bluuebunny/crossref_metadata_2025_split huggingface dataset:
Personal cell phones among children: attitudes of parents of primary school pupils
Authors: Austys D , Sprudzanaitė A , Arlauskas R , Stukas R 
Published: October 2020

Abstract

Background
A large number of primary school children have personal smartphones which enable them to communicate with lots of people and use social networks. However, social networking should not be accessible to primary school pupils due to existing age restrictions. Studies show that cell phones can be used to send offensive or sexual content to children or by them. This might have long-term effects on child's mental health and even provoke suicidal thoughts. While parents are able to control many aspects of children's life, we aimed to disclose parental attitudes towards use of mobile phones among children.

Methods
A total number of 619 parents of primary school children from middle-sized town of Lithuania participated in this study. Parents anonymously expressed their opinion to questions about personal cell phones usage among children. Distribution of participants was assessed according to social and demographic characteristics.

Results
Most of the respondents (79.8%) indicated that use of mobile phones might be harmful to children's health, 56.0% indicated that their children use social networks and every second child was registered by their parents (49.5%). Minority of the respondents (8.1%) thought that children (including children from other families) receive messages from strangers and communicate with them (2.1%). Similarly, very few of the respondents thought that children receive offensive (15.0%) or sexual (4.8%) content. Younger and lower educated parents registered their children to social networks more frequently (p-value less than 0.05). Lower educated parents more frequently indicated that offensive or sexual content can reach children via smartphones (p-value less than 0.05).

Conclusions
Majority of parents of primary school children thought that cell phones might be harmful to children's health but most of them did not pay attention to threats such as communication with strangers or transmission of sexual content.

Key messages
Only minority of parents of primary school children indicated communication with strangers or transmission of sexual content as threats induced by use of smartphones among children. Regardless that lower educated parents indicated awareness of content-related threats to children more frequently they registered their children to social networks more frequently as well.
Digital health and digital information in the context of big data. An ethical insight on interests
Authors: Mirchev M , Kerekovska A 
Published: October 2020

Abstract

Background
Health data is the key link between the prospects we face in improving health services and the context of current information reality. In the field of public health, the sheer scale of data collecting, digitalization and use is already raising questions related to the ethical norms among different stakeholders. The fact that it is personal data at stake, confronts at least two views: the individual versus the public interest. The more we ease the process of health data aggregation and use, the more risks of possible harms we face. So, whose interest is a priority?

Aim
To consider if it is possible to balance the conflicting interests of individuals and society in the digital health era by advocating for mutual compromises and rational argumentation.

Methods
Ethical, documental and historical research.

Results
The amount of digital health related personal data transforms both opportunities for improved healthcare and research, and possible uncertainties related to improper use, harms, abuses, injustice. This nourishes individuals' doubts and potentially restricts the public interest by putting limits on future use of data. A balance between the confronting interests is needed. Granting ownership rights over data requires entirely new legal frame, since property rights hardly encompass the unique nature of information. Moreover, data is a valuable artefact, and ownership could provoke further commercialization. On the other hand, it is virtually impossible to put a separating line between commercial and ideal use of health data for care improvements and science. Our focus should be on the ideal use and essentially on insuring individual's privacy and confidentiality, but not at the expense of public benefits and scientific progress.

Conclusions
Health information is a powerful tool, and its utilization suggests compromises, which are possible if rational argumentation and support is provided to individuals with the aim to overcome the existing discrepancies.

Key messages
The appearance of digital health fully represents the dynamic information reality in which constructing a balance between different stakeholder’s interests is vital and not impossible to achieve. Healthcare prospects depend on our individual responsibility and willing to share as we have the data and the means to use and secure it, and we have the duty to do it.
Influence of social media for sexuality of adolescents
Authors: Sousa M A , Oliveira P A , Lima M D O , Freitas M I F 
Published: October 2020

Abstract

Background
Adolescence is a phase of life of great emotional, cognitive, social and body changes. Also noteworthy are the changes related to the emotional relationship between young people and sexuality. Recent research indicates that the use of Social Media (MS) has increased dramatically among adolescents in the last 10 years, and they have a tendency to seek information on health, sexual health and STIs including AIDS in these media.

Objective
To understand the influences of social media for sexual health and sexuality in adolescents.

Methods
This is a research with a qualitative approach, based on the Theory of Social Representations. The study included 28 adolescents aged between 15 and 18 years old, high school students from two public schools in Belo Horizonte. Data collection took place through open and in-depth interviews, with a semi-structured script. The data were interpreted based on the Structural Analysis of the Narration, proposed by Demazière; Dubar.

Results
The results found point to positive and negative representations in relation to the interviewees' point of view on the influence of social media on the sexuality of these adolescents. The positive representations found revolve around the ease of access to information and the privacy of being able to search and answer your questions through the internet and other means of communication. The aforementioned negative representations point to the little media approach on the subject, in addition, they indicate sporadic approaches centered on festive periods and dates such as carnival, a unique focus on AIDS and aimed specifically at adult audiences.

Conclusions
It is necessary to rethink how adolescents and young people today experience their sexuality and how to reach them comprehensively, understanding the need to guarantee appropriate and quality information to adolescents.

Key messages
The present work leads to reflections on the ways that adolescents experience sexuality today. Currently, teenagers are involved in digital media, including social media, where they can express issues related to sexuality and the way they experience it.
Localising evidence for decision-making: participatory approach to inform schistosomiasis control
Authors: Fergus C A , Allen T , Parker M , Pearson G , Storer L , Dawson K 
Published: October 2020

Abstract

Background
The linear theories of change which ground many interventions do not account for the complex processes and systems in which they are implemented. This reductionist approach prioritises statistical methods which do not accommodate the stochastic, non-linear, dynamic interactions between humans and their environment. The inclusion of practitioners in the process of evidence development and utilisation of complex systems methods mitigates these issues and results in locally relevant, timely evidence for decision-making.

Methods
The aim of this work was to develop localised evidence for decision-making for schistosomiasis control in Uganda, Malawi, and Tanzania. Workshops were conducted with practitioners from the Ministries of Health at various levels and partner organisations to identify evidence needs for their decision-making processes and perceptions of disease transmission and control activities. Participatory systems mapping was used to identify factors directly and indirectly related to transmission. The maps were synthesised to a master complex systems map, which served as the blueprint for a generalised spatial agent-based model and specific ABMs tailored to the evidence needs of decision-makers.

Results
There was a gap in available evidence for practitioners to advocate for resources within the MoH and government budgets, as well as intervention efficacy and resource allocation. The adaptable and data-inclusive characteristics of the AMBs made them well-suited to produce localised outputs. Converted to NetLogo with a tailored user interface, these models were appropriate and responsive to the needs of decision-makers from village to national levels and across country contexts.

Conclusions
Used together, participatory and agent-based modelling resulted in the development of responsive and relevant evidence for practitioner decision-making. This process is generalisable and transferable to other diseases and locations outside of those in this study.

Key messages
The use of participatory systems mapping to develop agent-based models resulted in relevant and timely evidence for practitioner decision-making. The approach used here is transferable and generalisable outside schistosomiasis control and the contexts in this study.
Digital module of a complex school-based health education program tries to maintain equality
Authors: Eörsi D , Árva D , Herczeg V 
Published: October 2020

Abstract

Issue
Health education of adolescents requires digital communication channels besides the traditional interpersonal setting. Use of e-learnings can be beneficial in multiple aspects when targeting positive health behavior change.

Description
A complex, school-based health education program is operated by Semmelweis University in a North-Hungarian town, Balassagyarmat, given, that the vast majority of students have proper internet access. Ongoing peer education is completed by e-learning modules in order to improve the continuity of the program, repeat key statements, deliver more information and create a private channel to discuss intimate issues. The online system was built on novel educational techniques in gamification and rewarding to enhance motivation and engagement of participants. The same e-learning modules are available for all students from different type of education and sociocultural background. We try to assess if this concept provides equality.

Results
41 multimedia e-learning modules consisting of 12 types of interactive game-like activities has been developed in 10 topics. Each of them are used by around 60-70% of the participants of the program (about 240 students per year). High school students showed slight difference from vocational school students in activity and in performance. According to their feedback, pupils welcome this channel regardless to their type of education.

Lessons
While developing the digital health education program based on new pedagogical methods, the concept was not modified for students of different school types, but all of them participated in the same educational and rewarding system. We believe, that the project trends to maintain equality.

Key messages
Multimedia digital modules are favorable in health education for adolescents. Health education statements can be the same for students of different educational settings.
The exposome and meet-in-the-middle as tools in addressing open questions in air pollution research
Authors: Demetriou C A , Esposti D D , Fedinick K P , Russo F , Robinson O , Vineis P 
Published: October 2020

Abstract
Ambient particulate matter is the environmental factor with the highest contribution to global disease burden and mortality. Open questions remain regarding causality at low doses and the effects of specific pollutants. Establishing causality in regards to air pollution is methodologically challenging, affecting the establishment of regulatory policies.
In an effort to address this problem, we suggest combining the concept of the exposome with the Meet-in-the-Middle approach (MITM). This approach consists of measuring molecular fingerprints and relating them retrospectively to measurements of external exposure and prospectively to a health outcome. Markers robustly associated with both ends of the exposure-to-disease continuum, validate a causal hypothesis5. In the context of carcinogenesis, this approach allows establishing the relationship between the middle-to-outcome nature of the hallmarks of cancer with the bottom-to-middle approaches of the key characteristics of carcinogens. We recently demonstrated proof of principle of this approach, by investigating the temporal sequence of hallmarks of cancer from the point of view of pathological specimens of cancer (branched mutational spectra), and then by considering the key characteristics of the carcinogen, benzo(a)pyrene. The main cancer pathways affected follow a generally common sequence: resisting cell death, insensitivity to anti-growth signals, sustained proliferation (almost simultaneous), deregulated energetics, replicative immortality, and activation of invasion and metastasis. Angiogenesis and avoiding immune destruction display a varying position in the above sequence. At the same time, “key characteristics” of BaP were found associated with most hallmarks of cancer, supporting its carcinogenicity.
A MITM approach, using exposomic evidence, is a promising approach that can successfully address causality concerns in regards to air-pollution toxicology and the need for regulatory policies.

Key messages
Investigation of tumour mutational spectra and of the mechanisms of action of a carcinogen, reveals an overlap between the hallmarks of cancer and the key characteristics of the carcinogen. This investigation provides proof of principle that the exposome/meet-in-the-middle approach can address concerns in air-pollution toxicology and provide evidence to support regulatory policies.
Metabolic syndrome and endocrine disrupting chemicals: exposure and health effects
Authors: Haverinen E , Lange R , Tolonen H 
Published: October 2020

Abstract
Increasing prevalence of metabolic syndrome (MetS) is causing significant health burden among the European population. Current knowledge supports the notion that endocrine disrupting chemicals (EDCs) interfere with human metabolism and hormonal balance, contributing to the conventionally recognized life-style related risk factors for MetS. In relation to the Human biomonitoring initiative (HBM4EU) five priority substances (Bisphenol A, Per- and polyfluoroalkyl substances (PFASs), Phthalates, Cadmium and Arsenic) and their association with adverse metabolic health effects were examined.
A methodological framework for scoping reviews was followed to increase consistency and transparency throughout the process. A literature review was conducted to identify epidemiological studies focusing on the association between MetS or its individual components and the five HBM4EU priority substances.
Human biomonitoring studies have been able to present evidence supporting EDC exposure and development of individual MetS components; however the strength of the association varies between the components and EDCs. Most of the identified literature examined Bisphenol A and Phthalate exposure, usually targeting obesity, anthropometrics or glucose metabolism. Evidence suggests a positive association between Bisphenol A and Phthalate exposure and obesity-related components. The substance group of PFASs indicated weakest association, as the results were inconsistent and were suggestive only for a positive association with development of dyslipidaemia.
Current evidence on metabolic disturbances and EDCs are inconclusive and fragmented, hence establishing harmonized and standardized human biomonitoring procedures among the European population are needed. Rigorous and ongoing human biomonitoring in combination with health monitoring could provide comprehensive information on EDC exposure and association of metabolic disturbances.

Key messages
EDC exposure is ubiquitous within European population, hence more human biomonitoring in combination with health surveys is needed to strengthen knowledge on human’s metabolic health. MetS is an increasing global health concern, which requires novel approaches to tackle the challenge.
Air pollution health risk assessment: the role of benzene
Authors: Lanza T , Carini E , Villani L , Ricciardi W , Moscato U 
Published: October 2020

Abstract
Benzene is an aromatic polycyclic hydrocarbon (C6H6) ubiquitously present in the environment which results from the emissions of fires and volcanoes. However, the primary source is anthropogenic, mainly from industrial emissions and combustion. The aim of this study is to summarize the current evidence on benzene exposure in the Italian regions and the main health effects.
A retrospective observational study was conducted. Environmental data provided by ISPRA (Higher Institute for Environmental Protection and Research) relating to benzene pollution and the trend of national emissions of substance by region and sector of origin were analyzed.
Data available to date (1990-2016) show a significant decrease, over 91%, mainly due to the reduction in the transport sector. In 2016, the main share of substance relates to road transport (1,492 t), followed by use of solvents (1,100 t), and production processes (463 t). Much lower are the emissions due to the extraction and distribution of fossil fuels/geothermal (19 t) and combustion in the energy and transformation industries (5 t). The highest absolute values in 2015 were recorded in the Italian regions of Lombardia (751.4 t), Lazio (367.2 t), and Puglia (339.0 t). The lower values were in Valle d'Aosta (7.9 t), Molise (15,5 t) and Basilicata (25,3 t). The largest decrease in benzene exposure between 1990 and 2015 was recorded in Campania (-94.5%), Calabria (-93.9%) and Valle d'Aosta (-93.4%).
All Italian regions recorded a significant decrease in the absolute values of benzene emissions, mainly due to both the decrease of benzene in fuel composition during the 1990s and to the renewal of circulating cars equipped with energy saving systems (start and stop) and more optimized for low fuel consumption. The global reduction of energy sources based on fossil fuels, as well as a primary environmental objective to reduce Global Warming, would certainly constitute a way to decrease the impact of benzene on the environment.

Key messages
Additional efforts are needed to reduce energy sources based on fossil fuels. An information, training and health education policy through the environment aimed at implementing awareness and empowerment of the population would be desirable.
Perspective of low-cost biosensors for genotoxic potential evaluation of urban air
Authors: Traversi D , Pignata C , Anedda E , Gilli G 
Published: October 2020

Abstract

Background
Biosensor technology can potentially revolutionise the area of air pollution monitoring by providing data on early biological effect induction. Such data can be developed for supplementing routine pollution monitoring, improving exposure estimation, including a potential effect estimation and raising community awareness about air pollution. Especially in consideration of complex biological effect such as mutagenic, genotoxic and other proved effects due to the air mixture exposure. The aim of the study is to propose a short-time biosensor for the mutagenic properties evaluation of air pollution.

Methods
A simple biosensor was developed using genetically modified microorganisms. A first sampling session was conducted in one of the most air-polluted city of Italy using the biosensor and collecting the data of the usual monitoring system, including PM2.5, PM10, NOx, PAHs and metals concentrations.

Results
The biosensor is able to answer to polluted air mixture indicating a valuable genotoxic effect. Such effect - expressed in relation to the air sampled volume - is comparable to that recorded by traditional genotoxicity in vitro assay on organic extract of particulate matter. Moreover, a comparison with reference measurements is conducted. Repeatability, reproducibility, stability, limit of detection as the impact of environmental factors on biosensor output have been discussed.

Conclusions
Due to copious difficulties arising when airborne emissions are sampled, biological assays have been applied only sporadically. Aerosol particles are generally collected on a filter and following extraction procedure and bioassay were performed. Monitoring using the biosensor require low sample quantity, directly colliding with the microorganism, and supply good choice when air genotoxicity are to be determined.

Key messages
Low-cost biosensors can empower high density monitoring of air pollution. The proposed biosensor is able to evaluate genotoxic properties of the air mixture even if data quality is a major concern for its employment.
Regional analysis of pediatric admissions with complex chronic conditions in mainland Portugal
Authors: Lacerda A F , Oliveira G , Cancelinha C , Lopes S 
Published: October 2020

Abstract

Background
The expected rise in the number of children living longer with complex chronic conditions (CCC) and the social relevance of this group prompt the study of the patterns of their inpatient care utilization. We aimed to compare the utilization of inpatient care by children with CCC between regions of mainland Portugal.

Methods
Observational longitudinal retrospective study using anonymized administrative data for mainland Portuguese public hospitals. We selected admissions within the pediatric age limit (&lt;18yo), 2011-15. The variable of interest was the patient region of residence [Alentejo, Algarve, Centre, Lisbon Metropolitan Area (Lisbon MA), or North]. Variables related to condition (number and categories of CCC) and to care utilization [admission type, hospital type (I- community, II- regional, III- tertiary & university, IV- specialized), inpatient days, expenses] were described by region.

Results
A total of 64,918 pediatric admissions with CCC were included (ranging from 2,839 to 23,194 by region). The percentage of admissions with 2 or more CCC ranged from 16% to 22%. Haematologic & Immunologic and Metabolic categories were the ones with the highest range between regions (8%-19%; 5%-10%); the smallest range was seen in Cardiovascular (15%-18%). Urgent admissions ranged from 48% to 70%. Hospital type varied considerably, especially for type II (8%-69%). Median length of stay was 4-5 days, and median expense ranged from €1,256 to €1,467.

Conclusions
The utilization of inpatient care by children with CCC in mainland Portugal varied by region, mainly on type of admission, type of hospital, and distribution of CCC categories. Possible explanatory factors may include differences in CCC prevalence, patterns of care, and available care in each region.

Key messages
Differences in the percentage of urgent admissions require further analysis, aiming at reducing the disruption that healthcare needs may cause in the life of children with CCC and their families. There are considerable differences in the type of hospital where children with CCC in each region receive care. Healthcare system must ensure appropriate resources are available where needed.