Clinical Features, Laboratory Findings Outcomes in Multisystem Inflammatory Syndrome (Mis-C) Following Covid-19 Infection - a Multicenter, Observational, Ambidirectional Cohort Study in Rio De Janeiro State, Brazil

Objectives: As of March 5th, 2022, around 1.585 cases of MIS-C and 98 deaths (6,4%) were reported in Brazil. The state of Rio de Janeiro State (RJ) having 94 cases (5,9%) and 4 deaths (4,2%)1.Our aim was to evaluate clinical and laboratory features, and management of MIS-C in seven pediatric hospitals in RJ, Brazil. Method(s): Multicenter, observational, ambidirectional cohort study in seven tertiary hospitals in RJ(Brazil), assessing medical charts of pediatric inpatients (0-18 years) diagnosed with MIS-C according to WHO/CDC criteria, from August, 2020 to February, 2022. Descriptive statistics were used to analyze distributions of continuous variables, frequencies, and proportions. Result(s): A total of 112 cases of MIS-C were enrolled. The mean age was 4.2 years and thre was male predominance (59,8%). All cases had a SARS-CoV-2 contact (29.5% close contact;31.3%:positive PCR;serology:43.8%).Only 12.5% had comorbidities. Length of stay (LOS) was 7 days.Median duration of fever was 8 days. Most common symptoms were: rash(67%);gastrointestinal (67%);conjunctivitis (42%);neurological(39.6%);cardiovascular(37.5%);cervical lymphadenopathy (36.6%), and shock/hypotension(28.6%).Co-infection occurred in 3 patients. Forty-four patients fulfilled criteria for Kawasaki disease. Most patients were admitted to PICU(12;62,5%) for amedian of 2 days. Respiratory distress was seen in 18,7%;hypotension:28,6%, and shock in 23,2%. Main laboratory findings were: high C-reactive protein in 95%;D-dimer:77%, anemia:77%, thrombocytosis:63%;transaminitis:43.8%, lymphopenia:38%;hypoalbuminemia:34%;thrombocytopenia: 29%;hypertriglyceridemia:28%, and high pro-BNP in 27%. Echocardiogram was performed in 91/112 patients;abnormal in 70,3%;exhibiting myocardial dysfunction( 25%);pericardial effusion(21%);coronary dilation/aneurysms(11%) and, valvulitis (14.5%). IVIG+corticosteroids (CTC) were administered in 59.8%(67/ 112);18.6%(18/112) IVIG only;10.7%(12/112) CTC only;3.4%(4/112)biologics, and 15(13.3%) received no treatment. ASA low dose in 77.7% (87/112) and moderate/high dose in 34.8%. Oxygen support was needed in 27,7%;vasoactive amines:18,7%;dialysis:5,3%, and transfusion:18,7%.One patient died from a cytokine storm syndrome. Conclusion(s): Our study reports a higher number of MIS-C cases in RJ than the number reported to Brazilian authorities, highlighting underreporting. Our patients were younger, had fewer comorbidities, cardiovascular/gastrointestinal/renal involvement, shortest LOS in ICU, and a higher frequency of myopericarditis.

Safety of a mRNA COVID-19 vaccine in patients with indolent systemic mastocytosis

Background: The development of vaccines against coronavirus disease 2019 (COVID-19) and the report of associated allergic reactions has led to growing concern about their safety, especially in populations at risk for anaphylaxis such as patients with systemic mastocytosis. Method(s): We conducted a retrospective descriptive analysis of patients with systemic mastocytosis referred to our Allergy and Clinical Immunology Department, between June 2021 and February 2022, for COVID-19 vaccination. Patients were divided into two groups according to their risk of allergic reaction: low/moderate-risk (no history of severe allergic reaction, with or without a history of allergic disease) and high-risk (history of any severe allergic reaction). All patients were premedicated with 60 mg of oral prednisolone 24 hours and 1 hour prior inoculation, and with an oral antihistamine 1 hour before vaccine administration. Low/moderate-risk patients were monitored for 30 minutes after vaccine inoculation. High-risk patients got a peripheral venous access and remained under medical surveillance for 60 minutes. Result(s): A total of 45 patients were included in the analysis: 62.2% females, with a mean age of 48.8 years (range: 22-85). All patients had indolent systemic mastocytosis subtype, with a median tryptase level of 15.6 ng/mL (range: 4.3-185 ng/mL);11 (24.4%) were in the high-risk group (8 with history of anaphylaxis to hymenoptera venom and 3 with prior drug anaphylaxis). Low/moderate-risk and high-risk groups had similar median levels of serum tryptase (15.5 vs. 16.6 ng/ mL, p = 0.932). All patients received BNT162b2 mRNA COVID-19 vaccine and a total of 118 doses were administered (24.6% in the high risk group). No adverse events, including allergic reactions, after vaccine inoculation were recorded during the surveillance period. Conclusion(s): To our knowledge, this is the largest series reporting safety of a mRNA COVID-19 vaccine in patients with systemic mastocytosis. Our data reinforce the fact that even patients with increased risk for allergic reactions can be safely vaccinated against COVID-19, and that earlier concerns should be abandoned so a widespread immunization can be achieved.

Diversity in organizations: contributions to achieving the sustainable development goals of the 2030 Agenda

The aim of this theoretical essay is to reflect on the role and contributions of organizations to promote diversity in the business environment and achieve the Sustainable Development Goals (SDGs) of the 2030 Agenda. The study provides a synthesis of the multiple perspectives of diversity in organizations, from the perspective of Top Level and Critical Mass theories;presents an overview of the SDGs, with an emphasis on SDG5 (gender equality) and SDG10 (reducing inequalities);proposes a discussion on diversity in organizations and the 2030 Agenda, presenting challenges for organizations in the current context, such as the impacts of COVID-19 on achieving the SDGs, as well as strategies and practices that can be adopted by organizations, based on recommendations bodies such as the Ethos Institute and the UN;and proposes reflections that can serve as a basis for new research and debates, especially in the field of organizational studies and accounting, based on the construction of a future research agenda on the topics addressed. The study contributes to the advancement and discussion of the literature on the subject and emphasizes the need to increase the awareness of researchers and managers about the importance of diversity as a social issue, which has important implications for business strategies and stakeholder perceptions regarding social responsibility and corporate sustainability.

Dificuldades Encontradas Pelas Ligas De Hematologia Do Brasil

Introducao: As ligas academicas possuem papel decisivo na vida do estudante, pois, por meio delas, o individuo explora a sua autonomia, criticidade e comprometimento. Alem disso, o aluno procura as ligas tambem para suprir a necessidade de experiencia clinica e de qualificacao profissional. E notorio que muitas ligas enfrentam obstaculos em suprir as demandas dos participantes, seja em funcao da dificuldade de encontrar professores para ministrar aulas, da realizacao de pesquisas ou da disponibilidade de projetos de extensao. O objetivo desse trabalho e, portanto, discutir os principais obstaculos que as Ligas de Hematologia do Brasil enfrentam. Metodologia: Foi realizada uma pesquisa quantitativa por meio da aplicacao de questionarios online direcionados a ligas academicas de hematologia do Brasil, no ano de 2020. O questionario foi destinado a 44 ligas, sendo a taxa de resposta de 72,7%. Esta pesquisa foi aprovada pelo comite de etica da instituicao proponente sob o CAAE 24510719.2.0000.0029. Os dados foram analisados pela ferramenta Excel 2013, para analise descritiva e foram codificados, de forma a garantir o sigilo dos participantes. Resultados: Ao ser questionado as ligas sobre a publicacao de trabalhos em congressos, 78,1% afirmaram que fazem esse tipo de publicacao. Das 32 ligas analisadas, 75% possuem atividade de extensao, sendo 91,7% com contato direto com os pacientes. Alem disso, 71,9% possuem dificuldades em promover um projeto de extensao, por conta de diferentes motivos. Dessas ligas analisadas, 93,8% tem professor orientador e 40,6% tem dificuldades em encontrar professores dispostos a ministrar aulas sobre o assunto. Discussao: Na extensao universitaria, parte do tripe ensino-pesquisa-extensao, as Ligas de Hematologia conseguem desenvolver alguma atividade de extensao na grande maioria, no entanto encontram dificuldades na elaboracao dos projetos, possivelmente por falta de professores orientadores para auxiliar nas atividades e a necessidade de recursos e estrutura para a realizacao desses. A falta do professor orientador hematologista pode tambem estar relacionada ao menor numero de medicos especialista em hematologista no Brasil, que, apesar de terem aumentado nos ultimos anos de acordo com a Demografia Medica de 2018, ainda sao poucos em comparacao a outras especialidades. Para as atividades de ensino e pesquisa o advento das atividades online, durante a Pandemia da COVID-19, pode ter sido fator positivo que possibilitou as Ligas a realizacao de aulas online com especialistas de outras cidades e estados, alem de orientacao de trabalhos a distancia, mas, para confirmar tal relacao, novos estudos seriam necessarios. Conclusao: As Ligas, apesar de enfrentarem obstaculos, mantem atividades nos pilares de pesquisa, ensino e extensao, principalmente com regularidade de aulas e publicacoes cientificas, sendo, portanto, necessario mais estudos que possam analisar as causas especificas dos problemas. Copyright © 2022

Relato De Experiencia: Mutirao De Doacao De Sangue

Introducao: A doacao de sangue e essencial para manutencao dos bancos de sangue nos hospitais e servicos de saude. A transfusao sanguinea garante a seguranca e possibilidade da realizacao de procedimentos, sejam eles de urgencia ou eletivos, em que ha risco de hemorragias importantes ou hipovolemia, alem de constituir tratamento insubstituivel para inumeras patologias. Dessa forma, faz-se necessario incentivar o recrutamento de novos doadores, para que as reservas de sangue sejam supridas. Objetivos: O objetivo do trabalho e relatar o projeto de extensao entre a Liga Academica de Hematologia e Hemoterapia da Universidade Catolica de Brasilia (LiHema-UCB) em parceria com o Instituto Hemocentro de Brasilia (IHB), no ambito do componente curricular Projeto de Extensao I, oferecido ao 2degreesemestre do curso de Medicina desta Instituicao de Ensino Superior. Relato: Em parceria com a Universidade Catolica de Brasilia, em disciplina, Projeto de Extensao I, na qual os estudantes precisam propor e executar um projeto de extensao comunitaria, a Liga de Hematologia (LiHema UCB) realizou um mutirao de doacao de sangue em conjunto com o Hemocentro de Brasilia. Em parceria com a LiHema-UCB e a FHB, no 2degreesemestre de 2021, foi oferecida uma aula para a sensibilizacao dos estudantes sobre a necessidade da doacao de sangue. A partir disso, foi organizado um mutirao de doacao, com o apoio logistico da FHB. O Mutirao se deu em momento que o Hemocentro de Brasilia necessitava de reposicao em seus estoques, que sofreram queda expressiva desde a pandemia de COVID19. Foram oferecidas aulas que versavam sobre a importancia da doacao de sangue e cadastro para doacao de medula ossea, bem como material didatico digital. O Hemocentro de Brasilia forneceu transporte gratuito para grupos agendados previamente para os dias de doacao, tendo sido agendados 6 grupos, com um total de 76 doadores. Tambem foram realizados cadastros para doacao de medula ossea. Conclusao: A concretizacao desse projeto permitiu, atraves das inumeras doacoes, uma importante contribuicao para comunidade em periodo de grande necessidade. Ele permitiu aos estudantes perceberem o enorme potencial de transmissao de informacoes e educacao em saude, uma vez que a simples pratica de transmitir conhecimento foi capaz de transformar um numero significativo de pessoas nao doadoras em doadoras. Isso se refletiu na criacao de um novo projeto, com alunos do Centro Educacional Catolica de Brasilia, em que os membros da Liga serao encarregados de todos os anos realizarem aulas informativas sobre doacao de sangue e medula para o 3degreeano do ensino medio, como forma de incentiva-los a se tornarem doadores e, principalmente, se tornarem detentores de informacao que, se passada adiante, impacta de forma exponencial nossa comunidade em uma area de grande importancia. Copyright © 2022

Eficacia Do Tratamento Baseado Em Venetoclax Em Paciente Jovem Com Leucemia Mieloide Aguda Recidivada Candidato a Transplante De Medula Ossea Alogenico

Introducao: A Leucemia Mieloide Aguda (LMA) e uma doenca agressiva, e em geral, de prognostico reservado. O tratamento com intuito curativo e realizado com altas doses de quimioterapia, seguido ou nao por transplante de medula ossea (TMO) alogenico. Porem, a recidiva ainda representa um desafio a ser superado, levando a busca de novas opcoes terapeuticas, como o inibidor de bcl-2, Venetoclax. Objetivo: Relatar o caso de um paciente jovem com LMA recidivada com resposta ao tratamento baseado em Venetoclax, seguido por TMO alogenico. Metodo: Levantamento de dados do prontuario e revisao da literatura. Relato do caso: VSV, sexo masculino, 21 anos, diagnosticado com LMA em 18/02/2020, mielograma com 60,4% blastos, com fenotipo CD45+ intermediario;CD34+;CD13+;CD33 parcial;CD64 parcial;HLA-DR parcial;MPO parcial e cariotipo 46, XY [20]. Sem possibilidade de avaliacao molecular da doenca. O paciente recebeu tratamento de inducao padrao (D3A7) atingindo remissao completa apos um ciclo e seguindo com consolidacao com 3 ciclos de ARA-C 3g/m2 ate maio de 2020 (optou-se por nao realizar o 4ciclo devido a pandemia por COVID19). Apresentava doenca residual minima (DRM) negativa em reavaliacao medular de agosto de 2020, mantendo-se ate junho de 2021, quando apresentou recidiva com 33,8% de blastos em imunofenotipagem de reavaliacao. Internado em julho de 2021 para QT de resgate com FLAG, evoluiu com choque septico e insuficiencia respiratoria, sendo necessario suporte em unidade de terapia intensiva. Apos recuperacao clinica, obteve novamente DRM negativa, sendo encaminhado para TMO alogenico aparentado (irma "full match"). Entretanto, enquanto aguardava o transplante, apresentou nova recidiva (IF com 5,4% de blastos), sendo optado por tratamento com Venetoclax + Azacitidina, com reducao de DRM para 1,5%. Recebeu o segundo ciclo de Venetoclax combinado com citarabina, devido a indisponibilidade da Azacitidina, seguido por DRM negativa. O paciente foi submetido ao TMO alogenico em 31/03/22, com avaliacao medular no D+60 com quimerismo de 100%, mantendo DRM negativa no D+120. Discussao: O uso do inibidor de BCL-2 (Venetoclax), em combinacao com agentes hipometilantes ou doses baixas de citarabina, foi aprovado para pacientes recem-diagnosticados com LMA inelegiveis para quimioterapia intensiva, revolucionando o tratamento da doenca. Publicacoes recentes vem demonstrando novos beneficios dessa associacao, tanto previamente ao TMO (em primeira linha ou com doenca recidivada), como na terapia de resgate para recidiva pos-TMO. Tambem tendo sido evidenciado sucesso terapeutico em faixas etarias menores (incluindo criancas). Esses novos estudos motivaram o uso de terapia baseada em venetoclax nesse paciente jovem, com doenca recidivada, conseguindo atingir e manter DRM negativa. Conclusao: O caso relatado demonstra eficacia do Venetoclax (em combinacao com hipometilante ou citarabina) em promover remissao profunda da doenca, tornando o paciente habil para o transplante e aumentando a probabilidade de sobrevida a longo prazo. Copyright © 2022

The Effect of Storytelling Associated with COVID-19 on Engagement

The main objective of this investigation is to understand how the posts in form of stories published by brands associated with the COVID-19 pandemic affected engagement with their consumers. Regarding the stories, plot, characters and verisimilitude have been evaluated. With regard to consumer engagement (CE), affective, emotional and cognitive involvement have been assessed. This study uses a qualitative methodology with a netnographic approach that takes into account the comments of the advertisements published on two social networks, Facebook and Instagram, by nine Portuguese brands. The results of this research reveal that in order for the stories associated with COVID-19 to have a greater level of influence on the customer, they must use their elements as a whole, to encourage positive consumer engagement. © Universidade de Santiago de Compostela.

Let’s Play! or Don’t? The Impact of UX and Usability on the Adoption of a Game-based Student Response System

Remote teaching emerged as an alternative to face-to-face classes during the COVID-19 pandemic. In this scenario, teachers adopt formative assessments through different approaches. One of these approaches is Game-based Student Response Systems (GSRS). Kahoot! is a prominent GSRS widely adopted in the educational context. Previous studies investigated the effects and use of Kahoot! by students. Still, none of them reports the teachers’ perception of its Usability and User Experience (UX), attributes that influence the tool’s adoption. This paper presents the usability and UX evaluation of Kahoot! from the point of view of teachers and students. To comparatively visualize the difference in the experience of the two profiles of platform users, we included five students and five teachers in the study. The evaluation results showed that teachers were more dissatisfied, although the positive and negative emotions were similar for the two profiles. We then conducted interviews with the teachers to understand the motives behind their dissatisfaction. The interviews helped us determine which aspects related to usability and UX teachers perceived as critical during the use of Kahoot!. Copyright © 2022 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved.

Quality of life in dentistry students in the pandemic of COVID-19: a multicentric study

This study aimed to assess the quality of life (QOL) of dental students in the 2019 Coronavirus Disease pandemic (COVID-19). A cross-sectional study was carried out with undergraduate students in Dentistry from Higher Education Institutions (HEIs) in the state of Ceara, Brazil. Data collection took place in May 2020, online, using questionnaires with sociodemographic, course-related and behavioral variables, in addition to the World Health Organization Questionnaire for Quality of Life-bref (WHOQOL-bref). Multinomial logistic regression was performed. 864 students participated in this study. Variables such as higher income (p = 0.034), having religion (p = 0.010), having health insurance (p = 0.005), satisfaction with sleep quality (p < 0.001), absence of insomnia (p < 0.001) and practicing physical activity always (p < 0.001) were associated with greater satisfaction regarding QOL. The QoL of dental students was classified in the dissatisfaction category, being perhaps impacted by the pandemic of COVID-19. Variables that reflected a more economically favorable living condition were associated with satisfaction with the quality of life of this public in the COVID-19 pandemic.

Obstetric care in the COVID-19 pandemic: Communication interactions between nurse midwives, woman, and doula

Background: Obstetric care, a positive birth experience, and professional interactions were affected by the COVID-19 pandemic and had to be restructured. Objective: To describe the communication process between doulas and obstetric nurses during the COVID-19 pandemic. Main topics under analysis: Disturbances in the interaction of the health team have impacted as-pects such as communication in health and collaboration, with deficits in the interpersonal relationships between nurses, doulas, and women. It is associated with autonomy of action and professional interactions, where conflicts and loss of quality of care were observed. Health sector reforms are urgent, including the delivery of respectful and quality care to women, families, and communities. Conclusion: The communication process has been negatively affected by the COVID-19 pandemic, requiring the development of interaction mechanisms to facilitate care activities and strategies to improve power relations between obstetric nurses and doulas in caring for women. © 2022, Escola Superior de Enfermagem de Coimbra. All rights reserved.

Early together: A randomized phase III study of early palliative care in metastatic uveal melanoma (MUM)

Background: Uveal melanoma is a rare cancer. Up to 50% of patients (pts) develop metastasis, mainly hepatic. Overall survival in metastatic pts is 12 months (mo), contrasting with a good overall condition until death. To evaluate the impact of integrating early palliative care on patient needs and self-efficacy, we designed a comparative randomized trial in MUM pts. Methods: 162 pts will be randomized (1:2) between the control and the experimental groups in two French centres (Institut Curie-Paris and Centre Antoine Lacassagne-Nice). In the control group, palliative care is introduced according to international guidelines. In the experimental group, it is added earlier, concomitant to the announcement of metastases by the medical oncologist. The main objective is to assess if early supportive care impacts on patient psychological needs at 6 mo, versus standard of care, based on the SCNS-SF34 questionnaire. Secondary objectives include patient's other needs at 6 and 12 mo, quality of life (QLQC30), progression-free and overall survival, and partners' needs (SCNS-P&C). MUM pts, suitable for a treatment with no curative intent, ECOG PS 0-1, with no physical or biological sign of disease, and capable of filling questionnaires are eligible. Questionnaires are completed by all pts at each oncological visit (baseline, 3, 6, 9 and 12 mo). Supportive care visits take place every 6 weeks if needed and address patient's information needs, disease and treatment understanding, social and psychological status, symptoms, and partners' involvement. Prognostic uncertainty and disease seriousness in the absence of symptom is addressed depending on pts' expressed needs. Medical oncologists and supportive care physicians from both centres attend communication skill training provided by an expert during the study. Analyses: SCNS-SF34 psychological needs scale scores at 6-mo will be compared with a Student's t-test, in an ITT analysis. For 10 points mean score difference expected between groups (within standard deviation of 20 points) and a two-sided type 1 error of 5%, inclusion of 54 pts (control group) and 108 pts (experimental group) provides the study 85% of power. The planned inclusion period is 3 years, pts will be followed for one year, for a total study duration of 4 years. From July 2020 to January 2022, 63 pts have been enrolled in the trial;2 pts declined. Five pts were removed early from the study: one for consent retrieval, 4 for early death due to metastasis. COVID-19 delayed enrollment for 5 months. We plan to complete the study Q4 2023 and to analyze the data Q4 2024.

PEDIATRIC INFLAMMATORY MULTISYSTEM SYNDROME TEMPORALLY-ASSOCIATED with SARS-COV-2-A PORTUGUESE SINGLE CENTRE CASE SERIES

Background: Across the globe, coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 appears to affect paediatric population in a milder and non-threatening way, when compared to adults. However, since April 2020 case reports of previously healthy children presenting with unremitting fever, biologic infammatory syndrome and cardiac dysfunction have been emerging. This syndrome, which has been termed Pediatric Infammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 infection (PIMS-TS), represents a rare complication of COVID-19 in children1. Objectives: To describe the clinical, laboratory and imaging characteristics, course, management and outcomes of hospitalized children diagnosed with PIMS-TS in a Portuguese tertiary care hospital. Methods: A retrospective study including children (< 18 years) that attended our hospital from April 2020 to December 2021 was performed. All the children included fulflled the case defnition of PIMS-TS published by the Centre for Disease Control and Prevention. Sociodemographic and clinical data, laboratory markers and imaging fndings were collected. Results: A total of 19 children met the criteria for PIMS-TS, 68% male with a mean age at diagnosis of 8 years old (IQR 5.8-15). They were all caucasian, except for a mixed-race patient, and all previously healthy, except one patient who was obese. Twelve had recent infection by SARS-CoV-2 detected by reverse transcriptase (RT) PCR and 18 had positive IgG serology. All had fever at diagnosis, with a median duration of 6 days (IQR 5-6) and 89.5% had mucocutaneous, gastrointestinal and hematological attainment, respectively. Other affected systems were respiratory (73.7%), cardiovascular (63%), lymphoid organs (52.6%), musculoskeletal (47%), genito-urinary (31.6%) and neurological (26.3%). Laboratory fndings can be found in Table 1. Thirty-six percent were admitted in intensive care unit for a median duration of 8 days (IQR 4-9). 42.1% needed respiratory support, 87.5% with supplemental oxygen therapy, 62.5% with mechanical ventilation and 12.5% with non-invasive ventilation. All patients received intravenous (IV) immunoglobulin, 52.6% IV cor-ticosteroid (CS) pulses and 78.9% IV and oral CS. Other treatments included acetylsalicylic acid (n=18), heparin (n=8) and antibiotic therapy (n=19)-Table 3. Seventeen fully recovered and 2 had sequalae: one of them with coronary artery aneurysms and other exertional dyspnea. Conclusion: In this case series, there was a broad spectrum of clinical symptoms and disease severity, ranging from fever and systemic infammation to critical care admission with myocardial injury, shock, and development of coronary artery aneurysms. Despite short-term morbidity, there were no mortality cases, with most of them recovering without sequelae. All physicians providing clinical care to children should consider this rare but severe delayed syndrome in paediatric population.

CRYOPRESERVED SEMINAL SAMPLES FROM PATIENTS WITH ACUTE COVID-19 HAVE THE WORST POST-THAW QUALITY WHEN COMPARED TO OTHER ANDROLOGICAL DISEASES

OBJECTIVE: To evaluate the effect of COVID-19 in sperm cryopreservation processes, including functional parameters evaluated pre-cryopreservation and post-thaw, and to compare post-thaw results from COVID-19 patients to samples from others systemic and andrological Disease MATERIALS AND METHODS: In this cross-sectional study, 37 semen samples of male patients aged 18 to 45 years at Division of Urology, Department of Surgery, Hospital das Clinicas of the University of Sao Paulo or at Androscience- Science and Innovation Center in Andrology, High-Complex Clinical and Research Andrology Laboratory, were initially recruited from April 2020 to April 2021. Patients were categorized as acute COVID-19 (n=15), confirmed by RT-PCR (COVID-19 group), and healthy individuals with normozoospermic semen samples (n=22;Control group). Were evaluated seminal parameters, cryosurvival rates (%), mitochondrial activity (%;3,30 -diaminobenzidine stain), reactive oxygen species levels (ROS;chemiluminescent technique) and DNA fragmentation (%;SCSA method) in precryopreservation and post-thaw samples. Samples were cryopreserved by the slow freezing technique. A complementary retrospective study was performed comparing post-thawed samples from COVID-19 group with data from patients with others male diseases: Male infertility (n=35);Severe infertility (n=62), caused severe oligozoospermia, grade 3 varicocele, gonadal dysgenesis, testicular nodule, testicular hypotrophy;testicular cancer (n=55);and other malignant diseases (leukemia, lymphoma, sarcoma, multiple myeloma;n=30). Was used T-test to statistical analysis (p<0.05). RESULTS: Macroscopy analysis of COVID-group revealed abnormal viscosity in 53.33%, semen volume = 4.50 ± 1.72 ml and pH = 8.13 ± 0.23. COVID-19 fresh samples demonstrated mean of progressive motility = 29.07±16.83%, sperm morphology = 2.07±1.58%, and DNA fragmentation index = 42.91±33.38%. Cryopreservation decreased progressive motility (to 5.39±7.92%;p=0.02), sperm vitality (70.46±8.50 vs. 72.20±23.27;p=0.042) and ROS (0.516±0.978 vs. 4.393±9.956 x 104 cpm;p=0.018). When we compared with cryopreserved normozoospermic samples, there was observed a significant difference in HDS (p=0.002). Cryosurvival rate from COVID-19 samples was 19.93;19.71%, and had significant difference when compared with severe infertility (40.16;31.05%;p=0.003), and other malignant diseases (53.14;28.55%, <0.001). CONCLUSIONS: Seminal samples from patients with COVID-19 showed reduced fertile potential, especially when compared to the reference values. In the comparisons performed with samples from patients with different andrological diagnoses, common in the specialized andrology laboratory routine, we can suggest that samples from patients with the acute form of COVID-19 had the worst quality, with low cryosurvival rates. This information contribute to the conduct of these patients during assisted reproduction routines and preservation of male fertility. IMPACT STATEMENT: It will contribute to conducts in the cryopreservation of sperm in patients with acute COVID-19.

CAPTAÇÃO DE DOADORES EM UM HOSPITAL DE TRAUMA DE PORTO ALEGRE/RS DURANTE A PANDEMIA

Objetivos: Desenvolvimento e implementação de reforço do processo de captação ativa de doadores de sangue, a fim de suprir as demandas do Hospital Cristo Redentor (HCR), especializado no atendimento às vítimas de trauma na cidade de Porto Alegre/RS, tendo início em setembro de 2020. Material e métodos: Elaboração e implementação de um fluxo de abordagem humanizada, educativa e transparente dos usuários e familiares para captação/ sensibilização quanto à importância da doação de sangue. O fluxo tem início na entrada do paciente no hospital, adotando estratégia mais abrangente com todos os familiares dos pacientes internados. A solicitação de doadores varia conforme o tipo de cirurgia a ser realizado. As abordagens ocorrem com os pacientes ambulatoriais que internam para realizar cirurgias eletivas, durante a consulta médica e de enfermagem e na marcação cirúrgica. Os pacientes internados vindos da emergência têm seus familiares abordados pela equipe do Serviço Social, de forma a esclarecer as dúvidas referentes à doação e entendimento da importância quanto à necessidade de manter os estoques de hemocomponentes para atender as demandas da hemoterapia. Resultados: A partir da implementação do fluxograma de captação/sensibilização de doadores ocorreu aumento do número de doações direcionadas ao HCR recebidas no Banco de Sangue do Hospital Nossa Senhora da Conceição, que abastece a demanda de estoques de hemocomponentes do serviço. A Agência Transfusional do HCR realiza em média 250 transfusões mensais (período da pandemia), dessas 174 são de Concentrado de Hemácias (CH). O cálculo do percentual de doadores reposição é realizado de acordo com a equação: número de doadores aptos/número total de transfusões de CH. O percentual de reposição foi de 54% (1° semestre 2020) para 111% (2° semestre 2020) e 140% (1° semestre 2021). Discussão: Considerando a drástica diminuição de doações de sangue durante o período da pandemia de COVID-19 e a necessidade de manter um estoque adequado para atendimento de vítimas de trauma, foi necessário o desenvolvimento de estratégias que possibilitassem um incremento do número de doações, a fim de suprir as demandas da Agência Transfusional do HCR. Após a implementação de uma abordagem mais ativa sobre a importância da doação de sangue, observamos uma maior mobilização de amigos e familiares de pacientes internados e consequentemente aumento no número de doações para o HCR, mesmo em nome de pacientes que não necessitaram efetivamente de transfusão. Conclusão: O trabalho de captação de doadores é uma tarefa contínua e integrada que requer participação de todos profissionais da saúde. Diante das adversidades enfrentadas na pandemia, diminuição da capacidade de atendimento de doadores no Banco de Sangue, doações com horário marcado e o isolamento social foi necessário criar métodos para continuar atendendo a demanda de transfusões. O esclarecimento quanto à segurança da doação e da importância da mesma para familiares dos pacientes foi fundamental para o engajamento no processo de captação de doadores. Esse esforço resultou em um salto na média de doadores de reposição de 54% no primeiro semestre de 2020 para 140% no primeiro semestre de 2021. Um aumento considerável no número de doadores de sangue mesmo em um período complicado por tantas restrições.

The rescue of the culture of hand hygienization in health services in the pandemic context

The aim of this study was to identify, in the scientific literature, the strategies used by health services to influence the formation of a culture of patient safety through hand hygiene among health professionals during the Covid-19 pandemic. This is a descriptive study of an integrative literature review. An advanced search was performed in the databases that make up the Virtual Health Library (VHL), of the 700 scientific publications identified, after applying the inclusion and exclusion criteria, 11 publications were selected that made up the final sample of the study, as they were from according to the proposed theme. During the study analysis process, the following thematic categories were highlighted: "Hand hygiene and its main public policies", "Nursing and the Covid-19 pandemic" and "Consequences of the breach of the hand hygiene protocol regarding safety of the patient". The studied literature showed that the consequences in relation to breaking the hand hygiene protocol regarding patient safety, especially in the Covid-19 pandemic, are worrisome because they affect both the patient's safety and the health professional's integrity. Furthermore, an increase in hospital stay and hospital costs, increased demand for the use of broad-spectrum antibiotics and increased morbidity and mortality rates were also identified.

Benefits, concerns, and perceptions of knowledge workers regarding a video Stress Detection software

Introduction: Stress is not only highly destructive, causing various mental health disorders (anxiety, insomnia, depression), cardiovascular diseases, poor immune function, and presenteeism, as it is costly. While concerns about occupational stress have increased, new solutions for its management have emerged. Systems based on the use of facial recognition, posture, eye movements, video monitoring, and behavioral stress detection have shown good results. Their drawback has mainly been the recording of the said video feed and privacy threats proceeding. This Focus Groups aimed to raise the opinions, perceptions, and concerns of end users regarding the system under development. Material and Methods: With a new solution in mind, we gathered two groups of knowledge workers, one group of team leaders, and a group of consulting psychologists to gather their perceptions. A Focus Groups was conducted online via Microsoft Teams, as COVID-19 restrictions were applied during that period. Results: Against previous reports, knowledge workers showed that privacy threats were not their major concern. Both groups showed that Mental Health was their main focus as the follow-up structure regarding stress detection was the most prevalent topic being close to information sharing and software adaptation. Conclusions: The results highly contribute to the development of future stress detection applications/software and the importance of a detailed and thorough explanation regarding the software framework.

Consensus public policy in a moment of crisis: How regulatory arrangements enable creative solution?

This article analyzes how normative arrangements can enable creative consensus solutions involving the Government in times of crisis, based on the possible increased conflicts resulting from public policies in the period during and after COVID-19. The aim is to verify if Brazil has a consensual normative arrangement that allows an adequate and agile response to a high number of conflicts, considering normative structures from three countries that have become the epicenter of the crisis: Italy, Spain and the USA. For this purpose, data were collected on the regulation of consensus in Brazil compared with the legal system of the three other elected systems as well as a bibliographic analysis that concerns to the dogmas that prevent consensual numerical advance in disputes involving the Government. Lastly, it aims to address how an interruption in legal reasoning can contribute to solutions used in a period of crisis.

COVID-19 Next Day Trend Forecast

Historically, weather conditions are depicted as an essential factor to be considered in predicting variation infections due to respiratory diseases, including influenza and Severe Acute Respiratory Syndrome SARS-CoV-2, best known as COVID-19. Predicting the number of cases will contribute to plan human and non-human resources in hospital facilities, including beds, ventilators, and support policy decisions on sanitary population warnings, and help to provision the demand for COVID-19 tests. In this work, an integrated framework predicts the number of cases for the upcoming days by considering the COVID-19 cases and temperature records supported by a kNN algorithm. © 2021, ICST Institute for Computer Sciences, Social Informatics and Telecommunications Engineering.