Rapid diagnosis of COVID-19 using FT-IR ATR spectroscopy and machine learning.

Early diagnosis of COVID-19 in suspected patients is essential for contagion control and damage reduction strategies. We investigated the applicability of attenuated total reflection (ATR) Fourier transform infrared (FTIR) spectroscopy associated with machine learning in oropharyngeal swab suspension fluid to predict COVID-19 positive samples. The study included samples of 243 patients from two Brazilian States. Samples were transported by using different viral transport mediums (liquid 1 or 2). Clinical COVID-19 diagnosis was performed by the RT-PCR. We built a classification model based on partial least squares (PLS) associated with cosine k-nearest neighbours (KNN). Our analysis led to 84% and 87% sensitivity, 66% and 64% specificity, and 76.9% and 78.4% accuracy for samples of liquids 1 and 2, respectively. Based on this proof-of-concept study, we believe this method could offer a simple, label-free, cost-effective solution for high-throughput screening of suspect patients for COVID-19 in health care centres and emergency departments.

Birth Defects and Long-Term Neurodevelopmental Abnormalities in Infants Born During the Zika Virus Epidemic in the Dominican Republic.

Background: When acquired during pregnancy, Zika virus (ZIKV) infection can cause substantial fetal morbidity, however, little is known about the long-term neurodevelopmental abnormalities of infants with congenital ZIKV exposure without microcephaly at birth. Methods: We conducted a cross sectional study to characterize infants born with microcephaly, and a retrospective cohort study of infants who appeared well at birth, but had possible congenital ZIKV exposure. We analyzed data from the Dominican Ministry of Health's (MoH) National System of Epidemiological Surveillance. Neurodevelopmental abnormalities were assessed by pediatric neurologists over an 18-month period using Denver Developmental Screening Test II. Results: Of 800 known live births from 1,364 women with suspected or confirmed ZIKV infection during pregnancy, 87 (11%) infants had confirmed microcephaly. Mean head circumference (HC) at birth was 28.1 cm (SD ± 2.1 cm) and 41% had a HC on the zero percentile for gestational age. Of 42 infants with possible congenital ZIKV exposure followed longitudinally, 52% had neurodevelopmental abnormalities, including two cases of postnatal onset microcephaly, during follow-up. Most abnormalities resolved, though two infants (4%) had neurodevelopmental abnormalities that were likely associated with ZIKV infection and persisted through 15-18 months. Conclusions: In the DR epidemic, 11% of infants born to women reported to the MoH with suspected or confirmed ZIKV during pregnancy had microcephaly. Some 4% of ZKV-exposed infants developed postnatal neurocognitive abnormalities. Monitoring of the cohort through late childhood and adolescence is needed.

Zika Virus Epidemic in Pregnant Women, Dominican Republic, 2016-2017.

Zika virus infection during pregnancy may result in birth defects and pregnancy complications. We describe the Zika virus outbreak in pregnant women in the Dominican Republic during 2016-2017. We conducted multinomial logistic regression to identify factors associated with fetal losses and preterm birth. The Ministry of Health identified 1,282 pregnant women with suspected Zika virus infection, a substantial proportion during their first trimester. Fetal loss was reported for ≈10% of the reported pregnancies, and 3 cases of fetal microcephaly were reported. Women infected during the first trimester were more likely to have early fetal loss (adjusted odds ratio 5.9, 95% CI 3.5-10.0). Experiencing fever during infection was associated with increased odds of premature birth (adjusted odds ratio 1.65, 95% CI 1.03-2.65). There was widespread morbidity during the epidemic. Our findings strengthen the evidence for a broad range of adverse pregnancy outcomes resulting from Zika virus infection.

Outbreak of Severe Histoplasmosis Among Tunnel Workers-Dominican Republic, 2015.

Background: Histoplasmosis is a fungal infection associated with exposure to bat guano. An outbreak of an unknown severe febrile illness occurred among tunnel workers in the Dominican Republic, and resulted in several deaths. We conducted an investigation to confirm etiology and recommend control measures. Methods: A case was defined as fever and ≥2 symptoms consistent with histoplasmosis in a tunnel worker, July-September 2015. We interviewed workers and family members, reviewed medical records, tested serum and urine for Histoplasma antigen/antibody, and conducted a cohort study to identify risk factors for histoplasmosis and severe infection (intensive care). Results: A crew of 36 male workers removed large amounts of bat guano from tunnels without respiratory protection for a median of 24 days per worker (range, 1-25 days). Median age was 32 years (range, 18-62 years); none were immunocompromised. Thirty (83%) workers had illness that met the case definition, of whom 28 (93%) were hospitalized, 9 (30%) required intensive care, 6 (20%) required intubation, and 3 (10%) died. The median time from symptom onset to antifungal treatment was 6 days (range, 1-11 days). Twenty-two of 34 (65%) workers had laboratory evidence of infection. Conclusions: Severe illnesses and death likely resulted from exposure to large inocula of Histoplasma capsulatum spores in an enclosed space, lack of respiratory protection, and delay in recognition and treatment. Clinician education about histoplasmosis, improved laboratory capacity to diagnose fungal infections, and occupational health guidance to protect workers against endemic fungi are recommended in the Dominican Republic.

Chikungunya: un reto para los servicios de salud de la República Dominicana / Chikungunya: a challenge for the Dominican Republic's health services

Desde diciembre de 2013, la Región de las Américas se enfrenta por primera vez a una epidemia de chikungunya. Los casos iniciales se registraron en el Caribe francés y, debido al comercio y la movilización de personas, esta epidemia no tardó en llegar a la República Dominicana, cuya población es de 10 millones de habitantes y comparte con Haití la isla La Española. En este artículo se difunde información extraída de diversos artículos y documentos oficiales sobre el virus, la infección y la epidemia de chikungunya, que han sido de gran ayuda para orientar la respuesta en la República Dominicana y pueden ser útiles para mejorar tanto el conocimiento como las actuaciones frente a la epidemia de los trabajadores del sector salud de la Región. Se destaca la importancia que revisten las investigaciones realizadas en países y territorios afectados del océano Índico, como la isla de Reunión, durante la epidemia declarada entre 2005 y 2007, cuando se registró una tasa de ataque mayor de 30%, se identificaron los grupos de riesgo, las formas graves y atípicas de la infección, la transmisión vertical del virus, las formas crónicas, que pueden provocar dolores recurrentes durante tres años, y las defunciones directa o indirectamente relacionadas con el virus chikungunya. Por su alta tasa de ataque, el virus chikungunya se convierte en un reto sin precedentes para los ministerios de salud, que exige una adecuada organización de los servicios de salud, la priorización de la atención a los grupos de riesgo y a los pacientes con formas graves de la enfermedad, así como una adecuada comunicación social y respuesta intersectorial.

The Region of the Americas has been affected since December 2013 by a chikungunya epidemic for the first time. Although the first cases were recorded in the French Caribbean, the epidemic quickly spread to the Dominican Republic due to trade and people movements. The Dominican Republic, which shares the island of Hispaniola with Haiti, has a population of 10 million. This article contains information from a range of different publications and official documents about the chikungunya virus infection and epidemic. These papers were extremely helpful for guiding the response to the epidemic in the Dominican Republic and may also be useful for enhancing knowledge of the virus and responses among health workers elsewhere in the region. Particular attention is drawn to the important research undertaken in countries and territories affected by the epidemic in the Indian Ocean area. This is the case, for example, of the island of La Réunion, where the epidemic had an attack rate of more than 30% between 2005 and 2007. Researchers were able to identify risk groups, severe and atypical forms of the infection, cases of vertical transmission, chronic disease causing recurrent pain over three years, and directly- or indirectly-related deaths from the virus. Given its high attack rate, the chikungunya virus has emerged as an exceptional challenge for health ministries and calls for appropriate organized responses from the health services, prioritization of care for risk groups and patients exhibiting severe forms of the disease, and effective social communication and intersectoral actions.

Chikungunya en la República Dominicana: lecciones aprendidas en los primeros seis meses / Chikungunya in the Dominican Republic: lessons learned in the first six months

La epidemia de chikungunya en la República Dominicana se inició en febrero de 2014. En los primeros seis meses se registraron 429 421 casos, que representaron 65% de todos los notificados a la Organización Panamericana de la Salud por 33 países y territorios de la Región de las Américas. Esta epidemia se ha transmitido con rapidez en dicho país y ha demandado una intensa respuesta intersectorial, que ha liderado el Ministerio de Salud Pública y, especialmente, el Sistema Nacional de Vigilancia Epidemiológica y la red de los servicios de salud. Considerando que afectará a miles de personas, el objetivo de este artículo es describir las actuaciones realizadas y compartir los resultados y las lecciones aprendidas durante estos primeros meses con los ministerios de salud y los profesionales de los países de la Región para ayudarles a preparar una respuesta adecuada para afrontarla de forma efectiva y eficiente.

The chikungunya epidemic in the Dominican Republic began in February 2014. During the first six months 429 421 cases were recorded, representing 65% of all those notified to the Pan American Health Organization by 33 countries and territories of the Region of the Americas. This epidemic has spread quickly in the Dominican Republic, requiring a focused intersectoral response, led by the Ministry of Public Health and involving major efforts by the National Epidemiological System and the health services network. Given that the virus will affect thousands of people, this article seeks to describe the actions that have already been carried out, and to share the results and lessons learned during these first months with health ministries and professionals in the countries of the Region, in order to assist them to prepare an appropriate response to confront the epidemic effectively and efficiently.

[Chikungunya in the Dominican Republic: lessons learned in the first six months]. / Chikungunya en la República Dominicana: lecciones aprendidas en los primeros seis meses.

The chikungunya epidemic in the Dominican Republic began in February 2014. During the first six months 429 421 cases were recorded, representing 65% of all those notified to the Pan American Health Organization by 33 countries and territories of the Region of the Americas. This epidemic has spread quickly in the Dominican Republic, requiring a focused intersectoral response, led by the Ministry of Public Health and involving major efforts by the National Epidemiological System and the health services network. Given that the virus will affect thousands of people, this article seeks to describe the actions that have already been carried out, and to share the results and lessons learned during these first months with health ministries and professionals in the countries of the Region, in order to assist them to prepare an appropriate response to confront the epidemic effectively and efficiently.

[Chikungunya: a challenge for the Dominican Republic's health services]. / Chikungunya: un reto para los servicios de salud de la República Dominicana.

The Region of the Americas has been affected since December 2013 by a chikungunya epidemic for the first time. Although the first cases were recorded in the French Caribbean, the epidemic quickly spread to the Dominican Republic due to trade and people movements. The Dominican Republic, which shares the island of Hispaniola with Haiti, has a population of 10 million. This article contains information from a range of different publications and official documents about the chikungunya virus infection and epidemic. These papers were extremely helpful for guiding the response to the epidemic in the Dominican Republic and may also be useful for enhancing knowledge of the virus and responses among health workers elsewhere in the region. Particular attention is drawn to the important research undertaken in countries and territories affected by the epidemic in the Indian Ocean area. This is the case, for example, of the island of La Réunion, where the epidemic had an attack rate of more than 30% between 2005 and 2007. Researchers were able to identify risk groups, severe and atypical forms of the infection, cases of vertical transmission, chronic disease causing recurrent pain over three years, and directly- or indirectly-related deaths from the virus. Given its high attack rate, the chikungunya virus has emerged as an exceptional challenge for health ministries and calls for appropriate organized responses from the health services, prioritization of care for risk groups and patients exhibiting severe forms of the disease, and effective social communication and intersectoral actions.

Multinational cholera outbreak after wedding in the Dominican Republic.

We conducted a case­control study of a cholera outbreak after a wedding in the Dominican Republic, January 22, 2011. Ill persons were more likely to report having consumed shrimp on ice (odds ratio 8.50) and ice cubes in beverages (odds ratio 3.62). Travelers to cholera affected areas should avoid consuming uncooked seafood and untreated water.

Comparação da cifose torácica e capacidade funcional de mulheres idosas com e sem osteoporose / Comparison of the thoracic kyphosis and the functional capacity of elderly women with and without osteoporosis

A diminuição da densidade mineral óssea das vértebras, própria do processo de envelhecimento e que pode ser agravada pela osteoporose, determina uma diminuição da região anterior dos corpos vertebrais, resultando em compressão e colapso dessas vértebras, com maior estreitamento dos discos e espaços intervertebrais. Essas novas condições interferem no funcionamento normal de órgãos e sistemas do organismo. O objetivo foi avaliar o grau de cifose torácica e a capacidade funcional de mulheres idosas com e sem osteoporose. Foram avaliadas 30 idosas ativas fisicamente, sendo 20 sem osteoporose (GSO: 65,1 ± 4,67 anos) e 10 idosas com osteoporose (GCO: 68,6± 6,46anos). Foram avaliados a medida da cifose torácica, teste de caminhada de seis minutos (TC6’), Timed Up and go (TUG) e força dos músculos respiratórios (PImáx e PEmáx). Os dados obtidos foram analisados utilizando o teste t de Student. O nível de significância utilizado foi de 5% (α ≤0,05). Houve diferença significativa entre os grupos sem (GSO) e com osteoporose (GCO) somente no TC6’(GSO: 426,63 ± 46,36 m; GCO: 392,64 ± 36,68 m, α =0,02). As outras variáveis analisadas não apresentaram diferença significativa (Cifose torácica: α = 0,17; TUG: α =0,49; PImax: α =0,45; PEmax: α =0,19). A osteoporose não influenciou o grau de cifose torácica, a força dos músculos respiratórios e mobilidade das idosas. Entretanto, o desempenho no TC6’ foi influenciado negativamente pela osteoporose.

The vertebral bony mineral density reduction, due to the aging process and aggravated by osteoporosis, determines a reduction on the spine size, with a previous region reduction of the vertebral bodies, resulting in compression and collapse of these vertebras, with a bigger disc constriction and intervertebral spaces. These new conditions interfere at the organs and organism systems normal functioning, what is responsible for the flexibility and mobility reduction. The objective was to evaluate the thoracic kyphosis degree and the functional capacity of elderly women with and without osteoporosis. 30 elderly women were evaluated, being 20 without osteoporosis (average age: 65,1 ± 4,67) and 10 women with osteoporosis (average age: 68,6 ± 6,46). All of them, initially, were submitted to an evaluation form, from whom personal data were collected. It was also evaluated the thoracic kyphosis measure, a six-minute walking test (6-MWT), a mobility test (TUG) and breathing muscles strength (MIP and MEP). The obtained data were analyzed using the Student t test. The significance level used was of 5% (α ≤0,05). There was a meaningful difference between the non-osteoporosis (GNO) and the osteoporosis group (GO) and at the 6-MWT (GNO: 426,63 ± 46,36 m; GO: 392,64 ± 36,68 m , α =0,02). The other analyzed variables didn’t show any meaningful difference (kyphosis: α = 0,17; TUG: α =0,49; MIP: α =0,45; MEP: α =0,19). Osteoporosis didn’t influence the thoracic kyphosis, the breathing muscles strength and nor the elderly women mobility. However, the 6-MWT performance was negatively influenced by osteoporosis.

A função da nomeação oral sobre comportamentos emergentes de leitura e escrita ensinados por computador / The oral naming function on emergencies behaviors of reading and spelling teaching by computer

Os métodos de alfabetização utilizados em sala de aula não têm diminuído os índices de repetência nas séries iniciais. Por essa razão, o presente trabalho enfocou o comportamento de leitura e escrita como objeto de estudo. Para isso, utilizou-se o programa Mestre@ (Goyos & Almeida, 1994). Os objetivos foram o ensino de um repertório de leitura e escrita, composto de palavras regularmente utilizadas nas séries iniciais, e o desenvolvimento e sistematização de um procedimento de ensino, via software. O procedimento utilizado foi o de exclusão. Foi solicitada a um grupo de alunos, a nomeação oral do estímulo modelo antes de escolher e/ou montar as palavras que estavam sendo ensinadas. Os resultados indicam uma alta probabilidade da aprendizagem sem erro das relações ensinadas bem como leitura das palavras de generalização, além de mostrar efeitos diferenciais entre os grupos, isto é, facilitação para o grupo sem o procedimento de nomeação oral (AU)

A função da nomeação oral sobre comportamentos emergentes de leitura e escrita ensinados por computador / The oral naming function on emergencies behaviors of reading and spelling teaching by computer

Os métodos de alfabetização utilizados em sala de aula não têm diminuído os índices de repetência nas séries iniciais. Por essa razão, o presente trabalho enfocou o comportamento de leitura e escrita como objeto de estudo. Para isso, utilizou-se o programa Mestre@ (Goyos & Almeida, 1994). Os objetivos foram o ensino de um repertório de leitura e escrita, composto de palavras regularmente utilizadas nas séries iniciais, e o desenvolvimento e sistematização de um procedimento de ensino, via software. O procedimento utilizado foi o de exclusão. Foi solicitada a um grupo de alunos, a nomeação oral do estímulo modelo antes de escolher e/ou montar as palavras que estavam sendo ensinadas. Os resultados indicam uma alta probabilidade da aprendizagem sem erro das relações ensinadas bem como leitura das palavras de generalização, além de mostrar efeitos diferenciais entre os grupos, isto é, facilitação para o grupo sem o procedimento de nomeação oral.

Observação, em sala de aula, do comportamento de alunos em processo de aquisição de leitura e escrita por equivalência / Classroom observation of students behavior in reading and writing acquisition processes by equivalence

A sala de aula, enquanto contexto de ensino, pode configurar-se como local apropriado para a observação das relações professor-aluno, bem como das demais variáveis que interferem no processo ensino-aprendizagem. Para verificar os efeitos de um procedimento de ensino computadorizado, foram realizadas observações da interação professor-aluno em uma sala de aula de uma escola da rede pública antes e depois da aplicação do mesmo. Os comportamentos acadêmicos e não acadêmicos dos alunos e da professora foram observados, tendo por base algumas categorias comportamentais. Através dessas observações, pôde-se perceber que não houve uma correlação direta entre o desempenho no procedimento computadorizado e alteração no desempenho (aumento do porcentual dos comportamentos acadêmicos, do contato com a professora, entre outros) das crianças em sala de aula. Apesar disso, esse tipo de procedimento propõe-se a verificar mudanças que vão além das encontradas em situações experimentais controladas do laboratório (AU)

Observação, em sala de aula, do comportamento de alunos em processo de aquisição de leitura e escrita por equivalência / Classroom observation of students behavior in reading and writing acquisition processes by equivalence

A sala de aula, enquanto contexto de ensino, pode configurar-se como local apropriado para a observação das relações professor-aluno, bem como das demais variáveis que interferem no processo ensino-aprendizagem. Para verificar os efeitos de um procedimento de ensino computadorizado, foram realizadas observações da interação professor-aluno em uma sala de aula de uma escola da rede pública antes e depois da aplicação do mesmo. Os comportamentos acadêmicos e não acadêmicos dos alunos e da professora foram observados, tendo por base algumas categorias comportamentais. Através dessas observações, pôde-se perceber que não houve uma correlação direta entre o desempenho no procedimento computadorizado e alteração no desempenho (aumento do porcentual dos comportamentos acadêmicos, do contato com a professora, entre outros) das crianças em sala de aula. Apesar disso, esse tipo de procedimento propõe-se a verificar mudanças que vão além das encontradas em situações experimentais controladas do laboratório