Clinical characteristics of post-vaccination COVID-19 infection in health care workers exposed to Delta and Omicron variants in a COVID-19 dedicated facility from Qatar

Background: Evidence suggests that vaccines efficacy lies on the prevention of severe symptomatic disease. We aim to describe the clinical characteristics of COVID-19 infection among healthcare professionals (HCPs) after vaccination, during periods of transmission of SARS CoV-2 variants in a COVID-19 dedicated facility. Methods: A retrospective observational study of HCPs confirmed with COVID-19 during the period March 2021 to Jan 2022 was conducted. Delta period (March-August 2021), and Omicron period (Dec 2021-Jan 2022) were defined. Clinical, laboratory, radiology and vaccination history was collected from electronic medical records. Results: COVID-19 infection was reported in 16 and 138 HCPs during the Delta and Omicron period respectively. By category the nurses predominate, and a significant contribution of the healthcare related transmission against the community-related one. Higher frequency of loss of taste (37.5% vs 4.3%), and loss of smell (43.8% vs 3.6%) was observed during Delta period. Myalgia (12.5% vs 37.7%), and sore throat (6.3% vs 55.8%) predominated in Omicron period. Bilateral ground-glass appearance of the lung was observed in 28.6% and 7.1% in the Delta and Omicron period, respectively. Higher cycle threshold values of the polymerase chain reaction test during Omicron period, in comparison with Delta period, was observed (22.98 vs 25.98). Time from previous vaccine dose to positive laboratory test was longer during the Delta period (131 vs 98.26 days). Conclusion: SARS CoV-2 viral variants infections in HCPs were associated to selected clinical and epidemiological characteristics, with less severe disease for Omicron variant, and potential shorter duration of the immune response to vaccination. © 2020 The author (s)..

Distance evaluation in translation: synchronous exam proposal

This article presents a methodological proposal for online assessments undertaken working from home during lockdown and the health emergency arising from the Covid-19 pandemic. This proposal consisted in designing and implementing an online and synchronous format for a final written assessment, based on the following three factors: enablers, deterrents and supervision criteria. The model was applied to two subjects of the undergraduate degree in translation and interpreting from the Universitat Jaume I (Spain), in particular in German to Spanish I and II translation classes. The results of the pilot test allow us to draw conclusions about the pros and cons of remote assessment in translation and could be applied to other translation courses or subjects in other disciplines.

Pandemic and Primary School, an Experience with Educational Apps

The confinement by pandemic Covid-19 led to seek alternatives to innovate teaching and learning, during the period of professional practices developed in the sixth semester of the Bachelor's Degree in Elementary Education. The experience where educational Apps are used with second grade students of Francisco I. Madero Elementary School, Chilcuautla, Hidalgo, is presented. We start from the diagnosis, which considers internet access and skills in the use of devices such as cell phones;we design and implement the proposal where children interact with applications / games and at the end of teaching practice journey we analyze the results. Among those that stand out are that they learn with the use of the applications, interact with their peers and allow them to create their own conjectures about their learning.

Iatrogenic tracheal stenosis: another cause of persistent dyspnea after COVID-19

Introduction: During the COVID-19 pandemic, the number of patients who required admission to the intensive care unit (ICU) and prolonged intubation (ETI) or a tracheotomy (TT) due to severe ARDS has increased. Causes of persistent dyspnea after severe COVID-19 pneumonia include diffuse lung disease and pulmonary embolism. However, other causes of persistent dyspnea need to be ruled out in COVID-19 ICU-survivors, including iatrogenic tracheal stenosis (TS). Iatrogenic TS account for 50% of the 15-20 patients evaluated every year in the laryngotracheal multidisciplinary team (MDT) of our center. The management of these patients requires an individualized and multidisciplinary assessment, including Interventional Pulmonologists, Thoracic Surgeons and Otolaryngologists. The objective of this study was to describe the cases of iatrogenic TS after severe pneumonia due to COVID-19. Material(s) and Method(s): A descriptive study of the cases of iatrogenic TS in COVID-19 ICU-survivors evaluated at our center's MDT, from the end of the first wave to present. Result(s): A total of 10 patients were included, 70% were women, with a median age of 60 years [53.5-64.5]. The median ICU stay was 58.5 days [34-91]. All patients were intubated and 9 of them (90%) required TT, in 2 cases due to extubation failure. Symptoms at diagnosis included dyspnea in 3 (30%), stridor in 6 (60%) and 1 (10%) was asymptomatic. TS location was glottic in 2 (20%) and tracheal in 8 (80%). The main cause of TS was ring fracture secondary to TT (40%). Conclusion(s): Iatrogenic TS is a rare cause of dyspnea in COVID-19 ICU-survivors, but it must be considered in these patients given the high number of patients who required prolonged ETI or TT during the COVID-19 pandemic.

Relation between Ferritin Levels and Pulmonary Affectation in Covid-19

Introduction: In the SARS COV2 pneumonia acute-phase reactants, such as ferritin levels (FL), are elevated due to cytokine storm and hemophagocytic lymphohistocytosis. No direct relation between radiographic pulmonary involvement and blood levels of ferritin has been proved. In this study we try to identify this relation. Material(s) and Method(s): We carried on a descriptive retrospective matched cohort study of patients diagnosed with COVID-19 from 07/01/20 to 12/31/20 who were reviewed in PostCOVID consult. For quantifying the severity of pneumonia, a score was calculated by adapting and simplifying the Radiographic Evaluation of Pulmonary Edema (RALE) scale proposed by Warren et al (2018). We chose more severe X-rays at diagnosis and the FL at that time and at 6 weeks. Statistical studies were performed with SPSS (v25). Result(s): The analysed sample was 130 patients (70 men) with average age 62yrs. The 96% required hospitalization. FL at diagnosis were high, in men 1.080mug/l (IQR=1.036) and in women 629mug/l (IQR=816), p=0.003. No significant differences were found when analysing by age groups (<54, 55-75 and >75yrs). When we compared FL and severity of Xr affectation with SCORE RALE (SR) at diagnosis, we obtained p=0.007 for mild-severe comparison. No other comparisons with statistical significance were obtained. The median of FL at review normalized regardless of the initial SR (global decrease 66%), with no differences observed between groups. Conclusion(s): - The patients in our study had high FL at diagnosis, being higher in men, and were normalized at control. - Patients with severe radiographic affectation had higher median of ferritin at diagnosis compared to the ones with mild affectation.

‘Belong anywhere': Focusing on authenticity and the role of Airbnb in the projected destination image

There is little research that analyses the contribution of tourism-related digital platforms, and particularly Airbnb, to the creation and projection of international destinations' images. This study seeks to address this gap by developing a content analysis of the Airbnb Guides to more than 500 global urban neighbourhoods (globalhoods). We analysed Airbnb users' descriptions posted in the period following the Great Recession up to the COVID-19 pandemic. Content analysis shows how Airbnb projects the images of these globalhoods through a narrative based on creating a perception of authenticity but that finally projects a commodified image of destination identities and their communities. © 2022 The Authors. International Journal of Tourism Research published by John Wiley & Sons Ltd.

Biotechnology firms, signals, and venture capital investment

Purpose: Biotechnology has gained such prominence in the past years that approximately 50% of new drugs developed worldwide are of biotechnological origin. Some of the Covid-19 vaccines are a good example of this development. However, biotechnology R&D projects are characterized by high costs, prolonged development times, and a high degree of uncertainty and failure. Only few types of financial agents undertake such risky investments, among which are venture capital firms. In this paper, we analyse the signals that influence suchlike venture capital investment decisions. The very high level of risk, which differentiates biotechnology firms from other technology companies, justifies an analysis focused solely on biotechnology firms.Design/methodology: Hypotheses about the effectiveness of these signals are validated by means of a probit regression with panel data on a sample of 210 biotechnology companies established in Spain over a ten-year period.Findings: A positive and negative signalling effect has been found for some of the phenomena analysed, which validate the proposed model.Research limitations/implications: A convenience sample has been used for methodological reasons. Some phenomena that could have some effect on the venture capital investment decisions have not been possible to observe.Practical implications: It can be crucial for biotechnology firms for their managers to know which characteristics make these firms attractive to venture capital firms. Additionally, it is important to be aware of signals that, instead of favouring investment decisions, deter them.Originality/value: This is the first study conducted for the Spanish industry to focus on the first venture capital investment - rather than the typical focus on the amount invested-as an event that mitigates the information asymmetry level, and which includes also a distinction between four types of strategic alliance, the use of a probit regression with panel data, and a quantitative analysis on the biotech industry.As the Spanish biotechnology and venture capital industries differ from those established in other European countries, this work offers new elements of analysis, description, and comparison of these industries. In addition, the construction of a database on a sample of 210 Spanish biotechnology firms is unprecedented and can be used for future research.

Public food policies of different levels of government during the COVID-19 pandemic: the case of Bahia Blanca

This article analyses food policies implemented during the COVID-19 pandemic in Bahia Blanca, Buenos Aires, based on legislation, budgetary data and official statistics on poverty and indigence. During the pandemic, different levels of government increased the scope of most social programs and, in particular, those aimed at guaranteeing access to food directly or indirectly became of vital importance. In Bahia Blanca, most of the public investment allocated to the health emergency was directed to the purchase and distribution of food, which reflects an important role of the local level in food assistance programs. However, despite the initiatives of the different levels of government, these were not enough to address the increase in the potential need for food assistance in the population.

PRIOR EXPOSURE TO IMMUNOSUPPRESSIVE AGENTS AND COMORBIDITIES ARE ASSOCIATED WITH WORSE OUTCOMES OF SARS-COV2 INFECTION IN PH-NEG CHRONIC MYELOPROLIFERATIVE NEOPLASMS: RESULTS OF EPICOVIDEHA SURVEY

Background: Philadelphia-negatie chronic myeloproliferatie neoplasms (MPN) typically incur high rates of thrombosis and infections and cytoreductie drugs may modulate such risks. Aims: The present analysis aims at assessing the seerity and outcomes of MPN facing coronairus disease 2019 (COVID-19). Hence, we aimed to assess the impact of immunosuppressie agents and comorbidity burden in COVID- 19 outcome. Methods: The EPICOVIDEHA registry is an online surey (www.clinicalsureys.net) that has collected since April 2020 until January 2022 5,445 cases of COVID-19 in indiiduals with baseline haematological malignancies (Salmanton-García et al, 2021 Hemasphere) The surey is promoted by the European Hematology Association - Infectious Diseases Working Party (EHA-IDWP) and has been approed centrally by the Institutional Reiew Board and Ethics Committee of Fondazione Policlinico Uniersitario A. Gemelli - IRCCS - Uniersità Cattolica del Sacro Cuore, Rome, Italy (Study ID: 3226). Results: Oerall, 308 patients (5.6%) with MPN were obsered for a median of 102 days (IQR: 21-223, range 22-97) after COVID-19 diagnosis. Median age at infection was 69 years (IQR: 58-77, range 22-97) and at least one comorbidity was reported from most of the indiiduals (62.6%, n = 193). A large portion of patients had a history of cardiopathy (n=109, 35.4%), diabetes (n=40, 15.9%), or chronic pulmonary disease (n=44, 14.3%). Myelofibrosis (MF) (n=140, 45.4%) was the most prealent baseline malignancy, with 18 MF patients (12.9%) reporting 3 or more comorbidities. Out of the whole cohort, 72 patients (42.8% of MF) receied immunosuppressige therapies including steroids, immunomodulatory drugs (IMiDs) or JAK-inhibitors. Hospitalization and consecutie admission to intensie care unit was required for 187 (60.7%) and 45 (24%) patients, respectiely. At multiariate logistic regression, Hospital admission was predicted by age >70 years (OR 2.809;95% CI 1.651-4.779), exposure to immunosuppressie therapies (OR 2.802;95% CI 1.5380-5.103) and comorbidity burden. During the study follow-up (median 101 days;range 21-222) 84 patients deceased after a median time of 14 days (IQR: 8-49, range 0-457) since COVID-19 diagnosis. The fatality rate (FR) decreased from 40.3% (50 out of 124) in the first two quarters of year 2020 to 15.8% (3 out of 19) in the first two quarters of year 2021 (p<0.05). Death was principally attributable to COVID-19 in 58 patients (69.0%) and contributable by COVID-19 in 15 (17.9%). FR was particularly high (54 out of 140, 38.6%) in MF patients and in patients receiing immunosuppressie agents (32 out of 86, 37%). Moreoer, FR increased from 13.0% in indiiduals with no comorbidity to 36.0% and 62.1% in those with >2 or >3 comorbidities, respectiely. More specifically, three comorbidities independently increased the FR: chronic cardiopathy (HR 1.653;95%CI 1.017-2.687), chronic pulmonary disease (HR 1.847;95% CI 1.097-3.109), and diabetes mellitus (HR 1.712;95% CI 1.006-2.914). A heay comorbidity burden, namely 3 or more comorbidities (HR 2.956;95% CI 1.403-6.227), adanced age, namely >70 years (HR .809;95% CI 1.651-4.779), myelofibrosis (HR 2.501;95% CI 1.384-4.519), and ICU admission (HR 2.669;95% CI 1.641-4.342) independently predicted FR. (MF) (n=140, 45.4%) was the most prealent baseline malignancy, with 18 MF patients (12.9%) reporting 3 or more comorbidities. Out of the whole cohort, 72 patients (42.8% of MF) receied immunosuppressige therapies including steroids, immunomodulatory drugs (IMiDs) or JAK-inhibitors. Hospitalization and consecutie admission to intensie care unit was required for 187 (60.7%) and 45 (24%) patients, respectiely. At multiariate logistic regression, Hospital admission was predicted by age >70 years (OR 2.809;95% CI 1.651-4.779), exposure to immunosuppressie therapies (OR 2.802;95% CI 1.5380-5.103) and comorbidity burden. During the study follow-up (median 101 days;range 21-222) 84 patients deceased after a median time of 14 days (IQR: 8-49, range 0-457) since COVID-19 diagnosis. The fatality rate (FR) dec eased from 40.3% (50 out of 124) in the first two quarters of year 2020 to 15.8% (3 out of 19) in the first two quarters of year 2021 (p<0.05). Death was principally attributable to COVID-19 in 58 patients (69.0%) and contributable by COVID-19 in 15 (17.9%). FR was particularly high (54 out of 140, 38.6%) in MF patients and in patients receiing immunosuppressie agents (32 out of 86, 37%). Moreoer, FR increased from 13.0% in indiiduals with no comorbidity to 36.0% and 62.1% in those with >2 or >3 comorbidities, respectiely. More specifically, three comorbidities independently increased the FR: chronic cardiopathy (HR 1.653;95%CI 1.017-2.687), chronic pulmonary disease (HR 1.847;95% CI 1.097-3.109), and diabetes mellitus (HR 1.712;95% CI 1.006-2.914). A heay comorbidity burden, namely 3 or more comorbidities (HR 2.956;95% CI 1.403-6.227), adanced age, namely >70 years (HR .809;95% CI 1.651-4.779), myelofibrosis (HR 2.501;95% CI 1.384-4.519), and ICU admission (HR 2.669;95% CI 1.641-4.342) independently predicted FR. Summary/Conclusion: COVID-19 infection led to a particularly dismal outcome in patients exposed to immunosuppressie agents and in those with chronic heart or pulmonary diseases, or diabetes. These data allow to tailor future strategies for preenting seere COVID-19 in MPN patients. (Table Presented).

Electronic Vital Signs Monitoring System Based on IoT-COAP Protocol

The COVID-19 pandemic caused complications to the health system in Ecuador, both for medical care and for the prevention of the transmission of respiratory diseases. The project developed is a telemedicine system consisting of: A portable bracelet for data acquisition, a server for storing information in the cloud to display it in a web application and an assistant in the Telegram application for consultations and alerts with a smartphone. BPMs, SpO2 and body temperature levels are measured on the low-cost cuff and sent to the server via the CoAP protocol. The test group for data validation was 20 people between 25 and 40 years of age, obtaining a reliability of the device within the values allowed by the Pan American Health Organization (PAHO). © 2022, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.

STUDY 'aR-CAT INICI': MANAGEMENT of EARLY RHEUMATOID ARTHRITIS in CATALONIA

Background: Given the progressive change in the management of infammatory diseases,an observational study was conducted on the management of Early Rheumatoid Arthritis (ERA) in Catalonia. Objectives: To know the management of ERA in Catalonia, to assess whether the recommendations of the EULAR/ACR guidelines are followed and to study the causes of management variability,to set improvement objectives. Methods: An observational,descriptive,and cross-sectional study was conduct-ed,with data collection from June 15 to 30, 2021.The rheumatologists' partners of the Catalan Society of Rheumatology were the object of study. An online survey was conducted with 304 members on the management of the ERA. Variables related to the characteristics of the respondents,the derivation and variables of the disease including clinical variables,type of treatment and outcomes used for follow-up including the impact of the SARS-CoV2 pandemic were included. The univariate study was performed using a study of proportions with Pearson's correlation. Results: A total of 105 members (34.5%) responded to the survey.11.6%>60 y, only 7.8% <30y. 99% were in public assistance.The number of rheuma-tologists per service is 7.2[1-17],but 34.2% had< 5 rheumatologists,with a reference population of 200,000-300,000p in 42% of respondents.The number of weekly visits made is 67.5[20-130].42.2% do not have a monographic RA or ERA dispensary and 30.4%not have specialized nursing.Characteristics of ERA:77.5% are derived from primary care(PC),52% have been between 6 weeks,42.1%>3 months.54.9% make a frst visit within 2-4 weeks of PC referral and 14.7%> 8 weeks.100%provide previous analysis,only 47% had had RX performed.98% were previously treated(50.4%NSAIDs + CG,36.1%NSAIDs,12.3% CG).4.3% had GC doses>10 mg/day,11.3%> to 20mg/day.The treatment:DMARDs of choice in 100% is MTX,44.1% start doses of 10mg/week and 3.9%7.5 mg/week.The route of choice is oral(55.9% vs 44.1%).92.2% associate GC and 31.7% have not withdrawn them after 6 m.57.8% consider the maximum of MTX 25mg/W.87.1% use doses<10 mg/day,with the most used dose being 5 mg/day(35.6%).Follow-up after the start of DMARDs is performed 72.5% between 4-6 weeks and 12.7% is performed by nursing.100% use DAS 28 and 53.5% also CDAI.31.4% perform PROs(HAQ 83.3%,RAPID 3 14.3%).The use of systematic ultrasound is collected in 33%, being himself who performs it in 59.9% and an expert rheu-matologist in 46.1%.Finally, when asked about incidence of pandemic in the follow-up,53.3% consider that it is doing the same as before. 46.1% consider that telephone visits are not suitable for the follow-up of the ERAvs14.7% who consider that Yes.When questioning the situations in which they consider them to be appropriate,75.9% that it was adequate in the control after the beginning of the DMARDs.Regarding the treatment of ERA, 66% delayed the onset of biological DMARDs, 72.1% due to difficulty of follow-up and only 8.8% due to an increased risk of infection. When performing the univariate analysis, it is evident that having a monographic dispensary is associated with earlier onset of MTX(p< 0.001)and at doses≥15 mg/W(p = 0.05),greater nursing intervention(p< 0.001),greater use of PROs(p = 0.008)and there is a tendency to a shorter waiting time for frst visits(p = 0.07).It is also associated with not considering telephone visits(p< 0.001), making them in less than 25%(p< 0.0001).Similarly,hospital level is directly proportional to initiation at higher doses of MTX(p< 0.0001),lower use of GC<10mg.Among the rest of the variables, no association has been found. Conclusion: The recommendations of EULAR/ACR in the treatment and follow-up of ERA are consistently followed,although the wide use of MTX orally is striking.It is evident that the variable that most influences the early onset of FAME and at higher doses,is a monographic dispensary,as well as greater presence of nursing and performance of PROs.

Humoral Immune Response to SARS-CoV-2 Vaccination in MS Patients

Objective(s): The aim of this study was to study the humoral immune response to SARS-CoV-2 following vaccination in MS patients. Material(s) and Method(s): We performed a prospective study including all MS patients receiving one of the approved COVID-19 vaccines since January to September 2021. Demographic characteristics, MS treatments and adverse events reports after COVID-19 vaccination of vaccinated MS patients were collected. We analyzed the antibody response to SARS-CoV-2 vaccines with a chemiluminescent microparticle immunoassay (CMIA) from Abbot in MS patients with different DMTs at week 3, week 6 and month 3 after the first dose. The positivity cutoff is ≥50 AU/ml (manufacturer defined). 200 Healthy healthcare professionals were the control group. Result(s): We analyzed 165 vaccinated MS patients: 106 with Pfizer, 14 with Moderna, 42 with both doses of Astra zeneca and 3 with Jannsen. The mean age of patients was 45 (range: 21-71) and 46 for the controls. The most frequent adverse events were pain at injection site, headache and fatigue for 24-48 hours. No differences between MS patients and controls. No increased risk of relapse was noted in the first six months. 120 patients have received both doses of mRNA vaccine. Overall, mean antibody titers response to SARS-CoV-2 SARS-CoV-2 at three weeks was 7910,3 AU/mL (range 0-74947), at 6 weeks 16347,9 UA/mL (range:0-52380,5) and at 3 months 8182,10 UA/ml (range:0-33752,4) in mRNA vaccinated patients. By the mRNA vaccinated control group mean antibody titers response to SARS-CoV-2 SARS-CoV-2 at three weeks was 9397 AU/mL and at 6 weeks 18120 UA/mL Performing a subanalysis of the different DMTs: Only 3 out of 20 patients treated with ocrelizumab developed antibodies. Six vaccinated patients treated with rituximab had no antibody response. Four from 16 patients treated with fingolimod failed to develop a post-vaccination humoral response (< 50 AU/ml). 4 of 5 patients treated with ofatumumab developed have an adequate humoral response. Patients treated with interferon Beta, glatiramer acetate, teriflunomide, dimethyl fumarate, vaccinated with mRNA vaccines developed a similar post vaccination humoral response than healthy controls. Conclusion(s): Most of MS treated patients developed enough antibodies to SARS-CoV-2. The adverse events on MS patients were similar to the general population. No increase of relapse activity was observed. Some patients treated with ocrelizumab, rituximab and fingolimod have no developed a humoral response to SARS-CoV-2 vaccination. Hence we conclude that all approved COVID-19 vaccines are safe in MS patients and effective in most patients. However vaccine strategy in patients treated with anti-CD20 and fingolimod need further studies.

The perception of Engineering students toward teaching performance on online learning during COVID-19 pandemic

This study analyzed the perception of Mechanical Engineering and Systems Engineering students in the process of evaluating teacher performance in online teaching due to the COVID-19 pandemic. This was descriptive-correlational research. The results showed that the Systems Engineering students performed a better perception with the class session management factor and low qualification to the didactic strategies factor. Likewise, the Pearson correlation test indicated a significant relationship (0.000) between the specific factors on the overall performance factor. The topic factor has the greatest strength on the qualification of the overall performance factor, with a constant Pearson's correlation of 0.964. The Mechanical Engineering students showed a better perception with the class session planning factor and low qualification to the didactic strategies factor. Likewise, the Pearson correlation test indicated a significant relationship (0.000) between the specific factors on the overall performance factor. The didactic strategies factor being the one that has the greatest strength on the qualification of the overall performance factor, with a correlation constant Pearson's of 0.983. © 2022, Institute of Advanced Engineering and Science. All rights reserved.

Excess mortality in Ecuador during the COVID-19 pandemic: historical comparison

This research is an epidemiological analysis that seeks to apply the General Excess Mortality as indicator that complements the COVID-19 surveillance strategy during the first 15 months of the pandemic in Ecuador. The selection of data from the Ecuadorian Institute of Statistics and Censuses and Civil Registry allowed the identification of an excess of 163,595 absolute deaths, which represents 42.80% of the excess of national general mortality, with April being the most affected month with a 249%. of excess global mortality compared to the following months. Santa Elena and Guayas are the provinces with the highest excess mortality recorded historically with 935% followed by 674% respectively. There is a direct correlation between the estimate of excess mortality with the mortality rates by province. Administrative planning zone 9 was the one that registered the highest excess mortality with 100%. The pattern of influence of the COVID-19 pandemic on the population was different between geographic regions, with the Ecuadorian coast being the first to present excess general mortality, followed by the mountains and eastern regions.

T-MOOC for Initial Teacher Training in Digital Competences: Technology and Educational Innovation

Massive open online courses (MOOCs) are perceived as emerging technologies for training and innovation in the educational context. They have become approaches for distance education in the face of the new challenges, changes, and crises experienced by the COVID-19 pandemic. They represent, in turn, new emerging opportunities as a response to the United Nations recommendations for open education and the development of sustainable goals. The presence of technologies in the development of educational tasks means that the acquisition of Digital Competences (DC) by teachers and students in training goes beyond the mere mastery of content and teaching methodologies. The research presented aims to analyze the educational possibilities of T-MOOCs for the development of DC in teachers, and as resources that favor autonomous and collaborative learning in innovative scenarios. The study sample is made up of 313 students of the Primary Education Degree at the University of Seville (Spain). For this purpose, two online questionnaires (Google Forms) were applied at the beginning of the course: the Digital Teaching Competence Questionnaire (DigCompEdu), and the Content Questionnaire: Digital Resources and Digital Pedagogy. The results obtained show that the students' level of both digital competences and subject content is low to medium, so that training in educational technology is required for the acquisition of key digital competences. Based on the data obtained, the following actions are proposed: (a) The concretion of the contents structured by means of a learning guide and e-activities to be developed by the student body, taking into account the United Nations guidelines with regard to the Development of Sustainable Objectives;(b) The creation of a training and innovative environment under the T-MOOC architecture, based on open and distance learning due to the current health situation of COVID-19, which, on the one hand, empowers students to use digital tools, and on the other hand, facilitates the acquisition of the SDGs;and (c) The evaluation of the T-MOOC designed as a resource for autonomous, collaborative, guided learning in emerging contexts in which technologies and educational innovation play an important role for sustainable development.

Acral chilblain-like lesions and psychiatric symptoms: Skin manifestations as a diagnostic clue

Objectives: Aicardi-Goutières syndrome (AGS) is a rare neurological disease with cutaneous manifestations. We report a case of AGS with chilblain-like lesions and psychiatric symptoms, which are exceptionally presented in these patients. Moreover, the diagnostic process was challenging since skin lesions appeared during the COVID-19 pandemic, when chilblain-like lesions where commonly seen among pediatric and adolescent populations. Method: A 17-year-old man with personal history of pychomotor delay and limb spasticity, was seen at the emergency department with acral lesions worsened by exposure to cold, suggestive of perniosis. He presented one year later, during the first wave of the COVID-19 pandemic in Spain, with new chilblain-like lesions on his feet. Histological findings were consistent with trombotic vasculophaty. Coagulation workup and inmunological investigations were normal. Ten months later, the patient presented at the emergency department with hallucinations and catatonia, requiring hospitalization. Computed tomographic scan was performed showing intracranial calcifications. Results: Based on the developmental delay, spasticity, psychomotor retardation, cutaneous and radiological findings, AGS was suspected and confirmed with a genetic testing (biallelic pathogenic variants in SAMHD1). Discussion: AGS is considered a type I interferonopathie presenting with an early onset encephalopathy;however it has a broad clinical spectrum, with milder phenotypes of later onset, where the presenting symptom may be cutaneous rather than neurological. The genetic basis of AGS have highlighted the fundamental role of nucleic acid signalling in the induction of type I IFN and the range of phenotypes associated with mutations in these genes is much broader than previously realized. Skin manifestations represent the most prominent extraneurologic features, being chilblain-like lesions the most frequent. However, to our knowledge, there is only one previous report of AGS with psychiatric symptoms. The dermatologist must be aware of this syndrome, and consider it when assessing patients with chilblain-like lesions in the presence of neurological symptoms, even if they are mild.