Empowering healthcare education: A multilingual ontology for medical informatics and digital health (MIMO) integrated to artificial intelligence powered training in smart hospitals.

Objective: A comprehensive understanding of professional and technical terms is essential to achieving practical results in multidisciplinary projects dealing with health informatics and digital health. The medical informatics multilingual ontology (MIMO) initiative has been created through international cooperation. MIMO is continuously updated and comprises over 3700 concepts in 37 languages on the Health Terminology/Ontology Portal (HeTOP). Methods: We conducted case studies to assess the feasibility and impact of integrating MIMO into real-world healthcare projects. In HosmartAI, MIMO is used to index technological tools in a dedicated marketplace and improve partners' communication. Then, in SaNuRN, MIMO supports the development of a "Catalog and Index of Digital Health Teaching Resources" (CIDHR) backing digital health resources retrieval for health and allied health students. Results: In HosmartAI, MIMO facilitates the indexation of technological tools and smooths partners' interactions. In SaNuRN within CIDHR, MIMO ensures that students and practitioners access up-to-date, multilingual, and high-quality resources to enhance their learning endeavors. Conclusion: Integrating MIMO into training in smart hospital projects allows healthcare students and experts worldwide with different mother tongues and knowledge to tackle challenges facing the health informatics and digital health landscape to find innovative solutions improving initial and continuous education.

Enhancing Lessons on the Internet of Things in Science, Technology, Engineering, and Medical Education with a Remote Lab.

Integrating remote Internet of Things (IoT) laboratories into project-based learning (PBL) in higher education institutions (HEIs) while exploiting the approach of technology-enhanced learning (TEL) is a challenging yet pivotal endeavor. Our proposed approach enables students to interact with an IoT-equipped lab locally and remotely, thereby bridging theoretical knowledge with practical application, creating a more immersive, adaptable, and effective learning experience. This study underscores the significance of combining hardware, software, and coding skills in PBL, emphasizing how IoTRemoteLab (the remote lab we developed) supports a customized educational experience that promotes innovation and safety. Moreover, we explore the potential of IoTRemoteLab as a TEL, facilitating and supporting the understanding and definition of the requirements of remote learning. Furthermore, we demonstrate how we incorporate generative artificial intelligence into IoTRemoteLab's settings, enabling personalized recommendations for students leveraging the lab locally or remotely. Our approach serves as a model for educators and researchers aiming to equip students with essential skills for the digital age while addressing broader issues related to access, engagement, and sustainability in HEIs. The practical findings following an in-class experiment reinforce the value of IoTRemoteLab and its features in preparing students for future technological demands and fostering a more inclusive, safe, and effective educational environment.

Initiating a One Digital Health Unified Terminology (ODH-UT) to Facilitate Community Expansion.

One Digital Health (ODH) merges the Digital Health and One Health approaches to create a comprehensive framework for future health ecosystems. In this rapidly evolving field, a standardized vocabulary is not just a convenience, but a necessity to ensure efficient communication. This research proposes the development of a "One Digital Health-Unified Terminology" (ODH-UT) to facilitate communication among researchers and practitioners in Digital Health and One Health, addressing this crucial need.

A Structured Social-Media Health Support intervention Program after Bariatric Surgery.

BACKGROUND: Social media networks have been found to provide emotional, instrumental, and social support, which may contribute to improved adherence to post-bariatric surgery care recommendations. OBJECTIVES: To evaluate the impact of an online social media-based, healthcare professional-led, educational and support program on patients' long-term engagement with and adherence to follow-up guidelines, self-care recommendations, and weight management after bariatric surgery. METHODS: An observational cohort study, employing mixed methods, accompanied a 12-week interactive, structured, social-media psychoeducational intervention program delivered on Facebook. Program participants, who had undergone one bariatric surgery within the past 1-7 years and were at least 18 years old at the time of surgery, were invited to join the program via posts online. Interested individuals were provided information about the program and the accompanying evaluation study, and those who met requirements completed study questionnaires before and after the program. Questionnaires included demographic and anthropometric information; postoperative recommendations received and their clarity and implementation; attitudes towards recommendation adherence; and well-being. Daily system data on program engagement were collected from the Facebook website. RESULTS: Of the 214 participants enrolled in the program, 101 (80.2% female, mean age 43.8±9.1 years and mean BMI 30.2±6.8 kg/m2, 1-7 years after bariatric surgery) completed both baseline and end-of-program questionnaires and were included in the analysis. Following the program, improvements were observed in most aspects of participants' adherence to postoperative recommendations and well-being. Close to half of the participants (44.6%) reported reaching their postoperative target weight at the end of the program or maintaining it throughout the program. Video posts drew higher participant engagement than other media, and content about proteins received the highest number of reactions. However, participants' active engagement gradually declined over time. CONCLUSIONS: Interactive health support on social media can positively enhance patient engagement, adherence to treatment recommendations, health outcomes, and overall well-being.

Digital Health Education for the Future: The SaNuRN (Santé Numérique Rouen-Nice) Consortium's Journey.

SaNuRN is a five-year project by the University of Rouen Normandy (URN) and the Côte d'Azur University (CAU) consortium to optimize digital health education for medical and paramedical students, professionals, and administrators. The project includes a skills framework, training modules, and teaching resources. In 2027, SaNuRN is expected to train a significant portion of the 400,000 health and paramedical professions students at the French national level. Our purpose is to give a synopsis of the SaNuRN initiative, emphasizing its novel educational methods and how they will enhance the delivery of digital health education. Our goals include showcasing SaNuRN as a comprehensive program consisting of a proficiency framework, instructional modules, and educational materials and explaining how SaNuRN is implemented in the participating academic institutions. SaNuRN is a project aimed at educating and training health-related and paramedics students in digital health. The project results from a cooperative effort between URN and CAU, covering four French departments. The project is based on the French National Referential on Digital Health (FNRDH), which defines the skills and competencies to be acquired and validated by every student in the health, paramedical, and social professions curricula. The SaNuRN team is currently adapting the existing URN and CAU syllabi to FNRDH and developing short-duration video capsules of 20 to 30 minutes to teach all the relevant material. The project aims to ensure that the largest student population earns the necessary skills, and it has developed a two-tier system involving facilitators who will enable the efficient expansion of the project's educational outreach and support the students in learning the needed material efficiently. With a focus on real-world scenarios and innovative teaching activities integrating telemedicine devices and virtual professionals, SaNuRN is committed to enabling continuous learning for healthcare professionals in clinical practice. The SaNuRN team introduced new ways of evaluating healthcare professionals by shifting from a knowledge-based to a competencies-based evaluation, aligning with the Miller teaching pyramid and using the Objective Structured Clinical Examination and Script Concordance Test in digital health education. Drawing on the expertise of URN, CAU, and their public health and digital research laboratories and partners, the SaNuRN project represents a platform for continuous innovation, including telemedicine training and living labs with virtual and interactive professional activities. The SaNuRN project provides a comprehensive, personalized 30-hour training package for health and paramedical students, addressing all 70 FNRDH competencies. The program is enhanced using AI and NLP to create virtual patients and professionals for digital healthcare simulation. SaNuRN teaching materials are open-access. The project collaborates with academic institutions worldwide to develop educational material in digital health in English and multilingual formats. SaNuRN offers a practical and persuasive training approach to meet the current digital health education requirements.

Sharing Digital Health Educational Resources in a One-Stop Shop Portal: Tutorial on the Catalog and Index of Digital Health Teaching Resources (CIDHR) Semantic Search Engine.

BACKGROUND: Access to reliable and accurate digital health web-based resources is crucial. However, the lack of dedicated search engines for non-English languages, such as French, is a significant obstacle in this field. Thus, we developed and implemented a multilingual, multiterminology semantic search engine called Catalog and Index of Digital Health Teaching Resources (CIDHR). CIDHR is freely accessible to everyone, with a focus on French-speaking resources. CIDHR has been initiated to provide validated, high-quality content tailored to the specific needs of each user profile, be it students or professionals. OBJECTIVE: This study's primary aim in developing and implementing the CIDHR is to improve knowledge sharing and spreading in digital health and health informatics and expand the health-related educational community, primarily French speaking but also in other languages. We intend to support the continuous development of initial (ie, bachelor level), advanced (ie, master and doctoral levels), and continuing training (ie, professionals and postgraduate levels) in digital health for health and social work fields. The main objective is to describe the development and implementation of CIDHR. The hypothesis guiding this research is that controlled vocabularies dedicated to medical informatics and digital health, such as the Medical Informatics Multilingual Ontology (MIMO) and the concepts structuring the French National Referential on Digital Health (FNRDH), to index digital health teaching and learning resources, are effectively increasing the availability and accessibility of these resources to medical students and other health care professionals. METHODS: First, resource identification is processed by medical librarians from websites and scientific sources preselected and validated by domain experts and surveyed every week. Then, based on MIMO and FNRDH, the educational resources are indexed for each related knowledge domain. The same resources are also tagged with relevant academic and professional experience levels. Afterward, the indexed resources are shared with the digital health teaching and learning community. The last step consists of assessing CIDHR by obtaining informal feedback from users. RESULTS: Resource identification and evaluation processes were executed by a dedicated team of medical librarians, aiming to collect and curate an extensive collection of digital health teaching and learning resources. The resources that successfully passed the evaluation process were promptly included in CIDHR. These resources were diligently indexed (with MIMO and FNRDH) and tagged for the study field and degree level. By October 2023, a total of 371 indexed resources were available on a dedicated portal. CONCLUSIONS: CIDHR is a multilingual digital health education semantic search engine and platform that aims to increase the accessibility of educational resources to the broader health care-related community. It focuses on making resources "findable," "accessible," "interoperable," and "reusable" by using a one-stop shop portal approach. CIDHR has and will have an essential role in increasing digital health literacy.

Metrics reloaded: recommendations for image analysis validation.

Increasing evidence shows that flaws in machine learning (ML) algorithm validation are an underestimated global problem. In biomedical image analysis, chosen performance metrics often do not reflect the domain interest, and thus fail to adequately measure scientific progress and hinder translation of ML techniques into practice. To overcome this, we created Metrics Reloaded, a comprehensive framework guiding researchers in the problem-aware selection of metrics. Developed by a large international consortium in a multistage Delphi process, it is based on the novel concept of a problem fingerprint-a structured representation of the given problem that captures all aspects that are relevant for metric selection, from the domain interest to the properties of the target structure(s), dataset and algorithm output. On the basis of the problem fingerprint, users are guided through the process of choosing and applying appropriate validation metrics while being made aware of potential pitfalls. Metrics Reloaded targets image analysis problems that can be interpreted as classification tasks at image, object or pixel level, namely image-level classification, object detection, semantic segmentation and instance segmentation tasks. To improve the user experience, we implemented the framework in the Metrics Reloaded online tool. Following the convergence of ML methodology across application domains, Metrics Reloaded fosters the convergence of validation methodology. Its applicability is demonstrated for various biomedical use cases.

Understanding metric-related pitfalls in image analysis validation.

Validation metrics are key for tracking scientific progress and bridging the current chasm between artificial intelligence research and its translation into practice. However, increasing evidence shows that, particularly in image analysis, metrics are often chosen inadequately. Although taking into account the individual strengths, weaknesses and limitations of validation metrics is a critical prerequisite to making educated choices, the relevant knowledge is currently scattered and poorly accessible to individual researchers. Based on a multistage Delphi process conducted by a multidisciplinary expert consortium as well as extensive community feedback, the present work provides a reliable and comprehensive common point of access to information on pitfalls related to validation metrics in image analysis. Although focused on biomedical image analysis, the addressed pitfalls generalize across application domains and are categorized according to a newly created, domain-agnostic taxonomy. The work serves to enhance global comprehension of a key topic in image analysis validation.

Understanding metric-related pitfalls in image analysis validation.

Validation metrics are key for the reliable tracking of scientific progress and for bridging the current chasm between artificial intelligence (AI) research and its translation into practice. However, increasing evidence shows that particularly in image analysis, metrics are often chosen inadequately in relation to the underlying research problem. This could be attributed to a lack of accessibility of metric-related knowledge: While taking into account the individual strengths, weaknesses, and limitations of validation metrics is a critical prerequisite to making educated choices, the relevant knowledge is currently scattered and poorly accessible to individual researchers. Based on a multi-stage Delphi process conducted by a multidisciplinary expert consortium as well as extensive community feedback, the present work provides the first reliable and comprehensive common point of access to information on pitfalls related to validation metrics in image analysis. Focusing on biomedical image analysis but with the potential of transfer to other fields, the addressed pitfalls generalize across application domains and are categorized according to a newly created, domain-agnostic taxonomy. To facilitate comprehension, illustrations and specific examples accompany each pitfall. As a structured body of information accessible to researchers of all levels of expertise, this work enhances global comprehension of a key topic in image analysis validation.

International scientific communication on COVID-19 data: management pitfalls understanding.

BACKGROUND: During the pandemic, countries utilized various forms of statistical estimations of coronavirus disease-2019 (COVID-19) impact. Differences between databases make direct comparisons and interpretations of data in different countries a challenge. We evaluated country-specific approaches to COVID-19 data and recommended changes that would improve future international collaborations. METHODS: We compared the COVID-19 reports presented on official UK (National Health System), Israeli (Department of Health), Latvian (Center for Disease Prevention and Control) and USA (Centers for Disease Control and Prevention) health authorities' websites. RESULTS: Our analysis demonstrated critical differences in the ways COVID-19 statistics were made available to the general and scientific communities. Specifically, the differences in approaches were found in the presentation of the number of infected cases and tests, and percentage of positive cases, the number of severe cases, the number of vaccinated, and the number and percent of deaths. CONCLUSION: Findability, Accessibility, Interoperability and Reusability principles could guide the development of essential global standards that provide a basis for communication within and outside of the scientific community.

Digital Emergency Management for a Complex One Health Landscape: the Need for Standardization, Integration, and Interoperability.

OBJECTIVE: Planning reliable long-term planning actions to handle disruptive events requires a timely development of technological infrastructures, as well as the set-up of focused strategies for emergency management. The paper aims to highlight the needs for standardization, integration, and interoperability between Accident & Emergency Informatics (A&EI) and One Digital Health (ODH), as fields capable of dealing with peculiar dynamics for a technology-boosted management of emergencies under an overarching One Health panorama. METHODS: An integrative analysis of the literature was conducted to draw attention to specific foci on the correlation between ODH and A&EI, in particular: (i) the management of disruptive events from private smart spaces to diseases spreading, and (ii) the concepts of (health-related) quality of life and well-being. RESULTS: A digitally-focused management of emergency events that tackles the inextricable interconnectedness between humans, animals, and surrounding environment, demands standardization, integration, and systems interoperability. A consistent and finalized process of adoption and implementation of methods and tools from the International Standard Accident Number (ISAN), via findability, accessibility, interoperability, and reusability (FAIR) data principles, to Medical Informatics and Digital Health Multilingual Ontology (MIMO) - capable of looking at different approaches to encourage the integration between the ODH framework and the A&EI vision, provides a first answer to these needs. CONCLUSIONS: ODH and A&EI look at different scales but with similar goals for converging health and environmental-related data management standards to enable multi-sources, interdisciplinary, and real-time data integration and interoperability. This allows holistic digital health both in routine and emergency events.

Leveraging Data and Technology to Enhance Interdisciplinary Collaboration and Health Outcomes.

OBJECTIVE: To give an overview of recent research and propose a selection of best papers published in 2022 in Informatics for One Health. METHODS: An extensive search using PubMed and Web of Science was conducted to identify peer-reviewed articles published between December 2021 and December 2022, in order to find relevant publications in the 'Informatics for One Health' field. The selection process comprised three steps: (i) eight candidate best papers were first selected by the two section editors; (ii) external reviewers from internationally renowned research teams reviewed each candidate best paper; and (iii) the editorial committee of the Yearbook conducted the final best paper selection. RESULTS: The candidate best papers represent studies that characterized significant challenges facing Informatics for One Health. Other trends of interest related to the deployment of medical artificial intelligence tools and the implementation of the FAIR principles within the One Health broad scenario. In general, papers identified in the search fell into one of the following categories: 1) Health improvement via digital technology; 2) Climate change/Environment/Biodiversity; and 3) Maturity of healthcare services. CONCLUSION: The topic turns extremely important in the next future for what concerns the need to understand complex interactions in order to safeguard the health of populations and ecosystems.

Alert-Grouping: Smart Personalization of Monitoring System Thresholds to Help Healthcare Teams Struggle with Alarm Fatigue in Intensive Care.

In Intensive Care Units (ICUs), patients are monitored using various devices that generate alerts when specific metrics, such as heart rate and oxygen saturation, exceed predetermined thresholds. However, these alerts can be inaccurate and lead to alert fatigue, resulting in errors and inaccurate diagnoses. We propose Alert grouping, a "Smart Personalization of Monitoring System Thresholds to Help Healthcare Teams Struggle Alarm Fatigue in Intensive Care" model. The alert grouping looks at patients at the individual and cluster levels, and healthcare-related constraints to assist medical and nursing teams in setting personalized alert thresholds of vital parameters. By simulating the function of ICU patient bed devices, we demonstrate that the proposed alert grouping model effectively reduces the number of alarms overall, improving the alert system's validity and reducing alarm fatigue. Implementing this personalized alert model in ICUs boosts medical and nursing teams' confidence in the alert system, leading to better care for ICU patients by significantly reducing alarm fatigue, thereby improving the quality of care for ICU patients.

The Need for Green and Responsible Medical Informatics and Digital Health: Looking Forward with One Digital Health.

One Health is an important initiative to view the world in a more integrative sense of our health and environment. Digital Health provides essential support to all of us as healthcare professionals and customers. One Digital Health (ODH) combines both One Health and Digital Health to provide a technologically integrative view. ODH gives an essential place to the environment and ecosystems. Thus, health technologies and digital health must be "green" and eco-friendly as much as possible. We suggest in this position paper examples of developing and implementing ODH-related concepts, systems, and products with a respectful consideration of the environment. For humans and animals, developing cutting-edge technologies to improve wellness and healthcare is critical. Nevertheless, we can learn from One Health that digitalization and so One Digital Health must be built to implement green, eco-friendly, and responsible thinking.

One Digital Health Intervention for Monitoring Human and Animal Welfare in Smart Cities: Viewpoint and Use Case.

Smart cities and digital public health are closely related. Managing digital transformation in urbanization and living spaces is challenging. It is critical to prioritize the emotional and physical health and well-being of humans and their animals in the dynamic and ever-changing environment they share. Human-animal bonds are continuous as they live together or share urban spaces and have a mutual impact on each other's health as well as the surrounding environment. In addition, sensors embedded in the Internet of Things are everywhere in smart cities. They monitor events and provide appropriate responses. In this regard, accident and emergency informatics (A&EI) offers tools to identify and manage overtime hazards and disruptive events. Such manifold focuses fit with One Digital Health (ODH), which aims to transform health ecosystems with digital technology by proposing a comprehensive framework to manage data and support health-oriented policies. We showed and discussed how, by developing the concept of ODH intervention, the ODH framework can support the comprehensive monitoring and analysis of daily life events of humans and animals in technologically integrated environments such as smart homes and smart cities. We developed an ODH intervention use case in which A&EI mechanisms run in the background. The ODH framework structures the related data collection and analysis to enhance the understanding of human, animal, and environment interactions and associated outcomes. The use case looks at the daily journey of Tracy, a healthy woman aged 27 years, and her dog Mego. Using medical Internet of Things, their activities are continuously monitored and analyzed to prevent or manage any kind of health-related abnormality. We reported and commented on an ODH intervention as an example of a real-life ODH implementation. We gave the reader examples of a "how-to" analysis of Tracy and Mego's daily life activities as part of a timely implementation of the ODH framework. For each activity, relationships to the ODH dimensions were scored, and relevant technical fields were evaluated in light of the Findable, Accessible, Interoperable, and Reusable principles. This "how-to" can be used as a template for further analyses. An ODH intervention is based on Findable, Accessible, Interoperable, and Reusable data and real-time processing for global health monitoring, emergency management, and research. The data should be collected and analyzed continuously in a spatial-temporal domain to detect changes in behavior, trends, and emergencies. The information periodically gathered should serve human, animal, and environmental health interventions by providing professionals and caregivers with inputs and "how-to's" to improve health, welfare, and risk prevention at the individual and population levels. Thus, ODH complementarily combined with A&EI is meant to enhance policies and systems and modernize emergency management.

Early Detection and Control of the Next Epidemic Wave Using Health Communications: Development of an Artificial Intelligence-Based Tool and Its Validation on COVID-19 Data from the US.

Social media networks highly influence on a broad range of global social life, especially in the context of a pandemic. We developed a mathematical model with a computational tool, called EMIT (Epidemic and Media Impact Tool), to detect and control pandemic waves, using mainly topics of relevance on social media networks and pandemic spread. Using EMIT, we analyzed health-related communications on social media networks for early prediction, detection, and control of an outbreak. EMIT is an artificial intelligence-based tool supporting health communication and policy makers decisions. Thus, EMIT, based on historical data, social media trends and disease spread, offers an predictive estimation of the influence of public health interventions such as social media-based communication campaigns. We have validated the EMIT mathematical model on real world data combining COVID-19 pandemic data in the US and social media data from Twitter. EMIT demonstrated a high level of performance in predicting the next epidemiological wave (AUC = 0.909, F1 = 0.899).

Medical informatics and digital health multilingual ontology (MIMO): A tool to improve international collaborations.

BACKGROUND: Even if English is the leading language for international communication, it is essential to keep in mind that research runs at the local level by local teams generally communicating in their local/national language, especially in Europe among European projects. OBJECTIVE: Therefore, the European Federation for Medical Informatics - Working Group on Health Informatics for Inter-regional Cooperation" has one objective: To develop a multilingual ontology focusing on Health Informatics and Digital Health as a collaboration tool that improves international and, in particular, European collaborations. RESULTS: We have developed the Medical Informatics and Digital Health Multilingual Ontology (MIMO). Hosted on the Health Terminology/Ontology Portal (HeTOP), MIMO contains around 1,000 concepts, 460 MeSH Descriptors, 220 MeSH Concepts, and more than 300 newly created concepts. MIMO is continuously updated to comprise as recent as possible concepts and their translations in more than 30 languages. Moreover, the MIMO's development team constantly improves MIMO content and supporting information. Thus, during workshop discussions and one-on-one exchanges, the MIMO team has collected domain experts' opinions about the community's interests and suggestions for future enhancements. Moreover, MIMO will be integrated to support the annotation and categorization of research products into the HosmartAI European project involving more than 20 countries around Europe and worldwide. CONCLUSION: MIMO is hosted by HeTOP (Health Terminology/Ontology Portal), which integrates 100 terminologies and ontologies in 55 languages. MIMO is freely available online. MIMO is portable to other knowledge platforms as part of MIMO's main aims to facilitate communication between medical librarians, translators, and researchers as well as to support students' self-learning.

One Digital Health for more FAIRness.

BACKGROUND: One Digital Health (ODH) aims to propose a framework that merges One Health's and Digital Health's specific features into an innovative landscape. FAIR (Findable, Accessible, Interoperable, and Reusable) principles consider applications and computational agents (or, in other terms, data, metadata, and infrastructures) as stakeholders with the capacity to find, access, interoperate, and reuse data with none or minimal human intervention. OBJECTIVES: This paper aims to elicit how the ODH framework is compliant with FAIR principles and metrics, providing some thinking guide to investigate and define whether adapted metrics need to be figured out for an effective ODH Intervention setup. METHODS: An integrative analysis of the literature was conducted to extract instances of the need-or of the eventual already existing deployment-of FAIR principles, for each of the three layers (keys, perspectives and dimensions) of the ODH framework. The scope was to assess the extent of scatteredness in pursuing the many facets of FAIRness, descending from the lack of a unifying and balanced framework. RESULTS: A first attempt to interpret the different technological components existing in the different layers of the ODH framework, in the light of the FAIR principles, was conducted. Although the mature and working examples of workflows for data FAIRification processes currently retrievable in the literature provided a robust ground to work on, a nonsuitable capacity to fully assess FAIR aspects for highly interconnected scenarios, which the ODH-based ones are, has emerged. Rooms for improvement are anyway possible to timely deal with all the underlying features of topics like the delivery of health care in a syndemic scenario, the digital transformation of human and animal health data, or the digital nature conservation through digital technology-based intervention. CONCLUSIONS: ODH pillars account for the availability (findability, accessibility) of human, animal, and environmental data allowing a unified understanding of complex interactions (interoperability) over time (reusability). A vision of integration between these two worlds, under the vest of ODH Interventions featuring FAIRness characteristics, toward the development of a systemic lookup of health and ecology in a digitalized way, is therefore auspicable.

Digital Health Multilingual Ontology to Index Teaching Resources.

The aim of this paper is to present the use of Medical Informatics Multilingual Ontology (MIMO) to index digital health resources that are (and will be) included in SaNuRN (project to teach digital health). MIMO currently contains 1,379 concepts and is integrated into HeTOP, which is a cross-lingual multiterminogy server. Existing teaching resources have been reindexed with MIMO concepts and integrated into a dedicated website. A total of 345 resources have been indexed with MIMO concepts and are freely available at https://doccismef.chu-rouen.fr/dc/#env=sanurn. The development of a multilingual MIMO for enhancing the quality and the efficiency of international projects is challenging. A specific semantic search engine has been deployed to give access to digital health teaching resources.

Quantitative and qualitative analysis of the quality of life of Type 1 diabetes patients using insulin pumps and of those receiving multiple daily insulin injections.

INTRODUCTION: Insulin pump therapy represents an alternative to multiple daily injections and can improve glycemic control and quality of life (QoL) in Type 1 diabetes mellitus (T1DM) patients. We aimed to explore the differences and factors related to the T1DM-specific QoL of such patients in Latvia. DESIGN AND METHODS: A mixed-method cross-sectional study on 87 adult T1DM patients included 20 pump users and 67 users of injections who participated in the quantitative part of the study; 8 pump users and 13 injection users participated in the qualitative part. Patients were invited to participate using a dedicated digital platform. Their QoL and self-management habits were assessed using specially developed questionnaires adapted to Latvian conditions. Multiple logistic regression models were built to investigate the association between social and self-management factors and patients' QoL. In addition, qualitative analysis of answers was performed. RESULTS: Insulin pump users were younger, had higher incomes, and reported higher T1DM expenses than users of multiple daily injections. There were no differences in self-management between the groups; Total QoL differed at the 0.1 significance level. In fully adjusted multiple logistic regression models, the most important factor that increased Total QoL was lower T1DM-related expenses (odds ratio, OR 7.02 [95% confidence interval 1.29; 38.0]). Men and those with more years of living with T1DM had better QoL (OR 9.62 [2.20; 42.1] and OR 1.16 [1.05; 1.29], respectively), but the method of administration was not significantly associated with QoL (OR 7.38 [0.87; 62.9]). Qualitative data supported the results of quantitative analysis. CONCLUSIONS: QoL was the main reason to use an insulin pump, while the expense was the main reason to avoid the use of it or to stop using it. Reimbursement policies thus should be considered to enable patients to choose the more convenient method for themselves.