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iBuddy is a narrative game-based simulation session inspired by research evidence and designed to enhance secondary school and higher education students’ privacy awareness. Students enter the simulation through storytelling and are asked to install the iBuddy app. Later in the simulation, students discover that some of their personal information have been extracted from their devices and manipulated – and this generates a wow-effect that sparks questions and discussions. The simulation is backed-up by a lively debriefing phase, supported by original animation videos, interactive activities, and small group games. To overcome privacy issues, iBuddy sessions are played on a local network and the collected data, which are anonymous, are deleted before the end of the session. iBuddy exploits an original software, released as open source, with a layered architecture composed by app, server and operator interface. The system also includes an Artificial Intelligence filter for inappropriate content. Multilingual class materials are published under a Creative Commons license and are available on the www.protectyourdata.ch platform. Post-session assessments collected from over 970 students indicate that they enjoy iBuddy sessions and learn from it. Follow-up assessment data, collected on a portion of the participants, also suggest that iBuddy sessions are effective and conducive to medium-term behavioral change.

Currently approved COVID-19 vaccines prevent symptomatic infection, hospitalization, and death of the disease. However, the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants raises concerns of reduced vaccine effectiveness and increased risk of infection. Repeated homologous booster in elderly individuals and immunocompromised patients is considered to solve severe form of disease caused by new SARS-CoV-2 variants but cannot protect completely against breakthrough infection. In our previous study we assessed the immunogenicity of an adenovirus-based vaccine expressing SARS-CoV-2-S1 (Ad5.S1) in mice, resulting in that a single immunization with Ad5.S1, via subcutaneously injection or intranasal delivery, induced robust humoral and cellular immune responses [1]. As a follow up study, here we showed that vaccinated mice had high titers of anti-S1 antibodies at one year after vaccination compared to PBS immunized mice. Furthermore, one booster dose of non-adjuvanted recombinant S1Beta (rS1Beta) subunit vaccine was effective in stimulating strong long-lived S1-specific immune responses and inducing significantly high neutralizing antibodies against the Wuhan, Beta, and Delta strain with 3.6- to 19.5-fold change increases. Importantly, the booster dose elicits cross-reactive antibody responses resulting in ACE2 binding inhibition against spike of SARS-CoV-2 variants (Wuhan, Alpha, Beta, Gamma, Delta, Zeta, Kappa, New York, India) as early as two-week post-boost injection, persisting over 28 weeks after a booster vaccination. Interestingly, levels of neutralizing antibodies were correlated with not only level of S1-binding IgG but also level of ACE2 inhibition in the before- and after-booster serum samples. Our findings show that S1 recombinant protein subunit vaccine candidate as a booster has potential to offer cross-neutralization against broad variants, and has important implications for vaccine control of new emerging breakthrough SARS-CoV-2 variants in elderly individuals primed with adenovirus-based vaccine like AZD1222 and Ad26.COV2.S.

The bothersome secularity: constitutional secularity and religious freedom ABSTRACT: In recent years, there has been a certain disenchantment of religious denominations with secularity. At the very time when secularity as a constitutional principle offered a broad guarantee for religious pluralism, its concrete implementation seemed to contradict this potential. The article examines how the modern, narrative conception of this principle continues to influence-and hinder-the constitutional dimension of secularity by undermining the integrative function performed by this fundamental principle.

A ideia de organizar a coletânea “Saberes e práticas para uma Educação Inclusiva” surgiu a partir da premissa de que a área da educação especial na perspectiva da educação inclusiva necessita de reflexões, críticas, indagações, pesquisas e, principalmente, de anúncios de práticas pedagógicas positivas, que culminaram nos processos de ensino e aprendizagem dos discentes público-alvo da educação especial. As temáticas abordadas nos capítulos contemplam a conceitualização de inclusão, exclusão e vulnerabilidade, a inclusão da pessoa com transtorno do Espectro Autista, a Pedagogia Hospitalar sob o viés da fenomenologia existencial, a inclusão de estudantes com Deficiência Visual, a Educação bilíngue de surdos, a inclusão da pessoa com tremor Essencial e consequências do Bullying e, por fim, a alfabetização científica e suas potencialidades para o ensino de ciências a estudantes público-alvo da educação especial.

The role and durability of the immunogenicity of the BNT162b2 mRNA vaccine against severe acute respiratory virus 2 (SARS-CoV-2), in cancer patients one year after receiving the third dose have to be elucidated. We have prospectively evaluated the long-term immunogenicity of the third dose of the SARS-CoV-2 BNT162b2 mRNA vaccine in 55 patients undergoing active treatment. Neutralizing antibody (NT Ab) titers against Omicron variants and total anti-trimeric S IgG levels were measured one year after the third dose. Heparinized whole-blood samples were used for the assessment of the SARS-CoV-2 interferon-γ release assay (IGRA). Thirty-seven patients (67.3%) showed positive total anti-trimeric S IgG one year after the third dose. Looking at the T-cell response against the spike protein, the frequency of responder patients did not decrease significantly between six and twelve months after the third dose. Finally, less than 20% of cancer patients showed an undetectable NT Ab titer against BA.1 and BA.5 variants of concern (VOCs). Underlying therapies seem to not affect the magnitude or frequency of the immune response. Our work underlines the persistence of humoral and cellular immune responses against BNT162b2 in a cohort of cancer patients one year after receiving the third dose, regardless of the type of underlying therapy.

Novel SARS-CoV-2 variants of concern (VOC) Delta and Omicron are able to escape some monoclonal antibody therapies, making again COVID-19 convalescent plasma (CCP) a potential frontline treatment.In this study, we investigated the kinetics of anti-SARS-CoV-2 neutralizing antibodies (nAbs) against VOCs Delta and Omicron in vaccine breakthrough infected plasma donors. Serum samples from 19 donors were collected at the time of plasma donation and tested for anti-SARS-CoV-2 nAbs (using live authentic VOC viral neutralization test) and IgG (Liaison® SARS-CoV-2 S1/S2 and Liaison® SARS-CoV-2 TrimericS IgG assays, DiaSorin). Measures were correlated with different variables, including the time between last vaccine dose and CCP donation, and time between SARS-COV-2 infection and CCP donation.nAb titers against VOC Delta and Omicron were directly related to the time interval since last vaccine dose to CCP donation, but inversely related to time since COVID19 breakthrough infection.SARS-CoV-2 breakthrough infection in vaccinated in donors boosts nAb titers against VOCs Delta and Omicron, but such titers decay shortly after infection. Therefore, CCP must be collected early after vaccine breakthrough infection.

The COVID-19 pandemic has highlighted the need for safe and effective vaccines to be rapidly developed and distributed worldwide, especially considering the emergence of new SARS-CoV-2 variants. Protein subunit vaccines have emerged as a promising approach due to their proven safety record and ability to elicit robust immune responses. In this study, we evaluated the immunogenicity and efficacy of an adjuvanted tetravalent S1 subunit protein COVID-19 vaccine candidate composed of the Wuhan, B.1.1.7 variant, B.1.351 variant, and P.1 variant spike proteins in a nonhuman primate model with controlled SIVsab infection. The vaccine candidate induced both humoral and cellular immune responses, with T- and B cell responses mainly peaking post-boost immunization. The vaccine also elicited neutralizing and cross-reactive antibodies, ACE2 blocking antibodies, and T-cell responses, including spike specific CD4+T cells. Importantly, the vaccine candidate was able to generate Omicron variant spike binding and ACE2 blocking antibodies without specifically vaccinating with Omicron, suggesting potential broad protection against emerging variants. The tetravalent composition of the vaccine candidate has significant implications for COVID-19 vaccine development and implementation, providing broad antibody responses against numerous SARS-CoV-2 variants.

Monkeypox virus (MPXV) is a zoonotic disease endemic in the rain forest countries of Central and West Africa. Understanding the immune response in zoonosis is fundamental to prevent and contrast viral spreading. MPXV is a close relative of the Variola (smallpox) virus and vaccination with vaccinia virus give an 85% protection against MPXV. With the emergence of the recent MPXV outbreak, Jynneos vaccine has been proposed to individuals at high-risk of exposure. Comparative data on MPXV immune response in vaccinated or infected subjects is still scarce. Here we described the differences between a group of infected patients in comparison to smallpox or Jynneos vaccinated subjects. The patients’ response is stronger and faster, while the Jynneos vaccinated controls need more time to develop a good immunity. Interestingly, the historic smallpox-vaccinated controls retain a degree of protection, even after years from vaccination, which is most visible in the T-cellular memory that is comparable to the newly vaccinated subjects.

Background and Objectives: New SARS-CoV-2 variants may impact the effectiveness of previously stored convalescent plasma (CCP). We defined levels of anti-delta and anti-omicron SARS-CoV-2 neutralizing antibodies (Nt-Abs) and investigated possible differences of past CCP Nt-Abs responses related to donor location in North and South Italy. Methods: Serum from 153 donors recovered from SARS-COV-2 infection (98 from northern and 55 from southern Italy) were analyzed for Nt-Abs characterization using our in house microneutralization assay. Results were compared to anti-Spike IgG measured by chemiluminescent assay (CLIA) to define a possible agreement with a more affordable test. Results: delta Nt-Abs titer in comparison to the reference strain (PV10734 D614G) showed a reduction of 82% in northern and 77% in southern Italy groups. Omicron Nt-Abs titer showed a reduction of 97%. CCP corresponding to Nt-Abs titer > 1:80 showed a median of 1365 BAU/mL for delta strain and 653 BAU/mL for reference strain. We found no statistical differences between Nt-Abs responses in North and South CCP donors. Conclusions: Not all past CCP could be used to treat patients with SARS-CoV-2 delta and omicron infections due to the lack of specific Nt-Abs. For the moment, the neutralization test remains the gold standard to select potential CCP donors. Interestingly, our study did not find NT-Abs differences between plasma collected from donors living in different areas of Italy.

We reported the long-term kinetics of immune response after vaccination and evaluated the immunogenicity after a third dose of mRNA vaccine in 86 healthcare workers. Humoral response was analyzed by measuring anti-spike IgG and SARS-CoV-2 NTAbs titer; cell-mediated response was measured as frequency of IFN-γ producing T-cells and cell proliferation. Memory B cells secreting SARS-CoV-2 RBD-IgG were measured by B-spot assay. At three weeks after the third dose (T4), the frequency of subjects showing NT-Abs titer at the upper detection limit (≥640) was significantly higher than that observed at three weeks after the second dose (26/77; 33.7% vs. 9/77; 11.6%; p = 0.0018). Additionally, at T4, all the subjects reached positive levels of T-cell mediated response (median 110 SFU/106 PBMC, IQR 73-231). While the number of IFNγ-producing T-cells decreased between second and third dose administration, the T-cell proliferative response did not decrease but was sustained during the follow-up. Among T-cell subsets, a higher proliferative response was observed in CD4+ than in CD8+ population. Moreover, even if a decline in antibody response was observed between the second and third dose, a sustained persistence of memory B cells was observed. Subsequently, the third dose did not affect the frequency of memory B cells, while it restored or increased the peak antibody levels detected after the second dose.

Objectives: Internet-based interventions can help carers of people living with dementia to cope with care-related challenges and can help improve their wellbeing. This systematic review aimed at investigating the criteria of usability and acceptability of self-guided internet-based interventions for family carers of people living with dementia. Method: Searches were conducted on PubMed, Virtual Health Library Regional Portal (Americas), MEDLINE, PsycINFO, Scopus, and Cochrane. Studies published up to December 2019, in English, Portuguese, or Spanish, were eligible. We followed the definition/criteria from ISO ISO-9241-11 for usability (efficiency, effectiveness, and satisfaction) and acceptability (barriers for using and utility). Methodological quality was evaluated using specific tools according to each study design. Results: Ten studies were included, all of which had high methodological quality. Carers of people living with dementia indicated that internet-based interventions were mostly effective, efficient, and satisfactory. They considered these to be informative, relevant, and functional, highlighting the utility and intention of using the resource in the future. The high heterogeneity in the terms and methods used to evaluate usability and acceptability hindered cross-study comparisons, however internet-based interventions were considered useful and acceptable by most carers. Conclusion: Future research should consider expanding the criteria of usability and acceptability to better reflect the needs of this population.

The rapid aging of the Brazilian population is seeing people living longer but with comorbidities more common in older people and higher dependence in activities of daily living. Due to these factors, support from formal and informal carers is needed more frequently. Many informal carers are family members who manage the health of the older person they are caring for, including accompanying them to medical appointments and advocating for them when they are hospitalized1,2. As such, carers of older people often have a key role in accessing, understanding and supporting the implementation of health-related recommendations for the older person they provide care for...

The aim of change detection (CD) is to detect changes occurred in the same area by comparing two images of that place taken at different times. The challenging part of the CD is to keep track of the changes the user wants to highlight, such as new buildings, and to ignore changes due to external factors such as environmental, lighting condition, fog or seasonal changes. Recent developments in the field of deep learning enabled researchers to achieve outstanding performance in this area. In particular, different mechanisms of space-time attention allowed to exploit the spatial features that are extracted from the models and to correlate them also in a temporal way by exploiting both the available images. The downside is that the models have become increasingly complex and large, often unfeasible for edge applications. These are limitations when the models must be applied to the industrial field or in applications requiring real-time performances. In this work we propose a novel model, called TinyCD, demonstrating to be both lightweight and effective, able to achieve performances comparable or even superior to the current state of the art with 13-150X fewer parameters. In our approach we have exploited the importance of low-level features to compare images. We introduce a novel mixing block capable of cross correlating features in both space and time domains. Finally, to fully exploit the information contained in the computed features, we define the PW-MLP block able to perform a pixel wise classification.

INTRODUCTION: Little is known about management and mitigation of COVID-19 in long-term care facilities (LTCF) for older adults in Latin America. OBJECTIVE: To describe how the management of LTCF in Hispanic American countries plan and adapt their routines for coping with COVID-19 and whether they have been able to fulfill recommendations published by the World Health Organization (WHO). METHODOLOGY: A cross-sectional study was conducted by online survey of managers of LTCF located in Hispanic American i countries. A 46-item questionnaire (adopting the WHO principles) was sent to participants. Descriptive statistics were used to summarize the data. RESULTS: Twenty-three care home managers replied, responsible for a total of 874 older people (range: 5 - 270). One questionnaire was excluded because of missing responses. Fourteen LTCF (63.60%) were private, for-profit facilities. The rate of compliance with WHO recommendations exceeded 70% for the majority of items. Just over half of the institutions had developed dû a strategic management plan, or had identified strategies for dealing with deaths of suspected cases. Difficulty acquiring personal protective equipment (PPE) was reported by 59.10% of the LTCF surveyed. The homes’ capacity for SARS-Cov-2 testing was limited (36.36% of the institutions did not have any tests). CONCLUSIONS: The rate of compliance with recommendations published by the WHO for dealing with COVID-19 was greater than 70% at the majority of the LTCF surveyed. More than half of the institutions had strategic management plans. Availability of PPE and SARS-Cov-2 testing capacity were very unsatisfactory.

Objective To determine the re‐test reliability of the Health Literacy Questionnaire (HLQ) with carers of older adults discharged from hospital or attending the outpatient clinic. Methods Carers completed the HLQ twice by telephone and rated the acceptability of completing the tool. Tool completion time was recorded. Correlations were calculated between the test occasions using intraclass correlation coefficients (ICC) and 95% confidence intervals. Results Fifty‐one carers of older patients participated. The HLQ showed good reliability (ICC = 0.75‐0.90) for seven of the nine scales and moderate reliability (0.50‐0.74) for the other two scales. Median completion time was 16.5 minutes (range 9‐50), and acceptability was rated as 9.5/10. Conclusion The HLQ is a reliable tool for use with carers of older adults attending hospital. However, the length of time for completion of the HLQ may limit its feasibility for use by hospital staff and carers, given the high stress and time pressures of acute care.

Highlights • Persistent SARS-CoV-2 RNA detection resulted in prolonged quarantine. • In less than 3% of clinical samples with a high quantification cycle value (>30), cultivable virus was detected. • NGS analysis showed a fragmented genome, indicating no functional residual RNA., Real-time reverse transcription PCR is currently the most sensitive method to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Defining whether a patient could be contagious or not contagious in the presence of residual SARS-CoV-2 RNA is of extreme importance in the context of public health. In this prospective multicenter study, virus isolation was prospectively attempted in 387 nasal swabs from clinically recovered patients showing low viral load (quantification cycle, Cq, value greater than 30). The median Cq value was 36.8 (range 30.0–39.4). Overall, a cytopathic effect was detected in nine samples, corresponding to a culture positivity rate of 2.3% (9/387). The results of this study help to dissect true virus replication and residual viral RNA detection in recovered patients.

COVID-19 convalescent plasma (CCP) has been the only specific anti-viral therapy against SARS-CoV-2 available for more than one year. Following the negative results from most randomized controlled trials on its efficacy in COVID-19 hospitalized patients and the availability of anti-spike monoclonal antibodies (mAbs), the use of CCP has subsequently rapidly faded. However, the continuous appearance of new variants of concern (VOCs), most of which escape mAbs and vaccine-elicited neutralizing antibodies (nAbs), has renewed the interest towards CCP, at least in seronegative immunocompetent patients, and in immunocompromised patients not able to mount a protective immune response. We report here the experience of a single Italian hospital in collecting and transfusing CCP in immunocompromised patients hospitalized for severe COVID-19 between October 2021 and March 2022. During this 6-month period, we collected CCP from 32 vaccinated and convalescent regular blood donors, and infused high nAb-titer CCP units (titered against the specific VOC affecting the recipient) to 21 hospitalized patients with severe COVID-19, all of them seronegative at the time of CCP transfusion. Patients’ median age was 66 years (IQR 50–74 years) and approximately half of them (47.6%, 10/21) were immunocompromised. Two patients were rescued after previous failure of mAbs. No adverse reactions following CCP transfusion were recorded. A 28-day mortality rate of 14.3 percent (3/21) was reported, with age, advanced disease stage and late CCP transfusion associated with a worse outcome. This real-life experience also supports the use of CCP in seronegative hospitalized COVID-19 patients during the Delta and Omicron waves.

Resumo Objetivo: avaliar a adesão das instituições de longa permanência brasileiras às orientações de Prevenção e Controle de Infecções da Organização Mundial da Saúde, observando a associação entre seu porte e a adesão a essas recomendações. Método: estudo transversal realizado com gestores de estabelecimentos. Os autores desenvolveram um questionário de 20 itens, com base nessas orientações, e um escore global de adesão, com base na adesão a essas recomendações. A adesão foi classificada como (1) excelente para aquelas que atenderam ≥14 de 20 recomendações, (2) bom para 10 a 13 itens e (3) baixo para aquelas com menos de dez itens. O tamanho das instalações foi classificado como pequeno, médio e grande, de acordo com uma análise de cluster em duas etapas. Estatística descritiva e teste de qui-quadrado foram utilizados com nível de significância de 5%. Resultados: das 362 instituições incluídas, 308 (85,1%) aderiram a 14 ou mais recomendações. Em relação ao seu tamanho, a adesão à triagem de sintomas de COVID-19 dos visitantes (p=0,037) e ao isolamento de pacientes até que tenham dois exames laboratoriais negativos (p=0,032) foi menor em estabelecimentos maiores, em comparação com estabelecimentos de médio e pequeno porte. Conclusão: a adesão às medidas de mitigação da COVID-19 nas unidades brasileiras foi considerada excelente para a maioria das recomendações, independentemente do porte das unidades. Abstract Objective: to evaluate the adherence of Brazilian long-term care facilities to the World Health Organization Infection Prevention and Control guidance, and assess the association of their size with the adherence to these recommendations. Method: cross-sectional study conducted with facilities’ managers. Authors developed a 20-item questionnaire based on this guidance, and a global score of adherence, based on the adoption of these recommendations. Adherence was classified as (1) excellent for those who attended ≥14 out of 20 recommendations; (2) good for 10 to 13 items; and (3) low for those with less than ten items. Facilities’ sizes were established as small, intermediate, and large according to a two-step cluster analysis. Descriptive statistics and chi-square tests were used at a 5% significance level. Results: among 362 included facilities, 308 (85.1%) adhered to 14 or more recommendations. Regarding its size, adherence to screening COVID-19 symptoms of visitors (p=0.037) and isolating patients until they have had two negative laboratory tests (p=0.032) were lower on larger ones compared to medium and small facilities. Conclusion: adherence to COVID-19 mitigation measures in Brazilian facilities was considered excellent for most of the recommendations, regardless of the size of the units. Resumen Objetivo: evaluar la adhesión de instituciones brasileñas de larga estancia a las orientaciones de Prevención y Control de Infecciones de la Organización Mundial de la Salud y evaluar la asociación entre su tamaño y la adhesión a esas recomendaciones. Método: estudio transversal realizado con gerentes de establecimientos. Los autores desarrollaron un cuestionario de 20 ítems basado en estas directrices y un puntaje general de cumplimiento acorde a la observancia de estas recomendaciones. La adhesión se calificó (1) excelente para aquellas que cumplieron con ≥14 de 20 recomendaciones; (2) buena para 10 a 13 artículos; y (3) baja para aquellas con menos de diez elementos. El tamaño de las instalaciones se clasificó como pequeños, medianos y grandes de acuerdo con un análisis de clúster de dos pasos. Se utilizó estadística descriptiva y la prueba de chi-cuadrado con un nivel de significancia del 5%. Resultados: de las 362 instituciones incluidas, 308 (85,1%) se adhirieron a 14 o más recomendaciones. En cuanto a su tamaño, la adhesión al cribado de síntomas de COVID-19 de los visitantes (p=0,037) y al aislamiento de los pacientes hasta que tengan dos pruebas de laboratorio negativas (p=0,032) fue menor en los establecimientos más grandes en comparación con los establecimientos medianos y pequeños. Conclusión: la adhesión a las medidas de mitigación de la COVID-19 en las unidades brasileñas fue considerada excelente para la mayoría de las recomendaciones, independientemente del tamaño de las unidades.

The file attached to this record is the author's final peer reviewed version. The Brazilian care home sector is underdeveloped, and the limited available evidence suggests that care quality falls below international standards. Development of the Brazilian care home sector could be associated with better outcomes for those receiving care, and more efficient use of resources across health and social care. Research has an important role to play. This article summarises research priorities for Brazilian long-term care homes developed as part of an international workshop held in Brazil and the UK, and attended by 71 clinicians and researchers from 6 Brazilian Universities, supported by an international faculty of 8 Brazilian, 8 British, 2 Dutch and 1 Austrian academics. The research priorities identified were: understanding and supporting multidisciplinary working in care homes, with emphasis on describing availability of multidisciplinary teams and how they operate; dignity and sensitivity to cultural needs, with emphasis on collating accounts from Brazilian stakeholders about dignity in care and how it can be delivered; enriching the care home environment with art, music and gardens, with a focus on developing arts in the care home space in a way that is sensitive to Brazilian cultural identity; and benchmarking quality of care, with emphasis on exploring how international quality benchmarking tools can be adapted for use in Brazilian care homes, taking account of new initiatives to include person-centred outcomes as part of benchmarking. Instrumental to research in these priority areas will be establishing care home research capacity in Brazil.

A three-dimensional model of an external gear pump and a new application of an algorithm for the measurement of the unsteady flow rate in hydraulic pipes are presented. The experimental delivery flow ripple was compared with the outcomes of a simulation under different operating conditions. A comprehensive computational fluid dynamics model of the pump and of the high-pressure delivery circuit was developed in SimericsMP+®. The pump model considers the clearances, which vary according to the shaft angle, between the tip of the tooth and the inner surface of the stator, as well as between the flanks of the teeth that are in contact. The pump delivery circuit is constituted by a straight pipe with a fixed orifice at the end to generate the load. The model of the entire system was preliminarily validated in terms of delivery pressure ripple. Subsequently, the simulated flow ripple was contrasted with the instantaneous flow rate, measured by means of an innovative flow meter. It was found that the proposed flow meter is reliable in assessing the flow oscillations under the various working conditions.

INTRODUCTION: Little is known about management and mitigation of COVID-19 in long-term care facilities (LTCF) for the aged in Latin America. OBJECTIVE: To describe how the management of LTCF in Latin American countries plan and adapt their routines for coping with COVID-19 and whether they have been able to fulfill recommendations published by the World Health Organization (WHO). METHODOLOGY: A cross-sectional study was conducted by online survey of managers of LTCF located in Hispanic American countries. A 46-item questionnaire (adopting the WHO principles) was sent to participants. Descriptive statistics were used to summarize the data. RESULTS: Twenty-three care home managers replied, responsible for a total of 874 older people (range: 5 - 270). One questionnaire was excluded because of missing responses. Fourteen LTCF (63.60%) were private, for-profit facilities. The rate of compliance with WHO recommendations exceeded 70% for the majority of items. Just over half of the institutions had developed a strategic management plan, or had identified strategies for dealing with deaths of suspected cases. Difficulty acquiring personal protective equipment (PPE) was reported by 59.10% of the LTCF surveyed. The homes’ capacity for SARS-Cov-2 testing was limited (36.36% of the institutions did not have any tests). CONCLUSIONS: The rate of compliance with recommendations published by the WHO for dealing with COVID-19 was greater than 70% at the majority of the LTCF surveyed. More than half of the institutions had strategic management plans. Availability of PPE and SARS-Cov-2 testing capacity were very unsatisfactory.

Resumen Objetivo: evaluar la adhesión de instituciones brasileñas de larga estancia a las orientaciones de Prevención y Control de Infecciones de la Organización Mundial de la Salud y evaluar la asociación entre su tamaño y la adhesión a esas recomendaciones. Método: estudio transversal realizado con gerentes de establecimientos. Los autores desarrollaron un cuestionario de 20 ítems basado en estas directrices y un puntaje general de cumplimiento acorde a la observancia de estas recomendaciones. La adhesión se calificó (1) excelente para aquellas que cumplieron con ≥14 de 20 recomendaciones; (2) buena para 10 a 13 artículos; y (3) baja para aquellas con menos de diez elementos. El tamaño de las instalaciones se clasificó como pequeños, medianos y grandes de acuerdo con un análisis de clúster de dos pasos. Se utilizó estadística descriptiva y la prueba de chi-cuadrado con un nivel de significancia del 5%. Resultados: de las 362 instituciones incluidas, 308 (85,1%) se adhirieron a 14 o más recomendaciones. En cuanto a su tamaño, la adhesión al cribado de síntomas de COVID-19 de los visitantes (p=0,037) y al aislamiento de los pacientes hasta que tengan dos pruebas de laboratorio negativas (p=0,032) fue menor en los establecimientos más grandes en comparación con los establecimientos medianos y pequeños. Conclusión: la adhesión a las medidas de mitigación de la COVID-19 en las unidades brasileñas fue considerada excelente para la mayoría de las recomendaciones, independientemente del tamaño de las unidades.

Resumo Objetivo: avaliar a adesão das instituições de longa permanência brasileiras às orientações de Prevenção e Controle de Infecções da Organização Mundial da Saúde, observando a associação entre seu porte e a adesão a essas recomendações. Método: estudo transversal realizado com gestores de estabelecimentos. Os autores desenvolveram um questionário de 20 itens, com base nessas orientações, e um escore global de adesão, com base na adesão a essas recomendações. A adesão foi classificada como (1) excelente para aquelas que atenderam ≥14 de 20 recomendações, (2) bom para 10 a 13 itens e (3) baixo para aquelas com menos de dez itens. O tamanho das instalações foi classificado como pequeno, médio e grande, de acordo com uma análise de cluster em duas etapas. Estatística descritiva e teste de qui-quadrado foram utilizados com nível de significância de 5%. Resultados: das 362 instituições incluídas, 308 (85,1%) aderiram a 14 ou mais recomendações. Em relação ao seu tamanho, a adesão à triagem de sintomas de COVID-19 dos visitantes (p=0,037) e ao isolamento de pacientes até que tenham dois exames laboratoriais negativos (p=0,032) foi menor em estabelecimentos maiores, em comparação com estabelecimentos de médio e pequeno porte. Conclusão: a adesão às medidas de mitigação da COVID-19 nas unidades brasileiras foi considerada excelente para a maioria das recomendações, independentemente do porte das unidades.

Objectives To assess the humoral and cell-mediated response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) elicited by the mRNA BNT162b2 vaccine in SARS-CoV-2-experienced and -naive subjects against a reference strain and SARS-CoV-2 variants. Methods The humoral response (including neutralizing antibodies) and T-cell-mediated response elicited by BNT162b2 vaccine in 145 healthcare workers (both naive and positive for previous SARS-CoV-2 infection) were evaluated. In a subset of subjects, the effect of SARS-CoV-2 variants on antibody level and cell-mediated response was also investigated. Results Overall, 125/127 naive subjects (98.4%) developed both neutralizing antibodies and specific T cells after the second dose of vaccine. Moreover, the antibody and T-cell responses were effective against viral variants since SARS-CoV-2 NT Abs were still detectable in 55/68 (80.9%) and 25/29 (86.2%) naive subjects when sera were challenged against β and δ variants, respectively. T-cell response was less affected, with no significant difference in the frequency of responders (p 0.369). Of note, two doses of vaccine were able to elicit sustained neutralizing antibody activity against all the SARS-CoV-2 variants tested in SARS-CoV-2-experienced subjects. Conclusions BNT162b2 vaccine elicited a sustained humoral and cell-mediated response in immunocompetent subjects after two-dose administration of the vaccine, and the response seemed to be less affected by SARS-CoV-2 variants, the only exceptions being the β and δ variants. Increased immunogenicity, also against SARS-CoV-2 variant strains, was observed in SARS-CoV-2-experienced subjects. These results suggest that triple exposure to SARS-CoV-2 antigens might be proposed as valuable strategy for vaccination campaigns.

The effect of the fuel temperature on the hydraulic performance of a Common Rail diesel injector has been investigated with an integrated experimental-numerical approach. An experimental campaign pertaining to single and double injections has been performed for fuel tank temperatures ranging from 28°C to 68°C. In general, an augment in the injected mass has been observed for increasing values of the fuel tank temperature. Moreover, the interaction between the main and after injection changes with the temperature and the dwell time threshold for fusion-free injections increases with the fuel temperature. The temperature at the injector nozzle has been measured and compared with that obtained with a thermo-fluid dynamics simple model, showing that the real temperature and the estimated one correlate well. The influence of the fuel temperature on the internal injector dynamic has been explored by means of a validated 1D numerical model of the injector thermo-fluid dynamics. The main direct effect of the temperature variation concerns the needle lift, which reaches a larger peak value for a higher fuel temperature: this explains the general increment in the injected mass and the augmented value of the injection fusion threshold for the main-after injections. The obtained results could allow more accurate open-loop control strategies for the injected mass, which include thermal effects, to be implemented.

Uma das consequências do processo de envelhecimento é o aumento da prevalência de doenças crônico-degenerativas, acarretando ao idoso a perda de sua autonomia e independência, necessitando de auxílio em suas tarefas diárias. Objetivo: analisar a produção científica que aborda a qualidade de vida (QV) do cuidador familiar (60 anos ou mais) que cuida de outro idoso em ambiente familiar a partir de artigos primários. Os objetivos específicos foram: identificar a QV, os aspectos dos cuidados e a intervenção junto ao cuidador familiar idoso. Método: registrada no PROSPERO. Os artigos foram identificados pelas bases: PubMed, Embase, WOS, Scopus, Cinhal e Lilacs – 1988 a 2021, segundo os critérios de elegibilidade. Resultados: De 1.143 artigos selecionados, dez foram incluídos, pelas instruções do PRISMA. O conceito de qualidade de vida adotado tinha perspectivas multidimensionais. Os aspectos subjetivos destacaram-se como essenciais para a avaliação e compreensão da QV. Utilizaram-se diferentes instrumentos e um deles desenvolveu uma escala específica para cuidadores de idosos com demência (DQoL-OC). A maioria dos cuidadores eram mulheres e auxiliavam idosos com diferentes problemas de saúde, com destaque à demência. Conclusão: analisar a QV do cuidador familiar idoso é de extrema relevância, bem como o processo de intervenção adaptada à saúde e ao bem-estar desse indivíduo, que se evidenciaram como meios potenciais para melhoraria da QV dos cuidadores familiares idosos. Portanto, o aprofundamento desse tema é relevante face ao número crescente de pessoas idosas mundialmente.

Test the ability of Mirasol Pathogen Reduction Technology (PRT, Terumo BCT, Lakewood Co, USA) treatment with riboflavin and ultraviolet light (R + UV) in reducing SARS-CoV-2 infectivity while maintaining blood product quality.SARS-CoV-2 strains were isolated and titrated to prepare cell free virus for plasma units infection. The units were then under treatment with Mirasol PRT. The infectious titers were determined before and after treatment with an in house microtitration assay on Vero E6 cells. Thirty-six plasma pool bags underwent PRT treatment.In all the experiments, the measured titer following riboflavin and UV treatment was below the limit of detection of microtitration assay for all the different SARS-CoV-2 strains. Despite the high copies number detected by RT-PCR for each viral strain after treatment, viruses were completely inactivated and not able to infect VERO E6 cells.Riboflavin and UV light treatment effectively reduced the virus titers of human plasma to the limit of detection in tissue culture, regardless of the strain. These data suggest that pathogen reduction in blood products highlight the safety of CP therapy procedures for critically ill COVID-19 patients, while maintaining blood product quality.

Background: Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) disease (COVID-19) mainly affects the respiratory system, but cardiac complications occur very often. SARS-CoV-2 entry in host cells is mediated by the interaction between the viral Spike (S) glycoprotein and the host angiotensin-converting enzyme 2 (ACE2). The use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II type 1 receptor blockers (ARBs) might influence the expression of ACE2 and viral infection, but not much is known about these interactions. Aim: To evaluate the effects of ACEIs and ARBs during active viraemia. Methods: We tested the ACEI Lisinopril (at 100nM and 500nM) and the ARB Valsartan (at 10uM and 50uM) for one week on two cell types: cardiomyocytes derived from hiPSC (hiPSC-CMs) as heart model and a lung epithelial cancer cell line (16HBE) as pulmonary model. The SARS-CoV-2 wild strain was inoculated in the two treated cell types for one hour. Cell viability was measured 72 hours after infection. Supernatants were collected and titrated to verify the presence of infectious virus using a micro-neutralization assay on VERO-E6 cells. Levels of ACE2 mRNA and protein content on cell lysates were quantified after each treatment by RT-qPCR and western blot, respectively. Results: ACEI and ARB at both concentrations affected the viability of neither hiPSC-CMs nor 16HBE cells in the absence of virus. Vice versa, viral infection significantly decreased viability of both hiPSC-CMs (-46%; p Conclusion: These data suggest that ACEIs and ARBs do not worsen the SARS-CoV-2 infection. On the contrary, Valsartan seems to be protective against SARS-CoV-2 infection, possibly by reducing ACE2 expression.

The development and persistence of SARS-CoV-2-specific immune response in immunocompetent (IC) and immunocompromised patients is crucial for long-term protection. Immune response to SARS-CoV-2 infection was analysed in 57 IC and 15 solid organ transplanted (TX) patients. Antibody responses were determined by ELISA and neutralization assay. T-cell response was determined by stimulation with peptide pools of the Spike, Envelope, Membrane, and Nucleocapsid proteins with a 20-h Activation Induced Marker (AIM) and 7-day lymphoproliferative assays. Antibody response was detected at similar levels in IC and TX patients. Anti-Spike IgG, IgA and neutralizing antibodies persisted for at least one year, while anti-Nucleocapsid IgG declined earlier. Patients with pneumonia developed higher antibody levels than patients with mild symptoms. Similarly, both rapid and proliferative T-cell responses were detected within the first two months after infection at comparable levels in IC and TX patients, and were higher in patients with pneumonia. T-cell response persisted for at least one year in both IC and TX patients. Spike, Membrane, and Nucleocapsid proteins elicited the major CD4+ and CD8+ T-cell responses, whereas the T-cell response to Envelope protein was negligible. After SARS-CoV-2 infection, antibody and T-cell responses develop rapidly and persist over time in both immunocompetent and transplanted patients.

Summary Information concerning the longevity of immunity to SARS-CoV-2 following natural infection may have considerable implications for durability of immunity induced by vaccines. Here, we monitored the SARS-CoV-2 specific immune response in COVID-19 patients followed up to 15 months after symptoms onset. Following a peak at day 15–28 postinfection, the IgG antibody response and plasma neutralizing titers gradually decreased over time but stabilized after 6 months. Compared to G614, plasma neutralizing titers were more than 8-fold lower against variants Beta, Gamma, and Delta. SARS-CoV-2-specific memory B and T cells persisted in the majority of patients up to 15 months although a significant decrease in specific T cells, but not B cells, was observed between 6 and 15 months. Antiviral specific immunity, especially memory B cells in COVID-19 convalescent patients, is long-lasting, but some variants of concern may at least partially escape the neutralizing activity of plasma antibodies., Graphical abstract, Highlights • Plasma neutralizing antibodies persist in the majority of patients up to 15 months • Neutralizing activity is lower against variants of concern Delta, Beta, and Gamma • Specific memory B and T cells were present in 95% of patients up to 15 months • Specific T cells, but not B cells, were decreased between 6 and 15 months, Immunology; Immune response; Virology

SummaryBackgroundInformation concerning the longevity of immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) following natural infection may have considerable implications for durability of immunity induced by vaccines. Here, we monitored the SARS-CoV-2 specific immune response in convalescent coronavirus disease-2019 (COVID-19) patients up to 15 months after symptoms onset.MethodsThe levels of anti-spike and anti-receptor binding domain antibodies and neutralizing activities were tested in a total of 188 samples from 136 convalescent patients who experience mild to critical COVID-19. Specific memory B and T cell responses were measured in 76 peripheral blood mononuclear cell samples collected from 54 patients. Twenty-three vaccinated individuals were included for comparison.FindingsFollowing a peak at day 15-28 post-infection, the IgG antibody response and plasma neutralizing titers gradually decreased over time but stabilized after 6 months. Plasma neutralizing activity against G614 was still detected in 87% of the patients at 6-15 months. Compared to G614, the median neutralizing titers against Beta, Gamma and Delta variants in plasma collected at early (15-103 days) and late (9-15 month) convalescence were 16- and 8-fold lower, respectively. SARS-CoV-2-specific memory B and T cells reached a peak at 3-6 months and persisted in the majority of patients up to 15 months although a significant decrease in specific T cells was observed between 6 and 15 months.ConclusionThe data suggest that antiviral specific immunity especially memory B cells in COVID-19 convalescent patients is long-lasting, but some variants of concern, including the fast-spreading Delta variant, may at least partially escape the neutralizing activity of plasma antibodies.FundingEU-ATAC consortium, the Italian Ministry of Health, the Swedish Research Council, SciLifeLab, and KAW.

Objetivo: Analisar os resultados do acompanhamento psicológico, pela escuta psicanalítica, de idosos que cuidam de familiares idosos. Métodos: Intervenção e acompanhamento psicológicos individuais oferecidos a 51 idosos familiares que cuidam de idosos. Resultados: Dos 51, apenas cinco idosas cuidadoras (65-79 anos) demonstraram interesse no acompanhamento psicológico. Essas idosas cuidam dos maridos (68-85 anos) ou de suas mães (90-95 anos). Buscamos uma reflexão quanto às idosas ficarem na posição de submissão, de reclamações, de sofrimentos trazidos em seus discursos, com relação às desvantagens advindas do cuidar de dependentes exigentes, autoritários ou controladores. Identificamos que, inconscientemente, havia um algo a mais e, propusemos a ideia do “avantajamento”, que se refere a um processo inconsciente do idoso cuidador de reconhecer-se numa posição vantajosa frente ao familiar dependente. Conclusão: O acompanhamento psicológico das idosas cuidadoras possibilitou, por meio de uma escuta diferenciada, estímulo à implicação em seus sintomas e, inclusive, no propósito do cuidar. Com a abertura dessa chave inconsciente e da continuidade no processo analítico, cada idosa caminhou na busca de um reinvestimento em si e numa nova relação com o outro; de permitir-se ser um sujeito, que tem desejos, e não somente um idoso que cuida.

We aimed to explore whether variants of SARS-CoV-2 (Chinese-derived strain (D614, lineage A), Italian strain PV10734 (D614G, lineage B.1.1) and Alpha strain (lineage B.1.1.7)) were able to infect monocytes (MN) and monocyte-derived macrophages (MDM) and whether these infected cells may, in turn, be vectors of infection. For this purpose, we designed an in vitro study following the evolution of MN and MDM infection at different time points in order to confirm whether these cells were permissive for SARS-CoV-2 replication. Finally, we investigated whether, regardless of viral replication, the persistent virus can be transferred to non-infected cells permissive for viral replication. Thus, we co-cultured the infected MN/MDM with permissive VERO E6 cells verifying the viral transmission. This is a further in vitro demonstration of the important role of MN and MDM in the dissemination of SARS-CoV-2 and evolution of the COVID-19 disease.

COVID-19 related morbidity and mortality have been often attributed to an exaggerated immune response. The role of cytokines and chemokines in COVID-19 and their contributions to illness severity are known, and thus their profiling from patient bronchoalveolar lavage (BAL) samples would help in understanding the disease progression. To date, limited studies have been performed on COVID-19 BAL samples, as the manipulation of such specimens (potentially containing live viruses) requires several laboratorial precautions, such as personnel training and special equipment, a requirement that not all laboratories can fulfil. Here, we assessed two fast and easily applicable methods (ultrafiltration and ultraviolet–C irradiation) for their impact on viral load removal or inactivation, respectively and on cytokine profiles preservation. Eight samples of BAL fluids from SARS-CoV2 patients with high viral load were tested. For both methods, complete removal was confirmed by lack of viral replication in Vero E6 cells and by RT-qPCR. Although both methods showed to remove completely the active SARS-CoV2 viral load, only UVC treatment has little or no quantitative effect on total cytokines/chemokines measurements, however cytokines profile and relative ratios are preserved or minimally altered when compared data obtained by the two different decontamination methods. Sample preparation and manipulation can greatly affect the analytical results, therefore, understanding if changes occurred after sample processing is of outmost importance for reliable data and can be useful to improve clinical practice.

Resumo Objetivo Avaliar a frequência de Internação Hospitalar (IH) nos últimos doze meses em pessoas idosas atendidos na Atenção Primária à Saúde (APS) e seus fatores associados por meio de uma Avaliação Geriátrica Ampla (AGA). Métodos Estudo transversal, com amostra aleatória de 400 pessoas idosas atendidas em uma Unidade Básica de Saúde (UBS). A avaliação da frequência de IH por pelo menos 24 horas foi autorreferida (sim; não). Utilizou-se questionário sociodemográfico e de saúde, instrumentos para avaliar as atividades básicas e instrumentais da vida diária, status cognitivo, sintomas depressivos, queda e medo de cair. A regressão logística múltipla foi utilizada para investigar os fatores associados à IH. Resultados A média de idade foi de 75,23 (±8,53), 63,2% dos participantes eram do sexo feminino, 62,6% relataram um estado de saúde ruim/razoável e 38% relataram hospitalização nos últimos doze meses. Idade mais avançada, com pior percepção de saúde, doenças crônicas, uso diário de medicamentos, dependentes para as atividades básicas e instrumentais da vida diária, comprometimento do status cognitivo e queda no ano anterior demonstraram associação com a hospitalização. Saber ler e escrever foi associado com menor risco de hospitalização. Conclusão A frequência de IH de pessoas idosas atendidas em UBS foi alta e foi associada a fatores modificáveis e não modificáveis, indicando que a abordagem multidimensional é uma ferramenta importante no cuidado da pessoa idosa na atenção primária à saúde. Abstract Objective To evaluate the frequency of Hospital Admission (HA) in the last twelve months in older adults treated at Primary Health Care (PHC) and its associated factors, through a Comprehensive Geriatric Assessment (CGA). Methods Cross-sectional study, with a random sampling of 400 older adults using PHC. The frequency of HA for at least 24 hours was self-reported (yes; no). A sociodemographic and health survey was used, tools to evaluate basic and instrumental daily life activities, cognition, depression, falling, and fear of falling. The association of factors to HA was analyzed using multiple logistic regression analysis. Results Mean age was 75.23 (±8,53), 63.2% of participants were female 62.6% reported a poor/fair state of health and 38% reported HA in the previous twelve months. Older patients, with a poor perceived health, chronic illnesses, daily use of medications, dependent for basic and instrumental daily life activities, cognitive impairment, and having fallen in the previous year demonstrated associations with hospitalization. Knowing how to read and write was associated with protection from hospitalization. The frequency of hospitalization was high in this study. Conclusion The frequency of HA of older people attended at basic health units was high and was associated with modifiable and non-modifiable factors, indicating that the multidimensional approach is an important tool in the care of the older adults in primary health care settings.

Solid organ transplant recipients, due to the administration of post-transplant immunosuppressive therapies, are at greater risk of viral reactivation episodes, mainly from herpes viruses, including varicella-zoster virus (VZV). The aim of this pilot study was to develop functional immunological assays (VZV-ELISpot) for the quantification and characterization of the VZV-specific effector-memory and central-memory responses in healthy subjects and transplanted patients. Glycoprotein gE and immediate-early 63 (IE-63) were used as antigens for in vitro stimulation. VZV-seropositive healthy subjects showed higher responses in respect to seronegative subjects. Even if differences were observed between VZV-seropositive healthy subjects and transplanted subjects at pre-transplant, the VZV-specific T-cell response was reduced at 60 days after transplant, mainly for the high level of immunosuppression. Phenotypical characterization revealed that response against VZV was mainly mediated by CD4 T cells. The results obtained in this study might be useful for the definition of personalized follow-up of the transplanted patients, providing useful information on the status of the patient potentially at risk of viral reactivation or other opportunistic infections.

Vaccine breakthrough SARS-CoV-2 infection has been monitored in 3720 healthcare workers receiving 2 doses of BNT162b2. SARS-CoV-2 infection is detected in 33 subjects, with a 100-day cumulative incidence of 0.93%. Vaccine protection against acquisition of SARS-CoV-2 infection is 83% (95%CI: 58–93%) in the overall population and 93% (95%CI: 69-99%) in SARS-CoV-2-experienced subjects, when compared with a non-vaccinated control group from the same Institution, in which SARS-CoV-2 infection occurs in 20/346 subjects (100-day cumulative incidence: 5.78%). The infection is symptomatic in 16 (48%) vaccinated subjects vs 17 (85%) controls (p = 0.01). All analyzed patients, in whom the amount of viral RNA was sufficient for genome sequencing, results infected by the alpha variant. Antibody and T-cell responses are not reduced in subjects with breakthrough infection. Evidence of virus transmission, determined by contact tracing, is observed in two (6.1%) cases. This real-world data support the protective effect of BNT162b2 vaccine. A triple antigenic exposure, such as two-dose vaccine schedule in experienced subjects, may confer a higher protection., Several COVID-19 vaccines have shown good efficacy in clinical trials. Here, the authors provide real world effectiveness data in a group of BNT162b2 vaccinated health care workers and find that breakthrough infections are asymptomatic or mild.

The design procedure developed for a new type of heat-integrated distillation column was verified through the operation data of a commercial plant. In a conventional heat-integrated distillation column (HIDiC), optimal heat exchange cannot be achieved because the heat exchange between the rectifying section and the stripping section is executed through the wall at the same elevation physically. We have proposed a new process structure in which the heat exchange is executed between several pairs of stages in the rectifying and stripping sections; such a heat-integrated distillation column is hereafter called the discrete HIDiC (D-HIDiC). The energy-saving performance of D-HIDiC depends on the compositions to supply/remove the heat, the selection of the pair of stages to be heat-exchanged and the amount of heat transferred at each heat exchanger. We have developed a new graphical design procedure for D-HIDiC, in which a plausible design is interactively derived by using H-xy and T-xy diagram that is an extension of Ponchon–Savarit H-xy diagram. The proposed design procedure was applied to a design problem of a commercially operating column at Maruzen Petrochemical, Japan, and the existing column was replaced with a newly installed D-HIDiC. Through stable operation since August in 2016, it was verified that more than 55% energy conservation to the conventional distillation column could be achieved. In this paper, further energy conservation by modifying the operation condition is discussed. The heat allocations to side heat exchangers have been changed by referring to the design result on the proposed H-xy and T-xy diagram. As the adiabatic efficiency of the compressor was decreased in comparison to the original operation mode, the improvement of energy-saving was not so large. However, assuming the same adiabatic efficiency of the compressor, the simulation result has shown much better energy conservation compared to the original operation mode. Real operation data and simulation result demonstrated that the appropriate side heat exchanger allocation could achieve higher energy conservation. It was also verified that the direction of better operating condition can be obtained from the proposed design procedure by using H-xy and T-xy diagram.

Morphological evidence in active tectonic areas containing subcircular geometries suggests that these geometries may be the result of mechanisms other than those described by translational dynamics of complex faults. The mechanics of endogenic forces, particularly convection currents, have not been fully explained. Magma upwelling from the mantle, which differs in density from upward flows developing in the atmosphere and in water, can trigger endogenic vortexes under certain conditions and due to Coriolis Force.Vortexes apply lateral forces as a result of rotation at their onset and ascent phases, opening their way toward the surface and eventually stabilizing the channel. In contrast to a rising linear flow, which compacts overlaying materials, inhibiting its surge, vortex flows unload materials from the outside and compact them on the channel's lateral surface, making it more regular and stable.Torsional movements on the surface associated with volcanites, lateral ramps, and subcircular elevations can be seen. Volcanic cones with pseudo-rotations in the morphologies surrounding the crater are another phenomenon that could be caused by vortex dynamics.We propose a model for a vortex theory in this paper, which could explain Earth dynamics in terms of spiralling movement and magma upwelling stabilizing over time.