Determine Risk Factors Associated with Chronic Low Back Pain in Patients from 30 to 50 Years of Age at HGZ No. 3 Tuxtepec, Oaxaca

Objetivo: Determinar cuáles son los factores de riesgo asociados a lumbalgia crónica en trabajadores de 30 a 50 años. Material y métodos: Es un estudio de investigación de índole retrospectivo, descriptivo, observacional, en donde, se evaluaron expedientes médicos correspondientes al servicio de Traumatología y Ortopedia comprendido de Enero 2021 a Diciembre 2021, el estudio de investigación incluyó a pacientes de 30 a 50 años con diagnóstico de lumbalgia que se encuentran en seguimiento por parte del servicio de traumatología y ortopedia del Hospital General de Zona No. 3, en base en el diagnóstico de salud del HGZ No. 3 Tuxtepec, Oaxaca, se obtuvo una muestra con fórmula de poblaciones finitas de 133 pacientes, el cuál se desarrolló en un tiempo de 6 meses. Resultados: Los datos fueron ingresados en el programa IBM SPSS versión 22.0 en donde se realizó el análisis mediante tablas de contingencia para el cálculo de las pruebas diagnósticas. Para las variables cuantitativas y cualitativas, se usó frecuencia y porcentaje, según la naturaleza de las variables las cuáles se expresaron en gráficas. Conclusiones: Dentro de los factores de riesgo mas significativos se encontró que el IMC juega un papel muy importante en el desarrollo de esta patología, siendo la mayoría de los trabajadores de está investigación portadores de sobrepeso u obesidad, así mismo se encontró que la mayoría de los pacientes tienen una ocupación de obrero, y que es en su centro de trabajo donde con mayor frecuencia se produce esta patología.Objective: To determine the risk factors associated with chronic low back pain in workers between 30 and 50 years of age.  Material and methods: It is a retrospective, descriptive, observational research study, where medical records corresponding to the Traumatology and Orthopedics service will be evaluated from January 2021 to December 2021, the research study used on patients from 30 to 50 years with a diagnosis of low back pain who are under follow-up by the traumatology and orthopedics service of the General Hospital of Zone No. 3, based on the health diagnosis of HGZ No. 3 Tuxtepec, Oaxaca, a sample was obtained with the formula of finite populations of 133 patients, which will take place in no more than 6 months. Results: The data will be entered into the IBM SPSS version 22.0 program where the analysis will be carried out using contingency tables to calculate the diagnostic tests. For quantitative and qualitative variables, frequency and percentage will be used, depending on the nature of the variables, which will be expressed in graphs.  Conclusions: Among the most significant risk factors, it was found that BMI plays a very important role in the development of this pathology, with the majority of the workers in this research being overweight or obese, and it was also found that the majority of patients They have a worker's occupation, and it is in their workplace where this pathology occurs most frequently

In Vitro Evaluation of Laser-Induced Periodic Surface Structures on New Zirconia/Tantalum Biocermet for Hard-Tissue Replacement

This study investigates the biological response of zirconia/tantalum biocermet materials with laser-induced periodic surface structures (LIPSS) generated using a femtosecond laser working at 1030 nm wavelength. LIPSS were formed by laser radiation slightly above the applied threshold fluence. LIPSS features were characterized using techniques such as atomic force microscopy (AFM) and X-ray photoelectron spectroscopy (XPS). LIPSS were generated in this study by applying femtosecond pulses with 500 fs pulse duration at a high-repetition rate to smooth-polished zirconia/tantalum biocermet surfaces, with an original roughness value of 3.8 ± 0.2 and 3.1 ± 0.2 nm, respectively. We have demonstrated in vitro that LIPSS are an efficient option to increase osteoblastic differentiation of human bone marrow mesenchymal stem cells (hBMSCs) in ZrO2:Ta biocermets. LIPSS created increase cell metabolism statistically (best values in 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay) and decrease inflammatory response to the material (IL-6 and TNF-alpha values). Extracellular matrix production (ECM) is produced in more quantity and cells differentiate to osteoblast easily. These differences are seen from the beginning until the endpoint (day 20)

Global change at the Polar regions

CSIC SCIENTIFIC CHALLENGES: TOWARDS 2030, Vol. 7: GLOBAL CHANGE IMPACTS, CHALLENGE 4The Polar Regions are key Earth’s climate regulators and, hence, any perturbation in their baseline conditions can have global repercussions. Owing their intrinsic particularities such as the presence of huge amounts of sea and continental ice, their terrestrial and marine ecosystems are highly sensitive to temperature fluctuations. In fact, both the Arctic and the Antarctic Peninsula are the regions where temperature has raised most and faster than any other Earth’s place. Moreover, other environmental issues related to anthropogenic changes such as the occurrence of contaminants, invasive species, emerging diseases and exploitation of living marine resources are also affecting the Polar Regions. Therefore, sound, detailed and long-term knowledge of the polar systems functioning, interactions and feedbacks is of paramount importance to establish and characterize the main impacts and consequences in both polar and extra-polar latitudes. Only then, efficient and environmentally friendly measures would be established both to mitigate the negative effects of current anthropogenic impactsPeer reviewe

Beneficial Effect of Ursodeoxycholic Acid in Patients with ACOX2 Deficiency-Associated Hypertransaminasemia

Background: A variant (p.Arg225Trp) of peroxisomal acyl-CoA oxidase 2 (ACOX2), involved in bile acid (BA) side-chain shortening, has been associated with unexplained persistent hypertransaminasemia and accumulation of C27-BAs, mainly trihydroxycholestanoic acid (THCA). Aims: To investigate the prevalence of ACOX2 deficiency-associated hypertransaminasemia (ADAH), its response to ursodeoxycholic acid (UDCA), elucidate its pathophysiological mechanism and identify other inborn errors that could cause this alteration. Methods & results: Among 33 patients with unexplained hypertransaminasemia from 11 hospitals, and 13 of their relatives, 7 individuals with abnormally high C27-BA levels (>50% of total BAs) were identified by HPLC-MS/MS. The p.Arg225Trp variant was found in homozygosity (exon amplification/sequencing) in 2 patients and 3 family members. Two additional non-related patients were heterozygous carriers of different alleles: c.673C>T (p.Arg225Trp) and c.456_459del (p.Thr154fs). In ADAH patients, impaired liver expression of ACOX2, but not ACOX3, was found (immunohistochemistry). Treatment with UDCA normalized transaminases levels. Incubation of HuH-7 liver cells with THCA, which was efficiently taken up, but not through BA transporters, increased ROS production (flow cytometry), ER stress biomarkers (GRP78, CHOP and XBP1-S/XBP1-U ratio), and BAX¿ expression (RT-qPCR and immunoblot), whereas cell viability was decreased (MTT). THCA-induced cell toxicity was higher than that of major C24-BAs and was not prevented by UDCA. Fourteen predicted ACOX2 variants were generated (site-directed mutagenesis) and expressed in HuH-7 cells. Functional tests to determine their ability to metabolize THCA identified six with the potential to cause ADAH. Conclusion: Dysfunctional ACOX2 has been found in several patients with unexplained hypertransaminasemia. This condition can be accurately identified by a non-invasive diagnostic strategy based on plasma BA profiling and ACOX2 sequencing. Moreover, UDCA treatment can efficiently attenuate liver damage in these patients.This study was supported by the following grants: CIBERehd (EHD15PI05/2016); Fondo de Investigaciones Sanitarias, Instituto de Salud Carlos III, Spain (PI19/00819 and PI20/00189), co-funded by European Regional Development Fund/European Social Fund, “Investing in your future”; “Junta de Castilla y León” (SA074P20); Fundació Marato TV3 (201916–31); AECC Scientific Foundation (2017/2020), Spain; and “Centro Internacional sobre el Envejecimiento” (OLD-HEPAMARKER, 0348_CIE_6_E), Spain. We also acknowledge support from grants PID2019-111669RBI- 100, PID2020-115055RB- I00 from Plan Nacional de I+D funded by the “Agencia Estatal de Investigación” (AEI) and the center grant P50AA011999 Southern California Research Center for ALPD and Cirrhosis funded by NIAAA/NIH, as well as support from AGAUR of the “Generalitat de Catalunya” SGR-2017- 1112, European Cooperation in Science & Technology (COST) ACTION CA17112 Prospective European Drug-Induced Liver Injury Network. Marta Alonso-Peña was the recipient of a predoctoral fellowship from “Ministerio de Educación, Cultura y Deporte” (BOE-A- 2015- 9456; FPU-14/ 00214) and a Mobility Grant for Short Stays from “Ministerio de Ciencia, Innovación y Universidades” (EST17/00186). Ricardo Espinosa-Escudero is the recipient of a predoctoral fellowship from “Junta de Castilla y León” and “Fondo Social Europeo” (EDU/574/2018). The funding sources were not involved in the research design or preparation of the articl

Beneficial effect of ursodeoxycholic acid in patients with acyl-CoA oxidase 2 (ACOX2) deficiency-associated hypertransaminasemia

Background and aims: A variant (p.Arg225Trp) of peroxisomal acyl-CoA oxidase 2 (ACOX2), involved in bile acid (BA) side-chain shortening, has been associated with unexplained persistent hypertransaminasemia and accumulation of C27-BAs, mainly 3?,7?,12?-trihydroxy-5?-cholestanoic acid (THCA). We aimed to investigate the prevalence of ACOX2 deficiency-associated hypertransaminasemia (ADAH), its response to ursodeoxycholic acid (UDCA), elucidate its pathophysiological mechanism and identify other inborn errors that could cause this alteration. Methods and results: Among 33 patients with unexplained hypertransaminasemia from 11 hospitals and 13 of their relatives, seven individuals with abnormally high C27-BA levels (>50% of total BAs) were identified by high-performance liquid chromatography-mass spectrometry. The p.Arg225Trp variant was found in homozygosity (exon amplification/sequencing) in two patients and three family members. Two additional nonrelated patients were heterozygous carriers of different alleles: c.673C>T (p.Arg225Trp) and c.456_459del (p.Thr154fs). In patients with ADAH, impaired liver expression of ACOX2, but not ACOX3, was found (immunohistochemistry). Treatment with UDCA normalized aminotransferase levels. Incubation of HuH-7 hepatoma cells with THCA, which was efficiently taken up, but not through BA transporters, increased reactive oxygen species production (flow cytometry), endoplasmic reticulum stress biomarkers (GRP78, CHOP, and XBP1-S/XBP1-U ratio), and BAX? expression (reverse transcription followed by quantitative polymerase chain reaction and immunoblot), whereas cell viability was decreased (tetrazolium salt-based cell viability test). THCA-induced cell toxicity was higher than that of major C24-BAs and was not prevented by UDCA. Fourteen predicted ACOX2 variants were generated (site-directed mutagenesis) and expressed in HuH-7 cells. Functional tests to determine their ability to metabolize THCA identified six with the potential to cause ADAH. Conclusions: Dysfunctional ACOX2 has been found in several patients with unexplained hypertransaminasemia. This condition can be accurately identified by a noninvasive diagnostic strategy based on plasma BA profiling and ACOX2 sequencing. Moreover, UDCA treatment can efficiently attenuate liver damage in these patients.Funding information: This study was supported by the following grants: CIBERehd (EHD15PI05/2016); Fondo de Investigaciones Sanitarias, Instituto de Salud Carlos III, Spain (PI19/00819 and PI20/00189), co-funded by European Regional Development Fund/European Social Fund, “Investing in your future”; “Junta de Castilla y León” (SA074P20); Fundació Marato TV3 (201916–31); AECC Scientific Foundation (2017/2020), Spain; and “Centro Internacional sobre el Envejecimiento” (OLD-HEPAMARKER, 0348_CIE_6_E), Spain. We also acknowledge support from grants PID2019-111669RBI-100, PID2020-115055RB-I00 from Plan Nacional de I+D funded by the “Agencia Estatal de Investigación” (AEI) and the center grant P50AA011999 Southern California Research Center for ALPD and Cirrhosis funded by NIAAA/NIH, as well as support from AGAUR of the “Generalitat de Catalunya” SGR-2017-1112, European Cooperation in Science & Technology (COST) ACTION CA17112 Prospective European Drug-Induced Liver Injury Network. Marta Alonso-Peña was the recipient of a predoctoral fellowship from “Ministerio de Educación, Cultura y Deporte” (BOE-A-2015-9456; FPU-14/00214) and a Mobility Grant for Short Stays from “Ministerio de Ciencia, Innovación y Universidades” (EST17/00186). Ricardo Espinosa-Escudero is the recipient of a predoctoral fellowship from “Junta de Castilla y León” and “Fondo Social Europeo” (EDU/574/2018). The funding sources were not involved in the research design or preparation of the article

Fingerprints as Predictors of Schizophrenia: A Deep Learning Study

Background and hypothesis: The existing developmental bond between fingerprint generation and growth of the central nervous system points to a potential use of fingerprints as risk markers in schizophrenia. However, the high complexity of fingerprints geometrical patterns may require flexible algorithms capable of characterizing such complexity. Study design: Based on an initial sample of scanned fingerprints from 612 patients with a diagnosis of non-affective psychosis and 844 healthy subjects, we have built deep learning classification algorithms based on convolutional neural networks. Previously, the general architecture of the network was chosen from exploratory fittings carried out with an independent fingerprint dataset from the National Institute of Standards and Technology. The network architecture was then applied for building classification algorithms (patients vs controls) based on single fingers and multi-input models. Unbiased estimates of classification accuracy were obtained by applying a 5-fold cross-validation scheme. Study results: The highest level of accuracy from networks based on single fingers was achieved by the right thumb network (weighted validation accuracy = 68%), while the highest accuracy from the multi-input models was attained by the model that simultaneously used images from the left thumb, index and middle fingers (weighted validation accuracy = 70%). Conclusion: Although fitted models were based on data from patients with a well established diagnosis, since fingerprints remain lifelong stable after birth, our results imply that fingerprints may be applied as early predictors of psychosis. Specially, if they are used in high prevalence subpopulations such as those of individuals at high risk for psychosis.This work was supported by several grants funded by the Instituto de Salud Carlos III and the Spanish Ministry of Science and Innovation (co-funded by the European Regional Development Fund/European Social Fund “Investing in your future”): Miguel Servet Research Contract (CPII13/00018 to RS, CPII16/00018 to EP-C, CP20/00072 to MF-V), PFIS Contract (FI19/0352 to MG-R). Research Mobility programme (MV18/00054 to EP-C), Research Projects (PI18/00877 and PI21/00525 to RS). It has also been supported by the Centro de Investigación Biomédica en Red de Salud Mental and the Generalitat de Catalunya: 2014SGR1573 and 2017SGR1365 to EP-C and SLT008/18/00206 to IF-R from the Departament de Salut. The authors have declared that there are no conflicts of interest in relation to the subject of this study.S

Remdesivir in Very Old Patients (≥80 Years) Hospitalized with COVID-19: Real World Data from the SEMI-COVID-19 Registry

Background: Large cohort studies of patients with COVID-19 treated with remdesivir have reported improved clinical outcomes, but data on older patients are scarce. Objective: This work aims to assess the potential benefit of remdesivir in unvaccinated very old patients hospitalized with COVID-19; (2) Methods: This is a retrospective analysis of patients >= 80 years hospitalized in Spain between 15 July and 31 December 2020 (SEMI-COVID-19 Registry). Differences in 30-day all-cause mortality were adjusted using a multivariable regression analysis. (3) Results: Of the 4331 patients admitted, 1312 (30.3%) were >= 80 years. Very old patients treated with remdesivir (n: 140, 10.7%) had a lower mortality rate than those not treated with remdesivir (OR (95% CI): 0.45 (0.29-0.69)). After multivariable adjustment by age, sex, and variables associated with lower mortality (place of COVID-19 acquisition; degree of dependence; comorbidities; dementia; duration of symptoms; admission qSOFA; chest X-ray; D-dimer; and treatment with corticosteroids, tocilizumab, beta-lactams, macrolides, and high-flow nasal canula oxygen), the use of remdesivir remained associated with a lower 30-day all-cause mortality rate (adjusted OR (95% CI): 0.40 (0.22-0.61) (p < 0.001)). (4) Conclusions: Remdesivir may reduce mortality in very old patients hospitalized with COVID-19

FabLab en Educación: propuesta formativa y práctica para la creación de recursos didácticos dirigida a la docencia del profesorado universitario

El proyecto de innovación docente FabLab (laboratorios de fabricación digital) en educación pretende dotar al profesorado de una serie de competencias tecnológicas y pedagógicas que le permita ofrecer al alumnado una formación mucho más rica, integradora de contenidos, inclusiva, y que facilite el empoderamiento del alumnado para el emprendimiento profesional. El objetivo principal del proyecto es promover un cambio pedagógico en el profesorado para que sea capaz de adaptarse a las exigencias de una sociedad cada vez más tecnológica y en la que se demanda unos tipos de competencias que claramente no pueden adquirirse en la Universidad si no se tiene acceso, mínimamente, a unos recursos y dispositivos tecnológicos. En este sentido, la creación del FabLab permite crear un espacio creativo y productivo relacionado con la tecnología que favorece el acceso a ella y la adquisición de unas competencias tecnológicas y didácticas que, por la salida profesional del alumnado, permitiría acercar las materias denominadas STEM a las chicas de las etapas educativas no universitarias para que continúen estudios superiores relacionadas con estas asignaturas. El proyecto se articula en torno a cuatro fases: formación y sensibilización, diseño y desarrollo de materiales docentes, implementación en el estudiantado y la evaluación. Para el desarrollo del mismo se ha necesitado dos cursos académicos en los que el profesorado ha recibido una formación tanto virtual como presencial por diferentes especialistas. Para la formación y asesoramiento se ha contado con dos profesores de centros de secundaria de Granada que ya manejan algunos de los recursos y dispositivos tecnológicos en sus aulas. Además, han recibido formación sobre la gamificación de la docencia y el diseño de insignias para cuando se las tengan que otorgar al alumnado. Se han conseguido realizar diversos proyectos tecnológicos utilizando la placa Arduino y los diferentes componentes y accesorios como, por ejemplo, un vehículo sigue líneas con sensores de proximidad y un ascensor de vehículos automatizado al detectar el vehículo en el interior. También se ha elaborado un material digital con Inkscape, GIMP y Tinkercad para la para la impresión en 3D de ficha para la gamificación de diversos juegos elaborados para el aprendizaje de, por ejemplo, los mitos griegos. Para la docencia habitual, la formación recibida, así como los dispositivos utilizados y los materiales realizados, son un elemento innovador que les permite al profesorado ofrecer unos recursos atractivos para los aprendizajes de los contenidos de las diferentes materias que imparten.The FabLab (digital fabrication laboratories) teaching innovation project in education aims to provide teachers with a series of technological and pedagogical skills that will enable them to offer students a much richer, more inclusive and inclusive education that integrates content and facilitates the empowerment of students for professional entrepreneurship. The main objective of the project is to promote a pedagogical change in the teaching staff so that they are able to adapt to the demands of an increasingly technological society that demands certain types of skills that clearly cannot be acquired at the University if they do not have access, minimally, to technological resources and devices. In this sense, the creation of the FabLab makes it possible to create a creative and productive space related to technology that favours access to it and the acquisition of technological and didactic skills that, due to the students' professional opportunities, would bring STEM subjects closer to girls in non-university educational stages so that they can continue higher studies related to these subjects. The project is structured around four phases: training and awareness-raising, design and development of teaching materials, implementation among students and evaluation. It has taken two academic years to develop the project, during which the teaching staff have received both virtual and face-to-face training from different specialists. Two teachers from secondary schools in Granada, who already use some of the technological resources and devices in their classrooms, have been involved in the training and assessment. In addition, they have received training on the gamification of teaching and the design of badges for when they have to award them to students. They have managed to carry out various technological projects using the Arduino board and the different components and accessories, such as a vehicle that follows lines with proximity sensors and an automated vehicle lift when it detects the vehicle inside. Digital material has also been developed with Inkscape, GIMP and Tinkercad for the 3D printing of cards for the gamification of various games developed for the learning of, for example, Greek myths. For regular teaching, the training received, as well as the devices used and the materials produced, are an innovative element that allows teachers to offer attractive resources for learning the contents of the different subjects they teach.Unidad de Calidad, Innovación Docente y Prospectiva de la Universidad de Granad

Programas de optimización del uso de antimicrobianos en hospitales: guía de recomendaciones de expertos para actividades en poblaciones específicas, síndromes y otros aspectos (PROA-2) de la SEIMC, SEFH, SEMPSPGS, SEMICYUC y SEIP

[EN] In 2012, The Spanish Societies of Infectious Diseases and Clinical Microbiology (SEIMC), Hospital Pharmacy (SEFH), and Preventive Medicine, Public Health and Healthcare Management (SEMPSGS) lead a consensus document including recommendations for the implementation of antimicrobial stewardship (AMS) programs (AMSP; PROA in Spanish) in acute care hospitals in Spain. While these recommendations were critical for the development of these programs in many centres, there is a need for guidance in the development of AMS activities for specific patient populations, syndromes or other specific aspects which were not included in the previous document or have developed significantly since then. The objective of this expert recommendation guidance document is to review the available information about these activities in these patient populations or circumstances, and to provide guidance recommendations about them. With this objective the SEIMC, SEFH, SEMPSPGS, the Spanish Society of Intensive Care Medicine (SEMICYUC) and the Spanish Pediatric Infectious Disease Society (SEIP) selected a panel of experts who chose the different aspects to include in the document. Because of the lack of high-level evidence in the implementation of the activities, the panel opted to perform a narrative review of the literature for the different topics for which recommendations were agreed by consensus. The document was open to public consultation for the members of these societies for their comments and suggestions, which were reviewed and considered by the panel.[ES] En 2012, las Sociedades Españolas de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), Farmacia Hospitalaria (SEFH) y Medicina Preventiva, Salud Pública y Gestión Sanitaria (SEMPSPGS) lideraron un documento de consenso que incluía recomendaciones para la implementación de Programas de optimización del uso de antimicrobianos (PROA) en hospitales de agudos en España. Si bien estas recomendaciones fueron críticas para el desarrollo de estos programas en muchos centros, actualmente es necesario establecer unas guías para la implementación de las actividades de los PROA en determinadas poblaciones de pacientes, síndromes clínicos y otros aspectos específicos que no se incluyeron en el documento previo o que desde entonces se han desarrollado significativamente. El objetivo de esta guía de recomendaciones de expertos es revisar la información disponible acerca de esas actividades en estas poblaciones o circunstancias de pacientes y proporcionar unas recomendaciones que sirvan de guía sobre ellas. Con este objetivo, la SEIMC, la SEFH y la SEMPSPGS, así como la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC) y la Sociedad Española de Infectología Pediátrica (SEIP), seleccionaron un panel de expertos que eligieron los diferentes aspectos a incluir en el documento. Debido a la ausencia de evidencia de alto nivel en la implementación de las diferentes actividades, el panel optó por realizar una revisión narrativa de la literatura de los diferentes aspectos, en los que las recomendaciones se acordaron por consenso. El documento se abrió para consulta pública a los miembros de estas sociedades para sus comentarios y sugerencias, que fueron revisadas y consideradas por el panel.Peer reviewe

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio