada para apoyar las buenas prácticas contra COVID-19, tanto para pacientes como para el equipo de salud. Esta guía podrá tener actualizaciones según avance la información disponible.

Coronavirus Optimization Algorithm: A Bioinspired Metaheuristic Based on the COVID-19 Propagation Model.

This study proposes a novel bioinspired metaheuristic simulating how the coronavirus spreads and infects healthy people. From a primary infected individual (patient zero), the coronavirus rapidly infects new victims, creating large populations of infected people who will either die or spread infection. Relevant terms such as reinfection probability, super-spreading rate, social distancing measures, or traveling rate are introduced into the model to simulate the coronavirus activity as accurately as possible. The infected population initially grows exponentially over time, but taking into consideration social isolation measures, the mortality rate, and number of recoveries, the infected population gradually decreases. The coronavirus optimization algorithm has two major advantages when compared with other similar strategies. First, the input parameters are already set according to the disease statistics, preventing researchers from initializing them with arbitrary values. Second, the approach has the ability to end after several iterations, without setting this value either. Furthermore, a parallel multivirus version is proposed, where several coronavirus strains evolve over time and explore wider search space areas in less iterations. Finally, the metaheuristic has been combined with deep learning models, to find optimal hyperparameters during the training phase. As application case, the problem of electricity load time series forecasting has been addressed, showing quite remarkable performance.