bluuebunny/crossref_metadata_2025_split huggingface dataset:
What health risk factors are brought by the most popular Lithuanian influencers in social networks?
Authors: Basijokas R , Austys D 
Published: October 2023

Abstract

Background
Considering that content created by influencers in social networks might act as risk factor to health, we aimed to assess the prevalence of lifestyle-related risk factors in posts published by Lithuanian influencers on Facebook and Instagram.

Material and methods
All publicly available posts created by 12 most popular Lithuanian influencers on Facebook or Instagram between 1 Jan and 31 Dec of 2022 were included. The content analysis of the posts was performed in the structured manner. Information about foods, smoking, alcohol, physical activity, body type and mental health factors was registered and compared between the networks.

Results
A total number of 4075 posts were analysed. 30% of the posts presented foods. Among these posts, fast food was presented in 8.9%, sweets - in 45%, fried food - in 60%, vegetables - in 67%, fruits and berries - in 45%, cereals - in 44%, milk and dairy products - in 10%, eggs - 3%, meat - in 28%, seafood - in 14% and food supplements - in 1%. Sweets more often were presented on Facebook (15% vs 12%), fast food - on Instagram (4% vs 2%). Alcoholic beverages were presented in 3% of posts, more frequently - on Instagram (7% vs 1%). Smoking was presented in 0.4% of the posts, more frequently - on Instagram (0.8% vs 0.2%). Physical activity was presented in 10% of the posts. Slim body was presented in 2% of the posts, overweight body - in 16%, obese - in 2%. Barely covered body was presented in 10% of posts, more frequently - on Instagram (15% vs 6%). Aesthetic procedures were presented in 31% of posts, more frequently - on Instagram (46% vs 20%). Luxury was presented in 10% of posts, more frequently - on Instagram (17% vs 6%). Bullying was observed in 4% of posts, more frequently - on Facebook (5% vs 3%).

Conclusions
Presentation of fast food, smoking, alcohol, slim body, aesthetic procedures and luxury was more frequent on Instagram, sweets, overweight body, bullying and physical activity - on Facebook.

Key messages
• Both healthy and unhealthy foods are presented with similar frequency on social networks – this might lead to the overconsumption of unhealthy foods.
• Although the prevalence of risk factors was observed on both social networks, some of them were more often in Facebook, some – on Instagram. This should be taken into account during the interventions.
Patients’ attitudes towards remote primary healthcare services in Lithuania
Authors: Kaseliene S , Jankauskaite I , Sauliune S 
Published: October 2023

Abstract

Background
One of the largest changes that had to be implemented in the healthcare system worldwide in response to the COVID-19 pandemic was the introduction and expansion of remote healthcare services. The aim of this study is to evaluate attitudes of patients of primary healthcare institutions to the remote healthcare services in Lithuania.

Methods
A cross-sectional study was conducted in February - March 2023. A total of 313 patients of primary healthcare facilities in Vilnius city (Lithuania) aged 18-75 years were anonymously surveyed (response rate 78.3%). Chi-square and z tests were used to determine a relationship between two categorical variables (α = 0.05).

Results
78.8% of respondents report satisfaction with the quality of remote healthcare services. 74% of did not experience any technical difficulties during their most recent consultation. Most of patients agree that remote healthcare services save time (85.9%) and money (60.7%), as well as reduce the risk of contracting infectious diseases (62%). However, 61.9% of patients believe that remote services may increase the risk of medical errors. 53% believe that the accessibility of healthcare has improved with the introduction of remote services, and 82% of patients think that such services should constitute up to 50% of all healthcare services. Patients believe that the quality of remote healthcare services would improve with the advent of video consultations. Patients’ opinions about remote healthcare services significantly depend on their gender, employment status, and education (P &lt; 0.05).

Conclusions
Patients are satisfied with the quality of remote healthcare services. They have already discovered the benefits of remote healthcare, however, this requires changes to the existing legal framework.

Key messages
• Attitudes of patients towards the integration and quality of remote primary healthcare services are positive.
• According to many respondents, remote healthcare services should make up to 50% of all services provided.
Bringing an EU Joint Action to TikTok: the case of eCAN
Authors: Hermida E P , Hans Cano E , Ela-Aguilar S , Ferro T 
Published: October 2023

Abstract

Issue
The Joint Action (JA) on strengthening eHealth including telemedicine and remote monitoring for health care systems for cancer prevention and care (eCAN) is a project co-funded by the European Union from 2022 to 2024. The Work Package on Communication (WP2) disseminates the JA's activities and outputs. Social media (SM) is one of the pillars of the communication strategy to promote eCAN and engage target audiences. Although the health sector is often present on LinkedIn, Twitter and Facebook, there are few examples of TikTok use in this area, making it difficult to identify role models.

Description of the problem
After reviewing other JA's communication channels, eCAN opens six SM accounts and divides them into two groups: written-content focused (Facebook, LinkedIn & Twitter) and audiovisual-content focused (Instagram, YouTube & TikTok). The TikTok account aims at innovating the way EU initiatives communicate and disseminate results. At the same time, it is meant to try to achieve a broader scope of audiences by exploring original means to reach them.

Results
Main results of eCAN's TikTok account for the period mid-January to mid-April 2023*: Followers: 18; Likes: 181; Comments: 1; Nº of posts: 10; Views: 3.355
* Data to be updated with results up to mid-October at the conference.

Lessons
WP2 faces the barrier of reducing the gap existing in bringing healthcare literacy and scientific accuracy into the much less rigid format TikTok is, particularly regarding cancer and telemedicine outreach. Besides, this social network's rules and algorithms might be challenging in terms of achieving visibility. The success of dissemination strategy depends on an adequate planification of what contents need to be communicated altogether with what the best formats should be used to widen the audiences while maintaining the project's reliability.

Key messages
• The eCAN JA is the first initiative to incorporate TikTok as a platform for disseminating the projects updates, outcomes and issues related to telemedicine, cancer and digital transformation.
• This project explores new tools to be used in the health sector and within EU initiatives for reducing the gap in bringing health literacy and scientific accuracy to broader audiences.
Design of infrastructure for visualising and benchmarking patient data from general practice (CARA)
Authors: Garzon-Orjuela N , Garcia Pereira A , Vornhagen V , Stasiewicz K , Parveen S , Amin D , Porwol L , Vellinga A 
Published: October 2023

Abstract

Background
Patient Management Software (PMS) is commonly used for patient consultations. PMS supports individual patient data storage but accessing and using aggregated information is challenging. CARA set out to provide an infrastructure to enable Irish general practitioners (GPs) to understand their patient population, disease management and prescribing through dashboards. This paper explains the design and development of the CARA infrastructure.

Methods
The first exemplar dashboard focused on antibiotic prescribing to develop and showcase the proposed infrastructure. The data integration process involved extracting, loading and transforming de-identified patient data into data models. These, in turn, feed the interactive dashboards for GPs to visualise, compare and audit their data.

Results
The architecture of the CARA infrastructure includes two main sections: the ELT process (extract, load and transform anonymous patient data into data models) and a REST API (which provides the security barrier between the data models and their visualisation on the CARA dashboard). CARAconnect was created to facilitate data extraction and de-identification of patient data from the practice database.

Conclusions
CARA includes two dashboards, a practice overview and an exemplar dashboard focused on antibiotic prescribing which includes an audit tool as well as filters (within practice) and between-practice comparisons. Next steps will include the development of additional dashboards for topics such as chronic disease and mental health.

Key messages
• CARA developed a sustainable infrastructure to enable Irish GPs to better understand their patient population and management through dashboards.
• CARA infrastructure consists of CARAconnect to extract and de-identify data, a common data model (to combine data from different PMS systems), and CARA dashboards for use in Irish general practice.
Barriers for successful implementation of telemedicine in developing countries: the Colombian case
Authors: Valencia Rivero K , Muñoz Pinzón D , Caviativa Castro Y , Jaramillo Guzmán V , Álvarez Salazar C , Perea Rodríguez R , Sánchez Güette L , Valero Inerarity A , Hernández Garay A , Cruz Quiroga L 
Published: October 2023

Abstract

Implementation of telemedicine programs in Latin America has been documented in different reports, finding that Mexico, Chile and Colombia are the countries with the highest public coverage. Nevertheless, efforts made in Colombia in this regard are considered insufficient, and previously unidentified factors have delayed the full progress of this technology in the country. An integrative review was conducted in PubMed and ScienceDirect databases, and Colombian governmental repositories between 2011 and 2021. A total of 135 articles were processed in Rayyan QCRI software to characterize the telemedicine adoption process in Colombia. Published works in this area concern the economical evaluation of telemedicine services, focusing in estimating costs for its implementation, but cost-benefit, cost-effectiveness and cost-utility studies are needed for a complete policy in this regard, which should discuss important factors as infrastructure, current legislation, financing of public actors, availability of scientific evidence for decision-making, and political will. Finally, once the project is underway, monitoring, evaluation, and adaptation of the systems must be guaranteed to ensure the planned objectives and desired benefits are met, and barriers to the effective use of the project are overcome. Successful implementation of telemedicine programs in developing countries should consider several aspects. First, complexity, adaptability, compatibility with existing work practices, and cost of the project. Second, stakeholders must be included. Third, standards for interoperability, security, and privacy must be established to improve project acceptability and implementation. Fourth, sufficient financial and legislative support must be secured to support the project. Fifth, planning must be considered to ensure that the health system is ready for the project. Sixth, necessary education must be provided to all project stakeholders.

Key messages
• E-medicine barriers were identified to prompt its implementation in developing countries.
• Boost healthcare access, reduce costs, and enhanced disease surveillance is possible through telemedicine.
Artificial Intelligence Chatbots for medical training in Public Health: a tool to explore
Authors: Baglivo F , De Angelis L , Casigliani V , Arzilli G , Privitera G P , Rizzo C 
Published: October 2023

Abstract

Background
Artificial intelligence (AI) is a rapidly developing field with the potential to transform various aspects of healthcare and public health including medical training. During the ‘Hygiene and Public Health’ course for fifth-year medical students, a practical training session was conducted on vaccination using AI as an educational supportive tool. Before receiving specific training on vaccination, the students were given an online questionnaire on vaccination. After completing the questionnaire, a correction of each question was performed using AI chatbots.

Objectives
The main aim was to identify whether AI chatbots can be considered as educational support tool for training in public health. Secondary objective was to assess performance of 6 different AI chatbot models.

Results
The questionnaire consisted of 15 items selected from the Italian National Medical Residency Test (years 2015-2022) on the topic of vaccination. 36 medical students participated in the training, achieving a mean score of 8.22/15 on the quiz (range:3-15,median:8). 6 different AI chatbot models (3 modes of BingChat, ChatGPT, ChatSonic, and YouChat) were asked the same questions and achieved a mean score of 12.17/15 (range:10-15,median:11.5), ranking in the top 25% of medical student scores. During the class, the answers provided by the AI chatbots were evaluated with the students, paying particular attention to the completeness of the information, reliability of the sources cited, and use of technical language.

Conclusions
AI chatbots have shown to be efficient tools for retrieving bibliographic references from the web and answering questions related to specific topics such as vaccination. However, it is important to note that they cannot be considered more intelligent than students, as they may not perform as well when faced with situational questions. The responsible and critical use of AI should be integrated into medical education to ensure its effective utilization.

Key messages
• AI chatbots use as support tool in public health medical training should be further investigated and endorsed.
• AI chatbots could be a helpful resource for medical students in terms of researching and revising their knowledge.
Long-Term Efficacy of primary care combining a mobile healthcare application with human coaching
Authors: Ju H , Kang E 
Published: October 2023

Abstract

Background
Chronic diseases have become a global burden, and digital self-healthcare using mobile devices has gained importance in managing these conditions. However, barriers to implementing mobile self-management healthcare applications in current primary care system, and previous research has focused on short-term effects. This study aims to evaluate the long-lasting effect of combining human coaching with mobile self-management healthcare applications for chronic disease patients in primary healthcare services.

Methods
The study recruited 178 patients with chronic diseases from participating primary care clinics. The intervention group (N = 128) received a 12-week mobile self-management healthcare application service combined with traditional primary care, while the control group (N = 50) received only traditional healthcare. The Noom application was used, with two weekly human coaching sessions by a nutritionist. A telephone survey on weight changes was conducted one year after the intervention.

Results
The intervention group showed a greater weight loss compared to the control group during the intervention period (Intervention: -1.29 ± 2.94 vs Control: -0.38 ± 1.72, P-value 0.002). Although there was no statistically significant difference in additional weight change between the two groups during the follow-up period, the difference in weight loss during the intervention period was maintained (Intervention: -2.16 ± 5.54 vs Control: -1.06 ± 3.24, P-value: 0.008). Additionally, among the intervention group continuously for 1 year using the health management application, the average weight loss was higher than the other groups.

Conclusions
Combining a mobile self-management healthcare application with human coaching has long-lasting effects and can be effective in primary healthcare services. This suggests that such an approach has the potential to be a treatment option in current primary healthcare systems, but further large-scale long-term studies are needed.

Key messages
• This study suggests that using mobile self-management healthcare apps with human coaching can be an effective long-term treatment option for chronic disease patients in primary healthcare services.
• The combination of the two methods may provide better outcomes than traditional healthcare services alone.
Social Medi(a)cine: Use of a social media group for medical advice and education post covid-19
Authors: Peled-Raz M , Bleicher I , Tzemah S 
Published: October 2023

Abstract

Background
‘Ask an M.D’ is a private Facebook group, created in 2018, which grew dramatically during the Covid-19 pandemic, now serving over 52,000 members. It is a platform for asking medical questions, answered pro-bono, by about 180 physicians and pharmacists.

Methods
An anonymous questionnaire was posted on the group's page, inquiring about members’ demographics, consultation topics, scope of group's usage, and their reasons for using it. We also collected administrative data, tracking posts’ distribution over time, engagement in posts written by others and members’ demographics.

Results
The group grew from 5,000 to 19,000 members between 9.2019 and 9.2020. It now features 4,800 posts, 30,000 written responses, and 55,000 reactions yearly. 19,000 members viewed the questionnaire and 920 (∼5%) answered it. Respondents’ mean age was 37(18-70), 85% female and 18% live in the county's periphery. An overwhelming 66% had an academic degree. Only 1% did not finish high school. 61.5% ever consulted the group (36% once a year while 60% 2-5 times a year). Common fields of consultation were OBGYN (20%), Pediatrics (15%) and Dermatology (11%). 99% of respondents read other members’ consultations in the group. Reasons for using the group in last consultation were seeking second opinion (36%); long scheduled appointment (34%); sense of urgency (28%); 8.5% didn't know whom to consult, 7% were embarrassed of their doctor and 4% didn't understanding their doctors’ explanations.

Conclusions
Covid-19 emphasized the need for an available and reliable online source of medical consultation. Yet, a gap in access to medical information and consultation still exists and should not be viewed as a circumstantial occurrence. ‘Ask an M.D''s impact goes beyond mere individual consultations, as most members read others’ public consultations in addition to their own. Lack of online literacy serves as a barrier to usage of this type of tool among the less educated. These are preliminary results.

Key messages
• Reliable and accessible professional consultation on social media platforms is a timely and important health promotion tool.
• Utilization of such platforms should be embraced and encouraged, while striving to heighten online literacy and use amongst less educated groups.
Dissemination of health-related technologies in Germany between 2020 and 2022
Authors: Hannemann N , Babitsch B 
Published: October 2023

Abstract

Background
Health systems are facing major changes due to digitalization. ICTs offer the potential to improve healthcare, but the impact on health inequities is unclear. Therefore, the following research question will be addressed: How will health-related technologies be used in Germany between 2020 and 2022 and are there age- and gender-specific differences?

Methods
This analysis is based on three cross-sectional online surveys conducted in 2020 (N = 1570) and in 2022 (N = 1200; N = 1850). The sample is representative for age, gender, and federal state according to Eurostat. Participants indicated whether they used (yes/no) online booking for medical appointments (OB), video consultation (VC), and app-based transmission of health data to health insurers (DT). In 2020, participants were asked if they had used such technologies before and during the COVID-19 pandemic. For the stratified analysis, a Chi2-test was used.

Results
Before COVID-19, 34.5% of the participants used OB, 4.1% VC, and 18.8% DT. VC and DT differed by age, OB by gender only. In May 2020, there was a decrease in use of OB (21.6%) and DT (12.0%), but not VC (5.4%). Age-related differences existed for VC and DT. In March 2022, an increased usage was observed for all technologies (OB: 40.4%, DT: 22.3%, VC: 7.1%). Gender and age differences occurred for VC, but for age only for OB and DT. An increased use was also observed in autumn 2022 (OB: 57.6%, DT. 35.4%, VC: 11.1%). The usage of such technologies continued to vary by age and gender, with one exemption: no gender-specific differences appeared for VC.

Conclusions
With the exception of the onset of the COVID-19 pandemic, an increased diffusion of health-related technologies has been observed, accompanied by an elevated availability of such technologies after the pandemic. Although the diffusion of such technologies increased from 2020 to 2022, age- and gender-specific differences regarding their usage seem to emerge and tend to consolidate.

Key messages
• Between 2020 and 2022, an increased utilization of health technologies can be observed, which goes hand in hand with an expanded diffusion of such technologies in the German health system.
• Not all population groups participate in digitization in the same way. Whether these differences will contribute to health inequities needs to be closely examined.
Automated surveillance system for surgical site infections from hospital discharge letters
Authors: De Angelis L , Baglivo F , Arzilli G , Baggiani A , Gemignani G , Calamita L , Rocchi D , Grassi N , Ferragina P , Rizzo C 
Published: October 2023

Abstract

Background
The surgical site infection (SSI) occurs in the part of the body where the surgery took place within 30 days. In Europe, 1-10% of surgical patients develop a SSI. Clinical reporting can play an important role in identifying SSIs, but these clinical data should be integrated into surveillance systems to increase their performances. We aim at developing an automated surveillance system to identify SSIs from unstructured text of hospital discharge letters (HDLs).

Methods
We extracted a sample of 2020-2021 HDLs from the University Hospital of Pisa (Italy) and we used a set of 60 keywords to select only HDLs including surgery and infection related terms. Using a positive wound swab test as a proxy for suspected SSI, we performed a record-linkage between HDLs and laboratory data for 2021. We compared the number of records with suspected SSIs before and after the filtering, to assess its sensitivity. Filtered HDLs have been manually labeled by qualified operators in 3 classes: SSI, No SSI, or SSI caused by a prior hospitalization.

Results
From 63,609 HDLs in our sample, 22,625 were filtered through keywords. In the pre-filtered dataset (only 2021), 255 patients have at least a positive wound swab test. 92% (235/255) of the patients with a suspected SSI were included after the filtering. In a preliminary analysis, after the labeling of 9,385 HDLs (41% of the dataset) we identified 340 SSIs (3,6%), of which 254 (85%) were caused by a prior hospitalization.

Conclusions
The labeled dataset will be used to train a natural language processing classification algorithm, able to identify suspected SSIs from HDLs. The keyword filtering can be a useful support to reduce the number of HDLs that need to be manually labeled.

Key messages
• Keyword filtering is the first step for an automated surveillance system of surgical site infections from hospital discharge letters.
• Labeling is time-consuming but necessary for the development of a natural-language-processing-based surveillance system for surgical site infections.