Bifurcation analysis of the Microscopic Markov Chain Approach to contact-based epidemic spreading in networks

The dynamics of many epidemic compartmental models for infectious diseases that spread in a single host population present a second-order phase transition. This transition occurs as a function of the infectivity parameter, from the absence of infected individuals to an endemic state. Here, we study this transition, from the perspective of dynamical systems, for a discrete-time compartmental epidemic model known as Microscopic Markov Chain Approach, whose applicability for forecasting future scenarios of epidemic spreading has been proved very useful during the COVID-19 pandemic. We show that there is an endemic state which is stable and a global attractor and that its existence is a consequence of a transcritical bifurcation. This mathematical analysis grounds the results of the model in practical applications.

Cross-sectional analysis of coping strategies and anxiety and depression levels in a sample of the Andalusian population during the home lockdown caused by the COVID-19 pandemic

The restrictive measures put into place to control the COVID-19 pandemic in 2020 have prompted the need to study the possible health impacts in the middle term. Deprivation of the fundamental right to mobility results in an increase in affective disorders and the risks that they entail for the population. The goal of this study is to examine anxiety and depression levels during the first national lockdown and to determine the key coping strategies in order to develop health treatment and promotion programmes. The sample, comprised of 485 participants (mean age = 40) from Andalusia, received questionnaires via email between March and June. The results showed that acceptance, active coping and humour were the most effective coping strategies to explain and predict a decrease in anxiety and depression within the context of the home lockdown. Therefore, we recommend that these coping strategies be studied in order to develop programmes that help prevent the psychological consequences of the lockdown. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Spanish) Las medidas restrictivas puestas en marcha para el control de la pandemia de COVID-19 en el ano 2020, han provocado la necesidad de estudiar los posibles impactos para la salud a medio plazo. La privacion del derecho fundamental a la movilidad tiene como consecuencia el aumento de los trastornos afectivos y el riesgo que estos implican para la poblacion. El presente estudio tiene por objetivo estudiar los niveles de ansiedad y depresion durante el primer confinamiento nacional y determinar las estrategias de afrontamiento claves para el desarrollo de programas de intervencion y promocion de la salud. La muestra, compuesta por 485 participantes (edad media = 40 anos) procedentes de Andalucia, recibio los cuestionarios a traves de correo electronico entre los meses de marzo y junio. Los resultados muestran que la aceptacion, el afrontamiento activo y el humour han sido las estrategias de afrontamiento mas eficaces para explicar y predecir la disminucion de la ansiedad y la depresion en el contexto del confinamiento domiciliario. Por ello, recomendamos que estas estrategias de afrontamiento sean estudiadas para el desarrollo de programas que permitan prevenir las consecuencias psicologicas derivadas del confinamiento. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Spanish Asthma Management Guidelines (GEMA) v.5.1. Highlights and Controversies

In this fifth phase of development, the contents of the Spanish Asthma Management Guidelines (GEMA), which include versions 5.0 and 5.1, have undergone a thorough review. The aim here is to set the main changes in context. These could be summarized as follows: DIAGNOSIS: new FENO cut-off and severity classification based on treatment needed to maintain control;INTERMITTENT ASTHMA: a more restrictive concept and treatment extended to include a glucocorticoid/adrenergic combination as needed;MILD ASTHMA: glucocorticoid/adrenergic therapy as needed as an alternative in case of low therapeutic adherence to conventional fixed-dose steroids;SEVERE ASTHMA: readjustment of phenotypes, incorporation of triple therapy in a single inhaler, and criteria for selection of a biologic in severe uncontrolled asthma;OTHERS: specific scoring in childhood asthma, incorporation of certain organizational aspects (care circuits, asthma units, telemedicine), new sections on COVID-19 and nasal polyposis. Resumen La quinta fase de la Guía Española para el Manejo del Asma (GEMA) que incluye las versiones 5.0 y 5.1, ha efectuado una profunda revisión de su contenido. El presente texto tiene como objetivo contextualizar los principales cambios. Estos se podrían resumir en: DIAGNÓSTICO: nuevo punto de corte de FENO y clasificación de gravedad basada en el tratamiento necesario para mantener el control;ASMA INTERMITENTE: concepto más restrictivo y tratamiento ampliado a combinación de glucocorticoide/adrenérgico a demanda;ASMA LEVE: tratamiento con glucocorticoide/adrenérgico a demanda como alternativa si baja adhesión terapéutica a esteroide fijo clásico;ASMA GRAVE: reajuste de los fenotipos, incorporación de la triple terapia en un solo inhalador y criterios para la selección del fármaco biológico en asma grave no controlada;OTROS: puntualizaciones concretas en asma infantil, incorporación de determinados aspectos organizativos (flujos entre niveles asistenciales, unidades de asma, telemedicina), nuevas secciones de COVID-19 y de poliposis nasal.

Community Detection Problem Based on Polarization Measures: An Application to Twitter: The COVID-19 Case in Spain

In this paper, we address one of the most important topics in the field of Social Networks Analysis: the community detection problem with additional information. That additional information is modeled by a fuzzy measure that represents the risk of polarization. Particularly, we are interested in dealing with the problem of taking into account the polarization of nodes in the community detection problem. Adding this type of information to the community detection problem makes it more realistic, as a community is more likely to be defined if the corresponding elements are willing to maintain a peaceful dialogue. The polarization capacity is modeled by a fuzzy measure based on the JDJpol measure of polarization related to two poles. We also present an efficient algorithm for finding groups whose elements are no polarized. Hereafter, we work in a real case. It is a network obtained from Twitter, concerning the political position against the Spanish government taken by several influential users. We analyze how the partitions obtained change when some additional information related to how polarized that society is, is added to the problem.

Children Coping, Contextual Risk and their Interplay during the COVID-19 Pandemic: a Spanish Case (preprint)

The COVID-19 pandemic has changed the lives of millions of people around the globe and some of the unprecedent emerged disruptions, are likely to have been particularly challenging for young children (e.g., school closures, social distancing measures, movement restrictions). Studying the impact of such extraordinary circumstances on their well-being is crucial to identify processes leading to risk and resilience. To better understand how Spanish children have adapted (or fail to) to the stressful disruptions resulting from the pandemic outbreak, we examined the effects of child coping and its interactions with contextual stressors (pandemic and family-related) on child adjustment, incorporating in our analysis a developmental perspective. Data was collected in April 2020, through parent-reports, during the acute phase of the pandemic and, temporarily coinciding with the mandatory national quarantine period imposed by the Spanish Government. A sample of 1,123 Spanish children (50% girls) aged three to 12 (Mage = 7.26; SD = 2.39) participated in the study. Results showed differences in the use of specific strategies by children in different age groups (i.e., 3-6, 7-9 and 10-12-year-olds). Despite the uncontrollable nature of the pandemic-related stressors, child disengagement coping was distinctively associated to negative outcomes (i.e., higher levels of behavioral and emotional difficulties), whereas engagement coping predicted psychosocial adjustment across all age groups. Moreover, interactively with child coping, parent fear of the future and parent dispositional resilience appear as relevant contextual factors to predict both negative and positive outcomes, but their effects seem to be age dependent, suggesting a higher contextual vulnerability for younger children. These findings might have implications for identifying individual and contextual risk and informing potential preventive interventions aimed to reduce the impact of future pandemic outbreaks on children of different ages.

Testing the effects of COVID-19 confinement in Spanish children: The role of parents’ distress, emotional problems and specific parenting (preprint)

The COVID-19 outbreak has caused a great impact in our society. Because of its rapid spread, many countries, including Spain, were forced to impose drastic measures (i.e., restrictive lockdowns) to guarantee social distancing and isolation. In some countries, like Spain, these measures were particularly restrictive for children, who were forced to stay at home for more than 40 days, suffering a drastic change in their daily routines. The present study aimed to examine the effects of the Spanish confinement derived from the COVID-19 crisis on children and their families, accounting for child’s age. A range of child negative (e.g., conduct problems) and positive outcomes (e.g., routine maintenance) were examined, along with a set of parent-related variables, including resilience, perceived distress, emotional problems, parenting distress and specific parenting practices (e.g., structured or avoidant parenting), which were modeled through Path Analysis to better understand child adjustment. Data was collected in April 2020, through parent-reports, on a sample of 1,123 Spanish children (50% girls) aged three to 12 (Mage = 7.26; SD = 2.39). Results suggested that, according to parents’ information, most children did not show important changes in behavior, although some increase rates were observed for both negative and positive outcomes. Child adjustment was influenced by a chain of effects, derived from parents’ perceived distress and emotional response to the COVID-19 crisis, via parenting distress and specific parenting practices. While parenting distress particularly triggered child negative outcomes, specific parenting practices were more closely related to child positive outcomes. These findings may help to better inform, for potential future outbreaks, effective guidelines and prevention programs aimed at promoting child’s well-being in the family.

Management and Outcomes of Critically-Ill Patients with COVID-19 Pneumonia at a Safety-net Hospital in San Francisco, a Region with Early Public Health Interventions: A Case Series (preprint)

Background: Following early implementation of public health measures, San Francisco has experienced a slow rise and a low peak level of coronavirus disease 2019 (COVID-19) cases and deaths. Methods and Findings: We included all patients with COVID-19 pneumonia admitted to the intensive care unit (ICU) at the safety net hospital for San Francisco through April 8, 2020. Each patient had [≥]15 days of follow-up. Among 26 patients, the median age was 54 years (interquartile range, 43 to 62), 65% were men, and 77% were Latinx. Mechanical ventilation was initiated for 11 (42%) patients within 24 hours of ICU admission and 20 patients (77%) overall. The median duration of mechanical ventilation was 13.5 days (interquartile range, 5 to 20). Patients were managed with lung protective ventilation (tidal volume <8 ml/kg of ideal body weight and plateau pressure [≤]30 cmH2O on 98% and 78% of ventilator days, respectively). Prone positioning was used for 13 of 20 (65%) ventilated patients for a median of 5 days (interquartile range, 2 to 10). Seventeen (65%) patients were discharged home, 1 (4%) was discharged to nursing home, 3 (12%) were discharged from the ICU, and 2 (8%) remain intubated in the ICU at the time of this report. Three (12%) patients have died. Conclusions: Good outcomes were achieved in critically ill patients with COVID-19 by using standard therapies for acute respiratory distress syndrome (ARDS) such as lung protective ventilation and prone positioning. Ensuring hospitals can deliver sustained high-quality and evidence-based critical care to patients with ARDS should remain a priority.

Blocking of the CD80/86 axis as a therapeutic approach to prevent progression to more severe forms of COVID-19 (preprint)

In its more severe forms, COVID-19 progresses towards an excessive immune response, leading to the systemic overexpression of proinflammatory cytokines like IL6, mostly from the infected lungs. This cytokine storm can cause multiple organ damage and death. Consequently, there is a pressing need to identify therapies to treat and prevent severe symptoms during COVID-19. Based on previous clinical evidence, we hypothesized that inhibiting T cell co-stimulation by blocking CD80/86 could be an effective therapeutic strategy against progression to severe proinflammatory states. To support this hypothesis, we performed an analysis integrating blood transcriptional data we generated from rheumatoid arthritis patients treated with abatacept -- a CD80/86 co-stimulation inhibitor -- with the pathological features associated with COVID-19, particularly in its more severe forms. We have found that many of the biological processes that have been consistently associated with COVID-19 pathology are reversed by CD80/86 co-stimulation inhibition, including the downregulation of IL6 production. Also, analysis of previous transcriptional data from blood of SARS-CoV-infected patients showed that the response to abatacept has a very high level of antagonism to that elicited by COVID-19. Finally, analyzing a recent single cell RNA-seq dataset from bronchoalveolar lavage fluid cells from COVID-19 patients, we found a significant correlation along the main elements of the C80/86 axis: CD86+/80+ antigen presenting cells, activated CD4+ T cells and IL6 production. Our in-silico study provides additional support to the hypothesis that blocking of the CD80/CD86 signaling axis may be protective of the excessive proinflammatory state associated with COVID-19 in the lungs.

Monitoring and Tracking the Evolution of a Viral Epidemic Through Nonlinear Kalman Filtering: Application to the Covid-19 Case (preprint)

This work presents a novel methodology for systematically processing the time series that report the number of positive, recovered and deceased cases from a viral epidemic, such as Covid-19. The main objective is to unveil the evolution of the number of real infected people, and consequently to predict the peak of the epidemic and subsequent evolution. For this purpose, an original nonlinear model relating the raw data with the time-varying geometric ratio of infected people is elaborated, and a Kalman Filter is used to estimate the involved state variables. A hypothetical simulated case is used to show the adequacy and limitations of the proposed method. Then, several countries, including China, South Korea, Italy, Spain, UK and the USA, are tested to illustrate its behavior when real-life data are processed. The results obtained clearly show the beneficial effect of the social distancing measures adopted worldwide, confirming that the Covid-19 epidemic peak is left behind in those countries where the outbreak started earlier, and anticipating when the peak will take place in the remaining countries.

Considerations on the Implications of the Internet of Things in Spanish Universities: The Usefulness Perceived by Professors

<p>Internet of Things (IoT) is an emerging technology in the field of education, which has not yet been consolidated. Acceptance and adoption studies of IoT in higher education are scarce. Accordingly, the purpose of this study was to explore the acceptance of the IoT by university professors for future adoption in higher education. An online survey was implemented based on the unified theory of acceptance and use of technology (UTAUT), in a sample of 587 Spanish university teachers, aged between 21 and 58. The results showed that performance expectancy, facilitating conditions, and attitude toward using technology were influential in behavioral intention to use IoT. While the intention for use was similar between men and women and with respect to age. However, in the different constructs of the UTAUT model, the highest average scores were obtained in men and in teachers over 36 years of age. Finally, the findings and implications of the paper are discussed, showing empirical evidence on the adoption and acceptance of IoT in higher education in the context of Spain, highlighting the need for further research on emerging technologies in a context that is marked by COVID-19.</p>