摘要
The appearance of pressure ulcers (PU) is one of the frequent complications of prone position (PP), due to prolonged pressure and shear forces. OBJECTIVES: To compare the incidence of pressure ulcers secondary to prone position and describe their location among four Intensive Care Units (ICU) of public hospitals. METHODS: Multicenter descriptive and retrospective observational study. The population consisted of patients admitted to the ICU between February 2020 and May 2021, diagnosed with Covid-19 who required prone decubitus. The variables studied were sociodemographic, days of admission to the ICU, total hours on PP, PU prevention, location, stage, frequency of postural changes, nutrition and protein intake. Data collection was carried out through the clinical history of the different computerized databases of each hospital. Descriptive analysis and association between variables were performed using SPSS vs.20.0. RESULTS: A total of 574 patients were admitted for Covid-19, 43.03% were pronated. 69.6% were men, median age was 66 (IQR 55-74) and BMI 30.7 (RIC 27-34.2). Median ICU stay was 28 days (IQR 17-44.2), median hours on PD per patient 48â¯h (IQR 24-96). The incidence of PU occurrence was 56.3%, 76.2% of patients presented a PU, the most frequent location was the forehead (74.9%). There were significant differences between hospitals in terms of PU incidence (Pâ¯=â¯.002), location (Pâ¯=â¯.000) and median duration of hours per PD episode (Pâ¯=â¯.001). CONCLUSIONS: The incidence of pressure ulcers due to the prone position was very high. There is great variability in the incidence of pressure ulcers between hospitals, location and average duration of hours per episode of prone position.
摘要
Background: Neurocognitive symptoms are common in acute as well as convalescent (post-acute sequelae of COVID-19 [PASC]) COVID-19, but mechanisms of CNS pathogenesis are unclear. The aim of this study was to investigate cerebrospinal fluid (CSF) biomarker evidence of CNS infection, immune activation and neuronal injury in convalescent compared with acute infection. Method(s): We included 68 (35% female) patients >=18 years with CSF sampled during acute (46), 3-6 months after (22) SARS-CoV-2 infection or both (17), and 20 (70% female) healthy controls from longitudinal studies. The 22 patients sampled only at 3-6 months were recruited in a PASC protocol. CSF N-Ag was analyzed using an ultrasensitive antigen capture immunoassay platform (S-PLEX SARS-CoV-2 N Kit, Meso Scale Diagnostics, LLC. Rockville, MD). Additional analyses included CSF beta2-microglobulin (beta2M)], IFN-gamma, IL-6, TNF-alpha neurofilament light (NfL), and total and phosphorylated tau. Log-transformed CSF biomarkers were compared using ANOVA (Tukey post-hoc test). Result(s): Patients sampled during acute infection had moderate (27) or severe (19) COVID-19. In patients sampled at 3-6 months, corresponding initial severity was 10 (mild), 14 (moderate), and 15 (severe). At 3-6 months, 31/39 patients reported neurocognitive symptoms;8/17 patients also sampled during acute infection reported full recovery after 3-6 months. CSF biomarker results are shown in Figure 1. SARS-CoV-2 RNA was universally undetectable. N-Ag was detectable only during acute infection (32/35) but was undetectable in all follow up and control samples. Significantly higher CSF concentrations of beta2M (p< 0.0001), IFN-gamma (p=0.02), IL-6 (p< 0.0001) and NfL (p=0.04) were seen in acute compared to post-infection. Compared to controls, beta2M (p< .0001), IL-6 (p< 0.0001) and NfL (p=0.005) were significantly higher in acute infection. No biomarker differences were seen post-infection compared with controls. No differences were seen in CSF GFAp, t-tau or p-tau. Conclusion(s): We found no evidence of residual infection (RNA, N-Ag), inflammation (beta2M, IL-6, IFN-gamma, TNF-alpha), astrocyte activity (GFAp) or neuronal injury (NfL, tau) 3-6 months after initial COVID-19, while significantly higher concentrations of several markers were found during acute infection, suggesting that PASC may be a consequence of earlier injury rather than active CNS damage. CSF beta2M, IL-6, IFN-gamma and NfL were significantly lower after 3-6 months than during acute COVID-19 and not different from healthy controls. (Figure Presented).
摘要
The appearance of pressure ulcers (PU) is one of the frequent complications of prone position (PP), due to prolonged pressure and shear forces. Objectives: To compare the incidence of pressure ulcers secondary to prone position and describe their location among four Intensive Care Units (ICU) of public hospitals. Methods: Multicenter descriptive and retrospective observational study. The population consisted of patients admitted to the ICU between February 2020 and May 2021, diagnosed with Covid-19 who required prone decubitus. The variables studied were sociodemographic, days of admission to the ICU, total hours on PP, PU prevention, location, stage, frequency of postural changes, nutrition and protein intake. Data collection was carried out through the clinical history of the different computerized databases of each hospital. Descriptive analysis and association between variables were performed using SPSS vs.20.0. Results: A total of 574 patients were admitted for Covid-19, 43.03% were pronated. 69.6% were men, median age was 66 (IQR 55-74) and BMI 30.7 (RIC 27-34.2). Median ICU stay was 28 days (IQR 17-44.2), median hours on PD per patient 48 h (IQR 24-96). The incidence of PU occurrence was 56.3%, 76.2% of patients presented a PU, the most frequent location was the forehead (74.9%). There were significant differences between hospitals in terms of PU incidence (p = 0.002), location (p < 0.001) and median duration of hours per PD episode (p = 0.001). Conclusions: The incidence of pressure ulcers due to the prone position was very high. There is great variability in the incidence of pressure ulcers between hospitals, location and average duration of hours per episode of prone position.
摘要
Due to the scarce antecedents and the need to contribute to professional training, the following objectives were proposed: To study occupational hazards in the agricultural sector of the northeast of the province of Buenos Aires. To train students of the career of Higher Technician in Occupational Hygiene and Safety in the Workplace to carry out an investigation. A survey was carried out with 104 people of the local agricultural sector, during 2021 under the different modalities allowed by the coronavirus pandemics. The main risks surveyed were those related to the use of tractors and agricultural machinery, the use of agrochemicals, overexertion and exposure to climatic factors. A diversity of chemical products used was observed, which is directly related to the diversity of agricultural activities in the area. Training was scarce, with INTA being the main institution that carries out training in the region. The coronavirus pandemics had little impact on the activity, mainly in terms of less sales, difficulty in working according to protocols and loss of wages. There was agreement on the need for greater training and control by the authorities in terms of hygiene, safety and ergonomics in the field of agricultural work. With respect to the pedagogical objective sought, the research enabled the students to be trained for their future professional life. © 2022, Asociacion Argentina de Horticultura - ASAHO. All rights reserved.
摘要
The appearance of pressure ulcers (PU) is one of the frequent complications of prone position (PP), due to prolonged pressure and shear forces. Objectives: To compare the incidence of pressure ulcers secondary to prone position and describe their location among four Intensive Care Units (ICU) of public hospitals. Methods: Multicenter descriptive and retrospective observational study. The population consisted of patients admitted to the ICU between February 2020 and May 2021, diagnosed with Covid-19 who required prone decubitus. The variables studied were sociodemographic, days of admission to the ICU, total hours on PP, PU prevention, location, stage, frequency of postural changes, nutrition and protein intake. Data collection was carried out through the clinical history of the different computerized databases of each hospital. Descriptive analysis and association between variables were performed using SPSS vs.20.0. Results: A total of 574 patients were admitted for Covid-19, 43.03% were pronated. 69.6% were men, median age was 66 (IQR 55-74) and BMI 30.7 (RIC 27-34.2). Median ICU stay was 28 days (IQR 17-44.2), median hours on PD per patient 48 h (IQR 24-96). The incidence of PU occurrence was 56.3%, 76.2% of patients presented a PU, the most frequent location was the forehead (74.9%). There were significant differences between hospitals in terms of PU incidence (p = 0.002), location (p < 0.001) and median duration of hours per PD episode (p = 0.001). Conclusions: The incidence of pressure ulcers due to the prone position was very high. There is great variability in the incidence of pressure ulcers between hospitals, location and average duration of hours per episode of prone position.
摘要
Objective: To describe pediatric dentists' perceptions regarding dental biosafety in times of COVID-19 in Lima, 2020. Material(s) and Method(s): A qualitative, phenomenological and content-analysis study. In-depth semi-structured interviews were conducted with 18 pediatric dentists through the Zoom videoconferencing platform, following the guidelines described in a guide and after obtaining the pertinent virtual informed consent. ATLAS.ti software version 8.4 was used for data analysis, where all the verbatim files of each interview were uploaded. Result(s): Pediatric dentists perceived themselves to be professionally empowered with knowledge about biosafety measures. Moreover, they highlighted the mastery of various techniques such as mouthwash, use of personal protective equipment, control of aerosols, social distancing between patients and disinfection of environments, which are essential for patient safety. They also reported that biosafety regulations are somewhat confusing, unclear, and lack a pediatric approach. Conclusion(s): Pediatric dentists are strategic human resources for healthcare because they gained biosafety knowledge as part of their professional education and received training on new biosafety regulations in the context of the COVID-19 pandemic. It is important to standardize the criteria and approaches in the model of care for pediatric dentistry and guarantee the conditions for the sustainability of this professional practice. Copyright © La revista.
摘要
HEMOCOVID-19 is a multi-center trial aiming to assess the microvascular and endothelial health of severe COVID-19 patients in the intensive care using near-infrared spectroscopy. Here, we present the preliminary results, showing that peripheral microcirculatory alterations are associated with the severity of acute respiratory distress syndrome. © 2022 The Author(s).
摘要
Objective: To analyze the psychological impact and coping strategies in Peruvian adults during the Covid-19 pandemic. Methods: A qualitative study was developed with 6 males and 4 women, compiled through a semi-structured interview guide. Results: The most stressful situations for peruvian adults were their health vulnerability, the limitation of their freedoms, labor and economic changes, and family conflicts. The psychological impact on them was expressed through emotional distress, physiological, somatic and cognitive changes. And, they used selfcare, compliance with health measures, relaxation, relaxation and entertainment as coping strategies, as well as the reassessment of the situation. Conclusions: The pandemic and compulsory social confinement caused a psychological impact on peruvian adults and they have used active and avoidant coping strategies functional to the context.
摘要
We present the HEMOCOVID-19 study spanning four countries and eight hospitals where near-infrared spectroscopy is utilized to evaluate microvascular and endothelial health of severe COVID-19 patients at the intensive care. © 2021 SPIE. All rights reserved.
摘要
This paper addresses the potential of smart wearable and collaborative technologies in support of healthier, safer, and more productive shop floor environments during the present and post- coronavirus 2019 pandemic emerging digital manufacturing worlds. It highlights the urgent need to "digitally transform" many high-touch shop floor operations into low-touch or no-touch ones, aiming not only at a safer but also more productive return to work as well as a healthier continuity of production operations in more socially sustainable working environments. Furthermore, it discusses the interrelated roles of people, data, and technology to develop smart and sustainable shop floor environments. Lastly, it provides relevant recommendations to the key business units in a manufacturing enterprise in regard to the adoption and leverage of smart, wearable, and collaborative technologies on the shop floor in order to ensure the short- and long-term operation of a factory amid the coronavirus 2019 pandemic and the future of production and work in the Industry 4.0 era.
摘要
COVID-19, caused by SARS-CoV-2, emerged in late 2019 in Wuhan, China. Its clinical course is variable, as well as the mortality rate, which is higher among people over 65 years of age and persons with underlying conditions. Immunodeficiencies are potential risk factors for severe forms of COVID-19. Furthermore, patients with immunodeficiencies often undergo non-infectious complications, which could bear additional risk. So far, few reports of patients with COVID-19 and humoral immunodeficiencies have been published. Considering the importance of the study of this new viral disease and its potential health impact on patients with immunodeficiency disorders, we present six cases of COVID-19 in patients with impaired humoral immunity. Three were women and three were men. The average age was 48.5 years (range 20-67). Four had been diagnosed with primary antibody deficiency: three had common variable immunodeficiency and one had X-linked agammaglobulinemia. The other two patients had secondary hypogammaglobulinemia, one was associated with thymoma (Good's syndrome), and the other was associated with rituximab treatment. The evolution was favorable in all except the patient with Good's syndrome, who presented a marked decline in clinical status before contracting COVID-19.
主题 s
COVID-19/transmission , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Respiration, Artificial/adverse effects , Tracheotomy/instrumentation , COVID-19/prevention & control , Consensus , Equipment Design , Humans , Tracheotomy/adverse effects , Tracheotomy/methods摘要
The 23 June 2020 La Crucecita earthquake occurred at 10:29 hr on the coast of Oaxaca in an Mw 7.4 megathrust event at 22.6 km depth and triggered a tsunami recorded at tide gauge stations and a Deep-ocean Assessment and Reporting of Tsunamis off the coast of Mexico. Immediately after the earthquake, a rapid response effort was coordinated by members of the Tsunami and Paleoseismology Laboratory, Universidad Nacional Autónoma de México. Despite the challenges posed by the Coronavirus disease 2019 (COVID-19) pandemic crisis, a postearthquake and post-tsunami field survey went ahead two days after the event. We describe here the details of the rapid response survey of the vertical coseismic deformation, tsunami, geologic effects, and lessons from working in the field during the COVID-19 crisis. We surveyed 44 km along the coast of Oaxaca. Because of the COVID-19 pandemic, some local communities enforced rules of confinement. We solved most of the challenges faced during this crisis by rapidly networking with local organizations prior to surveying. We assessed coseismic uplift by means of mortality caused by vertical displacement of intertidal organisms and resurveying of benchmarks, and we measured tsunami runup. Our results show coastal uplift of 0.53 m near the epicenter and decreasing farther away from it;uplift was up to 0.8 m in areas related to exposure of the coast. Of our values of coastal uplift, about 0.53 m fit well with the 0.55 m of uplift reported by tide gauge data at Huatulco. Coastal uplift and low tide at the time of the event limited the tsunami inundation and runup on the Oaxaca coast. Nevertheless, we found tsunami inundation evidence at four confined coastal sites reaching a maximum runup of 1.5 m. The enclosed morphology of these sites determined higher runup and tsunami inundation. Local coastal morphology effects are not detected in tsunami models lacking detailed bathymetry and topography. This issue needs to be addressed during tsunami hazard assessments. © Seismological Society of America
摘要
The coronavirus disease 2019 (COVID-19) pandemic has exposed many issues within the global value chains and caught many companies with their guard down during the early stages of their digital transformation. Several COVID-19 mitigation measures, such as travel restrictions, social distancing, and remote work were quickly introduced, and many manufacturing companies have struggled to keep their factories operational. As a result, smart technologies, such as artificial intelligence and wearables, have been rapidly deployed on the shop floor to mitigate the COVID-19 impact with the short-term objective of keeping the workforce safe and the facilities compliant with the requirements to remain open. The majority of these newly introduced and rapidly deployed smart systems carry a significant price tag. This paper explores the impacts of this rapid adoption of smart technologies with regard to the workforce's role in smart manufacturing systems during and post-COVID-19. Furthermore, we attempt to provide initial insights to the question: "What is the long-term impact and value of these rapidly deployed and sophisticated smart technologies in the post-COVID-19 Smart Manufacturing Systems?"
摘要
Today’s fast-growing demands at the global level for mobile applications (apps) cause customers to call for the customization of their apps to fit their individualized needs and business realms. Customization is a challenge for apps-development companies when they want to satisfy their numerous users in a crowded competitive market. Moreover, pursuing customization involves additional challenges when ramping up app development projects in order to meet demands at a larger scale. To address this challenge, we proposed a framework to systematize and support mobile apps’ development consistently with a customer-driven approach and modular design philosophy. From a practical point of view, the proposed framework integrates quality function deployment (QFD), axiomatic design (AD) principles, and practices from the ITIL (Information Technology Infrastructure Library) framework. The framework supports a systematic process for translating customer needs into design parameters as well as supporting prioritization of ITIL practices for further development. The effectiveness of the framework was explored in practice through a case study about an app supporting relief in the 2020 COVID-19 pandemic, as well as a survey among potential users. The assessment of the framework indicated an average score ranging between 3.58 and 3.92 in a five-point Likert scale for all of the items used in the survey. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
摘要
OBJECTIVE: To analyze changes in the lifestyles of Brazilian adolescents during the COVID-19 pandemic. METHODS: Cross-sectional study carried out with adolescents who participated in the survey "ConVid Adolescentes - Pesquisa de Comportamentos". The indicators related to lifestyles before and during the COVID-19 pandemic were evaluated: consumption of healthy and unhealthy foods, physical activity and sedentary behavior, smoking and consumption of alcohol. Prevalence and 95% confidence intervals were calculated for the total population and according to sex and age group. RESULTS: A total of 9,470 adolescents participated in the study. During the period of social distancing, there was an increase in the prevalence of vegetables consumption (from 27.34 to 30.5%), frozen foods (from 13.26 to 17.3%), chocolates and sweets (from 48.58 to 52.51%), and time in front of screens (from 44.57 to 70.15%). On the other hand, there was a decrease in the practice of physical activity (from 28.70 to 15.74%) and in the consumption of alcohol (from 17.72 to 12.77%). Differences were observed according to sex and age group. CONCLUSION: The results show changes in the lifestyle of adolescents and an increase in health risk behaviors.