Development and evaluation of a machine learning-based in-hospital COVID-19 disease outcome predictor (CODOP): A multicontinental retrospective study

New SARS-CoV-2 variants, breakthrough infections, waning immunity, and sub-optimal vaccination rates account for surges of hospitalizations and deaths. There is an urgent need for clinically valuable and generalizable triage tools assisting the allocation of hospital resources, particularly in resource-limited countries. We developed and validate CODOP, a machine learning-based tool for predicting the clinical outcome of hospitalized COVID-19 patients. CODOP was trained, tested and validated with six cohorts encompassing 29223 COVID-19 patients from more than 150 hospitals in Spain, the USA and Latin America during 2020-22. CODOP uses 12 clinical parameters commonly measured at hospital admission for reaching high discriminative ability up to 9 days before clinical resolution (AUROC: 0.90-0.96), it is well calibrated, and it enables an effective dynamic risk stratification during hospitalization. Furthermore, CODOP maintains its predictive ability independently of the virus variant and the vaccination status. To reckon with the fluctuating pressure levels in hospitals during the pandemic, we offer two online CODOP calculators, suited for undertriage or overtriage scenarios, validated with a cohort of patients from 42 hospitals in three Latin American countries (78-100% sensitivity and 89-97% specificity). The performance of CODOP in heterogeneous and geographically disperse patient cohorts and the easiness of use strongly suggest its clinical utility, particularly in resource-limited countries

Residents' perceptions towards cross-border tourism

Residents are an important stakeholder in tourism destinations. In this sense, this study aimed to identify in the cross-border zone towards tourism. A questionnaire was applied between April and May 2023 to residents older than 18 years that were randomly approached in shops, parks, restaurants, streets, and residences. A total of 470 valid questionnaires were considered for descriptive analysis of the impacts' means and standard deviation. Residents tend to perceive positively tourism in cross-border areas. The impacts that presented the highest mean were the economics, followed by the sociocultural and in the last, the environmental impacts. One of the stuady's limitations is the sample number difference between the residents of Portugal and Spain, which makes some comparative aspects between the two populations difficult. This is the first study about residents perceptions in the cross-border area of Portugal (Terras de Trás-os-Montes) and Spain (Castilla y León), characterizing the study's originality.info:eu-repo/semantics/publishedVersio

Visitors' satisfaction in natural areas: the case of Vinhais biological park

Satisfaction is a widely studied issue in tourism as it provides an understanding of the performance of a tourism destination's offer, highlighting the most important features considered by tourists. The growth in tourism demand in natural areas also makes it an important factor in identifying visitor satisfaction, as sustainable planning of these areas may also rely on knowing the opinion of their visitors. In this context, this study aimed to determine the visitors´ satisfaction with Vinhais Biological Park, located in the northeast of Portugal, during the summer of 2022. A questionnaire consisting of 8 closed-ended questions to identify the socio-demographic profile and overall satisfaction was applied during July and August 2022. Therefore, 251 valid questionnaires were considered for the quantitative data analysis and a final sampling error of 6.13% was assumed. A descriptive statistical analysis was performed to identify the socio-demographic profile and the satisfaction with the resources offered. Four hypotheses were formulated to test the association between socio-demographic profile (age group, gender, nationality, and education level) and overall satisfaction. The χ2 test was used to test the hypotheses assuming a 5% significance level. The main findings showed that the socio-demographic profile of the sample is predominantly male (54.6%), aged between 11 and 40 years (77.6%), of Portuguese nationality (71.3%) and with higher education level (48.6%). Concerning the visit motivation, 61.4% went to the park after visiting the city of Vinhais or the region and nearly half (47%) of the respondents were satisfied. The results of χ2 test revealed no significant association between the socio-demographic profile and overall satisfaction, meaning that none of the hypotheses was supported. Considering the number of visitors received in the park annually, this study's sample can be regarded as a limitation, making the understanding of satisfaction limited to the period of analysis and at a period when the impact of COVID-19 is noticeable. Finally, for future studies, a comparative analysis with other natural parks, both Portuguese and Spanish, is suggested for better monitoring of visitor satisfaction.This project is being carried out within the scope of the DuraDOURO - El Duero como recurso perdurable del paisaje y el territorio de la frontera, 0785_DURADOURO_2_E, financed by FEDER, through the POCTEP. The authors are also grateful to the UNIAG, R&D unit funded by the FCT – Portuguese Foundation for the Development of Science and Technology, Ministry of Science, Technology and Higher Education. “Project Code Reference: UIDB/04752/2020 e UIDP/04752/2020”.info:eu-repo/semantics/publishedVersio