Increased 30-Day Mortality in Very Old ICU Patients with COVID-19 Compared to Patients with Respiratory Failure without COVID-19

Purpose: The number of patients ≥ 80 years admitted into critical care is increasing. Coronavirus disease 2019 (COVID-19) added another challenge for clinical decisions for both admission and limitation of life-sustaining treatments (LLST). We aimed to compare the characteristics and mortality of very old critically ill patients with or without COVID-19 with a focus on LLST. Methods: Patients 80 years or older with acute respiratory failure were recruited from the VIP2 and COVIP studies. Baseline patient characteristics, interventions in intensive care unit (ICU) and outcomes (30-day survival) were recorded. COVID patients were matched to non-COVID patients based on the following factors: age (± 2 years), Sequential Organ Failure Assessment (SOFA) score (± 2 points), clinical frailty scale (± 1 point), gender and region on a 1:2 ratio. Specific ICU procedures and LLST were compared between the cohorts by means of cumulative incidence curves taking into account the competing risk of discharge and death. Results: 693 COVID patients were compared to 1393 non-COVID patients. COVID patients were younger, less frail, less severely ill with lower SOFA score, but were treated more often with invasive mechanical ventilation (MV) and had a lower 30-day survival. 404 COVID patients could be matched to 666 non-COVID patients. For COVID patients, withholding and withdrawing of LST were more frequent than for non-COVID and the 30-day survival was almost half compared to non-COVID patients. Conclusion: Very old COVID patients have a different trajectory than non-COVID patients. Whether this finding is due to a decision policy with more active treatment limitation or to an inherent higher risk of death due to COVID-19 is unclear.info:eu-repo/semantics/publishedVersio

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

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 detail3–5. 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. © 2021, The Author(s), under exclusive licence to Springer Nature Limited

Geographical and temporal distribution of SARS-CoV-2 clades in the WHO European Region, January to June 2020

We show the distribution of SARS-CoV-2 genetic clades over time and between countries and outline potential genomic surveillance objectives. We applied three available genomic nomenclature systems for SARS-CoV-2 to all sequence data from the WHO European Region available during the COVID-19 pandemic until 10 July 2020. We highlight the importance of real-time sequencing and data dissemination in a pandemic situation. We provide a comparison of the nomenclatures and lay a foundation for future European genomic surveillance of SARS-CoV-2.Peer reviewe

Integral security model for the exchange of objects in Service Oriented Architecture

Nowadays, security approaches and solutions for SOA focus mainly on messages and data, but they forget the code security (both service code and exchanged code). Moreover, some security aspects (e.g. validity, correctness...) are usually forgotten. We state that any security approach will be incomplete if the security of both data (messages) and code (service code) is not addressed in a general sense. In this paper, we extend a previous approach about securing code in SOA. We analyze general problems related to the exchange of code and state in SOA and in the specific case of Web Services architectures. A new general model of security is presented. This model covers any aspect related to the authorship, distribution, transformation, execution and validation of both code and data

References-enriched Concept Map: A tool for collecting and comparing disparate definitions appearing in multiple references

Finding and sharing a common vocabulary is a critical task for the development of any area of knowledge. However, it is very common to find heated debate in the literature on the meaning of particular terms. Different authors propose different definitions, some of them even contradictory. This situation, while enriching the scientific process, may hinder the understanding of fundamental concepts regarding a certain subject. To address this problem, we propose a technique called References-enriched Concept Maps (RCM), inspired by concept maps. RCM can be used to compare definitions and therefore improve the understanding of terms, keeping track of the publications in which the different definitions were proposed. We present a method of RCM construction as well as different metrics for analysing them. An analysis carried out using the proposed metrics allows one to find answers while also raising new questions about the discussed concepts. © The Author(s) 2013

Modeling Issues: A Survival Guide for a Non-expert Modeler

While developing an integral security model to be used in a Service Oriented Architecture (SOA) context, we find a lot of ambiguities and inaccuracies when authors speak of models, metamodels, profiles and so on. This led us to study a great number of references in a search for precise definitions to help us to address our research. Our study and discussions were so extensive that we are convinced they will be a valuable contribution to the community. In particular, in this paper we present several Reference Concept Maps that depict graphically a large number of definitions with their associated bibliographical references. Nevertheless, we truly believe that there are still a lot of concepts to be clarified and that this clarification is essential so that basic modeling concepts can be best used by non-expert modelers. © 2010 Springer-Verlag

Scholarly Publishing, Freedom of Information and Academic Self-Determination: The UNAM-Elsevier Case

On February 1, 2015, the global information and analytics corporation Elsevier and the National Autonomous University of Mexico (UNAM) established the agreement UNAM-Elsevier contract DGAJ-DPI-39-081114-241, which saw the transfer from UNAM to Elsevier for the "production and hosting, advertising and support" of 44 Mexican open access academic journals published by UNAM. This article documents said contract and describes a Freedom of Information Request enquiring the total cost of the contract and its corresponding response. It also shares a series of considerations that, based on this case, can be helpful to other institutions that may face similar circumstances in the future. We conclude scholarly publishing and academic self-determination are interdependent and a crucial point of future debate for the future of University presses and Open Access worldwide

Modeling Issues: A Survival Guide for a Non-expert Modeler

While developing an integral security model to be used in a Service Oriented Architecture (SOA) context, we find a lot of ambiguities and inaccuracies when authors speak of models, metamodels, profiles and so on. This led us to study a great number of references in a search for precise definitions to help us to address our research. Our study and discussions were so extensive that we are convinced they will be a valuable contribution to the community. In particular, in this paper we present several Reference Concept Maps that depict graphically a large number of definitions with their associated bibliographical references. Nevertheless, we truly believe that there are still a lot of concepts to be clarified and that this clarification is essential so that basic modeling concepts can be best used by non-expert modelers. © 2010 Springer-Verlag