Medicinal plants and functional foods used as resources against Covid-19 by an andean population in Peru

Abstract The objective of this research was to identify those medicinal plants and functional foods that the population of Cusco, located in the Peruvian Andes, use as resources to cope with COVID-19 either for prevention or as an adjuvant to treatment with drugs. A descriptive, non-experimental and cross-sectional research was developed. The study population consisted of inhabitants over 20 and under 70 years of age, of both exes from the districts of Cusco, San Jeronimo, San Sebastian, Santiago and Wanchaq in the city of Cusco, Peru. A virtual survey was applied to 1747 inhabitants, for which a questionnaire was designed and elaborated with 07 items whose content was validated by 10 expert judges using Aiken’s V (Aiken’s V > 0.90). The data collected were exported to a database in Microsoft Excel. This research work was reviewed and approved by the Research Bioethics Committee of the National University of San Antonio Abad del Cusco. The results obtained show that the medicinal plants most used by the population studied were eucalyptus (70.2%), kion (68.3%), garlic (58.8%), matico (49.6%), chamomile (34.0%) and coca (21.6%). The functional foods consumed by the population include lemon (79.1%), kion (65.3%), orange (62.2%), honey (63.5%), onion (52.4%), avocado (40.2%), broccoli (35.8%),fish (35.5%) and tarwi (32.5%) for prevention, symptom relief and as an adjuvant in the treatment with drugs for COVID-19.ResumenLa presente investigación, tuvo como objetivo identificar aquellas plantas medicinales y alimentos funcionales que la población del Cusco ubicada en los Andes del Perú, hace uso como recursos para hacer frente a la COVID-19 ya sea para la prevención o como coadyuvante al tratamiento con medicamentos. Se desarrolló una investigación descriptiva, no xperimental y transversal. La población de estudio estuvo constituida por los habitantes mayores de 20 y menores de 70 años, de ambos sexos de los distritos de Cusco, San Jerónimo, San Sebastián, Santiago y Wanchaq de la ciudad del Cusco., Perú. Se aplicó una encuesta virtual a 1747 pobladores, para lo cual se diseñó y elaboró un cuestionario con 07 ítems cuyo contenido fue validado por 10 jueces expertos utilizando la V de Aiken (V de Aiken > 0,90). Los datos recopilados fueron exportados a una base de datos en el programa Microsoft Excel. Este trabajo de investigación fue revisado y aprobado por el Comité de Bioética en Investigación de la Universidad Nacional de San Antonio Abad del Cusco. Los resultados obtenidos muestran que las plantas medicinales más utilizadas por la población estudiada fueron eucalipto (70,2%), kión (68,3%), ajo (58,8%), matico (49,6%), manzanilla (34,0%) y coca (21,6%). En relación a los alimentos funcionales que la población consume se encuentran limón (79,1%), kión (65,3%), naranja (62,2%), miel (63,5%), cebolla (52,4%), palta (40,2%), brócoli (35,8%), pescado (35,5%) y tarwi (32,5%) con fines de prevención, alivio de síntomas y coadyuvante en el tratamiento con medicamentos para la COVID-19

Påverkar varsel om uppsägning aktiekursen? : Motiv bakom varsel och effekten före och efter tillkännagivandet

Enligt tidigare studier reagerar marknaden negativt när företag varslar om uppsägning, men reaktionen beror på motivet, som kan vara reaktivt eller proaktivt. Majoriteten av studierna undersöker den amerikanska marknaden och en lågkonjunktur vilket kan påverka resultatet. Denna uppsats undersöker den svenska marknaden samt fler konjunkturvariationer. Syftet är att undersöka den svenska aktiemarknadens reaktion när ett företag varslar, samt skillnaden beroende på det angivna motivet. Den onormala avkastningen studeras i en eventstudie. Totalt studeras 182 varsel från företag noterade på Stockholmsbörsen under 2006-2015. Resultaten visar ingen statistisk signifikant reaktion för gruppen med alla varsel. För reaktiva varsel finner vi en svag negativ onormal avkastning, och för proaktiva varsel finner vi överlag en positiv onormal avkastning. Vi uppmäter en mildare reaktion än tidigare studier. Anledningenkan vara att konjunkturläget påverkar marknadsreaktionen, att värderelevansen i varsel har förändrats sedan tidigare studier, eller att det finns en skillnad mellan reaktionen i olika länder

Use of medicinal plants for COVID-19 prevention and respiratory symptom treatment during the pandemic in Cusco, Peru: A cross-sectional survey

Background The burden of the COVID-19 pandemic in Peru has led to people seeking alternative treat- ments as preventives and treatment options such as medicinal plants. This study aimed to assess factors associated with the use of medicinal plants as preventive or treatment of respiratory symptom related to COVID-19 during the pandemic in Cusco, Peru. Method A web-based cross-sectional study was conducted on general public (20- to 70-year-old) from August 31 to September 20, 2020. Data were collected using a structured question- naire via Google Forms, it consisted of an 11-item questionnaire that was developed and validated by expert judgment using Aiken’s V (Aiken’s V > 0.9). Both descriptive statistics and bivariate followed by multivariable logistic regression analyses were conducted to assess factors associated with the use of medicinal plants for COVID-19 prevention and respiratory symptom treatment during the pandemic. Prevalence ratios (PR) with 95% Con- fidence Interval (CI), and a P-value of 0.05 was used to determine statistical significance. Results A total of 1,747 respondents participated in the study, 80.2% reported that they used medici- nal plants as preventives, while 71% reported that they used them to treat respiratory symp- toms. At least, 24% of respondents used medicinal plants when presenting with two or more respiratory symptoms, while at least 11% used plants for malaise. For treatment or prevention, the multivariate analysis showed that most respondents used eucalyptus (p < 0.001 for both), ginger (p < 0.022 for both), spiked pepper (p < 0.003 for both), garlic (p = 0.023 for prevention), and chamomile (p = 0.011 for treatment). The respondents with COVID-19 (p < 0.001), at older ages (p = 0.046), and with a family member or friend who had COVID-19 (p < 0.001) used more plants for prevention. However, the respondents with technical or higher education used less plants for treatment (p < 0.001). Conclusion There was a significant use of medicinal plants for both prevention and treatment, which was associated with several population characteristics and whether respondents had COVID-19

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society