Evaluation of real-world mepolizumab use in severe asthma across Europe: the SHARP experience with privacy-preserving federated analysis.

Background: An objective of the Severe Heterogeneous Asthma Registry, Patient-centered (SHARP) is to produce real-world evidence on a pan-European scale by linking nonstandardised, patient-level registry data. Mepolizumab has shown clinical efficacy in randomised controlled trials and prospective real-world studies and could therefore serve as a proof of principle for this novel approach. The aim of the present study was to harmonise data from 10 national severe asthma registries and characterise patients receiving mepolizumab, assess its effectiveness on annual exacerbations and maintenance oral glucocorticoid (OCS) use, and evaluate treatment patterns. Methods: In this observational cohort study, registry data (5871 patients) were extracted for harmonisation. Where harmonisation was possible, patients who initiated mepolizumab between 1 January 2016 and 31 December 2021 were examined. Changes of a 12-month (range 11-18 months) period in frequent (two or more) exacerbations, maintenance OCS use and dose were analysed in a privacy-preserving manner using meta-analysis of generalised estimating equation parameters. Periods before and during the coronavirus disease 2019 pandemic were analysed separately. Results: In 912 patients who fulfilled selection criteria, mepolizumab significantly reduced frequent exacerbations (OR 0.18, 95% CI 0.13-0.25), maintenance OCS use (OR 0.75, 95% CI 0.61-0.92) and dose (mean -3.93 mg·day-1, 95% CI -5.24-2.62 mg·day-1) in the pre-pandemic group, with similar trends in the pandemic group. Marked heterogeneity was observed between registries in patient characteristics and mepolizumab treatment patterns. Conclusions: By harmonising patient-level registry data and applying federated analysis, SHARP demonstrated the real-world effectiveness of mepolizumab on asthma exacerbations and maintenance OCS use in severe asthma patients across Europe, consistent with previous evidence. This paves the way for future pan-European real-world severe asthma studies using patient-level data in a privacy-proof manner.

Viruses responsible for acute respiratory infections before (2016-2019) and during (2021) circulation of the SARS-CoV-2 virus in pediatric patients in a reference center at Barranquilla Colombia: A pattern analysis.

OBJECTIVE: To evaluate the behavior of the viruses responsible for acute respiratory infections before (2016-2019) and after (2020-2021) the start of the circulation of the SARS-CoV-2 virus in pediatric patients treated at a reference center from Barranquilla, Colombia. MATERIALS AND METHODS: A descriptive observational study was carried out, and data were obtained by reviewing the influenza-like illness and severe acute respiratory infection database in the pediatric population of the sentinel surveillance reference center in the district of Barranquilla during the years 2016-2021, applying inclusion and exclusion criteria. RESULTS: During 2016-2019, the average age of individuals was 1.3 (±1.7) years, during 2021, it was 2.3 (±3.5) years. The distribution by sex was similar, predominantly male. August and February were the months with the highest record of symptoms for 2016-2019 and 2021, respectively, the most frequent being cough, fever, shortness of breath, and diarrhea. By 2021 there was a higher use of antibiotics and antivirals reported than in 2016-2019. Most patients tested negative for viral detection. When comparing the percentage of viruses detected by age group and years of detection, positivity was lower in 2021 by every age group, and respiratory syncytial virus (RSV) was the most frequently detected. CONCLUSIONS: There was less virus positivity in viral detection tests in the pediatric population in 2021. RSV persists as the main etiology affecting this population, especially infants. The use of antibiotic therapy in viral infections continues to be a problematic practice in their management. Sentinel surveillance can be strengthened throughout the country.

Diabetes medications and associations with Covid-19 outcomes in the N3C database: A national retrospective cohort study.

BACKGROUND: While vaccination is the most important way to combat the SARS-CoV-2 pandemic, there may still be a need for early outpatient treatment that is safe, inexpensive, and currently widely available in parts of the world that do not have access to the vaccine. There are in-silico, in-vitro, and in-tissue data suggesting that metformin inhibits the viral life cycle, as well as observational data suggesting that metformin use before infection with SARS-CoV2 is associated with less severe COVID-19. Previous observational analyses from single-center cohorts have been limited by size. METHODS: Conducted a retrospective cohort analysis in adults with type 2 diabetes (T2DM) for associations between metformin use and COVID-19 outcomes with an active comparator design of prevalent users of therapeutically equivalent diabetes monotherapy: metformin versus dipeptidyl-peptidase-4-inhibitors (DPP4i) and sulfonylureas (SU). This took place in the National COVID Cohort Collaborative (N3C) longitudinal U.S. cohort of adults with +SARS-CoV-2 result between January 1 2020 to June 1 2021. Findings included hospitalization or ventilation or mortality from COVID-19. Back pain was assessed as a negative control outcome. RESULTS: 6,626 adults with T2DM and +SARS-CoV-2 from 36 sites. Mean age was 60.7 +/- 12.0 years; 48.7% male; 56.7% White, 21.9% Black, 3.5% Asian, and 16.7% Latinx. Mean BMI was 34.1 +/- 7.8kg/m2. Overall 14.5% of the sample was hospitalized; 1.5% received mechanical ventilation; and 1.8% died. In adjusted outcomes, compared to DPP4i, metformin had non-significant associations with reduced need for ventilation (RR 0.68, 0.32-1.44), and mortality (RR 0.82, 0.41-1.64). Compared to SU, metformin was associated with a lower risk of ventilation (RR 0.5, 95% CI 0.28-0.98, p = 0.044) and mortality (RR 0.56, 95%CI 0.33-0.97, p = 0.037). There was no difference in unadjusted or adjusted results of the negative control. CONCLUSIONS: There were clinically significant associations between metformin use and less severe COVID-19 compared to SU, but not compared to DPP4i. New-user studies and randomized trials are needed to assess early outpatient treatment and post-exposure prophylaxis with therapeutics that are safe in adults, children, pregnancy and available worldwide.

Challenges and Opportunities Post Pandemic of Organizational Ergonomics to Promote the Social Sustainability in Cultural and Creative Industries: A Critical Review and Future Research Agenda

As background, the COVID pandemic affected the competitiveness and sustainability of cultural and creative industries around the world. In particular, social sustainability must be promoted in a formal framework, namely, an organizational ergonomics framework. However, there are not enough results and findings in the literature in this regard. This article shows a critical review of the literature related to the problem mentioned, intending to determine the opportunities, challenges, and controvertible aspects that could support development of the cultural and creative industries. As result, the main challenges are (1) the lack of reference frameworks and informality, (2) comparative understaffing, and (3) the strengthening of the value and supply chains. The opportunities are (1) cultural and creative industries as a new key element of strategic development for regional competitiveness, (2) cohesion and social belonging, and (3) the diversity of cultural and creative expressions. Finally, regarding the application of organizational ergonomics in the cultural and creative Industries to promote social sustainability, the theoretical and practical implications, managerial implications, and future research lines are discussed. In addition, the limitations of the research are explained, clarifying that the results generated are not conclusive, but rather that they establish a starting point for research, development, and innovation (R + D + i) in support of the orange economy.

Non-invasive oxygen therapy in patients with COVID-19: wu ji bi fan: too much of something is not good

In clinical practice, oxygen can save lives, although, wu ji bi fan: too much of something is not good and it can also cause toxicity;14% of patients with coronavirus disease 2019 (COVID-19) will need non-invasive oxygen therapy and approximately 5% will require invasive mechanical ventilation (IMV). Noninvasive oxygen therapy is the first-line treatment for patients with hypoxemic acute respiratory failure secondary to COVID-19. The devices through which this therapy is administered can be classified into low flow and high flow. In the presence of acute hypoxemic respiratory failure, the necessary flow can be 30 to 120 L/min, a number that cannot be achieved with conventional systems (low flow), therefore, high-flow devices can be effective in well-selected patients, the aim is to improve oxygenation, avoid orotracheal intubation of the patient, but without delaying it. Noninvasive oxygen therapy does not increase the risk of aerosol infection. (English) [ FROM AUTHOR]

High baseline expression of IL-6 and IL-10 decreased CCR7 B cells in individuals with previous SARS-CoV-2 infection during BNT162b2 vaccination.

The current pandemic generated by SARS-CoV-2 has led to mass vaccination with different biologics that have shown wide variations among human populations according to the origin and formulation of the vaccine. Studies evaluating the response in individuals with a natural infection before vaccination have been limited to antibody titer analysis and evaluating a few humoral and cellular response markers, showing a more rapid and intense humoral response than individuals without prior infection. However, the basis of these differences has not been explored in depth. In the present work, we analyzed a group of pro and anti-inflammatory cytokines, antibody titers, and cell populations in peripheral blood of individuals with previous SARS-CoV-2 infection using BNT162b2 biologic. Our results suggest that higher antibody concentration in individuals with an earlier disease could be generated by higher production of plasma cells to the detriment of the presence of memory B cells in the bloodstream, which could be related to the high baseline expression of cytokines (IL-6 and IL-10) before vaccination.

Ergonomic Factors That Impact Job Satisfaction and Occupational Health during the SARS-CoV-2 Pandemic Based on a Structural Equation Model: A Cross-Sectional Exploratory Analysis of University Workers.

This paper presents a structural equation model to determine the job satisfaction and occupational health impacts concerning organizational and physical ergonomics, using (as a study) objective unionized workers from the University of Sonora, South Campus, as an educational enterprise, during the SARS-CoV-2 pandemic. The above is a key element of an organizational sustainability framework. In fact, there exists a knowledge gap about the relationship between diverse ergonomic factors, job satisfaction, and occupational health, in the educational institution's context. The method used was a stratified sample of workers to which a job satisfaction-occupational health questionnaire was applied, consisting of 31 items with three-dimensional variables. As a result, the overall Cronbach's Alpha coefficient was determined, 0.9028, which is considered adequate to guarantee reliability (i.e., very high magnitude). Therefore, after the structural equation model, only 12 items presented a strong correlation, with a good model fit of 0.036 based on the root mean square error of approximation, 1.09 degrees of freedom for the chi-square, 0.9 for the goodness of fit index, and a confidence level of 95%. Organizational and physical factors have positive impacts on job satisfaction with factor loads of 0.37 and 0.53, respectively, and p-values of 0.016 and 0.000, respectively. The constructs related to occupational health that are considered less important by the workers were also determined, which would imply a mitigation strategy. The results contribute to the body of knowledge concerning the ergonomic dimensions mentioned and support organizational sustainability improvements in educational institutions and other sectors.

Identification of Novel Potential Heparanase Inhibitors Using Virtual Screening

Heparanase (HPSE) is a mammalian endo-β-D-glucuronidase that cleaves heparan sulphate (HS) side chains of heparin sulphate proteoglycans (HSPG), a class of molecules composed of repeating polysulfated disaccharide units of glucosamine and hexuronic acid residues. HPSE controls the availability of growth factors, chemokines, lipoproteins and other bioactive molecules by degrading HS into smaller fractions, allowing the release of saccharide fragments that activate a plethora of signaling processes. HPSE overexpression has been correlated with tumor survival and metastasis as well as several diseases associated with chronic inflammation, including the ongoing COVID-19 pandemic caused by SARS-CoV-2. Thus, the search for molecules that could potentially inhibit HPSE has become increasingly relevant in the clinic. In this study, we have integrated a strategy that combines virtual screening and molecular docking of publicly available chemical databases to identify small compounds that can be developed into novel HPSE inhibitors. Structural rationalization of the interactions previously reported compounds led us to identify promising unexplored chemotypes. Here we show that these novel potential HPSE inhibitors present optimized in silico druggability and docking properties and may serve as pharmacological tools for the treatment of chronic and infectious diseases associated with chronic inflammation.

Comparing body mass index and obesity-related comorbidities as predictors in hospitalized COVID-19 patients.

The association between body mass index (BMI) and poor COVID-19 outcomes in patients has been demonstrated across numerous studies. However, obesity-related comorbidities have also been shown to be associated with poor outcomes. The purpose of this study was to determine whether BMI or obesity-associated comorbidities contribute to elevated COVID-19 severity in non-elderly, hospitalized patients with elevated BMI (≥25 kg/m2 ). This was a single-center, retrospective cohort study of 526 hospitalized, non-elderly adult (aged 18-64) COVID-19 patients with BMI ≥25 kg/m2 in suburban New York from March 6 to May 11, 2020. The Edmonton Obesity Staging System (EOSS) was used to quantify the severity of obesity-related comorbidities. EOSS was compared with BMI in multivariable regression analyses to predict COVID-19 outcomes. We found that higher EOSS scores were associated with poor outcomes after demographic adjustment, unlike BMI. Specifically, patients with increased EOSS scores had increased odds of acute kidney injury (adjusted odds ratio [aOR] = 6.40; 95% CI 3.71-11.05), intensive care unit admission (aOR = 10.71; 95% CI 3.23-35.51), mechanical ventilation (aOR = 3.10; 95% CI 2.01-4.78) and mortality (aOR = 5.05; 95% CI 1.83-13.90). Obesity-related comorbidity burden as determined by EOSS was a better predictor of poor COVID-19 outcomes relative to BMI, suggesting that comorbidity burden may be driving risk in those hospitalized with elevated BMI.

Glycemic Control and Clinical Outcomes in U.S. Patients With COVID-19: Data From the National COVID Cohort Collaborative (N3C) Database.

OBJECTIVE: The purpose of the study is to evaluate the relationship between HbA1c and severity of coronavirus disease 2019 (COVID-19) outcomes in patients with type 2 diabetes (T2D) with acute COVID-19 infection. RESEARCH DESIGN AND METHODS: We conducted a retrospective study using observational data from the National COVID Cohort Collaborative (N3C), a longitudinal, multicenter U.S. cohort of patients with COVID-19 infection. Patients were ≥18 years old with T2D and confirmed COVID-19 infection by laboratory testing or diagnosis code. The primary outcome was 30-day mortality following the date of COVID-19 diagnosis. Secondary outcomes included need for invasive ventilation or extracorporeal membrane oxygenation (ECMO), hospitalization within 7 days before or 30 days after COVID-19 diagnosis, and length of stay (LOS) for patients who were hospitalized. RESULTS: The study included 39,616 patients (50.9% female, 55.4% White, 26.4% Black or African American, and 16.1% Hispanic or Latino, with mean ± SD age 62.1 ± 13.9 years and mean ± SD HbA1c 7.6% ± 2.0). There was an increasing risk of hospitalization with incrementally higher HbA1c levels, but risk of death plateaued at HbA1c >8%, and risk of invasive ventilation or ECMO plateaued >9%. There was no significant difference in LOS across HbA1c levels. CONCLUSIONS: In a large, multicenter cohort of patients in the U.S. with T2D and COVID-19 infection, risk of hospitalization increased with incrementally higher HbA1c levels. Risk of death and invasive ventilation also increased but plateaued at different levels of glycemic control.

Nosocomial Transmission of SARS-CoV-2 Involving Vaccinated Health Care Workers.

COVID-19 vaccination has proven to be effective at preventing symptomatic disease but there are scarce data to fully understand whether vaccinated individuals can still behave as SARS-CoV-2 transmission vectors. Based on viral genome sequencing and detailed epidemiological interviews, we report a nosocomial transmission event involving two vaccinated health care-workers (HCWs) and four patients, one of them with fatal outcome. Strict transmission control measures, as during the prevaccination period, must be kept between HCWs and HCWs-patients in nosocomial settings. IMPORTANCE COVID-19 vaccination has proven to be effective at preventing symptomatic disease. Although some transmission events involving vaccinated cases have also been reported, scarce information is still available to fully understand whether vaccinated individuals may still behave as vectors in SARS-CoV-2 transmission events. Here, we report a SARS-CoV-2 nosocomial transmission event, supported on whole genome sequencing, in early March 2021 involving two vaccinated HCWs and four patients in our institution. Strict transmission control measures between HCWs and HCWs - patients in nosocomial settings must not be relaxed, and should be kept as strictly as during the prevaccination period.

Factores relacionados con la neumonía bacteriana en pacientes con COVID-19 en una unidad de cuidados intensivos de Barranquilla, Colombia Factors related to bacterial pneumonia in patients with COVID-19 in an intensive care unit in Barranquilla, Colombia

Objetivo: Determinar los factores relacionados con la neumonía bacteriana en pacientes con COVID-19 en una Unidad de Cuidados Intensivos de Barranquilla, Colombia. Diseño: Estudio de casos y controles anidado, unicéntrico, realizado entre marzo y agosto del 2020. Pacientes: Pacientes mayores de 18 años, una estancia hospitalaria mayor a 72 horas, soporte de ventilación mecánica invasiva admitidos en la Unidad de Cuidados Intensivos. Intervenciones: Ninguna. Mediciones: Se agruparon variables clínicas tanto para casos y controles. Se calcularon medias y desviación estándar en variables cuantitativas y proporciones en variables categóricas. Para evaluar las diferencias entre proporciones se usó la prueba exacta de Fisher y para las diferencias de medias se usó la prueba de U Mann Whitney. Las variables con diferencia estadísticamente significativa se corrieron en un modelo explicativo basado en regresión logística binaria. Resultados: La frecuencia de neumonía bacteriana fue del 10,07% encontrando un elevado consumo de terapia antibiótica empírica. Se encontró asociación estadística entre el tiempo de uso de dexametasona (OR = 1.520 IC 95% 1.131 – 2.042) con el desarrollo de neumonía bacteriana. El resto de variables no resultaron estadísticamente significativas tras ajustar el modelo con regresión logística. Conclusión: Se encontraron tasas bajas de neumonía bacteriana predominando la Klebsiella pneumoniae como la bacteria más frecuente. El uso excesivo de dexametasona en pacientes con COVID-19 en UCI podría aumentar el riesgo de neumonía bacteriana. Por este motivo, debe evaluarse con mayor profundidad para explicar causalidad y efecto.

Factores relacionados con la neumonía bacteriana en pacientes con COVID-19 en una unidad de cuidados intensivos de Barranquilla, Colombia

Resumen Objetivo: Determinar los factores relacionados con la neumonía bacteriana en pacientes con COVID-19 en una Unidad de Cuidados Intensivos de Barranquilla, Colombia. Diseño: Estudio de casos y controles anidado, unicéntrico, realizado entre marzo y agosto del 2020. Pacientes: Pacientes mayores de 18 años, una estancia hospitalaria mayor a 72 horas, soporte de ventilación mecánica invasiva admitidos en la Unidad de Cuidados Intensivos. Intervenciones: Ninguna. Mediciones: Se agruparon variables clínicas tanto para casos y controles. Se calcularon medias y desviación estándar en variables cuantitativas y proporciones en variables categóricas. Para evaluar las diferencias entre proporciones se usó la prueba exacta de Fisher y para las diferencias de medias se usó la prueba de U Mann Whitney. Las variables con diferencia estadísticamente significativa se corrieron en un modelo explicativo basado en regresión logística binaria. Resultados: La frecuencia de neumonía bacteriana fue del 10,07% encontrando un elevado consumo de terapia antibiótica empírica. Se encontró asociación estadística entre el tiempo de uso de dexametasona (OR = 1.520 IC 95% 1.131 – 2.042) con el desarrollo de neumonía bacteriana. El resto de variables no resultaron estadísticamente significativas tras ajustar el modelo con regresión logística. Conclusión: Se encontraron tasas bajas de neumonía bacteriana predominando la Klebsiella pneumoniae como la bacteria más frecuente. El uso excesivo de dexametasona en pacientes con COVID-19 en UCI podría aumentar el riesgo de neumonía bacteriana. Por este motivo, debe evaluarse con mayor profundidad para explicar causalidad y efecto. Objective: To determine the factors related to bacterial pneumonia in patients with COVID-19 in an Intensive Care Unit in Barranquilla, Colombia. Design: Nested, single-center case-control study, conducted between March and August 2020. Patients: Patients over 18 years of age, a hospital stay greater than 72 hours, with invasive mechanical ventilation support admitted to the Intensive Care Unit. Interventions: None. Measurements: Clinical variables were grouped for both cases and controls. Means and standard deviation were calculated in quantitative variables and proportions in categorical variables. Fisher's exact test was used to evaluate the differences between proportions, and the Mann Whitney U test was used for differences in means. Variables with statistically significant differences were run in an explanatory model based on binary logistic regression. Results: The frequency of bacterial pneumonia was 10,07%, finding a high consumption of empirical antibiotic therapy. A statistical association was found between the time of dexamethasone use (OR = 1,520 95% CI 1,131 - 2,042) with the development of bacterial pneumonia. The rest of the variables were not statistically significant after adjusting the model with logistic regression. Conclusion: Low rates of bacterial pneumonia were found, with Klebsiella pneumoniae prevailing as the most frequent bacterium. Overuse of dexamethasone in ICU COVID-19 patients could increase the risk of bacterial pneumonia. For this reason, it must be evaluated in greater depth to explain causality and effect.

SARS-CoV-2 B.1.1.7 Decline Is Not Driven by the Introduction of a More Successful Variant.

The SARS-CoV-2 variant of concern (VOC) Delta (B.617.2 lineage) displaced the predominant VOC Alpha (B.1.1.7 lineage) in the United Kingdom. In Madrid, recent start of the decline of predominant VOC Alpha suggested an equivalent phenomenon. However, 11 different variants, none overrepresented in frequency, occupied progressively over a period of 7 weeks the niche previously dominated by VOC Alpha. Only after these 7 weeks, VOC Delta started to emerge. Viral competition due to the entry of VOC Delta is not the major force driving the start of VOC Alpha decline in Madrid. IMPORTANCE Our data indicate that the dynamics of SARS-CoV-2 VOCs turnover in our setting differ from those proposed for other countries. A systematic genomic analysis, updated on a weekly basis, of representative randomly selected samples of SARS-CoV-2 circulating variants allowed us to define a lapse of 7 weeks between the start of VOC Alpha decline and the final emergence of VOC Delta. During this period, VOC Alpha showed a sustained decline, while 11 VOCs, variants of interest (VOIs), and other identified variants, none overrepresented, occupied the niche left by VOC Alpha. Only after these 7 weeks, emergence of VOC Delta occurred, indicating that viral competition involving VOC Delta was not the exclusive direct driving force behind the starting of VOC Alpha decline.

Anxiety and Perceived Risk in Red Cross Volunteer Personnel Facing the Coronavirus Disease 2019 Pandemic.

In the current situation of sanitary emergencies, humanitarian organizations and their volunteers are playing an important role in the coronavirus disease 2019 (COVID-19) pandemic. A study is proposed that includes a network of volunteers who perform humanitarian activities during the COVID-19 pandemic to assess anxiety, perceived risk, and response behaviors and to explore their relationship with sociodemographic variables. For data collection, an online questionnaire was developed through the Google Forms® platform, where the perceived risk, anxiety, and behavioral responses of the general population to the Influenza A (H1N1) pandemic were assessed. The survey presented is a modified version of that survey adapted for COVID-19. This adaptation was endorsed by an experts committee made up of the health chief of the Ecuadorian Red Cross, the focus point of operations from the International Federation of the Red Cross in Ecuador, and a member from the Health Unit of the Americas Regional Office of the International Federation of the Red Cross. A significant relationship has been shown between the job situation and perceived risk and anxiety, being the staff who worked full time away from home, which was exposed to greater risk and anxiety. Both perceived risk and perceived anxiety are very high (according to a 5-point Likert scale). Knowing these data from this first-line personnel will allow adopting measures that could be beneficial for stress management and, therefore, contribute to the well-being and support of these humanitarian and volunteer organizations in the worldwide response to COVID-1 9.

Toward Non-Invasive Estimation of Blood Glucose Concentration: A Comparative Performance

The present study comprises a comparison of the Mel Frequency Cepstral Coefficients (MFCC), Principal Component Analysis (PCA) and Independent Component Analysis (ICA) as feature extraction methods using ten different regression algorithms (AdaBoost, Bayesian Ridge, Decision Tree, Elastic Net, k-NN, Linear Regression, MLP, Random Forest, Ridge Regression and Support Vector Regression) to quantify the blood glucose concentration. A total of 122 participants—healthy and diagnosed with type 2 diabetes—were invited to be part of this study. The entire set of participants was divided into two partitions: a training subset of 72 participants, which was intended for model selection, and a validation subset comprising the remaining 50 participants, to test the selected model. A 3D-printed chamber for providing a light-controlled environment and a low-cost microcontroller unit were used to acquire optical measurements. The MFCC, PCA and ICA were calculated by an open-hardware computing platform. The glucose levels estimated by the system were compared to actual glucose concentrations measured by venipuncture in a laboratory test, using the mean absolute error, the mean absolute percentage error and the Clarke error grid for this purpose. The best results were obtained for MCCF with AdaBoost and Random Forest (MAE = 11.6 for both).

European knowledge alliance for innovative measures in prevention of work-related musculoskeletal pain disorders (Prevent4Work Project): protocol for an international mixed-methods longitudinal study.

INTRODUCTION: Work-related musculoskeletal (MSK) pain is a highly prevalent condition and one of the main contributors to disability and loss of work capacity. Current approaches to the management and prevention of work-related MSK pain do not consistently integrate current evidence-based knowledge and seem to be outdated. The Prevent4Work (P4W) Project aims to collect and spread evidence-based information to improve the management and prevention of work-related MSK pain. P4W will longitudinally investigate (1) risk factors associated with the prevalence of work-related MSK pain, (2) predictive factors for new events of work-related MSK pain in the short term and (3) the modification of pain beliefs after participating in evidence-based e-learning courses. METHODS AND ANALYSIS: This project employs a mixed-methods design with international cohorts of workers from Spain, Italy and Denmark. All participants will be assessed using self-reported variables at baseline (ie, cross-sectional design) with follow-up after 3 and 6 months (ie, prospective-predictive design). Throughout the first phase (0-3 months), all participants will be offered to self-enrol in e-learning courses on work-related MSK pain. Changes in pain beliefs (if any) will be assessed. The dataset will include sociodemographic characteristics, physical and psychological job demands, lifestyle-related factors, MSK pain history and pain beliefs. At baseline, all participants will additionally complete the P4W questionnaire developed to detect populations at high risk of suffering work-related MSK pain.Descriptive statistics, binary logistic regression, and analysis of variance will be used to identify the significant factors that influence the history of work-related MSK pain, evaluate the short-term prediction capacity of the P4W questionnaire, and investigate whether workers' participation in e-learning courses will modify their pain beliefs. ETHICS AND DISSEMINATION: The study received ethical approval from the Ethical Committee of San Jorge University (USJ011-19/20). The results will be made available via peer-reviewed publications, international conferences and P4W official channels.

Disability-Adjusted Life Years for the COVID-19 Pandemic in the Mexican Population.

Mexico is one of the countries most affected by the COVID-19 disease. Although there is vast information on the disease, there still are unknown data on the societal and economic cost of the pandemic. To estimate this impact, the disability-adjusted life years (DALYs) can be a useful tool. Objective: To assess the DALYs due to COVID-19 in Mexico. Methods: We used the data released by the Mexican Ministry of Health to estimate the DALYs by the sum of the years of life lived with disability (YLDs) and the years of life lost (YLLs). Results: A total of 1,152,885 confirmed cases and 324,570 suspected cases of COVID-19 have been registered. Half of the cases were men, with a median age of 43.4 ± 16.9 years. About 8.3% died. A total of 39,202 YLDs were attributable to COVID-19. The total YLLs caused by COVID-19 were 2,126,222. A total of 2,165,424.5 DALYs for COVID-19 were estimated. The total DALYs were the highest in people between 50 and 59 years. The DALYs for each COVID-19 case were the highest in individuals between 60 and 79 years. Conclusion: The DALYs generated by the COVID-19 represent a more significant disease burden than that reported for other causes, such as the 2009 H1N1 influenza pandemic. Although it impacts all age groups in terms of disability, the most affected group are people over 50 years of age, whose risk of death is higher.