International Respiratory Infections Society COVID Research Conversations: Podcast 3 with Dr. Antoni Torres

Section(s) Topics 1–4 Introductions 5 “Spanish” influenza 6–9 Dr. Torres’ personal thoughts and experiences 10 COVID-19 hospitalizations in Barcelona 11 A threatening phone call 12–13 Origin of the CIBERESUCICOVID project 14 Baseline characteristics 15 Bloodwork at hospital admission; ICU admission vs. day 3 16 Treatments 17 Complications 18 Outcomes related to interventions 19 Viral RNA load in plasma associated with critical illness and dysregulated response 20 Follow-up with health care workers 21 Medical education 22 Conclusions 23–26 Interleukin 6 27–29 Ventilatory approach 30–33 Post-COVID syndrome 34–38 Impact on health care workers 39–41 Holidays and COVID-19 infection 42–43 New paradigm for medical education 44–45 Reducing travel for medical conferences 46–47 Improving treatment for COVID-19 48–53 Vaccination in Spain 54–57 Prioritizing clinical trials 58–65 COVID-19 as viral pneumonia 64–69 Thanks and sign-of

Perceptual mapping of mulitiple variable batteries by plotting supplementary variables in correspondence analysis of rating data

In this paper we consider the use of correspondence analysis (CA) of rating data. CA of rating data allows a joint representation of the rated items (e.g. attributes or products) and individuals. However, as the number of individuals increases, the interpretation of the CA map becomes difficult. To overcome this problem, we propose a method that allows the depiction of additional variables, for example, background characteristics that may be of interest in identifying consumer segments, in the CA map. The idea we use is based on the representation of supplementary variables in ordinary CA. However, as the format of the additional variables is typically different from the rating data, a recoding is required. We illustrate our new method by means of an application to data of a product perception study for five cream soups

Notes florístiques baleàriques. 2

Abstract not availabl

New Development in the core yarns manufacture

A new mechanism for the regulation of feeding tension of elastic filaments has been developed, in cooperation with a reputable manufacturer of textile machinery, to obtain “core spun” yarns. This device reduces, of a very significant form, the coefficient of variation of the elongation of the yarn and, consequently, the fabrics obtained with this yarns are more regular appearance. This mechanism is fundamental when the new spools of T-400, with diameter and weight superiors to the standard size, are processed.Postprint (published version

Helminth fauna of small mammals (insectivores and rodents) in Doñana (southeastern Iberian Peninsula)

Peer Reviewe

Biomarkers improve mortality prediction by prognostic scales in community-acquired pneumonia

Background: Prognostic scales provide a useful tool to predict mortality in community-acquired pneumonia (CAP). However, the inflammatory response of the host, crucial in resolution and outcome, is not included in the prognostic scales. Methods: The aim of this study was to investigate whether information about the initial inflammatory cytokine profile and markers increases the accuracy of prognostic scales to predict 30-day mortality. To this aim, a prospective cohort study in two tertiary care hospitals was designed. Procalcitonin (PCT), C-reactive protein (CRP) and the systemic cytokines tumour necrosis factor alpha (TNFalpha) and interleukins IL6, IL8 and IL10 were measured at admission. Initial severity was assessed by PSI (Pneumonia Severity Index), CURB65 (Confusion, Urea nitrogen, Respiratory rate, Blood pressure, > or = 65 years of age) and CRB65 (Confusion, Respiratory rate, Blood pressure, > or = 65 years of age) scales. A total of 453 hospitalised CAP patients were included. Results: The 36 patients who died (7.8%) had significantly increased levels of IL6, IL8, PCT and CRP. In regression logistic analyses, high levels of CRP and IL6 showed an independent predictive value for predicting 30-day mortality, after adjustment for prognostic scales. Adding CRP to PSI significantly increased the area under the receiver operating characteristic curve (AUC) from 0.80 to 0.85, that of CURB65 from 0.82 to 0.85 and that of CRB65 from 0.79 to 0.85. Adding IL6 or PCT values to CRP did not significantly increase the AUC of any scale. When using two scales (PSI and CURB65/CRB65) and CRP simultaneously the AUC was 0.88. Conclusions: Adding CRP levels to PSI, CURB65 and CRB65 scales improves the 30-day mortality prediction. The highest predictive value is reached with a combination of two scales and CRP. Further validation of that improvement is needed

Stability in community-acquired pneumonia: one step forward with markers?

Background: Biological markers as an expression of systemic inflammation have been recognised as useful for evaluating the host response in community-acquired pneumonia (CAP). The objective of this study was to evaluate whether the biological markers procalcitonin (PCT) and C-reactive protein (CRP) might reflect stability after 72 h of treatment and the absence of subsequent severe complications. Methods: A prospective cohort study was performed in 394 hospitalised patients with CAP. Clinical stability was evaluated using modified Halm's criteria: temperature (37.2uC; heart rate (100 beats/min; respiratory rate (24 breaths/min; systolic blood pressure >90 mm Hg; oxygen saturation >90%; or arterial oxygen tension >60 mm Hg. PCT and CRP levels were measured on day 1 and after 72 h. Severe complications were defined as mechanical ventilation, shock and/or intensive care unit (ICU) admission, or death after 72 h of treatment. Results: 220 patients achieved clinical stability at 72 h and had significantly lower levels of CRP (4.2 vs 7 mg/dl) and of PCT (0.33 vs 0.48 ng/ml). Regression logistic analyses were performed to calculate several areas under the ROC curve (AUC) to predict severe complications. The AUC for clinical stability was 0.77, 0.84 when CRP was added (p=0.059) and 0.77 when PCT was added (p=0.45). When clinical stability was achieved within 72 h and marker levels were below the cut-off points (0.25 ng/ml for PCT and 3 mg/dl for CRP), no severe complications occurred. Conclusions: Low levels of CRP and PCT at 72 h in addition to clinical criteria might improve the prediction of absence of severe complications

Randomized Trial of Ceftazidime-Avibactam vs Meropenem for Treatment of Hospital-Acquired and Ventilator-Associated Bacterial Pneumonia (REPROVE): Analyses per US FDA-Specified End Points

Background: Hospital-acquired and ventilator-associated pneumonia (HAP/VAP; nosocomial pneumonia) due to Gram-negative pathogens are associated with significant morbidity and mortality; treatment options for multidrug-resistant infections are limited. The pivotal phase III REPROVE trial evaluated the efficacy of ceftazidime-avibactam (CAZ-AVI) vs meropenem in the treatment of patients with HAP/VAP. Study results for prespecified analyses per US Food and Drug Administration-recommended trial end points are reported here. Methods: Hospitalized adults with HAP/VAP proven or suspected to be caused by a Gram-negative pathogen were randomized 1:1 to receive CAZ-AVI or meropenem for 7 to 14 days. The primary outcome was 28-day all-cause mortality in the intent-to-treat (ITT) population. Secondary outcomes included clinical cure at test of cure (TOC) in the ITT and microbiological ITT (micro-ITT) populations, and safety and tolerability throughout the study. Results: hundred seventy randomized patients received treatment and were included in the ITT population (CAZ-AVI, n = 436; meropenem, n = 434). CAZ-AVI was noninferior to meropenem for the primary end point (28-day all-cause mortality; ITT) based on the prespecified 10% noninferiority margin (CAZ-AVI, 9.6%; meropenem, 8.3%; difference, 1.5%; 95% confidence interval [CI], -2.4% to 5.3%) and for the clinical cure end point in the ITT population based on a prespecified -10% noninferiority margin (CAZ-AVI, 67.2%; meropenem, 69.1%; difference, −1.9%; 95% CI, -8.1% to 4.3%). Clinical cure rates at TOC for patients infected with CAZ-nonsusceptible pathogens were similar (CAZ-AVI, 75.5%; meropenem, 71.2%; micro-ITT). Safety data were consistent with established safety profiles for both agents. Conclusions: CAZ-AVI provides an important new treatment option for HAP/VAP due to Gram-negative pathogens, including CAZ-nonsusceptible strains