Seroprevalence of SARS-CoV-2 Among Pediatric Healthcare Workers in Spain

Spain is one of the countries most severely affected by the SARS-CoV-2 pandemic, with almost 190,000 cases as of April 18, 2020. As healthcare workers (HCW) are one of the groups hardest hit by the infection, it is important to know the seroprevalence of antibodies against SARS-CoV-2 in pediatric departments. We performed 175 immunoglobulin (Ig)M and IgG immunochromatographic rapid tests in the personnel working at the Pediatric Department of the Hospital Clinico Universitario of Santiago de Compostela (Spain), including pediatricians, residents, nurses, and other staff, on days 31-33 since the lockdown started. Seven out of the 175 tests were positive, including four for IgM and three for IgG, leading to a seroprevalence of 4.0% (95% CI: 1.1-6.9%). Only one of them had symptoms at the time of testing (sore throat). All seropositive cases yielded negative RT-PCR of the upper and lower respiratory tract. This is the first SARS-CoV-2 serological survey among HCWs reported in Spain. Notwithstanding the test limitations, our results reveal that personal protection policy and lockdown measures have been effective to limit population exposure. The low seroprevalence rate poses a significant challenge for the next strategic steps of pandemic control

Global diversity patterns of freshwater fishes - Potential victims of their own success

Aim To examine the pattern and cumulative curve of descriptions of freshwater fishes world-wide, the geographical biases in the available information on that fauna, the relationship between species richness and geographical rarity of such fishes, as well as to assess the relative contributions of different environmental factors on these variables. Location Global. Methods MODESTR was used to summarize the geographical distribution of freshwater fish species using information available from data-based geographical records. The first-order jackknife richness estimator was used to estimate the completeness of such data in all terrestrial 1-degree cells world-wide. An a-shape procedure was used to build range maps capable of providing relatively accurate species richness and geographical rarity values for each grid cell. We also examined the explanatory capacity of a high number of environmental variables using multiple regressions and Support Vector Machine. Results Cumulative species description curves show that a high number of species of freshwater fishes remain to be discovered. Completeness values indicate that only 199 one-degree grid cells, mainly located in eastern North America and Europe, could be considered as having relatively accurate inventories. Range maps provide species richness values that are positively and significantly related to those resulting from the first-order jackknife richness estimator. The relationship between species richness and geographical rarity is triangular, so that these species-rich cells are those with a higher proportion of distributionally rare species. Species richness is predicted by climatic and/or productivity variables but geographical rarity is not. Main conclusions In general, species-rich tropical areas harbour a higher number of narrowly distributed species although comparatively species-poor subtropical cells may also contain narrowly distributed species. Historical factors may help to explain the faunistic composition of these latter areas; a supposition also supported by the low predictive capacity of climatic and productivity variables on geographical rarity values

Olympic idea nowadays : perceptions and insights

The book Olympic Idea Nowadays : perceptions and insights offers a vision of the Olympic Movement and the Olympic Games in relation to the Olympic values system in the current social context. The book includes the contribution of 23 academics and experts in the field of Olympic studies sharing their reflections on the evolution of the Olympic Movement since Sydney 2000 and the impacts, contributions or changes posed by the London 2012 and Sochi 2014 Olympics

A procedure to assess the spatial variability in the importance of abiotic factors affecting distributions: the case of world freshwater fishes

Understanding the factors shaping species' distributions is a key longstanding topic in ecology with unresolved issues. The aims were to test whether the relative contribution of abiotic factors that set the geographical range of freshwater fish species may vary spatially and/or may depend on the geographical extent that is being considered. The relative contribution of factors, to discriminate between the conditions prevailing in the area where the species is present and those existing in the considered extent, was estimated with the instability index included in the R package SPEDInstabR. We used 3 different extent sizes: 1) each river basin where the species is present (local); 2) all river basins where the species is present (regional); and 3) the whole Earth (global). We used a data set of 16,543 freshwater fish species with a total of 845,764 geographical records, together with bioclimatic and topographic variables. Factors associated with temperature and altitude show the highest relative contribution to explain the distribution of freshwater fishes at the smaller considered extent. Altitude and a mix of factors associated with temperature and precipitation were more important when using the regional extent. Factors associated with precipitation show the highest contribution when using the global extent. There was also spatial variability in the importance of factors, both between species and within species and from region to region. Factors associated with precipitation show a clear latitudinal trend of decreasing in importance toward the equator

Predicting the effects of climate change on future freshwater fish diversity at global scale

The aim of the present study was to predict future changes in biodiversity attributes (richness, rarity, heterogeneity, evenness, functional diversity and taxonomic diversity) of freshwater fish species in river basins around the world, under different climate scenarios. To do this, we use a new methodological approach implemented within the ModestR software (NOO3D) which allows estimating simple species distribution predictions for future climatic scenarios. Data from 16,825 freshwater fish species were used, representing a total of 1,464,232 occurrence records. WorldClim 1.4 variables representing average climate variables for the 1960¿1990 period, together with elevation measurements, were used as predictors in these distribution models, as well as in the selection of the most important variables that account for species distribution changes in two scenarios (Representative Concentration Pathways 4.5 and 6.0). The predictions produced suggest the extinction of almost half of current freshwater fish species in the coming decades, with a pronounced decline in tropical regions and a greater extinction likelihood for species with smaller body size and/or limited geographical ranges.We acknowledge institutional support from the Unit of Information Resources for Research at the Unit of Information Resources for Research at the "Consejo Superior de Investigaciones Científicas" (CSIC) for the article-processing charges contribution

Substantial burden of non-medically attended RSV infection in healthy term infants – an international prospective birth cohort study

Background: During the first year of life, one in four infants develops a symptomatic respiratory syncytial virus (RSV) infection, yet only half seek medical attention. The current focus on medically attended RSV, therefore, underrepresents the true societal burden of RSV. We assessed the burden of non-medically attended RSV infections and compared them with medically attended RSV. Methods: We performed active RSV surveillance until the age of one year in a cohort (n=993) nested within RESCEU, a prospective birth cohort study enrolling healthy term-born infants in five European countries. Parent-reported daily symptoms, medication use, wheezing and impact on family life were analyzed. Results: For 97 of 120 (80.1%) non-medically attended RSV episodes sufficient data were available for analysis. In 50.5% (49/97), symptoms lasted ≥15 days. Parents reported impairment in usual daily activities in 59.8% (58/97), worries in 75.3% (73/97), anxiety in 34.0% (33/97), and work absenteeism in 10.8% (10/93) of episodes. Compared with medically attended RSV (n=102, 9 hospital admissions), ReSViNET severity scores were lower (3.5 vs. 4.6, p<0.001), whereas durations of respiratory symptoms and impairment of usual activities were comparable. Conclusion: Even when medical attendance is not required, RSV infection poses a substantial burden to infants, families and society at large. These findings are important for policymakers when considering the implementation of RSV immunization in national programs

Economic burden and health-related quality-of-life among infants with respiratory syncytial virus infection: a multi-country prospective cohort study in Europe

Background: Respiratory syncytial virus (RSV) causes a considerable disease burden in young children globally, but reliable estimates of RSV-related costs and health-related quality-of-life (HRQoL) are scarce. This study aimed to evaluate the RSV-associated costs and HRQoL effects in infants and their caregivers in four European countries. Methods: Healthy term-born infants were recruited at birth and actively followed up in four European countries. Symptomatic infants were systematically tested for RSV. Caregivers recorded the daily HRQoL of their child and themselves, measured by a modified EQ-5D with Visual Analogue Scale, for 14 consecutive days or until symptoms resolved. At the end of each RSV episode, caregivers reported healthcare resource use and work absenteeism. Direct medical costs per RSV episode were estimated from a healthcare payer's perspective and indirect costs were estimated from a societal perspective. Means and 95% confidence intervals (CI) of direct medical costs, total costs (direct costs + productivity loss) and quality-adjusted life-day (QALD) loss per RSV episode were estimated per RSV episode, as well as per subgroup (medical attendance, country). Results: Our cohort of 1041 infants experienced 265 RSV episodes with a mean symptom duration of 12.5 days. The mean (95% CI) cost per RSV episode was €399.5 (242.3, 584.2) and €494.3 (317.7, 696.1) from the healthcare payer's and societal perspective, respectively. The mean QALD loss per RSV episode of 1.9 (1.7, 2.1) was independent of medical attendance (in contrast to costs, which also differed by country). Caregiver and infant HRQoL evolved similarly. Conclusion: This study fills essential gaps for future economic evaluations by prospectively estimating direct and indirect costs and HRQoL effects on healthy term infants and caregivers separately, for both medically attended (MA) and non-MA laboratory-confirmed RSV episodes. We generally observed greater HRQoL losses than in previous studies which used non-community and/or non-prospective designs

Increased Serum Levels of sCD14 and sCD163 Indicate a Preponderant Role for Monocytes in COVID-19 Immunopathology

Background: Emerging evidence indicates a potential role for monocytes in COVID-19 immunopathology. We investigated two soluble markers of monocyte activation, sCD14 and sCD163, in COVID-19 patients, with the aim of characterizing their potential role in monocyte-macrophage disease immunopathology. To the best of our knowledge, this is the first study of its kind. Methods: Fifty-nine SARS-Cov-2 positive hospitalized patients, classified according to ICU or non-ICU admission requirement, were prospectively recruited and analyzed by ELISA for levels of sCD14 and sCD163, along with other laboratory parameters, and compared to a healthy control group. Results: sCD14 and sCD163 levels were significantly higher among COVID-19 patients, independently of ICU admission requirement, compared to the control group. We found a significant correlation between sCD14 levels and other inflammatory markers, particularly Interleukin-6, in the non-ICU patients group. sCD163 showed a moderate positive correlation with the time lapsed from admission to sampling, independently of severity group. Treatment with corticoids showed an interference with sCD14 levels, whereas hydroxychloroquine and tocilizumab did not. Conclusions: Monocyte-macrophage activation markers are increased and correlate with other inflammatory markers in SARS-Cov-2 infection, in association to hospital admission. These data suggest a preponderant role for monocyte-macrophage activation in the development of immunopathology of COVID-19 patients

Effects and mechanisms of mindfulness training and physical exercise on cognition, emotional wellbeing, and brain outcomes in chronic stroke patients : Study protocol of the MindFit project randomized controlled trial

Post-stroke cognitive and emotional complications are frequent in the chronic stages of stroke and have important implications for the functionality and quality of life of those affected and their caregivers. Strategies such as mindfulness meditation, physical exercise (PE), or computerized cognitive training (CCT) may benefit stroke patients by impacting neuroplasticity and brain health. One hundred and forty-one chronic stroke patients are randomly allocated to receive mindfulness-based stress reduction + CCT (n = 47), multicomponent PE program + CCT (n = 47), or CCT alone (n = 47). Interventions consist of 12-week home-based programs five days per week. Before and after the interventions, we collect data from cognitive, psychological, and physical tests, blood and stool samples, and structural and functional brain scans. The effects of the interventions on cognitive and emotional outcomes will be described in intention-to-treat and per-protocol analyses. We will also explore potential mediators and moderators, such as genetic, molecular, brain, demographic, and clinical factors in our per-protocol sample. The MindFit Project is a randomized clinical trial that aims to assess the impact of mindfulness and PE combined with CCT on chronic stroke patients' cognitive and emotional wellbeing. Furthermore, our design takes a multimodal biopsychosocial approach that will generate new knowledge at multiple levels of evidence, from molecular bases to behavioral changes. , identifier NCT04759950

Effects and mechanisms of mindfulness training and physical exercise on cognition, emotional wellbeing, and brain outcomes in chronic stroke patients: Study protocol of the MindFit project randomized controlled trial

Background: Post-stroke cognitive and emotional complications are frequent in the chronic stages of stroke and have important implications for the functionality and quality of life of those affected and their caregivers. Strategies such as mindfulness meditation, physical exercise (PE), or computerized cognitive training (CCT) may benefit stroke patients by impacting neuroplasticity and brain health. Materials and methods: One hundred and forty-one chronic stroke patients are randomly allocated to receive mindfulness-based stress reduction + CCT (n = 47), multicomponent PE program + CCT (n = 47), or CCT alone (n = 47). Interventions consist of 12-week home-based programs five days per week. Before and after the interventions, we collect data from cognitive, psychological, and physical tests, blood and stool samples, and structural and functional brain scans. Results: The effects of the interventions on cognitive and emotional outcomes will be described in intention-to-treat and per-protocol analyses. We will also explore potential mediators and moderators, such as genetic, molecular, brain, demographic, and clinical factors in our per-protocol sample. Discussion: The MindFit Project is a randomized clinical trial that aims to assess the impact of mindfulness and PE combined with CCT on chronic stroke patients' cognitive and emotional wellbeing. Furthermore, our design takes a multimodal biopsychosocial approach that will generate new knowledge at multiple levels of evidence, from molecular bases to behavioral changes. Clinical trial registration: www.ClinicalTrials.gov, identifier NCT04759950