bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-reported health effects from wildfire smoke: A cross-sectional study in New York State
Authors: Noel C A , Barrera E , Hayden A , Meredith G 
Published: October 2024

Abstract

Background
Wildfires and exposure to wildfire smoke (WFS) are forecasted to increase, in part driven by climate change. As witnessed in 2023, regions in Europe and North America are facing more sustained periods of poor air quality due to WFS. Growing evidence suggests average daily WFS correlates with morbidity and mortality, but the impact of prolonged WFS exposure remains understudied, especially in areas where WFS is a newer occurrence. We examine associations between consecutive days of WFS experienced and self-reported health symptoms in the northeastern United States.

Methods
This retrospective cross-sectional study explored New York State (NYS) residents’ experience with WFS in summer 2023 via an online survey. Participants reported the longest period of consecutive WFS days and symptoms experienced. Log-binomial regression models estimated prevalence ratios (PR) and 95% confidence intervals (CI).

Results
553 NYS residents were included, representing a healthy, primarily female and White population, ranging from 18 to 86 years. 549 (99.3%) reported experiencing WFS, with the longest period of consecutive WFS days varying (≤3 days: n = 152; 4 to 6 days: n = 255; ≥7 days: n = 146). 490 (88.6%) reported ≥1 health symptom, with itchy/watery eyes, sore throat, and headache as the most frequent. Compared to ≤ 3 consecutive WFS days, symptom prevalence was 9.1% higher for those reporting 4 to 6 days (PR [95% CI]:1.09 [1.00, 1.19]) and 16.7% higher for ≥7 days (1.17 [1.07, 1.27]). The trend of increased symptom prevalence with longer WFS periods persisted and was pronounced for specific symptoms. Control for potential confounders did not appreciably change estimates.

Conclusions
Our findings suggest longer sustained WFS exposure associates with higher symptom prevalence, which may be precursors to more serious health conditions. As global populations face more WFS with climate change, public health professionals should prioritize strategies to mitigate prolonged exposure.

Key messages
• In a convenience sample of 553 primarily healthy New York State residents, 99.3% reported experiencing wildfire smoke and 88.6% reported at least 1 symptom of poor health during summer 2023.
• Associations between consecutive days of wildfire smoke experienced and prevalence of any and specific symptoms tended to vary in a dose-response manner.
The INPHET- a global approach to Environmental Public Health Tracking
Authors: Yip F , Lauriola P , Zeka A , Crabbe H , Leonardi G 
Published: October 2024

Abstract
Environment and health monitoring and information systems are fundamental infrastructure for evidence provision for policy making. The International Network for Public Health and Environment Tracking (INPHET) was formed by a community of environmental public health practitioners to address common interests and activities that advance environmental public health surveillance (EPHS) and data systems, and their uses to inform public health actions. Its main goal is to address the vast inequalities across countries and communities in their ability to monitor, assess, inform and mitigate environmental and health issues. INPHET supports the relevant role of environmental epidemiology as the pillar science providing evidence for decision making and interventions aiming at reducing and preventing environmental related diseases and contributes to an overall vision for public health. As a “Community of Practice”, INPHET focuses on sharing experiences and expertise; addressing common challenges for implementing and enhancing the science of EPHS/tracking; improving understanding of the link between the environment and health; and providing the appropriate evidence that informs public policy. The network, initiated in conference meetings in 2012-13 and formally launched in Modena, Italy in 2014, has carried out several activities which aim at sharing expertise and learning from different models of environmental and health data integration and surveillance systems that directly inform policy. These include Twinning cooperation with Euro-Asian and Balkan countries and sharing of expertise with African Public Health Agencies. Some experiences are presented in this workshop and highlight the EPHS/EPHT model adopted by several national public health agencies. It promotes that such integration and uses of environmental and health data is key for EPHS, including their accessibility and usability for communities of public health researchers, practitioners and policy makers.
2008 economic crisis impact on perinatal and infant mortality in Southern European countries
Authors: Doetsch J N , Almendra R , Severo M , Leao T , Pilot E , Krafft T , Barros H 
Published: October 2024

Abstract

Introduction
The study of crisis events provides important lessons to prepare for upcoming events. The Great Recession’s impact on perinatal health in Europe can provide relevant insights into the healthcare and social protection systems’ response to protecting the health of the most vulnerable groups.

Objectives
To assess time trends and international disparities in perinatal mortality rates (PMR) and infant mortality rates (IMR), following the Great Recession, and their association with socioeconomic indicators in Portugal, Greece, Italy and Spain.

Methods
Associations were assessed through generalised linear models for all four countries. A Poisson joinpoint regression model was applied to explore PMR and IMR trend changes between 2000 and 2018. Country disparities were analysed using mixed-effects multilevel models.

Results
IMR and PMR have decreased overall in the four selected countries between 2000 and 2018. Still, whereas in Spain, Italy and Portugal the decreasing pace was attenuated after 2009, in Greece a positive trend was found after the 2008 crisis. IMR and PMR were significantly associated with socioeconomic indicators in all four countries. National disparities in the evolution of IMR and PMR were significantly associated with most socioeconomic indicators between 2000 and 2018.

Conclusions
Our results confirm the impact of the Great Recession on PMR and IMR trends in all four countries, taking recurring associations between macroeconomic cycles, variations in mortality trends, macroeconomic volatility and stagnation of IMR and PMR into account. The association with socioeconomic indicators stresses the need to strengthen social protection and healthcare systems to better protect the population’s health from the earliest days.

Key messages
• Mortality patterns refer to the internal variability of the crisis’ effect and to persistent spatial regional inequalities appealing to the need for attention in policymaking.
• The relevance of considering the political economy of global health finance and macroeconomic volatility as a major influence on the association of mortality rates with socioeconomic indicators.
Gender Differences in Years of Life Lost resulting from the 2015 Gorkha Earthquake in Nepal
Authors: Tonnelier M , Bhandari M , Delforge D , Moitinho de Almeida M , van Loenhout J , Devleesschauwer B , Haagsma J , Speybroeck N , Charalampous P 
Published: October 2024

Abstract

Background
Nepal has a history of regular natural hazards, including significant earthquakes and floods. Previous studies have shown that females, particularly younger females, are more likely to die due to disasters compared to males. This study aimed to explore gender differences in mortality - measured in Years of Life Lost (YLL) - caused by the 2015 Gorkha earthquake across 41 districts of Nepal.

Methods
Mortality counts were derived from the Nepal Police Report. YLL was estimated by multiplying mortality counts (stratified by age, gender, and district) by age-conditional life expectancy from the 2019 Global Burden of Disease reference life table. Both absolute numbers and rates of YLL per 100,000 population were calculated. YLL per deaths, stratified by age-gender-and-location, were estimated and compared. Male-to-female YLL rate ratios were estimated as well, and compared across districts.

Results
The 2015 Gorkha earthquake resulted in 8,950 deaths (females: 56.1% versus males: 43.9%), accounting for 526,617 YLL. Males had a slightly higher number of YLL per death (59.2) compared to females (58.5); this is mainly due to the different number of deaths between males and females. YLL per deaths ranged from 65.4 (Rautahat district) to 0 (in several districts) among males and, from 65.3 (Rautahat district) to 0 (in several districts) among females. The YLL rate per 100,000 population was higher for females (3,158 per 100,000) than for males (2,575 per 100,000). Approximately 40% of the districts had male-to-female YLL rate ratios of less than one, which can be partly explained by the gender distribution of the population at rik of dying due to earthquake.

Conclusions
The study found relatively higher YLL per death for males and higher YLL rates for females. This underscores the necessity to further investigate the factors that contribute to fatalities from earthquakes, especially in lower middle income countries such as Nepal.

Key messages
• Gender disparities in mortality following the 2015 Gorkha earthquake in Nepal were addressed using Years of Life Lost (YLLs); males had higher YLL per death, while females had higher YLL rates.
• Exploring the factors that contribute to earthquake-related fatalities should be a priority for disaster mitigation strategies.
Lifestyle factors before and after colorectal cancer treatment and their association with fatigue
Authors: Vlaski T , Caspari R , Fischer H , Rosenlechner S , Bilsing B , Fernandes-Almeida C M , Hoffmeister M , Slavic M , Brenner H , Schöttker B 
Published: October 2024

Abstract

Background
As colorectal cancer (CRC) survivorship increases, so does the challenge of managing cancer-related fatigue, a prevalent condition that severely impacts survivors’ ability to work and overall quality of life. This study delves into the relationship between lifestyle behaviors, assessed using the HEALTHY lifestyle score, and its influence on fatigue among CRC patients.

Methods
Data was derived from MIRANDA, a multicenter cohort study that enrolls adult CRC patients during a 3-week in-patient rehab within a year after primary CRC treatment. Up to date, n = 438 participants provided information on lifestyle factors at the rehabilitation start (baseline) and then every three months for the first year. The predictors were the HEALTHY lifestyle score and its components (diet, alcohol consumption, physical activity, BMI, and smoking status) calculated at three time points: before surgery, after surgery, and 12 months following rehabilitation. The outcome was fatigue, assessed using the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F-FS) scale.

Results
Participants with a higher HEALTHY lifestyle score after CRC surgery had statistically significantly lower fatigue levels. The components that contributed most to this finding were smoking and physical activity. Participants who engaged in exercise post-surgery or did not smoke before their cancer diagnosis experienced lower fatigue levels during rehabilitation.

Conclusions
Lifestyle modifications, such as increasing physical activity and smoking cessation, are crucial in preventing or reducing fatigue among CRC patients. Tailored public health initiatives that advocate for these lifestyle adjustments and their incorporation into CRC rehabilitation protocols could significantly advance survivor care, ultimately leading to better health outcomes.

Key messages
• The HEALTHY score is associated with fatigue of CRC patients during rehabilitation, highlighting the crucial role of lifestyle changes after CRC treatment.
• Smoking cessation and physical activity programs may be the most effective measures for decreasing the fatigue burden of these patients.
Educational inequalities in cervical cancer mortality in the Baltic Sea region in 2008–2015
Authors: Nõmm O , Innos K , Leinsalu M 
Published: October 2024

Abstract

Background
Reducing inequalities in cervical cancer mortality is a public health priority. This study aims to assess the absolute and relative educational inequalities in cervical cancer mortality in the Baltic countries and Finland in 2008-2015.

Methods
Data for Estonia, Latvia and Lithuania were obtained from longitudinal mortality follow-up studies of population censuses in 2000/2001 and 2011, and data for Finland from the longitudinal register-based population data file of Statistics Finland. Cervical cancer deaths (ICD-10 code C53) were linked from national mortality registries. Educational level was census- or registry-based. Absolute and relative educational inequalities in cervical cancer mortality were assessed in 2008-2015 for women aged 30-49 and 50-64, using age-standardized mortality rates (ASMRs) per 100 000 person-years and mortality rate ratios (RRs) with 95% confidence interval (CI).

Results
This study included 1724 cervical cancer deaths and about 22 million person-years. Absolute and relative educational inequalities in cervical cancer mortality were considerably larger in the Baltic countries compared to Finland. Among 30-49-year-olds, ASMRs for high educated ranged from 0.6 (95% CI: 0.4-1.0) in Finland to 3.6 (95% CI: 2.5-5.0) in Lithuania, and for low educated from 2.2 (95% CI: 1.2-3.7) in Finland to 24.6 (95% CI: 18.2-32.4) in Lithuania. RRs for low educated compared to high educated ranged from 3.51 (95% CI: 1.57-7.68) in Finland to 9.11 (95% CI: 4.28-19.32) in Estonia. Among 50-64-year-olds, ASMRs for high educated ranged from 1.3 (95% CI: 0.8-2.0) in Finland to 9.8 (95% CI: 7.2-13.1) in Estonia and for low educated from 2.9 (95% CI: 1.9-4.1) in Finland to 43.9 (95% CI: 34.4-55.1) in Lithuania. RRs for low educated compared to high educated ranged from 2.18 (95% CI: 1.20-4.05) in Finland to 6.32 (95% CI: 4.30-9.36) in Lithuania.

Conclusions
Equitable prevention is a key to reducing cervical cancer mortality in the Baltic countries.

Key messages
• Lower-educated women largely drive high cervical cancer mortality in the Baltic countries.
• Equity-focused prevention is crucial for reducing cervical cancer mortality in the Baltic countries.
Characteristics of fatal COVID-19 among pregnant women admitted to hospitals in Kazakhstan
Authors: Nurgaliyeva Z , Semenova Y , Santric-Milicevic M , Nikolic D , Lackovic M , Glushkova N , Sarria-Santamera A 
Published: October 2024

Abstract

Background
The factors contributing to the fatal outcome of COVID-19 in pregnant women remain not entirely clear. We compared the prevalence rates of comorbidities and laboratory test results in pregnant survivors and non-survivors.

Methods
This retrospective study relied on clinical and laboratory data obtained from medical records of pregnant women with COVID-19 admitted to three hospitals of the Republic of Kazakhstan from 16.07.2021 to 31.01.2022. Overall, we obtained data on 157 pregnant women with COVID-19, of whom 95.9 % survived and 4.1 % died in the hospitals.

Results
Arterial hypertension was present in 50% of non-survivors vs. 7.9% of survivors (P = 0.001), diabetes mellitus was diagnosed in 16.7% of non-survivors vs. 2.3% of survivors (P = 0.044), and the rate of hyperglycemia was 40% and 7.2%, respectively (P = 0.009). Heart rhythm disturbance was present in 50% of non-survivors vs. 6.4% of survivors (P &lt; 0.001), and already at the time of admission to the hospital, the non-survivors had significantly higher heart and respiratory rates. Laboratory tests showed that non-survivors had higher erythrocytes sedimentation rate, C-reactive protein, leukocyte count, and D-dimer levels (P = 0.001, P &lt; 0.001, P = 0.038, P = 0.014, respectively). The creatinine level was within the normal range in both study groups, but it was relatively higher in the deceased pregnant women (71.3; IQR: 66-251.75) vs. 52; IQR: 43-63; P = 0.001). Finally, a higher proportion of those who died presented with abnormal chest CT as compared with the survivors (33.3% vs. 4.2%, P &lt; 0.001).

Conclusions
The deceased had a higher rate of comorbidities. Given the vulnerability of pregnant women to COVID-19, it is essential to plan a prospective study to provide insights into the factors that contribute to severe COVID-19 outcomes in pregnant women.

Key messages
• Determining risk factors for fatal COVID-19 is crucial for effective medical care of pregnant women.
• Identifying potential risk factors of fatal COVID-19 among pregnant women could help inform public health policies and clinical guidelines.
Changes in overweight and overweight-related health behavior in higher education students in Finland
Authors: Parikka S , Ikonen J , Pohjola V , Sarttila K , Lundqvist A 
Published: October 2024

Abstract

Introduction
Covid-19 pandemic may have had negative effects on overweight and overweight-related health behavior in young adults. The aim was to examine the changes in overweight, physical activity, sedentary behavior and daytime tiredness in higher education students during and after the pandemic.

Methods
Two cross-sectional student representative surveys (aged 18-34 y) were conducted in 2021 (n = 6258, response rate 53 %) and 2024 (n = 3638, response rate 31 %). Overweight (BMI ≥25 kg/m2) was based on self-reported height and weight. Physical activity was dichotomized into those meeting physical activity recommendations and others. Sedentary behavior was dichotomized into sitting in front of TV, computer or smart device over three hours a day during leisure time and others. Daytime tiredness was dichotomized into those feeling tired 6-7 days a week and others.

Results
The preliminary results indicate that overweight in women increased from 34 % to 39 % whereas no increase was observed among men (47 % vs. 46 %) between 2021 and 2024. Meeting the physical activity recommendation increased from 46 % to 55 %, the change being similar for both sexes. Sitting over three hours in leisure time in front of TV, computer or smart device decreased from 54 % to 50 %. In men, the prevalence of sitting decreased (62% vs. 57 %) whereas in women no statistically significant change was observed (47% vs 45 %). No statistically significant change was observed in feeling tired almost every day (26 % vs 24 %).

Conclusions
Among higher education students, an increase in prevalence of overweight in women was observed for three years period. Favourable changes were observed in physical activity in both men and women, and sedentary behavior in men. Surveillance of the long-term health consequences of the pandemic in young adults is important for planning and targeting preventive activities.

Key messages
• Overweight increased among female higher education students after COVID-19 pandemic.
• Factors supporting favourable changes in health behaviour of young adults after pandemic should be examined in longitudinal setting.
Measles outbreak under the Leaning Tower of Pisa in Italy
Authors: Daole A , Giorgi S , Cruschelli G , Bonaldo L , Gallo A , Rizzo C 
Published: October 2024

Abstract

Background
Measles cases in Italy (58,9 mln population) were 8 in 2021, 15 in 2022 and 43 in 2023. Between January and April 2024 there were 213 cases in Italy, with higher incidence in children. Pisa Local Public Health Department (201073 population) experienced a measles outbreak in the same period.

Methods
Cases were classified according to Decision (EU) 2018/945. A bidirectional tracing (backward and forward) was conducted to identify transmission chain and contacts of cases. Immunization status was checked on Regional Vaccination Registry.

Results
33 suspected measles cases were notified in Pisa between 21st January and 17th April 2024: 16 by General Practitioners and 17 by Hospital Emergency Room. Additionally, 1 undiagnosed case was found during the epidemiological investigation. 2 notifications were withdrawn by General Practitioner because of lack of the diagnostic criteria. Laboratory analysis confirmed 24 cases. Last confirmed case occurred on 23rd February, while not confirmed cases occurred mostly in the last part of the period (6 in a row from 3rd March to 17th April), suggesting an infodemic effect. Women were more affected than men (17 vs. 7). Except for 2 babies (9 months and 1 year old age), the outbreak affected young adults with a mean age of 40 yo. Hospitalization rate was 37,5%. The first 5 unrelated cases occurred between 19th and 21st January. A second wave involved 13 people, 12 of them were related to a single case. Transmission occurred in Emergency Room (7), in a mall (1) and in the neighborhood (4). A third wave involved 4 cases (family contacts). 2 cases were imported from Sicily and Spain. All cases were unvaccinated, 2 were migrants. Around 950 contacts were traced.

Conclusions
In Pisa, high vaccination coverage of children &lt; 2years of age (≥95%) protected school population and cases to spread, but there are pockets of unvaccinated adults which could allow measles circulation.

Key messages
• An effective public health response is required to contrast increasing measles cases in EU/EE countries.
• As recommended by ECDC, public health services need to close immunity gaps, addressing catch-up actions towards adults and vulnerable groups as migrants.
Revisiting COVID-19 Maps with Bayesian Hierarchical Modelling: Socioeconomic Insights from Istanbul
Authors: Küçükali H , Sezerol M A 
Published: October 2024

Abstract

Objectives
This study explores the spatial disparities in COVID-19 incidence across neighborhoods in Uskudar, Istanbul, and examines the relationship between these disparities and neighborhood-level socioeconomic status.

Methods
This ecological study analyzed cumulative COVID-19 case data for 33 neighborhoods in Uskudar, collected up to 31 December 2020. Socioeconomic status was assessed using the Socioeconomic Development Index (SEDI) scores from Istanbul Metropolitan Municipality. Spatial analysis included Moran’s I statistics and Local Indicators of Spatial Association (LISA) cluster analysis. Bayesian Hierarchical Modeling with the Besag-York-Mollie (BYM) model was employed to decompose spatially structured and unstructured variations, adjusting for SEDI scores and their sub-components. Model validation involved convergence diagnostics and Monte Carlo error assessments.

Results
A total of 29,834 COVID-19 cases were identified, with an incidence rate of 56.1 per 1000 residents. Spatial analysis revealed significant clustering of high incidence rates in peripheral and inner city neighborhoods. Moran’s I statistic for COVID-19 incidence was 0.331 (p = 0.003), indicating positive spatial autocorrelation. SEDI scores were also spatially autocorrelated (Moran’s I = 0.293; p = 0.005) and negatively correlated with COVID-19 incidence (r = -0.570; p = 0.001). Bayesian hierarchical models confirmed the association between lower socioeconomic status and higher COVID-19 incidence, even after adjusting for spatial autocorrelation.

Conclusions
The study highlights significant spatial and socioeconomic disparities in COVID-19 incidence in Uskudar, Istanbul. Lower socioeconomic status is associated with higher COVID-19 incidence, underscoring the need for region-specific public health strategies that consider socioeconomic factors. These findings can guide future interventions to mitigate the impact of the pandemic on vulnerable populations.

Key messages
• Study reveals COVID-19 incidence in Uskudar is significantly influenced by socioeconomic status, highlighting need for targeted health interventions.
• Positive spatial autocorrelation found in COVID-19 cases and socioeconomic index suggests clustering in specific Uskudar neighborhoods.