Despite increasing research efforts, there is a lack of consensus on defining aging or health. To understand the underlying processes, and to foster the development of targeted interventions towards increasing one’s health, there is an urgent need: (1) to find a broadly acceptable and useful definition of health, based on a list of features (which may or may not be molecular); (2) to operationalize features of health so that it can be measured; (3) to identify predictive biomarkers and (molecular) pathways of health, and (4) to suggest interventions, such as nutrition and exercise, targeted at putative causal pathways and processes. Based on a survey of the literature, we propose to define health as a state of an individual characterized by the core features of (a) physiological function, (b) cognitive function and (c) physical function, amended, specifically in case of humans, by (d) lack of disease, and by (e) reproductive function. Often used concepts such as lack of frailty, allostatic load, or self-reported health (in case of human), and indices such as the Healthy Aging Index can be viewed as projections or surrogates of our definition. We further define aging as the set of all processes in an individual that reduce its “wellbeing”, that is, its health or survival or both. We define biomarkers of health by their attribute of predicting future health better than chronological age. We define healthspan pathways as molecular features of health that relate to each other, specifically by belonging to the same molecular pathway. Our conceptual framework may integrate diverse operationalizations of health and guide precision prevention efforts that are a key to reducing the need for medical and nursing care.

English has become the world language, which on the one side is a blessing for international communication. On the other side, its dominance tends to make large parts of the world rely on only one language for academic work. This impoverishes the conceptual, expressive and epistemological richness available in all the other languages and makes believe that a translation can bring every concept from one language to another. My aim here is to discuss one concrete problem with a missing concept in English; dance and music as a unity. I will test epistemological arguments; why should we keep dance and music apart and why should we unite them under a new term. I then ask why we do not see concepts from other languages as a resource to improve academic terminology in English and other European languages.

(1) Background: Resilience has been presented as a potential protective factor to be promoted in difficult experiences in the elderly. However, further clarification of the concept of resilience is needed about this population, as this is of critical interest for nursing care. (2) Aim: To develop the concept of resilience in the elderly to establish the elements that refer to the nursing outcome Personal resilience (1309) from the Nursing Outcomes Classification (NOC), specifically in the elderly. (3) Methods: Concept analysis using Beth Rodgers' evolutionary model. The attributes, antecedents, consequents and empirical elements were described in the integrative review, with searches in PubMed, CINAHL, PsycINFO, LILACS and Embase databases. A total of 2431 citations have been identified and 110 studies were included. (4) Results: The concept of “resilience in the elderly” is composed of two attributes: available resources and positive behaviours and is defined as positive attitudes of older people with the assistance of resources available from experiences of adversity. Conclusion: This analysis and concept development of resilience in the elderly provided sensitive indicators for nursing care in the context of adversity, considering available resources and with positive attitudes during this phase of life span.

The nursing process in clinical practice can be assessed using standardized language systems. The purpose is to find evidence on the effectiveness of the nursing process with standardized terminology using NANDA International, Nursing Interventions Classification, and Nursing Outcome Classification improving diag-nostic accuracy, nursing interventions, health outcomes, and people’s satisfaction. A systematic review was carried out in Medline and PreMedline, Embase, The Cochrane Library, CINAHL, SCI-EXPANDED, SSCI and Scielo and LILACS including randomized clinical trials, quasi-experimental, cohort and case-control studies. Selection and critical appraisal were conducted by two independent reviewers. The certainty of the evidence was assessed with Grading of Recommendations Assessment, Development and Evaluation Methodology. 17 studies were included with variability in the level and certainty of evidence. According to outcomes, 6 evaluated improvements in diagnostic accuracy and 11 evaluated improvements in individual health outcomes. No studies evaluated improvements in intervention efficacy or population satisfaction. There is a need to increase studies with rigorous methodologies that address diagnostic accuracy and indi-viduals’ health outcomes using NANDA International, Nursing Interventions Classification, and Nursing Outcome Classification; as well as implementing studies that evaluate the use of these terminologies for improvements in the efficacy of nurses' interventions and population satisfaction with the nursing process.

Expressive clinical terminologies are of utmost importance for achieving an semantically interoperable data exchange and reuse in healthcare. SNOMED CT, widely respected as the most comprehensive terminology in medicine, provides formal concept definitions based on description logic which not only allows for advanced querying of SNOMED CT-coded data but also for flexibly augmenting its 350,000 concepts. This ability for postcoordination largely increases the expressivity of the terminology but correlates with an intrinsic complexity. Complicated by the current lack of tooling support, postcoordination is widely either ignored or applied in an error-prone way. To help facilitate the adoption of postcoordination, we implemented a web application that guides through the creation of Postcoordinated expressions (PCEs) while ensuring the adherence to syntactic and semantic constraints. Our approach was largely facilitated by making use of the extensive SNOMED CT specifications as well as advanced HL7 FHIR Terminology Services. Qualitative evaluations confirmed the usability of the developed application and the correctness of PCEs created with it.

(1) Background: The CEECCA questionnaire assesses the ability to communicate among individuals with aphasia. It was designed using the NANDA-I and NOC standardised nursing languages (SNLs), reaching high content validity index and representativeness index values. The questionnaire was pilot-tested, demonstrating its feasibility for use by nurses in any healthcare setting. This study aims to identify the psychometric properties of this instrument. (2) Methods: 47 individuals with aphasia recruited from primary and specialist care facilities. The instrument was tested for construct validity and criterion validity, reliability, internal consistency, and responsiveness. The NANDA-I and NOC SNLs and the Boston test were used for criterion validity testing. (3) Results: 5 language dimensions explain 78.6% of the total variance. Convergent criterion validity tests showed concordances of up to 94% (Cohen’s κ: 0.9; p<0.001) using the Boston test, concordances of up to 81% using DCs of NANDA-I diagnoses (Cohen’s κ: 0.6; p<0.001), and concordances of up to 96% (Cohen’s κ: 0.9; p<0.001) using NOC indicators. Internal consistency (Cronbach’s alpha) was 0.98. Reliability tests revealed test-retest concordances of 76%-100% (p<0,001). (4) Conclusions: The CEECCA is an easy-to-use, valid, reliable instrument to assess the ability to communicate among individuals with aphasia.

Health-related data originating from diverse sources are commonly stored in manifold databases and formats, making it difficult to find, access and gather data for research purposes. In addition, so-called secondary use scenarios for health data are usually hindered by local data codes, missing dictionaries and the lack of metadata and context descriptions. Following the FAIR principles (Findable, Accessible, Interoperable and Reusable), we developed a decentralized infrastructure to overcome these hurdles and enable collaborative research by making the meaning of health-related data understandable to both, humans and machines. This infrastructure is currently being implemented in the realm of the Swiss Personalized Health Network (SPHN), a research infrastructure initiative for enabling the use and exchange of health-related data for research in Switzerland. The SPHN ecosystem for FAIR data consists of the SPHN Dataset (semantic definitions), the SPHN RDF Schema (linkage and transport of the semantics in a machine-readable format), a project RDF template, extensive guidelines and conventions on how to generate SPHN RDF schema, a Terminology Service (converter of clinical terminologies in RDF), and a Quality Assurance Framework (automated data validation with SHACLs and SPARQLs). The SPHN ecosystem has been built in a way that it can easily be adapted and extended by any SPHN project to fit individual needs. By providing such a national ecosystem, SPHN supports researchers in generating, processing and sharing FAIR data.

This brief commentary challenges the use of the term "energy deficiency" in nutrition and metabolism, providing a critical examination of its scientific and philosophical aspects. It emphasizes the need to consider rare diseases associated with actual energy deficiency, which extend beyond the scope of everyday tiredness or fatigue. By analyzing energy balance and its complexities, this critique underscores the oversimplification associated with the term and its potential for misleading implications. It highlights the dynamic nature of energy metabolism and the intricate mechanisms involved in maintaining energy equilibrium, including the impact of rare genetic and physiological abnormalities. In addition to the discussion on energy balance, this commentary explores the manifestation of rare diseases that disrupt energy production, utilization, or hormonal regulation. Conditions such as mitochondrial diseases, glycogen storage diseases, adrenal insufficiency, and Prader-Willi syndrome are examined, shedding light on their profound impact on individuals' energy levels and overall health. The distinct time courses, underlying mechanisms, and clinical implications of protein deficiency, energy deficiency, and vitamin C deficiency are also compared, further emphasizing the complexity of energy metabolism and its relationship with various nutrient deficiencies. To foster a more comprehensive understanding of energy metabolism and enhance clarity in communication within the field, the commentary proposes the adoption of alternative terminology, such as "energy flux," to capture the multifaceted nature of energy balance more accurately. By reevaluating the terminology employed, researchers and healthcare professionals can better convey the intricate dynamics of energy metabolism and address the unique challenges faced by individuals with rare diseases causing actual energy deficiency. In conclusion, this commentary serves as a thought-provoking exploration of the concept of energy deficiency in nutrition and metabolism. It highlights the limitations of the term in capturing the complexities of energy balance, particularly in the context of rare diseases. By broadening the discussion to include these rare conditions, it encourages a more comprehensive understanding of energy metabolism and calls for precise and nuanced terminology to facilitate effective communication and advancements in the field.

Cross-institutional secondary use of medical data benefits from structured semantic annotation, which, ideally, enables matching and merging semantically related data items from different sources and sites. While numerous medical terminologies and ontologies, as well as some tooling, exist to support such annotation, cross-institutional data usage based on independently annotated datasets is challenging for multiple reasons: the annotation process is resource intensive and requires a combination of medical and technical expertise since it often requires judgment calls to resolve ambiguities resulting from non-uniqueness of potential mappings to various levels of ontological hierarchies and relational and representational systems. Divergent resolution of such ambiguities can inhibit joint cross-institutional data usage based on semantic annotation since data items with related content from different sites will not be identifiable based on their respective annotations if different choices were made without further steps such as ontological inference, which is still an active area of research. We hypothesize that a collaborative approach to semantic annotation of medical data can contribute to more resource efficient and high-quality annotation by utilizing prior annotational choices of others to inform the annotation process, thus both speeding up the annotation itself and fostering a consensus approach to resolving annotational ambiguities by enabling annotators to discover and follow pre-existing annotational choices. Therefore, we have implemented a prototypical Collaborative Annotation Tool (CoAT), evaluated its usability, and present first inter-institutional experiences with this novel approach to promoting practically relevant interoperability driven by use of standardized ontologies.

Feedback from the earthquake zone in Kahramanmaraş, Turkey has established that the emerging field of Crisis Translation and Interpreting (CTInt) requires a free smartphone application, to enable Crisis Translators and Interpreters (CTIs) to access multilingual terminology resources on-/offline when assisting Search and Rescue (SAR) teams responding to man-made and/or natural disasters.The aim is to design not only a multilingual compilation of Crisis Terminology (CTerm), downloadable to smartphones enabling access when there is a failure in the internet connection, but also a unified search tool which will browse and redirect the user to existing termbanks when the internet is accessible. Nevertheless, terminological records available in the domain of CTerm are inadequate and dispersed, with different interfaces and language combinations, requiring enhancement and harmonisation. Furthermore, automated translation and interpreting software/systems supported by the multilingual compilation of the crisis terminology portal (CTermPort) ideally need to be developed or, alternatively, existing ones integrated into the crisis termbank (CTermBank) collection for those who would lack the support of CTIs.The design of the CTermPort will significantly impact civil societies by providing a lifesaving tool for CTIs who need a reliable terminological reference point and automated translation options, and those unable to be assisted. In this respect, the project also promises strong prospects of sustainability past the project duration, as the tool to be developed will serve international SAR teams working closely with CInts during response times, but also medical staff in field hospitals collaborating with CTIs in rehabilitation and recovery phases, and beyond.

Statistical machine translation (SMT) which was the dominant paradigm in machine translation (MT) research for nearly three decades has recently been superseded by the end-to-end deep learning approaches to MT. Although deep neural models produce state-of-the-art results in many translation tasks, they are found to under-perform on resource-poor scenarios. Despite some success, none of the present-day benchmarks that have tried to overcome this problem can be regarded as a universal solution to the problem of translation of many low-resource languages. In this work, we investigate the performance of phrase-based SMT (PB-SMT) and NMT on two rarely-tested low-resource language-pairs, English-to-Tamil and Hindi-to-Tamil, taking a specialised data domain (software localisation) into consideration. This paper demonstrates our findings including the identification of several issues of the current neural approaches to low-resource domain-specific text translation and rankings of our MT systems via a social media platform-based human evaluation scheme.

In this paper we explore extending the concept of common cross-study Common Data Element concepts beyond simple demographics to cover disease-specific concepts relevant to imaging. We test interactively linking the resulting database to the associated images in a federated manner. We examine the use of existing standards, not only for terminology, but for interchange of serialized data in forms familiar to imaging and clinical trials specialists and their dedicated systems. Our intent is to perform preliminary work to inform both the upcoming Imaging Data Commons specifically, as well as more general integration projects beyond imaging.