Pulmonary embolism at the emergency department during the COVID-19 pandemic. A comparative cohort study from a tertiary level hospital in southern Spain

This work was supported by the ‘Artificial Intelligence for the diagnosis and prognosis of COVID-19’ project (CV20-29480), funded by the Consejería de Transformación Económica, In- dustria, Conocimiento y Universidades, Junta de Andalucía, and the FEDER funds.Several studies have been published showing a significant increase in thrombotic complications in coronavirus disease 2019 (COVID-19) patients, including acute pulmonary embolism (PE). However, there is significant variability regarding published data on the number of computed tomography pulmonary angiography (CTPA) orders to rule out PE, frequency and characteristics of PE, and other factors that could have magnified the actual incidence of PE. The aim of this work is to analyze these factors during the first year of the pandemic. A longitudinal retrospective observational study was designed comparing two cohorts (preCOVID and COVID) of patients for whom an emergency CTPA was requested to rule out PE at the emergency department of our institution. Information was collected regarding the number of CTPAs requested, patient demographics, presence and extension of PE, and radiological signs of right ventricle strain/pulmonary hypertension (RVS/PH). Univariate and bivariate analyses were performed, with stratification by time intervals according to different pandemic waves in the COVID cohort. A total of 1905 patients (530 in the pre-COVID cohort and 1375 in the COVID cohort), with a mean age of 68.3 years (standard deviation, 16.5) and 981 (51.5%) women were included. No significant differences were observed regarding the incidence of PE between both cohorts. In patients with PE, no significant differences regarding age or sex were found, but a significantly higher frequency of peripheral PE was observed in the COVID cohort (42.0% vs. 6.5%, p < 0.001). Regarding signs of RVS/PH, a lower degree of septal deviation and contrast reflux to the inferior vena cava was observed in the COVID cohort, but no significant differences were observed in the right-to-left ventricular ratio. For the COVID cohort, the distribution of central vs. peripheral PE was similar in patients without laboratory-confirmed COVID-19 infection. Finally, the analysis of signs of RVS/PH stratifying by pandemic waves showed a lower frequency of RVS/PH signs in the 2nd and 3rd pandemic waves. In conclusion, despite a significantly higher number of CTPAs were performed during the pandemic, the incidence of PE was similar to that of the pre-pandemic period. A higher number of peripheral PE and less radiological signs of RVS/PH were observed during the pandemic. These findings could be explained by an increased incidental detection of PE during the pandemic. Our study has some limitations, mainly derived from its retrospective and single-center nature, which should be overcome in future research.Consejeria de Transformacion Economica, Industria, Conocimiento y Universidades CV20-29480Junta de AndaluciaEuropean Commissio

Synthesis and characterization of a cartilage model using hydroxyapatite, chitosan and polycaprolactone

El presente estudio se ha realizado en el marco del trabajo de fin de grado del autor principal. Agradecemos profundamente el trato y la ayuda prestada por los miembros del departamento de Histología de la facultad de Medicina de Granada.Introducción: El cartílago es una estructura clave que permite el deslizamiento de los huesos evitando la fricción y su desgaste. Sus propiedades biomecánicas vienen determinadas por la interacción entre sus componentes principales. La elevada incidencia de lesiones condrales ha originado un amplio número de estudios con objeto de tratar los defectos del cartílago articular. Las estrategias terapéuticas ensayas incluyen la terapia celular, el uso de biomateriales y, especialmente, la ingeniería tisular, que ha demostrado un gran potencial para tratar estos defectos. Se han ensayado diversos biomateriales para constructos tisulares e hidrogeles, incluyendo polímeros naturales y sintéticos. Objetivos: El objetivo de este trabajo es presentar un método de obtención de cartílago articular basado en quitosano (CS), policaprolactona (PCL) e hidroxiapatita (HA). Material y métodos: Se utilizaron como biomateriales de base el quitosano, policaprolactona y la hidroxiapatita. Se sintetizó una biomatriz de quitosano y policaprolactona mediante el método de disolución en medio ácido y la hidroxiapatita con productos químicos habituales. Se realizaron varias mezclas con distintas proporciones de quitosano, policaprolactona e hidroxiapatita y se evaluó su capacidad de absorción de agua, humedad, densidad, porosidad volumétrica y propiedades de procesamiento histológico, comparándose con los valores respectivos del cartílago articular normal. Resultados: De las mezclas ensayadas, la mezcla 80CS/15PCL/5HA mostró una mayor similitud al cartílago normal en los parámetros medidos. Asimismo, esta mezcla presentó unas características aptas para el procesamiento histológico habitual. Discusión: En este estudio se presenta un método sencillo y económico para obtener biomatrices basadas en quitosano, policaprolactona e hidroxiapatita. Para las proporciones ensayadas, la mezcla 80CS/15PCL/5HA presenta unas propiedades de gran interés para ser utilizada como modelo de cartílago articular artificial. En un futuro se caracterizarán otras propiedades biomecánicas y biológicas.Introduction: Articular cartilage (AC) is a key structure in bone displacement that limits its friction and subsequent erosion. The biochemical properties of AC are determined by the interaction of its constituents. The high incidence of chondral lesions has led to a number of studies aimed to developing therapies to heal cartilage defects. These include cell therapy, use of biomaterials and, especially, tissue engineering, which has shown promising results. Many biomaterials, including natural and synthetic polymers, have been explored to develop tissue constructs and hydrogels. Objectives: The present study aims to synthesize and evaluate bioscaffolds for articular cartilage made of chitosan (CS), polycaprolactone (PCL) and hyroxyapatite (HA). Materials and methods: CS, PCL and HA were used as biomaterials. CS-PCL bioscaffold was synthesized by acid solution method and HA with common chemicals. Several blends were prepared with varying percentages of CS, PCL and HA. Water uptake capability, humidity, density, volumetric porosity and properties of histological processing were assessed and compared to the values of normal AC. Results: For the assessed parameters and melts, the melt 80CS/15PCL/5HA showed the most similar values in comparison with normal cartilage. This melt also showed correct characteristics for standard histological processing. Discussion: In this study we present a simple and inexpensive method to obtain bioscaffolds based on CS, PCL and HA. For the percentages explored, the melt 80CS/15PCL/5HA showed promising properties to be used as artificial AC model. More biomechanical and biological properties shall be assessed in the future

Factors associated with readmission to the Emergency Department in a cohort of COVID-19 hospitalized patients

This work was supported by the 'Artificial Intelligence for the diagnosis and prognosis of COVID-19' project (CV20-29480), funded by the Consejeria de Transformacion Economica, Industria, Conocimiento y Universidades, Junta de Andalucia, and the FEDER funds. We acknowledge the Faculty of Medicine, University of Granada, for the successful organization of the final degree projects, since this work was designed and conducted during the project of Alvaro Romero-Duarte. We also acknowledge all the healthcare workers from the Department of Preventive Medicine and Public Health, San Cecilio University Hospital for their restless commitment during the pandemic of COVID-19 and their continuous efforts for investigating and communicating their results to the scientific community. Finally, we thank the SEMERGEN-UGR Chair of Teaching and Research in Family Medicine for being an example of support and encouragement in Primary Care research.Introduction: The aim of this study was to describe the symptomatology and main factors associated with readmission to the Emergency Department (ED) in COVID-19 patients discharged from hospital during the first wave of the pandemic at the San Cecilio University Hospital, Granada, Spain. Methods: An observational longitudinal study was conducted in a cohort of 441 patients admitted to our hospital with confirmed SARS-CoV-2 polymerase chain reaction (PCR) from 1 March to 15 April 2020. Patients were followed up through medical records 6 months after discharge. Sociodemographic, clinical and symptomatologic variables were collected. Descriptive, bivariate and multivariate logistic regression analyses were performed. Results: The mean age of patients in the cohort was 66.4 years (s = 15.3), with 55.1% men. In-hospital mortality was 18.1%. The presence of persistent symptomatology was high (64.5%), especially respiratory (53.2%), systemic (46.3%) and neurological (31.0%). A total of 75 (20.8%) patients were readmitted to the ED during the 6 months following hospital discharge. The main factors associated with readmission to the ED were polymedication (P = 0.031), living in a care home (P = 0.014), fever (P = 0.047), general malaise (P < 0.001), thoracic pain (P < 0.001), headache (P = 0.012), hematological symptoms (P = 0.011), nephrological symptoms (P = 0.047), depressive symptoms (P = 0.009), syncope or hypotension (P = 0.006) and superinfection (P = 0.018). After multivariate adjustment analysis, thoracic pain (OR: 4.45, 95% CI: 1.88– 10.52), general malaise and hematological symptoms (OR: 3.95, 95% CI: 1.12–13.89) remained as risk factors. Conclusions: The presence of persistent symptomatology after hospital discharge in our cohort was common and varied. Polymedication and living in a care home made up the most vulnerable profile of COVID-19 patients for returning to the ED. Thoracic pain, general malaise and hematological symptoms were identified as potential markers of severity, along with others predictors. These findings might be useful for optimizing follow-up strategies. Future studies conducted in other geographical areas are necessary to corroborate our results.'Artificial Intelligence for the diagnosis and prognosis of COVID-19' project - Consejeria de Transformacion Economica, Industria, Conocimiento y Universidades CV20-29480Junta de Andalucia European Commissio

Diseño de sistema de abastecimiento y distribución de agua potable para la comunidad de Quibuto, municipio de Telpaneca, departamento de Madriz

Se propone diseñar un sistema de abastecimiento y distribución de agua potable, se realiza un estudio socioeconómico a las familias beneficiadas por el proyecto, se hace un levantamiento topográfico para la determinación de las características del terreno, se realiza el aforo de la posible fuente de abastecimiento de agua, se estudia la calidad del agua de la fuente de captación, se hace un análisis hidráulico del sistema propuesto de abastecimiento de agua de la comunidad, se hace un estimado del presupuesto del sistema de abastecimiento de agua potable

Factors associated with mortality and sequelae in patients living in long-term facilities hospitalized for COVID-19: a longitudinal 6-month follow-up study

Objetivos: Evaluar los principales factores asociados al pronóstico (mortalidad, secuelas a los 6 meses y reingresos) de pacientes ingresados por COVID-19 en el Hospital Clínico San Cecilio que viven en una residencia para personas mayores. Métodos: Estudio observacional longitudinal realizado sobre la cohorte de 441 pacientes ingresados por COVID-19 confirmada por PCR en el Hospital Clínico San Cecilio entre los días 01/03/20 y 15/04/20. Dichos pacientes fueron seguidos, a través de sus historias clínicas, los 6 meses posteriores a su alta. Se recogieron variables sociodemográficas, de ingreso, clínicas, terapéuticas y secuelas. Se realizaron análisis descriptivos, bivariantes y modelos de regresión logística multivariante con el software estadístico R, a través de su herramienta R Commander. Resultados: La edad media de la cohorte fue de 66,4 años (s=15,3), con un 55,1% de varones. La mortalidad intrahospitalaria fue del 18,1%. Los pacientes que vivían en residencias de mayores tuvieron mayor edad media y mayores frecuencias de comorbilidades, mortalidad y reingresos hospitalarios. Durante los 6 meses posteriores al alta presentaron una alta frecuencia de secuelas (59%), y mayor frecuencia de confusión, problemas hematológicos, nefrológicos y sobreinfecciones. Los principales factores asociados a la mortalidad fueron la edad avanzada, sexo masculino, ingreso en UCI y vulnerabilidad al ingreso medida con escalas pronósticas clínicas. Conclusiones: Vivir en una residencia no constituyó un factor independiente de mortalidad, pero sí reunió a un grupo de especial vulnerabilidad frente a la COVID-19. Las causas de mortalidad analizas en este estudio podrían ser similares a las causas de mortalidad de las personas mayores en las residencias durante los primeros meses de la pandemia. Estos datos deben servir para optimizar las estrategias de manejo intrahospitalario y de seguimiento de personas mayores durante los meses posteriores al alta hospitalaria, e intentar disminuir la mortalidad no registrada por COVID-19 en esta población.Objectives: To evaluate the main factors associated with prognosis (mortality, sequelae at 6 months and readmissions) of patients admitted for COVID-19 at the Hospital Clínico San Cecilio who live in a long-term care facility. Methods: Longitudinal observational study carried out on the cohort of 441 patients admitted for COVID-19 confirmed by PCR at the Hospital Clínico San Cecilio between 01/03/20 and 15/04/20. These patients were followed up, through their medical records, for 6 months after discharge. Sociodemographic, admission, clinical, therapeutic and sequelae variables were collected. Descriptive and bivariate analyses and multivariate logistic regression models were performed with R statistical software, through its R Commander tool. Results: The mean age of the cohort was 66.4 years (s=15.3), with 55.1% male. In-hospital mortality was 18.1%. Patients living in nursing homes had higher mean age and higher frequencies of comorbidities, mortality and hospital readmissions. During the 6 months after discharge, they had a high frequency of sequelae (59%), and a higher frequency of confusion, hematologic and nephrological problems, and superinfections. The main factors associated with mortality were advanced age, male sex, admission to the ICU and vulnerability at admission measured with clinical prognostic scales. Conclusions: Living in a long-term care facility was not an independent factor of mortality, but it did bring together a group of special vulnerability to COVID-19. The causes of mortality analysed in this study could be similar to the causes of mortality of elderly people in nursing homes during the first months of the pandemic. These data should serve to optimize strategies for in-hospital management and follow-up of the elderly during the months following hospital discharge, and to try to reduce the unrecorded mortality due to COVID-19 in this population

Improving Emotion Recognition Systems by Exploiting the Spatial Information of EEG Sensors

Electroencephalography (EEG)-based emotion recognition is gaining increasing importance due to its potential applications in various scientific fields, ranging from psychophysiology to neuromarketing. A number of approaches have been proposed that use machine learning (ML) technology to achieve high recognition performance, which relies on engineering features from brain activity dynamics. Since ML performance can be improved by utilizing 2D feature representation that exploits the spatial relationships among the features, here we propose a novel input representation that involves re-arranging EEG features as an image that reflects the top view of the subject’s scalp. This approach enables emotion recognition through image-based ML methods such as pre-trained deep neural networks or "trained-from-scratch" convolutional neural networks. We have employed both of these techniques in our study to demonstrate the effectiveness of our proposed input representation. We also compare the recognition performance of these methods against state-of-the-art tabular data analysis approaches, which do not utilize the spatial relationships between the sensors. We test our proposed approach using two publicly available benchmark datasets for EEG-based emotion recognition tasks, namely DEAP and MAHNOB-HCI. Our results show that the "trained-from-scratch" convolutional neural network outperforms the best approaches in the literature, achieving 97.8% and 98.3% accuracy in valence and arousal classification on MAHNOB-HCI, and 91% and 90.4% on DEAP, respectively

Synthesis of quinoxaline 1,4-di-N-oxide derivatives on solid support using room temperature and microwave-assisted solvent-free procedures

We describe the synthesis of 12 new ethyl and methyl quinoxaline-7-carboxylate 1,4-di-N-oxide derivatives on solid supports with room temperature and microwave-assisted solvent-free procedures. Results show that solid supports have good catalytic activity in the formation of quinoxaline 1,4-di-N-oxide derivatives. We found that florisil and montmorillonite KSF and K10 could be used as new, easily available, inexpensive alternatives of catalysts. Additionally, room temperature and microwave-irradiation solvent-free synthesis was more efficient than a conventional procedure (Beirut reaction), reducing reaction time and increasing yield

Gestión de riesgos para la prevención de financiamiento al terrorismo para las distribuidoras de hidrocarburos y tiendas de conveniencia del municipio de Apopa.

El planteamiento de la gestión de riesgo para la prevención de financiamiento al terrorismo, supone una herramienta que oriente al profesional de contaduría pública, para profundizar en la identificación de situaciones de riesgo, las causas, consecuencias y posibles planes de acción que le permitan desarrollar la actividad de la entidad encontrándose dentro del marco de las disposiciones legales, convenios o recomendaciones locales como internacionales, cuyo fin es el de reducir o eliminar operaciones de carácter ilícito tipificadas como financiamiento al terrorismo. Para ello se analizaron los puntos críticos de la exposición al riesgo de las distribuidoras de hidrocarburos, se cuantifico impacto del riesgo en la entidad con los controles actuales considerando la probabilidad e impacto de los eventos posibles que amenacen las operaciones del negocio y se formularon controles para la mitigación de riesgos y se ejecutó nuevamente la cuantificación del impacto si los controles propuestos fueran implementados por la entidad. Las fuentes de consulta para la investigación fueron las estaciones de servicio y sus tiendas de conveniencia; las cuales, no han tomado el grado de importancia que el delito de financiamiento al terrorismo implica para ellas, pues no se han establecido, procedimientos o políticas referentes a la temática poniendo en riesgo su operatividad si se llegase a mantener cualquier tipo de relaciones con grupos catalogados como terroristas. Es por esta razón que surge la necesidad de crear una herramienta que brinde al profesional de la contaduría pública, una guía para la identificación, valoración, y mitigación de los riesgos, para no cometer en los delitos que conlleva el pago de una extorsión a grupos catalogados como terroristas por nuestra legislación. Para recabar información se utilizó el método de la encuesta, el resultado obtenido de las unidades de análisis, permitió establecer un marco de referencia de la situación actual del sector, el contexto en el que las entidades desarrollan sus actividades económicas, el grado de conocimiento en materia de prevención en financiamiento al terrorismo, que poseen tanto los contadores como los gerentes de cada estación de servicios y de controles o procedimientos establecidos para la mitigación de contingencias. Como resultado del proceso de investigación se puede exponer que: las entidades poseen controles en función de prevenir situaciones de riesgo, pero estos no establecen un plan de acción en caso la situación de riesgo no sea evitada y suceda; tampoco, dichos controles, crean procedimientos encaminados a tratar de manera específica la prevención de financiamiento al terrorismo. A la vez, como resultado de la investigación se recomendó que las entidades implementen una política de gestión de riesgo para la prevención de financiamiento al terrorismo, tomando en cuenta los factores internos y externos que puedan afectar la operatividad, su reputación, así mismo dar cumplimiento a las disposiciones legales y normativa técnica aplicable

The New Methodologies for Learning how to Teach a Foreign Language by Using Virtual Tools

This final report focuses in an online specialization course, developed from August, 2021, to February, 2022. This was the first experience that the Department of Foreign Languages had offering this innovating course. It served as a new modality that students could take as a substitute for the classic graduation work. In the new plan, students learned about how to apply technological strategies and how to exploit other tools that nowadays the technology offers us to be updated. One important thing is that the course was developed online by professors who were very capable to contribute to students´ learning and at the same time to prepare them to deal the technological and professional environment which have become so popular after the coronavirus pandemic. The experiences, main activities and principal course achievements are detailed in the present report. Key Words: Virtual Classroom ; Language Learning Theories ; Language Learning Strategy (LLS) ; Information and Communication Technologies (ICTs) and Asynchronous and Synchronous Communicative