bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elevated fatty liver index as a risk factor for all-cause mortality in HIV-HCV co-infected patients
Authors: Barré T , Protopopescu C , Bani-Sadr F , Piroth L , Sogni P , Salmon-Ceron D , Wittkop L , Lacombe K , Serfaty L , Marcellin F 
Published: November 2019

Abstract

Background
Thanks to innovation in treatment, people living with HIV and/or HCV now live longer but are growingly facing non-communicable disease burden. HIV-HCV co-infected patients are at high risk of metabolic complications and liver-related events, which are both associated with hepatic steatosis and its progressive form, non-alcoholic steatohepatitis (NASH), a known risk factor for mortality. The fatty liver index (FLI), a non-invasive steatosis biomarker, has recently drawn attention for its clinical prognostic value, but has never been applied to HIV-HCV co-infected patients. We aimed at testing whether elevated FLI (≥60) was associated with all-cause mortality in co-infected patients.

Methods
Our study is based on data from ANRS CO13 HEPAVIH, a French national prospective cohort of HIV-HCV co-infected patients. Socio-behavioral and clinical data from patients clinically followed-up were used in the analysis. Using a Cox proportional hazards model for mortality from all causes (983 patients; 4,432 visits), we computed hazard ratios associated with risk factors and confounders.

Results
After multiple adjustment, individuals with FLI≥60 had almost double the risk of all-cause mortality (adjusted hazard ratio [95% confidence interval]: 1.91 [1.17-3.12], p = 0.009), independently of HCV cure (0.21 [0.07-0.61], p = 0.004), advanced fibrosis (1.77 [1.00-3.14], p = 0.05), history of hepatocellular carcinoma and/or liver transplantation (7.74 [3.82-15.69], p &lt; 10-3), history of indirect clinical signs of cirrhosis (2.80 [1.22-6.41], p = 0.015), and HIV CDC clinical stage C (2.88 [1.74-4.79], p &lt; 10-3).

Conclusions
An elevated fatty liver index is a risk factor for all-cause mortality in HIV-HCV co-infected patients independently of liver fibrosis and HCV cure. In the present era of nearly 100% HCV cure rates, these findings encourage the more systematic use of non-invasive steatosis biomarkers to help identify co-infected patients with higher mortality risk.

Key messages
A FLI≥60 is strongly associated with mortality in HIV-HCV co-infected patients. FLI could be calculated routinely to identify most at-risk patients.
Diabetes in Israel- do all patients receive equal care?
Authors: Wolff Sagy Y , Krieger M , Horwitz E , Ben-Yehuda A , Paltiel O , Ravel-Vilk S , Manor O , Calderon-Margalit R 
Published: November 2019

Abstract

Background
Diabetes Mellitus (DM) is associated with micro- and macro-vascular complications, leading to high burden of morbidity and mortality. Populations of low socioeconomic position (SEP) in various countries were found to have increased prevalence of the disease, worse glycemic control, and increased complications. We aimed to examine whether there are social disparities in diabetes care in Israel, as reflected in a national program for quality indicators.

Methods
The Israel National Program for Quality Indicators in Community Healthcare obtains data from electronic medical records from all health plans, covering the entire Israeli population. In 2017, 497,397 individuals aged &gt;18 years were identified with DM. DM prevalence, quality of care indicators, including process and intermediate outcomes were explored by SEP categories (1-10), determined according to residential addresses.

Results
DM prevalence in Israeli adults in 2017 was 9.7%, showing a strong SEP gradient, with higher prevalence in individuals of lower SEP. No SEP disparities were observed in process indicators with overall rates of documentation of hemoglobin A1c (HbA1c) of 90.9%, ophthalmologic examinations of 72.5%, and kidney function examinations of 92.5%. However, strong SEP disparities were observed in the prevalence of uncontrolled diabetes (HbA1c≥9%), with an overall rate of 10.0%, and a 5.4-times higher rate in diabetics of the lowest SES level (23.5%) compared with the highest SEP level (4.3%). A somewhat weaker gradient was seen for the well-control of DM (HbA1c&lt;7-8%, according to duration of disease and age), with an overall rate of 69.7%, and a 1.7 ratio, comparing diabetics of the highest vs the lowest SEP level.

Conclusions
These findings suggest that access to care does not explain SEP disparities in diabetes control in Israel. There is a need to explore the underlying social, cultural, and possibly the benefits-policy determinants of poor control among individuals of low SEP.

Key messages
Wide socioeconomic disparities are present among Israeli adults in diabetes mellitus prevalence and control rates, but not in care processes indicators. These findings call for a deeper understanding of the determinants and perhaps a revision of current social benefits policy, which may encourage lack of glycemic control.
Rising prevalence of diabetes: evidence from the national registry in North Macedonia
Authors: Stamenova A , Stevanovski G , Spasovski M 
Published: November 2019

Abstract

Background
Disease reporting and data collection are key tools for the health care systems in order to identify opportunities to address burden of diseases. The country’s diabetes patients register was the first registry to be integrated with the e-health system in North Macedonia in 2017. We aimed to estimate type 2 diabetes mellitus prevalence and effectiveness of diabetes control as one of the proposed national priorities in tackling the non-communicable diseases.

Methods
Cross-sectional descriptive study was conducted on patients entered in the National Diabetes Register in 2017/2018. Patients’ socio-demographic and anthropometric characteristics in association with diabetes’ complications and outcomes were determined by Pearson correlation coefficient (P &lt; 0.0001, 95% CI).

Results
This study identified a total of 35541 patients with a diagnosis of diabetes, out of which 32888 with type 2. This corresponds to a prevalence rate of 1583.9 per 100,000 population. The prevalence increased with age (65+) and was higher among females than males (56.8% vs. 43.2%). Over 80% of type 2 patients were overweight out of which 34.5% obese (BMI&gt;30kg/m2). Diabetic retinopathy is reported as first diagnosed complication in diabetic patients, followed by neuropathies and vascular complications. Patient’s low level of education and higher BMI were associated with increased number of early and late-onset complications.

Conclusions
Evidence accumulating suggests high burden of complications in type 2 diabetic patients, indicating that the patients understanding of diabetes care, treatment adherence and healthy lifestyle are important topics to be address by health professionals in order to avoid complications and premature deaths in people with diabetes.

Key messages
Integrated reporting of non-communicable diseases and risk factors is needed to complete current information gaps, from completeness of data to quality and comparability. The action plan for chronic diseases should specifically address diabetes control, as most of the patients with diabetes have high prevalence of comorbidities, complications and unfortunate outcomes.
Socioeconomic inequalities in cognitive performance among early ageing people: The Constances cohort
Authors: Letellier N , Carrière I , Cadot E , Berkman L , Goldberg M , Zins M , Berr C 
Published: November 2019

Abstract

Background
In spite of the recent awareness of environmental characteristic’s impact on brain aging, links between contextual socioeconomic status and cognitive performance (CP) remains unclear. The objective was to investigate the influence of individual and contextual deprivation on cognitive performance in order to better characterize vulnerable population.

Methods
We performed cross-sectional analyses on 44,762 participants (45-70 y) of the French Constances cohort. Cognitive performance was assessed using a global cognitive score calculated with 6 cognitive tests evaluating global cognitive function, episodic verbal memory, language abilities, and executive functions. Poor performance was defined as a score below or equal to the 25th percentile of the distribution. We approached the deprivation by two validated multidimensional index: at individual level with the EPICES score (deprived if &lt; 30.17) and contextual level with the FDep09 score divided in quintile (Q5 being the most deprived). Associations were estimated with multilevel logistic regressions.

Results
At the individual level, participants more deprived had poorer CP independently to sex, age, education and health status (OR 1.58 [1.48; 1.69]). At the contextual level, the more people lived in deprived environment, the poorer their CP (p&lt;.0001), even after adjustment on individual deprivation and other individual characteristics (Q5 vs Q1: OR 1.28 [1.15; 1.41]).

Conclusions
In this large cohort of early-ageing people, area-based disparities in cognitive impairment were highlighted. A better understanding of the influence of living environment deprivation level on cognitive aging could help to define new strategies in prevention by targeting at-risk populations in interventions studies in order to reduce social health inequalities.

Key messages
Our study evidenced a strong socio-economic gradient of cognitive performance identifiable on both individual and contextual level, in a large sample of middle-aged volunteers. Independently to individual deprivation and other individual characteristics, living in a deprived environment may be detrimental to the brain health.
Cancer incidence in the vicinity of a waste incineration plant in the Nice area between 2005-2014
Authors: Mariné Barjoan E , Doulet N , Chaarana A , Festraëts J , Viot A , Géloen C , Ambrosetti D , Mounier N , Bailly L , Pradier C 
Published: November 2019

Abstract

Introduction
Few studies on cancer incidence have been conducted since the EU 2000/76/EC Waste incineration directive.

Objective
To measure cancer incidence among the population exposed to atmospheric emissions from the Ariane waste incineration plant near Nice, in the Alpes-Maritimes (AM), compared to the unexposed AM population.

Methods
All primary invasive cancers and malignant haematological conditions diagnosed among AM residents from 01/01/2005 to 31/12/2014 recorded by the CRISAPPACA Cancer Observatory, public and private hospitals and the ONCOPACA-Corsica Network were included. The exposed area, based on an average dioxin deposition model, was that with a concentration ≥4.25ng/m2/year. Each case was geolocated and assigned to a predefined geographic unit (IRIS): 36 units in the exposed area, 462 in the unexposed area. The adjusted incidence rate, the standardized incidence ratio (SIR) and the Comparative Morbidity Figure (CMF) were calculated for two periods: 2005-2009/2010-2014.

Results
We recorded 80,865 new cancers in the AM population (1,083,974 residents; 87,462 exposed). For the 2005-2009 period, among exposed women, excess SIR were recorded of acute myeloid leukaemia (SIR = 1.81 [1.03-2.93]), myelodysplastic syndromes (SIR = 2.58 [1.70-3.76]) and myeloma (SIR = 1.64 [1.09-2.37]); in exposed men, of soft tissue sarcomas (SIR = 1.65 [1.05-2, 48]), myeloma (SIR = 2.04 [1.39-2.90]) and lung cancer (SIR = 1.19 [1.03-1.36]). For the 2010-2014 period, there was no excess SIR among women, while among men an excess SIR of myeloma (SIR = 1.76 [1.21-2.47]) and lung cancer (SIR = 1.24 [1.08-1.41]) was observed.

Conclusions
The higher incidence of myeloma and lung cancer in both periods can be explained by their long latency and by other risk factors. The EU Directive appears to have resulted in limiting atmospheric emissions from the incinerator.
Study funded by the Nice Côte d’Azur Metropolis and with the support of the South-PACA Regional Health Agency.

Key messages
Few studies on cancer incidence have been conducted since the EU 2000/76/EC Waste incineration directive. The EU Directive appears to have resulted in limiting atmospheric emissions from the incinerator.
Towards a better integration of health in urban development project: from theory to action
Authors: Roue-Le Gall A , Deloly C , Clement B , Nassiet C , Romagon J , Thomas M-F 
Published: November 2019

Abstract

Background
Despite a well knowledge about links between urban planning and health, practices’ analyze highlights the difficulty to upgrade health into urban planning decisions. To overcome this issue, the EHESP has initiated a specific research dedicated to the development of tools for a better integration of health & wellbeing at different decision-making-level (urban planning & urban development project). The objective of this presentation is to focus on one dedicated research, Isadora project, and to share how the project was carried out to enable the production of an operational tool dedicated to urban planners to better integrate health issues into their practices.

Methods
The scientific management team mixed various skills from public health, environment and urban planning sectors which makes easier the implementation of two key-principles of research: (i) to adopt a systemic approach to health determinants, (ii) to address urban settings through an integrated approach to public health, environment and sustainable development issues. The implementation of this interdisciplinary and intersectorial project is based on a close collaboration with a national working group composed of various professionals and academics (urban planning, environment, and health). The Isadora project deliverables results from an iterative process between all the stakeholders involved in the project.

Results and conclusions
First, we will present how we facilitated the working group throughout the deliverables development process and how we overcame the challenges of implementing intersectorality. Then, we will present the operational tool structured around of 15 key sheets with health focus to help professionals to integrate health at each step of an urban development project.

Key messages
ISadOrA project aspires to promote an evolution of urban planner’s practices in order to achieve a healthy urban development project. This ambition requires the translation of concepts into actions.
Neighborhood environment and physical activity among rural Japanese older adults
Authors: Okuyama K , Abe T , Nabika T 
Published: November 2019

Abstract

Background
Physical inactivity is one of the global health concerns. Rural populations in general tend to be more physically inactive and have higher risk for chronic conditions. Although numerous studies have assessed the association between neighborhood environment and physical activity to implement population level intervention, most are limited to urban adults. This study investigated potential neighborhood environment associated with physical activity for rural older adults in Japan.

Methods
The study subjects were from Shimane where is a rural-mountainous region in Japan. Those agreed to participate in the Shimane CoHRE study as of baseline (2010) and followed-up after 5 years were included in the analysis (mean age=71, n = 717). Subjects were asked if they engage in 30 minutes exercise more than twice a week at baseline and follow-up surveys. As a primary exposure, we computed mean land slope within 500 m street network buffer from residential point of each subject by geographic information system. Multiple logistic regression was conducted to estimate the odds of exercise engagement after 5 years by slope categorized in tertile, adjusting for age, BMI, and exercise habit at baseline.

Results
Significantly higher odds of exercise engagement was observed among those living in the hilly area compared to moderately hilly area after 5 years adjusting for baseline age, BMI, and exercise habit, (Odds ratio (OR): 1.71, 95% Confidence Interval (95%CI): 1.119, 2.616). There was no significant difference of odds between those in flat area and moderately hilly area (OR: 1.137, 95%CI: 0.738, 1.751).

Conclusions
This finding suggests that people living in hilly neighborhoods are more likely to maintain or start engaging in exercise after 5 years. Considering other potential environmental factors and farming culture within rural areas, future studies should capture various forms of environmental components and physical activity to dissect the mechanism.

Key messages
There are limited studies focus on rural older adults. Unique geographic feature in rural areas, i.e. hilly neighborhood might be associated with physical activity.
Environmental noise levels and noise annoyance in Novi Sad, 2012-2016
Authors: Zivadinovic E , Jevtic M , Dragic N , Bijelovic S 
Published: November 2019

Abstract

Objective
Increased noise level represents a significant public health problem in urban environments. The aim of this paper is to examine the annoyance of the population by road traffic noise in the City of Novi Sad.

Methods
The results of 161 24-hour noise measurements in Novi Sad were analyzed. Measurements were done by Public Health Institute of Vojvodina, according to accredited and standardized national methodology during 2012 - 2016.

Results
Total noise indicator (Lden) / night noise indicator (Lnight) ranged from 61,1 dB / 50,7 dB in residential, up to 66,3 dB / 58,1 dB in recreation / hospital areas, 68,0 dB / 60,3 dB in city traffic areas and 70,2 dB / 62,7 dB in business and residential areas. Taking into account the results and using methodology prescribed by national regulations, the percentage of highly annoyed population (% HA) was found to be in the range 11-25% during the day, and 6-13% during the night. Using ISO 1996-1:2016, prevalence of a population highly annoyed (PHA) was established to be in the range 9,2-33,9% in residential; 18,4-45,7% in recreation / hospital areas 22,9-50,6 in city traffic; 27,7-55,4% in business and residential areas.

Conclusions
The results confirm that urban noise seriously disturbs people. It was established that about a half of the population was highly annoyed which poses a serious challenge for public health. The results have social, health and economic importance for the population. Activities to reduce the noise level could also stimulate economic, health, social and community programs for sustainable development aiming to preserve and improve human health.
Acknowledgment: Supported by the Ministry of Education and Science of the Republic of
Serbia - Project “Biosensing Technologies and Global System for Continuous Research and
Integrated Management”, No.43002

Key messages
Continous noise monitoring is important for understanding the impact of noise on human health. About a half of the population was highly annoyed by noise, which poses a big challenge for public health in urban areas.
Evaluation of growth monitoring activity in Yopougon-Est Health District (Abidjan, Côte d’Ivoire)
Authors: Gbogbo F , Thonneau P 
Published: November 2019

Abstract

Background
Malnutrition represents 11% of disease burden in the world and is an underlying cause of 45% of under-5 deaths. Prevention is paramount in the fight strategy. That is why, “growth monitoring” which goal is to prevent and to detect malnutrition, has been integrated into health programs. In Côte d’Ivoire, although this activity is carried out in the health centers and despite the existence of Guidelines to improve services, under-5 malnutrition prevalence remains above thresholds. Our purpose was to assess the gap between the National Guidelines for growth monitoring and the practices of health workers.

Methods
A descriptive cross-sectional study was conducted in all the 6 public health centers of Yopougon-Est District, from August 22 to September 05, 2018. Data were collected using an observation grid developed from the Guidelines and 3 questionnaires. Six growth monitoring sessions were observed; 6 responsibles, 9 health workers assigned to the activity and 133 mothers came to monitor their child were interviewed after informed consent.

Results
The growth monitoring sessions were held every working day in 4 centers. Half of health workers assigned to the activity had not received training. All centers had baby scale, 5 had horizontal height, but only one had vertical height and person scale. Most health workers (78%) were not aware of Guidelines. The steps of “interrogation and examination” component were only 58% completed. The steps for weight measurement were completed at 96% and at 70% for size. The nutritional status of children was evaluated in only one center. In no center, health workers traced growth curve. Nearly half of the mothers surveyed (45%) had not received counseling during their visits.

Conclusions
The study highlighted shortcomings that do not allow the achievement of growth monitoring objectives. This study cannot be extrapolated however it raises real questions about the quality of the services provided in health centers.

Key messages
An evaluation at large scale needs to be conducted and corrective actions to be taken to improve the growth monitoring activity for effective prevention and early detection of malnutrition. Growth monitoring will be effective in preventing malnutrition only if it is well conducted by health workers.
Evaluation, recommendation and implementation of the local hospital catering system
Authors: Barocco G , Germano D , Patussi V , Cella M , Tiziana L , Pernarcic A , Occoni E , Calabretti A , Bogoni P 
Published: November 2019

Abstract

According to the literature the prevalence of the risk of malnutrition o hospitalized people exceeds 25% of patients, this evidence is also related to low meal satisfaction. To reduce hospital malnutrition it is also important to improve the consumption of meals by implementing organoleptic and nutritional quality (O&NQ).
The Local Health Agency of Trieste (ASUITS) has conducted surveys to find out how to evaluate and improve the procurement qualifications of hospital catering systems (HCS) and how to implement O&NQ. The production processes of meals served in two clinics using Cook Chill (CC) and Cook/Fresh - Hot Hold (CFHH) production process, respectively, were evaluated from 2017 - 2019. The Nutrient Analysis Critical Control Point process was applied for the evaluation of two catering systems. In addition, the antiradicalic power (ARP) of 120 samples of meals by the University of Trieste was analysed. In 2019 an investigation was conducted to compare the satisfaction and ARP content of meals served to patients in two hospital wards (N = 60). The meals to patients of two wards respectively with CC Cold Plating Retherm (PR) and CC Hot PR were served.
Meals produced by the CC production process highlight the average loss of 50% of ARP compared to the CFHH. Meals produced by the CC Cold PR method limit the loss of ARP by 15-40% less compared to the CC Hot PR method. The satisfaction of patients who have consumed meals produced by the CC Cold PR method is double compared to that of patients who have consumed meals produced by the CC Hot PR method. The surveys have produced significant evidence to evaluate hospital meal production processes and to improve O&NQ. The results were used to develop recommendations for the drafting of tender specifications capable of also protecting nutritional variables.
The evaluation of the O&NQ of HCS represents a central determinant of food safety and nutrition security and must be taken into consideration in the procurements procedure.

Key messages
Hospital catering contracts must evaluate and guarantee organoleptic and nutritional quality. Integrated evaluation of organoleptic and nutritional quality is an integral part of hospital meals.