Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

COVID-19 outbreak in long-term care facilities from Spain. Many lessons to learn.

Background/objectivesTo analyze mortality, costs, residents and personnel characteristics, in six long-term care facilities (LTCF) during the outbreak of COVID-19 in Spain.DesignEpidemiological study.SettingSix open LTCFs in Albacete (Spain).Participants198 residents and 190 workers from LTCF A were included, between 2020 March 6 and April 5. Epidemiological data were also collected from six LTCFs of Albacete for the same period of time, including 1,084 residents.MeasurementsBaseline demographic, clinical, functional, cognitive and nutritional variables were collected. 1-month and 3-month mortality was determined, excess mortality was calculated, and costs associated with the pandemics were analyzed.ResultsThe pooled mortality rate for the first month and first three months of the outbreak were 15.3% and 28.0%, and the pooled excess mortality for these periods were 564% and 315% respectively. In facility A, the percentage of probable COVID-19 infected residents were 33.6%. Probable infected patients were older, frail, and with a worse functional situation than those without COVID-19. The most common symptoms were fever, cough and dyspnea. 25 residents were transferred to the emergency department, 21 were hospitalized, and 54 were moved to the facility medical unit. Mortality was higher upon male older residents, with worse functionality, and higher comorbidity. During the first month of the outbreak, 65 (24.6%) workers leaved, mainly with COVID-19 symptoms, and 69 new workers were contracted. The mean number of days of leave was 19.2. Costs associated with the COVID-19 in facility A were estimated at € 276,281/month, mostly caused by resident hospitalizations, leaves of workers, staff replacement, and interventions of healthcare professionals.ConclusionThe COVID-19 pandemic posed residents at high mortality risk, mainly in those older, frail and with worse functional status. Personal and economic costs were high

Estableciendo "puentes" entre la Universidad y el tejido social madrileño : cómo los estudiantes de la Asignatura Ciudad y Urbanismo pueden colaborar en la búsqueda de soluciones urbanísticas a históricas reclamaciones vecinales en el entorno de Puente de Vallecas

Publicación de los trabajos elaborados por los estudiantes del curso 2022/23 de la asignatura Ciudad y Urbanismo (35001304) de la Escuela Técnica Superior de Arquitectura de la Universidad Politécnica de Madrid en el marco de un proyecto de Aprendizaje-Servicio y reflexiones sobre el proceso tanto de los agentes sociales que formaron parte del mismo, como de los profesores que ha participado en la docencia

Currículo Educación Secundaria Obligatoria y relaciones entre sus elementos

Se recoge el articulado del Decreto 43/2015, de 10 de junio, por el que se regula la ordenación y se establece el currículo de Educación Secundaria Obligatoria en el Principado de Asturias, publicado en el BOPA (Boletín Oficial del Principado de Asturias) el 30 de junio de 2015. La publicación incluye además la metodología didáctica, los contenidos, los criterios de valuación y estándares de aprendizaje evaluables de las distintas materias troncales, específicas y de aquéllas de libre configuración autonómica, y el total de sesiones lectivas de las distintas asignaturas de los ciclos educativos de la Educación Secundaria Obligatoria.ES

Currículo Bachillerato y relaciones entre sus elementos

Contiene el Decreto 42/2015, de 10 de junio, por el que se regula la ordenación y se establece el currículo del Bachillerato en el Principado de Asturias. Publicado en el BOPA (Boletín Oficial del Principado de Asturias) el 29 de junio de 2015. Incluye además, la metodología didáctica, los contenidos, los criterios de valuación y estándares de aprendizaje evaluables de las distintas materias troncales, específicas y de aquéllas de libre configuración autonómica, y el total de sesiones lectivas de las distintas asignaturas del Bachillerato.ES

Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2