17 research outputs found

    The news gap in the «triple digital agenda»: The different interests of media, audience and networks

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    Digital transformations entail continually reviewing the various Communication models and processes. The influence of the media themselves as agenda setters for an ever more active audience and social networks that select and make certain content they receive viral are also affected by such a convergent context. This current research analyses a model called here the ‘triple agenda’ within the media themselves, in which the journalistic criterion of relevance and their audience’s preferences in the web and the networks travel along different paths. The proposal includes the users and the viral effect as influencing agents in the shape and selection of news, generating a news gap of interests between the media and their audiences. In order to test this model, we study an exploratory case in ElPaís.es, applying a content analysis to the information (n=420) distributed among the online front page, what is most read by the audience in its webpage, and the most viral in its Twitter account. The main objective is to check whether or not these three spheres of relevance operate independently, showing different informative interests f rom the thematic selection that the medium establishes f rom its agenda, its audience and its social networks. The results confirm that there is a gap in the informative interests of the three spheres analysed, especially between the agenda marked by the medium and the interests that are reflected in their web audience, which is more attracted to soft news and the clickbait technique; while there is a greater coincidence of interests between the newspaper’s front page and the users’ selection in their social networks.Las transformaciones digitales conllevan una revisión permanente de los modelos y procesos de la Comunicación. En este contexto convergente también se ve afectada la propia influencia de los medios como fijadores de la agenda frente a una audiencia cada vez más activa y unas redes sociales que seleccionan y viralizan el contenido que les llega. La presente investigación analiza un modelo denominado aquí de ‘triple agenda’ dentro de los propios medios, en los que discurren de manera diferente el criterio periodístico de relevancia y las preferencias de su audiencia en la web y las redes. La propuesta incluye a los usuarios y el efecto de la viralidad como actores influyentes en la conformación y selección noticiosa, generando una brecha, o news gap, de intereses informativos entre el medio y su audiencia. Para poner a prueba este modelo, se recurre a un estudio de caso exploratorio en ElPaís.es, aplicando un análisis de contenido de sus informaciones (n=420), distribuidas entre la portada online, lo más leído por la audiencia en su web y lo más viralizado en su Twitter. El objetivo principal es comprobar si estas tres esferas de relevancia temática operan, o no, de forma independiente, mostrando intereses informativos dispares entre la selección temática que establece el medio desde su agenda, de su audiencia y de las redes. Los resultados confirman una brecha en el interés informativo de las tres esferas analizadas, especialmente entre la agenda que marca el medio y los intereses que reflejan su audiencia web, más atraída por las soft news y las técnicas del clickbait, mientras que existe una mayor coincidencia de intereses entre la portada periodística y la selección de los usuarios en sus redes sociales

    New insights into the genetic etiology of Alzheimer's disease and related dementias

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    Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

    Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

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    Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

    Spatiotemporal Characteristics of the Largest HIV-1 CRF02_AG Outbreak in Spain: Evidence for Onward Transmissions

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    Background and Aim: The circulating recombinant form 02_AG (CRF02_AG) is the predominant clade among the human immunodeficiency virus type-1 (HIV-1) non-Bs with a prevalence of 5.97% (95% Confidence Interval-CI: 5.41–6.57%) across Spain. Our aim was to estimate the levels of regional clustering for CRF02_AG and the spatiotemporal characteristics of the largest CRF02_AG subepidemic in Spain.Methods: We studied 396 CRF02_AG sequences obtained from HIV-1 diagnosed patients during 2000–2014 from 10 autonomous communities of Spain. Phylogenetic analysis was performed on the 391 CRF02_AG sequences along with all globally sampled CRF02_AG sequences (N = 3,302) as references. Phylodynamic and phylogeographic analysis was performed to the largest CRF02_AG monophyletic cluster by a Bayesian method in BEAST v1.8.0 and by reconstructing ancestral states using the criterion of parsimony in Mesquite v3.4, respectively.Results: The HIV-1 CRF02_AG prevalence differed across Spanish autonomous communities we sampled from (p < 0.001). Phylogenetic analysis revealed that 52.7% of the CRF02_AG sequences formed 56 monophyletic clusters, with a range of 2–79 sequences. The CRF02_AG regional dispersal differed across Spain (p = 0.003), as suggested by monophyletic clustering. For the largest monophyletic cluster (subepidemic) (N = 79), 49.4% of the clustered sequences originated from Madrid, while most sequences (51.9%) had been obtained from men having sex with men (MSM). Molecular clock analysis suggested that the origin (tMRCA) of the CRF02_AG subepidemic was in 2002 (median estimate; 95% Highest Posterior Density-HPD interval: 1999–2004). Additionally, we found significant clustering within the CRF02_AG subepidemic according to the ethnic origin.Conclusion: CRF02_AG has been introduced as a result of multiple introductions in Spain, following regional dispersal in several cases. We showed that CRF02_AG transmissions were mostly due to regional dispersal in Spain. The hot-spot for the largest CRF02_AG regional subepidemic in Spain was in Madrid associated with MSM transmission risk group. The existence of subepidemics suggest that several spillovers occurred from Madrid to other areas. CRF02_AG sequences from Hispanics were clustered in a separate subclade suggesting no linkage between the local and Hispanic subepidemics

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

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    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

    Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

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    Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

    The news gap in the «triple digital agenda»: The different interests of media, audience and networks

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    Digital transformations entail continually reviewing the various Communication models and processes. The influence of the media themselves as agenda setters for an ever more active audience and social networks that select and make certain content they receive viral are also affected by such a convergent context. This current research analyses a model called here the ‘triple agenda’ within the media themselves, in which the journalistic criterion of relevance and their audience’s preferences in the web and the networks travel along different paths. The proposal includes the users and the viral effect as influencing agents in the shape and selection of news, generating a news gap of interests between the media and their audiences. In order to test this model, we study an exploratory case in ElPaís.es, applying a content analysis to the information (n=420) distributed among the online front page, what is most read by the audience in its webpage, and the most viral in its Twitter account. The main objective is to check whether or not these three spheres of relevance operate independently, showing different informative interests f rom the thematic selection that the medium establishes f rom its agenda, its audience and its social networks. The results confirm that there is a gap in the informative interests of the three spheres analysed, especially between the agenda marked by the medium and the interests that are reflected in their web audience, which is more attracted to soft news and the clickbait technique; while there is a greater coincidence of interests between the newspaper’s front page and the users’ selection in their social networks.Las transformaciones digitales conllevan una revisión permanente de los modelos y procesos de la Comunicación. En este contexto convergente también se ve afectada la propia influencia de los medios como fijadores de la agenda frente a una audiencia cada vez más activa y unas redes sociales que seleccionan y viralizan el contenido que les llega. La presente investigación analiza un modelo denominado aquí de ‘triple agenda’ dentro de los propios medios, en los que discurren de manera diferente el criterio periodístico de relevancia y las preferencias de su audiencia en la web y las redes. La propuesta incluye a los usuarios y el efecto de la viralidad como actores influyentes en la conformación y selección noticiosa, generando una brecha, o news gap, de intereses informativos entre el medio y su audiencia. Para poner a prueba este modelo, se recurre a un estudio de caso exploratorio en ElPaís.es, aplicando un análisis de contenido de sus informaciones (n=420), distribuidas entre la portada online, lo más leído por la audiencia en su web y lo más viralizado en su Twitter. El objetivo principal es comprobar si estas tres esferas de relevancia temática operan, o no, de forma independiente, mostrando intereses informativos dispares entre la selección temática que establece el medio desde su agenda, de su audiencia y de las redes. Los resultados confirman una brecha en el interés informativo de las tres esferas analizadas, especialmente entre la agenda que marca el medio y los intereses que reflejan su audiencia web, más atraída por las soft news y las técnicas del clickbait, mientras que existe una mayor coincidencia de intereses entre la portada periodística y la selección de los usuarios en sus redes sociales

    COVID-19 in hospitalized HIV-positive and HIV-negative patients : A matched study

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    CatedresObjectives: We compared the characteristics and clinical outcomes of hospitalized individuals with COVID-19 with [people with HIV (PWH)] and without (non-PWH) HIV co-infection in Spain during the first wave of the pandemic. Methods: This was a retrospective matched cohort study. People with HIV were identified by reviewing clinical records and laboratory registries of 10 922 patients in active-follow-up within the Spanish HIV Research Network (CoRIS) up to 30 June 2020. Each hospitalized PWH was matched with five non-PWH of the same age and sex randomly selected from COVID-19@Spain, a multicentre cohort of 4035 patients hospitalized with confirmed COVID-19. The main outcome was all-cause in-hospital mortality. Results: Forty-five PWH with PCR-confirmed COVID-19 were identified in CoRIS, 21 of whom were hospitalized. A total of 105 age/sex-matched controls were selected from the COVID-19@Spain cohort. The median age in both groups was 53 (Q1-Q3, 46-56) years, and 90.5% were men. In PWH, 19.1% were injecting drug users, 95.2% were on antiretroviral therapy, 94.4% had HIV-RNA < 50 copies/mL, and the median (Q1-Q3) CD4 count was 595 (349-798) cells/μL. No statistically significant differences were found between PWH and non-PWH in number of comorbidities, presenting signs and symptoms, laboratory parameters, radiology findings and severity scores on admission. Corticosteroids were administered to 33.3% and 27.4% of PWH and non-PWH, respectively (P = 0.580). Deaths during admission were documented in two (9.5%) PWH and 12 (11.4%) non-PWH (P = 0.800). Conclusions: Our findings suggest that well-controlled HIV infection does not modify the clinical presentation or worsen clinical outcomes of COVID-19 hospitalization
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