GLOBAL PRODUCTION NETWORKS IN THE REGIONAL ANALYSIS FRAMEWORK: CASE OF THE EU PERIPHERAL AUTOMOTIVE MANUFACTURING

Recent transformations following the global financial crisis of 2009, COVID-19 pandemic, supply chains disruptions and newest shocks have radically reshaped global production landscape and challenged comparative benefits of global production networks (GPN) vs global value chains (GVC) paradigms in international production analysis. The study tests the hypothesis that GPN concept allows for a better identification of structural shifts in international production structures while revealing regional patterns of cooperation. In the first section, the main methodological constraints of GVC paradigm are specified. Additionally, the reasons for the application of network-based approach to international production are outlined. The second section dissects the EU automotive manufacturing to support the theoretical propositions. While comparing GVC and GPN quantitative toolkits, the possible trade-off has been reached which is to calculate network indicators (transitivity, centrality, etc.) on the inter-country input-output tables. As a result, the hypothesis was confirmed. Specifically, betweenness centrality metric suggests that Czechia and Slovakia have immediately favoured a positive effect of the entry into the EU, whereas neither of GVC indicators reveals such a shift. Simultaneously, 2008 crisis is depicted via GVC indicators, whilst network metrics suggest no structural changes in the production system. These results corroborate to our theoretical juxtaposition of GVC/GPN approaches. The methodological cohesion of two sets of indicators further advances the views on European regional core-periphery integration and automotive production networks dynamics. At the same time, the findings may contribute to the reassessment of regional integration developments in Europe, as well as in Latin America and Eurasia. © González G. H., Sapir E. V., Vasilchenko A. D. Text. 2023.

A guide for the implementation of network resources

Introduction: Changes in higher medical education, caused by the SARS-CoV-2 virus pandemic, prompted the integration of information and communication technologies to teaching in Cuba and the world. The virtual university of health became an important means to support the teaching-educational processes;therefore, professors had to face the challenge of virtualizing their training activities. Objective: To validate a guide for designing and assembling virtual teaching-learning environments in undergraduate and postgraduate medical education. Methods: A technological innovation research was carried out in three stages: design of the guide, implementation and validation. A survey was conducted to the participants of the virtual training in virtual teaching-learning environments. Results: Six steps were proposed for the design and implementation of training processes through the virtual modality: analysis of resources and feasibility;course design or adaptation of an existing program;content production;resource uploading and activity configuration;training action;and course assessment, improvement and redesign. Conclusions: The integration of technology to higher education teaching is a reality driven by the epidemiological situation, which will continue to develop until it becomes part of the professor's regular work. This guide systematizes and simplifies actions to facilitate the initial virtualization process. A flexible and scalable model is proposed to improve continuously the quality of the educational teaching process in virtual teaching-learning environments. © 2023, Editorial Ciencias Medicas. All rights reserved.

Psychological impact of a country-wide lockdown. Role of personal, behavioral, social, and physical conditions on negative and positive affect and meaning in life

During the early outbreak of COVID-19 in 2020, a strict home lockdown was maintained in Spain for more than 50 days, disrupting social and economic activities. The aim of this study is to explore affective and well-being responses during the initial period of mandatory home lockdown. Specifically, we analyzed: 1) differences in risk perception according to sociodemographic and health profile;2) relation between social and environmental characteristics of home isolation, positive and negative affect and meaning in life;and 3) the relationship between activities and behaviors performed by people under lockdown and well-being. A total of 1343 Spanish residents participated in this correlational and cross-sectional study. Results show a significant relationship between health and economic risk perception associated with confinement. Higher health risk perception was identified among the older population and those belonging to high-risk groups. High resilience was linked to lower negative affect and greater positive affect and meaning in life. Regarding social and environmental characteristics of home isolation, people living with others reported greater negative affect than people living alone and the daily frequency of use of open-air spaces was linked to positive affect. Higher positive affect and meaning in life were also reported in people who frequently participated in community activities or by helping others. Lower negative affect was only associated with physical exercise. © 2022, Sociedad Interamericana de Psicologia. All rights reserved.

T-cell responses to SARS-CoV-2 in patients during acute disease, convalescence and after vaccination

Background: T-cell response against SARS-CoV-2 is essential for disease control and to understand correlates of protection against various disease outcomes in COVID-19. This makes T-cell measurement an important tool for clinical management. Aim(s): To evaluate the IFN-gamma-releasing T-cell response against spike (S), nucleocapsid (N) and membrane (M) SARS-CoV-2 antigens using an ELISPOT-based assay in acute, convalescent, and vaccinated individuals. Method(s): Blood samples were collected from acute (n=71) and convalescent (n=59) individuals classified according to severity;and from vaccinated (n=48) and non-vaccinated (n=80) controls. After stimulating with S, N and M antigens overnight, T-cell response was measured (T-SPOT Discovery SARS-CoV-2. Oxford Immunotec, UK). IgG against S and N were also measured. Result(s): S antigen triggered the highest number of T-cell responses (46%), although responses against N and M were in a large percentage of individuals. The majority of convalescent individuals (93%) had a reactive T-cell response more than 200 days after diagnosis. Such response increased with severity. Acute patients had fewer positive responses (68%). S antigen triggered most responses in vaccinated controls, but only in half of them T-cell response was observed after the second dose. A higher percentage of individuals showed IgG response compared to IFN-gamma-releasing T-cell responses, and moderate correlations between both quantitative responses were seen. Conclusion(s): T-cell response against SARS-CoV-2 is low during acute phase but may increase over time, as seen in convalescent individuals. Regarding vaccinated individuals, half had a positive test result after the second dose.

Smart Contract to Traceability of Food Social Selling

Traditionally, food sustainability has been considered solely in the stage of agricultural production. However, globalization, the expansion of the food production industry, and the emergence of supermarket chains that control the retail food market require specific significant changes in supply chains in the food sector and, therefore, we need to address the economic, social, and environmental impacts of these events. On the other hand, social selling has increased rapidly in recent years, with a further boom, following current events related to the coronavirus disease (COVID-19). This explosion of social sales, where there are usually no control and regulation entities, can bring problems associated with mishandling items. In this paper, we expose how Blockchain technology supports the traceability of social sales by validating the data provided by the chain participants such as digital health passports, production and transport data in the sale process;the proposed solution generates recommendations on productmanagement considering the agreements previously made by the network actors. To evaluate the proposed smart contracts, we useHyperledger Caliper, obtaining an average throughput of 12.6 transactions per second and an average latency of 0.3 s for the asset update process. We also use a study case to evaluate the proposed project platform's selling-transport stage using Internet of Things (IoT) sensors. © 2023 Tech Science Press. All rights reserved.

Smart Contract to Traceability of Food Social Selling

Traditionally, food sustainability has been considered solely in the stage of agricultural production. However, globalization, the expansion of the food production industry, and the emergence of supermarket chains that control the retail food market require specific significant changes in supply chains in the food sector and, therefore, we need to address the economic, social, and environmental impacts of these events. On the other hand, social selling has increased rapidly in recent years, with a further boom, following current events related to the coronavirus disease (COVID-19). This explosion of social sales, where there are usually no control and regulation entities, can bring problems associated with mishandling items. In this paper, we expose how Blockchain technology supports the traceability of social sales by validating the data provided by the chain participants such as digital health passports, production and transport data in the sale process;the proposed solution generates recommendations on productmanagement considering the agreements previously made by the network actors. To evaluate the proposed smart contracts, we useHyperledger Caliper, obtaining an average throughput of 12.6 transactions per second and an average latency of 0.3 s for the asset update process. We also use a study case to evaluate the proposed project platform's selling-transport stage using Internet of Things (IoT) sensors. © 2023 Tech Science Press. All rights reserved.

Impact of plasmapheresis on severe COVID-19.

The clinical course of COVID-19 may show severe presentation, potentially involving dynamic cytokine storms and T cell lymphopenia, which are leading causes of death in patients with SARS-CoV-2 infection. Plasma exchange therapy (PLEX) effectively removes pro-inflammatory factors, modulating and restoring innate and adaptive immune responses. This clinical trial aimed to evaluate the impact of PLEX on the survival of patients with severe SARS-CoV-2 and the effect on the cytokine release syndrome. Hospitalized patients diagnosed with SARS-CoV-2 infection and cytokine storm syndrome were selected to receive 2 sessions of PLEX or standard therapy. Primary outcome was all-cause 60-days mortality; secondary outcome was requirement of mechanical ventilation, SOFA, NEWs-2 scores modification, reduction of pro-inflammatory biomarkers and hospitalization time. Twenty patients received PLEX were compared against 40 patients receiving standard therapy. PLEX reduced 60-days mortality (50% vs 20%; OR 0.25, 95%CI 0.071-0.880; p = 0.029), and this effect was independent from demographic variables and drug therapies used. PLEX significantly decreased SOFA, NEWs-2, pro-inflammatory mediators and increased lymphocyte count, accompanied with a trend to reduce affected lung volume, without effect on SatO2/FiO2 indicator or mechanical ventilation requirement. PLEX therapy provided significant benefits of pro-inflammatory clearance and reduction of 60-days mortality in selected patients with COVID-19, without significant adverse events.

Patient Engagement in Management of Recurrent Urinary Tract Infections

Purpose of Review: Recurrent urinary tract infections (rUTIs) are highly prevalent among women and can be challenging to manage for both clinicians and patients. This review aims to outline and analyze important studies relevant to clinical care and provide patient-centered recommendations. Recent Findings: The current literature supports that the treatment of rUTIs is multifaceted, and improving patient engagement requires clinical strategies that prioritize improving women's quality of life. Culture-directed treatment of recurrent infections to prevent collateral damage from antibiotics is supported by the 2019 Recurrent Uncomplicated Urinary Tract Infections in Women Guidelines published by the American Urological Association, Canadian Urology Association, and Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction. Qualitative studies have identified important considerations for patients such as antibiotic and non-antibiotic treatment options, financial costs, as well as physical and mental health impairments. Summary: Solely treating the physical symptoms caused by recurrent urinary tract infections without discussing prevention strategies and quality of life challenges caused by rUTIs will likely lead to poor patient engagement and satisfaction. Building a medical practice with ancillary physician support to expedite and increase convenience may help meet patient expectations and ease the burden of care identified in prior studies. Physicians should prioritize antibiotic stewardship and be mindful that microbiome research has demonstrated that healthy bladders have been found to have commensal bacteria, which may act as barriers against uropathogens, thus helping prevent urinary tract infections. Copyright © 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

From the right to food to Good Eating. Notes for an XXI century agrarian question

Agroextractivism and its effects on the enjoyment and access to food in developing countries populations, is, without a doubt, a post-pandemic issue that urgently needs to reconceptualize, in the light of the devastating effects of COVID 19 on the population with food and nutritional deficiencies derived from the imbalance in the agri-food production chain, in the current context of the globalisation of commodities: food from here, there and nowhere, which arrives at our table without food and cultural identity, and with questionable nutritional value. Through a descriptive analysis, bibliographic content related to agroextractivism, published from 2000 to 2020, was analyzed, seeking to recognize its impact on the food systems of indigenous peasant communities in Mexico, the Caribbean and the Southern Cone, considering the effects on the biodiversity of the ecosystems of the communities and agricultural knowledge, climate change, and the enjoyment of the right to food and the access to it.. As a result of this literature review, new conceptual elements were found, recognizing the right to food as a peasant human right;and Good Eating as the agri-food worldview of the peasant communities of the indigenous peoples of Latin America. In addition, the right to food and Good Eating are proposed as emerging epistemic paradigms for the study and analysis of the agrarian question of the XXI Century.

Eating habits and academic stress among university students during the COVID-19 pandemic, Paraguay 2021

The objective of the study was to identify the eating habits related to the level of stress among students of the National University of Caaguazu during the COVID-19 pandemic. A descriptive, observational, cross-sectional study was carried out with 353 students selected from different faculties. Demographic variables, eating habits and academic stress were studied. A total of 353 university students were included in the study, 64.9% female, and 59.5% under 23 years of age. 36.5% belonged to the Faculty of Production Sciences while 30% were from the third year. In total, 64.8% (229 students) had a high level of stress. High stress level was related to high consumption of sweets (AOR= 2.94, 1.57-5.51), high consumption of fast food (AOR= 2.23, 1.14-4.32), low consumption of fruits (AOR= 1.66, 0.99-2.79), skipping lunch (AOR= 2.94, 1.55-5.60), and increased daily snacks (AOR= 3.36, 1.74-6.47). The results of our study made visible the problem that academic stress during the Covid-19 pandemic influenced the acquisition of bad eating habits. Copyright © 2022, Sociedad Chilena de Nutricion Bromatologia y Toxilogica. All rights reserved.

Phantosmia May Predict Long-Term Measurable Olfactory Dysfunction After COVID-19.

OBJECTIVES: Persistent olfactory dysfunction (OD) after 6 months caused by SARS-CoV-2 infection has been reported with a variable prevalence worldwide. This study aimed to determine the prevalence of long-term OD and identify predisposing factors. METHODS: A prospective cohort study was conducted on 100 adults with COVID-19. Olfactory function was assessed with the University of Pennsylvania Smell Identification Test and a symptom survey at the onset of disease and 30 days later. Patients with persistent quantitative OD at the second assessment were reevaluated after 1 year. Demographic variables, symptoms, and the degree of smell loss were analyzed. RESULTS: Participants included 100 patients. The mean age was 42.2 ± 15.6 years, 55 (55%) were female, and 56 (56%) were outpatients. Baseline smell loss was identified in 75/100 (75%) patients, decreasing to 39/95 (40%) after 1 month, and persisting in 29 patients after 1 year. Phantosmia at baseline was the only risk factor identified for persistent OD after 1 year (relative risk 2.51; 95% confidence interval 1.53-4.12; p < 0.001). Regardless of the outcome in smell function, a significant decline in olfaction was associated with the presence of phantosmia at 1 month (ß = -12.39; 95% CI -19.82 to -4.95; p < 0.01). CONCLUSIONS: SARS-CoV-2 (2019-2020 variants) produced a highly frequent OD that persisted in 29% of the patients after 1 year. The presence of phantosmia at baseline and 1 month was associated with a worse evolution, but phantosmia may interfere with the performance in an identification smell test. A longer follow-up is required in these patients. LEVEL OF EVIDENCE: 2 Laryngoscope, 132:2445-2452, 2022.

The problem of assigning bus drivers to trips in a Spanish public transport company

This article addresses a particular bus Crew Scheduling Problem (CSP) that arises in a public transport company in Spain. The classical CSP problem tries to create bus driver schedules covering all the bus schedules published by the company. The problem posed does not require satisfying any restriction due to the lack of drivers. This relaxed restriction emerged in the time of Covid-19 for different reasons. This is why the need arose in the company for a tool that allows optimizing the daily work of the drivers. The objective function of the problem requires servicing the greatest number of passengers possible, instead of minimizing the schedule cost. A model and strategies for solving the problem exactly are introduced: clustering, re-optimization, etc. Additionally, a re-optimization model is proposed using prior feasible solutions to speed up the resolution of the problem. The integration and practical use of the solutions obtained and their corresponding monitoring in the decision-making process of the company are described.

Protagonism and Commitment of the University Extension in the Current Cuban Context

The university is a social institution that as such has the mission of preserving, developing and promoting culture in a broad sense, which it materializes through its teaching, research and university extension processes. Extension as a substantive process has gone through different stages in its development, ranging from marginalization to integration. The present work aims to reveal the leading role that university extension has played in the Cuban pandemic context and the commitment shown by its actors since the appearance of COVID 19. The studies carried out using theoretical and empirical methods reveal that during this period the university institutions have had to reconfigure their processes and assume new missions, which, although associated with the fulfillment of their social task of contributing to the cultural development of the society in which they are located, have required new ways of acting and the assumption of new roles, so the agility, dynamism and flexibility of the extension process has been vital in this endeavor.

Near-Surface Atmospheric Behavior over Complex Tropical Topography in Puerto Rico Dominated by Seasonal Patterns Despite Frequent Environmental Changes

Understanding near-surface atmospheric behavior in the tropics is imperative given the role of tropical energy fluxes in Earth’s climate cycles, but this area is complicated by a land–atmosphere interaction that includes rugged to-pography, seasonal weather drivers, and frequent environmental disturbances. This study examines variation in nearsurface atmospheric behaviors in northeastern Puerto Rico using a synthesis of data from lowland and montane locations under different land covers (forest, urban, and rural) during 2008–21, when a severe drought, large hurricanes (Irma and Maria), and the COVID-19 mobility-reducing lockdown occurred. Ceilometer, weather, air quality, radiosonde, and satellite data were analyzed for annual patterns and monthly time series of data and data correlations. The results showed a system that is strongly dominated by easterly trade winds transmitting regional oceanic patterns over terrain. Environmental disturbances affected land–atmosphere interaction for short time periods after events. Events that reduce the land signature (reducing greenness: e.g., drought and hurricanes, or reducing land pollution: e.g., COVID-19 lockdown) were evidenced to strengthen the transmission of the oceanic pattern. The most variation in near-surface atmospheric behavior was seen in the mountainous areas that were influenced by both factors: trade winds, and terrain-induced orographic lifting. As an exception to the rest of the near-surface atmospheric behavior, pollutants other than ozone did not correlate positively or negatively with stronger trade winds at all sites across the region. Instead, these pollutants were hypothesized to be more anthropogenically influenced. Once COVID-19 lockdown had persisted for 3 months, urban pollution decreased and cloud base may have increased. © 2022, American Meteorological Society. All rights reserved.

[Impact of the COVID-19 pandemic on patient safety incident and medication error reporting systems]. / Impacto de la pandemia COVID-19 en los sistemas de notificación de incidentes de seguridad del paciente y errores de medicación.

BACKGROUND AND AIM: To determine the impact of the COVID-19 pandemic on the epidemiology of safety incidents (SI) and medication errors (ME) reported to the CISEMadrid notification system in the hospital and primary care settings of the Madrid Health Service (SERMAS). MATERIALS AND METHODS: Observational and descriptive study with a retrospective analysis of data including all CISEMadrid notifications from 01-Jan-2018 to 31-Dec-2020, from 33 hospitals and 262 health care centres of the SERMAS. The two periods in 2020 with the greatest increase in COVID-19 cases were identified to compare incidents reported in the pre-pandemic and pandemic periods. RESULTS: 36,494 incidents were reported. Comparing both periods, an overall decrease in pandemic notifications of 60.7% was observed, being higher in primary care, falling to 33% of previous levels. The reduction in notifications was similar in the peaks and valleys of the waves. The three most frequent SIs in both periods and care settings were: diagnostic tests, medical devices/equipment/clinical furniture and organisational management/citations. In ME, dose failure and inappropriate selection were the most frequent in both settings and periods. There were no relevant differences in patient consequences in both periods. CONCLUSIONS: During the pandemic, patient safety notifications decreased although the most frequent types remained the same, as did their impact on the patient, both in hospitals and in primary care. The safety culture of organisations is a critical aspect for the maintenance of reporting systems.

Evaluation of competency-driven training for facilitators delivering a psychological intervention for children in Lebanon: a proof-of-concept study.

AIMS: The mounting evidence for effective delivery of psychological interventions by non-specialists in low- and middle-income settings has led to a rapid expansion of mental health and psychosocial support trainings globally. As such, there is a demand for strategies on how to train and implement these services to attain adequate quality. This study aims to evaluate the added value of a competency-driven approach to training of facilitators for a group intervention for children with severe emotional distress in Lebanon. METHODS: In a controlled before and after study, 24 trainees were randomly allocated to participate in either a competency-driven training (CDT) or training-as-usual (TAU) (1 : 1) for a psychological intervention for children with severe emotional distress. We assessed the change in demonstrated competencies, using standardised role-plays, before and after the training. Measures included the 13-item Working with children-Assessment of Competencies Tool (WeACT), the 15-item ENhancing Assessment of Common Therapeutic factors (ENACT) and the 6-item Group facilitation: Assessment of Competencies Tool (GroupACT). The trainer in the experimental arm used pre-training and during training competency assessment scores to make real-time adjustment to training delivery. Due to COVID-19 pandemic restrictions, all activities were done remotely. RESULTS: CDT resulted in significantly better outcomes on increasing competencies on the WeACT (repeated measures analysis of variance; F(1, 22) = 6.49, p < 0.018) and on the GroupACT (Mann-Whitney U = 22, p < 0.003), though not statistically significant on the ENACT. There is no significant between-group difference on the reduction of harmful behaviours, mainly because both forms of training appear equally successful in eliminating such behaviours. CONCLUSIONS: This proof-of-concept study demonstrates the potential of CDT, using standardised assessment of trainee competencies, to contribute to better training outcomes without extending the duration of training. CDT can result in up to 18% greater increase in adequate competency, when compared to TAU. The study also yields recommendations for further enhancing the benefits of competency-driven strategies. A fully powered trial is needed to confirm these findings.

YouTube as a Source of Information on COVID-19 Vaccination and Fertility: A Content Analysis

INTRODUCTION: Social media claims of COVID-19 vaccination causing infertility has contributed to vaccine hesitancy among reproductive-aged women. YouTube is the most extensively used video sharing platform, delivering information to 2.3 billion users. We conducted a cross-sectional study to assess the accuracy, content, and viewership of YouTube videos on COVID-19 vaccines and fertility. METHODS: YouTube videos identified using the search term 'COVID vaccine fertility' were classified independently by three professionals. Five-point ordinal scales were used to grade reliability and quality. Information regarding source of upload, video content in six pre-defined domains, reasons for vaccine hesitancy in eight pre-defined domains, and various video-viewer interaction metrics were collected. RESULTS: Of the 112 videos with cumulative duration of 17.2 hours and viewership of approximately 3.5 million, 16 (14.41%) were from government/professional societies, 41 (36.94%) were from hospitals, 36 (32.43 %) were from News/Commercial organizations, and 18 (16.22%) were from individual users. Videos from government/professional societies were rated more likely to be useful and had the highest quality scores. However, individual accounts had the highest viewership at a median of 286.5 views per day compared to 28.8 views per day for government videos (P<.05). Among videos from government/professional societies, 62.50% reported on pregnancy related complications. In contrast, among individual videos, 66.67% reported on COVID-19 vaccine clinical trials. Among all videos, the most reported reason for vaccine hesitancy were claims of antibodies disrupting placentation. CONCLUSION: Social media websites such as YouTube may provide an accessible platform for disseminating information to reproductive-aged women contemplating COVID-19 vaccination.

DIFFERENTIALLY EXPRESSED IMMUNOLOGICAL GENES in MILD and SEVERE CASES of COVID-19

Background: Coronavirus disease 2019 (COVID19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has varied clinical presentations from mild subclinical to severe disease with high mortality. Our aim was to determine whether examining immune-related gene expression early in infection could predict progression to severe disease. Methods: In subjects of the All Ireland Infectious Diseases Cohort study, we analysed expression of 579 genes with the NanoString nCounter Immunology panel in peripheral blood mononuclear cells in those with confirmed SARS-CoV-2 infection collected within 5 days of symptom onset and matched SARS-CoV-2 negative controls with respiratory infection. Subsequent maximum COVID19 disease severity was classified as mild or severe. Read counts were normalized using panel housekeeping genes. Expression changes in severity groups were estimated against control baseline. Results: Between April and July of 2020, we recruited 120 subjects, 62 with COVID19 and 58 controls, with average age 59 y.o. (IQR 34-88), 66% males and 69% Caucasian ethnicity. Maximal disease severity was used to separate COVID19 cases into mild (n=31) and severe (n=31). We identified 20 significantly deregulated genes between those with COVID19 and controls (;log2 fold;>0.5, p<0.05, Benjamin-Yekutieli p-adjustment). Function of 12 of these genes related to cytokine signaling, 9 upregulated genes to type I interferon signaling (MX1, IRF7, IFITM1, IFI35, STAT2, IRF4, PML, BST2, STAT1), while 7 downregulated genes mapped to innate immune function (IRF7, ICAM2, SERPING1, IFI16, BST2, FCER1A, PTK2). Expression in the severe group showed downregulation of FCER1A (innate immunity regulation), IL1B and TNF (inflammatory cytokines), and PTGS2 (inflammatory mediator) and greater upregulation of TNFSF4 (cytokine signaling) and PTK2 (innate immunity). Mild cases presented higher upregulation of IFIT2 (type I interferon signaling). Conclusion: Observed early downregulation of regulators and mediators of inflammation in those who developed severe COVID19, suggested dysregulation of inflammation. Specifically, IFIT2 upregulation in mild cases and FCER1A downregulation in severe cases, points to early differences in host responses centered on deregulation of the interferon and inflammation responses. Whether these patterns reflect delayed interferon involvement in pathways to control the infection and contribute to pathological inflammation and cytokine storms observed in severe COVID19 requires further research.

Impacto de la pandemia COVID-19 en los sistemas de notificación de incidentes de seguridad del paciente y errores de medicación Impact of the COVID-19 pandemic on patient safety incident and medication error reporting systems

Antecedentes y objetivo Conocer el impacto de la pandemia por COVID-19 en la epidemiología de los incidentes de seguridad (IS) y de los errores de medicación (EM) notificados al sistema de notificación CISEMadrid, del ámbito hospitalario y de atención primaria del Servicio Madrileño de Salud (SERMAS). Materiales y métodos Estudio observacional y descriptivo con análisis retrospectivo de los datos, en el que se incluyeron todas las notificaciones de CISEMadrid desde el 01-enero-2018 al 31-diciembre-2020, de 33 hospitales y 262 centros de salud del SERMAS. Se identificaron los 2 periodos en 2020 de mayor aumento de casos de COVID-19, para comparar los incidentes notificados en periodo prepandemia y pandemia. Resultados Se notificaron un total de 36.494 incidentes. Comparando ambos periodos, se observó una disminución general de notificaciones en pandemia del 60,7%, siendo mayor en atención primaria, cayendo hasta un 33% de niveles previos. La reducción de notificaciones fue similar en los picos y valles de las olas. Los 3 IS más frecuentes en ambos periodos y ámbitos asistenciales fueron: pruebas diagnósticas, dispositivos médicos/equipamientos/mobiliario clínico y gestión organizativa/citaciones. En los EM los fallos de dosis y selección inapropiada fueron los más frecuentes en ambos ámbitos y periodos. No hubo diferencias relevantes en las consecuencias para el paciente en ambos periodos. Conclusiones Durante la pandemia disminuyeron las notificaciones de seguridad del paciente, aunque se mantuvieron los tipos más frecuentes, así como su impacto en el paciente, tanto en hospitales como en atención primaria. La cultura de seguridad de las organizaciones es un aspecto crítico para el mantenimiento de los sistemas de notificación.