Progress Achieved, Landmarks, and Future Concerns in Biomedical and Health Informatics.

BACKGROUND: The biomedical and health informatics (BMHI) fields have been advancing rapidly, a trend particularly emphasised during the recent COVID-19 pandemic, introducing innovations in BMHI. Over nearly 50 years since its establishment as a scientific discipline, BMHI has encountered several challenges, such as mishaps, delays, failures, and moments of enthusiastic expectations and notable successes. This paper focuses on reviewing the progress made in the BMHI discipline, evaluating key milestones, and discussing future challenges. METHODS: To, Structured, step-by-step qualitative methodology was developed and applied, centred on gathering expert opinions and analysing trends from the literature to provide a comprehensive assessment. Experts and pioneers in the BMHI field were assigned thematic tasks based on the research question, providing critical inputs for the thematic analysis. This led to the identification of five key dimensions used to present the findings in the paper: informatics in biomedicine and healthcare, health data in Informatics, nurses in informatics, education and accreditation in health informatics, and ethical, legal, social, and security issues. RESULTS: Each dimension is examined through recently emerging innovations, linking them directly to the future of healthcare, like the role of artificial intelligence, innovative digital health tools, the expansion of telemedicine, and the use of mobile health apps and wearable devices. The new approach of BMHI covers newly introduced clinical needs and approaches like patient-centric, remote monitoring, and precision medicine clinical approaches. CONCLUSIONS: These insights offer clear recommendations for improving education and developing experts to advance future innovations. Notably, this narrative review presents a body of knowledge essential for a deep understanding of the BMHI field from a human-centric perspective and, as such, could serve as a reference point for prospective analysis and innovation development.

INSAFEDARE Project: Innovative Applications of Assessment and Assurance of Data and Synthetic Data for Regulatory Decision Support.

Digital health solutions hold promise for enhancing healthcare delivery and patient outcomes, primarily driven by advancements such as machine learning, artificial intelligence, and data science, which enable the development of integrated care systems. Techniques for generating synthetic data from real datasets are highly advanced and continually evolving. This paper aims to present the INSAFEDARE project's ambition regarding medical devices' regulation and how real and synthetic data can be used to check if devices are safe and effective. The project will consist of three pillars: a) assurance of new state-of-the-art technologies and approaches (such as synthetic data), which will support the validation methods as part of regulatory decision-making; b) technical and scientific, focusing on data-based safety assurance, as well as discovery, integration and use of datasets, and use of machine learning approaches; and c) delivery to practice, through co-production involving relevant stakeholders, dissemination and sustainability of the project's outputs. Finally, INSAFEDARE will develop an open syllabus and training certification for health professionals focused on quality assurance.

Montenegrin Digital Academic Innovation Hub: Experience in Supporting Digital Health Innovations.

Montenegrin Digital Academic Innovation Hub established within Erasmus+ project DigNEST is essential institutional support for developing innovations in the field of health in academic-business cooperation and partnership. Experience of 18 months in running Hub service provides preliminary results in analysis received innovation ideas, provided support and potentials/capacities in medical informatics advancements at national, regional and global level.

Continuing Educational Program in Nursing Informatics for Greek Nurses.

Nurses are required to adapt to a complex and rapidly evolving environment that incorporates new IT technologies. Continuing, lifelong learning, especially in the fast-growing fields of Nursing Informatics, eHealth and related Information and Communication Technologies, is vital to the professionalism of nurses. The study presents the curriculum development and implementation of the educational project entitled "Training of Nurses in Nursing Informatics and Information and Communication Technologies (ICT)" which has been designed and offered to Greek nurses as a continuing - lifelong online educational program by the Health Informatics Laboratory of the National and Kapodistrian University of Athens. The training material was created in three modules and 29 sub-modules, considering the new advancements and recommended competencies, necessary for the nurse, in the fields of Nursing Informatics and ICT. So far, eight training cycle courses have been offered to 1388 nurses, free of charge. Each course integrates synchronous and asynchronous distance learning methods and requires a workload of 70 hours over 10 weeks. The initial evaluation of the course by the participants, concerning its effectiveness, usefulness, and innovation are very encouraging.

Cattle aggregations at shared resources create potential parasite exposure hotspots for wildlife.

Globally rising livestock populations and declining wildlife numbers are likely to dramatically change disease risk for wildlife and livestock, especially at resources where they congregate. However, limited understanding of interspecific transmission dynamics at these hotspots hinders disease prediction or mitigation. In this study, we combined gastrointestinal nematode density and host foraging activity measurements from our prior work in an East African tropical savannah system with three estimates of parasite sharing capacity to investigate how interspecific exposures alter the relative riskiness of an important resource - water - among cattle and five dominant herbivore species. We found that due to their high parasite output, water dependence and parasite sharing capacity, cattle greatly increased potential parasite exposures at water sources for wild ruminants. When untreated for parasites, cattle accounted for over two-thirds of total potential exposures around water for wild ruminants, driving 2-23-fold increases in relative exposure levels at water sources. Simulated changes in wildlife and cattle ratios showed that water sources become increasingly important hotspots of interspecific transmission for wild ruminants when relative abundance of cattle parasites increases. These results emphasize that livestock have significant potential to alter the level and distribution of parasite exposures across the landscape for wild ruminants.

Predicting Mortality in COVID-19 Patients Using 6 Machine Learning Algorithms.

In late 2019, COVID-19 appeared and has since spread worldwide as the new pandemic, causing more than 6 million deaths. In dealing with this global crisis, the contribution of Artificial Intelligence was also important through the possibilities of creating predictive models through Machine Learning algorithms, which are already successfully applied to solving a multitude of problems, for many scientific fields. This work aims to find the best model for predicting the mortality of patients with COVID-19, through the comparison of 6 classification algorithms, i.e. Logistic Regression, Decision Trees, Random Forest, eXtreme Gradient Boosting, Multi-Layer Perceptrons, K-Nearest Neighbors. We used a dataset containing more than 12 million cases which was cleansed, modified, and tested for each model. The best model is XGBoost (Precision: 0.93764, Recall: 0.95472, F1-score: 0.9113, AUC_ROC: 0.97855 and Runtime: 6.67306 sec), which is recommended for the prediction and priority treatment of patients with high mortality risk.

SNA: The Optimal Nodes to Raise Nurses' Infosec Awareness.

Social Network Analysis (SNA) can promote Infosec awareness. A sample of 164 nurses selected the most trusted actors to get Infosec updates. UCINET 6 and NetDraw were used for mapping and PSPP 1.6.2 was used for data analysis. Nurses tend to trust managers, colleagues and IT professionals for retrieving Infosec updates.

The User, the Watch, and the Bestseller: Study on the Utilization of Smart Medical Wearables and Their User Manuals.

In this paper, we present a study on the utilization of smart medical wearables and the user manuals of such devices. A total of 342 individuals provided input for 18 questions that address user behavior in the investigated context and the connections between various assessments and preferences. The presented work clusters individuals based on their professional relation to user manuals and analyzes the obtained results separately for these groups.

Web and Mobile Enabled Application for Public Health Inspections.

This work aims to promote and improve Public Health practices by creating an Information System (IS) to register health inspections performed in health stores by the Public Health Inspectors of the Health Departments of Regions in Greece. The IS was implemented based on open-source programming languages and frameworks. The front end was implemented by JavaScript and Vue.js framework, and the back end by Python and Django.

A Conversational Web-Based Chatbot to Disseminate COVID-19 Advisory Information.

Chatbots are computer programs which integrate Artificial Intelligence (AI) and Natural Language Processing (NLP) technologies to simulate human conversation. The use of chatbots has significantly been increased during the COVID-19 pandemic to support healthcare procedures and systems. The purpose of this study is to present the design, implementation, and initial evaluation of a web-based conversational chatbot aiming at the immediate and reliable information regarding the COVID-19 disease. The implementation of the chatbot was built on IBM's Watson Assistant. The chatbot "Iris" that was created is highly developed with the ability to support dialogue, since it has a satisfactory understanding of the relevant subject matter. The system was pilot evaluated using the University of Ulster's Chatbot Usability Questionnaire (CUQ). The results confirmed its usability and that Chatbot "Iris" is a pleasant experience for users. Finally, the related study's limitations and future steps are discussed.

Digital Transformation Efforts in Greece: Evaluation of the E-Prescription System.

In recent years, Greece has made efforts towards digital transformation. The most significant was the installation and use of eHealth systems and applications by health professionals. The purpose of this study is to investigate the views of physicians on the usefulness, ease of use and user satisfaction of the eHealth applications and especially the e-prescription system. Data were collected by using a 5-point Likert-scale questionnaire. The study indicated that the usefulness, ease of use and user satisfaction of eHealth applications: a)are rated at moderate levels and b) are not affected by characteristics such as gender, age, education, years of practicing the medical profession, the type of medical practice and the use of different electronic applications.

AI Techniques to Identify Nerve Cell Alterations in Digital Images.

Artificial intelligence (AI), utilising computing power, has managed to influence the health sector with many applications based on algorithms, tools, and automated processes. In this work, neuronbiological images acquired by an electronic microscope are assessed under appropriate image processing to identify areas of interest. The algorithmic steps identified the alterations of nerve cells that appeared as areas in the red channel of each digital image.

Health Informatics Training Programs to Strengthen Health Workforce in Montenegro.

Health informatics plays a crucial role in modern healthcare provision. Training and continuous education are essential to bolster the healthcare workforce on health informatics. In this work, we present the training events within EU-funded DigNest project. The aim of the training events, the subjects offered, and the overall evaluation of the results are described in this paper.

Train Digital Entrepreneurship on Health Informatics in Western Balkan Countries.

The BeWell@Digital project aims to improve Western Balkans' youth mental health by empowering them through digital education, peer-to-peer counselling services, and employment opportunities in the digital working arena. The Greek Biomedical Informatics and Health Informatics Association developed six teaching sessions about Health literacy and digital entrepreneurship, each comprising a teaching text, presentation, lecture video, and multiple-choice exercises, as part of this project. These sessions aim to improve counsellors' knowledge of technology and their ability to utilise it efficiently.

Montenegrin Digital Academic Innovation Hub: Supporting Digital Education, Business and Innovations in Medical Informatics.

This poster presents a Montenegrin Digital Academic Innovation Hub aimed to support education, innovations, and academia-business cooperation in medical informatics (as one of four priority areas) at national level in Montenegro. The Hub topology and its organisation in the form of two main nodes, with services established within key pillars: Digital Education; Digital Business Support; Innovations and cooperation with industry; and Employment support.

Corrigendum to "Biomedical and health informatics teaching in Portugal: Current status" [Heliyon 9(3) (March 2023) e14163].

[This corrects the article DOI: 10.1016/j.heliyon.2023.e14163.].

MedSecurance Project: Advanced Security-for-Safety Assurance for Medical Device IoT (IoMT).

The MedSecurance project focus on identifying new challenges in cyber security with focus on hardware and software medical devices in the context of emerging healthcare architectures. In addition, the project will review best practice and identify gaps in the guidance, particularly the guidance stipulated by the medical device regulation and directives. Finally, the project will develop comprehensive methodology and tooling for the engineering of trustworthy networks of inter-operating medical devices, that shall have security-for-safety by design, with a strategy for device certification and certifiable dynamic network composition, ensuring that patient safety is safeguarded from malicious cyber actors and technology "accidents".

InfoSec Practices - a Survey Conducted in Greek Hospitals.

Background: Langerhans The information technology is present in every aspect of private, social, and professional sphere and is constantly evolving whilst remaining vulnerable to security alerts and attacks. The healthcare sector contains sensitive information and can be compromised causing even fatal delays to healthcare delivery, loss of reputation of the organizations, and traumatic experiences for patients who might be stigmatized by the disclosure of their medical files. Infosec practices that are applied by nurses can make the difference in defending or compromising healthcare data. Objective: The aim of this research is to investigate the Infosec practices which are applied by nurses who work in Greek hospitals. Correlation between the Infosec practices, the knowledge on Infosec policies, and attitude towards Infosec policies will be further examined. Methods: The KAP model is applied and the HAIS-Q tool consisted of 45 items in five areas of interest was used. A sample of 277 nurses was collected. Confidentiality issues and consent were respected. IBM SPSS 25.0 was used for the statistical analysis. Descriptive analysis (mean, st. dev.) and inferential statistics, ANOVA, and Pearson Corerelations were conducted. The significance level was set up to 0.05. Results: A strong correlation between knowledge on Infosec policies and attitude towards Infosec policies, attitude towards Infosec policies and Infosec practices, and knowledge on Infosec policies and Infosec practices was established. Nurses apply good Infosec practices in three out of five areas of interest, while their practices concerning the report of security violations and their practices related to the Internet usage are average. Overall, nurses' Infosec awareness is good. Conclusion: The findings showed that nurses demonstrate average to good knowledge on Infosec policies, good attitude towards Infosec policies, good to average Infosec practices and good total Infosec awareness.The most vulnerable area is the Internet usage.

Biomedical and health informatics teaching in Portugal: Current status.

Background: The domain of Biomedical and Health Informatics (BMHI) lies in the intersection of multiple disciplines, making it difficult to define and, consequently, characterise the workforce, training needs and requirements in this domain. Nevertheless, to the best of our knowledge, there isn't any aggregated information about the higher education programmes in BMHI currently being delivered in Portugal, and which knowledge, skills, and competencies these programmes aim to develop. Aim: Our aim is to map BMHI teaching in Portugal. More specifically, our objective is to identify and characterise the: a.) programmes delivering relevant BMHI teaching; b.) geographical distribution and chronological evolution of such programmes; and c.) credit distribution and weight. Methods: We conducted a descriptive, cross-sectional study to systematically identify all programmes currently delivering any core BMHI modules in Portugal. Our population included all graduate-level programmes being delivered in the 2021/2022 academic year in any Portuguese higher education institution. Results: We identified 23 programmes delivering relevant teaching in BMHI in Portugal. Of these, eight (35%) were classified as dedicated educational programmes in BMHI, mostly delivered in polytechnic institutes at a master's level (5; 63%) and located preferentially in the northern part of the country (7). Currently, there are four programmes with potential for accreditation but still requiring some workload increase in certain areas in order to be eligible.