Digital Transformation and Local Government Response to the COVID-19 Pandemic: An Assessment of Its Impact on the Sustainable Development Goals.

This paper analyzes how Digital Transformation (DT) processes have influenced the Attitude of local governments (LGs) toward the COVID-19 pandemic and their effect on achieving the United Nations' Sustainable Development Goals (SDGs). The data were collected from LGs in Spain (n = 124) through a questionnaire in which the IT skills of their workers, the DT processes, budgets, degree of regulatory compliance, and implementation of trust seals were measured, together with the IT security measures adopted. The contrast between the proposed model and the results showed that the direct influence of IT security influences the government's attitude toward COVID-19 and DT implementing actions to achieve SDGs. The findings of this work are of great value both for the actors involved in the design and implementation of public policies and for those responsible for local governance in their objective to improve citizens' experience of the services provided and in exceptional situations such as the one experienced as a result, of-COVID-19.

Systematic literature review and bibliometric analysis on virtual reality and education.

The objective of this study is to identify and analyze the scientific literature with a bibliometric analysis to find the main topics, authors, sources, most cited articles, and countries in the literature on virtual reality in education. Another aim is to understand the conceptual, intellectual, and social structure of the literature on the subject and identify the knowledge base of the use of VR in education and whether it is commonly used and integrated into teaching-learning processes. To do this, articles indexed in the Main Collections of the Web of Science, Scopus and Lens were analyzed for the period 2010 to 2021. The research results are presented in two parts: the first is a quantitative analysis that provides an overview of virtual reality (VR) technology used in the educational field, with tables, graphs, and maps, highlighting the main performance indicators for the production of articles and their citation. The results obtained found a total of 718 articles of which the following were analyzed 273 published articles. The second stage consisted of an inductive type of analysis that found six major groups in the cited articles, which are instruction and learning using VR, VR learning environments, use of VR in different fields of knowledge, learning processes using VR applications or games, learning processes employing simulation, and topics published during the Covid-19 pandemic. Another important aspect to mention is that VR is used in many different areas of education, but until the beginning of the pandemic the use of this so-called "disruptive process" came mainly from students, Institutions were reluctant and slow to accept and include VR in the teaching-learning processes.

Assessing Trustworthy AI in Times of COVID-19: Deep Learning for Predicting a Multiregional Score Conveying the Degree of Lung Compromise in COVID-19 Patients.

This article's main contributions are twofold: 1) to demonstrate how to apply the general European Union's High-Level Expert Group's (EU HLEG) guidelines for trustworthy AI in practice for the domain of healthcare and 2) to investigate the research question of what does "trustworthy AI" mean at the time of the COVID-19 pandemic. To this end, we present the results of a post-hoc self-assessment to evaluate the trustworthiness of an AI system for predicting a multiregional score conveying the degree of lung compromise in COVID-19 patients, developed and verified by an interdisciplinary team with members from academia, public hospitals, and industry in time of pandemic. The AI system aims to help radiologists to estimate and communicate the severity of damage in a patient's lung from Chest X-rays. It has been experimentally deployed in the radiology department of the ASST Spedali Civili clinic in Brescia, Italy, since December 2020 during pandemic time. The methodology we have applied for our post-hoc assessment, called Z-Inspection®, uses sociotechnical scenarios to identify ethical, technical, and domain-specific issues in the use of the AI system in the context of the pandemic.

The heart and SARS-CoV-2. / Corazón y SARS-CoV-2.

SARS-CoV-2 is currently causing a persistent COVID-19 pandemic, which poses a risk of causing long-term cardiovascular sequels in the population. The viral mechanism of cell infection through the angiotensin 2 converter enzyme receptor and the limited antiviral innate immune response are the suspected causes for a more frequent cardiovascular damage in SARS-CoV-2 infection. Knowledge of the appearance during acute infection of other cardiac conditions beyond the classical myocarditis and pericarditis, the long-term cardiac manifestations (persistent COVID-19), and the increased incidence of myocarditis and pericarditis after vaccination is of special interest in order to offer our patients best practices based on current scientific evidence.

The heart and SARS-CoV-2.

SARS-Cov2 is currently causing a persistent Covid-19 pandemic, which poses a risk of causing long-term cardiovascular sequels in the population. The viral mechanism of cell infection through the angiotensin 2 converter enzyme receptor and the limited antiviral innate immune response are the suspected causes for a more frequent cardiovascular damage in SARS-Cov2 infection. Knowledge of: the appearance during acute infection of other cardiac conditions beyond the classical myocarditis and pericarditis), the long-term cardiac manifestations (persistent Covid-19), and the increased incidence of myocarditis and pericarditis after vaccination; it is of special interest in order to offer our patients best practices based on current scientific evidence.

El SARS-Cov2 está causando actualmente una pandemia sostenida de Covid-19, con el riesgo de causar secuelas cardíacas a largo plazo en la población. El temor que el SARS-Cov2 cause un daño miocárdico mayor que otros virus convencionales se basa en su mecanismo de infección de células humanas a través del receptor de la enzima convertidora de la angiotensina 2 y las defensas antivirales innatas hasta ahora reducidas contra un nuevo virus. El conocimiento de: la aparición durante la infección aguda de otras afectaciones cardiacas además de las clásicas miocarditis y pericarditis, las manifestaciones cardiacas observadas a largo plazo (Covid-19 persistente) y, la incidencia incrementada de miocarditis y pericarditis tras la vacunación; resulta de especial interés a fin de ofrecer a nuestros pacientes la mejor atención posible basada en la evidencia científica actual.

Kinetic of the Antibody Response Following AddaVax-Adjuvanted Immunization with Recombinant Influenza Antigens.

Notwithstanding the current SARS-CoV-2 pandemic, influenza virus infection still represents a global health concern in terms of hospitalizations and possible pandemic threats. The objective of next-generation influenza vaccines is not only to increase the breadth of response but also to improve the elicitation of an effective and robust immune response, especially in high-risk populations. To achieve this second objective, the administration of adjuvanted influenza vaccines has been considered. In this regard, the monitoring and characterization of the antibody response associated with the administration of adjuvanted vaccines has been evaluated in this study in order to shed light on the kinetic, magnitude and subclass usage of antibody secreting cells (ASCs) as well as of circulating antigen-specific serum antibodies. Specifically, we utilized the DBA/2J mouse model to assess the kinetic, magnitude and IgG subclass usage of the antibody response following an intramuscular (IM) or intraperitoneal (IP) immunization regimen with AddaVax-adjuvanted bivalent H1N1 and H3N2 computationally optimized broadly reactive antigen (COBRA) influenza recombinant hemagglutinins (rHAs). While the serological evaluation revealed a homogeneous kinetic of the antibody response, the detection of the ASCs through a FluoroSpot platform revealed a different magnitude, subclass usage and kinetic of the antigen-specific IgG secreting cells peaking at day 5 and day 9 following the IP and IM immunization, respectively.

Corazón y SARS-Cov2 The heart and SARS-Cov2

El SARS-Cov2 está causando actualmente una pandemia sostenida de Covid-19, con el riesgo de causar secuelas cardíacas a largo plazo en la población. El temor que el SARS-Cov2 cause un daño miocárdico mayor que otros virus convencionales se basa en su mecanismo de infección de células humanas a través del receptor de la enzima convertidora de la angiotensina 2 y las defensas antivirales innatas hasta ahora reducidas contra un nuevo virus. El conocimiento de: la aparición durante la infección aguda de otras afectaciones cardiacas además de las clásicas miocarditis y pericarditis, las manifestaciones cardiacas observadas a largo plazo (Covid-19 persistente) y, la incidencia incrementada de miocarditis y pericarditis tras la vacunación;resulta de especial interés a fin de ofrecer a nuestros pacientes la mejor atención posible basada en la evidencia científica actual.

Dynamics of disease characteristics and clinical management of critically ill COVID-19 patients over the time course of the pandemic: an analysis of the prospective, international, multicentre RISC-19-ICU registry.

BACKGROUND: It remains elusive how the characteristics, the course of disease, the clinical management and the outcomes of critically ill COVID-19 patients admitted to intensive care units (ICU) worldwide have changed over the course of the pandemic. METHODS: Prospective, observational registry constituted by 90 ICUs across 22 countries worldwide including patients with a laboratory-confirmed, critical presentation of COVID-19 requiring advanced organ support. Hierarchical, generalized linear mixed-effect models accounting for hospital and country variability were employed to analyse the continuous evolution of the studied variables over the pandemic. RESULTS: Four thousand forty-one patients were included from March 2020 to September 2021. Over this period, the age of the admitted patients (62 [95% CI 60-63] years vs 64 [62-66] years, p < 0.001) and the severity of organ dysfunction at ICU admission decreased (Sequential Organ Failure Assessment 8.2 [7.6-9.0] vs 5.8 [5.3-6.4], p < 0.001) and increased, while more female patients (26 [23-29]% vs 41 [35-48]%, p < 0.001) were admitted. The time span between symptom onset and hospitalization as well as ICU admission became longer later in the pandemic (6.7 [6.2-7.2| days vs 9.7 [8.9-10.5] days, p < 0.001). The PaO2/FiO2 at admission was lower (132 [123-141] mmHg vs 101 [91-113] mmHg, p < 0.001) but showed faster improvements over the initial 5 days of ICU stay in late 2021 compared to early 2020 (34 [20-48] mmHg vs 70 [41-100] mmHg, p = 0.05). The number of patients treated with steroids and tocilizumab increased, while the use of therapeutic anticoagulation presented an inverse U-shaped behaviour over the course of the pandemic. The proportion of patients treated with high-flow oxygen (5 [4-7]% vs 20 [14-29], p < 0.001) and non-invasive mechanical ventilation (14 [11-18]% vs 24 [17-33]%, p < 0.001) throughout the pandemic increased concomitant to a decrease in invasive mechanical ventilation (82 [76-86]% vs 74 [64-82]%, p < 0.001). The ICU mortality (23 [19-26]% vs 17 [12-25]%, p < 0.001) and length of stay (14 [13-16] days vs 11 [10-13] days, p < 0.001) decreased over 19 months of the pandemic. CONCLUSION: Characteristics and disease course of critically ill COVID-19 patients have continuously evolved, concomitant to the clinical management, throughout the pandemic leading to a younger, less severely ill ICU population with distinctly different clinical, pulmonary and inflammatory presentations than at the onset of the pandemic.

[Pericardial and myocardial involvement after SARS-CoV-2 infection: a cross-sectional descriptive study in healthcare workers]. / Afección pericárdica y miocárdica tras infección por SARS-CoV-2: estudio descriptivo transversal en trabajadores sanitarios.

Introduction and objectives: The cardiac sequelae of SARS-CoV-2 infection are still poorly documented. We conducted a cross-sectional study in healthcare workers to report evidence of pericardial and myocardial involvement after SARS-CoV-2 infection. Methods: We studied 139 healthcare workers with confirmed past SARS-CoV-2 infection. Participants underwent clinical assessment, electrocardiography, and laboratory tests, including immune cell profiling and cardiac magnetic resonance (CMR). Clinically suspected pericarditis was diagnosed when classic criteria were present and clinically suspected myocarditis was based on the combination of at least 2 CMR criteria. Results: Median age was 52 (41-57) years, 71.9% were women, and 16.5% were previously hospitalized for COVID-19 pneumonia. On examination (10.4 [9.3-11.0] weeks after infection-like symptoms), participants showed hemodynamic stability. Chest pain, dyspnea or palpitations were present in 41.7% participants, electrocardiographic abnormalities in 49.6%, NT-proBNP elevation in 7.9%, troponin in 0.7%, and CMR abnormalities in 60.4%. A total of 30.9% participants met criteria for either pericarditis and/or myocarditis: isolated pericarditis was diagnosed in 5.8%, myopericarditis in 7.9%, and isolated myocarditis in 17.3%. Most participants (73.2%) showed altered immune cell counts in blood, particularly decreased eosinophil (27.3%; P < .001) and increased cytotoxic T cell numbers (17.3%; P < .001). Clinically suspected pericarditis was associated (P < .005) with particularly elevated cytotoxic T cells and decreased eosinophil counts, while participants diagnosed with clinically suspected myopericarditis or myocarditis had lower (P < .05) neutrophil counts, natural killer-cells, and plasma cells. Conclusions: Pericardial and myocardial involvement with clinical stability are frequent after SARS-CoV-2 infection and are associated with specific immune cell profiles.Full English text available from:www.revespcardiol.org/en.

Long-term effect of SARS-CoV-2 infection: Post-Covid-19 neurological syndrome / Efecto a largo plazo de la infección por SARS-CoV-2: Síndrome neurológico post-Covid-19

RESUMEN La pandemia de la COVID-19 ha provocado aproximadamente 182 millones de casos y cerca de cuatro millones de muertes en todo el mundo, comprometiendo con mayor frecuencia a personas de 25 y 64 años de edad. Esta infección afecta principalmente al sistema respiratorio, pero otros órganos y sistemas pueden verse afectados a corto plazo como el neurológico. Una gran población de pacientes ha logrado superar la infección por el SARS-CoV-2, sin embargo, han comenzado a reportarse una serie de manifestaciones clínicas tardías, básicamente neuropsiquiátricas, dentro de ellas se ha referido a la ansiedad, depresión, deterioro del sueño, dolor muscular, mareos, cefaleas, fatiga, anosmia, entre otros; a este conjunto de manifestaciones tardías se le ha denominado síndrome neurológico post-Covid-19 y requiere por un lado, la atención de la comunidad médica para investigar las manifestaciones tardías o secuelas de esta enfermedad y por otro lado, una vigilancia médica ante la consulta de pacientes con estas manifestaciones.

ABSTRACT The COVID-19 pandemic has caused approximately 182 million cases and nearly four million deaths worldwide, most frequently involving people between 25 and 64 years of age. This infection primarily affects the respiratory system, but other organs and systems can be affected in the short term, such as the neurological system. A large population of patients has managed to overcome the SARS-CoV-2 infection, however, a serie of late clinical manifestations have begun to be reported, basically neuropsychiatric, including anxiety, depression, disorder of sleep, muscle pain, dizziness, headaches, fatigue, anosmia, among others; this set of late manifestations has been called post-Covid-19 neurological syndrome and requires, on the one hand, the attention of the medical community to investigate the late manifestations or sequel of this disease and, on the other hand, medical vigilance when consulting patients with these manifestations.

Afección pericárdica y miocárdica tras infección por SARS-CoV-2: estudio descriptivo transversal en trabajadores sanitarios Pericardial and myocardial involvement after SARS-CoV-2 infection: a cross-sectional descriptive study in healthcare workers

Introducción y objetivos: Las secuelas cardiacas tras la infección por SARS-CoV-2 todavía están poco documentadas. Se realizó un estudio transversal en trabajadores sanitarios para estudiar la prevalencia de afección pericárdica y miocárdica tras la infección por SARS-CoV-2. Métodos: Se estudió a 139 trabajadores sanitarios con infección previa por SARS-CoV-2 confirmada. Los participantes se sometieron a evaluación clínica, electrocardiograma, pruebas de laboratorio que incluyeron el perfil de células inmunitarias y resonancia magnética cardiaca (RMC). El diagnóstico clínico de pericarditis se realizó según los criterios clásicos y el diagnóstico clínico de miocarditis, ante la presencia de al menos 2 criterios en la RMC. Resultados: La mediana de edad fue 52 (intervalo, 41-57) años, el 71,9% eran mujeres y el 16,5% se había hospitalizado previamente por neumonía por COVID-19. En la evaluación (10,4 [9,3-11,0] semanas después de los síntomas de infección), todos los participantes presentaban estabilidad hemodinámica. El 41,7% tenía dolor torácico, disnea o palpitaciones;el 49,6%, alteraciones electrocardiográficas;el 7,9%, elevación de NT-proBNP;el 0,7%, elevación de troponina y el 60,4%, alteraciones en la RMC. El 30,9% de los participantes cumplían los criterios clínicos establecidos de pericarditis o miocarditis: pericarditis aislada en el 5,8%, miopericarditis en el 7,9% y miocarditis aislada en el 17,3%. La mayoría de los participantes (73,2%) mostraron recuentos alterados de células inmunitarias en sangre, en particular diminución de eosinófilos (27,3%;p < 0,001) y aumento del número de células T citotóxicas (17,3%;p < 0,001). La sospecha clínica de pericarditis se asoció (p < 0,005) particularmente con un elevado número de células T citotóxicas y recuento de eosinófilos disminuido, mientras que los participantes con sospecha clínica de miopericarditis o miocarditis tenían recuentos de neutrófilos, células natural killer y células plasmáticas más bajos (p < 0,05). Conclusiones: La afección pericárdica y miocárdica con estabilidad hemodinámica es frecuente después de la infección por SARS-CoV-2 y se asocia con perfiles de células inmunitarias específicas.

Date of Admission during COVID-19 Pandemic Impacted Patient Outcomes in Addition to the Higher Efficacy of Tocilizumab Plus High-Dose Corticosteroid Therapy Compared to Tocilizumab Alone.

BACKGROUND: The evidence for the efficacy of glucocorticoids combined with tocilizumab (TCZ) in COVID-19 comes from observational studies or subgroup analysis. Our aim was to compare outcomes between hospitalized COVID-19 patients who received high-dose corticosteroid pulse therapy and TCZ and those who received TCZ. METHODS: A retrospective single-center study was performed on consecutive hospitalized patients with severe COVID-19 between 1 March and 23 April 2020. Patients treated with either TCZ (400-600 mg, one to two doses) and methylprednisolone pulses (MPD-TCZ group) or TCZ alone were analyzed for the occurrence of a combined endpoint of death and need for invasive mechanical ventilation during admission. The independence of both treatment groups was tested using machine learning classifiers, and relevant variables that were potentially different between the groups were measured through a mean decrease accuracy algorithm. RESULTS: An earlier date of admission was significantly associated with worse outcomes regardless of treatment type. Twenty patients died (27.0%) in the TCZ group, and 33 (44.6%) died or required intubation (n = 74), whereas in the MPD-TCZ group, 15 (11.0%) patients died and 29 (21.3%) patients reached the combined endpoint (n = 136; p = 0.006 and p < 0.001, respectively). Machine learning methodology using a random forest classifier confirmed significant differences between the treatment groups. CONCLUSIONS: MPD and TCZ improved outcomes (death and invasive mechanical ventilation) among hospitalized COVID-19 patients, but confounding variables such as the date of admission during the COVID-19 pandemic should be considered in observational studies.

Pericardial and myocardial involvement after SARS-CoV-2 infection: a cross-sectional descriptive study in healthcare workers.

INTRODUCTION AND OBJECTIVES: The cardiac sequelae of SARS-CoV-2 infection are still poorly documented. We conducted a cross-sectional study in healthcare workers to report evidence of pericardial and myocardial involvement after SARS-CoV-2 infection. METHODS: We studied 139 healthcare workers with confirmed past SARS-CoV-2 infection. Participants underwent clinical assessment, electrocardiography, and laboratory tests, including immune cell profiling and cardiac magnetic resonance (CMR). Clinically suspected pericarditis was diagnosed when classic criteria were present and clinically suspected myocarditis was based on the combination of at least 2 CMR criteria. RESULTS: Median age was 52 (41-57) years, 71.9% were women, and 16.5% were previously hospitalized for COVID-19 pneumonia. On examination (10.4 [9.3-11.0] weeks after infection-like symptoms), participants showed hemodynamic stability. Chest pain, dyspnea or palpitations were present in 41.7% participants, electrocardiographic abnormalities in 49.6%, NT-proBNP elevation in 7.9%, troponin in 0.7%, and CMR abnormalities in 60.4%. A total of 30.9% participants met criteria for either pericarditis and/or myocarditis: isolated pericarditis was diagnosed in 5.8%, myopericarditis in 7.9%, and isolated myocarditis in 17.3%. Most participants (73.2%) showed altered immune cell counts in blood, particularly decreased eosinophil (27.3%; P<.001) and increased cytotoxic T cell numbers (17.3%; P <.001). Clinically suspected pericarditis was associated (P <.005) with particularly elevated cytotoxic T cells and decreased eosinophil counts, while participants diagnosed with clinically suspected myopericarditis or myocarditis had lower (P <.05) neutrophil counts, natural killer-cells, and plasma cells. CONCLUSIONS: Pericardial and myocardial involvement with clinical stability are frequent after SARS-CoV-2 infection and are associated with specific immune cell profiles.

Toward a Better Understanding of the Intention to Use mHealth Apps: Exploratory Study.

BACKGROUND: An increasing number of mobile health (mHealth) apps are becoming available for download and use on mobile devices. Even with the increase in availability and use of mHealth apps, there has still not been a lot of research into understanding the intention to use this kind of apps. OBJECTIVE: The purpose of this study was to investigate a technology acceptance model (TAM) that has been specially designed for primary health care applications. METHODS: The proposed model is an extension of the TAM, and was empirically tested using data obtained from a survey of mHealth app users (n=310). The research analyzed 2 additional external factors: promotion of health and health benefits. Data were analyzed with a PLS-SEM software and confirmed that gender moderates the adoption of mHealth apps in Spain. The explanatory capacity (R2 for behavioral intention to use) of the proposed model was 76.4%. Likewise, the relationships of the external constructs of the extended TAM were found to be significant. RESULTS: The results show the importance of healthy habits developed by using mHealth apps. In addition, communication campaigns for these apps should be aimed at transferring the usefulness of eHealth as an agent for transforming attitudes; additionally, as more health benefits are obtained, ease of use becomes greater. Perceived usefulness (PU; ß=.415, t0.001;4999=3.442, P=.001), attitude toward using (ß=.301, t0.01;499=2.299, P=.02), and promotion of health (ß=.210, t0.05;499=2.108, P=.03) were found to have a statistically significant impact on behavior intention to use eHealth apps (R2=76.4%). Perceived ease of use (PEOU; ß=.179, t0.01;499=2.623, P=.009) and PU (ß=.755, t0.001;499=12.888, P<.001) were found to have a statistically significant impact on attitude toward using (R2>=78.2%). Furthermore, PEOU (ß=.203, t0.01;499=2.810, P=.005), health benefits (ß=.448, t0.001;499=4.010, P<.001), and promotion of health (ß=.281, t0.01;499=2.393, P=.01) exerted a significant impact on PU (R2=72.7%). Finally, health benefits (ß=.640, t0.001;499=14.948, P<.001) had a statistically significant impact on PEOU (R2=40.9%), while promotion of health (ß=.865, t0.001;499=29.943, P<.001) significantly influenced health benefits (R2=74.7%). CONCLUSIONS: mHealth apps could be used to predict the behavior of patients in the face of recommendations to prevent pandemics, such as COVID-19 or SARS, and to track users' symptoms while they stay at home. Gender is a determining factor that influences the intention to use mHealth apps, so perhaps different interfaces and utilities could be designed according to gender.

Clinical and epidemiological characteristics of children with SARS-CoV-2 infection admitted in a Peruvian hospital. / Características clínicas y epidemiológicas de niños con infección por SARS-CoV-2 internados en un hospital peruano.

We carried out an observational, retrospective and descriptive study in order to identify the clinical and epidemiological characteristics of children with SARS-CoV-2 infection admitted to a Peruvian national referral hospital. We included patients from one month old to fourteen years old hospitalized between March and August 2020. A total of 125 patients with SARS-CoV-2 infection were admitted, 18.4% (n = 23) had critical illness and 16.8% (n = 21) had multisystem inflammatory syndrome (MIS-C). The absence of comorbidities and previous history of epidemiological contact were more frequent in patients with MIS-C. Patients in critical condition and patients with MIS-C had lower lymphocyte and platelet counts, and higher C-reactive protein, ferritin and D-dimer values than patients who did not have said conditions. Six (4.8%) out of 125 children died, as well as 3 (13%) children from the group of patients in critical condition. None of the children with MIS-C died.

Con el objetivo de conocer las características clínicas y epidemiológicas de niños con infección por SARS-CoV-2 internados en un hospital peruano de referencia nacional realizamos un estudio observacional, retrospectivo y descriptivo e incluimos pacientes de un mes a catorce años hospitalizados entre marzo a agosto del 2020. Se ingresaron 125 pacientes con infección por SARS-CoV-2, el 18,4% (n = 23) presentaron enfermedad crítica y 16,8% (n = 21) síndrome inflamatorio multisistémico (SIM). En los pacientes con SIM fue más frecuente la ausencia de comorbilidades y el antecedente de contacto epidemiológico. Tanto el grupo en estado crítico como del grupo con SIM, en comparación con los que no tuvieron estas condiciones, presentaron menores recuentos de linfocitos y plaquetas, y mayores valores de proteína C reactiva, ferritina y dímero D. Seis (4,8%) niños de los 125 fallecieron, 3 (13%) del grupo en estado crítico y ninguno del grupo con SIM.

Development of a severity of disease score and classification model by machine learning for hospitalized COVID-19 patients.

BACKGROUND: Efficient and early triage of hospitalized Covid-19 patients to detect those with higher risk of severe disease is essential for appropriate case management. METHODS: We trained, validated, and externally tested a machine-learning model to early identify patients who will die or require mechanical ventilation during hospitalization from clinical and laboratory features obtained at admission. A development cohort with 918 Covid-19 patients was used for training and internal validation, and 352 patients from another hospital were used for external testing. Performance of the model was evaluated by calculating the area under the receiver-operating-characteristic curve (AUC), sensitivity and specificity. RESULTS: A total of 363 of 918 (39.5%) and 128 of 352 (36.4%) Covid-19 patients from the development and external testing cohort, respectively, required mechanical ventilation or died during hospitalization. In the development cohort, the model obtained an AUC of 0.85 (95% confidence interval [CI], 0.82 to 0.87) for predicting severity of disease progression. Variables ranked according to their contribution to the model were the peripheral blood oxygen saturation (SpO2)/fraction of inspired oxygen (FiO2) ratio, age, estimated glomerular filtration rate, procalcitonin, C-reactive protein, updated Charlson comorbidity index and lymphocytes. In the external testing cohort, the model performed an AUC of 0.83 (95% CI, 0.81 to 0.85). This model is deployed in an open source calculator, in which Covid-19 patients at admission are individually stratified as being at high or non-high risk for severe disease progression. CONCLUSIONS: This machine-learning model, applied at hospital admission, predicts risk of severe disease progression in Covid-19 patients.

Virtual Teams in Times of Pandemic: Factors That Influence Performance.

In the digital age, the global software development sector has been a forerunner in implementing new ways and configurations for remote teamwork using information and communication technologies on a widespread basis. Crises and technological advances have influenced each other to bring about changes in the ways of working. In the 70's of the last century, in the middle of the so-called oil crisis, the concept of teleworking was defined using remote computer equipment to access office equipment and thus avoid moving around using traditional vehicles. Then from the 90s, with the advent of communications and the widespread use of the Internet, the first virtual work teams were implemented in software development companies that already had some of the important characteristics needed to work in this way, such as, cultural diversity, characterized tasks, geographical distribution of members, communication, interdependence of tasks, leadership, cohesion, empowerment, confidence, virtuality. This manuscript groups the main factors into different models proposed by the literature and also analyzes the results of a study conducted in the midst of the Covid-19 crisis on 317 software development teams that had to work in virtual teams (VT). The results of the quantitative methodology with structural equation modeling based on variance using the partial least squares route method are analyzed. The results of the research focus on some determinants that can directly affect the performance of the virtual team. A first determinant is communication in relation to the tasks. The second is trust in relation to leadership, empowerment and cohesion. The results of virtual teams provide information that can serve as a basis for future research lines for the implementation of virtual work strategies in post-pandemic work.

Researching COVID-19 tracing app acceptance: incorporating theory from the technological acceptance model.

BACKGROUND: The expansion of the coronavirus pandemic and the extraordinary confinement measures imposed by governments have caused an unprecedented intense and rapid contraction of the global economy. In order to revive the economy, people must be able to move safely, which means that governments must be able to quickly detect positive cases and track their potential contacts. Different alternatives have been suggested for carrying out this tracking process, one of which uses a mobile APP which has already been shown to be an effective method in some countries. OBJECTIVE: Use an extended Technology Acceptance Model (TAM) model to investigate whether citizens would be willing to accept and adopt a mobile application that indicates if they have been in contact with people infected with COVID-19. Research Methodology: A survey method was used and the information from 482 of these questionnaires was analyzed using Partial Least Squares-Structural Equation Modelling. RESULTS: The results show that the Intention to Use this app would be determined by the Perceived Utility of the app and that any user apprehension about possible loss of privacy would not be a significant handicap. When having to choose between health and privacy, users choose health. CONCLUSIONS: This study shows that the extended TAM model which was used has a high explanatory power. Users believe that the APP is useful (especially users who studied in higher education), that it is easy to use, and that it is not a cause of concern for privacy. The highest acceptance of the app is found in over 35 years old's, which is the group that is most aware of the possibility of being affected by COVID-19. The information is unbelievably valuable for developers and governments as users would be willing to use the APP.

A Social Network Analysis of Tweets Related to Masks during the COVID-19 Pandemic.

BACKGROUND: High compliance in wearing a mask is a crucial factor for stopping the transmission of COVID-19. Since the beginning of the pandemic, social media has been a key communication channel for citizens. This study focused on analyzing content from Twitter related to masks during the COVID-19 pandemic. METHODS: Twitter data were collected using the keyword "mask" from 27 June 2020 to 4 July 2020. The total number of tweets gathered were n = 452,430. A systematic random sample of 1% (n = 4525) of tweets was analyzed using social network analysis. NodeXL (Social Media Research Foundation, California, CA, USA) was used to identify users ranked influential by betweenness centrality and was used to identify key hashtags and content. RESULTS: The overall shape of the network resembled a community network because there was a range of users conversing amongst each other in different clusters. It was found that a range of accounts were influential and/or mentioned within the network. These ranged from ordinary citizens, politicians, and popular culture figures. The most common theme and popular hashtags to emerge from the data encouraged the public to wear masks. CONCLUSION: Towards the end of June 2020, Twitter was utilized by the public to encourage others to wear masks and discussions around masks included a wide range of users.