Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19.

Objectives To evaluate the strength of association between maternal and pregnancy characteristics and the risk of adverse perinatal outcomes in pregnancies with laboratory confirmed COVID-19. Methods Secondary analysis of a multinational, cohort study on all consecutive pregnant women with laboratory-confirmed COVID-19 from February 1, 2020 to April 30, 2020 from 73 centers from 22 different countries. A confirmed case of COVID-19 was defined as a positive result on real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of nasal and pharyngeal swab specimens. The primary outcome was a composite adverse fetal outcome, defined as the presence of either abortion (pregnancy loss before 22 weeks of gestations), stillbirth (intrauterine fetal death after 22 weeks of gestation), neonatal death (death of a live-born infant within the first 28 days of life), and perinatal death (either stillbirth or neonatal death). Logistic regression analysis was performed to evaluate parameters independently associated with the primary outcome. Logistic regression was reported as odds ratio (OR) with 95% confidence interval (CI). Results Mean gestational age at diagnosis was 30.6+/-9.5 weeks, with 8.0% of women being diagnosed in the first, 22.2% in the second and 69.8% in the third trimester of pregnancy. There were six miscarriage (2.3%), six intrauterine device (IUD) (2.3) and 5 (2.0%) neonatal deaths, with an overall rate of perinatal death of 4.2% (11/265), thus resulting into 17 cases experiencing and 226 not experiencing composite adverse fetal outcome. Neither stillbirths nor neonatal deaths had congenital anomalies found at antenatal or postnatal evaluation. Furthermore, none of the cases experiencing IUD had signs of impending demise at arterial or venous Doppler. Neonatal deaths were all considered as prematurity-related adverse events. Of the 250 live-born neonates, one (0.4%) was found positive at RT-PCR pharyngeal swabs performed after delivery. The mother was tested positive during the third trimester of pregnancy. The newborn was asymptomatic and had negative RT-PCR test after 14 days of life. At logistic regression analysis, gestational age at diagnosis (OR: 0.85, 95% CI 0.8-0.9 per week increase; pPeer reviewe

Training during the COVID-19 lockdown : knowledge, beliefs, and practices of 12,526 athletes from 142 countries and six continents

OBJECTIVE Our objective was to explore the training-related knowledge, beliefs, and practices of athletes and the influence of lockdowns in response to the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS Athletes (n = 12,526, comprising 13% world class, 21% international, 36% national, 24% state, and 6% recreational) completed an online survey that was available from 17 May to 5 July 2020 and explored their training behaviors (training knowledge, beliefs/attitudes, and practices), including specific questions on their training intensity, frequency, and session duration before and during lockdown (March–June 2020). RESULTS Overall, 85% of athletes wanted to “maintain training,” and 79% disagreed with the statement that it is “okay to not train during lockdown,” with a greater prevalence for both in higher-level athletes. In total, 60% of athletes considered “coaching by correspondence (remote coaching)” to be sufficient (highest amongst world-class athletes). During lockdown, < 40% were able to maintain sport-specific training (e.g., long endurance [39%], interval training [35%], weightlifting [33%], most (83%) training for “general fitness and health maintenance” during lockdown. Athletes trained alone (80%) and focused on bodyweight (65%) and cardiovascular (59%) exercise/training during lockdown. Compared with before lockdown, most athletes reported reduced training frequency (from between five and seven sessions per week to four or fewer), shorter training sessions (from ≥ 60 to < 60 min), and lower sport-specific intensity (~ 38% reduction), irrespective of athlete classification. CONCLUSIONS COVID-19-related lockdowns saw marked reductions in athletic training specificity, intensity, frequency, and duration, with notable within-sample differences (by athlete classification). Higher classification athletes had the strongest desire to “maintain” training and the greatest opposition to “not training” during lockdowns. These higher classification athletes retained training specificity to a greater degree than others, probably because of preferential access to limited training resources. More higher classification athletes considered “coaching by correspondence” as sufficient than did lower classification athletes. These lockdown-mediated changes in training were not conducive to maintenance or progression of athletes’ physical capacities and were also likely detrimental to athletes’ mental health. These data can be used by policy makers, athletes, and their multidisciplinary teams to modulate their practice, with a degree of individualization, in the current and continued pandemic-related scenario. Furthermore, the data may drive training-related educational resources for athletes and their multidisciplinary teams. Such upskilling would provide athletes with evidence to inform their training modifications in response to germane situations (e.g., COVID related, injury, and illness).A specific funding was provided by the National Sports Institute of Malaysia for this study.The National Sports Institute of Malaysia.https://www.springer.com/journal/40279am2023Sports Medicin

COVID-19 lockdown : a global study investigating athletes’ sport classification and sex on training practices

PURPOSE : To investigate differences in athletes’ knowledge, beliefs, and training practices during COVID-19 lockdowns with reference to sport classification and sex. This work extends an initial descriptive evaluation focusing on athlete classification. METHODS : Athletes (12,526; 66% male; 142 countries) completed an online survey (May–July 2020) assessing knowledge, beliefs, and practices toward training. Sports were classified as team sports (45%), endurance (20%), power/technical (10%), combat (9%), aquatic (6%), recreational (4%), racquet (3%), precision (2%), parasports (1%), and others (1%). Further analysis by sex was performed. RESULTS : During lockdown, athletes practiced body-weight-based exercises routinely (67% females and 64% males), ranging from 50% (precision) to 78% (parasports). More sport-specific technical skills were performed in combat, parasports, and precision (∼50%) than other sports (∼35%). Most athletes (range: 50% [parasports] to 75% [endurance]) performed cardiorespiratory training (trivial sex differences). Compared to prelockdown, perceived training intensity was reduced by 29% to 41%, depending on sport (largest decline: ∼38% in team sports, unaffected by sex). Some athletes (range: 7%–49%) maintained their training intensity for strength, endurance, speed, plyometric, change-of-direction, and technical training. Athletes who previously trained ≥5 sessions per week reduced their volume (range: 18%–28%) during lockdown. The proportion of athletes (81%) training ≥60 min/session reduced by 31% to 43% during lockdown. Males and females had comparable moderate levels of training knowledge (56% vs 58%) and beliefs/attitudes (54% vs 56%). CONCLUSIONS : Changes in athletes’ training practices were sport-specific, with few or no sex differences. Team-based sports were generally more susceptible to changes than individual sports. Policy makers should provide athletes with specific training arrangements and educational resources to facilitate remote and/or home-based training during lockdown-type events.https://journals.humankinetics.com/view/journals/ijspp/ijspp-overview.xmlhj2023Sports Medicin

Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection.

OBJECTIVES: To evaluate the maternal and perinatal outcomes of pregnancies affected by SARS-CoV-2 infection. METHODS: This was a multinational retrospective cohort study including women with a singleton pregnancy and laboratory-confirmed SARS-CoV-2 infection, conducted in 72 centers in 22 different countries in Europe, the USA, South America, Asia and Australia, between 1 February 2020 and 30 April 2020. Confirmed SARS-CoV-2 infection was defined as a positive result on real-time reverse-transcription polymerase chain reaction (RT-PCR) assay of nasopharyngeal swab specimens. The primary outcome was a composite measure of maternal mortality and morbidity, including admission to the intensive care unit (ICU), use of mechanical ventilation and death. RESULTS: In total, 388 women with a singleton pregnancy tested positive for SARS-CoV-2 on RT-PCR of a nasopharyngeal swab and were included in the study. Composite adverse maternal outcome was observed in 47/388 (12.1%) women; 43 (11.1%) women were admitted to the ICU, 36 (9.3%) required mechanical ventilation and three (0.8%) died. Of the 388 women included in the study, 122 (31.4%) were still pregnant at the time of data analysis. Among the other 266 women, six (19.4% of the 31 women with first-trimester infection) had miscarriage, three (1.1%) had termination of pregnancy, six (2.3%) had stillbirth and 251 (94.4%) delivered a liveborn infant. The rate of preterm birth before 37 weeks' gestation was 26.3% (70/266). Of the 251 liveborn infants, 69/251 (27.5%) were admitted to the neonatal ICU, and there were five (2.0%) neonatal deaths. The overall rate of perinatal death was 4.1% (11/266). Only one (1/251, 0.4%) infant, born to a mother who tested positive during the third trimester, was found to be positive for SARS-CoV-2 on RT-PCR. CONCLUSIONS: SARS-CoV-2 infection in pregnant women is associated with a 0.8% rate of maternal mortality, but an 11.1% rate of admission to the ICU. The risk of vertical transmission seems to be negligible. © 2020 International Society of Ultrasound in Obstetrics and Gynecology

PSICOLOGIA DO TRABALHO E ATENÇÕES PSICOSSOCIAIS: EXPERIÊNCIAS NO SINDICATO DOS TRABALHADORES E DAS TRABALHADORAS DA AGRICULTURA FAMILIAR

Os trabalhadores e trabalhadoras rurais há muito vem passando por diversas ondas de dificuldades vivenciais, no campo familiar, por conta das migrações dos mais jovens para os centros urbanos em buscas de possibilidades de empregos, no campo financeiro, onde devem se refazer, se reinventar para prover o sustento diário, seja na produção de insumos para consumo próprio, seja na venda de produtos, seja no campo assistencial, onde devem ir à busca de políticas públicas de programas de controle à pobreza. Fora essas, e dezenas de outras problemáticas, o ano de 2020 ainda trouxe o advento da COVID-19, doença com altos níveis de contágio e proliferação. A COVID-19 desestabilizou estruturas mundiais, estas econômicas, de produção, e de vivências sociais, sendo necessárias modificações nas formas de se relacionar com os familiares, com os trabalhos e sobrevivência. As mudanças impostas mundialmente foram nítidas e amplamente debatidas, mas quando pensamos nos setores rurais, não temos, de fato, uma visão clara de como o vírus modificou a vida dos moradores. Assim, objetivando entender as dinâmicas modificadas, destruídas e reconstruídas, assim como as questões sociais e psíquicas, objetivas e subjetivas, de trabalhadores rurais, o estágio desenvolveu-se na cidade de Pedra Branca – CE, no Sindicato dos Trabalhadores e das Trabalhadoras Rurais Na Agricultura Familiar (SINTRAF), no período de setembro a dezembro de 2020. Para fins de coleta de dados utilizou-se como instrumento o Questionário de Acompanhamento Psicossocial dos Trabalhadores. O instrumento contava com nove questões abertas, onde, mediante conversa com os trabalhadores, questionou-se sobre em como, e se, a doença modificou suas relações sociais, tal como as dinâmicas de trabalho e saúde física e mental. Foram entrevistados, até o momento, dezesseis ruralistas, com idade média de cinquenta anos, sendo dividido em onze mulheres e cinco homens. Mediante as conversas soube-se que, nas suas realidades, pouca coisa foi modificada, por se tratar de uma zona rural, no interior sertanejo, souberam da doença por televisão e/ou rádio. Outra informação dada fora que as diretrizes de cuidado e distanciamento pouco se aplicavam nas comunidades, sendo vistas, quase que exclusivamente, nas idas a cidade, onde, ao irem realizar alguma tarefa, tinham que se adequar ao uso de máscaras e distanciamento. Faz-se importante pontuar que mesmo com os relatos afirmando a pouca mudança, duas das entrevistas relataram terem tido COVID-19, não sabendo como ou onde ficaram infectadas. Outro ponto alavancado, pelas mulheres, exclusivamente, era o medo, uma “agonia”, que pode ser interpretada como ansiedade em decorrência da situação. Portanto o que percebemos a partir das respostas dos questionários é ainda um distanciamento, não apenas geográfico, mas social, em relação aos trabalhadores rurais, onde, mesmo que não estivessem de fato inseridos nos epicentros das situações pandêmicas, desenvolveram sintomas preocupantes, seja a própria doença, sejam as ansiedades. Outro ponto digno de nota é o não conhecimento daquilo que se sente, onde a ansiedade é descrita como “agonia/ preocupação/ medo”, dificultando possíveis intervenções mais pontuais

Methotrexate in the treatment of systemic glucocorticoid-dependent severe persistent asthma: a word of caution.

Methotrexate should not be prescribed to every systemic glucocorticoid-dependent asthmatic. In fact, while methotrexate may be advantageous in selected patients, every attempt to control asthma with regular anti-asthma agents should be made. Most studies on the effects of methotrexate in the treatment of systemic glucocorticoid-dependent asthmatics include small numbers of patients and are all of relatively short duration. Thus, large long-term multicentre trials are urgently needed. In these studies, a uniform accepted definition of systemic glucocorticoid-dependent asthmatics should be used. For the time being, we reinforce the recommendation of the NHLBI/ WHO panel that methotrexate and other systemic glucocorticoid sparing drugs should be considered experimental medications, and used only in selected patients under the supervision of an asthma specialist with previous experimental experience

Cubesat Mission with technological demonstrator payload for high data-rate downlink and health monitoring

The HyperCube payload will be composed by two different technological experiment, an high data-rate C band antenna, and a demonstrator for a remote structural health monitoring system. The first one has been thought with the aim to give Cubesats the capability to download an high quantity of data; it could be useful either if the data requiring the high data-rate downlink is on-board generated or simply retransmitted. The applications for which this payload could be used are several; an example for the first category of application is to download the data generated by another payload; the high data-rate capability could be necessary due to the narrow visibility window with the ground station, affected also by the absence of an active AOCS subsystem, which makes difficult the alignment of the on board antenna with the ground one. But the C band antenna could also be used to act as a “space–repeater”, downloading up–linked information. The second payload is related to the need to take under strictly control the health of the structures (not only the ones strictly belonging to primary structures, but also that of any subsystem component). In order to do that, smart materials are integrated into the structural component that need to be monitored; in particular, piezoelectric patches are used as sensors. As the structure is stressed, and the integrated piezoelectric sensors are subjected to mechanical deformation, they produce an electric signal; acquiring and properly studying the produced signal it is possible to monitor the mechanical condition of the structures. The health monitoring system is completed by a MicroController Unit which acquires, samples and stores the signal produced, and a transmitting system, which could be the C band antenna, or the TT&C antenna which each satellite needs

Marcatori infiammatori nella diagnosi e nel monitoraggio dell\u2019 asma

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Trueperella bernardiae bloodstream infection following onco-gynaecologic surgery and literature review

Trueperella bernardiae is a Gram-positive commensal bacillus of the human skin and oropharynx. It is known as an opportunistic human pathogen causing surgical wound, skin, and soft tissue, osteoarticular, and bloodstream infections (BSIs) with severe complications. We report a case of surgical wound related T. bernardiae BSI following onco-gynaecologic surgery together with a comprehensive literature review of T. bernardiae infections to alert clinicians about this emerging pathogen

Clinical Features of LMNA-Related Cardiomyopathy in 18 Patients and Characterization of Two Novel Variants

Dilated cardiomyopathy (DCM) refers to a spectrum of heterogeneous myocardial disorders characterized by ventricular dilation and depressed myocardial performance in the absence of hypertension, valvular, congenital, or ischemic heart disease. Mutations in LMNA gene, encoding for lamin A/C, account for 10% of familial DCM. LMNA-related cardiomyopathies are characterized by heterogeneous clinical manifestations that vary from a predominantly structural heart disease, mainly mild-to-moderate left ventricular (LV) dilatation associated or not with conduction system abnormalities, to highly pro-arrhythmic profiles where sudden cardiac death (SCD) occurs as the first manifestation of disease in an apparently normal heart. In the present study, we select, among 77 DCM families referred to our center for genetic counselling and molecular screening, 15 patient heterozygotes for LMNA variants. Segregation analysis in the relatives evidences other eight heterozygous patients. A genotype–phenotype correlation has been performed for symptomatic subjects. Lastly, we perform in vitro functional characterization of two novel LMNA variants using dermal fibroblasts obtained from three heterozygous patients, evidencing significant differences in terms of lamin expression and nuclear morphology. Due to the high risk of SCD that characterizes patients with lamin A/C cardiomyopathy, genetic testing for LMNA gene variants is highly recommended when there is suspicion of laminopathy