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2. Neurologic Manifestations of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Hospitalized Patients During the First Year of the COVID-19 Pandemic
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Anna M. Cervantes-Arslanian, MD, Chakradhar Venkata, MD, Pria Anand, MD, Joseph D. Burns, MD, Charlene J. Ong, MD, Allison M. LeMahieu, MS, Phillip J. Schulte, PhD, Tarun D. Singh, MD, Alejandro A. Rabinstein, MD, Neha Deo, BS, Vikas Bansal, MBBS, MPH, Karen Boman, BS, Juan Pablo Domecq Garces, MD, Donna Lee Armaignac, PhD, APRN, Amy B. Christie, MD, Roman R. Melamed, MD, Yasir Tarabichi, MD, MSCR, Sreekanth R. Cheruku, MD, MPH, Ashish K. Khanna, MD, FCCP, FCCM, FASA, Joshua L. Denson, MD, MS, Valerie M. Banner-Goodspeed, MPH, Harry L. Anderson, III, MD, FACS, FICS, FCCM, FCCP, FAIM, Ognjen Gajic, MD, MS, Vishakha K. Kumar, MD, MBA, Allan Walkey, MD, Rahul Kashyap, MD, MBA, on behalf of the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group, Jean-Baptiste Mesland, Pierre Henin, Hélène Petre, Isabelle Buelens, Anne-Catherine Gerard, Philippe Clevenbergh, Rolando Claure-Del Granado, Jose A. Mercado, Esdenka Vega-Terrazas, Maria F. Iturricha-Caceres, Ruben Garza, Eric Chu, Victoria Chan, Oscar Y Gavidia, Felipe Pachon, Yeimy A Sanchez, Danijel knežević, Mohamed El Kassas, Mohamed Badr, Ahmed Tawheed, Hend Yahia, Dimitrios Kantas, Vasileios Koulouras, Estela Pineda, Gabina María Reyes Guillen, Helin Archaga Soto, Ana Karen Vallecillo Lizardo, Csaba Kopitkó, Ágnes Bencze, István Méhész, Zsófia Gerendai,, Girish Vadgaonkar, Rekha Ediga, Shilpa Basety, Shwetha Dammareddy, Phani Sreeharsha Kasumalla, Smitha S. Segu, Tuhin Chakraborty, Epcebha Joyce, Sridhar Papani, Mahesh Kamuram, Mradul Kumar Daga, Munisha Agarwal, Ishan Rohtagi, Anusha Cherian, Sreejith Parameswaran, Magesh Parthiban, Phaneendra Doddaga, Neethi Chandra, Puneet Rijhwani, Ashish Jain, Aviral Gupta, Ram Mohan Jaiswal, Ambika Tyagi, Nimish Mathur, Madhav Prabhu, Vishal Jakati, Mukur Petrolwala, Bharat Ladva, Surapaneni Krishna Mohan, Ekambaram Jyothisree, Umamaheswara Raju, Janaki Manduva, Naresh Kolakani, Shreeja Sripathi, Sheetal Chaitanya, Kamlesh Kumar Agrawal, Vijendra Baghel, Kirti Kumar Patel, Nooshin Dalili, Mohsen Nafa, Wataru Matsuda, Reina Suzuki, Michihito Kyo, Shu Tahara, Mineji Hayakawa, Kunihiko Maekawa, Masamitsu Sanui, Sho Horikita, Yuki Itagaki, Akira Kodate, Yuki Takahashi, Koyo Moriki, Takuya Shiga, Yudai Iwasaki, Hidenobu Shigemitsu, Yuka Mishima, Nobuyuki Nosaka, Michio Nagashima, Abdulrahman Al-Fares, Rene Rodriguez-Gutierrez, Jose Gerardo Gonzalez-Gonzalez, Alejandro Salcido-Montenegro, Adrian Camacho-Ortiz, Mariana Janeth Hermosillo Ulloa, Fatimah Hassan-Hanga, Hadiza Galadanci, Abubakar Shehu Gezawa, Halima M. S. Kabara, Taiwo Gboluwaga Amole, Halima Kabir, Dalha Gwarzo Haliru, Abdullahi S Ibrahim, Muhammad Sohaib Asghar, Mashaal Syed, Syed Anosh Ali Naqvi, Igor Borisovich Zabolotskikh,, Konstantin Dmitrievich Zybin, Sergey Vasilevich Sinkov, Tatiana Sergeevna Musaeva, Razan K Alamoudi, Hassan M. AlSharif, Sarah A. Almazwaghi, Mohammed S Elsakran, Mohamed A Aid, Mouaz A Darwich, Omnia M Hagag, Salah A Ali, Alona rocacorba, Kathrine Supeña, Efren Ray Juane, Jenalyn Medina, Jowany Baduria, Marwa Ridha Amer, Mohammed Abdullah, Bawazeer, Talal I. Dahhan, Eiad Kseibi, Abid Shahzad Butt, Syed Moazzum Khurshid, Muath Rabee, Mohammed Abujazar, Razan Alghunaim, Maal Abualkhair, Abeer Turki AlFirm, Yaseen M Arabi, Sheryl Ann Abdukahil, Mohammed A Almazyad, Mohammed I Alarifi, Jara M Macarambon, Ahmad Abdullah Bukhari, Hussain A. Albahrani, Kazi N Asfina, Kaltham M Aldossary, Marija Zdravkovic, Zoran Todorovic, Viseslav Popadic, Slobodan Klasnja, Ana Andrijevic, Srdjan Gavrilovic, Vladimir Carapic, Bojan Kovacevic, Jovana Bojicic, Stevanovic Predrag, Dejan S Stojakov, Duska K Ignjatovic, Suzana C Bojic, Marina M Bobos, Irina B Nenadic, Milica S Zaric, Marko D Djuric, Vladimir R Djukic, Santiago Y. Teruel, Belen C. Martin, Uluhan Sili, Huseyin Bilgin, Pinar Ay, Varsha P Gharpure, Usman Raheemi, Kenneth W. Dodd, Nicholas Goodmanson, Kathleen Hesse, Paige Bird, Chauncey Weinert, Nathan Schoenrade, Abdulrahman Altaher, Esmael Mayar, Matthew Aronson, Tyler Cooper, Monica Logan, Brianna Miner, Gisele Papo, Eric M. Siegal, Phyllis Runningen, Suzanne Barry, Christopher Woll, Gregory Wu, Erin Carrole, Kathryn Burke, Mustafa Mohammed, Roman R. Melamed, David M. Tierney, Love A. Patel, Vino S. Raj, Barite U. Dawud, Narayana Mazumder, Abbey Sidebottom, Alena M. Guenther, Benjamin D. Krehbiel, Nova J. Schmitz, Stacy L. Jepsen, Lynn Sipsey, Anna Schulte, Whitney Wunderlich, Cecely Hoyt, Abhijit A Raval, Andrea Franks, Katherine Irby, Ronald C. Sanders, Jr., Glenda Hefley, Jennifer M. Jarvis, Anmol Kharbanda, Sunil Jhajhria, Zachary Fyffe, Stephen Capizzi, Bethany Alicie, Martha Green, Lori Crockarell, Amelia Drennan, Kathleen Dubuque, Tonya Fambrough, Nikole Gasaway, Briana Krantz, Peiman Nebi, Jan Orga, Margaret Serfass, Alina Simion, Kimberly Warren, Cassie Wheeler, CJ Woolman, Amy B. Christie, Dennis W. Ashley, Rajani Adiga, Andrew S. Moyer, George M. Verghese, Andrea Sikora Newsome, Christy C. Forehand, Rebecca Bruning, Timothy W. Jones, Moldovan Sabov, Fatema Zaidi, Fiona Tissavirasingham, Dhatri Malipeddi, Jarrod M Mosier, Karen Lutrick, Beth Salvagio Campbell, Cathleen Wilson, Patrick Rivers, Jonathan Brinks, Mokenge Ndiva Mongoh, Boris Gilson, Donna Lee Armaignac, Don Parris, Maria Pilar Zuniga, Ilea Vargas, Viviana Boronat, Anneka Hutton, Navneet Kaur, Prashank Neupane, Nohemi Sadule-Rios, Lourdes M. Rojas, Aashish Neupane, Priscilla Rivera, Carlos Valle Carlos, Gregory Vincent, Mahesh Amin, Mary E Schelle, Amanda Steadham, Christopher M Howard, Cameron McBride, Jocelyn Abraham, Orlando Garner, Katherine Richards, Keegan Collins, Preethi Antony, Sindhu Mathew, Valerie C. Danesh, Gueorgui Dubrocq, Amber L. Davis, Marissa J Hammers, ill M. McGahey, Amanda C. Farris, Elisa Priest, Robyn Korsmo, Lorie Fares, Kathy Skiles, Susan M. Shor, Kenya Burns, Corrie A Dowell, Gabriela “Hope” Gonzales, Melody Flores, Lindsay Newman, Debora A Wilk, Jason Ettlinger, Jaccallene Bomar, Himani Darji, Alejandro Arroliga, Alejandro C Arroliga, Corrie A. Dowell, Gabriela Hope Conzales, Debora A. Wilk, Paras B. Khandhar, Elizabeth Kring, Valerie M. Banner-Goodspeed, Somnath Bose, Lauren E. Kelly, Melisa Joseph, Marie McGourty, Krystal Capers, Benjamin Hoenig, Maria C. Karamourtopoulos, Anica C. Law, Elias N. Baedorf Kassis, Allan J. Walkey, Sushrut S. Waikar, Michael A. Garcia, Mia Colona, Zoe Kibbelaar, Michael Leong, Daniel Wallman, Kanupriya Soni, Jennifer Maccarone, Joshua Gilman, Ycar Devis, Joseph Chung, Munizay Paracha, David N. Lumelsky, Madeline DiLorenzo, Najla Abdurrahman, Shelsey Johnson, Maj Andrew M. Hersh, CPT Stephanie L Wachs, Brittany S. Swigger, Stephanie L Wachs, Capt Lauren A. Sattler, Capt Michael N. Moulton, Kimberly Zammit, Patrick, J McGrath, William Loeffler, Maya, R. Chilbert, Aaron S. Miller, Edwin L. Anderson, Rosemary Nagy, Ravali R. Inja, Pooja A. Nawathe, Isabel Pedraza, Jennifer Tsing, Karen Carr, Anila Chaudhary, Kathleen Guglielmino, Raghavendra Tirupathi, Alymer Tang, Arshad Safi, Cindy Green, Jackie Newell, Rayan E. Ihle, Shelda A. Martin, Elaine A. Davis, Katja M. Gist, Imran A Sayed, John Brinton, Larisa Strom, Kathleen Chiotos, Allison M. Blatz, Giyoung Lee, Ryan H. Burnett, Guy I. Sydney, Danielle M. Traynor, Karissa Nauert, Annika Gonzalez, Mariel Bagley, Anita Santpurkar, Salim Surani, Joshua White, Aftab Khan, Rahul Dhahwal, Sreekanth Cheruku, Farzin Ahmed, Christopher Deonarine, Ashley Jones, Mohammad-Ali Shaikh, David Preston, Jeanette Chin, Vidula Vachharajani, Abhijit Duggal, Prabalini Rajendram, Omar Mehkri, Siddharth Dugar, Michelle Biehl, Gretchen Sacha, Stuart Houltham, Alexander King, Kiran Ashok, Bryan Poynter, Mary Beukemann, Richard Rice, Susan Gole, Valerie Shaner, Adarsh Conjeevaram, Michelle Ferrari, Narendrakumar Alappan, Steven Minear, Jaime Hernandez-Montfort, Syed Sohaib Nasim, Ravi Sunderkrishnan, Debasis Sahoo, Patrick S. Milligan, Sandeep K. Gupta, Joy M. Koglin, Regina Gibson, Lana Johnson, Felicia Preston, Crimson Scott, Bethany Nungester, Dana D Byrne, Christa A Schorr, Katie Grant, Katherine L Doktor, Maura C Porto, Olga Kaplan, James E. Siegler, III, Brian Schonewald, Ashley Woodford, Alan Tsai, Savina Reid, Kuntal Bhowmick, Saba Daneshpooy, Cyrus Mowdawalla, Trishna Akshay Dave, Wilhemina Kennedy, Connor Crudeli, Christopher Ferry, Long Nguyen, Sneha Modi, Niharika Padala, Pavan Jitendra Patel, Belle Lin, Lena Chatterjee, Jamie Qiuyun, Fan Mandi Liu, Rasagna Kota, Annesha Banerjee, Steven K. Daugherty, Sam Atkinson, Kelly Shrimpton, Sidney Ontai, Brian Contreras, Uzoma Obinwanko, Nneka Amamasi, Amir Sharafi, Sarah Lee, Zahia Esber, Chetna Jinjvadia, Raquel R Bartz, Vijay Krishnamoorthy, Bryan Kraft, Aaron Pulsipher, Eugene Friedman, Sachin Mehta, Margit Kaufman, Gregg Lobel, Nisha Gandhi, Amr Abdelaty, Elizabeth Shaji, Kiana Lim, Juan Marte, Dani Ashley Sosa, David P. Yamane, Ivy Benjenk, Nivedita Prasanna, Nicholas Perkins, Prera J. Roth, Banu Sivaraj, Haley Fulton, Madison G Herin, Marissa Crum, Morgan E. Fretwell, Emily-Rose Zhou, Christine Waller, Kara Kallies, Jonean Thorsen, Alec Fitzsimmons, Haley Olsen, Heda R. Dapul, Sourabh Verma, Alan Salas, Ariel Daube, Michelle Korn, Michelle Ramirez, Logi Rajagopalan, Laura Santos, Héctor Collazo Santiago, Ricardo Alan Hernandez, Norma Smalls, Asher G Bercow, Mark Shlomovich, Christine Crandall, Sasko Stojanovski, Kristin Johnson, Kelly Michienzi, Steven Q. Davis, Valentina Jovic, Max Masuda, Amanda Hayes, Katharine Nault, Michael Smith, William Snow, Riley Liptak, Hannah Durant, Valerie Pendleton, Alay Nanavati, Risa Mrozowsk, Namrata Nag, Jeff Brauer, Ashwin Dharmadhikari, Sahib Singh, Franco Laghi, Ghania Naeem, Andrew Wang, Kevin Bliden, Amit Rout, Jaime Barnes, Martin Gesheff, Asha Thomas, Melbin Thomas, Alicia R. Liendo, Jovan Milosavljevic, Kenan Abbasi, Nicholas B. Burley, Nicole Rapista, Samuel Amankwah, Sanjay K Poude, Saroj Timilsina, Sauradeep Sarkar, Oluwasayo Akinyosoye, Shashi K. Yalamanchili, Sheena Moorthy, Sonia Sugumar, Jonathan Ford, Martin C. Taylor, Charlotte Dunderdale, Alyssa Henshaw, Mary K. Brunk, Jessica Hagy, Shehryar Masood, Sushrutha Sridhar, Yuk Ming Liu, Sarah Zavala, Esther Shim, Ronald A. Reilkoff, Julia A. Heneghan, Sarah Eichen, Lexie Goertzen, Scott Rajala, Ghislaine Feussom, Ben Tang, Christine C. Junia, Robert Lichtenberg, Hasrat Sidhu, Diana Espinoza, Shelden Rodrigues, Maria Jose Zabala, Daniela Goyes, Ammu Susheela, Buddhi Hatharaliyadda, Naveen Rameshkumar, Amulya Kasireddy, Genessis Maldonado, Lisseth Beltran, Akshata Chaugule, Hassan Khan, Namrata Patil, Ruhi Patil, Rodrigo Cartin-Ceba, Ayan Sen, Fahimeh Talaei, Rahul Kashyap, Juan Pablo Domecq, Ognjen Gajic, Vikas Bansal, Aysun Tekin, Amos Lal, John C. O’Horo, Neha N. Deo, Mayank Sharma, Shahraz Qamar, Romil Singh, Diana J. Valencia Morales, Abigail T. La Nou, Marija Bogojevic, Simon Zec, Devang Sanghavi, Pramod Guru, Pablo Moreno Franco, Karthik Gnanapandithan, Hollie Saunders, Zachary Fleissner, Juan Garcia, Alejandra Yu Lee Mateus, Siva Naga Yarrarapu, Nirmaljot Kaur, Abhisekh Giri, Mohammed Mustafa Hasan, Ashrita Donepudi, Syed Anjum Khan, Nitesh Kumar Jain, Thoyaja Koritala, Alexander Bastidas, Gabriela Orellana, Adriana Briceno Bierwirth, Eliana Milazzo, Juan Guillermo Sierra, Thao Dang, Rahul S Nanchal, Paul A Bergl, Jennifer L Peterson, Jessica Timmer, Kimberly Welker, Travis Yamanaka, Nicholas A. Barreras, Michael Markos, Anita Fareeduddin, Rohan Mehta, Chakradhar Venkata, Miriam Engemann, Annamarie Mantese, Yasir Tarabichi, Adam Perzynski, Christine Wang, Dhatri Kotekal, Adriana C Briceno Bierwirth, Gabriela M Orellana, Gerardo Catalasan, Shohana Ahmed, Carlos F Matute, Ahmad Hamdan, Ivania Salinas, Genesis Del Nogal, Angel Tejada, Anna Eschler, Mary Hejna, Emily Lewandowski, Kristen Kusmierski, Clare Martin, Jen-Ting Chen, Aluko Hope, Zoe Tsagaris, Elise Ruen, Aram Hambardzumyan, Nasar A Siddiqi, Lesly Jurado, Lindsey Tincher, Carolyn Brown, Prithvi Sendi, Meghana Nadiger, Balagangadhar Totapally, Bhagat S. Aulakh, Sandeep Tripathi, Jennifer A. Bandy, Lisa M. Kreps, Dawn R. Bollinger, Neha Gupta, Brent R Brown, Tracy L Jones, Kassidy Malone, Lauren A Sinko, Amy B Harrell, Shonda C Ayers, Lisa M Settle, Taylor J Sears, Roger Scott Stienecker, Andre G. Melendez, Tressa A. Brunner, Sue M Budzon, Jessica L. Heffernan, Janelle M. Souder, Tracy L. Miller, Andrea G. Maisonneuve, Roberta E. Redfern, Jessica Shoemaker, Jennifer Micham, Lynn Kenney, Gabriel Naimy, Victoria Schauf, Sara Utley, Holly Balcer, Kerry P. J. Pulver, Jennifer Yehle, Alicia Weeks, Terra Inman, Majdi Hamarshi, Jeannette Ploetz, Nick Bennett, Kyle Klindworth, Moustafa Younis, Adham Mohamed, Brian L. Delmonaco, Anthony Franklin, Mitchell Heath, Diane Barkas, Antonia L. Vilella, Sara B. Kutner, Kacie Clark, Danielle Moore, Shina Menon, John K McGuire, Deana Rich, Harry L. Anderson, III, Dixy Rajkumar, Ali Abunayla, Jerrilyn Heiter, Howard A. Zaren, Stephanie J. Smith, Grant C. Lewis, Lauren Seames, Cheryl Farlow, Judy Miller, Gloria Broadstreet, John Lin, Cindy Terrill, Brock Montgomery, Sydney Reyes, Summer Reyes, Alex Plattner, Anthony Martinez, Micheal Allison, Aniket Mittal, Rafael Ruiz, Aleta Skaanland, Robert Ross, Umang Patel, Jordesha Hodge, Krunal Kumar Patel, Shivani Dalal, Himanshu Kavani, Sam Joseph, Michael A. Bernstein, Ian K. Goff, Matthew Naftilan, Amal Mathew, Deborah Williams, Sue Murdock, Maryanne Ducey, Kerianne Nelson, Jason Block, James Mitchel, Connor G O’Brien, Sylvan Cox, William Marx, Ioana Amzuta, Asad J. Choudhry, Mohammad T. Azam, Kristina L Carter, Michael A Olmos, Brittany M Parker, Julio Quintanilla, Tara A Craig, Brendon J Clough, Jeffrey T Jameson, Utpal S. Bhalala, Joshua Kuehne, Melinda Garcia, Morgan Beebe, Heather Herrera, Chris Fiack, Stephanie Guo, May Vawer, Beth Blackburn, Caleb Darby, Kristy Page, Amanda Brown, Jessie McAbee, Katherine A. Belden, Michael Baram, Devin M. Weber, Rosalie DePaola, Yuwei Xia, Hudson Carter, Aaron Tolley, Mary Barletta, Mark Steele, Laurie Kemble, Joshua L. Denson, A. Scott Gillet, Margo Brown, Rachael Stevens, Andrew Wetherbie, Kevin Tea, Mathew Moore, Abdurrahman Husain, Atul Malhotra, Qais Zawaydeh, Benjamin J Sines, Thomas J Bice, Emily A. Vail, Susannah Nicholson, Rachelle B. Jonas, AnnaRose E. Dement, William Tang, Mark DeRosa, Robert E. Villarreal, Rajany V. Dy, Alfredo Iardino, Jill Sharma, Richard Czieki, Julia Christopher, Ryan Lacey, Marwan Mashina, Kushal Patel, Erica C. Bjornstad, Nancy M. Tofil, Scott House, Isabella Aldana, Nikhil K. Meena, Jose D. Caceres, Nikhil K Meena, Sarenthia M. Epps, Harmeen Goraya, Kelsey R. Besett, Ryan James, Lana Y. Abusalem, Akash K. Patel, Lana S Hasan, Dina Gomaa, Michael Goodman, Devin Wakefield, Anthony Spuzzillo, John O. Shinn II, Robert MacLaren, Azra Bihorac, Tezcan Ozrazgat Baslanti, George Omalay, Haleh Hashemighouchani, Julie S. Cupka, Matthew M Ruppert, Patrick W. McGonagill, Colette Galet, Janice Hubbard, David Wang, Lauren Allan, Aditya Badheka, Madhuradhar Chegondi, Usman Nazir, Garrett Rampon, Jake Riggle, Nathan Dismang, Vicki Montgomery, Janice Sullivan, Sarah Morris, Jennifer Nason, Ozan Akca, Rainer Lenhardt, Rodrigo S. Cavallazzi, Ann Jerde, Alexa Black, Allison Polidori, Haily Griffey, Justin Winkler, Thomas Brenzel, Roger A. Alvarez, Amarilys Alarcon-Calderon, Marie Anne Sosa, Sunita K. Mahabir, Mausam J. Patel, Pauline Park, Andrew Admon, Sinan Hanna, Rishi Chanderraj, Maria Pliakas, Ann Wolski, Jennifer Cirino, Dima Dandachi, Hariharan Regunath, Maraya N. Camazine, Grant. E. Geiger, Abdoulie O. Njai, Baraa M. Saad, Faraaz Ali Shah, Byron Chuan, Sagar L. Rawal, Manal Piracha, Joseph E. Tonna, Nicholas M. Levin, Kayte Suslavich, Rachel Tsolinas, Zachary T. Fica, Chloe R. Skidmore, Renee D. Stapleton, Anne E. Dixon, Olivia Johnson, Sara S. Ardren, Stephanie Burns, Anna Raymond, Erika Gonyaw, Kevin Hodgdon, Chloe Housenger, Benjamin Lin, Karen McQuesten, Heidi Pecott-Grimm, Julie Sweet, Sebastian Ventrone, Nita Khandelwal, T. Eoin West, Ellen S. Caldwell, Lara Lovelace-Macon, Navya Garimella, Denisse B. Dow, Sreekanth R. Cheruku, Catherine Chen, Murtaza Akhter, Rania Abdul Rahman, Mary Mulrow, Erin M. Wilfong, Kelsi Vela, Ashish K. Khanna, Lynne Harris, Bruce Cusson, Jacob Fowler, David Vaneenenaam, Glen McKinney, Imoh Udoh, Kathleen Johnson, Patrick G. Lyons, Andrew P Michelson, Sara S. Haluf, Lauren M. Lynch, Nguyet M. Nguyen, Aaron Steinberg, Nicholas Braus, Vishwanath Pattan, Jessica Papke, Ismail Jimada, Nida Mhid, Samuel Chakola, Kevin Sheth, Abdalla Ammar, Mahmoud Ammar, Victor Torres Lopez, Charles Dela Cruz,, Akhil Khosla, and Samir Gautam
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Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
OBJECTIVES:. To describe the prevalence, associated risk factors, and outcomes of serious neurologic manifestations (encephalopathy, stroke, seizure, and meningitis/encephalitis) among patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN:. Prospective observational study. SETTING:. One hundred seventy-nine hospitals in 24 countries within the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study COVID-19 Registry. PATIENTS:. Hospitalized adults with laboratory-confirmed SARS-CoV-2 infection. INTERVENTIONS:. None. RESULTS:. Of 16,225 patients enrolled in the registry with hospital discharge status available, 2,092 (12.9%) developed serious neurologic manifestations including 1,656 (10.2%) with encephalopathy at admission, 331 (2.0%) with stroke, 243 (1.5%) with seizure, and 73 (0.5%) with meningitis/encephalitis at admission or during hospitalization. Patients with serious neurologic manifestations of COVID-19 were older with median (interquartile range) age 72 years (61.0–81.0 yr) versus 61 years (48.0–72.0 yr) and had higher prevalence of chronic medical conditions, including vascular risk factors. Adjusting for age, sex, and time since the onset of the pandemic, serious neurologic manifestations were associated with more severe disease (odds ratio [OR], 1.49; p < 0.001) as defined by the World Health Organization ordinal disease severity scale for COVID-19 infection. Patients with neurologic manifestations were more likely to be admitted to the ICU (OR, 1.45; p < 0.001) and require critical care interventions (extracorporeal membrane oxygenation: OR, 1.78; p = 0.009 and renal replacement therapy: OR, 1.99; p < 0.001). Hospital, ICU, and 28-day mortality for patients with neurologic manifestations was higher (OR, 1.51, 1.37, and 1.58; p < 0.001), and patients had fewer ICU-free, hospital-free, and ventilator-free days (estimated difference in days, –0.84, –1.34, and –0.84; p < 0.001). CONCLUSIONS:. Encephalopathy at admission is common in hospitalized patients with SARS-CoV-2 infection and is associated with worse outcomes. While serious neurologic manifestations including stroke, seizure, and meningitis/encephalitis were less common, all were associated with increased ICU support utilization, more severe disease, and worse outcomes.
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- 2022
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3. Variation in Use of Repurposed Medications Among Patients With Coronavirus Disease 2019. From The Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study: Coronavirus Disease 2019 Registry Investigator Group
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Michael A. Garcia, MD, Shelsey W. Johnson, MD, Nicholas A. Bosch, MD, MSc, Emily K. Sisson, MA, Christopher R. Sheldrick, PhD, Vishakha K. Kumar, MD, MBA, Karen Boman, BS, Scott Bolesta, PharmD, Vikas Bansal, MBBS, MPH, Neha Deo, BS, J. P. Domecq, MD, Amos Lal, MD, Amy B. Christie, MD, Valerie M. Banner-Goodspeed, MPH, Devang Sanghavi, MD, MHA, Girish Vadgaonkar, MBBS, Ognjen Gajic, MD, MSc, Rahul Kashyap, MBBS, MBA, Allan J. Walkey, MD, MSc, for the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study Investigators, Jean-Baptiste Mesland, Pierre Henin, Hélène Petre, Isabelle Buelens, Anne-Catherine Gerard, Philippe Clevenbergh, Dragana Markotić, Ivana Bošnjak, Ruben Garza, Eric Chu, Victoria Chan, Oscar Y Gavidia, Felipe Pachon, Yeimy A Sanchez, Mohamed El Kassas, Mohamed Badr, Ahmed Tawheed, Hend Yahia, Jose Luis Ramos Coello, Guillermo Perez, Ana Karen Vallecillo Lizardo, Gabina María Reyes Guillen, Helin Archaga Soto, Smitha S. Segu, Tuhin Chakraborty, Epcebha Joyce, Girish Vadgaonkar, Rekha Ediga, Shilpa Basety, Shwetha Dammareddy, Phani Sreeharsha Kasumalla, Umamaheswara Raju, Janaki Manduva, Naresh Kolakani, Shreeja Sripathi, Sheetal Chaitanya, Mradul Kumar Daga, Munisha Agarwal, Ishan Rohtagi, Sridhar Papani, Mahesh Kamuram, Kamlesh Kumar Agrawal, Vijendra Baghel, Kirti Kumar Patel, Surapaneni Krishna Mohan, Ekambaram Jyothisree, Wataru Matsuda, Reina Suzuki, Michihito Kyo, Yuki Itagaki, Akira Kodate, Yuki Takahashi, Koyo Moriki, Fatimah Hassan-Hanga, Hadiza Galadanci, Abubakar Shehu Gezawa, Halima M. S. Kabara, Taiwo Gboluwaga Amole, Halima Kabir, Dalha Gwarzo Haliru, Abdullahi S Ibrahim, Muhammad Sohaib Asghar, Mashaal Syed, Syed Anosh Ali Naqvi, Igor Borisovich Zabolotskikh, Konstantin Dmitrievich Zybin, Sergey Vasilevich Sinkov, Tatiana Sergeevna Musaeva, Mohammed A Almazyad, Mohammed I Alarifi, Jara M Macarambon, Ahmad Abdullah Bukhari, Hussain A. Albahrani, Kazi N Asfina, Kaltham M Aldossary, Marija Zdravkovic, Zoran Todorovic, Viseslav Popadic, Slobodan Klasnja, Bojan Kovacevic, Jovana Bojicic, Predrag D Stevanovic, Dejan S Stojakov, Duska K Ignjatovic, Suzana C Bojic, Marina M Bobos, Irina B Nenadic, Milica S Zaric, Marko D Djuric, Vladimir R Djukic, Santiago Y. Teruel, Belen C. Martin, Uluhan Sili, Huseyin Bilgin, Pinar Ay, Abhijit A Raval, Andrea Franks, Anmol Kharbanda, Sunil Jhajhria, Zachary Fyffe, Stephen Capizzi, Bethany Alicie, Martha Green, Lori Crockarell, Amelia Drennan, Kathleen Dubuque, Tonya Fambrough, Nikole Gasaway, Briana Krantz, Peiman Nebi, Jan Orga, Margaret Serfass, Alina Simion, Kimberly Warren, Cassie Wheeler, CJ Woolman, Amy B. Christie, Dennis W. Ashley, Rajani Adiga, Andrew S. Moyer, George M. Verghese, Andrea Sikora Newsome, Christy C. Forehand, Rebecca Bruning, Timothy W. Jones, Moldovan Sabov, Fatema Zaidi, Fiona Tissavirasingham, Dhatri Malipeddi, Donna Lee Armaignac, Don Parris, Maria Pilar Zuniga, Ilea Vargas, Viviana Boronat, Anneka Hutton, Navneet Kaur, Prashank Neupane, Nohemi Sadule-Rios, Lourdes M. Rojas, Aashish Neupane, Priscilla Rivera, Carlos Valle Carlos, Gregory Vincent, Valerie M. Banner-Goodspeed, Somnath Bose, Lauren E. Kelly, Melisa Joseph, Marie McGourty, Krystal Capers, Benjamin Hoenig, Maria C. Karamourtopoulos, Anica C. Law, Elias N. Baedorf Kassis, Allan J. Walkey, Sushrut S. Waikar, Michael A. Garcia, Mia Colona, Zoe Kibbelaar, Michael Leong, Daniel Wallman, Kanupriya Soni, Jennifer Maccarone, Joshua Gilman, Ycar Devis, Joseph Chung, Munizay Paracha, David N. Lumelsky, Madeline DiLorenzo, Najla Abdurrahman, Shelsey Johnson, Kimberly Zammit, Patrick, J McGrath, William Loeffler, Maya, R Chilbert, Raghavendra Tirupathi, Alymer Tang, Arshad Safi, Cindy Green, Jackie Newell, Katja M. Gist, Imran A Sayed, John Brinton, Larisa Strom, Steven K. Daugherty, Sam Atkinson, Kelly Shrimpton, David P. Yamane, Ivy Benjenk, Nivedita Prasanna, Norma Smalls, Michael Smith, William Snow, Riley Liptak, Hannah Durant, Valerie Pendleton, Alay Nanavati, Risa Mrozowsk, Yuk Ming Liu, Sarah Zavala, Esther Shim, Ronald A. Reilkoff, Julia A. Heneghan, Sarah Eichen, Lexie Goertzen, Scott Rajala, Ghislaine Feussom, Ben Tang, Christine C. Junia, Robert Lichtenberg, Hasrat Sidhu, Diana Espinoza, Shelden Rodrigues, Maria Jose Zabala, Daniela Goyes, Ammu Susheela, Buddhi Hatharaliyadda, Naveen Rameshkumar, Amulya Kasireddy, Genessis Maldonado, Lisseth Beltran, Akshata Chaugule, Hassan Khan, Rodrigo Cartin-Ceba, Ayan Sen, Amanda Palacios, Giyth M. Mahdi, Rahul Kashyap, Ognjen Gajic, Vikas Bansal, Aysun Tekin, Amos Lal, John C. O’Horo, Neha N. Deo, Mayank Sharma, Shahraz Qamar, Juan Pablo Domecq, Romil Singh, Alex Niven, Abigail La Nou, Marija Bogojevic, Barbara Mullen, Devang Sanghavi, Pablo Moreno Franco, Pramod Guru, Karthik Gnanapandithan, Hollie Saunders, Zachary Fleissner, Juan Garcia, Alejandra Yu, Lee Mateus, Siva Naga Yarrarapu, Nirmaljot Kaur, Abhisekh Giri, Syed Anjum Khan, Nitesh Kumar Jain, Thoyaja Koritala, Jessica Timmer, Kimberly Welker, Chakradhar Venkata, Miriam Engemann, Annamarie Mantese, Anna Eschler, Mary Hejna, Emily Lewandowski, Kristen Kusmierski, Clare Martin, Bhagat S. Aulakh, Sandeep Tripathi, Jennifer A. Bandy, Lisa M. Kreps, Dawn R. Bollinger, Roger Scott Stienecker, Andre G. Melendez, Tressa A. Brunner, Sue M Budzon, Jessica L. Heffernan, Janelle M. Souder, Tracy L. Miller, Andrea G. Maisonneuve, Brian L. Delmonaco, Anthony Franklin, Mitchell Heath, Antonia L. Vilella, Sara B. Kutner, Kacie Clark, Danielle Moore, Harry L. Anderson, III, Dixy Rajkumar, Ali Abunayla, Jerrilyn Heiter, Howard A. Zaren, Stephanie J. Smith, Grant C. Lewis, Lauren Seames, Cheryl Farlow, Judy Miller, Gloria Broadstreet, Anthony Martinez, Micheal Allison, Aniket Mittal, Rafael Ruiz, Aleta Skaanland, Robert Ross, Paul K Mohabir, Connor G O’Brien, Komal Dasani, Neha Gupta, Tracy L Jones, Shonda C Ayers, Amy B Harrell, Brent R Brown, Megan Edwards, Caleb Darby, Kristy Page, Amanda Brown, Jessie McAbee, Katherine A. Belden, Michael Baram, Devin M. Weber, Rosalie DePaola, Yuwei Xia, Hudson Carter, Aaron Tolley, Mary Barletta, Mary Ferranti, Benjamin J Sines, Thomas J Bice, Patrick W. McGonagill, Colette Galet, Janice Hubbard, David Wang, Lauren Allan, Aditya Badheka, Madhuradhar Chegondi, Usman Nazir, Garrett Rampon, Jake Riggle, Nathan Dismang, Roger A. Alvarez, Amarilys Alarcon-Calderon, Marie Anne Sosa, Sunita K. Mahabir, Mausam J. Patel, Dima Dandachi, Hariharan Regunath, Maraya N. Camazine, Grant. E. Geiger, Abdoulie O. Njai, Baraa M. Saad, Renee D. Stapleton, Anne E. Dixon, Olivia Johnson, Sara S. Ardren, Stephanie Burns, Anna Raymond, Erika Gonyaw, Kevin Hodgdon, Chloe Housenger, Benjamin Lin, Karen McQuesten, Heidi Pecott-Grimm, Julie Sweet, Sebastian Ventrone, Ashish K. Khanna, Lynne Harris, Bruce Cusson, Jacob Fowler, David Vaneenenaam, Glen McKinney, Imoh Udoh, Kathleen Johnson, Vishwanath Pattan, Jessica Papke, Ismail Jimada, Nida Mhid, Samuel Chakola, Kevin Sheth, Abdalla Ammar, Mahmoud Ammar, Victor Torres Lopez, Charles Dela Cruz, Akhil Khosla, and Samir Gautam
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Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
IMPORTANCE:. At the start of the coronavirus disease 2019 pandemic, medications repurposed for management of coronavirus disease 2019 were used in the absence of clinical trial evidence. OBJECTIVES:. To describe the variation and evolution in use of repurposed medications for coronavirus disease 2019. DESIGN, SETTING, AND PARTICIPANTS:. Observational cohort study of adults hospitalized with coronavirus disease 2019 between February 15, 2020, and April 12, 2021, across 76 United States and international hospitals within the Society of Critical Care Medicine’s Discovery Viral Infection and Respiratory Illness Universal Study coronavirus disease 2019 registry. MAIN OUTCOMES AND MEASURES:. Hospital variation was quantified using multivariable adjusted random effects logistic regression models and unsupervised clustering. Repurposed medications included antivirals, corticosteroids, hydroxychloroquine, immunomodulators, and therapeutic dose anticoagulants. RESULTS:. Among 7,069 adults hospitalized with coronavirus disease 2019, 1,979 (28%) received antivirals, 2,876 (41%) received corticosteroids, 1,779 (25%) received hydroxychloroquine, 620 (9%) received immunomodulators, and 2,154 (31%) received therapeutic dose anticoagulants. Contribution of hospital site to risk-adjusted variation was 46% for antivirals, 30% for corticosteroids, 48% for hydroxychloroquine, 46% for immunomodulators, and 52% for therapeutic dose anticoagulants. Compared with the early pandemic, the later pandemic practice phenotypes converged with increased use of antivirals (odds ratio, 3.14; 95% CI, 2.40–4.10) and corticosteroids (odds ratio, 5.43; 95% CI, 4.23–6.97), with decreased use of hydroxychloroquine (odds ratio, 0.02; 95% CI, 0.01–0.04) and immunomodulators (odds ratio, 0.49; 95% CI, 0.34–0.70). There was no clinically significant change in the use of therapeutic dose anticoagulants (odds ratio, 1.01; 95% CI, 1.01–1.02). There were no differences in risk-adjusted mortality between hospitals with high rates of repurposed medication use compared with hospitals with low rates of use. CONCLUSIONS AND RELEVANCE:. Hospital variation in the use of repurposed medications varied widely across hospitals early in the pandemic and later converged with the emergence of randomized clinical trials. Platforms developed for rapid activation and enrollment in clinical trials of repurposed medications are needed prior to the next pandemic to expedite effective, evidence-based practice.
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- 2021
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4. Risk Factors for Critical Coronavirus Disease 2019 and Mortality in Hospitalized Young Adults: An Analysis of the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS) Coronavirus Disease 2019 Registry
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Sandeep Tripathi, MD, MS, Imran A. Sayed, MD, Heda Dapul, MD, Jeremy S. McGarvey, MS, Jennifer A. Bandy, RN, Karen Boman, BS, Vishakha K. Kumar, MD, MBA, Vikas Bansal, MBBS, MPH, Lynn Retford, CAE, Sreekanth Cheruku, MD, MPH, Margit Kaufman, MD, FASA, Smith F. Heavner, MS, RN, Valerie C. Danesh, PhD, RN, Catherine A. St. Hill, DVM, PhD, Ashish K. Khanna, MD, Utpal Bhalala, MD, Rahul Kashyap, MBBS, MBA, Ognjen Gajic, MD, MS, Allan J. Walkey, MD, MS, Katja M. Gist, DO, MSc, for The Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group, Jean-Baptiste Mesland, Pierre Henin, Hélène Petre, Isabelle Buelens, Anne-Catherine Gerard, Philippe Clevenbergh, Rolando Claure-Del Granado, Jose A. Mercado, Esdenka Vega-Terrazas, Maria F. Iturricha-Caceres, Ruben Garza, Eric Chu, Victoria Chan, Oscar Y Gavidia, Felipe Pachon, Yeimy A Sanchez, Mohamed El Kassas, Mohamed Badr, Ahmed Tawheed, Hend Yahia, Sierra-Hoffman, Fernando Valerio, Oscar Diaz, Jose Luis Ramos Coello, Guillermo Perez, Ana Karen Vallecillo Lizardo, Gabina María Reyes Guillen, Helin Archaga Soto, Mradul Kumar Daga, Munisha Agarwal, Ishan Rohtagi, Anusha Cherian, Sreejith Parameswaran, Magesh Parthiban, Menu Priya A., Girish Vadgaonkar, Rekha Ediga, Shilpa Basety, Shwetha Dammareddy, Phani Sreeharsha Kasumalla, Sridhar Papani, Mahesh Kamuram, Smitha S. Segu, Tuhin Chakraborty, Epcebha Joyce, Umamaheswara Raju, Janaki Manduva, Naresh Kolakani, Shreeja Sripathi, Sheetal Chaitanya, Surapaneni Krishna Mohan, Ekambaram Jyothisree, Kamlesh Kumar Agrawal, Vijendra Baghel, Kirti Kumar Patel, Nooshin Dalili, Mohsen Nafa, Sandeep Tripathi, Yuki Itagaki, Akira Kodate, Reina Suzuki, Yuki Takahashi, Koyo Moriki, Michihito Kyo, Masamitsu Sanui, Sho Horikita, Wataru Matsuda, Shu Tahara, Mineji Hayakawa, Kunihiko Maekawa, Takuya Shiga, Yudai Iwasaki, Abdulrahman AlFares, Rene Rodriguez-Gutierrez, Jose Gerardo Gonzalez-Gonzalez, Alejandro Salcido-Montenegro, Adrian Camacho-Ortiz, Fatimah Hassan-Hanga, Hadiza Galadanci, Abubakar Shehu Gezawa, Halima M. S. Kabara, Taiwo Gboluwaga Amole, Halima Kabir, Dalha Gwarzo, Haliru, Abdullahi S Ibrahim, Muhammad Sohaib Asghar, Mashaal Syed, Syed Anosh Ali Naqvi, Igor Borisovich Zabolotskikh, Konstantin Dmitrievich Zybin, Sergey Vasilevich Sinkov, Tatiana Sergeevna Musaeva, Marwa Ridha Amer, Mohammed Abdullah Bawazeer, Talal I. Dahhan, Eiad Kseibi, Abid Shahzad Butt, Syed Moazzum Khurshid, Muath Rabee, Mohammed Abujazar, Razan Alghunaim, Maal Abualkhair, Abeer Turki AlFirm, Razan K Alamoudi, Hassan M. AlSharif, Sarah A. Almazwaghi, Mohammed S Elsakran, Mohamed A Aid, Mouaz A Darwich, Omnia M Hagag, Salah A Ali, Alona rocacorba, Kathrine Supeña, Efren Ray Juane, Jenalyn Medina, Jowany Baduria, Mohammed A Almazyad, Mohammed I Alarifi, Jara M Macarambon, Ahmad Abdullah Bukhari, Hussain A. Albahrani, Kazi N Asfina, Kaltham M Aldossary, Predrag D Stevanovic, Dejan S Stojakov, Duska K Ignjatovic, Suzana C Bojic, Marina M Bobos, Irina B Nenadic, Milica S Zaric, Marko D Djuric, Vladimir R Djukic, Bojan Kovacevic, Jovana Bojicic, Marija Zdravkovic, Zoran Todorovic, Viseslav Popadic, Slobodan Klasnja, Santiago Y. Teruel, Belen C. Martin, Himat Sulaimonov, Firuza Khudonazarova, Nabi Bakhtibekov, Nekruz Jamshedov, Uluhan Sili, Huseyin Bilgin, Pinar Ay, Varsha P Gharpure, Usman Raheemi, Kenneth W. Dodd, Nicholas Goodmanson, Kathleen Hesse, Paige Bird, Chauncey Weinert, Nathan Schoenrade, Abdulrahman Altaher, Esmael Mayar, Matthew Aronson, Tyler Cooper, Monica Logan, Brianna Miner, Gisele Papo, Eric M. Siegal, Phyllis Runningen, Catherine A. St. Hill, Roman R. Melamed, David M. Tierney, Love A. Patel, Vino S. Raj, Barite U. Dawud, Narayana Mazumder, Abbey Sidebottom, Alena M. Guenther, Benjamin D. Krehbiel, Nova J. Schmitz, Stacy L. Jepsen, Abhijit A Raval, Andrea Franks, Katherine Irby, Ronald C. Sanders, Jr., Glenda Hefley, Anmol Kharbanda, Sunil Jhajhria, Zachary Fyffe, Stephen Capizzi, Bethany Alicie, Martha Green, Lori Crockarell, Amelia Drennan, Kathleen Dubuque, Tonya Fambrough, Nikole Gasaway, Briana Krantz, Peiman Nebi, Jan Orga, Margaret Serfass, Alina Simion, Kimberly Warren, Cassie Wheeler, CJ Woolman, Andrew S. Moyer, George M. Verghese, Andrea Sikora Newsome, Christy C. Forehand, Rebecca Bruning, Timothy W. Jones, Moldovan Sabov, Fatema Zaidi, Fiona Tissavirasingham, Dhatri Malipeddi, Jarrod M Mosier, Karen Lutrick, Beth Salvagio Campbell, Cathleen Wilson, Patrick Rivers, Jonathan Brinks, Mokenge Ndiva Mongoh, Boris Gilson, Donna Lee Armaignac, Don Parris, Maria Pilar Zuniga, Ilea Vargas, Viviana Boronat, Anneka Hutton, Navneet Kaur, Prashank Neupane, Nohemi Sadule-Rios, Lourdes M. Rojas, Aashish Neupane, Priscilla Rivera, Carlos Valle Carlos, Gregory Vincent, Mahesh Amin, Mary E Schelle, Amanda Steadham, Christopher M Howard, Cameron McBride, Jocelyn Abraham, Orlando Garner, Katherine Richards, Keegan Collins, Preethi Antony, Sindhu Mathew, Valerie C. Danesh, Gueorgui Dubrocq, Amber L. Davis, Marissa J Hammers, ill M. McGahey, Amanda C. Farris, Elisa Priest, Robyn Korsmo, Lorie Fares, Kathy Skiles, Susan M. Shor, Kenya Burns, Corrie A Dowell, Melody Flores, Lindsay Newman, Debora A Wilk, Jason Ettlinger, Jaccallene Bomar, Himani Darji, Alejandro Arroliga, Alejandro C Arroliga, Corrie A. Dowell, Gabriela Hope Conzales, Debora A. Wilk, Paras B. Khandhar, Elizabeth Kring, Valerie M. Banner-Goodspeed, Somnath Bose, Lauren E. Kelly, Melisa Joseph, Marie McGourty, Krystal Capers, Benjamin Hoenig, Maria C. Karamourtopoulos, Anica C. Law, Elias N. Baedorf Kassis, Allan J. Walkey, Sushrut S. Waikar, Michael A. Garcia, Mia Colona, Zoe Kibbelaar, Michael Leong, Daniel Wallman, Kanupriya Soni, Jennifer Maccarone, Joshua Gilman, Ycar Devis, Joseph Chung, Munizay Paracha, David N. Lumelsky, Madeline DiLorenzo, Najla Abdurrahman, Shelsey Johnson, Andrew M. Hersh, Stephanie L Wachs, Brittany S. Swigger, Lauren A. Sattler, Michael N. Moulton, Kimberly Zammit, J Patrick, William McGrath, Maya Loeffler, R Chilbert, Aaron S. Miller, Edwin L. Anderson, Rosemary Nagy, Ravali R. Inja, Raghavendra Tirupathi, Alymer Tang, Arshad Safi, Cindy Green, Jackie Newell, Rayan E. Ihle, Shelda A. Martin, Elaine A. Davis, Katja M. Gist, Imran A Sayed, John Brinton, Larisa Strom, Kathleen Chiotos, Allison M. Blatz, Giyoung Lee, Ryan H. Burnett, Guy I. Sydney, Danielle M. Traynor, Karissa Nauert, Annika Gonzalez, Mariel Bagley, Anita Santpurkar, Salim Surani, Joshua White, Aftab Khan, Rahul Dhahwal, Sreekanth Cheruku, Farzin Ahmed, Christopher Deonarine, Ashley Jones, Mohammad-Ali Shaikh, David Preston, Jeanette Chin, Vidula Vachharajani, Abhijit Duggal, Prabalini Rajendram, Omar Mehkri, Siddharth Dugar, Michelle Biehl, Gretchen Sacha, Stuart Houltham, Alexander King, Kiran Ashok, Bryan Poynter, Mary Beukemann, Richard Rice, Susan Gole, Valerie Shaner, Adarsh Conjeevaram, Michelle Ferrari, Narendrakumar Alappan, Steven Minear, Jaime Hernandez-Montfort, Syed Sohaib Nasim, Ravi Sunderkrishnan, Debasis Sahoo, Patrick S. Milligan, Sandeep K. Gupta, Joy M. Koglin, Regina Gibson, Lana Johnson, Felicia Preston, Crimson Scott, Bethany Nungester, Steven K. Daugherty, Sam Atkinson, Kelly Shrimpton, Sidney Ontai, Brian Contreras, Uzoma Obinwanko, Nneka Amamasi, Amir Sharafi, Sarah Lee, Zahia Esber, Chetna Jinjvadia, Kimberly Welker, Francis M. Maguire, Jessica Timmer, Raquel R Bartz, Vijay Krishnamoorthy, Bryan Kraft, Aaron Pulsipher, Eugene Friedman, Sachin Mehta, Margit Kaufman, Gregg Lobel, Nisha Gandhi, Amr Abdelaty, Elizabeth Shaji, Kiana Lim, Juan Marte, Dani Ashley Sosa, David P. Yamane, Ivy Benjenk, Nivedita Prasanna, Smith F. Heavner-Sullivan, Prera J. Roth, Banu Sivaraj, Haley Fulton, Madison G Herin, Marissa Crum, Morgan E. Fretwell, Emily-Rose Zhou, Christine Waller, Kara Kallies, Jonean Thorsen, Alec Fitzsimmons, Haley Olsen, Heda R. Dapul, Sourabh Verma, Alan Salas, Ariel Daube, Michelle Korn, Michelle Ramirez, Logi Rajagopalan, Laura Santos, Orma Smalls, Atul Malhotra, Abdurrahman Husain, Qais Zawaydeh, J.H. Steuernagle, Steven Q. Davis, Valentina Jovic, Max Masuda, Amanda Hayes, Katharine Nault, Michael Smith, William Snow, Riley Liptak, Hannah Durant, Valerie Pendleton, Alay Nanavati, Risa Mrozowsk, LiManoj K Gupta, Franscene E. Oulds, Akshay Nandavar, Yuk Ming Liu, Sarah Zavala, Esther Shim, Ronald A. Reilkoff, Julia A. Heneghan, Sarah Eichen, Lexie Goertzen, Scott Rajala, Ghislaine Feussom, Ben Tang, Christine C. Junia, Robert Lichtenberg, Hasrat Sidhu, Diana Espinoza, Shelden Rodrigues, Maria Jose Zabala, Daniela Goyes, Ammu Susheela, Buddhi Hatharaliyadda, Naveen Rameshkumar, Amulya Kasireddy, Genessis Maldonado, Lisseth Beltran, Akshata Chaugule, Hassan Khan, Namrata Patil, Ruhi Patil, Rodrigo Cartin-Ceba, Ayan Sen, Amanda Palacios, Giyth M. Mahdi, Rahul Kashyap, Ognjen Gajic, Vikas Bansal, Aysun Tekin, Amos Lal, John C. O’Horo, Neha N. Deo, Mayank Sharma, Shahraz Qamar, Cory J. Kudrna, Juan Pablo Domecq Garces, Abigail T. La Nou, Marija Bogojevic, Devang Sanghavi, Pramod Guru, Karthik Gnanapandithan, Hollie Saunders, Zachary Fleissner, Juan Garcia, Alejandra Yu Lee Mateus, Siva Naga Yarrarapu, Syed Anjum Khan, Juan Pablo Domecq, Nitesh Kumar Jain, Thoyaja Koritala, Alexander Bastidas, Gabriela Orellana, Adriana Briceno Bierwirth, Eliana Milazzo, Juan Guillermo Sierra, Thao Dang, Amy B. Christie, Dennis W. Ashley, Rajani Adiga, Rahul S Nanchal, Paul A Bergl, Jennifer L Peterson, Travis Yamanaka, Nicholas A. Barreras, Michael Markos, Anita Fareeduddin, Rohan Mehta, Chakradhar Venkata, Miriam Engemann, Annamarie Mantese, Yasir Tarabichi, Adam Perzynski, Christine Wang, Dhatri Kotekal, Adriana C Briceno Bierwirth, Gabriela M Orellana, Gerardo Catalasan, Shohana Ahmed, Carlos F Matute, Ahmad Hamdan, Ivania Salinas, Genesis Del Nogal, Angel Tejada, Anna Eschler, Mary Hejna, Emily Lewandowski, Kristen Kusmierski, Clare Martin, Jen-Ting Chen, Aluko Hope, Zoe Tsagaris, Elise Ruen, Aram Hambardzumyan, Prithvi Sendi, Meghana Nadiger, Balagangadhar Totapally, Bhagat S. Aulakh, Jennifer A. Bandy, Lisa M. Kreps, Dawn R. Bollinger, Roger Scott Stienecker, Andre G. Melendez, Tressa A. Brunner, Sue M Budzon, Jessica L. Heffernan, Janelle M. Souder, Tracy L. Miller, Andrea G. Maisonneuve, Roberta E. Redfern, Jessica Shoemaker, Jennifer Micham, Lynn Kenney, Gabriel Naimy, Sara Utley, Holly Balcer, Kerry P. J. Pulver, Jennifer Yehle, Alicia Weeks, Terra Inman, Brian L. Delmonaco, Anthony Franklin, Mitchell Heath, Antonia L. Vilella, Sara B. Kutner, Kacie Clark, Danielle Moore, Shina Menon, John K McGuire, Deana Rich, Harry L. Anderson, III, Dixy Rajkumar, Ali Abunayla, Jerrilyn Heiter, Howard A. Zaren, Stephanie J. Smith, Grant C. Lewis, Lauren Seames, Cheryl Farlow, Judy Miller, Gloria Broadstreet, John Lin, Cindy Terrill, Brock Montgomery, Sydney Reyes, Summer Reyes, Alex Plattner, Anthony Martinez, Micheal Allison, Aniket Mittal, Rafael Ruiz, Aleta Skaanland, Robert Ross, Umang Patel, Jordesha Hodge, KrunalKumar Patel, Shivani Dalal, Himanshu Kavani, Sam Joseph, Michael A. Bernstein, Ian K. Goff, Matthew Naftilan, Amal Mathew, Deborah Williams, Sue Murdock, Maryanne Ducey, Kerianne Nelson, Paul K Mohabir, Connor G O’Brien, Komal Dasani, William Marx, Ioana Amzuta, Asad J. Choudhry, Mohammad T. Azam, Kristina L Carter, Michael A Olmos, Brittany M Parker, Julio Quintanilla, Tara A Craig, Brendon J Clough, Jeffrey T Jameson, Neha Gupta, Tracy L Jones, Shonda C Ayers, Amy B Harrell, Dr.Brent R Brown, Utpal S. Bhalala, Joshua Kuehne, Melinda Garcia, Morgan Beebe, Heather Herrera, Chris Fiack, Stephanie Guo, May Vawer, Beth Blackburn, Megan Edwards, Caleb Darby, Kristy Page, Amanda Brown, Jessie McAbee, Katherine A. Belden, Michael Baram, Devin M. Weber, Rosalie DePaola, Yuwei Xia, Hudson Carter, Aaron Tolley, Mark Steele, Laurie Kemble, Joshua L. Denson, A. Scott Gillet, Margo Brown, Rachael Stevens, Andrew Wetherbie, Kevin Tea, Mathew Moore, Benjamin J Sines, Thomas J Bice, Emily A. Vail, Susannah Nicholson, Rachelle B. Jonas, AnnaRose E. Dement, William Tang, Mark DeRosa, Robert E. Villarreal, Rajany V. Dy, Alfredo Iardino, Jill Sharma, Richard Czieki, Julia Christopher, Ryan Lacey, Marwan Mashina, Kushal Patel, Erica C. Bjornstad, Nancy M. Tofil, Scott House, Isabella Aldana, Nikhil K. Meena, Jose D. Caceres, Nikhil K Meena, Sarenthia M. Epps, Harmeen Goraya, Kelsey R. Besett, Ryan James, Lana Y. Abusalem, Akash K. Patel, Lana S Hasan, Dina Gomaa, Michael Goodman, Devin Wakefield, Anthony Spuzzillo, John O. Shinn, II, Azra Bihorac, Tezcan Ozrazgat Baslanti, George Omalay, Haleh Hashemighouchani, Julie S. Cupka, Matthew M Ruppert, Patrick W. McGonagill, Colette Galet, Janice Hubbard, David Wang, Lauren Allan, Aditya Badheka, Madhuradhar Chegondi, Usman Nazir, Garrett Rampon, Jake Riggle, Nathan Dismang, Vicki Montgomery, Janice Sullivan, Sarah Morris, Jennifer Nason, Roger A. Alvarez, Amarilys Alarcon-Calderon, Marie Anne Sosa, Sunita K. Mahabir, Mausam J. Patel, Pauline Park, Andrew Admon, Sinan Hanna, Rishi Chanderraj, Maria Pliakas, Ann Wolski, Jennifer Cirino, Dima Dandachi, Hariharan Regunath, Maraya N. Camazine, Grant. E. Geiger, Abdoulie O. Njai, Baraa M. Saad, Faraaz Ali Shah, Byron Chuan, Sagar L. Rawal, Manal Piracha, Joseph E. Tonna, Nicholas M. Levin, Kayte Suslavich, Rachel Tsolinas, Zachary T. Fica, Chloe R. Skidmore, Renee D. Stapleton, Anne E. Dixon, Olivia Johnson, Sara S. Ardren, Stephanie Burns, Anna Raymond, Erika Gonyaw, Kevin Hodgdon, Chloe Housenger, Benjamin Lin, Karen McQuesten, Heidi Pecott-Grimm, Julie Sweet, Sebastian Ventrone, Nita Khandelwal, T. Eoin West, Ellen S. Caldwell, Lara Lovelace-Macon, Navya Garimella, Denisse B. Dow, Murtaza Akhter, Rania Abdul Rahman, Mary Mulrow, Erin M. Wilfong, Kelsi Vela, Ashish K. Khanna, Lynne Harris, Bruce Cusson, Jacob Fowler, David Vaneenenaam, Glen McKinney, Imoh Udoh, Kathleen Johnson, Patrick G. Lyons, Andrew P Michelson, Sara S. Haluf, Lauren M. Lynch, Nguyet M. Nguyen, Aaron Steinberg, Nicholas Braus, Vishwanath Pattan, Jessica Papke, Ismail Jimada, Nida Mhid, and Samuel Chakola
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Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
IMPORTANCE:. Even with its proclivity for older age, coronavirus disease 2019 has been shown to affect all age groups. However, there remains a lack of research focused primarily on the young adult population. OBJECTIVES:. To describe the epidemiology and outcomes of coronavirus disease 2019 and identify the risk factors associated with critical illness and mortality in hospitalized young adults. DESIGN, SETTINGS, AND PARTICIPANTS:. A retrospective cohort study of the Society of Critical Care Medicine’s Viral Infection and Respiratory Illness Universal Study registry. Patients 18–40 years old, hospitalized from coronavirus disease 2019 from March 2020 to April 2021, were included in the analysis. MAIN OUTCOMES AND MEASURES:. Critical illness was defined as a composite of mortality and 21 predefined interventions and complications. Multivariable logistic regression was used to assess associations with critical illness and mortality. RESULTS:. Data from 4,005 patients (152 centers, 19 countries, 18.6% non-U.S. patients) were analyzed. The median age was 32 years (interquartile range, 27–37 yr); 51% were female, 29.4% Hispanic, and 42.9% had obesity. Most patients (63.2%) had comorbidities, the most common being hypertension (14.5%) and diabetes (13.7%). Hospital and ICU mortality were 3.2% (129/4,005) and 8.3% (109/1,313), respectively. Critical illness occurred in 25% (n = 996), and 34.3% (n = 1,376) were admitted to the ICU. Older age (p = 0.03), male sex (adjusted odds ratio, 1.83 [95% CI, 1.2–2.6]), and obesity (adjusted odds ratio, 1.6 [95% CI, 1.1–2.4]) were associated with hospital mortality. In addition to the above factors, the presence of any comorbidity was associated with critical illness from coronavirus disease 2019. Multiple sensitivity analyses, including analysis with U.S. patients only and patients admitted to high-volume sites, showed similar risk factors. CONCLUSIONS:. Among hospitalized young adults, obese males with comorbidities are at higher risk of developing critical illness or dying from coronavirus disease 2019.
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- 2021
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5. IP Telephony Applicability in Cloud Computing
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Francisco Palacios, Mitchell Vásquez Bermúdez, Fausto Orozco, and Diana Espinoza Villón
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VoIP ,Cloud Computing ,Elastix ,Amazon Web Service ,Technology ,Science - Abstract
This paper carries out a research related to the applicability of VoIP over Cloud Computing to guarantee service stability and elasticity of the organizations. In this paper, Elastix is used as an open source software that allows the management and control of a Private Branch Exchange (PBX); and for developing, it is used the services given Amazon Web Services due to their leadership and experience in cloud computing providing security, scalability, backup service and feasibility for the users.
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- 2018
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6. Vulnerabilidad de la cuenca amazónica ante fenómenos hidroclimáticos extremos
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José Daniel Pabón-Caicedo, Rosa del Pilar Ycaza, Fanny Friend, Diana Espinoza, Norbert Fenzl, and María Apostolova
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fenómenos hidroclimáticos extremos ,índice estandarizado de precipitación ,inundaciones en la Amazonía ,sequías en la Amazonía ,variabilidad climática en la Amazonía ,Geography (General) ,G1-922 - Abstract
Por su impacto y área de cobertura, las inundaciones y las sequías son los fenómenos hidroclimáticos extremos de mayor relevancia en la Amazonía. Con series del índice estandarizado de precipitación (SPI), se contaron los eventos con valores por encima de 2.0 (excesos extremos) o por debajo de -2.0 (déficit extremo), estableciendo que estos fenómenos son más recurrentes en la Amazonía boliviana. Con datos socioeconómicos y biofísicos, se identificaron los sistemas expuestos a estos fenómenos y los diferentes grados de amenaza para los sistemas agropecuarios y la población. Al analizar la vulnerabilidad de estos sistemas, se pudo establecer que la sequía es mayor en la parte alta andina (Amazonía boliviana, peruana y ecuatoriana); en el sur, en el sector de la cuenca del río Juruena; en el oriente, sobre un amplio sector entre las cuencas de Xingú y Tocantins; y en el norte, en un pequeño sector correspondiente a la parte alta del río Branco. Respecto a las inundaciones, la mayor vulnerabilidad se da en un amplio sector en el suroriente del Amazonas, en sectores del piedemonte de los Andes y en toda la zona plana contigua al río Amazonas o de sus afluentes.
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- 2018
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7. USO DE LA EXCRECIÓN DE CREATININA COMO MÉTODO ALTERNATIVO A LA COLECTA TOTAL DE ORINA EN VACAS HOLSTEIN USE OF THE CREATININE EXCRETION AS ALTERNATIVE METHOD TO TOTAL URINE COLLECTION IN HOLSTEIN COWS
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Libardo Escobar Puerta, Diana María Bolívar Vergara, and Diana Espinoza García
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Muestra puntual ,nutrición ,rumiantes ,volumen urinario ,Nutrition ,ruminants ,samples spot ,urinary volume ,Agriculture ,Agriculture (General) ,S1-972 - Abstract
La investigación en producción animal requiere la recolección total de orina, para estimar la excreción de compuestos nitrogenados y derivados púricos, lo cual trae grandes dificultades, siendo necesario buscar técnicas alternas. El objetivo de este trabajo fue determinar el volumen de orina de vacas Holstein por colecta total con arneses y por muestras puntuales ”spot”, utilizando la excreción de creatinina como marcador interno y evaluar la variación en la excreción diaria de creatinina utilizando colectas durante siete días. El volumen de orina observado (colecta total) y el estimado (muestra spot) fueron comparados por una prueba de medias de datos apareados (5% de probabilidad). La comparación entre días de colecta se realizó mediante un modelo mixto con medidas repetidas en el tiempo, del mismo animal (efecto aleatorio) y día de evaluación (efecto fijo). Se utilizó el procedimiento MIXED y el comando REPEATED del programa SAS (2001). Para la correlación entre el volumen de orina observado y estimado se utilizó PROC CORR y para la regresión PROC REG de SAS (2001). La excreción de creatinina promedio fue de 29,89 mg/kg PV/día. No se encontró diferencia entre las dos técnicas. El volumen de orina obtenido fue 19,8 L y el estimado 19,7 L. Se encontró una alta correlación entre las dos técnicas (r=0,82; PThe research in animal production requires the total harvesting of tinkles to estimate the excretion of nitrogenated compounds and puric derivates, which brings great difficulties, doing necessary the search of alternating techniques. The objective of this work was to determine the volume of tinkles of Holstein cows by collects total with harness and the gathering samples spot using the excretion creatinine like internal marker and evaluate the variation in daily creatinine excretion using collections for seven days. A paired test (5% probability) was used to compare observed (total collection) and estimated (samples spot) urine volumes. Number of sampling days was compared by mixed model with repeated measures over time, the same animal (random effect) and day (fixed effects). Also was used the MIXED procedure and REPEATED command (SAS, 2001). The correlation between observed and estimated urine volume was performed by PROC CORR and regression was performed by PROC REG (SAS, 2001). The creatinine excretion average was 29.89 mg/kg of BW. It was not difference between the two techniques. The urine volume obtained was 19.8 L and the estimated urine volume was 19.7 L. There was a high correlation between the two techniques (r=0.82; P
- Published
- 2010
8. Bofedales: high altitude peatlands of the central Andes Bofedales: turberas de alta montaña de los Andes centrales
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FRANCISCO A SQUEO, BARRY G WARNER, RAMÓN ARAVENA, and DIANA ESPINOZA
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Altiplano ,central Andes ,turberas ,estepa árida ,Andes centrales ,América del Sur ,peatlands ,arid grasslands ,South America ,Zoology ,QL1-991 ,Botany ,QK1-989 - Abstract
There is an exceptional group of alpine peatlands in the world situated in the arid grasslands of the central Andes. The peatlands in northern Chile occur in the most arid part of their range. Members of the Juncaceae are the primary peat-forming plant species. Fresh and mildly saline groundwaters originate from glaciers, snowmelt and rain are the water sources for the northern Chile peatlands. Paleoecological investigations suggest that some peatlands are recent features of the landscape having developed within the last three thousand years or less. These peatlands are unique, extremely fragile water features sensitive to climate changes and human disturbances such as regional mining activity. Much more work is required to develop scientifically based sound management and conservation programs for the rare plants and animals that live in them and to ensure the future livelihoods of the indigenous peoples who depend on themExiste un grupo excepcional de turberas (bofedales) de alta montaña en el mundo situados en la estepa árida de los Andes centrales. Los bofedales en el norte de Chile están presentes en la parte más árida de su rango. Las principales especies de plantas responsables de la formación de turba corresponden a miembros de Juncaceae. El agua fresca y medianamente salina de los bofedales proviene de agua subterránea asociada a riachuelos proveniente de glaciares, derretimiento de nieve y lluvia. Investigaciones paleoecológicas sugieren que algunos bofedales son integrantes recientes del paisaje, habiéndose desarrollado durante los últimos tres mil años o menos. Estos bofedales son entidades únicas, extremadamente frágiles por su dependencia del agua, sensibles a los cambios climáticos y vulnerables a la alteración humana tal como la actividad minera en la región. Se requiere mucho más trabajo para desarrollar programas de manejo y conservación, con sólidas bases científicas, de las plantas y animales que viven en ellos, y para asegurar la capacidad futura de pastoreo de la cual dependen los pueblos indígenas
- Published
- 2006
9. Emisiones de gases de efecto invernadero en una plantación de café (Coffea arabica) con y sin sombra de moringa (Moringa oleífera) bajo fertilización orgánica y mineral en Barva de Heredia
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Ellen Sancho Barrantes and Diana Espinoza Ballestero
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General Engineering - Abstract
Se realizó una comparación de las emisiones de gases de efecto invernadero asociados a dos patrones de fertilización (orgánica y mineral) en una plantación de café (Coffea arabica) variedad Obatá con y sin sombra de Moringa (Moringa oleifera) en la Finca Experimental Santa Lucía en Barva de Heredia, Costa Rica. Para cada uno de los tratamientos T1: con sombra, fertilización orgánica, T2: con sombra fertilización mineral, T3: sin sombra, fertilización orgánica, T4: sin sombra, fertilización mineral. Solo se midieron los flujos de emisión de tres diferentes gases: dióxido de carbono (CO2), metano (CH4) y óxido nitroso (N2O). Desde el 2016 se realizó tres fertilizaciones (mineral y orgánica), para el 2018 cada vez que se fertilizó se realizó muestreo de gases de efecto invernadero con la técnica de cámaras cerradas para su posterior análisis por cromatografía. Las tomas de muestras de gases se realizaron durante las tres fertilizaciones anuales, a los días 0, 5, 15 y 30 posteriores a la aplicación. Para cada muestra, se extrajeron submuestras de gases de la cámara al minuto 0, 10, 20 y 30 minutos después de colocada la cámara. Además, se hizo una relación de la emisión con variables climáticas como la temperatura, la humedad y la precipitación. Se obtuvieron comportamientos distintos para cada gas. La relación de la sombra con las emisiones de los gases fue baja. Al comparar los diferentes tipos de fertilizaciones, las emisiones fueron superiores en tratamientos sometidos a fertilizantes orgánicos respecto a las de la fertilización mineral. Solo las emisiones de dióxido de carbono correlacionaron con factores climáticos, al registrar una mayor emisión con el incremento de la temperatura.
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- 2022
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10. 1210: THE METABOLIC SUBPHENOTYPE: A PROTECTIVE FACTOR IN ARDS SECONDARY TO SEPSIS OR PNEUMONIA
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Pagliaro, Jaclyn, primary, Tea, Kevin, additional, Zu, Yuanhao, additional, Chung, Cheng Han, additional, Mehta, Prakriti, additional, Grewal, Himmat, additional, Denson, Joshua, additional, Khan, Yasin, additional, Shaffer, Jeffrey, additional, Douglas, Ivor, additional, and Barrera, Diana Espinoza, additional
- Published
- 2022
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11. 311: SEVERE HYPERAMMONEMIA CAUSED BY CARNITINE DEFICIENCY DURING ADULTHOOD
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Spaedy, Abigail, primary, Barrera, Diana Espinoza, additional, Anderrson, Hans, additional, and Denson, Joshua, additional
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- 2022
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12. If the Test Fits: Diagnosis to Aid in the Treatment of Influenza
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Raul Rodriguez, Diana Espinoza, and Christine Junia
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General Engineering - Published
- 2022
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13. Learning Based on Board Game to Inspire Mathematical Thinking
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Diana Espinoza-Espinosa, Janio Jadán-Guerrero, Marco Santorum, and and Isabel L. Nunes
- Abstract
Math learning is, together with reading and writing, one of the fundamental learnings of elementary education, given the instrumental nature of these subjects. However, it has been identified the difficulty that students have when they need to solve addition and subtraction math problems with numbers of up to three digits, which is why it is necessary to find new ways to teach students to reason. This article proposes the design of a board game to strengthen logical reasoning. The methodology used in the research began with a diagnosis of 37 fourth grade students from a private school in Ecuador through a pre-test, later an interaction with the board game and finally a post-test. Two math teachers and two designers participated in the board game design. The information obtained from the experts helped with the design of the game, the data collected from teachers made it easier to identify the main problems that students present in terms of understanding mathematical problems. The design of the game was based on the narrative of superheroes such as: Spidermas, Superesta, Dividivertido, Centella, Sumager, among others, as well as in the most representative places at the Downtown of Quito. The game is designed for three or four students; the game’s mechanics consist in that the participants must solve math problems proposed in the board and if they can solve them properly, they advance in the game. Among the main results and conclusions of this research is that the students feel motivated to learn using the game; in addition, collaborative work is evidenced, and soft skills are enhanced such as teamwork, problem solving, analytical thinking and autonomy. For future work, the board game can be used in other topics where students face difficulties, such as: fractions, multiplication and division.
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- 2022
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14. 1210: THE METABOLIC SUBPHENOTYPE: A PROTECTIVE FACTOR IN ARDS SECONDARY TO SEPSIS OR PNEUMONIA
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Jaclyn Pagliaro, Kevin Tea, Yuanhao Zu, Cheng Han Chung, Prakriti Mehta, Himmat Grewal, Joshua Denson, Yasin Khan, Jeffrey Shaffer, Ivor Douglas, and Diana Espinoza Barrera
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Critical Care and Intensive Care Medicine - Published
- 2022
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15. 311: SEVERE HYPERAMMONEMIA CAUSED BY CARNITINE DEFICIENCY DURING ADULTHOOD
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Abigail Spaedy, Diana Espinoza Barrera, Hans Anderrson, and Joshua Denson
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Critical Care and Intensive Care Medicine - Published
- 2022
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16. El efecto de la fertilización mineral, orgánica y mineral-orgánica sobre las características agroproductivas en plantas de café y de la calidad de taza
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Diana Espinoza Ballestero, Diego Aguirre Rosales, and Ellen Sancho Barrantes
- Abstract
Se llevó a cabo un experimento durante seis años (2013-2018) en el cual se evaluó el efecto de tres tipos de fertilizantes sobre las características agroproductivas en plantas de café (Coffea arabica, variedad caturra), en la Finca Experimental Santa Lucía de la Universidad Nacional en Barva de Heredia, Costa Rica. Los tratamientos fueron: T1 fertilización mineral, T2 fertilización mineral + lombricompost y T3 compost + gallinaza. Se midió la altura de las plantas (eje ortotrópico), el largo de bandola (eje plageotrópico), el número de entrenudos y la producción en fanegas por hectáreas de la cosecha 2016-17 y 2017-2018. Para observar la respuesta de la poda en el 2018 se realizó una poda total. Además, se hizo un análisis de calidad de taza de las cosechas 2014-15, 2015-16 y 2016-17. Respecto a las variables de crecimiento, se tomó el efecto acumulativo del último año; para la variable altura se encontró diferencia estadística entre el T1 y T2 (superiores) respecto al T3. El mismo comportamiento se presentó en el número de nudos, y respecto al crecimiento de bandola el T2 presentó diferencias estadísticas superiores respecto a T1 y T3. Los tres tratamientos sobrepasaron la media productiva del país sin obtener diferencia significativa entre ellos. Respecto a la cantidad de rebrotes, el T3 fue superior con una media de 9.29 rebrotes por punto de siembra. La mejor calidad de taza la obtuvo el T3, catalogándose como café de especialidad.
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- 2019
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17. COVID-19 infection characteristics and outcomes in a predominantly Latino community hospital
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Daniel Colon Hidalgo, Manasa Jasti, Natalie Tapaskar, Christine Junia, Akshata Chaugule, Fanny Giron Galeano, Daniel C Alcantar, Maria Jose Zabala Ramirez, Jose L Zabala Genovez, Gabino Maza Rodas, Diana Espinoza Barrera, Raul Rodriguez, and Fritzie Albarillo
- Subjects
Microbiology (medical) ,Infectious Diseases ,General Immunology and Microbiology ,Epidemiology ,Public Health, Environmental and Occupational Health ,Original Article - Abstract
INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has rapidly spread worldwide and claimed millions of lives. Several studies have attempted to understand the relationship between COVID-19 infection and health disparities. The aim of the current work was to evaluate the pre-admission health characteristics, symptomatology, diagnostic abnormalities, treatment measures and clinical outcomes of the community served by our institution, with a sub-analysis of our Hispanic community. METHODS: This is a single-center, cross-sectional cohort study of patients with COVID-19 admitted from 15 March 2020 to 30 April 2020 to MacNeal Hospital. A retrospective chart review was performed including patients >18 years and a positive nasopharyngeal SARS-CoV-2 PCR. Demographical data, comorbidities, clinical data, treatment regimen, and patient outcomes were collected. RESULTS: A total of 257 patients were included in the study of which 60.4% were identified as Hispanic. The median age at admission of Hispanic patients was significantly lower compared to non-Hispanic patients (56.6 vs. 65.7 years, p10 mg/dL (OR 4.53, 95%CI 1.49-13.38) and D-dimer >1.5 mcg/mL (OR 3.63, 95%CI 1.31-10.05). An oxygen saturation of >90% on room air on presentation was a protective factor when predicting intubation (OR 0.11, 95%CI 0.03-0.33). The overall 30-day mortality rate was 17.1% (n=44); 11.9% in the Hispanic group vs 26.3% in the non-Hispanic group (p
- Published
- 2021
18. Cardiovascular Disease Risk and Outcomes in Patients Infected With SARS-CoV-2
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Umme Haani Malwi, Christine Junia, Manasa Jasti, and Diana Espinoza
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medicine.medical_specialty ,chest pain ,Myocarditis ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Cardiology ,Infectious Disease ,030204 cardiovascular system & hematology ,Chest pain ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Internal Medicine ,medicine ,risk factors ,In patient ,Risk factor ,cardiac compromise ,biology ,troponin ,business.industry ,cardiovascular ,General Engineering ,medicine.disease ,mortality ,Troponin ,covid-19 ,inflammation ,syncope ,Disease risk ,biology.protein ,myocarditis ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Cardiovascular involvement is one of the end-organ complications commonly reported in coronavirus disease 2019 (COVID-19). It has also been postulated to be an independent risk factor for increased mortality in COVID-19-infected patients. With such a significant effect of COVID-19 on the cardiovascular system and vice versa, it is pivotal for physicians to observe this association closely for improving management and understanding prognosis in these patients. Here, we present three patients and describe their baseline cardiac risk factors, the cardiac complications they developed in association with COVID-19 infection, and their varying outcomes.
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- 2021
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19. Características epidemiológicas, clínicas, pre y posnatales de los neonatos, hijos de madre con la Covid-19, y del seguimiento hasta los 14 días post alta, en Lima-Perú
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José Antonio Salazar, Olga Lizama, Diana Espinoza, Maria del Carmen Chincaro, Karenina Agüero, José Ulloa, César García, Jorge Mucha, and Gaby Giraldo
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Pregnancy ,medicine.medical_specialty ,embarazo ,Coronavirus disease 2019 (COVID-19) ,Minimal risk ,Post discharge ,Obstetrics ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,General Medicine ,medicine.disease ,Body weight ,PCR ,Pcr test ,Recien nacido ,medicine ,infección por coronavirus ,business ,Recién nacidos - Abstract
Objective: To describe prenatal and post-natal clinical features of neonates born from mothers with COVID-19 including 14-day follow-up post discharge. Methods: Case series of neonates attended at Hospital Guillermo Almenara born from mothers infected with COVID-19 during the lockdown implemented by the Peruvian government. Neonates were divided in two groups based on positivity of the nasopharyngeal PCR test. Results:201 pregnant women with COVID-19 diagnosed by rapid tests who delivered 206 neonates were identified; 4 of these neonates had positive nasopharyngeal PCR tests. Pregnants infected with COVID-19 were younger than non-infected, but no differences were observed in route of delivery, sex of the newborn and body weight at birth. Two hundred and five neonates were discharged one week after birth ;181 neonates with negative nasopharyngeal negative PCR tests and 4 neonates with a positive PCR test were followed for 14 days, none presented symptoms and received mixed lactation. Conclusions: Neonates born from mother infected with COVID-19 had minimal risk of getting the infection and their pre and post-natal development will not be affected despite of having a positive PCR test. Objetivo: Describir las características clínicas prenatales y post natales de los neonatos hijos de madres con la Covid-19, y seguimiento hasta los 14 días post alta. Material y métodos: Estudio tipo observacional, serie de casos, censal de los neonatos nacidos en el Hospital Guillermo Almenara Irigoyen, hijos de madres con la Covid-19, que nacieron durante la cuarentena decretada por el gobierno peruano. Los neonatos se dividieron en 2 grupos: con la prueba PCR nasofaríngea positiva o no y se observó si alguna de estas características estuvieron asociadas con la presentación de esta prueba positiva. Resultados: Hubieron 201 gestantes con diagnóstico de Covid-19 por prueba rápida y que tuvieron 206 neonatos. De ellos, 4 neonatos tuvieron la PCR nasofaríngea positiva y 202, negativa. La edad materna fue menor en el grupo con la prueba positiva, pero no hubo diferencia respecto al tipo de parto: césarea, fueron a termino, con adecuado peso al nacer y ningún sexo predominó. Doscientos cinco (99,51%) neonatos salieron de alta en la primera semana de vida; 181 (90,05%) neonatos con PCR nasofaríngea negativa y los4 neonatos con prueba positiva fueron seguidos por 2 semanas; ninguno presentó síntomas y el tipo de lactancia fue mixta. Conclusiones: Los neonatos hijos de madres con la Covid-19, tendrían una mínima posibilidad de contraer esta enfermedad. Y su desarrollo prenatal y post natal no se vería afectado, a pesar de incluso tener la prueba PCR nasofaríngea positiva.
- Published
- 2021
20. Damned If You Drain, Damned If You Don't: A Case of Pericardial Decompression Syndrome
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Swathi Rao, Diana Espinoza, Daniel Alcantar, and Robert Lichtenberg
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pericardial window ,medicine.medical_specialty ,medicine.medical_treatment ,Cardiology ,heart failure ,pericardium ,030204 cardiovascular system & hematology ,Pericardial effusion ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Cardiac tamponade ,Internal Medicine ,pericardial decompression syndrome ,medicine ,Pericardium ,business.industry ,right heart failure ,Cardiogenic shock ,cardiogenic shock ,General Engineering ,medicine.disease ,pericardial effusion ,Pericardial window ,medicine.anatomical_structure ,Pericardiocentesis ,Cardiac/Thoracic/Vascular Surgery ,pericardiocentesis ,cardiac tamponade ,Tamponade ,Transthoracic echocardiogram ,business ,030217 neurology & neurosurgery - Abstract
Pericardial decompression syndrome (PDS) is an unusual clinical scenario with a reported incidence of 5% in all surgical or percutaneously managed pericardial tamponade patients. It is defined as a paradoxical hemodynamic instability leading to left ventricular (LV), right ventricular (RV), or biventricular dysfunction. An 84-year-old female with a history of a chronic pericardial effusion presented with symptoms of tamponade. She had had multiple prior admissions with an extensive and unyielding workup for the etiology of her pericardial effusion. During the present admission, a transthoracic echocardiogram (TTE) confirmed an augmenting pericardial effusion causing cardiac tamponade. She underwent a pericardial window with the removal of 1.2 liters of serous fluid. Postoperatively, she went into cardiogenic shock from right heart failure. Unfortunately, there also was re-accumulation of the pericardial effusion and worsening hemodynamic instability. Due to her poor prognosis, she was transitioned to comfort care. Although the etiology of PDS is unknown, it has been theorized to be caused by an imbalance of sympathetic-parasympathetic states after a rapid decompression. Currently, there are no clear guidelines or recommendations regarding the quantity of fluid that can be removed safely. More awareness leading to a more cautious and staged pericardial drainage might be the required solution.
- Published
- 2020
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21. 24 Hours: A Case of Multiorgan Failure Associated With COVID-19
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Diana Espinoza, Andrew Kowalski, and Raul Rodriguez
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medicine.medical_specialty ,ARDS ,renal failure ,Pulmonology ,medicine.medical_treatment ,Infectious Disease ,Disease ,medicine.disease_cause ,Internal medicine ,Internal Medicine ,Medicine ,risk factors ,Acidosis ,Coronavirus ,hemodialysis ,business.industry ,General Engineering ,Acute kidney injury ,Metabolic acidosis ,medicine.disease ,mortality ,covid-19 ,cytokine storm ,Hemodialysis ,acidosis ,medicine.symptom ,business ,Cytokine storm - Abstract
Coronavirus has caused thousands of deaths due to several mechanisms of injury including acute kidney injury (AKI). Most of the patients have a fast progression of the disease leading to death in the second week of hospital admission, however, here we have a case of a 58-year-old female who died in less than 24 hours of admission due to severe metabolic acidosis, acute respiratory distress syndrome (ARDS) and renal failure.
- Published
- 2020
22. SAT-472 An Atypical Presentation of Severe Hypothyroidism, a Case of Large Posterior Pericardial Effusion Without Hemodynamic Compromise
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Robert C. Lichtenberg, Paola Andrea Sanchez Garay, Swathi Rao, Daniele Restifo, Madalina Liliana Ionescu, and Diana Espinoza
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Thyroid ,medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.disease ,Pericardial effusion ,Thyroid Disorders Case Reports II ,Severe hypothyroidism ,Hemodynamic compromise ,Internal medicine ,medicine ,Cardiology ,Presentation (obstetrics) ,business ,AcademicSubjects/MED00250 - Abstract
BACKGROUND We are reporting a case of a Hispanic female who presented with a pericardial effusion as a complication of hypothyroidism, untreated due to lack of medical care, which demonstrates health disparities in chronic diseases. CLINICAL CASE The patient is a 48 year-old Hispanic female with PMHx of hypothyroidism, non-compliant with medical therapy, who presented to the ED with fatigue and dyspnea. Despite progressively worsening symptoms for the past 4 months, she had refused to be seen by a physician because she was uninsured. Her physical exam was notable for generalized pallor and bradycardia, with otherwise normal cardiopulmonary exam. Her initial laboratory data showed hemoglobin of 5.5 g/dl. CXR demonstrated an enlarged cardiac silhouette, which on CT was found to represent a large pericardial effusion. On admission her laboratory data demonstrated low ferritin, TSH of 94 mIU/L and T4 of 1.4 mcg/dl. m. Cortisol was 9 mcg/dl at 11 am. Repeat hemoglobin post-transfusion was 9 g/dl The patient was started on IV levothyroxine and hydrocortisone. Echocardiogram showed a large posterior wall pericardial effusion without evidence of RV strain. Pericardiocentesis was attempted but was unsuccessful because of difficult access to the fluid location. She was discharged on levothyroxine 88mcg QD and recommended to follow up with endocrinology and cardiology as an outpatient. It is well known that the United States spends a disproportionate amount of money in healthcare in comparison to developing countries (1). Underinvestment in social services and high prices set by pharmaceutical companies are likely contributing factors (1). Unfortunately, the resulting outcomes do not necessarily reflect the spending. Minorities are well known to have a higher morbidity and mortality as well as to present more frequently with dramatic manifestations of chronic diseases. This can often be attributed to a lack of access to medical care and poor follow up. Our patient was diagnosed with pericardial effusion as a complication of untreated hypothyroidism, a condition that is underdiagnosed despite a high incidence (3-37%). This pericardial effusion was initially concerning due to its large volume. The fact that she was hemodynamically stable reflects its chronicity, but it could have led to a fatal complication if she continued without appropriate therapy for a longer period of time. CONCLUSION A case such as this should make us question what more we can do to improve healthcare outcomes for minorities in the USA. REFERENCES (1). Papanicolas, Irene, Liana R. Woskie, and Ashish K. Jha. “Health care spending in the United States and other high-income countries.” Jama 319.10 (2018): 1024-1039.
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- 2020
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23. IP Telephony Applicability in Cloud Computing
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Fausto R. Orozco, Mitchell Vásquez Bermúdez, Diana Espinoza Villón, and Francisco G. Palacios
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Voice over IP ,business.industry ,Computer science ,lcsh:T ,Cloud computing ,Cloud Computing ,computer.software_genre ,lcsh:Technology ,VoIP ,Operating system ,Amazon Web Service ,Elastix ,lcsh:Q ,business ,lcsh:Science ,computer - Abstract
espanolEste trabajo lleva a cabo una investigacion relacionada con la aplicabilidad de VoIP sobre Cloud Computing para garantizarla estabilidad del servicio y la elasticidad de las organizaciones. En este documento, Elastix se utiliza como un software de codigo abierto que permite gestion y control de una central telefonica privada (PBX); y para el desarrollo, se utilizan los servicios prestados a Amazon Web Services debido a su liderazgo y experiencia en computacion en la nube que brinda seguridad, escalabilidad y servicio de respaldo y viabilidad para los usuarios. EnglishThis paper carries out a research related to the applicability of VoIP over Cloud Computing to guarantee service stabilityand elasticity of the organizations. In this paper, Elastix is used as an open source software that allows the management and controlof a Private Branch Exchange (PBX); and for developing, it is used the services given Amazon Web Services due to their leadership and experience in cloud computing providing security, scalability, backup service and feasibility for the users.
- Published
- 2018
24. Reliability analysis of a measurement instrument of organizational capacities in the commercial sector
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Diana Espinoza-Torres, Maria Teresa Cordova Lopez, Julio Rios-Zaruma, and Glenda Edith Ponce-Espinosa
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0508 media and communications ,Cronbach's alpha ,Alpha Value ,Computer science ,Order (business) ,0502 economics and business ,05 social sciences ,050801 communication & media studies ,Cohesion (computer science) ,Construct (philosophy) ,050203 business & management ,Reliability (statistics) ,Manufacturing engineering - Abstract
This article analyzes the reliability of an instrument that determines the organizational capacities of the commercial sector companies of Loja — Ecuador, the method used is exploratory and qualitative, the cronbach alpha is applied in order to determine the internal cohesion of the items proposed for each construct studied. The results allowed to validate the proposed instrument after eliminating items that did not meet the minimum required alpha value, therefore, a final instrument is determined that is related to the results found in other similar studies.
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- 2018
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25. Vulnerabilidad de la cuenca amazónica ante fenómenos hidroclimáticos extremos
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Fanny Friend, Diana Espinoza, Maria Apostolova, Norbert Fenzl, José Daniel Pabón-Caicedo, and Rosa del Pilar Ycaza
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inundações na Amazônia ,9 Geografía e Historia / History and geography ,Geography, Planning and Development ,0211 other engineering and technologies ,fenómenos hidroclimáticos extremos ,lcsh:G1-922 ,02 engineering and technology ,Environmental Science (miscellaneous) ,extreme hydroclimatic phenomena ,Earth and Planetary Sciences (miscellaneous) ,variabilidade climática na Amazônia ,floods in the Amazon region ,secas na Amazônia ,sequías en la Amazonía ,021110 strategic, defence & security studies ,droughts in the Amazon region ,climate variability in the Amazon region ,índice estandarizado de precipitación ,021107 urban & regional planning ,índice padronizado de precipitação ,fenômenos hidroclimáticos extremos ,inundaciones en la Amazonía ,variabilidad climática en la Amazonía ,Standard Precipitation Index ,lcsh:Geography (General) - Abstract
Por su impacto y área de cobertura, las inundaciones y las sequías son los fenómenos hidroclimáticos extremos de mayor relevancia en la Amazonía. Con series del índice estandarizado de precipitación (SPI), se contaron los eventos con valores por encima de 2.0 (excesos extremos) o por debajo de -2.0 (déficit extremo), estableciendo que estos fenómenos son más recurrentes en la Amazonía boliviana. Con datos socioeconómicos y biofísicos, se identificaron los sistemas expuestos a estos fenómenos y los diferentes grados de amenaza para los sistemas agropecuarios y la población. Al analizar la vulnerabilidad de estos sistemas, se pudo establecer que la sequía es mayor en la parte alta andina (Amazonía boliviana, peruana y ecuatoriana); en el sur, en el sector de la cuenca del río Juruena; en el oriente, sobre un amplio sector entre las cuencas de Xingú y Tocantins; y en el norte, en un pequeño sector correspondiente a la parte alta del río Branco. Respecto a las inundaciones, la mayor vulnerabilidad se da en un amplio sector en el suroriente del Amazonas, en sectores del piedemonte de los Andes y en toda la zona plana contigua al río Amazonas o de sus afluentes. Given their impact and coverage area, floods and droughts are the most relevant extreme hydroclimatic phenomena in the Amazon region. After counting events with values above 2.0 (extreme excess) or below -2.0 (extreme deficit), using Standard Precipitation Index (SPI) series, it was possible to establish that these phenomenaare more recurrent in the Bolivian Amazon region. Socioeconomic and biophysical data were used to identify the systemsexposed to these phenomena and the different degrees of threat for agricultural systems and the population. The analysis of the vulnerability of these systems made it possible to establish that droughts are greater in the high Andean area (Bolivian,Peruvian, and Ecuadorean Amazon); to the south, in the basin of the Juruena river; to the east, in a large sector between the basins of the Xingú and Tocantins rivers; as well as to the north, in a smallzone corresponding to the upper Río Branco. Regarding droughts, the greatest vulnerability is found in the southeastern Amazon, in parts of the Andean piedmont and in the entire flatland zone adjacent to the Amazon river and its tributaries. Por seu impacto e área de cobertura, as inundações e as secas são os fenômenos hidroclimáticos extremos de maior relevância na Amazônia. Com séries do índice padronizado de precipitação (SPI), contaram-se os eventos com valores acima de 2.0 (excessos extremos) ou abaixo de -2.0 (déficit extremo), estabelecendo que esses fenômenos são mais recorrentes na Amazônia boliviana.Com dados socioeconômicos e biofísicos, identificaram-se os sistemas expostos a esses fenômenos e os diferentes graus de ameaça para os sistemas agropecuários e para a população. Ao analisar a vulnerabilidade desses sistemas, pôde-se estabelecer que a seca é maior na parte alta andina (Amazônia boliviana, peruana eequatoriana); no sul, no setor da bacia do rio Juruena; no leste, sobre um amplo setor entre as bacias de Xingu e Tocantins; no norte, num pequeno setor correspondente à parte alta do rio Branco. A respeito das inundações, a maior vulnerabilidadeacontece num amplo setor no sudeste do Amazonas, em setores do sopé dos Andes em toda a região plana contígua ao rio Amazonas ou de seus afluentes.
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- 2018
26. Bofedales: high altitude peatlands of the central Andes
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Barry G. Warner, Ramon Aravena, Francisco A. Squeo, and Diana Espinoza
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0106 biological sciences ,2. Zero hunger ,010504 meteorology & atmospheric sciences ,South America ,15. Life on land ,arid grasslands ,010603 evolutionary biology ,01 natural sciences ,Geography ,13. Climate action ,General Agricultural and Biological Sciences ,Humanities ,peatlands ,0105 earth and related environmental sciences ,General Environmental Science - Abstract
Existe un grupo excepcional de turberas (bofedales) de alta montana en el mundo situados en la estepa arida de los Andes centrales. Los bofedales en el norte de Chile estan presentes en la parte mas arida de su rango. Las principales especies de plantas responsables de la formacion de turba corresponden a miembros de Juncaceae. El agua fresca y medianamente salina de los bofedales proviene de agua subterranea asociada a riachuelos proveniente de glaciares, derretimiento de nieve y lluvia. Investigaciones paleoecologicas sugieren que algunos bofedales son integrantes recientes del paisaje, habiendose desarrollado durante los ultimos tres mil anos o menos. Estos bofedales son entidades unicas, extremadamente fragiles por su dependencia del agua, sensibles a los cambios climaticos y vulnerables a la alteracion humana tal como la actividad minera en la region. Se requiere mucho mas trabajo para desarrollar programas de manejo y conservacion, con solidas bases cientificas, de las plantas y animales que viven en ellos, y para asegurar la capacidad futura de pastoreo de la cual dependen los pueblos indigenas
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- 2006
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27. 1210: THE METABOLIC SUBPHENOTYPE: A PROTECTIVE FACTOR IN ARDS SECONDARY TO SEPSIS OR PNEUMONIA.
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Pagliaro, Jaclyn, Tea, Kevin, Zu, Yuanhao, Chung, Cheng Han, Mehta, Prakriti, Grewal, Himmat, Denson, Joshua, Khan, Yasin, Shaffer, Jeffrey, Douglas, Ivor, and Barrera, Diana Espinoza
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- 2023
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28. 311: SEVERE HYPERAMMONEMIA CAUSED BY CARNITINE DEFICIENCY DURING ADULTHOOD.
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Spaedy, Abigail, Barrera, Diana Espinoza, Anderrson, Hans, and Denson, Joshua
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- 2023
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29. Estudio bacteriano en úteros de vacas sacrificadas en el rastro municipal DE Tulancingo, Hidalgo.
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Diana, Espinoza-Santillán, Víctor, Martínez-Juárez, Jesús, Peralta-Ortiz, Pedro, Molina-Mendoza, José, Olave-Leyva, and Rogelio, Ávila-Castillo
- Abstract
The aim of this study was to evaluate the presence and identification of bacterial microorganisms in uterus from slaughtered cows. Thirty-two samples of uterine lavage were obtained, these samples were used to inoculate blood agar and McConkey agar culture media, subsequently these underwent Gram staining for classification in Gram-positive and Gram-negative. A Catalase test, besides a mannitol salt agar culture and coagulase, were performed to the Gram-positive bacteria, while to the Gram-negative bacteria, the IMViC tests were performed. 100% of the samples showed bacterial isolation; from these, 40.62% were coagulase-negative Staphylococcus (SCN), likely epidermis species, representing the highest frequency of bacterial isolates (P <0.05). Among the Gram-negative isolates Salmonella spp. prevailed with 15.62% and 12.5% for Escherichia coli. The results demonstrate that, in the uterus from slaughtered cows at the slaughterhouse, bacterial organisms, live as part of normal microbiota of the uterus, however, these bacteria are also described as opportunistic pathogens that cause different degrees of uterine infection, which may be related with reproductive tract infections, and adverse effects on fertility, encouraging the animal sacrifice. [ABSTRACT FROM AUTHOR]
- Published
- 2016
30. COVID-19 infection characteristics and outcomes in a predominantly Latino community hospital.
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Hidalgo DC, Jasti M, Tapaskar N, Junia C, Chaugule A, Galeano FG, Alcantar DC, Ramirez MJZ, Genovez JLZ, Rodas GM, Barrera DE, Rodriguez R, and Albarillo F
- Abstract
Introduction: The coronavirus disease 2019 (COVID-19) pandemic has rapidly spread worldwide and claimed millions of lives. Several studies have attempted to understand the relationship between COVID-19 infection and health disparities. The aim of the current work was to evaluate the pre-admission health characteristics, symptomatology, diagnostic abnormalities, treatment measures and clinical outcomes of the community served by our institution, with a sub-analysis of our Hispanic community., Methods: This is a single-center, cross-sectional cohort study of patients with COVID-19 admitted from 15 March 2020 to 30 April 2020 to MacNeal Hospital. A retrospective chart review was performed including patients >18 years and a positive nasopharyngeal SARS-CoV-2 PCR. Demographical data, comorbidities, clinical data, treatment regimen, and patient outcomes were collected., Results: A total of 257 patients were included in the study of which 60.4% were identified as Hispanic. The median age at admission of Hispanic patients was significantly lower compared to non-Hispanic patients (56.6 vs. 65.7 years, p<0.01). Non-Hispanic patients had lower prevalence of hypertension, coronary artery disease, and chronic lung disease. Most common at presentation were shortness of breath (69.6%), cough (69.2%), and fever (64%). Hypertension was the most common comorbidity (53.6%). Approximately 89% of the patients received antibiotics, 40.4% hydroxy-chloroquine, 13.2% steroids, and 6% tocilizumab. Twenty six percent required mechanical ventilation (MV), and over half of them (56.7%) were Hispanic. The strongest factors associated with MV were smoking (OR 2.97, 95%CI 1.01-8.69), CRP >10 mg/dL (OR 4.53, 95%CI 1.49-13.38) and D-dimer >1.5 mcg/mL (OR 3.63, 95%CI 1.31-10.05). An oxygen saturation of >90% on room air on presentation was a protective factor when predicting intubation (OR 0.11, 95%CI 0.03-0.33). The overall 30-day mortality rate was 17.1% (n=44); 11.9% in the Hispanic group vs 26.3% in the non-Hispanic group (p<0.003)., Conclusions: Our review of consecutive patients admitted with COVID-19 demonstrated that over half of patients were of Hispanic descent. Interestingly enough, despite being significantly younger and healthier, the need for mechanical ventilation in the Hispanic group was not significantly different compared to the non-Hispanic group. However, the Hispanic group had a lower mortality rate., Competing Interests: Conflicts of interest: All authors – none to declare., (GERMS.)
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- 2022
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