Hepatitis C diagnosis slowdown in high-prevalence groups and using decentralised diagnostic strategies during the COVID-19 pandemic.

INTRODUCTION: The COVID-19 pandemic has had a major impact on hepatitis C virus (HCV) diagnosis by hindering the path to elimination, although probably in an uneven manner depending on the risk group and diagnostic strategy. METHODS: We recorded the requests of antibodies/RNA by venipuncture at the hospital and primary care centres (centralised), as well as the requests via venipuncture or dried blood spot test at prison and drug treatment centres referred for central processing (integrated decentralised), for one year before and after the onset of the COVID-19 health alarm. RESULTS: A total of 20,600 tests (51% male, 47.9±15.8 years) were recorded. Among them, 96.5% of the cases came from centralised and 3.5% from decentralised settings, with an active infection rate of 0.2% and 2.3% (p<0.001), respectively. There was a 31.3% decrease in the number of requests during the pandemic compared to the pre-pandemic period, which was more pronounced in decentralised diagnosis than centralised (60 vs. 30%, p<0.001). In addition, there was a 31.5% decline in screening and an 18.2% decrease in the diagnosis of new cases of active infection, showing a statistically significant decrease in decentralised compared to centralised diagnosis. CONCLUSIONS: During the COVID-19 pandemic, a decline in HCV diagnostic effort has been observed, especially in decentralised strategies with a higher prevalence of infection. Our results suggest a diagnostic delay that will prevent Spain from reaching the elimination target in 2023, and therefore the reactivation of strategies particularly targeting the priority groups is urgently required.

Evolución de la microbiota en un aula de farmacia pre y post primera oleada de la pandemia COVID-19

La microbiota varía con el tiempo, por ello durante el curso académico 2019-20, coincidiendo con la pandemia SARS-COV-2, se evaluó la evolución de la misma en un aula de la Facultad de Farmacia de la Universidad de Salamanca con la espectrometría de masas Matrix-assisted laser desorption ionization time-of-flight. Además, se comparó con otros estudios, así como con las directrices de la Comisión de la Comunidad Europea de calidad del aire de interiores. Tras el estudio se concluyó que dicha aula presentaba un grado de contaminación muy bajo, y que la mayoría de la microbiota era saprofítica. Asimismo, de forma general se puede concluir que de forma cuantitativa los hongos y de forma cuali-cuantitativa las bacterias no presentaban un riesgo para la salud. Por otro lado, entre las variables más importantes encontramos la afluencia de personas, la frecuencia de limpieza y la ventilación. Finalmente, este estudio recoge la poca normativa que existe sobre la calidad del aire en interiores no industriales y no hospitalarios.Alternate abstract:Microbiota varies over time, therefore during 2019-20 academic year, coinciding with the SARS-COV-2 pandemic, the evolution of it was evaluated in a classroom of the Faculty of Pharmacy of the University of Salamanca with mass spectrometry Matrix-assisted laser desorption ionization time-of-flight. In addition, this study was compared with others, as well as with guidelines of the European Community Commission on indoor air quality. After the study, it was concluded that said classroom had very low contamination degree and that most of microbiota was saprophytic. Furthermore, it can be concluded that quantitatively fungi and quantitatively and qualitatively the bacteria did not present a health risk. On the other hand, the most important variables that were found were the influx of people, the frequency of cleaning and ventilation. Finally, this study shows off the lack of regulation that exists on air quality in non-industrial and non-hospital interiors.

Analysis of the determinants of sleep quality in a Spanish population: a study protocol for a cross-sectional study.

INTRODUCTION: Sleep problems are a growing public health concern being related, among others, to an increased risk of cardiovascular diseases or worse cognitive functioning. In addition, they can affect aspects related to personal motivation and quality of life. However, very few studies have analysed the possible determinants of sleep quality in the adult population as a whole, establishing patterns based on these determinants.The objectives are to evaluate the determinants of sleep quality in a representative sample of the general adult population between 25 and 65 years old, and to establish patterns of sleep quality based on lifestyles, psychological factors, morbidities, sociodemographic variables, biological markers and other possible determinants. METHODS AND ANALYSIS: Descriptive observational cross-sectional study. The study population will include a representative sample of 500 people between 25 and 65 years old from the cities of Salamanca and Ávila (Spain) selected by random sampling stratified by age groups and sex. A 90-minute visit will be performed, during which sleep quality will be assessed. The variables collected will be: morbidity, lifestyles (physical activity, diet, toxic habits), psychological factors (depression, stress, occupational stress and anxiety), socioeconomic and work-related variables, habitability conditions of the habitual residence and rest area, screen time, relaxation techniques and melatonin as a biological marker related to sleep quality. DISCUSSION: With the results of this work, improved interventions for behaviour modification could be designed, as well as intervention and education programmes or other research aimed at improving sleep quality. ETHICS AND DISSEMINATION: This study has a favourable opinion from the Ethics Committee for Drug Research of the Health Areas of Salamanca and Ávila (CEim Code: PI 2021 07 815). The results of this study will be published in international impact journals of different specialties. TRIAL REGISTRATION NUMBER: NCT05324267.

Extended reality as a training method for medical first responders in mass casualty incidents: A protocol for a systematic review.

INTRODUCTION/BACKGROUND: Mass-casualty incidents (MCIs) and disasters require an organised and effective response from medical first responders (MFRs). As such, novel training methods have emerged to prepare and adequately train MFRs for these challenging situations. Particular focus should be placed on extended reality (XR), which encompasses virtual, augmented and mixed reality (VR, AR, and MR, respectively), and allows participants to develop high-quality skills in realistic and immersive environments. Given the rapid evolution of high-fidelity simulation technology and its advantages, XR simulation has become a promising tool for emergency medicine. Accordingly, this systematic review aims to: 1) evaluate the effectiveness of XR training methods and 2) explore the experience of MFRs undergoing such training. METHODS: A comprehensive search strategy will encompass four distinct themes: MFRs, disasters/MCIs, education and simulation, and XR. Four databases (MEDLINE, EMBASE, CINAHL and LILACs) will be searched along with an in-depth examination of the grey literature and reference lists of relevant articles. MetaQAT will be used as a study quality assessment tool and integrated into Covidence as part of the data extraction form. Given the predicted high heterogeneity between studies, it may not be possible to standardise data for quantitative comparison and meta-analysis. Thus, data will be synthesised in a narrative, semi-quantitative manner. DISCUSSION: This review will examine the existing literature on the effectiveness of XR simulation as a tool to train MFRs for MCIs, which could ultimately improve preparedness and response to disasters. TRIAL REGISTRATION: Protocol registration: PROSPERO CRD42021275692.

SARSPLEX: Multiplex Serological ELISA with a Holistic Approach.

Currently, there are over 602 million severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases and 6.4 million COVID-19 disease-related deaths worldwide. With ambitious vaccine strategies, reliable and accurate serological testing is needed to monitor the dynamics of the novel coronavirus pandemic and community immunity. We set out to improve serological testing of the immune response against SARS-CoV-2. We hypothesize that by multiplexing the serological diagnostic test kit (SARSPLEX) and screening for three antibodies, an even more robust diagnostic can be developed. A total of 293 sera were analyzed for IgM, IgG, or IgA immune reactions to the subunit 1 spike glycoprotein and the nucleocapsid protein in a standardized ELISA platform. Testing IgM, IgG, and IgA demonstrated high positive and negative agreements compared to RT-PCR and serology reference tests. Comparison with the pre-2019-CoV (n = 102) samples highlighted the specificity of this test kit and indicated that no unspecific binding, even with the summer flu patients (n = 44), was detected. In addition, SARSPLEX demonstrated to be a valuable occupational surveillance tool used in a functional medicine facility. With increased and broader testing, SARSPLEX will be a valuable tool in monitoring immunity and aid in prioritizing access to the SARS-CoV-2 vaccine for high-risk patients.

Comparison of Physical Fitness Profiles Obtained before and during COVID-19 Pandemic in Two Independent Large Samples of Children and Adolescents: DAFIS Project.

COVID-19 pandemic restrictions might have negatively affected the health-related physical fitness of children and adolescents. The aim of this study was to contrast the body composition and physical fitness data of two independent samples of children and adolescents obtained from an online database (DAFIS project) before (n = 15,287) and during (n = 2101) the first academic year of the COVID-19 pandemic. The results revealed higher values for the body mass index (p = 0.002), waist circumference (p < 0.001), and waist to hip and waist to height ratios (p < 0.001) during than before the pandemic, particularly in the case of boys. On the other hand, lower muscular fitness was observed for girls during the pandemic. Quantitative and qualitative analysis did not detect relevant changes in cardiorespiratory fitness in children or adolescents (p > 0.05). Our data suggested that pandemic constraints might have affected body composition and muscular fitness of children and adolescents. These results might be of interest for designing specific interventions oriented toward counteracting the negative effects of pandemic restrictions on health-related physical fitness.

Comparison of Physical Fitness Profiles Obtained before and during COVID-19 Pandemic in Two Independent Large Samples of Children and Adolescents: DAFIS Project

COVID-19 pandemic restrictions might have negatively affected the health-related physical fitness of children and adolescents. The aim of this study was to contrast the body composition and physical fitness data of two independent samples of children and adolescents obtained from an online database (DAFIS project) before (n = 15,287) and during (n = 2101) the first academic year of the COVID-19 pandemic. The results revealed higher values for the body mass index (p = 0.002), waist circumference (p < 0.001), and waist to hip and waist to height ratios (p < 0.001) during than before the pandemic, particularly in the case of boys. On the other hand, lower muscular fitness was observed for girls during the pandemic. Quantitative and qualitative analysis did not detect relevant changes in cardiorespiratory fitness in children or adolescents (p > 0.05). Our data suggested that pandemic constraints might have affected body composition and muscular fitness of children and adolescents. These results might be of interest for designing specific interventions oriented toward counteracting the negative effects of pandemic restrictions on health-related physical fitness.

Povidone-Iodine as a Pre-Procedural Mouthwash to Reduce the Salivary Viral Load of SARS-CoV-2: A Systematic Review of Randomized Controlled Trials.

The use of pre-procedural rinses has been investigated to reduce the number of viral particles and bacteria in aerosols, potentially decreasing the risk of cross-infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during medical and dental procedures. This review aims to confirm whether there is evidence in the literature describing a reduction in salivary load of SARS-CoV-2 when povidone-iodine (PVP-I) is used as a pre-intervention mouthwash. An search of the MEDLINE, Embase, SCOPUS, and the Cochrane library databases was conducted. The criteria used followed the PRISMA® Statement guidelines. Randomized controlled trials investigating the reduction of salivary load of SARS-CoV-2 using PVP-I were included. Ultimately, four articles were included that met the established criteria. According to the current evidence, PVP-I is effective against SARS-CoV-2 in saliva and could be implemented as a rinse before interventions to decrease the risk of cross-infection in healthcare settings.

Antiviral Activities of Halogenated Emodin Derivatives against Human Coronavirus NL63.

The current COVID-19 outbreak has highlighted the need for the development of new vaccines and drugs to combat Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2). Recently, various drugs have been proposed as potentially effective against COVID-19, such as remdesivir, infliximab and imatinib. Natural plants have been used as an alternative source of drugs for thousands of years, and some of them are effective for the treatment of various viral diseases. Emodin (1,3,8-trihydroxy-6-methylanthracene-9,10-dione) is a biologically active anthraquinone with antiviral activity that is found in various plants. We studied the selectivity of electrophilic aromatic substitution reactions on an emodin core (halogenation, nitration and sulfonation), which resulted in a library of emodin derivatives. The main aim of this work was to carry out an initial evaluation of the potential to improve the activity of emodin against human coronavirus NL63 (HCoV-NL63) and also to generate a set of initial SAR guidelines. We have prepared emodin derivatives which displayed significant anti-HCoV-NL63 activity. We observed that halogenation of emodin can improve its antiviral activity. The most active compound in this study was the iodinated emodin analogue E_3I, whose anti-HCoV-NL63 activity was comparable to that of remdesivir. Evaluation of the emodin analogues also revealed some unwanted toxicity to Vero cells. Since new synthetic routes are now available that allow modification of the emodin structure, it is reasonable to expect that analogues with significantly improved anti-HCoV-NL63 activity and lowered toxicity may thus be generated.

Sociodemografía de la desigualdad por Covid-19 en México

Los efectos del Covid-19 han sido devastadores. En México, la desigualdad exis-tente recrudeció sus efectos en diferentes poblaciones. Este artículo analiza, desde la demografía de la desigualdad, la información estadística del gobierno federal sobre la mor-talidad por Covid-19;con especial referencia a las implicaciones en la salud de la población masculina por factores biopsicosociales de su género. Se incorporan datos de la Primera Encuesta Costos-Beneficios de las Estrategias de Adaptación en Salud, Economía y Sociedad (CoBESS-2020), realizada entre mayo y julio de 2020, que documenta algunas de las principa-les consecuencias que viven distintas pobla-ciones afectadas en México.Alternate abstract:ovid-19 has had devastating effects. In Mexico, the existing inequality in-tensified its effects on different populations. Using a demography of inequality approach, this article analyzes statistical information pro-duced by the federal government on Covid-19 mortality;special reference is made to how the health of the male population is affected due to biopsychosocial factors proper to their gender. The article uses data from the First Survey on the Costs and Benefits of Adapta-tion Strategies in Health, Economy and Society (CoBESS-2020), conducted between May and July 2020, which documents some of the main consequences experienced by different affec-ted populations in Mexico.