bluuebunny/crossref_metadata_2025_split huggingface dataset:
Environmental and climatic risk factors for cystic and alveolar echinococcosis in Kyrgyzstan
Authors: Paternoster G , Boo G , Flury R , Raimkulov K M , Minbaeva G , Usubalieva J , Müllhaupt B , Deplazes P , Furrer R , Torgerson P R 
Published: October 2020

Abstract
Cystic and alveolar echinococcosis-CE and AE-are parasitic zoonoses caused by tapeworms Echinococcus granulosus and E. multilocularis. Their lifecycle is associated with particular environmental and climatic conditions, which have been identified as risk factors for CE and AE transmission. In this study, we assessed potential environmental and climatic risk factors for CE and AE in Kyrgyzstan where both diseases are endemic.
We previously estimated CE and AE surgical incidence and standardised incidence ratio (SIR) at the local community level in Kyrgyzstan for the period 2014-2016. We obtained 190 geospatial covariates on potential environmental and climatic risk factors for the two diseases from remotely sensed datasets. To account for the prolonged latency of CE and AE, we used covariates for different years (i.e. 2000, 2005 and 2010) and for an extended period of 30 years (i.e. monthly mean). We summarised the different covariates at the local community level and assessed correlations with the SIR of CE and AE using the Spearman's rank correlation test. We also computed the variance inflation factor (VIF) to assess multicollinearity between covariates. We then fitted three types of conditional autoregressive (CAR) models for each disease, namely an independent, a convolution, and a so-called Leroux model. We used covariates exhibiting significant correlation with the SIR of CE or AE and no multicollinearity as explanatory variables, and case counts as response variables. We selected the best CAR model and further refined the covariate selection using the Deviance Information Criterion (DIC).
Convolution models exhibited the best fit in terms of DIC for both diseases. None of the selected environmental variables exhibited significant effect on the number of CE cases, whilst there was a significative negative effect of mean annual temperature in 2005 on AE cases. These preliminary findings might inform targeted prevention and control in high-risk areas.

Key messages
We assessed environmental and climatic risk factors for cystic and alveolar echinococcosis in Kyrgyzstan. Our preliminary findings suggest that alveolar echinococcosis risk in Kyrgyzstan is associated with climatic factors such as 10-year lag mean annual temperature.
Post-stroke epilepsy and mortality: an observational study on healthcare administrative database
Authors: Antonazzo I C , Cozzolino P , Cortesi P A , Cesana G , Mantovani L , Mazzaglia G 
Published: October 2020

Abstract

Background
Post-stroke epilepsy (PSE) has been associated with hospitalization and increased mortality risk. So far, evidence on PSE and mortality risk is lacking. Therefore, this study aimed to evaluate the association between PSE and mortality in different type of stroke.

Methods
A retrospective observational study was conducted using healthcare administrative databases of Lombardy, a northern Italian region (16.4% of the Italian population). Patients aged 40 years or older admitted to the hospital between 1/1/2004 and 31/12/2008 with diagnosis of hemorrhagic (HS)- or ischemic (IS)- stroke were included. Diagnosis of seizure/epilepsy was identified by using discharge ICD9-CM codes, exemption code or use of antiepileptic drugs. This date was considered the index date. For each stroke cohort case of PSE was matched with 2 non post-stroke epileptic (PNS) individuals. Demographic and clinical characteristics were compared between PSE and PSN among the stroke cohorts. Cox proportional regression model was used to estimate the hazard ratio (HRs) and 95% confidence intervals (95%CI) of mortality.

Results
In the observed period, 13,749 of patients (4,583 PSE Vs 9,166 PSN) had IS and 4,875 (1,625 PSE Vs 3,250 PNS) had HS. Individuals were ≥75-year-old with no difference among cohorts (p value &gt;0.9). Similarly, no differences were observed for gender (p = 1.00) and Charlson'comorbidity index (p = 1.00). Early seizure occurred in 15% of ischemic cohort and 20% of hemorrhagic one. Differences in antithrombotic drug use were observed among PSE and PSN in IS (p = 0.009) and HS cohort (p = 0.03). In ischemic cohort PSE was positively associated with increased mortality risk (HRadj: 1.67; 95%CI: 1.57-1.79), whereas no significant result was observed in hemorrhagic cohort (1.06; 0.94-1.20).

Conclusions
This study demonstrated a twofold increased risk of mortality in IS cohort. Further studies need to deeply characterize possible association between PSE and mortality in HS individuals.

Key messages
Occurrence of seizure/epilepsy in ischemic post-stroke patients represents a risk factor for morality. New studies need to clarify the contrasting result observed for hemorrhagic PSE patients.
Towards NCD surveillance in Germany – diabetes as a paradigm
Authors: Reitzle L , Paprott R , Heidemann C , Schmidt C , Baumert J , Färber F , Du Y , Scheidt-Nave C , Ziese T 
Published: October 2020

Abstract

Background
Non-communicable diseases (NCD) are a major public health challenge in Germany and throughout the world. The epidemiology of diabetes, in particular type 2 diabetes, exemplifies the need for effective prevention and control. To support policy making with actionable evidence, the Robert Koch Institute (RKI) is developing a diabetes surveillance system for Germany serving as model for NCD surveillance.

Methods
First, we consented a conceptual framework and key indicators among experts and stakeholders based on an extensive literature review including national and international NCD surveillance systems. After prioritization of indicators applying a two-step Delphi method, we identified data sources for sustainable surveillance including data from nationwide RKI health surveys as well as external data such as claims or registry data. Lastly, in cooperation with stakeholders we developed first dissemination products.

Results
During concept phase, we identified 40 indicators ranging from risk factors, disease incidence and prevalence to quality of care, mortality and burden of disease. During implementation, suitable data sources and results on temporal trends have been obtained for a large part of the indicators. For dissemination we developed a website with interactive visualization of results supported by an explainer video on YouTube. Additionally, we prepared a printed diabetes report summarizing and interpreting key findings for a broader audience, including health politicians and public health researchers.

Conclusions
We demonstrated the feasibility of the systematic collection and analysis of health data to describe the disease and care situation of diabetes in Germany. The methodology and data sources of indicators can be transferred to further NCDs and shared risk factors are already depicted. Next steps are to close remaining data gaps and to advance dissemination products in collaboration with our stakeholder network tailored to their information needs.

Key messages
Considering available health data, we showed the feasibility of implementing a diabetes surveillance system for Germany providing reliable information on disease dynamics for various stakeholders. The knowledge on methodology and data sources gained establishing a diabetes surveillance system can be extended to other noncommunicable diseases.
Mental health from childhood to adulthood: Results of the 11-year follow-up of the BELLA study
Authors: Wüstner A , Otto C , Reiss F , Voss C , Meyrose A-K , Hölling H , Ravens-Sieberer U 
Published: October 2020

Abstract

Background
Mental health problems in children, adolescents and young adults are highly prevalent and cause a significant burden for both individuals and society, resulting in a high relevance to public health. Longitudinal studies are needed to provide profound population-based data on mental health and well-being. In the present study, first results of the 11-year follow-up of the German BELLA study are presented. These include age- and gender-specific courses of general health and well-being, long-term health outcomes of mental health problems, and the utilisation of mental health services.

Methods
The longitudinal BELLA study is the module on mental health and well-being within the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The BELLA study has gathered data since 2003 at five measurement points using standardised measures. In the most recent 11-year follow-up, N = 3,492 young people aged 7 to 31 years participated. Individual growth modeling, linear regression and descriptive analyses were conducted.

Results
Self-reported general health and well-being were both better in younger than older and in male compared to female participants using data from all five measurement points. Mental health problems in childhood and adolescence (measured at baseline) were associated with adverse general, mental and physical health outcomes at 6-year and 11-year follow-ups. About 75 % of children and adolescents with a diagnosed mental disorder were under mental health treatment.

Conclusions
With its 11-year follow-up, the longitudinal BELLA study provides new data on mental health and well-being in German children, adolescents and young adults. Our findings are important for the development of targeted mental health promotion and early prevention strategies. Promising future analyses are planned.

Key messages
The BELLA study provides data on developmental trajectories of mental health from childhood to adulthood, on long-term health outcomes of mental health problems and on mental health care use. The findings of the present study are of great relevance for the development of targeted health promotion and prevention programs.
Preventing postpartum depression using an educational video on infant crying
Authors: Doi S , Fujiwara T , Isumi A , Nakai A , Ogita K , Mitsuda N 
Published: October 2020

Abstract

Background
Perception of and reactive behaviors towards infant crying is one of the modifiable risk factors for postpartum depression. The aim of this study was to examine the impact of watching an educational video on infant crying within 1 week of age after delivery at maternity wards to reduce the prevalence of postpartum depressive symptoms at 1 month after giving birth.

Methods
Study design was a cluster randomized controlled trial (UMIN000015558). The intervention hospitals were randomly assigned, stratified by area and function of the hospital. Participants included 47 obstetrics hospitals or clinics out of 150 hospitals or clinics in Osaka Prefecture, Japan. In total, 44 hospitals or clinics completed the trial and 2,601 (intervention group=1,040, control group=1,561) caregivers responded to the questionnaire on postpartum depression. Mothers in the intervention group watched a 11-minute educational video, within 1 week of age, during hospitalization at maternity wards. Primary outcome in this study was postpartum depression assessed by the Edinburgh Postnatal Depression Scale as 9+, and assessed via questionnaire at a 1-month health checkup.

Results
In the intervention group, 142 (13.7%) mothers reported postpartum depression compared to 250 (16.0%) in the control group. Intention-to-treat analysis showed no significant difference in the prevalence of postpartum depression between the groups. However, among young mothers (&lt;25 years old), the analysis showed a 67% reduction in postpartum depression (OR:0.33, 95%CI:0.15-0.72).

Conclusions
Watching an educational video on infant crying did not reduce postpartum depression at 1 month after giving birth, but it was effective for young mothers aged less than 25 years old. It may be easier to introduce our approach to any opportunity for meeting mothers during perinatal period because it does not require specialized manpower and a significant amount of time for the intervention.

Key messages
The educational video on infant crying, “Baby Doesn't Stop Crying,” had no effect in preventing postpartum depressive symptoms. Among young mothers aged &lt;25 years, the educational video had a protective effect on postpartum depressive symptoms, which was not observed for mothers aged ≥25 years.
Predictors of exclusive breastfeeding in Roma and non-Roma population in Serbia
Authors: Stamenković Ž , Bjegovic-Mikanovic V , Matejic B , Djikanovic B 
Published: October 2020

Abstract

Background
Exclusive breastfeeding is essential for early childhood development, although the use of adaptive milk formulas instead of breastfeeding is widespread nowadays. This study examined the prevalence of exclusively breastfed infants under the age of 6 months in non-Roma and Roma population and factors associated with this practice.

Material and Methods
This study is a secondary analysis of the Serbian Multiple Indicator Cluster Survey investigating non-Roma and Roma infants under the age of 6 months. The study included mothers of 321 non-Roma and 164 Roma infants younger than 6 months. Univariate and multivariate logistic regression served to analyze factors associated with the practice of exclusive breastfeeding.

Results
The prevalence of exclusive breastfeeding was almost the same among mothers in both non-Roma and Roma population (13.3% vs. 13%). Exclusive breastfeeding was significantly more often (p &lt; 0.001) among wealthier women, multipara, and women who had not established menstrual cycle among both populations. Unexpectedly, in the non-Roma population, not staying in the same room with the newborn in the maternity ward increases the chance for the baby to be exclusively breastfed (OR 7.19, CI 95% 1.80-28.68). The same pattern has been observed in Roma population. Non-Roma mothers multipara are more likely to exclusively breastfeed their children than primipara (OR 7.78, CI 95% 1.09-20.93), while among Roma mothers, the inverse association has been found although not significant. Attending a childbirth preparation program more than 18 times increases the chances of infants being exclusively breastfed (OR 18.65, CI 95% 1.34-53.67). In the Roma population, there was no single woman that attended a childbirth preparation program.

Conclusions
The pattern of exclusive breastfeeding significantly differs between non-Roma and Roma populations. Preventive work should have a focus on strengthening support to mothers and medical staff in maternity wards.

Key messages
Understanding the predictors of exclusive breastfeeding can help in the process of creating health promotion programs that lead to more infants exclusively breastfed according to the WHO guidelines. Decision-makers and public health authorities should acknowledge the existing breastfeeding problems.
Risk for HIV acquisition among sub-Saharan African migrant travelers in Belgium and Portugal
Authors: Dias S , Loos J , Gama A , Simões D , Nöstlinger C 
Published: October 2020

Abstract
Migrants often travel back to the origin countries and to other European states after settling in the residence country. Mobility along with structural vulnerabilities may increase HIV acquisition risk. Knowledge on HIV risk exposure when traveling is limited, yet crucial to inform prevention. This study aims to explore risky sexual behaviors and assess HIV prevalence among sub-Saharan African migrants (SAMs) who travel, residing in two European cities.
Two cross-sectional biobehavioral surveys were conducted in Lisbon and Antwerp with a venue-based sample of 1508 SAMs. Descriptive and multivariable logistic regression analyses were performed to examine travel patterns and associated sexual risk behaviors.
Overall, 68.4% of participants had traveled to other countries after settling in the residence country; 41% had traveled back to Africa and within Europe, 25.2% only to Africa and 33.8% only to Europe. Among travelers who reported sexual encounters abroad (49.2%), condomless sex at last intercourse was high both abroad (62.5%) and in the host country (70.7%). Odds of condomless sex at the last sexual encounter in the host country were five times higher among those who also reported no condom use abroad [OR: 5.32; 95% CI: 2.98-9.25], controlling for gender, age, educational level, relationship status, survey country, partner type and origin, and number of sexual partners over the last year. Condomless sex was higher with a regular partner and with an African partner, both abroad (79.9% and 67.5%, respectively) and in the host country (81.3% and 74.6%, respectively). Among the 75 participants who tested HIV-positive (around 5%), more than half had travelled to other countries; of these, about half reported condomless sex with their last sexual partner abroad.
SAMs are a mobile population and are exposed to sexual HIV risk both while traveling and in host countries. Prevention interventions should address the complex interplay between migrants' mobility and HIV risk.

Key messages
Migrants often travel to their origin home countries and other destinations after having settled in host countries, and this mobility increases exposure to HIV risk. A transnational perspective on HIV prevention and sexual health promotion is needed for effectively reducing migrants’ HIV risk related to their mobility.
Sodium intake in Italy from 2008 to 2019: results of the CUORE Project-Health Examination Surveys
Authors: Donfrancesco C , Lo Noce C , Russo O , Bellisario P , Galeone D , Vannucchi S , Giampaoli S , Galletti F , Palmieri L , Strazzullo P 
Published: October 2020

Abstract

Background
The WHO Global Action Plan for the Prevention of NCDs recommends a 30% relative reduction in mean population intake of salt/sodium. To this end, the Italian Ministry of Health (MoH) has strengthened prevention and health promotion through the “Gaining health: making healthy choices easy” Programme and the National Preventive Plan 2014-2019, in collaboration with the Interdisciplinary Working group for Salt Reduction in Italy. To estimate the habitual salt intake and its trend in the general adult population, national surveys, funded by the MoH-CCM, are conducted within the CUORE Project.

Methods
Baseline salt intake by the use of 24h urine collections was assessed in 2008-2012 from representative random samples of residents in all Italian Regions. A new survey was conducted in 2018-2019 involving random samples of residents in 10 Regions. Urinary sodium excretion is assayed by a central lab at Federico II University of Naples, subjected to strict quality controls. Comparisons are made considering, for both periods, the first seven regions examined in the 2018-2019 survey and the age range of 35-74 years.

Results
Within the 2008-2012 survey, mean level of sodium chloride per day in 642 men and 627 women were 10.6 g (10.3-11.0 g) and 8.0 g (7.7-8.3 g) respectively, whereas in the 2018-2019 survey the corresponding mean levels in 673 men and 709 women were 9.3 g (95% C.I.: 9.1-9.6 g) and 7.1 g (6.9-7.3 g), respectively. A sodium chloride intake level lower than the WHO recommended target of 5g/day (or 85 mmol/day) was detected in 5% (3-6%) of men and 16% (13-19%) of women examined in 2008-2012 vs 9% (6-11%) of men and 24% (20-27%) of women examined in 2018-2019.

Conclusions
These preliminary data show that the average habitual sodium intake in Italy is still higher than recommended but a significant reduction seems to occur. These results fully justify and encourage the ongoing preventive initiatives of MoH, facilitating the meeting of the WHO-NCD target.

Key messages
Habitual salt intake in the Italian general adult population is still higher than the recommended by the WHO. If confirmed, in the last ten years a reduction of habitual salt intake in Italian general adult population seems to be occurred.
Low-calorie-sweeteners in foods with front-of-package child-directed advertising in Brazil
Authors: Grilo M F , Ricardo C Z , Taillie L S , Martins A P B , Mais L A , Duran A C F L 
Published: October 2020

Abstract

Background
Low-calorie sweeteners (LCS) are currently found in ultra-processed foods, even in those with high content of sugar, without any front-of-package (FOP) information for LCS content. The aim was to assess the presence of LCS and the combination of LCS and added sugars in foods and beverages with FOP child-directed advertising in the Brazilian packaged food supply.

Methods
In this cross-sectional study, we used data from the nutrition facts panel (NFP) dataset that includes 11,434 unique foods and beverages collected in 2017 in the five largest food retailers in Brazil. We used information on the NFP and the list of ingredients to determine the presence of LCS and added sugars. A subsample of the packages had the available FOP advertising strategies classified using the INFORMAS methodology (n = 3,491). We estimated the prevalence of LCS and the combination of LCS and added sugar presence in the Brazilian food supply, and assessed the prevalence of foods and beverages with FOP child-directed advertising.

Results
Out of 3,491 products assessed, 8.9% of the products contained LCS, of which 12.9% were advertised towards children. Regarding the presence of LCS and added sugars, 7.3% of products presented that combination, with 14.6% of those having child-directed FOP advertising. The food groups with the highest prevalence of LCS were: sugary drinks (juices, nectars, fruit-flavored drinks, sodas and other beverages) (40.6%), breakfast cereals and granola bars (31.6%), and sweetened dairy products (23.5%). From those, 5.5%, 6.7% and 17.1%, accordingly, were advertised towards children.

Conclusions
In this sample, 9% of the foods contained LCS or a combination of LCS and added sugars. In products advertised towards children, we found higher rates of products with LCS and greater presence of LCS in beverages, breakfast cereals and granola bars with children-directed advertising.

Key messages
This study demonstrates that almost 9% of Brazilian packaged foods have LCS, and that 7% have both LCS and added sugars. In products advertised towards children, such rates were higher (13 - 15%). A clearer information on the front-of-package of foods and beverages regarding the presence of LCS in Brazil is necessary, particularly among those products advertised towards children.