El papel del modelado estadístico en la gestión de emergencias es fundamental para perfilar o apoyar las decisiones en torno a la atención de los eventos. En 2020 con el surgimiento de la pandemia ...por coronavirus, los países rápidamente se prepararon para la atención del comportamiento de contagio y el impacto que tendría en la salud pública. En Costa Rica, un equipo de especialistas preparó estudios sobre el comportamiento de la curva de contagio y su efecto en la ocupación de camas hospitalarias durante los primeros tres meses de la presencia de la epidemia. Los estudios se basaron en la estimación de modelos estadísticos de crecimiento exponencial y logístico, los cuales proporcionaron los pronósticos del número de casos diarios y acumulados. La predicción de casos permitió alimentar un modelo de simulación para la proyección de demanda de camas hospitalarias por pacientes de la COVID-19. Los análisis se basaron en los datos aportados por el Ministerio de Salud en torno a los casos confirmados por coronavirus desde la aparición del primer caso en Costa Rica. Se estimaron cuatro modelos: logístico, Richards, Gompertz y exponencial, los cuales generaron la predicción de casos diarios. También se estimó el número de reproducibilidad mediante estadística bayesiana para cuantificar la transmisibilidad del virus. Los resultados permitieron anticipar el comportamiento inicial del virus en Costa Rica y el potencial efecto de las medidas de contención que se adopta-ron a partir de la declaratoria de emergencia nacional. JEL: C15 Métodos de simulación estadística
Corticosteroids are one of the few drugs that have shown a reduction in mortality in coronavirus disease 2019 (COVID-19). In the RECOVERY trial, the use of dexamethasone reduced 28-day mortality ...compared to standard care in hospitalized patients with suspected or confirmed COVID-19 requiring supplemental oxygen or invasive mechanical ventilation. No benefit in patients not requiring respiratory support at randomization was observed. However, we believe that the use of corticosteroids in patients with COVID-19 pneumonia might not be subject to a decision based solely on oxygen needs. Evidence has shown that 30% of COVID-19 patients in its initial phases will progress to acute respiratory distress syndrome, particularly patients in whom laboratory inflammatory biomarkers associated with COVID-19 disease progression are detected. We postulated that corticosteroids in patients with COVID-19 in its initial phases and risk of progressing to severe disease might lead to a decrease in the development of acute respiratory distress syndrome, and thereby reduce death.
A procedure is presented to detect changes in a video sequence based on the Viola & Jones Method to obtain images of faces of persons; videos are taken of the web. The software allows to obtain ...images or frames separated from nose, mouth, and eyes but the case of the eyes is taken as an example. Change detection is done by using correlation and the Harris detector. The correlation results allow us to recognize changes in position in the person or movement of the camera if the individual remains fixed and vice versa. It is possible to analyze a part of the face thanks to the Harris detector; It is possible with detected reference points to recognize very small changes in the video sequence of a particular organ; such as the human eye, even when the image is of poor quality as is the case of videos downloaded from the Internet or taken with a low-resolution camera.
The objective of this study was to identify the perceived problems by medical and nursing professionals that have arisen in the Spanish Emergency Medical Services (EMS) as a consequence of the first ...wave of the severe acute respiratory syndrome-coronavirus-2/SARS-CoV-2 pandemic, as well as the measures or solutions adopted to manage those problems and improve response.
This was a cross-sectional study of quantitative and qualitative methodology ("mixed methods") using a self-administered questionnaire in 23 key informants of EMS of Spain selected by purposeful sampling, followed by the statistical analysis of both types of variables and an integration of the results in the discussion.
Common problems had been identified in many EMS, as well as similar solutions in some of them. Among the former, the following had been found: lack of leadership and support from managers, initial shortage of personal protective equipment (PPE), lack of participation in decision making, initial lack of clinical protocols, and slowness and/or lack of adaptability of the system, among others. Among the solutions adopted: reinforcement of emergency call centers, development of specific coronavirus disease 2019 (COVID-19) telephone lines and new resources, personal effort of professionals, new functions of EMS, support to other structures, and reinforcement of the role of nursing.
The general perception among the respondents was that there was a lack of support and communication with health care managers and that the staff expertise was not used by policy makers to make decisions adapted to reality, also expressing the need to improve the capacity for analysis of the EMS response. Few respondents reported good overall satisfaction with their EMS response. The EMS adopted different types of measures to adapt to the COVID-19 pandemic.
Latin America has a high diversity of Macrobrachium prawns, some of them with commercial interest. Among them, the cauque river prawn Macrobrachium americanum is a large prawn of the western coast ...with commercial value due to its size and taste, but it has been extensively subjected to fishery exploitation, leading to population decline. Cultivation is an option for commercial production and conservation. Some research focused on domestication has been performed. Here, we revise the status of that research and discuss possibilities for sustainable freshwater prawn aquaculture in Mexico and elsewhere in Latin America.
The binding energy of a negatively charged hydrogenic impurity with on- and off-center positions in a spherical Gaussian quantum dot was calculated with the configuration interaction method. Our ...calculations show that
E
b
is always positive for on-center impurities with a maximum near to the radius for one-electron stability of the potential well
R
c
. For off-center positions the binding energy can assume negative values within a range of the quantum dot radius, thus indicating the instability of the system.
Background:
Patients with sepsis with a concomitant coronavirus (COVID-19) infection are related to a high morbidity and mortality rate. We investigated a large cohort of patients with sepsis with a ...concomitant COVID-19, and we developed a risk score for the estimation of sepsis risk in COVID-19.
Methods:
We conducted a sub-analysis from the international Health Outcome Predictive Evaluation Registry for COVID-19 (HOPE-COVID-19-Registry, NCT04334291). Out of 5,837 patients with COVID-19, 624 patients were diagnosed with sepsis according to the Sepsis-3 International Consensus.
Results:
In multivariable analysis, the following risk factors were identified as independent predictors for developing sepsis: current smoking, tachypnoea (>22 breath per minute), hemoptysis, peripheral oxygen saturation (SpO
2
) <92%, blood pressure (BP) (systolic BP <90 mmHg and diastolic BP <60 mmHg), Glasgow Coma Scale (GCS) <15, elevated procalcitonin (PCT), elevated troponin I (TnI), and elevated creatinine >1.5 mg/dl. By assigning odds ratio (OR) weighted points to these variables, the following three risk categories were defined to develop sepsis during admission: low-risk group (probability of sepsis 3.1–11.8%); intermediate-risk group (24.8–53.8%); and high-risk-group (58.3–100%). A score of 1 was assigned to current smoking, tachypnoea, decreased SpO
2
, decreased BP, decreased GCS, elevated PCT, TnI, and creatinine, whereas a score of 2 was assigned to hemoptysis.
Conclusions:
The HOPE Sepsis Score including nine parameters is useful in identifying high-risk COVID-19 patients to develop sepsis. Sepsis in COVID-19 is associated with a high mortality rate.
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