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Medicīna Veselības aprūpe Medicine Health Care Saistībā ar Kovid-19 pandēmiju Multisistēmu iekaisuma sindroms bērniem (MIS-C) ir kļuvusi par jaunu slimību bērnu populācijā. Tiek uzskatīts, ka tā ir SARS-CoV-2 infekcijas imūnmediēta pēcinfekcijas komplikācija, lai gan tieša cēloņsakarība starp abām slimībām vēl nav skaidra. Sindroms izpaužas ar līdzīgu klīnisko ainu kā Kavasaki slimība un toksiskā šoka sindroms, izraisot vairāku orgānu mazspēju. Tas izpaužas 2-6 nedēļas pēc akūtas Covid-19 infekcijas ar drudzi un galvenokārt kuņģa un zarnu trakta, sirds un asinsvadu sistēmas un gļotādas simptomiem. Bieži sastopama hemodinamikas nestabilitāte un šoka attīstība ar vazopresoru terapiju. Iekaisuma marķieri ir vispārēji paaugstināti. Ārstēšana ietver imunomodulējošu un pretiekaisuma terapiju. Lielākajai daļai bērnu nepieciešama intensīva terapija. Tomēr kopējais mirstības līmenis ir zems, un prognoze ir laba. Sindroma ilgtermiņa sekas pašlaik nav zināmas, tāpēc ir nepieciešama regulāra novērošana. Šis jaunais sindroms ir plaši novērots, un visā pasaulē ir publicēti gadījumu apraksti un pētījumi, lai to raksturotu. Es esmu tos pārskatījis, lai aprakstītu sindromu attiecībā uz tā patofizioloģiju, klīnisko izpausmi, laboratorijas un attēlu izmaiņām, ārstēšanas iespējām un iznākumu saskaņā ar pašreizējo zināšanu līmeni. Multisystem inflammatory disease in children (MIS-C) has been emerging as a novel condition in the paediatric population in relation to the Covid-19 pandemic. It is thought to be an immune-mediated post-infectious complication of a SARS-CoV-2 infection, although the direct causality between the two is not yet understood. The syndrome presents with a similar clinical picture as Kawasaki disease and toxic shock syndrome, leading to multi-organ failure. It presents 2 to 6 weeks after an acute Covid-19 infection with fever and predominantly gastrointestinal, cardiovascular and mucocutaneous symptoms. Haemodynamic instability and development of shock with vasopressor treatment is common. Inflammatory markers are universally increased. Treatment includes immunomodulatory and anti-inflammatory therapy. With most children requiring intensive care treatment. Nonetheless, the overall mortality rate is low, and the prognosis good. Long-term sequelae of the syndrome is unknown at this point in time, warranting a regular follow-up. This new syndrome has been extensively observed and case reports and studies have been published across the globe, to characterise it. I have reviewed these, to describe the syndrome regarding its pathophysiology, clinical presentation, laboratory and imaging changes, treatment options and outcome, according to the current state of knowledge.

An extended brief overviewing a bread swath of responses from higher educational institutions worldwide, to the COVID-19 pandemic.

The emergence of the COVID-19 pandemic changed the world, and its spread left drastic consequences for everyday life and business both in the world and in the Republic of Croatia. Given such a situation, we are forced to change established habits and behavior, adapt and survive. This applies to all of us, but especially to entrepreneurs, who were brought to the position of closing their companies overnight, and transferring part of their activities to the virtual world in order to ensure at least some income, necessary for the company's survival. With the digitization of business, numerous destination management companies have developed their web shops, e-commerce, while conducting meetings and certain events online. In order to maintain their business, numerous destination management companies were encouraged to create a personalized product. Examples are Booking.com and Expedia, which increased their investments in technology and data platforms, while on the other hand, they were forced to reduce the number of employees in order to maintain their operations. The purpose of this work is to present the operations of destination management companies during the Covid-19 pandemic, the interpretation of the measures and restrictions they have taken. Pojava pandemije COVID-19 promijenila je svijet, a njezino širenje ostavilo je drastične posljedice na svakodnevni život i poslovanje kako u svijetu tako i u Republici Hrvatskoj. S obzirom na takvu situaciju, prisiljeni smo promijeniti ustaljene navike i ponašanje, prilagoditi se i preživjeti. Ovo se odnosi na sve nas, ali posebno na poduzetnike, koji su preko noći dovedeni u poziciju zatvaranja firmi, te prebacivanja dijela djelatnosti u virtualni svijet kako bi osigurali barem neki prihod, potreban za opstanak firme. Digitalizacijom poslovanja brojne destinacijske menadžment kompanije razvile su svoje web shopove, e-commerce dok su sastanke i određene događaje vodile online putem. Kako bi održali svoje poslovanje brojne destinacijske menadžment kompanije bile su potaknute kreiranju presonaliziroanog proizvoda. Sami primjer su nam Booking.com i Expedia koji su povećali svoja ulaganja u tehnološke i podatkovne platforme dok su s druge strane bile primorane smanjiti broj zaposlenih kako bi održali poslovanje. Svrha je ovoga rada je prikaz poslovanja destinacijskih menadžment kompanija za vrijeme pandemije Covid-19, tumačenje primjenjenih mjera i restrikcija koje su poduzele.

O presente trabalho investiga o comportamento dos investidores nos mercados financeiros em períodos de crise. Em particular, este estudo investiga quais os determinantes sociodemográficos do comportamento dos investidores durante o período de crise fruto da pandemia COVID-19, usando o principal índice português, o PSI 20, como objeto de estudo. Os dados foram disponibilizados por uma das principais instituições financeiras do mercado português e contêm transações de 15 943 indivíduos para os anos de 2019 e 2020. Através de testes ANOVA e do método dos mínimos quadrados, é concluído que há efetivamente variáveis sociodemográficas que impactam o comportamento dos investidores nos mercados financeiros em períodos de crise. Investidores do género masculino são os mais ativos no mercado bolsista em períodos de crise e o estado civil não se relaciona com a atividade nos mercados de capitais. Riqueza, educação e a idade do investidor têm um impacto positivo nos montantes investidos em períodos de crise e a antiguidade do cliente tem um impacto negativo. Relativamente às características do individuo perante a instituição, a posse de uma conta de depósito a prazo com a instituição tem um impacto negativo no montante investido no mercado de capitais em períodos de crise. Já a posse de pelo menos um empréstimo com a instituição demonstra ter um impacto positivo na variável, com os investidores que possuem empréstimos a investir mais no mercado de capitais durante a pandemia. This paper investigates the sociodemographic characteristics of capital markets investors' behaviour during the pandemic period. For this purpose, we use data provided by a major Portuguese financial institution that comprises data for 15,943 individuals' transactions during 2019 and 2020. Using ANOVA tests and OLS estimations it was concluded that there are sociodemographic variables that impact investors’ behaviour towards the market in crisis periods. Male investors are more active during crisis periods than female investors and marital status was seen to not impact trading activity. Investors' wealth, education and age influence invested amounts in a positive way whereas client seniority has a negative impact. The possession of a savings account was seen to impact trading activity negatively while the possession of a loan had a positive impact on amounts traded during the pandemic.

Background: Our March 2021 edition of this review showed thoracic imaging computed tomography (CT) to be sensitive and moderately specific in diagnosing COVID-19 pneumonia. This new edition is an update of the review. Objectives: Our objectives were to evaluate the diagnostic accuracy of thoracic imaging in people with suspected COVID-19; assess the rate of positive imaging in people who had an initial reverse transcriptase polymerase chain reaction (RT-PCR) negative result and a positive RT-PCR result on follow-up; and evaluate the accuracy of thoracic imaging for screening COVID-19 in asymptomatic individuals. The secondary objective was to assess threshold effects of index test positivity on accuracy. Search methods: We searched the COVID-19 Living Evidence Database from the University of Bern, the Cochrane COVID-19 Study Register, The Stephen B. Thacker CDC Library, and repositories of COVID-19 publications through to 17 February 2021. We did not apply any language restrictions. Selection criteria: We included diagnostic accuracy studies of all designs, except for case-control, that recruited participants of any age group suspected to have COVID-19. Studies had to assess chest CT, chest X-ray, or ultrasound of the lungs for the diagnosis of COVID-19, use a reference standard that included RT-PCR, and report estimates of test accuracy or provide data from which we could compute estimates. We excluded studies that used imaging as part of the reference standard and studies that excluded participants with normal index test results. Data collection and analysis: The review authors independently and in duplicate screened articles, extracted data and assessed risk of bias and applicability concerns using QUADAS-2. We presented sensitivity and specificity per study on paired forest plots, and summarized pooled estimates in tables. We used a bivariate meta-analysis model where appropriate. Main results: We included 98 studies in this review. Of these, 94 were included for evaluating the diagnostic accuracy of thoracic imaging in the evaluation of people with suspected COVID-19. Eight studies were included for assessing the rate of positive imaging in individuals with initial RT-PCR negative results and positive RT-PCR results on follow-up, and 10 studies were included for evaluating the accuracy of thoracic imaging for imagining asymptomatic individuals. For all 98 included studies, risk of bias was high or unclear in 52 (53%) studies with respect to participant selection, in 64 (65%) studies with respect to reference standard, in 46 (47%) studies with respect to index test, and in 48 (49%) studies with respect to flow and timing. Concerns about the applicability of the evidence to: participants were high or unclear in eight (8%) studies; index test were high or unclear in seven (7%) studies; and reference standard were high or unclear in seven (7%) studies. Imaging in people with suspected COVID-19. We included 94 studies. Eighty-seven studies evaluated one imaging modality, and seven studies evaluated two imaging modalities. All studies used RT-PCR alone or in combination with other criteria (for example, clinical signs and symptoms, positive contacts) as the reference standard for the diagnosis of COVID-19. For chest CT (69 studies, 28285 participants, 14,342 (51%) cases), sensitivities ranged from 45% to 100%, and specificities from 10% to 99%. The pooled sensitivity of chest CT was 86.9% (95% confidence interval (CI) 83.6 to 89.6), and pooled specificity was 78.3% (95% CI 73.7 to 82.3). Definition for index test positivity was a source of heterogeneity for sensitivity, but not specificity. Reference standard was not a source of heterogeneity. For chest X-ray (17 studies, 8529 participants, 5303 (62%) cases), the sensitivity ranged from 44% to 94% and specificity from 24 to 93%. The pooled sensitivity of chest X-ray was 73.1% (95% CI 64. to -80.5), and pooled specificity was 73.3% (95% CI 61.9 to 82.2). Definition for index test positivity was not found to be a source of heterogeneity. Definition for index test positivity and reference standard were not found to be sources of heterogeneity. For ultrasound of the lungs (15 studies, 2410 participants, 1158 (48%) cases), the sensitivity ranged from 73% to 94% and the specificity ranged from 21% to 98%. The pooled sensitivity of ultrasound was 88.9% (95% CI 84.9 to 92.0), and the pooled specificity was 72.2% (95% CI 58.8 to 82.5). Definition for index test positivity and reference standard were not found to be sources of heterogeneity. Indirect comparisons of modalities evaluated across all 94 studies indicated that chest CT and ultrasound gave higher sensitivity estimates than X-ray (P = 0.0003 and P = 0.001, respectively). Chest CT and ultrasound gave similar sensitivities (P=0.42). All modalities had similar specificities (CT versus X-ray P = 0.36; CT versus ultrasound P = 0.32; X-ray versus ultrasound P = 0.89). Imaging in PCR-negative people who subsequently became positive. For rate of positive imaging in individuals with initial RT-PCR negative results, we included 8 studies (7 CT, 1 ultrasound) with a total of 198 participants suspected of having COVID-19, all of whom had a final diagnosis of COVID-19. Most studies (7/8) evaluated CT. Of 177 participants with initially negative RT-PCR who had positive RT-PCR results on follow-up testing, 75.8% (95% CI 45.3 to 92.2) had positive CT findings. Imaging in asymptomatic PCR-positive people. For imaging asymptomatic individuals, we included 10 studies (7 CT, 1 X-ray, 2 ultrasound) with a total of 3548 asymptomatic participants, of whom 364 (10%) had a final diagnosis of COVID-19. For chest CT (7 studies, 3134 participants, 315 (10%) cases), the pooled sensitivity was 55.7% (95% CI 35.4 to 74.3) and the pooled specificity was 91.1% (95% CI 82.6 to 95.7). Authors' conclusions: Chest CT and ultrasound of the lungs are sensitive and moderately specific in diagnosing COVID-19. Chest X-ray is moderately sensitive and moderately specific in diagnosing COVID-19. Thus, chest CT and ultrasound may have more utility for ruling out COVID-19 than for differentiating SARS-CoV-2 infection from other causes of respiratory illness. The uncertainty resulting from high or unclear risk of bias and the heterogeneity of included studies limit our ability to confidently draw conclusions based on our results.

ImagineThe internet stops workingelectricity is cutthe many screens which connect you to the world turn blackyou no longer have access to your bank accountor functioning credits cardsthe walls behind which you retreated fade awayand you find yourself under the open skynow you are like menothing but a “dangerous body” on the streetwhat can you do now?what must you do now?out in the open where an invisible virus lurks?you roamroam the city forfoodinformationand means to protect those you love

En el año 2020 la Organización Mundial de la Salud (OMS) declaro al COVID-19 como una pandemia que afecto la economía en varios países y Colombia no fue la excepción, ya que el ministerio de salud decreto medidas de confinamiento en el mes de marzo del 2020 para mitigar la rápida propagación del virus. Debido a esto, muchos sectores económicos en Colombia se vieron afectados en sus finanzas por las repentinas restricciones en su funcionamiento habitual, lo cual los llevo a tomar medidas para afrontar esta problemática. A pesar que el sector financiero en Colombia fue uno de los más favorecidos durante el principio de la pandemia COVID-19 en el año 2020, el sector financiero vio un deterioro por parte de algunos de sus usuarios para el pago de sus obligaciones, lo cual se vio reflejado en el recaudo de la cartera tanto en los bancos, cooperativas, etc… Debido a lo mencionado anteriormente, la presente investigación se centra en la cooperativa de ahorro y crédito COOTRACERREJÓN en el periodo 2020 y las incidencias que tuvo su cartera de crédito frente al impacto de la pandemia del COVID-19, lo cual nos permitió analizar el comportamiento de la misma y así identificar las estrategias diseñadas para mitigar los factores influyentes en el incremento de la cartera vencida, por lo que se desarrolla un tipo de investigación cuantitativa con enfoque no experimental cuyos diseños transaccionales son exploratorios. Al utilizar este método de investigación se pudo profundizar en el análisis de la cartera vencida a través de la revisión de informes financieros y tablas compartidas por la cooperativa COOTRACERREJÓN, donde se evidencia el cumplimiento del propósito para destacar los aspectos fundamentales de la problemática planteada y donde se encontró los procedimientos adecuados que permitieron elaborar esta investigación. In 2020 the World Health Organization (WHO) declared COVID-19 as a pandemic that affected the economy in several countries and Colombia was no exception, since the Ministry of Health decreed containment measures in March 2020 to mitigate the rapid spread of the virus. Due to this, many economic sectors in Colombia were affected in their finances by the sudden restrictions in their normal operation, which led them to take measures to face this problem. Although the financial sector in Colombia was one of the most favored during the beginning of the COVID-19 pandemic in the year 2020, the financial sector saw a deterioration on the part of its users for the payment of their obligations, which was reflected in the collection of the portfolio in banks, cooperatives, etc.... Due to the above mentioned, this research focuses on the savings and credit cooperative COOTRACERREJÓN in the period 2020 and the incidences that its credit portfolio had due to the impact of the COVID-19 pandemic, which allowed us to analyze the behavior of the same and thus identify the strategies designed to mitigate the influential factors in the increase of the overdue portfolio, so a type of quantitative research is developed with a non-experimental approach whose transactional designs are exploratory. By using this research method, it was possible to deepen the analysis of the overdue portfolio through the review of financial reports and tables shared by the cooperative COOTRACERREJÓN, where it is evident the fulfillment of the purpose to highlight the fundamental aspects of the problem raised and where it was found the appropriate procedures that allowed the elaboration of this research.

Absence from work can be caused by various factors, and determining the reason for the absence is a particularly important rule for employers. In practice, one of the most common reasons for absence from the workplace is absence based on temporary incapacity for work. The health system of each country, determines guidelines and passes laws, according to which it is defined in what way and under what conditions compensation will be paid during the insured's sick leave. Experience gained, average and salary level, type and duration of illness are some of the criteria on the basis of which it will be determined at whose expense this type of compensation will be paid and in what amount. Specifics in the calculations, during the duration of the COVID 19 pandemic, and the impact of the pandemic on the working population, will be presented and explained through the work using credible statistical data. zostanak s posla može biti uzrokovan raznim čimbenicima, a za poslodavce osobito je značajno pravilo utvrđivanje razloga odsustva. U praksi je jedan od najčešćih povoda odsustva s radnog mjesta, izostanak na temelju privremene nesposobnosti za rad. Zdravstveni sustav svake zemlje, određuje smjernice i donosi zakone, prema kojima se definira na koji će se način i pod kojim uvjetima, isplaćivati naknada za vrijeme bolovanja osiguranika. Stečeni staž, prosjek i visina plaća, vrsta i duljina trajanja bolesti neki su od kriterija na temelju kojih će se odrediti na čiji teret će se ovakav tip naknada isplaćivati i u kojem iznosu. Specifičnosti u obračunima, za vrijeme trajanja COVID 19 pandemije, te utjecaji pandemije na radno aktivno stanovništvo, biti će prikazani i objašnjeni kroz rad koristeći se vjerodostojnim statističkim podacima.

Dado que los coronavirus no siempre permanecen confinados al sistema respiratorio, en determinadas condiciones pueden invadir distintos sistemas incluido el sistema nervioso, conllevando a la presentación de manifestaciones neurológicas diversas. Objetivos: Establecer la prevalencia de manifestaciones neurológicas en pacientes con infección por COVID-19 y su relación con las comorbilidades presentes en los sujetos del estudio. Materiales y métodos: Se realizó una revisión sistemática cuantitativa, a partir de los datos aportados por los estudios que hasta la fecha se han realizado en pacientes con COVID 19 encontrados en las bases de datos (MedRxiv, PUBMED, OVID, EMBASE, MEDLINE y SCOPUS. El tiempo de la revisión abarca desde el 01 de diciembre del 2019 hasta el 31 de mayo del 2020. Resultados: Mediante la estrategia de búsqueda PRISMA, se pudieron identificar 162 artículos siendo seleccionados para este estudio 58 de ellos. Conclusiones: La incidencia de manifestaciones neurológicas en pacientes con infección por COVID-19 resulta importante, por lo que se recomiendan todos los esfuerzos del personal médico para su detección oportuna, de tal forma que se brinden las opciones terapéuticas necesarias para impactar tanto en la mortalidad como en la discapacidad que puedan generar. Since coronaviruses do not always remain confined to the respiratory system, under certain conditions they can invade different systems including the nervous system, leading to the presentation of various neurological manifestations. Objectives: To establish the prevalence of neurological manifestations in patients with COVID-19 infection and its relationship with the comorbidities present in the study subjects. Materials and methods: A quantitative systematic review was carried out, based on the data provided by the studies that have been carried out to date in patients with COVID 19 found in the databases (MedRxiv, PUBMED, OVID, EMBASE, MEDLINE and SCOPUS). The time during which the information in the databases was reviewed corresponds from December 1, 2019 to May 31, 2020. Results: Using the PRISMA search strategy, we were able to identify 162 articles. Finally, we had 58 articles for synthesis. Conclusions: Future epidemiological studies and case registries should give importance to the incidence of neurological manifestations, in addition to their pathogenic mechanisms, which leads to optimal therapeutic options that impact both mortality and disability.