bluuebunny/crossref_metadata_2025_split huggingface dataset:
How to tackle the growing problem of type 2 diabetes in the European Union?
Authors: Mahrouseh N M , Njuguna D W , Varga O A 
Published: October 2020

Abstract

Background
There is an alerting increase in the population affected by type 2 diabetes mellitus (T2DM) in the European Union (EU) with significant socioeconomic burden. According to an estimation by the International Diabetes Federation, by 2030, the total number of diabetic patients will be 38 million in EU. The “screen and treat” strategies that predominantly applied in policies to prevent T2DM have not achieved significant success, as reported by a large systematic review and meta-analysis published in 2017. Although the member states of the EU have almost full responsibilities for actions in the field of health, the EU has to tackle non-communicable diseases by targeting health determinants and lifestyle mostly through non-binding policies. The goal of this work is to review the T2DM prevention policies in the EU and compare with tobacco policies, from a legal perspective.

Methods
Following the systematic search and screening of policies from EUR-lex, a content analysis was carried out by using MonQcle as publicly available legal text document analysis platform, by two coders. The search was limited for regulations, directives and white papers.

Results
Our data collection consisted of 19 documents including 10 regulations, 6 directives and 3 white papers with relevance to T2DM, covering the following topics: health infrastructure and services, informational policies, economic policies, environmental policies, command and control and social policies. The identified policies covered the time frame of 1972 to 2020. Diabetes was targeted as part of non-communicable diseases. None of the policies was legally binding addressing T2DM directly which is in sharp contrast to the tobacco control policies in the EU.

Conclusions
T2DM, in fact, is largely preventable. EU institutions should consider to reframe T2DM prevention strategies and consider applying a wide range of population-level legislative and innovative actions to prevent T2DM e.g. taxes on unhealthy food products.

Key messages
T2DM is a largely preventable disease, effective legal tools should be created and applied matching the scale of such public health problem. T2DM policies of the EU may be subject to change due to additional value of actions taken by the EU compared to that could have been achieved by member states alone.
Prospective associations of four nutrient profiles with weigh gain, overweight and obesity risk
Authors: Egnell M , Neal B , Ni Mhurchu C , Rayner M , Jones A , Seconda L , Touvier M , Kesse-Guyot E , Hercberg S , Julia C 
Published: October 2020

Abstract

Background
Nutrient Profiling Systems (NPSs), including the UK Food Standards Agency NPS and its variants are used to classify foods according to their nutritional composition for nutrition policies. The prospective validity of these NPSs requires however further investigation. The study investigates the associations of the original Food Standards Agency (FSA)-NPS and three variants - the Food Standards Australia New Zealand Nutrient Profiling Scoring Criterion (NPSC), the Health Star Rating (HSR) system NPS and the French NPS (HCSP-NPS) -, which are used as a basis for nutrition policies, with weight status.

Methods
Dietary indices based on each of the four investigated NPSs applied at the food level were computed at the individual level to characterize the diet quality of 71,178 French individuals from the NutriNet-Santé cohort. Associations of these Dietary Indices (DIs) (as tertiles) with weight gain were assessed using multivariable mixed models, and with overweight and obesity risks using multivariable Cox models.

Results
For the four NPSs, participants with a lower diet nutritional quality were more likely to have an increase in body mass index over time (median follow-up of 3.14 ± 2.76 years, beta coefficients positive, all p ≤ 0.0001), and an increased risk of overweight (HRT3vs.T1=1.27 [1.17-1.37] for the HCSP-DI, followed by the original FSA-DI with HRT3vs.T1=1.18 [1.09-1.28], the NPSC-DI with HRT3vs.T1=1.14 [1.06-1.24] and the HSR-DI, HRT3vs.T1=1.12 [1.04-1.21]). Whilst differences were small, the HCSP-DI appeared to show significantly greater association with risk of overweight compared to other NPS.

Conclusions
Less healthy diets defined using the Food Standards Agency-NPS and related systems were all associated with weight gain and overweight risk. Demonstrating this association with health outcomes is an important indicator of one validity dimension of NPSs and supports their use in public policies for the prevention of diet-related chronic diseases.

Key messages
Nutrient profile models of foods and beverages allow capturing the nutritional quality of diets and are prospectively associated with weight gain and obesity. The French NPS which underpins the front-of-pack Nutri-Score appeared to have a small but significant higher performance.
The metabolic profile associated with head and neck cancer genetic variation and dietary intake
Authors: Hoxhaj I , Ahmad S , Liu J , Pastorino R , Boccia S , van Duijn C M , Amin N 
Published: October 2020

Abstract

Introduction
Various single nucleotide polymorphisms (SNPs) have been associated with Head and Neck Cancer (HNC) susceptibility and prognosis. The pathogenesis of HNC is related to alterations in metabolite concentrations. Dietary intake may also influence the metabolic profile. We aimed to evaluate the association between serologic metabolites on the one hand and on the other hand HNC related SNPs and dietary intake.

Methods
This study included participants from the Erasmus Rucphen Family Study (ERF). We identified the SNPs associated with HNC from the GWAS Catalog, reaching genome-wide significance at P &lt; 5 × 10−8. We performed regression analyses to evaluate the association of SNPs dosage with the metabolites and the association between metabolites and dietary intake.

Results
The study included 2758 participants, in whom 820 metabolites were analyzed. Four SNPs showed a significant association with circulating metabolites: rs174549 with phosphatidylcholine diacyl (β = 0.45; p-value= 7.17 × 10− 40), rs310518 with lipoprotein IDL sub-fraction, rs1229984 with triglycerides and rs1494961 with propionylcarnitine. The minor variant allele of the 4 SNPs showed increased level of the metabolites in blood. As to the association diet and metabolite concentration, significant associations were found for dairy products with sphingomyelin, fish intake with phosphatidylcholines, cholesterol esters with vegetables and myoinositol with fruits intake.
When the results of both analyses were merged, 5 metabolites were found to be associated with dietary variables and rs174549. In the minor allele carriers, phosphatidylcholines increased with consumption of fish and phosphatidylethanolamine increased with consumption of diary products.

Conclusions
The genetic variants rs174549, which is a determinant of genetic HNC susceptibility, is associated with phosphatidylcholines and phosphatidylethanolamine in the circulation.

Key messages
In the minor allele carriers of rs174549, phosphatidylcholine diacyl level in circulation increased with consumption of fish. In the minor allele carriers of rs174549, phosphatidylethanolamine level in circulation increased with consumption of diary products.
Geographic Information System as a health improvement tool: a resettlement camp in Mozambique
Authors: Pinto de Oliveira A , Kapasula F , Correia F 
Published: October 2020

Abstract
Cyclone Idai have devastated and displaced an estimated 1.85 million individuals across Mozambique. Around 90,000 cyclone survivors have been relocated to 66 resettlement camps. Doctors of the World Portuguese Delegation team is supporting the Sanitary Post of a resettlement camp, located in a remote rural area with limited resources. The first intervention was to build an epidemiological surveillance system in order to prevent and control communicable and non-communicable diseases and to improve access to health care.
The health status in the resettlement camp using conventional and geographic information system techniques were attempted as a community-based census-type cross-sectional study. Location of tents, water holes and latrines were mapped.
There were 2,170 people living in the 402 households interviewed. The reported age range of population was 1 day to 99 years, with a mean 19.3 years and a median of 15 years. Among residents, 4% (n = 90) reported a non-communicable disease: hypertension (75.5%), respiratory disease (22.2%), and a range of conditions (2.3%). The prevalence of mental and physical disabilities was 1.8% (n = 39). Regarding individual behavioral risk factors, 6.7% and 5.6% of the residents over 15 years, were currently using tobacco and alcohol, respectively. The distance from any household to the nearest waterpoint is less than 500 meters and almost all households (98.5%) distance more than 50 meters from the nearest toilet, as the standard recommended. The average number of people in the camp are in the standard recommended of 20 people per toilet facility with a ratio 15.8 person per latrine.
Geographic information system technology was helpful for the improvement of strategies on surveillance, prevention and control regarding communicable and non-communicable diseases, in the resettlement camp. Also made it possible to set up a home health care system, promoting access to health care for the disabled residents.

Key messages
Geographic information systems proved to be very useful in the implementation and organization of the epidemic surveillance system of resettlement camp. The epidemic surveillance system allowed us to implement a home care system for patients with disabilities, to respond to acute illnesses and chronic diseases agudizations, and to identify outbreaks.
Identifying language disorder in bilingual children is possible only if both languages are assessed
Authors: Nayeb L , Sarkadi A , Eriksson M , Salameh E K , Lagerberg D 
Published: October 2020

Abstract

Background
The number of bilingual people increases worldwide. In Sweden, one-third of all preschool age children are bilingual. Previous studies reported that bilingual children are at risk of being overlooked for early identification of language difficulties. There is a need of validated assessment instruments for identification of language disorder in bilingual children.

Aim
To investigate whether the language screening for three-year-olds used in Swedish Child healthcare would detect developmental language disorder (DLD) in bilingual children 6 month earlier.

Methods
Overall, 111 bilingual children (51% girls), 29-33 months, were screened from November 2015 to June 2017. They were recruited from three child health centres serving areas of low socio-economic status in Gävle, Sweden. The children were screened both in their mother tongue and in Swedish at the child health centre and consecutively assessed for DLD by a speech and language pathologist, blinded to the screening outcomes.

Results
Preliminary results from combining screening in Swedish and the child's mother tongue showed good accuracy: 88% sensitivity, 82% specificity, 67% positive and 94% negative predictive values. DLD was confirmed in 32 children (29%), of which 87.5% had screened positive and 12.5% negative. Specificity and positive predictive value increased radically when both languages were assessed, whereas sensitivity was less affected. A majority of the children who did not cooperate in the screening turned out to have DLD.

Conclusions
A language screening should be performed in the child's both languages, in order to achieve adequate sensitivity, specificity and positive predictive value. This procedure is highly relevant for children from low socio-economic families with a complex linguistic environment who tend to be at an increased risk of severe DLD.

Key messages
The procedure combining the child’s two languages identified language disorder in bilingual children at age 2.5 compared with assessment in only one language. Child healthcare nurses should screen bilingual children in both their languages in order to reflect their full language capacity equally as in monolingual children.
Bias correction in self-reported high blood pressure prevalence based on objectively measured data
Authors: Kislaya I , Leite A , Machado A , Tolonen H , Torres A , Nunes B 
Published: October 2020

Abstract

Background
Reliable and precise estimates of high blood pressure (HBP) prevalence are essential to inform decision-making and policies evaluation. Self-reported HBP may be underestimated by surveys due to misclassification of health status by participants. Misclassification may lead to inaccurate inference. We aimed to assess a feasibility of correcting misclassification bias in self-reported HBP in the Portuguese component of the European Health Interview Survey (INS2014) using data on objective blood pressure measurements from a smaller health examination survey (INSEF).

Methods
We assumed that “true” measured HBP status was missing at random for INS2014 participants (n = 13937). Using a multiple imputation method of logistic regression for monotone missing data patterns, HBP was imputed for INS2014 sample. Auxiliary data on measured HBP from INSEF (n = 4910) was used. Crude and corrected HBP prevalence rates stratified by sex and age group were calculated.

Results
HBP prevalence based on INS2014 increased significantly after multiple imputation correction, from 22.0% [CI95%:20.6-23.5%] to 38.8% [35.4-41.9%] for men and from 26.8% [25.3-28.3%] to 33.0% [30.5-35.4%] for women. Corrected estimates were similar to the objectively measured from INSEF, 39.6% for men and 32.7% for women. Corrected HBP prevalence in INS2014 increased from 4.1% [2.9-5.9%] to 7.9% [4.0-11.8%] in 25-34 years old (yo); from 9.3% [7.8-11.0%] to 17.6% [14.0-21.3%] in 35-44 yo; from 22.5% [20.3-24.8%] to 38.7% [34.2-43.2%] in 45-54 yo; from 39.8% [37.2-42.4%] to 53.8% [49.1-58.5%] in 55-64 yo and from 54.3% [51.5-57.1%] to 67.7% [63.1-72.3%] in 65-74 yo. Corrected rates were similar to the obtained by INSEF (5.7%, 17.0%, 35.8%, 54.8% and 71.3%, respectively).

Conclusions
Our results highlight the importance of bias analysis when using self-reported data on HBP. Multiple imputation is a feasible approach to adjust misclassification bias in health outcomes collected by population surveys.

Key messages
The magnitude and direction of misclassification bias in self-reported health outcomes should be investigated. Multiple imputation is a feasible approach to misclassification bias correction in self-reported survey data.
Decannulation in Acquired Brain Injury patients: the clinical impact of the process standardization
Authors: d'Angelo M , Michelutti A , Biasutti E , Quattrin R 
Published: October 2020

Abstract

Background
Decannulation is one of the first rehabilitation goals for Acquired Brain Injury (ABI) patients: from July 2017 the ABI unit of the Institute of Physical and Rehabilitation Medicine 'Gervasutta” adopted a decannulation protocol developed by the Italian Society of Physical Medicine and Rehabilitation (SIMFER). The current study aims to evaluate the impact of the process standardization on ABI patients.

Methods
A retrospective case-control study was conducted: clinical outcome and hospitalization indicators in ABI patients with tracheal cannula were measured in reference to the decannulation procedure applied. Data were collected from patients' records from 2014 to 2017. SISA software was used for the statistical analysis.

Results
A sample of 141 ABI patients was collected: among these 57 (40.4%) were treated with the new procedure. No statistically significant differences between control and case group were reported in terms of age, gender, aetiology of brain damage, cognitive and functional impairment as well as in terms of average days from admission to decannulation [39 (27); 35 (30)] and percentages of respiratory complications [20% vs 29.8%]. Decannulation rate was significantly higher in the case group (OR = 1.8; 95% CI = 1.2- 9.8; p &lt; 0.01). Considering the case group, the simple linear regression analysis highlights a positive significant correlation between the length of hospitalization and days from decannulation to discharge (r = 0.3; p = 0.01) as well as from the date of oral feeding resumption and discharge (r = 0.4; p &lt; 0.01).

Conclusions
Higher decannulation rate with no increase in respiratory complications was registered with the introduction of the new protocol. The shortening of average days from patients' admission to decannulation, even if not statistically significant, as well as the results from the simple linear regression analysis probably highlights further advantages due to a major safety related to the presence of a decision algorithm.

Key messages
The standardization of the decannulation process allowed the achievement of one of the first goals for the rehabilitation of Acquired Brain Injury (ABI) patients. The process standardization allowed a reduction of average days from patients’ admission to decannulation, probably due to a major safety related to the presence of a decision algoritm.
A retrospective study of a pre-travel consultation in the Lisbon Metropolitan Area, Portugal
Authors: Galhano Lopes D , Bragança Pereira M , Machado Gil M , Duarte S , Moreira A , Cunha I , Abreu Gomes F , Bastos L , Esteves H 
Published: October 2020

Abstract

Background
Travel from Portugal to other countries has increased in the past 5 years. A pre-travel health consultation is advised to all travellers to raise awareness and reduce travel-related risk. We describe the experience of a pre-travel consultation centre in the public health service.

Methods
A retrospective observational study about consultations in an international vaccination centre between 2014-2018. Variables included were: sex, age, destination, purpose, referral, and prescriptions. Descriptive analyses were performed for all variables.

Results
Between 2014 and 2018, there were 1,546 consultations. Regarding individual characteristics, 54% were female, and 80% had between 15 and 64 years of age. There was no referral in 66% of the consultations, followed by 16% from general practitioners in the Primary Care Centres Group. The leading destination was Africa (54%), in a downward trend (74% in 2015 and 32% in 2018) followed by Asia (18%) with an upward trend (12% to 28% in the same period). The primary purpose was tourism (83%), followed by work (9%). In total, 3,287 vaccines were prescribed with typhoid fever vaccine accounting for 26%, hepatitis A vaccine 22%, and yellow fever vaccine 15%. Mefloquine was the primary therapeutic drug prescribed for destinations with risk for malaria (41%). Regarding destinations with low risk for malaria, in 42% of the consultations, personal protective measures were the only recommendation.

Conclusions
Our data show that pre-travel consultations seem to be valued and actively asked for by travellers, but medical referral is still insufficient. Regarding health promotion and prevention of diseases, tracking trends in the most common destinations allows to optimize the information provided in the consultation, effectively capacitating the traveller to recognize and act on the most common travel-related health risks. In further studies, a post-travel follow-up should be carried out to determine the impact of the consultation.

Key messages
Pre-travel consultation is an actively sought-after service by the community, but awareness should be promoted in the medical community. Pre-travel consultation can have an important role in the health literacy of travellers.
MoRoNet a network to strengthen the quality of measles and rubella surveillance in Italy
Authors: Magurano F , Baggieri M , Bucci P , D'Ugo E , Sabbatucci M , Maraglino F , Iannazzo S , Marchi A , Nicoletti L 
Published: October 2020

Abstract

Background
Measles is a vaccine-preventable infectious disease and it remains one of the leading causes of infant mortality globally. The World Health Organization (WHO) has adopted the goal of eliminating measles and rubella. Detection and control of communicable diseases would not be possible without accurate laboratory results regarding when and where a particular disease circulates.

Methods
WHO/Europe therefore works with all Member States to steadily improve the quality of the laboratory data in order to determine the Region's progress towards measles and rubella elimination. For this purpose coordinates the European Measles and Rubella Laboratory Network (MR LabNet). National labs in this network undergoes regular external quality assessment through an annual accreditation programme.

Results
In Italy, a Sub-national Reference Laboratories Network for measles and rubella (MoRoNET) has been developed since March 2017 and currently includes 15 laboratories. MoRoNet was developed following the indications of the MR LabNet. It is accreditate, coordinated and supervised by the National Reference Laboratory.

Conclusions
Strengthening the role of national laboratories in overseeing the performance of subnational laboratories has become a critical need in order to properly monitor the Region's measles and rubella elimination efforts. MoRoNet permits to Italy to develop a country-specific work plan for establishing national networks and oversight mechanism, including preliminary monitoring and evaluation indicators compliant with MR LabNet standards. This is very significant not only to optimize the participation in national and regional processes to verify disease elimination, but also to strengthen the quality of vaccine-preventable disease surveillance.
MoRoNet Group: A Amendola; F Baldanti; MR Capobianchi; M Chironna; MG Cusi; P D'Agaro; P Lanzafame; T Lazzarotto; K Marinelli; A Orsi; E Pagani; G Palù; F Pittaluga, A Sacchi; F Tramuto.

Key messages
MoRoNet has permitted to Italy to develop a country-specific work plan for establishing national networks and oversight mechanism, compliant with WHO MR LabNet standards. MoRoNet network has permitted to optimize the participation in processes to verify disease elimination, but also to strengthen the quality of vaccine-preventable disease surveillance.