bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of pediatric hypercholesterolemia with a clinical data warehouse
Authors: Dhalluin T , De Luca A , Salpetrier C , Guillon L , Hankard R 
Published: October 2020

Abstract

Introduction
Familial hypercholesterolemia (FH) in children and adolescents is a genetic cause of premature coronary heart disease. Early detection of patients with FH could improve their management and life expectancy.

Methods
A retrospective observational study was conducted using our university hospital clinical data warehouse including children born after 01/01/2000, with at least one available lipid profile. Phenotypic diagnosis of hypercholesterolemia was defined by a plasma LDL-C level ≥5 mmol/L (190 mg/dL). Above-threshold children were compared with below-threshold children on available features: age, sex, weight and height, plasma total, HDL, LDL cholesterol, triglycerides, creatinine, urea, protein, albumin, thyroid stimulating hormone and cortisol levels.

Results
1,362 children were included, of whom 48 had at least one LDL-C measurement ≥5 mmol/L and 1,314 below (control). Only 2 children presented with a specific E78 hypercholesterolemia code versus 8 in the control group. Patients above the threshold were 1.5 years younger, with a mean cortisolaemia lower compared to the controls.

Discussion
Lipid profile is not routinely prescribed for children, and they are not routinely managed for their increased cholesterol levels. Lipid profile for children and adolescents were mainly prescribed in intensive care settings or in association with endocrine checkup. Hospital clinical data warehouse is an opportunity to specify practices in screening for Familial Hypercholesterolemia and lipid profile prescription in children.

Key messages
Lipid profile is not routinely prescribed for children. Hospital clinical data warehouse is an opportunity to specify practices in screening for Familial Hypercholesterolemia.
Malignant mesotheliomas in residents in the National Priority Contaminated Sites in Tuscany
Authors: Chellini E , Martini A 
Published: October 2020

Abstract

Background
Asbestos is a well-known carcinogen. A law banning asbestos is active in Italy since 1992. A surveillance system on malignant mesothelioma is ongoing in Tuscany since 1988. The aim is to describe mesothelioma incidence in the specific regional areas defined as National Priority Contaminated Sites in order to have suggestions on specific environmental remediation activities focused on asbestos.

Methods
Malignant mesotheliomas diagnosed in residents during 1988-2019 in the above cited areas are extracted from the specific regional registry. Standardized incidence rates are calculated by area and gender using 2013 European as standard population. Standardized incidence ratios are also calculated by area in the whole period, using the regional rates as reference. The distribution of cases by exposure and areas are analyzed.

Results
In the examined areas 510 cases are registered (423 in men and 87 in women). Male incidence rates are 10.0 (IC90% 8.4-11.6), 5.8 (IC90%3.2-8.3), 5.5 (IC90% 4.1-6.9) and 1.7 (IC90% 0.0-3.9) respectively in Livorno, Piombino, Massa and Orbetello. Female incidence rates are far below than those observed for men. The highest standardized incidence ratio is observed in Livorno (3.1, IC90% 2.6-3.6). The vast majority of cases (no.393) are related to occupational asbestos exposure, mainly occurred in the same residence area. Asbestos familial and environmental exposure was attributed respectively to 22 and 4 cases.

Conclusions
The availability of a long series of incidence data on malignant mesotheliomas allowed to evaluate the asbestos impact among residents in Tuscan contaminated areas. The results obtained show the great importance of past occupational asbestos exposure.

Key messages
Malignant mesothelioma is a sentinel event of past asbestos exposure. The mesothelioma burden in the contaminated area is helpful to prioritise specific environmental remediation activities.
The effects of lockdown on lifestyle habits of adults during the coronavirus pandemic in Cyprus
Authors: Philippou E , Demetriou C , Heraclides A , Mosquera M C , Quattrocchi A , Derlagen A , Pinnawala N U , Kolokotronı O 
Published: October 2020

Abstract

Background
Despite widespread adoption of lockdown by governments in the COVID-19 response, research on how it affects the individual pillars of Lifestyle Medicine is limited. We aimed to explore the effects of COVID-19 lockdown on healthy eating, physical activity, sleep, stress, social support and use of risky substances.

Methods
This was a cross-sectional study on a convenient sample of adults who resided in Cyprus during the lockdown. An anonymous questionnaire was completed online in Greek or English comprised of five validated tools in relation to their behaviours before and during the lockdown. We compared median values for each variable/tool before and during lockdown, using Wilcoxon Signed Rank test, and performed stratified analyses for sociodemographic characteristics.

Results
Out of 745 respondents, 74% were female and median age was 39. Overall scores showed significantly increased sleep quality difficulty (4 v 5, p &lt; 0.001), decreased social support (71 v 68, p &lt; 0.001), and increased perceived stress (22 v 25, p &lt; 0.001) between February 2020 and the month in lockdown. Mediterranean diet adherence increased significantly only in those who followed religious fasting during lockdown (6 v 7, p &lt; 0.001). Total minutes spent sitting significantly increased (120 v 180, p &lt; 0.001) although overall physical activity score did not significantly change. Smoking intensity (daily number of cigarettes and e-cigarettes) as well as frequency of alcohol consumption (daily number of drinks) increased significantly (p trend=0.029 and &lt;0.001, respectively).

Conclusions
Many aspects of lifestyle were adversely affected by lockdown in Cyprus. As people return to their pre-lockdown routines, the outcomes described provide data to inform the design of lifestyle interventions that support changing or maintaining lifestyle habits. Such interventions can then help decrease people's risk for future poor health outcomes, including the risk for COVID-19 infection.

Key messages
This study describes aspects of lifestyle affected by the Cyprus COVID-19 lockdown, significant when considering future lockdowns and pre-, during or post-lockdown healthful lifestyle interventions. The outcomes provide data to inform the design of lifestyle interventions to support changing or maintaining healthy lifestyle habits.
Sugar-sweetened beverage intake in relation to reproductive parameters in young men
Authors: Kiwitt Cárdeas J , Mendiola Olivares J , Adoamnei E , Arense-Gonzalo J J , Torres Cantero A M 
Published: October 2020

Abstract

Background
There has been a decrease in male fertility in recent years. During the same period, there were important dietary changes, including an increase in sugar-sweetened beverage intake (SSB). The relation between SSB and male reproduction functions in humans are barely described in the literature.

Methods
Cross-sectional study with 209 participants (18-23 years old) recruited during one year in Murcia, Spain. All men provided semen and blood sample the same day. SSB consumption was evaluated using a 101-item validated food frequency questionnaire. Reproductive hormones were analyzed from serum samples, obtaining levels of follicle-stimulating hormone (FSH), inhibin B, luteinizing hormone (LH), estradiol (E2) and testosterone (T). The evaluation of semen analysis consisted of seminal volume, sperm concentration, total sperm count, percentage of morphologically normal sperm and percentage of motile sperm. SSB intake association with semen parameters and hormone levels were examined using linear regression, adjusting for possible confounders.

Results
Men in the highest quartile of the SSB intake had higher percentage of morphologically normal sperm, 37,4% [6.1, 68.3] than men in the lowest quartile (P, trend= 0.047) and higher estradiol levels than those in the first quartile (9,5% [-3.5, 22.5] (P, trend=0.047)). SSB intake was unrelated to other semen quality parameters or reproductive hormone levels.

Conclusions
Our results indicate that sperm morphology and estradiol levels may be associated with sugar-sweetened beverage intake. These findings might be explained by physiological metabolism homeostasis, though more studies are required to confirm these results and draw conclusions in other male populations.

Key messages
Fertility is an increasing Public Health Problem. Sugar-sweetened beverage intake is increasing amongst the population.
Is the consumption of sweets a risk factor for thyroid cancer?
Authors: Ferrante M , Okatyeva V , Lo Bianco S , Oliveri Conti G , Zuccarello P , Copat C , Caltabiano R , Fiore M 
Published: October 2020

Abstract

Background
Several studies have investigated the role of diet as a risk and/or protective factor on the development of the thyroid cancer but the results are unclear. The aim of this study was to investigate the role of eating habits on the risk of thyroid cancer.

Methods
We carried out a hospital-based case-control study. The eating habits of the participants were investigated through a validated Lifestyles Questionnaire. The frequency of consumption of the different types of food was reported on a 4-level scale (never, 1 time per week, 2-3 times a week, 6 times a week). Logistic regression models were used to estimate the ORs and their 95% confidence intervals adjusted for age, gender and BMI. Statistical data analysis was conducted using the IBM SPSS Statistics 21.0 program.

Results
One hundred and six cases (91.2% CA papillary type) and 217 controls were recruited. A positive association was observed for BMI (OR: 1.085; IC95% = 1.022-1.152), consumption of complex carbohydrates (OR: 2,324; IC95%: 1,364-3,960) and a low consumption of legumes, cereals, potatoes, fruit and vegetables (OR: 2.285, 95% CI: 1.330-3.926). The consumption of sweets decreased with age (Rho: -0.445, N = 318, p = 0.000), but at the same age the cases had a higher consumption than controls. In particular, the consumption of sweets was higher in the age group between 39 and 52 years old.

Conclusions
Our study adds new and relevant information to support the hypothesis that a sugar rich diet may increase the risk of developing thyroid cancer.

Funding
This research was funded by Intradepartmental Research Plan 2016/2018 of Department of Medical, Surgical and Advanced Technologies, University of Catania, grant number: 5C722012104.

Key messages
Future studies need to clarify the mechanisms that associate the diet with the risk of thyroid cancer. More research is also needed to explain the differences in thyroid cancer among women and men.
Evaluation of public health literacy in adults who applied for primary health care in Turkey
Authors: Kılınç A , Çam C , Aydoğan Gedik S , Oktar D , Taşcıoğlu U , Öznur Muz F N , Önsüz M F , Metintaş S 
Published: October 2020

Abstract

Background
The climate change, conflicts, mass migrations and global epidemics happening in today's world shows that it's necessary for the communities to implement public health decisions. In this context, the degree of obtaining and complying with the information required for individuals to process, understand and evaluate public health decisions has revealed the concept of public health literacy. The aim of the study was to determine the public health literacy (PHL) levels in adults applying for health care.

Methods
This is a cross-sectional study conducted on 1672 adults who applied for primary health care in Eskişehir in 2019. Public Health Literacy Knowledge Scale (PHLKS) which is created with a WHO initiative was used to assess the PHL levels. The scores that can be obtained from this scale ranges from 0 to 17 and higher score implies higher literacy levels. In the study group, Cronbach's alpha value was 0.72 for the PHLKS. Multiple linear regression was used to determine the variables that affect PHLKS score.

Results
In the study group; 924 (55.3%) were male, 399 (23.9%) were living in a rural area, their ages ranged from 18 to 87 and the mean age was 40.94 ± 15.22. The median score from the PHLKS was 13.0 and mean score was 12.38 ± 2.99. Among the participants, 27.8% of them had a correct response rate of ≥ 90% for the items of the scale. Variables related to PHLKS were found to be high level of education, to exercise regularly and to perceive the general health status as good (F = 28.869, p &lt; 0.001, R2 = 0.161). Education level was the most important variable related with PHL level (Standardized β coefficient: 0.34 95% CI: 0.28-0.39).

Conclusions
PHL levels of the participants was thought to be moderate. Education level and the lifestyle choices were related to PHL.

Key messages
It was thought that new and improved tools to measure public health literacy levels are needed. Societies should improve their education levels and invest in health education programs for more effective public health interventions.
Patient-assessed quality of care in type 2 diabetes in a German nationwide health survey 2017
Authors: Baumert J , Schmid G L , Du Y , Paprott R , Carmienke S , Stühmann L M , Frese T , Heidemann C , Scheidt-Nave C 
Published: October 2020

Abstract

Background
Patient-assessed quality of chronic illness care is important to guide medical care for patients with diabetes and other complex chronic diseases, but information from epidemiological studies is scarce. Thus, we examined self-assessed quality of care among adults with type 2 diabetes (T2D) based on a population-based design.

Methods
The study population was drawn from a nationwide survey on diabetes-related knowledge and information needs conducted in Germany in 2017 and included participants aged ≥18 years with known type 2 diabetes (T2D) in the last 12 months (n = 1,328). A German short version of the “Patient assessment of chronic illness care (PACIC-DSF)” consisting of 9 items based on 5-point Likert scale was applied to assess self-reported quality of care in diabetes which was operationalized by a standardized PACIC sum score ranging from 1 to 5. Linear regression with different stages of adjustment was applied to assess the association of basic characteristics and diabetes-related factors with the PACIC score.

Results
Quality of care was assessed less favorably by women than by men (PACIC score: 2.38 vs. 2.47) overall and decreased along with age. The PACIC score significantly increased in participants with insulin use (β = 0.16, p = 0.024), ever participating in a diabetes education program (β = 0.33, p &lt; 0.001), following a diet plan at least once a week (β = 0.33, p &lt; =0.001) as well as performing daily self-examination of feet (β = 0.14, p = 0.023), self-control of blood glucose (β = 0.34, p &lt; 0.001), and being physically active for at least 30 min (β = 0.21, p &lt; 0.001) compared to participants without the respective trait.

Conclusions
Self-assessed quality of care by adults with known T2D from this population-based study is moderate and seems lower compared to findings from clinical studies.

Key messages
An active involvement of people with type 2 diabetes into the implementation of care is essential and may contribute to improved self-perceived quality of care. To identify and overcome obstacles in diabetes care based on the patient’s perspective remains a public health challenge.
Impact of clinical risk management in pediatric intensive care units: a systematic review
Authors: Di Pilla A , Specchia M L , Perilli A , Tofani N , Carini E , Ricciardi W , Damiani G 
Published: October 2020

Abstract

Background
Clinical risk is the probability that a patient is the victim of an adverse event attributable to medical care, albeit unintentionally; clinical risk management is therefore a key area for the quality of healthcare, especially in care-intensive settings; even more for pediatric patients. The objective of this review is to assess the impact of the application of tools and methodologies for clinical risk management in pediatric care-intensive settings.

Methods
Pubmed and Web of Science were queried to carry out a systematic review, using the PICO methodology to formulate the research strategy and query (June 2019). Application experiences of clinical risk management that had quantitative and qualitative impacts in pediatric intensive care units were included.

Results
A total of 1178 papers were reviewed and 22 articles were included, most of them from the US (8). Out of the 22 experiences described, 11 were related to reactive management tools, 7 to proactive tools; 4 experiences reported the use of both reactive and proactive tools; 11 articles made explicit a reduction in adverse events following the intervention in the study (29.8%-78.8%, p &lt; 0.001); 8 articles made explicit organizational changes triggered by the intervention; 2 proactive tools were also used in order to specifically assess the economical savings related to the changes that occurred as a result of the intervention; 1 article compared two reactive clinical risk management systems in the same context, underlining that a more innovative system tended to highlight more systemic errors, while a more traditional one focused on errors that were less common but potentially more dangerous; 14 studies were specifically dedicated to risk in drug management.

Conclusions
The application of clinical risk management tools made changes in pediatric intensive care units; the integrated use of different methodologies, both proactive and passive, for the management of clinical risk is highlighted in many studies.

Key messages
Methodologies for clinical risk management can have significant impacts on organizational processes and outcomes of pediatric intensive care units, improving safety of patient and operators. The simultaneous use of several clinical risk management tools, both proactive and reactive, is increasingly widespread.
The challenges of communicating vaccination benefit and risk in the family
Authors: Bouder F 
Published: October 2020

Abstract
Public perceptions of vaccination are complex and ambivalent. People often fear the vaccine more than the disease itself. They fear the unknown substance or adjuvants, worry that vaccines weaken their immunity system, or resent the involuntariness of mandated vaccination. The risk of the disease, on the other hand is often attenuated. Many vaccine-preventable diseases are rarely encountered in everyday situations and remain abstract concepts. Others, like influenza, may not be taken seriously; it is often seen as nothing worse than a “bad cold”. The sensationalist coverage of disease outbreaks is often perceived first as apocalyptic, then as “false alarms”. To fight these cognitive biases many risk communicators have focused on top-down persuasion, for instance telling parents that they must give the vaccine to their children and blaming them for not doing so. From a risk science perspective, however, it is well established that top-down persuasion that neglects to address negative perceptions is counter-productive. Any effort to bridge cognitive gaps and improve vaccine communication requires to understand perceptions. It is essential to understand the drivers that motivate parents' decision making and the dilemma they face between vaccinating and not vaccinating. The immunisation of children is particularly difficult because the communication's recipient are typically adults, which calls for strategies to talk to parents as well as reach children. Variations are observed across age as well as countries, which raises questions about national attitudes towards different types of vaccination affecting different age groups. This creates a more complex environment that is particularly challenging for healthcare professionals who have been identified as the primary “go to” authoritative source of information for adults. Obstacles to effective communication therefore needs to be addressed in a science-informed manner, if the objective is truly to ensure better uptake rates.
A lay provider delivered behavioral intervention for Syrian refugees and their children in Jordan
Authors: Bryant R , Giardinelli L , Bawaneh A , Awwad M , Hadeel N , Whitney C , Akhtar A 
Published: October 2020

Abstract

Background
Refugees and their children are exposed to many distressing events, including detention in refugee camps. Not surprisingly, refugees are at high risk for common mental disorders. A major barrier to addressing mental health problems in refugees is that most host countries lack sufficient mental health specialists to provide high-intensity treatments.
A recent trend has focused on training non-specialists to deliver simple psychosocial programs to those with distress. One such program is Problem Management Plus (PM+) which was developed by the World Health Organization; it comprises 5 small-group sessions that teach behavioural skills to reduce distress. This study reports the first evaluation of group PM+ in a refugee camp. We investigated the extent to which PM+ provided to adult Syrian refugees can benefit their children.

Methods
480 Adult Syrian refugees in the Azraq Refugee Camp were randomized to either PM+ or Treatment as Usual (TAU). Participants were independently assessed prior to the program, immediately following the program, and 3 months later. Outcome variables included anxiety, depression, functioning, posttraumatic stress, and grief and parenting behaviours. Children's psychological wellbeing was assessed in one child of each participant.

Results
Of the 650 adult refugees were screened in the camp, 96% met the cut-off for psychological distress and 76% met criteria for functional impairment. 480 participants were randomized to PM+ or TAU. The baseline assessment indicated 85% of refugees met criteria for depression, 84% met criteria for anxiety, and 84% met criteria for posttraumatic stress disorder. The 3-month assessment will be presented following linear mixed modelling to determine the relative gains made by refugees and their children in PM+ and TAU.

Conclusions
These findings will be discussed in terms of implementation of scalable programs in refugee settings, and specifically how these can benefit participants and their children.