bluuebunny/crossref_metadata_2025 huggingface dataset:
Equity assessment in innovative cancer genomic interventions: the Can.Heal project
Authors: Molina-Barceló A , Romeo-Cervera P , Pinto-Carbó M , Vanaclocha-Espí M , de Pablo-Pardo T , Alessandrello R , Van Valckenborgh E , van den Bulcke M
Published: October 2024

Background

The Can.Heal project (https://canheal.eu/) aims to build a cancer and public health genomic platform. The aim of this study is to assess the extent of integration of the equity perspective in the Can.Heal project.

Methods

An Equity Guide was developed in the context of the Can.Heal project including guidance and support to implement equity-focused actions in cancer genomics. The Guide consists of a comprehensive set of 18 equity actions organized into three domains: 1) capacity-building, 2) cancer genomic research, 3) cancer genomic services. An equity self-assessment tool was developed to assess the degree of incorporation of the equity perspective in the innovative interventions included in the project, for both the definition and the execution phase. A descriptive analysis was performed.

Results

Taking into account the 3 domains, the most progress in incorporating equity perspective, in both the definition and execution phase, is observed in the “capacity building” domain (75% and 30%), followed by the “cancer genomic services” domain (43% and 11%), and the “cancer genomic research’ domain (33% and 10%). Equity actions mostly followed in both phases are: “multidisciplinary approach” (80% and 40%), “networking” (70% and 20%), and “ethics, law, and citizen engagement” (80% and 40%). The least performed actions are: “equity evidence assessment” (0% and 0%), “equity in return of genomic results” (29% and 0%), “patients’ experience’ (13% and 0%) and “diverse samples in research studies and clinical trials” (25% and 25%).

Conclusions

Equity perspective is more considered in the definition phase. More efforts should be done in the execution of equity actions in the Can.Heal project.

Key messages

• Including a multidisciplinary approach, networking and considering ethics, law, and citizen engagement are the most followed equity actions in Can.Heal project.

• There is a need to integrate equity perspective in Can.Heal project, especially in cancer genomic research.
Impact of infectious diseases associated with passenger ships on ports: a systematic review
Authors: Neumann J , Zimmermann J , Frese M , Kleine-Kampmann S , Dirksen-Fischer M , Harth V , Heidrich J
Published: October 2024

Background

In an enclosed ship environment, close contact between passengers and crew members is inevitable. As a result, passenger ships can be a suitable environment for the transmission of infections between people. In this context, it is essential to establish effective prevention and control measures to protect the health of passengers and crew members while ensuring that shipping minimizes its contribution to the global spread of disease. The aim of this review is to provide knowledge on the impact of infectious diseases on board large passenger ships on the port, the port community and other land-based operations to better understand the effectiveness of the prevention, mitigation and management (PMM) measures implemented, in particular ship-to-shore communication.

Methods

A systematic literature review was conducted according to the PRISMA guidelines, searching three databases and including additional articles from hand searches up to November 2023. Peer-reviewed studies of infectious disease outbreaks on large passenger ships that described ship-shore interaction, port preparedness, impact on the port community, and impact on other modes of transportation were included.

Results

A total of 555 publications were initially identified. Finally, 22 articles were included. Most studies reported on COVID-19 outbreaks on cruise ships; other communicable diseases reported were influenza, gastroenteritis and varicella. The articles highlighted the importance of comprehensive management plans and proactive risk assessment during infectious disease outbreaks.

Conclusions

Effective stakeholder collaboration, ship-to-shore communication, and coordination of medical transport, isolation, and quarantine measures are essential components of infectious disease PMM in maritime passenger shipping and ship-to-shore operations. The findings suggest that further research is needed to improve the evidence and knowledge about this important issue.

Key messages

• Proactive risk assessment, comprehensive management plans and effective collaboration are critical to preventing, mitigating and managing infectious diseases on passenger ships.

• Overall, very little evidence of effective practices and capacities related to the interaction of passenger ships with land-based operations, stakeholders and port communities.
Organizational health literacy responsiveness in community pharmacies in Serbia
Authors: Krajnović D , Stević I , Nikolić K , Čavrak J , Grahovac A , Milošević Georgiev A
Published: October 2024

Background

The Faculty of Pharmacy at the University of Belgrade conducted a pilot study at community pharmacies in Serbia in 2023 in the framework of the M-POHL organizational health literacy (OHL) project. Community pharmacies in Serbia are considered relevant settings where people’s health can be promoted within the organization.

Methods

The validated and culturally adopted Serbian version of the International Self-Assessment Tool for Organizational Health Literacy in Primary Health Care Services (OHL-PHC) was used. We recruited employees from 3 pharmacy chains with pharmacists from different units. A preparatory workshop was organized to explain the procedure and the concept of OHL. First, the self-assessment was performed in a small group of 5 persons individually, and then the results were discussed in a joint assessment. The self-assessment was based on the degree of fulfillment of 4 categories offered for each indicator: not fulfilled (0-25%), predominantly not fulfilled (26-50%), predominantly fulfilled (51-75%), and completely fulfilled (76-100%). The same scale was applied for the indicators, sub-standards and standards and the final score was the mean of the individual scores (min. 0, max. 4).

Results

The overall score of the OHL on the sample level was 1.93±0.86, with the highest score for providing of easy access to primary care service and facilitating navigation (2.3±0.5). The least fulfilled standards were related to promotion of digital health literacy and promoting health literacy with the same score values of 1.7±1.0. Out of 69 indicators 1 had been self-assessed as not fulfilled and 15 reached low consensus (SD ≤ 1), and needed to be discussed further.

Conclusions

Improvements in OHL in the piloted institutions are necessary for successful healthcare and health promotion and could be tailed in further usage of the OHL-PHC on a broader scope. More pilot studies are needed in other healthcare settings at primary level in Serbia.
Treatment of kidney disease: an analytical decision model at a Swiss university hospital
Authors: Endrich O , Triep K , Messerli M , Nakas C , Fiedler M
Published: October 2024

Background

An observational hospital-based cohort study, where the kidney disease staging is identified as a digital marker, and the association between the standardised staging of Kidney Disease (KD) and the outcomes is assessed along the treatment process.

Methods

The clinical and administrative data for all patients are stored in the Clinical Data Warehouse. A specific digital marker for an exact KD staging is applied. Three retrospective patient cohorts for exact and imprecise staging and missing diagnosis are defined and compared regarding the in-hospital mortality, all-cause mortality and disease progression.

Results

In total, 83146 hospitalisations of 40421 patients with KD, treated in 2014-2023 (2016-2023 will be updated) were identified; the number of the first hospitalisations with exact staging was 847 (2%), unprecise 29934 (72%) and missing diagnosis (26%). The demographic and baseline factors distribution between groups was tested with no association (chi-squared test statistic). The median survival time with a 95% CI was 7.94 (7.66, 8.81) years for the exact and 7.47 (7.42, 7.53) for the imprecise staging group. A log-rank and loglikelihood tests indicated a significant difference in survival between the groups, p < 0.0001. The Cox regression model shows a statistically significant difference in Hazard Ratio; KD staging, age, Elixhauser van Walraven index, treatment, nephrotoxic medication, contrast agent application, and AKI were identified as the significant covariates, C-statistic 0.730, Likelihood ratio test, Wald test, log-rank score on 42 df, p < 2e-16. ANOVA analysis confirmed a significant difference in cost distribution between the groups. An economic decision model proposal integrates the findings, combining a profile-level Markov cohort with a Discreet Time-To-Event Simulation DICE.

Conclusions

The study demonstrates a better outcome regarding all-cause mortality, in-hospital mortality, and costs if a standardised KD staging was applied.

Key messages

• Intuition (clinical judgement) and standardised kidney disease staging perform differently regarding clinical outcomes and costs.

• The study demonstrates a better outcome regarding all-cause mortality, in-hospital mortality, and costs if a standardised KD staging was applied.
The New Healthcare: AI-Driven Population Stratification, Proactive Medicine, and Predictive Analysis
Authors: Mormile M E , Rollo G , Grieco A , Mormile P , De Rosa M , Russo D R , Gigante V , Cisotta F , Rollo R
Published: October 2024

Background

The Covid-19 pandemic has highlighted structural and functional weakness of local health services. Italy carried out its reorganization with DM 77/2022, financed by Mission 6 PNRR of the CE. The model adopted aims to move from a reactive to proactive medicine, to be implemented close to the places where citizens live. The priority objective is to know data on the progress of chronic pathologies and non self-sufficiency using advanced digitalization tools.

Methods

14 types of administrative data from 2022 to 2023, concerning 180000 (ISTAT data) people in the Lecce Social Health District (DSS Lecce), were analyzed with AI (Chat GPT).

Results

Thanks to algorithms, 6 categories of clinical complexity were identified. The analysis showed that the population assisted is 198696, for temporary presences, with the most represented age group being 50-55 years. Births decreased by 36% in 10 years (from 1681 to 1076), with 2197 deaths in 2023. 42,38% of the population (average age 38,58 years) did not use healthcare resources, while 57,62% (average age 54,19 years) required them. 48646 patients have cardiovascular disease, but only 10% with heart failure were actively monitored. 25047 have metabolic disease, 11195 are diabetics, 5929 have chronic respiratory diseases, 8167 chronic neurological diseases and 907 are cancer patients. Increasing age leads to polymorbidity and show signs of social, economic and health fragility.

Conclusions

the strategic objective of the Lecce DSS was management of chronicity according to specific care pathways, PDTA. Create healthcare teams capable of being case managers depending on the level of complexity (family doctors, nurses, etc). With the 2024 data there will be 3 consecutive years of analysis which will allow the development of predictive systems to identify population clusters at risk of increasing complexity and in need of proactive medical interventions, use of telemedicine with the support of a Territorial Operations Center.

Key messages

• AI-driven stratification supports personalized health plans to improve healthcare delivery, patient outcomes, and optimize resource allocation.

• A new model of Population Health Management supported by Artificial Intelligence.
Sex-specific immune responses to COVID-19 vaccination in end-stage renal disease patients
Authors: Gingras S N , Kirby S E , Seo G E , Lopez C , Ahmed J , Ball T B , Card C M , Bueti J , Kiazyk S A , McLaren P J
Published: October 2024

Background

End-stage renal disease (ESRD) patients have muted memory B cell formation and reduced humoral responses to COVID-19 vaccination; however, early innate immune responses have yet to be characterized. Sex-stratification is also limited in COVID-19 vaccination research.

Methods

We collected blood before (BD1) and 1-4 days post-dose 1 (PD1) of BNT162b2 vaccination for RNA-sequencing in ESRD patients (n = 35 BD1; 18 PD1) and healthy controls (HC) (n = 31 BD1; 30 PD1). Additionally, 20 plasma cytokines were quantified in ESRD patients (n = 39 BD1, 35 PD1) and HC (34 BD1, 15 PD1).

Results

Transcriptional profiling of vaccine responses identified 125 significantly differentially expressed genes (DEG) (padj<0.04) in ESRD patients and 107 DEGs (padj<0.05) in HC. 71 DEGs were shared, 54 unique to ESRD, and 36 unique to HC. DEG, pathway analyses, and cytokine responses in the combined dataset showed ESRD patients were more inflamed than HC at baseline, with an elevated inflammatory cytokine profile compared to HC. These results were driven by female ESRD patients where IL-2, IL-10, and IP-10 were more significant in females (p < 0.001) compared to males (p < 0.01). While IL-6, IFN-γ, IL-13, eotaxin, were exclusively associated in females (p < 0.05). Healthy females also had a stronger immunological response to vaccination compared to healthy males.

Conclusions

Despite baseline inflammation, ESRD patients were able to mount similar early immune responses to vaccination as HC, with females in both populations more reactogenic than males. Sex-stratification is recommended for ongoing immunological research to better understand unique responses to COVID-19 vaccination.

Key messages

• End-stage renal disease patients have similar early innate immune responses to COVID-19 vaccination as healthy controls.

• Sex-stratification is important to identify unique immunological responses that may be leveraged for sex-specific vaccination strategies.
Use of intraoral mobile photography for screening of oral health in children
Authors: Mania L , Nanobashvili K , Manjavidze T , Benashvili M , Astamadze I
Published: October 2024

Background

The aim of the study is to evaluate the diagnostic accuracy of intraoral mobile photography to assess caries intensity (DMFT/deft), simplified oral hygiene index (S-OHI) and modified gingival index (MGI).

Methods

Children aged 7-12 were included in the study. The clinical doctor evaluated the oral health indicators by visual examination: DMFT, deft, S-OHI, MGI were calculated. Dental students independently captured photos with a mobile phone (iPhone-11) in 8 predetermined projections. Dental images were kept in coded folders for research anonymity. Another professional calculated index based on the photos. Variables were used with binary values (DMFT/deft = 0/≥1; MGI=0/≥1; S-OHI≤1.2/>1.2). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of dental photography were evaluated and Cohen’s Kappa was calculated to measure the level of agreement between two independent observers.

Results

2864 photographs were evaluated for 358 participants. The sensitivity and specificity of intraoral mobile photography for DMFT index is 95.8 (95% CI: 93.4-98.3) and 89.2 (95% CI: 83-95.5); For deft index: 100.0 (95% CI: 100-100) and 88.6 (95% CI: 79.3-98); For MGI: 89.7 (95% CI: 85.8-93.5) and 91.4 (95% CI: 86.3-96.5); For S-OHI: 77.6 (95% CI: 67.6-87.6) and 93.8 (95% CI: 91-96.6); The PPV value for DMFT, deft, MGI and S-OHI is 96.2; 97.7; 95.6 and 74.3 and the NPV value is 88.3; 100.0; 80.9 and 94.8 respectively. It was achieved substantial and perfect agreement between two independent raters: For DMFT, deft, MGI, S-OHI indices Cohen’s Kappa =0.85; 0.93; 0.78; 0.70 correspondingly.

Conclusions

Intraoral mobile photography, if applied within appropriate guidelines is reliable for assessing caries intensity, simplified hygiene index and modified gingival index as well as visual screening and may become a priority for dental public health. The involvement of dental students in studies of similar design is appropriate.

Key messages

• Intraoral mobile photography can be used for oral health screening in children.

• The involvement of dental program students in screening studies conducted with intraoral mobile photography is appropriate.
Longitudinal associations of daily activities and presenteeism among teleworkers in Japan
Authors: Otsuka Y , Itani O , Kaneita Y
Published: October 2024

Objectives

Many workers had to switch their standard work from the office to home-based telework during the COVID-19 pandemic. Previous studies reported that telework was associated with increased sickness presenteeism. Several studies have examined the association between lifestyle behaviors and presenteeism among workers. However, there are few studies investigating the relationship among teleworkers. Thus, this study examined the association between daily activities and presenteeism in a longitudinal cohort of teleworkers in Japan.

Methods

A prospective cohort study with a two-year observation was conducted. The participants were 831 workers belonged to five companies in Japan. For both surveys, self-administered questionnaire surveys on daily activities and presenteeism were conducted. Presenteeism was assessed using the short-form Japanese version of the World Health Organization Health and Work Performance Questionnaire. The data were analyzed using a generalized estimating equation approach, controlling for potential confounders such as age, gender, working hours, position, and health status.

Results

742 participants who teleworked in both surveys with no missing answers were analyzed. Among male workers (n = 427), chatting (β = 5.30, 95% CI: 1.52-9.07) and setting daily goals (β = 4.16, 95% CI: 1.52-9.07) were associated with decreased presenteeism. Among female workers, exercise (β = 4.33, 95% CI: 0.95-7.71) was associated with decreased presenteeism.

Conclusions

Although gender differences were observed, there is preliminary evidence from longitudinal studies that frequent activities such as chatting, setting daily goals, and exercising may protect against presenteeism among teleworkers. Our findings could be used to educate daily telework activities to prevent sickness presenteeism.

Key messages

• Daily activities during telework may worsen or improve presenteeism.

• Social isolation may be an important indicator of presenteeism during telework.
Subtle Biases Towards a New Colleague Depend on Sexual Orientation and Relationship Status
Authors: Komlenac N , Aigner A , Haller M , Birke J , Walther A
Published: October 2024

Background

Allonormative beliefs entail the idea that all people desire sexual activity with other people. Single and/or asexual individuals may face social disapproval or discrimination for not being in line with allonormative beliefs. The present study investigated whether individuals offered help or were likely to befriend a new co-worker differently depending on the co-worker’s sexual orientation (i.e., heterosexual vs. asexual) and relationship status (i.e., in a relationship vs. single).

Methods

The online study included 1,028 participants (50.0% women and 50.0% men; Mage = 29.2, SD = 8.8) from German-speaking countries. Each participant read one of twelve short descriptions of a working situation in which they got to know a new co-worker. The description of the new colleague’s gender, sexual orientation, and relationship status varied. Participants had to indicate how likely they would share information with, befriend, gossip about, or have other-interests in the new colleague. A multivariate analysis of co-variance was calculated.

Results

Female participants had lower intentions to share knowledge with persons who were singles by circumstance than with persons in a relationship and male participants were more likely to befriend a single gay man by choice than a gay man in a relationship.

Conclusions

Bias against single persons or prejudice resulting from heteronormative beliefs might lead to subtle differences in behavior towards a co-worker. Such subtle “micro-practices” can be harmful because micro-practices accumulate over time and situations. Interventions at organizations need to help employees realize their own biases that might be based on prejudices against people with different sexual orientations and relationship statuses.

Key messages

• Overall women are more pressured by allonormative ideas and might therefore have lower intentions to share knowledge with persons who were singles by circumstance than with persons in a relationship.

• The differing treatment of single gay men by choice and gay men in relationships may not be solely due to adherence to allonormativity, but rather could stem from heterosexist beliefs.
Exploring Health Professionals’ Views on Hive: A Digital collaborative space for Health Emergencies
Authors: Hang F , Farhat M , Yau B , Latinovic L , von Harbou K , Emiroglu N , Kovačev N
Published: October 2024

Background

The rapidly changing media landscape has significantly affected how information is consumed, particularly during health emergencies. Conflicting information shared or information lacking in scientific rigour can be exploited nefariously online to undermine the health response and damage trust. Digital platforms have become increasingly vital for facilitating communication, and in response, the WHO developed the Hive digital space to provide a safe environment for public health professionals to convene, share information, ask questions, and learn from each other. This study aims to explore the experiences of public health professionals in health emergencies to assess the added value of the Hive platform to coordinate and connect health expertise globally.

Methods

This study uses a cross-sectional online survey distributed to Hive users focusing on their experiences of working in health emergencies. The responses will undergo descriptive and thematic analysis, as well as inferential statistics such as one-way ANOVA and post-hoc analysis. The survey will emphasize the practical application, value, satisfaction, perceptions, and strategy for the Hive platform to be utilised for global health emergency coordination.

Expected Outcomes

Insights from this study will delineate how the Hive platform is used by public health experts at all levels in emergency management. It will also highlight the challenges, needs and demands for digital tools to connect skills, experience and knowledge in one place. These insights will demonstrate how the Hive can streamline these processes and provide a safe space for information exchange for a coordinated response to health emergencies.

Conclusions

Understanding the needs and perceptions of Hive users involved in health emergency prevention, preparedness, response, and resilience will provide critical insights into optimizing the platform’s usability, connectiveness across emergency teams and sustainability of the platform.

Key messages

• Connecting communities, fostering collaboration and co-creation for improved health emergency management.

• Hive enhances collaboration among health professionals, providing a safe environment for knowledge and information sharing.
Barriers and challenges to telemedicine usage among the elderly population in Israel
Authors: Haimi M , Goren U , Grossman Z
Published: October 2024

Background

Despite the challenges to its adoption, telemedicine is becoming more and more popular for helping elderly people preserve their independence and continue to live in their own homes.

Aims

We investigated the challenges and barriers experienced by the elderly population when using telemedicine services in Israel.

Methods

Fourteen elderly people were recruited for the study and interviewed in person using a semi structured interview protocol, using a qualitative technique. Participants’ replies were evaluated and analyzed thematically. The participants were questioned regarding their usage of telehealth services, the benefits they perceive in them, any potential difficulties to use, and suggestions they had for making these services more readily available and simpler to use for the elderly.

Results

Most participants recognized the advantages of telehealth services, particularly for the elderly population during pandemics and normal times. However, most of them also expressed various challenges that face the elderly population in using these services. Many participants were concerned that the quality of telemedicine sessions may not be good enough compared to in-person sessions, and expressed a lack of confidence in telemedicine services, and frustration from the absence of in person interaction. Many participants highlighted the technological challenges in the use of computers and applications in general and in the context of healthcare, in particular, in addition to physiological and literacy difficulties. Finally, the participants suggested several ways to increase the accessibility and usage of telemedicine solutions by elderly people.

Conclusions

A proactive approach to identifying and resolving telehealth barriers can maximize virtual interactions for the older population and alleviate care inequities. There is a need to increase awareness of the availability, benefits, and uses of each telehealth service in comparison to in-person consultations.

Key messages

• A proactive approach to identifying and resolving telehealth barriers can maximize virtual interactions for the older population and alleviate care inequities.

• There is a need to increase awareness of the availability, benefits, and uses of each telehealth service in comparison to in-person consultations.
Physical activity for the elderly: systematic review and synthesis of digital health interventions
Authors: Di Pumpo M , Miatton A , Riccardi M T , Graps E A , Baldo V , Buja A , Damiani G
Published: October 2024

Background

Physical activity (PA) is key for the well-being of the elderly. Despite its proven efficacy, many older adults remain sedentary. Digital health interventions offer promising results. The study aimed to appraise scientific literature evidence regarding digital interventions to improve physical activity levels among community-dwelling adults aged 60 years or older.

Methods

A systematic review and semiquantitative analysis were performed. Digital interventions were included if using eHealth/mHealth tools, app-based technologies and text messaging. An intervention control was required. Main outcomes consisted in physical activity levels and related measures. A semiquantitative approach was chosen for evidence synthesis, using a harvest plot to visually facilitate the weighing of results with sample size and quality assessment.

Results

A total of 10 studies (13 publications) were included, from which five main intervention types were identified (2 studies per each intervention type). A semiquantitative evidence synthesis via a harvest plot was performed, to base the studies evaluation on the simultaneous consideration of sample size, study quality by type and effectiveness of intervention. Interventions adopting dynamically-adjusted exercise plans via wearables and app-based digital peer-support resulted the most successful, whereas PA digital coaching interventions resulted the least recommendable for adoption. Motivating interventions through digital platforms and digital diaries showed inconclusive results.

Conclusions

Personalized interventions using dynamically-adjusted wearable-based technology and app-based digital peer-support ones resulted as the most promising. Their ability to provide real-time, personalized feedback and foster social support is key for health promotion. It is crucial to leverage these promising tools for enhancing population health, integrating them into comprehensive, equitable, sustainable and engaging public health interventions.

Key messages

• Interventions using personalized and dynamically-adjusted plans result as the most effective to increase physical activity amond the elderly.

• It is key to integrate effective digital health tools into comprehensive, equitable, sustainable and engaging public health interventions to enhance population health.
Digital communication and techno-stress among health professionals: a cross-sectional study in Italy
Authors: Butnaru A M , Scaioli G , Lodin M , Toffanin C , Cataldo A , Lo Moro G , Bert F , Siliquini R
Published: October 2024

Background

Digital technologies are increasingly indispensable in physicians’ clinical practice. Despite their advantages, they are also linked to information overload and constant availability, which might affect healthcare professionals’ quality of life. The study aims to investigate the utilisation of digital technologies among healthcare providers and to identify possible predictors of techno-stress associated with these technologies.

Methods

A cross-sectional study was conducted through an anonymous questionnaire distributed to Medical Doctors (MDs) via social media. The main outcomes were “Impact of digital technologies” and “E-mail overload” (EO), and “Whatsapp overload” (WO) as indicators of techno-stress. Univariable and multivariable regression models analyzed the association between the outcome variables and selected independent variables.

Results

Preliminary results were conducted on 246 MDs. Most respondents declared that using digital technologies positively impacted their relationship with patients and colleagues (67.1% and 56.7%, respectively). Multivariable linear regression analyses highlighted that variables associated with a higher or lower EO and/or WO were age (WO: adjusted coefficient (adjCoeff)=0.24, p = 0.004), being a specialist compared to a General Practitioner (GP) (EO: adjCoeff -8.42, p = 0.000; WO: adjCoeff=-5.2, p = 0.02), the number of patients visited each day (EO: adjCoef=16.10, p = 0.000; WO: adjCoeff=10.43, p = 0.001), working in a town with a larger population (EO: adjCoeff=-8.22, p = 0.001).

Conclusions

In agreement with the literature, GPs were the medical category most affected by techno-stress. Doctors with a higher volume of patients and who work in smaller towns have a higher likelihood of techno-stress. These findings underscore the necessity of interventions to address the issue, specifically through increased MD education and enhanced EU-wide regulations on digital technology use in healthcare.

Key messages

• Digital technologies positively impact physicians’ relationships with patients and colleagues, but also contribute to techno-stress, especially among General Practitioners and those with more patients.

• Interventions like improved Medical Doctors’ education and stronger European regulations are needed to manage techno-stress and optimize the use of digital technologies in healthcare.
Evaluating Accuracy of AI-Generated Travel Vaccine Recommendations: GPTs in Public Health
Authors: Marin-Rodriguez J A , Rodriguez M , Leyva L , Torralba C , Agustin F , Enriquez F
Published: October 2024

Introduction

Artificial intelligence (AI), particularly generative pre-trained transformers (GPTs), holds promise for enhancing public health strategies like travel vaccine recommendations. This pilot study evaluated GPTs’ accuracy in delivering tailored vaccine advisories compared to standards set by public health professionals. Integrating AI’s data analysis capabilities into healthcare decision-making could improve recommendation precision and personalization.

Methods

This retrospective study analyzed GPT travel vaccine recommendation accuracy against a gold standard from health professionals for 90 travelers visiting various countries. Sociodemographic data and vaccine recommendation outcomes were examined. Accuracy assessments were stratified by age, sex, country of travel, duration of travel, type of travel, and specific vaccines.

Results

Preliminary results showed an 77.43% overall accuracy across all vaccine recommendations. Specific vaccine accuracies varied, with 97.78% alignment for hepatitis A, 93.51% for typhoid fever and 89.36% for rabies. However, lower accuracies were observed for cholera (33.33%) and encephalitis (56.25%). Moderate accuracies were noted for yellow fever (75%), 74.07% for malaria prophylaxis, diphtheria and tetanus (63.33%), and dengue (57.58%). Stratified analyses are expected to provide more realistic results and highlight discrepancies in certain groups.

Conclusions

This pilot demonstrates GPTs can be a valuable tool for supporting international vaccination professionals, but they are still not a substitute for these professionals, achieving 77.43% overall accuracy. Recommendations include: a) Educate health professionals in the use of GPTs, b) Developing guidelines for ethical and accurate AI use in public health, c) Using AI to strengthen surveillance and response systems. Combining AI with traditional strategies aims to optimize international traveler health outcomes.

Key messages

• Using artificial intelligence can optimize and facilitate the task of clinical consultancy in traveler’s advice.

• It is necessary to establish guidelines for AI use to ensure ethical and accurate applications.
Impact of in-silico technologies in the development of high-risk medical devices on healthcare
Authors: Roesler D , Czypionka T , Eisenberg S , Kraus M , Reiss M , Zech C
Published: October 2024

This study examines the impact of in-silico technologies (IST), such as virtual cohorts and digital twins, on the development of high-risk medical devices within the healthcare sector. An iterative empirical approach combining a literature review, exploratory and in-depth interviews with stakeholders from academia, industry, regulators, healthcare professionals, and focus groups with patients across Europe, Japan, and the USA was employed to gain insight into the implications of IST on healthcare. The findings indicate that IST can reduce the time to market for medical devices, thereby facilitating faster, broader, and more equitable access for patients. The implementation of extensive early testing, optimized study designs and increased sample sizes in trials can facilitate the achievement of enhanced safety. The early identification of adverse effects can enhance the safety of medical devices and improve patient outcomes. Furthermore, IST may facilitate the inclusion of underrepresented groups, such as children, in clinical trials, thereby enhancing their representation in medical research. The reduction in costs associated with IST may facilitate innovation cycles. However, the impact on prices is contingent on competition. Furthermore, IST have the potential to reduce the need for animal testing. Nevertheless, several uncertainties and potential adverse effects have been identified. Physician training on new devices remains a bottleneck, which may limit the benefits of new products. Despite the advancements, a complete replacement of traditional clinical and preclinical trials with IST is not seen to be feasible. From a policy perspective, it is crucial to promote regulatory clarity by providing guidance for the usage of IST, to offer incentives for the adoption of IST, and to foster competition. These findings demonstrate the multifaceted potential benefits and challenges of IST, including enhanced safety, accessibility, and innovation in healthcare.

Key messages

• In-silico technologies can reduce time-to market of medical devices up medical device and improve safety for patients.

• Challenges like physician training and regulatory guidance must be addressed to fully realize benefits of in silico technologies.
Occupational Hazards: The Impact of Streptococcus suis Infections in Portuguese Pig Farming
Authors: Salvador S , Sousa S , Sousa-Gomes D , Ferreira R
Published: October 2024

Background

In Portugal, the commensal and opportunistic bacteria Streptococcus suis is prevalent among pigs. Recognizing its public health significance, this systematic review investigates the relationship between occupational exposure in pig farming and the incidence of S. suis infections among workers. The importance of this study is to identify high-risk occupational activities and formulate effective public health interventions.

Methods

This review analyzed 20 scientific studies from 1986 to 2023 on human infections with S. suis in Portugal. The primary sources included articles in Portuguese from databases like MedLine, Scopus, and Pubmed. Studies were selected based on their focus on occupational exposure and the details provided on epidemiological context, clinical presentations, and outcomes.

Results

The review found that 85% of infection cases occurred in occupational settings, particularly among butchers (53%) and pig breeders or handlers (29%). Clinical manifestations predominantly included acute bacterial meningitis, with significant occurrences of neurosensory hearing loss as a sequelae. The average age of affected individuals was 44, predominantly male.

Conclusions

The study confirms a significant correlation between occupational exposure in pig farming and S. suis infections in humans. The findings underscore the need for stringent occupational health measures and integrated approaches encompassing human, animal, and environmental health under the One Health initiative. Innovations in public health interventions recommended include enhanced surveillance, improved workplace hygiene, and targeted health education for at-risk populations.

Key messages

• Occupational exposure in pig farming is a significant risk factor for S. suis infections in humans.

• Integrative One Health approaches are essential for preventing S. suis infections in occupational settings.
Born in Ethiopia
Authors: Capitani E , Cozzolino M , Nante N , Alaimo L
Published: October 2024

Background

Goal 3 of the United Nation 2030 Agenda states that we want to ensure health and well-being for all. This is even more true for countries in the IV World. The aim of our study is to investigate the timing of childbirth in Ethiopia.

Methods

The stages of our ethnographic study include: choosing the study topic and location, participating in group life, collecting and analysing data. The field experience, led by a midwife, took place from September 2023 to October 2023 in Ethiopia, within the Saint Luke Catholic Hospital in Wolisso.

Results

The instruments that the midwives have at their disposal are few and obsolete: the most is Pinard’s stethoscope. The mothers are all very young: the youngest woman was fourteen years old while the oldest woman was thirty-eight years old. As for parity, the fertility rate is around 4.6 live births per woman. Women’s family members take care of them in all aspects of care. Pregnant and new mothers receive support from their attendants, an all-female network. Pregnancy monitoring is almost non-existent. There is no prenatal diagnosis. In 2022, St. Luke’s hospital saw a 20% caesarean section rate, an increase from the previous two years. Poverty and the lack of government facilities that can support a problem child are two of the reasons why many of these children are abandoned. In terms of maternal and child health, mortality indicators are still too high for mothers and children. There are 353 mothers dying per 100,000 live births and 41 babies dying per 1,000 live births.

Conclusions

The biomedical model exported from the Western world, as shown for example by the increase in caesarean sections, has led to a slow but progressive hospitalisation of childbirth in the search for safety from maternal and neonatal mortality.

Key messages

• Poverty, malnutrition, lack of sanitation and drinking water, as well as early pregnancies and high parity remain among the leading causes of mortality in Ethiopia.

• The biomedical model exported from the Western world has led to a slow but progressive hospitalisation of childbirth in the search for safety.
A Multidisciplinary One Health Approach to Addressing Unsanitary Conditions: The Case of Cascais
Authors: Quelhas C , Lopes M , Silva J , Nunes R , Fernandes M
Published: October 2024

Unsanitary conditions in domiciles often stem from complex social and health-related issues, involving the elderly and/or individuals with mental health problems. These situations typically lead to a decreased quality of life for those involved, directly and indirectly, and may pose a risk to public health depending on their magnitude. In Cascais municipality, identified cases of unsanitary conditions undergo a multidisciplinary analysis. It has been established a Local Technical Group for Domiciliary Unsanitary Situations, comprising various institutions such as local authorities, law enforcement agencies, civil protection, health and social security ministries, and the animal rescue center. This group operates under a One Health approach, encompassing human health, environmental health, and animal health. Interventions are determined by the working group, with the aim of promoting health and enhancing citizens’ quality of life. Cases of unsanitary conditions reported are subsequently discussed within the technical group, which has regular meetings, and may organize joint assessment visits and appropriate actions. This social and environmental initiative responds to the growing need to address unsanitary and cluttered living conditions, which significantly impact individuals’ physical, emotional, and social well-being. The objective is to restore housing conditions in homes by removing waste and unnecessary items, contributing to general individual well-being. While international studies suggest a correlation between unsanitary conditions and hoarding disorder, it’s crucial to differentiate between distinct and independent situations caused by various physical, psychological, and cognitive processes. The establishment of a Local Technical Group for Domiciliary Unsanitary Situations exemplifies a proactive approach to addressing complex health and social challenges, emphasizing collaboration, and holistic intervention strategies, always with a One Health approach.

Key messages

• Addressing unsanitary conditions is crucial for safeguarding public health, impacting physical, emotional, and social well-being.

• The establishment of a Local Technical Group for Domiciliary Unsanitary Situations, under a One Health framework, reflects a collaborative approach to addressing complex health and social challenges.
Social patterning of health misinformation in two Eastern Mediterranean populations
Authors: Heraclides A , Kouvari K , Hadjikou A , Gkoutzourelas A
Published: October 2024

Background

Health misinformation, the spread of false or misleading information relevant to health, has been proposed as a major global public health thread by the WHO. We aimed to identify the major social determinants of health misinformation in the general Greek and Cypriot populations.

Methods

Following proportional quota sampling we recruited a nationwide sample of 585 adults from Greece and Cyprus between January 2022 and May 2023. A newly developed, culturally adopted questionnaire comprising 48 items, was used to assess misinformation on COVID-19 vaccines and the pandemic. Sociodemographic determinants of interest included gender, age, marital status, area of residence, educational attainment, and income. Multiple linear regression was used to determine associations between the aforementioned social factors and the two dimensions of health misinformation, applying mutual adjustment.

Results

Misinformation about both vaccination and the pandemic was higher in younger age groups (p-trend 0.026 and 0.007, respectively), among those separated, divorced, or widowed (mean difference, 95% CI compared to those single: 9.73, 0.45, 19.01), and among those living in semi-urban compared to urban areas (11.14, 1.32; 20.97 and 9.44, 1.96; 16.92, respectively). We also detected strong inverse socioeconomic gradients in health misinformation based on educational attainment and income (p-trend <0.001, for both).

Conclusions

Younger individuals, those living alone, those residing in semi-urban areas, and those with lower educational attainment and income are particularly prone to health misinformation. Our adjusted models show that this social phenomenon is not simply explained by differences in education, hence more complex, cultural, political, perceptual, and psychosocial dynamics might be in place. Addressing the social patterning of health misinformation would help manage the issue more effectively and also reduce health inequalities.

Key messages

• Health misinformation is strongly socially patterned in two Eastern Mediterranean European populations.

• Targeting efforts to tackle health misinformation to those more vulnerable, would render such programmes more effective, also helping reduce social inequalities in health.
Improving transparency: Development of reporting guidelines for burden of disease studies
Authors: Devleesschauwer B , Gorasso V , Charalampous P , Haagsma J A
Published: October 2024

The burden of disease (BOD) approach, originating with the Global Burden of Disease (GBD) study in the 1990s, has become a cornerstone for population health monitoring. Despite the widespread use of the Disability-Adjusted Life Year (DALY) metric, variations in methodological approaches and reporting inconsistencies hinder comparability across studies. To tackle this issue, we set out to develop guidelines for reporting DALY calculation studies to improve the transparency and comparability of BOD estimates. The development of the STROBOD statement began within the European Burden of Disease Network, evolving from initial concepts discussed in workshops and training sessions focused on critical analysis of BOD studies. In 2021, a working group was formed to refine the preliminary version into the final Standardised Reporting of Burden of Disease studies (STROBOD) statement, consisting of 28 items structured across six main sections. These sections cover the title, abstract, introduction, methods, results, discussion, and open science, aiming to ensure transparency and standardization in reporting BOD studies. Notably, the methods section of the STROBOD checklist encompasses aspects such as study setting, data inputs and adjustments, DALY calculation methods, uncertainty analyses, and recommendations for reproducibility and transparency. A pilot phase was conducted to test the efficacy of the STROBOD statement, highlighting the importance of providing clear explanations and examples for each reporting item. The inaugural STROBOD statement offers a crucial framework for standardizing reporting in BOD research, with plans for ongoing evaluation and potential revisions based on user feedback. While the current version focuses on general BOD methodology, future iterations may include specialized checklists for distinct applications such as injury or risk factor estimation, reflecting the dynamic nature of this field.