Molecular characterization of imported and autochthonous dengue in northeastern spain

Dengue is the most significant arbovirus worldwide and a public health threat to nonendemic areas in which Aedes vectors are present. Autochthonous dengue transmission has been reported in several European countries in the last decade. Infected travelers from endemic regions arriving to areas colonized by Aedes albopictus in Europe need to be monitored in surveillance and control programs. We aimed to perform molecular characterization of RT-PCR-positive dengue cases detected in Catalonia, northeastern Spain, from 2013 to 2018. The basic demographic information and the geographical regions of importation were also analyzed. One-hundred four dengue cases were studied (103 imported infections and the first autochthonous case in our region). The dengue virus strains detected were serotyped and genotyped using molecular methods, and phylogenetic analyses were conducted. All four dengue serotypes were detected in travelers, including up to 10 different genotypes, reflecting the global circulation of dengue in endemic areas. The primary travel-related case of the 2018 autochthonous transmission was not identified, but the molecular analysis revealed dengue serotype 1, genotype I of Asian origin. Our results highlight the diversity of imported dengue virus strains and the role of molecular epidemiology in supporting arbovirus surveillance programs

Safety and immunogenicity of the protein-based PHH-1V compared to BNT162b2 as a heterologous SARS-CoV-2 booster vaccine in adults vaccinated against COVID-19 : a multicentre, randomised, double-blind, non-inferiority phase IIb trial

A SARS-CoV-2 protein-based heterodimer vaccine, PHH-1V, has been shown to be safe and well-tolerated in healthy young adults in a first-in-human, Phase I/IIa study dose-escalation trial. Here, we report the interim results of the Phase IIb HH-2, where the immunogenicity and safety of a heterologous booster with PHH-1V is assessed versus a homologous booster with BNT162b2 at 14, 28 and 98 days after vaccine administration. The HH-2 study is an ongoing multicentre, randomised, active-controlled, double-blind, non-inferiority Phase IIb trial, where participants 18 years or older who had received two doses of BNT162b2 were randomly assigned in a 2:1 ratio to receive a booster dose of vaccine-either heterologous (PHH-1V group) or homologous (BNT162b2 group)-in 10 centres in Spain. Eligible subjects were allocated to treatment stratified by age group (18-64 versus ≥65 years) with approximately 10% of the sample enrolled in the older age group. The primary endpoints were humoral immunogenicity measured by changes in levels of neutralizing antibodies (PBNA) against the ancestral Wuhan-Hu-1 strain after the PHH-1V or the BNT162b2 boost, and the safety and tolerability of PHH-1V as a boost. The secondary endpoints were to compare changes in levels of neutralizing antibodies against different variants of SARS-CoV-2 and the T-cell responses towards the SARS-CoV-2 spike glycoprotein peptides. The exploratory endpoint was to assess the number of subjects with SARS-CoV-2 infections ≥14 days after PHH-1V booster. This study is ongoing and is registered with , . From 15 November 2021, 782 adults were randomly assigned to PHH-1V (n = 522) or BNT162b2 (n = 260) boost vaccine groups. The geometric mean titre (GMT) ratio of neutralizing antibodies on days 14, 28 and 98, shown as BNT162b2 active control versus PHH-1V, was, respectively, 1.68 (p < 0.0001), 1.31 (p = 0.0007) and 0.86 (p = 0.40) for the ancestral Wuhan-Hu-1 strain; 0.62 (p < 0.0001), 0.65 (p < 0.0001) and 0.56 (p = 0.003) for the Beta variant; 1.01 (p = 0.92), 0.88 (p = 0.11) and 0.52 (p = 0.0003) for the Delta variant; and 0.59 (p ≤ 0.0001), 0.66 (p < 0.0001) and 0.57 (p = 0.0028) for the Omicron BA.1 variant. Additionally, PHH-1V as a booster dose induced a significant increase of CD4 + and CD8 + T-cells expressing IFN-γ on day 14. There were 458 participants who experienced at least one adverse event (89.3%) in the PHH-1V and 238 (94.4%) in the BNT162b2 group. The most frequent adverse events were injection site pain (79.7% and 89.3%), fatigue (27.5% and 42.1%) and headache (31.2 and 40.1%) for the PHH-1V and the BNT162b2 groups, respectively. A total of 52 COVID-19 cases occurred from day 14 post-vaccination (10.14%) for the PHH-1V group and 30 (11.90%) for the BNT162b2 group (p = 0.45), and none of the subjects developed severe COVID-19. Our interim results from the Phase IIb HH-2 trial show that PHH-1V as a heterologous booster vaccine, when compared to BNT162b2, although it does not reach a non-inferior neutralizing antibody response against the Wuhan-Hu-1 strain at days 14 and 28 after vaccination, it does so at day 98. PHH-1V as a heterologous booster elicits a superior neutralizing antibody response against the previous circulating Beta and the currently circulating Omicron BA.1 SARS-CoV-2 variants in all time points assessed, and for the Delta variant on day 98 as well. Moreover, the PHH-1V boost also induces a strong and balanced T-cell response. Concerning the safety profile, subjects in the PHH-1V group report significantly fewer adverse events than those in the BNT162b2 group, most of mild intensity, and both vaccine groups present comparable COVID-19 breakthrough cases, none of them severe. HIPRA SCIENTIFIC, S.L.U

Spread of a SARS-CoV-2 variant through Europe in the summer of 2020

[EN] Following its emergence in late 2019, the spread of SARS-CoV-21,2 has been tracked by phylogenetic analysis of viral genome sequences in unprecedented detail3,4,5. Although the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced. However, travel within Europe resumed in the summer of 2020. Here we report on a SARS-CoV-2 variant, 20E (EU1), that was identified in Spain in early summer 2020 and subsequently spread across Europe. We find no evidence that this variant has increased transmissibility, but instead demonstrate how rising incidence in Spain, resumption of travel, and lack of effective screening and containment may explain the variant’s success. Despite travel restrictions, we estimate that 20E (EU1) was introduced hundreds of times to European countries by summertime travellers, which is likely to have undermined local efforts to minimize infection with SARS-CoV-2. Our results illustrate how a variant can rapidly become dominant even in the absence of a substantial transmission advantage in favourable epidemiological settings. Genomic surveillance is critical for understanding how travel can affect transmission of SARS-CoV-2, and thus for informing future containment strategies as travel resumes.S

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Utilitat de l’anàlisi automàtica d’imatges de vídeo pel diagnòstic de la síndrome d’apnea-hipopnea del son

La present tesi doctoral es basa en els resultats de dos articles que avaluen la utilitat del processament i l’anàlisi automàtica d’imatges gravades en vídeo dels moviments respiratoris i corporals del pacient mentre dorm com a mètode no invasiu pel diagnòstic de la síndrome d’apnea-hipopnea del son (SAHS). Sleepwise (SW) és un sistema no invasiu pel diagnòstic de la SAHS, que és capaç de detectar esdeveniments respiratoris a partir de sèries d’imatges enregistrades per una càmera de vídeo digital convencional. Aquesta càmera de vídeo grava els moviments respiratoris i corporals del pacient durant el son. La tecnologia d’SW es basa en el principi físic que el volum d’aire que entra als pulmons és proporcional al moviment de la caixa toràcica que presenta un subjecte mentre respira. En aquests estudis SW ha demostrat tenir una bona concordança diagnòstica tant amb la polisomnografia (PSG) realitzada al laboratori de son com amb la poligrafia respiratòria domiciliària (PRD) per a tots els graus de gravetat de la SAHS. SW ha demostrat ser un mètode diagnòstic no invasiu, portàtil, còmode, fàcil d’usar i altament precís pel diagnòstic de la SAHS tant al laboratori de son com al domicili del pacient.La presente tesis doctoral se basa en los resultados de dos artículos que evalúan la utilidad del procesamiento y el análisis automático de imágenes grabadas en vídeo de los movimientos respiratorios y corporales del paciente mientras duerme como método no invasivo para el diagnóstico del síndrome de apnea-hipopnea del sueño (SAHS). Sleepwise (SW) es un sistema no invasivo para el diagnóstico del SAHS, que es capaz de detectar eventos respiratorios a partir de series de imágenes registradas por una cámara de vídeo digital convencional. Esta videocámara graba los movimientos respiratorios y corporales del paciente durante el sueño. La tecnología de SW se basa en el principio físico que el volumen de aire que entra en los pulmones es proporcional al movimiento de la caja torácica que presenta un sujeto mientras respira. En estos estudios SW ha demostrado tener una buena concordancia diagnóstica tanto con la polisomnografía (PSG) realizada en el laboratorio de sueño como con la poligrafía respiratoria domiciliaria (PRD) para todos los grados de gravedad del SAHS. SW ha demostrado ser un método diagnóstico no invasivo, portátil, cómodo, fácil de usar y altamente preciso para el diagnóstico del SAHS tanto en el laboratorio de sueño como en el domicilio del paciente.The present doctoral thesis is based on the results of two articles that evaluate the utility of the processing and automatic analysis of video-recorded images of the patient’s respiratory and body movements while sleeping as a non-invasive method for the diagnosis of obstructive sleep apnea syndrome (OSA). Sleepwise (SW) is a non-invasive system for the diagnosis of OSA, which is able to detect respiratory events from a series of images recorded by a conventional digital video camera. This video camera records the patient’s respiratory and body movements during sleep. SW technology is based on the physical principle that the volume of air entering the lungs is proportional to the movement of the thorax while breathing. In these studies, SW presented a good diagnostic agreement with both in-laboratory polysomnography (PSG) and in-home respiratory polygraphy for all degrees of severity of OSA. SW is a non-invasive, portable, comfortable, easy-to-use, and highly accurate diagnostic method for OSA in both the sleep laboratory and the patient’s home.Universitat Autònoma de Barcelona. Programa de Doctorat en Medicin

Diagnosticar sense tocar

Diagnosticar sense tocar; Diagnosticar per vídeo; SleepwiseDiagnose without touching; Diagnose by video; SleepwiseDiagnosticar sin tocar; Diagnosticar por vídeo; SleepwiseComunicació que presenta la tècnica Sleepwise, que permet diagnosticar les síndromes de l'apnea del son sense tocar el pacient

Taxa de reincidència en la llibertat condicional i d’inactivitat delictiva a 3r grau a Catalunya

L’any 2013 el CEJFE va dur a terme l’estudi sobre la llibertat condicional (LC) a Catalunya, on s’analitzaven totes aquelles persones que es trobaven en LC, comparant-les amb una mostra d’interns que es trobaven en 3r grau i un altre grup que es trobava en 2n grau, tot i complir algunes condicions objectives per estar en medi obert. En total eren 3.340 persones. Ara, 5 anys després hem volgut saber què ha passat amb la progressió penitenciària dels subjectes que formaven par de la mostra, en la reincidència penitenciària i en la taxa d’inactivitat delictiva per aquells casos on el temps de seguiment no arribi al període estàndards que utilitzem en els nostres estudis per parlar de reincidència, que és de 5 anys. La recerca recull per primer cop dades sobre dos mesures concretes de 3r grau: les unitats dependents (que són habitatges ubicats fora del recinte penitenciari on comencen a fer activitats formatives i laborals en l’entorn comunitari) i els interns a qui s’aplica l’Art.86.4 (amb control telemàtic o sense). En l’estudi es dona resposta a la pregunta si és més eficaç el compliment íntegre en medi tancat o la progressió pautada i controlada cap a medi obert per evitar la reincidència. També es dona resposta al debat criminològic actual en la societat espanyola que gira entorn de suprimir els beneficis penitenciaris i les mesures de progressió a medi obert de les persones encarcerades. L’estudi respon a la pregunta si fer-ho millorarà la taxa de reincidència en el futur