bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community Health Centers for Resilient Communities in the post-COVID-19 era
Authors: Buffoli M , Gola M , Mosca EI , Ugolini M , Lettieri E , Capolongo S 
Published: October 2021

Abstract

Background
The synergy between territorial services and hospital organizations plays a crucial role for health promotion. Starting from the recent pandemic, the Community Health Centers (CHCs) could turn out particularly efficient in cases of high emergencies, avoiding the overflow of users in the hospital thanks to health home care management or low and medium-care facilities. The aim of the research is to identify evidence based experiences that supports the efficacy of design and management of CHCs, also during pandemics.

Methods
The methodology is based on the analysis of several European case studies, selected by an extensive analysis of the main EU countries, through a comparative matrix with different criteria related to: a) general information; b) urban relationship with the healthcare territorial network; c) number of inhabitants and population basins; d) building typology, dimensions, flexibility and layout issues; e) healthcare staff involved, the number of workers and volumes of activities; f) sanitary and not sanitary functions before and during the COVID-19 pandemic, and transformations applied.

Results
The analysis gives rise to several correlations due the localization of CHCs and the healthcare territorial network, dimensions and staff involved, sanitary and not sanitary functions -before and during the pandemic- and the flexibility of the CHCs, that permits to list experience based best practices for the design and management of resilient CHCs, as useful strategic lines for professionals in public health and healthcare design. The survey highlights the strategic role of CHCs for the healthcare territorial network with particular evidence during pandemics.

Conclusions
The strategies aim to encourage the introduction of CHCs for the access to care for the population. The outcomes of the analysis are related to the research project Cities and Health Community Centers for Resilient Communities funded by PoliSocial Award 2020 of Politecnico di Milano.

Key messages
definition of design and organizational strategies for Community Health Centers for Resilient Communities in the post-COVID-19 era. qualitative and quantitative data analysis of European Community Health Centers before and during the COVID-19 pandemic.
Co-occurring addiction problems among high school students in Sousse (Tunisia)
Authors: Ben Nasrallah C , Maatoug J , Ghammem R , Mbarki O , Zammit N , Ben Fredj S , Misbah R , Ghannem H 
Published: October 2021

Abstract

Background
Adolescence is a transitory period characterized by psychological, physical and emotional changes. Teenagers seek new experiences and engage in a range of risky behaviors, including the consumption of psychoactive substances that lead to addiction problems. Adolescent addiction represents a major public health and safety issue. Addictions co-occur in the same individual, increasing the risk of negative outcomes and health problems.
We aimed to determine the prevalence of occurring and co-occurring addiction behaviors among high school students in the region of Sousse and to specify the risk factors.

Methods
A cross-sectional study was conducted from February 5 to March 14, 2018 in public high schools in the governorate of Sousse. The data were collected by anonymous self-administered questionnaire, then processed and analyzed using the SPSS software version 10.

Results
A total of 1399 high school students were included in our study. An average age of 17±2.28 years and a female predominance (60.5%) were noted. The prevalence of tobacco product use and alcohol consumption was 20.9% and 10.1% respectively. The prevalence of illicit substance use was 7%. Facebook and video game addiction were reported among 36.1% and 35.3% high school students respectively. The analysis of co-occurring addiction problems showed that 12.2% and 4.5% had two and three addiction problems, respectively. Almost 3% of included adolescents had the maximum number of four addiction problems. Multivariate analysis showed that co-occurring addiction increases among boys, participants that repeated the grade and among those with moderate or severe depression, anxiety and alexithymia.

Conclusions
The findings have implications for identifying the risk factors of co-occurring addictive behaviors, and the development of primary prevention strategies resulting from such factors

Key messages
The prevalence of addictive behavior is very high in middle school students. Understanding the risk factors of co-occurrence addictive problems is important for prevention program planning.
COVID-19 - pandemic effect on Human Papilloma Virus Vaccination of eighth grade students in Croatia
Authors: Rajn V , Vuljak-Vulić J , Kos Milkić A , Jureša V 
Published: October 2021

Abstract

Issue/problem
Vaccination at the time of the Covid-19 pandemic is a challenge for vaccinators. The consequences of not vaccinating against human papilloma virus (HPV) of youngs for their future reproductive health are far-reaching. In Croatia, HPV vaccination is voluntary and free for all school children and students.

Description of the problem
Rate of HPV vaccination in eighth grade students before the epidemic school year 2018/19, at the onset of the epidemic 2019/20 and 2020/21 in the midst of the epidemic, Croatia in the city of Koprivnica and 11 municipalities in the Koprivničko-križevačka County. The research included 1530 children of eighth grade during three school years in the city of Koprivnica and 11municipalities. Data were collected by the School Health Service. Before the panidemic, vaccinations took place at school, and during the epidemic exclusively in school medicine practices. Completely vaccinated are considered those vaccinated with two or three doses depending the student age.

Results
Fully vaccinated students 2018/2019 is 54.2% (277/511), urban area 48.0% (133/277) and rural area 61.5% (144/234). 2019/2020 62.0% (330/532) of students were vaccinated, urban area 56.3% (160/284) and rural area 68.6% (170/248). Coverage of girls with full vaccination 2018/2019 is 63.4% and boys 46.6%. In 2019/2020 71.8% girls and 52.3% boys were fully vaccinated. In 2020/2021 the first dose received 53.4% (260/487), girls 65.3% and boys 43.4%. The second dose did not received in 2018/2019 5.2% students and 2019/2020 8.8%. The main reason in the rural area is the distance from school clinics and the inability to vaccinate children at school.

Lessons
In the school year 2019/2020 there was an increase in vaccination compared to 2018/2019 of 7.8%, despite difficult conditions.

Key messages
Unexpectedly during the epidemic the response to vaccination increased. HPV vaccination should remain a priority in adolescent health protection.
Monitoring the health status of the elderly in an urban area in Athens, Greece
Authors: Stamatopoulos Z , Bakola M , Kitsou KS , Kallianezos P , Charalambous G , Jelastopulu E 
Published: October 2021

Abstract

Background
Aging of population brings changes in needs and capacities. People live longer and chronic diseases appear to be a potential risk of major causes of disability and functional dependency. The aim of this study was to investigate the physical and mental health of the elderly residing in an urban area in Athens,Greece.

Methods
In this population-based study using a convenience sampling, seniors aged ≥65 years old, under no medical treatment were selected from Korydalos area, Athens, Greece. A translated version of the General Health Questionnaire (GHQ-28) was used and associations with other parameters were performed. Higher GHQ-28 scores indicate higher levels of distress.

Results
A total of 100 seniors participated in the study, 64% females, mean age 71.4 years. 51% were married, 40% lived alone and 82% had primary or secondary education. 59% received a pension from the state, out of them 42% between 601-1000 euros and 33% between 301-600 euros, monthly. The mean GHQ-28 score, for a potential mental disorder in the somatization, anxiety, social dysfunction, and depression factors, was 24.3, 29.1, 42.9 and 10.2, respectively. Females presented higher scores in total GHQ score (p = 0.018), in somatization (p = 0.019) and in social dysfunction (p = 0.001). Higher age was associated with higher total GHQ score (p = 0.001), higher anxiety (p = 0,006) and higher dysfunction (p = 0.006). Seniors with lower educational level had higher total GHQ score (p = 0.032) and higher social dysfunction (p &lt; 0.001). Low financial status was associated with higher social dysfunction (p = 0.005).

Conclusions
The study revealed an overall moderate emotional distress in elderly. However, a high risk in social dysfunction is obvious, whereas risk of depression is very low. Age, educational level and financial status are associated with various dimensions of distress and psychiatric disorders. GHQ-28 is a suitable screening tool and can be used to prevent chronic disease and mental disorder

Key messages
GHQ-28 can be used as a screening tool in elderly in urban communities to assess psychological well-being and detect possible psychiatric morbidity and to improve their overall health.
Insulin resistance and sleep complains in ten years follow-up
Authors: Podlipskyte A , Mickuviene N , Kazukauskiene N , Varoneckas G 
Published: October 2021

Abstract

Background
The serious health consequence that comes from disrupted and poor sleep quality is an increased risk for cardiac diseases and diabetes. The goal was to investigate the association of insulin resistance with sleep complains in ten years follow-up.

Methods
A randomized epidemiological follow up study with 835 subjects: 300 (35.9%) men and 535 (64.1%) women was performed in 2003 and in 2013. The Basic Nordic Sleep Questionnaire was used to assess the frequency of sleep complaints in the first and the follow up survey. Insulin resistance was evaluated by homeostasis model assessment of insulin resistance (HOMA-IR). The contingent was divided into 2 groups: insulin resistance group (HOMA-IR&gt; 2.7) 33% and No- insulin resistance group (HOMA-IR ≤2.7) 67%.

Results
A statistically significantly increased number of persons with diabetes mellitus and high body mass index was seen in both groups after 10-year period; however, in insulin resistance group an increase was more expressed. A statistically significant change of sleep complains after 10-year period was seen in insulin resistance group; while in no-insulin resistance group there were no significant modifications. Individuals with insulin resistance were more likely to complain of difficulty falling asleep (from 11.2% to 17.8%, p = 0.031) and early wake up in the morning (from 12.6% to 24.5%, p = 0.003) after 10-year period. Daytime sleepiness was also more frequently observed among persons with insulin resistance (from 9.0% to 14.7, p = 0.037). They were more likely to use sleeping pills (from 4.0% to 8.3%, p = 0.034) and, not surprisingly, were more likely to use alcohol to improve sleep (from 1.1% to 4.4%, p = 0.012).

Conclusions
A statistically significant increase in body mass index and diabetes as well as difficulty to fall asleep, early waking up in the morning, severe drowsiness in the morning and daytime sleepiness was found in ten years follow-up in insulin resistance group.

Key messages
A statistically significant increase of sleep complains after ten years follow-up was seen in insulin resistance group. Insulin resistance and metabolic syndrome in parallel with disturbed sleep may lead to the development of diabetes in follow-up.
Accuracy of identifcation of traumatic brain injuries in routine hospital data
Authors: Staines A , O'Farrell A , Healy A , O'Donnell K , McGettrick G , Bourke T , Johnson H , Corrigan C 
Published: October 2021

Abstract

Background
Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Much work on the epidemiology of TBI uses routinely collected health care data. There is no separate code for TBI in ICD-10, a common coding system for acute care. One reason for reported variations in TBI prevalence between countries is differences in the identification of TBI from routine data. This study assessed the performance of an Australian classification system (Pozzatto et al 2019), using a standardised approach to ICD-10 codes to identify cases of likely TBI in routine hospital discharge data.

Methods
The original study was done on hospital data from New South Wales. We replicated their approach using Irish hospital data, held by Health Intelligence, from 2013 to 2020. Cases not classified as TBI by this system, but with codes, such as loss-of-consciousness, skull fracture or intra-cranial injury were manually reviewed.

Results
All 98,419 discharges with any code in S00 to S99 were reviewed. 27,851 (28.3%) had a skull fracture or intracranial injury. 12,106 (12.3%) had loss-of-consciousness and/or post-traumatic amnesia. 11,976 (98.9%) of these (12.2% of the total) had either a skull fracture or an intra-cranial injury reported. 26,085 (26.5%) of the original 98,419 cases were classified as TBI using the NSW classification. Manual review of 1.3% (1,356) cases added a maximum of 0.32% (321) further possible cases of TBI, suggesting a sensitivity of the classification of 98.8% (95% CI 98.6% - 98.9%).

Discussion
The main limitation is that it is not possible to identify false positive cases - those coded as TBI, but where no TBI was present. This approach to identifying TBI works well, and is feasible for wider implementation. It provides comparability between different studies.
Pozzato I et al. (2019), Epidemiology of hospitalised traumatic brain injury in the state of New South Wales, Australia: a population-based study. Australian and New Zealand Journal of Public Health. 2019

Key messages
There are problems comparing data on TBI between different countries because no single code for TBI exists in ICD-10, and this is a real challenge for epidemiologists and health services researchers. The use of an agreed system, developed in Australia, for recoding injury data to identify TBI has promise, and shows excellent sensitivity in two countries.
SSI and antibiotic prophylaxis adequacy in hysterectomy surgery in Murcia, Spain
Authors: Monteagudo JF , Pérez-Romero SB , Arana-Aragón B , Rueda-Nieto S , Román-Sánchez J , Podio-Martínez M , Yepes-García P , Sánchez-Rodríguez D 
Published: October 2021

Abstract

Background
Surgical site infections (SSIs) are among the most common healthcare-associated infections (HAIs). Our objective was to describe incidence of SSI and adequacy of surgical antibiotic prophylaxis (SAP) in abdominal hysterectomy (HYST) interventions in our center.

Methods
A prospective study was carried out in Hospital General Universitario Reina Sofia, Murcia. Patients subjected to HYST between May 1st and November 30th of 2020 were included. No exclusion criteria were established. SSI surveillance was done following CDC -NNIS guidelines. Data were obtained from clinical documents and electronic records, evaluated following local antimicrobial stewardship program (ASP) guidelines and classified as adequate or inadequate. Inadequate SAP was divided into five categories: “Length of administration”, “Antibiotic election”, “Inadequate Timing”, “Antibiotic indication” and “Other”.

Results
A total of 57 interventions were recorded. Mean age was 52,7 y (sd = 11,4y). 3 SSI were found: 1 superficial and 2 deep. Total cumulative incidence was 5,3%. Grouping by NNIS risk score, cumulative incidence in NNIS 2-3 patients was 33,3%, while in NNIS 0 and NNIS 1 was 2,6% and 6,2%. Median hospitalization length was 3 days (IQR = 1). Median time from surgery to infection was 5 days (IQR =0.5). SAP was found to be adequate in 71% of interventions. Main causes of inadequacy were inadequate timing (77,7%), indication (11,1%), election (5,5%) and length of administration (5,5%).

Conclusions
SSI incidence in HYST in our center was found to be slightly higher than other studies found in the literature. Moreover, our findings show that 29% of abdominal hysterectomy surgeries received inadequate SAP, being inadequate timing the main cause of inadequacy.

Key messages
SSI surveillance is crucial when it comes to monitoring and preventing HAI. Monitoring SAP adequacy is a helpful resource to assure compliance and improve our patients surgery-related safety.
Automata theory approach to predicate intuitionistic logic
Authors: Zielenkiewicz Maciej , Schubert Aleksy 
Published: October 2021

Abstract
Predicate intuitionistic logic is a well-established fragment of dependent types. Proof construction in this logic, as the Curry–Howard isomorphism states, is the process of program synthesis. We present automata that can handle proof construction and program synthesis in full intuitionistic first-order logic. Given a formula, we can construct an automaton such that the formula is provable if and only if the automaton has an accepting run. As further research, this construction makes it possible to discuss formal languages of proofs or programs, the closure properties of the automata and their connections with the traditional logical connectives.
A road-map to white dwarf pollution: Tidal disruption, eccentric grind-down, and dust accretion
Authors: Brouwers Marc G , Bonsor Amy , Malamud Uri 
Published: October 2021

Abstract
A significant fraction of white dwarfs show metal lines indicative of pollution with planetary material but the accretion process remains poorly understood. The main aim of this paper is to produce a road-map illustrating several potential routes for white dwarf pollution and to link these paths to observational outcomes. Our proposed main road begins with the tidal disruption of a scattered asteroid and the formation of a highly eccentric tidal disc with a wide range of fragment sizes. Accretion of these fragments by Poynting-Robertson (PR) drag alone is too slow to explain the observed rates. Instead, in the second stage, several processes including differential apsidal precession cause high-velocity collisions between the eccentric fragments. Large asteroids produce more fragments when they disrupt, causing rapid grind-down and generating short and intense bursts of dust production, whereas smaller asteroids grind down over longer periods of time. In the final stage, the collisionally produced dust circularises and accretes onto the white dwarf via drag forces. We show that optically thin dust accretion by PR drag produces large infrared (IR) excesses when the accretion rate exceeds 107 g/s. We hypothesise that around white dwarfs accreting at a high rate, but with no detected infrared excess, dust circularisation requires enhanced drag - for instance due to the presence of gas near the disc’s pericentre.
Supernova induced processing of interstellar dust: impact of interstellar medium gas density and gas turbulence
Authors: Kirchschlager Florian , Mattsson Lars , Gent Frederick A 
Published: October 2021

ABSTRACT
Quantifying the efficiency of dust destruction in the interstellar medium (ISM) due to supernovae (SNe) is crucial for the understanding of galactic dust evolution. We present 3D hydrodynamic simulations of an SN blast wave propagating through the ISM. The interaction between the forward shock of the remnant and the surrounding ISM leads to destruction of ISM dust by the shock-heated gas. We consider the dust processing due to ion sputtering, accretion of atoms/molecules, and grain–grain collisions. Using 2D slices from the simulation time series, we apply post-processing calculations using the paperboats code. We find that efficiency of dust destruction depends strongly on the rate of grain shattering due to grain–grain collisions. The effective dust destruction is similar to previous theoretical estimates when grain–grain collisions are omitted, but with grain shattering included, the net destruction efficiency is roughly one order of magnitude higher. This result indicates that the dust-destruction rate in the ISM may have been severely underestimated in previous work, which only exacerbates the dust-budget crises seen in galaxies at high redshifts.
The magnetized white dwarf + helium star binary evolution with accretion-induced collapse
Authors: Ablimit Iminhaji 
Published: October 2021

ABSTRACT
Accretion-induced collapse (AIC) from oxygen/neon/magnesium composition white dwarf (ONeMg WD) + stripped helium (He) star binaries is one promising channel to form peculiar neutron star objects. It has been discussed that the WD’s magnetic field may alter the accretion phase in the WD binary evolution. By considering non-magnetic and sufficiently magnetized WDs, we investigate the evolution of ONeMg WD + He star binaries with detailed stellar evolution and binary population synthesis simulations. The role of the magnetically confined accretion in the possible formation pathway for like millisecond pulsars (MSPs) and magnetars is also studied. Comparing with the case of spherically symmetric accretion, the mass accumulation efficiency of the WDs is enhanced at low mass-transfer rate under the magnetic confinement model. The initial parameter space of the potential AIC progenitor systems moves toward shorter orbital period and lower donor mass (but not so significantly) due to the effect of the magnetic confinement. This also allows final MSPs to have lower mass WD companions and shorter orbital periods. There is no significant difference between the Galactic birth rates of the AIC derived with and without the magnetic confinement, which implies that the magnetic field of the WD does not dramatically change the number of ONeMg WD + He star binaries which can produce AIC. It is worth noting that these conclusions can be applied for the carbon/oxgen (CO) WD + He star binaries as progenitors of type Ia supernovae, because the accretion phases of ONeMg WDs and CO WDs are similar. The Galactic rate of magnetars possibly formed via AIC of highly magnetized WDs is $0.34\times 10^{-4}\, {\rm yr}^{-1}$.
The Copernican principle in light of the latest cosmological data
Authors: Camarena David , Marra Valerio , Sakr Ziad , Clarkson Chris 
Published: October 2021

ABSTRACT
We pursue a program to confront observations with inhomogeneous extensions of the FLRW metric. The main idea is to test the Copernican principle (CP) rather than assuming it a priori. We consider the ΛCDM model endowed with a spherical ΛLTB inhomogeneity around us, that is, we assume isotropy and test the hypothesis of homogeneity. We confront the ΛLTB model with the latest available data from cosmic microwave background, BAO, type Ia supernovae, local H0, cosmic chronometers, Compton y-distortion, and kinetic Sunyaev–Zeldovich effect. We find that these data can constrain tightly this extra inhomogeneity, almost to the cosmic variance level: on scales ≳ 100 Mpc structures can have a small non-Copernican effective contrast of just δL ∼ 0.01. Furthermore, the constraints on the standard ΛCDM parameters are not weakened after marginalizing over the parameters that model the local structure, to which we assign ignorance priors. In other words, dropping the CP assumption does not imply worse constraints on the cosmological parameters. This positive result confirms that the present and future data can be meaningfully analyzed within the framework of inhomogeneous cosmology.