Youth resilience in front of hyperconnectivity during the pandemic in Catalonia

The purpose of this article is to present the results of four discussion groups between young people, experts, and professionals in various fields in Catalonia. Participatory and critical action research was carried out on the issues on which the effects of COVID-19 had a huge impact: 1) Mental health and youth violence;2) Hypercon-nectivity and information overload;3) Health and climate emergency;4) Unem-ployment and youth emancipation. The diversity of effects on youth has been mostly negative, however, there is also evidence of a series of positive effects or resilience by youngsters. © GKA Ediciones, authors.

Use of Mobile Phones in Classrooms and Digitalisation of Educational Centres in Barcelona

In the wake of the COVID-19 pandemic, multiple educational contexts experienced a sudden and accelerated digital transformation. However, this is not a new phenomenon. For years, public and private initiatives have been designed and tested in Spain. In this regard, the role and use of cell phones in the classroom has been a key and, at the same time, controversial aspect. In Barcelona (Catalonia), for example, recent educational policies have promoted the pedagogical use of cell phones. Within this framework, this article analyses whether these initiatives to promote the use of mobile phones are effectively transferred and implemented in the classroom. Using qualitative research, based on co-design, case studies and content analysis, we examined the reality of three educational centres in Barcelona. In these three contexts, field observations, interviews with management teams and ICT coordinators, and discussion groups with teachers were conducted. The information generated was grouped into five main categories of analysis. As a result, it was observed that the mobile phone has been losing prominence in the classroom. Schools tend to prohibit the use of cell phones and prefer computers to give priority to the control of technological tools in order to use the Internet safely. Mobile phones, in this sense, are only used at certain times when there is a pedagogical objective, although there is still a need for more pedagogical and digital training for teachers. © 2022 by the authors.

Upper respiratory tract viral load quantification in COV ID-19 patients at hospital admission and its association with disease severity

Introduction: There are aspects of COVID-19 pathogenesis that are still unknown. Objective: To determine the relationship between severity, mortality and viral replication in patients with COVID-19. Methods: Clinical characteristics, severity and mortality of 203 patients hospitalized for COVID-19 were analyzed and correlated with viral load (VL) and threshold cycle (TC) at admission;nasopharyngeal swab was obtained. Results: Mean VLs in surviving patients with mild to moderate, moderate to severe and severe disease were the following: 6.8 x 10(6), 7.6 x 10(7) and 1.0 x 10(9), respectively;and in patients with critical disease who died, VL was 1.70 x 10(9). TCs were 26.06, 24.07, 22.66 and 21.78 for the same groups. In those who died, a higher mean VL was observed at admission in comparison with those who survived (1.7 x 10(9) vs 9.84 x 10(6);p < 0.001). A significant correlation was observed between VL, severity and death (r = 0.254, p < 0.045 and r = 0.21, p < 0.015). High VL was associated with increased in-hospital mortality in comparison with low VL (OR = 2.926, p < 0.017). Conclusion: SARS-CoV-2 VL determined at hospital admission might classify risk simultaneously with other factors described in COVID-19.

The role of telemedicine in care of patients with cancer: A real-world experience from a Peruvian cancer institute during the COVID-19 pandemic

Background: For patients with cancer, the COVID-19 pandemic has increased morbidity and mortality due to their bigger susceptibility to infection and to the discontinuity of treatment. In this context, telemedicine has become an invaluable tool for cancer care. The purpose of this study is to describe the impact of telemedicine in the care of cancer patients from a Latin American public institution. Methods: Retrospective, descriptive and cross-sectional study of cancer patients who received medical care through telemedicine from the Department of Medical Oncology of the Instituto Nacional de Enfermedades Neoplasicas (INEN) during the COVID-19 pandemic, from March 2020 to February 2021. Data collection was performed in real time by medical oncologists. Impact was mesuared with a comparison between the amount of cancer care during the COVID 19 pandemic vs the previous year. A modified version of the University of Kansas Cancer Center telephone satisfaction survey was conducted. Variables included the process of requesting an appointment by telemedicine, satisfaction with telemedicine service and distribution of drugs. Results: 16 456 telemedicine visits were carried out in one year time, 96.1% were conducted by telephone and only 3.9% used a video communication platform. 73% of patients were female and 62% were in the age group from 31 to 60 years old. 43% corresponded to solid tumors where breast cancer was the most frequent diagnosis. Patients in active treatment represented 70% (n = 11587), with 64% of patients being treated with curative intent and 36% within the palliative setting. Regarding the result of telemedicine visits, 62% (n = 10,281) had a medical prescription (40% corresponded to hormonal therapy;and 19%, to intravenous or subcutaneous systemic treatment). Overall, 8% (n = 56) of cases required an in-person visit. In the annual comparative analysis (against in-person visits during the previous year), the gap was 23% (60%, 20%, 8% and 13% during the first, second, third and fourth quarters, respectively). According to the type of medical care, telemedicine accounted for the 27.6% of the total medical care employed during in the year. The maximum level of usage was in May 2020 with 52% and in February 2021 with 48%, coinciding with the first and second waves of COVID in Peru. The satisfaction survey was applied to 5765 randomly chosen patients from July to October 2020. The mean scores for the 3 variables studied were: 4.6 / 5 points for the process of requesting an appointment, 4.58 / 5 points for telemedicine service and 4.33 / 5 points for the distribution of medicines and orders. Conclusions: Telemedicine is key to guarantee the continuity of care for cancer patients with an adequate level of satisfaction. If the Telemedicine service had not been implemented, the number of medical consultations would have dropped to 40% in comparison to the previous year.

How Filipino Fishers Use Traditional Knowledge in Identifying Species of Juvenile Mangrove Crabs for Grow-out Culture

Mangrove crab growers in the Philippines still rely on wild-caught late instar to early juvenile mangrove crablets, as supplies from hatcheries are limited. Any batch of crablets caught from the wild is a mix of the three native species under the genus Scylla. Scylla species have different growth rates. Since grow-out culture depends heavily on species' growth, growers should be able to distinguish the species as early as the juvenile stage, which is taxonomically difficult. This study was done to consolidate low-cost traditional identification techniques for juvenile Scylla from fishers of the Philippines for future validation. Focused group discussions were done in fishing communities from Bataan, Pangasinan, and Cagayan on the island of Luzon. The study was continued through online surveys, as travel was restricted due to the Covid-19 pandemic. Results indicate that 70.58% of respondents identify the species of crabs by looking at their claws and 55.88% observe the color of the crabs. Almost half, or 41.17% of respondents, consider the width and size of the carapace. Unique methods in certain Philippine regions include observation of the behavior patterns, carapace texture, rate of weight gain, and seasonality. Validation of the traditional practices identified in this study would result in a reliable "at-a-glance" method of identifying juvenile Scylla in the Philippines, which would shorten the culture period, improve production gains, and manage local populations. © 2021 The authors. Published by the National.

Multicenter Evaluation of Superinfection Occurrence and Impact on Clinical Outcomes in Patients with COVID-19

Background. The coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spread globally throughout late 2019. During this pandemic, concern for bacterial and fungal superinfections has been present during the treatment of these patients. Methods. Hospitalized, adult patients with laboratory confirmed and symptomatic COVID-19 disease admitted between March 12, 2020 and May 31, 2020 were eligible for inclusion in this study. Data was obtained from electronic medical records and the hospital system's clinical surveillance program including demographics, comorbidities, hospitalization dates, laboratory values, mechanical ventilation, positive blood and respiratory cultures, treatment administration for COVID-19 as defined by the system's fluid treatment algorithm, and discharge disposition. Outcomes of this analysis include overall bacterial and fungal superinfection occurrence rate within 28 days of admission, patient characteristics that correlate with a higher risk of a superinfection, and the effect on 28-day mortality. Results. A total of 404 patients were included in the study analyses of which 56 (13.9%) had a documented superinfection within 28-days from admission. The most common superinfection organisms observed were Staphylococcus spp. (36.9%), Candida spp. (16.7%), and Klebsiella spp. (13.1%). Mortality was significantly higher in patients with superinfections (12.1% vs 5.8%, p < 0.001). To best assess characteristics that place patients at a higher risk of superinfection, a backwards, stepwise, multivariable logistic regression was performed. Black ethnicity, chronic kidney disease, intensive care unit (ICU) upon admission, lymphocytopenia, and receipt of tocilizumab were found to more likely have a superinfection within 28-days from admission. Comparison and analysis of baseline characteristics in patients with or without superinfection present. Day-28 mortality comparison in patients with or without superinfection. Mortality was observed in 7/58 patients with a superinfection versus 20/346 patients without superinfection present (p < 0.001). Multivariable analysis results for increased superinfection risk. All baseline characteristics with univariate analysis resulting in a p value of < 0.2 were included in the backwards, stepwise logistic regression model. Conclusion. In conclusion, our retrospective cohort study reports a superinfection rate of 13.9%. Presence of a superinfection significantly increases the likelihood of mortality within 28-days from admission. Characteristics that have a significant correlation to increased risk of superinfections include Black ethnicity, chronic kidney disease, ICU upon admission, and receipt of tocilizumab.

A Comprehensive COVID-19 Daily News and Medical Literature Briefing to Inform Health Care and Policy in New Mexico: Implementation Study.

BACKGROUND: On March 11, 2020, the New Mexico Governor declared a public health emergency in response to the COVID-19 pandemic. The New Mexico medical advisory team contacted University of New Mexico (UNM) faculty to form a team to consolidate growing information on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its disease to facilitate New Mexico's pandemic management. Thus, faculty, physicians, staff, graduate students, and medical students created the "UNM Global Health COVID-19 Intelligence Briefing." OBJECTIVE: In this paper, we sought to (1) share how to create an informative briefing to guide public policy and medical practice and manage information overload with rapidly evolving scientific evidence; (2) determine the qualitative usefulness of the briefing to its readers; and (3) determine the qualitative effect this project has had on virtual medical education. METHODS: Microsoft Teams was used for manual and automated capture of COVID-19 articles and composition of briefings. Multilevel triaging saved impactful articles to be reviewed, and priority was placed on randomized controlled studies, meta-analyses, systematic reviews, practice guidelines, and information on health care and policy response to COVID-19. The finalized briefing was disseminated by email, a listserv, and posted on the UNM digital repository. A survey was sent to readers to determine briefing usefulness and whether it led to policy or medical practice changes. Medical students, unable to partake in direct patient care, proposed to the School of Medicine that involvement in the briefing should count as course credit, which was approved. The maintenance of medical student involvement in the briefings as well as this publication was led by medical students. RESULTS: An average of 456 articles were assessed daily. The briefings reached approximately 1000 people by email and listserv directly, with an unknown amount of forwarding. Digital repository tracking showed 5047 downloads across 116 countries as of July 5, 2020. The survey found 108 (95%) of 114 participants gained relevant knowledge, 90 (79%) believed it decreased misinformation, 27 (24%) used the briefing as their primary source of information, and 90 (79%) forwarded it to colleagues. Specific and impactful public policy decisions were informed based on the briefing. Medical students reported that the project allowed them to improve on their scientific literature assessment, stay current on the pandemic, and serve their community. CONCLUSIONS: The COVID-19 briefings succeeded in informing and guiding New Mexico policy and clinical practice. The project received positive feedback from the community and was shown to decrease information burden and misinformation. The virtual platforms allowed for the continuation of medical education. Variability in subject matter expertise was addressed with training, standardized article selection criteria, and collaborative editing led by faculty.

Remdesivir versus standard of care for severe COVID-19

Background: Remdesivir (RDV), a direct-acting nucleotide pro-drug inhibitor of viral RNA-dependent RNA polymerases, was approved by the FDA for the treatment of hospitalized patients (pts) with COVID-19 infection and has been shown to shorten time to recovery and improve clinical outcomes in randomized clinical trials. We present the final Day 28 (D28) analysis of RDV vs standard of care (SOC) (interim Day 14 [D14] analysis published [Olender et al. Clin Infect Dis 2020]). Methods: Final comparative analysis from two studies: a prospective phase 3, randomized study of RDV (RDV cohort) and a real-world retrospective cohort study of SOC (non-RDV cohort). Both studies enrolled pts with SARS-CoV-2 infection confirmed by polymerase chain reaction, who had oxygen saturation ≤94% on room air or required supplemental oxygen and had pulmonary infiltrates. Pts in the RDV cohort were randomized 1:1 to receive IV RDV for 5 or 10 days (200 mg on Day 1 followed by 100 mg/day on Days 2-5 or 2-10), plus SOC;the two randomized dose-groups were combined for analysis. Pts in the non-RDV cohort received SOC as determined by local treatment practices (excluding RDV). Analysis populations were balanced using propensity score (PS) matching. The coprimary endpoints were D14 clinical recovery (determined using a 7-point ordinal scale) and D28 all-cause mortality. Factors associated with D28 mortality were assessed using a multivariable logistic regression model. Results: After PS matching, baseline characteristics were generally similar in the RDV and non-RDV cohorts;median age 61 years, 63% male, 42% obese, 12% Black, 71% no/low-flow oxygen use, 25% high-flow oxygen, 3% ventilated. Pts in the RDV cohort had significantly higher D14 clinical recovery rates (65% vs 57%) and significantly lower D28 mortality rates (12% vs 16%) compared with the non-RDV cohort (Table). In the multivariable analysis, in addition to RDV use, a lower risk of death at D28 was associated with: younger age;being female;being White (versus being Black/African American);receiving an HIV protease inhibitor prior to baseline;not having cardiovascular disease or COPD;more days of symptoms prior to baseline;and being on room air or low-flow oxygen at baseline (versus being on invasive mechanical ventilation). Conclusion: RDV was associated with significantly higher rates of clinical recovery at Day 14 and lower Day 28 mortality compared with SOC in hospitalized pts with severe SARS-CoV-2 infection.