Using Big Data and Serverless Architecture to Follow the Emotional Response to the COVID-19 Pandemic in Mexico

The emergence of the COVID-19 pandemic has led to an unprecedented change in the lifestyle routines of millions of people. Beyond the multiple repercussions of the pandemic, we are also facing significant challenges in the population's mental health and health programs. Typical techniques to measure the population's mental health are semiautomatic. Social media allow us to know habits and daily life, making this data a rich silo for understanding emotional and mental well-being. This study aims to build a resilient and flexible system that allows us to track and measure the sentiment changes of a given population, in our case, the Mexican people, in response to the COVID-19 pandemic. We built an extensive data system utilizing modern cloud-based serverless architectures to analyze 760,064,879 public domain tweets collected from a public access repository to examine the collective shifts in the general mood about the pandemic evolution, news cycles, and governmental policies using open sentiment analysis tools. We provide metrics, advantages, and challenges of developing serverless cloud-based architectures for a natural language processing project of a large magnitude. © 2022, The Author(s).

Dysfunctional hemostasis in patients under extracorporeal life support. A rapid diagnostic approach with therapeutical guidance intentions

Background: Short-term cardiopulmonary extracorporeal life supports (ECLS) are invasive devices whose use has increased exponentially during the COVID-19 pandemic. Major bleeding is a main cause of morbi-mortality in ECLS patients and acquired von Willebrand disease (aVWD) could justify this complication. Aim(s): We aim at investigating the primary hemostasis alterations profile in ECLS patients, and to propose a potential treatment if bleeding. Method(s): Patients in ECLS at our center since June 2021 were included (n = 25). Primary hemostasis was evaluated by: Von Willebrand Factor antigen (VWF:Ag) and activity (VWF:GPIbM) measurement (immunoturbidimetry), VWF multimeric analysis (agarose-gels and immunoblotting), platelet function analysis (PFA-200), and platelet activation (CD62P and CD63 expression by flow cytometry). Studies were performed 24 h after implant, each 7 days, and in the first week after ECLS extraction. T-TAS was used for hemostasis analysis in samples from bleeding patients, before and after in vitro addition of purified VWF. This study was approved by the Hospital Clinic's Ethics Committee (HCB/2021/0200). Result(s): After 24 h of ECLS implant, increased VWF:Ag levels and prolonged PFA occlusion times. In 60% of patients, altered VWF:GPIbM/VWF:Ag ratio ( < 0.7) and loss of VWF high molecular weight multimers (HMWM) were observed. CD62P expression was slightly higher in ECLS patients platelets than in controls (MFI+/-SD of 4.34 +/- 2.2 vs. 3.27 +/- 0.6, respectively;p = 0.3). Early after ECLS extraction, there was normalization of the VWF multimeric profile and PFA values. Interestingly, in samples from bleeding patients, addition of purified VWF reduced significantly the T-TAS occlusion times (776 s+/-207 s vs. 1161 s+/-251 s, Mean+/-SD, post vs. pre, respectively;p = 0.033). Conclusion(s): ECLS caused primary hemostasis alterations, leading to aVWD and platelet activation, solved early after support removal. Hemostatic efficiency in ECLS bleeding patients, with lack of HMWM, was corrected in vitro by providing functional purified VWF. (Figure Presented).

Extracorporeal membrane oxigenation in COVID-19 patients: Results of the ECMO-COVID Registry of the Spanish Society of Cardiovascular and Endovascular Surgery

Background and aim: COVID-19 patients with severe heart or respiratory failure are potential candidates for extracorporeal membrane oxygenation (ECMO). Indications and management of these patients are unclear. Our aim is to describe the results of a prospective registry of COVID-19 patients treated with ECMO. Methods: An anonymous prospective registry of COVID-19 patients treated with veno-arterial (V-A) or veno-venous (V-V) ECMO was created on march 2020. Clinical, analytical and respiratory preimplantation variables, implantation data and post-implantation course data were recorded. The primary endpoint was all cause in-hospital mortality. Secondary events were functional recovery and the combined endpoint of mortality and functional recovery in patients followed at least 3 months after discharge. Results: Three hundred and sixty-six patients from 25 hospitals were analyzed, 347 V-V ECMO and 18 V-A ECMO patients (mean age 52.7 and 49.5 years respectively). Patients with V-V ECMO were more obese, had less frequently organ damage other than respiratory failure and needed less inotropic support;Thirty three percent of V-A ECMO and 34.9% of V-A ECMO were discharged (P = NS). Hospital mortality was non-significantly different, 56.2% versus 50.9% respectively, mainly during ECMO therapy and mostly due to multiorgan failure. Other 51 patients (14%) remained admitted. Mean follow-up was 196 ± 101.7 days (95%CI: 170.8-221.6). After logistic regression, body weight (OR 0.967, 95%CI: 0.95-0.99, P = 0.004) and ECMO implantation in the own centre (OR 0.48, 95%CI: 0.27-0.88, P = 0.018) were protective for hospital mortality. Age (OR 1.063, 95%CI: 1.005-1.12, P = 0.032), arterial hypertension (3.593, 95%CI: 1.06-12.19, P = 0.04) and global (2.44, 95%CI: 0.27-0.88, P = 0.019), digestive (OR 4,23, 95%CI: 1.27-14.07, P = 0.019) and neurological (OR 4.66, 95%CI: 1.39-15.62, P = 0.013) complications during ECMO therapy were independent predictors of primary endpoint occurrence. Only the post-discharge day at follow-up was independent predictor of both secondary endpoints occurrence. Conclusions: Hospital survival of severely ill COVID-19 patients treated with ECMO is near 50%. Age, arterial hypertension and ECMO complications are predictors of hospital mortality, and body weight and implantation in the own centre are protective. Functional recovery is only predicted by the follow-up time after discharge. A more homogeneous management of these patients is warranted for clinical results and future research optimization. © 2022 Sociedad Española de Cirugía Cardiovascular y Endovascular

Documento de consenso SEDAR/SECCE sobre el manejo de ECMO

Resumen La oxigenación por membrana extracorpórea (extracorporeal membrane oxygenation, ECMO) es un sistema extracorpóreo de asistencia cardiorrespiratoria cuya utilización se ha visto incrementada en la última década. La insuficiencia respiratoria, el shock postcardiotomía y el fallo primario del injerto cardíaco o pulmonar son complicaciones que pueden requerir la utilización de asistencia mecánica cardiorrespiratoria y, en este escenario, el conocimiento de las peculiaridades perioperatorias médicas y quirúrgicas es fundamental. A pesar de la evolución tecnológica en el área de la asistencia extracorpórea, la morbimortalidad de estos pacientes continúa siendo elevada, por lo tanto, la decisión del implante de la ECMO como la de su retirada debe establecerse dentro de un equipo multidisciplinar experto en el área. El presente documento de consenso pretende unificar conocimientos y aportar recomendaciones basadas tanto en la bibliografía reciente como en la experiencia de los principales centros nacionales implantadores de ECMO con el objetivo final de mejorar la atención integral al paciente. ECMO is an extracorporeal cardiorespiratory support system whose use has been increased in the last decade. Respiratory failure, postcardiotomy shock, and lung or heart primary graft failure may require the use of cardiorespiratory mechanical assistance. In this scenario perioperative medical and surgical management is crucial. Despite the evolution of technology in the area of extracorporeal support, morbidity and mortality of these patients continues to be high, and therefore the indication as well as the ECMO removal should be established within a multidisciplinary team with expertise in the area. This consensus document aims to unify medical knowledge and provides recommendations based on both the recent bibliography and the main national ECMO implantation centers experience with the goal of improving comprehensive patient care.

Visually impaired user experience using a 3D-enhanced facility management system for indoors navigation

We developed a 3D-Enhanced Facility Management System for Indoors Navigation (3D-EFMS-IN) to assist visually impaired users (VIU). Additionally, the system aims to facilitate the management of estate property and provide support for future scenarios related to emergencies, security, and robotics devices. The system combines four main subsystems: Mapping, Navigation Paths, Indoor Localisation and Navigation, and a Visualisation. An Integration of the subsystems has been done and a pretest with one VIU was performed to obtain feedback and tune the critical characteristics of our development. We observed that the system offers an acceptable preliminary user experience for VIU and future tests require to improve the latency of the system and usability. Shortly, we aim to obtain qualitative and quantitative measurements in a significant pool of users once the COVID lockdown ends. © 2020 ACM.

COVID-19: from epidemiology to treatment.

The COVID-19 pandemic has greatly impacted the daily clinical practice of cardiologists and cardiovascular surgeons. Preparedness of health workers and health services is crucial to tackle the enormous challenge posed by SARS-CoV-2 in wards, operating theatres, intensive care units, and interventionist laboratories. This Clinical Review provides an overview of COVID-19 and focuses on relevant aspects on prevention and management for specialists within the cardiovascular field.