European Open Research Articles

Updating Linked Data practices for FAIR Digital Object principles

Updating Linked Data practices for FAIR Digital Object principles

FAIR-IMPACT

In this poster we present the FAIR-IMPACT project, “Expanding FAIR solutions across EOSC”, which is funded by the European Commission Horizon Europe programme. The acronym FAIR stands for Findable, Accessible, Interoperable and Reusable. The project is coordinated by DANS and supported by 27 additional partners from 11 countries. FAIR-IMPACT will build on the successful practices, policies, tools and technical specifications arising from FAIRsFAIR other H2020 projects and initiatives, and from the FAIR and other relevant Working Groups of the former European Open Science Cloud (EOSC) Executive Board. The FAIR-IMPACT project is active between June 2022 and May 2025. Cascading grants will be available to support uptake of FAIR solutions and practices. The overall objective of FAIR-IMPACT is to realise a FAIR EOSC, that is an EOSC of FAIR data and services, by supporting the implementation of FAIR-enabling practices across scientific communities and research outputs at a European, national, and international level. Advancing findability, accessibility, interoperability and reusability (“FAIRness”) of data and other research objects are at the core of this project, which closely collaborates with the FAIRCORE4ESOC project (https://faircore4eosc.eu/ ). We will coordinate the implementation of frameworks and the alignment of FAIR data practices on metadata and persistent identifiers (PIDs) in order to achieve the wide uptake of and compliance with FAIR principles by national and European research data and metadata providers and repositories. In the poster we present our work on the implementation of the FAIR principles and practices. Among other things we aim at a coherent implementation of PIDs and more exact data citation, as services then are able to support better data quality with suitable PID solutions. A broader and more targeted use of PIDs, based on end-user needs, can support trust and risk management and requires collaboration among PID service providers and developing PID policies. Special attention will be paid to reproducibility and to sensitive data. As semantic artefacts are an important element in creating semantic interoperability, they are also regarded as digital objects with their own recommendations for FAIR implementation, as are software. Working together with the FAIRCORE4ESOC project, we can address things like kernel information profiles that are highly relevant for FAIR digital objects. The project will also focus on increasing data accessibility through enhancing interoperability on all levels, with specific steps taken to address recommendations outlined in the EOSC (The EOSC Interoperability Framework). Validation of core interoperability components through metadata mechanisms across scientific disciplines, fostering interoperability alignment with the nine European Data Spaces, and the DAMA framework (DAMA-DMBoK), i.e. the EOSC ecosystem, are of relevance. Metrics and FAIR assessment are also addressed in this project, that will extend and adapt the FAIRsFAIR data object assessment metrics and F-UJI tool to be more disciplinary-context aware and to include more discipline specific tests. The FAIR-IMPACT project will closely work with how the FAIR principles are implemented within the EOSC and how digital objects can be identified and managed.

Creating lightweight FAIR Digital Objects with RO-Crate

Creating lightweight FAIR Digital Objects with RO-Crate

Challenges of promoting open science within the NI4OS-Europe project in Hungary

National Initiatives for Open Science in Europe (NI4OS-Europe) is a Horizon 2020 project, one of whose objectives is to promote the European Open Science Cloud (EOSC) and open science in 15 Central and East European EU states and EU associated countries.
 This paper describes the variety of NI4OS-Europe promoting activities carried out in Hungary by the Governmental Agency for IT Development (KIFÜ). All these activities aim at different, and sometimes overlapping groups and involve: 
 ▸ publishing researcher interviews on research data management and open science practices for early career researchers;▸ open science news feed for open science practitioners;▸ publishing an e-learning course on EOSC and open science for graduate and PhD students;▸ testing research data management (RDM) tools for the Hungarian research community;▸ organising various events, including the Hungarian Open Science Forum targeting senior researchers and stakeholders;▸ an EOSC Champion programme at three major Hungarian universities. 
 Identifying good practices will give us the chance to find the best communication channels andmethods to promote open science and to manage expectations of funders, researchers, and librarians. 
 We will analyse audience diversity at six NI4OS events organised as part of the project. The anonymized dataset based on registration forms will be filtered by affiliation and profession. We will attempt to identify the main event features that mostly attract librarians or researchers. We will test the hypothesis that open science is generally more welcomed by research institutions’ librarians than, researchers, whose interests are more attached to funds and applications.
 We will also study usage data of open science news feeds. Having around 200 posts and 5000 visitors from May 2021 to April 2022 gives us the chance to learn more about the characteristics of the most visited, event-related posts, followed by posts related to national policies, which are visited more frequently than international ones.
 The paper will also argue that bottom-up and top-down approaches of promoting EOSC need to be used in a delicate balance to reach out to the widest audience possible.

Open Science in an open cloud

European Open Science Cloud (EOSC) is an European wide initiative that aims to develop a ‘Web of FAIR Data and Services’ for science in Europe that will provide researchers, students, companies and citizens with a federated and open multi-disciplinary environment where they can collaborate, share and reuse data, tools and services. EOSC Portal Catalogue and Marketplace is an entry point which improves the findability and accessibility of the scientific resources, their curation, support and training activities.In order to empower local stakeholders (researchers, policy makers, research performing organisations, etc.), NI4OS-Europe project (National Initiatives for Open Science in Europe) provides technical support for onboarding, i.e. making scientific web services compliant with the NI4OS/EOSC requirements and inclusion in catalogues. At the same time, as open science cloud initiatives emerge across the EU landscape, in the terms of infrastructure and policy development, it also supports building the Croatian Open Science Cloud (abbrev. locally HR-OOZ) Initiative. HR-OOZ is gathering prominent national institutions with an active role regarding open science covering all important stakeholder groups: research performing organisations (RPO), research funding organisations, research supporting organisations and policy makers. The Initiative aims to build a modern, high-quality, internationally relevant, and competitive science system based on the principles of open science, which is harmonised and connected with the European Research Area and relevant European initiatives. The Initiative has two main goals. The first goal is to set up the HR-OOZ which includes tasks of defining its organisational structure, defining the technological principles of services that will make the HR-OOZ, and ensuring its sustainability. The second goal of the Initiative is to draft the proposal of the National Action Plan for Open Science and propose changes to the law governing scientific activities.We will present the interconnections between national and European initiatives and how they complement each other as well as the proposed mechanisms for incentivizing and rewarding OS practices which are the vital components of the whole OS ecosystem.

The impact of pre-existing chronic heart failure on the intensive care treatment and outcome of old intensive care patients suffering from COVID-19

Abstract Background Patients suffering from COVID-19 with pre-existing chronic heart failure (CHF) are considered to have a significant risk regarding morbidity and mortality. Similarly, older patients on the intensive care unit (ICU) constitute another vulnerable subgroup. This study investigated the association between pre-existing CHF and clinical practice in critically ill older ICU patients with COVID-19. Methods Patients with severe COVID-19 and who were ≥70 years old were recruited from this prospective multicenter international study. Patients' treatment, follow-up, and pre-existing heart failure data were collected during ICU stay. Univariate and multivariate logistic regression analyses examined the association between pre-existing heart failure and the primary endpoint of 30-day mortality. Results The study included 3,917 patients, with 407 patients (17%) evidencing pre-existing CHF. These patients were older (77±5 versus 76±5, p<0.001) and more frail (Clinical Frailty Scale 4±2 versus 3±2, p<0.0001). The other comorbidities were also significantly more common in CHF patients. Before hospital admission, CHF patients suffered fewer days from symptoms (5 days (3–8) versus 7 days (4–10), p<0.001), but there was no difference in the days in the hospital before ICU admission (2 days (1–5) versus 2 (1–5) days, p=0.21). At ICU admission, disease severity assessed by SOFA scores was significantly higher in CHF patients (7±3 versus 5±3). During ICU-stay, intubation, mechanical ventilation, and tracheostomy occurred significantly more often in patients without CHF (63% versus 69%, p=0.017; and 13% versus 18%, p=0.002, respectively). In contrast, there was no difference regarding non-invasive ventilation (28% versus 27%, p=0.20), and the need for vasoactive drugs (66% versus 64, p=0.30). Regarding the limitation of life-sustaining therapy, therapy was significantly more often withheld (32% versus 25%, p=0.001) but not withdrawn (18% versus 17%, p=0.21) in CHF patients. Length of ICU stay was significantly shorter in CHF patients (166 (72–336) hours versus 260 hours (120–528), p<0.001). CHF patients had significantly higher ICU- (52% versus 46%, p=0.007), 30-day mortality (60% vs. 48%, p<0.001; OR 1.87, 95% CI 1.5–2.3) and 3-month mortality (69% vs. 56%, p<0.001). In the univariate regression analysis, having pre-existing CHF was significantly associated with 30-day mortality (OR 1.89, 95% CI 1.5–2.3; p<0.001), but after adjusting for confounders (SOFA, age, gender, frailty), heart failure was not independently associated any more (aOR 1.2, 95% CI 0.5–1.5; p=0.137). Conclusion In critically ill old COVID-19 patients, pre-existing chronic heart failure is associated with significantly increased short- and long-term mortality, but heart failure is not independently associated with increased 30-day mortality when adjusted for confounders. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): This study was endorsed by the ESICM. Free support for running the electronic database and was granted from the dep. of Epidemiology, University of Aarhus, Denmark. The support of the study in France by a grant from “Fondation Assistance Publique-Hôpitaux de Paris pour la recherche” is greatly appreciated. In Norway, the study was supported by a grant from the Health Region West. In addition, the study was supported by a grant from the European Open Science Cloud (EOSC). EOSCsecretariat.eu has received funding from the European Union's Horizon Programme call H2020-INFRAEOSC-05-2018-2019, grant agreement number 831644. This work was supported by the Forschungskommission of the Medical Faculty of the Heinrich-Heine-University Düsseldorf, No. 2018-32 to GW and No. 2020-21 to RRB for a Clinician Scientist Track.

About The Author

About The Author

Agenda Setting on FAIR Guidelines in the European Union and the Role of Expert Committees

Abstract The FAIR Guidelines were conceptualised and coined as guidelines for Findable, Accessible, Interoperable and Reusable (FAIR) data at a conference held at the Lorentz Centre in Leiden in 2014. A relatively short period of time after this conference, the FAIR Guidelines made it onto the public policy agenda of the European Union. Following the concept of Kingdon, policy entrepreneurs played a critical role in creating a policy window for this idea to reach the agenda by linking it to the policy of establishing a European Open Science Cloud (EOSC). Tracing the development from idea to policy, this study highlights the critical role that expert committees play in the European Union. The permeability of the complex governance structure is increased by these committees, which allow experts to link up with the institutions and use the committees to launch new ideas. The High Level Expert Groups on the EOSC provided the platform from which the FAIR Guidelines were launched, and this culminated in the adoption of the FAIR Guidelines as a requirement for all European-funded science. As a result, the FAIR Guidelines have become an obligatory part of data management in European-funded research in 2020 and are now followed by other funders worldwide.

Teaching resources for the European Open Platform for Prescribing Education (EurOP2E)—a nominal group technique study

The European Open Platform for Prescribing Education (EurOP2E) seeks to improve and harmonize European clinical pharmacology and therapeutics (CPT) education by facilitating international collaboration and sharing problem-based, online, open educational resources. The COVID-19 pandemic forced teachers to switch to virtual modalities, highlighting the need for high-quality online teaching materials. The goal of this study was to establish the online problem-based teaching resources needed to sustain prescribing education during the pandemic and thereafter. A nominal group technique study was conducted with prescribing teachers from 15 European countries. Results were analyzed through thematic analysis. In four meetings, 20 teachers from 15 countries proposed and ranked 35 teaching materials. According to the participants, the most necessary problem-based-online teaching materials related to three overarching themes. Related to learning outcomes for CPT, participants proposed creating prescription scenarios, including materials focusing on background knowledge and resources on personalized medicine and topical/ethical issues such as the prescription’s impact on planetary health. Second, related to teaching, they proposed online case discussions, gamification and decision support systems. Finally, in relation to faculty development, they recommend teacher courses, a repository of reusable exam questions and harmonized formularies. Future work will aim to collaboratively produce such materials.

Open Science for Better FAIRness: A biodiversity virtual research environment point of view

"FAIR (Findable, Accessible, Interoperable, Reusable) principles" (Wilkinson et al. 2016) and "open science" are two complementary movements in biodiversity science. Although we need to transition to making scientific data and associated material more FAIR, this does not necessarily imply open data or open source algorithms. Here, based on the experience of the French Biodiversity Data Hub ("Pôle national de données de Biodiversité" - PNDB), which is an e-infrastructure for and by researchers, we want to showcase how focusing on openness can be a strategy to efficiently reach greater FAIRness. Following DataOne guidance, we can build a complete data/metadata ecosystem allowing us to structure heterogeneous environmental information systems. Using the Galaxy analysis platform and its related initiatives (Galaxy training network, European Erasmus+ Gallantries project, bioconda, bioContainer), we can thus illustrate how we can create transparent, peer-reviewed and accessible tools and workflows and collaborative training material. The Galaxy platform also facilitates use of high performance computing infrastructure through notably the European Open Science Cloud marketplace. Finally, through our experiences contributing to open source projects like EML (Ecological Metadata Language (Michener et al. 1997)) Assembly Line, EDI (Environmental Data Initiative, or PAMPA (Indicators of Marine Protected Areas performance for managing coastal ecosystems, resources and their uses), a French platform to help protected areas managers to standardize and analyse their data, we also show how building open source "doors" through the R Shiny programming language to these environments can be beneficial for all.

Knowledge Access through Libraries in the United Digital Market

The European Open Science Cloud and the strategy for unified digital market are corner stones in the way of Europe's economy, industry, and society to the new digital era. In this paper, we will analyze how digital libraries can be best utilized for knowledge access and sharing in the new digital market.

A Critical Reassessment: The European Cloud University Platform and New Challenges of the Quartet Helix Collaboration in the European University System

The European Commission has presented how it intends to give Europe a lead in the data-driven economy by enabling cloud-based services and world-class infrastructures for industry, scientists, and public services. In 2011 we discussed and proposed the cloud university platform for the European Union in the European Integration Studies. The purpose of the study is to deliver a critical reassessment of the European Cloud University Platform. Today a new European Open Science Cloud (EOSC) will offer Europe's 1.7 million researchers and 70 million science and technology professionals a virtual environment to store, share and re-use the large volumes of information generated by the big data revolution. The EOSC will be underpinned by the European Data Infrastructure, deploying the high-bandwidth networks and super-computer capacity necessary to effectively access and process large datasets stored in the cloud. There is also a target to build a single market for the Internet of Things: with the right standards for interoperability, and open cross-sector platforms for IoT devices and services to connect seamlessly, and scale-up, up anywhere in the EU. Our assessment is focused on the European Open Science Cloud (EOSC) and its operational functioning and implementation process. The study is based on conventional assessment methods and tools. The methodology is a mostly mixed methodology (with both qualitative and quantitative data analytics) and it pays attention to argumentation logic and actual policy planning process and operational implementation of the EOSC. The role of Research Infrastructures (RIs), as well as cross-border innovation management approach are emphasized in recent transnational European research and innovation policy. Support for RIs form important pillars in the Horizon 2020-framework, as well as in the Horizon Europe-framework based on the idea that modern science requires unique global competitive capabilities, which individual institutions, or even individual European countries, often cannot provide by themselves. There are very good reasons to perform a critical assessment, because according to the European Cloud Initiative, over the coming 5 years, the European Commission will put forward proposals to meet the €4.7 billion investment need to integrate and consolidate data infrastructure. These vital proposals will bring together the EU and other sources, including Member States and private investments. By 2017, all scientific data produced by projects under the €77 billion within the Horizon 2020 research and innovation programme will become open by default to ensure that the scientific community can re-use the enormous amount of data they generate. This change is not marginal and needs more reflective discussions. The primary database of reassessment is the documents of the European Open Science Cloud (EOSC) and (1) associated European Commission work programme (overview of institution-wide deliverables), (2) the strategic plan (department strategy, objectives for 2016-2020) and (3) other EU management plans and scientific discussion associated with platform economy research. These EU documents were published after our original EIS article. The key results of critical reassessment are: (1) There are concrete needs to strengthen links between the European Open Science Cloud, Industry 4.0 strategy and Industry 4.0 Curriculum in Europe, (2) the concept of platform needs more discussion in the future developments of the European Open Science Cloud (EOSC), (3) country-level university and research community participation in the EOSC requires more discussion and more updated operational implementation plans and programs, and (4) there is need to plan symbiotic digitalized innovation eco-system policy and economic growth policy framework for the European Union. We summarise our critical reassessment with a critical note that there are big integration challenges of the European Open Science Cloud. Keywords: European Open Science Cloud, Big Data, Industry 4.0, Higher education, European integration, Digitalization, Platform economy, Open science policy, Open innovation paradigm, Collaboration framework of European universities, Data governance, Digital platforms, Data infrastructure, European data politics, Data policy

Invasiveness of Ventilation Therapy Is Associated to Prevalence of Secondary Bacterial and Fungal Infections in Critically Ill COVID-19 Patients.

Superinfections are a fundamental critical care problem, and their significance in severe COVID-19 cases needs to be determined. This study analyzed data from the Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS) cohort focusing on intensive care patients. A retrospective analysis of patient data from 840 cases of COVID-19 with critical courses demonstrated that co-infections were frequently present and were primarily of nosocomial origin. Furthermore, our analysis showed that invasive therapy procedures accompanied an increased risk for healthcare-associated infections. Non-ventilated ICU patients were rarely affected by secondary infections. The risk of infection, however, increased even when non-invasive ventilation was used. A further, significant increase in infection rates was seen with the use of invasive ventilation and even more so with extracorporeal membrane oxygenation (ECMO) therapy. The marked differences among ICU techniques used for the treatment of COVID-19-induced respiratory failure in terms of secondary infection risk profile should be taken into account for the optimal management of critically ill COVID-19 patients, as well as for adequate antimicrobial therapy.

FAIR Research Objects for realizing Open Science with RELIANCE EOSC project

FAIR Research Objects for realizing Open Science with RELIANCE EOSC project

Biodiversity Informatics: A success story for the long-term financial sustainability of the European Open Science Cloud (EOSC)

The European Open Science Cloud's (EOSC) ambition to provide European researchers, innovators, companies, and citizens with a federated and open multi-disciplinary environment where they can publish, find and reuse data, tools and services for research, innovation, and educational purposes. To enable this, EOSC promotes the use of the FAIR (Findable, Accessible, Interoperable and Re-usable) principles. The EOSC Sustainability Working Group under the EOSC Secretariat published the FAIR Lady Report (European Commission, Directorate-General for Research and Innovation, 2020), formulating recommendations for sustainability in the form of a Minimal Viable EOSC (MVE) including criteria for its sustainable implementation, formed by three essential components: EOSC Core, containing the minimum set of components necessary to provide researchers with the means to discover, share, access and reuse data and services; ESOC Exchange, a marketplace built on top of the EOSC Core to extend the set of public and private providers, and EOSC Data federation. EOSC Core, containing the minimum set of components necessary to provide researchers with the means to discover, share, access and reuse data and services; ESOC Exchange, a marketplace built on top of the EOSC Core to extend the set of public and private providers, and EOSC Data federation. The EOSC Association was established in July 2020 as the legal entity to govern EOSC. The Association appointed several Advisory Groups to provide recommendations towards the implementation of EOSC, including two Task Forces on Long Term Data Preservation and on the Financial Sustainability for Sustaining EOSC. This presentation will focus on the Financial Sustainability Task Force. The Task Force formed three "Working Streams" following the recommendation of the FAIR Lady Report to tackle the EOSC Core, Exchange, and Data Federation in smaller groups. Within the Data Federation Working Stream, the experts have identified many thematic data federations that have exisisted for quite some time, notably in environmental sciences, biodiversity, and social sciences. The case of Biodiversity Informatics is presented here as one of these sucess stories, retracing the history of major data federations such as GBIF (Global Biodiversity Information Facility), the CoL (Catalogue of Life), BHL (Biodiversity Hertiage Library) and how they managed to move from community-driven initiatitves to structurally funded research infrastructures supported by national and international governmental authorities with a long term perspective, leading to the establishment of infrastructures like the Distributed System of Scientific Collections (DiSSCo) and LifeWatch. This presentation will also address the essential contributions of associations like TDWG (Biodiversity Information Standards) and CETAF (Consortium of European Taxonomic Facilities) to achieving long-term sustainability and on how to successfully obtain complementary funds from EU projects in Horizon 2020 and its successor, Horizon Europe, with programs such as Synthesis of Systematic Resources (SYNTHESYS), DiSSCo Prepare, Biodiversity Community Integrated Knowledge Library (BiCiKL), and Transforming European Taxonomy through Training, Research, and Innovations (TETTRIs), to name a few.

Hospitalized patients dying with SARS-CoV-2 infection-An analysis of patient characteristics and management in ICU and general ward of the LEOSS registry.

COVID-19 is a severe disease with a high need for intensive care treatment and a high mortality rate in hospitalized patients. The objective of this study was to describe and compare the clinical characteristics and the management of patients dying with SARS-CoV-2 infection in the acute medical and intensive care setting. Descriptive analysis of dying patients enrolled in the Lean European Open Survey on SARS-CoV-2 Infected Patients (LEOSS), a non-interventional cohort study, between March 18 and November 18, 2020. Symptoms, comorbidities and management of patients, including palliative care involvement, were compared between general ward and intensive care unit (ICU) by univariate analysis. 580/4310 (13%) SARS-CoV-2 infected patients died. Among 580 patients 67% were treated on ICU and 33% on a general ward. The spectrum of comorbidities and symptoms was broad with more comorbidities (≥ four comorbidities: 52% versus 25%) and a higher age distribution (>65 years: 98% versus 70%) in patients on the general ward. 69% of patients were in an at least complicated phase at diagnosis of the SARS-CoV-2 infection with a higher proportion of patients in a critical phase or dying the day of diagnosis treated on ICU (36% versus 11%). While most patients admitted to ICU came from home (71%), patients treated on the general ward came likewise from home and nursing home (44% respectively) and were more frequently on palliative care before admission (29% versus 7%). A palliative care team was involved in dying patients in 15%. Personal contacts were limited but more often documented in patients treated on ICU (68% versus 47%). Patients dying with SARS-CoV-2 infection suffer from high symptom burden and often deteriorate early with a demand for ICU treatment. Therefor a demand for palliative care expertise with early involvement seems to exist.

Market Return Around the Clock: A Puzzle

AbstractWe study how the market return depends on the time of the day using E-mini S&P 500 futures actively traded around the clock. Strikingly, 4 hours around European open account for the entire average market return. This period’s returns have a 1.6 Sharpe ratio and remain high after transaction costs. Average returns are a noisy zero during the remaining 20 hours. High returns are consistent with European investors processing information accumulated overnight and thus resolving uncertainty. Indeed, uncertainty reflected by VIX futures prices rises overnight and falls around European open. The results are stronger during the 2020 COVID crisis.

Position paper on management of personal data in environment and health research in Europe.

Management of datasets that include health information and other sensitive personal information of European study participants has to be compliant with the General Data Protection Regulation (GDPR, Regulation (EU) 2016/679). Within scientific research, the widely subscribed'FAIR' data principles should apply, meaning that research data should be findable, accessible, interoperable and re-usable. Balancing the aim of open science driven FAIR data management with GDPR compliant personal data protection safeguards is now a common challenge for many research projects dealing with (sensitive) personal data. In December 2020 a workshop was held with representatives of several large EU research consortia and of the European Commission to reflect on how to apply the FAIR data principles for environment and health research (E&H). Several recent data intensive EU funded E&H research projects face this challenge and work intensively towards developing solutions to access, exchange, store, handle, share, process and use such sensitive personal data, with the aim to support European and transnational collaborations. As a result, several recommendations, opportunities and current limitations were formulated. New technical developments such as federated data management and analysis systems, machine learning together with advanced search software, harmonized ontologies and data quality standards should in principle facilitate the FAIRification of data. To address ethical, legal, political and financial obstacles to the wider re-use of data for research purposes, both specific expertise and underpinning infrastructure are needed. There is a need for the E&H research data to find their place in the European Open Science Cloud. Communities using health and population data, environmental data and other publicly available data have to interconnect and synergize. To maximize the use and re-use of environment and health data, a dedicated supporting European infrastructure effort, such as the EIRENE research infrastructure within the ESFRI roadmap 2021, is needed that would interact with existing infrastructures.

Prediction of Acute Kidney Injury in the Intensive Care Unit: Preliminary Findings in a European Open Access Database.

Acute kidney injury (AKI) is a common complication in critically ill patients and is associated with long-term complications and an increased mortality. This work presents preliminary findings from the first freely available European intensive care database released by Amsterdam UMC. A machine learning (ML) model was developed to predict AKI in the intensive care unit 12 hours before the actual event. Main features of the model included medications and hemodynamic parameters. Our models perform with an accuracy of 81.8% on moderate to severe AKI and 79.8% on all AKI patients. Those results can compete with models reported in the literature and introduce an ML model for AKI based on European patient data.

Obesity and Impaired Metabolic Health Increase Risk of COVID-19-Related Mortality in Young and Middle-Aged Adults to the Level Observed in Older People: The LEOSS Registry.

Advanced age, followed by male sex, by far poses the greatest risk for severe COVID-19. An unresolved question is the extent to which modifiable comorbidities increase the risk of COVID-19-related mortality among younger patients, in whom COVID-19-related hospitalization strongly increased in 2021. A total of 3,163 patients with SARS-COV-2 diagnosis in the Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS) cohort were studied. LEOSS is a European non-interventional multi-center cohort study established in March 2020 to investigate the epidemiology and clinical course of SARS-CoV-2 infection. Data from hospitalized patients and those who received ambulatory care, with a positive SARS-CoV-2 test, were included in the study. An additive effect of obesity, diabetes and hypertension on the risk of mortality was observed, which was particularly strong in young and middle-aged patients. Compared to young and middle-aged (18–55 years) patients without obesity, diabetes and hypertension (non-obese and metabolically healthy; n = 593), young and middle-aged adult patients with all three risk parameters (obese and metabolically unhealthy; n = 31) had a similar adjusted increased risk of mortality [OR 7.42 (95% CI 1.55–27.3)] as older (56–75 years) non-obese and metabolically healthy patients [n = 339; OR 8.21 (95% CI 4.10–18.3)]. Furthermore, increased CRP levels explained part of the elevated risk of COVID-19-related mortality with age, specifically in the absence of obesity and impaired metabolic health. In conclusion, the modifiable risk factors obesity, diabetes and hypertension increase the risk of COVID-19-related mortality in young and middle-aged patients to the level of risk observed in advanced age.