Healthcare-associated Respiratory Syncytial Virus in Children's Hospitals.

BACKGROUND: Outbreaks of healthcare-associated respiratory syncytial virus (HA-RSV) infections in children are well described, but less is known about sporadic HA-RSV infections. We assessed the epidemiology and clinical outcomes associated with sporadic HA-RSV infections. METHODS: We retrospectively identified hospitalized children <18 years old with HA-RSV infections in six children's hospitals in the United States during the respiratory viral seasons October-April in 2016-2017, 2017-2018, and 2018-2019 and prospectively from October 2020 through November 2021. We evaluated outcomes temporally associated with HA-RSV infections including escalation of respiratory support, transfer to the pediatric intensive care unit (PICU), and in-hospital mortality. We assessed demographic characteristics and comorbid conditions associated with escalation of respiratory support. RESULTS: We identified 122 children (median age 16.0 months [IQR 6, 60 months]) with HA-RSV. The median onset of HA-RSV infections was hospital day 14 (IQR 7, 34 days). Overall, 78 (63.9%) children had two or more comorbid conditions; cardiovascular, gastrointestinal, neurologic/neuromuscular, respiratory, and premature/ neonatal comorbidities were most common. Fifty-five (45.1%) children required escalation of respiratory support and 18 (14.8%) were transferred to the PICU. Five (4.1%) died during hospitalization. In the multivariable analysis, respiratory comorbidities (aOR: 3.36 [CI95 1.41, 8.01]) were associated with increased odds of escalation of respiratory support. CONCLUSIONS: HA-RSV infections cause preventable morbidity and increase healthcare resource utilization. Further study of effective mitigation strategies for HA-respiratory viral infections should be prioritized; this priority is further supported by the impact of the COVID-19 pandemic on seasonal viral infections.

International Classification of Diseases (ICD)

This article presents the history, contents, structures, functions, and applications of the International Classification of Diseases (ICD), which is a global standard maintained by the World Health Organization (WHO). The article aims to present ICD from the knowledge organization perspective and focuses on the current versions, ICD-10 and ICD-11. It also introduces the relationship between ICD and other health knowledge organization systems (KOSs), plus efforts in research and development reported in health informat-ics. The article concludes that the high-level effort of promoting a unified classification system such as ICD is critical in providing a common language for systematic recording, reporting, analysis, interpretation, and comparison of mortality and morbidity data. It greatly enhances the constancy of coding across languages, cultures, and healthcare systems around the world.

Cristalización legislativa de los procesos de securitización de la covid-19. Aplicabilidad del modelo de la Escuela de Seguridad de Copenhague al análisis de la Ley 4/1981 sobre los estados de alarma, excepción y sitio y la Ley 2/2021 de medidas para la gestión de la pandemia

El objeto de este artículo es realizar una propuesta teórico-metodológica a partir del modelo de análisis de la Escuela de seguridad de Copenhague para incorporar el examen de textos legislativos al estudio de los procesos de securitización. Con este objetivo, se realiza una aproximación al estudio de la securitización de la pandemia de la covid-19 a través del análisis comparativo de dos textos que han dado cobertura legislativa a la gestión de esta crisis sanitaria en España. El texto de la Ley orgánica 4/1981 sobre los estados de alarma, excepción y sitio;y el texto de la Ley 2/2021 del Parlamento Vasco de medidas para la gestión de la pandemia. Metodológicamente, este artículo analiza la securitización de la covid-19 a partir del modelo propuesto por la Escuela de seguridad de Copenhague desarrollado a raíz de la publicación de Security: A New Framework For Analysis (Buzan et al., 1997). Numerosas investigaciones han aplicado este modelo de análisis en el estudio de las políticas de seguridad sobre fenómenos como los movimientos migratorios (Müller y Gerbauer, 2021), la emergencia climática o la crisis sanitaria de la covid-19, examinando objetos tan diversos como los textos publicados en medios de comunicación social (Karyotis et al., 2021), el análisis de las audiencias (Bengtsson y Rhinard, 2019) o los discursos políticos (Kuleteva y Clifford, 2021). Un modelo que también se nutrió de las contribuciones posteriores de Balzacq (2005), Salter (2008) y Stritzel (2007, 2012) que ampliaron aún más los objetos de estudio de la securitización, que dejaron de ser exclusivamente textos de carácter político comunicados de manera lineal, para incorporar el análisis de la audiencia como un agente que interactúa y participa de la creación del discurso securitizador, la performance asociada a la ejecución del discurso o la interactividad del discurso en las redes sociodigitales. Sin embargo, pese a esta diversificación de estudios, la mayoría de las investigaciones sobre la securitización siguen centrándose en textos pertenecientes a discursos políticos o mediáticos. Se observa una ausencia de análisis de otro tipo de textos como aquellos de carácter legislativo, que también es interesante estudiar en el marco de estos procesos. Se trata de textos que, en muchos casos, dan cobertura legislativa a la aplicación de políticas de seguridad y podrían representar la cristalización legal de discursos político mediáticos previos. Dicho esto, dado el carácter jurídico de los textos que se examinan en este artículo, conviene señalar que el análisis que se propone es de carácter discursivo. Sin analizar las implicaciones jurídicas de los textos, cuestión que necesitaría otro tipo de tratamiento teórico-metodológico, nos proponemos observar la construcción discursiva de la seguridad que subyace en ellos y las consecuencias que, siguiendo las hipótesis de la Escuela de seguridad de Copenhague, esto conlleva. El artículo se estructura en tres partes. En el primer apartado, se realiza un breve acercamiento a la evolución de la investigación sobre seguridad en el campo de las Relaciones Internacionales y a la teoría de la securitización elaborada por la Escuela de seguridad de Copenhague en los años noventa. En el segundo apartado, se describe el contexto de crisis sanitaria global y, en concreto, en el caso de España, junto con los procesos de securitización que la acompañan. En tercer lugar, se presentan los documentos examinados y la operacionalización que permite su análisis. Posteriormente, se aborda la discusión sobre los resultados y las conclusiones.Alternate abstract:The aim of this article is to present a theoretical-methodological proposal based on a model of analysis from the Copenhagen School of Security Studies, which incorporates the examination of legislative texts into the study of securitization processes. With this objective, we propose an approach to the study of the securitization of the Covid-19 pandemic through the comparative analysis o two texts that have given legislative coverage to the management of this health crisis in Spain. The text of (1) Organic Law 4/1981 on the states of alarm, exception and siege;and the text of (2) Law 2/2021 of the Basque Parliament on measures for managing the pandemic. After the publication of Security:A New Framework For Analysis (Buzan et al.l997), numerous investigations have used the securitization analysis model of the Copenhagen School of Security Studies to study security policies on phenomena such as migratory movements (Müller and Gerbauer, 2021), the climate emergency, or the health crisis of Covid-19 by examining the texts published on social media (Karyotis et al., 202l),or the analysis of the audiences (Bengtsson and Rhinard, 2019) or political discourses (Kuleteva and Clifford, 2021). Securitization theory holds that what gives an issue the status of threat results from an interaction between an actor, whether it is a state, an organization, or the media, and which tries to define a certain problem as an existential threat, and an audience that accepts or rejects this attempt. Under this premise, security is considered a social construct, which has enormous consequences when it comes to its study.The analysis of the security agenda no longer consists of evaluating those threats considered real, but rather aims at the communicative processes through which actors and audiences agree to securitize an issue. The contributions of Balzacq (2005), Salter (2008) and Stritzel (2007;20l2), among others, have also broadened the objects of study of securitization, which have ceased to be exclusively texts of a political nature communicated in a linear manner to incorporate also the audience as an agent that interacts and participates in the creation of the securitizing discourse, the performance associated with the execution of the discourse or the interactivity of the discourse in socio-digital networks. However, despite this diversification in the approach to the study of securitization, most research continues to focus on texts belonging to political or media discourse.There is an absence of analysis of securitization in other types of texts, such as those of a legislative nature which are also interesting to study within the framework of these processes.That is, texts that, in many cases, give legislative coverage to the application of security policies and could represent the legal crystallization of previous political-media discourses. That said, given the legal nature of the texts examined in this article, it is important to make clear that the analysis proposed is, following the model of the Copenhagen School, a discursive analysis. This article does not carry out a legal analysis of the documents or a study on the legal consequences of the implementation of these laws, a study that would need another theoretical-methodological approach. Without conducting a legal analysis, we propose to observe the discursive construction of security that underlies the texts analyzed and the consequences that, according to the hypothesis of the Copenhagen School, this entails. Thus, the current analysis is about the securitization processes of the Covid-19 crisis.This health crisis has been one of the most disruptive episodes globally in recent decades. The unexpected appearance of the virus and its rapid spread made Covid-19, in just a few weeks, as UN Secretary General Antonio Guterres pointed out, the greatest threat to global security. The pandemic surpassed any of the established international protocols, and the lack of multilateral agreements between different countries and measures against the virus showed in turn a lack of global governance to deal with this type of threat. At first sight, we could say that Covid-19, an illness that, being new, poses a threat to the health of the entire world population since most people do not have immunity against it. However, this health crisis is once again a good scenario in which to observe that the threat is perceived and constructed in a very diverse way among the populatio .The study by Kirk (2022) on the securitization of Covid-19 in the United States refers to this. She analyzes the discursive battle between different security narratives about the health crisis in a country where the wearing or not wearing of a mask in public places often becomes an expression of a political position. The delimitation of the object of study to the examination of the texts of the Organic Law 4/1981 on states of alarm, exception, and siege, and (2) the Law 2/2021 of the Basque Parliament on measures for the management of the pandemic, is done for several reasons. In the first place, both texts, of an eminently legal nature, respond to the necessary characteristics to carry out the analysis in accordance with the objective of the study. Secondly, despite the substantial differences that both laws maintain in their preamble and the context of their drafting, the two texts have served as a legal framework for taking measures to deal with similar events, specifically, the crisis health of covid-19. This allows, following the proposal of the Copenhagen School, to contextualize the analysis of the securitization construction of the texts based on these facts. Third, the choice of texts, which share a legal framework, responds to the proposal to carry out an analysis of a state nature, and not an international one, given the prominence of state legislation in the coverage of policies and implementation of the security measures against the covid-19 disease because of the lack of international legal frameworks. The article is structured in three parts. In the first section, a brief theoretical-methodological approach is elaborated on the evolution of security research in the field of International Relations and to the theory of securitization developed bythe Copenhagen School. In the second, the context of the global health crisis and the case of Spain are described together with the securitization processes that accompany it.Thirdly, the documents examined and the operationalization that allows their analysis are presented. Subsequently, the discussion on the results and conclusions is addressed.

What is really 'Long COVID'?

The previous acute respiratory diseases caused by viruses originating from China or the middle east (e.g., SARS, MERS) remained fast developing short diseases without major sequalae or any long-lasting complications. The new COVID-19, on the other hand, not only that it rapidly spread over the world, but some patients never fully recovered or even if they did, a few weeks later started to complain not only of shortness of breath, if any, but general weakness, muscle pains and 'brain fog', i.e., fuzzy memories. Thus, these signs and symptoms were eventually labelled 'long COVID', for which the most widely used definition is 'new signs and symptoms occurring 4-8 weeks after recovering from acute stage of COVID-19'. The other most frequent manifestations associated with long COVID include headache, loss of memory, smell and of hair, nausea, and vomiting. Thus, long COVID is not a simple disease, but complex disorder of several organ systems malfunctioning; hence, it is probably more appropriate to call this a syndrome. The pathogenesis of long COVID syndrome is poorly understood, but initial and persistent vascular endothelial injury that often triggers the formation of microthrombi that if dislodged as emboli, damage several organs, especially in the brain, heart and kidney, by creating microinfarcts. The other major contributory mechanistic factor is the persistent cytokine storm that may last longer in long COVID patients than in others, probably triggered by aggregates of SARS-Co-2 discovered recently in the adrenal cortex, kidney and brain. The prevalence of long COVID is relatively high, e.g., initially varied 3-30%, and recent data indicate that 2.5% of UK population suffers from this syndrome, while in the US 14.7% of acute COVID-19 patients continued to have symptoms longer than 2 months. Thus, the long COVID syndrome deserves to be further investigated, both from clinical and basic research perspectives.

Symptom-based case definitions for COVID-19: Time and geographical variations for detection at hospital admission among 260,000 patients.

Introduction: Case definitions are used to guide clinical practice, surveillance and research protocols. However, how they identify COVID-19-hospitalised patients is not fully understood. We analysed the proportion of hospitalised patients with laboratory-confirmed COVID-19, in the ISARIC prospective cohort study database, meeting widely used case definitions. Methods: Patients were assessed using the Centers for Disease Control (CDC), European Centre for Disease Prevention and Control (ECDC), World Health Organization (WHO) and UK Health Security Agency (UKHSA) case definitions by age, region and time. Case fatality ratios (CFRs) and symptoms of those who did and who did not meet the case definitions were evaluated. Patients with incomplete data and non-laboratory-confirmed test result were excluded. Results: A total of 263,218 of the patients (42%) in the ISARIC database were included. Most patients (90.4%) were from Europe and Central Asia. The proportions of patients meeting the case definitions were 56.8% (WHO), 74.4% (UKHSA), 81.6% (ECDC) and 82.3% (CDC). For each case definition, patients at the extremes of age distribution met the criteria less frequently than those aged 30 to 70 years; geographical and time variations were also observed. Estimated CFRs were similar for the patients who met the case definitions. However, when more patients did not meet the case definition, the CFR increased. Conclusions: The performance of case definitions might be different in different regions and may change over time. Similarly concerning is the fact that older patients often did not meet case definitions, risking delayed medical care. While epidemiologists must balance their analytics with field applicability, ongoing revision of case definitions is necessary to improve patient care through early diagnosis and limit potential nosocomial spread.

Performance of Existing and Novel Symptom- and Antigen Testing-Based COVID-19 Case Definitions in a Community Setting.

Point-of-care antigen tests are an important tool for SARS-CoV-2 detection yet are less clinically sensitive than real-time reverse-transcription PCR (RT-PCR), impacting their efficacy as screening procedures. Our goal in this analysis was to see whether we could improve this sensitivity by considering antigen test results in combination with other relevant information, namely exposure status and reported symptoms. In November of 2020, we collected 3,419 paired upper respiratory specimens tested by RT-PCR and the Abbott BinaxNOW antigen test at two community testing sites in Pima County, Arizona. We used symptom, exposure, and antigen testing data to evaluate the sensitivity and specificity of various symptom definitions in predicting RT-PCR positivity. Our analysis yielded 6 novel multi-symptom case definitions with and without antigen test results, the best of which overall achieved a Youden's J index of 0.66, as compared with 0.53 for antigen testing alone. Using a random forest as a guide, we show that this definition, along with our others, does not lose the ability to generalize well to new data despite achieving optimal performance in our sample. Our methodology is broadly applicable, and our code is publicly available to aid public health practitioners in developing or fine-tuning their own case definitions.

The Measurement of Precarious Work and Market Conditions: Insights from the COVID-19 Disruption on Sample Selection

The precarious work construct combines employment instability and employment-contingent outcomes. Yet, I argue that confining the scope of the investigation to employed individuals creates a sample selection that disguises the heterogeneous nature of employment instability. The COVID-19 skyrocketing unemployment rate provides both a compelling motivation and a unique opportunity to revisit the construct of precarious work. Using pre-COVID and COVID-19 era data of the working-age population in Israel, the results demonstrate that by pushing less stable individuals out of employment, the COVID-19 recession strengthened the negative relationship between volatility and employment opportunities and accentuated sample selection. Because the selection into employment was not random, this introduces a bias into the measurement of precarious work, one that is more severe during a recession than in a full-employment market. The discussion highlights the broader significance of this lacuna and suggests a way to hone the conceptualization and operationalization of the precarious work construct.

Homeschooling Reconsidered

Homeschooling was occasionally a subject of popular interest pre-COVID, when media reported horrific cases of child abuse under the guise of homeschooling, or when controversies erupted over efforts in state legislatures or local school boards to introduce very modest oversight measures. COVID made homeschooling something nearly every parent considered as a long-term educational option for their children, and something arguably -- depending on one's definition of homeschooling -- nearly all experienced. This article extracts from the societal experience of forced remote learning, challenging theoretical questions about the distinction between homeschooling and "regular schooling", the wisdom of traditional brick-and-mortar, multi-service schooling, and the appropriateness of state officials passing judgement on any private form of schooling.

Geriatric Sepsis in the COVID-19 Era: Challenges in Diagnosis and Management

The elderly or geriatric patients represent a significant portion of emergency department (ED) admissions. Factors affecting poor outcome in these patients suspected or diagnosed with sepsis include shock, hyperlactatemia, and organ failure. Atypical presentations should be emphasized in the training of triage and ED personnel due to difficulties and pitfalls in diagnostic processes for sepsis. The vital organ functions of the elderly, who are among the highest risk groups in the management of sepsis, may deteriorate rapidly with very few precursors, and aggressive methods should be used rapidly when necessary. Interactions of drug doses in the elderly, problems in excretion and differences in metabolism should be considered in treatment regimens. Healthcare workers should try to eliminate colonization risks such as vascular catheterization, unnecessary vascular access and urinary catheters should be removed.In the long term after recovery from sepsis, heart failure, peripheral vascular disease, dementia, and diabetes are the most common entities recorded in the literature. This review was intended to provide an overview of the overall management and give some practical tips for this fragile group of patients in the post-pandemic era.

Comparison of national early warning score 2 and quick sepsis-related organ failure assessment score in predicting severe coronavirus disease 2019: A validation study

BACKGROUND AND AIM: Coronavirus disease 2019 (COVID-19) has imposed a heavy burden on the intensive care unit and health care systems worldwide. Therefore, early detection of high-risk patients in terms of poor prognosis is crucial. We aimed to compare the diagnostic yield of the two most reliable scoring systems (National Early Warning Score 2 [NEWS 2] and quick Sepsis-related Organ Failure Assessment [qSOFA]) when repeatedly performed during the COVID-19 course. METHODS: The data of 403 COVID-19 patients admitted to our hospital between March 1, 2020, and November 30, 2020, were retrospectively reviewed. The demographic, comorbidity, and clinical data of the patients were recorded in the evaluation. NEWS2 and qSOFA score were retrospectively calculated at the time of admission, 24th hour, and 48th hour. We compared the effectiveness of qSOFA and NEWS2 for predicting the prognosis of COVID-19. RESULTS: The mean NEWS2 at the time of admission, 24th hour, and 48th hour was significantly higher in patients with poor outcomes than in patients with good outcomes. The 48th-hour NEWS2 was found to be the most successful score in predicting the poor outcome (AUC: 0.854;95% CI: 0.81-0.88;p<0.001). NEWS2 at 0th, 24th, and 48th hours were found to be superior to qSOFA scores at the same time points. CONCLUSIONS: NEWS2 was superior to qSOFA in determining the need for intensive care support and/or mortality. A high NEWS2 at the 48th hour seems to be more valuable to predict worse outcomes.

COVID-19-Associated Pulmonary Aspergillosis (CAPA) in Northern Greece during 2020-2022: A Comparative Study According to the Main Consensus Criteria and Definitions.

Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) has emerged as an important complication among patients with acute respiratory failure due to SARS-CoV-2 infection. Almost 2.5 years since the start of the COVID-19 pandemic, it continues to raise concerns as an extra factor that contributes to increased mortality, which is mostly because its diagnosis and management remain challenging. The present study utilises the cases of forty-three patients hospitalised between August 2020 and February 2022 whose information was gathered from ten ICUs and special care units based in northern Greece. The main aim was to describe the gained experience in diagnosing CAPA, according to the implementation of the main existing diagnostic consensus criteria and definitions, and present the different classification of the clinical cases due to the alternative algorithms.

Preface for the 66th Special Feature "Novel Aspects and Approaches to Experimental Methods for ElectrochemistryӠ

The Kansai Branch of the Electrochemical Society of Japan publishes a collection of papers in Electrochemistry, which serve as a commentary to the 51st Electrochemistry Workshop. This attempt is motivated by the fact that the domestic seminars are now widely publicized through the on-demand event triggered by COVID-19. This preface consists of the significance of the publication and an introduction of the lecturers as a part of special future for "Novel Aspects and Approaches to Experimental Methods for Electrochemistry.” in this issue of Electrochemistry. © 2022 Electrochemical Society of Japan. All rights reserved.

The 66th special feature "Novel Aspects and Approaches to Experimental Methods for Electrochemistry"

The Kansai Branch of the Electrochemical Society of Japan publishes a collection of papers in Electrochemistry, which serve as a commentary to the 51st Electrochemistry Workshop. This attempt is motivated by the fact that the domestic seminars are now widely publicized through the on-demand event triggered by COVID-19. This preface consists of the significance of the publication and an introduction of the lecturers as a part of special future for "Novel Aspects and Approaches to Experimental Methods for Electrochemistry." in this issue of Electrochemistry. (C) The Author(s) 2022. Published by ECSJ.

High Monocyte Count Associated with Human Cytomegalovirus Replication In Vivo and Glucocorticoid Therapy May Be a Hallmark of Disease.

Cytomegalovirus (CMV) syndrome and infectious disease are defined as pathogen detection with appropriate clinical symptoms, but there are not pathognomonic signs of CMV disease. Although the prodrome of acute minor viral infections leukopenia (lymphopenia and neutropenia) is noted with onset of fever, followed by monocytosis, the role of monocytosis in CMV disease has not been described. Furthermore, under influence of corticosteroid therapy, CMV reactivation and monocytosis are described, but without a strict relationship with steroids dose. In the study, the monocyte level was investigated during the CMV infectious process. Regrettably, a non-selected group of 160 patients with high CMV viremia showed high dispersion of monocyte level and comparable with the median value for healthy subjects. Therefore, we investigated monocyte level in CMV-infected patients in relation to the logarithmic phase of the infectious process. Samples from patients with active CMV replication (exponential growth of CMV viremia) were tested. Significant monocytosis (above 1200/µL) during the logarithmic phase of CMV infection (with exponent between 3.23 and 5.77) was observed. Increased count and percentage of monocytes correlated with viral replication in several clinical situations except when there was a rapid recovery without relapse. Furthermore, glucocorticoids equivalent to 10 and 20 mg of dexamethasone during a 2-3-week period caused monocytosis-significant increase (to 1604 and 2214/µL, respectively). Conclusion: In light of the logarithmic increase of viral load, high monocytosis is a hallmark of CMV replication. In the COVID-19 era, presence of high virus level, especially part of virome (CMV) in the molecular technique, is not sufficient for the definition of either proven or probable CMV replication at any site. These preliminary observations merit additional studies to establish whether this clinical response is mediated by monocyte production or by decrease of differentiation to macrophages.

Investigating the First Robotic Nurses: Humanoid Robot Nightingale and Partners for COVID-19 Preventive Design

Responding to these global COVID-19 changes for daily healthcare services clinic, while maintaining safe social distancing, the paper reports the human-centred iterative design with real-fields feasibility inquiries to investigate the first robotic nurse and her partners in Wales. The research adapted the ancient Eastern human nature of seven emotions and six biological wills for the selection criteria and novel design principles for the care robots. We report the preliminary work for integrating, customising, implementing and evaluating three novel robotic nurses: Robot Nightingale, Robot Almeida and Robot Eureka in a care home and a hospital. Bionic Scenarios Definition with 5 merging principles are extracted from the Feasibility Inquiries 1–3. Limitations are discussed from the stakeholders’ experiences. Our research has no intension to replace human nurses, but a thoughtful feasibility and interdisciplinary study for bionic robotic nurses for conventional engineers’ and practitioners’ references. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Exposing the Mythology of Balance and the Ecology of Graduate Student Mother Resilience in COVID-19

While the COVID-19 pandemic has amplified the once marginalized conversation of academia's gendered imbalance of opportunity, discussion of its impact on graduate student mothers has remained absent. Resilience has been cited as key to overcoming in the pandemic era with little discussion of how its conceptualization continues to marginalize females in the academy. Our phenomenological study explores graduate student mothers' conceptualizations of balance, failure, success, and resilience using a family resilience framework which acknowledges the multiple identities to which they may avow and contexts in which they may operate. Employing an ecological conceptual framework, we engaged nine graduate student mothers and their children in focus groups and analyzed data using a constructivist grounded theory approach. Our research found that many graduate student mothers' definitions of success led them to delay qualifying exams and comps during the pandemic. Our exploration of the ecology of our participants' resilience during quarantine begins the generation of a new graduate student mother resilience theory in which the ability to overcome adversity is rooted in celebration, gratitude, collaborative problem-solving, connection, and flexibility. We recommend continued development of this new theory and provide insight into the supports higher education can offer to address the leaky academic pipeline.

Risk Measurement of Perinatal and Neonatal Morbidity Characteristics and Applicability of GAIA Case Definitions: Results and Lessons Learnt of a Hospital-Based Prospective Cohort Study in the Valencia Region (2019-2020).

Post-marketing safety surveillance of new vaccines aimed to be administered during pregnancy is crucial to orchestrate efficient adverse events evaluation. This is of special relevance in the current landscape of new vaccines being introduced in the pregnant women population, and particularly due to the recent administration of COVID-19 vaccines in pregnant women. This multi-center prospective cohort study, nested within the WHO-Global Vaccine Safety-MCC study, involved two hospitals in the Valencia region. Hereby, the incidence rates of seven perinatal and neonatal outcomes in the Valencia region are presented. The pooled data analysis of the two Valencian hospitals allowed the estimation of incidence rates in the Valencia Region (per 1000 live births): 86.7 for low birth weight, 78.2 for preterm birth, 58.8 for small for gestational age, 13 for congenital microcephaly, 0.4 for stillbirth, 1.2 for neonatal death and 6.5 for neonatal infection. These figures are in line with what is expected from a high-income country and the previously reported rates for Spain and Europe, except for the significantly increased rate for congenital microcephaly. Regarding the data for maternal immunization, the vaccination status was collected for 94.4% of the screened pregnant women, highlighting the high quality of the Valencian Vaccine Registry. The study also assessed the Valencian hospitals' capacity for identifying and collecting data on maternal immunization status, as well as the applicability of the GAIA definitions to the identified outcomes.

Concept and solution of digital twin based on a Stieltjes differential equation

We introduce the concept of a digital twin by using Stieltjes differential equations. A precise mathematical definition of solution to the problem is presented. We also analyze the existence and uniqueness of solutions, introduce the concept of main digital twin. As a particular case, the classical compartmental SIR (susceptible, infected, recovered) epidemic model is considered and we study the interrelation between the digital twin and the system. In doing so, we use Stieltjes derivatives to feed the data from the real system to the virtual model which, in return, improves it in real time. Numerical simulations with real data of the COVID-19 epidemic show the accuracy of the proposed ideas. © 2022 The Authors. Mathematical Methods in the Applied Sciences published by John Wiley & Sons, Ltd.

Arguing About “COVID”: Metalinguistic Arguments on What Counts as a “COVID-19 Death”

In this contribution, we explore the plausibility and consequences of treating arguments over what counts as a COVID-19 death as metalinguistic arguments. While unquestionably related to the epidemiological and public health issues, these arguments are also arguments about how a term should be used. As such, they touch upon some of the foundational issues in meta-semantics, discussed in the recent literature on metalinguistic negotiations, conceptual ethics, and conceptual engineering. Against this background, we study official statements (of WHO, governments) and media reports to critically reconstruct the metalinguistic elements of the dispute over what a COVID-19 death is. We analyze in particular how epistemic and practical reasons are intertwined in nuanced and complex ways to produce an interesting type of metalinguistic interventions. © 2022, The Author(s).