Membrane dysfunction in patients with severe COVID-19 treated with venovenous extracorporeal membrane oxygenation - analysis from a pooled data from a single centre

Objectives: It is well known that severe COVID-19 is associated with complex immunological and inflammatory dysregulation. Both these physiopathological events translate to a high risk of major thrombotic or hemorrhagic events. In patients treated with venovenous extracorporeal membrane oxygenation (VVECMO), membrane dysfunction might affect systemic oxygenation and limit its duration-expectancy. This study aimed to assess the possible causes of extracorporeal membrane failure in COVID-19 patients and its impact on outcome. Method(s): Retrospective, single-center, observational case-control study involving adult COVID-19 patients admitted to an ECMO referral centre in a tertiary university hospital. All patients required VVECMO for acute respiratory failure, including 48 cases who needed one or more extracorporeal membrane exchanges and 45 controls (no membrane exchange). These two groups were compared for demographic characteristics, severity of the disease using validated scores (SAPS II and SOFA), duration of ECMO run, coagulation assessment, cumulative anticoagulation dose, associated complications, and outcomes (ICU and hospital mortality). Result(s): Most patients were males (71.0%) and younger than 50 years (79.5%). Median ECMO run duration was significantly longer in the case group (35.0 vs 14.0 days, p <0.001), as well as ICU length-of-stay (45.5 vs 28 days, p <0.001). Membrane exchange tended to be associated with sepsis (56% vs 33%, p=0.037), major hemorrhage (58% vs 43%, p=0.022), heparin-induced thrombocytopenia (25% vs 9%, p=0.054), higher D-dimer title (17.36 ng/dL vs 7.5 ng/dL, p=0.07) and lower platelet counts (133.000/muL vs 154.000/muL). Median SAPS II (32.0 vs 33.0, p=0.20) and the mortality (27% vs 24%, p >0.99) were similar between these groups. Conclusion(s): In patients with SARS-CoV-2 pneumonia and severe hypoxemia treated with VVECMO support the emergence of infection, coagulopathy and inflammation were associated with high risk of membrane dysfunction. No impact on mortality could be confirmed from these data. Anticoagulation monitoring and dosing strategies should be reinforced to promote membrane protection.

Scenarios of social isolation during the first wave of the COVID-19 pandemic in Rio de Janeiro, Brazil

This work analyses the construction of social isolation as a public problem during the first wave of COVID-19, drawing on experiences in Rio de Janeiro which, in addition to being one of the country's major cities, had among the highest mortality rates in Brazil in 2020. We consider both the legal measures enacted by government agencies to contain the contagion and media coverage on the effects of these measures at the local level. The results show that, in the absence of compulsory confinement measures, urban public spaces were deployed both by government agencies and the media in a process by which social isolation was framed as a public problem. Legal measures affected daily patterns of movement, mobility, and sociability, and intervened in the dynamics of central urban functions and in access to and use of public spaces. Media reports gave voice to levels of public agreement or disagreement with regulations and emphasised the significance of legal measures to contain the spread of the virus. Public spaces are at the core of debates about compliance with legal measures to enforce social isolation because they are privileged places where social issues become visible and problematic material expressions of relationships between citizens and the law.

Adsorption of Covid-19-related drug from contaminated water using activated carbon

Chloroquine has been adopted in some countries such as Brazil as a Covid-19 prevention proto-col;consequently, chloroquine has contaminated water resources in large quantities. In response to this menace, an adsorbent material from animal bone was used to remove chloroquine from contaminated water. Notably, no drug adsorption studies have been conducted in the past. The adsorbent was characterized by scanning electron microscopy and zeta potential measurements that exhibited favorable characteristics for the adsorbent. In this study, it was determined that the optimal mass of the adsorbent was 0.02 g at pH 7. The kinetic study demonstrated that 300 min was sufficient to reach equilibrium, and the best fit was pseudo-second-order. The adsorption isotherms were fitted in the Langmuir model, obtaining a maximum adsorp-tion capacity of 77.60 mg–1 at a temperature of 298 K. The thermodynamic parameters demonstrated a spontaneous, exothermic, and reversible process. Briefly, the adsorbent used had the potential to remove emerging pollutants from the environment. © 2022 Desalination Publications. All rights reserved.

Prevalence of Charles Bonnet syndrome among UK visually impaired military veterans and associated impact of visual hallucinations during the COVID-19 pandemic

Purpose : Charles Bonnet syndrome (CBS) is characterised by visual hallucinations secondary to sight loss. Aside from sight loss, other risk factors associated with CBS include social isolation, loneliness, and post-traumatic stress. The health and lifestyle circumstances of visually impaired military veterans place this profile at an increased risk of developing CBS. The purpose of this study was to estimate the prevalence of CBS through an analysis of health records for members of a UK sight loss charity (Blind Veterans UK) and report experiences of CBS during the COVID-19 pandemic. Methods : A retrospective analysis and screening/filtering of military veterans' electronic membership records at Blind Veterans UK. Text analysis was used to identify CBS cases. A cross sectional survey of individuals with active CBS was used to measures patientreported features of hallucinatory experiences during the COVID-19 pandemic and perceived episode triggers. Results : Analysis was conducted on 4109 members of Blind Veterans UK. Following screening and exclusion of members with non-sight loss related hallucination risk factors (e.g., Alzheimer's disease), 532 members were identified as CBS cases, representing 12.9% (95% CI: 11.1%-14.7%) of the cohort. Forty-five individuals with CBS completed the survey. Loneliness during the pandemic was associated with changes in the nature of visual hallucinations (p=0.04). Individuals experiencing greater loneliness were, on average, older than those with no changes to their feelings of loneliness (p=0.03). Despite experiencing greater feelings of loneliness (67%), most individuals had not accessed support services. Conclusions : The relative high prevalence of CBS among visually impaired military veterans indicates that this cohort may be at greater risk of the condition. Approximately half of survey respondents experienced exacerbation of visual hallucinations during the COVID-19 pandemic, which may partly be explained by loneliness and/or environmental triggers.

Diagnostic Approach and Treatment of Lung Cancer Patients in Portugal: Portuguese Lung Cancer Study Group Survey

Introduction: In Portugal, in 2020, 5415 new lung cancer patients were diagnosed and 4797 deaths were caused by lung cancer. Lung cancer ranks third in terms of cancer incidence and is the leading cause of cancer mortality. Early diagnosis, complete and fast patient assessment and staging, multidisciplinary approach, access to personalized medicine, new treatment options and research are essential to improve survival and quality of life. Access to clinical trials is critical for this improvement.The aim of this study is to assess the techniques available to the diagnostic work-up, treatments, the waiting time and the needs perceived by physicians. Methods: The Portuguese Lung Cancer Study Group launched a survey in order to study the diagnostic approach and treatment of lung cancer patients in Portugal. An online survey with 47 questions was sent to all Portuguese hospitals that treat lung cancer, referring to the pre-COVID-19 pandemic experience. Results: Responses from 31 Portuguese hospitals were collected, between May and September 2020. Availability to bronchoscopy, image-guided transthoracic needle biopsy (TNB), endobronchial ultrasound- transbronchial needle aspiration (EBUS-TNBA), PET/CT, molecular biology testing is presented in table I. In 58% (n=18) the molecular biology test was performed as a "reflex test". About 68% (n=21) of hospitals used next generation sequencing. Two hospitals (7%) reported not having access to liquid biopsies.Video-assisted thoracoscopic surgery was the main surgical technique (61%;n=19). The waiting time for the first radiation oncology consultation was less than 15 days in 71% (n=26). About 61% (n=19) of hospitals had clinical trials. A wide majority of doctors (77%) would like to have more clinical trials. In 71% (n=22) of the hospitals, it was possible to refer patients to Palliative Care receiving systemic anticancer therapy. [Formula presented] Conclusions: Despite the limitations of the methods, this study allowed us to deepen our knowledge about the work-up technologies and treatments available for lung cancer patients in Portugal. It has also identified future opportunities, such as increasing accessibility to some diagnostic tools and clinical trials. Keywords: Diagnosis and treatment approach, Lung Cancer in Portugal, Health Services Research - Portugal

TEACHING WORK IN COVID-19 TIMES: BETWEEN WRITTEN AND LIVED IN REMOTE TEACHING

The objective of this study is to analyze how basic education teachers in the city of Fortaleza/CE develop their teaching work in times of social distancing, due to Covid-19. Therefore, we opted for a qualitative approach, of an exploratory nature, of case study type, bibliographic and documentary, to analyze the work and teaching knowledge, the conceptions about Covid-19 and the SME/Fortaleza guidelines for remote work due to the consequences of the pandemic. As a strategy to approach the subjects, six teachers from different segments working in public schools in Fortaleza/CE were asked to describe, through the writing of a "Pedagogical Letter', how their work is being developed during this period. The results showed that, even under multiple pressure and challenges, teachers have always been imbued with genuine effort and a sense of superior ethical purpose to deal with the confrontations of remote teaching. In addition, we noticed the discomfort of not being able to equip and empower their students as they deserve, however, amid all the emotional and even physical exhaustion, these teachers do not tire of betting on the development of their students, never leaving aside the reception and affection in their pedagogical actions.

Impact of COVID-19-Related Distress on Anxiety and Depression of College Students

The current study explores the impact of COVID-19 related distress factors on the mental well-being of college students. For the purpose of the study, mental well-being is measured through the depression symptoms and general anxiety levels of the students. The study used judgemental sampling to identify the respondents of the study. The final sample consisted of 147 respondents and the data was analysed on SPSS. The results suggested that while COVID-19 distress factors were not significant in predicting the level of depression symptoms experienced by the students, the general anxiety levels were significantly impacted by the distress factors. The findings are particularly useful for the teachers and institutions working to connect and teach through online platforms. © 2022, Commonwealth of Learning. All rights reserved.

COVID-19 Sentiment Analysis applying BERT

The growth of social data on the internet has accelerated during the last two decades. As a result, researchers can access data and information for various academic and commercial purposes. The novel coronavirus disease (COVID-19) is a current pandemic that has sparked widespread concern worldwide. Spreading misleading information on social media platforms like Twitter, on the other hand, is exacerbating the disease's concern. This research aims to examine tweets and develop a model that can detect public sentiment from social media posts;consequently, necessary precautions can be taken to preserve adequate validity of information for the general public. We believe that various social media platforms have a significant impact on creating public awareness about the disease's importance and encouraging preventive measures among community members. For this study, we applied the Bidirectional Encoder Representations from Transformers (BERT) model, a new deep-learning technique for text analysis and performance with exceptional multi-class accuracy. We also compared it with six shallow machine learning models. © 2022 IEEE.

Morphological changes in leukocytes of acute SARS-CoV-2 infection patients, Amazon, Brazil

Introduction: The pandemic for the new coronavirus (SARS-CoV-2) brought many uncertainties about which laboratory parameters would be most suitable during the evolution of COVID 19. Objectives: Correlate the results of the blood count (BC), the neutrophil/lymphocyte ratio (N/LR), the C-reactive protein (CRP) and morphological findings of individuals diagnosed with SARS-CoV-2 infection through Polymerase Chain Reaction in Real Time (RT-PCR) in a private laboratory in Belém, Pará, from March to September 2020. Materials and Methods: Retrospective study with 30 individuals, of both sexes, any age and clinical complaint, of home or hospital origin who underwent BC, CRP and RT-PCR for COVID 19 until the 8th day of infection. Morphological changes were analyzed after selecting the slides for these patients. Results: Sample composed of 15 men and 15 women, aged between 7 and 92 years. Of these 12/30 individuals were at home and 18/30 were hospitalized. The main complaints were fever, malaise, diarrhea and respiratory distress. The statistical study showed a direct dependency relationship between increases in N/LR, CRP and the need for hospitalization (p = 0.0005). Morphological analysis showed hyposegmented neutrophils with toxic granulations, vacuolated monocytes, and reactive lymphocytes with basophilic cytoplasm. Conclusion: Our results associate intermediate and elevated levels of N/LR with increased CRP and disease severity, however, unrelated to the morphological findings in neutrophils, lymphocytes and monocytes that were common to all patients diagnosed up to the 8th day of infection.

Virtual Community Mentoring Models for Middle School Underachievers’ Psychosocial Development and Well-Being During COVID-19

Recent studies highlight the outcomes of COVID-19 on the psychosocial skills of early adolescents. It shows the unavailability of virtual community mentoring models for teenagers' individual and interpersonal growth in the virtual scenario. Hence, there emerges a need to explore and apply the available virtual communication resources by facilitators, families, and other community professionals for teenagers’ self-development. This article reports the application of virtual resources like WhatsApp, graphic design platforms (CANVA and Adobe), graphic interchange formats (GIPHY App), all-in-one visual content editing forums (InShot App), and memes (Meme Generator App) in engaging and supporting community mentoring capacities leading to psychosocial development and well-being for teenagers during COVID-19. Through this article, contemporary virtual models are explored and executed with community guidance to integrate the personal developmental skills of middle school underachievers. There is also a need to work with community interventions by using virtual mentoring skillsets for positive youth development. © 2022, Commonwealth of Learning. All rights reserved.

Digital technologies to learn and teach English in Brazil

In a post-industrial society marked by the rise of information and communication technologies and networked architecture, investigations on the use of technological resources to teach and learn languages are becoming increasingly important to understand the state of diffusion of these innovations. This online survey aimed to investigate what digital tools are most used by English learners and teachers in Brazil. The investigation was carried out in 2018 and 2019, before the Covid-19 (SARS-CoV-2) pandemic, and the participants were teachers and students from all regions of Brazil. The participants completed a questionnaire announced in social networks and scientific events in the area of Arts. They demonstrated to identify affordances of digital resources to learn and teach English.

Visual and multimodal metaphors in the conceptualization of COVID-19

This article intends to contribute to a social discussion about the metaphorical representation of the dynamics of contamination, contagion, and lethality of the SARS-CoV-2 virus, in the first months of the pandemic. Accordingly, the analysis addresses the conceptualization process underlying visual and multimodal metaphors that refer to the virus, the disease, and the pandemic phenomenon. It is focused on a set of visual and multimodal nature texts, constitutively metaphorical, collectively constituted by under graduation students of Letras, in an activity that sought to critically reflect on the role of metaphor in the coronavirus pandemic social narrative in 2020. By articulating theoretical constructs that aim to understand metaphor in a cognitive linguistic perspective (conceptual domains, visual metaphor, multimodal metaphor) and associating principles of the Grammar of Visual Design (compositional meta-function), the analysis is dedicated to the interpretation of the metaphorical conceptualization process involved in the discursivization of the health crisis, as well as the explanation of the effects of meaning projected by the discursive practices under study. In addition to recursive updating of conceptual metaphors such as DISEASE IS A JOURNEY and DISEASE IS A WAR, data analysis reveals that the social experience of the pandemic is also constructed by the personification of the coronavirus, the conceptualization of contagion as a chain reaction caused by human action, by the projection of government leaders in fictional characters known for childishness, and the metaphorization of the Brazilian people as blind and festive. © 2021 Universidade do Vale do Rio dos Sinos. All rights reserved.

Active collaborative learning in a web conferencing environment

Resulting from the COVID-19 pandemic, the 2020 school year has been defined by remote online teaching, taking place in learning management systems and/or in webconference services. Considering this scenario, the aim of this paper is to present teaching strategies for remote synchronous classes in webconference systems so that they are managed in order to encourage greater student engagement, in the perspective of active collaborative learning. The strategies were developed based on the analysis of data generated by the collection of testimonies, the application of questionnaires with teachers of basic education and higher education and the adoption of a class log of the use of three webconference platforms in a postgraduate course, in the current pandemic year. We discuss what changes when it is not possible to teach presentially, but with the use of web conferencing platforms and their functionalities, as well as of different digital tools that can help the teacher stimulate student participation during the lessons. As a result, four types of teaching strategies are presented for the management of remote online classes focused on active collaborative student learning, which can be used by teachers of different educational levels and areas of knowledge.

Call center in the clash against COVID-19

The pandemic caused by Covid-19 has demanded new forms of health care. The Ponta Grossa State University (UEPG, Portuguese acronym) Institutional Support Program to Outreach Actions of Prevention, Care and Response to the Pandemic of the New Coronavirus" was created in order to answer, clarify and guide the population. The program is financially supported by the General Superintendence of Science, Technology and Higher Education, the Secretariat of Health and by the Araucaria Foundation of Scientific and Technological Development Support of the State of Parana. The program is developed in partnership with seven state universities and the Federal University of Parana. The program acts on three aspects: information centers, call centers working alongside local health units and attention to the Parana borders. This article reports the experiences of call centers' team, an important social tool in call centers, which are under studied. Call centers are fast and easy access tools as they use various forms of contact such as smartphones, computers, tablets as well as numerous forms of interaction in the social networks, for example, chats, voice and video calls to reach different social classes and age groups.

P09.02 Impact of COVID-19 in Portuguese Lung Cancer Patients’ Treatment: Portuguese Lung Cancer Study Group Survey

Introduction: The first patient with COVID-19 in Portugal was diagnosed on March 2. There was a lack of knowledge concerning the risks of COVID-19 infection in lung cancer patients, prognostic factors, the influence of cancer treatments and cure criteria. Treatments and consultations were readjusted in order to maintain the ones that increase patients’ survival, while reducing the risks of SARS-CoV-2 infection. International and national “guidelines” were followed, but each hospital had its own strategies to reduce COVID-19 risk. Purpose: The Portuguese Lung Cancer Study Group launched a survey in order to study the early impact of COVID-19 in lung cancer patients, changes in treatments and the way of implementation of COVID-free circuits. Methods: A survey was sent to lung cancer doctors of all the Portuguese hospitals. Results: At the data cut-off, information from twenty one hospitals was collected, corresponding to about 66% (n=3.446) of each year new diagnoses of lung cancer in Portugal. In March and April there was a reduction in newly lung cancer diagnosed patients while comparing with 2019: in March, 86% had a reduction;in April, 90% of the hospitals reported a reduction and it was greater than 40% in eight hospitals (38%). About 62% of the doctors considered less referral from primary care as a cause, and 33% delayed biopsies or other imaging exams. The most difficult exams to obtain were CT guided biopsies and EBUS for 48%. The majority of the hospitals (57%) were also referral for COVID-19 patients’ treatment. In 48% of the lung cancer treating departments’ there were doctors reallocated to COVID-19 treatment areas. In 48% the assistance teams were divided into teams that weren’t previously working together. The majority of doctors (90%) reported having individual protection equipment available. Hospitals performed teleconsultation (100%), and, in seven hospitals (33%), more than half of the consultations were done using communication technology. All the hospitals were able to perform SARS-CoV-2 testing. It was done before every cycle of chemotherapy in 90% of the hospitals. In the majority (67%) it was only performed before day D1, in D1 and D8 chemotherapy protocols. About 19% reported changes in prescription of adjuvant chemotherapy and in maintenance chemotherapy, 33% increased the prescription of oral chemotherapy, 33% changed the periodicity, 29% reported reduction in inclusion in clinical trials. In 33% there was an earlier end of chemotherapy in ECOG2 and vulnerable patients. In 38% the prescription of G-CSF (Granulocity-colony stimulating factor) increased, being used for prophylaxis if the risk of febrile neutropenia was more than 10-15%. The periodicity of consultations was changed for patients under TKI treatment in 86%, and 67% hospitals reported changes in immune checkpoint inhibitor treatment schedule. In 29% oral drugs could be delivered at patients’ home. All the patients admitted for surgery were tested for SARS-CoV-2, and 86% performed SARS-COV-2 testing before radiotherapy. Conclusion: Portuguese hospitals responded to the sudden need of creation of COVID-free circuits, change protocols and even teleconsultation. With a larger follow up we will study the late consequences of COVID-19 pandemic in lung cancer diagnosis and treatment. Keywords: COVID-19, survey, Portuguese Lung Cancer Study Group

Covid-19 and its propagation dynamics in Ceara (Brazil) urban network

The text proposal aims to apprehend some experiences of the SARS-CoV-2 virus propagation in Ceara state from its urban network. The starting point is the notion that circulation and velocity are important vectors for the Covid-19 dissemination in the territory, where the flows of people and objects with different frequencies maintain relations among cities with many sizes and functions. Information related to the virus diffusion in the urban system is interpreted using data collected by the Ministry of Health (IntegraSUS) and the Health Department of Ceara State. By reading the spatial discontinuities and indicating an observation plan that skips scales and articulates points aligned according to their spatial interactions, the urban network approach contributes greatly to the vision that captures density, connectivity and circulation, which are the factors presented as responsible for the spread of the disease.

Gamification in Remote Teaching of SE Courses: Experience Report

Distance education is understood as well-planed online learning mediated by computer technologies. Online learning involves more planning and design decisions and thus it is more rigorous than Emergency Remote Teaching (ERT). Given the COVID-19 pandemic several undergraduate and graduate classroom courses had to adapt their traditional classes to ERT. In this context, we have adapted our methodology based on face-To-face classes to incorporate the gamification as a strategy to deal with ERT. The goal of this paper is to present the remote methodology based on the gamification that we have applied on two Computer Science courses. To use the gamification, we have selected a free online gamification, called Classcraft, that enable us to use asynchronous tools. In our methodology, we first organized the course' contents into modules and then, for each module, we defined the activities to work the module's topics;the interactions between the professor and students;and the evaluation criteria. The results showed that the gamification as ERT strategy is effective to engage the students during the pandemic. However, they had difficulties to understand the purpose of using asynchronous tools such as forum. © 2020 ACM.

Outcomes of the reorganisation of a medical oncology department during the COVID-19 pandemic: Real-word experience

Background: The coronavirus disease 2019 (COVID-19) pandemic has transformed health care delivery in the world, forcing clinicians to make challenging triage decisions. COVID-19 represents a significant harm for cancer patients, who are at high risk of infections due to their immunosuppressed status and serious COVID-19-related events. Portuguese oncologists joined forces to ensure safety of clinical practice without compromising cancer patients care, as the benefit of ensuring an anti-cancer treatment outweighs the risks of COVID-19. Methods: Description and outcomes analysis of structural organization measures adopted by a Portuguese Medical Oncology Department during the COVID-19 pandemic. Results: A proactive approach to the actual emergency panorama was promptly implemented: use of individual protection equipment, triage of patients accessing the hospital, use of telemedicine in selected patients with no need for on-site assessment, customising treatment delivery, regularly test patients under immunosuppressive treatments, test all patients prior to admission in oncology wards, limited access for visitors and caregivers, health professionals worked in “mirror teams” and most multidisciplinary boards have been converted in telematic meetings. Despite all the constraints in the activity, the number of consultations (including tele-consultations) increased compared to the same period of the previous year (3245 consultations from 1/03 to 15/05/2020 versus 3305 in the same period of 2019), the number of first consultations remained similar comparatively (15%) and were carried out in a timely manner, indicative that the cancer patient circuit was not compromised. 368 fewer treatments were performed in the same period, compared to 2019. Until May 15th, 288 tests have been carried out. Four patients were positive for COVID-19 without severity criteria, two of them with a diagnosis of cure, currently being under antineoplastic treatment without related complications. Conclusions: Practice recommendations from European and national oncology societies were applied, which translated into a safe continuum of cancer care delivery. In the middle-term, will be a priority to assess the real impact on cancer mortality. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.