bluuebunny/crossref_metadata_2025 huggingface dataset:
Die interessante Technik – Koronare Translation mittels ventro-dorsaler Osteotomie und Korrekturspondylodese bei fixierter, koronarer und sagittaler Dysbalance
Authors: Hammer Alexander , Streikus Jonas , Zolotoverkh Oleksandr , Schnake Klaus John
Published: October 2023

Kombinierte koronare und sagittale Dysbalancen erfordern teils sehr aufwändige operative Lösungen mittels kombinierter Osteotomieformen und Zugängen unterschiedlicher Invasivität, oftmals einhergehend mit einer hohen Begleitmorbidität. Wir zeigen den Fall einer kombinierten koronaren und sagittalen Dysbalance einer bereits voroperierten 67-jährigen Patientin mit einer schweren translationalen Gefügestörung in Höhe LWK1/2, welche vor allem für die koronare Dysbalance verantwortlich war und die operative Hauptherausforderung darstellte. Gelöst wurde diese kombinierte Dysbalance mit translationaler Gefügestörung mittels einer mehrzeitigen dorso-ventralen Korrektur.

In erster operativer Sitzung erfolgte ein ALIF-Interponat LWK 4-SWK 1 und eine asymmetrische Osteotomie LWK 1/2. Danach wurde eine dorsale Implantatentfernung und Neuinstrumentierung von BWK 3 – S2-Ala-Ilium sowie Laminektomie LWK 1 durchgeführt. In der abschließenden Sitzung wurden eine Pedikelsubtraktion sowie eine manuelle Translation und Lordosierung in Höhe LWK 1/2 durchgeführt. Hierbei gelang die Korrektur mit Hilfe eines joystickartigen Systems mit einem Konstrukt aus Doppelkopfschrauben, zu Henkeln gebogenen Stäben und Stabfasszangen.

Die vorgestellte Technik kann zur Korrektur ausgeprägter koronarer Fehlstellungen in Betracht gezogen werden.
Single crystal synthesis, structure, and magnetism of Pb10−xCux(PO4)6O
Authors: Puphal P. , Akbar M. Y. P. , Hepting M. , Goering E. , Isobe M. , Nugroho A. A. , Keimer B.
Published: October 2023

The recent claim of superconductivity above room temperature in Pb10−xCux(PO4)6O with 0.9 < x < 1 (referred to as LK-99) has sparked considerable interest. To minimize the influence of structural defects and impurity phases on the physical properties, we have synthesized phase-pure single crystals with a copper doping level of x ∼ 1. We find that the crystals are highly insulating and optically transparent. X-ray analysis reveals an uneven distribution of the substituted Cu throughout the sample. Temperature (T) dependent magnetic susceptibility measurements for 2 ≤ T ≤ 800 K reveal the diamagnetic response characteristic of a non-magnetic insulator, as well as a small ferromagnetic component, possibly originating from frustrated exchange interactions in Cu-rich clusters in the Pb10−xCux(PO4)6O structure. No anomalies indicative of phase transitions are observed. We, therefore, rule out the presence of superconductivity in Pb9Cu(PO4)6O crystals and provide some considerations on the origin of anomalies previously reported in experiments on polycrystalline specimens.
Reflection by two level system: phase singularities on the Poincaré hypersphere
Authors: Lang Ben , Harbord Edmund , Oulton Ruth
Published: October 2023

We consider the reflection of a photon by a two-level system in a quasi-one-dimensional waveguide. The waveguide polarisation at the location of the two-level system and the transition dipole are key determinants of the physics, controlling of the phase and amplitude of the scattered light in both directions. In most cases full control is possible by tuning only one of these two degrees of freedom. In reverse, this enables unique characterisation of the dipole from measurements of the scattered light. Phase singularities occur where the reflection coefficient is zero, with the (hyper-)spherical parameter space determining the dynamics of these singularities.
THPLM: a sequence-based deep learning framework for protein stability changes prediction upon point variations using pretrained protein language model
Authors: Gong Jianting , Jiang Lili , Chen Yongbing , Zhang Yixiang , Li Xue , Ma Zhiqiang , Fu Zhiguo , He Fei , Sun Pingping , Ren Zilin , Tian Mingyao
Published: October 2023

Motivation

Quantitative determination of protein thermodynamic stability is a critical step in protein and drug design. Reliable prediction of protein stability changes caused by point variations contributes to developing-related fields. Over the past decades, dozens of structure-based and sequence-based methods have been proposed, showing good prediction performance. Despite the impressive progress, it is necessary to explore wild-type and variant protein representations to address the problem of how to represent the protein stability change in view of global sequence. With the development of structure prediction using learning-based methods, protein language models (PLMs) have shown accurate and high-quality predictions of protein structure. Because PLM captures the atomic-level structural information, it can help to understand how single-point variations cause functional changes.

Results

Here, we proposed THPLM, a sequence-based deep learning model for stability change prediction using Meta’s ESM-2. With ESM-2 and a simple convolutional neural network, THPLM achieved comparable or even better performance than most methods, including sequence-based and structure-based methods. Furthermore, the experimental results indicate that the PLM’s ability to generate representations of sequence can effectively improve the ability of protein function prediction.

Availability and implementation

The source code of THPLM and the testing data can be accessible through the following links: https://github.com/FPPGroup/THPLM.
Elderly male patients with hidradenitis suppurativa have more severe disease independent of disease duration
Authors: Nielsen Valdemar Wendelboe , Ring Hans Christian , Holgersen Nikolaj , Thomsen Simon Francis
Published: October 2023

The recent study by van der Weijden et al. proposed defining hidradenitis suppurativa (HS) in the elderly (> 60 years of age) as ‘HS tarda’. We verify and extend the findings by van der Weijden et al. by demonstrating that variation in HS severity is explained to an increasing extent by sex with increasing age, but is independent of overall disease duration, and that HS in the elderly shows significant variation in age of onset and body area involvement. This supports the idea that HS activity varies between different age groups, but the relationship remains more complex than a binary definition.
Simultaneous Determination of Thirteen Iridoid Glycosides in Crude and Processed Fructus Corni from Different Areas by UPLC–MS/MS Method
Authors: Zhang Fan , Yan Yu , Xu Jie-Kun , Zhang Lin-Mei , Li Li , Chen Xin , Li Dong-Xu , Peng Ying , Yang Hua , Li Ling-Zhi , He Jun , Zheng Jiang , Zhang Wei-Ku
Published: October 2023

Fructus Corni (F. Corni) is the dried mature pulp of Cornus officinalis Sieb. et Zucc.(Cornaceae), which is rich in iridoids. In this study, a simple, sensitive and rapid UPLC–MS/MS method was developed for the simultaneous determination of 13 iridoid glycosides of F. Corni from different areas. Specifically, we included five new compounds (cornusdiridoid C, cornusdiridoid E, cornusdiridoid F, 3′′,5′′-dehydroxycornuside and 2′-O-p-coumaroyl-kingiside) and isomers (2′-O-p-E-coumaroylloganin and 2′-O-p-Z-coumaroylloganin) for the first time in the quality markers of F. Corni. A total of 13 compounds and two pairs of isomers were well isolated and tested within just 14 min. All calibration curves showed good linear regression (r2 ≥ 0.99) within the tested concentration ranges. The limit of detection and limit of quantification were in the range of 0.19–1.90 and 0.38–3.76 ng/mL, respectively. The intra-day and inter-day precision were <3.21% and 12.49%, the RSD values of repeatability did not exceed 6.81% and the average recoveries were 90.95–113.59% for the analytes. All iridoid glycosides stabilized within 12 h (RSD < 10.99%). This method has been successfully applied to the quality evaluation of crude and processed F. Corni from different areas. The determination of characteristic iridoid glycosides and isomers will provide a more reliable and comprehensive method for the evaluation of F. Corni.
Absence of visible infarction on cardiac magnetic resonance imaging despite the established diagnosis of myocardial infarction by 4th Universal Definition of Myocardial Infarction
Authors: Salatzki Janek , Giannitsis Evangelos , Hegenbarth Anastasia , Mueller-Hennessen Matthias , André Florian , Frey Norbert , Biener Moritz
Published: October 2023

Aims

Myocardial scarring due to acute myocardial infarction (AMI) can be visualized by late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging. However, a recent study revealed a group of Type 1 AMI patients with undetectable myocardial injury on LGE. This study aims to describe these cases in detail and explore possible explanations for this new phenomenon.

Methods and results

A total of 137 patients diagnosed with either ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (non-STEMI) diagnosed according to the 4th Universal Definition of Myocardial Infarction underwent LGE-CMR after invasive coronary angiography. Fourteen of them (10.2%) showed no LGE and were included in the final study population. Most patients presented with acute chest pain, 3 patients were diagnosed as STEMI, and 11 as non-STEMI. Peak high-sensitive cardiac troponin T ranged from 45 to 1173 ng/L. A culprit lesion was identified in 12 patients. Severe coronary stenoses were found in five patients, while seven patients had subtotal to total coronary artery occlusion. Percutaneous coronary intervention was performed in 10 patients, while 2 patients required coronary artery bypass grafting and no intervention was required in 2 patients. Cardiac magnetic resonance was performed 30 (4–140) days after the initial presentation. Most patients showed preserved left ventricular ejection fraction on CMR. No alternative reasons for the rise/fall of high-sensitive cardiac troponin T were found.

Conclusion

The absence of LGE on CMR in patients with Type 1 AMI is a new finding. While insufficient spatial resolution of LGE imaging, delayed CMR performance, spontaneous reperfusion, and coronary collaterals may provide some explanations, further investigations are required to fully understand this phenomenon.
Austerity Harmed Student Achievement
Authors: Pavese Caterina , Rubolino Enrico
Published: October 2023

This paper shows that austerity spending cuts harmed student performance in standardised national tests. To identify this relationship, we use cross-municipality variation in the timing of eligibility for the Italian Domestic Stability Pact as an exogenous shifter of local public spending. We then compare test scores for students that were from the same municipality, but who were exposed to different levels of austerity cuts based on their birth year. Combining administrative data on public spending and test scores with an instrumental variable model, we show that the test score impact from austerity spending cuts is around 5.1% of a standard deviation in math and 4.6% in reading. These effects are more pronounced for children with limited resources at home. We provide suggestive evidence that school budget cuts account for most of the observed test score impact.
Building the future One Health workforce
Authors:   Organised by: ASPHER, EHMA
Published: October 2023

What are the skills required by new graduates seeking work in the public health and health care fields in the 21st century? Skills that will help them address the issues of global and planetary ill health, environmental degradation, increasing inequalities in health, disinformation, using the new tools of the digital revolution, new philosophies of care like ‘One Health’, and new ethical references. The plenary will seek to answer some of these questions using a mix of youth and experience, and hearing from work in progress defining the 21st century public health and healthcare skills our societies need. Lessons from the EHMA ‘BE-WELL’ programme and the ASPHER curriculum review.

Moderators:

Todorka Kostadinova, EHMA Board of Directors; Vice-Rector for International Cooperation, Accreditation and Quality, Medical University Varna, Bulgaria

Henrique Barros, Vice-President ASPHER

Keynote speakers:

Mary Codd, Associate Professor School of Public Health Physiotherapy and Sports Science, University College Dublin, Ireland

George Valiotis, Executive Director EHMA

Panellists:

Lucy Nugent, President European Association of Hospital Managers and Chief Executive of Tallaght University Hospital, Dublin, Ireland

Patrick Wall, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland

Monica Georgiana Brînzac, EUPHAnxt coordinator, Research Assistant, Department of Public Health, Babeş-Bolyai University, Cluj-Napoca, Romania

Milka Sokolović, Director General European Public Health Alliance

Victoria Stanford, Early career graduate of EHESP, Paris, France and Specialty Registrar in Public Health, Shropshire, UK
Vaccine hesitancy in Europe: the long and winding road
Authors: Cadeddu C
Published: October 2023

Vaccine hesitancy has always been a hot topic in the European public health discussions and the COVID-19 pandemic has increased its relevance for consequences not exclusively related to health. In this presentation, results of a recent analysis carried out on data from the last round of the European Social Survey will be shown, highlighting that the relationship of vaccine hesitancy with many socio-cultural elements, among which conspiracy theories and distrust towards scientific community. As for other public health topics, these considerations underline the need for a multidisciplinary and multistakeholder approach to vaccine hesitancy, particularly important for countries like Eastern Europe where hesitancy and conspiracy theories appear to be widespread. This approach would be able to explore and understand all the addressable factors to structure the right way of communicating and disseminating evidence, engaging the population of any sociocultural area, and reducing hesitancy by increasing trust in scientists and institutions, driving safely on this long and winding vaccination road.
Air pollution, mortality, and hospital admissions in Scotland: A 16 years register-based study
Authors: Abed Al Ahad M , Demšar U , Sullivan F , Kulu H
Published: October 2023

Background

Air pollution is associated with poor health and higher mortality. However, studies that link high spatial resolution air pollution data for several pollutants to individual-level data over prolonged period (>10 years) and assess multiple health outcomes are limited. In this study, we investigated the association between 16-years exposure to air pollution and all-cause and cause-specific (cardiovascular, respiratory, cancer, infectious, and mental/behavioural disorders) mortality and hospital admissions in Scotland.

Methods

Individual-level data from the “Scottish Longitudinal Study” for 202,237 individuals (2002-2017) were linked to yearly concentrations of NO2, SO2, PM10, and PM2.5 pollutants at 1-Km2 spatial resolution using the individual's residential postcode. The association between air pollution and mortality and hospital admissions was examined using Cox Proportional-Hazards and multilevel mixed-effects negative binomial models, respectively.

Results

Increasing concentrations of PM2.5, PM10, and NO2 pollutants were associated with higher rates of all-cause, cardiovascular, respiratory, cancer, and infectious mortality and hospital admissions. Mortality from respiratory diseases increased by 6.2% (95%CI=2.8%−9.6%), 2.5% (95%CI=0.5%−4.5%), and 1.2% (95%CI=0.5%−1.9%) per 1 µg/m3 increase in PM2.5, PM10 and NO2 pollutants, respectively. Exposure to SO2 was mainly linked to mental/behavioural disorders mortality (HR = 1.05; 95%CI=1.02-1.07) and respiratory hospital admissions (IRR=1.02; 95%CI=1.01-1.03).

Conclusions

This study revealed a positive association between air pollution and mortality and hospital admissions in Scotland. Interventions on air pollution through stricter environmental regulations could help ease the mortality and hospital admission burden, for both physical and mental illness.

Key messages

• Air pollution is associated with a higher risk of mortality and hospital admissions for both physical and mental health-related outcomes.

• Policymakers are urged to provide incentives for the usage of greener energy sources to reduce air pollution emissions.
1.I. Keeping health at the forefront: A debate on health priorities of the European Union
Authors:   Organised by: European Commission, European Observatory on Health Systems and Policies,   Chair person: Matthias Wismar (European Observatory)
Published: October 2023

The European Commission has launched a public debate on health priorities of the European Union in partnership with the European Observatory on Health Systems and Policies. Taking stock of achievements and current actions, this debate serves to gather different stakeholder perspectives and foster in-depth discussions on the way forward, while keeping health at the forefront of political agendas. This session will allow participants to dig deep into policy-relevant topics centred around tackling challenges such as climate change and ageing, as well as strengthening and promoting the sustainable transformation of health systems in the digital age. Expert opinions will inform the debate, followed by interactions with the audience allowing participants to share their perspectives. Inputs gathered during this session will feed directly into the European Commission's Conference plenary session held on Saturday. The ultimate aim of this public debate is to generate ideas, gather perspectives and to establish a meaningful dialogue that can support the European Union in carving out health priorities for the future.

Speakers/Panelists

Monica Brînzac

EUPHAnxt

Alessandro Berionni

Young WFPHA and Medical Resident in Public Health, San Raffaele University, Milan, Italy

Cristina Alina Modoran

DG Sante, European Commission, Brussels, Belgium

Matthias Wismar

European Observatory, Brussels, Belgium
1.K. Workshop: Health Promoting Sports Clubs: tackling intervention implementation and evaluation challenges
Authors:   Organised by: University of Limerick (Ireland), Katholieke Universiteit Leuven (Belgium),   Chair persons: Aurélie Van Hoye (Ireland), Jan Seghers (Belgium)
Published: October 2023

Settings have been defined as ‘the place or social context where people engage in daily activities in which environmental, organizational and personal factors interact to affect health and well-being’. Settings-based approaches have successfully been applied in different traditional settings, like schools, cities, and workplaces. During the last two decades, the health promoting sports clubs theoretical and empirical foundation has emerged to support sports clubs’ investment in health promotion beyond the provision of sport itself, leading to physical, social and mental benefits. Two recent literature reviews have showed limited evidence on validated health promotion measurement instrument and interventions, identifying only three interventions worldwide that have been rigorously evaluated. The present workshop will synthetises the mechanisms used in different health promoting sports clubs’ interventions, reflect on methods for intervention evaluation and offer guidelines for sports federation and clubs. The first presentation will set the scene by describing youth sports club's participation in Finland from 2016 to 2022, specifically providing insights on the determinants of sport drop out. The second presentation will offer a deep understanding of context and mechanisms leading to effectiveness, used in interventions to promote men's health in organised sport, using a rapid realist review methodology. The third presentation will complete the second by mapping provision and evaluation practice of interventions delivered by professional sports clubs in the UK, through a practice-based targeted review. The fourth presentation will showcase the type of evaluation needed to investigate health promoting sports club's intervention, drawing from a pragmatic feasibility trial conducted in Ireland. The fifth presentation will offer practical guidelines for national sports federation on how to implement health promoting sports clubs, through a toolkit which has been edited in collaboration with the World Health Organisation. Based on the different presentations, discussion will be engaged with Jan Seghers, who has conducted major work on implementing health promoting sports clubs in Flanders, as well as the speakers and the audience. We also plan to discuss the active mechanisms identified in the interventions and how to address challenges in conducting empirical research on health promoting sports clubs. Lastly, we will open the floor for reflections on intervention research conducted in other settings.

Key messages

• The workshop will synthetises evidence on health promoting sports club's intervention implementation and evaluation.

• The workshop will provide guidelines and recommendations for conducting and evaluating health promoting sports clubs’ interventions.
Health literacy practices in 3D social virtual world
Authors: McElhinney E
Published: October 2023

Background

Social Virtual Worlds (VWs), for example, Second Life are online 3D multiuser virtual environments (MUVE). Access by users or ‘residents’ of these environments is through the creation of a representation of themselves, known as an avatar. These social immersive environments have been used to present health information using interactive games, simulations, support groups and healthcare seminars. The use of these environments during COVID-19 increased especially in countries with strict lockdown rules. However, limited published studies have investigated the health literacy (HL) skills and practices undertaken by individuals or communities in virtual worlds. Therefore, this study aimed to advance understanding of the social skills and health literacy practices used by individuals and communities within this immersive ‘place’ and the influence on physical world health behaviour.

Methods

25 semi-structured interviews were conducted with participants within the virtual world Second Life.

Results

Findings demonstrated that participants used their social VW networks within the VW to search for, access, experience, appraise, understand, and make decisions to use health information. These social methods allowed reciprocal sharing of information, access to people within multiple VW groups who had different VW knowledge, skills, and health literacy practices. Additionally, this maximised the health literacy resources available, meaning improvements to individual or community HL.

Conclusions

An adapted framework of social skills and cultural literacy competencies used within VWs to improve individual and community HL be discussed and how this leads to distributed HL within the community. This framework is the first collection of social skills and adult HL used within VWs and make a unique contribution to ncreasing the understanding of the type of literacies used in social VWs to manage health information in online and offline communities.
The Future of HSR Program Evaluation: A European Perspective
Authors: Sirven N , Mousquès J
Published: October 2023

There is a long tradition of program evaluation in public health, due to the influence of medical approaches and the development of evidence-based medicine. Health services research have thus provided substantial evidence and built itself partially on the evaluation of organizational innovations over time in various international healthcare settings. What is new here? What is the future of HSR from an evaluation perspective? Since the turn of the century, two main shifts in the resources and methods available to public health researchers could provide a significant leap for HSR research in Europe, and in France especially. First, more data are being produced and made available to researchers. Most healthcare systems in Europe have implemented DRGs and for doing so, information systems have been developed incidentally. This led to the routine production of data initially used for payment schemes, that are now increasingly being used for research. Although this is similar to what happened in the US, the main difference with European healthcare systems lies in the generalized approach of the welfare system to the whole population. Second, evaluation methods recently evolved towards the framework of what is known as “realist evaluation” based on the causal analysis of programs or public policies while incorporating contextual effects and a theoretical perspective to explain rather than merely measure the effect - or lack thereof. To conclude, we shall argue that the future of HSR program evaluation may bring together researchers, health professionals and policymakers to discuss, explore, experiment and implement innovative actions in healthcare to address the challenges to come.
Uncovering gender bias in health services: the case of kidney transplantation
Authors: Komla Adoli L , Châtelet V , Daugas E , Vabret E , Jais J P , Bayer F , Vigneau C , Couchoud C , Bayat-Makoei S
Published: October 2023

Gender-based inequalities of access to health care are major public health issues. Studies performed in several countries and in some French regions showed that women had less access to kidney transplantation waiting list (KTWL) than men. Through a quantitative study based on REIN registry data, we analysed gender-based disparities in the access to KTWL in France. All incident patients who initiated dialysis from 2017 to 2019 and aged between 18 and 85 years old were included. Cox proportional hazard models, adjusted on age, comorbidities and neighbourhood deprivation level using European Deprivation Index (EDI), at national level and in all French regions, were performed. Among 29 395 patients who started dialysis in 2017-2019, 35% were women. 40% of women and 34% of men lived in most deprived areas. Men were more comorbid than women at dialysis start. At the national level, women had less access to the KTWL compared to men one and three years after dialysis start. Analyses were stratified by age (<60 and ≥ 60 years old). Only women aged more than 60 had less access to the KTWL one year (adjHR: 0.76 [0.71 - 0.82]) and three years (adjHR: 0.75 [0.71 - 0.81]) after dialysis start. At regional level, the same trends were found in Nouvelle Aquitaine and Pays de Loire one year after dialysis start and two more regions (Bourgogne-Franche-Comté and Île-de-France) 3 years after dialysis start. Gender-based disparities in KTWL persist even after controlling for EDI and comorbidities, especially among women over 60. These results are issued from a health service research project on gender-based disparities of access to KTWL in France. A qualitative study is ongoing to better understand the reasons of these disparities. Patients’ perspectives on Kidney transplantation and nephrologists’ practices are studied using Semi-structured interviews in three French regions.
What steps can improve and promote investment in the health and care workforce in Europe?
Authors: Williams G
Published: October 2023

Background

Recent experiences from Ireland and elsewhere have shown the urgent need for countries and international actors to prioritize investment in the health and care workforce (HCWF) and ensure funding is used well. This research, based on a European Observatory on Health Systems and Policies policy brief, explores: i) areas for strategic investments in the HCWF; and ii) how greater funding from domestic and international sources can be secured.

Methods

A scoping review of English-language peer reviewed and grey literature was conducted across databases and online repositories including PubMed, Scopus, Web of Science, Google Scholar, WHO data collections. The literature search focused on two areas: 1) areas for strategic investments in the organization, training, deployment and management of the HCWF; 2) actions that can help scale-up investment from domestic and international financing sources.

Findings

Strategic investments to effectively enhance the sustainability of the HCWF can be grouped into strategies that aim to: 1) increase the quantity, quality and diversity of available HCWs through education investments; 2) reskill and optimize use of the HCWF through investments in preventative and primary care, skill mix reforms and digital technologies; 3) improve employment and retention through labour market interventions and protecting, supporting and managing the HCWF. Ministries of Health must be able to share the measurable benefits of workforce development to secure greater investment, which requires: evidence on the socioeconomic benefits of HCWF investments; strong leadership and capacity; improved intersectoral governance processes; and more efficient and transparent health sector budget cycle processes.

Conclusions

Education, employment and retention of HCWs needs to be a priority in public expenditure to increase supply, protect the existing workforce and plan ahead to address future challenges.
Food, Nutritional Status and Health Literacy
Authors: Saboga-Nunes L , Medeiros M
Published: October 2023

Introduction

Azores is an autonomous region of Portugal situated in the middle of the Atlantic Ocean. As a catchment area of cultural identity, it can be an interesting setting to better understand Health Literacy (HL) personal & community development. Therefore developing ChildRen and ADolescents’ health Literacy (CrAdLiSa) become a local government strategy for all children and adolescents in the region. The aim of this study, is to explore the relationship between several components of adolescents living in Azores, like sustainable life style, focusing food, nutritional status, e.g. water intake (WI), and HL. With this situation diagnosis local authorities aim to develop policies towards HL increment while fighting health disparities.

Methods

A population (N = 852) cross-sectional study included (n = 515)) children enrolled in the 7th school year 2018/2019 of six schools in Ponta Delgada, Azores. Several indicators like anthropometric data, water intake, HL levels (using the HLS-EU-PT questionnaire) were collected with the CrAdLiSa online self-administered questionnaire.

Results

The instrument to measure HL (HLS-EU-PT) (Cronbach's alpha coefficient 0,94) allowed to consider that there is an association between HL and WI (p = 0,029), i.e. children with higher levels of HL have greater WI as they have a broader perception of the adequate amount of water needed to be healthy.

Discussion

These results continue to explore CrAdLiSa study, to better inform with ground base data policy makers regarding HL development.
From Data to Action: How the European Climate and Health Observatory is addressing climate and health challenges
Authors: Kazmierczak A
Published: October 2023

The European Climate and Health Observatory is a partnership between the European Commission, the European Environment Agency (EEA) and several other organisations that aims to support Europe in preparing for and adapting to the impacts of climate change on human health by providing access to relevant information and tools. This presentation will describe the aims and objectives of the European Climate and Health Observatory. As climate change continues to have far-reaching impacts on human health, it is important to have reliable information and data to guide policy decisions and public health interventions. The European Climate and Health Observatory aims to provide that by bringing together data and information on the health impacts of climate change in Europe, as well as the policies and interventions that can help mitigate those impacts. During this presentation, we will discuss the specific objectives of the Observatory, including its focus on providing accessible and timely information to policymakers, health professionals, and the public. We will also highlight key resources that are available through the Observatory, such as indicators of climate change impacts on human health, map viewers on risks, and examples of responses in policy and practice. Finally, we will discuss how the Observatory is working to engage stakeholders across the health and climate change communities, and how individuals and organizations can get involved in supporting its work. The aim is to build a robust and comprehensive understanding of the complex interactions between climate change and health, and to develop evidence-based solutions that can protect the health and well-being of individuals and communities.
Allergens detection in food and environmental samples in northern Italy
Authors: Pavoni E , Bertasi B , Finazzi G , Filipello V , Ragni L , Abdul M E , Losio M N
Published: October 2023

Background

The raise in global food trading showed an increase in allergic cases in Europe. Ethnic, novel and hidden food enhanced the probability of consumers to adverse events. The demand for allergens-free food grew with the need to be informed on the ingredients content. EU Reg. 1169/2011, details the products causing allergies or intolerances that must be indicated on the label if present. This work studied the prevalence of suspected allergens into apparently compliant food and environmental samples, aiming to verify their safety.

Methods

Totally, 1611 foodstuffs and 128 swabs were received from January 2022 to April 2023. They were independently tested for gluten, milk, egg, mustard, peanut, pistachio, sesame, soy or hazelnut. Commercial ELISA kits were used according to manufacturers’ instructions. Non-compliance to gluten was >20 ppm, and for the other allergens it was “presence” above the limit of detection.

Results

Data showed 46 non-compliant samples (2.6%): 37 foodstuffs (2.1%) and 9 swabs (0.5%). Of these, 16 were irregular for gluten (34.8%) and 14 (9 swabs, 5 food) for egg (30.4%); 9 contained milk (19.5%), 4 (8.7%) hazelnut, 2 (4.3%) soy and 1 (2.2%) peanut. No positives for other allergens. The most tested parameters were gluten (85%) and milk (10%).

Conclusions

The frequency of food allergy in Europe has been increasingly reported. In this study, 97.4% of samples complied with the label and were safe for allergic consumers. Clients were highly sensitive to gluten, egg, milk, soy and nut-free products. Considering the importance of food for human health and the increase in illness cases, checking of compliance to the rules is important.

Key messages

• The majority of allergens can affect seriously allergic consumers (also death), even if present in traces. A continuous surveillance is very important to prevent risks for sensitive consumers.

• The foodstuffs collected in this survey are mainly safe for allergic people.
Point prevalence survey on healthcare-associated infections in Apulian region, Italy, 2022-2023
Authors: Fortunato F , Martinelli D , Iannelli G , Ascatigno L , Lopalco P L , Prato R
Published: October 2023

Background

Since 2011-2012, the ECDC coordinates the measurement of Healthcare-associated infections (HAIs) and antimicrobial use (AMU) in European acute-care hospitals through repeated point prevalence surveys (PPS) every five years. Here we present the main results of the 3rd ECDC-PPS conducted in Apulia region, Italy, during November 2022, in comparison as a benchmark with data from Italian PPS 2016-2017.

Methods

The ECDC protocols were applied. Prevalence of HAIs and AMU was expressed as percentages. Proportion of isolates resistant to selected AMR markers were also calculated.

Results

Twenty-four/39 Apulian hospitals provided data on 3,710 patients. The prevalence of patients with ≥1 HAI was 9.9% (PPS-2016-17:8.03%). The highest prevalence was recorded in rehabilitation wards (31.6%; PPS-2016-17:16.4%), in large hospitals (10.5%; PPS-2016-17:9.3%), among elderly (11.2%; PPS-2016-17:9.1%), males (11.1%; PPS-2016-17:7.9%), and patients with a rapidly fatal McCabe score (28%; PPS-2016-17:18.8%). The most reported types of HAI were pneumonia (19.8%; PPS-2016-17:22.8%) and urinary tract infections (18.3%; PPS-2016-17:18%). Prevalence of patients with ≥1 antimicrobial was 49.3% (PPS-2016-17:44.5%). At least a positive microbiological result was reported for 66.1% of the HAIs (N = 244/369; PPS-2016-17:53.8%). Klebsiella pneumoniae (14.9%; PPS-2016-17:10.4%) and Escherichia coli (9.8%; PPS-2016-17: 13%) were the most frequently isolated microorganisms. The susceptibility tests were available for 56% of microorganisms (N = 177/316) and a resistant result was reported for 50.3% (PPS-2016-17:42.3%) of tests.

Conclusions

HAI, AMU, and AMR prevalence estimated in Apulia region was higher, when compared with previous national PPS. Efforts in implementing antimicrobial stewardship and reducing HAIs should be established.

Key messages

• HAI and AMR remain a major public health threat in Apulia region, particularly for K. pneumoniae and E. coli.

• Frail patients bear a greater burden of illness.
Healthcare utilization during the COVID-19 pandemic: changes, potential causes. A Swiss cohort study
Authors: Harju E , Speierer A , Jungo K T , Levati S , Baggio S , Puhan M A , Probst-Hensch N , Michel G , Rodondi N , Chocano-Bedoya P
Published: October 2023

Background

The COVID-19 pandemic led to a decrease in the provision and use of healthcare. Few studies reported reasons for these changes. We aimed to (i) describe the frequency of changes in healthcare utilization in those requiring ongoing treatment, and possible reasons thereof, and (ii) assess characteristics associated with change, during the second wave of the pandemic.

Methods

Participants from the Corona Immunitas e-cohort study (age ≥20 years) completed monthly questionnaires between September 2020 and February 2021. We used descriptive and bivariate statistics, to compare participants reporting a change in healthcare utilization with those who reported no change. We used negative binomial regression to explore characteristics associated with the number of changes.

Results

In total, 3190 adults from nine research sites participated in this study. One-fifth (N = 658, 21%) reported the need for regular treatment. About 14% of them reported a change in healthcare utilization, defined as events in which participants reported that they changed their ongoing treatment, irrespective of the reason. Reported reasons for change were medication changes and side-effects, specifically for hypertension, or pulmonary embolism treatment. Females were more likely to report changes in healthcare utilization (Incidence Rate Ratio (IRR)=1.69, p = 0.030), and those with hypertension were least likely to report changes (IRR=0.45, p = 0.092).

Conclusions

Among those who needed regular treatment, few reported changes in healthcare utilization. The importance of continuity of care for females and chronic diseases other than hypertension must be emphasized. This calls for tailored measures considering gender disparities.

Key messages

• Changes in healthcare utilization were more pronounced in women than men during the Covid-19 pandemic.

• Tailored disease surveillance is necessary considering gender disparities and chronic diseases other than hypertension.
Innovative strategies for the management of common mental disorders
Authors: Ali S
Published: October 2023

Innovations such as computerized/internet-based interventions are taking centre stage in the management of common mental disorders. For example, computer-assisted cognitive behavior therapy (CCBT) has been proposed as a method for improving access to effective psychotherapy, reducing cost, and increasing the convenience and efficiency of treatment for depression. Results from our own research suggest that CCBT may have significantly greater effects on depressive symptoms than treatment as usual (TAU) in primary care patients with depression. Our study population included people with lower income and lack of internet access who typically have been underrepresented or not included in earlier investigations of CCBT; hence, results suggest that this form of treatment can be acceptable and useful in diverse primary care settings.
Comparison, by Country, of the Uptake of COVID-19 Vaccination by Health Care Workers in the EU/EEA
Authors: McGlacken T , Codd M
Published: October 2023

Health Care Workers (HCWs) are at high risk of exposure to COVID-19 when providing care to patients. We investigated the uptake of COVID-19 vaccination among HCWs in the EU/EEA and discuss the factors which influence this uptake.- The aim of this study was to compare, by country, COVID-19 vaccination uptake by HCWs from January to June 2021, to assist with policy making and prospective planning in these countries during the current pandemic and into the future. The study population included all the countries in the European Union (EU) and European Economic Area (EEA). The secondary data file was downloaded from the European Centre for Disease Prevention and Control (ECDC) website Descriptive and comparative data were analysed and presented using Excel and Chi-square test of hypothesis. The percentage of HCWs in EU/EEA countries ranged from 1.2% to 5.1% per population. From January to June 2021, the percentage of first and second dose vaccinations of HCWs ranged from 20% to 100% and from 21% to 100%, respectively. The Comirnaty-Pfizer/BioNTech vaccine (COM) was the most administered vaccine in all EU/EEA countries, followed by the Moderna mRNA-1273 vaccine (MOD) and the Astra-Zeneca-Vaxzevria vaccine (AZ). The Janssen-Ad26.COV 2.5 vaccine (Janss) use ranged from 0.1% to 4.8% for the one dose vaccine. Hungary was the only country that administered the Sputnik V vaccine (SPU) and the Beijing CNBG vaccine (BECNBG). In January 2021, a median of 29% of HCWs received their first dose of COVID-19 vaccination. Italy was the only country with a mandatory vaccination policy for HCWs. Vaccination uptake rates were statistically different among EU countries (p < 0.05). Data such as these could be used in mathematical modelling potential future pandemics to predict vaccine up-take by selected, exposed, vulnerable sectors of the population, for whom it is relevant.

Key messages

• Vaccine hesitancy in healthcare workers.

• Planning for the next pandemic.
Viricide activity of antimicrobial blue light (405 nm) against the SARS-CoV-2 and influenza virus
Authors: Dragoni L , Amodeo D , Cevenini G , Marchi S , Trombetta C , Nante N , Messina G
Published: October 2023

Background

Over the years, antimicrobial blue light (aBL) at a 405 nm wavelength has emerged as a potential alternative treatment for reducing the environmental contamination. It is well accepted that aBL is much less detrimental to host cells than UV-C irradiation and can be used in the presence of people. This study aims to determine the viricide activity, against the SARS-CoV-2 and influenza virus types A and B, of the nUV-A radiation, using a customized nUV-A ceiling lamp System.

Methods

The experiment took place in March 2023. An nUV-A ceiling lamp prototype, composed of 9 LEDs at 405 nm, was fixed on a metal scaffold, on which the outline of a multiwell plate (24 wells) was traced to carry out the tests correctly. Each plate well was inoculated with 100 µL of SARS-CoV2 or influenza virus types A or B suspension. The multiwell plate was irradiated at 32 cm for 45 and 90 minutes, with an emitted energy dose of 12 J/cm2 and 24 J/cm2. Three samples were inoculated with viruses and subjected to the action of nUV-A as per protocol, and 3 samples were inoculated but not treated with nUV-A to determine viral titer after recovery and examined immediately after inoculation. The re-collected suspensions were used to inoculate a wells plate into which the VERO E6 cell cultures were fixed and then incubated for 3 days at 37° C.

Results

The results showed that after a 45 min exposition, the measurable log10 mean reduction was 1.50 for SARS-CoV2, 0.13 for influenza virus type A and 0.12 for type B; after 90 min the log10 mean reduction was 2.33 for SARS-CoV2, 0.16 for influenza virus type A and 0.17 for type B.

Conclusions

Tests have shown that aBL can be effective in reducing the viral load of the SARS-CoV2 virus and, to a lesser extent, the influenza A/B viruses. Disinfection with aBL appears effective and avoid the adverse effects of using UV-C. Further studies will evaluate how to improve the results on influenza viruses and the application on other viruses such as RSV.

Key messages

• NearUV-A lamp has proven to reduce the virucide activity of all viruses, more for sars-cov2.

• Using aBL avoids the adverse UV-C’s effects.
Management and control of an outbreak of NDM-producing Klebsiella pneumoniae in a teaching hospital
Authors: Tocco Tussardi I , Stevanin G , Montesarchio L , Palladini F , Aprili I , Zandonà E , Tardivo S
Published: October 2023

Background

Outbreaks caused by New Delhi metallo-β-lactamase (NDM)-producing Enterobacteriaceae are a major public health threat. We report an outbreak caused by NDM-producing Klebsiella pneumoniae (KP) in an Italian teaching hospital and describe the composite management approach that led to a successful containment.

Methods

On August 12 2022, a 39-year old Ukrainian patient with known colonization (rectal swab) by NDM-producing KP was admitted to the Hematology Unit of the University Hospital of Verona, Italy. Six days after, a second patient tested positive for carbapenem-resistant (CR) KP from rectal swab and 2 additional cases (rectal and pharyngeal swab respectively) were identified in the following 2 weeks. The 4 cases were identical strains.

Results

A multidisciplinary team coordinated the response actions. Isolation measures were ordered for positive patients, including use of dedicated instruments. Screening at admission and every 7 days was placed for all the ward patients. On-site inspections and microbiological screening of ward surfaces and devices were carried out. Infection prevention and control (IPC) measures were strengthened among personnel. Environmental cleaning was implemented by deep treatment of critical points (e.g. toilets) and reinforcement of routine cleaning. The Risk Manager developed an original checklist based on literature to review the implementation of IPC practices for CR Enterobacteriaceae. No new cases were identified from screening in the following weeks and the Unit returned to standard IPC measures. Given that environmental samples were negative and the cases had overlapping personnel, the hypothesis of contact transmission through caregivers was the most plausible. Reinforcement of training on hand hygiene and transmission-based precautions was planned.

Conclusions

It was possible to contain the hospital outbreak through rapid and diversified reaction capacity. Continuous IPC education is an essential control measure.

Key messages

• The spread of NDM-producing Enterobacteriaceae in the hospital setting must be countered with enhanced prevention and, in case of outbreak, rapid control.

• Effective containment involves a mix of established measures (screening, hygiene, environmental controls) and innovative approaches (e.g. literature-based checklists).