Evolucion De La Epidemiologia De La Enfermedad Celiaca E Impacto De La Covid19. Resultados Preliminares Del Plan Nacional De Enfermedad Celiaca-Ciberehd

Introduccion: Se ha reportado que tanto la prevalencia como la incidencia de la enfermedad celiaca (EC) estan aumentando a nivel mundial. Este aumento podria ser atribuido a infecciones viricas como desencadenante de la EC, entre otros factores. La COVID-19 ha impactado de lleno en la realizacion del estudio de prevalencia del Plan Nacional de EC promovido por el CIBERHED. Se ha sugerido que SARS-CoV-2, que penetra por via digestiva, podria desencadenar brotes de EC. Objetivos: 1) Evaluar la prevalencia actual de EC en comparacion con la de la cohorte 2004-2009. 2) Evaluar el impacto de la COVID-19 en la prevalencia actual de EC. Metodos: Desde enero 2021 hasta la actualidad se han incluido 1886 individuos de entre 1 y 90 anos atendidos por cirugia menor en los 6 hospitales participantes (Hospitales Universitarios (HU) Mutua Terrassa- Sant Joan de Deu, HU Virgen del Rocio, HU Central de Asturias, HU Galdakao-Cruces y HU Fundacion Jimenez Diaz) (calculo muestral: 5.300). La inclusion se realiza ajustada por edad y sexo a la piramide poblacional. Se determinan Ac. antitransglutaminasa (tTGA) y en los casos positivos se confirma el diagnostico segun guias de consenso. Se reporta la prevalencia serologica (tTGA > 7 U/ml) mas los casos prevalentes previamente diagnosticados. La relacion entre COVID19, registrada mediante cuestionario, y los casos positivos (tTGA > 7 U/mL y tTGA zona gris 2-7 U/mL) se ha evaluado mediante prueba exacta de Fisher. Resultados: Se han detectado 11 sujetos con serologia positiva y 2 pacientes con diagnostico previo de EC;prevalencia 6,89 x 1.000, IC95% 3,68-11,76. En comparacion con la prevalencia de la cohorte (2004-2007), 5,67 x 1.000, no existen diferencias significativas. Se han detectado 3 casos con serologia tTGA positiva y COVID-19 sobre un total de 335 pacientes infectados y 8 casos con serologia tTGA positiva sin COVID-19 sobre un total de 1.547 individuos no infectados (p = 0,4247). Tampoco se ha encontrado relacion entre COVID-19 y valores de serologia en la zona gris. Conclusiones: No se detecta un incremento de la prevalencia de EC en las ultimas dos decadas en nuestro medio. La infeccion por COVID19 no ha tenido impacto en la aparicion de nuevos casos de la enfermedad.Copyright © 2023 Elsevier Espana, S.L.U. Todos los derechos reservados.

The Importance of Making Moroccan Women in Andalusia More Visible Today

In this research we present the main results of an investigation whose objective was to analyse five key questions as a clear reference point for the social and labour integration of Moroccan women in Andalusia: (i) why do Moroccan women emigrate?, (ii) do their families support their migration project?, (iii) how do Moroccan women arrive in Andalusia?, (iv) what do they do?, (v) what are the effects of covid on their labour integration?, (vi) what are the effects of covid on their labour market insertion? To do this, we have used qualitative methodology. Through the in-depth interview technique, we have given voice to the reflections and approaches of our key informants. The results show the need to implement strategies that favour their socio-occupational inclusion where situations of social vulnerability and labour exploitation are eradicated. At present, it is essential to be aware of this reality in order to make them visible and to advance in terms of rights in order to achieve their empowerment in Andalusia. © 2022,Migraciones.All Rights Reserved.

Evolution of academic data in the pharmacy degree of the University of Granada during COVID-19

Introduction: The Quality Internal Guarantee Committee of the Degree in Pharmacy is responsible for annually analysing the results of the teaching-learning process obtained from the databases of the Quality, Innovation and Prospective Unit of the University of Granada (UGR). During the academic year 2019/20, COVID-19 pandemic caused several adaptations in teaching methodologies. The objective of this work is to study the effect of COVID-19 pandemic on the performance indicators and satisfaction rate with the study plan in the Degree in Pharmacy of the UGR, and to conduct a comparative study with previous years. Method(s): The following indicators were analysed: satisfaction levels with the study plan, demand rate, performance rate, overall qualifications and number of final projects (TFG) performed for the Degree in Pharmacy during last academic years. Result(s): The general level of students' satisfaction with the study plan has decreased slightly in the academic year 2019/20. This decrease may be related to: a) the delay in the information on the adaptations made to the Teaching Guides, and b) the lack of teaching coordination between teachers, especially among those who teach different subjects in the same course. However, the performance indicators for pharmacy degree in this last academic year have been very positive (acceptable). A decrease in the initial dropout rate (7.7%) and an increase in the graduation, success and performance rates (52.4%, 78.8% and 88.4%, respectively), which reached maximum levels, were observed. However, failure and non-attend rates among pharmacy degree' students were lower than previous academic years (5% and 9%, respectively). Conclusion(s): The health crisis caused by COVID-19 has been a great challenge for the adaptation of the Pharmacy Degree curriculum. The analysis of the performance indicators and satisfaction rate has allowed the Quality Internal Guarantee Committee to implement several improvement actions to upgrade the adaptations in teaching methodologies for the pharmacy degree.

Influence of government communication on risk perception. An analysis based on the context of the sixth wave of Covid-19 in Madrid

Risk theorists have frequently discussed the discursive construction of risk perception. In particular, the effect of media consumption on increasing the subjective perception of risk has been highlighted. Not much is known about how government communication affects citizens' impressions and attitudes in this area, something that this research seeks to address. During the sixth wave of Covid-19, triggered by the emergence of the Omicron variant, government discourse shifted from initial concern to what has become known as the "influenzaisation” paradigm, an attempt to normalise the disease. Based on the results of a survey carried out in January 2022 amongst 664 citizens of the Community of Madrid, we sought to demonstrate, using binary logistic regression (BLR) models, to what extent the degree to which the citizens of Madrid internalised the government's thesis of "influenzaisation” was related to a lower perception of risk. Similarly, the aim is to show whether agreement with the "influenzaisation” thesis also favoured positions that were less inclined to restrictions, so that government communication succeeded in reducing the social demand for measures. Finally, the study evaluates the predictive character of ideology on levels of risk perception and attitudes towards restrictive mea-sures. The findings indicate that acceptance of the "influenzaisation” story led to a lower perception of risk and, as a con-sequence, reduced support for restrictive measures among those most exposed to this thesis. The discursive articulation of risk in government communication becomes a central element of crisis management and the strategic formulation of "risk de-escalation” or "post-risk” messages. © 2022, El Profesional de la Informacion. All rights reserved.

Intelligent Modular Camera Rig for Classroom Lecture Video Recording System with Automatic Lighting Adjustment

In today's scheme where COVID-19 is the biggest problem faced by the entire world in which it almost forced all schools to suspend and obliged the students to stay at home for their safety., a video recorded lecture is one of the best solutions and ways to help students in their studies. The researchers were intended to improve distance learning as well as its effectiveness to deliver a high-quality video by developing an intelligent system that can be beneficial for both users and viewers. The usage of Arduino Uno served as the brain that controls everything, which makes the system a one-person operation. Given the scenarios of having different values of lux in a room caused by multiple kinds of events, achieving the preferred luminance will be difficult. Nevertheless, our prototype will automatically produce and attain the necessary amount of lighting needed using the LDR sensor along with the code in Arduino. The movement of the platform where the camera is placed follows wherever the user goes in front of the rig as much as the face is recognized. It was then tested using different calibrations by testing and simulating different situations where there are different variables included, such as camera movement and light. The data will be examined using ANOVA test. © 2022 IEEE.

Social Exclusion, Pandemic and Social Policies in Spain: An Analysis from Social Work

This reflection article offers a framework for analytical reflection, from the perspective of social work, on the measures implemented to curb the impact of the pandemic in Spain. Starting from the situation prior to its arrival, we evaluated and examined its incidence and effects. The results show that the social policies implemented to improve the socio-economic and health conditions of the population play a decisive role. In this sense, it is essential to recognize the efforts of the group of social workers who carry out their professional practice with the aim of empowering the Spanish population in times of pandemic.

Group testing with nested pools

In order to identify the infected individuals of a population, their samples are divided in equally sized groups called pools and a single laboratory test is applied to each pool. Individuals whose samples belong to pools that test negative are declared healthy, while each pool that tests positive is divided into smaller, equally sized pools which are tested in the next stage. In the (k + 1)-th stage all remaining samples are tested. If p <1 -3-1/3, we minimize the expected number of tests per individual as a function of the number k + 1 of stages, and of the pool sizes in the first k stages. We show that for each p ∈(0, 1 -3-1/3) the optimal choice is one of four possible schemes, which are explicitly described. We conjecture that for each p, the optimal choice is one of the two sequences of pool sizes (3k or 3k-14, 3k-1,..., 32, 3), with a precise description of the range of p’s where each is optimal. The conjecture is supported by overwhelming numerical evidence for p >2-51. We also show that the cost of the best among the schemes (3k,..., 3) is of order O(p log(1/p)), comparable to the information theoretical lower bound p log2(1/p) + (1 -p) log2(1/(1 -p)), the entropy of a Bernoulli(p) random variable. IEEE

[Severe SARS-CoV-2 infection: Clinical assessment and biomechanical functional evaluation one month after hospital discharge]. / Infección grave por SARS-CoV-2: valoración clínica y evaluación funcional biomecánica al mes del alta hospitalaria.

OBJECTIVE: To describe by an observational cross-sectional study the clinical and functional situation, at one month after hospital discharge, of patients admitted with COVID-19 in the hospital ICU between March and December 2020. MATERIAL AND METHODS: 59 patients were studied using different clinical scales and biomechanical analysis tests (hand dynamometry, fall risk assessment, gait and balance analysis). RESULTS: At one month after discharge, patients reported persistent symptoms: dyspnea (47.5%), arthromyalgia (45%) and cough (22%). In the EQ-5D-5L questionnaire up to 73% of patients reported levels of anxiety or depression. 74.6% and 69.5% presented alterations in the strength of the right and left hand, respectively. The risk of falls in 38% of patients was moderate to very high. The somatosensory index remained within normal parameters, while the vestibular and, to a lesser extent, the visual indexes were altered. In gait, 81.4% of patients showed no abnormalities outside the normal range, with a normal average walking speed. CONCLUSIONS: In the short term after severe COVID-19, patients have persistent symptomatology, anxiety/depression, impaired balance with increased risk of falls and loss of grip strength in both hands.

[Extrathoracic manifestations of COVID-19 in adults and presentation of the disease in children]. / Manifestaciones extratorácicas de la COVID-19 en adultos y presentación de la enfermedad en niños.

In March 2020, the World Health Organization declared a global pandemic of COVID-19, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); epidemic conditions continue in nearly all countries today. Although the symptoms and imaging manifestations of COVID-19 predominantly involve the respiratory system, it is fundamental to know the manifestations of the disease and its possible complications in other organs to help in diagnosis and orient the prognosis. To improve the diagnostic process without increasing the risk of contagion unnecessarily, it is crucial to know when extrathoracic imaging tests are indicated and which tests are best in each situation. This paper aims to provide answers to these questions. To this end, we describe and illustrate the extrathoracic imaging manifestations of COVID-19 in adults as well as the entire spectrum of imaging findings in children.

Proposal for a fuzzy model to assess cost overrun in healthcare due to delays in treatment

Apart from the effects of treating those infected with COVID‐19, the pandemic has also affected treatment for other diseases, which has been either interrupted or canceled. The aim of this paper is to provide a financial model for obtaining the cost overrun resulting from the worsening of illnesses and deaths for each of the causes considered. To achieve this, first deaths have been classified into causes of death and for each of these causes, an estimation has been made of the worsening condition of patients due to delay in treatment. Through these data, a fuzzy relation between deaths and the worsening condition of patients can be obtained. Next, the expertise process has been used to estimate cost overrun in relation to patients’ pathologies. The experts’ opinions have been aggregated using ordered weighted average (OWA). Lastly, using fuzzy logic again, a correction coefficient has been determined, which optimizes the future implementation of the proposed model without the need for a new estimation of inputs. The paper concludes with a numerical example for a better comprehension of the proposed theoretical model. Ultimately, it provides the scientific community in general and in particular managers of public administration entities with a novel tool for improving the efficiency of the healthcare system. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

When pneumonia is not COVID-19

During the COVID-19 epidemic, the prevalence of the disease means that practically any lung opacity on an X-ray could represent pneumonia due to infection with SARS-CoV-2. Nevertheless, atypical radiologic findings add weight to negative microbiological or serological tests. Likewise, outside the epidemic wave and with the return of other respiratory diseases, radiologists can play an important role in decision making about diagnoses, treatment, or preventive measures (isolation), provided they know the key findings for entities that can simulate COVID-19 pneumonia. Unifocal opacities or opacities located in upper lung fields and predominant airway involvement, in addition to other key radiologic and clinical findings detailed in this paper, make it necessary to widen the spectrum of possible diagnoses. Resumen La prevalencia en fase epidémica de la COVID-19 hace que prácticamente cualquier opacidad pulmonar en la radiografía de tórax pueda ser una neumonía por SARS-CoV-2. Sin embargo, hallazgos radiológicos atípicos aumentarán la credibilidad de un resultado microbiológico o serológico negativo. Asimismo, fuera de la ola epidémica y con el retorno de otras entidades respiratorias, el radiólogo puede tener gran relevancia en la toma de decisiones diagnósticas, terapéuticas o preventivas (aislamiento) si conoce las claves diagnósticas de las entidades simuladoras de neumonía COVID-19. La distribución unifocal o en campos pulmonares superiores de las opacidades y la afectación predominante de vía aérea, entre otras claves radiológicas y clínicas detalladas en este capítulo, implican necesariamente ampliar el abanico de posibilidades diagnósticas.

When pneumonia is not COVID-19. / Cuando la neumonía no es COVID-19.

During the COVID-19 epidemic, the prevalence of the disease means that practically any lung opacity on an X-ray could represent pneumonia due to infection with SARS-CoV-2. Nevertheless, atypical radiologic findings add weight to negative microbiological or serological tests. Likewise, outside the epidemic wave and with the return of other respiratory diseases, radiologists can play an important role in decision making about diagnoses, treatment, or preventive measures (isolation), provided they know the key findings for entities that can simulate COVID-19 pneumonia. Unifocal opacities or opacities located in upper lung fields and predominant airway involvement, in addition to other key radiologic and clinical findings detailed in this paper, make it necessary to widen the spectrum of possible diagnoses.

Measures under COVID-19 and commercial law (part i: Company and stock market aspects)

The crisis generated by the COVID-19 pandemic has forced it to take multiple measures of different kinds to mitigate its effects under the alarm state. These measures include those that have repercussions on various commercial law institutions, such as those relating to company law and the stock market. © 2020 Ibero-American Law Institute. All rights reserved.

[Repetition of microbiological tests in suspect of SARS-CoV-2 infection: utility of a score based on clinical probability]. / Repetición de las pruebas microbiológicas en la sospecha de la infección por SARS-CoV-2: utilidad de un score basado en la probabilidad clínica.

OBJECTIVE: The diagnosis of SARS-CoV-2 infection presents some limitations. RT-PCR in nasopharyngeal swabs is considered the gold standard for the diagnosis, although it can have false negative results. We aimed to analyze the accuracy of repeating nasopharyngeal swabs based on different clinical probabilities. METHODS: Retrospective observational study of the first patients admitted to a two COVID Internal Medicine wards at the University Hospital Marqués de Valdecilla, Santander, from March to April 2020. RT-PCR targering E, N, RdRP and ORFab1 genes and antibody tests detecting IgG. RESULTS: A total of 145 hospitalized patients with suspected SARS-Cov2 infection were admitted and in 98 (67.5%) diagnosis was confirmed. The independent predictive variables for SARS-CoV-2 infection were: epidemiological contact, clinical presentation as pneumonia, absence of pneumonia in the last year, onset of symptoms > 7 days, two or more of the following symptoms -dyspnea, cough or fever- and serum lactate dehydrogenase levels >350 U/L (p<0.05). A score based on these variables yielded an AUC-ROC of 0.89 (CI95%, 0.831-0.946; p<0.001). The accuracy of the first nasopharyngeal swabs was 54.9%. Repeating nasopharyngeal swabs two or three times allows to detect an additional 16% of positive cases. The overall accuracy of successive RT-PCR tests in patients with low pre-test probability was <5%. CONCLUSIONS: We have defined a pre-test probability score based on epidemiological and clinical data with a high accuracy for diagnosis of SARS-CoV-2. Repeating nasopharyngeal swabs avoids sampling errors, but only in medium of high probability pre-test clinical scenarios.