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Health care workers (HCW) are a high-risk population to acquire SARS-CoV-2 infection from patients or other fellow HCW. This study aims at estimating the seroprevalence against SARS-CoV-2 in a random sample of HCW from a large hospital in Spain. Of the 578 participants recruited from 28 March to 9 April 2020, 54 (9.3%, 95% CI: 7.1–12.0) were seropositive for IgM and/or IgG and/or IgA against SARS-CoV-2. The cumulative prevalence of SARS-CoV-2 infection (presence of antibodies or past or current positive rRT-PCR) was 11.2% (65/578, 95% CI: 8.8–14.1). Among those with evidence of past or current infection, 40.0% (26/65) had not been previously diagnosed with COVID-19. Here we report a relatively low seroprevalence of antibodies among HCW at the peak of the COVID-19 epidemic in Spain. A large proportion of HCW with past or present infection had not been previously diagnosed with COVID-19, which calls for active periodic rRT-PCR testing in hospital settings. Health care workers (HCW) are a high-risk population for SARS-CoV-2 infection. Here, the authors determine seroprevalence against SARS-CoV-2 in HCWs of a large Spanish reference hospital and find a cumulative prevalence of SARS-CoV-2 infection (presence of antibodies or past or current positive rRT-PCR) of 11%.

Unraveling the long-term kinetics of antibodies to SARS-CoV-2 and the individual characteristics influencing it, including the impact of pre-existing antibodies to human coronaviruses causing common cold (HCoVs), is essential to understand protective immunity to COVID-19 and devise effective surveillance strategies. IgM, IgA and IgG levels against six SARS-CoV-2 antigens and the nucleocapsid antigen of the four HCoV (229E, NL63, OC43 and HKU1) were quantified by Luminex, and antibody neutralization capacity was assessed by flow cytometry, in a cohort of health care workers followed up to 7 months ( N  = 578). Seroprevalence increases over time from 13.5% (month 0) and 15.6% (month 1) to 16.4% (month 6). Levels of antibodies, including those with neutralizing capacity, are stable over time, except IgG to nucleocapsid antigen and IgM levels that wane. After the peak response, anti-spike antibody levels increase from ~150 days post-symptom onset in all individuals (73% for IgG), in the absence of any evidence of re-exposure. IgG and IgA to HCoV are significantly higher in asymptomatic than symptomatic seropositive individuals. Thus, pre-existing cross-reactive HCoVs antibodies could have a protective effect against SARS-CoV-2 infection and COVID-19 disease. Long-term characterisation of SARS-CoV-2 antibody kinetics is needed to understand the protective role of the immune response. Here the authors describe antibody levels and neutralisation activity in healthcare workers over seven months and investigate the role of immunity to endemic human coronaviruses.

MRI plays an increasingly important role in the diagnosis of status epilepticus (SE). Approximately half of patients with SE do not have pre-existing epilepsy, and the cause of de novo SE is frequently unknown. The role of MRI in the identification of causes of SE is invaluable. MRI is often helpful as a diagnostic tool in cases of non-convulsive status epilepticus (NCSE) with ambiguous EEG findings. Thus, MRI is recommended for all patients presenting with de novo SE, patients with known epilepsy with the first episode of SE and NCSE with equivocal EEG. Different peri-ictal MRI (PMA) alterations may be seen during ongoing SE or briefly after its cessation. They commonly present as peri-ictal hyper-perfusion, diffusion restriction and/or FLAIR-hyperintensity affecting specific brain areas such as the cortex, hippocampus, pulvinar of the thalamus, splenium of the corpus callosum, claustrum or cerebellum, frequently in combination, suggesting the existence of a “status epilepticus network”. MRI sequences, which are necessary for detecting PMA, include diffusion-weighted imaging, fluid attenuated inversion recovery, T1-weighted imaging with and without contrast application, as well as perfusion sequences such as arterial spin labeling. Recent research suggests that they may serve as biomarkers for predicting an outcome in SE. Patients with PMA seem to have a higher mortality rate compared to those without PMA. However, there is still a substantial knowledge gap and there are many open questions related to imaging in SE. Further prospective quantitative MRI studies with uniform protocols, timing and follow-up periods are needed to answer these important and clinically relevant questions.

Telemonitoring for inflammatory bowel disease (IBD) has not consistently demonstrated superiority over standard care; however, noninferiority may be an acceptable outcome if remote care proves to be more efficient. This study aims to compare the remission time and quality of life of patients with active IBD managed through standard care versus the TECCU (Telemonitoring of Crohn Disease and Ulcerative Colitis) app. A 2-arm, randomized, multicenter trial with a noninferiority design was conducted across 24 hospitals in Spain. The study included adult patients with IBD who were starting immunosuppressive or biological therapy. Participants were randomized into 2 groups: the telemonitoring group (G_TECCU) and the standard care group (G_Control). The follow-up schedule for the telemonitoring group (G_TECCU) was based on contacts via the TECCU app, while the control group (G_Control) adhered to standard clinical practice, which included in-person visits and telephone calls. In both groups, treatment adjustments were made based on the progression of disease activity and medication adherence, assessed using specific indices and biological markers at each check-up. The primary outcome was the duration of remission after 12 weeks, while secondary outcomes included quality of life, medication adherence, adverse events, and patient satisfaction. Of the 169 patients enrolled, 158 were randomized and 150 were analyzed per protocol: telemonitoring (n=71) and control (n=79). After 12 weeks, the time in clinical remission was not inferior in the telemonitoring group (mean 4.20, SD 3.73 weeks) compared with the control group (mean 4.32, SD 3.28 weeks), with a mean difference between arms of -0.12 weeks (95% CI -1.25 to 1.01; noninferiority P=.02). The mean reduction in C-reactive protein values was -15.40 mg/L (SD 90.15 mg/L; P=.19) in the G_TECCU group and -13.16 mg/L (SD 54.61 mg/L; P=.05) in the G_Control group, with no significant differences between the 2 arms (P=.73). Similarly, the mean improvement in fecal calprotectin levels was 832.3 mg/L (SD 1825.0 mg/L; P=.003) in the G_TECCU group and 1073.5 mg/L (SD 3105.7 mg/L; P=.03) in the G_Control group; however, the differences were not statistically significant (P=.96). Quality of life improved in both groups, with a mean increase in the 9-item Inflammatory Bowel Disease Questionnaire score of 13.44 points (SD 19.1 points; P<.001) in the G_TECCU group and 18.23 points (SD 22.9 points; P=.001) in the G_Control group. Additionally, the proportion of patients who adhered to their medication significantly increased from 35% (25/71) to 68% (48/71) in the G_TECCU group (P=.001) and from 46% (36/79) to 73% (58/79) in the G_Control group (P=.001). The satisfaction rate remained stable at around 90%, although noninferiority was not demonstrated for the secondary outcomes. Telemonitoring patients with active IBD is not inferior to standard care for achieving and maintaining short-term remission. The TECCU app may serve as a viable alternative follow-up tool, pending confirmation of improved health outcomes and cost-effectiveness over the long-term. ClinicalTrials.gov NCT06031038; https://clinicaltrials.gov/ct2/show/NCT06031038. RR2-10.2196/resprot.9639.

Epilepsy is widely known as a network disease. Ictal and interictal activities are generated and spread within the existing networks involving different regions of the brain. Network alterations affect both grey and white matter, deep brain nuclei, including those of the ascending reticular formation. These structures may be involved in a disorganized connectome associated with epilepsy. A growing body of neuroimaging and neuropsychological findings suggests that global and focal network aberrations are closely linked to cognitive deficits in epilepsy patients. This evidence relates equally to focal epilepsies, such as temporal lobe epilepsy or extra-temporal lobe epilepsy, as well as generalized epilepsies, such as juvenile myoclonic epilepsy. Network abnormalities have been associated with a broad range of cognitive impairments, including language, memory, and executive functions, as well as sensory and motor functions. Whole-brain structural connectome models help in the understanding of seizure generation and spread. Identifying key nodes of seizure propagation may help in planning surgical procedures in individual patients by simulating epilepsy surgery on virtual models. Functional connectomic profiles may predict seizure outcomes in patients who undergo deep brain stimulation due to intractable seizures. Therefore, individualized interventional strategies could be developed based on connectome characteristics.

This work analyzes the role of the women's press in the political construction of the feminism based on the magazine Nosotras. The conditions of production of the publication are studied, and the discussions that arise around the definition of feminism and its political nature. It seeks to account for the way in which the publication contributes to consolidating the foundations of the main feminist currents of the period: the liberal and socialist currents. Este trabajo analiza el papel de la prensa femenina en la construcción política del feminismo a partir de la revista Nosotras. Se estudian las condiciones de producción de la publicación y las discusiones que se plantean en torno a la definición del feminismo y al carácter político del mismo. Se busca dar cuenta del modo en que la publicación contribuye a consolidar los fundamentos de las principales corrientes feministas del período: la corriente liberal y la socialista.

Intracerebral hemorrhages (ICH) during implantation of stereo‐EEG electrodes are rare. The impact of tobacco‐free nicotine consumption on periprocedural bleeding is uncertain. We present a 20+ year‐old man with drug‐resistant epilepsy who underwent stereo‐EEG with 17 depth electrodes. Within a few days after insertion, the patient developed multiple ICHs in the electrode trajectories and an intradural hemorrhage after a diagnostic spinal tap. We performed the investigation of the clotting system and whole‐exome sequencing (WES). WES identified a heterozygous mutation c.4698G>T, p.(Trp1566Cys) in COL4A2 (NM_001846.4) encoding a collagen type‐IV alpha‐2 chain inherited from his seemingly healthy mother. As COL4A2 mutations had been identified in four adult patients with ICH we postulated that the identified variant presents a potential risk factor. Notably, mutations encoding other collagens have been linked to cerebral hemorrhages (COL4A1) and increased propensity to trigger ICH upon smoking (COL1A2). Our patient consumed at least 24 oral nicotine pouches (containing 11 mg nicotine each) per day. We consider the patient's COL4A2 mutation in combination with his substantial nicotine consumption as likely predisposition to multiple ICHs precipitated by stereo‐EEG. Patients with nicotine consumption and any collagen mutation may have a substantially higher risk for hemorrhagic complications in SEEG and other neurosurgical procedures. Plain Language Summary A young man with drug‐resistant epilepsy experienced multiple intracerebral hemorrhages after implantation of SEEG electrodes for presurgical evaluation and concomitantly a intradural hemorrhage after a lumbar spinal tap. A collagen IV mutation of unclear significance and heavy use of oral nicotine pouches were the only potential risk factors identified. As collagen mutations were previously described risk factors and smoking in particular worsens the bleeding risk in collagen mutations, further research is warranted to prevent hemorrhages in neurosurgical procedures. Nicotine consumption in any form is a preventable risk factor.

Editado en 1936, Educación y lucha de clases, del argentino Aníbal Ponce, se destacó durante décadas como uno de los pocos manuales latinoamericanos de introducción al marxismo. A los varios análisis que recibió dicho ensayo, el presente artículo suma uno anclado en su primer contexto de producción y circulación. Con ello recupera la discusión de ese texto con la Escuela Nueva y en particular la tácita polémica que Ponce mantuvo con Educación y plenitud humana (1933), del pedagogo argentino Juan Mantovani. Ante el creciente interés que se registra actualmente respecto de la circulación latinoamericana del “escolanovismo”, nos valemos de la perspectiva de la historia intelectual para reconstruir la participación que tuvo Ponce. Ello nos lleva a analizar no sólo las tesis de Ponce y Mantovani sino también la sociabilidad y la trama editorial en la que intervenían esas tesis; esto es, el proyecto de extensión y de defensa antifascista de la cultura organizado desde 1930 en Buenos Aires por el Colegio Libre de Estudios Superiores. Ponce se contó entre los seis fundadores y hasta su exilio en 1937 fue quien más cursos dictó y más publicó en la revista del Colegio, Cursos y conferencias (1931-1960). A fines de 1934, dejó las lecciones sobre psicología infantil y adolescente que venía impartiendo desde 1930 para ocuparse de “Las luchas de clase y la educación”, ocho lecciones cuya versión taquigráfica fue publicada primero en entregas en Cursos y conferencias y luego como el mencionado ensayo Educación y lucha de clases. El recorrido que proponemos recupera las instancias colectivas de discusión pedagógica y política de entonces y muestra que el curso de Ponce constituyó un modo de prolongar y corregir la reflexión iniciada en el Colegio con la “Introducción filosófica a los problemas pedagógicos”, que Mantovani había ofrecido en 1931 y que la Biblioteca del Colegio publicó como Educación y plenitud humana en 1933. Edited in 1936, Educación y lucha de clases, by the Argentine Aníbal Ponce, stood out for decades as one of the few Latin American introductory textbooks on Marxism. To the various analyses that this essay received, this article adds one anchored in its first context of production and circulation. With this, it recovers the discussion of this text with the Escuela Nueva and in particular the tacit polemic that Ponce maintained with Educación y Plenitud Humana (1933), by the Argentine pedagogue Juan Mantovani. Given the growing interest currently registered regarding the Latin American circulation of “Escolanovism”, we use the perspective of intellectual history to reconstruct Ponce’s participation. This leads us to analyze not only the theses of Ponce and Mantovani but also the sociability and editorial framework in which these theses intervened, that is, the project of extension and anti-fascist defense of culture organized since 1930 in Buenos Aires by the Colegio Libre de Estudios Superiores. Ponce was one of the six founders and until his exile in 1937 he was the one who gave the most courses and published the most in the College’s magazine, Cursos y Conferencias (1931-1960). At the end of 1934, he left the lectures on child and adolescent psychology that he had been giving since 1930 to focus on “Las luchas de clase y la educación”, eight lectures whose shorthand version was first published in installments in Cursos y Conferencias and then as the aforementioned essay Educación y lucha de clases. The route we propose recovers the collective instances of pedagogical and political discussion of that time and shows that Ponce’s course constituted a way of prolonging and correcting the reflection begun at the College with the “Introducción filosófica a los problemas pedagógicos”, which Mantovani had offered in 1931 and which the College Library published as Educación y plenitud humana in 1933. Publicado em 1936, Educación y lucha de clases, do argentino Aníbal Ponce, destacou-se durante décadas como um dos poucos manuais latino-americanos de introdução ao marxismo. Às diversas análises que este ensaio recebeu, este artigo acrescenta uma ancorada no seu primeiro contexto de produção e circulação. Com isso recupera a discussão desse texto com a Escola Nova e em particular a polêmica tácita que Ponce manteve com Educación y plenitud humana (1933), do pedagogo argentino Juan Mantovani. Dado o interesse crescente que se regista atualmente pela circulação latino-americana do “escolanovismo”, utilizamos a perspectiva da história intelectual para reconstruir a participação que Ponce teve. Isto nos leva a analisar não apenas as teses de Ponce e Mantovani, mas também a sociabilidade e a trama editorial em que intervieram essas teses, ou seja, o projeto de extensão e defesa antifascista da cultura organizado desde 1930 em Buenos Aires pelo Colégio Livre de Estudos Superiores. Ponce esteve entre os seis fundadores e até seu exílio em 1937 foi o que mais ministrou cursos e mais publicou na revista do Colégio, Cursos y Conferencias (1931-1960). No final de 1934, deixou as aulas de psicologia infantil e juvenil que lecionava desde 1930 para tratar de “Las luchas de clase y la educación”, oito aulas cuja versão taquigráfica foi publicada primeiro em fascículos em Cursos y Conferencias e depois como o ensaio acima mencionado Educación y lucha de clases. O itinerário que propomos recupera as instâncias coletivas de discussão pedagógica e política da época e mostra que o curso de Ponce constituiu uma forma de prolongar e corrigir a reflexão iniciada no Colégio com a “Introducción filosófica a los problemas pedagógicos”, que Mantovani havia oferecido em 1931 e que a Biblioteca da Faculdade publicou como Educación y Plenitud Humana em 1933.

Amyotrophic lateral sclerosis (ALS) is the most common neurodegenerative disease affecting motor neurons (MNs). Although a small percentage of ALS has a familial origin, the vast majority of cases are sporadic in which genetic factors and environment interact with each other leading to disease onset in genetically predisposed individuals. In the current model of the disease, each individual has a determined genetic load, some degree of cell degeneration related to age and several risky environmental exposures. In this scenario, MN degeneration would occur when the sum of these factors reach a certain threshold. To date, an extensive list of environmental factors has been associated to ALS, including different categories, such as exposure to heavy metals and other toxicants, cyanotoxins or infectious agents. In addition, in recent years, lifestyle and other demographic parameters are gaining relevance in the genesis of the disease. Among them, physical activity, nutrition, body mass index, cardiovascular risk factors, autoimmune diseases and cancer are some of the conditions which have been related to the disease. In this review, we will discuss the potential mechanisms of environmental conditions in motor neuron degeneration. Understanding the role of each one of these factors as well as their interactions appears as a crucial step in order to develop new preventive, diagnostic and therapeutic approaches for ALS patients.

Background: The burden of hospital-associated infections (HAIs) and antimicrobial resistance (AMR) in Latin America is high. Improving engagement by healthcare workers (HCWs) in infection prevention and control (IPC) may lead to better patient outcomes; however, little is known about HCW perceptions of IPC in the region. We sought to understand HCW perceptions of IPC processes and practices. Methods: During August–September 2022, HCWs from 30 hospitals with IPC programs in 4 Latin American countries (Panama, Guatemala, Ecuador, and Argentina) were invited to participate in an electronic, voluntary, anonymous survey about their perceptions of IPC at their hospitals. Physicians, nurses, and environmental care (EVC) personnel were prioritized for recruitment. All respondents were asked 18 questions; IPC team members were asked 5 additional questions about specific activities implemented by IPC programs, how data are used, and how IPC could be improved. Answers with 5-point Likert scale responses were categorized into 2 groups (eg, strongly agree or agree vs neutral, disagree, or strongly disagree) for analysis. Results: Of 1,252 HCWs who completed the survey, 181 (14%) were IPC team members, 1,095 (87%) had direct patient contact, and 1,156 (92%) worked >20 hours per week. Figure 1 shows participant characteristics. Most participants (56%) rated their IPC program as very good, 38% rated it as good, and 6% rated it as bad. Physicians were less likely to give a favorable rating. Compliance with prevention bundles and hand hygiene (HH) by colleagues was rated as poor by 28% and 22% of HCWs, respectively; however, only 11% and 5% indicated that their own compliance was poor, respectively. Also, 25% of participants reported not receiving or only occasionally receiving HH compliance data. Similarly, 41% of participants reported not receiving HAI data on a regular basis, and 19% of IPC nurses reported not receiving data despite being responsible for conducting surveillance. Furthermore, 41% of respondents indicated not receiving or only occasionally receiving IPC training or education relevant to their role. When asked about the safety climate, 16% of participants reported not feeling appreciated. In addition, 22% of IPC nurses and 37% of individuals in the “other” category (eg, health technicians and therapists) were more likely to report this. When IPC team members were asked how frequently specific activities were conducted (Fig. 2), several opportunities for improvement were identified, including improving HCW access to HH data and development of strategic plans. Conclusions: Improving HCW access to training on IPC and to data on HAI burden and compliance with HH and prevention bundles should be emphasized in Latin American hospitals. Disclosures: None