Allergic asthma and viruses

Asthma, Allergens and Viral Infections: An Intricate Relationship Airborne bacteria, virus, fungal spores, pollen and other bioparticles are essential for the reproduction and propagation of organisms through diverse ecosystems, and may cause or worsen diseases in humans, animals and plants. Their interaction is implicated in serious pathologies such as asthma, stroke, ischemic heart disease and cancer. Viruses and other selfish genetic elements are dominant entities in the biosphere, with respect to both physical abundance and genetic diversity. In eukaryotes, RNA viruses account for the majority of the virome diversity although ssDNA and dsDNA viruses are common as well. Viruses may cause respiratory allergic pathology in both the upper and lower airways in susceptible people, and have been implicated in other allergic disorders such as chronic obstructive pulmonary disease, pneumonitis and alveolitis [1, 2]. In this chapter, we will discuss the latest developments in research and knowledge on virus-induced asthma exacerbations, COVID-19 and asthma relationship during the pandemic and consider recent advances in treatment options. © 2023 Nova Science Publishers, Inc. All rights reseverd.

Rural and urban education: a virtual perspective, a case study of the miracle of Ecuador

The general objective of this article is to analyze the digital differences between rural and urban areas on how to educate in virtuality during the shutdown caused by the global health crisis COVID-19. A descriptive study was conducted using online survey methodology on a sample of 250 cases. Data from urban and rural groups were compared and analyzed using descriptive statistics, hypothesis testing and qualitative content analysis. The results indicate that, although few, there are still digital gaps in access to means and resources to continue the educational process at home. © 2022, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.

Admission glycemia associated with mortality and hospital stay in a multidisciplinary service of a Peruvian national hospital

Objective: Evaluate the association between glycemia on admission and adverse outcomes in hospitalized patients with COVID19 in a Peruvian national hospital. Methods: Retrospective, observational cohort study. We collected data from electronic medical records of COVID19 patients in a medical specialties service. Patients were classified according to blood glucose levels on admission: <= and >140mg/dL. Primary outcome was mortality, and the secondary a composite that included mortality, septic shock, mechanical ventilation, or transfer to ICU. We also evaluated hospital stay and a multivariate logistic regression sub analysis was performed in diabetic patients. Results: 169 patients were evaluated. The mean age was 61 years, 64.5% were male. 71% had at least one comorbidity, the most frequent: arterial hypertension (34%), obesity (30%) and diabetes (26%). 70% presented tomographic gravity. Median blood glucose at admission was 126.5mg/dL (IQR: 109- 157mg/dL), one of every 3 had blood glucose levels >140mg/dL. Mortality rate was 9700 deaths per 100000 person-weeks, with a frequency of 21.3%. No significant difference was found between hyperglycemia and normoglycemia, mortality and in composite outcome. Patients with hyperglycemia on admission had longer hospital stay than normoglycemic patients (19 vs 13 days, p<0.01). In sub-analysis with multivariate logistic regression for composite outcome among diabetic patients, admission blood glucose >180mg/dL presented OR of 6.42 (95% CI: 1.07-38.6) for composite outcome, adjusted for age and clinical severity at admission. Conclusions: Hyperglycemia at admission was associated with a longer hospital stay and diabetic patients with hyperglycemia >180mg/dL had a 6-fold increased risk of presenting an adverse outcome.

Study of the Quality of Work Life and the Collateral Effects of Covid-19 in the Workers of Universities of the State of Sonora, Mexico

The objective of this research work is to know the level of quality of working life and the collateral effects of COVID-19 in workers at universities in the state of Sonora, with a mixed methodological design, analyzing three dimensions within the instrument;quality of working life, organizational management and organizational performance, with the support of 419 workers who participated from the different universities, obtaining as results the assessment of the dimensions, which determine that the quality of life variable is 3.71, which is favorable, while the level of collateral affectation by the pandemic is 3.5 which is not favorable, due to the fact that in the new remote modality spaces are not promoted to interact with the staff in activities other than those of daily work, It has the necessary resources, equipment, material tools to carry out the activities properly, given the situation that arises, the collaborators have been forced to adapt to new ways of working with the challenges that these entail.

[Comparison of the first and sixth waves of the SARS-COV-2 coronavirus pandemic in patients with immune-mediated disease.] / Comparación entre la primera y la sexta ola de la pandemia por el coronavirus SARS-COV-2 en pacientes con enfermedad inmunomediada.

Recent evidence shows that COVID-19 infection does not have a worse prognosis in patients with immune-mediated inflammatory diseases (IMID), although they develop a worse response to vaccination.Objective To compare the incidence of COVID-19 and clinical features in patients with IMID between the first and sixth waves.Method Prospective observational study of two cohorts of IMID patients diagnosed with COVID-19. First cohort March to May 2020, and second cohort December/2021 to February/2022.Sociodemographic and clinical variables were collected and, in the second cohort, COVID-19 vaccination status. Statistical analysis established differences in characteristics and clinical course between the two cohorts.Results In total, 1627 patients were followed up, of whom 77 (4.60%) contracted COVID-19 during the first wave and 184 in the sixth wave (11.3%). In the sixth wave, there were fewer hospitalisations, intensive care unit admissions, and deaths than in the first wave (p=.000) and 180 patients (97.8%) had at least one dose of vaccine.Conclusion Early detection and vaccination have prevented the occurrence of serious complications.

Development of a monitoring system for COVID-19 monitoring in early stages

Covid-19 is considered the most infectious virus today. Likewise, the struggle to mitigate the effects of the variants, the flexibility in some measures such as the use of face masks, the advancement of vaccination and prevention and self-care campaigns continue to be topics of research and of global interest. The world health authorities published that the disease was characterized by presenting the same symptoms as the flu along with a complex picture where in the most serious cases they lead to difficulty breathing due to pneumonia, sepsis and septic shock that can lead to death. Some systems implemented for taking body temperature such as thermographic cameras, digital thermometers, for the description of symptoms in the people they analyze at the time of carrying out the epidemiological fences are not enough, since they handle low precision, are taken in isolation, individually or randomly and is not suitable for characterizing interest groups. Then, establishing risk levels by measuring non-invasive variables can be considered inputs into prevention campaigns and a low-cost way of monitoring the community. This article shows the design of a non-invasive embedded device for the measurement of 5 priority variables for the detection of the risk of covid-19 infection. The proposed device was duly calibrated and synchronized for the acquisition of data from 594 people in the city of Bucaramanga, Colombia, who authorize the monitoring of the symptoms. The people must be in a state of rest to be able to acquire the data with great accuracy, in this way the data is entered into the system in charge of doing the monitoring analysis. Additionally, the implementation of an interface that allows the visualization of results, laying the foundations for the development of automatic learning techniques or models for the risk classification in future work. © The Author 2023. This work is licensed under a Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) that allows others to share and adapt the material for any purpose (even commercially), in any medium with an acknowledgement of the work's authorship and initial publication in this journal.

Comparación entre la primera y la sexta ola de la pandemia por el coronavirus SARS-COV-2 en pacientes con enfermedad inmunomediada Comparison of the first and sixth waves of the SARS-COV-2 coronavirus pandemic in patients with immune-mediated disease

Las últimas evidencias revelan que la infección por Covid-19 no tienen peor pronóstico en los pacientes con enfermedades inflamatorias inmunomediadas (EIMI), aunque desarrollan menor respuesta a la vacunación. Objetivo Comparar la incidencia de COVID-19 y características clínicas en pacientes EIMI entre la primera y sexta olas. Método Estudio observacional prospectivo de dos cohortes de pacientes con EIMI diagnosticados de COVID-19. Primera cohorte: marzo-mayo de 2020, y la segunda diciembre/2021 a febrero/2022. Se recogieron variables sociodemográficas y clínicas y, en la segunda cohorte, estado de vacunación contra la covid-19.  El análisis estadístico estableció las diferencias de las características y evolución clínica entre ambas cohortes. Resultados De un total de 1627 pacientes en seguimiento, contrajeron Covid-19 durante la primera ola 77 (4.60%) y 184 en la sexta (11.3%). En la sexta hubo menos hospitalizaciones, ingresos en Cuidados Intensivos y fallecimientos que en la primera (p=0.000) y 180 pacientes (97.8%) tenían al menos una dosis de vacuna. Conclusión La detección precoz y la vacunación han evitado la aparición de complicaciones graves.

Educational Technologists during the COVID 19 pandemic: Recommendations for the post-pandemic Latin American University

During 2020, in the context of the health emergency caused by COVID19, Universidad de la República (Udelar) already had installed capacities (human and technological) that allowed it to continue teaching activities uninterruptedly. This was possible thanks to different factors that gave continuity to the educational processes of that year: the consolidation of the Virtual Learning Environments (VLE), as widely used spaces throughout the educational community, the deployment of highly trained human resources in charge of the VLE in each educational technology service and a basic technological infrastructure. This article tries to give an account of the state of the human resources associated with the educational technology services, its main characteristics. In addition, an approach to what has been the development of their tasks in the context of a health emergency is presented. A mixed methods study was carried out during the second semester of 2020 and first semester of 2021. The results obtained show a consolidation of the educational technologists role in the university. A greater visibility of the tasks they perform due to the increase in demand by the educational community caused by the Emergency Remote Teaching (ERT) was highlighted. However, no significant increases have been made in the assigned workloads or in new hires to enable a greater response from the educational technology services around the digital education activities during COVID 19 ERT. Analysis and recommendations on educational, organizational and technological dimensions can be extended to other Latin American universities to face the challenge of post-pandemic digital education. © 2022 IEEE.

Impact of the SarsCov2 Booster Dose on Clinical Events in Heart Transplant Patients in Galicia. INMU TC Study

Heart transplant (HT) patients have a higher risk of severity after SARS-CoV-2 (COVID-19) infection than general population. Serological response to the initial vaccination regimen is lower. The clinical impact of the booster vaccination regimen in HT patients is unknown. The INMU_TC study analyze the immunogenicity after the COVID19 vaccination schedule and the clinical impact in patients with HT in Galicia. : To analyze the clinical events related to COVID-19 infection after receiving the booster dose in a population of patients with CT. Prospective observational study. HT recipients followed in the Galician Health System who had received a booster dose of COVID-19 vaccine according to the regional protocol were consecutively included. Serum anti-SARS-COV2 IgG concentration was determined between 14-30 days after the last vaccination dose. A value ≥33 BAU/ml was considered positive. COVID-19 clinical events were recorded. : We included 275 HT recipients, median age 64.5 years (IQR:55.1-70.7), and 21.8% female. Median time since HT was 7.4 years (IQR:2.5-14.9). Of these, 41 patients (14.9%) had COVID-19 after the booster dose, with an incidence rate of 300.6 per 1000 patient-year. Fourteen patients (34.2% of those infected) required hospital admission, and 4 died from the infection (9.8%). No significant differences were found between infected and non-infected patients after the third dose, except for renal function, more deteriorated in infected patients (creatinine 1.8±1.6 vs 1.4±0.8;p=0.008) and treatment with RAASi (12(29.3%) vs 123(52.6%);p=0.005). There were no significant differences in immunosuppression. A higher percentage of patients with infection, admission, and death had a negative serologic test. Serum concentration of antiSARSCoV2 IgG was lower in infected patients (735.8±895.0 vs 1318.1±847.9;p<0.001) and in patients requiring admission (266.9±581.8 vs 1282±862.2;p<0.001). Patients admitted to ICU and those who died had undetectable titers (<4.81 BAU/ml). HT patients with COVID-19 after the booster vaccine dose had lower serum concentration of anti-SARS-COV2 IgG, being even lower in those who presented a more unfavorable evolution. These data could suggest the importance of monitoring the response to vaccination in these patients in order to evaluate other therapeutic options. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Burnout syndrome increase during COVID-19 pandemic in attending Internal Medicine physicians.

INTRODUCTION: Burnout is a psychosocial syndrome caused by stressful situations in the workplace. It affects 30%-60% of medical professionals. The aim of this study is to carry out a comparative analysis of its frequency before and after the COVID-19 outbreak in Spanish internal medicine attending physicians. METHODS: Surveys that included the Maslach Burnout Inventory were sent via email and associated social networks to physicians who were members of the Spanish Society of Internal Medicine in 2019 and 2020. RESULTS: A non-significant increase in burnout was observed (38.0% vs. 34.4%). However, an increase in low personal fulfilment was observed (66.4% vs. 33.6%; p = 0.002), a dimension associated with the prevention of psychiatric morbidity, in addition to two others: emotional fatigue and depersonalization, which can negatively affect patient care. CONCLUSIONS: It is essential to address this syndrome individually and institutionally.

Processing of Images Based on Machine Learning to Avoid Unauthorized Entry

The proposal of a facial recognition system to increase security, through facial recognition with multiple utilities such as facilitating the access of people with adequate protection measures in times of Covid-19, as well as security when seeking to hide their identity. The methodology considers the use of tools such as Python and OpenCV, as well as models such as Eigen Faces, Fisher Faces, and LBPH Faces, as units of analysis are considered photographs and portions of the video that capture facial expressions that then their patterns are trained with facial recognition algorithms. The results obtained show that the LBPH Faces obtained confidence values lower than 70, with a 95% certainty of recognition and a shorter recognition time, improving the accuracy of facial recognition, also with the increase of the data was achieved to improve the accuracy of recognition as well as improve confidence regarding the safety of people. © 2022 IEEE.

Patterns of populist mobilization: comparing narratives on COVID-19 in the global South

This article explores the narratives shaping the official discourse on COVID-19 in five countries governed by populists in different world regions. It is based on the assumption that a crisis like the pandemic constitutes a perfect occasion for populist mobilization, allowing populist leaders to construct reality in their favour by deliberately promoting own narratives about the pandemic, its origin and management. Analyzing 357 original-language speeches and statements by representatives of the populist governments of Brazil, Israel, India, Mexico and Turkey, the article shows that populists in power use crises to mobilize support in very different ways. Surprisingly, most populist governments neither resorted to anti-scientific claims or conspiratorial discourses attributing the crisis to obscure elites, nor blamed minorities not belonging to the 'true people'. By contrast, except for Bolsonaro in Brazil, all other populist governments tried to mobilize support by emphasizing the strength of the 'people' or even by promoting an inclusive discourse of national unity, leaving aside the more divisive elements of their general populist discourse. Based on the cases analysed, the article concludes by developing hypotheses on the possible drivers of such variations in patterns of populist mobilization. [ FROM AUTHOR]

[Burnout syndrome increase during COVID-19 pandemic in attending Internal Medicine physicians]. / Aumento del síndrome de burnout en los adjuntos de Medicina Interna durante la pandemia de COVID-19.

Introduction: Burnout is a psychosocial syndrome caused by stressful situations in the workplace. It affects 30% to 60% of medical professionals. The aim of this study is to carry out a comparative analysis of its frequency before and after the COVID-19 outbreak in Spanish internal medicine attending physicians. Methods: Surveys that included the Maslach Burnout Inventory were sent via email and associated social networks to physicians who were members of the Spanish Society of Internal Medicine in 2019 and 2020. Results: A non-significant increase in burnout was observed (38.0% vs. 34.4%). However, an increase in low personal fulfilment was observed (66.4% vs. 33.6%; p = 0.002), a dimension associated with the prevention of psychiatric morbidity, in addition to two others: emotional fatigue and depersonalization, which can negatively affect patient care. Conclusions: It is essential to address this syndrome individually and institutionally.

Experiences and Concerns of Female Hotel Housekeepers in the First Stages of the Covid-19 Lockdown in the Balearic Islands (Spain): A Qualitative Study

Strongly enforced mobility restrictions to deter the spread of COVID-19 severely impacted tourism, a pivotal economic sector of the Balearic Islands. Little is known about the experiences of the most economically affected groups, such as hotel housekeepers. This study aimed to explore the experiences and concerns of hotel housekeepers (approximately 13,000 worked in the Balearic Islands before the pandemic) during the first stages of the COVID-19 lockdown. Semi-structured interviews were conducted by telephone in April of 2020. Thematic analysis was used for interpretation. Eighteen hotel housekeepers were interviewed. Main experiences and concerns identified were: (a) distress due to employment status and economic situation, (b) concerns for children's education, (c) health-related concerns, mainly regarding the possibility of infecting someone, and (d) feelings related to home confinement (e.g., sense of security against infection, tedium, and boredom). Uncertainty permeated all discourses, generating feelings of fear and distress, particularly related to employment status and the general economic situation. Our findings shed light on the impact of public health measures to control COVID-19 spread in the different areas of life of hotel housekeepers, one of the most economically affected occupational groups. The trade-off between economics and health must be considered in future decisions on public health.

Brain phaeohyphomycosis secondary to immunosuppressant therapy due to Rhinocladiella mackenziei

Two cases of Rhinocladiella mackenziei have been noted in our institute, the first case in 2015 (post-renal transplant) and the second case in 2021 (post-COVID infection). Both the patients had received immunosuppressants for varying dura-tion. Both the cases presented to the hospital with neurological deficit secondary to brain abscess. On initial assessment, the melanized fungus was noted which was later identified as Rhinocladiella on culture and further confirmed with molecular meth-ods. Both the cases were treated with injection of L AmB, voriconazole and 5FC for a prolonged duration and later discharged when the condition improved. The renal transplant patient was advised lifelong voriconazole since he would continue to be on immunosuppressants. To our knowledge, the second patient diagnosed post-COVID could be the first case report of invasive dematiaceous fungal infection in an apparently immunocompetent individual. Both cases also highlight the challenges in man-agement such as designing an appropriate regimen, deciding the optimum duration of antifungal therapy, and managing the toxicities associated with long-term antifungal use. R. mackenziei is a frequently fatal melanized neurotropic fungus known to carry almost 100% mortality despite the combination of antifungal agents and surgery. Central nervous system infections due to R. mackenziei have been exclusively reported from the Middle East, except for cases recently reported from India.

"I've discovered the COVID-19 vaccine". Approach of a bipolar disorder clinical case in the Mental Health Day Hospital of Salamanca during the pandemic

Introduction: A 21-year-old woman diagnosed with bipolar disorder was hospitalized in the Mental Health Day Hospital of Salamanca during the Covid pandemic. The patient engaged with 4 different jobs and a master's degree, beginning with verbose speech, dysphoria, global insomnia, grandiose delusions, extremely high energy and thinking she has the vaccine. She works the following objectives: illness insight, risk factors, psychopathological stabilization, social skills, slowing down of activities and taking responsibilities. Objective(s): The objective is do a follow-up of the patient during her hospitalization in the Mental Health Day Hospital and to carry out a structured search in PubMed and Up-to-Date about psychotherapy and bipolar disorder. Method(s): 3-month follow-up of a 21-year-old woman diagnosed with bipolar disorder during her hospitalization in the Mental Health Day Hospital in Salamanca and a structured search in PubMed and Up-to-Date in April 2021 in English, French and Spanish, including the last 10 years with the keywords "psychotherapy", "psychotherapies" and "bipolar disorder ".77 studies were analyzed: 12 included, 65 excluded. Result(s): Several randomized trials highlight the efficacy of group psychoeducation and cognitive-behavioural therapy in relapse prevention, improving illness insight, medical adherence and less hospitalizations. Therapeutic alliance plays a significant role in the process. Our patient improved her knowledge of her illness and treatment, her social skills and reconnected with her relatives and slowed down her activity. She then was referred to her community mental heath center psychiatrist. Conclusion(s): The insight in bipolar disorder plays an important role in medical adherence and prevention of relapses. Therapeutic alliance improves their insight, their functionality in their daily life and enables close monitoring. Medical treatment should be accompanied by psychotherapy for a complete approach of the treatment.

Effectiveness of a flash glucose monitoring systems implementation program through a group and telematic educational intervention in adults with type 1 diabetes

Objectives: Verifying the clinical effectiveness and the impact on quality-of-life parameters, fear of hypoglycaemia and satisfaction with the treatment obtained with a flash glucose monitoring (MFG) devices implantation program that includes a telematic and group educational intervention in adults with type 1 diabetes. Patients and Methods: Prospective quasi-experimental study, carried out during the COVID-19 pandemic period with a 9-month follow-up at the Virgen Macarena University Hospital, Sevilla. Result(s): Eighty-eight participants were included (men: 46.6%;mean age (years) 38.08, SD: 9.38);years of DM1 evolution: 18.4 (SD: 10.49);treatment with multiple doses insulin (MDI) 70.5% vs 29.5% subcutaneous insulin infusion therapy (CSII)). Baseline HbA1c was 7.74% (1.08). After the intervention, the global decrease in HbA1c was -0.45% (95% CI [-0.6, -0.25], P<.01), increasing to -1.08% in the group that started with HbA1c>=8% (P<.01). A mean decrease in the Fear of Hypoglycemia 15 (FH15) test score of -6.5 points was observed (P<.01). In the global score of the spanish version of Diabetes Quality Of Life (DQOL-s) test, the decrease was -8.44 points (P<.01). In Diabetes Treatment Satisfaction Questionnaire test (DTQ-s), global score increased in + 4 points (P<.01). Conclusion(s): The incorporation of an educational program in group and telematic format within the development of MFG devices implantation strategies is an effective option, with associated benefits in quality of life and fear of hypoglycemia in adult patients with DM1. This option can be implemented in usual clinical practice. Copyright © 2021 SEEN y SED

Evaluation of a bimodal teaching system by nursing students

The global health situation caused by the SARS-CoV-2 virus has forced some universities to combine face-to-face and online teaching. The objective of this investigation is to analyze how university students themsel-ves assessed bimodal teaching. 445 students from the four Nursing Degree programs completed a survey that gathered data on sociodemographic variables and included a Likert-type scale on bimodal teaching. Values of central tendency and dispersion were calculated, as were correlations between the different variables. 17 of the 24 items of the scale are distributed into 3 groups. The first compares face-to-face and online teaching (M = 3.70, SD = .94), the second asks about the adaptation of the teaching center to bimodality (M = 3.58, SD = 2.02) and the third investigates the role of teachers (M = 3.58, SD = .86). More than 76% of students express a preference for face-to-face teaching, almost 80% positively assess their centers' organization, and 67% positively assess the role of teachers. Knowledge of university students' opinions about bimodal teaching as a potential educational model will help reduce this model's weaknesses.

An"Early Adopter" of CPQR's Patient Reported Outcome (PRO) Initiative: Lessons Learned Through Implementation of an Electronic PRO Platform Across a Mulit-Center Radiation Oncology Department

Purpose: Beyond patient symptom management during treatment, patient reported outcomes (PRO) play a critical role in oncology survivorship. Although considered standard of care, PRO collection and use is challenging for radiotherapy (RT) centres lacking electronic PRO (ePRO) infrastructure. This work outlines facilitators and barriers to the implementation of an ePRO program across a multicentre radiation oncology department. Material(s) and Method(s): Dalhousie University's Department of Radiation Oncology (DRO) is composed of four RT centres across three provinces. Department-wide implementation of ePRO was precipitated by several key events: In 2009, a Canadian Partnership Against Cancer (CPAC) grant enabled 2 centres to begin paper-based PRO using the Canadian Problem Checklist (CPC) and Edmonton Symptom Assessment System (ESASr). In 2015, the Department's research retreat set ePRO as a priority. In 2017, Accreditation Canada mandated routine evaluation of patient outcomes and in 2018, the Canadian Partnership for Quality Radiotherapy (CPQR) identified Dalhousie's DRO as an early adopter within the pan-Canadian PRO initiative. In 2019, three DRO centres were awarded CPAC funding to launch ePROs. The fourth centre now hopes to use lessons learned in order to facilitate their ePRO implementation. Result(s): ePRO was launched in September 2021 with a phased approach across centres and tumour sites so that user feedback can inform the roll out. Clinic workflows now includes ePRO at consultation, first and last RT review as well as follow-up. Within the ePRO application (Noona), CPQR-endorsed PRO tools include CPC, ESASr, and the Brief Pain Inventory (BPI), with use of other tumour-site specific questionnaires planned. Project charter included needs assessments (human resource, staff /patient education) and change management strategies required to obtain buy-in from front line staff. Although coordination of such a large-scale initiative was challenged by COVID restrictions, project priority was escalated with ePRO recognized as a powerful tool to assess patient symptoms in clinic or remotely. Research unit support was invaluable to navigate IT project complexities including vendor/collaborator contracts, processes of Privacy Impact Assessments and IT architectural reviews. From the advisory board to PRO working groups, mullti-stakeholder feedback and collaboration has been key, including representatives of patients, cancer program leadership, project managers/principle investigators, administrative staff, nurses, radiation therapists, radiation oncologists, industry, IT and legal. Conclusion(s): Multi-centre implementation of an ePRO program has been feasible but complex and time intensive. It is hoped that our lessons learned may benefit those RT centres aiming to transition from paper-based to ePRO systems. With critical electronic infrastructure now in place, we await data to analyze ePRO amongst other patient outcomes in ongoing RT Big Data initiatives. Copyright © 2022 Elsevier Ireland Ltd. This is an open access article under the CC-BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).