The main aim of this study was to compare coping strategies in obsessive-compulsive disorder (OCD) patients and a healthy control group during COVID-19 lockdown and to analyze the relationship with ...some variables which may influence results (depression, anxiety, comorbidity, subtype of obsession-compulsion). Method: There were 237 participants, 122 OCD and 115 healthy controls, aged 17-61 years old (M = 33.48, SD = 11.13). Results: Groups showed differences in the use of some adaptive strategies (positive reinterpretation, acceptance, humor) and maladaptive (denial, self-blame). Within obsessive-compulsive group, comorbidity affected the greater use of inappropriate strategies (denial, substance abuse and self-blame) while type of obsession-compulsion did not influence use. Anxiety and depression levels were related to the use of less adaptive strategies. Conclusions: These findings strengthen the need for training in the use of effective and adaptive coping strategies, making it necessary to improve clinical follow-up of these patients. It is relevant to be in contact with healthcare professionals, review medication and observe the anxiety and depression levels.
El objetivo de este estudio fue comparar las estrategias de afrontamiento utilizadas por pacientes con Trastorno obsesivo-compulsivo (TOC) durante el confinamiento debido a la COVID-19 frente a controles sanos y analizar su relación con algunas variables que pueden influir en los resultados (ansiedad, depresión, comorbilidad, tipo de obsesiones-compulsiones). Método: Los participantes fueron 237, 122 diagnosticados de Trastorno obsesivo-compulsivo y 115 controles sanos, con edades comprendidas entre 13 y 58 años (M = 34,60, DT = 10,41). Resultados: Los grupos presentaron diferencias en el uso de algunas estrategias adaptativas (reinterpretación positiva, aceptación, humor) y desadaptativas (negación, autoculpa). Dentro del grupo TOC, la comorbilidad afectó para el mayor uso de estrategias inadecuadas (negación, abuso de sustancias y autoculpa), mientras que el tipo de obsesiones-compulsiones no influyó en el uso de las mismas. Los niveles de ansiedad y depresión estaban relacionadas con el uso de estrategias menos adaptativas. Conclusiones: Estos hallazgos refuerzan la necesidad de entrenar en la utilización de estrategias de afrontamiento eficaces y adaptativas, siendo necesario mejorar el seguimiento clínico de estos pacientes. Es importante estar en contacto con profesionales de la salud, revisar la medicación y observar los niveles de ansiedad y depresión.
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GEOZS, IJS, IMTLJ, IZUM, KILJ, KISLJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Two types of cost-efficient antennas based on dielectric gradient index dielectric lens have been designed for 5G applications at 28 GHz. The first is a linearly polarized flat lens antenna (LP-FLA) ...for terrestrial 5G communications. The second is a novel circularly polarized stepped lens antenna (CP-SLA) for 5G satellite services. An efficient design method is presented to optimize and conform the lens topology to the radiation pattern coming from the antenna feeder. The LP-FLA is fed by a traditional linearly polarized pyramidal horn antenna (PHA). The CP-SLA is fed by an open-ended bow-tie waveguide cavity (BCA) antenna. This cavity feeder (BCA), using cross-sections with bow-tie shapes, allows having circular polarization at the desired frequency bandwidth. The two types of presented antennas have been manufactured in order to verify their performance by an easy, low-cost, three-dimensional (3D) printing technique based on stereolithography. The peak realized gain value for the flat (LP-FLA) and stepped (CP-SLA) lens antennas have been increased at 28 GHz to 25.2 and 24.8 dBi, respectively, by disposing the lens structures at the appropriated distance from the feeders. Likewise, using an array of horns (PHA) or open-ended bow-tie waveguide cavity (BCA) antenna feeders, it is possible to obtain a maximum steering angle range of 20° and 35°, for a directivity over 15 dBi and 10 dBi, in the planar and stepped lens antennas, respectively.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
3.
Low‐cost lens antenna for 5G multi‐beam communication Garcia‐Marin, Eduardo; Filipovic, Dejan S.; Masa‐Campos, Jose Luis ...
Microwave and optical technology letters,
November 2020, 2020-11-00, 20201101, Volume:
62, Issue:
11
Journal Article
Peer reviewed
A planar dielectric lens has been designed for low‐cost multi‐beam antennas in the 26‐GHz band of 5G communications. The lens feeder is a stacked‐patch microstrip antenna with four input ports, thus ...permitting four independent high‐directivity radiation beams. Maximum steering of 25° can be attained, which a simulated gain over 18 dB for all scanning angles. The antenna has been implemented with low‐cost manufacturing techniques. The feeder is fabricated as a printed circuit board, while the lens is realized as a perforated 3D‐printed dielectric piece. Experimental results confirm the multi‐beam capability of the lens system, suggesting that the spillover efficiency can be improved in further works.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
The main aim was to examine changes in coping strategies, anxiety and depression in obsessive-compulsive and schizophrenia patients during COVID-19, in addition to controlling the influence of ...intolerance to uncertainty and experiential avoidance.
The first time, the study comprised (15-30 April 2020) 293 patients, 113 of whom were diagnosed with obsessive-compulsive disorder, 61 with schizophrenia and 119 healthy controls, aged 13-77 years (
= 37.89,
= 12.65). The second time (15-30 November), the study comprised 195 participants (85 obsessive-compulsive patients, 42 schizophrenic patiens and 77 healthy controls participants). The evaluation was carried out through an online survey.
The clinical groups worsened over time in cognitive coping, anxiety and depression, while the control group only worsened in depression. Intergroup differences in anxiety, depression and coping strategies were maintained, highlighting the use of some maladaptive strategies (avoidance, spiritual) in clinical groups. Experiential avoidance and tolerance for uncertainty mainly affected coping.
The duration of COVID-19 not only produced changes in anxiety and depression in clinical groups but also in coping strategies to face this pandemic and its consequences.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Purpose
Venous thromboembolic disease (VTE) in critically ill patients has a high incidence despite prophylactic measures. This fact could be related to an inappropriate use of these measures due to ...the absence of specific VTE risk scores. To assess the current situation in Spain, we have performed a cross-sectional study, analyzing if the prophylactic measures were appropriate to the patients’ VTE risk.
Methods
Through an electronic questionnaire, we carried out a single day point prevalence study on the VTE prophylactic measures used in several critical care units in Spain. We performed a risk stratification for VTE in three groups: low, moderate–high, and very high risk. The American College of Chest Physicians guidelines were used to determine if the patients were receiving the recommended prophylaxis.
Results
A total of 777 patients were included; 62 % medical, 30 % surgical, and 7 % major trauma patients. The median number of the risk factors for VTE was four. According to the proposed VTE risk score, only 2 % of the patients were at low risk, whereas 83 % were at very high risk. Sixty-three percent of patients received pharmacological prophylaxis, 12 % mechanical prophylaxis, 6 % combined prophylaxis, and 19 % did not receive any prophylactic measure. According to criteria suggested by the guidelines, 23 % of medical, 71 % of surgical, and 70 % of major trauma patients received an inappropriate prophylaxis.
Conclusions
Most critically ill patients are at high or very high risk of VTE, but there is a low rate of appropriate prophylaxis. The efforts to improve the identification of patients at risk, and the implementation of appropriate prevention protocols should be enhanced.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Background:
Coronavirus disease (COVID-19) with acute respiratory distress syndrome is a life-threatening condition. A previous diagnosis of chronic liver disease is associated with poorer outcomes. ...Nevertheless, the impact of silent liver injury has not been investigated. We aimed to explore the association of pre-admission liver fibrosis indices with the prognosis of critically ill COVID-19 patients.
Methods:
The work presented was an observational study in 214 patients with COVID-19 consecutively admitted to the intensive care unit (ICU). Pre-admission liver fibrosis indices were calculated. In-hospital mortality and predictive factors were explored with Kaplan–Meier and Cox regression analysis.
Results:
The mean age was 59.58 (13.79) years; 16 patients (7.48%) had previously recognised chronic liver disease. Up to 78.84% of patients according to Forns, and 45.76% according to FIB-4, had more than minimal fibrosis. Fibrosis indices were higher in non-survivors Forns: 6.04 (1.42) versus 4.99 (1.58), p < 0.001; FIB-4: 1.77 (1.17) versus 1.41 (0.91), p = 0.020), but no differences were found in liver biochemistry parameters. Patients with any degree of fibrosis either by Forns or FIB-4 had a higher mortality, which increased according to the severity of fibrosis (p < 0.05 for both indexes). Both Forns HR 1.41 (1.11–1.81); p = 0.006 and FIB-4 HR 1.31 (0.99–1.72); p = 0.051 were independently related to survival after adjusting for the Charlson comorbidity index, APACHE II, and ferritin.
Conclusion:
Unrecognised liver fibrosis, assessed by serological tests prior to admission, is independently associated with a higher risk of death in patients with severe COVID-19 admitted to the ICU.
A poor implementation of VTE prophylactic measures recommended for critically ill patients has been observed in several epidemiological studies. The clinical factors associated with this have not ...been clearly established. The objective of our study was to identify which factors could be related to the inappropriate use of VTE prophylaxis.
Analytic epidemiological study based on different aspects of VTE prophylaxis performed on Spanish ICU patients. A multiple logistic regression analysis was conducted to identify the risk factors associated with inappropriate prophylaxis, according to the American College of Chest Physicians 2012 guidelines.
We enrolled 777 patients. On admission, 62% presented medical, 30% surgical and 8% major trauma pathology. Of all patients, 41% were receiving an inappropriate prophylaxis, including 19% which did not receive any prophylaxis. The presence of a contraindication for pharmacological prophylaxis (OR 3.91, 95% CI 2.50–6.10) and non-medical pathology at ICU admission (OR 11.09; 95% CI 7.63–16.12) were associated with inappropriate prophylaxis. In contrast, mechanical ventilation (OR 0.70, 95% CI 0.45–0.98), bed rest>48h (OR 0.61, 95% CI 0.49–0.98), the use of a protocol for VTE prophylaxis (OR 0.66, 95% CI 0.45–0.98) and a VTE risk scoring system (OR 0.49, 95% CI 0.24–0.98) were associated with adequate prophylaxis.
Our study highlighted a poor compliance with the VTE prophylaxis recommendations proposed for critical patients. The implementation of specific protocols for prophylaxis that include a correct evaluation according to VTE and haemorrhage risk, would allow for optimisation of mechanical and combined prophylaxis, improving adherence to the clinical practice guidelines.
•VTE is an important healthcare and socio-economic problem due to its high morbidity and mortality.•The use of VTE prophylaxis in ICU has shown to be effective, reducing its incidence.•A poor implementation of VTE prophylaxis in ICU has been observed in epidemiological studies.•According to guidelines, 41% of all patients were receiving an inappropriate prophylaxis.•Correct evaluation of thrombotic and bleeding risk optimises mechanical and combined prophylaxis use.•Implementation of prophylaxis protocols would improve adherence to clinical practice guidelines.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Two designs of conical-beam array antennas are presented for different fifth-generation applications. They are based on slotted cylindrical waveguides and a travelling-wave topology, where the ...waveguide is used to progressively excite a cross-slot array. A total of 384 cross-slots, formed by transversal and longitudinal slots, are grouped in rings of eight equally-spaced cross-slots. The propagation of TM 01 and TE 01 modes in the cylindrical waveguide can provide dual polarization by the independent excitation of transversal and longitudinal slots, respectively. Firstly, a dual linearly-polarized antenna design in the 37-40 GHz band is presented, conforming a high-gain conical-beam pattern. Secondly, a similar antenna design working in the 5G dual-band of 26-30 GHz and 37-40 GHz is also presented. In this last case, transversal and longitudinal slots are designed to radiate at two different frequency bands of 26-30 GHz (vertical polarization) and 37-40 GHz (horizontal polarization), recently assigned for very high-speed 5G applications. The dual-band design has been prototyped by combining 3D-printing and CNC milling techniques to experimentally validate the proposed topology, providing high experimental performance. Directive tilted omnidirectional coverages with peak realized gains around 14 dBi have been obtained, as well as a total efficiency between 83% and 90% for both frequency bands.
Some recent waveguide-based antennas are presented in this paper, designed for the next generation of communication systems operating at the millimeter-wave band. The presented prototypes have been ...conceived to be manufactured using different state-of-the-art techniques, involving subtractive and additive approaches. All the designs have used the latest developments in the field of manufacturing to guarantee the required accuracy for operation at millimeter-wave frequencies, where tolerances are extremely tight. Different designs will be presented, including a monopulse antenna combining a comparator network, a mode converter, and a spline profile horn; a tunable phase shifter that is integrated into an array to implement reconfigurability of the main lobe direction; and a conformal array antenna. These prototypes were manufactured by diverse approaches taking into account the waveguide configuration, combining parts with high-precision milling, electrical discharge machining, direct metal laser sintering, or stereolithography with spray metallization, showing very competitive performances at the millimeter-wave band till 40 GHz.
COVID-19 can course with respiratory and extrapulmonary disease. SARS-CoV-2 RNA is detected in respiratory samples but also in blood, stool and urine. Severe COVID-19 is characterized by a ...dysregulated host response to this virus. We studied whether viral RNAemia or viral RNA load in plasma is associated with severe COVID-19 and also to this dysregulated response.
A total of 250 patients with COVID-19 were recruited (50 outpatients, 100 hospitalized ward patients and 100 critically ill). Viral RNA detection and quantification in plasma was performed using droplet digital PCR, targeting the N1 and N2 regions of the SARS-CoV-2 nucleoprotein gene. The association between SARS-CoV-2 RNAemia and viral RNA load in plasma with severity was evaluated by multivariate logistic regression. Correlations between viral RNA load and biomarkers evidencing dysregulation of host response were evaluated by calculating the Spearman correlation coefficients.
The frequency of viral RNAemia was higher in the critically ill patients (78%) compared to ward patients (27%) and outpatients (2%) (p < 0.001). Critical patients had higher viral RNA loads in plasma than non-critically ill patients, with non-survivors showing the highest values. When outpatients and ward patients were compared, viral RNAemia did not show significant associations in the multivariate analysis. In contrast, when ward patients were compared with ICU patients, both viral RNAemia and viral RNA load in plasma were associated with critical illness (OR CI 95%, p): RNAemia (3.92 1.183-12.968, 0.025), viral RNA load (N1) (1.962 1.244-3.096, 0.004); viral RNA load (N2) (2.229 1.382-3.595, 0.001). Viral RNA load in plasma correlated with higher levels of chemokines (CXCL10, CCL2), biomarkers indicative of a systemic inflammatory response (IL-6, CRP, ferritin), activation of NK cells (IL-15), endothelial dysfunction (VCAM-1, angiopoietin-2, ICAM-1), coagulation activation (D-Dimer and INR), tissue damage (LDH, GPT), neutrophil response (neutrophils counts, myeloperoxidase, GM-CSF) and immunodepression (PD-L1, IL-10, lymphopenia and monocytopenia).
SARS-CoV-2 RNAemia and viral RNA load in plasma are associated with critical illness in COVID-19. Viral RNA load in plasma correlates with key signatures of dysregulated host responses, suggesting a major role of uncontrolled viral replication in the pathogenesis of this disease.
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