Symptom-Based Predictive Model of COVID-19 Disease in Children

COVID-19; Microbiology; PaediatricsCOVID-19; Microbiología; PediatríaCOVID-19; Microbiologia; PediatriaBackground: Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is neither always accessible nor easy to perform in children. We aimed to propose a machine learning model to assess the need for a SARS-CoV-2 test in children (<16 years old), depending on their clinical symptoms. Methods: Epidemiological and clinical data were obtained from the REDCap® registry. Overall, 4434 SARS-CoV-2 tests were performed in symptomatic children between 1 November 2020 and 31 March 2021, 784 were positive (17.68%). We pre-processed the data to be suitable for a machine learning (ML) algorithm, balancing the positive-negative rate and preparing subsets of data by age. We trained several models and chose those with the best performance for each subset. Results: The use of ML demonstrated an AUROC of 0.65 to predict a COVID-19 diagnosis in children. The absence of high-grade fever was the major predictor of COVID-19 in younger children, whereas loss of taste or smell was the most determinant symptom in older children. Conclusions: Although the accuracy of the models was lower than expected, they can be used to provide a diagnosis when epidemiological data on the risk of exposure to COVID-19 is unknown.This research has received external funding from the Fundació la Marató tv3 after being awarded in the COVID-19 research call with the expedient number 202134-30-31

Virtual Reality on pediatric pain and fear during procedures involving needles: a systematic Review and Meta-analysis

Background: Virtual reality (VR) is used as a distraction measure during painful clinical procedures. Objective: The objective of the study was to collect and analyze the evidence regarding the effectiveness of VR as a tool to distract children from pain and fear during needle procedures, as compared to standard techniques. Methods: A systematic review and meta-analysis was performed. Studies were those whose main distraction measure was VR in a sample aged less than 21 years old that evaluated the pain generated by a needle during medical procedures. Databases included: PubMed, the Web of Science, Scopus, Psycinfo, Cinahl, and Cochrane. Among 665 unique search results, publications were included if they used VR as a distraction measure and if they evaluated the pain generated by a needle procedure. For the systematic review, the studies were analyzed by using the CASPe guide and Jadad scale. In the meta-analysis, the effect size of the studies was analyzed based on the results for pain and fear in children. Results: A total of 25 studies were included in this systematic review; most of them had reported low methodological quality. The study sample cohorts ranged from a minimum of 14 participants to a maximum of 220 individuals. In the meta-analysis were included 10 studies. The global effect of using VR as a distraction measure had significantly reduced pain in children in the experimental groups (IV=−2.37, 95% CI [−3.20, −1.54]; Z=5.58; p<.001) and fear (IV=−1.26, 95% CI [−1.89, −0.63]; Z=3.92; p<.001) Conclusions: The quality of the studies was mostly low. The main limitations are the impossibility of blind both the participants and healthcare personnel to the VR intervention. The use of VR as a distraction measure is effective in reducing pain and fear in children during procedures involving needles. Trial Registration: The systematic review was registered with the Open Science Framework (Osf.io/cd8nr) in October, 2021

The Impact of COVID-19 on the Lifestyles of University Students: A Spanish Online Survey

The present study aimed to investigate the perceived changes in lifestyle behaviors among Spanish university students during COVID-19-related confinement. An observational, descriptive, and cross-sectional survey study was conducted during April 2020. Sociodemographic and anthropometric data were then obtained. The FANTASTIC questionnaire was used to assess the lifestyles of the 488 participants who took part in the study. Of the participants, 76.3% were female. Overall, the lifestyles of university students significantly deteriorated during the period of confinement caused by the COVID-19 pandemic in Spain. University female students were especially affected compared to their male fellows (p = 0.010). For women, social and family relationships (p < 0.001), personality (p < 0.001), interior (p < 0.001), and career (p < 0.001) were the aspects that worsened during confinement. For men, lack of physical exercise (p < 0.001), social and family relationships (p < 0.001), and career (p = 0.002) were affected to a greater extent. In both cases, confinement was a protective factor against the consumption of tobacco, toxins (p < 0.001), and alcohol (p < 0.001). Gender (p = 0.008) and obesity (p = 0.044) were the two factors that most affected the change in the score of the FANTASTIC questionnaire. Spanish university students’ lifestyles worsened during the lockdown caused by the COVID-19 pandemic, especially those of women, who were the most affected. Some aspects, such as those related to social and emotional behaviors, were deeply affected, while confinement could be a protective factor against previous toxic habits

Symptom-based predictive model of COVID-19 disease in children

Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is neither always accessible nor easy to perform in children. We aimed to propose a machine learning model to assess the need for a SARS-CoV-2 test in children (<16 years old), depending on their clinical symptoms. Methods: Epidemiological and clinical data were obtained from the REDCap® registry. Overall, 4434 SARS-CoV-2 tests were performed in symptomatic children between 1 November 2020 and 31 March 2021, 784 were positive (17.68%). We pre-processed the data to be suitable for a machine learning (ML) algorithm, balancing the positive-negative rate and preparing subsets of data by ageThis research has received external funding from the Fundació la Marató tv3 after being awarded in the COVID-19 research call with the expedient number 202134-30-31.Objectius de Desenvolupament Sostenible::3 - Salut i BenestarPostprint (published version

Validación de la utilidad de los parámetros de deformación miocárdica para excluir el rechazo agudo tras el trasplante cardiaco: un estudio multicéntrico

Multicenter study[Abstract] Introduction and objectives: Two-dimensional speckle-tracking echocardiography has emerged as a promising alternative to endomyocardial biopsy to rule out acute cellular rejection after orthotopic heart transplantation (OHT) in single center studies. In an original cohort, 15.5% and 17% of cutoff points for left ventricular global longitudinal strain (LVGLS) and free-wall right ventricular longitudinal strain, respectively, achieved 100% negative predictive value to exclude moderate or severe acute cellular rejection (ACR ≥ 2R). Our objective was to demonstrate the usefulness of speckle-tracking and validate these cutoff points in an external cohort. Methods: A prospective, multicenter study that included patients who were monitored during their first year after OHT was conducted. Echocardiographic studies analyzed by local investigators were compared with simultaneous paired endomyocardial biopsies samples. Results: A total of 501 endomyocardial biopsy-echocardiographic studies were included in 99 patients. ACR≥2R was present in 7.4% of samples. LVGLS and free-wall right ventricular longitudinal strain were significantly reduced during ACR≥2R on univariate analysis. On multivariate analysis, LVGLS was independently associated with the presence of ACR≥2R. The original cutoff points demonstrated a negative predictive value of 94.3% to exclude ACR≥2R. Conclusions: This study maintained a strong negative predictive value to exclude ACR≥2R after OHT and LVGLS was independently associated with the presence of ACR≥2R. We propose the use of speckle-tracking, especially LVGLS, as part of the noninvasive diagnosis and management of ACR.[Resumen] Introducción y objetivos. Algunos estudios indican que los parámetros de strain por speckle-tracking pueden ser una alternativa no invasiva a la biopsia endomiocárdica para excluir el rechazo celular agudo (RCA) moderado o grave (≥ 2 R) tras el trasplante cardiaco (TxC). En una cohorte inicial, unos puntos de corte del 15,5% para el strain longitudinal global del ventrículo izquierdo (SLGVI) y el 17% para el strain de pared libre del ventrículo derecho mostraron un valor predictivo negativo del 100% para excluir RCA ≥ 2 R. Nuestro objetivo es analizar la utilidad del strain y validar estos puntos de corte en una cohorte multicéntrica prospectiva externa. Métodos. Estudio multicéntrico y prospectivo que incluyó a pacientes con seguimiento el primer año tras el TC. Se compararon los resultados de biopsias electivas con ecocardiogramas realizados el mismo día. Resultados. Se incluyó a 99 pacientes y 501 pares de biopsias-ecocardiogramas. El RCA ≥ 2 R en las biopsias fue del 7,4%. El SLGVI y el strain longitudinal de pared libre del ventrículo derecho fueron menores durante los RCA ≥ 2 R en el análisis univariante. En el análisis multivariante, el SLGVI se asoció de manera independiente con el RCA ≥ 2 R. Los puntos de corte originales mostraron un valor predictivo negativo del 94,3% el RCA ≥ 2 R. Conclusiones. Este estudio mantiene un alto valor predictivo negativo para excluir RCA ≥ 2 R tras el TxC y el SLGVI se asoció de manera independiente con el RCA ≥ 2 R. El strain y, principalmente, el SLGVI pueden ser de utilidad en el diagnóstico y el tratamiento no invasivo del RCA

Conflictos en torno a la representación moderna de los mitos. Relaciones violentas entre extremismos políticos y arte en India

Taking reference from two major violent events against art and artists in India, this article shows how the idea of unity is a modern construction and how some groups impose their version by force, contrary to the inherent flexibility of the diversity of the Subcontinent.Tomando de referencia dos importantes acontecimientos violentos contra el arte y los artistas en la India, este texto pretende mostrar cómo la unidad es una construcción moderna y cómo algunos grupos imponen su versión por la fuerza, en contra de la flexibilidad inherente de la diversidad del Subcontinente