bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for COVID-19 infection among the German older adult population
Authors: Ordonez Cruickshank A , Gaertner B , Neuhauser H , Zanuzdana A , Poethko-Muelller C , Nowossadeck E , Fuchs J 
Published: October 2024

Abstract

Background
There are scarce analyses on COVID-19 infection risk factors for the older adult population. This study aims to examine COVID-19 infection risk factors in the older adult general population.

Methods
The data for this analysis came from the population-representative Study on Health of Older People in Germany (Gesundheit65+) conducted by the Robert Koch Institute from 10/2021 to 08/2022. We considered information on COVID-19 infection status (self-reported infection confirmed by PRC test at least once vs. never), socio-demographic factors, health risk factors, and different face-to-face interactions. The analysis was restricted to 2,976 individuals aged 65+ years with complete infection status information. We assessed weighted prevalences and used univariable and multivariable logistic regressions to evaluate infection risk factors.

Results
The overall prevalence of infection was 7.2% (95% confidence interval, 6.0-8.7). Infection prevalences were significantly higher (compared to their respective reference group) among participants living in assisted living facilities (24.7% vs. 6.7%), individuals who got help to perform basic activities of daily living (10.8% vs. 6.8%), COVID-19 unvaccinated individuals (25.2% vs. 6.9%), individuals who did not meet family or friends in the last month (12.7% vs. 6.7%), and participants who did not smoke (7.8% vs. 2.6%). No other variable was significantly related to COVID-19 infection. In multivariable analysis, variables independently associated with higher odds ratio (OR) of COVID-19 infection were: living in an assisted living facility OR 3.6 (1.8-7.2), not being vaccinated against COVID-19 OR 4.6 (1.5-14.1), and not smoking OR 1.6 (1.1-2.6).

Conclusions
The preliminary results of this study align with the prevalence of COVID-19 infection found in concomitant studies. A noteworthy element of our study is the vaccine’s protective effect. The pandemic had a particularly detrimental effect on residents of assisted living facilities

Key messages
• Improvement in quality of care and infection preventive measures in nursing homes is necessary.
• Pandemic preparedness must consider the need for help in the daily life of the older population.
Neonatal screening for hearing loss and its associated factors: A pediatric hospital experience
Authors: Ceballos Vela M C , Ruiz Hernandez L D , Diaz Macedo R , Colonna Aguirre B , Martinez Breton P , Viñas Dozal J C , Castillo Ceballos C E , Villegas-Dominguez J E 
Published: October 2024

Abstract

Introduction
Hearing impairment affects 0.6% of children worldwide, with 60% of cases being preventable. Identifying risk factors for hearing impairment would facilitate early detection and better patient prognosis.

Objectives
To identify factors associated with abnormalities in auditory screening in a pediatric hospital.

Methods
A cross-sectional study was conducted on patients assessed in the early hearing detection program at the Pediatric Tower of the High Specialty Hospital of Veracruz, Mexico, between June 2022 and 2023. Screening was performed using otoacoustic emissions initially. Those with abnormalities underwent two retests, and those positive in all three evaluations underwent confirmatory testing. Newborn screening was conducted at discharge for healthy neonates and after reaching a weight of over 1.8 kg and more than 34 gestational weeks for preterm infants. For term and low-birth-weight babies, screening occurred when they reached 2 kg, considering positive results in any of the three tests indicative of altered screening and probable hearing impairment.

Results
A total of 2731 patients were fully evaluated, with 1416 (51.8%) being male, and a median Apgar score of 9 at 5 minutes. The incidence of hearing impairment was 0.7%, comprising 19 patients. Evaluation of sex, 5-minute Apgar score, weight, gestational age, congenital malformations, history of neonatal asphyxia, hyperbilirubinemia, sepsis, TORCH infections, family history of hearing impairment, maternal exposure to ototoxic drugs, substances, COVID-19, gestational diabetes, or maternal hypertension obtaining values of p &gt; 0.05 in each of them.

Conclusions
The prevalence of hearing loss is similar to that reported in the literature. In our population, auditory screening abnormalities are not associated with classic perinatal factors, indicating the complexity of contributors to neonatal hearing impairment.

Key messages
• The neonatal screening program plays a fundamental role in identifying patients with hearing loss even without any clinical factor that arouses suspicion of hearing loss.
• Early diagnosis will favor timely care for patients with hearing loss, favoring their development with adequate care to improve their quality of life.
Epidemiology of ESKAPEE Complex at Veracruz Children’s Hospital during 2023
Authors: Ceballos Vela M C , Castillo Ceballos C E , Marín Vargas J A , Villegas-Dominguez J E , Carranza Promotor G J , Perez Villanueva M , Sosa Gonzalez Y R , Bravo Sarmiento E , Alba Aburto D E 
Published: October 2024

Abstract

Introduction
The ESKAPEE complex comprises bacterial species known for their propensity to develop multiple mechanisms of resistance against antibiotics. The elevated rates of mortality and morbidity associated with these microorganisms, along with the challenges posed by their treatment, have transformed them into a significant concern in global public health. However, in Mexico, the prevalence of the ESKAPEE complex in pediatric patients within tertiary care hospitals remains understudied compared to adults.

Materials and methods
A cross-sectional, retrospective, and descriptive study was conducted, encompassing 179 bacteria belonging to the ESKAPEE complex. These bacteria were isolated from pediatric patients between January and December 2023 at Veracruz Children’s Hospital. Laboratory samples were processed using the VITEK 2.0 system, and descriptive statistical analyses were performed using SPSS v22 software.

Results
A total of 179 antibiograms were analyzed, with 55.1% corresponding to male patients. The most prevalent age group among pediatric patients was school children (5 to 11 years old), comprising 20.2% of the sample. Blood culture was the most frequently sampled site, representing 35.4% of cases. Klebsiella pneumoniae emerged as the most common bacterium, accounting for 22.5% of isolates. The Pediatric Emergency Department was the primary area from which samples were obtained, constituting 18.5% of the total.

Conclusions
Klebsiella pneumoniae was the most frequently isolated bacteria inside de hospital in 2023, especially among school-aged patients, followed by E. coli, which coincides with reports in the literature from various countries around the world.

Key messages
• Establishing a national surveillance network within public health institutions is imperative, where ESKAPEE complex microorganisms are reported.
• Knowing the epidemiological profile of the ESKAPEE complex will favor the diagnosis and intentional search for infections with greater etiological certainty.
Double edged tech: navigating the public health and legal challenges of digital twin technology
Authors: Delerm F , Pilottin A 
Published: October 2024

Abstract

This research addresses the legal challenges posed by the implementation of digital twin technology in public health. Digital twins are advanced computational models which aim to replicate human organ functions and biological processes. Their goal is to enable the simulation of the entire human body and to personalize the outputs with individual patient’s health data. Digital twin technology promises to bridge gap between personalized medicine and precision public health. This research is based on a comprehensive review of the current European and Swiss legal frameworks for medical devices and data protection that apply to digital twin technology. Within these frameworks, digital twins are in a grey area, as they are only considered as medical device software when applied to individuals. They also incorporate artificial intelligence, machine learning, and data analytics, which are already a source of legal concern in a healthcare setting, but their effective use in public health raises additional issues. Preliminary findings suggest significant shortcomings in the legal frameworks regarding data privacy, and the potential for increased surveillance by health insurance systems, which could lead to human rights violations. The public health application of digital twins would require global data analysis of sensitive personal information, raising further questions about the secure storage, transmission, and processing of this data. The study concludes that current legal frameworks must be future proofed to manage the complexities introduced by digital twins in public health. In particular, it suggests that regulatory oversight of medical devices needs to be significantly improved in order to safely harness the potential of digital twin technologies for public health. Finally, the new European Union health data space and the forthcoming EU AI act will also play important roles in the implementation of digital twin technologies.

Key messages
• Applying digital twin technology in public health faces considerable challenges, particularly the issues around data privacy, potential discrimination, and increased surveillance.
• We need to adapt and strengthen existing legal frameworks to effectively manage the complexities introduced by digital twins, ensuring that these technologies can be safely used for public health.
Effect of unprocessed and minimally processed foods on blood pressure in children
Authors: Mastroeni S , Kasmirski G , Torres C , Mastroeni M 
Published: October 2024

Abstract

Background
The poor eating habits of children, including a decrease in the consumption of unprocessed foods and an increase in the consumption of processed foods, have been associated with excess body weight, which is a well-established risk factor for cardiovascular diseases (CVDs), especially high blood pressure (BP). We aimed to investigate whether the consumption of unprocessed and minimally processed foods is associated with high BP in children at nine years of age.

Methods
Cross-sectional study of 142 Brazilian children participating in a cohort study conducted at the participant’s home. The child’s food consumption markers were evaluated using the Brazilian Food and Nutrition Surveillance System (SISVAN) and were classified by NOVA. Using a standardized procedure for approaching the child, BP was measured by the auscultatory method. Biological, socioeconomical, demographic, and anthropometric data of the mother and child were also collected. Logistic regression analysis adjusting for important predictors was used to evaluate the association between food consumption and BP.

Results
The prevalence of high BP in children was 20.4%, and the mean systolic and diastolic BP were significantly (p &lt; 0.05) higher in children classified as high BP (110.1 and 71.3 mmHg, respectively). An important proportion (44.8%) of children had excess body weight (&gt;85th percentile) and high BP when compared to eutrophic children. Not consuming healthy foods was associated with high systolic BP, even after adjustment for other important covariates (OR = 3.97; p = 0.028).

Conclusions
Not consuming healthy foods was associated with increased odds of children having high BP at nine years of age. Interventions promoting a healthy diet and the consumption of fruits and vegetables in childhood may contribute to preventing diseases associated with CVD, a global public health problem.

Key messages
• Educating parents to avoid processed foods and monitoring children’s BP are essential actions to prevent associated chronic diseases throughout life.
• Public policies aimed at educating parents to encourage the consumption of healthy foods may significantly contribute to reducing adverse cardiovascular outcomes.
Total sugar intake significantly associated with systolic blood pressure in small sample population
Authors: Pessoa L , Viegas C , Rodrigues P O , Bandarra N M , Bispo P 
Published: October 2024

Abstract

Background
Hypertension contributes to 45% of all deaths from heart disease and up to 51% of deaths from strokes. Dietary factors, such as sodium (Na+) and potassium (K+) can play a role, but recent studies have also highlighted the importance of sugar intake on blood pressure. Very few studies have evaluated the impact of these factors and their ratio on cardiometabolic biomarkers. This study aims to assess the impact of dietary sugar intake, Na+, K+ and NA+/K+ ratio on hypertension and cardiometabolic biomarkers.

Methods
Fasting venous blood was collected to measure glucose, triacylglycerols (TAG), total cholesterol, HDL-c, ApoA1, ApoB, or hs-CRP, with enzymatic and turbidimetric techniques, and oxidized LDL by ELISA, and IL-6 and TNFa by Luminex system, the latter’s in a subset sample. Blood pressure (SBP, DBP, and HR) was measured at least twice with an automatic recorder. Dietary intake was obtained using semi-quantitative FFQ, comprising 82 items, and reported to the previous year. Data was analysed using R software through descriptive analysis and partial correlations adjusted to the participant’s BMI. A significant level of 0.05 was used.

Results
78 participants, aged from 19 to 80 years old (M = 48,5±13,5) were evaluated, with 47% taking hypertensive medication. BMI ranged from 19,7 to 41,1 Kg/m2 (M = 29,2±5,4). The average intake of Na+, K+ and NA+/K+ ratio were 3805±1397 mg, 3980±1300 mg and 1.65±0,38, respectively. Total mean sugar intake (% energy) represents 21,4%. No significant correlation was found between Na+ or K+ with SBP, HR, and the cardiometabolic biomarkers (p &gt; 0.05). A positive correlation was found between % sugar intake and SBP (rs = 0,29, p &lt; 0,05), which remains significant after adjusting for BMI, and a positive correlation, in the borderline of significance, with TAG (rs = 0,23, p = 0,0561).

Conclusions
N+, K+, and their ratio do not associate with SBP, HR and cardiometabolic biomarkers. However, % of sugar intake is positively associated with SBP.

Key messages
• Sodium and potassium may not always be associated with changes in blood pressure.
• Sugar intake might have an important role in the etiopathology of hypertension.
Overcoming barriers in implementing healthy school nutrition policies: insights from Ukraine
Authors: Yurochko T , Heiko L 
Published: October 2024

Abstract

The general mortality rate from NCDs in Ukraine exceeds that in European Union countries, (Yurochko et al., 2023) exacerbated by the ongoing war. Healthy nutrition plays a pivotal role in enhancing the overall quality of life and curbing the prevalence of non-communicable diseases (NCDs). Despite its significance, ensuring healthy eating habits, particularly during the early stages of life at the period of setting lifelong habits (Jackson et al., 2020; Riley et al., 2018), remains a challenge. Besides, school-based settings represent an ideal environment for effective intervention because they offer a shared common physical, academic, and social space (Tapia-Fonllem et al., 2020). Through a series of semi-structured interviews with key stakeholders, this study identifies barriers and facilitators to policy implementation, with a focus on educational institutions. Qualitative analysis reveals barriers such as inadequate human resources, funding constraints, resistance from the food industry, and ineffective communication strategies at the family level. Moreover, there exists a disjointed understanding of nutrition standards. However, collaborative efforts with civil society, empowerment of nursing roles, strategic utilization of grants and fundraising, engagement with the food industry, and the adoption of a family-oriented approach emerge as crucial enablers for successful policy implementation. These findings offer theoretical foundations for fostering healthier nutrition environments within schools. This research serves as a roadmap for policymakers and educators striving to create sustainable and effective strategies for promoting healthy eating among early school-age children in Ukraine and beyond. Study finds human resource shortages, funding constraints, and food industry resistance as major barriers to school nutrition policy. Recommendations include collaborative approaches, nurse involvement, and aligned standards for effective school nutrition policy.

Key messages
• Healthy nutrition plays a pivotal role in enhancing the overall quality of life and curbing the prevalence of non-communicable diseases.
• Through a series of semi-structured interviews with key stakeholders, this study identifies barriers and facilitators to policy implementation, with a focus on educational institutions.
Exploring the use of meal delivery services in Belgium
Authors: Oostenbach L , Thornton L 
Published: October 2024

Abstract

Background
Ready-to-eat meal delivery services have become commonplace in recent years and their growth accelerated during the COVID-19 pandemic. However, the potential ramifications on dietary habits and subsequent health outcomes remain largely unexplored. Given the well-established links between unhealthy dietary patterns and chronic diseases such as obesity, type II diabetes, and cardiovascular diseases, understanding the determinants and public health implications of ready-to-eat meal delivery services use is imperative. This study aims to investigate the determinants associated with the use of ready-to-eat meal delivery services and their implications for health behaviours and outcomes.

Methods
This cross-sectional study is conducted amongst adults residing in Flanders or Brussels, Belgium. A quantitative online survey commenced in April 2024 and is scheduled to conclude by June 2024. Structural equation models will be used to assess determinants and implications of ready-to-eat meal delivery services use. Latent class analysis will be used to identify user profiles and subsequent structural equation modelling will assess determinants of these profiles and their associated health (behaviour) outcomes.

Results
Preliminary results suggest meal delivery usage was higher in younger and middle-income users. Main reasons of use amongst users (n = 139) were more time for leisure activities (66%) and supermarket avoidance (64%). Main reasons for non-use amongst non-users (n = 69) were not wanting to spend money with meal delivery services (70%) and preference to cook own meals (81%). Data collection is currently ongoing. Further analysis is planned, and full results will be available by November 2024.

Conclusions
This study will provide a better understanding of drivers of meal delivery services use in Belgium and their potential impact on public health. It will also help inform public health strategies targeted at improving dietary habits.

Key messages
• Recognising that meal delivery services will become ever present in the future, insights into why people order meals for delivery and the potential health implications of such services are essential.
• The use of advanced statistical techniques highlights the potential of the study to offer novel insights into determinants and ramifications of meal delivery services usage.
Representativeness of disadvantaged pupils in a trial to improve beverage consumption in Belgium
Authors: Desbouys L , Assakali W , Thiébaut I , Castetbon K 
Published: October 2024

Abstract

Background
The cluster-randomized controlled trial DRINK was implemented in 2021 to evaluate the effect of interventions aimed at reducing sweetened beverages and increasing tap water consumption among children in French-speaking primary schools in Belgium. Multiple participation issues related to the implementation in the school setting were encountered. Our aim was to describe the individual characteristics of pupils at baseline and their participation in the data collection.

Methods
In 2021, out of a sample of 168 schools stratified by region and socioeconomic index (SEI), 46 were included. Children in grades 3 to 5 were asked to complete a 4-day diary to record all beverages consumed. Questionnaires were completed by children and parents, from which individual characteristics were summarised, such as the Family Affluence Scale (FAS; in three groups).

Results
School participation (overall: 29.0%) was higher in Wallonia (33.0%) than in Brussels (22.0%), and in schools with an intermediate SEI (33.0%). At baseline, a total of 3,631 children participated in the data collection, either through the 4-day diary, the child questionnaire, or the parent questionnaire; 2,013 completed all three instruments. Participating children were more likely to be girls, to have an intermediate FAS, to be born in Belgium, and to have two working parents. The proportion of children attending schools in the Brussels region was 27.9% of the total participating children and dropped to 11.5% for those who returned three valid questionnaires. The proportions of low FAS (14.4% to 11.8%), birth outside Belgium (11.8% to 8.7%), and low parents’ schooling (35.3% to 33.8%) were lower among children who completed the three instruments.

Conclusions
The low participation of Brussels schools, possibly exacerbated by the Covid-19 impact, may explain why disadvantaged children were less represented in the baseline sample. Such knowledge is valuable for interpreting the findings of such a trial.

Key messages
• Participation issues may have affected the representativeness of less advantaged children.
• Documenting such disparities is key to understanding the context in which interventions were implemented.