Corona Larona: A 2.5D Mobile Game Advocating COVID-19 Safety Protocols and Mitigation Strategies

Governments and health agencies around the world have been at the forefront of managing the COVID-19 pandemic. To control the spread of the outbreak, mandatory safety protocols have been put into effect. Despite the continuous development and strict enforcement of these preventive guidelines, non-compliance with these mandatory safety protocols has been reported. Getting the message to the public is one of the key challenges in convincing people to follow mitigation policies. In this study, we employed the media of video games to advocate for COVID-19 safety protocols. We developed a video game called "Corona Larona"that features microgames with action gameplay playable on a mobile platform. Our video game concentrated on several preventive measures such as physical distancing, hand washing, wearing face masks as well as basic knowledge about the virus using in-game multiple choice questions. To our knowledge, this is the first video game dedicated to the COVID-19 outbreak and the mandatory safety protocols. In a time when many people play video games to survive their current situation, the Corona Larona game is a strategic example of using and maximizing this form of media for a more noble purpose. © 2022 IEEE.

Business, Government and the SDGs: The Role of Public-Private Engagement in Building a Sustainable Future

This book seeks to revise and challenge the roles and traditional realms of influence that national and local governments, and businesses at a critical juncture in terms of achieving sustainable development, faces when tackling the dual challenges of climate change and post-COVID recovery. Using the broader lens of the 2030 UN Sustainable Development Goals (SDGs) to assess the roles and responsibilities of each of these stakeholders and their relationships, the book offers policy, economic arguments, case studies and examples to argue that neither national or local governments, nor companies, could afford to deviate from the SDGs in the recovery from the current crisis, nor that the imperative of bold climate action should detract from the broader focus on sustainability. The analysis frames the debate of how a balance between people, planet, and profits can be achieved and how nations, regions and cities, and businesses, with their representative organizations, can achieve a sustainable recovery from the current global crisis, and contribute to climate smart, resilient and inclusive development. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023. All rights reserved.

ASSESSMENT OF MENTAL HEALTH IN MEDICAL PROFESSIONALS WHO EXERCISED THEIR ACTIVITY DURING THE COVID-19 HEALTH CRISIS.

Objectives: To study the impact of the health crisis on the mental health status of medical professionals who worked during the COVID-19 pandemic. Material(s) and Method(s): Anonymous online survey with occupational and non-occupational variables, Goldberg anxiety and depression questionnaire and the SF-12 perceived quality of life, conducted in September 2022, assessing current situation and one year ago in medical professionals. Result(s): In 2021, 58.1% had anxiety and in 2022, 46.5%. Regarding depression, in 2021 it was 39.5% and in 2022 it was 37.2%. The decrease in the anxiety score was significant (p <0.001). And the perceived quality of life (SF-12) on its mental scale in 2021 was 42.4 +/- 13.0 vs 47.1 +/- 11.8 in 2022, improving significantly (p <0.033). Conclusion(s): We found a high prevalence of anxiety and depression that is currently maintained, so it is of interest to implement mental health intervention programs for healthcare workers.Copyright © 2023, Accion Medica S.A.. All rights reserved.

Why Are Patients Not Getting a Graft? An Intent-to-Transplant Analysis in the Times of Universal Coverage and Haploidentical Donors

Introduction: Allogeneic hematopoietic stem cell transplantation (alloHSCT) is a potentially curative option for patients with hematologic diseases. When considered candidates, patients face barriers to receive a transplant. Therefore, we aimed to analyze factors that limit or favor access to an alloHSCT in a population that has been HLA typed and therefore with a potential intent-to-transplant. Method(s): We retrospectively reviewed records from 2015 until the start of the COVID19 pandemic in two Mexican government- funded transplant centers and one private that have in-house HLA typing;in two of them, an outpatient transplant strategy is followed for most patients. HLA-typed patients who were potentially eligible for transplantation were included and their outcomes were assessed in an intent-to-transplant basis. We compared the outcomes of patients who underwent transplantation to those who did not and evaluated contributing barriers to access alloHSCT with multivariate logistic regression. Result(s): A total of n=374 patients were analyzed. The median age at HLA-typing was 35 years (IQR 23-47);59.3% had acute(Table Presented) leukemia, 17.4% bone marrow failure or myelodysplastic neoplasms, 13.1% lymphoma, 8% myeloproliferative neoplasms, 1.1% chronic lymphocytic leukemia and 1.1% multiple myeloma. Most patients (55.9%) had government insurance coverage. Median time from diagnosis to HLA-typing was 8 months (IQR 3-19). The majority had a potential donor (94.4%): 56.4% haploidentical, 37.4% a matched sibling donor and 0.5% an unrelated donor. Almost half of them received a transplant (n=185, 49.5%), the median time from HLA-typing to alloHSCT was 2 months (IQR 1-5.5). Disease activity or progression was the biggest barrier for transplantation;Table 1. Donor availability limited transplant access for 12.1% of patients. Access to transplantation was favored by private/out-of-pocket payment (OR 2.1 95% CI 1.3-3.4), and receiving care in the outpatient center (OR 6.4 95% CI 4-10.0), while HLA matching was not (OR 1.2 95% CI 0.8-1.8). Non-relapse mortality in alloHSCT was 21%. Median overall survival (OS) from the intent-to-transplant cohort was 16 months (CI 95% 12.4-19.6). An OS landmark analysis for patients alive at or beyond 2 months (the median time from HLA-typing to alloHSCT) showed prolonged survival in alloHSCT (30 vs 12 months, p <.001), Figure 1. By the time of the analysis 159 patients (42.5%) were still alive and 115 (30.7%) were event-free.(Figure Presented)Conclusion: The most frequent barrier to transplantation was the disease itself, followed by the transplant waitlist and comorbidities. Access to resources and an outpatient strategy or "center effect" favored alloHSCT. In the era of haploidentical transplantation, donor availability was a smaller issue. Efforts to improve timely referrals and access to effective pre-transplant therapies should be undertaken.Copyright © 2023 American Society for Transplantation and Cellular Therapy

Characteristics of patients treated for suicidal behavior during the pandemic in a psychiatric emergency department in a Spanish province

Introduction: Different studies have suggested that psychological, social and economic factors could contribute to an increase in the suicide. That is why the scientific community fear an epidemic of suicides secondary to this crisis. The objective is to evaluate the variables related to suicidal behavior during the two states of alarm and to review if there were sociodemographic or clinical differences with respect to periods prior to the COVID-19 pandemic. Material(s) and Method(s): We compared visits to the emergency room and their characteristics of all patients with suicidal behavior before and after the pandemic in Lerida. Information on sociodemographic status, reason for consultation, diagnosis and characteristics of suicidal behavior was obtained from the electronic medical record. Result(s): No differences were observed in the percentage of suicidal ideation or attempts in the three periods (p = 0.201). The characteristics in the multiple logistic regression associated with suicidal behavior are: being a woman (OR: 1.81 [1.27-2.56]), living with relatives (OR: 1.55 [1.05-2.32]) and have a diagnosis of non-alcohol related substance use disorder (OR: 1.94 [1.09-3.42]). As protective factors, being visited in the emergency room during the second state of alarm (OR: 0.68 [0.48-0.96]) and having depression (OR: 0.67 [0.47-0.96]). Conclusion(s): Emergency care for suicidal behavior did not increase during the pandemic and, in fact, in 2020 completed suicides decreased by almost half in the province. Risk factors for suicide attempt were female gender, living with relatives, and having a substance use disorder diagnosis. Instead, depression was a protective factor.Copyright © 2022

Graphical-mathematical model to estimate CO2 concentration level as an indicator of SARS-CoV-2 transmission

The first documented cases of Coronavirus disease of 2019 (COVID-19) in Wuhan city (Hubei province, China) were caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), studies mention viral transmission is more common in indoor and poorly ventilated environments compared to outdoor environments or environments with abundant airflow. In this context, this research aimed to estimate, through a mathematical model by a Box-Behnken design, the time and occupancy required in a physical space to reach CO2 levels that exceed the risk level established as a safer condition of 700 ppm for SARS-CoV-2 transmission. According to the proposed mathematical model, it is possible to predict safe conditions. With this, it was found that natural ventilation is the best option to reduce CO2 concentration, considering the occupancy/m3 and time, allowing a constant airflow;the use of air conditioners to control the temperature in rooms without natural ventilation is suggested;notwithstanding, these types of equipment are not designed to reduce CO2 concentration. Thus, their use in rooms with open windows and doors leads to a shorter equipment lifetime, for this reason, its operation in special conditions, such as in rooms without natural ventilation should be considered

[Impact of Staphylococcus aureus bacteremia in COVID-19 patients]. / Impacto de la bacteriemia por Staphylococcus aureus en pacientes con COVID-19.

OBJECTIVE: The disease caused by SARS-CoV-2 (COVID-19) has been a challenge for healthcare professionals since its appearance. Staphylococcus aureus has been described as one of the main pathogens causing bacterial infections in viral pandemics. However, co- infection with S. aureus causing bacteremia in patients with COVID-19 has yet to be well studied. METHODS: We performed a e study of S. aureus bacteremia (SAB) at Hospital Miguel Servet (Zaragoza) from March 2020 to February 2021. The clinical characteristics, mortality and risk factors of adults hospitalized patients with BSA associated COVID-19 compared to patients without COVID-19. RESULTS: A total of 95 patients with SAB were identified. 27.3% were positive for SARS-CoV-2. SAB represented 9.9% of bacteremia, being the second agent in frequency after E. coli. Nosocomial bacteremia was more frequent in the group of COVID-19 patients. The most frequent source of BSA in these patients was the respiratory source (26.9% vs 0%; P<0.001) followed by the skin (15.5% vs 15.9%; P=1). The development of sepsis was more frequent in COVID-19 patients (61,5% vs 7,8%; P=0,336) and among them, who received dexamethasone at doses > 6 mg/day (62.5% vs. 37.5%, P<0.05). CONCLUSIONS: Our data suggest that BSA has a negative impact on the evolution of patients with COVID-19. However, further and preferably prospective studies are required to obtain solid data on the impact of BSA on coronavirus patients.

Assessing satisfaction with the care given by peritoneal dialysis patients during the pandemic

Introduction: The COVID-19 pandemic forced our unit to alternate in-person consultations with telephone consultations, without this increasing urgent visits. Therefore, it seemed necessary to know the patient's opinion regarding this matter. Objective: To assess the satisfaction of patients receiving peritoneal dialysis with the quality of care received through a mixed model of in-person and teleconsultations. Material and Method: PA descriptive cross-sectional study was conducted between February and March 2021, using an anonymous telephone survey conducted by an independent interviewer. Inclusion criteria: aged over 18, receiving peritoneal dialysis, and giving their consent. Variables collected: age, sex, primary caregiver, provider (Baxter® / Fresenius® ), hospital admission (Yes/No). Satisfaction questionnaire (9 questions): 2 open-ended, 1 semi-closed with a dichotomous response and free text, and 6 closed with Likert-type response from 0-10. Results: Of the 78 peritoneal dialysis patients, 71 participants were included. 59.1% (n=42) were men, with an average age of 66.1 years (23.33-91.23 years). The average score for healthcare received through the mixed model of visits was 9.5 ±1.13. Regarding aspects to improve in phone consultations, 61.2% (n=41) considered it unnecessary to assign a specific time, 11.2% (n=8) stated the need to receive changes in writing, 4.5% (n=3) requested an improvement in the request for laboratory analysis at the healthcare center, and none considered video calls necessary. Conclusions: The patient's satisfaction with our mixed model of visits seems to reflect a good quality of care, subject to improvement and individualization. © 2023, Sociedad Espanola de Enfermeria Nefrologica. All rights reserved.

Covid-19 Literacy as a Modulator of Emotions Linked to the Pandemic

An inquiry-based teacher training proposal concerning covid-19 was implemented during lockdown with Pre-Primary Education Degree students. The objective was to analyse how the workshop changed the students' emotions and their knowledge linked to the pandemic. To this end, the participants responded to an open-ended questionnaire passed out before and after the workshop, and to a Likert-type questionnaire on emotions when they handed in their responses. The results show that, in the case of learning, the students modified their covid-19 literacy to a greater or lesser extent and, in the case of emotions, they felt less fear, anger, concern, and insecurity, and greater tranquillity and optimism. In conclusion, an emotional modulation is perceived in which scientific literacy participates. © 2023 Eskisehir Osmangazi University. All rights reserved.

Seroprevalence of ANTI-SARS-CoV-2 antibodies in patients with inflammatory bowel disease.

Patients with inflammatory bowel disease (IBD) treated with biologic and/or immunosuppressant drugs are at increased risk for opportunistic infections. Seroprevalence studies can confirm the diagnosis of SARS-CoV-2 infections as well as the associated risk factors. This is a descriptive study which primary endpoints were to highlight the prevalence of SARS-CoV-2 antibodies in a cohort of IBD patients in March 2021, and to analyze seroconversion in patients with known COVID-19 infection and its relationship with IBD treatments. Patients filled in a questionnaire about symptoms of COVID-19 infection and clinical information about their IBD. All included patients were tested for SARS-CoV-2 antibodies. 392 patients were included. Among patients with clinical infection, 69 patients (17,65%) were IgG-positive, 286 (73,15%) IgG-negative and 36 (9,21%) indeterminate. In relation to seroconversion among patients under biologic treatment, 13 patients of the 23 with a previous positive CRP developed antibodies (56.5%). However, when the influence of immunosuppressive treatment on the probability of developing antibodies was analyzed, no significant differences were seen between those patients with or without treatment (77.8% vs. 77.1%, p = 0.96). In our cohort of IBD patients, after one year of pandemic, there were 18.64% IgG positive patients, a higher prevalence than the general population (15.7%).

Raspberry-based Low-resolution Thermal image system using a Smoothing Filter-based Kalman

Since the emergence of global epidemics such as SARS-CoV-2, H1N1, SARS and MERS, a wide range of systems for measuring temperature have been developed based on computer vision to reduce and prevent the virus contagious. By implementing a Raspberry-based Low-resolution embedded system based and a FLIR Lepton® sensor human body temperature is measured and improved by four different algorithms implemented. Firstly, three traditional time-series processes solving such as, Simple Mean (SM), Simple Moving Average (SMA), and Multi Lineal Regression (MLR), and secondly, and online filter-based Kalman predictor were implemented to increase the signal to noise ratio of the acquired temperature magnitude. Results of average prediction for different benchmarks demonstrate the best performance of Kalman Filter upon traditional processes. In addition, this algorithm achieves to smooth output temperature with fewer samples (∼10% of total samples) in comparison MLR and SMA. Finally, Raspberry-based Low-resolution Thermal image system is a feasible tool as a high-speed temperature estimator, by implementation of algorithms codified in Python language. © 2022 IEEE.

Sotrovimab: a new therapeutic option in lung transplant

Introduction: SARS-CoV2 infecction has a high impact on lung transplant patients. Sotrovimab, an Ig1 monoclonal antibody, has been shown to be effective for the treatment of SARS-CoV2 infection, and could be an option for these patients. Aims and objectives: Describe the evolution of the patients who have received treatment with Sotrovimab. Method(s): Observational retrospective study, which included lung transplant patients who received Sotrovimab for SARS-CoV2 infection, at the Puerta de Hierro Hospital. The study period is from November 2021 to January 2022. Variables: age, sex, type of transplant, days from Active Infection Diagnostic Test (AIDT) until drug administration, admission unit - ward, Intermediate Respiratory Care Unit (IRCU) or Intensive Care Unit (ICU) and days of admission. Also need for respiratory support, complications and death. Result(s): A total of 13 patients (9 males) with a mean age of 61 years (+/-12.3) with doble-lung transplant in 10 of them. The mean time from the AIDT until recieve Sotrovimab was 6+/-3 days. All patients required hospitalization with a mean of stay 16+/-11 days. 5 patients were admitted to the IRCU and 1 patient to the ICU. 2 patients were still hospitalized at the time of data collection (1 in the IRCU and 1 in the ICU). All patients required respiratory support (table 1). The complications are described in table 1. 3 patients died. Conclusion(s): Sotrovimab is a therapeutic option in lung transplant patients with SARS-CoV2 infection.

IMPACT OF THE APPLICATION OF THE "FLIPPED CLASSROOM" METHODOLOGY ON THE APPROPRIATION OF THEORETICAL CONTENTS IN A PROJECT COURSE

The technological advances of recent times have allowed them to innovate in different teaching methods with the aim of enriching the learning of the students. Also, in the current era of COVID 19 educational institutions have had the need to adapt to these technologies to provide classes in a virtual way, simultaneously seeking better pedagogical methodologies. In the specific case of this research, learning results will be analyzed when a change of methodology is introduced in the dictation of the subject in a virtual environment. The research developed using a mixed methodology of analysis seeks to compare in two virtual teaching scenarios - learning, the implementation or not of the flipped classroom. Analyzing the appropriation of theoretical contents in a project course through quantitative methods. Surveys will also be applied, which will have open questions, providing in this way the information necessary to carry out a content analysis of this and thus determine the most relevant aspects that this methodology has contributed to students. These results will provide evidence of those positive and negative aspects that, as lessons learned, will improve the results of the teaching process - learning. © 2022 by the authors. Licensee AEIPRO, Spain.

Digital Nomad Tourism: The Experience of Living at the Destination

The negative impact of COVID-19 on international tourism mobility generated two opposite types of discussion: one focusing on how to return to "normality,” and another on how to transform this crisis into an opportunity for redesigning tourism. Mobility restrictions have created a test scenario for teleworking, which has led to the consolidation of the number of digital nomads, describing the professional who uses digital technology and needs a high-quality Internet connection to be able to develop both a professional and a social online and offline lifestyle, while travelling. Digital nomadism represents an increasing tendency worldwide, questioning the existing forms of combining work and leisure and blurring the boundaries between mobility for work and for tourism. As a consequence of the rapid growth of digital nomadism, various destinations have refocused their marketing strategy and present themselves as "digital nomad-friendly” destinations, with ideal conditions to live and work. Urban spaces were the first to react to this new demand due to existing infrastructure standards, whereas rural territories entered the game without much preparation due to the need for escaping the pandemic's effects, considered as isolated and safe areas. Through a theoretical perspective, this paper investigates innovation in the tourism sector in general, as it focuses on the analysis of not only a new segment of tourism but also the analysis of a new concept of mobility that challenges the conventional profile of a tourist and offers new opportunities both for rural and urban destinations. A number of emerging concepts of analysis associate coworking spaces with tourist attractions and the gender perspective within this type of mobility. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Guidelines on epidemics in Mexico. Historical perspective.

A perspective of epidemics and pandemics in Mexico is offered, focusing on three time periods, namely, end of the 18th century, the 20th century, and the 21st century, in order to analyze how they were approached by health and government authorities, as well as the challenges they have represented. Historical documentary sources were consulted and, in current cases, participation in them was analyzed. Epidemiological and social historical methodologies were combined. The presence of epidemics in Mexico is a constant on its evolution, which highlights the need for the epidemiological surveillance system to be updated, the importance of being prepared to face an epidemic and to develop a contingency plan.Copyright © 2022 Academia Nacional de Medicina de Mexico, A.C. Publicado por Permanyer.

Influence of diabetes mellitus on the prognosis of patients hospitalised for COVID-19

Background: Various studies have established a relationship between coronavirus infection (COVID-19) and diabetes mellitus (DM) as a factor of poor prognosis. Purpose(s): To determine the influence of DM on the evolution of patients hospitalised by COVID-19. Method(s): Retrospective observational study. All hospitalised patients with COVID-19 infection treated with Lopinavir/Ritonavir and Hydroxychloroquine during March and April 2020 were included. Two cohorts were performed: patients with DM and patients without DM. Patients who were not discharged or exited until April 30th 2020, were excluded. The treatment guidelines used were: Lopinavir/Ritonavir 200/50 every 12 hours mg for 14 days and Hydroxychloroquine 400 mg every 12 hours on the first day, followed by 200 mg every 12 hours during four days. Data were obtained through the Athos-Prisma inpatient prescription programme and review of medical records at Diraya. The chi-square test of comparison between data series of the two patient subgroups was performed. Result(s): Fifty-six (56) patients, 40 men and 16 women were included. The cohort of patients with DM (n=15) presented a mean of 66.7 years (53.8-79.6) vs 65.8 years (52.4-75.7) in the cohort of patients without DM (n=41). Mortality in the group with DM was 46.6% vs. 29.2% in the group without DM. After performing the chi-square test, a p>0.05 was obtained, so the differences between the two subgroups were not statistically significant. Conclusion(s): Our results do not associate DM with a poor prognostic factor in COVID-19 infection, although they are conditioned to the small sample size available. New studies with a larger number of patients will be necessary.

MODELLING THE COVID-19 PANDEMIC: VARIANTS AND VACCINES

In December 2019, a new coronavirus, the SARS-CoV-2, was detected in the Chinese city of Wuhan. Since then, many mathematical models have been developed to study the possible evolution of the COVID-19 disease and shed some light on the different biological processes of concern. On 14 December 2020, the United Kingdom reported a potentially more contagious and lethal variant of the virus, at the same time that different vaccines were being tested in order to prevent severe forms of the disease. In the following lines, we revisit a model proposed by our team, which took into account these two determining facts, showing its performance with real Italian data. © 2022, Scipedia S.L. All rights reserved.

Selection of the best of 2022 in cardiac imaging

This review article aims to summarize the role of cardiac imaging regarding the most relevant technical and knowledge advances published within the last year. Although diagnosis and detection of cardiac involvement due to coronavirus disease maintain a prominent place, other interesting hot topics have been raised. Among the most relevant, it is noteworthy to highlight the prognostic utility of different parameters obtained by advanced imaging techniques in the field of valvular heart disease, cardiovascular prevention or cardio-oncology, the prominent role of imaging in the first diagnostic step of the new Chest Pain guidelines or the exponential growth of percutaneous structural interventionism, where further knowledge is demanded in terms of patient selection, procedure timing or predictors of success. Finally, artificial intelligence is a promising tool already in our hands, we hope that diagnostic precision and interpretation time will improve thanks to these technological advances. Copyright © 2022 Sociedad Espanola de Cardiologia

Background rates of 41 adverse events of special interest for COVID-19 vaccines in 10 European healthcare databases - an ACCESS cohort study.

BACKGROUND: In May 2020, the ACCESS (The vACCine covid-19 monitoring readinESS) project was launched to prepare real-world monitoring of COVID-19 vaccines. Within this project, this study aimed to generate background incidence rates of 41 adverse events of special interest (AESI) to contextualize potential safety signals detected following administration of COVID-19 vaccines. METHODS: A dynamic cohort study was conducted using a distributed data network of 10 healthcare databases from 7 European countries (Italy, Spain, Denmark, The Netherlands, Germany, France and United Kingdom) over the period 2017 to 2020. A common protocol (EUPAS37273), common data model, and common analytics programs were applied for syntactic, semantic and analytical harmonization. Incidence rates (IR) for each AESI and each database were calculated by age and sex by dividing the number of incident cases by the total person-time at risk. Age-standardized rates were pooled using random effect models according to the provenance of the events. FINDINGS: A total number of 63,456,074 individuals were included in the study, contributing to 211.7 million person-years. A clear age pattern was observed for most AESIs, rates also varied by provenance of disease diagnosis (primary care, specialist care). Thrombosis with thrombocytopenia rates were extremely low ranging from 0.06 to 4.53/100,000 person-years for cerebral venous sinus thrombosis (CVST) with thrombocytopenia (TP) and mixed venous and arterial thrombosis with TP, respectively. INTERPRETATION: Given the nature of the AESIs and the setting (general practitioners or hospital-based databases or both), background rates from databases that show the highest level of completeness (primary care and specialist care) should be preferred, others can be used for sensitivity. The study was designed to ensure representativeness to the European population and generalizability of the background incidence rates. FUNDING: The project has received support from the European Medicines Agency under the Framework service contract nr EMA/2018/28/PE.