COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Aprendizagem mediada por ferramentas de interação: análise do discurso de professores em um curso de formação continuada a distância Learning mediated by interaction tools: analyzing teachers' discourse in a distance learning course of continued formation

Este texto traz resultados de uma pesquisa sobre a Internet como espaço virtual de aprendizagem. A amostra estudada foi de 80 concluintes de um curso de Extensão para professores. Analisamos os discursos dos fóruns, listas de discussão e e-mails, à luz de categorias, retiradas da obra de Jean Piaget: Predominou a informação adaptada - mostrando interação entre os interlocutores, informando e influindo sobre o comportamento mutuamente, colaborando e discutindo idéias. São atributos indispensáveis para a constituição de "comunidades de aprendizagem virtual", assim como o desenvolvimento de competências como a capacidade de pensar categorialmente, utilizar novos recursos lingüísticos, auto-regular o comportamento e aprendizagem, potencializar determinadas áreas cognitivas, criar novas formas de convívio social, afetivo e cultural.<br>This text brings results of a research about the Internet as a virtual learning environment. The studied sample was a group of 80 students from a teacher extension course. We analyzed speeches from the forums, discussion lists and e-mails, in the light of categories from Jean Piaget's studies. Adapted information prevailed - showing interaction among speakers, informing and mutually influencing behavior, collaborating and discussing ideas. These are indispensable attributes for the constitution of "virtual learning communities", as well as the development of competences such as the capacity to think through categories, use new linguistic resources, regulate one's own behavior and learning, potentiate certain cognitive areas, and create new forms of social, emotional and cultural conviviality

Follow-up Study of Unknowingly Pregnant Women Vaccinated Against Rubella in Brazil,\ud 2001–2002

Background. Brazil conducted mass immunization of women of childbearing age in 2001 and 2002. Surveillance\ud was initiated for vaccination of women during pregnancy to monitor the effects of rubella vaccination on fetal outcomes.\ud Methods. Women vaccinated while pregnant or prior to conception were reported to the surveillance system.\ud Susceptibility to rubella infection was determined by anti-rubella immunoglobulin (Ig) M and IgG immunoassays.\ud Susceptible women were observed through delivery. Live-born infants were tested for anti-rubella IgM antibody;\ud IgM-seropositive newborns were tested for viral shedding and observed for 12 months for signs of congenital rubella\ud syndrome. Incidence of congenital rubella infection was calculated using data from 7 states.\ud Results. A total of 22 708 cases of rubella vaccination during pregnancy or prior to conception were reported\ud nationwide, 20 536 (90%) of which were from 7 of 27 states in Brazil. Of these, 2332 women were susceptible to\ud rubella infection at vaccination. Sixty-seven (4.1%) of 1647 newborns had rubella IgM antibody (incidence rate, 4.1\ud congenital infections per 100 susceptible women vaccinated during pregnancy [95% confidence interval, 3.2–5.1]).\ud None of the infants infected with rubella vaccine virus was born with congenital rubella syndrome.\ud Conclusions. As rubella elimination goals are adopted worldwide, evidence of rubella vaccine safety aids in\ud planning and implementation of mass adult immunization.Funding: Brazilian Ministry of Health, State Health Departments, and the Pan- American Health Organization

Neotropical freshwater fisheries : A dataset of occurrence and abundance of freshwater fishes in the Neotropics

The Neotropical region hosts 4225 freshwater fish species, ranking first among the world's most diverse regions for freshwater fishes. Our NEOTROPICAL FRESHWATER FISHES data set is the first to produce a large-scale Neotropical freshwater fish inventory, covering the entire Neotropical region from Mexico and the Caribbean in the north to the southern limits in Argentina, Paraguay, Chile, and Uruguay. We compiled 185,787 distribution records, with unique georeferenced coordinates, for the 4225 species, represented by occurrence and abundance data. The number of species for the most numerous orders are as follows: Characiformes (1289), Siluriformes (1384), Cichliformes (354), Cyprinodontiformes (245), and Gymnotiformes (135). The most recorded species was the characid Astyanax fasciatus (4696 records). We registered 116,802 distribution records for native species, compared to 1802 distribution records for nonnative species. The main aim of the NEOTROPICAL FRESHWATER FISHES data set was to make these occurrence and abundance data accessible for international researchers to develop ecological and macroecological studies, from local to regional scales, with focal fish species, families, or orders. We anticipate that the NEOTROPICAL FRESHWATER FISHES data set will be valuable for studies on a wide range of ecological processes, such as trophic cascades, fishery pressure, the effects of habitat loss and fragmentation, and the impacts of species invasion and climate change. There are no copyright restrictions on the data, and please cite this data paper when using the data in publications

A multi-country analysis of COVID-19 hospitalizations by vaccination status

Background: Individuals vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), when infected, can still develop disease&nbsp;that requires hospitalization. It remains unclear whether these patients differ from hospitalized unvaccinated patients with regard to presentation, coexisting comorbidities, and outcomes. Methods: Here, we use data from an international consortium to study this&nbsp;question and assess whether differences between these groups are&nbsp;context specific. Data from 83,163 hospitalized COVID-19 patients (34,843 vaccinated, 48,320 unvaccinated) from 38 countries were analyzed. Findings: While typical symptoms were more often reported in unvaccinated patients, comorbidities, including some associated with worse prognosis in previous studies, were more common in vaccinated patients. Considerable between-country variation in both in-hospital fatality risk and vaccinated-versus-unvaccinated difference in this outcome was observed. Conclusions: These findings will inform allocation of healthcare resources in future surges as well as design of longer-term international studies to characterize changes in clinical profile of hospitalized COVID-19 patients related to vaccination history. Funding: This work was made possible by the UK Foreign, Commonwealth and Development Office and Wellcome (215091/Z/18/Z, 222410/Z/21/Z, 225288/Z/22/Z, and 220757/Z/20/Z); the Bill&nbsp;&amp; Melinda Gates&nbsp;Foundation (OPP1209135); and the philanthropic support of the donors&nbsp;to the University of Oxford's COVID-19 Research Response Fund (0009109). Additional funders are listed in the "acknowledgments" section