Breast Cancer Biopsy Rates in Chile: Is There Justification for Adopting Innovative Anatomic Pathology Technologies in Public Providers?

Objectives: Breast cancer is increasing in Chile, and also the need for biopsies. We aim to identify the evolution of breast cancer diagnosis needs to be measured as Core Needle Biopsy (CNB), Stereotactic Biopsy (SB), Hematoxylin and Eosin staining Histopathological Study (H&ES), Immunohistochemical Study (IS) in relation to echography and mastectomy rates, to understand local needs of adopting innovative pathology technologies in public providers. Method(s): Time-series analysis, based on an open-access national database for the following variables: CNB, SB, H&ES, IS, echography, and mastectomy for a decade (2010-2021). The data is representative of the national activity in public providers, for which the intra-period variation and median-growth rate (MGR) were estimated. Result(s): CNB experimented a 630.7% increase in the period (MGR 19.8%). SB increased 92.3% at an MGR of 6.1%. H&ES and IS increased 19.1% and 379.4% (MRG 1.6% and 15.3% respectively). Lumpectomy and Radical Mastectomies (RM) behaved differently. Lumpectomy varied in 31.2% (MGR of 2.5%) whereas RM varied in -13.6% (negative MGR -1.3%). The covid-19 pandemic significantly decreased activity for SB, lumpectomies, and RM (p <0.05). Echography exhibits an increase of 27.5% (MGR 6.3% per year). The biopsy versus surgeries ratio was estimated, resulting in a variation from 0.537 in 2011 to 1.9 in 2021;this is 1.9 biopsies per surgery in the public system. Conclusion(s): Anatomic pathology based-analysis in breast cancer has increased in the last decade in Chile. The ratio of biopsy versus surgery has changed dramatically, pushing for innovation in the process of analysis of samples in a local setting of pathologist scarcity (1.22 pathologist per 100,000 public patients). Copyright © 2022

Validation of a questionnaire on learning through ICT and its Effect on University Students’ Wellbeing During COVID-19

Covid-19 virus presence in most countries of the world has lead to an overuse of information and communication technologies (ICT) during training processes. This has made it possible to continue studies in different conditions than the ones experienced in 2019, now in compulsory social isolation and home study environments. This article aims to design and validate an instrument that allows measuring learning by information technologies and its effect on the welfare of university students who assist to online education. Authors began with a documentary analysis for the construction of the theoretical framework and then, the validity of the instrument is checked in a pilot sample of 1952 students. The result was an instrument with a Crombach’s alpha of 0.8. It is concluded that the instrument can be applied in studies related to similar problematic situations. © 2022, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.

Soda Bottling Process Through the Virtual Hardware in the Loop Technique

Currently, the world is going through an unprecedented health crisis, which has caused significant impacts in the teaching–learning area during the confinement stage due to the COVID-19 pandemic. Therefore, the education system has opted for virtual education through immersive technologies. In this sense, this work presents the development of an industrial process of packaging bottles implemented in the Unity 3D graphics engine. The proposed control scheme considers the hardware in the loop simulation technique, consisting of: (i) process simulation, this stage considers the virtualized process and the mathematical equations that represent the dynamic behavior of the industrial process;the process simulation is implemented in a main computer, and (ii) target hardware, this stage considers the implementation of the advanced control algorithm in low-cost embedded cards. The results obtained allowed the immersion and interaction of the user with the virtual environment, which is part of the hardware in the loop simulation technique. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Mental health and uses of technology in the university context. A review of the literature

This article aims to analyse the different ways in which digital technologies affect the health of young people. To this end, a literature review was carried out in two stages. Sixty-five (65) scientific publications were studied and processed in two successive stages. In the first stage, 30 studies exclusively available in the ScienceDirect Database were processed, revealing a conceptual relationship in the field of mental health and the use of digital technologies. In the second stage, only sources including the subject of COVID-19 and its relationships with mental health and the use of digital technologies were included, in a context of differentiated contributions in the university sphere. The thematic content of the literature was analysed and the results summarized as follows: 1) the use of digital technologies has both positive and negative effects on young people, but there are significant differences in the number of publications and the effects described;2) during the Pandemic, mental health problems have worsened in young people who use technologies due to causes associated with confinement, learning environments and those related to the fear of contagion. © 2021 University of Granada. All rights reserved.

PRS28 A Scoping Review of Consequences of Untreated Stroke: Economic Burden Due to COVID-19?

Objectives: Stroke is associated with high costs for society and healthcare systems. Specialists agree on the importance of early treatment to improve the prognosis of patients. We identified the international literature regarding untreated stroke’s main consequences in the context of the decrease in emergency care for ischemic stroke during the covid-19 outbreak. Methods: A Scoping Review was conducted following the PCC strategy (population, context, and concept) to identify the international literature regarding the decrease in stroke-emergency care and the main consequences of untreated stroke. The search was carried out in PubMed, Cochrane, ScienceDirect, Google, and Google Scholar, combining Mesh terms and Boolean terms. Results: N=1748 articles were retrieved, and n=53 were included for analysis. International data shows a decrease in emergency care (20% less), endovascular procedures (up to 32% less), and indications for thrombolysis (5.5% less). Fewer admissions for stroke (46% less) are temporally related to the pandemic’s onset and quarantines. Untreated stroke patients are more likely to present severe stroke, 13% more severe disability, 12% more functional dependence at 6-12 months (p<0.001), higher rehabilitation costs and hospital length-of-stay (>15% more), more cognitive disability (16.6% more likely for stroke recurrence (p=0,006)) and 4-6% more likely to die, compared to patients treated with thrombolysis (r-tPA). Conclusions: The increase in patients with unfavorable outcomes due to untreated stroke, including increased disability and death, will put an added economic burden on healthcare systems and society, already greatly affected by the coronavirus pandemic. This information justifies carrying-out future studies of costs borne by families.

PND48 Real World Data and COVID-19: Healthcare Impact in Emergency Care, Stroke Emergency Care and Stroke-Related Deaths in Chile

Objectives: Stroke is a disabling condition and a leading cause of premature deaths in Chile. Before the covid-19 outbreak, access to first-line and second-line treatments was scarce already. The covid-19 outbreak was pointed-out as responsible for decreasing general emergency care, stroke emergency care, and stroke-related death rates, and there is a need to quantify those effects. Methods: A retrospective time series analysis using national real-world data was performed. The data were extracted from the records of emergency care and the deaths database published by the Ministry of Health for 2016-2020, for the public and private sector. Time series of emergency care, stroke care, confirmed covid-19 cases, and deaths due to stroke were constructed and compared against the previous year and the average observed between 2016 and 2019 using ANOVA, followed by post-hoc paired t-tests. Heat maps and box-plots were generated to demonstrate the changes in the demand for emergency care. Results: Emergency care in Chile has diseased significantly (p<0.001) since the first confirmed case (44% less during the covid-19 outbreak compared to 2019). Admissions for stroke decreased 18% and 7% compared to 2019 and 2016-2019 period. In 2020, in January and February, care for stroke increased 8% and 3%, respectively. In March, at the onset of confirmed cases, there was a decrease of 30% and 16% in emergency care and stroke care compared to the previous year. Stroke-related deaths decreased 17% in all types of stroke and 6% for ischemic stroke when compared to 2019. Conclusions: Results demonstrate that access to stroke care has fallen in Chile during the covid-19 outbreak. Future studies are needed to quantify the effects on disease burden due to the lack of interventions. Authorities shall bring this information into the design of future strategies to avoid unnecessary and harmful lack of access for groups at risk.

Impact of diabetes in the immune response against sars-cov-2

The infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has had an important impact in public health during the first half of 2020. Given its high contagion rate, it has managed to disseminate worldwide, forcing the World Health Organization to raise international alarms. This clinical entity has been observed to display greater severity in patients with cardiometabolic comorbidities, especially diabetes mellitus (DM), with high mortality rates. This disease produces a significant state of immune dysfunction, facilitating infections, with a tangible tendency towards worse clinical evolution. COVID-19 is no exception, various clinical studies have demonstrated diabetic patients tend to require admission into intensive care units or invasive or noninvasive mechanical ventilation with greater frequency;as well as greater risk of worse cases, with more complications, and higher mortality. Numerous factors contribute to immune dysfunction in patients with DM, including hyperglycemia, inhibition of chemotaxis, altered release of cytokines, phagocytic dysfunction, alterations in the immune response mediated by T cells, and inefficient microbial clearing. The objective of this review is to assess the immune alterations inherent to DM and how they influence the current SARS-CoV-2 pandemic to explain the high morbimortality of these patients.