bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of ventricular tachycardia cycle length in the outcomes after catheter ablation or antiarrhythmic drugs in the SURVIVE-VT trial
Authors: Avila Alonso P , Berruezo A , Jimenez-Candil J , Tercedor L , Arribas F , Fernandez-Portales J , Merino J L , Hernandez-Madrid A , Bermejo-Thomas J , Arenal A
Published: October 2024

Background

It has been suggested that antiarrhythmic drugs (AAD) are less effective and safe in slow ventricular tachycardia (VT) due to their effect on conduction velocity, which could stabilize reentry. Conversely, catheter ablation aims to disrupt the VT circuit. Because of the distinct mechanisms of action of AAD and catheter ablation on the VT circuit, VT cycle length (VT-CL) may play a crucial role in determining their therapeutic efficacy. Therefore, VT-CL could be important in selecting VT treatment.

Purpose

The aim of this study was to assess the impact of VT-CL on outcomes following catheter ablation or antiarrhythmic drugs in AAD-naïve patients with ischemic cardiomyopathy presenting with VT.

Methods

This is a post hoc analysis of the previously published Substrate Ablation vs Antiarrhythmic Drug Therapy for Symptomatic Ventricular Tachycardia (SURVIVE-VT) trial. In summary, 144 patients with ischemic cardiomyopathy and symptomatic VT were randomized to receive either catheter ablation (N=71) or AAD (N=73) as first-line therapy. We analyzed VT recurrence, implantable cardioverter-defibrillator (ICD) therapies, and the incidence of slow/incessant VT/VT storm using Cox proportional hazard models, with treatment and VT-CL interaction terms, adjusted for age. Missing VT-CL data for five patients were imputed using the median value.

Results

In patients with chronic ischemic heart disease and VT treated with either AAD or catheter ablation, a significant interaction was observed between clinical VT-CL and treatment effect on VT recurrence (p=0.016 for the interaction). Specifically, slower VT cycle lengths were associated with higher rates of VT recurrence (hazard ratio per 10 ms [HR] 1.094, 95% confidence interval [CI] 1.015, 1.179; p=0.037) in patients treated with AAD, while no significant effect was observed in those undergoing catheter ablation (see Figure 1). Survival freedom from VT recurrence in patients with VT-CL ≥300ms was significantly higher in patients treated with catheter ablation (78.8% vs 58.1%, log-rank p=0.044, see Figure 2). As expected, VT-CL was significantly associated with a higher risk of slow/incessant VT/VT storm (HR per 10 ms 1.115, 95% CI 1.017-1.222, p=0.047) but was not associated with ICD therapies (HR per 10 ms 1.082, 95% CI 0.994-1.178, p=0.102).

Conclusion

VT-CL significantly influences treatment outcomes, with slower VT cycles associated with an increased risk of VT recurrence in patients treated with AAD, but not in those undergoing catheter ablation. Therefore, VT-CL should be taken into consideration when selecting the optimal therapy for patients with ischemic cardiomyopathy and VT.Figure 1Figure 2
Epicardial ablation in patients with Brugada syndrome: a single centre experience
Authors: Rafaj A , Peichl P , Krebsova A , Wichterle D , Stojadinovic P , Cihak R , Haskova J , Stiavnicky P , Borisincova E , Kautzner J
Published: October 2024

Introduction

Brugada syndrome (BrS) is a rare disease associated with an increased risk of ventricular fibrillation (VF), ventricular tachycardia (VT), and sudden cardiac death (SCD). The standard prevention of SCD in patients with BrS is the implantation of an implantable cardioverter-defibrillator (ICD), especially in patients who have previously suffered cardiac arrest or arrhythmogenic syncope. Catheter ablation is an effective method to prevent recurrences of VF/VT in these patients.

Purpose

Retrospective analysis of the results of catheter ablation by epicardial approach and genetic testing in patients with a diagnosis of BrS and repeated adequate ICD interventions.

Methods

In 2013-2024, catheter ablation by epicardial approach was performed in our centre in 9 patients diagnosed with Brugada syndrome (mean age 41±6 years, nine males, left ventricular ejection fraction 57±4%). All patients had an ICD implanted for secondary prevention of SCD and presented with adequate ICD therapies (mean 9±11 shocks/patient in the last six months before catheter ablation). Before catheter ablation, two patients were treated with quinidine. Patients underwent cardiogenetic testing by next-generation sequencing of 228 genes.

Results

Type 1 electrocardiogram (ECG) pattern was present at baseline ECG in four (44%) patients; in five (56%) patients, type 1 was induced after ajmaline administration. Genetic testing was performed in seven patients, and only one patient (14%) was found to have a relevant pathogenic mutation in the SCN5A gene. Prior to ablation, sustained VT/VF could be induced by programmed electrical stimulation in three patients (33%). Epicardial ablation was targeted at areas of abnormal electrograms located over the right ventricular outflow tract. No complications were noted. The mean follow-up period was 25±30 months. In one patient (11%), reablation was required to suppress ventricular arrhythmias successfully. After the last ablation, no recurrence of VT/VF was observed in any patient.

Conclusions

Epicardial ablation is an effective method that leads to the suppression of ventricular arrhythmias in patients with a diagnosis of BrS and repeated ICD interventions. Despite the malignant arrhythmic phenotype, patients in our cohort had a rather low prevalence of signs associated with a high risk of VT/VF, such as spontaneous ECG pattern of BrS, inducibility of VT/VF during electrical programmed stimulation, or the presence of a causative genetic mutation.
Health literacy challenges of young adults with rheumatic diseased in the transition to adult care
Authors: Scharmga A , Bakker M , Gorter S
Published: October 2024

Background

For young people living with a chronic illness (such as rheumatic diseases), transitioning from youth to adult care is a challenging process requiring adequate health literacy (HL). Insight into the specific HL-challenges of young people with rheumatic diseases could contribute to preventing loss to follow-up, and improving medication adherence, health outcomes, and social participation.

Methods

A mixed-methods study was conducted among young adults (16-25 years old) living with rheumatic disease in the Netherlands. Participants were recruited at two clinics and through social media of patient initiatives. Quantitative data were digitally self-reported using the Health Literacy Questionnaire (HLQ) and Medication Adherence Report Scale (MARS). Qualitative data were collected through semi-structured interviews. Hierarchical cluster analysis of HLQ-data was used to identify health literacy profiles, uncovering strengths and weaknesses. Interview transcripts were analysed using content analysis and used to explore health literacy needs and confirm the HLQ results.

Results

Sixty-two participants completed the questionnaire and ten participants were interviewed. Six HL-profiles were identified, representing diverse strengths and weaknesses. Having sufficient information, social support, and critical appraisal were challenging across profiles. Some participants (particularly in profile 3) reported difficulties in taking medication. The interviews confirmed the quantitative findings and unveiled HL needs across seven categories, particularly the need for in-depth information and support, with a focus on (social) aspects of having a chronic illness as a young person.

Conclusions

HL-challenges of young adults with rheumatic diseases are similar to adult populations, but age-specific needs exist. The results can inform development of HL-responsive rheumatology services, for example during consultations or at the transition clinic.
Research ethics implications in the development of personalised therapy for pediatric SIRS patients
Authors: Yankulovska S , Stolte F , Thiemicke P , Orzechowski M , Steger F
Published: October 2024

Background

Pediatric Systemic Inflammatory Response Syndrome (SIRS) presents diagnostic and therapeutic challenge that can be addressed through personalised therapy. Related ethical challenges are understudied. Our report aims at identification and analysis of research ethics implications within the bigger ERA PerMed funded project of development of tailored immunotherapy for paediatric SIRS patients (TIPS) coordinated by Prof. Catharina Schütz from Technic University Dresden.

Methods

A sample of 10 experts with different backgrounds was studied through semi-structured interviews. Systematic literature review grounded the interview questionnaire. The transcripts were subjected to thematic analysis by two independent researchers.

Results

Five classical research ethics issues were identified: respect for autonomy; informed consent; risk-benefits ratio; data protection; social justice. All experts favoured the empowerment of children (N = 10) and obtainment of informed consent rather than assent was seen as a common goal (N = 5). The emergency context of SIRS research impeded the informed consent. Despite favourable risk-benefits ratio, no direct benefits resulted to study participants. Data anonymisation though necessary (N = 10), hinders proper dealing with incidental findings. Social justice issues apparently accompanied research design in personalised medicine (N = 2) but should not extend to access to personalised therapy.

Conclusions

The classical framework of research ethics is challenged by the new fields of medical research. Traditional concepts, such as informed consent in minors, are subject to rethinking. Current ethical and legal guidelines fall short of proper practical instructions in the specific case of SIRS pediatric patients. Thus, ethical aspects of new technology development should always be studied in parallel to the biometrics within personalised medicine projects so as to the development of guidelines is more evidence-based than precautionary driven.

Key messages

• Current ethical and legal guidelines fall short of proper practical instructions in the specific case of SIRS pediatric patients.

• Ethical aspects of new technology development should always be studied within personalised medicine projects so as to the development of guidelines is more evidence-based than precautionary driven.
The role of communication in the successful implementation of the Slovenian NCCP
Authors: Plantosar K , Duratovic Konjevic A , Tomsic S , Zgajnar J , Zakotnik B , Torkar K
Published: October 2024

Issue

Cancer remains a significant global public health challenge, necessitating comprehensive strategies for effective control and management. Slovenian National Cancer Control Programme (NCCP) addresses this challenge by prioritizing proactive communication with various stakeholders engaged in cancer care planning, delivery and advocacy. The communication strategy within this programme plays a pivotal role in its successful implementation.

Description of the problem

Active engagement and collaboration among stakeholders is crucial for achieving the programme’s objectives. NCCP seeks to address this challenge through various communication activities by fostering dialogue, sharing best practices, and facilitating networking opportunities among oncology professionals throughout Slovenia. Additionally, it seeks to strengthen partnerships with sectors beyond health and prioritizes engagement with cancer patient advocacy groups.

Results

The programme has devised a long-term communication strategy, guiding annual communication plans to engage stakeholders and foster support for its objectives. Notable communication activities in the period 2022-2024 include: organizing annual meetings for different oncology stakeholders including cancer patient associations, hosting impactful professional events, conducting visits to regional cancer hospitals, distributing e-newsletters and managing a NCCP website. Initial outcomes indicate strengthened communication and collaboration among professionals and institutions in the field of oncology nationwide. Engagement with patient advocacy groups has facilitated discussions on topics important to patients.

Lessons

Effective communication with diverse stakeholders is crucial for comprehensive cancer control. Collaborating across sectors enhances the impact of cancer control initiatives. Enhanced networking fosters innovation and synergy among oncology professionals, positioning Slovenia for greater success in cancer control.

Key messages

• Slovenia’s NCCP prioritizes proactive communication, fostering collaboration among stakeholders. Annual events, newsletter, and partnerships strengthen awareness and drive comprehensive cancer control.

• Long-term communication strategy of Slovenia’s NCCP drives stakeholder engagement, and supports strategic objectives. This proactive approach strengthens comprehensive cancer control efforts.
Using artificial intelligence to support and streamline rapid systematic evidence reviews
Authors: Dobbins M , Traynor R , Clark E , Neil-Sztramko S
Published: October 2024

Issue

The Rapid Evidence Service, initiated by the National Collaborating Centre for Methods and Tools (NCCMT) during COVID-19, supports public health decision making by conducting rapid reviews on priority topics.

Description of issue

Integral to rapid reviews is an expedited timeline but the quantity of available literature for most public health review questions takes significant time to screen manually. NCCMT integrated 4 artificial intelligence (AI) features into the screening process. DAISY Rank applies predictions learned from manual screening patterns to re-order remaining studies, with most relevant appearing first. AI Screening automatically screens remaining studies based on prediction scores. Check for Screening Errors and Re-Rank Report use previous screening patterns to identify studies that were potentially falsely excluded and predict the total number of included studies, respectively. These features were tested by comparing results provided by AI with those produced manually for select test sets.

Results

NCCMT used AI to support and expedite screening, assess screening progress, and/or minimize risk of inappropriately excluding studies for 35 rapid reviews on 20 topics. Using DAISY Rank enabled one screener to review over 4000 references in 9 hours, compared to a different review, where the same amount of screening took 28 hours without DAISY Rank. AI Screening correctly excluded up to 80% of irrelevant search results across reviews. Check for Screening Errors identified 37 potential includes manually excluded in one review; these were reviewed and 3 were included. Re-Rank Report allowed NCCMT to re-allocate staff to subsequent steps in the review process when most included studies were identified.

Lessons

Integrating AI features into screening led to less time required, better anticipated timelines, more accurate staff allocation and reduced errors. More rigorous study of AI best practices is needed to continue to improve rapid review method efficiencies.

Key messages

• Rapid reviews can be an important source of evidence for decision makers if they can be completed quickly but maintain rigor and accuracy.

• AI holds promise as a way to improve screening efficiency.
Data-driven prediction of early language delay at Youth Health Care Services in the Netherlands
Authors: Putrik P , Hendriks M , van de Kraats C , Reijs R , Ravesteijn B
Published: October 2024

Introduction

Language development in early childhood significantly impacts future academic success, social interaction, and emotional well-being. This study aimed to develop and evaluate a prediction model using data on developmental milestones and parents’ socio-economic background known at age 2, and translate the results into an interactive digital dashboard and pilot it with Youth Health Care (YHC) professionals and parents.

Methods

A mixed-method study on retrospective cohort of children attending YHC at age 2, followed up until age 4. Data on language development, gender, parental education, and home language environment were obtained from YHC digital dossiers and linked to parental socio-economic status characteristics, and perinatal outcomes and healthcare costs using a secure remote access environment of Statistics Netherlands. Random forest and logistic regression models were computed with language development at age 4 as an outcome, initially using all available data at age 2 as predictors and then with a restricted model using variables readily available in YHC settings. Models performance was assessed using sensitivity, specificity, and AUC value. Results were visualized through an interactive dashboard and pilot-tested in simulated consultations.

Results

Among 9,148 children, 13.2% had language development delay at age 4. The full model had an AUC of 0.78, while the restricted model (gender, parental education, language environment, and language development), achieved an AUC of 0.77. YHC professionals and parents recognized the value of individualized, data-driven risk assessment for potential language delay to stimulate the discussion of preventive interventions.

Conclusions

A good quality prediction model for language development at age 4 can be derived from just a few background characteristics of the child and parents at age 2. The digital dashboard presents a practical approach of integrating prediction model results into daily YHC practice.

Key messages

• Language development at age of 4 can be predicted as early as age of 2 using just a few background characteristics of child and parents, which presents a window of opportunity for prevention.

• The digital dashboard presents a practical approach of integrating prediction model results into preventive care practice.
Reduced physical activity in youth during the COVID-19 pandemic: systematic review and meta-analysis
Authors: Ludwig-Walz H , Siemens W , Heinisch S , Dannheim I , Loss J , Bujard M
Published: October 2024

Background

Emerging research suggests that physical activity among children and adolescents decreased during the COVID-19 pandemic. As a summarizing analysis of changes in youth’s physical activity for Europe is lacking, we performed a systematic review and meta-analysis to close this research gap. Amongst others, we examined the relevance of restriction stringency policies and potentially vulnerable groups.

Methods

In consideration of the PRISMA statement, we searched seven databases and included studies for children and adolescents (≤19 years) of the WHO European Region that compared physical activity during the pandemic with a pre-pandemic baseline using validated measurement instruments. We used the Oxford Stringency Index as an indicator of restriction stringency. Screening for eligibility, data extraction, assessment of the study risk of bias (using ROBINS-E instrument) and certainty grading of evidence (using the GRADE approach), were all done in duplicate. Data were pooled in random effects models (Trial registration: PROSPERO: CRD42023395871).

Results

Of 14,897 non-duplicate records, 26 publications (n = 15,038 pre-pandemic, n = 13,041 during pandemic) met our inclusion criteria. Comparison before vs during the COVID-19 pandemic revealed a significant reduction in total physical activity (standardized mean difference [SMD], -0.57 [95% CI, -0.95; -0.20]) and moderate-to-vigorous physical activity (SMD, -0.43 [95% CI, -0.75; -0.10]), corresponding to a decrease of 12 min/day (a 20% reduction of the WHO recommendation). Subgroup analyses suggested that children aged 8-12 were particularly affected. The analyses outline a possible association between school closures and more reductions in physical activity.

Conclusions

A sharp decline in all forms of physical activity was recorded among European children and adolescents during the COVID-19 pandemic, particularly in middle childhood. Policy-makers, teachers and practitioners must act to reverse this decline.

Key messages

• Physical activity in European children & adolescents decreased significantly during the COVID-19 pandemic.

• Immediate action by policy-makers and practitioners is imperative to reverse this trend.
Evaluation of Previous ECG Algorithms for Identifying the Culprit Artery in Inferior STEMI
Authors: Fall S , Elhraiech A , Ghali H , Farhat S , Slim M , Ouennes S , Ben Ali I , Thabet H , Gribaa R , Neffati I
Published: October 2024

Background

ST elevation myocardial infarction (STEMI) is the leading cause of cardiovascular related mortality. In the context of Inferior STEMI, the culprit artery is whether the right coronary artery (RCA) or left circumflex coronary artery (LCx). An accurate prediction of culprit artery prior to primary percutaneous coronary intervention (PCI) could improve the door-to-balloon time and could prevent contrast-induced-nephropathy. However algorithms established for that purpose were not evaluated within the Tunisian population. We aimed then to assess their performance in our population

Methods

We conducted a single-center hostorical cohort study from January 2014 to December 2022 on patients admitted at Sahloul university hospital Sousse Tunisia for PCI following an inferior STEMI. We analyzed the ST segment deviations at the J-point and 80 ms after the J-point then evaluated the performance of previous algorithms.

Results

We collected data from 156 patients, of which 130 (83.3%) hada RCA occlusion, and 26 (16.7%) a LCx occlusion. We evaluated 19 published algorithms. The criterion of zimetbaum et al (ST elevation in III> II and I and/or VL <-1 mm) had the highest AUC 0.77[0.66 - 0.88] YI = 52 accuracy = 0.81. The criterion of Herz et al (ST III > II) had AUC ROC of 0.71 [0.58 - 0.83] YI = 0.41 accuracy = 0.78, the algorithm of Tierala et al: AUC = 0.70[0.58 - 0.83] YI = 0.40 accuracy = 0.78. The algorithm og Fiol et al: AUC = 0.79 [0.58-0.83] YI = 0.59 accuracy = 0.73.

Conclusions

The Zimetbaum criterion had the highest performance in predicting the culprit artery and Fiol’s algorithm was the most specific to the LCx occlusion in our population. Further study on the impact of these algorithms on patients outcome is necessary.

Key messages

• The prediction of the culprit artery in inferior STEMI is challenging.

• The criterion of Zimetbaum et al had a good performance for that regard.
Evaluating a Novel Hospital-Integrated Vaccination Pathway: Enhancing Coverage among Frail Patients
Authors: Di Pumpo M , Tona D M , Porcelli M , Lontano A , Regazzi L , Pascucci D , Bruno S , Cadeddu C , Laurenti P , Pastorino R
Published: October 2024

Background

The 2022-2025 Italian Plan for vaccine prevention (PNPV), recognizes vaccine-preventable diseases (VPDs) as significant contributors to mortality, morbidity, and healthcare expenditure. While the digitalization of the national vaccine registry is underway, initiatives aimed at enhancing digital integration between hospitals and territories are limited. There is still a gap in the development of automated systems for identifying patients who could benefit from vaccinations. The “Caring for frail patients through vaccination” (CareVax) Project aims to eliminate these gaps by providing new digital tools and integrated systems.

Methods

1500 patients will be recruited at teaching hospital “A. Gemelli” over four years. With the assistance of an automated algorithm, electronic hospital and vaccination records will be utilised to assess eligibility for vaccinations against SARS-CoV-2, H. Zoster, Influenza, S.Pneumoniae and HBV. Eligible patients will be invited to schedule a vaccination appointment and will be asked to fill a questionnaire evaluating patient-reported experience measures (PREMs). The outcomes of interest include assessing the feasibility of the pathway, measuring patients’ satisfaction and concerns, and evaluating its impact on vaccination coverage.

Results

It is expected that frail patients’ vaccine coverage will improve, being offered an expedited booking process to get the vaccines either in the ambulatories of the Local Health Authority or in Hospital. The algorithm has already been successfully validated on a sample of anonymized patients. The results of the study will provide evidence on novel, hospital-integrating, vaccination pathways.

Conclusions

The results obtained from the intervention will help reduce VDPs and facilitate identification of the frail patients, ensuring easy access to vaccination and increasing vaccination coverage.

Key messages

• Carevax will test their feasibility in an Italian teaching hospital, leveraging digital technologies to reduce the burden of VPDs novel approaches.

• Hospital-Territory integrated vaccination pathways represent a novel digital approach to reduce the burden of VPDs.
Enhancing Public Health: training an AI chatbot for complex tasks support
Authors: Aloise I , Migliara G , Franceschetti A , Pistollato A , Mancini C , Forcella C , Baccolini V , De Vito C
Published: October 2024

Background

The evolution of Large Language Models (LLMs) such as GPT-4, Gemini, and Copilot has transformed the field of Natural Language Processing, demonstrating human-level capabilities and potential applications in Public Health. Here, we report on the training of a chatbot model based on GPT-4 designed to assist operators with relevant and complex public health tasks.

Methods

A scoping review of existing studies on the application of LLMs in Public Health settings was conducted to understand the landscape and identify gaps in their current implementations. We then proceeded to analyse the necessary skills and competencies required for public health professionals to adequately instruct the model on required tasks. Finally, we selected the Italian regulations and guidelines with the greatest relevance in the public health field to provide the knowledge base to the model.

Results

The review revealed no relevant documents on the use of LLMs in areas related to Public Health. Skills and competencies were retrieved from the Guidelines of the Italian Society of Hygiene for Public Health operators and used to instruct the model on how to address public health tasks. As for the knowledge base, we retrieved 25 documents regulating specific areas of the public health field, such as vaccinations, hygiene and safety at work, infection prevention, and school hygiene. Such documents were used to train the model, after formatting them appropriately.

Conclusions

Despite challenges with non-standardized and technically complex documentation, preliminary testing of our model has shown its versatility and utility in supporting daily public health operations. A validation phase is under definition and will involve a DELPHI process, in which products of the custom GPT model will be evaluated by a panel of public health operators to evaluate its performance in real-world settings, ensuring compliance with national health regulations.

Key messages

• Training a GPT-4-based chatbot to support complex tasks in Public Health, tailored by relevant national guidelines.

• Our custom model, informed by public health guidelines, showed potential in preliminary tests.
Application of artificial intelligence to study the causality in public health: a systematic review
Authors: La Mastra C , Barchitta M , Maugeri A , Agodi A
Published: October 2024

Introduction

In epidemiology, establishing causation requires meeting rigorous criteria beyond mere association. Traditional methodologies often struggle to provide definitive causal conclusions due to confounding variables. However, leveraging artificial Intelligence (AI) and machine Learning (ML) offers a promising solution by modeling complex interactions among relevant factors. This systematic review explores the AI techniques utilized to uncover causal relationships in public health applications.

Methods

A literature search was conducted in Pubmed, Web of Science, and Scopus, employing the following search strategy: (Causalit*[Title/abstract] OR Causation*[Title/abstract] OR Causal[Title/abstract]) AND (‘Machine Learning’[Title/abstract] OR “Deep Learning” [Title/abstract] OR ‘Artificial Intelligence’ [Title/abstract] OR Algorithm* [Title/abstract]). The search aimed to identify studies encompassing causal inference techniques utilizing ML and AI methodologies in public health.

Results

From a total of 28,230 articles published up to August 2023, after removing duplicates (11,158) and articles that did not meet the inclusion criteria (16,168 post title/abstract screening, and 856 post full-text screening), the systematic review included 48 articles. Bayesian additive regression trees, Bayesian network models, causal forests analysis, and graphical causal models emerged as the prevailing causal methodologies. AI-driven causal methodologies have been investigated across various domains within public health, encompassing disease prediction, evaluation of treatment efficacy, identification of risk factors, analysis of health behaviors, precision Public Health initiatives, and environmental health assessment.

Discussion

While our systematic review affirms the potential of AI-driven causal approaches across several public health domains, further research is warranted before these emerging techniques can be effectively integrated into real settings.

Key messages

• In epidemiology, establishing causation requires meeting rigorous criteria beyond mere association and traditional methodologies often struggle to provide definitive causal conclusions.

• This systematic review explores the AI techniques utilized to uncover causal relationships in public health applications.
Investigating the impact of the WHO Hive platform for health emergencies preparedness and response
Authors: Farhat M , Latinovic L , von Harbou K , Emiroglu N , Hang F , Yau B , Kovačev N
Published: October 2024

Background

Recent global health emergencies, such as the COVID-19 pandemic, showed there is a growing need for enhanced collaboration and knowledge sharing across global health communities. The WHO Hive platform provides a centralized hub for public health experts to connect, share and access valuable resources. This study aims to analyze the impact of the Hive following its launch of 4 tools within the Hive to enhance engagement and collaboration: Community space, Chat and discussion forum, Video conferencing, Hive drive document repository. The study will explore further technological and structural needs required to increase its usage in health emergency preparedness and response.

Methods

This study employs a structured survey for users of the Hive that will be anonymized and stratified by non-identifying data such as professional roles and geographic locations to highlight trends and patterns within specific subgroups. This approach ensures that the analysis is representative of the diverse user base on the Hive platform, with currently over 700 public health experts from more than 200 organizations across 105 countries.

Expected Outcomes

The study is expected to provide a comprehensive evaluation of Hive’s operational effectiveness in enhancing community collaboration, engagement, and knowledge-sharing, and highlighting its strengths and areas for improvement. The results will help inform future development to enhance collaboration and engagement.

Conclusions

The WHO Hive offers a unique value proposition as a platform developed by a trusted global health authority, enhancing credibility and fostering greater participation between health professionals. Feedback from the users is crucial to optimize future development to sustain it as a resource for health emergencies preparedness, readiness and response.

Key messages

• Digital tools for stronger health emergency preparedness and response to enhance collaboration and engagement.

• Highlighting key areas for digital integration to strengthen health emergency preparedness and response.
Clustering Portuguese municipalities based on population health indicators
Authors: Magalhães C M , Cruz M , Matos C
Published: October 2024

Background

The large number of publicly available health-related indicators poses challenges in health planning to policymakers. Identifying patterns among municipalities may assist these processes, by grouping similar contexts and pointing out relevant differences among neighbouring locations. The aim of this work was to define clusters of municipalities based on health-related indicators.

Methods

All health-related indicators available at municipality level for the year 2021 were obtained from the Portuguese National Statistics Office website. Missing values were imputed with the closest available year or excluded. Indicators were standardized and K-means clustering was applied. Elbow criterion was used to select the optimal number of clusters. Sensitivity analysis was performed with a priori exclusion of indicators less directly associated with health outcomes.

Results

The clustering analysis revealed five distinct clusters of municipalities. Clusters were associated with specific socio-demographic patterns, providing insights into common health challenges and strengths within each group. Interestingly, geographic profiles emerged (e.g. coastal vs inland), despite no geographic information being specifically provided. One outlier municipality was identified (Lisbon), highlighting a need for special consideration.

Conclusions

Clustering techniques provide a data-driven approach to inform public health planning. Our findings show previously unrecognized patterns and relationships between municipalities. Using these clusters, policymakers may implement interventions based on what has been proven to work in similar contexts, enhance collaboration opportunities and promote a tailored policy development, contributing to an overall improvement of public health outcomes.

Key messages

• Clustering machine learning techniques provide a data-driven approach to inform public health planning.

• Identifying comparable municipalities based on health-related indicators allows targeted public health interventions.
Beneficial effect of honey from algae extract-fed bees on quality of life
Authors: Hajzer Z , Oláh C , Oláh Z , Szekér Z , Oláh B , Shaikh A , Daróczi L , Prokisch J
Published: October 2024

Background

Our team has been researching and developing special honeys from bees fed with syrups containing natural plant extracts for decades. Several pre-clinical studies have demonstrated that honey from bees fed with Chlorella algae extract contains a number of algal active ingredients with beneficial effects on the human body.

Methods

We conducted a prospective double-blind functional food study with 30 healthy volunteers with ethical approval. Based on strict inclusion and exclusion criteria, 30 gramms of honey has been eaten twice a day for 3 weeks under 150 ml of yoghurt. 15 people were fed honey from bees with special algae extract, while 15 concerned - as a control group - consumed acacia honey. Before and after the study, sleep quality was assessed by the SQS questionnaire, and quality of life by the SF-36, EORTC Q-C30 and EQ-5D tests.

Results

The specific algae extract contained honey improved the people’s sleep quality, their EQRTC parameters, their appetite, their digestion, and it also significantly reduced pain (p = 0.01), boosted the patients cognitive function, and reduced both constipation and diarrhoea. Significant differences in SF-36 parameters: pain decreased (12.9±1.6vs 6.6±1.1; p = 0.01), physical function (21.2±6.3vs 27.1±3.6; p = 0.01) and energy (11.2±2.7vs 13.9±1.4; p = 0.01) improved. No such changes occurred in control group.

Conclusions

Honey from bees fed with algae extract has a number of beneficial physiological effects on the human body, improving many parameters of quality of life.

Key messages

• The consumption of honey from bees fed with algae extract improves sleep, reduces pain, and has a positive effect on digestive and gastrointestinal symptoms.

• Within public health, quality of life is an increasingly important issue and improving it with functional foods is an important area of research.
Blood pressure and its control in adults: the Italian Health Examination Survey 2023-CUORE Project
Authors: Marcozzi B , Lo Noce C , Di Lonardo A , Vannucchi S , Damiano C , Galeone D , Bellisario P , Palmieri L , Donfrancesco C
Published: October 2024

Background

The WHO recommends a 25% relative reduction in the prevalence of raised blood pressure (RBP) by 2025, considering 2010 as baseline. To monitor the achievement of this target, prevalence of RBP and mean blood pressure were measured in the Italian general adult population within periodic health examination surveys (HESs) conducted within the CUORE Project.

Methods

In 2023 a new HES started including, up to now, data from random samples of residents aged 35-74 years (706 men, 727 women) in 7 Regions (of 20 regions) distributed in North, Centre and South of Italy. Blood pressure was measured at the right arm, in sitting position, by automated oscillometric device using standardized procedures and methods; the average of two measurements performed with 1 minute interval was used for the analysis. RBP is defined as systolic and/or diastolic blood pressure equal or greater than 140/90 mmHg. The survey is funded by the Italian Ministry of Health-CCM.

Results

Preliminary analysis shows that prevalence of RBP is 37% (95% Confidence Interval-CI: 30-46%) in men and 23% (17-29%) in women. Mean value of systolic blood pressure is 134 mmHg (133-136 mmHg) in men and 126 mmHg (125-127 mmHg) in women. Mean value of diastolic blood pressure is 80 mmHg (78-81 mmHg) in men and 75 mmHg (74-76 mmHg) in women. Among those with RBP and/or in treatment (49% of men and 39% of women), 35% of men and 19% women are unaware they could have BP control problems, 8% and 9% are aware but not in treatment, 24% and 40% are under treatment and at target, 33% and 22% are under treatment but not at target, respectively.

Conclusions

These preliminary data underline that RBP is still high in the Italian adult population. Significant reductions in RBP prevalence occurred in comparison to previous HES data, 20% from 25 years ago, about 10% from 15 year ago, while a stable trend was found in comparison to 5 years ago. Improvements on RBP awareness and control are still necessary.

Key messages

• Raised blood pressure is still high in the Italian general adult population.

• Implementing periodic HES is fundamental to measure blood pressure and estimate awareness and control of hypertension in the general population.
Evaluating the feasibility of an Adapted Physical Activity intervention among breast cancer patients
Authors: Hasnaoui S , Van Hoye A , Soudant M , Rotonda C , Carvalho de Freitas A , Yacoubou Omorou A , Poussel M
Published: October 2024

Adapted physical activity (PA) programs have shown promising results to reduce physical, psychological and social side effects associated with breast cancer (BC), but the extent to which they can be effectively adopted, implemented and maintained is unclear. The aim of this study is to use the RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework to evaluate RIPOSTE (Reconstruction, Image de soi, Posture, Oncologie, Santé, Thérapie, Escrime), an innovative intervention focused on improving the quality of life (QoL) of BC surgery patients through fencing. A convergent mixed-methods pilot study was conducted to evaluate the RE-AIM dimensions of RIPOSTE. 24 participants who have just undergone surgery for invasive BC were randomly allocated either in the “RIPOSTE” group (starting immediately after their inclusion), or the “Delayed RIPOSTE” group (starting at 3 months following their inclusion). They answered to questionnaires at inclusion and at the end of the program on QoL, shoulder functional capacity, fatigue, anxiety-depression and PA. Interviews were conducted with 10 participants, 3 sports physicians and 1 fencing master. RIPOSTE program was able to reach mainly young and dynamic participants, attracted by the originality of fencing and keen to improve their physical condition. Regarding effectiveness, our results suggest a trend to the improvement of health indicators, even without any significant differences between the two groups. The cooperation, exchanges and cohesion within the group greatly facilitated the adoption of the program, whereas interruptions during vacations were the main barriers. Maintenance analyses showed that most participants continued to practice PA after the program. RIPOSTE is an acceptable and effective program for involving BC survivors in PA, that needs to be tested at larger scale to investigate its effectiveness, but has the potential to be transferred and scaled up worldwide.

Key messages

• These results would help to enrich the literature on how to best intervene to enhance treatment and recovery among patients and facilitate transfer from a research program to a field daily practice.

• By highlighting complexities of RIPOSTE effectiveness and implementation, this study could lead to a more complete program that addresses issues related to improving external and internal validity.
Colorectal screening program implementation in primary health care, in Loures-Odivelas, Portugal
Authors: Gomes F , Sousa C , Marques R
Published: October 2024

Problem

In 2020, Portugal had the highest cumulative incidence of colorectal cancer (CRC) in the European Union (103 new cases/100,000 inhabitants). The Colorectal Cancer Screening Program (CRCS) is based on fecal occult blood testing (FOBT) as the primary screening method. With the delivery of the stool sample collection device; instruction on its use is provided by the Primary Health Care team. The sample is processed at the Clinical Pathology laboratory of the Hospital Center (HC). In case of a positive result, the general practitioner communicates the result and refers the individual to the Follow-up and Treatment Center.

Description

The general objective of this project was to implement the CRCS in the 19 Family Health Units (FHU) of Loures-Odivelas Health Center Group, between September 2022 and April 2023. The following activities were carried out: 1. Sessions to present the patient pathway, record platform, and stool sample collection device; 2. Application of a checklist of essential points for the start of screening; 3. Preparation and dissemination of monitoring reports to the FHU; 4. Follow-up visits to clarify doubts.

Results

By March 2023, CRCS had been implemented in 15 of the 19 FHU (79%). Between September 2022 and March 2023, 1,430 devices were delivered and 959 FOBT samples were received (67%). Among the devices received with biological samples, it was not possible to issue a result for 5%.

Lessons

The activities carried out allowed for the initiation of CRCS in most FHU. The involvement of professionals in these activities contributes to increased patient adherence and proper collection technique, reducing inconclusive FOBT results. It is necessary to continue this strategy of personalized support for the FHU to consolidate the implementation of CRCS in LO HCG. Ensuring that the necessary materials are available and that result issuance and referral deadlines are met are important factors for maintaining professional motivation.

Key messages

• The objective was to implement the Colorectal Cancer Screening Program (CRCS) in 19 Family Health Units (FHU) in Loures-Odivelas. By March 2023, CRCS had been implemented in 15 of 19 FHU (79%).

• It is important to continue these activities in order to put into operation the CRCS in all FHU and to tackle the problem of colorectal cancer.
Same term, but unequal understanding: differences in digital public health intervention features
Authors: Maaß L , Angoumis K , Freye M , Pan C-C
Published: October 2024

Digital technologies have transformed healthcare delivery and public health, with many countries integrating interventions such as online consultations, electronic health records, and telemedicine to improve population health and healthcare accessibility. Multinational assessments for benchmarking system maturity ask for the degree of implementation of such tools. However, are these interventions as comparable as they claim to be? This talk presents a qualitative analysis of 179 digital public health (DiPH) interventions described in scientific articles. We categorized interventions based on their implementation stages, public health functions, and reported and non-technical features. Telemedicine, health apps, and electronic health record interventions dominated the diverse landscape. While these technology groups already differed greatly in their functions, we identified equally significant differences in the reported intervention characteristics within the groups. For example, telemedicine was not only used in healthcare settings for patients and health professionals but also in primary prevention and research for researchers, policymakers, and healthy individuals. Different interventions reported varying functions, such as remote monitoring, self-monitoring, alarm systems, patient motivation, and user empowerment modules. So, is there one common telemedical intervention? No. Instead, all individual technologies differed to varying degrees. The analysis underscored the diversity of DiPH interventions among and within intervention groups and highlighted the importance of precise terminology for effective planning and evaluation. Instead of using broad classifications like ‘telemedicine,’ interventions should be defined and communicated based on specific technological functions, non-technical characteristics, use cases, and user groups. This approach will promote cross-disciplinary collaboration and foster international comparability across DiPH systems.
Eco-anxiety: an additional burden for university students?
Authors: Tavolacci M , Ladner J
Published: October 2024

Background

Eco-anxiety encompasses climate change anxiety, including global warming, as well as anxiety about a multiplicity of environmental disasters, which not be directly caused by climate change The objective is to assess eco-anxiety in healthcare and non healthcare students and investigate a relationship with health behaviour, mental health, and environmental opinion.

Methods

A cross-sectional study was conducted among voluntary university students in the Rouen University in Normandy, France. Volunteer healthcare students aged 18 years and older were included. Eco-anxiety was assessed with the Hogg Eco-Anxiety Scale (HEAS-13). Socio-demographics, health behavior, mental health and healthcare data were also collected.

Results

A total of 1,887 students were included with 74.3% of women and a mean age of 21.1 years (SD = 6.8). The HEAS-13 mean was 13.2 (SD = 2.6): affective symptoms 4.1 (SD = 2.7), eco-rumination 3.7 (SD = 2.4), behaviour 1.0 (SD = 1.5), and anxiety about one’s personal impact on the planet 4.4 (SD = 2.5). Respectively, 59.6% and 31.4% of students are moderately and very much involved in pro environmental-behaviour. 84.6% of students will consider environmental issues in their career choices. Eco-anxiety was associated with being a woman, being in curricula other than health, accommodation with roommates or in couple, use of cannabis, eating disorders, insomnia, emotional exhaustion, cynicism, depression, quality of life, and visiting a general practitioner for stress.

Conclusions

An high eco-anxiety was associated with impaired mental health and could be an additional burden for university students. Intervention options for those that do experience eco-anxiety and suffering can be as prescribing environmental action, mental health skills, and climate change resolution without imposing the burden of change solely on young people

Key messages

• A high eco-anxiety is prevalent among university.

• The eco-anxiety impaired mental health that could be an additional burden for university students.