Entrepreneurship innovation using social robots in tourism: a social listening study

The tourism sector has been one of the most impacted by the COVID-19 pandemic, due to restrictions on mobility and fear of social contact. In this context, business innovation through digital transformation is presented as a great opportunity for the tourism industry and the inclusion of social robots in service tasks is an example. This transformation requires new methodologies, skills and talent that must be promoted to improve the innovative tourism ecosystem. With this research, we try to determine how the inclusion of social or service robots in hotels can improve the image and perception held by clients or guests. For that, we first analyse the degree of knowledge and sentiment generated by social robots through a social listening study in social networks. In addition, we determine whether these perceptions on the subject are in tune with other more formal fields, such as scientific research, or with the strategies followed at a national or international level by companies, agencies and organisations related to the technology and innovation of social robotics. For both objectives, we use the Simbiu social listening tool, a software-based program on Talkwalker, and we obtain interesting results. Basically, people on Twitter have a neutral or positive feeling about the use of social robots, and people who write in English have a more positive attitude towards social robots than Spanish speakers. After COVID-19, are necessary changes in strategic decisions of the hospitality and it is essential to continue investigating the role of social robots in this new context.

Multi-Illumination Single-Holographic-Exposure Lensless Fresnel (MISHELF) Microscopy: Principles and Biomedical Applications.

Lensless holographic microscopy (LHM) comes out as a promising label-free technique since it supplies high-quality imaging and adaptive magnification in a lens-free, compact and cost-effective way. Compact sizes and reduced prices of LHMs make them a perfect instrument for point-of-care diagnosis and increase their usability in limited-resource laboratories, remote areas, and poor countries. LHM can provide excellent intensity and phase imaging when the twin image is removed. In that sense, multi-illumination single-holographic-exposure lensless Fresnel (MISHELF) microscopy appears as a single-shot and phase-retrieved imaging technique employing multiple illumination/detection channels and a fast-iterative phase-retrieval algorithm. In this contribution, we review MISHELF microscopy through the description of the principles, the analysis of the performance, the presentation of the microscope prototypes and the inclusion of the main biomedical applications reported so far.

Carbapenemase-Producing Klebsiella pneumoniae in COVID-19 Intensive Care Patients: Identification of IncL-VIM-1 Plasmid in Previously Non-Predominant Sequence Types.

During the COVID-19 pandemic, intensive care units (ICUs) operated at or above capacity, and the number of ICU patients coinfected by nosocomial microorganisms increased. Here, we characterize the population structure and resistance mechanisms of carbapenemase-producing Klebsiella pneumoniae (CP-Kpn) from COVID-19 ICU patients and compare them to pre-pandemic populations of CP-Kpn. We analyzed 84 CP-Kpn isolates obtained during the pandemic and 74 CP-Kpn isolates obtained during the pre-pandemic period (2019) by whole genome sequencing, core genome multilocus sequence typing, plasmid reconstruction, and antibiotic susceptibility tests. More CP-Kpn COVID-19 isolates produced OXA-48 (60/84, 71.4%) and VIM-1 (18/84, 21.4%) than KPC (8/84, 9.5%). Fewer pre-pandemic CP-Kpn isolates produced VIM-1 (7/74, 9.5%). Cefiderocol (97.3-100%) and plazomicin (97.5-100%) had the highest antibiotic activity against pandemic and pre-pandemic isolates. Sequence type 307 (ST307) was the most widely distributed ST in both groups. VIM-1-producing isolates belonging to ST307, ST17, ST321 and ST485, (STs infrequently associated to VIM-1) were detected during the COVID-19 period. Class 1 integron Int1-blaVIM-1-aac(6')-1b-dfrB1-aadAI-catB2-qacEΔ1/sul1, found on an IncL plasmid of approximately 70,000 bp, carried blaVIM-1 in ST307, ST17, ST485, and ST321 isolates. Thus, CP-Kpn populations from pandemic and pre-pandemic periods have similarities. However, VIM-1 isolates associated with atypical STs increased during the pandemic, which warrants additional monitoring and surveillance.

Sports entrepreneurship during COVID-19: Technology as an ally to maintain the competitiveness of small businesses.

The sports sector, specifically the field of personal trainer entrepreneurship, has been severely affected by the COVID-19 crisis. However, there are still few empirical studies that analyze how the actions taken before and during this crisis can affect sports entrepreneurs' performance. This research aims to analyze which combinations of sports entrepreneurs' personal characteristics and actions performed have been most and least effective in minimizing the negative impact of COVID-19 on their businesses. A validated online questionnaire was administered to personal trainer entrepreneurs from May to June 2020 before they reopened their facilities. Fuzzy-set qualitative comparative analysis (fsQCA) was performed to assess the impacts. The results show that both post-COVID measures (adaptation of the business model) and previous strategic orientation seemed essential. Specifically, high levels of sports entrepreneurs' resilience and innovation/R&D when competing against their closest competitors before the COVID-19 pandemic and the increased use of technologies (sports services digitization) during the pandemic have been essential to maintaining the performance of the sports business. Thus, improvements in the digital competencies of personal trainers' sports entrepreneurs, the development of strategic plans and activities related to innovation/R&D and process improvements are important measures to maintain the competitiveness of small sports businesses during crises.

Outpatient surveillance programme for health workers with COVID 19 in Mexico: an observational study of ambulatory treatment and early hospitalization.

Introduction: International guidelines recommend hospital care for patients with severe Coronavirus disease (COVID-19), but fragile health care systems struggle to cope with high number of admissions, placing patients at risk of receiving substandard care. We describe an outpatient ambulatory surveillance and treatment strategy (OPAT) for health care workers (HCWs) with severe COVID-19 during low hospital bed availability periods in Mexico City. Methods: In this observational, descriptive, retrospective study, we included HCWs with severe disease for whom there were no hospital beds available at the time of evaluation. We provided daily assessments by infectious disease specialists, daily ambulatory steroid, oral thromboprophylaxis and domiciliary low-dose oxygen. We recorded the number of patients who recovered, were hospitalized or died on follow-up. Results: From 18 March 2020 to 16 July 2021, 1739 HCWs attended our service. A total of 540 were diagnosed with COVID-19. Seventy-four had severe COVID-19 and needed hospitalization. Immediate hospitalization was not possible in 56 patients who were sent to the OPAT and included in our study. Twenty-four patients subsequently required hospitalization and 32 recovered as outpatients. Conclusions: We describe a feasible and safe outpatient management strategy for HCWs with severe COVID-19 in a low-resource setting.

Risk of Pulmonary Fibrosis and Persistent Symptoms Post-COVID-19 in a Cohort of Outpatient Health Workers.

BACKGROUND: Infection by SARS-CoV-2 has been associated with multiple symptoms; however, still, little is known about persistent symptoms and their probable association with the risk of developing pulmonary fibrosis in patients post-COVID-19. METHODS: A longitudinal prospective study on health workers infected by SARS-CoV-2 was conducted. In this work, signs and symptoms were recorded of 149 health workers with a positive PCR test for SARS-CoV-2 at the beginning of the diagnosis, during the active infection, and during post-COVID-19 follow-up. The McNemar chi-square test was used to compare the proportions and percentages of symptoms between the baseline and each follow-up period. RESULTS: The signs and symptoms after follow-up were cardiorespiratory, neurological, and inflammatory. Gastrointestinal symptoms were unusual at the disease onset, but unexpectedly, their frequency was higher in the post-infection stage. The multivariate analysis showed that pneumonia (HR 2.4, IC95%: 1.5-3.8, p < 0.001) and positive PCR tests still after four weeks (HR 5.3, IC95%: 2.3-12.3, p < 0.001) were factors associated with the diagnosis of post-COVID-19 pulmonary fibrosis in this study group. CONCLUSIONS: Our results showed that pneumonia and virus infection persistence were risk factors for developing pulmonary fibrosis post-COVID-19, after months of initial infection.

Project Design and Management of Optimized Self-Protection Plans: A Case Study for Spanish Public Buildings

Featured ApplicationA novel methodology for project management applicable for self-protection plans for public buildings based on the best practices of technologies, systems, and methods.Self-protection plans are the fundamental tool established to prevent and control the risks that threaten people and assets. In turn, they are essential to provide an adequate response to possible emergency situations that may occur in public or private buildings, facilities, or events. In this context, current and future challenges advocate increasing the usefulness, versatility, and adaptability of self-protection plans. For this purpose, this paper aims to develop a conceptual model for the project management of self-protection plans with a lifecycle approach. The research provides results concerning guidelines, aspects, and potential regulations, technologies, tools, methodologies, and maintenance frameworks to be followed for any building in different project phases. The methodology followed has consisted of a process in stages, with literature review and a conceptual development to obtain an adaptable model to any public building. The adaptability of the framework relies on the definition of potential methods, information systems, and technologies that can support any phase during the Self-Protection Plan life cycle. Moreover, it was applied in a specific environment, such as in public buildings under the Spanish regulation using the most common tools and applications available. Results proved that although it is possible to make a base model applicable to any publicly owned building, there is an extensive and precise subsequent work of adaptation to specific cases in which the applicable legal framework makes this task challenging. Finally, the results obtained have allowed us to reflect on future research needs.

Omnichannel Management in a B2B context: Concept, research agenda and bibliometric review

The COVID-19 pandemic has driven increases in the provision of services through digital channels, even by more traditional companies. An Omnichannel model of service provision poses new management challenges for companies. This research reviews the literature on Omnichannel Management by companies whose clients are other companies (B2B) and classifies the different areas of research to date. The principal finding is that, despite considerable academic interest in Omnichannel management, there have been few studies of Omnichannel in the B2B field. This emphasizes a significant research gap to address. We have also outlined the Research Agenda to highlight future lines of research.

Therapeutic versus Prophylactic Bemiparin in Hospitalized Patients with Nonsevere COVID-19 Pneumonia (BEMICOP Study): An Open-Label, Multicenter, Randomized, Controlled Trial.

Thromboprophylaxis with low molecular weight heparin in hospitalized patients with COVID-19 is mandatory, unless contraindicated. Given the links between inflammation and thrombosis, the use of higher doses of anticoagulants could improve outcomes. We conducted an open-label, multicenter, randomized, controlled trial in adult patients hospitalized with nonsevere COVID-19 pneumonia and elevated D-dimer. Patients were randomized to therapeutic-dose bemiparin (115 IU/kg daily) versus standard prophylaxis (bemiparin 3,500 IU daily), for 10 days. The primary efficacy outcome was a composite of death, intensive care unit admission, need of mechanical ventilation support, development of moderate/severe acute respiratory distress, and venous or arterial thrombosis within 10 days of enrollment. The primary safety outcome was major bleeding (International Society on Thrombosis and Haemostasis criteria). A prespecified interim analysis was performed when 40% of the planned study population was reached. From October 2020 to May 2021, 70 patients were randomized at 5 sites and 65 were included in the primary analysis; 32 patients allocated to therapeutic dose and 33 to standard prophylactic dose. The primary efficacy outcome occurred in 7 patients (22%) in the therapeutic-dose group and 6 patients (18%) in the prophylactic-dose (absolute risk difference 3.6% [95% confidence interval [CI], -16% -24%]; odds ratio 1.26 [95% CI, 0.37-4.26]; p = 0.95). Discharge in the first 10 days was possible in 66 and 79% of patients, respectively. No major bleeding event was registered. Therefore, in patients with COVID-19 hospitalized with nonsevere pneumonia but elevated D-dimer, the use of a short course of therapeutic-dose bemiparin does not appear to improve clinical outcomes compared with standard prophylactic doses. Trial Registration: ClinicalTrials.gov NCT04604327.

Shopping motivation in consumer loyalty formation process: the case of Spanish retail

PurposeWith the gradual decline of the small retail sector in the past recent years, few researchers have been addressing the issue from a motivational approach. This paper aimed to examine the role of utilitarian, hedonic and ethical motives in the process of forming consumer loyalty in a retail setting.Design/methodology/approachA total of 213 surveys were carried out among regular fashion and accessories shoppers in Spanish small-sized retailers. A two-step methodology proposed by Anderson and Gerbing (1988) was applied to test the model.FindingsEthical shopping motivation was found to have the most relevant impact on its perceived quality and on its reassurance to a small-sized retailer, as it represented a strategic asset. Although the most appropriate approach would not be focused mainly on ethical aspects in order to be competitive in the new retailing landscape, consumers should recognize that they are contributing to a worthy cause while enjoying the shopping experience.Practical implicationsSmall-sized retailers should provide consumers with good reasons for shopping in their businesses rather than their competitors’. Moreover, it is key to differentiate and build customer loyalty with the purpose of becoming more competitive. As a consequence, in this paper, we propose a measurement scale that can be used to evaluate and complex consumers’ shopping motivations.Originality/valueThe pursuit of more precise knowledge of factors that lead consumers to shop for a specific product is vital for small-sized retailers, toward sustainable competitiveness. Here we analyzed the impact of the three innovative dimensions in shopping motivation on consumers’ perceived quality and their influence on repurchase intention.

Prioritization, patient selection, and multimodal perioperative management of colorectal cancer facing health-care system saturation.

OBJECTIVE: The aim is to analyze the usefulness of pre-operative COVID-19 screening to detect asymptomatic patients, the capability of our patient selection algorithm to detect patients with more advanced tumors and the results of colorectal cancer surgery managed with a multimodal approach. We propose the use of a preoperative patient selection algorithm to prioritize the surgical treatment of patients with worse oncological prognosis and lower perioperative risk in situations of health system saturation. MATERIAL AND METHODS: Prospective descriptive study including 71 patients operated on for colorectal cancer during COVID-19's high incidence period. A division was made into two periods of time that were later compared with the aim of assessing whether the scale used identified those patients with lower surgical risk and higher oncological priority for their priority scheduling. RESULTS: Post-operative severe acute respiratory syndrome coronavirus 2 infection occurred in one patient (1.4%). Pre-operative polymerase chain reaction detected one asymptomatic patient (3%). Tumor stage was ≥ IIIA in 39% and node positive in 39% of patients in the first period, while 26% and 21% in the second period, respectively (p = 0.320; p = 0.179), without increasing the surgical stay or complications. Median hospital stay was 5 days. Grades III and IV morbidity were 4.4% and 1.4%. CONCLUSION: The use of an algorithm and Patient Selection Scale can detect patients with more advanced tumors to be operated before. Multimodal management/ERAS have a role in achieving short stay and low morbidity.

OBJETIVO: El retraso terapéutico derivado de la saturación del Sistema sanitario conlleva un peor pronóstico oncológico y un aumento de complicaciones en el cáncer colorrectal. Proponemos el usode un algoritmo de selección de pacientes de forma preoperatoria para priorizar el tratamiento quirúrgico de los pacientes con peor pronóstico oncológico y menor riesgo perioperatorio. MATERIAL Y MÉTODOS: Realizamos un estudio descriptivo prospectivo de 71 pacientes intervenidos por cáncer colorrectal durante el periodo de máxima incidencia por COVID. Se realizó una división en dos periodos de tiempo que fueron comparados posteriormente con el objetivo de valorar si la escala utilizada conseguía identificar aquellos pacientes con menor riesgo quirúrgico y mayor prioridad oncológica para su programación prioritaria. RESULTADOS: Utilizando la escala de priorización de pacientes (PSS) observamos que el estadio tumoral fue mayor de IIIA en un 39% de los pacientes con un 39% de ganglios positivos en un primer periodo, frente a un 26% y 21% en un segundo periodo (p = 0.320; p = 0.179) de tiempo, sin aumentar la estancia operatoria ni las complicaciones. Se realizaron dos métodos de cribado de COVID-19 en dos periodos de tiempo, detectando un 3% de pacientes asintomáticos de forma preoperatoria con PCR, y documentando un 1.4% de infección por COVID postoperatoria. CONCLUSIONES: Ante la saturación del sistema sanitario, la utilización de protocolos y algoritmos para selección de pacientes con cáncer colorrectal puede ayudar a dar preferencia quirúrgica a aquellos casos que no deben ser demorados.

Depressive symptomatology in adults during the COVID-19 pandemic.

Depression entails changes in the mental health of individuals worldwide. Episodes of depression lead to mood swings and changes in the motivational dimension. Our research focused on the prevalence of depression in the adult population and on how it affected the social and affective dimensions. Owing to the current pandemic, we deemed it necessary to explore how protective measures against COVID-19 infection, such as quarantines, could be related to mental health. Moreover, we found it important to determine the prevalence of depressive and anxious symptomatology in adults from the Valle del Cauca region in Colombia during the social isolation connected to COVID-19. Our study was descriptive, analytical and cross-sectional, and involved 1248 subjects. As tools, we used the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale. The data demonstrated that women were more likely to display symptoms of depression and that individuals aged between 24 and 29 were less likely to reveal symptoms of anxiety than those aged between 18 and 23. Moreover, childless or economically dependent individuals proved to be more likely to display symptoms of depression during the pandemic.

Spanish Pacemaker Registry. 18th Official Report of the Cardiac Pacing Section of the Spanish Society of Cardiology (2020).

INTRODUCTION AND OBJECTIVES: This report describes the cardiac pacing activity performed in Spain in 2020, including the number and type of implanted devices, demographic and clinical factors, and data on remote monitoring. METHODS: Information consisted of the European Pacemaker Patient Card, data submitted to the cardiodispositivos.es online platform, the databases of participating centers, and supplier-reported data. RESULTS: A total of 14 662 procedures were registered from 102 hospitals, representing 39.2% of the estimated activity. The implantation rates of conventional and low-energy resynchronization pacemakers were 759 and 31 units per million population, respectively. In all, 520 leadless pacemakers were implanted, 70 with atrioventricular synchrony. The mean age at implantation was high (78.8 years), and the most frequent electrocardiographic change was atrioventricular block. There was a predominance of dual-chamber pacing mode but VVI/R single-chamber pacing was used in 19% of patients in sinus rhythm, depending on age and sex. Remote monitoring capability was present in 18.5% of implanted conventional pacemakers and 45.6% of low-energy resynchronization pacemakers, although registration in this system increased by 53% in 2020. CONCLUSIONS: In 2020, in the context of the SARS-CoV-2 pandemic, the number of implanted conventional pacemakers decreased by 8% and cardiac resynchronization therapy by 4.6%. The number of leadless pacemakers increased by 16.5%. Sequential pacing was predominant, influenced by age and sex. Home monitoring played a fundamental role as a mode of follow-up in this SARS-CoV-2 pandemic year.

Evaluation of the Efficiency of European Health Systems Using Fuzzy Data Envelopment Analysis.

Many studies that assess efficiency in health systems are based on output mean values. That approach ignores the representativeness of the average statistic, which can become a serious problem in estimation. To solve this question, this research contributes in three different ways: the first aim is to evaluate the technical efficiency in the management of European health systems considering a set of DEA (Data Envelopment Analysis) and FDEA (Fuzzy Data Envelopment Analysis) models. A second goal is to assess the bias in the estimation of efficiency when applying the conventional DEA. The third objective is the evaluation of the statistical relationship between the bias in the efficiency estimation and the macroeconomic variables (income inequality and economic freedom). The main results show positive correlations between DEA and FDEA scores. Notwithstanding traditional DEA models overestimate efficiency scores. Furthermore, the size of the bias is positively related to income inequality and negative with economic freedom in the countries evaluated.

Facial Hair Decreases Fit Factor of Masks and Respirators in Healthcare Providers.

In response to the current state of the COVID-19 pandemic, healthcare providers are using common surgical masks and filtering respirators in conjunction with the presence of facial hair, which could lead to a large number of particles passing into their respiratory system. The purpose of this study was to determine the fit factor effectiveness of filtering respirators and surgical masks in bearded versus non-bearded healthcare providers. A controlled randomized clinical trial (NCT04391010) was carried out, analyzing a sample of 63 healthcare providers. The fit factors of surgical masks and FFP3 filtering respirators for healthcare providers with (n = 32) and without (n = 31) facial hair were compared. Fit factors were measured during an exercises protocol in which healthcare providers wore surgical masks and FFP3 filtering respirators. Surgical mask fit factor comparisons did not show significant differences (p > 0.05) between healthcare providers with and without facial hair. In contrast, filtering respirator fit factor comparisons showed statistically significant differences (p < 0.01) between both groups, indicating that healthcare providers with facial hair showed lower fit factor scores, which implies a worse fit factor with respect to healthcare providers without facial hair. The fit factor effectiveness of filtering respirators was reduced in healthcare providers with facial hair. The authors of this paper encourage healthcare providers to trim their beards during filtering respirator use or wear full-mask filtering facepiece respirators, especially during the COVID-19 pandemic.

Minimally Invasive Laparoscopic Technique for Lymph Node Dissection in Penile Cancer: The Pelvic and Inguinal Single-Site Approach: PISA Technique.

BACKGROUND: Lymph node dissection(LND) remains the gold standard in the staging and treatment of locally advanced penile cancer(PC)1. OBJECTIVE: To describe our initial experience with a new minimally invasive inguinal and pelvic single-access laparoscopic approach2,for performing LND in PC, first described in Urology by our group in 20153: the Pelvic and Inguinal Single Access(PISA) technique (Fig. 1). MATERIAL: Between 2015 and 2018, 10 consecutive patients with different PC stages and indication of inguinal LND (cN0 and ≥pT1G3 or cN1/cN2)1 were operated by means of the PISA technique (Table 1). Intraoperative frozen section(FS)4 analysis was carried out routinely and if ≥2 inguinal nodes(pN2) or extracapsular nodal extension(pN3) are detected1,5, ipsilateral pelvic LND was performed sequentially as a single-stage procedure and using the same surgical incisions. If this condition occurs bilaterally in the inguinal LND, the pelvic LND will be bilateral. The video shows the PISA technique in a step-by-step. Instrumental requirements: 30°laparoscopy optic, monopolar scissors,Ligasure (Covidien Surgical,Minneapolis,MN,USA) vascular sealant, extraction-bag, bipolar forceps and 5-mm endo-clip(Hem-o-lok)are required. RESULTS: Intraoperative and postsurgical variables are shown in Table 2. Inguinal LND was bilateral in all cases. Pelvic LND was required in 40% of patients. Total operative time was 120-170 minutes. Median estimated blood loss(EBL) was 66(30-100)cc, but no blood transfusion was required. No intraoperative complications were noted. 40% of patients had postoperative complications (10% major complication- symptomatic inguinal lymphocele). Median lenght of hospital stay(LOS)was 5.8(3-10) days. Median inguinal drain removal was 4.7 days. The pathological analysis outcomes are shown in Table 3. Mean number of lymph nodes removed by inguinal LND was 10.25(8-14). CONCLUSION: PISA technique allow a minimally invasive inguinal and pelvic LND using the same set of incisions and carry it out in the same surgical procedure. PISA technique in PC LND seems to be safe, with a low rate of major complications and preserving oncological efficacy.

Long-term survival of mechanically ventilated patients with severe COVID-19: an observational cohort study.

BACKGROUND: Information is lacking regarding long-term survival and predictive factors for mortality in patients with acute hypoxemic respiratory failure due to coronavirus disease 2019 (COVID-19) and undergoing invasive mechanical ventilation. We aimed to estimate 180-day mortality of patients with COVID-19 requiring invasive ventilation, and to develop a predictive model for long-term mortality. METHODS: Retrospective, multicentre, national cohort study between March 8 and April 30, 2020 in 16 intensive care units (ICU) in Spain. Participants were consecutive adults who received invasive mechanical ventilation for COVID-19. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection detected in positive testing of a nasopharyngeal sample and confirmed by real time reverse-transcriptase polymerase chain reaction (rt-PCR). The primary outcomes was 180-day survival after hospital admission. Secondary outcomes were length of ICU and hospital stay, and ICU and in-hospital mortality. A predictive model was developed to estimate the probability of 180-day mortality. RESULTS: 868 patients were included (median age, 64 years [interquartile range [IQR], 56-71 years]; 72% male). Severity at ICU admission, estimated by SAPS3, was 56 points [IQR 50-63]. Prior to intubation, 26% received some type of noninvasive respiratory support. The unadjusted overall 180-day survival rates was 59% (95% CI 56-62%). The predictive factors measured during ICU stay, and associated with 180-day mortality were: age [Odds Ratio [OR] per 1-year increase 1.051, 95% CI 1.033-1.068)), SAPS3 (OR per 1-point increase 1.027, 95% CI 1.011-1.044), diabetes (OR 1.546, 95% CI 1.085-2.204), neutrophils to lymphocytes ratio (OR per 1-unit increase 1.008, 95% CI 1.001-1.016), failed attempt of noninvasive positive pressure ventilation prior to orotracheal intubation (OR 1.878 (95% CI 1.124-3.140), use of selective digestive decontamination strategy during ICU stay (OR 0.590 (95% CI 0.358-0.972) and administration of low dosage of corticosteroids (methylprednisolone 1 mg/kg) (OR 2.042 (95% CI 1.205-3.460). CONCLUSION: The long-term survival of mechanically ventilated patients with severe COVID-19 reaches more than 50% and may help to provide individualized risk stratification and potential treatments. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04379258. Registered 10 April 2020 (retrospectively registered).

Registro Español de Marcapasos. XVIII Informe Oficial de la Sección de Estimulación Cardiaca de la Sociedad Española de Cardiología (2020)

Resumen Introducción y objetivos Se describe la actividad de estimulación cardiaca realizada en España en 2020: cuantía y tipo de dispositivos, factores demográficos y clínicos y datos sobre monitorización a distancia. Métodos Se utilizan como fuentes de información la Tarjeta Europea de paciente portador de Marcapasos, la plataforma online cardiodispositivos.es, las bases de datos propias de centros y los datos facilitados por las empresas proveedoras. Resultados Se registran 14.662 procedimientos de 102 hospitales, lo que supone el 39,2% de la actividad estimada. La tasa de marcapasos convencionales y resincronizadores de baja energía es de 759 y 31 unidades/millón respectivamente. Se implantan 520 marcapasos sin cables, 70 con sincronía auriculoventricular. La media de edad al implante es elevada (78,8 años) y el bloqueo auriculoventricular, la alteración electrocardiográfica más frecuente. Predomina el modo de estimulación bicameral, aunque en el 19% de los pacientes en ritmo sinusal se realiza una estimulación monocameral VVI/R, condicionada por edad y sexo. Se incluyen en programa de monitorización a distancia el 18,5% de los marcapasos implantados y el 45,6% de los resincronizadores de baja energía, aunque aumentan en un 53% las altas en este sistema durante 2020. Conclusiones En 2020, en contexto de la pandemia por SARS-CoV-2, disminuye el número de marcapasos convencionales implantados un 8% y el de terapias se resincronización cardiaca, un 4,6%. Aumenta el número de marcapasos sin cables un 16,5%. Predomina la estimulación secuencial, influida por edad y sexo. La monitorización domiciliaria cobra un papel fundamental como modo de seguimiento en el año de la pandemia por SARS-CoV-2. Introduction and objectives This report describes the cardiac pacing activity performed in Spain in 2020, including the number and type of implanted devices, demographic and clinical factors, and data on remote monitoring. Methods Information consisted of the European Pacemaker Patient Card, data submitted to the cardiodispositivos.es online platform, the databases of participating centers, and supplier-reported data. Results A total of 14662 procedures were registered from 102 hospitals, representing 39.2% of the estimated activity. The implantation rates of conventional and low-energy resynchronization pacemakers were 759 and 31 units per million population, respectively. In all, 520 leadless pacemakers were implanted, 70 with atrioventricular synchrony. The mean age at implantation was high (78.8 years), and the most frequent electrocardiographic change was atrioventricular block. There was a predominance of dual-chamber pacing mode but VVI/R single-chamber pacing was used in 19% of patients in sinus rhythm, depending on age and sex. Remote monitoring capability was present in 18.5% of implanted conventional pacemakers and 45.6% of low-energy resynchronization pacemakers, although registration in this system increased by 53% in 2020. Conclusions In 2020, in the context of the SARS-CoV-2 pandemic, the number of implanted conventional pacemakers decreased by 8% and cardiac resynchronization therapy by 4.6%. The number of leadless pacemakers increased by 16.5%. Sequential pacing was predominant, influenced by age and sex. Home monitoring played a fundamental role as a mode of follow-up in this SARS-CoV-2 pandemic year. Full English text available from:www.revespcardiol.org/en