bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seasonal Variation in Vascular Dehydration Risk: Insights from the KOBE Study
Authors: Nishikawa T , Miyamatsu N , Higashiyama A , Kubota Y , Hirata T , Hirata A , Nishida Y , Kubo S , Miyazaki J , Okamura T 
Published: October 2024

Abstract

Objectives
Dehydration, a risk factor for ischemic cerebrovascular diseases, is common in summer; however, the incidence of ischemic diseases is not necessarily higher in summer. The phenomenon may be influenced by the differences in the susceptibility to vascular dehydration based on the season. Therefore, this study aimed to distinguish types of dehydration in colder and warmer seasons by analyzing serum osmolarity, hematocrit, and daily non-alcohol drink (NAD) intake.

Methods
Participants in the Kobe Orthopedic and Biomedical Epidemiologic (KOBE) Study, consisting of healthy individuals, were categorized into two groups based on the examination month: the warmer and colder seasons. Multivariate analyses were conducted to examine disparities in serum osmolarity, hematocrit, and NAD intake between these two groups.

Results
Participant ratios by age group and the seasons (warmer season/colder season) were as follows: Women under 50 (35/62), 50-60 (77/126), 60-70 (123/170), over 70 (58/52); Men under 50 (14/17), 50-60 (22/36), 60-70 (57/71), over 70 (55/34). The colder season was found to be negatively correlated with serum osmolarity and NAD intake, but positively correlated with hematocrit, even after adjusting for relevant factors. Age was independently associated with serum osmolarity, but not with hematocrit and NAD intake.

Conclusions
This study highlights that vascular dehydration is more likely in the colder season despite lower serum osmolarity than the warmer season. Age-related increases in serum osmolarity without a corresponding rise in water intake may contribute to this. These findings emphasize the importance of addressing dehydration in the colder season, particularly in older adults.

Key messages
• The colder season showed a negative correlation with serum osmolarity and NAD intake but a positive correlation with hematocrit.
• Raising awareness about the importance of hydration during winter may be essential.
Social inequalities in cancer incidence, survival and mortality: An umbrella review
Authors: Francis M , Peña S , von Wright T , Lindell E , Bellos I , Benetou V , Kestilä L 
Published: October 2024

Abstract

Background
An increasing number of systematic reviews investigating differences in cancer burden by social factors such as race, ethnicity, and socioeconomic status have been published in recent years. Our study aims to evaluate the strength and quality of evidence from systematic reviews investigating associations between social factors and cancer incidence, survival, and mortality to help policy-makers reduce existing social inequalities in the burden of cancer.

Methods
Our study is a pre-registered umbrella review (PROSPERO; CRD42024552884). We systematically searched Medline, Scopus, Web of Science, CINAHL, PsycINFO, the Cochrane Library, the JBI EBP database, and Epistemonikos without date restrictions for published systematic reviews with or without meta-analyses on June 17, 2024. The search identified 15,542 records, which were reduced to 7,421 after deduplication. We are currently screening studies to include systematic reviews of cohort or case-control studies that examined associations between one or more social factors (gender, race/ethnicity, education, occupation, socioeconomic status, place of residence, religion, social capital) and cancer outcomes. Study screening, data extraction, and quality appraisal will be done in duplicate using pre-piloted forms. The strength of evidence of reported associations between social factors and cancer outcomes will be assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria. Before data synthesis, we will assess the degree of overlap between primary studies in the eligible reviews by creating citation matrices and calculating corrected covered area indices. Following this, we will narratively summarize associations (for systematic reviews without meta-analyses) and pool the risk estimates for individual social factors and cancer outcomes (for reviews with meta-analyses) using random-effects meta-analysis models. We will have preliminary results ready by November 2024.

Key messages
• Our umbrella review aims to evaluate the strength and quality of evidence from systematic reviews which have examined social inequalities in cancer incidence, survival, and mortality.
• This high-level evidence synthesis can help policy-makers better plan and target interventions to reduce the existing social inequalities in the burden of cancer.
Serum circulating liver enzymes and human diseases
Authors: Feng Q 
Published: October 2024

Abstract

Background
This study aimed to comprehensively investigate the observational and Mendelian randomization (MR) associations between liver enzymes (ALP, ALT, AST and GGT) with a wide spectrum of human diseases.

Methods
UK Biobank data was used for observational analysis. Cox proportional hazard models were used to quantify the observational associations between liver enzymes and risks of 1109 diseases, adjusted for covariates. A correction was applied to allow for multiple comparisons. Two-sample MR was performed to replicate the identified observational associations. We assessed the strength, consistency and pleiotropy of these MR associations.

Results
In 438571 participants with a median 12.4 years of follow-up, we found evidence linking liver enzymes and 654 diseases, 254 of which were further assessed in subsequent MR. In MR, 52 associations were replicated (10 for ALP, 14 for ALT, 10 for AST and 18 for GGT). Specifically, ALT was associated with liver conditions, diabetes, abnormal bleeding from the female genital tract, and prostate cancer. AST showed associations with prostate cancer, anxiety, diabetic neuropathy, and stroke. GGT was linked to hepatic and biliary conditions, coronary atherosclerosis, and pneumonia, while ALP displayed positive associations with vitamin D-calcium-parathyroid-bone conditions.

Conclusions
Elevated liver enzymes are risk factors for a wide range of hepatic and extrahepatic diseases, predominantly digestive, circulatory, metabolic/endocrine (including diabetes) diseases. Furthermore, the four liver enzymes demonstrated distinct patterns of disease associations.

Key messages
• Elevated liver enzymes are risk factors for a wide range of hepatic and extrahepatic diseases.
• The four liver enzymes demonstrated distinct patterns of disease associations.
Tobacco and nicotine products use among adolescents in Serbia – Latent class analysis
Authors: Kilibarda B , Gudelj Rakic J , Jovanovic V , Vasic M , Tosic M 
Published: October 2024

Abstract

Background
In parallel with a decline in cigarette smoking in the previous decade, other tobacco and nicotine products (TNPs), that are often used concurrently, have gained popularity among adolescents. The purpose of this study was to identify patterns of tobacco and nicotine product use among Serbian adolescents.

Methods
Data for this study were obtained from Health Behavior in School-aged Children (HBSC), a WHO collaborative cross-national study of adolescent health and well-being, that was conducted in Serbia in 2022 on a sample of 3713 students 11,13 and 15 years old. Descriptive statistics was used as well as latent class analysis to classify students based on their past-month use of cigarettes, e-cigarettes, heated tobacco products, waterpipes, and oral tobacco/nicotine products.

Results
Among students 11,13 and 15 years old, 10.2% smoke cigarettes, 13% use e-cigarettes, 11.1% waterpipes, 3.7% oral tobacco/nicotine products, and 4.5% heated tobacco products with differences by age and sex. We found high percentages of dual use of TNPs among cigarette smokers. Among students who smoke cigarettes, 61.6% also use e-cigarettes, 36.2% smoke waterpipes, 30.2% heated tobacco products, and 24.1% oral tobacco/nicotine products. Latent class analysis identified three classes as optimal solution: (1) dual e-cigarette and cigarette users (6.9%); (2) minimal/non-users (83.2%) and (3) poly tobacco and nicotine products users (9.9%). Statistically significant differences between classes were found in age and sex.

Conclusions
Dual and poly-tobacco and nicotine use is common among Serbian adolescents and presents a challenge for monitoring and public health response. Findings contribute to a better understanding of patterns and heterogeneity of TNPs use among adolescents and might have implications for prevention and cessation interventions for youth.

Key messages
• Among students 11,13 and 15 years old, tobacco and nicotine products, other than cigarettes is gaining popularity and with the e-cigarettes being the most popular product.
• Dual and poly tobacco and nicotine products use is new challenged that should be taken into account in tobacco and nicotine monitoring, cessation and prevention.
Utilization and subjective effectiveness of post-COVID-19 therapies in patients with chronic fatigue
Authors: Stolz M , Burger B , Herrmann-Lingen C , Stahmeyer J T , de Zwaan M , Krauth C 
Published: October 2024

Abstract

Background
A significant proportion of people who have had a SARS-CoV-2 infection suffer from persistent symptoms for more than three months, referred to as post-COVID-19 condition (PCC). Chronic fatigue syndrome (CFS) is common in people with PCC. Little is known about the use of therapeutic measures for people with CFS, and the effect of active exercise in particular is a subject of controversial debate.

Methods
From November 2023 to January 2024, an online survey was conducted among a random sample of statutorily-insured people with PCC (ICD10 U09.9). Patients with CFS were identified using the DSQ-PEM. The utilization of various physical, psychological and alternative medical therapies and their subjective effectiveness on a scale from 1 (significantly worsened) to 5 (significantly improved) were recorded. Mann-Whitney-U-tests were carried out.

Results
Preliminary analyses of 1,699 participants with persisting PCC revealed an indication for CFS in 310 participants. Looking at the active exercises, there is no difference in the utilization of functional training between people with and people without CFS (14.6 % vs. 14.5 %, p = 1.0), while rehabilitation sport is utilized significantly more frequently by people with CFS (26.5% vs. 18.7%, p = 0.003). While 45-48% of CFS patients benefited from active therapies, 20-30% showed a worsening of their symptoms. On average, people with CFS also showed significantly less improvement from rehabilitation sports (M 3.28 vs. 3.72, p = 0.002) and functional training (M 3.16 vs. 3.81, p = 0.002) than people without CFS.

Conclusions
People with CFS due to PCC are significantly more likely to utilize therapeutic services than people with PCC without CFS. Active therapies seemed to benefit almost half of CFS patients but led to worsening of symptoms in up to 20-30%. Further studies are needed to provide evidence-based treatment recommendations for this vulnerable population.

Key messages
• People with PCC and CFS benefit less from active therapies than people with PCC without CFS. Utilization of active therapies worsen symptoms in a relevant minority of 20-30% of CFS patients.
• Further research should focus on evidence-based treatment recommendations for people with PCC and CFS.
Advancing mammography uptake among vulnerable groups: a systematic review of intervention strategies
Authors: Ferrari A , Jael Herrera D , van de Veerdonk W , D’haenens W , Ruiz Alejos A , Van Bos L , Talboom S , Ding L , Goossens M , Van Hal G 
Published: October 2024

Abstract

With over 2 million cases diagnosed annually, breast cancer is a leading cause of cancer-related disability and mortality. Despite global efforts to implement mammography screening programs, uptake rates vary widely across settings due to socioeconomic factors and accessibility challenges. To improve participation, targeted interventions addressing barriers faced by underserved groups are essential for promoting inclusive screening and early detection. As part of the ENTER project, which aims to address disparities in breast cancer screening participation among women with low socioeconomic status (SES) in Flanders, Belgium, we conducted a systematic review and meta-analysis on the effectiveness of interventions to enhance mammography uptake. To explore the differential impact of interventions on mammography uptake among vulnerable groups, including individuals with low SES, underinsured, with immigrant background or part of an ethnic minority, subgroup analyses were performed. 7 databases were searched, resulting in the inclusion of 54 out of 9,366 papers for analysis. 14 types of interventions were identified. The meta-analysis showed significant pooled effects of interventions that increased mammography uptake [OR 1.8 (95%CI 1.6-2.2)], particularly among vulnerable populations [OR 2.2 (95%CI 1.7-2.8)]. The most effective interventions were educational interventions [OR 3.03 (95%CI 2.2-4.9); in vulnerable groups OR 2.7 (95%CI 1.9-3.9)]. As expected, interventions adapted to linguistic needs and culturally sensitive approaches showed a significant effect among vulnerable target groups [OR 2.9 (95%CI 1.1-7.9) and OR 2.5 (95%CI 1.1-5.6), respectively]. Reminders were also highly effective [OR 1.8 (95%CI 1.5-2.1); in vulnerable groups OR 2.5 (95%CI 1.9-3.1)]. This review underscores the critical role of targeted interventions in augmenting screening mammography uptake, particularly among vulnerable populations, where odds of participation can increase by up to 2-3 times.

Key messages
• Interventions adapted to the linguistic needs of the target population and culturally sensitive approaches, aligned with values and beliefs of a specific community, can greatly enhance screening rates.
• Considering costs, practicality and impact, reminder letters with culturally and linguistically adapted content emerged as the most promising option for implementation in the ENTER project.
Dementia in migrants living in Lazio region, Italy: prevalence and population characteristics
Authors: Angelici L , Acampora A , Cascini S , Cacciani L , Canevelli M , Cova I , Contoli B , Pomati S , Bellomo G , Bargagli A 
Published: October 2024

Abstract

Background
Given ongoing demographic and epidemiological transitions, dementia prevalence is expected to rise among both native populations and migrants. Understanding this phenomenon is crucial for healthcare planning. This study, part of the IMMIDEM project (GR-2021-12372081), aims to estimate dementia prevalence in Lazio by migrant status.

Methods
A cross-sectional study was conducted on individuals aged ≥50, living in Lazio and receiving assistance from the Regional Health Service as of December 31, 2022. A validated algorithm based on Health Information Systems identified patients with dementia. Migrant status was defined by Country of birth, categorized as native Italians, migrants from Highly Developed Countries (HDCs) and from High Migratory Pressure Countries (HMPCs). Age-standardized prevalence of dementia was estimated overall and by migrant status, and 95% confidence intervals (CI) were calculated. Dementia population characteristics were described and compared according to migrant status using χ2test.

Results
The study included 3,976,160 individuals: 88.9% Italians, 1.7% migrants from HDCs, and 9.4% from HMPCs. Among them, 38,708 had dementia, with a prevalence of 8.48‰ (CI: 8.39-8.57). Dementia prevalence by migrant status was 8.68‰ (CI: 8.58-8.77) in Italians, 6.90‰ (CI: 6.19-7.62) in HDCs migrants, and 5.73‰ (CI:5.37-6.10) in HMPCs migrants. Demographic traits across migrant categories reveal distinct age and gender patterns, with more elderly Italians and a higher male percentage among migrants. From a clinical perspective, Italians showed a higher percentage of circulatory system diseases than migrants (23.5% Italians, 19.2% HDCs, 18.7% HMPCs, p = 0.001), along with a greater percentage of anti-dementia drug prescriptions (54.4% Italians, 50.9% HDCs, 47.4% HMPCs, p &lt; 0.001).

Conclusions
The study found lower dementia prevalence among migrants compared to native Italians, with reduced access to healthcare services, especially in individuals from HMPCs.

Key messages
• The dementia prevalence in migrants is lower than in native Italians.
• These findings suggest potential underdiagnosis and undertreatment, urging policymakers and healthcare providers to address these healthcare disparities.
Improving breast cancer care post-pandemic from the patient perspective
Authors: Myers C , Bennett K , Cahir C 
Published: October 2024

Abstract

Background
Since the onset of the pandemic, breast cancer (BC) services have been disrupted in most countries. The purpose of this qualitative study is to explore the unmet needs, patient-priorities, and recommendations for improving BC healthcare post-pandemic for women with BC and to understand how they may vary based on socio-economic status (SES).

Methods
37 women were invited to take part in follow-up semi-structured qualitative interviews in early 2023. The interviews explored their perspectives of BC care since the easing of COVID-19 government restrictions, including unmet needs, patient-priorities, and recommendations specific to BC care. Thematic analysis was conducted to synthesize each topic narratively with corresponding sub-themes. Additionally, variation by SES was analysed within each sub-theme.

Results
Of the 28 women who participated in interviews, 39% were categorized as high-SES, while 61% were categorized as low-SES. Women expressed unmet needs in their BC care including routine care and mental and physical well-being care, as well as a lack of financial support to access BC care. Patient-priorities included: developing cohesion between different aspects of BC care; communication with and between healthcare professionals; and patient empowerment within BC care. Recommendations moving forward post-pandemic included: improving the transition from active to post-treatment; enhancing support resources; and implementing telemedicine where appropriate. Overall, women of low-SES experienced more severe unmet needs, which resulted in varied patient-priorities and recommendations.

Conclusions
As health systems are recovering from the COVID-19 pandemic, the emphasis should be on restoring access to BC care and improving the quality of BC care, with a particular consideration given to those women from low-SES, to reduce health inequalities post-pandemic.

Key messages
• The pandemic has impacted BC services considerably and this study has identified a range of unmet needs, patient-centered priorities, and recommendations.
• Particular consideration needs to be given to those women from lower socioeconomic groups, in order to reduce health inequalities, which have been further exacerbated by the pandemic.
Compliance of physical activity among adults with metabolic syndrome with the WHO recommendations
Authors: Radionova Z , Birdanova V 
Published: October 2024

Abstract

Introduction
Low physical activity is a leading factor in 6% of deaths worldwide. In Bulgaria, it contributes to the deterioration of the health status of the population and determines 4.3% of the global burden of diseases. Over 70% of Bulgarian adults have insufficient physical activity during their free time. The aim of the study is to measure and assess the level of physical activity among adults with metabolic syndrome with the World Health Organization (WHO) Global recommendations.

Methods
A comparative study of the physical activity of a representative sample of 200 individuals with metabolic syndrome aged 54.7±10.5 from Pleven region was made with the WHO Global recommendations on physical activity for people living with chronic conditions. Modified Physical activity Questionnaire (PAQ) for adults was used for assessment of the physical activity. Data were processed with IBM SPSS v. 25.

Results
The weekly frequency of the vigorous-intensity physical activity (VIPA) was 1,61 days with a weekly duration of 215 minutes, which met the WHO recommendations on physical activity for people living with chronic conditions, but 64% of the respondents had none and only 26% had VIPA on 2 and more days a week. More than half of the respondents (55%) had none moderate-intensity aerobic PA. From the remaining, 34% had this type of PA on 3 and more days a week with duration of 225 minutes, which met the WHO recommendations. Walking more than 10 minutes a day on 5 and more days a week had 69% of the respondents (40 minutes/day). Only 12% had none walking. Only 2% stated that the physical inactivity is the most important cause for the rise of many non-communicable diseases.

Conclusions
More than half of the respondents had none vigorous- and moderate-intensity PA but the PA of the remaining met the WHO recommendations. Although physical inactivity is among the risk factors for the rise of many non-communicable diseases, contributing to death, it was not recognised by the respondents.

Key messages
• Walking is the most important physical activity for the adults with metabolic syndrome.
• Increasing the duration of walking should be encouraged and supported to manage the metabolic syndrome.
The interplay between healthy lifestyle and body mass index in metabolic syndrome
Authors: Jääskeläinen T , Lehtoranta L , Palosaari T , Männistö S , Kaartinen N E , Lundqvist A , Lahti J 
Published: October 2024

Abstract

The prevalence of metabolic syndrome (MS) tends to increase as body mass index (BMI) increases. However, the interplay between BMI and overall healthy lifestyle in MS remains unclear. We aimed to examine the association between healthy lifestyle and MS in BMI categories. Data comprised participants aged 30-64 years from the Healthy Finland Survey representing the Finnish adults (n = 2027). Information was collected through health examination measurements, blood sampling and questionnaires in 2023. Healthy Lifestyle Score (HLS) was defined as: 1) vegetables and fruits several times/day; 2) adherence to physical activity recommendations; 3) sufficient sleep duration; 4) no current daily smoking; 5) no risky alcohol drinking. Total score ranged 0-5; categorized as 0-2 (unhealthiest), 3, 4-5 (healthiest). MS was defined as exceeding risk limit in ≥ 3 of the following conditions: waist circumference, fasting glucose, triglycerides, blood pressure and HDL-cholesterol. BMI (kg/m2) was categorized as normal weight (&lt;25), overweight, and obesity (≥ 30). Weighted prevalence and 95% confidence intervals (CIs) stratified by sex were calculated considering sampling design and non-response. In both sexes, the prevalence of MS was lowest in those with normal weight and healthiest lifestyle (men 7%; 95% CI 2-11; women 9%; 6-13) and highest in those with obesity and unhealthiest lifestyle (m 86%; 80-92; w 67%; 56-78). In men, the prevalence of MS decreased within each BMI class as HLS scores increased, but the difference between healthiest and unhealthiest lifestyle was greatest in those with normal weight (7% vs. 26%) and lowest in those with obesity (71% vs. 86%). In women, the differences were greatest among those with overweight. Obesity and unhealthy lifestyle together form a major risk factor for MS. Differences in the prevalence of MS according to lifestyle were evident especially in men with normal weight or overweight, but decreased when the obesity threshold was exceeded.

Key messages
• Obesity is strongly linked to the high prevalence of metabolic syndrome but maintaining a healthy lifestyle is important regardless of body mass index.
• The results indicate the importance of multifaceted prevention influencing lifestyle factors and supporting weight management to enhance the cost-effective prevention of metabolic risk accumulation.