AUTHIC: herramienta computacional para niños con espectro autista

[ES]El proyecto AUTHIC se enmarca en las denominadas Tecnologías de Ayuda y tiene como objetivo, desarrollar herramientas que auxilien a los niños con trastorno de espectro autista (TEA) a comprender y a interpretar las expresiones faciales asociadas a una emoción, mediante juegos interactivos supervisados por un terapeuta o sombra. Al tratarse de una investigación de carácter traslacional partimos de los hallazgos de las ciencias de la salud en la comprensión de la emoción y en la universalidad de las expresiones faciales de la emoción para fundamentar el desarrollo de aplicaciones multimedia que hacen uso de las metodologías del diseño centrado en el usuario y de la gamificación. Las rutinas de aprendizaje, hasta ahora realizadas, posibilitan el entrenamiento de los niños con TEA en la identificación de emociones de forma interactiva y amena

Kinetics of immune responses elicited after three mRNA COVID-19 vaccine doses in predominantly antibody-deficient individuals

Mass vaccination campaigns reduced COVID-19 incidence and severity. Here, we evaluated the immune responses developed in SARS-CoV-2-uninfected patients with predominantly antibody-deficiencies (PAD) after three mRNA-1273 vaccine doses. PAD patients were classified based on their immunodeficiency: unclassified primary antibody-deficiency (unPAD, n = 9), common variable immunodeficiency (CVID, n = 12), combined immunodeficiency (CID, n = 1), and thymoma with immunodeficiency (TID, n = 1). unPAD patients and healthy controls (HCs, n = 10) developed similar vaccine-induced humoral responses after two doses. However, CVID patients showed reduced binding and neutralizing titers compared to HCs. Of interest, these PAD groups showed lower levels of Spike-specific IFN-γ-producing cells. CVID individuals also presented diminished CD8+T cells. CID and TID patients developed cellular but not humoral responses. Although the third vaccine dose boosted humoral responses in most PAD patients, it had limited effect on expanding cellular immunity. Vaccine-induced immune responses in PAD individuals are heterogeneous, and should be immunomonitored to define a personalized therapeutic strategies.info:eu-repo/semantics/publishedVersio

Changes in humoral immune response after SARS-CoV-2 infection in liver transplant recipients compared to immunocompetent patients

The protective capacity and duration of humoral immunity after SARS-CoV-2 infection are not yet understood in solid organ transplant recipients. A prospective multicenter study was performed to evaluate the persistence of anti-nucleocapsid IgG antibodies in liver transplant recipients 6 months after coronavirus disease 2019 (COVID-19) resolution. A total of 71 liver transplant recipients were matched with 71 immunocompetent controls by a propensity score including variables with a well-known prognostic impact in COVID-19. Paired case-control serological data were also available in 62 liver transplant patients and 62 controls at month 3 after COVID-19. Liver transplant recipients showed a lower incidence of anti-nucleocapsid IgG antibodies at 3 months (77.4% vs. 100%, p <.001) and at 6 months (63.4% vs. 90.1%, p <.001). Lower levels of antibodies were also observed in liver transplant patients at 3 (p =.001) and 6 months (p <.001) after COVID-19. In transplant patients, female gender (OR = 13.49, 95% CI: 2.17-83.8), a longer interval since transplantation (OR = 1.19, 95% CI: 1.03-1.36), and therapy with renin-angiotensin-aldosterone system inhibitors (OR = 7.11, 95% CI: 1.47-34.50) were independently associated with persistence of antibodies beyond 6 months after COVID-19. Therefore, as compared with immunocompetent patients, liver transplant recipients show a lower prevalence of anti-SARS-CoV-2 antibodies and more pronounced antibody levels decline

Clinical and Ecological Impact of an Educational Program to Optimize Antibiotic Treatments in Nursing Homes (PROA-SENIOR): A Cluster, Randomized, Controlled Trial and Interrupted Time-Series Analysis

[Background] Antimicrobial stewardship programs (ASPs) are recommended in nursing homes (NHs), although data are limited. We aimed to determine the clinical and ecological impact of an ASP for NHs.[Methods] We performed a cluster, randomized, controlled trial and a before–after study with interrupted time-series analyses in 14 NHs for 30 consecutive months from July 2018 to December 2020 in Andalusia, Spain. Seven facilities implemented an ASP with a bundle of 5 educational measures (general ASP) and 7 added 1-to-1 educational interviews (experimental ASP). The primary outcome was the overall use of antimicrobials, calculated monthly as defined daily doses (DDD) per 1000 resident days (DRD).[Results] The total mean antimicrobial consumption decreased by 31.2% (−16.72 DRD; P = .045) with respect to the preintervention period; the overall use of quinolones and amoxicillin–clavulanic acid dropped by 52.2% (P = .001) and 42.5% (P = .006), respectively; and the overall prevalence of multidrug-resistant organisms (MDROs) decreased from 24.7% to 17.4% (P = .012). During the intervention period, 12.5 educational interviews per doctor were performed in the experimental ASP group; no differences were found in the total mean antimicrobial use between groups (−14.62 DRD; P = .25). Two unexpected coronavirus disease 2019 waves affected the centers increasing the overall mean use of antimicrobials by 40% (51.56 DRD; P < .0001).[Conclusions] This study suggests that an ASP for NHs appears to be associated with a decrease in total consumption of antimicrobials and prevalence of MDROs. This trial did not find benefits associated with educational interviews, probably due to the coronavirus disease 2019 pandemic.[Clinical Trials Registration] NCT03543605.Peer reviewe

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

Spatiotemporal Characteristics of the Largest HIV-1 CRF02_AG Outbreak in Spain: Evidence for Onward Transmissions

Background and Aim: The circulating recombinant form 02_AG (CRF02_AG) is the predominant clade among the human immunodeficiency virus type-1 (HIV-1) non-Bs with a prevalence of 5.97% (95% Confidence Interval-CI: 5.41–6.57%) across Spain. Our aim was to estimate the levels of regional clustering for CRF02_AG and the spatiotemporal characteristics of the largest CRF02_AG subepidemic in Spain.Methods: We studied 396 CRF02_AG sequences obtained from HIV-1 diagnosed patients during 2000–2014 from 10 autonomous communities of Spain. Phylogenetic analysis was performed on the 391 CRF02_AG sequences along with all globally sampled CRF02_AG sequences (N = 3,302) as references. Phylodynamic and phylogeographic analysis was performed to the largest CRF02_AG monophyletic cluster by a Bayesian method in BEAST v1.8.0 and by reconstructing ancestral states using the criterion of parsimony in Mesquite v3.4, respectively.Results: The HIV-1 CRF02_AG prevalence differed across Spanish autonomous communities we sampled from (p &lt; 0.001). Phylogenetic analysis revealed that 52.7% of the CRF02_AG sequences formed 56 monophyletic clusters, with a range of 2–79 sequences. The CRF02_AG regional dispersal differed across Spain (p = 0.003), as suggested by monophyletic clustering. For the largest monophyletic cluster (subepidemic) (N = 79), 49.4% of the clustered sequences originated from Madrid, while most sequences (51.9%) had been obtained from men having sex with men (MSM). Molecular clock analysis suggested that the origin (tMRCA) of the CRF02_AG subepidemic was in 2002 (median estimate; 95% Highest Posterior Density-HPD interval: 1999–2004). Additionally, we found significant clustering within the CRF02_AG subepidemic according to the ethnic origin.Conclusion: CRF02_AG has been introduced as a result of multiple introductions in Spain, following regional dispersal in several cases. We showed that CRF02_AG transmissions were mostly due to regional dispersal in Spain. The hot-spot for the largest CRF02_AG regional subepidemic in Spain was in Madrid associated with MSM transmission risk group. The existence of subepidemics suggest that several spillovers occurred from Madrid to other areas. CRF02_AG sequences from Hispanics were clustered in a separate subclade suggesting no linkage between the local and Hispanic subepidemics

Centro de recreación y desarrollo infantil en el municipio de Puebla, Pue

“Actualmente en la ciudad de Puebla, existe una amplia gama de centros y actividades recreativas enfocadas a la población adulta, ya que no se cuenta con espacios diseñados especialmente para la población infantil, estos se ven en la necesidad de tener que a adaptarse a dichos espacios. Otras condiciones como la inseguridad, la situación económica y los medios de comunicación, han generado cambios drásticos en los hábitos, costumbres y actividades de los niños. Provocando una creciente tendencia de obesidad, estrés infantil y llevándolos a una vida sedentaria. Para el desarrollo y crecimiento de los niños, un aspecto fundamental es el medio que los rodea, en el cual los niños desarrollan sus habilidades, hábitos y valores; así por medio del juego, experimentan, y aprenden. Por lo anterior, planteamos el diseño de un centro de recreación y desarrollo infantil, destinado para los habitantes de la colonia ‘‘Las Animas’, ubicada en el municipio de Puebla, en el estado de Puebla

Neonatal Infection Due to SARS-CoV-2: An Epidemiological Study in Spain

Objective: Coronavirus disease 2019 (COVID-19) cases caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to increase worldwide. Although some data from pediatric series are available, more evidence is required, especially in neonates, a group with specific characteristics that deserve special attention. This study aimed to describe general and clinical characteristics, management, and treatment of postnatal-acquired (community and nosocomial/hospital-acquired) COVID-19 neonatal cases in Spain. Methods: This was a national prospective epidemiological study that included cases from a National Registry supported by the Spanish Society of Neonatology. Neonates with postnatal SARS-CoV-2 infection were included in this study. General data and infection-related information (mode and source of transmission, age at diagnosis, clinical manifestations, need for hospitalization, admission unit, treatment administered, and complementary studies performed, hospital stay associated with the infection) were collected. Results: A total of 40 cases, 26 community-acquired and 14 nosocomial were registered. Ten were preterm newborns (2 community-acquired and 8 nosocomial COVID-19 cases). Mothers (in both groups) and healthcare workers (in nosocomial cases) were the main source of infection. Hospital admission was required in 22 community-acquired cases [18 admitted to the neonatal intermediate care unit (NIMCU) and 4 to the neonatal intensive care unit (NICU)]. Among nosocomial COVID-19 cases (n = 14), previously admitted for other reasons, 4 were admitted to the NIMCU and 10 to the NICU. Ten asymptomatic patients were registered (5 in each group). In the remaining cases, clinical manifestations were generally mild in both groups, including upper respiratory airways infection, febrile syndrome or acute gastroenteritis with good overall health. In both groups, most severe cases occurred in preterm neonates or neonates with concomitant pathologies. Most of the cases did not require respiratory support. Hydroxychloroquine was administered to 4 patients in the community-acquired group and to 2 patients in the nosocomial group. Follow-up after hospital discharge was performed in most patients. Conclusions: This is the largest series of COVID-19 neonatal cases in Spain published to date. Although clinical manifestations were generally mild, prevention, treatment, and management in this group are essential

La salud de la mujer en condiciones de vulnerabilidad, pobreza y desigualdad social en Córdoba, Colombia

El hecho de analizar la salud de la mujer en una región con altos índices de pobreza, desigualdad social e inequidad, como el Departamento de Córdoba (1,2), obliga a determinar no solo la concepción que se asume frente a la vida, los padecimientos y su relación con las condiciones de existencia o el entorno social, económico y político, sino, también, la forma en que los hombres y mujeres entienden, sienten y reaccionan ante su propio proceso de salud-enfermedad. En otras palabras, se trata de comprender las distintas realidades de cada persona; de forma tal que puedan ser valoradas con una mirada de alteridad, desde las circunstancias y situaciones que vive y experimenta el otro.AGRADECIMIENTOS..................................................9PRESENTACIÓN..............................................10INTRODUCCIÓN..........................................................12CAPÍTULO 1: FACTORES SOCIALES Y EMBARAZO ADOLESCENTE EN UNA POBLACIÓN DESPLAZADA DE MONTERÍA, CÓRDOBA, COLOMBIA................................25INTRODUCCIÓN .........................................................26OBJETIVO...............................................................31BASES TEÓRICAS..........................................................31MATERIALES Y MÉTODOS .................................................39RESULTADOS.....................................................................42DISCUSIÓN.............................................................................53CONCLUSIONES.....................................................................54REFERENCIAS..................................................................56CAPÍTULO 2: EMBARAZO EN LA ADOLESCENCIA: EFECTO DE LOS DETERMINANTES SOCIALES DE LA SALUD........................................................................................................................................63INTRODUCCIÓN......................................................64MATERIALES Y MÉTODOS.............................................................73RESULTADOS Y ANÁLISIS........................................................80DISCUSIÓN........................................................................................................98CONCLUSIONES.................................................................................102REFERENCIAS........................................................................................104CAPÍTULO 3: CREENCIAS EN SALUD ORAL DE UN GRUPO DE GESTANTES DE MONTERÍA, DEPARTAMENTO DE CÓRDOBA, COLOMBIA ................................................................112INTRODUCCIÓN............................................113OBJETIVO..............................................................115BASES TEÓRICAS.............................................116RUTA METODOLÓGICA.....................................................124RESULTADOS Y DISCUSIÓN.............................................127CONCLUSIONES..............................................................145REFERENCIAS.............................................147CAPÍTULO 4: TUVE QUE VIVIR UN VERDADERO VIACRUCIS PARA PODER RESIGNIFICAR MI FUTURO REPRODUCTIVO...............................................................................156INTRODUCCIÓN.........................................................157OBJETIVO.............................................................159RUTA METODOLÓGICA...............................................159RESULTADOS.....................................................................165DISCUSIÓN............................................................................173CONCLUSIONES...................................................179REFERENCIAS..............................................................181CAPÍTULO 5: LA CONFIGURACIÓN SOCIAL DE LA SÍFILIS CONSTRUIDA POR GESTANTES DE MONTERÍA, DEPARTAMENTO DE CÓRDOBA, COLOMBIA...................190INTRODUCCIÓN..............................................................191OBJETIVO................................................................194BASES TEÓRICAS............................................................194RUTA METODOLÓGICA............................................202RESULTADOS...................................................206DISCUSIÓN................................................................212CONCLUSIONES...............................................................217REFERENCIAS...................................................................217CAPÍTULO 6: TRAZOS SOCIODEMOGRÁFICOS DE LA SÍFILIS GESTACIONAL EN CÓRDOBA........................................224INTRODUCCIÓN...................................................225MATERIAL Y MÉTODO.....................................................228RESULTADOS............................................................230CONCLUSIONES.................................................................235REFERENCIAS................................................................236CAPÍTULO 7: LAS VOCES DE LAS MUJERES QUE LOGRAN SALIR DEL CICLO DE LA VIOLENCIA DE PAREJA ÍNTIMA.......................................................................................................240CAPÍTULO 7: LAS VOCES DE LAS MUJERES QUE LOGRAN SALIR DEL CICLO DE LA VIOLENCIA DE PAREJA ÍNTIMA.......................................................................................................240INTRODUCCIÓN.........................................................................241BASES TEÓRICAS.......................................................................244RUTA METODOLÓGICA..............................................247DISCUSIÓN..........................................................................264CONCLUSIÓN...................................................................269REFERENCIAS........................................................................269CAPÍTULO 8: ESTRATEGIAS DE AFRONTAMIENTO Y PERCEPCIONES DE CALIDAD DE VIDA DE MUJERES CON DIAGNÓSTICO DE CÁNCER DE MAMA EN EL DEPARTAMENTO DE CÓRDOBA EN EL PERIODO 2013-2017..................................................................................................275INTRODUCCIÓN...................................................276OBJETIVO..............................................................................279BASES TEÓRICAS..........................................................279MATERIALES Y MÉTODOS...........................................286RESULTADOS Y ANÁLISIS................................................289DISCUSIÓN..............................................................................301CONCLUSIONES..............................................................................304REFERENCIAS.................................................................................306CAPÍTULO 9: FUNCIONALIDAD FAMILIAR EN MUJERES QUE HAN PADECIDO CÁNCER DE MAMA....311INTRODUCCIÓN...............................................................312BASES TEÓRICAS...............................................................316MATERIALES Y MÉTODOS...............................................323RESULTADOS..............................................................................328DISCUSIÓN.......................................................................333CONCLUSIONES............................................................334REFERENCIAS..................................................................33