Cardiovascular risk among patients recovered from COVID-19 in the short and medium term: what does the current evidence conclude?.

Cardiovascular risk and diseases among patients recovered from COVID-19 is a recent field of study in the world medical literature and is also of vital importance because a large number of patients develop complications once the acute phase of the disease is over. The broad spectrum of myocardial injury in cardiovascular diseases can range from the asymptomatic elevation of cardiac troponin levels to the development of fulminant myocarditis and/or circulatory shock, which can leave significant sequelae. Despite the fact that there is no clear strategy to treat cardiac events that occur during COVID-19 infection and taking into account that treatment is mainly aimed at relieving patients' symptoms as they arise, the objective of this work was to find out and collect current evidence on this subject, so that readers can be offered a reference guide in Spanish that contributes to the development of their health profession. The methodology used was a literature search in databases including Medline, Scopus and ScienceDirect within a time window between 2019 and 2022. The main results revealed that the molecular and pathophysiological mechanisms involved in post-COVID-19 syndrome include the renin-angiotensin-aldosterone system since SARS-CoV-2 tropism is linked to angiotensin-converting enzyme 2. This causes an alteration of the neurohumoral response of the cardiovascular, renal and digestive systems, generating deficits in the signaling pathways and causing direct damage to the heart, lungs and other organs. Post-COVID-19 syndrome, in general, is defined as the occurrence or persistence of symptoms three or four weeks after the acute phase of the disease. This could then be considered as a time window of risk and strict follow-up to assess in a personalized way the risk among the different groups of patients, especially those with a past history of cardiovascular disease. The main results revealed disorders such as heart failure, arrhythmias, pericarditis and myocarditis, which require early detection and occur days or even weeks after the acute phase of COVID-19.Copyright © La revista. Publicado por la Universidad de San Martin de Porres, Peru.

Resilience in healthcare systems: Cyber security and digital transformation

The digital transformation of the healthcare sector is an essential development as societies move into a post-industrial, knowledge-based economy. The adoption of the latest technologies and their applications in the health and care systems must be managed effectively from the perspective of their cyber security and resilience. However, there is still a limited understanding of the key concepts that must define the strategic vision of a resilient and sustainable digital transformation of the healthcare sector. Using data collected at the peak of the COVID-19 pandemic from owners and C-level executives from critical infrastructure sectors in the United Kingdom, this research analysed core constructs that contribute to the required transformative, adaptive and absorptive capacities for health systems digital resilience. The research found that a balanced base of cyber security knowledge development, uncertainty management, and consideration for the sector's high levels of systemic and organisational interdependence are essential for its digital resilience and for the sustainability of its digital transformation efforts. The paper describes the implications of these findings for research and manage-ment practice.

Characterization of food patterns during the COVID 19 pandemic in Chile.

Background: Confinement to prevent contagion by COVID-19 has been shown to have a negative impact on different components of the population's health, food being one of the most notable. The objective of this work was to characterize the intake of certain foods according to sex, age, and educational and socioeconomic level during the COVID 19 pandemic in Chile.. Method(s): cross-sectional study through an online survey. Each person answered a food intake questionnaire on the self-administered form, and questions about the type and duration of confinement and sociodemographic data. Result(s): 1722 people participated (82.5% female). When evaluating the% of compliance with the recommendations for each food, fruit and dairy, it is less than 10%, but being significantly higher in women, whereas the consumption of sugary drinks, caffeinated drinks and alcohol, the highest in men. When comparing by age, it was observed that in those over 55 years of age the majority of healthy foods were reduced, more unhealthy foods such as sugary drinks and junk food and when comparing by socioeconomic level, a lower consumption of healthy foods was observed in people of lower level Socioeconomic, on the contrary, the consumption of unhealthy foods was higher, except for alcohol, caffeinated beverages and sugar. Conclusion(s): There is a high consumption of unhealthy foods during the pandemic, and there are differences in intake according to sex, age and socioeconomic level.Copyright © 2022 Sociedad Espanola de Nutricion Comunitaria. All rights reserved.

Linking unlearning with the intention to recommend through destination image

Purpose: The intangible nature of tourism means that variables such as destination image (DIM) or intention to recommend (IR) are crucial for tourists, as they are reliable sources of information. However, since these are dynamic variables, they have been affected by Covid-19 and need to be updated. Based on the above, the purpose of this study is to examine how the unlearning (UL) process helps tourists to become aware of the new situation, relinquish old habits and relearn, thus, influencing DIM and the IR destinations. Furthermore, the relationship between DIM and IR is analysed. Design/methodology/approach: To analyse the proposed model, an empirical analysis was carried out through an online survey obtaining a valid sample of 457 Spanish domestic travellers. The data were analysed using partial least square structural equation modelling (PLS-SEM). Findings: Results show a positive effect between the UL outcomes and IR a destination, as well as a mediator effect of DIM on this relationship. Originality/value: To the best of the authors' knowledge, this study analyses for the first time UL in the tourism sector as an individual process carried out by tourists and shows how it influences their decision-making process. © 2023, International Tourism Studies Association.

Central Nervous System Metastases from Exocrine Glands Carcinoma: Case Management in Low Resource Setting and Review of Literature

INTRODUCTION: Head and neck exocrine gland tumors metastases to central nervous system (CNS) account for less than 1% with median survival of less than 6 months. Unlike brain metastases from lung, breast, melanoma, and colon, there is no established consensus or published clinical guidelines in the management from excorine glands. Filipino patients are manage individually but experienced delays due to limited access to a tertiary level health care and with scarcity of treatment protocols. Methods and RESULTS: We present two cases with exocrine glands carcinoma with CNS metastases. First case is a 51/F with a known case of left parotid cystic adenocarcinoma s/p parotidectomy and radiation therapy 2 years prior to the development of neurological deficits and COVID-19 infection, neuroimaging noted extra-axial 7.5 x 5 x 4.5 cm contrast enhancing tumor at bilateral frontal convexity. She underwent bifrontal craniotomy, gross total excision of tumor and anterior sagittal sinus, histopathology results cystic adenocarcinoma. She was discharged GOS 2, planned for chemoradiotherapy but lost to follow up and expired after 2 months post op. Second case is a 28/M known case of lacrimal gland pleomorphic adenocarcinoma OD s/p excision biopsy 2 years prior to the development of multiple right frontal lobe, right orbital wall and right pterion metastases. He underwent gross excision of extracranial and intracranial tumors and a right orbital exenteration. He was discharged GOS 2 and underwent chemoradiation as outpatient with good tumor control and no tumor recurrence after 1 year of treatment. DISCUSSION: CNS metastases from exocrine glands are rare and difficult to manage since no approved protocol was established. Patients in low resource setting were then manage on individual basis since molecular and genomic studies are not available. The delays in the management are multifactorial such as geographic disadvantages, COVID-19 pandemic, and government's inadequate support for health system.

Evolution of social mood in Spain throughout the COVID-19 vaccination process: a machine learning approach to tweets analysis.

OBJECTIVES: This paper presents a new approach based on the combination of machine learning techniques, in particular, sentiment analysis using lexicons, and multivariate statistical methods to assess the evolution of social mood through the COVID-19 vaccination process in Spain. METHODS: Analysing 41,669 Spanish tweets posted between 27 February 2020 and 31 December 2021, different sentiments were assessed using a list of Spanish words and their associations with eight basic emotions (anger, fear, anticipation, trust, surprise, sadness, joy and disgust) and three valences (neutral, negative and positive). How the different subjective emotions were distributed across the tweets was determined using several descriptive statistics; a trajectory plot representing the emotional valence vs narrative time was also included. RESULTS: The results achieved are highly illustrative of the social mood of citizens, registering the different emerging opinion clusters, gauging public states of mind via the collective valence, and detecting the prevalence of different emotions in the successive phases of the vaccination process. CONCLUSIONS: The present combination in formal models of objective and subjective information would therefore provide a more accurate vision of social reality, in this case regarding the COVID-19 vaccination process in Spain, which will enable a more effective resolution of problems.

Impact of the COVID-19 Pandemic on a Cancer Fast-Track Programme.

INTRODUCTION: The COVID-19 pandemic has disrupted many aspects of clinical practice in oncology, particularly regarding early cancer diagnosis, sparking public health concerns that possible delays could increase the proportion of patients diagnosed at advanced stages. In 2009, a cancer fast-track program (CFP) was implemented at the Clinico-Malvarrosa Health Department in Valencia, Spain with the aim of shortening waiting times between suspected cancer symptoms, diagnosis and therapy initiation. OBJECTIVES: The study aimed to explore the effects of the COVID-19 pandemic on our cancer diagnosis fast-track program. METHODS: The program workflow (patients included and time periods) was analysed from the beginning of the state of alarm on March 16th, 2020 until March 15th, 2021. Data was compared with data from the same period of time from the year before (2019). RESULTS: During the pandemic year, 975 suspected cancer cases were submitted to the CFP. The number of submissions only decreased during times of highest COVID-19 incidence and stricter lockdown, and overall, referrals were slightly higher than in the previous 2 years. Cancer diagnosis was confirmed in 197 (24.1%) cases, among which 33% were urological, 23% breast, 16% gastrointestinal and 9% lung cancer. The median time from referral to specialist appointment was 13 days and diagnosis was reached at a median of 18 days. In confirmed cancer cases, treatment was started at around 30 days from time of diagnosis. In total, 61% of cancer disease was detected at early stage, 20% at locally advanced stage, and 19% at advanced stage, displaying time frames and case proportions similar to pre-pandemic years. CONCLUSIONS: Our program has been able to maintain normal flow and efficacy despite the challenges of the current pandemic, and has proven a reliable tool to help primary care physicians referring suspected cancer patients.

SANITARY WASTE IN TIMES OF PANDEMIC AND UNDER THE CURRENT CIRCULAR ECONOMY MODEL

Medical waste constitutes a complex legal reality. This is the consequence of a disperse and heterogeneous regulatory group that is structured mainly through regional regulation. Although matters related to medical waste have been part of the sectoral legislation on waste, their prominence has been less, as evidenced in the latest regulatory updates that, influenced by the principle of waste hierarchy and under the inspiration of economics circular, have given a secondary space to sanitary waste. However, the health crisis caused by COVID- 19 has revealed the effects that incorrect treatment and management of this waste can have on the population and in relation to public health.

CHALLENGES IN THE NEUROSURGICAL CARE OF PEDIATRIC PATIENTS WITH CENTRAL NERVOUS SYSTEM TUMORS DURING THE COVID-19 PANDEMIC

INTRODUCTION: Central nervous system (CNS) tumors account for 20 - 30% of all childhood cancers. The Philippines is a lower-middle income country, wherein brain centers are located mostly in urban areas. We aimed to identify challenges that pediatric patients with CNS tumors encountered during the COVID-19 pandemic, which aggravated delays in their diagnosis and treatment. METHODS: This is a retrospective review of all pediatric patients who underwent neurosurgery for CNS tumors at the Jose R. Reyes Memorial Medical Center, a tertiary referral center, from January 2020 until December 2021. We summarized patients' demographic data, clinical course, and perioperative outcomes. RESULTS: A total of 38 pediatric patients underwent neuro-oncologic surgery in our center during the study period. There were 18 males and 20 females, with a mean age of 7.5 ± 4.9 years. Tumor was biopsied and/or resected in 35 cases (92%). The most common histologic diagnoses were medulloblastoma (n=8, 21%) and high-grade glioma/glioblastoma (n=5, 13%). Median preoperative length of stay and total length of stay were 10 (IQR: 17) and 28 (IQR 33.75), respectively. There was a high perioperative mortality rate in 2020 (71%), but this decreased to 20% in 2021. Six patients (16%) developed COVID-19 infection during the perioperative period. There were nine patients (24%) who had documented tumor progression because of delays in adjuvant therapy. DISCUSSION: Aside from geographic barriers and catastrophic health expenditure, the major challenges that disrupted the care of pediatric patients with CNS tumors in our center during the COVID-19 pandemic were delays in neuroimaging for diagnosis, unavailability of operating room slots, deficiency in critical care beds, and workforce shortage due to COVID-19 infection among health workers. Health care systems must adapt to the changes brought about by the pandemic, so that children with CNS tumors are not neglected.

BARRIERS IN THE MANAGEMENT OF PEDIATRIC HIGHGRADE GLIOMAS IN A LOW-RESOURCE SETTING DURING THE COVID ERA

INTRODUCTION: High-grade gliomas account for <5% of all pediatric brain tumors with a 20% 5-year overall survival even with maximal safe resection followed by concurrent radiotherapy and chemotherapy. Patients in low-and middle-income countries already face delays and barriers to the treatment they require. The current COVID pandemic has added unique challenges to the delivery of complex, multidisciplinary health services to these patients. METHODOLOGY AND RESULTS: We retrospectively reviewed the records of four patients, ages 2-18 years old, with histologically confirmed high-grade glioma managed in a tertiary government institution from 2020-2021. Three of the patients had a supratentorial tumor and one patient had multiple tumors located in both supra-and infratentorial compartments. Neurosurgical procedures performed were: gross total excision (1), subtotal excision (2), and biopsy (1). The tissue diagnoses obtained were glioblastoma (3) and high-grade astrocytoma (1). Two patients survived and are currently undergoing adjuvant radiotherapy and chemotherapy. The remaining two patients expired: one from hospital-acquired pneumonia and the other from COVID-19 infection. DISCUSSION: Decreased mobility due to lockdowns, the burden of requiring negative COVID-19 results before admission for surgery, reduced hospital capacity to comply with physical distancing measures, the postponement of elective surgery to minimize COVID-19 transmission, physician and nursing shortages due to infection or mandatory isolation of staff, cancellation of face-to-face outpatient clinics, and hesitation among patients and their families to go to the hospital for fear of exposure were found to be common causes of delays in treatment. Also, the redirection of health resources and other government and hospital policies to handle the COVID-19 pandemic resulted in an overall delay in the delivery of health services. In particular, the management of pediatric patients with cancers, especially high-grade gliomas, was significantly disrupted.

Communicative frames in the online strategy of European political parties during the coronavirus crisis: a polyhedral look at the far right

The current debate in the academic sphere regarding the role of extreme right-wing parties during the coronavirus pandemic extends to its communicative aspect. While some authors argue that these parties have focused their messages on the perspectives of fear, the threat represented by immigrants, or conspiracies in an unsuccessful way, even considering them to be the "losers of the crisis," others emphasize their ability to build a sense of community through resilience. The present research aims to take up these discussions and delve deeper into the study of the communicative frames of European political parties, with a particular focus on the far right, to draw more nuanced conclusions. For this purpose, a double methodology has been implemented through the coding of the frames used in a total of 2,757 Twitter posts during the month of March 2020 from the major government and extreme right-wing parties in Germany, France, Spain, and Poland. The results show that the parties studied present differences in their communicative frames, not according to their position on the ideological spectrum, as might be expected, but rather to their role as the executive power in the government or as part of the opposition of their respective legislative chambers.

Verification squaring the circle against misinformation and fake news?

In the last decades, disinformation has been multiplied exponentially within the information landscape. However, the COVID-19 pandemic has turned the situation critical. Fake news have become a real public health problem, spreading even faster than true information. To combat fake news, several fact-checking initiatives have been set up around the world, particularly in the context of the current health crisis. For its part, the European Union is one of the most exposed international organisations towards disinformation. It, therefore, counts on various stakeholders and tools to face it. Likewise, Spain also presents several experiences of news verification. On the other hand, technology companies also play a key role to fight against hoaxes, and some of them have already started to implement mechanisms against fake news. However, data verification is under debate due to the possibility of a backfire effect. In view of this, this paper has carried out a bibliographic review of previous research, combined with a non-experimental qualitative analysis of the results obtained. The aim has been to understand the phenomenon of fact-checking, its evolution and characteristics in order to analyse it as a potential final solution to disinformation. From this research, feedback from the scientific/university academia is sought in order to broaden their knowledge of the disinformation phenomenon. Therefore, the results of this study have a clear European public service vocation.

Impacto de la Covid19 en las barreras percibidas para practicar actividad física en las personas usuarias de centros fitness en España

Esta investigación pretende conocer las barreras percibidas, así como posibles variables predictoras, en personas que practican actividad física en centros fitness que se encontraban confinadas en el hogar por la pandemia de COVID19. La muestra estuvo conformada por 8.087 practicantes de actividad física. Se administró un cuestionario en línea por correo electrónico. Se realizó un análisis descriptivo de las barreras percibidas y un análisis de regresión logística para determinar posibles variables predictoras. Las barreras percibidas más importantes fueron el precio y la suerte de la seguridad. La edad, el sexo, la frecuencia de práctica física vigorosa y la observación de las recomendaciones de la OMS serían las variables predictoras en mayor medida de las barreras percibidas. Los resultados son relevantes para que las organizaciones deportivas planifiquen su oferta de servicios después del confinamiento.Alternate :This research intends to know the perceived barriers, as well as their predictor variables, in people who practice Physical Activity in fitness centers and were home confined due to the COVID-19 pandemic. The sample was conformed of 8,087 physical activity practitioners. An online questionnaire was administered by email. A descriptive analysis of the perceived barriers was done, and logistic regression analysis to determine possible predictor variables. The most important perceived barriers were price and a lack of safety. Age, gender, the vigorous physical practice frequency and the observation of the WHO recommendations would be the predictor variables to a larger extend for the perceived barriers. The results are relevant for sport organizations to plan their services offer post lockdown.Alternate :Esta pesquisa tem como objetivo conhecer as barreiras percebidas, bem como possíveis variáveis preditivas, em pessoas que praticam atividade física em academias de ginástica que ficaram confinadas em casa pela pandemia do COVID-19. A amostra foi composta por 8.087 praticantes de atividade física. Um questionário online foi administrado por e-mail. Uma análise descritiva das barreiras percebidas e uma análise de regressáo logística foram realizadas para determinar possíveis variáveis preditoras. As barreiras percebidas mais importantes foram o preçõ e a sorte na seguranęa. Idade, sexo, frequencia de prática física vigorosa e observancia das recomendações da OMS seriam as variáveis preditoras em maior extensáo das barreiras percebidas. Os resultados são relevantes para que as organizações esportivas planejem sua oferta de serviçõs após o confmamento.

Diachronic links. Re-signifying architectural heritage for the urban regeneration of central Granada

Central areas of cities such as Granada suffer strong pressures from tourism. They are constantly threatened by gentrification, declining social diversity, as well as by the deterioration and loss of meaning of their urban space. To counter this, urban planning needs to take advantage of the potential of the historic city. This is especially true in contexts such as Spain, where instruments and investments to develop adequate urban regeneration policies have been insufficient, mainly since the crisis of the second decade of twenty-first century, aggravated by the COVID-19 pandemic. For this reason, we believe that it is necessary to optimise the city's tourist resources, making heritage the driver of urban revitalisation that it can be. The study explores the strategic potential of architectural heritage to fully regenerate the city, from a spatial, functional and landscape perspective. The work begins by addressing a series of keys that have been internationally implemented in the discipline in recent decades to interpret and strengthen the concept of "heritage city". The approach seeks to link the listed architecture, both to itself and to its spatial environment: urban tourism, central public spaces as flexible and shared areas, the effects of gentrification, walkability, etc. Granada city centre's population vacuum was analysed, together with its standardisation and loss of public space quality, an evident urban theming and lack of comprehensive planning. We then propose the configuration of diachronic links, reflecting the city's evolution through time, using a cartographic approach, a functional analysis and a heritage characterisation that prioritises the environment. Thus, an assessment-diagnostic method is proposed that gives heritage new meanings and accentuates its urban role. We advance a number of sequences, whose topology is guided by the relational game between urban form, topography, social and functional realities and urban landscape. We conclude with a systematisation of the multidimensional attributes of heritage in the given sequence, leading to the promotion of future urban regeneration strategies. This way, we go beyond the isolated and static logic of a listed vision and bring about a dynamic and relational re-signification.

IMPACT of TENOFOVIR on SARS-CoV-2 INFECTION among PEOPLE LIVING with HIV

Background: The impact of some antiretrovirals against SARS-CoV-2 infection and disease severity is conflicting. We evaluated the effect of tenofovir alafenamide/emtricitabine (TAF/FTC) and tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) against SARS-CoV-2 infection and associated clinical outcomes among people living with (PLWH). Methods: We conducted a propensity score-matched analysis leveraging data from the PISCIS cohort of PLWH in Catalonia (Spain). We matched for TAF/FTC versus ABC/3TC in a ratio of 1:1, and 1:3 for TDF/FTC versus ABC/3TC, and TDF/FTC versus TAF/FTC. We used logistic regression to assess the association between tenofovir-based ART and SARS-CoV-2 diagnosis and associated hospitalisation. Results: In our entire cohort [median age: 46.1 years, 82.3% males], 7550 PLWH were being treated with TAF/FTC, 1020 receiving TDF/FTC, and 4135 receiving ABC/3TC. After propensity score-matching, SARS-CoV-2 diagnosis rates were the same in TAF/FTC versus ABC/3TC recipients (12.2% vs 12.2%, P=1.00);lower among TDF/FTC versus ABC/3TC recipients (9.7% vs 12.4%, P=0.05) with borderline significance;and lower among TDF/FTC versus TAF/FTC recipients (9.7% vs 12.6%, P=0.03). In well-adjusted logistic regression models, TAF/FTC was not associated with reduced SARS-CoV-2 diagnosis (adjusted odds ratio [aOR] 0.97;95% confidence interval [CI], 0.83-1.12) or associated hospitalisation (aOR 0.95;95% CI, 0.62-1.45). TDF/FTC compared to ABC/3TC, was not associated with reduced SARS-CoV-2 diagnosis (aOR 0.81;95% CI, 0.61-1.07) or hospitalisation (aOR 0.49;95% CI, 0.14-1.27). TDF/FTC was not associated with reduced SARS-CoV-2 diagnosis (aOR 0.81;95% CI, 0.61-1.07) or associated hospitalisation (aOR 0.47;95% CI, 0.14-1.22) compared to TAF/FTC. Conclusion: TAF/FTC or TDF/FTC were not associated with reduced SARS-CoV-2 diagnosis rates or associated hospitalisations among PLWH. TDF/FTC users had baseline characteristics intrinsically associated with more benign SARS-CoV-2 infection outcomes. Tenofovir exposure or not should not modify the preventive or therapeutic SARS-CoV-2 infection management.

Impact of Covid19 on perceived barriers to practice physical activity in users of fitness centers in Spain

This research intends to know the perceived barriers, as well as their predictor variables, in people who practice Physical Activity in fitness centers and were home confined due to the COVID-19 pandemic. The sample was conformed of 8,087 physical activity practitioners. An online questionnaire was administered by email. A descriptive analysis of the perceived barriers was done, and logistic regression analysis to determine possible predictor variables. The most important perceived barriers were price and a lack of safety. Age, gender, the vigorous physical practice frequency and the observation of the WHO recommendations would be the predictor variables to a larger extend for the perceived barriers. The results are relevant for sport organizations to plan their services offer post lockdown. © 2022. Servicio de Publicaciones de la Universidad de Murcia. All Rights Reserved.

Comparative analysis of positive mental health between men and women university students under COVID-19 social isolation

The main objective of this research study is to conduct a comparative analysis of positive mental health between men and women university students isolated due to COVID-19. Positive mental health is reviewed theoretically, including its associated measurement factors. Basic concepts of discriminant analysis are examined. Discriminant analysis is applied to assess significant differences between 337 men and women university students by using the Lluch’s Positive Mental Health scale, which measures the following factors: pro-social attitude, autonomy, self-control, personal satisfaction, problem solving, and interpersonal relationships. The results show that pro-social attitude, self-control, and problem-solving are significant factors for positive mental health of male and female university students. In conclusion, these findings can be used to prioritize intervention factors in programs or processes to improve psychosocial conditions of a given population in educational contexts. © 2022