Unveiling Pandemic Patterns: A Detailed Analysis of Transmissibility and Severity Parameters Across Four COVID-19 Waves in Bogotá, Colombia (preprint)

This retrospective study on COVID-19's four waves in Bogotá, Colombia, scrutinises 1.77 million cases from March 2020 to April 2022, revealing significant shifts in both transmissibility and severity. The study highlights dynamic changes in the instantaneous reproduction number (Rt), with the highest values (> 2.5) corresponding to the ancestral and Omicron variants. There was a notable 88% decrease in the Case Fatality Ratio (CFR) from the first to the fourth wave, emphasising changing severity levels. The third wave, marked by the Mu variant, saw the highest case and death counts, yet paradoxically showed a decrease in CFR and an increase in the hospitalisation fatality ratio. Conversely, the fourth wave, dominated by Omicron, had the lowest severity despite higher hospitalisation rates in children. Additionally, the study records a consistent reduction in average hospital and ICU stay durations, from 10.84 days to 7.85 days and from 16.2 days to 12.4 days respectively, across the waves. These findings underscore the importance of ongoing epidemiological surveillance and adaptable public health strategies in lower-middle-income regions like Bogotá, deepening our understanding of COVID-19's impact in Latin America.

Virological evidence of the impact of non-pharmaceutical interventions against COVID-19 in a resource-limited setting (preprint)

Ecuador was an early COVID-19 hotspot with substantial COVID-19-mortality. In developed countries, low socioeconomic status is associated with COVID-19 infection and low compliance with non-pharmaceutical interventions (NPIs). However, if NPI were successful in resource-limited settings with high human mobility and informal labour is still unclear. We performed a retrospective observational molecular and serological study of Ecuadors reference laboratory. We tested 1,950 respiratory samples from COVID-19 surveillance for SARS-CoV-2 and 12 respiratory viruses using RT-PCR, characterized 642 SARS-CoV-2 genomes, and examined SARS-CoV-2 seroprevalence in 1,967 samples from patients with fever in Ecuadors reference laboratory during 2020-2021. Molecular and serological data were compared to NPI stringency in Bayesian, maximum-likelihood and modelling frameworks. SARS-CoV-2 (Pearson correlation test; r=-0.74; p=0.01) and other respiratory viruses (r=-0.68; p=0.02) detection correlated negatively with NPI stringency. SARS-CoV-2 seroprevalence increased from <1% during February-March 2020 to 50% within 6 weeks and plateaued after NPI implementation. Decrease of effective reproduction number <1 and antibody reactivity over time suggested intense SARS-CoV-2 transmission during pandemic onset, subsequently limited by NPIs. Phylogeographic analyses revealed that travel restrictions were implemented late not preventing 100 near-parallel SARS-CoV-2 introductions, and implementation of NPIs modified SARS-CoV-2 geographic spread by restricting recreational activity. NPIs stringency correlated negatively with the number of circulating SARS-CoV-2 lineages (r=-0.69; p=0.02). Virological evidence supports NPIs restricting human movement as an effective public health tool to control the spread of respiratory pathogens in resource-limited settings, providing a template for emerging SARS-CoV-2 variants and future epidemics.

Tenofovir Disoproxil Fumarate Reduces the Severity of COVID-19 in Patients with Chronic Hepatitis B.

BACKGROUND AND AIMS: HIV-positive patients on tenofovir hydroxyl fumarate (TDF)/emtricitabine have a lower risk of COVID-19 and hospitalization than those given other treatments. Our aim was to analyze the severity of COVID-19 in patients with chronic hepatitis B (CHB) on TDF or entecavir (ETV). METHODS: Spanish hospital databases (n = 28) including information regarding adult CHB patients on TDF or ETV for the period February 1st to November 30th 2020 were searched for COVID-19, defined as a positive SARS-CoV-2 polymerase chain reaction, and for severe COVID-19. RESULTS: Of 4736 patients, 117 had COVID-19 (2.5%), 67 on TDF and 50 on ETV. Compared to patients on TDF, those on ETV showed (p < 0.05) greater rates of obesity, diabetes, ischemic cardiopathy, and hypertension. COVID-19 incidence was similar in both groups (2.3 vs. 2.6%). Compared to TDF, patients on ETV more often (p < 0.01) had severe COVID-19 (36 vs. 6%), required intensive care unit (ICU) (10% vs. 0) or ventilatory support (20 vs. 3%), were hospitalized for longer (10.8 ± 19 vs. 3.1 ± 7 days) or died (10 vs. 1.5%, p = 0.08). In an IPTW propensity score analysis adjusted for age, sex, obesity, comorbidities, and fibrosis stage, TDF was associated with a sixfold reduction in severe COVID-19 risk (adjusted-IPTW-OR 0.17, 95%CI 0.04-0.67, p = 0.01). CONCLUSION: Compared to ETV, TDF seems to play a protective role in CHB patients with SARS-CoV-2 whereby the risk of severe COVID-19 is lowered.

Aprendizaje automático aplicado al análisis del confinamiento por COVID-19 y su relación con el rendimiento de los estudiantes de educación superior

: This article analyzes the academic performance of third level students and the effect of the COVID-19 pandemic due to the change in study modality. Using the Lesmeister methodology, the k-means and hierarchical clustering algorithms were applied to a sample of 400 records corresponding to two study periods, pre-pandemic and in pandemic, of the students of the "Instituto Superior Tecnológico Sudamericano" in the city of Loja, obtaining three groupings related to academic performance. Regarding a general analysis of the groups, it can be established that no significant difference was found in the variables of gender, ethnicity, type of school, employment status, scholarship holders, total household income and household members. Keywords: machine learning;academic performance;pandemic;COVID-19;higher education. 1.Introducción En el año 2020 la pandemia de COVID-19 irrumpió en la vida cotidiana de todo el mundo, las actividades que se desarrollaban a diario cambiaron de modalidad para reducir la propagación del coronavirus, acciones comunes de los gobiernos han seguido normas similares que limitan el contacto social manteniendo a todas las personas en un confinamiento obligatorio. Datos Bajo este contexto, se generaron un total de 900 registros base para la investigación, luego de un proceso de validación y limpieza de datos se obtuvieron un nuevo total de 400 registros referentes a los estudiantes de la carrera de electrónica del instituto, los cuales fueron la población para analizar y el principal insumo para el algoritmo de Machine Learning (ML) a utilizar.

O-Linked Sialoglycans Modulate the Proteolysis of SARS-CoV-2 Spike and Contribute to the Mutational Trajectory in Variants of Concern (preprint)

The emergence of a polybasic cleavage motif for the protease furin in the SARS-CoV-2 spike protein has been established as a major factor for enhanced viral transmission in humans. The peptide region N-terminal to that motif is extensively mutated in major variants of concern including alpha, delta and omicron. Besides furin, spike proteins from these variants appear to rely on other proteases for maturation including TMPRSS2 that may share the same cleavage motif. Glycans found near the cleavage motif have raised questions about proteolytic processing and the consequences of variant-borne mutations. Here, with a suite of chemical tools, we establish O-linked glycosylation as a major determinant of SARS-CoV-2 spike cleavage by the host proteases furin and TMPRSS2 and a likely driving force for the emergence of common mutations in variants such as omicron, delta and alpha. We provide direct evidence that the glycosyltransferase GalNAc-T1 primes glycosylation at Thr678 in the living cell. A novel strategy for rapid bioorthogonal modification of Thr678-containing glycopeptides reveals that introduction of a negative charge completely abrogates furin activity. In a panel of synthetic glycopeptides containing elaborated O-glycans, we find that sialic acid moieties reduce furin cleavage rate by up to 65%. Similarly, O-glycosylation had a general negative impact on spike cleavage by TMPRSS2, with core 1 (Gal{beta}1-3GalNAc-) O-glycan-containing glycopeptides having the largest effect. With a chemistry-centered approach, we thus firmly establish O-glycosylation as a major determinant of spike maturation. We propose that a disruption of O-GalNAc glycosylation is a substantial driving force for the evolution of variants of concern.

JUSTICIA TRIBUTARIA EN TIEMPOS DE PANDEMIA: EL INCENTIVO FISCAL PARA FOMENTAR LA REBAJA DE LA RENTA ARRENDATICIA

La pandemia por la propagación del SARS-CoV-2 ha supuesto un elevadísimo coste en vidas humanas. El establecimiento por las diferentes autoridades gubernativas de medidas restrictivas para intentar evitar los contagios ha conducido, además, a una notoria reducción en el crecimiento económico y a que múltiples empresas se hayan visto obligadas a cesar en su actividad. Para ayudar a paliar esta adversa situación en los sectores más desfavorecidos con la crisis sanitaria, las potestades del Estado han adoptado medidas de carácter económico y social como el establecimiento del incentivo fiscal para fomentar la rebaja o moratoria de la renta arrendaticia a ciertos sectores de negocio. En el presente trabajo se realizará un exa- men de esta medida de justicia tributaria, abordando en un primer lugar el contexto en el que se ha instaurado, sus diferentes ámbitos de aplicación, la relevancia práctica de su reconocimiento y, finalmente, los problemas que acarrea desde la perspectiva de la igualdad de trato y no discriminación fiscal. Todas estas cuestiones serán tratadas desde una perspectiva crítica para invitar a la reflexión y mejora de este incentivo, que hace destacar el elemento de justicia que preside e inspira nuestro sistema fiscal.Alternate :The pandemic due to the spread of the SARS-CoV-2 has meant a very high cost in human lives. The establishment by the different government authorities of restrictive measures to try to avoid contagion has also led to a marked reduction in economic growth and that multiple companies being forced to cease their activity. To help alleviate this adverse situation in the most disadvantaged sectors with the health crisis, the Powers of the State have adopted measures of an economic and social nature such as the establishment of the tax incentive to promote the reduction or moratorium of rental income to certain business sectors. In this work, we will do an examination of this tax justice measure, addresing in the first place the context in which it has been established, its different areas of application, the practical relevance of its recognition and, finally, the problems it entails from the perspective of equal treatment and non-discrimination in taxation. All these issues will be treated from a critical perspective to invite reflection and improvement of this incentive, which highlights the element of justice that presides over and inspires our tax system.

Developing New Teaching Materials to Enhance Students Learning and Engagement at University (preprint)

Pandemic scenario has significantly changed several factors of life, including teaching, and learning at university. The development of suitable teaching materials to support university studies is mandatory to overcome distance learning difficulties and improve traditional teaching methodologies. This work explains a novel method for the preparation of teaching materials for medical sciences, but also plausible for other learning fields. An encephalon was extracted and prepared by using this methodology for teaching purposes. More than 200 students evaluated several factors of the material prepared this way, indicating a better understanding (up to 80%) of theoretical contents related to this human section, together with a high usability and good physical appearance

INTENCIÓN DE PARTICIPACIÓN EN PROGRAMAS UNIVERSITARIOS DE MAYORES EN MODALIDAD A DISTANCIA. IDENTIFICACIÓN DE PERFILES MEDIANTE ANÁLISIS DE SEGMENTACIÓN 1

RESUMEN: Los Programas Universitarios para Personas Mayores (PUM) brindan espacios organizados de formación, interacción y relación social. La situación de emergencia internacional provocada por la pandemia COVID19 ha significado el cierre casi total de este tipo de programas, limitando el contacto y las relaciones personales en condiciones de presencialidad. Esta situación, junto a un potente y cada vez más accesible escenario tecnológico conducen a valorar nuevas áreas de formación y aprendizaje online, también para las personas mayores. Este estudio tiene por objetivo explorar la intención de participación en un programa universitario de mayores en formato online. Esta intención puede predecirse en función de determi nados factores o variables de tipo sociodemográfico y contextual. En el estudio participaron un total de 1633 personas mayores con una media de edad de 68,2 años, todos ellos asistentes a 17 sedes del PUM de la Comunidad de Castilla y León. Para el tratamiento de los datos se utilizó la técnica no paramétrica de árboles de clasificación. Se consideraron 3 variables criterio («Intención de participar en e-PUM>>;«Actitud hacia TD>>;y «Frecuencia de uso tecnológico») entorno a las cuales se configuran perfiles de sujetos en función de una serie de características individuales sociodemográficas, psicográficas y conductuales, todas ellas consideradas como variables predictoras. Los resultados ofrecen claves para comprender por qué los mayores aceptan (o no aceptan) esta modalidad de participación, identificando perfiles o rasgos que caracterizan cada uno de los perfiles o subgrupos de sujetos con mayor o menor predisposición a este tipo de participación socioeducativa, lo cual puede servir de base en la toma de decisiones de política social y/o educativa.Alternate :The University Programmes for Older Adults (PUM) provide organised spaces for training, interaction and social relations. The international emergency situation caused by the COVID19 pandemic has meant the almost total closure of this type of programme, limiting contact and personal relations in face-to-face conditions. This situation, together with a powerful and increasingly accessible technological scenario, leads to the assessment of new areas of online training and learning, also for older people. This study aims to explore the intention to participate in a university programme for older people in an online format. This intention can be predicted on the basis of certain socio-demographic and contextual factors or variables. A total of 1633 older adults with an average age of 68.2 years participated in the study, all of them attending 17 PUM sites in the Community of Castilla y León. The non-parametric technique of classification trees was used to process the data. Three criterion variables were considered («Intention to participate in e-PUM>>;«Attitude towards TD>>;and «Frequency of technological use>>) around which profiles of subjects are configured according to a series of individual sociodemographic, psychographic and behavioural characteristics, all of them considered as predictor variables. The results offer keys to understanding why the elderly accept (or do not accept) this form of participation, identifying profiles or traits that characterise each of the profiles or subgroups of subjects with a greater or lesser predisposition to this type of socio-educational participation, which can serve as a basis for making social and/ or educational policy decisions.Alternate :RESUMO: Os Programas Universitarios para Adultos Idosos (PUM) proporcionam espaços organizados de formaçao, interacçao e relaçöes sociais. A situaçao de emergencia internacional causada pela pandemia COVID19 implicou o encerramento quase total deste tipo de programa, limitando o contacto e as relaçöes pessoais em condiçöes presenciais. Esta situaçao, juntamente com um cenário tecnológico poderoso e cada vez mais acessível, leva a avaliaçao de novas áreas de formaçao e aprendizagem em linha, ambém para pessoas idosas. Este estudo visa explorar a intençao de participar num programa universitário para pessoas idosas em formato online. Esta intençao pode ser prevista com base em certos factores ou variáveis sociodemográficos e contextuais. Um total de 1633 adultos idosos com uma idade média de 68,2 anos participou no estudo, todos eles frequentando 17 sítios PUM na Comunidade de Castilla y León. A técnica nao paramétrica das árvores de classificaçao foi utilizada para processar os dados. Foram consideradas tres variáveis de critério (<<Intençao de participar em e-PUM>>;<<Atitude para TD>>;e <<Frequencia de uso tecnológico») em torno da qual os perfis dos sujeitos sao configurados de acordo com uma série de características sociodemográficas, psicográficas e comportamentais individuais, todas elas consideradas como variáveis preditoras. Os resultados oferecem chaves para compreender por que razao os idosos aceitam (ou nao aceitam) esta forma de participaçao, identificando perfis ou traços que caracterizam cada um dos perfis ou subgrupos de sujeitos com maior ou menor predisposiçao para este tipo de participaçao sócio-educativa, que pode servir de base para a tomada de decisöes políticas sociais e/ou educativas.

RECOMENDACIONES PARA EL USO DE OXÍGENO Y SUS DISPOSITIVOS BÁSICOS Y AVANZADOS: RACIONALIDAD Y SEGURIDAD EN TIEMPOS DE PANDEMIA POR SARS CoV2 EN COLOMBIA RECOMMENDATIONS FOR THE USE OF OXYGEN AND ITS BASIC AND ADVANCED SUPPLY DEVICES: RATIONALITY AND SAFETY IN TIMES OF SARS CoV2 PANDEMIC IN COLOMBIA

En medio de la pandemia de COVID-19, y ante la inminencia de desabastecimiento de oxígeno en Colombia, la red de Gestión y Transferencia de Conocimiento, integrada por 19 sociedades científicas, instituciones de salud y universidades, genera una actualización al documento liderado por la Asociación Colombiana de Medicina Critica e incluye nuevos lineamientos informados en evidencia para el manejo racional de la oxigenoterapia, así como los dispositivos básicos y avanzados para la oxigenoterapia. Las recomendaciones se refieren a: uso racional de oxígeno orientado por metas, estandarización del seguimiento y ajuste de dosis, uso adecuado de los dispositivos de oxigenoterapia, uso racional de ventilación mecánica invasiva, y uso racional de la terapia con membrana de oxigenación extracorpórea. Al ejercer su juicio, se espera que los profesionales y equipos de atención tengan en cuenta estos lineamientos con el fin de hacer un uso racional y seguro de la oxigenoterapia y sus dispositivos básicos y avanzados, junto con las necesidades individuales y preferencias de las personas que están bajo su cuidado.

RECOMENDACIONES PARA EL USO DE OXÍGENO Y SUS DISPOSITIVOS BÁSICOS Y AVANZADOS: RACIONALIDAD Y SEGURIDAD EN TIEMPOS DE PANDEMIA POR SARS CoV2 EN COLOMBIA

Resumen En medio de la pandemia de COVID-19, y ante la inminencia de desabastecimiento de oxígeno en Colombia, la red de Gestión y Transferencia de Conocimiento, integrada por 19 sociedades científicas, instituciones de salud y universidades, genera una actualización al documento liderado por la Asociación Colombiana de Medicina Critica e incluye nuevos lineamientos informados en evidencia para el manejo racional de la oxigenoterapia, así como los dispositivos básicos y avanzados para la oxigenoterapia. Las recomendaciones se refieren a: uso racional de oxígeno orientado por metas, estandarización del seguimiento y ajuste de dosis, uso adecuado de los dispositivos de oxigenoterapia, uso racional de ventilación mecánica invasiva, y uso racional de la terapia con membrana de oxigenación extracorpórea. Al ejercer su juicio, se espera que los profesionales y equipos de atención tengan en cuenta estos lineamientos con el fin de hacer un uso racional y seguro de la oxigenoterapia y sus dispositivos básicos y avanzados, junto con las necesidades individuales y preferencias de las personas que están bajo su cuidado. In the midst the COVID-19 pandemic, and given the imminence of oxygen shortages in Colombia, the Knowledge Management and Transfer Network, made up of 19 scientific societies, health institutions, and universities, generates an update to the document led by the Colombian Association of Critical Medicine and includes new evidence-informed guidelines for the rational management of oxygen therapy, as well as basic and advanced devices for oxygen therapy. The recommendations refer to five topics: goal-oriented rational use of oxygen, standardization of follow-up and dose adjustment, effective use of oxygen therapy devices, rational use of invasive mechanical ventilation, and rational use of extracorporeal oxygenation membrane therapy. When exercising their judgment, it is expected that professionals and care teams will take into account these guidelines to make rational and safe use of oxygen therapy and its basic and advanced devices, together with the individual needs and preferences of the people who are under their care.

The potential impact of delta variant of SARS-CoV-2 in the context of limited vaccination coverage and increasing social mixing in Bogota, Colombia (preprint)

BackgroundIn Bogota by August 1st, more than 27,000 COVID-19 deaths have been reported, while complete and partial vaccination coverage reached 30% and 37%, respectively. Although reported cases are decreasing, the potential impact of new variants is uncertain. MethodsWe used an agent-based model of COVID-19 calibrated to local data. Variants and vaccination strategies were included. We estimated the impact of vaccination and modelled scenarios of early and delayed introduction of the delta variant, along with changes in mobility, social contact, and vaccine uptake over the next months. FindingsBy mid-July, vaccination may have prevented 17,800 (95% CrI: 16,000 - 19,000) deaths in Bogota. We found that delta could lead to a fourth wave of magnitude and timing dependent on social mixing, vaccination strategy, and delta dominance. In scenarios of early dominance of delta by mid-July, age prioritization and maintaining the interval between doses were important factors to avert deaths. However, if delta dominance occurred after mid-September, age prioritization would be less relevant, and the magnitude of a four wave would be smaller. In all scenarios, higher social mixing increased the magnitude of the fourth wave. Increasing vaccination rates from 50,000/day to 100,000/day reduced the impact of a fourth wave due to delta. InterpretationThe magnitude and timing of a potential fourth wave in Bogota caused by delta would depend on social mixing and the timing of dominance. Rapidly increasing vaccination coverage with non-delayed second doses could reduce the burden of a new wave. FundingNSF RAPID DEB 2027718. HERMES 50419. Medical Research Council. MR/R024855/1 Research in ContextO_ST_ABSEvidence before this studyC_ST_ABSThe impact of vaccination strategies in the context of emerging SARS-CoV-2 variants and increasing social mixing in Colombia had not been previously evaluated through mathematical modelling. We searched PubMed for modelling studies using the terms "COVID-19 vaccine AND model AND variant AND Colombia" or "SARS-CoV-2 AND vaccine AND model AND variant AND Colombia" (From 2021/1/1 to 2021/07/31). We did not find studies addressing this question. However, we found a model describing the evolution of the epidemic in the country during the first year, and research on the emergence of alpha, gamma, and B.1.621 variants in Colombia. We extended a previous version of our SARS-CoV-2 agent-based model for Bogota to include the potential effect of vaccination and variants. This model simulates transmission of SARS-CoV-2 based on daily activity patterns of a synthetic population, representing demographic and geographic characteristics of the total population of the city. Added value of this studyFirst, our study provides a preliminary estimate of the impact of the vaccination program in Bogota in terms of the number of deaths prevented. The second major finding is the indication that due to the introduction of the delta variant in the city, and based on the current knowledge of its biology, there is a risk of a fourth epidemic wave, whose time of occurrence and magnitude would depend mainly on three factors: when delta becomes dominant, the intensity of social contact, and vaccination roll-out strategy and coverage. Implications of all the available evidenceWe estimate that by mid-July, vaccination may have already prevented 17,800 (95% CrI: 16,000 - 19,000) deaths in Bogota. The delta variant could become dominant and lead to a fourth wave later in the year, but its timing will depend on the date of introduction, social mixing patterns, and vaccination strategy. In all scenarios, higher social mixing is associated with a fourth wave of considerable magnitude. If an early delta introduction occurred (dominance by mid-July), a new wave may occur in August/September and in such case, age prioritization of vaccination and maintaining the 21-day interval between doses of the Pfizer-BioNTech BNT162b2 are more important. However, if introduction occurred one or two months later (with dominance by mid-August/September) a fourth wave would be of smaller magnitude, the age-prioritization is less relevant, but maintaining the dose scheme without postponement is more important. In all scenarios we found that increasing the vaccination rate from the current average of 50,000/day to 100,000/day reduces the impact of a potential fourth wave due to the delta variant. Our study indicates that given the possibility of a fourth wave in the city, it is necessary to continue maintaining adherence to non-pharmacological interventions, such as the use of face masks and physical distancing, to be cautious with the intensification of social activities, and that it is essential to increase the current pace of vaccinations to rapidly reach high vaccination coverage in the population of the city.

Registro Español de Trasplante Cardiaco. XXXII Informe Oficial de la Asociación de Insuficiencia Cardiaca de la Sociedad Española de Cardiología

Resumen Introducción y objetivos Se actualizan las características y los resultados del trasplante cardiaco en España con los hallazgos de los procedimientos realizados en 2020. Métodos Se describen las características de receptores, donantes, procedimiento quirúrgico e inmunosupresión en el año 2020. Se analizan las tendencias de estas características y los resultados (supervivencia) en el último periodo 2011-2019. Resultados En 2020 se han realizado 278 trasplantes cardiacos (un 7,3% menos que el año anterior). Los hallazgos de 2020 confirman las tendencias previas a un aumento de la esternotomía previa, una discreta disminución del trasplante urgente realizado sobre todo con dispositivos de asistencia ventricular, una ligera disminución de la edad del donante con aumento del uso de donantes con parada cardiaca previa y una disminución del tiempo de isquemia. La supervivencia continúa mejorando en los últimos trienios y alcanza el 82,0% al primer año en el trienio 2017-2019. Conclusiones La ligera disminución en la actividad del trasplante cardiaco en España en 2020, en relación con la pandemia por SARS-CoV-2, no ha cambiado las principales características del procedimiento. No se detectan cambios en la tendencia a la mejora de la supervivencia de los pacientes trasplantados. Introduction and objectives The present report updates the main characteristics and outcomes of heart transplants in Spain to 2020. Methods We describe the main features of recipients, donors, surgical procedure, and immunosuppression in 2020. We also analyze the temporal trends of these characteristics and outcomes (survival) for the period 2011 to 2019. Results In 2020, 278 heart transplants were performed (7.3% decrease vs 2019). The findings in 2020 confirmed previous observations of an increase in pretransplant sternotomy, a slight decrease in urgent transplants carried out with ventricular assist devices, a slight decrease in donor age, an increase in the use of allografts with previous arrest, and a decrease in ischemia time. Survival continued to improve in recent triennia, reaching 82.0% at 1 year in the period 2017 to 2019. Conclusions The slight decrease in the number of heart transplants performed in 2020 in Spain, most likely due to the SARS-CoV-2 pandemic, did not change the main characteristics of the procedure. No change was observed in the tendency to improved survival. Full English text available from:www.revespcardiol.org/en

Genomic epidemiology of SARS-CoV-2 transmission lineages in Ecuador (preprint)

Characterisation of SARS-CoV-2 genetic diversity through space and time can reveal trends in virus importation and domestic circulation, and permit the exploration of questions regarding the early transmission dynamics. Here we present a detailed description of SARS-CoV-2 genomic epidemiology in Ecuador, one of the hardest hit countries during the early stages of the COVID-19 pandemic. We generate and analyse 160 whole genome sequences sampled from all provinces of Ecuador in 2020. Molecular clock and phylgeographic analysis of these sequences in the context of global SARS-CoV-2 diversity enable us to identify and characterise individual transmission lineages within Ecuador, explore their spatiotemporal distributions, and consider their introduction and domestic circulation. Our results reveal a pattern of multiple international importations across the country, with apparent differences between key provinces. Transmission lineages were mostly introduced before the implementation of non-pharmaceutical interventions (NPIs), with differential degrees of persistence and national dissemination.

Results of training on COVID-19. University of Medical Sciences of Cienfuegos, 2020

RESUMEN Fundamento: la COVID 19 se ha constituido en pandemia. La comunidad científica la estudia, pues es una enfermedad nueva. Los profesionales de la salud y pueblo en general necesitan conocer todo lo relacionado con esta afección, en aras de enfrentarla lo mejor posible. Objetivo: describir los resultados de la capacitación desarrollada por el Departamento de Posgrado de la Universidad de Ciencias Médicas de Cienfuegos sobre la COVID-19. Métodos: estudio descriptivo sobre acciones de capacitación desarrolladas desde febrero a abril de 2020, en un universo de 147 677 profesionales de la salud y otras esferas, así como estudiantes, personal de dirección, cuentapropistas y miembros de organizaciones de masa. Se realizó por etapas, según indicaciones recibidas por el Ministerio de Salud Pública. Resultados: del universo que debía capacitarse, fue capacitado el 98,78 %, destacándose la segunda etapa con un total de 108 901. Algunos de los temas impartidos fueron: bioseguridad, cuidados intensivos, ventilación mecánica, realización de pruebas rápidas y asimilación - adhesión a las diferentes versiones de los protocolos de actuación. Conclusiones: Cienfuegos cuenta con una elevada cifra de personal capacitado, en diferentes áreas del conocimiento, para enfrentar la COVID-19, lo que permite poseer una población más instruida y preparada. ABSTRACT Foundation: COVID 19 has become a pandemic. As a new disease, the scientific community is studying it. Health professionals and people in general need to know everything related to this condition, in order to face it as well as possible. Objective: to describe the results of the training developed by the Post graduate Department of the Cienfuegos University of Medical Sciences on COVID-19. Methods: descriptive study on training actions conducted from February to April 2020, in a universe of 147 677 health professionals and other areas, as well as students, management personnel, self-employed and members of mass organizations. It was carried out in stages, according to indications received by the Ministry of Public Health. Results: out of the universe, a percentage of 8.78% was trained, highlighting the second period with a total of 108,901. Some of the topics taught were: biosecurity, intensive care, mechanical ventilation, rapid tests and assimilation - adherence to the different action protocols versions. Conclusion: Cienfuegos has a high number of trained personnel, in different areas of knowledge, to face COVID-19, which allows having a more educated and prepared population.

Telecardiology and Digital Health for Cardiac Care During COVID-19 Pandemic: Opportunities and Precautions

The COVID-19 pandemic has provided a substantial impetus for the rapid expansion of digital health services worldwide. With the rule of social distancing and quarantine following the outbreak of Coronavirus infection in many countries, special attention has been made to telecardiology as one of the best alternatives to traditional in-person cardiac care. The imposition of unprecedented restrictions on close encounters in almost all sectors, including health care necessitated the expansion of telemedicine and digital health in cardiology services (telecardiology). This paper highlights the benefits and potential risks of the rapid adoption of telecardiology and other digital health solutions for the management of patients with chronic cardiac conditions such as heart failure.

Cross-sectional study of self-concept and gender in relation to physical activity and martial arts in Spanish adolescents during the COVID-19 lockdown

The COVID-19 lockdown has negatively affected individuals’ welfare. However, there has been no research published heretofore about the levels of self-concept (SC) in adolescents, nor how having practised martial arts (MA) or any physical activity (PA) before the lockdown may have influenced the SC in that time. Hence, this study aimed to analyze some demographic, physical, and psychosocial parameters in Spanish adolescents throughout the COVID-19 quarantine through a cross-sectional investigation, establishing correlations among these factors. Methods: The present study had a descriptive, comparative, and cross-sectional design. The sample comprised of 54 (39.7%) male and 82 (60.3%) female Spanish adolescents aged 12–18 (M = 14.49;SD = 1.80). An ad-hoc questionnaire collected sociodemographic data;the self-concept Form 5 (AF5) questionnaire obtained data on SC dimensions. Results: There were some differences among the SC dimensions, with family and academic dimensions having higher values than the physical and emotional ones. Females’ academic SC was higher than that of males (p = 0.019). The practice of PA before the lockdown was positively associated with physical (p < 0.001) and social (p = 0.012) SC, yet there was no significant association between the previous practice of MA and SC (p > 0.050). Conclusions: the findings suggest that the COVID-19 lockdown negatively affected Spanish adolescents by decreasing their total SC and some dimensions of it, although PA may buffer psychological harmfulness in adolescents.

Variable Importance Analysis in Imbalanced Datasets: A New Approach

Decision-making using machine learning requires a deep understanding of the model under analysis. Variable importance analysis provides the tools to assess the importance of input variables when dealing with complex interactions, making the machine learning model more interpretable and computationally more efficient. In classification problems with imbalanced datasets, this task is even more challenging. In this article, we present two variable importance techniques, a nonparametric solution, called mh-chi(2), and a parametric method based on Global Sensitivity Analysis. The mh-chi(2) employs a multivariate continuous response framework to deal with the multiclass classification problem. Based on the permutation importance framework, the proposed mh-chi(2) algorithm captures the dissimilarities between the distribution of misclassification errors generated by the base learner, Conditional Inference Tree, before and after permuting the values of the input variable under analysis. The GSA solution is based on the Covariance decomposition methodology for multivariate output models. Both solutions will be assessed in a comparative study of several Random Forest-based techniques with emphasis in the multiclass classification problem with different imbalanced scenarios. We apply the proposed techniques in two real application cases in order first, to quantify the importance of the 35 companies listed in the Spanish market index IBEX35 on the economic, political and social uncertainties reflected in economic newspapers in Spain during the first quadrimester of 2020 due to the COVID-19 pandemic and second, to assess the impact of energy factors on the occurrence of spike prices on the Spanish electricity market.