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Objectives: To summarize the activities of the International Academy of Health Sciences Informatics (IAHSI) in 2021 and welcome its 2021 Class of Fellows. Methods: Report on governance, strategic directions, newly elected fellows, plenary meetings, and other activities of the Academy. Results: As in 2020, all of the Academy's activities were carried out virtually due to the COVID-19 pandemic. In 2021, new Board members were elected. Strategic activities in data standards and interoperability and in mentorship moved forward. A new class of 26 Fellows was elected, bringing the total membership of the Academy to 204 Fellows from all regions of the world. In addition, a virtual plenary meeting was held. Conclusions: The Academy has continued to pursue its role as the honorific society globally for biomedical and health informatics. Expansion of strategic activities and membership will continue moving forward.

Background Melphalan flufenamide (melflufen), an alkylating peptide-drug conjugate, plus dexamethasone showed clinical activity and manageable safety in the phase 2 HORIZON study. We aimed to determine whether melflufen plus dexamethasone would provide a progression-free survival benefit compared with pomalidomide plus dexamethasone in patients with previously treated multiple myeloma. Methods In this randomised, open-label, head-to-head, phase 3 study (OCEAN), adult patients (aged ≥18 years) were recruited from 108 university hospitals, specialist hospitals, and community-based centres in 21 countries across Europe, North America, and Asia. Eligible patients had an ECOG performance status of 0–2; must have had relapsed or refractory multiple myeloma, refractory to lenalidomide (within 18 months of randomisation) and to the last line of therapy; and have received two to four previous lines of therapy (including lenalidomide and a proteasome inhibitor). Patients were randomly assigned (1:1), stratified by age, number of previous lines of therapy, and International Staging System score, to either 28-day cycles of melflufen and dexamethasone (melflufen group) or pomalidomide and dexamethasone (pomalidomide group). All patients received dexamethasone 40 mg orally on days 1, 8, 15, and 22 of each cycle. In the melflufen group, patients received melflufen 40 mg intravenously over 30 min on day 1 of each cycle and in the pomalidomide group, patients received pomalidomide 4 mg orally daily on days 1 to 21 of each cycle. The primary endpoint was progression-free survival assessed by an independent review committee in the intention-to-treat (ITT) population. Safety was assessed in patients who received at least one dose of study medication. This study is registered with ClinicalTrials.gov, NCT03151811, and is ongoing. Findings Between June 12, 2017, and Sept 3, 2020, 246 patients were randomly assigned to the melflufen group (median age 68 years [IQR 60–72]; 107 [43%] were female) and 249 to the pomalidomide group (median age 68 years [IQR 61–72]; 109 [44%] were female). 474 patients received at least one dose of study drug (melflufen group n=228; pomalidomide group n=246; safety population). Data cutoff was Feb 3, 2021. Median progression-free survival was 6·8 months (95% CI 5·0–8·5; 165 [67%] of 246 patients had an event) in the melflufen group and 4·9 months (4·2–5·7; 190 [76%] of 249 patients had an event) in the pomalidomide group (hazard ratio [HR] 0·79, [95% CI 0·64–0·98]; p=0·032), at a median follow-up of 15·5 months (IQR 9·4–22·8) in the melflufen group and 16·3 months (10·1–23·2) in the pomalidomide group. Median overall survival was 19·8 months (95% CI 15·1–25·6) at a median follow-up of 19·8 months (IQR 12·0–25·0) in the melflufen group and 25·0 months (95% CI 18·1–31·9) in the pomalidomide group at a median follow-up of 18·6 months (IQR 11·8–23·7; HR 1·10 [95% CI 0·85–1·44]; p=0·47). The most common grade 3 or 4 treatment-emergent adverse events were thrombocytopenia (143 [63%] of 228 in the melflufen group vs 26 [11%] of 246 in the pomalidomide group), neutropenia (123 [54%] vs 102 [41%]), and anaemia (97 [43%] vs 44 [18%]). Serious treatment-emergent adverse events occurred in 95 (42%) patients in the melflufen group and 113 (46%) in the pomalidomide group, the most common of which were pneumonia (13 [6%] vs 21 [9%]), COVID-19 pneumonia (11 [5%] vs nine [4%]), and thrombocytopenia (nine [4%] vs three [1%]). 27 [12%] patients in the melflufen group and 32 [13%] in the pomalidomide group had fatal treatment-emergent adverse events. Fatal treatment-emergent adverse events were considered possibly treatment related in two patients in the melflufen group (one with acute myeloid leukaemia, one with pancytopenia and acute cardiac failure) and four patients in the pomalidomide group (two patients with pneumonia, one with myelodysplastic syndromes, one with COVID-19 pneumonia). Interpretation Melflufen plus dexamethasone showed superior progression-free survival than pomalidomide plus dexamethasone in patients with relapsed or refractory multiple myeloma., Oncopeptides AB

With millions of people in the world in situations of physical distancing because of COVID-19, information and communication technology (ICT) has become as one of the principal means of interaction and collaboration. The following advantages of ICT have been cited since the start of the new millennium: increased access to information and service delivery, educational strengthening, quality control of screening programs, and reduction of health care costs. In the case of telemedicine, however, a number of barriers-especially technological, human and social, psychosocial, anthropological, economic, and governance-related-have stood in the way of its adoption. The past 20 years have seen an increase in the availability of resources and technical capacity, improvements in digital education, empowerment of patients regarding their treatment, and increased public interest in this area. Successes have included the use of interdisciplinary teams, academic and professional networking, and virtual medical consultations. After reviewing the state of telemedicine in the Region of the Americas, the authors recommend the urgent adoption of measures aimed at implementing national telemedicine policies and programs, including a regulatory framework and adequate funding. Implementation of the measures should be integrated and interoperable and include the support of academic networks and the collaboration of specialized institutions. The policies should generate an enabling context that ensures sustainability of the progress achieved, bearing in mind the possible barriers mentioned.Com milhões de pessoas no mundo em situação de distanciamento físico devido à COVID-19, as tecnologias da informação e comunicação (TICs) se enquadraram como um dos meios principais de interação e colaboração. Já no início deste milênio, começaram a ser mencionadas as seguintes vantagens: maior acesso à informação e à prestação de serviços; fortalecimento da educação; controle de qualidade dos programas de detecção e redução dos custos na atenção à saúde. No entanto, entre as principais barreiras de adoção da telemedicina se encontram as de caráter: tecnológico; humano e social; psicossocial e antropológico; de governança e econômico. Nestes 20 anos, houve um aumento nos recursos e na capacidade técnica, uma melhora na educação digital, um empoderamento do paciente em seu tratamento e um maior interesse público nessa área. Em especial, são consideradas bem-sucedidas a constituição de equipes interdisciplinares e as redes acadêmicas e profissionais, e as consultas médicas virtuais. Após revisar o estado da telemedicina na Região das Américas, os autores recomendam a adoção de medidas urgentes para implementar políticas e programas nacionais de telemedicina, incluindo o marco normativo e o orçamento necessário. Essa implementação deve ser realizada de maneira integral e interoperável e sustentada por redes acadêmicas, de parceria e instituições especializadas. Tais políticas devem gerar um contexto favorável, dando sustentabilidade ao avanço obtido e considerando os aspectos mencionados nas possíveis barreiras.

Introducción: La participación de la mujer en publicación científica es limitada, especialmente en posiciones jerárquicas. Objetivo: Estimar la participación de la mujer en publicaciones pediátricas latinoamericanas y su variación en 35 años. Métodos: Se identificaron todos los artículos de Archivos Argentinos de Pediatría, Jornal de Pediatria y Revista Chilena de Pediatría de los años analizados (1985,1995, 2005, 2015, 2020), calculando la proporción de mujeres autoras, y como primer y último autor. Para cada variable, se evaluaron las modificaciones en el período estudiado (X2 para tendencia). Resultados: Evaluamos 1860 artículos (6039 autores). Luego de un incremento significativo en el período evaluado, en 2020, 59,1 % de los autores, 59,7 % de los primeros autores, y 44,4 % de los últimos eran mujeres. Conclusión: La proporción de mujeres autoras en revistas pediátricas latinoamericanas se incrementó en 35 años, alcanzando 59,1 %, pero su participación en lugares de prestigio es aún limitada.

Objectives: To summarize the major activities of the International Academy of Health Sciences Informatics (IAHSI) in the 2020 time period and to welcome its 2020 Class of Fellows. Method: Report from the members of the Academy’s Board. Results: Due to the SARS-CoV-2 pandemic, both Plenary meetings in 2020 had to be organized as virtual meetings. Scientific discussions, focusing on mobilizing computable biomedical knowledge and on data standards and interoperability formed major parts of these meetings. A statement on the use of informatics in pandemic situations was elaborated and sent to the World Health Organization. A panel on data standards and interoperability started its work. 34 Fellows were welcomed in the 2020 Class of Fellows so that the Academy now consists of 179 members. Conclusions: There was a shift from supporting to strategic activities in the Academy’s work. After having achieved organizational stability, the Academy can now focus on its strategic work and so on its main objective.

espanolEl rango de distribucion de Panthera onca se ha reducido debido a la transformacion de habitat a gran escala, caza intensiva, trafico ilegal, fragmentacion y la construccion de carreteras e infraestructuras. Como consecuencia, la poblacion de jaguares ha disminuido, lo que ha generado que la especie haya cambiado de categoria vulnerable a especie amenazada. Debido a la importancia ecologica de esta especie, organizaciones como la Red Colombiana de Seguimiento de Fauna Atropellada han propuesto el establecimiento de corredores de vida silvestre. Pero se sabe poco sobre que esta impulsando estos cambios de habitat y donde deberian establecerse estos corredores. Para abordar esta falta de informacion, determinamos en un grado espacial la distribucion actual y el acceso al habitat de P. oncay evaluamos si estos factores estan siendo impulsados por deforestacion, conflicto armado, expansion agricola, urbanizacion y construccion de carreteras en el area del Bajo Magdalena en Colombia. Con estos resultados identificamos areas potenciales para proponer corredores de conservacion. Para hacer esto, utilizamos la informacion geoespacial disponible sobre la distribucion de P. onca en las areas vigiladas por la Corporacion Autonoma Regional en los municipios de Puerto Salgar, Caparrapi y Guaduas, asi como la red de transporte, la unidad administrativa y los datos de deforestacion de 2010 a 2018. Tambien calculamos las distancias del habitat a los centros donde se encuentra la poblacion y la distribucion de P. onca en relacion con las carreteras. Nuestros hallazgos sugieren que la poblacion urbana y las carreteras afectan el 83 % del area total de su distribucion; la deforestacion aumento en 47.9 km2 en el area de estudio de 105.24 km2 con 5.6 km2 solo en el habitat de P. onca. Por tanto, concluimos que las iniciativas de conservacion deben implementarse dentro del rango de distribucion y las zonas de amortiguamiento de P. onca. En particular, la urbanizacion y la construccion de carreteras fueron variables muy influyentes asociadas con la perdida del habitat de P. onca. Ademas, se deben tomar en cuenta precauciones a lo largo de la carretera principal que conecta Puerto Salgar y Guaduas para mantener el flujo genetico y el movimiento de la poblacion de P. onca, ya que afecta a 87 km de este corredor propuesto. EnglishThe distribution range of Jaguar (Panthera onca) is being reduced due to multi-scale habitat conversion, intensive hunting, illegal trafficking, habitat fragmentation, and the construction of highways and other infrastructure. Because of the decrease in population, this species’ listing has changed from vulnerable to a threatened category. Due to the ecological importance of this species, organizations like Red Colombiana de Seguimiento de Fauna Atropellada have proposed the establishment of wildlife corridors. But little is known as to recognize the driving forces in these habitat changes and where these corridors should be established. To address this lack of information, we determined the spatial extent to which the current distribution and access to P. onca habitat is being driven by deforestation, armed conflict, agriculture expansion, urbanization and the construction of highways in the Bajo Magdalena area of Colombia. We then identified potential areas for proposing conservation corridors. To do this, we used available geospatial information on P. onca distribution in the Corporacion Autonoma Regional areas in the municipalities of Puerto Salgar, Caparrapi and Guaduas, as well as transportation network, administrative unit, and deforestation data from 2010 to 2018. We also calculated habitat distances to population centers and the distribution of P. onca relative to roads. Our findings suggest that urban population and highways affect 83 % of the total area of its distribution; deforestation increased by 47.9 km2 in the 105.24 km2 study area with 5.6 km2 alone left as P. onca habitat. We concluded that conservation initiatives must be implemented inside P. onca’sdistributional range and buffer zones. Urbanization and the construction of highways were highly influential variables associated with the loss of P. onca habitat. Further, we propose that precautions along the principal road that connects Puerto Salgar and Guaduas should be taken into consideration to maintain the genetic flow and movement of the P. onca population as it affects 87 km of this proposed corridor.

Since the summer of 2020, researchers from ten projects pertaining to the Horizon2020 Science with and for Society (SwafS) call have been meeting virtually as the SwafS14 Monitoring and Evaluation ecosystem. Topics of discussion were the trials and tribulations of their regional Responsible Research and Innovation (RRI) projects as well as their strategies for monitoring and evaluation. In this paper we make a first attempt at presenting these issues as problems of translation between different kinds of stakeholders. After an exploration of the diversity of stakeholders and the process of translation in regional RRI, we suggest evaluative conversations as a way of improving regional RRI. We intend to develop this idea in the future and that these conversations will facilitate more responsible and engaged monitoring and evaluation and contribute to better R&I policies.

To identify scientific evidence on the use and results of information and communication technologies for the improvement of neonatal health in general or specific health problems or interventions, and to describe the type of intervention and its results.A systematic review of the available evidence was performed. The search was carried out in peer-reviewed journals between January 1, 2008 and April 30, 2018, in English and Spanish. The searched key terms were (health informatics OR telemedicine OR mHealth) AND (newborn OR newborn care OR neonatal care).From a total of 305 articles initially identified, 10 articles fulfilled the inclusion criteria. The main domains of eHealth identified as applied to neonatal health were telemedicine (3 studies), eLearning (1 study) and mHealth (7 studies). Target population were health care providers or parents. The studies aimed at diagnosis, provision of health care and training, promoting adherence to interventions in parents or improving quality of care.The use of eHealth in general and specifically focused on neonatal health shows important possibilities for development and expansion, given the advances and present needs, and should be considered a key tool for the reduction of inequalities.Identificar la evidencia científica sobre el uso y los resultados de las tecnologías de la información y la comunicación para mejorar la salud neonatal en general o problemas de salud o intervenciones específicos, y describir el tipo de intervención y sus resultados.Se realizó una revisión sistemática de la evidencia disponible. La búsqueda se llevó a cabo en revistas revisadas por pares entre el 1 de enero de 2008 y el 30 de abril de 2018, en español e inglés. Los términos clave de la búsqueda fueron (health informatics OR telemedicine OR mHealth) AND (newborn OR newborn care OR neonatal care).De un total de 305 artículos identificados inicialmente, 10 artículos cumplieron los criterios de inclusión. Los principales dominios de la eSalud aplicados a la salud neonatal fueron la telemedicina (3 estudios), el aprendizaje electrónico (1 estudio) y la salud móvil (7 estudios). La población destinataria consistió en los proveedores de atención de la salud o los padres. Los estudios tenían por objeto el diagnóstico, la prestación de atención sanitaria y la capacitación, la promoción del cumplimiento de las intervenciones en los padres o la mejora de la calidad de la atención.El uso de la eSalud en general, y específicamente en la salud neonatal, muestra importantes posibilidades de desarrollo y expansión, dados los avances y las necesidades actuales, y debería considerarse un instrumento clave para la reducción de las desigualdades.

Background: The International Academy of Health Sciences Informatics (IAHSI) is the Academy of the International Medical Informatics Association (IMIA). As an international forum for peers in biomedical and health informatics, the Academy shall play an important role in exchanging knowledge, providing education and training, and producing policy documents. Objectives: A major priority of the Academy’s activities in its inaugural phase was to define its strategy and focus areas in accordance with its objectives and to prioritize the Academy’s work, which can then be transferred to respective taskforces. Method: This document reflects the major outcomes of intensive discussions that occurred during 2019. It was presented at the Academy’s 3rd Plenary on August 25th, 2019, in Lyon, France. Results: Regardless of the ‘living nature’ of the strategy and focus areas document, it was concluded during the Plenary that the first version, which will be used as a base for decisions on the Academy’s future activities, should be made available to a broad audience. Three out of eight ‘Visions for IAHSI‘, presented in the IMIA Yearbook of Medical Informatics 2018, were identified as central for developing, implementing, and evaluating the Academy’s strategic directions: (1) advise governments and organizations on developing health and health sciences through informatics, (2) stimulate progress in biomedical and health informatics research, education, and practice, and (3) share and exchange knowledge. Taskforces shall be implemented to work in the following areas, which were considered as priority themes: (1) artificial intelligence in health: future collaboration of entities with natural and with artificial intelligence in health care, and (2) current landscape of standards for digital health. Conclusions: Taskforces are now being established. Besides specific key performance indicators, suggested for monitoring the work of theses taskforces, the strategy to monitor the progress of the Academy itself has to be measured by relevant and acceptable metrics.

The implementation of electronic medical record tools in pediatric care implies the creation of use recommendations and a clear definition of functional features. The objective of this paper is to describe minimum specific functionalities for an electronic medical record in pediatrics, with the aim to contribute to a definition of design criteria and best practices for its use. In this report, we will go over the generic functionality of the electronic medical record; we will frame the legal context in Argentina; we will approach some implementation aspects; and finally, we will describe minimum pediatric specific functionalities. Despite the adoption barriers in the field of pediatrics when it comes to incorporating electronic medical records into their professional activity, there are multiple resources to enable this digital transformation process. It is also fundamental to understand that, like any other technology, there are responsibilities related to their appropriate use.

Most cancers are characterized by the somatic acquisition of genomic rearrangements during tumour evolution that eventually drive the oncogenesis. Here, using multiplatform sequencing technologies, we identify and characterize a remarkable mutational mechanism in human hepatocellular carcinoma caused by Hepatitis B virus, by which DNA molecules from the virus are inserted into the tumour genome causing dramatic changes in its configuration, including non-homologous chromosomal fusions, dicentric chromosomes and megabase-size telomeric deletions. This aberrant mutational mechanism, present in at least 8% of all HCC tumours, can provide the driver rearrangements that a cancer clone requires to survive and grow, including loss of relevant tumour suppressor genes. Most of these events are clonal and occur early during liver cancer evolution. Real-time timing estimation reveals some HBV-mediated rearrangements occur as early as two decades before cancer diagnosis. Overall, these data underscore the importance of characterising liver cancer genomes for patterns of HBV integration., Hepatitis B virus (HBV) infection and DNA integration is a frequent cause of hepatocellular carcinoma (HCC), but the consequences of this process are not fully understood. Here the authors use whole-genome and long-read sequencing data from HCC patient samples to study the timing and alterations induced by HBV insertions.

The implementation of electronic medical record tools in pediatric care implies the creation of use recommendations and a clear definition of functional features. The objective of this paper is to describe minimum specific functionalities for an electronic medical record in pediatrics, with the aim to contribute to a definition of design criteria and best practices for its use. In this report, we will go over the generic functionality of the electronic medical record; we will frame the legal context in Argentina; we will approach some implementation aspects; and finally, we will describe minimum pediatric specific functionalities. Despite the adoption barriers in the field of pediatrics when it comes to incorporating electronic medical records into their professional activity, there are multiple resources to enable this digital transformation process. It is also fundamental to understand that, like any other technology, there are responsibilities related to their appropriate use.La implementación de herramientas de registro médico electrónico en la atención pediátrica implica la creación de recomendaciones de uso y una clara definición de las características operativas. El objetivo de este trabajo es describir dichas funcionalidades a los fines de contribuir en la definición de criterios para su diseño y buenas prácticas de uso. Haremos un breve repaso de las funcionalidades genéricas de la historia clínica electrónica, enmarcaremos el contexto legal en Argentina, abordaremos algunas cuestiones de implementación y, finalmente, describiremos las funcionalidades mínimas específicas para pediatría. A pesar de los interrogantes que se les presentan a los pediatras a la hora de incorporar una historia clínica electrónica en su actividad profesional, existen múltiples recursos que permiten conducir este proceso de transformación digital. Asimismo, es fundamental comprender que, como cualquier otra tecnología, existen responsabilidades vinculadas a su buen uso.

Background: Lower cranial nerve schwannomas are rare and only 63 cases originating from the accessory nerve have been documented. Case Description: We report a 61-year-old man who presented with a 3-month history of dysmetria, ataxic gait, and frequent falls. Magnetic resonance imaging revealed a giant rim-enhancing cystic lesion at the right cerebellomedullary cistern, which markedly displaced the brainstem and caused a critical compression on surrounding structures and mild hydrocephalus. Even though the nature of this lesion was not clear, it received a radiological diagnosis of meningioma as first option. Surgery was performed through an extended far lateral retrosigmoid approach with C1 hemilaminectomy, with intraoperative neurophysiological monitoring. A near-total resection was achieved due to the adhesion of the lesion to the brainstem and to the cranial nerves VII, VIII, IX, X, XI, and XII. Intraoperatively, the tumor was found to arise from the accessory nerve. The histopathological analysis concluded with a final diagnosis of ancient schwannoma, a rare histological subtype characterized by degenerative changes, typical from long-standing tumors. Conclusion: Very few cases of intracranial ancient schwannomas have been described. To the best of our knowledge, this is the first report of this extremely rare histological variant arising from the intracisternal component of the XI nerve. The rarity of this disease at this location may lead to preoperative misdiagnosis.

To describe and assess clinical characteristics and factors associated with mortality in adult patients with COVID-19 admitted to a national referral hospital in Peru.We conducted a prospective cohort study that included hospitalized patients older than 18 years with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection diagnosis. Patients with a positive rapid serological test on admission but no respiratory symptoms nor compatible images were excluded. We collected the data from clinical records.A total of 813 adults were included, 544 (66.9%) with confirmed COVID-19. The mean age was 61.2 years (standard deviation: 15.0), and 575 (70.5%) were male. The most frequent comorbidities were hypertension (34.1%) and obesity (25.9%). On admission, the most frequent symptoms were dyspnea (82.2%) and cough (53.9%). A total of 114 (14.0%) patients received mechanical ventilation, 38 (4.7%) were admitted to the intensive care unit, and 377 (46.4%) died. The requirement for ventilatory support, greater lung involvement, and inflammatory markers were associated with higher mortality. It was found that for every 10-year age increase, the risk of dying increased 32% (relative risk: 1.32; 95% confidence interval: 1.25 to 1.38). Those who were admitted to the intensive care unit and and were placed on mechanical ventilation had 1.39 (95% confidence interval: 1.13 to 1.69) and 1.97 (95% confidence interval: 1.69 to 2.29) times the risk of dying compared to those who did not, respectively.We found a high mortality rate among hospitalized patients associated with older age, higher inflammatory markers, and greater lung involvement.Describir las características clínicas y evaluar los factores asociados con la mortalidad de los pacientes adultos con la nueva enfermedad causada por coronavirus 2019 (COVID-19) ingresados a un hospital de referencia nacional de Perú.Se realizó un estudio de cohorte prospectivo. Se incluyó a pacientes mayores de 18 años hospitalizados con el diagnóstico de infección por coronavirus 2 del síndrome respiratorio agudo severo (SARS-CoV-2). Se excluyó a quienes ingresaron con prueba rápida serológica positiva al ingreso, sin clínica sugestiva ni imágenes compatibles. Los datos se recolectaron a partir de la historia clínica.Se incluyó un total de 813 adultos, 544 (66,9%) tuvieron COVID-19 confirmado. La media de la edad fue de 61,2 años (desviación estándar: 15) y 575 (70,5%) fueron de sexo masculino. Las comorbilidades más frecuentes fueron hipertensión arterial (34,1%) y obesidad (25,9%). Los síntomas más frecuentes al ingreso fueron disnea (82,2%) y tos (53,9%). Un total de 114 (14%) pacientes recibieron ventilación mecánica, 38 (4,7%) ingresaron a unidad de cuidados intensivos y 377 (46,4%) fallecieron. Se asociaron a la mortalidad el requerimiento de soporte ventilatorio, el mayor compromiso pulmonar y los marcadores inflamatorios. Encontramos que por cada 10 años que aumentó la edad, el riesgo de morir se incrementó en 32% (riesgo relativo: 1,32; intervalo de confianza 95%: 1,25 a 1,38). Aquellos pacientes que requirieron ingreso a unidad de cuidados intensivos y ventilación mecánica tuvieron 1,39 (intervalo de confianza 95%: 1,13 a 1,69) y 1,97 (intervalo de confianza 95%: 1,69 a 2,29) veces el riesgo de morir, respectivamente.La mortalidad encontrada en nuestro estudio fue alta y estuvo asociada a la edad, marcadores inflamatorios y compromiso respiratorio.

Trabajo presentado en 16th International Symposium on the Analytic Hierarchy Process, celebrado en modalidad virtual del 3 al 6 de diciembre de 2020.

Objetivos. Determinar los factores asociados a mortalidad de los pacientes adultos hospitalizados con COVID-19 en un hospital de referencia de la seguridad social. Materiales y métodos. Se realizó un estudio de cohorte prospectivo. Se incluyó a pacientes mayores de 18 años hospitalizados con el diagnostico de infección por SARS-CoV-2 y se excluyó a quienes ingresaron asintomáticos respiratorios, con prueba rápida serológica positiva al ingreso y sin imágenes compatibles. Los datos se recolectaron a partir de la historia clínica. Resultados. Se incluyó un total de 813 adultos, 544 (66.9%) tuvieron COVID-19 confirmado. La media de la edad fue de 61.2 años (DE: 15.0) y 575 (70.5%) fueron de sexo masculino. Las comorbilidades más frecuentes fueron hipertensión arterial (34.1%) y obesidad (25.9%). Los síntomas más frecuentes al ingreso fueron disnea (82.2%) y tos (53.9%). Un total de 114 (14.0%) pacientes recibieron ventilación mecánica, 38 (4.7%) ingresaron a UCI y 377 (46.4%) fallecieron. El requerimiento de soporte ventilatorio, el mayor compromiso pulmonar, las comorbilidades y los marcadores inflamatorios se asociaron a la mortalidad. Se halló que por cada 10 años que aumenta la edad, el riesgo de morir se incrementa en 32% (RR: 1.32 IC95%: 1.25 a 1.38). Aquellos que requirieron ingreso a UCI y ventilación mecánica tuvieron 1.39 (IC95%: 1.13 a 1.69) y 1.97 (IC95%: 1.69 a 2.29) veces el riesgo de morir, respectivamente. Conclusión. La mortalidad encontrada en nuestro estudio fue alta y estuvo asociada a la edad, marcadores inflamatorios y compromiso respiratorio.

Summary Objectives: To summarize the major activities of the International Academy of Health Sciences Informatics (IAHSI) from 2018 until 2019, and to provide an outline of actions planned for 2020. Method: Reporting about these activities and actions by the members of the Academy's first Board. Results: Academy bylaws were accepted by the Academy Plenary and the IMIA General Assembly on August 25th, 2019 and August 26th, 2019, respectively. Academy's strategy and focus areas were developed. Based on the Academy's eligibility criteria, the 2018/2019 Class made of 26 new Academy Fellows was elected. Future activities will concentrate on building taskforces for developing and implementing major Academy focus areas. Conclusions: We are glad to report that the Academy is strong and thriving.

Education in health informatics is a lifelong process that has to be adapted to provide what the students need in order to acquire the competencies that are necessary for the development of the discipline. Most of the experience in health informatics education comes from countries in Europe and North America. Thanks to different initiatives in countries in Latin America to develop a National eHealth agenda, there is a need to have trained professionals to accompany the growth and evolution of the discipline in the region. In this chapter we will describe the initiatives of four countries in the region spanning the experience of healthcare organizations, universities and government agencies to provide an overview of the different initiatives that are ongoing in the region. This overview also aims to describe the diverse training possibilities available and how the training needs have been addressed with local skills.