Impact of SARS-Cov-2 infection in patients with hypertrophic cardiomyopathy : results of an international multicentre registry

To describe the natural history of SARS-CoV-2 infection in patients with hypertrophic cardiomyopathy (HCM) compared with a control group and to identify predictors of adverse events. Three hundred and five patients [age 56.6 ± 16.9 years old, 191 (62.6%) male patients] with HCM and SARS-Cov-2 infection were enrolled. The control group consisted of 91 131 infected individuals. Endpoints were (i) SARS-CoV-2 related mortality and (ii) severe clinical course [death or intensive care unit (ICU) admission]. New onset of atrial fibrillation, ventricular arrhythmias, shock, stroke, and cardiac arrest were also recorded. Sixty-nine (22.9%) HCM patients were hospitalized for non-ICU level care, and 21 (7.0%) required ICU care. Seventeen (5.6%) died: eight (2.6%) of respiratory failure, four (1.3%) of heart failure, two (0.7%) suddenly, and three (1.0%) due to other SARS-CoV-2-related complications. Covariates associated with mortality in the multivariable were age {odds ratio (OR) per 10 year increase 2.25 [95% confidence interval (CI): 1.12-4.51], P = 0.0229}, baseline New York Heart Association class [OR per one-unit increase 4.01 (95%CI: 1.75-9.20), P = 0.0011], presence of left ventricular outflow tract obstruction [OR 5.59 (95%CI: 1.16-26.92), P = 0.0317], and left ventricular systolic impairment [OR 7.72 (95%CI: 1.20-49.79), P = 0.0316]. Controlling for age and sex and comparing HCM patients with a community-based SARS-CoV-2 cohort, the presence of HCM was associated with a borderline significant increased risk of mortality OR 1.70 (95%CI: 0.98-2.91, P = 0.0600). Over one-fourth of HCM patients infected with SARS-Cov-2 required hospitalization, including 6% in an ICU setting. Age and cardiac features related to HCM, including baseline functional class, left ventricular outflow tract obstruction, and systolic impairment, conveyed increased risk of mortality

An Eight-Year Followup Study after Heart Transplantation: The Relevance of Psychosocial and Psychiatric Background

A heart transplantation (HT) is performed when a patient’s heart health has been severely compromised. However, the health care needs of a patient throughout the transplantation process are also significant. In order to investigate these postoperative heart transplant challenges, this study has two objectives: to find which psychosocial and psychiatric variables relate to good prognosis at the end of the followup period and to assess cognitive status and quality of life at the end of the study. Therefore, we divided the sample according to the completion success and then studied and compared the differences in participants’ personality, coping mechanisms, locus of control, clinical, and epidemiological information. Cognitive function and quality of life assessments were also undertaken for participants who completed their followup period. Higher significant differences were found in openness to experience (personality), self-perceived support (locus of control), and positive reinterpretation (coping) among those who completed the followup period. On the other hand, a higher age and current or historical psychiatric diagnoses were more prevalent in the group who did not complete the followup period. Our assessment of the participants after the followup period showed normal levels of cognitive function and quality of life

An Eight-Year Followup Study after Heart Transplantation: The Relevance of Psychosocial and Psychiatric Background

A heart transplantation (HT) is performed when a patient’s heart health has been severely compromised. However, the health care needs of a patient throughout the transplantation process are also significant. In order to investigate these postoperative heart transplant challenges, this study has two objectives: to find which psychosocial and psychiatric variables relate to good prognosis at the end of the followup period and to assess cognitive status and quality of life at the end of the study. Therefore, we divided the sample according to the completion success and then studied and compared the differences in participants’ personality, coping mechanisms, locus of control, clinical, and epidemiological information. Cognitive function and quality of life assessments were also undertaken for participants who completed their followup period. Higher significant differences were found in openness to experience (personality), self-perceived support (locus of control), and positive reinterpretation (coping) among those who completed the followup period. On the other hand, a higher age and current or historical psychiatric diagnoses were more prevalent in the group who did not complete the followup period. Our assessment of the participants after the followup period showed normal levels of cognitive function and quality of life

Economic evaluation of a guided and unguided internet-based CBT intervention for major depression: Results from a multi-center, three-armed randomized controlled trial conducted in primary care

Depression is one of the most common mental disorders and will become one of the leading causes of disability in the world. Internet-based CBT programs for depression have been classified as “well established” following the American Psychological Association criteria for empirically supported treatments. The aim of this study is to analyze the cost effectiveness at 12-month follow-up of the Internet-based CBT program “Smiling is fun” with (LITG) and without psychotherapist support (TSG) compared to usual care. The perspective used in our analysis is societal. A sample of 296 depressed patients (mean age of 43.04 years; 76% female; BDI-II mean score = 22.37) from primary care services in four Spanish regions were randomized in the RCT. The complete case and intention-to-treat (ITT) perspectives were used for the analyses. The results demonstrated that both Internet-based CBT interventions exhibited cost utility and cost effectiveness compared with a control group. The complete case analyses revealed an incremental cost-effectiveness ratio (ICER) of €-169.50 and an incremental cost-utility ratio (ICUR) of €-11389.66 for the TSG group and an ICER of €-104.63 and an ICUR of €-6380.86 for the LITG group. The ITT analyses found an ICER of €-98.37 and an ICUR of €-5160.40 for the TSG group and an ICER of €-9.91 and an ICUR of €496.72 for the LITG group. In summary, the results of this study indicate that the two Internet-based CBT interventions are appropriate from both economic and clinical perspectives for depressed patients in the Spanish primary care system. These interventions not only help patients to improve clinically but also generate societal savings.This study was financed by the Instituto de Salud Carlos III of the Spanish Ministry of Economy and Competitiveness with the PI10/ 01083 grant (Eficacia y coste-efectividad de un programa de psicoterapia asistida por ordenador para el tratamiento de la depresio´n mayor en atencio´n primaria: estudio controlado, randomizado y cualitativo). The project also received funding from the Network for Prevention and Health Promotion in primary Care (RD12/ 0005) and CIBER Physiopathology Obesity and Nutrition (CB06/03) grants from the Instituto de Salud Carlos III of the Ministry of Economy and Competitiveness (Spain). Both grants are cofunded by European Regional Development Fund/ European Social Fund) "Investing in your future"). The first author (PRS) has a Rı´o Hortega contract awarded by the Instituto de Salud Carlos III (CM13/ 00115). The fourth author (JVL) has a Miguel Servet contract awarded by the Instituto de Salud Carlos III (CP14/00087

D6.9 INTEGRATION OF RESULTS: POLICYCLOUD COMPLETE ENVIRONMENT M36

This deliverable has been released in December 2022, at M36 of the project, and its main objective is to specify the final integration results between the PolicyCLOUD components. This deliverable will follow the methodology of D6.2 and D6.8 that were respectively submitted in M12 (December 2020) and M24 (December 2021) which have two main pillars: Define common practices for integration and validation of the outcomes of the project Detail the cloud environment the project will make use of to demonstrate the results Regarding the former, GitLab will be the base code repository for the project, where the project already owns an organizational account. Over GitLab [1], the trunk-based development branching policy has been applied, as we considered it the most suitable policy given the project characteristics. Also, GitLab’s issue reporting tool has been adopted, as it is fully integrated with GitLab’s features. The test bed to support the demonstrators has been deployed over EGI’s (EGI) infrastructure where flexibility is one of the critical features. This deliverable abstractly incorporates all the changes and implementations that WP2, WP3, WP4 and WP5 had made during the second year of the project. More details about the components and the actual implementation can be found in the related WP deliverables [7] [8] [9]. In detail, the schemas of the data have been finalized so the standard version that we defined initiated the data import to the repository of PolicyCLOUD. Moreover, the infrastructure (IaaS) and the platform deployment (PaaS/ Serverless) have been restructured and reshaped based on the latest needs of the components. EGI deployed the new flavour of PolicyCLOUD to the Openstack Infrastructure and IBM made the proper changes to the Openwhisk middleware for the serverless and other services. The related WP deliverables highlight detailed information and instructions for each component change that in total orchestrate the PolicyCLOUD engine.This deliverable is submitted to the EC, not yet approved

D2.7 CONCEPTUAL MODEL & REFERENCE ARCHITECTURE

The third and final version of the PolicyCLOUD Conceptual Model & Reference Architecture (originally submitted as Deliverable D2.2 in September 2020 [20] with the second version submitted as D2.6 in June 2021 [21]) is presented in this document. The PolicyCLOUD Conceptual Model presents the overall project concept along 2 main axes. Along the first data axis PolicyCLOUD delivers Cloud Gateways and APIs to access data sources and adapt to their interfaces so as to simplify interaction and data collection from any source. Along the second main axis, the Policies Management Framework of PolicyCLOUD allows the definition of forward-looking policies as well as their dynamic adaptation and refocusing to the population they are applied on. Based on the project’s offerings along the main two axes of the Concept, five main building blocks (in a layered manner) define its Architecture: (1) The Cloud Based Environment and Data Acquisition, (2) Data Analytics, (3) the Policies Management Framework, (4) the Policy Development Toolkit and (5) The Marketplace. The architecture also includes a Data Governance Model, Protection and Privacy Enforcement and the Ethical Framework as depicted in Figure 2. The architecture allows for integrated data acquisition and analytics. It also allows data fusion with processing and initial analytics (see 7.6.5) as well as seamless analytics (see 7.6.6) on hybrid data at rest. Integration in PolicyCLOUD follows three directions: (i) architecture integration, (ii) integration with the cloud infrastructure and (iii) integration with Use Case scenarios through the implementation of end-to- end scenarios. Additional integration activities take place along the two frameworks of PolicyCLOUD, (a) the Data Governance model, protection and privacy enforcement mechanism and (b) the Ethical and Legal Compliance framework. For end-to-end data path analysis we have used two Use Case scenarios: (i) the scenario of Use Case 1: “Radicalization incidents” and the scenario of Use Case 2: “Visualization of negative and positive opinions on social networks for different products”. The new updates in this final document provide the following: Analysis of how External Frameworks can be integrated with PolicyCLOUD (section 7.6.11.4); Presentation of the overall Conceptual View and architecture of the Data Marketplace (section 7.9.1); Outline of the mechanisms developed for initialising the Policy Development Toolkit with Policy Model components and the visualization of results (section 7.8.3); Analysis of the Ethical and Legal Compliance Framework positive interventions to the PolicyCLOUD architecture, including the addition of specific fields/parameters to the registration Application Programming Interfaces to be populated with details regarding each individual analytics tool and dataset/data source (section 7.5); Presentation of the integration of the Data Governance model, protection and privacy enforcement mechanisms with the Policy Development Toolkit, the cloud gateways and the marketplace (section 7.10.2), and within the same context, the integration of EGI-Check-in with Keycloak including the integration of the Data Governance model, protection and privacy enforcement mechanisms with the Kubernetes cluster. The document also addresses the Reviewers’ comments to the previous version of the deliverable (Deliverable D2.6), included in the second review report. In order to address these comments, additional updates of Deliverable D2.7 include: (i) links to specific user/stakeholder requirements (D2.5), (ii) descriptions and implementation details for the two remaining pilot Use Cases (Sofia and London) and (iii) reference to EOSC and to the role of the Conceptual Model & Reference Architecture document for the identification of the relevant services and of their providers, and description of the onboarding process based on Deliverable D3.4 [22].This deliverable is submitted to the EC, not yet approved

Impact of SARS‐Cov‐2 infection in patients with hypertrophic cardiomyopathy: results of an international multicentre registry

Abstract Aims To describe the natural history of SARS‐CoV‐2 infection in patients with hypertrophic cardiomyopathy (HCM) compared with a control group and to identify predictors of adverse events. Methods and results Three hundred and five patients [age 56.6 ± 16.9 years old, 191 (62.6%) male patients] with HCM and SARS‐Cov‐2 infection were enrolled. The control group consisted of 91 131 infected individuals. Endpoints were (i) SARS‐CoV‐2 related mortality and (ii) severe clinical course [death or intensive care unit (ICU) admission]. New onset of atrial fibrillation, ventricular arrhythmias, shock, stroke, and cardiac arrest were also recorded. Sixty‐nine (22.9%) HCM patients were hospitalized for non‐ICU level care, and 21 (7.0%) required ICU care. Seventeen (5.6%) died: eight (2.6%) of respiratory failure, four (1.3%) of heart failure, two (0.7%) suddenly, and three (1.0%) due to other SARS‐CoV‐2‐related complications. Covariates associated with mortality in the multivariable were age {odds ratio (OR) per 10 year increase 2.25 [95% confidence interval (CI): 1.12–4.51], P = 0.0229}, baseline New York Heart Association class [OR per one‐unit increase 4.01 (95%CI: 1.75–9.20), P = 0.0011], presence of left ventricular outflow tract obstruction [OR 5.59 (95%CI: 1.16–26.92), P = 0.0317], and left ventricular systolic impairment [OR 7.72 (95%CI: 1.20–49.79), P = 0.0316]. Controlling for age and sex and comparing HCM patients with a community‐based SARS‐CoV‐2 cohort, the presence of HCM was associated with a borderline significant increased risk of mortality OR 1.70 (95%CI: 0.98–2.91, P = 0.0600). Conclusions Over one‐fourth of HCM patients infected with SARS‐Cov‐2 required hospitalization, including 6% in an ICU setting. Age and cardiac features related to HCM, including baseline functional class, left ventricular outflow tract obstruction, and systolic impairment, conveyed increased risk of mortality