Use of Tenecteplase in Acute Ischemic Stroke in the Time of SARS-CoV-2.

Tenecteplase (TNK) is a fibrinolytic drug that is administrated in a single bolus, recommended in eligible patients with acute ischemic stroke prior to mechanical thrombectomy. This study explores its usefulness in adverse situations, such as the SARS-CoV-2 pandemic. We conducted a retrospective study involving consecutive patients with suspected acute ischemic stroke treated either with intravenous fibrinolysis with alteplase during 2019 or with TNK (.25 mg/kg) between March 2020 and February 2021. A comparative analysis was made to compare patient treatment times and prognosis. A total of 117 patients treated with alteplase and 92 with TNK were included. No significant differences were observed in age, main vascular risk factors or previous treatments. The median National Institutes of Health Stroke Scale was 8 in the alteplase group and 10 in those treated with TNK (P = .13). Combined treatment with mechanical thrombectomy was performed in 47% in the alteplase group and 46.7% in the TNK group; Thrombolysis In Cerebral Infarction scale 2b-3 recanalization was achieved in 83% and 90.7%, respectively (P = .30). There was a decrease in onset-to-needle median time (165 min vs 140 min, P < .01) and no significant variations in door-needle median time. There was no significant difference in the incidence of symptomatic hemorrhagic transformation in mortality or functional independence at 3 months. The easier administration of TNK has improved the accessibility of fibrinolytic therapy, even in adverse circumstances, such as the COVID-19 pandemic. Its use appears to be safe and effective, even in patients who are not candidates for mechanical thrombectomy.

Erythroprotective Potential of Phycobiliproteins Extracted from Porphyridium cruentum.

There are multiple associations between the different blood groups (ABO and RhD) and the incidence of oxidative stress-related diseases, such as certain carcinomas and COVID-19. Bioactive compounds represent an alternative to its prevention and treatment. Phycobiliproteins (PBP) are bioactive compounds present in the microalga Porphyridium cruentum and, despite its antioxidant activity, their inhibitory effect on hemolysis has not been reported. The aim of this work was to evaluate the erythroprotective potential of phycobiliproteins from P. cruentum in different blood groups. The microalga was cultured in F/2 medium under controlled laboratory conditions. Day 10 of culture was determined as the harvest point. The microalgal biomass was lyophilized and a methanolic (MetOH), Tris HCl (T-HCl), and a physiological solution (PS) ultrasound-assisted extraction were performed. Extract pigments were quantified by spectrophotometry. The antioxidant activity of the extracts was evaluated with the ABTS+•, DPPH•, and FRAP methods, finding that the main antioxidant mechanism on the aqueous extracts was HAT (hydrogen atom transfer), while for MetOH it was SET (single electron transfer). The results of the AAPH, hypotonicity, and heat-induced hemolysis revealed a probable relationship between the different antigens (ABO and RhD) with the antihemolytic effect, highlighting the importance of bio-directed drugs.

Humoral response after the fourth dose of the SARS-CoV-2 vaccine in the CKD spectrum: a prespecified analysis of the SENCOVAC study.

BACKGROUND: There is scarce evidence on fourth doses of SARS-CoV-2 vaccines in chronic kidney disease (CKD) patients. We have evaluated the humoral response and effectivity of the fourth dose in the CKD spectrum: non-dialysis CKD (ND-CKD), hemodialysis (HD), peritoneal dialysis (PD) and kidney transplant (KT) recipients. METHODS: This is a prespecified analysis of the prospective, observational, multicentric SENCOVAC study. In patients with CKD who had received a complete initial vaccination and one or two boosters and had anti-Spike antibody determinations 6 and 12 months after the initial vaccination, we analyzed factors associated to persistent negative humoral response and to higher anti-Spike antibody titers as well as the efficacy of vaccination on COVID-19 severity. RESULTS: Of 2186 patients (18% KT, 8% PD, 69% HD and 5% ND-CKD), 30% had received a fourth dose. The fourth dose increased anti-Spike antibody titers in HD (P = 0.001) and ND-CKD (P = 0.014) patients and seroconverted 72% of previously negative patients. Higher anti-Spike antibody titers at 12 months were independently associated to repeated exposure to antigen (fourth dose, previous breakthrough infections), previous anti-Spike antibody titers and not being a KT. Breakthrough COVID-19 was registered in 137 (6%) patients, of whom 5% required admission. Admitted patients had prior titers below 620 UI/ml and median values were lower (P = 0.020) than in non-admitted patients. CONCLUSIONS: A fourth vaccine dose increased anti-Spike antibody titers or seroconverted many CKD patients, but those with the highest need for a vaccine booster (i.e. those with lower pre-booster antibody titers or KT recipients) derived the least benefit in terms of antibody titers. Admission for breakthrough COVID-19 was associated with low anti-Spike antibody titers.

Efficacy of Bromhexine versus Standard of Care in Reducing Viral Load in Patients with Mild-to-Moderate COVID-19 Disease Attended in Primary Care: A Randomized Open-Label Trial.

A 28-day randomized open-label multicenter study was conducted to assess the efficacy of bromhexine plus standard of care (SOC) (n = 98) vs. SOC alone (n = 93) in 191 outpatients with mild-to-moderate COVID-19 in the primary health care setting. Bromhexine three daily doses of 10 mL (48 mg/day) were administered for seven days. The primary efficacy endpoint was the reduction of viral load estimated as the cycle thresholds (Ct) to detect ORF1ab, N Protein, and S Protein genes by RT-qPCR in saliva samples on day 4 as compared with baseline. Ct values of the three genes increased from baseline throughout days 4 to 14 (p < 0.001) but significant differences between the study groups were not found. Differences in the percentages of patients with low, medium, and high viral loads at 4, 7, and 14 days were not found either. In summary, treatment with bromhexine plus SCO was associated with a viral load reduction of ORF1ab, N Protein, and S Protein genes at day 4, which was not significantly different than similar viral load reductions observed with SOC alone. The present findings do not seem to favor the use of bromhexine as an antiviral in patients with COVID-19.

COVID-19 y las Bibliotecas especializadas en Ciencias de la Salud de hospitales públicos en España

La pandemia de COVID-19 ha afectado al funcionamiento de las bibliotecas de todos los ámbitos, incluidas las sanitarias. El objetivo de este estudio es analizar su impacto en las bibliotecas especializadas de Ciencias de la Salud de hospitales públicos en España. Metodología: Estudio descriptivo transversal realizado desde junio a noviembre de 2020, mediante cuestionario de 35 ítems enviado por correo electrónico donde se recogieron datos respecto al funcionamiento de las bibliotecas, personal, servicios y colecciones antes y durante la fase 0 del estado de alarma. Resultados: Se identificaron 137 bibliotecas. Se analizaron 100. Durante la fase 0, un 72% de las bibliotecas permanecieron cerradas, el 76% del personal teletrabajó alternando con modalidad presencial. Los servicios más demandados fueron el de obtención de documentos y la búsqueda bibliográfica. Las colecciones no sufrieron cambios. Destacan las oportunidades colaborativas surgidas entre las bibliotecas. Conclusiones: El sistema bibliotecario hospitalario ha experimentado un proceso de adaptación y de reinvención que conlleva cambios en la relación con los usuarios, la forma de trabajo y de colaboración.Alternate :The COVID-19 Pandemic has ostensibly affected the workability of libraries in all sectors, including health service libraries. The aim of this study is to analize the impact of this situation with a descriptive cross-sectional study carried out in specialized libraries of health sciences within public hospitals in Spain. Methodology: This study was carried out via an email questionnaire from june to november of 2020, comprising 35 items and it gathered data in reference to personnel, services and collections before and during phase 0 of the alarm state. Results: 137 libraries were identified and 100 were analyzed. During the phase 0 of the alarm state 72% remained closed and 76% of the staff combined working in person with working from home. The greatest demand was for research papers/documentation and bibliography searches, no change was experienced with regard to collections. More than half who have participated in collaborative work groups value it as very useful. According to the authors, while this situation has revealed that the librarians have had a great capacity to readapt, they conclude that it has also directly affected libraries with their temporary reconversion or in some cases their total closure.

Personality, Intervention and Psychological Treatment: Untangling and Explaining New Horizons and Perspectives.

Personality-as a construct-is involved in both health and disease [...].

Mainstreaming a gender perspective into the study of energy poverty in the city of Madrid

The feminisation of energy poverty in the city of Madrid is currently impossible to measure through statistics for those women who are not the main breadwinners. However, a crescent body of knowledge about qualitative research applied to the study of energy poverty has disclosed several aspects related to vulnerability to energy poverty and its impacts. The paper shows the results of a qualitative characterisation of 16 women from Madrid based on interviews conducted during the winters of 2019 and 2020, before and after the COVID-19 lockdown. Four different ways in which gender roles shape experiences of energy poverty are revealed. First, the assumption of responsibility for the home well-being is intrinsically linked to women's identity. Second, how patterns and habits of energy consumption are influenced because of gender. In the third place, how emotions are not only a consequence of suffering from energy poverty but can also help to hide it. Lastly, segregation of capabilities by gender roles from the early age contributes to condition knowledge of household energy management. The importance of reformulating gender inequality dynamics by focusing on personal experience and being able to extract conclusions joining quantitative studies shall be included in future studies.

Disproportionate Burden of COVID-19 Infection Among Hispanic Patients During the First COVID-19 Surge in South Texas.

Introduction: The morbidity and mortality of the COVID-19 pandemic have disproportionately burdened Hispanic populations in the United States. While health equity research is typically conducted in populations where Hispanics are the minority, this project analyzes COVID-19 racioethnic transmission trends over the first 6 months of the pandemic within a large majority-minority city in South Texas. Methods: Patients diagnosed with COVID-19 across inpatient, emergency department, and outpatient settings of a large county health system were included in a clinical registry. For 4644 COVID-19-positive patients between March 16 and August 31, 2020, demographic and clinical data were abstracted from the registry. Race/ethnicity trends over time were compared for patients with and without COVID-19 diagnoses. Logistic regressions identified predictors of inpatient diagnosis by age, race/ethnicity, and testing delay. Results: The proportion of patients with COVID-19 identifying as Hispanic increased rapidly during the pandemic's first months: from 55.6% in March to 85.7% in June. A significantly greater proportion of patients identified as Hispanic within the COVID-19 cohort compared to other diagnoses cohort. Testing delay was 11.6% longer for Hispanic patients, with each day of testing delay associated with 7% increased odds of inpatient COVID-19 diagnosis. Conclusion: These findings highlight the disproportionate impact of COVID-19 on Hispanic populations even within a majority-minority community. In the United States, Hispanic persons are more likely to work frontline jobs, live in multigenerational homes in poverty, and be uninsured. The burden of COVID-19 cases within Bexar County's largest hospital system reflects this systemic inequity. Identifying racioethnic health disparities supports efforts toward mitigating structural factors that predispose minority groups to illness and death.

Heterogeneity of In Vitro Expanded Mesenchymal Stromal Cells and Strategies to Improve Their Therapeutic Actions

Beneficial properties of mesenchymal stromal cells (MSCs) have prompted their use in preclinical and clinical research. Accumulating evidence has been provided for the therapeutic effects of MSCs in several pathologies, including neurodegenerative diseases, myocardial infarction, skin problems, liver disorders and cancer, among others. Although MSCs are found in multiple tissues, the number of MSCs is low, making in vitro expansion a required step before MSC application. However, culture-expanded MSCs exhibit notable differences in terms of cell morphology, physiology and function, which decisively contribute to MSC heterogeneity. The changes induced in MSCs during in vitro expansion may account for the variability in the results obtained in different MSC-based therapy studies, including those using MSCs as living drug delivery systems. This review dissects the different changes that occur in culture-expanded MSCs and how these modifications alter their therapeutic properties after transplantation. Furthermore, we discuss the current strategies developed to improve the beneficial effects of MSCs for successful clinical implementation, as well as potential therapeutic alternatives.

Post-COVID-19 fatigue: the contribution of cognitive and neuropsychiatric symptoms.

Fatigue in its many forms of physical, mental, and psychosocial exhaustion is a common symptom of post-COVID-19 condition, also known as "Long COVID." Persistent fatigue in COVID-19 patients is frequently accompanied by cognitive dysfunction and neuropsychiatric symptoms; however, less is known about the relationships between these components of post-COVID-19 condition and fatigue itself. Consequently, the present study sought to (1) distinguish the types of fatigue experienced by participants, and (2) investigate whether cognitive deficits across various domains and neuropsychiatric conditions predicted these different types of fatigue. The study included 136 COVID-19 patients referred for neuropsychological evaluation due to cognitive complaints 8 months on average after SARS-CoV-2 infection. Measures included self-reported fatigue (physical, cognitive, and psychosocial), neuropsychiatric questionnaires (assessing symptoms of depression, anxiety, apathy, and executive functioning), a comprehensive neuropsychological assessment, and self-reported quality of life and everyday functioning. Results showed that reports of clinical significant fatigue were pervasive in our sample (82.3% of participants), with physical fatigue rated highest on average relative to the subscale maximum. Elevated levels of apathy, anxiety, and executive dysfunction in neuropsychiatric measures along with executive and attentional difficulties on cognitive tests were found to be consistently important predictors among different types of fatigue. This implicates both cognitive and neuropsychiatric symptoms as predictors of fatigue in post-COVID-19 condition, and stresses the importance of a holistic approach in assessing and considering potential treatment for COVID-19 patients experiencing fatigue.

Breastfeeding experiences during the COVID-19 pandemic in Spain:a qualitative study.

BACKGROUND: The pandemic caused by COVID-19 has affected reproductive and perinatal health both through the infection itself and, indirectly, as a consequence of changes in medical care, social policy or social and economic circumstances. The objective of this study is to explore the impact of the pandemic and of the measures adopted on breastfeeding initiation and maintenance. METHODS: A qualitative descriptive study was conducted by means in-depth semi-structured interviews, until reaching data saturation. The study was conducted between the months of January to May 2021. Participants were recruited by midwives from the Primary Care Centres of the Andalusian provinces provinces of Seville, Cádiz, Huelva, Granada, and Jaén. The interviews were conducted via phone call and were subsequently transcribed and analysed by means of reflexive inductive thematic analysis, using Braun and Clarke's thematic analysis. RESULTS: A total of 30 interviews were conducted. Five main themes and ten subthemes were developed, namely: Information received (access to the information, figure who provided the information), unequal support from the professionals during the pandemic (support to postpartum hospitalization, support received from Primary Health Care during the postpartum period), social and family support about breastfeeding (support groups, family support), impact of confinement and of social restriction measures (positive influence on breastfeeding, influence on bonding with the newborn), emotional effect of the pandemic (insecurity and fear related to contagion by coronavirus, feelings of loneliness). CONCLUSION: The use of online breastfeeding support groups through applications such as WhatsApp®, Facebook® or Instagram® has provided important breastfeeding information and support sources. The main figure identified that has provided formal breastfeeding support during this period was that of the midwife. In addition, the social restrictions inherent to the pandemic have exerted a positive effect for women in bonding and breastfeeding, as a consequence of the increase in the time spent at their homes and in the family nucleus co-living.

Neuropsychological deficits in patients with cognitive complaints after COVID-19.

BACKGROUND: While much of the scientific focus thus far has been on cognitive sequelae in patients with severe COVID-19, subjective cognitive complaints are being reported across the spectrum of disease severity, with recent studies beginning to corroborate patients' perceived deficits. In response to this, the aims of this study were to (1) explore the frequency of impaired performance across cognitive domains in post-COVID patients with subjective complaints and (2) uncover whether impairment existed within a single domain or across multiple. METHODS: Sixty-three patients with subjective cognitive complaints post-COVID were assessed with a comprehensive protocol consisting of various neuropsychological tests and mood measures. Cognitive test performance was transformed into T scores and classified based on recommended guidelines. After performing a principal component analysis to define cognitive domain factors, distributions of test scores within and across domains were analyzed. RESULTS: Results revealed pervasive impact on attention abilities, both as the singularly affected domain (19% of single-domain impairment) as well as coupled with decreased performance in executive functions, learning, and long-term memory. These salient attentional and associated executive deficits were largely unrelated to clinical factors such as hospitalization, disease duration, biomarkers, or affective measures. DISCUSSION: These findings stress the importance of comprehensive evaluation and intervention to address cognitive sequelae in post-COVID patients of varying disease courses, not just those who were hospitalized or experienced severe symptoms. Future studies should investigate to what extent these cognitive abilities are recuperated over time as well as employ neuroimaging techniques to uncover underlying mechanisms of neural damage.

The anti-scientists bias: The role of feelings about scientists in COVID-19 attitudes and behaviors.

Across three studies, we investigated who expresses concern for COVID-19, or coronavirus, and engages in behaviors that are consistent with slowing the spread of COVID-19. In Studies 1 and 2 (n = 415, n = 199), those with warmer feelings toward scientists were more concerned and engaged in greater COVID-preventative behaviors, regardless of partisanship. That is, an anti-scientists bias was related to lessened concern and toward less preventive behaviors. Furthermore, those who were the most optimistic about hydroxychloroquine, a purported but unproven treatment against the virus, were less likely to engage in behaviors designed to decrease the spread of COVID-19. In Study 3 (n = 259), asking participants to watch a scientist discuss hydroxychloroquine on Fox News led people to greater endorsement of COVID behaviors. In short, positive feelings toward scientists, rather than political attitudes or knowledge, related to who was concerned and those willing to engage in pandemic reducing behaviors. These behaviors were not immutable and can be changed by scientific out-reach.

Information and communication technologies and quality of life in home confinement: Development and validation of the TICO scale

The mandatory home confinement of the Spanish population, implemented in response to the COVID-19 pandemic, presents a unique opportunity to study the use and influence of Information and Communication Technologies (ICT) in people's perception of quality of life during this exceptional situation. This article adapts and validates a psychometric scale designed to identify and measure the main dimensions of the Quality of Life construct perceived through ICT use. To this end, an exploratory and transversal study has been carried out in Spain on a sample of 2,346 participants. Data processing has been carried out with SPSS and EQS. The results provide evidence of the reliability and psychometric quality on the scale, which exhibits adequate consistency that facilitates its application. The confirmatory factor analysis showed a hierarchical model of three correlated factors that account for the dimensions "Satisfaction with life", "Emotional support" and "Social support", which have enough correlation to measure the personal perception of quality of life associated with ICT use and are consistent with previous psychometric studies. The results of the TICO scale indicate that more than 70% of the sample feel ICT have united their family during home confinement and more than 45% experience happy feelings when they use ICT. In home confinement, ICT use has improved users' quality of life, mainly their satisfaction with life and social and family support. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Journalistic Fact-Checking of Information in Pandemic: Stakeholders, Hoaxes, and Strategies to Fight Disinformation during the COVID-19 Crisis in Spain.

The public health crisis created by COVID-19 represents a challenge for journalists and the media. Specialised information in healthcare and science has turned into a need to deal with the current situation as well as the demand for information by society. In this context of increased uncertainty, the circulation of fake news on social networks and messaging applications has proliferated, producing what has been known as 'infodemic'. This paper is focused on the fact-checking of journalistic content using a combined methodology: content analysis of information denied by the main Spanish fact-checking platforms (Maldita and Newtral) and an in-depth questionnaire to these stakeholders. The results confirm the quantitative and qualitative evolution of disinformation. Quantitatively, more fact-checking is performed during the state of alarm. Qualitatively, hoaxes increase in complexity as the pandemic evolves, in such a way that disinformation engineering takes place, and it is expected to continue until the development of a vaccine.

Information and communication technologies and quality of life in home confinement: Development and validation of the TICO scale.

The mandatory home confinement of the Spanish population, implemented in response to the COVID-19 pandemic, presents a unique opportunity to study the use and influence of Information and Communication Technologies (ICT) in people's perception of quality of life during this exceptional situation. This article adapts and validates a psychometric scale designed to identify and measure the main dimensions of the Quality of Life construct perceived through ICT use. To this end, an exploratory and transversal study has been carried out in Spain on a sample of 2,346 participants. Data processing has been carried out with SPSS and EQS. The results provide evidence of the reliability and psychometric quality on the scale, which exhibits adequate consistency that facilitates its application. The confirmatory factor analysis showed a hierarchical model of three correlated factors that account for the dimensions "Satisfaction with life", "Emotional support" and "Social support", which have enough correlation to measure the personal perception of quality of life associated with ICT use and are consistent with previous psychometric studies. The results of the TICO scale indicate that more than 70% of the sample feel ICT have united their family during home confinement and more than 45% experience happy feelings when they use ICT. In home confinement, ICT use has improved users' quality of life, mainly their satisfaction with life and social and family support.

Comunicación y crisis del coronavirus en España Primeras lecciones

Coronavirus crisis has caused a complicated situation at a sanitary, economic and social levels, that requires of a fundamental work in communication area so that the society comprise and collaborate with the adopted measures. Through the review and synthesis of the scientific and reference literature, the present paper contrasts lessons learnt in previous public health crisis against the communication implemented from the institutional voices and from the press coverage during the first stages of the Covid-19 outbreak in Spain. This paper detects that the absence of an early announcement (or overtaking of the negative stage) and the control messages in a context of uncertainty caused a brusque transition to the following stage of the crisis, coincident with an explosion of the number of contagions, what generated fear. The spokesperson formula applied is against all recommendations of crisis communication. Regarding the journalistic coverage, examples of alarmism and sensationalism news arised. The numeric data have been the resource more valuable and the computer graphics the multimedia content more developed. Since the pandemic is still on course, it is recommended the learning and the adjustment of the communication and information to the citizens in the following stages of this crisis or in future crisis taking into account the group of first lessons presented here. (English) [ABSTRACT FROM AUTHOR] La crisis del coronavirus ha generado una complicada situación a nivel sanitario, económico y social, que requiere de una labor de comunicación fundamental para que la sociedad comprenda y colabore con las medidas adoptadas. A través de la revisión y síntesis de la bibliografía científica y de referencia, el presente trabajo contrapone lecciones aprendidas en crisis de salud pública previas con la comunicación efectuada desde las voces institucionales y desde la cobertura de prensa durante las primeras etapas de la crisis del Covid-19 en España. Se detecta que la ausencia de un anuncio temprano (o adelantamiento del escenario negativo) y los mensajes de control en un contexto de incertidumbre provocaron una transición brusca a la siguiente etapa de la crisis, coincidente con una explosión en el número de contagios, lo que generó miedo. La fórmula de portavocía adoptada incumple toda recomendación de comunicación de crisis. En cuanto a la cobertura periodística, se localizan ejemplos de alarmismo y de sensacionalismo en el tratamiento informativo de la pandemia. Los datos numéricos han sido el recurso informativo más valioso y las infografías el contenido multimedia más desarrollado. Dado que la pandemia se encuentra todavía en curso, se recomienda el aprendizaje y la corrección de la comunicación e información a los ciudadanos en base a este conjunto de primeras lecciones en las etapas siguientes o futuras crisis. (Spanish) [ABSTRACT FROM AUTHOR] Copyright of El Profesional de la Información is the property of EPI SCP and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)