Analisis Del Impacto Del Covid-19 En Pacientes Con Enfermedad Inflamatoria Intestinal Empleando Inteligencia Artificial (Savana Manager)

Introduccion: Estudiamos el impacto del COVID-19 en pacientes con Enfermedad Inflamatoria Intestinal (EII) en Castilla-La Mancha. Metodos: Estudio observacional retrospectivo utilizando inteligencia artificial con capacidad de procesamiento de lenguaje natural, SAVANA manager. Esta herramienta, a pesar de sus sesgos (ej: duplicacion de casos), permite analizar grandes poblaciones. Analizamos datos de 1.808.010 pacientes durante 2020. Resultados: Se identificaron 2.243 pacientes con EII y COVID-19, que en comparacion con los casos de COVID-19 sin EII hubo mas hipertension arterial, diabetes mellitus, dislipemia, obesidad o tabaquismo. A pesar de ello, no se apreciaron diferencias en hospitalizacion (0,8607, 0,7320-1,0121, p = 0,0696), ingreso en UCI (0,4113, 0,1025-1,6508, p = 0,2102) o mortalidad (0,9099, 0,6123-1,3521, p = 0,6402). COVID-19 fue mas frecuente en pacientes con EII (3,6413, 3,4616-3,8303, p < 0,0001). Comparando pacientes con EII y COVID-19 segun sus tratamientos, vedolizumab es el unico con mayor riesgo de COVID-19 (0,3091, 0,0967-0,9886, p = 0,0478), sin embargo, el riesgo de hospitalizacion para vedolizumab es menor (0,3091, 0,0967-0,9886, p = 0,0478). Los inmunomoduladores tambien tienen un menor riesgo de hospitalizacion tanto solos (0,6677, 0,4650-0,9588, p = 0,0287) como combinados con anti-TNF (0,5109, 0,2836-0,9205, p = 0,0254). No se encontraron diferencias para monoterapia anti-TNF, ustekinumab o tofacitinib. La tasa de UCI y la mortalidad no son diferentes entre los tratamientos, salvo para tofacitinib (tasa de UCI 0,00%, mortalidad 10,00%), sin embargo, el pequeno numero de pacientes podrian sesgar este resultado. [Table presented] Conclusiones: COVID-19 en pacientes con EII no es diferente en hospitalizacion, ingreso en UCI o mortalidad en comparacion con la poblacion sin Ell. Los pacientes con Ell expuestos a inmunomoduladores y vedolizumab tienen menor riesgo de hospitalizacion que los no expuestos, no se encontraron diferencias para anti-TNF monoterapia o ustekinumab.Copyright © 2023 Elsevier Espana, S.L.U. Todos los derechos reservados.

Exploring the Experiences of Latinx Immigrant Families who are Undocumented during the COVID-19 Pandemic through an Ecosystemic Perspective

Latinx families in the United States who are undocumented face challenges that worsened during the COVID-19 pandemic and negatively impacted child development and well-being. The purposes of this paper are to present this community's experiences from an ecosystemic perspective and provide guidelines and implications for child welfare professionals. This paper urges child welfare professionals to develop models and initiatives that alleviate effects of barriers to access care and services experienced by this community.

Patterns of Self-medication During the COVID-19 Pandemic in a Colombian population.

Introduction: Self-medication is considered one of the most relevant problems for public health, since it is described as the voluntary use of drugs by the patient. Since the beginning of the health crisis caused by the COVID-19 pandemic, it has been evident that this practice has increased considerably, especially in the adult population. Objective(s): To evaluate the different patterns that influence self-medication during the COVID-19 pandemic. Method(s): A survey was conducted among the population of two vicinities of Bogota and the statistical program SPSS was used for data analysis to identify the main practices that increase the risks derived from self-medication, the most used drugs and their adverse effects. Socioeconomic factors related to self-medication were evaluated. A comparative study was carried out to observe their behavior before and during the pandemic. Additionally, the influence of the people who are part of the family and social environment on self-medication was evaluated. Result(s): The total number of surveys carried out was 301. The average age was 44.18 years. It was found that before the pandemic there was a higher frequency of self-medication of analgesics (49.1 %) and anti-influenza drugs (19.5 %), and during the pandemic it was of non-steroidal anti-inflammatory drugs (4.43 %), home remedies (6.69 %) and antibiotics (30.38 %). In addition, it was found that those who had the greatest influence on self-medication were family members (23.9 %), friends or acquaintances (17.3 %) and the pharmaceutical chemist (5.0 %). Conclusion(s): It is evident that during the COVID-19 pandemic self-medication is higher than in the pre-pandemic era, increasing the risk of adverse events and compromised patient safety.Copyright © 2023, Editorial Ciencias Medicas. All rights reserved.

Characterization of food patterns during the COVID 19 pandemic in Chile.

Background: Confinement to prevent contagion by COVID-19 has been shown to have a negative impact on different components of the population's health, food being one of the most notable. The objective of this work was to characterize the intake of certain foods according to sex, age, and educational and socioeconomic level during the COVID 19 pandemic in Chile.. Method(s): cross-sectional study through an online survey. Each person answered a food intake questionnaire on the self-administered form, and questions about the type and duration of confinement and sociodemographic data. Result(s): 1722 people participated (82.5% female). When evaluating the% of compliance with the recommendations for each food, fruit and dairy, it is less than 10%, but being significantly higher in women, whereas the consumption of sugary drinks, caffeinated drinks and alcohol, the highest in men. When comparing by age, it was observed that in those over 55 years of age the majority of healthy foods were reduced, more unhealthy foods such as sugary drinks and junk food and when comparing by socioeconomic level, a lower consumption of healthy foods was observed in people of lower level Socioeconomic, on the contrary, the consumption of unhealthy foods was higher, except for alcohol, caffeinated beverages and sugar. Conclusion(s): There is a high consumption of unhealthy foods during the pandemic, and there are differences in intake according to sex, age and socioeconomic level.Copyright © 2022 Sociedad Espanola de Nutricion Comunitaria. All rights reserved.

Densely Connected Neural Network and Permutation Entropy in the Early Diagnostic in COVID Patients

The COVID-19 pandemic has been characterized by the high number of infected cases due to its rapid spread around the world, with more than 6 million of deaths. Given that we are all at risk of acquiring this disease and that vaccines do not completely stop its spread, it is necessary to continue proposing tools that help mitigate it. This is the reason why it is ideal to develop a method for early detection of the disease, for which this work uses the Stanford University database to classify patients with SARS-CoV-2, also commonly called as COVID-19, and healthy ones. In order to do that we used a densely connected neural network on a total of 77 statistical features, including permutation entropy, that were contrasted from two different time windows, extracted from the heart rate of 24 COVID patients and 24 healthy people. The results of the classification process reached an accuracy of 86.67% and 100% of precision with the additional parameters of recall and F1-score being 80% and 88.89% respectively. Finally, from the ROC curve for this classification model it could be calculated an AUC of 0.982. © 2022 Creative Commons.

The impact of COVID-19 on patients with Inflammatory Bowel Disease: A population-based study using artificial intelligence

Background: Coronavirus disease 2019 (COVID-19) has been a pandemic that is still very prevalent. Patients with Inflammatory Bowel Disease (IBD) represent a special population considering their already altered immune system and their exposure to several immunosuppressive therapies. We pretend to study the impact of COVID-19 on IBD patients in our community, Castilla-La Mancha (a region in central Spain). Method(s): Retrospective observational study using an artificial intelligence with natural language processing capability, the SAVANA manager, we analyzed data from 1 808 010 patients with Electronic Medical Records (EMR) within the public health system of Castilla-La Mancha from March 1st 2020 to January 1st 2021. Data on demographic characteristics, hospitalization, ICU admission and mortality were collected. We compared COVID outcomes between IBD and non-IBD patients. We compared COVID outcomes in IBD patients according to their treatment (comparing each treatment group to those IBD patients with no treatment);we considered: Immunomodulators (azathioprine, mercaptopurine, methotrexate), antiTNF alone or combined with immunomodulator, vedolizumab, ustekinumab and tofacitinib;mesalazine and corticosteroids were not analyzed. Result(s): 2 243 patients with IBD suffered COVID-19, compared to COVID-19 cases without IBD there were less females, they suffered more arterial hypertension, diabetes mellitus, dyslipidemia, obesity, or tabacco use (TABLE 1). And yet, despite these being proven risk factors for worse outcomes for COVID-19, no differences were appreciated in hospitalization rate, ICU admission, or mortality between those with or without IBD (TABLE 2). COVID-19 was more frequent in IBD patients (32.59 vs 13.28%). Comparing IBD patients with COVID-19 according to their treatments (TABLE 3), vedolizumab is the only treatment with a higher risk for COVID-19 infection, however the hospitalization risk for vedolizumab is lower than for those without it. Immunomodulators do also have a lower hospitalization risk both alone or in combination with antiTNF, no differences were found for antiTNF monotherapy, ustekinumab or tofacitinib. ICU rate and mortality are no different between treatments, except for tofacitinib (0.00% ICU rate, 10.00% mortality), however the small number of patients using this treatment may bias this result. Conclusion(s): COVID-19 in IBD patients is no different in hospitalization, ICU admission or mortality compared to non-IBD population. IBD patients exposed to immunomodulators and vedolizumab have less hospitalization risk than those not exposed, no differences were found for antiTNF alone or ustekinumab. The impact of tofacitinib in COVID outcomes requires further investigation.

Burnout syndrome, anxiety, depression and occupational well-being among Peru hospital staff during the COVID-19 pandemic

Introduction: The COVID-19 pandemic has had serious consequences for the mental health of individuals, especially health care providers, who have experienced symptoms of stress, anxiety and depression that affect their personal, family and social lives. This situation has led health entities to evaluate the negative effects and to design interventions. Objective: To establish the relationship between burnout syndrome, anxiety, depression and work well-being, considering sociodemographic and work variables, including differences according to the type of work. Methods: The present study is non-causal, comparative, cross-sectional and prospective. The sampling was intentional non-probabilistic, with a total of 366 participants from three hospitals in Ancash (Peru) under COVID-19 conditions during the second wave. For the measurement of the variables, the Maslach Burnout Inventory, the Goldberg anxiety/depression subscales and the Sánchez-Cánovas work well-being subscales were used. Results: The results indicated multiple relationships among burnout syndrome, anxiety, depression and work well-being (p <0.05). Likewise, these relationships were also presented considering some sociodemographic and labor variables (p <0.05). Conclusions: The variables studied have a significant relationship in the health care personnel examined. Based on these findings, it is possible to have a baseline of the mental health of health personnel to plan interventions that emphasize those variables and groups at risk that require special attention. © 2022, Editorial Ciencias Medicas. All rights reserved.

Student Teachers' Classroom Impact during Their Practicum in the Times of the Pandemic

The COVID-19 pandemic impacted societal structures worldwide. In the educational realm, the forced closure, and subsequent reopening of school settings disrupted the personal and professional lives of administrators, teachers, parents, and students. Two groups of Spanish stakeholders affected by the return to face-to-face instruction during the pandemic were the University of Extremadura's student teachers and their mentors during the practicum, as student teaching is known in Spain. This study investigated 28 student teachers' and 26 mentors' responses to a questionnaire enquiring on the main challenges resulting from the pandemic, as well as student teachers' contributions to the classroom during this difficult time. Cualitative software was used to analyze participants' responses allowed us to identify four main themes: attitudes;classroom management issues;adaptations and restrictions;and academic–experiential modifications. Overall, the findings revealed student teachers' and mentors' positive opinions about their joint work experience and about student teachers' logistical and technological support. © 2023 by the authors.

Diabetes mellitus: Lessons from COVID-19 for monkeypox infection.

BACKGROUND AND AIMS: Type 2 Diabetes Mellitus is known to be linked to malfunctioning antiviral defense; however, its association with the severity of monkeypox is poorly understood. In this review, we discuss key immunological mechanisms in the antiviral response affected by poor glucose control that could impact the susceptibility and severity of monkeypox infection, leading to a heightened emphasis on the use of the available antidiabetic drugs. METHODS: We searched PubMed and Google scholar for articles published from January 1985 to August 2022. No criteria for publication data were set, and all articles in English were included. RESULTS: Currently, there are no studies about the risk or consequences of monkeypox infection in the diabetic population. A high incidence of diabetes is reported in countries such as China, India, Pakistan, EUA, Indonesia, Brazil, Mexico, Bangladesh, Japan, and Egypt, where unfortunately imported cases of monkeypox have been reported and the infection continues to spread. CONCLUSIONS: High incidence of diabetes together with the cessation of smallpox vaccination has left large numbers of the human population unprotected against monkeypox. The best option for the population remains confined to the prevention of infection as well as the use of hypoglycemic agents that have also been shown to improve immune mechanisms associated with viral protection.

EVALUATION OF THE EFFECTS OF CONSUMER TRUST ON ELECTRONIC WORD-OF-MOUTH (E-WOM) IN E-COMMERCE STORES IN COLOMBIA

ASBTRACT: Restrictions imposed to contain covid-19 during 2020 caused a large growth in e-commerce that was not the same for all products. The product categories with less favorable performance require tools to stim-ulate sales through the digital channel, while high-selling products need to retain their customers. Within such a setting, the generation of electronic word of mouth (e-WoM) is one of the marketing strategy tools that foster e-commerce, so it is important to analyze the variables that affect this asset. One of these variables is consumer confidence in online stores, which has proved to promote e-WoM in international contexts. To add to this field of study, we conducted a cross-sectional research based on a structural equation model that adopts confidence and e-WOM scales found in the literature, which were validated using the partial least squares regression technique in the SmartPLS3 software. Additionally, a group of customers of B2C e-commerce stores in Bogotá, Medellín and Cali were surveyed. Our results show that marketing experts in Colombia should look for mechanisms to strengthen trust in online stores, as this contributes to the spread of electronic word of mouth. © 2023, Universidad Nacional de Colombia. All rights reserved.

Molecular diagnosis of SARS-CoV-2 at LIORAD-AICA+ laboratories, a one-year work experience

Introduction: The increase in the number of cases of COVID-19 in Cuba demanded of new capacities for the molecular diagnosis of the infection. A Laboratory of Molecular Biology for the molecular diagnosis of this disease was installed at the Base Business Unit LIORAD-AICA+ Laboratories in Havana.

Learning Strategies and Achievement of Generic Competencies in Nursing Students

Introduction: The changes in education that have occurred in the world due to the COVID-19 pandemic lead to the transformation of paradigms in teachers and students, who must assume new learning strategies to achieve the competencies established in the nursing academic-professional profile and thus approach patient care with quality. Objective: To describe learning strategies and their relationship with the achievement of generic competencies in undergraduate nursing students. Methods: A quantitative, descriptive, correlational and cross-sectional study was conducted at the Professional School of Nursing, Universidad Nacional Mayor de San Marcos, Lima-Peru, between August and November 2020. The population was 96 nursing students. The technique used was the interview and the instruments applied were the ACRA learning strategies scale, reliability (0.869) and a Likert-type scale to evaluate the achievement of generic competencies, reliability (0.986). The data were processed using IBM SPSS version 25 software;descriptive statistics and Pearson's Chi-square method for the relationship between variables were used for the analysis. Results: Pearson's Chi-square test showed a significant and strong correlation between both variables (p = 0.784). Cognitive (71.90 %), metacognitive (62.50 %), and affective (74.30 %) learning strategies are little used by nursing students;systemic (65.60 %), instrumental (58.30 %), and interpersonal (63.50 %) generic competencies are in the process of achievement. Conclusions: Significant and strong relationship was found between learning strategies and the achievement of generic competencies of undergraduate nursing students. © 2022, Editorial Ciencias Medicas. All rights reserved.

Molecular diagnosis of SARS-CoV-2 at LIORAD-AICA+ laboratories, a one-year work experience

Introduction: The increase in the number of cases of COVID-19 in Cuba demanded of new capacities for the molecular diagnosis of the infection. A Laboratory of Molecular Biology for the molecular diagnosis of this disease was installed at the Base Business Unit LIORAD-AICA+ Laboratories in Havana. Objective(s): To analyze a one-year work experience in the molecular diagnosis of COVID-19 at the Laboratory of Molecular Biology, LIORAD-AICA+. Method(s): To begin with the molecular diagnosis of SARS-CoV-2 at LIORAD-AICA+, a group of actions were carried out aimed at evaluating the risks, establishing the working areas and flow, and training the work team. Personnel were trained, and procedures and guidelines were drawn up and modified. Result(s): Risk assessment allowed identifying several risks associated with the diagnostic activity, and measures were established to mitigate them. The laboratory personnel received 23 training sessions;and eight procedures and guidelines, and two registers were drawn up. The laboratory processed a total of 125 154 samples in a year. Conclusion(s): During the work year, the accurate diagnosis of the disease was conducted at the Laboratory of Molecular Biology, LIORAD-AICA+. This evidences the importance of personnel training and the compliance with good practices and biosafety measures when working with potentially infectious samples. Copyright © 2022, Editorial Ciencias Medicas. All rights reserved.

SAFETY AND EFFICACY OF THYMIC PEPTIDES IN THE TREATMENT OF HOSPITALIZED COVID-19 PATIENTS IN HONDURAS.

Coronavirus disease 2019 (Covid-19) active cases continue to demand the development of safe and effective treatments. This is the first clinical trial to evaluate the safety and efficacy of oral thymic peptides. ; We conducted a nonrandomized phase 2 trial with a historic control group to evaluate the safety and efficacy of a daily 250-mg oral dose of thymic peptides in the treatment of hospitalized Covid-19 patients. Comparisons based on standard care from registry data were performed after propensity score matching. The primary outcomes were survival, time to recovery, and number of participants with treatment-related adverse events or side effects by day 20. ; A total of 44 patients were analyzed in this study: 22 in the thymic peptide group and 22 in the standard care group. There were no deaths in the intervention group compared to 24% mortality in standard care by day 20 (log-rank P=0.02). Kaplan-Meier analysis showed a significantly shorter time to recovery by day 20 in the thymic peptide group than in the standard care group (median, 6 days vs. 12 days; hazard ratio for recovery, 2.75 [95% confidence interval, 1.34 to 5.62]; log-rank P=0.002). No side effects or adverse events were reported. ; In patients hospitalized with Covid-19, the use of thymic peptides resulted in no side effects, adverse events, or deaths by day 20. Compared with the registry data, a significantly shorter time to recovery and mortality reduction were measured.

Effect of nutritional supplementation on skeletal muscle mass in patients hospitalized for COVID-19 in a National Hospital, 2022

Introduction: The SARS-CoV-2 virus has generated a series of disorders such as hyporexia, fatigue, considerably impacting the atrophy of skeletal muscle mass, so the use of nutritional supplements is an alternative to avoid complications such as pneumonia, fatigue and muscle atrophy. Objective: To evaluate the effect of nutritional supplementation on skeletal muscle mass in patients hospitalized for COVID-19. Materials and methods: Quantitative, quasi-experimental study, the population was composed of 32 patients hospitalized at the Cayetano Heredia Hospital. The sample was of 30 participants, the groups were formed in an intentional non-probabilistic way: one control and one research;8 men and 7 women in the control group, the mean age was 52.33, range 26 and standard deviation 8.98;in the research group 9 men and 6 women, the mean age was 50.66, range 25 and standard deviation 8.49;who responded to previously established inclusion criteria, the control group was given a standardized balanced diet and the research group was additionally administered a nutritional supplement based on whey protein, leucine and vitamin D for 15 days. Skeletal muscle mass was assessed in both groups at the beginning and end of the nutritional intervention through electrical bioimpedance, the information was collected in a data sheet. Results: It was evidenced that most of the patients were male and adults older than 50 years. At the beginning of the investigation, both study groups presented decreased skeletal muscle mass (p<0.05), at the end of the nutritional intervention most of the participants in the control group improved (<(X)over bar>=22.05), while in the research group all improved ((X) over bar =24.67), the results showed a significant difference (p<0.00). Conclusions: The intake of the nutritional supplement based on whey protein, leucine and vitamin D is effective because it increases the skeletal muscle mass of patients hospitalized for COVID-19.

Characterization of the dietary profile of the old adults in Ibero-american during of pandemic by COVID 19

Objective: To characterize the food profile of the Older People of Ibero-America in times of the COVID 19 pandemic. Material and methods: Multicenter study in 12 Ibero-American countries, an online survey was applied that included sociodemographic questions and a Food Intake questionnaire that included the frequency of consumption for vegetables, sugary drinks, legumes, dairy products and portion of food. Results: The sample was made up of 624 participants, 72.1% (n= 450) of women. 54.7% of women do not consume sugary drinks, while in men 54% consume at least one glass a day (p=0.012). 35.6% of men consumed >= 3 legumes per week versus 23% of women (p=0.020). 37.3% of women consume >= 2 daily servings of dairy products, in men only 28.1% (p= 0.030). Women have a higher consumption of vegetables (44.7%, n= 201) compared to men (28.7%), (p=0.001). 17.4% of the total sample increased the size of the food portion, being higher in women (p=0.005). Conclusion: Women have healthier eating habits than men based on fruits, vegetables, on the other hand, the variation in size increases, especially in women.

Dietary Patterns and Dietary Recommendations Achievement From Latin American College Students During the COVID-19 Pandemic Lockdown

This study aimed to compare the diet quality of different dietary patterns among college students from Latin American countries, including vegetarians, vegans, and omnivores during the COVID-19 pandemic. A cross-sectional, observational, multicenter study was conducted including a non- probabilistic sample of university students from 10 countries. University students were invited to participate in the study through social network platforms. Participants were self-reported to have followed a specific dietary pattern;either the Prudent diet, Western diet, Ovo-dairy-vegetarian diet, Fish-vegetarian diet, Strict vegetarian diet (vegan) or other. The last three patterns (vegetarians and vegans) were grouped as following a plant-based diet. A self-assessment survey was used to evaluate healthy eating habits using a questionnaire with values between 1 (do not consume) and 5 (consume) for a total of 9–45 points (higher values represent better eating habits). Unhealthy habits were assessed with nine questions. A total of 4,809 students filled out the questionnaire, and the majority of them were females (73.7%). A high percentage have been in lockdown for more than 5 months and were in lockdown when the survey was released. 74.3% were self-reported to follow a prudent diet, while 11.4% reported following a western dietary pattern and 8.8% a plant-based diet. When compliance with healthy and unhealthy dietary habits was analyzed, although all groups had low compliance, the plant-based diet group (56.09 ± 6.11) performed better than the Western diet group (48.03 ± 5.99). The total diet quality score was significantly higher for plant-based diet followers, who also tended to better achieve the recommendations than omnivorous students, especially the ones following a western diet. These results present evidence that young adults such as college-aged students have unhealthy dietary habits. However, the ones who follow a plant-based diet such as vegetarians and vegans exhibit better scores and healthier dietary conducts. Copyright © 2022 Murillo, Gómez, Durán-Agüero, Parra-Soto, Araneda, Morales, Ríos-Castillo, Carpio-Arias, Cavagnari, Nava-González, Bejarano-Roncancio, Núñez-Martínez, Cordón-Arrivillaga, Meza-Miranda, Mauricio-Alza and Landaeta-Díaz.

Assessment of alprazolam abuse: Data from the French addictovigilance network

Introduction: Alprazolam is a high potency and short-acting anxiolytic benzodiazepine. Alprazolam was one of the most misused benzodiazepines during the first lockdown related to the Covid-19 pandemic [1]. Thus, an evaluation of the abuse of alprazolam was requested by the French Medicines Agency. Material and methods: Analysis of the epidemiological tools of the French Addictovigilance network (FAN) over the period 2011-2020: spontaneous notifications (NotS), supplemented by data collected in addictology care centers (OPPIDUM), false prescriptions (OSIAP), substance-related deaths (DRAMES), and chemical submission data. Results: During the study period, among the 675 NotS analysed, women were slightly in the majority (51.7%), and the median age of users was 39 years. The desired effects were the intensification of the therapeutic or recreational effects, a euphoric effect and the management of withdrawal from other substances (opioids, psychostimulants). Regarding tools, a male predominance (60-72%) was observed with an age of approximately 35-39 years. Alprazolam was the 3rd benzodiazepine listed in OPPIDUM after diazepam and oxazepam. Analysis of NotS and OPPIDUM showed a recent increase in the combination of alprazolam and opioids. In DRAMES, alprazolam was found in 10 deaths/11. Regarding CHEMICAL SUBMISSION, alprazolam was the 1st benzodiazepine reported in 2019. Finally, in the OSIAP survey, alprazolam was in 2020 the 5th drug cited and the first benzodiazepine ahead of bromazepam, diazepam and oxazepam (citation rate: 7.8%, slightly increasing since 2019). It should also be noted a rejuvenation of this population and an increase in the proportion of men during the study period. Discussion/Conclusion: Analysis of FAN data showed an increase in criteria for abuse: false prescriptions and users seen in drug addiction care centres. In addition, the increase of the alprazolam-opioid combination and the significant part of this association in deaths constitute a signal already observed in the international literature and to be investigated [2].

Implementation of a Surface Guide Radiotherapy (SGRT) system a Spain Multicenter Experience

Purpose or Objective The surface-guided radiotherapy (SGRT) VisionRT® system uses a combination of real-time optical and laserbased imaging to accurately position patients receiving radiotherapy. The aim of this study is to analyse the implementation efficiency of SGRT in four Genesis Care radiotherapy centers in Spain and to collect the RTT impressions regarding this system. Materials and Methods The system was implemented at GenesisCare facilities in Madrid, Barcelona, Alicante, and Málaga starting on August 15, 2020. Prior to this implementation, the centers were trained in a training program consisting of: A) An online course;B) A didactic weekend course;and C) Go live supervision during the first treatments for three days. The course was delivered by an expert VisionRT® trainer and a qualified radiotherapy technician. After two months of implementation, we collected the diagnostic and staging information of patients treated with the VisionRT system between the go live and October 16,2020. To evaluate the efficacy, we considered a goal of patients with SGRT in the practice: > 75% High, 75%- 50%: moderate, < 50%: low. Tattoo base method set up was allow for head and neck immobilization, skin cancer or clinician discretion. A questionnaire was carried out to the RTT working in these centers. The questionnaire contained a 1-5 satisfaction scale asking about the SGRT system: 1. very poor;2. poor;3. fair;4. good;or 5. very good regarding six points. These were safety (patient ID recognition), set up (precision increase, time reduction), management (no covid contact), confidence (technique), improvement (daily practice), and patient satisfaction (RTT point of view). Results 93.4 % of the patients in these four centers were positioned under SGRT conditions, and 6.6 % were positioned with a tattoo-based method. OF the total of 295 patients with SGRT, 212 of them were positioned without tattoos. The evaluated patients have breast cancer (43.0%), prostate cancer (18.6%), metastatic cancer (8.1 %) or lung cancer (5.4%). 21 RTT responded to the questionnaire. Results are as follows: 1. Safety: 61.9% very good and 38.1% good;2. Set-up: 61.9% very good, 28.6% good, and 9.5% moderate;3. Accuracy increase: 42.8% very good, 19% good, 28.6% fair, 4.8% poo,r and 4.8% very poor;4. Management (contactless COVID): 47.6% very good, 14.3% good, 23.8% fair, and 14.3% poor;5. Confidence (real time): 9.6% very good, 47.6% good, 33.2% fair, and 9.6% poor;5. Improvement: 52.4% very good, 23.8% good, 23.8% fair;6. Patient satisfaction with tattoo less from the technician point of view: 90.4% very good, 4.8% good, and 4.8% moderate. Conclusion The implementation of SGRT was carried out with high efficiency considering that 93,4% of care were delivered with this technique. RTT consider this technique very good for safety, accuracy, confidence, and improvement in the daily practice.