The Australian Park Life project: Development of a nationally standardised spatial layer and public participatory GIS for greenspace in Australian capital cities.

This paper introduces the 'Australian Park Life Project' and describes a protocol to standardise the capture and collation of public open greenspace spatial data across Australian cities. This method will progress greenspace research allowing for unique coherent national analyses and comparative research across Australia. We also outline the development of the Park Life public participatory geographic information system (PPGIS) to spatially explore what, and how, public open greenspaces are being used by Australian communities. The combination of community crowdsourced spatial data providing location-specific information on the green public open spaces used, in combination with the national spatial layer of greenspace allows for unique analyses exploring the role of greenspace provision and design on use and represents a transformative strategy in shaping public open space policy and strategy.•A spatial layer of public open greenspace was created for the eight Australian State and Territory capital cities using a standardised data capture and collection method from local government planning schemes and land use data, and listings of managed and demarcated parks and reserves.•The Park Life public participatory geographic information system (PPGIS) was built to capture spatially referenced information on the use of greenspaces - specifically what spaces are used, and how they are used.

A novel tool using social and environmental determinants of health to assess pediatric asthma in the emergency department.

Asthma, the most common chronic disease in children, affects more than 4 million children in the United States, disproportionately affecting those who are economically disadvantaged and racial and ethnic minorities. Studies have shown that the racial and ethnic disparities in asthma outcomes can be largely explained by environmental, socioeconomic and other social determinants of health (SDoH). Utilizing new approaches to stratify disease severity and risk, which focus on the underlying SDoH that lead to asthma disparity, provides an opportunity to disentangle race and ethnicity from its confounding social determinants. In particular, with the growing use of geospatial information systems, geocoded data can enable researchers and clinicians to quantify social and environmental impacts of structural racism. When these data are systematically collected and tabulated, researchers, and ultimately clinicians at the bedside, can evaluate patients' neighborhood context and create targeted interventions toward those factors most associated with asthma morbidity. To do this, we have designed a view (mPage in the Cerner electronic health record) that centralizes key clinical information and displays it alongside SDoH variables shown to be linked to asthma incidence and severity. Once refined and validated, which is the next step in our project, our goal is for emergency medicine clinicians to use these data in real time while caring for patients with asthma. Our multidisciplinary, patient-centered approach that leverages modern informatics tools will create opportunities to better triage patients with asthma exacerbations, choose the best interventions, and target underlying determinants of disease.

How to Tell Whether Patients Engage and Use a Patient Portal - An Analysis of Five Functions.

BACKGROUND: The road to a more sustainable healthcare system includes creating a digital interface to the healthcare system that patients can use to engage in their health problems while outside the consultation room. The aim of the study was to evaluate trends in the use of functions in a patient portal and assess which functions were most likely to contribute to sustainable healthcare. STUDY DESIGN: Open, uncontrolled retrospective analysis of citizens' use of the patient portal. METHODS: Extraction and statistical analysis of log data. RESULTS: Log analysis revealed that patients engaged with the patient portal to make appointments, fill out and submit questionnaires, send messages to their care provider, inspect their laboratory results, and view notes about themselves. The functions that displayed a significantly increasing trend were the number of appointments made, the number of messages sent, and the number of checked test results. DISCUSSION: While portal engagement can reduce patient dependency on healthcare services, external factors also influence this outcome. Further research is needed to investigate which functions support healthcare sustainability and enhance patient empowerment, possibly through other study designs.

Toward Laboratory Notification in Pediatric Emergency Departments.

This study explores how patient's laboratory result are accessed in pediatric emergency departments. The rapid turnaround of laboratory results and their timely access by the medical team are crucial for effective patient management and care decision-making. This study revealed a systematic access prioritization to the Electronic Health Record, led by physicians, followed by nurses, and then other healthcare staff Despite efforts to streamline access through computerized laboratory results, optimized laboratory turnaround time and integration of final results into the electronic health record remain key challenges. Delays in accessing analysis results issued by the central hospital laboratory are consistently experienced across various laboratory types, indicating broader systemic workflow issues rather than inefficiencies specific to individual laboratories.

Proposal for a Patient Centered Health Information Framework for Clinical and Personal Data Movement.

This paper focuses on defining a framework to allow individual patients to track their own health related data. We propose a Patient Centered Information Framework (PCIF) allowing patient to manage their own data by using discharge letters. Discharge letters summarize information from a hospital stay, such as medical history, diagnoses, treatments and follow up, needed for continuity of care. It enables patients to share data with different organizations ensuring personal data protection, even when moving from different places and countries. A record of clinical management may thus be guaranteed when moving among different health structures as well as simplifying obtaining medications. We propose an approach to allow citizens to manage their health related data in a cross borders fashion. We compare the regulation of discharge letters among a sample of countries. We propose a management protocol for using a commonly adopted patient discharge letter framework within a PCIF.

Applying Large Language Models to Interpret Qualitative Interviews in Healthcare.

To address the persistent challenges in healthcare, it is crucial to incorporate firsthand experiences and perspectives from stakeholders such as patients and healthcare professionals. However, the current process of collecting, analyzing and interpreting qualitative data, such as interviews, is slow and labor-intensive. To expedite this process and enhance efficiency, automated approaches aim to extract meaningful themes and accelerate interpretation, but current approaches such as topic modeling reduce the richness of the raw data. Here, we evaluate whether Large Language Models can be used to support the semi-automated interpretation of qualitative interview data. We compare a novel approach based on LLMs to topic modeling approaches and to manually identified themes across two different qualitative interview datasets. This exploratory study finds that LLMs have the potential to support incorporating human perspectives more widely in the advancement of sustainable healthcare systems.

Pediatric Sedation Assessment and Management System (PSAMS) for Pediatric Sedation in China: Development and Implementation Report.

Background: Recently, the growing demand for pediatric sedation services outside the operating room has imposed a heavy burden on pediatric centers in China. There is an urgent need to develop a novel system for improved sedation services. Objective: This study aimed to develop and implement a computerized system, the Pediatric Sedation Assessment and Management System (PSAMS), to streamline pediatric sedation services at a major children's hospital in Southwest China. Methods: PSAMS was designed to reflect the actual workflow of pediatric sedation. It consists of 3 main components: server-hosted software; client applications on tablets and computers; and specialized devices like gun-type scanners, desktop label printers, and pulse oximeters. With the participation of a multidisciplinary team, PSAMS was developed and refined during its application in the sedation process. This study analyzed data from the first 2 years after the system's deployment. Unlabelled: From January 2020 to December 2021, a total of 127,325 sedations were performed on 85,281 patients using the PSAMS database. Besides basic variables imported from Hospital Information Systems (HIS), the PSAMS database currently contains 33 additional variables that capture comprehensive information from presedation assessment to postprocedural recovery. The recorded data from PSAMS indicates a one-time sedation success rate of 97.1% (50,752/52,282) in 2020 and 97.5% (73,184/75,043) in 2021. The observed adverse events rate was 3.5% (95% CI 3.4%-3.7%) in 2020 and 2.8% (95% CI 2.7%-2.9%) in 2021. Conclusions: PSAMS streamlined the entire sedation workflow, reduced the burden of data collection, and laid a foundation for future cooperation of multiple pediatric health care centers.

An integration of expectation confirmation model and information systems success model to explore the factors affecting the continuous intention to utilise virtual classrooms.

Virtual classrooms have recently gained significant consideration in educational institutes and universities due to their potential to encourage and support students' learning activities. Although recent research has focused extensively on online learning, virtual classrooms and the factors affecting their continuous use have garnered little attention, especially in Arab Gulf countries such as Saudi Arabia. Thus, this study integrates the expectation confirmation model and the information systems success model to assess the factors affecting students' continuous intention to utilise virtual classrooms in higher education. We examined the effects of information quality, service quality, system quality, confirmation, perceived usefulness, and satisfaction on the continuous intention to utilise virtual classrooms. Data were collected from 441 students and analysed using structural equation modelling "SEM". SEM is a powerful multivariate approach used increasingly in empirical investigation for evaluating and testing casual relationships. The results revealed that the proposed model demonstrated high explanatory power in explaining students' continuous intention to utilise virtual classrooms (R2 = 0. 86). Additionally, information quality had a significant effect on confirmation and an insignificant effect on perceived usefulness. System quality affected perceived usefulness and confirmation. Contrary to our expectations, service quality had a significant negative effect on perceived usefulness and confirmation. Additionally, perceived usefulness and confirmation affected students' satisfaction with using virtual classrooms, and satisfaction affected students' continuous intention to utilise virtual classrooms. This study contributes to the literature by offering a holistic integrated model that increases the understanding of the factors influencing students' continuous intention to utilise virtual classrooms, hence aiding in increasing their utilisation. Furthermore, it provides practical implications for enhancing students' continuous intention to utilise virtual classrooms. Virtual classroom developers must focus on improving the system quality of virtual classrooms. According to our results, higher system quality led the students to perceive virtual classrooms as useful and confirmed their favourable experiences with virtual classrooms. Additionally, providing students with high information quality in virtual classrooms would enhance their confirmation experiences, leading to the continuous intention to utilise virtual classrooms.

Assessing the Environmental Impacts, Condition and Sustainability of Mountain Biking Trails in an Urban National Park.

Mountain biking is a popular recreational activity in natural areas, with thousands of formal trails designed, constructed and maintained by land managers. Increasingly, there are also rising numbers of informal trails created by riders. A challenge for land managers is identifying, assessing, and then mitigating environmental impacts created by trails, including in protected areas. Here we assessed mountain biking trails in a large, popular national park on the Gold Coast, Australia, addressing the currently limited research comparing the extent, environmental impacts, condition and sustainability of these trails. Impacts from the 31.4 km of formal and 33.7 km of informal trails through the forests in Nerang National Park (1659 ha) included soil erosion (16.48 m3) and loss of vegetation along and adjacent to the trails (90,955 m2). Formal trails were six times more popular and wider on average (1.1 m vs 0.7 m) than informal trails, but less incised than informal trails (4.6 cm deep vs 6.3 cm). Generalised Linear Models showed that Trail Grade, slope and alignment best-predicted trail condition, highlighting the importance of good trail design in minimising trail impacts. It is recommended most of the informal trails are closed and rehabilitated, as they were not well-designed, increase fragmentation and have environmental impacts, with some traversing ecologically sensitive areas. In addition, some formal trails need to be upgraded to deal with erosion and other impacts. More broadly, the increasing demand for mountain biking must be addressed, including exploring opportunities to promote areas outside of national parks while minimising environmental impacts and other challenges associated with the creation and use of informal mountain bike trails in protected areas.

Severity of illness and risk of mortality from all patient refined-diagnosis related groups: Two scales of different concepts or two sides of the same coin?

All patient refined-diagnosis related groups (APR-DRGs) includes severity of illness (SOI) and risk of mortality (ROM) subclasses. For predictions, both subscales are used together or interchangeably. We aimed to compare SOI and ROM by evaluating the reliability and agreement between both. We performed a retrospective observational study using mainland Portuguese public hospitalisations of adult patients from 2011 to 2016. Reliability (quadratic weighted kappa) and agreement (proportion of agreement) between SOI and ROM were analysed overall and by APR-DRG. While overall reliability and agreement between SOI and ROM were high (weighted kappa: 0.717, 95% CI 0.717-0.718; proportion of agreement: 69.0%, 95% CI 69.0-69.0) there was high heterogeneity across APR-DRGs, ranging from 0.016 to 0.846 on reliability and from 23.1% to 94.8% on agreement. Most of APR-DRGs (263 out of 284) showed a higher proportion of episodes with ROM level above the SOI level than the opposite. In conclusion, SOI and Risk of Mortality measures must be clearly distinguished and are 'two scales of different concepts' rather than 'two sides of the same coin'. However, this is more evident for some APR-DRGs than for others.

Predicted distribution of Metaparasitylenchus hypothenemi (Tylenchida: Allantonematidae), parasite of the coffee berry borer.

Metaparasitylenchus hypothenemi is an endoparasitic nematode of the coffee berry borer Hypothenemus hampei. The nematode has only been recorded across a limited geographical range in coffee-growing areas of southeastern Mexico. Because of its confined geographical distribution, the effect of altitude, temperature, and mean annual precipitation on M. hypothenemi's presence/absence in the Soconusco region of Mexico was investigated. The geographical distribution of this parasite was predicted based on current data, using geographical information systems (GIS), the MaxEnt algorithm, and historical data to improve the prediction accuracy for other Neotropical regions. In Soconusco, the presence of this parasite is directly related to annual precipitation, especially in the areas with the highest annual rainfall (4000 - 4700 mm/year). Four species distribution models were generated for the Neotropical region with environmental variables for sites with parasite presence data, predicting a range of possible distribution with a high probability of occurrence in southeastern Mexico and southwestern Guatemala and a low probability in areas of Central and South America. Characterization of the abiotic habitat conditions suitable for M. hypothenemi development allows us to predict its distribution in the Neotropics and contributes to our understanding of its ecological relationship with environmental variables.

Surgeon perspectives on preference cards and environmental stewardship.

BACKGROUND: Refinement of surgical preference cards may reduce waste from surgery. This study aimed to characterize surgeon perceptions and practices regarding preference card maintenance, identify barriers to updating preference cards, and explore whether opinions on environmental stewardship relate to preference card maintenance. METHODS: This was a mixed methods survey performed at a single tertiary academic medical center. Surgeons completed questions on accuracy, frequency of updates, and perceived environmental impact of their preference cards. Responses were compared between early career and mid-to late-career surgeons using Kruskal-Wallis, chi-squared, and Fisher's exact tests. RESULTS: The response rate was 46.4% (n = 89/192). Among respondents, 46.1% (n = 41/89) rarely or never updated preference cards. Nearly all (98.9%, n = 87/88) said some of their cases had unused items on their cards. Most (87.6%, n = 78/89) made updates via verbal requests. Unfamiliar processes (83.7%, n = 72/86) and effort required (64.0%, n = 55/86) were viewed as barriers to card maintenance. Most agreed that more frequent updates would reduce waste (80.5%, n = 70/87), but respondents did not feel knowledgeable about the environmental impact of items on their cards (62.1%, n = 54/87). Mid-to late-career surgeons were less likely to update their cards annually or more often compared to early career surgeons (18.9%, n = 7/37 vs. 57.1%, n = 24/42, p < 0.001). No other responses varied significantly between early career and mid-to late-career surgeons. CONCLUSIONS: Surgeons acknowledged the utility of preference card maintenance in environmental stewardship, but unfamiliar systems and perceived effort hindered preference card review. Greater attention to preference card maintenance would promote environmentally sustainable practices in surgery.

Benefits and challenges of geographic information systems (GIS) for data-driven outreach in black communities experiencing overdose disparities: results of a stakeholder focus group.

BACKGROUND: Black individuals in the U.S. face increasing racial disparities in drug overdose related to social determinants of health, including place-based features. Mobile outreach efforts work to mitigate social determinants by servicing geographic areas with low drug treatment and overdose prevention access but are often limited by convenience-based targets. Geographic information systems (GIS) are often used to characterize and visualize the overdose crisis and could be translated to community to guide mobile outreach services. The current study examines the initial acceptability and appropriateness of GIS to facilitate data-driven outreach for reducing overdose inequities facing Black individuals. METHODS: We convened a focus group of stakeholders (N = 8) in leadership roles at organizations conducting mobile outreach in predominantly Black neighborhoods of St. Louis, MO. Organizations represented provided adult mental health and substance use treatment or harm reduction services. Participants were prompted to discuss current outreach strategies and provided feedback on preliminary GIS-derived maps displaying regional overdose epidemiology. A reflexive approach to thematic analysis was used to extract themes. RESULTS: Four themes were identified that contextualize the acceptability and utility of an overdose visualization tool to mobile service providers in Black communities. They were: 1) importance of considering broader community context; 2) potential for awareness, engagement, and community collaboration; 3) ensuring data relevance to the affected community; and 4) data manipulation and validity concerns. CONCLUSIONS: There are several perceived benefits of using GIS to map overdose among mobile providers serving Black communities that are overburdened by the overdose crisis but under resourced. Perceived potential benefits included informing location-based targets for services as well as improving awareness of the overdose crisis and facilitating collaboration, advocacy, and resource allocation. However, as GIS-enabled visualization of drug overdose grows in science, public health, and community settings, stakeholders must consider concerns undermining community trust and benefits, particularly for Black communities facing historical inequities and ongoing disparities.

Spatial dependence of non-traumatic out-of-hospital cardiac arrest in a Swiss region: A retrospective analysis.

Background: Out-of-hospital cardiac arrest (OHCA) incidence and survival often vary within regions according to patient-related and contextual factors. This study aims to establish the overall spatial dependence of incidence, bystander cardiopulmonary resuscitation (BCPR) and 48-h survival of OHCA with their associated demographic and socioeconomic characteristics in a Swiss region. Methods: We conducted a retrospective study using data of all OHCAs recorded between 2007 and 2019 in the canton of Vaud and, more specifically, in the Lausanne area. Provision of BCPR and 48-h survival were analysed using Getis-Ord Gi statistics and OHCA incidence by local Moran's I with empirical Bayes standardised rates. Demographic and socioeconomic characteristics were compared between incidence clusters generated by local Moran's I method. Results: Significant spatial variations of OHCA incidence, BCPR and 48-h mortality were observed. Although BCPR was statistically more likely in rural areas, 48-h survival was improved in a few main cities. At the cantonal level, postcode areas with a higher incidence of OHCAs were less densely inhabited with lower salary levels, more Swiss citizens, and an older population. At city level, small area variations were detected within urban neighbourhoods. The more affected hectares with more OHCAs were less inhabited, with a better median salary, more Swiss citizens, and off-centre. Conclusions: Spatial variations associated with demographic and socioeconomic factors were observed for OHCA incidence and survival, with sparsely populated areas particularly at risk. These data suggest an unmet need for targeted prevention interventions and structural modifications of the existing prehospital system at the cantonal level.

Enhancing Patient Understanding of Laboratory Test Results: Systematic Review of Presentation Formats and Their Impact on Perception, Decision, Action, and Memory.

BACKGROUND: Direct access of patients to their web-based patient portal, including laboratory test results, has become increasingly common. Numeric laboratory results can be challenging to interpret for patients, which may lead to anxiety, confusion, and unnecessary doctor consultations. Laboratory results can be presented in different formats, but there is limited evidence regarding how these presentation formats impact patients' processing of the information. OBJECTIVE: This study aims to synthesize the evidence on effective formats for presenting numeric laboratory test results with a focus on outcomes related to patients' information processing, including affective perception, perceived magnitude, cognitive perception, perception of communication, decision, action, and memory. METHODS: The search was conducted in 3 databases (PubMed, Web of Science, and Embase) from inception until May 31, 2023. We included quantitative, qualitative, and mixed methods articles describing or comparing formats for presenting diagnostic laboratory test results to patients. Two reviewers independently extracted and synthesized the characteristics of the articles and presentation formats used. The quality of the included articles was assessed by 2 independent reviewers using the Mixed Methods Appraisal Tool. RESULTS: A total of 18 studies were included, which were heterogeneous in terms of study design and primary outcomes used. The quality of the articles ranged from poor to excellent. Most studies (n=16, 89%) used mock test results. The most frequently used presentation formats were numerical values with reference ranges (n=12), horizontal line bars with colored blocks (n=12), or a combination of horizontal line bars with numerical values (n=8). All studies examined perception as an outcome, while action and memory were studied in 1 and 3 articles, respectively. In general, participants' satisfaction and usability were the highest when test results were presented using horizontal line bars with colored blocks. Adding reference ranges or personalized information (eg, goal ranges) further increased participants' perception. Additionally, horizontal line bars significantly decreased participants' tendency to search for information or to contact their physician, compared with numerical values with reference ranges. CONCLUSIONS: In this review, we synthesized available evidence on effective presentation formats for laboratory test results. The use of horizontal line bars with reference ranges or personalized goal ranges increased participants' cognitive perception and perception of communication while decreasing participants' tendency to contact their physicians. Action and memory were less frequently studied, so no conclusion could be drawn about a single preferred format regarding these outcomes. Therefore, the use of horizontal line bars with reference ranges or personalized goal ranges is recommended to enhance patients' information processing of laboratory test results. Further research should focus on real-life settings and diverse presentation formats in combination with outcomes related to patients' information processing.

Relationship Between Primary Care Physician Capacity and Usual Source of Care.

BACKGROUND: The NASEM Primary Care Report and Primary Care scorecard highlighted the importance of primary care physician (PCP) capacity and having a usual source of care (USC). However, research has found that PCP capacity and USC do not always correlate. This exploratory study compares geographic patterns and the characteristics of counties with similar rates of PCP capacity but varying rates of USC. METHODS: Our county-level, cross-sectional approach includes estimates from the Robert Graham Center and data from the Robert Wood Johnson County Health Rankings (CHR). We utilized conditional mapping methods to first identify US counties with the highest rates of social deprivation (SDI). Next, counties were stratified based on primary care physician (PCP) capacity and usual source of care (USC) terciles, allowing us to identify 4 types of counties: (1) High-Low (high PCP capacity, low USC); (2) High-High (high PCP capacity, high USC); (3) Low-High (low PCP capacity, high USC); and (4) Low-Low (low PCP capacity, low USC). We use t test to explore differences in the characteristics of counties with similar rates of primary care capacity. RESULTS: The results show clear geographic patterns: High-High counties are located primarily in the northern and northeastern US; High-Low counties are located primarily in the southwestern and southern US. Low-High counties are concentrated in the Appalachian and Great Lakes regions; Low-Low counties are concentrated in the southeastern US and Texas. Descriptive results reveal that rates of racial and ethnic minorities, the uninsured, and social deprivation are highest in counties with low rates of USC for both high PCP and low PCP areas. CONCLUSIONS: Recognizing PCP shortages and improving rates of USC are key strategies for increasing access to high-quality, primary care. Targeting strategies by geographic region will allow for tailored models to improve access to and continuity of primary care. For example, we found that many of the counties with the lowest rates of USC are found in non-Medicaid expansion states (Texas, Georgia, and Florida) with high rates of uninsured populations, suggesting that expanding Medicaid and improving access to health insurance are key strategies for increasing USC in these states.

Distributed management of patient data-sharing informed consents for clinical research.

BACKGROUND: The consent protocol is now a critical part in the overall orchestration of clinical research. We aimed to demonstrate the feasibility of an Ethereum-based informed consent system, which includes an immutable and automated channel of consent matching, to simultaneously assure patient privacy and increase the efficiency of researchers' data access. METHOD: We simulated a multi-site scenario, each assigned 10000 consent records. A consent record contained one patient's data-sharing preference with regards to seven data categories. We developed a blockchain-based infrastructure with a smart contract to record consents on-chain, and to query consenting patients corresponding to specific criteria. We measured our system's recording efficiency against a baseline design and verified accuracy by testing an exhaustive list of possible queries. RESULTS: Our method achieved ∼3-4% lead with an average insertion speed of ∼2 s per record per node on either a 3-, 4- or 5-node network, and 100 % accuracy. It also outperformed other solutions in external validation. DISCUSSION: The speed we achieved is reasonable in a real-world system under the realistic assumption that patients may not change their minds too frequently, with the added benefit of immutability. Furthermore, the per-insertion time did improve slightly as the number of network nodes increased, attesting to the benefit of node parallelism as it suggests no attrition of insertion efficiency due to scale of nodes. CONCLUSIONS: Our work confirms the technical feasibility of a blockchain-based consent mechanism, assuring patients with an immutable audit trail, and providing researchers with an efficient way to reach their cohorts.

Using Spatial Scan Statistics and Geographic Information Systems to Detect Monthly Human Mobility Clusters and Analyze Cluster Area Characteristics.

Introduction: This study evaluated the detection of monthly human mobility clusters and characteristics of cluster areas before the coronavirus disease 2019 (COVID-19) outbreak using spatial epidemiological methods, namely, spatial scan statistics and geographic information systems (GIS). Methods: The research area covers approximately 10.3 km2, with a population of about 350,000 people. Analysis was conducted using open data, with the exception of one dataset. Human mobility and population data were used on a 1-km mesh scale, and business location data were used to examine the area characteristics. Data from January to December 2019 were utilized to detect human mobility clusters before the COVID-19 pandemic. Spatial scan statistics were performed using SaTScan to calculate relative risk (RR). The detected clusters and other data were visualized in QGIS to explore the features of the cluster areas. Results: Spatial scan statistics identified 33 clusters. The detailed analysis focused on clusters with an RR exceeding 1.5. Meshes with an RR over 1.5 included one with clusters for 1 year which is identified in all months of the year, one with clusters for 9 months, three with clusters for 6 months, three with clusters for 3 months, and four with clusters for 1 month. September had the highest number of clusters (eight), followed by April and November (seven each). The remaining months had five or six clusters. Characteristically, the cluster areas included the vicinity of railway stations, densely populated business areas, ball game fields, and large-scale construction sites. Conclusions: Statistical analysis of human mobility clusters using open data and open-source tools is crucial for the advancement of evidence-based policymaking based on scientific facts, not only for novel infectious diseases but also for existing ones, such as influenza.

Machine learning modelling for predicting the utilization of invasive and non-invasive ventilation throughout the ICU duration.

The goal of this work is to develop a Machine Learning model to predict the need for both invasive and non-invasive mechanical ventilation in intensive care unit (ICU) patients. Using the Philips eICU Research Institute (ERI) database, 2.6 million ICU patient data from 2010 to 2019 were analyzed. This data was randomly split into training (63%), validation (27%), and test (10%) sets. Additionally, an external test set from a single hospital from the ERI database was employed to assess the model's generalizability. Model performance was determined by comparing the model probability predictions with the actual incidence of ventilation use, either invasive or non-invasive. The model demonstrated a prediction performance with an AUC of 0.921 for overall ventilation, 0.937 for invasive, and 0.827 for non-invasive. Factors such as high Glasgow Coma Scores, younger age, lower BMI, and lower PaCO2 were highlighted as indicators of a lower likelihood for the need for ventilation. The model can serve as a retrospective benchmarking tool for hospitals to assess ICU performance concerning mechanical ventilation necessity. It also enables analysis of ventilation strategy trends and risk-adjusted comparisons, with potential for future testing as a clinical decision tool for optimizing ICU ventilation management.

New directions for malaria vector control using geography and geospatial analysis.

As we strive towards the ambitious goal of malaria elimination, we must embrace integrated strategies and interventions. Like many diseases, malaria is heterogeneously distributed. This inherent spatial component means that geography and geospatial data is likely to have an important role in malaria control strategies. For instance, focussing interventions in areas where malaria risk is highest is likely to provide more cost-effective malaria control programmes. Equally, many malaria vector control strategies, particularly interventions like larval source management, would benefit from accurate maps of malaria vector habitats - sources of water that are used for malarial mosquito oviposition and larval development. In many landscapes, particularly in rural areas, the formation and persistence of these habitats is controlled by geographical factors, notably those related to hydrology. This is especially true for malaria vector species like Anopheles funestsus that show a preference for more permanent, often naturally occurring water sources like small rivers and spring-fed ponds. Previous work has embraced geographical concepts, techniques, and geospatial data for studying malaria risk and vector habitats. But there is much to be learnt if we are to fully exploit what the broader geographical discipline can offer in terms of operational malaria control, particularly in the face of a changing climate. This chapter outlines potential new directions related to several geographical concepts, data sources and analytical approaches, including terrain analysis, satellite imagery, drone technology and field-based observations. These directions are discussed within the context of designing new protocols and procedures that could be readily deployed within malaria control programmes, particularly those within sub-Saharan Africa, with a particular focus on experiences in the Kilombero Valley and the Zanzibar Archipelago, United Republic of Tanzania.