Organic Electrochemical Transistors functionalized with Protein Minibinders for Sensitive and Specific Detection of SARS-CoV-2

There is a need for rapid, sensitive, specific, and low-cost virus sensors. Recent work has demonstrated that organic electrochemical transistors (OECTs) can detect the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein. Here, a simple and low-cost approach to the fabrication of OECT devices with excellent stability and unprecedented sensitivity and specificity for the detection of SARS-CoV-2 virus is demonstrated. The devices rely on the engineered protein minibinder LCB1, which binds strongly to SARS-CoV-2. The resulting devices exhibit excellent sensitivity for the detection of SARS-CoV-2 virus and SARS-CoV-2 spike protein receptor binding domain (RBD). These results demonstrate a simple, effective, and low-cost biomolecular sensor applicable to the real-time detection of SARS-CoV-2 virus and a general strategy for OECT device design that can be applied for the detection of other pathogenic viruses.

[Incremental innovation in healthcare in Spain during the COVID-19 pandemic]

OBJECTIVE: It is important to understand the impact of the COVID-19 pandemic on incremental innovation and its protection through industrial property rights, in order to acquiring valuable insights to develop effective public policies and corporate strategies. The objective was to analyze incremental innovations in response to the pandemic that have been protected by industrial property rights, and to examine whether the COVID-19 pandemic had a positive or negative effect on incremental innovation, promoting or inhibiting it. METHODS: Utility models in the health patent class have been used as indicators (01.01.20 to 31.12.21), since the information they provide and their characteristics (requirements of applications and publication) allowed us to obtain preliminary conclusions in the short term. Their frequency of application during the pandemic months was analyzed and compared with an equivalent period immediately before (01.01.18 to 31.12.19). RESULTS: The analysis showed that there had been greater activity in healthcare innovation by all agents (individuals, companies and the public sector). In the pandemic period of 2020-2021, 754 utility models were requested, representing a nearly 40% increase compared to the equivalent period of 2018-2019, of which 284 were identified as pandemic-related innovations, with 59.7% of rights holders being individuals, 36.4% being companies, and only 3.9% being public entities. CONCLUSIONS: In general, incremental innovations require less investment and shorter technology maturation times, which had made it possible to respond, in some cases successfully, to situations of initial shortages of many medical devices, such as ventilators and protective equipment.

[Incremental innovation in healthcare in Spain during the COVID-19 pandemic]

OBJECTIVE: It is important to understand the impact of the COVID-19 pandemic on incremental innovation and its protection through industrial property rights, in order to acquiring valuable insights to develop effective public policies and corporate strategies. The objective was to analyze incremental innovations in response to the pandemic that have been protected by industrial property rights, and to examine whether the COVID-19 pandemic had a positive or negative effect on incremental innovation, promoting or inhibiting it. METHODS: Utility models in the health patent class have been used as indicators (01.01.20 to 31.12.21), since the information they provide and their characteristics (requirements of applications and publication) allowed us to obtain preliminary conclusions in the short term. Their frequency of application during the pandemic months was analyzed and compared with an equivalent period immediately before (01.01.18 to 31.12.19). RESULTS: The analysis showed that there had been greater activity in healthcare innovation by all agents (individuals, companies and the public sector). In the pandemic period of 2020-2021, 754 utility models were requested, representing a nearly 40% increase compared to the equivalent period of 2018-2019, of which 284 were identified as pandemic-related innovations, with 59.7% of rights holders being individuals, 36.4% being companies, and only 3.9% being public entities. CONCLUSIONS: In general, incremental innovations require less investment and shorter technology maturation times, which had made it possible to respond, in some cases successfully, to situations of initial shortages of many medical devices, such as ventilators and protective equipment.

Local Naïve Bayes for Predicting Evolution of COVID-19 Patients on Self Organizing Maps

The most recent Clinical Decision Support Systems use the potential of Machine Learning techniques to target clinical problems, avoiding the use of explicit rules. In this paper, a model to monitor and predict the risk of unfavourable evolution (UE) during hospitalization of COVID-19 patients is proposed. It combines Self Organizing Maps and local Naïve Bayes (NB) classifiers because of interpretation purposes. We used the results of six blood tests (leukocytes, D-dimer, among others) provided by a Spanish hospital group. The probabilistic approach allows us to get the daily risk of UE for each patient in an interpretable way. Several variants of the NB classifiers family have been explored, mainly weighting and likelihood estimation (parametric and nonparametric). Despite the over-simplified assumptions of the NB classifiers, they provided good predictive results in terms of sensitivity and specificity. The model with nonparametric likelihood estimation provided the best risk prediction over time even when designed with a limited number of samples. Specifically, the median value and interquartil range for the risk prediction were quite reliable even 10 days before the event day for patients hospitalized longer than 7 days. The risk median values also agree with the gold-standard for patients with a hospital stay shorter than 7 days, though the interquartil range can be too wide (probably because of the variability in the inpatient days - sometimes, just 2 days). Though a deepest analysis considering more patients and features would be convenient, our results show the potential of the proposed approach, both from a technical and clinical viewpoint. © 2022 IEEE.

Pandemic fatigue as psychological sequel of COVID-19 in Matanzas province, Cuba

Introduction: The prolonged nature of the current pandemic means that people have to adopt a different style of coping than assumed at the beginning, and as a result it can be fatigue and demotivation. Objective(s): To characterize the manifestations of pandemic fatigue in the population of the town of Santa Marta, Matanzas province. Method(s): A descriptive observational cross-sectional study was conducted from May 7 to 10, 2021 in 105 members of 51 randomly selected families from the Family Doctor's Office #27 in the town of Santa Marta. The variables were grouped into socio-demographic, clinical and related to the characteristics of pandemic fatigue explored through a survey. The data was stored and processed in Microsoft Excel spreadsheets. Result(s): 38.1 % were in the age group 46-59 years of age;36.2% of the population has made trips at least once;22.9% reported having sporadic problems of coexistence;78.1% have felt concern for the health of all members of their family;40% experienced sudden changes in their mood and 28.6% did not perform physical or didactic activities. Conclusion(s): Pandemic fatigue manifested itself in the population studied through the presence of psychological stress, neglect of hygienic-sanitary measures, misinformation about the epidemiological situation and other symptoms of attrition. Copyright © 2022, Editorial Ciencias Medicas. All rights reserved.

A PROSPECTIVE MULTICENTER SURVEY ABOUT THE USE OF NEW TECHOLOGIES AND DIGITAL HEALTH TOOLS IN PATIENTS (PTS) WITH HEMATOLOGICAL MALIGNANCIES

Background: Telemedicine has landed on the care of pts with hematological malignancies enhanced by the COVID-19 pandemic On the other hand, the use of eHealth and new forms of communication technologies requires technological skills on the part of pts In order to guarantee the success of communication through these new tools, patients must be willing to and have access to this form of communication. Aims: We hypothesize that telemedicine and eHealth have great acceptance among pts with hematololgical malignancies increasing their interest during the pandemic Methods: Pts with any oncohaematological malignancy receiving oral and/or intravenous treatment in daytime Hospital were included in our study between 1st February and 30th November 2021 in 4 Hospitals. We conducted a cross-sectional, multicenter, prospective study, based on the validation design of a survey offered to these patients, where demographic and social characteristics, tumor characteristics, management characteristics of the technologies of information and communication, as well as the patient portal and data on the COVID-19 pandemic were included. Our endpoint was to describe the pattern of access and use of new technologies of patients treated in Hematology Services for some hematological malignancy and Medical Oncology for a solid tumor. Results: Two hundred patients were included in our study. Median age was 60 years (range 21-87), and 119 (59.5%) were male. About the use of information and communication technologies (ICTs), 136 (69.5%) patients reported daily use of the internet and 172 (86%) have a smartphone. 85 (43.1%) of patients included in the study do health research on the internet, and 181 (90.5) think e-health tools may help them to improve the communication with the medical team during their treatment. The most chosen way to communicate is the mobile phone (45%). When we analyzed the use of digital health and ITCs, patients older than 60 years old, without superior education and retired are the ones who never use internet, never do health research on the internet and do not think the use of these tools may help them to improve their communication with the medical team, with statistically significant differences (Table 1). No differences in gender were found. (Figure Presented ) Summary/Conclusion: Although in the past years e-Health solutions development has exponentially increased motivated by COVID-19 pandemic, preferences and needs of patients remain unknown. In our study, most of them believe new technologies are accessible, useful, and the preferred way to use them is the mobile phone. We can differentiate a group of patients older than 60 years, without superior studies and retired, who are out of this trend. Efforts to adapt digital solutions to this group's needs and limitations should be made in order to avoid the digital gap.

Mapping Health Trajectories on Self Organizing Maps using COVID-19 Patient's Blood Tests

Since COVID-19 appeared in December 2019, scientists are researching new ways to improve the management of the disease. Considering machine learning approaches have proven to be very useful tools to discover hidden patterns in data, we propose in this paper to apply a Self Organizing Map (SOM) to characterize the health-status evolution of COVID-19 patients. The SOM is a neural network whose neurons can be represented as cells in a bi-dimensional grid preserving the mapping from the original space to the map units. We consider real-world data of hospitalized COVID-19 patients in a Spanish hospital during the first wave of the pandemic. Patients are represented by six blood tests (leukocytes and D-dimer, among others) in a daily basis. Besides, each patient is associated with one of two different health-status: favorable evolution (discharged home) and unfavorable evolution (exitus or admission to the intensive care unit). We show the potential of our approach by detailing the mapping of the health trajectory associated with different particular cases and drawing their trajectory on the bi-dimensional map of the SOM. © 2021 IEEE.

Air quality in the Port of Veracruz, Mexico

The increase in the ships operations in the Port of Veracruz, Mexico represents a potential source of air pollution of gases and particles from maritime transport for coastal communities, having a negative impact on air quality. The estimation of emissions was performed by applying emission factors (EF) from ships in the hoteling phase of important pollutants, e.g., criteria, toxics, and greenhouse gases (GHG), of which resulted of real-time air quality monitoring for SO2 and PM2.5 were presented for one year (October 2019 to October 2020). The air quality and meteorology monitoring station is located within the Veracruz Port Area to determine the spatio-temporal variation of atmospheric pollutants during the expansion and operation activities. In December 2019, present days that coincide in the increase of the species of interest and also appear on some days in February and March, registering two days with SO2 concentrations of 2.5 and 2.3 ppb, being the highest concentration recorded during the year and compared with its ambient air quality standard (MAAQS) established for periods of 24 hr (40 ppb) comply with current environmental regulations. Regarding the concentrations registered for PM2.5 in the months of April and June (56 and 60 μg /cu m, respectively), they exceededed its MAAQS which establishes a concentration of 45 μg /cu m for 24 hr. Regarding the SO2 estimated emissions, ships with rolling cargo in the months of January and February presented a greater contribution, while container ships increased it as of April. Concentrations could be directly related to combustion processes by mobile sources that occur in the region derived from port activity, which have increased since April, after a period of confinement derived from the COVID 19 pandemic.

Incidence and evolution of SARS-CoV2 infection in patients with inflammatory bowel disease in Southern Spain (Andalusia)

Introduction: The respiratory infection caused by SARS-CoV2, known as COVID-19, has presented a fast worldwide expansion with significant sanitary repercussion as well as social and economic. Globally, patients with inflammatory bowel disease (IBD) have been considered as population at risk for viral infections. To date, the evidence has not proved an increased risk for COVID-19 in this group. Aims & Methods: Our aim was to describe the main characteristics of our IBD patients who suffered SARS-CoV2 infection and to analyze both the evolution of their IBD and the infection's evolution. An observational, longitudinal, ambispective and multicentric study was performed. Patients with IBD with positive SARS-CoV2 PCR were included. Demographic variables along with data regarding to the COVID-19 infection were collected. SPSS® software version 20.0 was used for the statistic analysis. Results: We included 97 patients, 51.5% men. Overall mean age 43 (16-73) years old. Active smokers 13.5%, hypertensive 15.5%, diabetics 7.2% and obese 6.2%. According to the IBD 39.2% suffered from ulcerative colitis (UC), 55.7% Crohn's disease (CD), 2.1% linfocitic colitis and 2.1% indeterminate colitis. Mean IBD duration was 10.3 (SD 8.3) years. Perianal disease was present in 16.5% and extraintestinal manifestations (EIMs) 26.8% (77% joint involvement). Upon the time of infection 28.4% had active IBD. Regarding treatment, 55.7% were on aminosalycilates (5ASA), 45.8% on immunosuppressants, 25% on steroids and 41.7% on biologics. The main symptoms of SARS-CoV2 infection were astenia (62%), cough (60%), fever (58%), headache (52%) and diarrhoea (45%). Hospital admission was required in 24.2% (61% suffering from severe respiratory disease) and ICU was required in 17.4% of them. There were no deaths. Compared to those who did not need hospital admission;the admitted patients were older (50 vs 40 years old, p=0.006), were more likely to be obese (20% vs 2.8%, p=0.017), to suffer from hypertension (39% vs 8.3%, p=0.0001), from heart failure (13% vs 0%, p=0.002), had more EIMs (43.5% vs 22.2%, p= 0.047), had a higher previous hospitalization within the last 3 months (43.3% vs 8.3%, p=0.002), were more on 5ASA (91.3% vs 45.8%, p=0.0001) and showed higher C-reactive protein levels (71 vs 13.7, p=0.017). Hospitalized patients were more likely to present diarrhoea (63.8% vs 36.2%, p=0.009), dyspnoea (65.2% vs 20.6%, p=0.0001), hypoxemia (39.1% vs 1.5%, p=0.0001), hyporexia (60.9% vs 19.1%, p=0.0001), abdominal pain (36.4% vs 14.5%, p=0.025) and fever (82.6% vs 50%, p=0.006). Related to need of ICU admission, EIMs (75% vs 25.3%, p=0.029) and previous admission within the last 3 months (50% vs 13.2%, p=0.042), were more frequent. Neither immunosuppressant treatment (45.8% vs 47.8%, p=0.87) nor biologic therapy (43.1% vs 34.8%, p=0.48) were related to the need for hospital admission. Conclusion: A quarter part of the patients with IBD and SARS-CoV2 infection needed hospitalisation. An older age, presence of comorbidities, hospital admission within the previous 3 months, treatment with 5ASA and EIMs were more frequent in those requiring admission. There was not identified any relation between active IBD or the use of immunosuppressants/ biologics and a worse evolution of the infection.

Service-Learning, Movies, and Infectious Diseases: Implementation of an Active Educational Program in Microbiology as a Tool for Engagement in Social Justice.

Service-Learning is an educational methodology that allows student learning while addressing community needs. A program in microbiology and infectious diseases was implemented in Universidad Complutense de Madrid, Spain. University lecturers, clinical microbiologists, doctorate students, and undergraduates from several Bachelor Degrees and courses worked in an interdisciplinary team along with social institutions that attend disadvantaged persons. Using commercial movies that deal with infectious diseases, the students learn clinical microbiology, prepare divulgation materials, visit social centers to accompany, and help others to know about illnesses and prevention. The program was developed through two academic years and involved 58 voluntary students, 13 teachers and tutors, and 4 social entities as community partners. Postsurvey evaluation of the program revealed a highly satisfactory achievement of goals: acquiring scientific and personal competencies by university students, including critical analysis and science diffusion, solving problems or collaborative team working, and contributing, together with the tutors, to the social responsibility of the university.

Low positivity rate in antibody SARS-CoV2 tests in patients with rheumatic diseases treated with rituximab. a case control study of a high impact SARS-CoV2 infection area

Background: Diagnosis of previous SARS-COV2 infection may be challenging in immunocompromised patients. Objectives: To analyze positivity rate to SARS-COV2 antibody tests (SC2AT) in patients diagnosed of rheumatic diseases (RMD) treated with Rituximab. Methods: We conducted a case-control study of patients diagnosed of RMD followed in a referral hospital in Madrid, Spain. Positivity rate to IgG-SC2AT were analyzed in Rituximab-treated patients (RTX) compared with patients treated with TNF inhibitors (TNFi) and/or conventional DMARDs (cDMARDs) (N-RTX). We included patients that received Rituximab in the previous year to a confirmed SARS-COV2 infection (defined as a positive polymerase chain reaction test (PCR) and/or compatible chest Xray), to a suspected SARS-COV2 infection (2 or more symptoms) or to SC2AT determination. Patients with RMD treated with other biological DMARDs (bDMARDs) rather than Rituximab or TNFi were excluded. Results: We included 152 patients with RMD who underwent a SC2AT. Main characteristics are reported in Table 1. Among RTX and N-RTX, 4/48 (8.3%) and 35/104 (33.7%) showed a positive IgG-SC2AT, respectively. Four out of 104 (38.5%) N-RTX tested positive without previous symptoms. No asymptomatic infection was diagnosed among RTX. Univariable analysis showed a lower rate of positivity to SC2AT in confirmed and suspected infection among RTX [Positive IgG-SC2AT in confirmed infection: RTX 4/10 (40%), N-RTX 16/20 (80%);p=0.045. Positive IgG-SC2AT in suspected infection: RTX 0/3 (0%), N-RTX 15/18 (83.3%);p=0.015]. A logistic binary regression identified previous symptoms [OR 61.2, 95CI(13.3-280.6) p=0.0001], male sex [OR 4.8, 95CI(1.3-17.8) p=0.02], non-rituximab treatment [OR 19.7, 95CI(3.6-106.3) p=0.001] as independent factors associated with a higher probability of positive IgG-SC2AT. Age, previous PCR status, corticosteroid and cDMARD use showed no statistical significance. This model accounted for 47.6% of positive cases. Conclusion: RTX had a lower rate of positivity to IgG-SC2AT compared to N-RTX. Previous symptoms, male sex and non-RTX treatment were independently associated with higher probability of positive IgG-SC2AT.

Recommendations for the suspected diagnosis and management of Multisystemic Inflammatory Syndrome (MIS-C) in the context of a SARS-CoV-2 pandemic. April 2021

Multisystem inflammatory syndrome temporally associated with COVID-19 (MIS-C) is a post-infectious complication described in children and adolescents with previous exposure to SARS-CoV-2. Because of its potential to evolve to severe disease-including cardiovascular impairment and multiple organ failure-it requires a prompt diagnosis and appropriate management, including intensive care for most cases. These guidelines compile recent information from scientific literature, from our local clinical experiences during the past pandemic year, and have been discussed by experts. The recommendations provided are meant to help the clinical work of health teams attending the pediatric population.

COVID-19: Doctors, gastroenterology and emotions

COVID-19 is a pandemic with clinical and emotional implications, sometimes invisible to gastroenterologists. Although dying is part of life, the risk for some doctors may be greater. Specifically, gastroenterologists are affected by the fear of restarting medical check-ups and endoscopic procedures. Amid a sea of information –even with contradictions between different experts— following the guidelines of the Colombian Associations of the Digestive Tract could help reassure doctors and patients. Although the pathologies will continue to appear, the fear of the population to be infected can generate consequences such as delaying the treatment of digestive tract cancers. Physical self-care through protection strategies and the emotional care, are important to help our immune system. Adapting to function during the pandemic, using tele-orientation through digital platforms, is a creative way to reduce collective anxiety. © 2020 Asociaciones Colombianas de Gastroenterología, Endoscopia digestiva, Coloproctología y Hepatología.

Recommendations for the suspected diagnosis and management of multisystemic inflammatory syndrome (Mis-c) in the context of a sars-cov-2 pandemic. april 2021

Multisystem inflammatory syndrome temporally associated with COVID-19 (MIS-C) is a post-infectious complication described in children and adolescents with previous exposure to SARS-CoV-2. Because of its potential to evolve to severe disease-including cardiovascular impairment and multiple organ failure-it requires a prompt diagnosis and appropriate management, including intensive care for most cases. These guidelines compile recent information from scientific literature, from our local clinical experiences during the past pandemic year, and have been discussed by experts. The recommendations provided are meant to help the clinical work of health teams attending the pediatric population.