Autoimmune manifestations associated with coronavirus disease 2019.

Introduction: Coronavirus disease 2019 (COVID-19), caused by a new coronavirus. Severe acute respiratory syndrome coronavirus 2 is having a devastating impact throughout the world. Its pathophysiology is the result of direct cytopathic effects of SARS-CoV-2 on respiratory epithelium, endothelium, other organ-specific cell types and the subsequent induction of a pro-inflammatory cytokine storm and dysregulated adaptive immunity, causing severe tissue damage. Objective(s): To describe autoimmune characteristics present during SARS-Cov-2 infection. Method(s): A literature review on COVID-19 and autoimmune manifestations was carried out. The articles were selected from a search of the following websites: Pubmed, Medline, SciELO. An analysis and summary of the reviewed information was made. Analysis and synthesis of information: Viruses have been considered the main infectious agents that trigger autoimmune phenomena in genetically susceptible individuals. SARS-CoV-2 has already been linked to a long list of autoinflammatory and autoimmune conditions that can be induced by various mechanisms proposed to explain virus-induced autoimmunity. In this pathology, the most described, is molecular mimicry. COVID-19 shares similarities with autoimmune diseases in its clinical manifestations, pathophysiological mechanisms and therapeutic response, such powerful immune reactions participate in the pathogenesis of both entities. Conclusion(s): SARS-CoV-2 infection may represent the complex and interrelated link between infections and autoimmunity.Copyright © 2022, Editorial Ciencias Medicas. All rights reserved.

Autoimmune manifestations associated with coronavirus disease 2019

Introduction: Coronavirus disease 2019 (COVID-19), caused by a new coronavirus. Severe acute respiratory syndrome coronavirus 2 is having a devastating impact throughout the world. Its pathophysiology is the result of direct cytopathic effects of SARS-CoV-2 on respiratory epithelium, endothelium, other organ-specific cell types and the subsequent induction of a pro-inflammatory cytokine storm and dysregulated adaptive immunity, causing severe tissue damage. Objective(s): To describe autoimmune characteristics present during SARS-Cov-2 infection. Method(s): A literature review on COVID-19 and autoimmune manifestations was carried out. The articles were selected from a search of the following websites: Pubmed, Medline, SciELO. An analysis and summary of the reviewed information was made. Analysis and synthesis of information: Viruses have been considered the main infectious agents that trigger autoimmune phenomena in genetically susceptible individuals. SARS-CoV-2 has already been linked to a long list of autoinflammatory and autoimmune conditions that can be induced by various mechanisms proposed to explain virus-induced autoimmunity. In this pathology, the most described, is molecular mimicry. COVID-19 shares similarities with autoimmune diseases in its clinical manifestations, pathophysiological mechanisms and therapeutic response, such powerful immune reactions participate in the pathogenesis of both entities. Conclusion(s): SARS-CoV-2 infection may represent the complex and interrelated link between infections and autoimmunity. Copyright © 2022, Editorial Ciencias Medicas. All rights reserved.

Rural tourism networking and covid-19 crisis: a gender perspective

This paper studies networking in rural tourism from a gender perspective comparing pre and post Covid period. The empirical study consisted of a questionnaire answered by 154 tourism promoters. Results showed a higher percentage of promoters belonging to an association during the Covid-19. There was a link between receiving training and belonging to an association and a significant relationship between participation in associations and receiving public funds, this relationship being found more among male promoters. On the other hand, a higher score was given by women for the advantages of networking, and mainly for the following: ‘Simplifies the management of booking’. © 2022, The Author(s).

Analysis of Claims to the Emergency Department of a tertiary care hospital in the first year of the Pandemic

The hospital emergency department (ED) has become the gateway to the health system during the first COVID-19 wave. The objective of this study is to describe the behaviour of claims in the first year of the pandemic, comparing them with the previous year. Method: Retrospective descriptive study of the complaints addressed to the ED of the Nuestra Senora de Candelaria University Hospital Complex (CHUNSC) during the years 2019 and 2020. The variables studied were: the number of claims received at the CHUNSC and at the ED and of the latter: year, month, dimensions, reasons, professional category, sex, relationship of the claimant and the number of emergencies attended. Results: 347 claims from the ED and 6259 from the CHUNSC were analyzed, with the average for 2019 being higher than that of 2020. The most requested dimension in the ED is health care assistance and the reason for dissatisfaction for the provision of care. The professional category with more claims is health care staff and the user himself, is the one who claims the most. Conclusions: the number of claims has decreased in the first year of the pandemic but the dimension has not changed, nor the reason in relation to the previous year.

PUTTING RESEARCH INTO PRACTICE: KNOWLEDGE TRANSLATION AND IMPLEMENTATION FOR ACTION ON NUTRITION

The transfer of research evidence into practice has been historically slow, and requires an integration of many elements, including quality evidence, supportive physical and intellectual environments, and facilitation, as discussed at the NNEdPro Sixth International Summit on Nutrition and Health. Examples of applying clinical research into practice focused on the use of group consultations (also known as group clinics or shared medical appointments) to support behaviour change, the role of dietary micronutrients during the COVID-19 pandemic and the potential of Precision Nutrition. An emerging area from early implementation evidence includes group consultations, also known as shared medical appointments, as discussed by Dr Fallows. Group consultations have been shown to improve clinical outcomes for some patient groups (e.g., HbA1c, lipids, BMI), as well as improve self-care and health education, and patient and clinician satisfaction. These groups have been piloted throughout the UK both face-to-face and virtually, with initial findings suggesting they are feasible and acceptable to patients and clinicians. Further work is needed to assess whether these could be cost-effective when scaled-up in National Health Service UK primary care. During the COVID- 19 pandemic, there has been increasing emphasis on the central role of nutrition in health, including the role of dietary micronutrients, as discussed by Dr Van Dael and Shane McAuliffe. Nutrition plays an important role in immunity, yet the nutritional status of the most vulnerable population groups is likely to deteriorate further due to the health and socio-economic impacts of the novel coronavirus. Thus, implementation of this evidence into health care practice is key. Precision Nutrition, defined as an 'approach that uses information on individual characteristics to develop targeted nutrition advice, products or services', offers an exciting opportunity to further individualise dietary advice for behaviour change, as discussed by Dr Kohlmeier and Dr Hernandez. Precision nutrition is underpinned by the recognition that individuals differ in many important ways due to identifiable molecular traits and can be utilised to determine personalised weight loss interventions based on genetic variants. Use of implementation science is in line with one of the six cross-cutting pillars of the Nutrition Decade: Aligned health systems for universal coverage of nutrition actions. Dr Bell, an Advanced Accredited Practising Dietitian in Australia, provided an overview of key implementation science models and frameworks. Implementation frameworks such as the Action Research Framework, the Knowledge to Action Cycle, and the Spread and Sustain Framework, are underpinned by knowledge creation, effective education, and culture change. Dr Bell then highlighted how theoretical frameworks have provided guidance for the implementation of real world, complex nutrition interventions, including the Systematised Interdisciplinary Program for Implementation and Evaluation (SIMPLE) in Australia, and the More-2-Eat program in Canada.

FEDERALISM AND COVID-19 IN ARGENTINA: Centralisation and hyper-presidentialism

The Covid-19 pandemic posed several serious challenges to the Argentine federation. When the Covid-19 pandemic reached Argentina in March 2020, all federal institutions were set in motion, demonstrating the importance of federalism in the fight against the pandemic. The first decisions were taken (almost simultaneously) by the four levels that make up the federation: the federal government, the provinces, the autonomous city of Buenos Aires, and the municipalities. When the federal government took the lead in the matter, coordination and dialogue were present in the most important decisions taken initially. But soon after, centralist practices prevailed again. This chapter analyses the initiatives taken by the different levels of government and the lack of an adequate conduct of intergovernmental relations. It concludes that in this emergency the country once again reaffirmed its tendency towards centralisation through hyper-presidentialism, which has not respected the important competences of the provinces, the Autonomous City of Buenos Aires, and the municipalities. © 2022 selection and editorial matter, Nico Steytler.

Risk mitigation and disease control challenges of SARS-CoV-2 multidirectional transmission at ski resorts

Background: During the COVID-19 pandemic, skiing venues were labeled high-risk, and in Colorado, ski resorts were considered the epicenter of the COVID-19 outbreak. The aim of this study is to examine trends in COVID-19 outbreaks at ski resorts and restaurants near ski resorts in Colorado during the 2020 to 2021 ski season to explore the potential multidirectional influence of COVID-19 within local communities. Furthermore, this study identifies potential high-risk settings associated with ski resorts and details infection control and risk mitigation strategies to inform future response planning. Methods: COVID-19 ski resort and restaurant outbreak data reported by the Colorado Department of Public Health and Environment during the 2020 to 2021 ski season was evaluated. The number of outbreaks and cases were described by county and month. Means described the number of cases and duration of outbreaks by setting type and differences were assessed using Welch's Two Sample T-tests. Results: A total of 57 COVID-19 outbreaks and 429 COVID-19 cases from seven counties with ski resorts were reported. Of the ski resort-related outbreaks, the majority of outbreaks occurred in maintenance and operation settings accounting for 39.0% (n=22) of the total outbreaks reported. However, 62.0% (n=266) of the total number of cases were reported from lodging settings. Of the total 429 cases, 425 (99.1%) were reported in resort workers, including one death. Additionally, 66 restaurant-related outbreaks were detected, yielding 266 COVID-19 cases in restaurant-related settings potentially associated with ski resort tourism. Conclusions: The results of this study suggest that COVID-19 ski-resort related outbreaks were highest in settings that typically involved close and frequent contact between individuals. There is little evidence to support increased transmission of SARS-CoV-2 and the activity of skiing outdoors. Nearly all the reported outbreak-related cases occurred among workers, suggesting the potential for multidirectional disease transmission between guests and workers within the community. This study highlights the importance of implementing improved disease monitoring and surveillance measures, as well as establishing multilayered infection control and risk mitigation strategies to prepare for future public health challenges. © 2022 Journal of Innovation Management. All rights reserved.

Behavior of logistics in Latin American countries under COVID19 pandemic conditions

The objective of this research is to analyze how government decisions adopted in Latin America, in terms of internal and external mobility, shaped the behavior of organizations to adapt to changing conditions in order to face the pandemic. The emerging parameters related to COVID 19 are identified through qualitative research applied to discourse analysis. The source of procedural changes in the different countries is DSV: De Sammensluttede Vognmænd, from March 17, 2020, to January 25, 2021. The contribution of this study lies in determining the type and variety of government decisions adopted in the region. The results show the dynamic behavior during the study period, with similar prevailing measures varying from the beginning of the pandemic to the first signs of economic recovery. In conclusion, the investigation shows the close relationship between international and urban logistics that are affected by government decisions, by the accumulation of loads, changes in the periods of inputs supply, leading to the need for companies to rethink their value chain distribution by the contingency plans installed to deal with disruptive events. © 2022, Universidad del Zulia. All rights reserved.

Online learning in higher music education: Benefits, challenges and drawbacks of one-to-one videoconference instrumental lessons

Online music courses are becoming more common in higher education thanks to the always increasing technological advances. Due to the COVID-19 pandemic many universities around the world have been forced to turn to online learning. There are currently several options to deliver online musical tuition, but most of them offer limited results. Online learning provides many advantages related to time and money saving, as well as ecological-related matters, access from remote areas and interaction between students and teachers around the world. However, most often communication will take place using platforms tailored for speech, which will have a significant impact on the lesson quality. Although face-to-face lessons cannot be completely replaced to guarantee quality tuition, online lessons can be a helpful complement in certain situations. This article aims to identify the most common limitations of the platforms available at the moment, suggesting different approaches to lessen the weaknesses of online instrumental one-to-one teaching.

Detection of SARS-CoV-2 in dialysis effluent on a peritoneal dialysis program in mexico city: four cases

Introduction: Since the rapid spread of the COVID 19 pandemic, it is crucial to identify possible sources of transmission of the SARS-COV-2 virus in order to perform procedures safely. There has been interest to identify the presence of SARS-CoV-2 in different compartments including peritoneal compartment. SARS-CoV-2 was detected by reverse transcriptase-polymerase chain reaction (RT-PCR) in dialysis effluent on a few single cases while other authors have reported negative results. Peritoneal membrane pores have a diameter of 20-40 nm while the SARS-CoV-2 virion diameter is between 60 to 140 nm, theoretically the virion could reach the peritoneal cavity by hematogenous diffusion or through the dialysis catheter after contact contamination. Case Description: We report dialysis effluent findings of four patients, two women and two men, with an age range of 35 to 64 years and different comorbidities including: diabetes mellitus, hypertension and obesity. They were diagnosed with COVID-19 using RT-PCR assay on nasopharyngeal samples or by tomography findings. RT-PCR samples of peritoneal effluent were obtained with a length of stay on peritoneal cavity of 6 hours, without centrifugation of the sample. Three patients were positive for presence of SARSCoV-2 on nasopharyngeal sample and dialysis effluent, while the fourth patient was negative in both samples despite having tomography findings suggestive of COVID-19 infection. It should be noted that in the 3 patients that had a positive RT-PCR on both nasopharyngeal and peritoneal effluent, samples were obtained within the first 7 days following the onset of symptoms associated with COVID-19 and on the fourth patient the peritoneal effluent sample was obtained 12 days after initial symptoms. All patients presented with acellular peritoneal fluid. No abdominal symptoms were reported. Discussion: Presence of SARS-CoV-2 on peritoneal fluid continues to be a subject of debate. Peritoneal effluent sample-drawing procedure has not been standardized, which may explain the inconsistent results noted by different authors. The positive results of the RT-PCR for SARS-CoV2 on peritoneal effluent must be confirmed on a larger sample. Although based on a small group, these findings should prompt to consider these fluids as potentially infective.