bluuebunny/crossref_metadata_2025_split huggingface dataset:
Objective and subjective assessment of the neighborhood health environment, Limassol, Cyprus
Authors: Kleopa D , Panayiotou A , Kouta C , Middleton N 
Published: October 2021

Abstract

Background
While neighborhood audit tools are commonly assessed for inter- and intra-rater reliability, validity and relevance are not always demonstrated.

Methods
A stratified random sample of 45 neighbourhoods in Limassol were audited with the 150-item Cyprus Neighborhood Observational Tool for urban environments (CyNOTes). Ratings were correlated with census indicators of socioeconomic disadvantage. The extent to which residents' neighborhood assessment (Place Standard, N = 444) and self-rated quality of life (SF-36 in second sample N = 450) differed across neighborhoods classified according to domain were explored in mixed random effect models.

Results
CyNOTes items are organized in 9 domains (internal consistency=0.5-0.9) with a 3-factor higher structure. In seven, a stepwise pattern of lower mean ratings was observed across increasing socioeconomic disadvantage, for domains rated generally high across neighborhoods (e.g. lack of physical disorder) and low (e.g. outdoor spaces). Though not always statistically significant, a systematic pattern of higher self-rated health was observed in better-off neighborhoods across most domains. “Pedestrian environment” captured the largest difference for both physical (1.34 95%CI 0.42,2.26), p = 0.005 per tertile increase) and mental health (1.46 95% 0.54,2.40; p = 0.003). “Social contact” and “Safety: lack of security-related features” were more likely to be rated favorably in disadvantaged neighborhoods, however no associations with quality of life were observed. While the residents' assessment was often in the expected direction, more for built environment features, this was not always the case.

Conclusions
The study demonstrated the content, construct, criterion and predictive validity of an audit tool for supplementary profiling the built, physical and social health-related neighbourhood environment. Concurrent validity against residents' perceptions was not always supported, raising questions about differential expectations.

Key messages
Neighbourhood audits can provide useful supplementary information not captured by other community assessment methods and independent of residents’ perceptions. Depicting the social gradient in the neighborhood microenvironment can trigger and contextualize the conversation about place effects on health among Public Health research and policy community.
Non-driving older adults living in a rural hilly area are at high risk for poor physical function
Authors: Abe T , Okuyama K , Miyazaki R 
Published: October 2021

Abstract

Background
While some studies have found an association between built environments and physical function, it is unclear whether living in a hilly area is associated with poor physical function among older adults, and whether this association varies by car driving status. This cross-sectional study investigated the association between hilliness and physical function in community-dwelling older adults and whether it varied according to their car driving status.

Methods
Data were collected from 633 participants aged 60 years and older living in Okinoshima Town, Shimane prefecture, Japan, in 2018. Physical function was objectively assessed; &lt; 1.0 m/s was defined as poor walking speed, and hilliness was measured by mean land slope within a 1000-meter network buffer zone around each participant's home using geographic information system. Logistic regression examined whether hilliness was associated with poor walking speed adjusted for sex, age, body mass index, current smoking, current alcohol consumption, exercise habits, current chronic disease, and living arrangements. A stratified analysis by car driving status was also conducted.

Results
A total of 159 (25.1%) participants had poor walking speed. After adjusting for all confounders, hilliness was positively associated with poor walking speed (OR = 1.07, 95% CI, 1.02-1.12). The stratified analysis by car driving status showed that living in a hilly area was positively associated with poor walking speed among non-drivers (OR = 1.10, 95% CI, 1.03-1.17), though there were no associations among drivers (OR = 1.00, 95% CI 0.92-1.08).

Conclusions
Our study found that a hilly environment was associated with poor walking speed in community-dwelling older adults in Japan. Moreover, car driving status potentially modified the relationship between living in a hilly environment and poor walking speed.

Key messages
Older adults living in a hilly environment were more likely to have poor walking speed, compared to those living in less hilly area. The stratified analysis by car driving status showed that non-driving older adults living in a rural hilly environment may be at high risk for poor physical function.
Natural radiation and high metal soil content are linked with higher cancer mortality rates
Authors: Katsifara A , Sazakli E , Jelastopulu E , Leotsinidis M 
Published: October 2021

Abstract

Background
General population is at continuous risk of exposure to both natural and anthropogenic pollutants via the oral, respiratory and dermal routes. In Greece, there are areas where the geological background is rich in both radioactivity and toxic elements, whereas anthropogenic activities, like lignite or metal mining, augment the general population exposure. The aim of the study was to compare cancer mortality rates among neighboring prefectures that share similar demographic and socio-economic characteristics, but differ in natural radioactivity and in carcinogenic metals' burden in soils.

Methods
Based on radiological and geochemical maps, five prefectures of North Greece with high radioactivity and metal's content in soil were chosen. Two similar prefectures with low radioactivity and metals' content served as control areas. Data about population structure and number of deaths due to neoplasms were obtained from the Hellenic Statistical Authority for a 15-year interval (1999-2015). Cancer mortality rates were calculated and compared between areas by Poisson regression.

Results
The total population in burdened areas was 660.091, while in the control areas was 207.117 (2011 Census). Mortality rates from burdened areas were higher than those in the control areas. Odds ratios ranged from 1.42 (95% CI: 1.35-1.49) to 1.79 (95% CI 1.71-1.88) for males and from 1.27 (95% CI: 1.19-1.35) to 1.85 (95% CI: 1.74-1.96) for females. For both sexes, the odds ratios ranged from 1.35 (95% CI: 1.30-1.41) to 1.80 (95% CI: 1.74-1.87).

Conclusions
Undoubtedly, our preliminary results reveal that residents in burdened areas are at higher risk for cancer death due to exposure to naturally occurring metals and radiation. Both the general population and the health authorities are unaware of these possible threats and no protective measures have been taken so far. Viable strategies to minimize or prevent these unintentional risks are of high priority in these areas.

Key messages
Population should be informed about the unintentional environmental exposures that pose health risks. Appropriate mitigation strategies should be implemented by the health authorities.
The behavioral risk factors of non-communicable diseases in the Russian Federation
Authors: Soshnikov S , Halfin R , Madyanova V 
Published: October 2021

Abstract

Background
Behavioral risk factors are one of the significant problems in Public health around the world. The authors of the current research are involved in The Global Burden of Diseases, Injuries, and Risk Factors Study, which provides a graded and complete estimation of risk factor exposure, relative risk, and attributable burden.

Methods
Relative risks we assessed as a function of exposure based on issued systematic reviews for the GBD 2019 study and meta-regression. The exposure levels for each year, age, gender, location included in the survey we calculated based on all available data sources using Gaussian Spatio-temporal regression, DisMod-MR 2.1, Bayesian meta-regression method.

Results
Behavioral risk factors determine a loss of 42.2% DALYs (56% in males and 28.5% in females) from all non-communicable diseases (NCD) in the Russian Federation. It causes 49% of all NCD-related deaths (62% in males and 37% in females). The main burden came from cardiovascular diseases (CVD). Behavioral risk factors affect 60% of DALYs (71.5% in males and 47.6% in females) burden and determine 54% of all NCD deaths (67% in males and 44.5% in females). In second place are neoplasms determined by behavioral risk factors on 39% of DALYs (51.6% in males and 23.6% in females) and 38% of deaths (53% in males and 22% in females).

Conclusions
Behavioral risk factors are one of Russia's most critical public health challenges; they affect about half of the loss of health of the population from non-communicable diseases. The appropriate policies for preventing non-communicable diseases that include consideration of behavioral risk factors, it is possible to achieve excellent results in preventing premature mortality and loss of public health. We have a great potential to reduce health losses from NCD in Russia.

Key messages
The behavioral risk factors determine almost half of all NCD-related deaths in the Russian Federation. Males in Russia are more susceptible to behavioral risk factors than females.
A proteomic approach of the different environmental conditions of Listeria monocytogenes
Authors: D'Onofrio F , Krasteva I , Schirone M , Torresi M , Tittarelli M , Pomilio F , Iannetti L , Di Febo T , Luciani M 
Published: October 2021

Abstract

Listeria monocytogenes is the ubiquitous food-borne pathogen which causes listeriosis, a disease with a high mortality rate, mostly transmitted through contaminated ready-to-eat foods. To better understand the systemic response of L. monocytogenes exposed at 3 environmental factors (T, pH and NaCl), the proteome of L. monocytogenes strain NRG 1749-2016, isolated from a meat product, was investigated to identify differences in the protein patterns of such pathogen. Four different conditions were carried out as follows: A) T 37 °C, pH 7.0, NaCl 0.5%; B) T 37 °C, pH 5.5, NaCl 7%; C) T 12° pH 7, NaCl 0.5%; D) T 12 °C, pH 5.5, NaCl 7%. The proteins belonging to cytosol (C1) and vesicles (C2) were isolated and purified by CelLytic B Cell Lysis Reagent and CelLytic IB Inclusion Body Solubilization Reagent according manufacturer's instructions. The analysis were conducted by SDS PAGE and Immunoblotting techniques. The protein concentrations were evaluated by Pierce BCA Protein Assay Kit. From preliminary results, the protein banding patterns generated by 1D SDS PAGE were found to be different at visual observation for C1 and C2, in A, B, C and D conditions. The presence of specific antigen-antibody immunocomplexes (Ag-Ab ICs) was identified by Immunoblotting, in C1 at 100, 60, 55, 35 and 25 kDa for all incubated conditions with a positive serum to L. monocytogenes. As regards C2, Ag-Ab ICs at 110 kDa were observed in A and B, Ag-Ab ICs at 80 kDa in C and D, Ag-Ab ICs at 60 kDa in A and D, while Ag-Ab ICs at 40 and 30 kDa in all conditions. The analysis of the proteome profiles shows an intra-strain variation in the protein patterns produced by L. monocytogenes during the adaptation at different environmental conditions. Further analysis will be carried out to better understand the systemic response of L. monocytogenes, in particular in order to characterize the immunogenic proteins highlighted by Immunoblotting and their role in the virulence expression of such pathogen.

Key messages
Understand how L. monocytogenes adapts physiologically to different environmental factors. Development of new detection method of L. monocytogenes and prevention strategies for listeriosis outbreaks.
Antimicrobial resistance of Listeria monocytogenes human strains and correlation to genomic data
Authors: Chiaverini A , Curi R , Gori M , Blasi G , Torresi M , Centorotola G , Di Francesco CE , Acciari VA , Pomilio F , Centorame P 
Published: October 2021

Abstract

Background
Studies checking antimicrobial resistance (AMR) of Listeria monocytogenes (Lm) are ongoing, coupled with disease surveillance. Lm resistant strains are reported and are increasing. The aim of the work was to investigate AMR of clinical strains of Lm collected from nine regions (mostly in Lombardy and Marche regions) from 2008 to 2020.

Methods
The dataset consisted of 233 Lm human strains collected from nine regions during the period 2008-2020. All the strains were tested using Sensititre™ Haemophilus Plate (Thermo Scientific, Milano, Italy). Results were expressed according to EUCAST breakpoints for Lm, S. pneumoniae and E. faecalis. Resistant strains were sequenced using Illumina platform, ABRicate was used to predict antimicrobial resistance genes and plasmids.

Results
Most of the strains were detected in Lombardy and Marche. The MIC results showed that 11 out of 233 strains were resistant, one to ampicillin, four to tetracycline and six to clarithromycin. Analysing the sequences, all the resistant strains showed to have a common antimicrobial resistant pattern (mprF, norB, FosX, (MLS)lin, lin and lmo0919). Genomic determinants for ampicillin and clarithromycin resistance were not detected. Indeed, only in 3 out of 4 resistant strains tetM was found. Meanwhile, plasmids were detected in 7 strains.

Conclusions
The distribution of the strains considered in this work did not reflect the real epidemiological situation in Italy, because their origin was mostly from two regions. The emergence of AMR also for Lm needs to be considered. Moreover, official breakpoints for Lm are not defined and to date limited to five antimicrobials excluding clarithromycin and tetracycline, where the pathogen showed resistance. Finally, the incongruence between phenotypic and genomic data suggests that the mechanisms involved in the resistance is not fully known especially for ampicillin. Further investigations are needed to improve the knowledge on Lm AMR.

Key messages
Monitoring AMR of Listeria monocytogenes is crucial, only effective drug in clinical cases should be used. Further investigations are needed to explore the mechanisms involved in antimicrobial resistance of Listeria monocytogenes.
Health impact assessment of a voluntary protocol to decrease salt in bread: what can we learn?
Authors: Costa L , Santos J , Alves J , Braz P , Brazão R , Costa A , Santos M , Assunção R , Caldas de Almeida T 
Published: October 2021

Abstract

Issue
Hypertension (HT) is a major and modifiable risk factor for cardiovascular diseases (CVD), which can be caused by excessive salt intake. Portugal has one of the highest mortality rate due to CVD in Europe, mainly due to HT. Thus, reduction of salt intake from food products is one of major strategies advocated to modify blood pressure (BP) and its impact on HT.

Description of the problem
The Portuguese population has excessive daily salt intake mainly due to bread consumption. Thus, in 2017 a voluntary ‘Protocol' was signed between stakeholders with the goal to reduce salt content in bread by 2021. Herein, using a Health Impact Assessment (HIA) approach we aimed to estimate the potential effect in BP from the implementation of this ‘Protocol'. Thus, two national surveys were used to find average values of salt intake and BP on population, while estimates of BP reduction were calculated based upon meta-analysis data.

Results
It was expected that the implementation of the ‘Protocol' could reduce salt ingestion and have a higher BP effect, mostly in more vulnerable populations. In fact, results showed that individuals with low educational level, men, aged and residents in the South region of Portugal were the ones that could more benefit from the ‘Protocol' implementation. However, this study found that the effects were be very low for all groups analysed, suggesting that only slight health gains can occur.

Lessons
The ‘Protocol' as a voluntary agreement is not sufficient to attain the public health targets devised. Following the HIA framework, further complementary and intersectoral integrated measures, through the use of compulsory food and fiscal policies preferably extended to other highly consumed food products, were thus recommended. HIA could be used as a comprehensive tool to assess health impacts, supporting at each national context the design and implementation of effective strategies to promote salt intake reduction and effectively prevent hypertension.

Key messages
The systematic use of HIA to design the appropriate policy framework and to inform adequately political decision-making is crucial to promote health and prevent Non-Communicable Diseases. Voluntary agreements should be complemented by other integrated measures to improve the efficacy of policies aiming to reduce salt intake and prevent hypertension.
Sustainable initiatives to limit the spread of corona-virus among Danish school teachers
Authors: Rueskov Poulsen VD , Nabe-Nielsen K , Larsen I , Vibe Fuglsang N , Juul Nilson C 
Published: October 2021

Abstract

Background
Schoolteachers play an important role in limiting the spread of corona-virus among pupils while carrying out their core tasks. This double role affects teachers' mental health negatively. Still, open schools are important for pupils' learning and wellbeing. Hence, it is crucial to identify viable strategies for virus control that can be implemented in schools without draining teachers' resources. Thus, our aim was to analyze the sustainability of interventions aimed at hindering spread of virus in public schools.

Methods
The qualitative data consisted of 700 free text responses from a survey among 1332 Danish schoolteachers from Nov 25 to Dec 9, 2020, i.e. when facing the second wave of the COVID-19 pandemic. Using Thematic Network Analysis, we analyzed the participants' answers to the question “What initiatives to prevent the spread of infection would you be able to carry out for a longer period of time?”

Results
Most initiatives consumed resources (financial, staffing, time, mental, and relational) to an extend that was unacceptable for the participants. Improved hygiene and ventilation were sustainable initiatives given that the allocation of responsibility was clear. The sustainability of using visor/facemask was compromised by its negative effects on social interactions and by stigma. Isolation of teachers, when having been in contact with infected pupils, had major consequences for the teachers' private life. Finally, the sustainability of initiatives to keep a physical distance was challenged by implications related to the possibility of comforting younger schoolchildren and teaching activities demanding proximity to pupils.

Conclusions
It should be ensured that schools have the resources needed to hinder spread of virus while delivering high quality teaching. In addition, our findings suggest that school leaders clarify the prioritization between preventive initiatives and core tasks, and inform about responsibilities and academic expectations.

Key messages
Actions to make preventive initiatives sustainable within school environments are highly needed to keep schools open during this and future pandemics. Policies should ensure that schools have the resources needed in order to hinder spread of virus while delivering high quality teaching.
Cancer biomarkers testing in Russia: implementation issues and ways to improve
Authors: Mishurovskiy G , Meretukov D , Glushenko A , Kravchenko A , Kakorina E 
Published: October 2021

Abstract

Background
In 2019 Russian Ministry of Health launched the federal program “Oncology”. Its main goals include an increase of 5-year cancer patient survival up to 60% or more by 2024. An improvement in survival may be achieved by prescribing innovative cancer drug regimens, which require prior molecular diagnosing. Healthcare in Russia is state-funded and every constituent territory defines the list of molecular tests available and their costs independently. The aim research was to perform a comparative analysis of molecular testing costs and availability in all 85 units of Russia.

Methods
The data for the research was obtained from the rate agreements of Territorial Compulsory Medical Insurance Funds of each territory, available online. The list of biological markers analyzed was based on local guidelines and included EGFR, ALK, ROS1, BRAF, KRAS/NRAS, BRCA1/2, HER2, PD-L1 and MSI.

Results
At the time of research, only 50 territories had all tests included in the rate agreements. 35 territories had only some of these tests available or stated the availability of “molecular diagnostics” with a fixed cost for any test falling into this category. The titles and costs of same molecular tests varied between different territories with up to 10-fold difference in cost for certain tests. The mean number of tests planned for payment by the state was 7 per 10,000 population per year, though the estimated number of tests required is 17.4 per 10,000 population per year.

Conclusions
Our research revealed significant variation in molecular testing naming, availability and costs. This complicates planning and funding of cancer diagnostics programs and obstructs the process of drug prescription, making it difficult to achieve an improvement in patient survival. The situation could be amended by the development of standardized test naming and cost calculation.

Key messages
Almost half of Russia’s constituent territories have legal obstructions to perform some or every of essential oncological molecular tests, which hinders improvement in survival of cancer patients. The naming and cost calculation of molecular tests in Russia’s Territorial Insurance Funds are not standardized, causing inadequate funding and reduced availability of molecular diagnosing.
Clustering of health behaviours and association with sociodemographic factors among adults in Japan
Authors: Satoh M 
Published: October 2021

Abstract

Background
Health behaviours (HBs) commonly co-occur, acting synergistically. Little is known about the clustering of HBs in the Japanese population. Therefore, this study aimed to investigate the clusters of HB patterns and sociodemographic factors related to the clusters in the Japanese population.

Methods
Data used in this study was obtained from the Japanese and Keio Household Panel Surveys. The responses of 1,554 questionnaires (aged 27 − 65 years) were analysed. The surveys probed HBs (alcohol consumption, smoking, vegetable and fruit consumption, breakfast consumption habits, and physical activity) and sociodemographic characteristics. Latent class analysis was used to identify the clusters, and latent regression was used to investigate sociodemographic characteristics related to the clusters by gender.

Results
Two HB clusters were identified: ‘inactive, moderately healthy' and ‘inactive, high alcohol consumption, poor nutrition'. Age in the 60s indicated significantly higher odds ratios (ORs) of the ‘inactive, moderately healthy' cluster in men and women [OR = 1.820, 95% confidence interval (CI)=1.109 − 2.985, p = 0.018; OR = 3.865, CI = 1.830 − 8.163, p = 0.000]. In men, living with families and higher education levels indicated significantly higher ORs of the ‘inactive, moderately healthy' cluster (OR = 1.812, CI = 1.078 − 3.047, p = 0.025; OR = 2.236, CI = 1.698 − 2.943, p = 0.000). In women, being married, higher socioeconomic status, and higher education levels indicated significantly higher ORs of the ‘inactive, moderately healthy' cluster (OR = 2.097, CI = 1.309 − 3.359, p = 0.002; OR = 2.068, CI = 1.092 − 3.917, p = 0.026; OR = 2.516, CI = 1.563 − 4.051, p = 0.000).

Conclusions
Policymakers must recognise HB clusters unique to Japanese adults and have to build effective strategies based on understanding gender differences and similarities in sociodemographic factors associated with HB clusters.

Key messages
Interventions for multiple HB simultaneously should be designed and developed. Health behavior patterns have to be clarified for targeting population when interventions are built.