A tecnologia digital como mecanismo auxiliador no envelhecimento ativo no século XXI / Digital technology as an auxiliary mechanism for active aging in the 21st century

Objetivo: Analisar os efeitos benéficos do uso da tecnologia digital no envelhecimento ativo, considerando o contexto pós-pandemia Sars-Cov-2-covid-19. Além disso, pretende-se identificar as vantagens e desvantagens do uso dessas tecnologias pelas pessoas idosas no mundo contemporâneo. Método: estudo descritivo, tipo análise teórico reflexiva, desenvolvido a partir de duas questões norteadoras relacionados à temática, subsidiado por levantamento bibliográfico, considerando publicações pertinentes à temática, disponíveis nas bases de dados do Portal Regional da BVS, Portal de Periódicos Capes, SciELO e Pubmeb. por meio dos descritores controlados DECS /MeSH. Resultados: as TIC's estão desempenhando um papel crucial na vida das pessoas idosas, melhorando a comunicação, promovendo a saúde, facilitando o aprendizado e proporcionando um acesso mais fácil à informação e aos cuidados médicos. Conclusão: a tecnologia digital é um mecanismo auxiliador no envelhecimento ativo; quando bem implementado pode trazer mais vantagens do que desvantagens.(AU)

Objective: To analyze the beneficial effects of digital technology usage in active aging, considering the post-Sars-Cov-2-covid-19 pandemic context. Additionally, the aim is to identify the advantages and disadvantages of older individuals using these technologies in the contemporary world. Method: A descriptive study, specifically a theoretical reflective analysis, developed based on two guiding questions related to the theme. The study was supported by a literature review, considering publications relevant to the topic available in the databases of the Regional Portal of BVS, Capes Periodicals Portal, SciELO, and Pubmeb, using controlled descriptors such as DECS/MeSH. Results: Information and communication technologies (ICTs) are playing a crucial role in the lives of older individuals, enhancing communication, promoting health, facilitating learning, and providing easier access to information and medical care. Conclusion: Digital technology serves as an auxiliary mechanism in active aging; when well implemented, it can bring more advantages than disadvantages.(AU)

Objetivo: Analizar los efectos beneficiosos del uso de la tecnología digital en el envejecimiento activo, considerando el contexto post-pandemia de Sars-Cov-2-covid-19. Además, se pretende identificar las ventajas y desventajas del uso de estas tecnologías por parte de las personas mayores em mundo contemporáneo. Método: Estudio descriptivo, tipo análisis teórico reflexivo, desarrollado a partir de dos preguntas orientadoras relacionadas con el tema, respaldado por revisión bibliográfica que considera publicaciones pertinentes disponibles en las bases de datos del Portal Regional de BVS, Portal de Periódicos Capes, SciELO y Pubmeb, mediante descriptores controlados DECS/MeSH. Resultados: tecnologías de la información y la comunicación (TIC) desempeñan un papel crucial en la vida de las personas mayores, mejorando la comunicación, promoviendo la salud, facilitando aprendizaje y proporcionando acceso fácil a información y atención médica. Conclusión: La tecnología digital es un mecanismo auxiliar en el envejecimiento activo cuando se implementa adecuadamente puede aportar más ventajas que desventajas.(AU)

Aplicaciones para dispositivos móviles de uso estomatológico

Introducción: El uso de tecnologías móviles para apoyar el logro de los objetivos de salud tiene el potencial de influir y transformar la provisión de servicios mundialmente. Objetivo: Reflexionar sobre la utilidad de las aplicaciones para dispositivos móviles en las ramas estomatológicas. Comentarios principales: Las aplicaciones para dispositivos móviles tienen muchas ventajas: son constantemente accesibles, se pueden ajustar a las necesidades del usuario, pueden proporcionar comentarios personalizados, son más anónimas que el contacto cara a cara, pueden enviar recordatorios, y tienen un amplio alcance y características interactivas. Consideraciones globales: La utilidad de las aplicaciones para dispositivos móviles en las ramas estomatológicas es innegable. Esta variante tecnológica se ha impuesto como un arma valiosa dentro de los servicios de salud móvil en áreas como la promoción y la prevención de salud, la información a pacientes, la comunicación entre profesionales y el diagnóstico de entidades patológicas. Es una necesidad la búsqueda de la calidad en las que se creen y que se incorporen a la práctica de la profesión para potencializar los beneficios que ofrecen(AU)

Introduction: Using mobile technologies to support the achievement of health goals is very much likely to influence and transform service provision globally. Objective: To reflect on the usefulness of mobile device applications in the branches of dentistry. Key remarks: Mobile device applications have many advantages: they are accessible at any time, they can be adjusted to the user's needs, they provide personalized feedback, they are more anonymous than face-to-face contact, they can send reminders; in addition, they have a wide reach and interactive features. Global considerations: The usefulness of mobile device applications in the branches of dentistry is undeniable. This technological variant has established itself as a valuable weapon within mobile health services in areas such as health promotion and prevention, patient information, communication between professionals, and diagnosis of pathological entities. It is necessary to search for quality, creating and incorporating mobile device applications into the professional practice, in order to maximize the benefits that they offer(AU)

Diseño curricular del programa académico de la Maestría en Informática Médica Aplicada

Introducción: el Ministerio de Salud Pública de Cuba realiza numerosos esfuerzos por garantizar la informatización de sus procesos, donde la superación profesional representa un eslabón fundamental. La Escuela Nacional de Salud Pública implementa la Maestría en Informática en Salud, dirigida a los profesionales del sector que participan en el proceso de informatización. Sin embargo, el programa actual no se enfoca hacia el desarrollo de habilidades técnicas de los especialistas informáticos. Objetivo: diseñar el programa académico de la Maestría en Informática Médica Aplicada, enfocado al desarrollo de habilidades técnicas de los especialistas informáticos, que desde su puesto de trabajo contribuyen a la informatización de la salud pública cubana. Materiales y métodos: la investigación tiene un enfoque cualitativo, con alcance descriptivo, de tipo retrospectivo y diseño no experimental, de corte longitudinal. Se realizó un análisis documental, donde se identificaron las bases teóricas y los programas académicos existentes, que fundamentan el diseño curricular presentado. Resultados: se diseñó la propuesta de programa académico de la Maestría en Informática Médica Aplicada, con una estructura de 78 créditos. Cuenta con tres bloques de cursos básicos y especializados en temas de salud e informática. Es coordinado por la Universidad de las Ciencias Informáticas en colaboración con la Escuela Nacional de Salud Pública. Conclusiones: el programa implementado es pertinente y contribuye al desarrollo de habilidades técnicas en los especialistas informáticos, que participan en el proceso de informatización de la salud pública cubana, muestra de ello lo constituyen las estadísticas de la primera edición en curso de la maestría.

Introduction: The Cuban Ministry of Public Health makes numerous efforts to guarantee the computerization of its processes, where professional improvement represents a fundamental link. The National School of Public Health implements the Master´s Degree in Health Informatics aimed at managers of the sector who participate in the computerization process. However, the current program does not focus on developing the technical skills of computer specialists. Objective: To design the academic program of the Master´s Degree in Applied Medical Informatics, focused on the development of technical skills of computer specialists who, from their work position, contribute to the computerization of the Cuban public health. Material and methods: The research has a qualitative approach and a descriptive, retrospective, non-experimental, longitudinal design. A documentary analysis was carried out, where the theoretical bases and existing academic programs were identified, which underpin the presented curriculum design. Results: The proposed academic program for the Master´s Degree in Applied Medical Informatics was designed, with a structure of 78 credits. It has three blocks of basic and specialized courses in health and computer science topics. It is coordinated by the University of Informatics Sciences in collaboration with the National School of Public Health. Conclusions: The implemented program is relevant and contributes to the development of technical skills in computer specialists who participate in the process of computerization of Cuban public health, which is evidenced by the statistics of the first ongoing edition of the master´s program.

Producción científica de la Revista Cubana de Informática Médica desde el año 2017 hasta el 2021

Introducción: La Bibliometría como ciencia, permite el análisis detallado de las publicaciones, se hace cada vez más necesaria, y en el campo investigativo ha creado tendencia. Objetivo: Describir la producción científica de la Revista Cubana de Informática Médica en el periodo desde 2017 hasta 2021. Métodos: Se realizó un estudio descriptivo transversal mediante el análisis bibliométrico de la Revista Cubana de Informática Médica desde 2017 hasta 2021. El universo lo conformaron 131 artículos publicados en el periodo de estudio. Se estudiaron las tipologías de artículos, la cantidad de artículos por años y de autores, así como el país de procedencia. Para el cálculo de la obsolescencia de las referencias se empleó el índice de Price. Resultados: El año 2021 presentó el mayor número de publicaciones en el periodo de estudio para un 25,19 %, los artículos originales representaron el 68,70 % del total. La cantidad de autores por artículos que predominó fue 3, lo que representa el 25,95 %. Se destacan los artículos de Cuba con el 90,08% del total. Los manuscritos de revisión mostraron el mayor índice de Price con 0.96 y los originales el menor con un 0.66. Conclusiones: La Revista Cubana de Informática Médica ha mantenido un crecimiento en las publicaciones, destacándose en el año 2021 el incremento de artículos originales, predominaron las publicaciones con 3 autores, Cuba es el país que más aportó. Las revisiones mostraron mayor nivel de actualidad de las referencias bibliográficas que los originales.

Introduction: Bibliometrics as a science allows the detailed analysis of publications, becoming more and more necessary and creating a trend in the research field. Objective: To describe the scientific production of the Cuban Journal of Medical Informatics in the period from 2017 to 2021. Methods: Descriptive cross-sectional study by conducting the bibliometric analysis of the Cuban Journal of Medical Informatics from 2017 to 2021. The universe consisted of 131 articles published in this study period. The typologies of articles, the number of articles and authors per years, and the country of origin were revealed in the study. Price index was the indicator used to calculate the obsolescence of references. Results: The year 2021 presented the highest number of publications in the aforementioned study period (25.19%); original articles accounted for 68.70% of the total. The predominant number of authors per articles was 3, representing 25.5%. Cuban articles stood out with 90.08% of the total of articles. Review manuscripts showed the highest Price index (0.96) while original articles revealed the lowest one (0.66). Conclusions: The Cuban Journal of Medical Informatics has maintained a growth in publications, standing out an increase in original articles in 2021 and predominating those publications with 3 authors. The reviews showed higher level of currentness of bibliographic references than original works.

Information and Communication Technologies for promotion of physical activity

Background: information and communication technologies have produced lifestyle changes, especially in physical activity. Therefore, it is important to promote the use of those resources through innovative processes to improve the quality of life. Objective: to analyze the scientific evidence on the information and communication technologies used for the promotion of physical activity. Method: a bibliographic search of publications in scientific journals between 2013 and 2019 was carried out. The descriptors technology, physical activity, innovation and their equivalences in English were used. The analyzed elements were title, abstract, publication year, language, country and publication source. From the complete text, the variables technology, population group, activities or strategies and results were analyzed. Results: 32 full articles that met the inclusion criteria were analyzed. The most used technologies for the promotion of physical activity in the different groups were PPPs and mobile phones; the evidence concludes that their use generates adherence and contributes to life quality. Conclusion: the need for the use of information and communication technologies was evidenced, therefore, innovative physical activity practice in different populations is encouraged. The challenge for professionals who work on the area is to take such technologies and start their implementation.

Antecedentes: las tecnologías de la información y la comunicación han configurado cambios en los estilos de vida de los sujetos, especialmente aquellos relacionados con la actividad física, por ello, es importante que a través de procesos innovadores se promueva la utilización de las mismas, que permitan el aprovechamiento de este recurso para la mejora de la calidad de vida. Objetivo: analizar la evidencia científica sobre la utilización de las tecnologías de la información y la comunicación para el fomento de la actividad física. Método: se realizó una búsqueda bibliográfica de publicaciones en revistas científicas, entre los años 2013 y 2019. Se utilizaron los descriptores tecnología, actividad física, innovación y sus correspondientes en inglés. Los artículos fueron analizados a partir del título, resumen, año de publicación, idioma, país y fuente de publicación. A partir del texto completo se analizaron las variables tecnología utilizada, grupo poblacional, actividades o estrategias y resultados. Resultados: fueron revisados para el análisis 32 artículos en texto completo que cumplieron criterios de inclusión, las tecnologías más utilizadas para el fomento de la actividad física en los diferentes grupos fueron las APP y los teléfonos móviles, la evidencia concluye que su uso genera adherencia y aporta para la calidad de vida. Conclusión: se evidenció la necesidad de la utilización de las tecnologías de la información y la comunicación para que de manera innovadora se fomente la práctica de la actividad física en diferentes poblaciones, el reto para los profesionales que trabajan el tema es apropiarlas e iniciar su implementación.

Antecedentes: as tecnologias da informação e a comunicação tem configurado câmbios nos estilos de vida dos sujeitos, especialmente aqueles relacionados com a atividade física, por isto, é importante que a través de processos inovadores se promove a utilização das mesmas, que permitam o aproveitamento destes recursos para a melhora da qualidade de vida. Objetivo: analisar a evidencia científica sobre a utilização das tecnologias da informação e a comunicação para a promoção da atividade física. Método: Realizou-se uma busca bibliográfica de publicações em revistas científicas, entre os anos 2013 e 2019. Utilizaram-se os descritores tecnologia, atividade física, inovação e seus correspondentes em inglês. Os artigos foram analisados a partir do título, resumo, ano de publicação, idioma, país e fonte de publicação. A partir do texto completo se analisaram as variáveis, tecnologia utilizada, grupo populacional, atividades as estratégias e resultados. Resultados: foram revisados para a análise 32 artigos em texto completo que cumpriram critérios de inclusão, as tecnologias mais utilizadas para o aumento da atividade física nos diferentes grupos foram as APP e os telefones móveis, a evidencia conclui que seu uso gera aderência e contribui para a qualidade de vida. Conclusão: Evidenciou-se a necessidade da utilização das tecnologias da informação e a comunicação para que de maneira inovadora se fomente a prática da atividade física em diferentes povoações, o reto para os profissionais que trabalham o tema é apropria-las e iniciar sua implementação.

Aplicación de la dinámica de sistemas en el análisis de la evolución de la hipoacusia y la evaluación del impacto de estrategias sanitarias

Objetivos: Aplicar la dinámica de sistemas para estimar la evolución de la incidencia y la prevalencia de hipoacusia en personas mayores en países de bajos, medios y altos ingresos, así como el acceso al tratamiento, y evaluar la influencia de la implementación de estrategias sanitarias sobre estos indicadores. Metodología: Los análisis se realizaron mediante simulación con dinámica de sistemas según parámetros globales. Para ello, se desarrolló un diagrama de bucles causal, integrando la incidencia, la prevalencia y el tratamiento de hipoacusia con el nivel de desigualdad, factores de riesgo, uso de dispositivos de ayuda auditiva, fuerza laboral de audiólogos y otorrinolaringólogos según el nivel de ingresos del país. Luego, se construyó un diagrama de flujo para ejecutar las simulaciones durante un período de 100 años. Además, se ejecutaron cuatro simulaciones con estrategias sanitarias (reducción de factores de riesgo, mejora en el uso dispositivos de ayuda auditiva, aumento del número de audiólogos y otorrinolaringólogos) y se estimó el porcentaje de cambio respecto al modelo basal. Resultados: Los países de bajos ingresos mostraron una mayor incidencia y prevalencia de hipoacusia, menor acceso a tratamiento adecuado y una mayor prevalencia de hipoacusia sin tratar o con tratamiento inadecuado. La reducción de factores de riesgo creció en un 15 y 33 % la población con audición normal en los próximos 50 y 100 años, respectivamente. Además, la mejora en el uso de dispositivos de ayuda auditiva logró una reducción del 60 % de la población con tratamientos inadecuados o sin tratamiento, y el aumento de audiólogos y otorrinolaringólogos incrementó un 250 % el acceso a un tratamiento adecuado. Conclusiones: La evolución de la salud auditiva está condicionada por factores económicos, donde los entornos más desfavorecidos muestran peores indicadores. Además, la implementación de estrategias combinadas favorecería la salud auditiva en el futuro.

Objectives: To estimate the evolution of the incidence and prevalence of hearing loss in the elderly in low-, middle- and high-income countries by means of system dynamics simulation according to global parameters and to analyze the influence of the implementation of health strategies. Methodology: A causal loop diagram was developed to relate the incidence, prevalence and treatment of hearing loss to the level of inequality, risk factors (RF), use of hearing aids (HA), audiologist and otolaryngologist (ENT) workforce by country income level. A flow chart was then constructed to run the simulations over a 100-year period. In addition, four simulations were run with health strategies (reduction of RF, improvement in HA use, increase in the number of audiologists and ENT specialists) and the percentage change from the baseline model was estimated. Results: Low-income countries showed a higher incidence and prevalence of hearing loss, less access to adequate treatment, and a higher prevalence of untreated or inadequately treated hearing loss. The reduction of RF increased the population with normal hearing by 15% and 33% over the next 50 and 100 years, respectively. In addition, the improvement in the use of ha achieved a 60% reduction in the population with inadequate or untreated treatment, and the increase in audiologists and ENT specialists improved the access to adequate treatment by 250%. Conclusions: The evolution of hearing health is conditioned by economic factors, where the most disadvantaged environments show worse indicators. In addition, the implementation of combined strategies would favor hearing health in the future. System dynamics is a very useful methodology for health managers because it enables to understand how a disease evolves and define what are the best health interventions considering different scenarios.

Objetivos: Aplicar a dinâmica do sistema para estimar a evolução da incidência e prevalência da perda auditiva em pessoas idosas em países de baixo, médio e alto rendimento, bem como o acesso ao tratamento, e avaliar a influência da implementação de estratégias de saúde sobre estes indicadores. Metodologia: As análises foram conduzidas utilizando simulação da dinâmica do sistema com base em parâmetros globais. Para tal, foi desenvolvido um diagrama do laço causal, integrando a incidência, prevalência e tratamento da perda auditiva com o nível de desigualdade, fatores de risco, utilização de aparelhos auditivos, mão-de-obra de audiologistas e otorrinolaringologistas por nível de rendimento nacional. Foi então construído um fluxograma para executar as simulações ao longo de um período de 100 anos. Além disso, foram realizadas quatro simulações com estratégias de saúde (reduzindo os fatores de risco, melhorando a utilização de aparelhos auditivos, aumentando o número de audiologistas e otorrinolaringologistas) e foi estimada a mudança percentual em relação ao modelo de base. Resultados: Os países de baixos rendimentos mostraram maior incidência e prevalência de perda auditiva, menor acesso a tratamento apropriado e maior prevalência de perda auditiva não tratada ou tratada de forma inadequada. A redução dos fatores de risco aumentou a população com audição normal em 15 e 33% durante os próximos 50 e 100 anos, respectivamente. Além disso, uma melhor utilização de aparelhos auditivos permitiu uma redução de 60% na população mal tratada ou não tratada, e o aumento do número de audiologistas e especialistas em ORL aumentou em 250% o acesso ao tratamento adequado. Conclusões: A evolução da saúde auditiva é condicionada por fatores económicos, com os ambientes mais desfavorecidos a apresentarem indicadores piores. Além disso, a implementação de estratégias combinadas favoreceria a saúde auditiva no futuro.

El impacto de la pandemia del COVID-19 en la educación médica: adaptabilidad y experiencia con enseñanza a distancia de la Sociedad Médica Peruano Americana

La pandemia del COVID-19 tuvo un impacto significativo en el cuidado y la educación médicos en el Perú. En respuesta, la Sociedad Médica Peruano Americana (PAMS), una organización médica benéfica con sede en los EE.UU., adoptó sus misiones médicas y educativas en Perú usando estrategias virtuales. Desarrollamos colaboración con varias facultades de medicina y la Asociación Peruana de Facultades de Medicina (ASPEFAM) y ofrecimos un panel de veinte y cuatro miembros para brindar conferencias y seminarios multidisciplinarios en español. Hicimos 19 seminarios, incluyendo temas relacionados y no relacionados al COVID-19, que en los últimos dos años atrajo a 14 489 participantes de 23 países. Ellas fueron la base de 20 publicaciones en revistas médicas peruanas. Nuestro concurso de investigaciones clínicas y nuestro proyecto piloto de mentoría de investigación fueron recibidos positivamente. La pandemia del COVID-19 tuvo un efecto positivo en la misión educativa de PAMS en Perú.

The COVID-19 pandemic had a significant impact on medical care and medical education in Peru. In response, the Peruvian American Medical Society (PAMS), a charitable medical organization based in the USA, pursued its medical and educational missions in Peru by adopting virtual learning technology. We developed closer collaborative relationships with several medical schools and the Peruvian Association of Medical Schools (ASPEFAM) while offering a faculty panel of twenty-four members to provide lectures and multidisciplinary webinars in Spanish. We conducted 19 webinars including COVID -19 and non-COVID-19 related topics that over the last two years attracted 14,489 participants from 23 countries. They were the foundation for twenty publications in Peruvian medical journals. Our clinical investigations competition was positively received as was our pilot project on research mentorship. The COVID -19 pandemic had a positive effect on the educational mission of PAMS in Peru.

Credibility, accuracy and readability of patient-oriented information about low back pain on Brazilian websites: a mixed-method review / Credibilidade, acurácia e legibilidade das informações orientadas ao paciente sobre dor lombar em sites brasileiros: uma revisão de método misto

ABSTRACT BACKGROUND AND OBJECTIVES: Low-quality online health-related content may lead to inefective or harmful decision-making from patients related to their healthcare. The aim of this study was to evaluate the credibility, accuracy and readability of web-based content on Brazilian websites. METHODS: This is a mixed-method review with exploratory sequential design. Google was selected as the search engine for retrieving web-information about low back pain (LBP) in Brazilian websites. We assessed the URL on three domains: credibility, accuracy, and readability. Qualitative analysis of each URL was performed in three steps: (1) organization into thematic units; (2) data exploration; and (3) interpretation of the data and summarization. RESULTS: Credibility was assessed in 135 URLs, 72 (53%) URLs had no authorship, 119 (88%) did not mention the sources of their information, none presented a declaration of conflict of interest or the declared source of funding, 76 (56%) URLs present the date of creation. Accuracy was assessed in 121 URLs and none fully adhered to the guidelines. Readability was assessed in 128 and texts were classified as "very easy" or "easy" to read. Five main themes emerged in the qualitative analysis: (1) Explanations and causes for low back pain, (2) diagnosis, (3) recommendation about treatment, (4) recommendation for coping and self-management, and (5) lifestyle factors. CONCLUSION: Content analysis of web-based searches on the Brazilian Portuguese language demonstrated low credibility standards, mostly inaccurate information, and moderate-high readability levels about low back pain.

RESUMO JUSTIFICATIVA E OBJETIVOS: O conteúdo on-line relacionado à saúde quando apresenta baixa qualidade pode levar a tomadas de decisão ineficazes ou prejudiciais por parte dos pacientes. O objetivo deste estudo foi avaliar a credibilidade, acurácia e legibilidade do conteúdo em portais brasileiros. MÉTODOS: Esta é uma revisão de método misto com design sequencial exploratório. O Google foi selecionado como o mecanismo de busca para recuperar informações da web sobre dor lombar em sites brasileiros. Avaliamos os URL em três domínios: credibilidade, acurácia e legibilidade. A análise qualitativa de cada URL foi realizada em três etapas: (1) organização em unidades temáticas; (2) exploração de dados; e (3) interpretação dos dados e resumo. RESULTADOS: A credibilidade foi avaliada em 135 URLs, 72 (53%) URLs não tinham autoria, 119 (88%) não mencionavam as fontes de suas informações, nenhuma apresentava declaração de confito de interesse ou fonte de fnanciamento declarada, 76 (56%) URLs apresentam a data de criação. A acurácia foi avaliada em 121 URLs e nenhuma aderiu totalmente às diretrizes. A legibilidade foi avaliada em 128 e os textos foram classificados como "muito fáceis" ou "fáceis" de ler. Cinco temas principais emergiram na análise qualitativa: (1) Explicações e causas da dor lombar, (2) diagnóstico, (3) recomendação sobre tratamento, (4) recomendação para enfrentamento e autogerenciamento e (5) fatores de estilo de vida. CONCLUSÃO: A análise de conteúdo de pesquisas baseadas na web, no idioma português do Brasil, demonstrou baixos padrões de credibilidade, acurácia e níveis moderados a altos de legibilidade sobre a dor lombar.

Virtual assistant: a tool for health co-production in coping with covid-19 / Asistente virtual: una herramienta para co-producción en salud con el fin de hacer frente al covid-19 / Assistente virtual: ferramenta para coprodução em saúde no enfrentamento à covid-19

ABSTRACT Objective: to describe the development of a virtual assistant as a potential tool for health co-production in coping with COVID-19. Method: this is an applied technological production research study developed in March and April 2020 in five stages: 1) literature review, 2) content definition, 3) elaboration of the dialog, 4) test of the prototype, and 5) integration with the social media page. Results: the literature review gathered diverse scientific evidence about the disease based on the Brazilian Ministry of Health publications and by consulting scientific articles. The content was built from the questions most asked by the population, in March 2020, evidenced by Google Trends, in which the following topics emerged: concept of the disease, prevention means, transmission of the disease, main symptoms, treatment modalities, and doubts. Elaboration of the dialog was based on Natural Language Processing, intentions, entities and dialog structure. The prototype was tested in a laboratory with a small number of user computers on a local network to verify the functionality of the set of apps, technical and visual errors in the dialog, and whether the answers provided were in accordance with the user's question, answering the questions correctly and integrated into Facebook. Conclusion: the virtual assistant proved to be a health education tool with potential to combat "Fake News". It also represents a patient-centered form of health communication that favors the strengthening of the bond and interaction between health professionals and patients, promoting co-production in health.

RESUMEN Objetivo: describir el desarrollo de un asistente virtual como posible herramienta para la co-producción en salud a fin de hacer frente al COVID-19. Método: trabajo de investigación aplicado de producción tecnológica, desarrollado en marzo y abril de 2020 en cinco etapas: 1) revisión de la literatura, 2) definición del contenido, 3) elaboración del diálogo, 4) prueba del prototipo y 5) integración con la página web del medio social. Resultados: en la revisión de la literatura se reunieron evidencias científicas sobre la enfermedad a partir de las publicaciones del Ministerio de Salud de Brasil, al igual que sobre la base de consultas en artículos científicos. El contenido se elaboró a partir de las preguntas más frecuentes de la población, en marzo de 2020, puestas en evidencia por medio de Google Trends, donde surgieron los siguientes temas: concepto de la enfermedad, formas de prevención, transmisión de la enfermedad, principales síntomas, modalidades de tratamiento y dudas. La elaboración del diálogo se basó en el Procesamiento de Lenguaje Natural, en intenciones, en entidades y en la estructura del diálogo. El prototipo se puso a prueba en un laboratorio con una cantidad reducida de computadoras usuario en una red local para verificar la funcionalidad del conjunto de aplicaciones, errores técnicos y visuales acerca del diálogo, y si las respuestas proporcionadas estaban de acuerdo con la pregunta del usuario, respondiendo correctamente los interrogantes e integrado a Facebook. Conclusión: el asistente virtual demostró ser una herramienta de educación en salud con potencial para combatir Fake News. También representa una forma de comunicación en salud centrada en el paciente que favorece el fortalecimiento del vínculo y la interacción entre profesionales de la salud y pacientes, promoviendo así la coproducción en salud.

RESUMO Objetivo: descrever o desenvolvimento de um assistente virtual como ferramenta potencial para a coprodução em saúde no enfrentamento à COVID-19. Método: trata-se de uma pesquisa aplicada de produção tecnológica, desenvolvida nos meses de março e abril de 2020 em cinco etapas: 1) revisão de literatura, 2) definição de conteúdo, 3) construção do diálogo, 4) teste do protótipo e 5) integração com página de mídia social. Resultados: a revisão de literatura reuniu evidências científicas sobre a doença a partir das publicações do Ministério da Saúde, no Brasil, e de consultas em artigos científicos. O conteúdo foi construído a partir das perguntas mais realizadas pela população, em março de 2020, evidenciadas por meio do Google Trends, em que emergiram os seguintes temas: conceito da doença, formas de prevenção, transmissão da doença, principais sintomas, formas de tratamento e dúvidas. A construção do diálogo foi baseada em Processamento de Linguagem Natural, intenções, entidades e estrutura de diálogo. O protótipo foi testado em laboratório com um número reduzido de computadores usuários em uma rede local para verificar a funcionalidade do conjunto de aplicações, erros técnicos e visuais acerca do diálogo e se as respostas fornecidas estavam de acordo com a pergunta do usuário, respondendo de forma correta os questionamentos e integrado ao Facebook. Conclusão: o assistente virtual mostrou-se uma ferramenta de educação em saúde e com potencial para combater fake news. Também representa uma forma de comunicação em saúde centrada no paciente, que favorece o fortalecimento de vínculo e interação entre profissionais de saúde e pacientes, promovendo a coprodução em saúde.

Aplicativo SARA para tratamento de pessoas com tuberculose: estudo metodológico / Aplicación SARA para tratamiento de personas con tuberculosis: estudio metodológico / SARA application for treating people with tuberculosis: a methodological study

Resumo Objetivo Construir um aplicativo para o acompanhamento do tratamento de pessoas com tuberculose. Métodos Estudo metodológico com três fases: preparação do mapa conceitual por meio de manuais do Ministério da Saúde do Brasil e da Organização Mundial da Saúde; a construção do aplicativo com a elaboração do projeto de navegação e a prototipagem; e validação por conteúdo e semântica guiada pelo método de Pasquale com validação de conteúdo por juízes especialistas em saúde em ambiente online e validação de semântica pelo público-alvo, pessoas com tuberculose atendidas em uma unidade de saúde de Natal, no Rio Grande do Norte, Brasil, por meio da Técnica Delphi analisada a partir do Índice de Validade de Conteúdo. Resultados Construiu-se o aplicativo em sua versão final após três etapas da Técnica Delphi. Na etapa Delphi 3, o Índice de Validade de Conteúdo global foi de 0,92, sendo avaliado por sete juízes especialistas nas regiões Norte, Nordeste, Centro-Oeste, Sul e Sudeste e validado por seis pessoas com tuberculose atendidas, alcançando um Índice de Validade de Conteúdo global de 0,98. Conclusão O aplicativo foi validado quanto ao conteúdo e à semântica por juízes especialistas, em uma perspectiva multiprofissional, e atuantes na área de tuberculose de mais de uma região do Brasil e pelo público-alvo a que se destina, sendo considerado uma ferramenta importante para somar às estratégias de controle para o fim da tuberculose.

Resumen Objetivo Elaborar una aplicación para el seguimiento del tratamiento de personas con tuberculosis. Métodos Estudio metodológico de tres fases: preparación del mapa conceptual por medio de manuales del Ministerio de Salud de Brasil y de la Organización Mundial de la Salud; desarrollo de la aplicación con la elaboración del proyecto de navegación y creación del prototipo; y validación de contenido y semántica guiada por el método de Pasquale, en la cual la validación de contenido fue realizada por jueces especialistas en salud en ambiente virtual y la validación semántica por el público destinatario, personas con tuberculosis atendidas en una unidad de salud de Natal, estado de Rio Grande do Norte, Brasil, mediante el método Delphi analizado a partir del Índice de Validez de Contenido. Resultados Se elaboró la aplicación en su versión final luego de tres etapas del método Delphi. En la etapa Delphi 3, el Índice de Validez de Contenido global fue 0,92, evaluado por siete jueces especialistas de las regiones Norte, Nordeste, Centro-oeste, Sur y Sudeste, y validado por seis personas con tuberculosis atendidas, con un Índice de Validez de Contenido global de 0,98. Conclusión La aplicación fue validada respecto al contenido y a la semántica por jueces especialistas, bajo una perspectiva multiprofesional y del área de tuberculosis con presencia en más de una región de Brasil, y por el público destinatario. Fue considerada una herramienta importante para sumar a las estrategias de control para el fin de la tuberculosis.

Abstract Objective To develop an application for monitoring the treatment of individuals with tuberculosis. Methods A methodological study with three phases: preparation of the concept map according to the manuals of the Brazilian Ministry of Health and the World Health Organization; development of the application, with navigation and prototyping design; and based on Pasquale's method, content validation was performed by health experts in an online environment with semantic validation by the target audience, individuals with tuberculosis treated in a health unit in Natal, Rio Grande do Norte, Brazil, using the Delphi technique, analyzed using the Content Validity Index. Results The final version of the application was developed after three rounds of the Delphi technique. In the third Delphi round, the overall Content Validity Index was 0.92, as rated by seven expert evaluators in the North, Northeast, Central-West, South, and Southeast of Brazil, and validated by six patients being treated for tuberculosis, obtaining an overall Content Validity Index of 0.98. Conclusion The application was validated regarding content and semantics by expert evaluators working in the area of tuberculosis in more than one region of Brazil, from a multidisciplinary perspective, and by the target audience for which it is intended. It was considered an important tool to contribute to control strategies for the treatment of tuberculosis.

Adaptação transcultural e avaliação das propriedades psicométricas de dois instrumentos de letramento digital em saúde para adolescentes brasileiros: eHealth Literacy Scale e Digital Health Literacy Instrument / Cross-cultural adaptation and evaluation of the psychometric properties of two digital health literacy instruments for brazilian adolescents: eHealth Literacy Scale and Digital Health Literacy Instrument

Com a ampliação do acesso à internet e digitalização dos serviços de saúde, os usuários adolescentes devem apresentar um conjunto de habilidades para seu uso adequado, o chamado Letramento Digital em Saúde (LDS). O objetivo deste estudo foi adaptar transculturalmente e avaliar as propriedades psicométricas de dois instrumentos de LDS, eHealth Literacy Scale (eHEALS) e Digital Health Literacy Instrument (DHLI), para adolescentes brasileiros. O instrumento eHEALS é uma medida de oito itens que mensura a autopercepção relacionada ao LDS. O instrumento DHLI é composto por 21 itens de autorrelato e por sete itens de habilidades que avaliam o desempenho prático do indivíduo. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Minas Gerais. A amostra foi composta por indivíduos de 13 a 19 anos, matriculados em escolas públicas de Belo Horizonte, MG, Brasil. Os instrumentos eHEALS e DHLI foram previamente traduzidos e adaptados para adultos brasileiros. Utilizamos as versões brasileiras dos intrumentos e foram realizadas as seguintes etapas metodológicas: comitê de especialistas; retro-tradução; síntese das retrotraduções; avaliação dos autores originais; pré-teste com 42 adolescentes utilizando-se entrevistas cognitivas com perguntas de sondagem e produção da versão final em português direcionada para adolescentes. Um total de 260 adolescentes participaram do teste e responderam aos instrumentos de LDS, eHEALS e DHLI direcionados para adolescentes do Brasil (eHEALS-BrA e DHLI-BrA), aos instrumentos de letramento em saúde, Newest Vital Sign (NVS-BR) e Rapid Estimate Adult Literacy in Medicine and Dentistry (REALMD-20), um instrumento de qualidade de vida, World Health Organization Quality of Life-Bref (WHOQOL-bref), e um questionário sociodemográfico, de acesso à internet e uso de eSaúde. Além disso, após 15 dias, 67 adolescentes responderam novamente ao eHEALS-BrA e ao DHLI-BrA. A confiabilidade do instrumento foi testada através da consistência interna (alfa de Cronbach e Ômega de McDonald's) e da confiabilidade teste-reteste. Análise fatorial confirmatória (AFC) avaliou a dimensionalidade do instrumento e a validade foi testada pelas associações entre os scores do eHEALS-BrA e DHLI-BrA com as variáveis de interesse (p<0,05). O eHEALS-BrA demonstrou boa confiabilidade interna (α e ω=0,71) e boa estabilidade (ICC=0.82, 95% CI:0,70-0,89). Testes preliminares mostraram que os dados eram adequados para análise dos componentes principais: KMO=0,78 e teste de esfericidade de Barlett (p<0,001). O modelo mais bem ajustado na AFC foi composto por um fator único (χ²=49,884 (p=0,0002), CFI=0,934, TLI=0,908, RMSEA=0,076 e RMSR=0,045). O DHLI-BrA autorrelatado demonstrou confiabilidade interna satisfatória (α e ω = 0,83) e boa estabilidade (ICC=0,906 (IC 95%: 0,75-0,95). Na AFC, o modelo mais bem ajustado foi composto por seis fatores (χ²=229,173 (p=0,0032), CFI=0,944, TLI=0,933, RMSEA=0,035 e RMSR=0,047). O DHLI-BrA baseado em desempenho demonstrou confiabilidade interna satisfatória (α=0,57 e ω =0,58) e boa estabilidade (ICC=0,86; IC 95%: 0,76-0,92). Na AFC o modelo mais bem ajustado foi composto por um fator único (χ²=17,901 (p=0,2113), CFI= 0,952; TLI= 0,927; RMSEA=0,033; RMSR=0,038). Conclui-se que as versões produzidas dos instrumentos eHEALS-BrA e DHLI-BrA demonstraram boas propriedades psicométricas para a mensuração do LDS em adolescentes do Brasil.

With the expansion of internet access and digitization of health services, adolescent users must have a set of skills for their proper use, called Digital Health Literacy (DHL). The objective of this study was to cross-culturally adapt and evaluate the psychometric properties of two DHL instruments, eHealth Literacy Scale (eHEALS) and Digital Health Literacy Instrument (DHLI), for Brazilian adolescents. The eHEALS instrument is an eight-item measure that assesses DHL self-perception. The DHLI instrument consists of 21 self-report items and seven skill items that assess the individual's practical performance. The study was approved by the Research Ethics Committee of the Federal University of Minas Gerais. The sample consisted of individuals aged 13 to 19 years, enrolled in public schools in Belo Horizonte, MG, Brazil. The eHEALS and DHLI instruments were previously translated and adapted for Brazilian adults. We used the Brazilian versions of the instruments and the following methodological steps were performed: expert committee; back-translation; synthesis of back-translations; evaluation by original authors; pre-test with 42 adolescents using cognitive interviews with probing questions and production of the final Portuguese version directed at adolescents. A total of 260 adolescents participated in the testing phase and answered DHL instruments, eHEALS and DHLI directed at Brazilian adolescents (eHEALS-BrA and DHLI-BrA), health literacy instruments, Newest Vital Sign (NVS-BR) and Rapid Estimate Adult Literacy in Medicine and Dentistry (REALMD-20), a quality-of-life instrument, World Health Organization Quality of Life-Bref (WHOQOL-bref), and a sociodemographic questionnaire, internet access and use of eHealth. In addition, after 15 days, 67 adolescents responded again to eHEALS-BrA and DHLI-BrA. The instrument's reliability was tested through internal consistency (Cronbach's alpha and McDonald's omega) and test-retest reliability. Confirmatory factor analyses (CFA) evaluated the instrument's dimensionality and the validity was tested by associations between the eHEALS-BrA and DHLI-BrA scores and variables of interest (p<0.05). eHEALS-BrA demonstrated good internal reliability (α and ω=0.71) and good stability (ICC=0.82, 95% CI:0.70-0.89). Preliminary tests showed that the data were adequate for principal component analysis: KMO=0.78 and Barlett's sphericity test (p<0.001). The best-fitting model in CFA consisted of a single factor (χ²=49.884 (p=0.0002), CFI=0.934, TLI=0.908, RMSEA=0.076, and RMSR=0.045). The self-report items of DHLI-BrA demonstrated satisfactory internal reliability (α and ω = 0.83) and good stability (ICC=0.906 (IC 95%: 0.75-0.95). In CFA, the best-fitting model consisted of six factors (χ²=229.173 (p=0.0032), CFI=0.944, TLI=0.933, RMSEA=0.035, and RMSR=0.047). Performance-based DHLI-BrA demonstrated satisfactory internal reliability (α=0.57e ω =0.58) and good stability (ICC=0.86; IC 95%: 0.76-0.92). In CFA the best-fitting model consisted of a single factor (χ²=17,901 (p=0,2113), CFI= 0,952; TLI= 0,927; RMSEA=0,033; RMSR=0,038). It is concluded that the versions of eHEALS-BrA and DHLI-BrA instruments produced demonstrated good psychometric properties for measuring DHL in Brazilian adolescents.

Construction and validation of a prognostic model for colon cancer based on inflammatory response-related genes / 肿瘤研究与临床

Objective:To screen the differentially expressed genes (DEG) related to inflammatory response associated with the prognosis of colon cancer based on the bioinformatics approach, and to construct and validate a prognostic model for colon cancer.Methods:RNA sequencing and clinical data of 472 colon cancer patients and normal colon tissues of 41 healthy people were retrieved from the Cancer Genome Atlas (TCGA) database. Gene expression related to prognosis of colon cancer and clinical data were retrieved from the International Cancer Genome Consortium (ICGC) database. The retrieval time was all from the establishment of library to November 2022. A total of 200 genes associated with inflammatory response obtained from the Gene Set Enrichment Analysis (GSEA) database were compared with the RNA sequencing gene dataset of colon cancer and normal colon tissues obtained from the TCGA database, and then DEG associated with inflammatory response were obtained. The prognosis-related DEG in the TCGA database were analyzed by using Cox proportional risk model, and the inflammatory response-related DEG were intersected with the prognosis-related DEG to obtain the prognosis-related inflammatory response-related DEG. The prognostic model of colon cancer was constructed by using LASSO Cox regression. Risk scores were calculated, and colon cancer patients in the TCGA database were divided into two groups of low risk (< the median value) and high risk (≥the median value) according to the median value of risk scores. Principal component analysis (PCA) was performed on patients in both groups, and survival analysis was performed by using Kaplan-Meier method. The efficacy of risk score in predicting the overall survival (OS) of colon cancer patients in the TCGA database was analyzed based on the R software timeROC program package. Clinical data from the ICGC database were applied to externally validate the constructed prognostic model, and patients with colon cancer in the ICGC database were classified into high and low risk groups based on the median risk score of patients with colon cancer in the TCGA database. By using R software, single-sample gene set enrichment analysis (ssGESA), immunophenotyping difference analysis, immune microenvironment correlation analysis, and immune checkpoint gene difference analysis of immune cells and immune function were performed for prognosis-related inflammation response-related DEG in the TCGA database.Results:A total of 60 inflammatory response-related DEG and 12 prognosis-related DEG were obtained; and 6 prognosis-related inflammatory response-related DEG (CCL24, GP1BA, SLC4A4, SRI, SPHK1, TIMP1) were obtained by taking the intersection set. LASSO Cox regression analysis showed that a prognostic model for colon cancer was constructed based on 6 prognosis-related inflammatory response-related DEG, and the risk score was calculated as = -0.113×CCL24+0.568×GP1BA+ (-0.375)×SLC4A4+(-0.051)×SRI+0.287×SPHK1+0.345×TIMP1. PCA results showed that patients with colon cancer could be better classified into 2 clusters. The OS in the high-risk group was worse than that in the low-risk group in the TCGA database ( P < 0.001); the area of the curve (AUC) of the prognostic risk score for predicting the OS rates of 1-year, 3-year, 5-year was 0.701, 0.685, and 0.675, respectively. The OS of the low-risk group was better than that of the high-risk group in the ICGC database; AUC of the prognostic risk score for predicting the OS rates of 1-year, 2-year, 3-year was 0.760, 0.788, and 0.743, respectively. ssGSEA analysis showed that the level of immune cell infiltration in the high-risk group in the TCGA database was high, especially the scores of activated dendritic cells, macrophages, neutrophils, plasmacytoid dendritic cells, T helper cells, and follicular helper T cells in the high-risk group were higher than those in the low-risk group, while the score of helper T cells 2 (Th2) in the high-risk group was lower compared with that in the low-risk group (all P < 0.05); in terms of immune function, the high-risk group had higher scores of antigen-presenting cell (APC) co-inhibition, APC co-stimulation, immune checkpoint, human leukocyte antigen (HLA), promotion of inflammation, parainflammation, T-cell stimulation, type Ⅰ interferon (IFN) response, and type ⅡIFN response scores compared with those in the low-risk group (all P < 0.05). The results of immunophenotyping analysis showed that IFN-γ-dominant type (C2) had the highest inflammatory response score, and the differences were statistically significant when compared with trauma healing type (C1) and inflammatory response type (C3), respectively (all P < 0.05). Immune microenvironment stromal cells and immune cells were all positively correlated with prognostic risk scores ( r values were 0.35 and 0.21, respectively, both P < 0.01). The results of immune checkpoint difference analysis showed there was a statistically significant difference in programmed-death receptor ligand 1 (PD-L1) expression level between high-risk group and low-risk group ( P = 0.002), and PD-L1 expression level was positively correlated with prognostic risk score ( r = 0.23, P < 0.01). Conclusions:Inflammatory response-related genes may play an important role in tumor immunity of colon cancer and can be used in the prognostic analysis and immunotherapy of colon cancer patients.

Screening of endoplasmic reticulum stress signature-related genes in gastric cancer and the establishment of prognostic risk models / 肿瘤研究与临床

Objective:To screen the endoplasmic reticulum stress (ERS) signature-related differentially expressed genes (DEG) in gastric cancer and to construct a prognostic risk model based on a bioinformatics.Methods:Transcriptome sequencing data (RNA-seq) of 375 gastric cancer and 32 paracancerous tissue samples downloaded from The Cancer Genome Atlas (TCGA) database and the corresponding clinical information were obtained as training set samples; data of 387 gastric cancer patients (GSE84437) from Gene Expression Omnibus (GEO) database were downloaded as validation set samples. All data were obtained on December 25, 2021. A total of 785 ERS signature-related genes (ERS-RG) were obtained from the GeneCards database. DEG between gastric cancer tissues and paracancerous tissues in the TCGA database was analyzed. The identified gastric cancer DEG were intersected with ERS-RG from the GeneCards database to obtain gastric cancer ERS signature-related DEG, which were analyzed for gene ontology (GO) function and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment. Univariate Cox proportional risk model was used to screen ERS signature-related DEG with prognostic value in gastric cancer, and LASSO regression analysis was performed to construct a polygenic prognostic risk model, and to calculate the prognostic risk score. The patients in training set and validation set were divided into high-risk group and low-risk group according to the median of the prognostic risk score (2.369); Kaplan-Meier survival analysis was used to compare the overall survival (OS) and to draw time-dependent receiver operating characteristic (ROC) curves of patients in the two groups; nomogram was drawn based on the prognostic independent influencing factors of gastric cancer. The characteristic immune cell infiltration abundance between the two groups was analyzed by using the inverse convolution-based CIBERSORT algorithm. Cytolytic activity scores were calculated by using the geometric mean of granzyme A and perforin 1 expression. According to the median prognostic risk score (2.369) and median tumor mutation burden (TMB) (3.000), all patients with gastric cancer were divided into high risk score-high TMB group, high risk score-low TMB group, low risk score-high TMB group and low risk score-low TMB group to compare the OS of patients in each group.Results:A total of 444 ERS signature-related DEG in gastric cancer including 168 down-regulated genes and 276 up-regulated genes were obtained, which were mainly enriched in biological processes such as protein processing in the endoplasmic reticulum, extracellular matrix (ECM) receptor interactions and unfolded protein responses (all P < 0.05). Univariate Cox regression analysis showed that 12 prognostic-related ERS signature-related DEG in gastric cancer were screened out. LASSO regression analysis was performed to obtain a prognostic risk score = 0.052×NOS3+0.137×PON1+0.067×CXCR4+0.131×MATN3+0.116×ANXA5+0.090×SERPINE1. The results of Kaplan-Meier analysis showed that the OS of the low-risk group in both the training and validation sets was better than that of the high-risk group (all P < 0.01). The results of the time-dependent ROC curve analysis showed that the AUC for the 3-year, 5-year, 8-year OS rates was 0.695, 0.786, 0.698, respectively in the training set, while the AUC for the 3-year 5-year, 8-year OS rates was 0.580, 0.625, 0.627, respectively in the validation set. Multivariate Cox regression analysis showed that prognostic risk score ( HR = 3.598, 95% CI 2.290-5.655, P < 0.001) and tumor stage ( HR = 1.344, 95% CI 1.057-1.709, P < 0.05) were independent factors influencing the prognosis of gastric cancer. Among 375 gastric cancer patients in the TCGA database, the expression levels of ATF6, HSPA5, XBP1 and ATF4 in the high-risk group were higher than those in the low-risk group (all P < 0.05); CIBERSORT results showed that the abundance of activated CD4 memory T cells in the high-risk group was lower than that in the low-risk group, and the abundance of both M0 and M2 macrophages in the high-risk group was higher than that in the low-risk group (all P < 0.05). The expression levels of common immune checkpoints (CD274, CTLA4, TNFRSF9, TIGIT, PDCD1, LAG3) in the high-risk group were all higher than those in the low-risk group (all P < 0.05). Cytolytic activity score in the high-risk group was higher than that in the low-risk group ( P < 0.05). The prognostic risk score was negatively correlated with TMB ( r = -0.20, P < 0.001). Patients in the low-risk score-high TMB group had the best OS and those in the high-risk score-low TMB group had the worst OS (both P < 0.001). Conclusions:The prognostic risk score model is established based on 6 ERS signature-related DEG in gastric cancer and its prognostic risk score may be effective as an independent prognostic factor to predict the prognosis of gastric cancer patients.

Effects of long non-coding RNA HAGLR on the prognosis of breast cancer and the construction of competitive endogenous RNA interaction network / 肿瘤研究与临床

Objective:To explore the expression of long non-coding RNA (lncRNA) HAGLR in breast cancer and its effect on the prognosis of breast cancer, and to construct a competitive endogenous RNA (ceRNA) network.Methods:The Atlas of Genetics and Cytogenetics in Oncology and Haematology website was used to search for HAGLR chromosome gene mapping and transcript expression. The lnclocater website was used to predict the subcellular localization of HAGLR, and the differential expression of HAGLR in breast cancer tissues and adjacent tissues was analyzed by using lnCAR database. The patients in lnCAR database were divided into HAGLR high expression group and HAGLR low expression according to HAGLR expression. The Kaplan-Meier method was used to analyze the overall survival (OS) and metastasis-free survival, which was verified by using UCSC Xena database. lnCAR database was used to search the co-expressed genes of HAGLR. The top 200 co-expressed genes were submitted to the Metascape website for Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) functional enrichment analysis, and protein interaction network (PPI) was constructed. Starbase, a bioinformatics online analysis website, was used to predict HAGLR targeting mircoRNA (miRNA) and mRNA that directly encoded proteins. ceRNA network of HAGLR was constructed with Cytoscape3.8 software.Results:HAGLR gene was localized in 2q31.1 and mainly distributed in cytoplasm. The expression level of HAGLR in breast cancer tissues was higher than that in adjacent tissues, and the difference was statistically significant ( P < 0.001). lnCAR database and UCSC Xena database analysis showed that OS in HAGLR high expression group was worse than that in HAGLR low expression group (all P < 0.01). lnCAR database, the metastasis-free survival in HAGLR high expression group was worse than that in HAGLR low expression group ( P = 0.030). Among the top 200 HAGLR co-expressed genes, 129 genes were negatively correlated with HAGLR and 71 genes were positively correlated with HAGLR. KEGG pathway analysis showed that HAGLR was related to metabolic pathways, MAPK signaling pathway, JAK-STAT signaling pathway and cancer pathway. GO annotation analysis showed that HAGLR was mainly enriched in cell cycle, centromeric complex assembly, mitotic progression, protein kinase binding, kinase activity regulation, cell response to DNA damage stimulation and other functions. hsa-miR-130b-3p, hsa-miR-1245b-5p, hsa-miR-182b-5p, hsa-miR-512-3p, hsa-miR-302b-3p, hsa-miR-185b-5p, hsa-miR-106b-5p were HAGLR targeting miRNA. Conclusions:HAGLR is highly expressed in breast cancer tissues, and it may be a biomarker for predicting the prognosis of breast cancer.

Preliminary evaluation of the practicability of a clinical decision support system for diagnosis and treatment of thyroid cancer (CDSS-TC) / 中华内分泌外科杂志

Objective:To study the practical efficacy of the clinical decision support system for diagnosis and treatment of thyroid cancer (CDSS-TC) in assisting doctors to complete several diagnosis and treatment tasks, and to make a preliminary evaluation of its clinical practicability according to the test results.Methods:From Jan. 2022 to Mar. 2022, 90 patients with thyroid cancer who were admitted to the Head and Neck Surgery Department of Shaw Hospital affiliated to Zhejiang University were prospectively analyzed, and the average time spent in reading the pre-operative B-ultrasound report, as well as the individual fitness of the dose adjustment of eugenol in 70 patients with thyroid cancer after surgery. A retrospective analysis was made of the compliance of the basis of the "recommended scheme" and the deviation of the basis of the doctor’s "final scheme" for the preoperative surgery of 120 patients with thyroid cancer who were treated for the first time in the head and neck surgery of Shaw Hospital affiliated to Zhejiang University from Mar. 2021 to May. 2021. All cases were treated by pure artificial (group A) and CDSS-TC assisted (group B) , and the differences in organization were compared.Results:The average time for disposal of a single B-ultrasound report in Group B was much shorter than that in Group A ( P=5.600E-04) ; The number of patients with excellent grade and the total number of patients with excellent grade and qualified grade recommended by the doctor in group B were significantly higher than those in group A ( P=7.819E-20 and P=1.335E-18) ; The conformity rate of the basis of CDSS-TC "Recommended Scheme" ≥ 98%; The deviation rate of the basis for "final protocol" of doctors in group B was lower than that in group A ( P=0.059 for total resection or not, P=0.075 for lateral neck dissection or not) . Conclusions:CDSS-TC can accurately extract the disease-related source information in all the original examination/laboratory reports, and provide accurate decision-making suggestions through efficient correlation analysis. In view of the accurate and objective conclusions of its analysis, it can provide high-quality and all-link decision support for doctors’ clinical diagnosis and treatment, and is an ideal information work platform.

Screening and functional verification of key genes in acute myeloid leukemia / 白血病·淋巴瘤

Objective:To explore the key genes related to the development, progression and prognosis of acute myeloid leukemia (AML) based on bioinformatics, and to analyze their functions.Methods:The chip expression profile GSE84881 data set of AML patients including 19 AML samples and 4 normal tissue samples was downloaded from the gene expression omnibus (GEO) database. GEO online tool GEO2R was used to screen the differentially expressed genes (DEG). The DAVID online database was used to make gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis of DEG. The STRING online database was used to analyze the protein interaction (PPI) network of DEG, and the key genes were screened by using the Cytoscape software. The weighted gene co-expression network analysis (WGCNA) was used to build co-expressed network and obtain the central genes.LC-Bio online platform was used to construct Venn diagram and the key genes and central genes in PPI were crossed to finally obtain the true key genes. RNA-seq datasets GSE2191 and GSE90062 of human tissues were downloaded from GEO database to verify the screened key genes. Kaplan-Meier method was used to analyze the effects of key genes on the overall survival (OS) of AML based on the data of GEPIA database.Results:A total of 247 DEG were identified in GSE84881 data set, including 112 up-regulated genes and 135 down-regulated genes. According to the results of GO enrichment analysis, 247 DEG were mainly enriched in the regulation of signal transduction and cell proliferation in the biological process (BP); the cell composition (CC) revealed that these genes were mainly involved in the cytoplasm and exosomes; the molecular function (MF) analysis showed that these genes were mainly enriched in protein binding and calcium binding. Further KEGG pathway enrichment analysis showed that these 247 DEG were mainly involved in NOD-like receptor signal pathway and interleukin 17 (IL-17) signal pathway. And then the 12 key genes were obtained from PPI. WGCNA software was used to screen 13 central genes from GSE84881 dataset and finally 1 real key gene EGF was obtained after taking intersection. Kaplan-Meier method showed that OS time of AML patients in EGF high expression group was decreased than that in EGF low expression group, and the difference was statistically significant( P = 0.044). Conclusions:EGF may be an important diagnosis and treatment target of AML and may become a potential biomarker for clinical treatment and prognosis prediction of AML.

Conocimientos, habilidades, actitudes y prácticas en telesalud de los profesionales de la salud durante la pandemia de COVID-19

Introducción: La pandemia por el SARS-CoV-2 estableció desafíos para los sistemas de salud en función de dar continuidad a la atención de los pacientes por medio de la rápida adopción de la telesalud. Esto conllevó retos para los profesionales que se enfrentaron a las tecnologías de la información y la comunicación. Objetivos: Identificar conocimientos, habilidades, actitudes y prácticas de los profesionales de la salud que emplearon la telesalud en el ámbito ambulatorio durante la pandemia y analizar los posibles factores relacionados con las barreras que presentan los profesionales para implementar de forma efectiva los servicios de telesalud. Métodos: Estudio descriptivo de corte transversal analítico. Se aplicó una encuesta electrónica a profesionales de salud de tres centros médicos de Colombia. Resultados: Se aplicaron 430 encuestas. La mediana de edad fue de 39 años y el 79 % fueron mujeres. El 57 % no habían sido capacitados en aspectos técnicos, normativos y éticos de la telesalud; el 46 % reportó dificultad para administrar el tiempo; el 81 % manifestó el aumento en su carga laboral. La dificultad para emplear las herramientas tecnológicas se asoció 4,67 veces más a la percepción de alteración de su propio estado de salud; sin embargo, el 92 % manifestó que seguiría usando la telesalud. Conclusiones: La actitud frente al uso de la telesalud fue positiva; el conocimiento, habilidades y entrenamiento en telesalud parece determinar su aceptabilidad. Esta es una primera evaluación que revela los puntos a trabajar en el caso de los profesionales, en función de la permanencia de la telesalud como herramienta para la atención de pacientes.

Introduction: The SARS-CoV-2 pandemic posed challenges for health systems in terms of providing continuity of patient care through the rapid adoption of telehealth. This brought challenges for professionals who dealt with information and communication technologies. Objectives: To identify knowledge, skills, attitudes, and practices of health professionals who used telehealth in the outpatient setting during the pandemic and to analyze possible factors related to the barriers that professionals present to effectively implement telehealth services. Methods: This is a descriptive analytical cross-sectional study. An electronic survey was used on health professionals from three medical centers in Colombia. Results: Four hundred thirty (430) surveys were used. The median age was 39 years and 79% were women. 57% had not been trained in technical, regulatory and ethical aspects of telehealth; 46% reported difficulty managing time; 81% reported an increase in their workload. The difficulty in using technological tools was associated 4.67 times more with the perception of alteration of their own state of health; however, 92% said they would continue to use telehealth. Conclusions: The attitude towards the use of telehealth was positive; knowledge, skills, and training in telehealth seem to determine its acceptability. This is a first evaluation that reveals the points to work on in the case of professionals, based on the permanence of telehealth as a tool for patient care.

Percepción de brechas y oportunidades en eSalud de estudiantes de último año de Medicina en Colombia

Introducción: En los últimos años la explosión de dispositivos con acceso a internet en el mundo ha presentado una oportunidad para el desarrollo de intervenciones en salud. Métodos: Se realizó un estudio observacional transversal de tipo descriptivo; se clasificaron las propuestas de innovación presentadas por estudiantes de último año de medicina como trabajo final de un curso de eSalud. Los proyectos se clasificaron en tres dimensiones: grupo poblacional, problema de salud a resolver y tipo de intervención de salud digital. Resultados: Se analizaron 86 proyectos entre los años 2017 y 2020. El 80,2 % se orienta a la población general, seguidos por la gestante (10,4 %), la infantil (8,14 %) y la geriátrica (1,2 %). El 36 % de los proyectos no mencionaban una condición particular de salud; el 12,8 % se dedicó a la salud sexual y reproductiva; el 10,4 % a las enfermedades cardiovasculares; el 9,3 % a la salud mental y el 4,65 % a aspectos de crecimiento y desarrollo. El 59,3 % de los proyectos se dirigía a apoyar las actividades del prestador de servicios de salud; el 34,9 % estaba orientado hacia las necesidades de los usuarios de los sistemas de salud y el 5,9 % se enfocó en los servicios de datos. Conclusiones: La percepción colectiva de los estudiantes refleja la oportunidad de fortalecer la atención primaria en salud mediante el uso de las tecnologías de la información y las comunicaciones, con énfasis en las poblaciones vulnerables. Los estudiantes empiezan a identificar los servicios de datos como oportunidad de intervención.

Introduction: In recent years, the explosion of devices with Internet access in the world has presented an opportunity for the development of health interventions. Methods: A descriptive cross-sectional observational study was carried out. Innovation proposals submitted by last-year medical students were classified as the final project of an eHealth course. The projects were classified into three dimensions: population group, health problem to be solved, and type of digital health intervention. Results: Eighty-six projects were analyzed from 2017 to 2020. 80.2% were aimed at the general population, followed by pregnant women (10.4%), children (8.14%) and geriatrics (1, 2 %). 36% of the projects did not mention a particular health condition; 12.8% was dedicated to sexual and reproductive health; 10.4% to cardiovascular diseases; 9.3% to mental health and 4.65% to aspects of growth and development. 59.3% of the projects were aimed at supporting the activities of the health service provider; 34.9% were oriented towards the needs of users of health systems and 5.9% focused on data services. Conclusions: The collective perception of the students reflects the opportunity to strengthen primary health care through the use of information and communication technologies, with emphasis on vulnerable populations. Students begin to identify data services as an opportunity for intervention.

Implementação de Prontuário Eletrônico por profissionais médicos e enfermeiros da Atenção Primária à Saúde / Implementation of Electronic Medical Records by physicians and nurses in Primary Health Care

Objetivo: Avaliar a implementação o Prontuário Eletrônico do Cidadão da estratégia e-SUS na Atenção Primária a Saúde pelos médicos e enfermeiros de duas macrorregiões de saúde de Minas Gerais. Métodos: Estudo de método misto explanatório sequencial quanti-qualitativo. A coleta de dados ocorreu por meio de um formulário online. Foi construída uma matriz de análise e julgamento para avaliar e ponderar as questões avaliativas no instrumento de coleta. Resultados: De maneira geral, o grau de implementação de cada uma das funcionalidades (assistenciais e gerenciais) foi classificado como não adequado, mas há diferença quando se compara as profissões. Os dados mostram que a medicina quando comparada com a enfermagem tem a utilização do prontuário com escore menor, indicando que médicos informaram usar menos o prontuário eletrônico do que os enfermeiros. Conclusões: Apesar dos grandes esforços governamentais para expandir a implantação do prontuário eletrônico, sua implementação, de forma geral, ainda não é adequada. Dessa forma, a utilização do prontuário eletrônico como potencial qualificador de dados em saúde deve ser estimulada em direção à gestão e coordenação do cuidado(AU)

Objective: To evaluate the implementation of the Electronic Citizen's Record of the e-SUS strategy in Primary Health Care by physicians and nurses from two health macro-regions in Minas Gerais. Methods: Estudio de método mixto explicativo secuencial cuantitativo-cualitativo. Data collection took place through an online form. An analysis and judgment matrix were built to evaluate and weigh the evaluative questions in the collection instrument. Results: In general, the degree of implementation of each of the functionalities (assistance and management) was classified as not adequate, but there is a difference when comparing the professions. The data show that medicine, when compared to nursing, uses the medical record with a lower score, indicating that physicians reported using the electronic medical record less than nurses. Conclusions: Despite major government efforts to expand the implementation of electronic medical records, its implementation, in general, is still not adequate. Thus, the use of electronic medical records as a potential qualifier of health data should be encouraged towards the management and coordination of care(AU)

Objetivo: Evaluar la implementación del Registro Ciudadano Electrónico de la estrategia e-SUS en la Atención Primaria de Salud por médicos y enfermeros de dos macrorregiones de salud de Minas Gerais. Métodos: La recolección de datos se realizó a través de un formulario en línea, se construyó una matriz de análisis y juicio para evaluar y ponderar las preguntas evaluativas del instrumento de recolección. Resultados: En general, el grado de implantación de cada una de las funcionalidades (asistencia y gestión) fue catalogado como no adecuado, pero hay diferencias, al comparar las profesiones. Los datos muestran que la medicina, en comparación con la enfermería, utiliza la historia clínica con una puntuación más baja, lo que indica que los médicos utilizan menos la historia clínica electrónica que las enfermeras. Conclusiones: A pesar de los grandes esfuerzos gubernamentales por ampliar la implementación de la historia clínica electrónica, su implementación, en general aún no es adecuada. Por lo tanto, se debe fomentar el uso de la historia clínica electrónica como potencial calificador de datos de salud para la gestión y coordinación de la atención(AU)