[Cryptogenic new-onset super-refractory status epilepticus following SARS-CoV-2 vaccination. A case report]. / Estado epiléptico superrefractario de nueva aparición criptógeno tras vacunación contra el SARS-CoV-2. A propósito de un caso.

INTRODUCTION: New-onset super-refractory status epilepticus (NOSRSE) is a neurological emergency characterised by the development of status epilepticus in a patient without epilepsy or any known prior neurological disease and with no clear structural, toxic or metabolic cause, which recurs after 24 hours of induced coma. The most common identifiable cause is inflammatory-autoimmune. Consequently, we present a case of NOSRSE related to SARS-CoV-2 vaccination as an opportunity to investigate the dysimmune origin of this pathology. CASE REPORT: We report the case of a 40-year-old male who presented at the emergency department with fever and headache with no clear source of infection. His personal history included bacterial meningitis in childhood without any sequelae and protein S deficiency without treatment at the time, as well as vaccination with ChAdOx1 nCoV-19 21 days earlier. He was initially diagnosed with a urinary tract infection and treated with cefuroxime. Two days later, he was taken back to the emergency department with confusional symptoms and tonic-clonic seizures. He did not respond to midazolam and finally required sedation and orotracheal intubation for refractory status epilepticus. While in hospital, he required a number of lines of antiepileptic drugs, ketamine, a ketogenic diet, immunotherapy and plasmapheresis in order to successfully limit NOSRSE. The aetiological study offered normal results for serology, antineuronal antibodies in serum and cerebrospinal fluid, transthoracic echocardiography, testicular ultrasound and computed tomographic angiography. Only the control MRI scan showed a diffuse and bilateral alteration of the right hemispheric cortex and thalamic pulvinar as the only finding. CONCLUSION: It is crucial to report suspected adverse reactions associated with SARS-CoV-2 vaccination, thereby allowing continued monitoring of the risk/benefit ratio of vaccination.

TITLE: Estado epiléptico superrefractario de nueva aparición criptógeno tras vacunación contra el SARS-CoV-2. A propósito de un caso.Introducción. El estado epiléptico superrefractario de nueva aparición (NOSRSE) es una emergencia neurológica caracterizada por el desarrollo de estado epiléptico en un paciente sin epilepsia ni enfermedad neurológica previa conocida y sin clara causa estructural, tóxica o metabólica, que recurre tras 24 horas del coma inducido. La causa identificable más frecuente es la inflamatoria-autoinmune. En consecuencia, planteamos un caso de NOSRSE relacionado con la vacunación para el SARS-CoV-2 como una oportunidad de indagar el origen disinmune de esta patología. Caso clínico. Varón de 40 años que acude al servicio de urgencias refiriendo fiebre y cefalea sin claro foco infeccioso. Entre sus antecedentes personales destacamos una meningitis bacteriana en la infancia sin secuelas y un déficit de proteína S sin tratamiento en ese momento, así como vacunación con ChAdOx1 nCoV-19 21 días antes. Fue inicialmente diagnosticado de infección del tracto urinario y tratado con cefuroxima. Dos días después, se le llevó de nuevo a urgencias con cuadro confusional y crisis tonicoclónicas, sin respuesta al midazolam, y requirió finalmente sedación e intubación orotraqueal por estado epiléptico refractario. Durante su ingreso requirió múltiples líneas de antiepilépticos, quetamina, dieta cetógena, inmunoterapia y plasmaféresis para conseguir limitar el NOSRSE. El estudio etiológico ofrecía normalidad de los resultados de serología, anticuerpos antineuronales en el suero y líquido cefalorraquídeo, ecocardiografía transtorácica, ecografía testicular y angiotomografía computarizada. Únicamente la resonancia magnética de control mostró una alteración difusa y bilateral de la corteza hemisférica y pulvinar talámica derecha como único hallazgo. Conclusión. Es crucial notificar las sospechas de reacciones adversas asociadas a la vacunación frente al SARS-CoV-2, permitiendo así una supervisión continuada de la relación riesgo/beneficio de ésta.

[Impact of days elapsed from the onset of symptoms to hospitalization in COVID-19 in-hospital mortality: Time matters]. / Impacto de los días transcurridos desde el inicio de los síntomas hasta la hospitalización en la mortalidad hospitalaria por COVID-19: el tiempo importa.

Background: COVID-19 shows different clinical and pathophysiological stages over time. Theeffect of days elapsed from the onset of symptoms (DEOS) to hospitalization on COVID-19prognostic factors remains uncertain. We analyzed the impact on mortality of DEOS to hospital-ization and how other independent prognostic factors perform when taking this time elapsedinto account. Methods: This retrospective, nationwide cohort study, included patients with confirmed COVID-19 from February 20th and May 6th, 2020. The data was collected in a standardized online datacapture registry. Univariate and multivariate COX-regression were performed in the generalcohort and the final multivariate model was subjected to a sensitivity analysis in an earlypresenting (EP; < 5 DEOS) and late presenting (LP; ≥5 DEOS) group. Results: 7915 COVID-19 patients were included in the analysis, 2324 in the EP and 5591 in theLP group. DEOS to hospitalization was an independent prognostic factor of in-hospital mortalityin the multivariate Cox regression model along with other 9 variables. Each DEOS incrementaccounted for a 4.3% mortality risk reduction (HR 0.957; 95% CI 0.93---0.98). Regarding variationsin other mortality predictors in the sensitivity analysis, the Charlson Comorbidity Index onlyremained significant in the EP group while D-dimer only remained significant in the LP group. Conclusion: When caring for COVID-19 patients, DEOS to hospitalization should be consideredas their need for early hospitalization confers a higher risk of mortality. Different prognosticfactors vary over time and should be studied within a fixed timeframe of the disease.

Neoliberalism, ideology and Covid-19: An analysis from the perspective of Slavoj Žižek

This article looks at the Covid-19 pandemic as a contingent factor in, and its revelatory effect on, various contemporary expressions of neoliberal ideology in Latin America. Based on philosophical and psychoanalytical concepts of a Lacanian nature fundamentally proposed by Slavoj Žižek, it examines the critical uses of the notion of ideology in its various manifestations: fear of the other, imposition of the logic of self-promotion, destruction of social ties, extractivism of nature, and fetishization of the discourses of unity in the face of the pandemic. The hypothesis is that the pandemic offers an opportunity to rethink contemporary subjectivity, through a confrontation with the Real that borders on symbolization and, ultimately, ideological capture, in order to question the assertion that there is no alternative. © 2023 Universitat Autonoma de Barcelona and Universitat de Girona. All rights reserved.

Impacto de los días transcurridos desde el inicio de los síntomas hasta la hospitalización en la mortalidad hospitalaria por COVID-19: el tiempo importa Impact of days elapsed from the onset of symptoms to hospitalization in COVID-19 in-hospital mortality: Time matters

Antecedentes La COVID-19 muestra diferentes fases clínicas y fisiopatológicas a lo largo del tiempo. El efecto de los días transcurridos desde el comienzo de los síntomas (DTCS) hasta la hospitalización sobre los factores pronósticos de la COVID-19 sigue siendo incierto. Analizamos el impacto en la mortalidad de los DTCS hasta la hospitalización y cómo se comportan otros factores pronósticos independientes al tener en cuenta dicho tiempo transcurrido. Métodos En este estudio de cohortes nacional retrospectivo se incluyó a pacientes con COVID-19 confirmada entre el 20 de febrero y el 6 de mayo de 2020. Los datos se recopilaron en un registro normalizado de captura de datos en línea. Se realizó una regresión de Cox uni y multifactorial en la cohorte general y el modelo multifactorial final se sometió a un análisis de sensibilidad en un grupo de presentación precoz (PP) < 5 DTCS y otro de presentación tardía (PT) ≥ 5 DTCS). Resultados En el análisis se incluyó a 7.915 pacientes con COVID-19, 2.324 en el grupo de PP y 5.591 en el de PT. Los DTCS hasta la hospitalización fueron un factor pronóstico independiente de mortalidad intrahospitalaria en el modelo de regresión de Cox multifactorial junto con otras nueve variables. Cada incremento en un DTCS supuso una reducción del riesgo de mortalidad del 4,3% (RRI = 0,957;IC 95%, 0,93-0,98). En cuanto a las variaciones de otros factores predictivos de la mortalidad en el análisis de sensibilidad, únicamente el índice de comorbilidad de Charlson siguió siendo significativo en el grupo de PP, mientras que únicamente el dímero D lo siguió siendo en el grupo de PT. Conclusiones Al atender a pacientes con COVID-19 hay que tener en cuenta los DTCS hasta la hospitalización porque la necesidad de hospitalización precoz confiere un mayor riesgo de mortalidad. Los diferentes factores pronósticos varían con el tiempo y deberían estudiarse dentro de un marco temporal fijo de la enfermedad.

Relationship between Krebs Von Den Lungen-6 (Kl-6) Levels and the Severity of Patients of a Post-Covid Multidisciplinary Unit

Aim: The aim of this study was to determine severity in patients who have had SARS-CoV2 pneumonia. Method(s): A cohort of 802 patients from our post-COVID multidisciplinary unit treated at least 30 days after being discharged from hospital was analyzed. Patients were divided into three groups: group 1 (admission to the Intensive Care Unit or Intermediate Respiratory Care Unit), group 2 (admission to conventional hospitalization), and group 3 (outpatient management without hospitalization). Symptoms, quality of life, daily physical activity, emotional state, biomarkers of systemic inflammation and KL-6 levels were evaluated. Result(s): A total of 802 patients with a median (interquartile range) age 59 (48-70 years) at diagnosis were reviewed, of whom 439 (54.8%) were women. Dyspnea was reported by 351 (66.%) patients and 142 (36.4%) had a grade more than 2 on the mMRC scale. Likewise, 106 (20.1%) presented dry cough and 233 (44.5%) asthenia. There were significant differences between groups 2 and 3 in: dyspnea (p=0.04), myalgia (p=0.04) and asthenia (p=0.01). Group 1 had a higher score in the TTO and VAS rates of the EuroQuoL scale compared to group 2. Finally, the KL6 levels in groups 1, 2 and 3 were: 381.50 (304 - 511.75) U/ml, 372 (249 - 483) U/ml and 298 (231.5 - 398) U/ml, respectively. Statistically significant differences were observed between the 3 groups (p=0.001) and in the post-hoc analysis, lower levels of KL-6 were observed in group 3 compared to the other two groups. Conclusion(s): There is evidence to affirm that KL6 levels in post-COVID patients are related to the severity of the acute episode.

Pulmonary telerehabilitation in patients with chronic respiratory diseases during the pandemic by COVID-19 in Argentina. A multicenter observational study

Introduction: To our knowledge, there are no published studies on the implementation and results of Pulmonary telerehabilitation (PTR) in Argentina. Our objective was to describe PTR strategies used during the COVID-19 pandemic, the results of the different PTR modalities and the patient satisfaction. Method(s): A prospective study was carried out between April and August 2020. Patients who switched to different PTR modalities participated: synchronous (SPTR) or asynchronous (APTR). The level of satisfaction, quality of life with the St. George's Respiratory Questionnaire (SGRQ) and anxiety and depression with the Hospital Anxiety and Depression Scale (HADS) at baseline, 6 and 12 weeks were evaluated. Result(s): 20 centers participated. 299 patients were included (55.9% female), with a median (P25-75) age of 68 (62- 72) years, 184/249 (73.9%) diagnosed with COPD, 37 (14.9%) interstitial lung diseases, 12 (4.8%) asthma and 16 (6.4%) other CRD. 110 (36.8%) patients underwent SPTR and 189 (63.2%) with APTR. No differences were observed in the SGRQ and HADS except in the activities subscale of the SGRQ that increased significantly (p<0.05) in both groups, the impact subscale and the total that increased significantly in the SPTR group at 12 weeks (p<0.01). Both groups reported being satisfied with the PTR, 5.9 (5.4-6.3) in SPTR and 5 (4.6-5.4) in APTR, being significantly higher in SPTR (p=0.004) Conclusion(s): We observed significant satisfaction with PRT during the pandemic. No improvements were seen in quality of life, anxiety, or depression.

Evolution of asthmatic patients at 6 and 12 months after acute COVID-19 recovery

Nowadays, beyond the acute phase of COVID-19, there is a growing interest in the clinical manifestations that appear after the recovery of this phase, giving the potential repercussions that this could have in the recovered population. Asthma is a prevalent disease, and it is possible that its pathogenic basis could affect the postCOVID-19 course. Objective(s): evaluate the evolution of asthmatic patients at 6 and 12 months after the recovery of COVID-19. Method(s): Data was collected through manual revision of electronic clinical histories. There were included as demographic features the age and sex, and comorbidities such as smoking habit, COPD, obesity (BMI > 30 Kg/m2), obstructive sleep apnea, gastroesophagic reflux, rinosinusitis, nasal poliposis, anxiety and depression. Patients were classified according to whether they had T2 asthma or not. There were considered previous pneumonia, need of conventional hospitalization or ICU. Symptoms (chest pain, cough, sputum production and dyspnoea) and the development of further complications were also recorded. Result(s): After analyzing the variables at 6 months after recovery, we found statistical significance in the presence of chest pain in patients with previous COVID-19 pneumonia (p=0.009). In the same period, lower eosinophil blood levels were found in patients that had dyspnoea (p=0.043). Additionally, there was a significant association between smoking habit and pulmonary embolism at 12 months after recovery (p=0.025). Conclusion(s): Developing COVID-19 associated pneumonia in asthmatic patients is related to the presence of chest pain at 6 months after recovery. Also, the smoking habit seems to be associated with thromboembolic disease in postCOVD-19 period.

Impact of days elapsed from the onset of symptoms to hospitalization in COVID-19 in-hospital mortality: time matters.

BACKGROUND: COVID-19 shows different clinical and pathophysiological stages over time. The effect of days elapsed from the onset of symptoms (DEOS) to hospitalization on COVID-19 prognostic factors remains uncertain. We analyzed the impact on mortality of DEOS to hospitalization and how other independent prognostic factors perform when taking this time elapsed into account. METHODS: This retrospective, nationwide cohort study, included patients with confirmed COVID-19 from February 20th and May 6th, 2020. The data was collected in a standardized online data capture registry. Univariate and multivariate COX-regression were performed in the general cohort and the final multivariate model was subjected to a sensitivity analysis in an early presenting (EP; <5 DEOS) and late presenting (LP; ≥5 DEOS) group. RESULTS: 7915 COVID-19 patients were included in the analysis, 2324 in the EP and 5591 in the LP group. DEOS to hospitalization was an independent prognostic factor of in-hospital mortality in the multivariate Cox regression model along with other 9 variables. Each DEOS increment accounted for a 4.3% mortality risk reduction (HR 0.957; 95% CI 0.93-0.98). Regarding variations in other mortality predictors in the sensitivity analysis, the Charlson Comorbidity Index only remained significant in the EP group while D-dimer only remained significant in the LP group. CONCLUSION: When caring for COVID-19 patients, DEOS to hospitalization should be considered as their need for early hospitalization confers a higher risk of mortality. Different prognostic factors vary over time and should be studied within a fixed timeframe of the disease.

Therapeutic scale stem cell-derived exosomes for COVID-19: Models—Validation, management, and strategies

COVID-19 has ravaged our planet, altering human behavior as we know it forever. The disease has raised challenges that have been met with supportive therapy, aggressive new drugs, antibody treatments, and rapid vaccine development. Even as the day-to-day obstacles in disease management are overcome, the long-term societal burden rests uneasily on us. This chapter addresses the origin of the disease and some of the cell-based therapies trialed as a solution to the multifaceted challenges. Derivation of cell-free methodology and how to facilitate the same in addressing current situation is also outlined. The technology and techniques mentioned here are constantly improving in efficiency and outcome. © 2022 Elsevier Inc. All rights reserved.

Functional foods and medicinal plants versus COVID-19

Introduction: The world has been suffering from the SARS-CoV-2 (COVID-19) pandemic since December 2019. To date there is no specific treatment for such a deadly disease, but there are some plants with different phytochemical components that help the body to combat and reduce the sequelae along with the other treatments. Objective: To identify foods and medicinal plants that could be useful in the prevention, treatment and recovery of patients with COVID-19. Methods: Theoretical methods and analysis, and interpretation of available information on foods and medicinal plants and their usefulness in COVID-19 were used. It was conducted a search that included more than 50 original, review and systematic review articles in Spanish, English and Portuguese. Results: The integrity of nutritional status contributes significantly to protecting people against contagion by different infectious agents and during convalescence associated with any type of inflammatory process, including infection by the SARS-CoV-2 virus. There are countless treatments for viruses that include natural products such as plants of different species with antiviral, anti-inflammatory, immunomodulatory, antioxidant and protective properties of cell membranes that have shown some effect on the viruses that cause respiratory infections. Conclusions: 11 medicinal plants with antiviral, immunomodulatory and anti-inflammatory effect are recognized. These actions were evaluated in preclinical and clinical studies. Of these, eight have in silico studies demonstrating their anti-SARS CoV2 action, nine have demonstrated immunomodulatory action, and all have anti-inflammatory action. Micronutrients present in functional foods play an important role in the immune system for the prevention, treatment and recovery of COVID-19 patients. © 2022, Editorial Ciencias Medicas. All rights reserved.

Functional foods and medicinal plants versus COVID-19

Introduction: The world has been suffering from the SARS-CoV-2 (COVID-19) pandemic since December 2019. To date there is no specific treatment for such a deadly disease, but there are some plants with different phytochemical components that help the body to combat and reduce the sequelae along with the other treatments.

Satisfaction Level of Engineering Students in Face-to-Face and Online Modalities under COVID-19-Case: School of Engineering of the University of Leon, Spain

University education in times of COVID-19 was forced to seek alternative teaching/learning methods to the traditional ones, having to abruptly migrate to the online modality, changes that have repercussions on student satisfaction. That is why this study aims to compare the level of student satisfaction in face-to-face and "forced" online modalities under COVID-19. A quantitative, cross-sectional methodology was applied to two groups of students: Under a face-to-face modality (n = 116) and under an online modality (n = 120), to which a questionnaire was applied under a Likert scale, with four dimensions: Course design structure, content, resources, and instructor. Non-parametric statistics, specifically the Mann-Whitney U-test, were used to compare the groups. The results showed that there are significant differences in the level of satisfaction of students in the face-to-face and online "forced" modalities (p = 0.01984 < 0.05), and the dimensions of the level of satisfaction that presented significant differences were course design structure (p = 0.04523 < 0.05) and content (p = 0.00841 < 0.05). The research shows that students in the face-to-face modality express a higher level of satisfaction, which is reflected in the dimension design structure of the course, specifically in its workload indicator, as well as in the dimension content, in its indicators, overlapping with other courses and materials.

[Impact of the alteration of the continuity of care in diabetes type 2 patients during the COVID-19 pandemic]. / Impacto de la alteración de la continuidad asistencial en los pacientes con diabetes tipo 2 durante la pandemia de COVID-19.

AIM: To assess the impact of the alteration of the continuity of care in patients with type 2 diabetes during the COVID-19 pandemic. MATERIAL AND METHOD: Follow-up study with 587 primary care patients with DM2, and control according to the redGDPS-2018 criteria in 2018 and 2020. Activities carried out and control status of patients were compared using statistical tests appropriate to type and distribution of each variable, for a significance level P≤.05. RESULTS: Sample was made up of 587 patients with glycosylated hemoglobin (A1c) in 2018 (54% men), age of 66±11, in range of 29-91 years. All the care indicators decreased in 2020: A1c was determined in 68% of patients (382/558 after 29 deaths); 59% remained with good control, 17% with poor control, 10% improved and 14% worsened (P<.001). Those who had ECG and retinography performed in 2018 and not in 2020 show a lower degree of worsening than those who did not have them done in 2018 but they did in 2020 (16% vs 25%, P<.001 and 13% vs 42%, P=.002). Those who decrease their visits to family doctor and nurse show less deterioration than those who increase them (14% vs 26%; P<.001 and 17% vs 23%; P<.001). CONCLUSIONS: Inattention impeded control of 32% of the patients. Poor control in 2020 was lower in those who were controlled in 2018, and who decreased their attendance at the health center in 2020. Possibly adequate pre-pandemic training in self-care has led to the empowerment of the patient during a pandemic period.

Concept and solution of digital twin based on a Stieltjes differential equation

We introduce the concept of a digital twin by using Stieltjes differential equations. A precise mathematical definition of solution to the problem is presented. We also analyze the existence and uniqueness of solutions, introduce the concept of main digital twin. As a particular case, the classical compartmental SIR (susceptible, infected, recovered) epidemic model is considered and we study the interrelation between the digital twin and the system. In doing so, we use Stieltjes derivatives to feed the data from the real system to the virtual model which, in return, improves it in real time. Numerical simulations with real data of the COVID-19 epidemic show the accuracy of the proposed ideas. © 2022 The Authors. Mathematical Methods in the Applied Sciences published by John Wiley & Sons, Ltd.

Remote Monitoring System for Covid-19 Patients in Home Isolation and Pilot Study Results in A High Altitude Population

A remote monitoring device for measuring oxygen saturation by finger pulse oximetry, axillary temperature and respiratory rate has been constructed. This device has been tested in a pilot study on patients with confirmed Covid-19, determined by antigen tests, who were undergoing home quarantine. The system uses a Raspberry pi CPU with a PiCamera attached to perform optical character recognition from the displays of low-cost finger pulse oximeters and digital axillary thermometers. The temperature of the finger being measured using pulse oximetry was also recorded, as an additional variable, using a thermistor in contact with the finger. In a pilot prototype validation study, undertaken in Peru with eleven patients, the average oxygen saturation of patients living at 3350 meters above sea level was 92.88%, with a standard deviation of 1.65%. A patient with moderate symptoms and a patient with a deteriorating condition had temporary saturation levels below 88%. Axillary temperature and respiratory rate did not vary considerably over the study period. Finger temperature data was used to determine correct human-computer interaction with respect to measurement errors, failed attempts and to control sampling efficiency, which can be affected by cold fingers. © 2021 IEEE.

Evaluation of Optimal Methylprednisolone Dose in Patients with Covid 19

Background. Optimal dose of methylprednisolone in patients with moderate or severe COVID-19 is unclear. In our hospital, the use of 250-500 mg/day of methylprednisolone was frequent in the first wave of the pandemic. Lower dose were recommended in our protocol since September 2020. The aim was to evaluate the impact of methylprednisolone dose in the outcome of patients with moderate or severe COVID-19. Methods. This is a retrospective and observational study. Inclusion criteria: SARS-CoV-2 infection diagnosed by PCR, admission to our hospital between March 2020 and February 2021, SatO2 < 94% or SatO2/FiO2 < 447. Two treatment groups were compared: patients treated with 0.5-1.5 mg/kg/day (group 1) and patients treated with more than 1.5 mg/kg/day (group 2). The primary outcome analyzed was orotracheal intubation (OTI) or death from any cause at 28 days after admission. Differences in demographic, clinical and laboratory characteristics between treatment groups were analyzed. Variables with P < 0.1 were included in a binary logistic regression model, calculating a propensity score for assigning each patient to group 1 treatment. Bivariate analysis was performed to identify variables associated with worst outcome. Finally, Cox regression was performed including treatment group, propensity score as covariate and all the variables with P< 0.05 in the bivariate analysis. Results. 285 patients were included, 197 in group 1 and 88 in group 2. The median age was 73 years, 52,3% were male. Mortality or OTI at 28 days was 24,9%. There was a higher proportion of patients in group 1 with COPD (9,6% vs 1.1%, P< 0.01), dyspnea (60.4% vs 45.5%, P=0.01), sepsis (22.8% vs 13.6%, P=0.07). Patients in group 2 had more impaired consciousness (18.2% vs 8.6%, P=0.02). The median of lymphocytes count was lower in group 1 (900 vs 1025, P=0.01). There were no differences in the primary outcome between treatment groups (26.1% in the group 2 vs 24.4% in the group 1, P=0.7). Conclusion. The use of high dose of methylprednisolone compared with intermediate dose is not associated with a better outcome in patients with moderate or severe COVID-19.

Identification and Characterization of Peruvian Native Bacterial Strains as Bioremediation of Hg-Polluted Water and Soils Due to Artisanal and Small-Scale Gold Mining in the Secocha Annex, Arequipa

The water and soils pollution due to mercury emissions from mining industries represents a serious environmental problem and continuous risk to human health. Although many strategies have been designed for the recovery or elimination of this metal from environmental sources, microbial bioremediation has proven to be the most effective and environmentally friendly strategy and thus control heavy metal contamination. The main objective of this work, using native bacterial strains obtained from contaminated soils of the Peruvian region of Secocha, was to identify which of these strains would have growth capacity on mercury substrates to evaluate their adsorption behavior and mercury removal capacity. Through a DNA analysis (99.78% similarity) and atomic absorption spectrometry, the Gram-positive bacterium Zhihengliuella alba sp. T2.2 was identified as the strain with the highest mercury removal capacity from culture solutions with an initial mercury concentration of 162 mg·L−1. The removal capacity reached values close to 39.5% in a period of incubation time of 45 days, with maximum elimination efficiency in the first 48 h. These results are encouraging and show that this native strain may be the key to the bioremediation of water and soils contaminated with mercury.

Predictive model to identify indexes by country that affect the mortality rate from COVID-19

The incursion of the coronavirus contagion phenomenon and its subsequent classification as a pandemic has been unforeseen and significantly impacts the indicators of all countries worldwide. The economic reports that measure the consequences of the measures of the different governments to reduce the rate of infections in the context of the pandemic, show a significant reduction in income and employment that ultimately results in a decrease in the quality of life of the population. In order to understand a little more the consequences that this situation of high uncertainty brings with it, this article presents the results of the construction of a predictive analysis based on neural networks by means of which 27653 data from the daily report of dates between the January 22 and July 10, 2020 and which were extracted from the coronanet project in which, through the interaction of indices by country, the order of importance of predictors of the virus mortality rate was identified. Among the results obtained, in addition to obtaining a model with a precision of 77.5%, it is highlighted that although the type of measure adopted by governments is an incident factor in the increase in mortality per country, they are specific characteristics such as the transparency index and the globalization index which allow a predictive analysis of mortality. © 2021, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.

The infinite extension: when will the legal effect of the Electronic administration in Spain?

This study analyzes the right of citizens to interact electronically with the Administration. For this, the applicable legislation is developed, and the various vicissitudes by which the entry into force of the Electronic Administration in Spain has been successively delayed by different extensions, and has not been implemented. One of the last extensions has been caused by the health crisis of COVID-19. With this, we will reflect on the current situation, as well as the consequences that said extension has in the field of citizen participation.

Referral Criteria for Asthma: An Updated Consensus

Asthma is one of the most prevalent chronic diseases in Spain. In 2019, the Spanish Society of Allergology and Clinical Immunology (SEAIC), the Spanish Society of Primary Care Physicians (SEMERGEN), the Spanish Society of Family and Community Medicine (semFYC), the Spanish Society of General and Family Physicians (SEMG) and the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) drafted a document laying down the criteria for referral and action guidelines in the diagnosis, control and monitoring of the asthmatic patient to facilitate ongoing care and improved attention in every setting. The new circumstances derived from the Covid-19 pandemic have demanded that some of the recommendations of the previous edition be updated and adapted to the new healthcare situation. © 2021 Sociedad Española de Neumología y Cirugía Torácica (SEPAR)