bluuebunny/crossref_metadata_2025_split huggingface dataset:
AI-driven ethical issues in the development of personalised therapy for pediatric SIRS patients
Authors: Yankulovska S , Stolte F , Thiemicke P , Orzechowski M , Steger F 
Published: October 2024

Abstract

Background
Systemic Inflammatory Response Syndrome (SIRS) is a rare disease often presenting emergency. While the aetiology varies, current diagnostic criteria do not allow differentiation. Hopes are placed on OMICs research and development of Artificial intelligence (AI) algorithms for personalised disease management. Our report aims at identification and analysis of AI-driven ethical issues within the bigger ERA PerMed funded project of development of tailored immunotherapy for paediatric SIRS patients (TIPS) coordinated by Prof. Catharina Schütz from Technic University Dresden.

Methods
Systematic literature review followed by qualitative research methodology. Ten experts with different backgrounds were interviewed. Subsequent thematic analysis was performed by two independent researchers.

Results
Experts were on the opinion that AI can lead to a depart from individual approach in the medicine, as the physician may be induced to only act based on algorithms that are more or less representative (N = 2). Interviewees were aware that AI can lead to changes in the assessment of reality, as it is dependent on data quality (N = 4). AI-aided decision-making might be useful for special therapeutic situations, although it may not always capture the subtleties of individual situations (N = 2). Positive implications of AI were significantly more emphasised, though current frameworks were perceived as more limiting than enabling.

Conclusions
Personalised therapy is making its first steps while the ethical apprehensions has already been there with a strong emphasis on precautionary principle and resulting limitations on the application of AI-algorithms. The multifaceted nature of the AI-driven ethical issues in personalised medicine research requires an interdisciplinary discourse, strengthened ethics training of all professionals involved in the technology development and more active involvement of physicians in the shaping of AI.

Key messages
• AI algorithms promise therapeutic benefits, not achievable by other means, for specific categories of vulnerable pediatrics patients.
• The multifaceted nature of the AI-driven ethical issues in personalised medicine research requires an interdisciplinary discourse and further ethics training of all stakeholders.
Undernutrition, and overweight and obesity: the two faces of malnutrition in Brazil, 1990-2019
Authors: Carvalho Malta D , Saar Gomes C , Felisbino-Mendes M S , Malta dos Santos F , Augusto Veloso G , de Oliveira Cardoso L , Eloha Machado I , Constance Jaime P , Lucia de Couto Vasconcelos L , Naghavi M 
Published: October 2024

Abstract

Background
The double burden of malnutrition consists of the coexistence of nutritional deficiencies (malnutrition and overweight/obesity. Approximately 2.28 billion children and adults are overweight, and more than 150 million children are malnourished. The Decade of Action on UN Nutrition and SDGs that broaden the focus to both sides of malnutrition: overweight/obesity and nutritional deficiencies.

Objectives
To analyze the global burden of disease attributable to undernutrition and high body mass index (BMI) in Brazil and its 27 states, as well as its association with the socio-demographic index (SDI) from 1990 to 2019.

Methods: Study design
This is an epidemiological time-series study. This study analyzed the undernutrition and high BMI estimated by the Global Burden of Disease study conducted from 1990 to 2019 for Brazil and its states, using the following metrics: absolute number of deaths, standardized mortality rate, and disability-adjusted life years (DALYs). This study also analyzed the correlation between the percentage variation of mortality rates and SDI.

Results
A decrease in the number of deaths (75%), mortality rate (75.1%), and DALYS (72%) attributable to undernutrition was found in Brazil and in all regions. As regarding the high BMI, an increase in the number of deaths was found (139.6%); however, the mortality rate (9.7) and DALYs (6.4 %) declined in all regions, except in the North and Northeast regions, which showed an increase. A strong correlation was identified between undernutrition and high BMI with SDI.

Conclusions
Our study observed a double burden of malnutrition in Brazil, with a reduction in the burden of diseases due to malnutrition in Brazil and variation in the burden due to high BMI according to the socioeconomic status of the region. Public policies are necessary in order to guarantee the human right to a healthy and sustainable diet, together with food and nutrition security and a diminishing of social inequality.

Key messages
• Overcome the malnutrition public policies are necessary to guarantee the human right to healthy and sustainable food, such as encouraging the production and commercialization of fruits & vegetables.
• Overcoming undernutrition and excess weight requires public policies aimed at reducing social inequality and providing access to healthy food for all, and taxation of ultra-processed foods.
Evaluation of Label Compliance to Allergens in Imported Asian Food Sold in Northern Italy
Authors: Ragni L , Bertolassi R , Magagna G , Tilola M , Bertasi B , Pavoni E , Finazzi G , Losio M-N 
Published: October 2024

Abstract

Background
The import of Asian food is strongly increasing in the EU. In Italy, the Asian market has expanded over the last 3 decades. Unfortunately, the labelling of these products often implies errors, mainly due to linguistic differences. Consequently, it can become a consistent problem regarding food safety, in particular for allergens declaration. According to EU Reg. 1169/2011 (Annex II), allergens must be labelled in bold and translated in the current language of the Member State. Asian food non-compliant labelling could enhance the probability of allergic consumers to get adverse events; accordingly, it is important to increase controls on the imported products. The present work investigates the label compliance to allergens on Asiatic products imported in Northern Italy.

Methods
Totally, 39 foodstuffs were tested for gluten, 93 for white egg proteins and 118 for milk proteins by commercial ELISA kits according to manufacturers’ instructions. Samples were considered non-compliant when the results were above 20 mg/Kg, the law limit for gluten, or above the milk LOD (10 µg/Kg) and the egg LOD (0.4 mg/Kg).

Results
Data showed 18% (CI 95% 0.09-0.32) of non-compliant samples for gluten: 6 samples &gt; 80 mg/Kg (snacks and ready to eat meal) and 1 sample containing 48 mg/Kg (snack). In addition, 19.4 % (CI 95% 0.13-0.28) showed presence of egg proteins (noodles, snacks, patties and pasty). Finally, 13.6% (CI 95% 0.08-0.21) samples were irregular for undeclared milk (noodles and snacks).

Conclusions
Products label report their content and represent an important element for food trading and tracing. The results obtained confirm a high percentage of non-compliant labels, underlining how the consumption of imported products can represent a health risk for allergic consumers. The present work highlights the importance of imported food monitoring to guarantee the consumers health, and of the implementation of standardized/international regulated labelling rules.

Key messages
• Many non-compliant labels about allergens was observed on Asiatic products.
• Correct labelling of allergens in imported food should be monitored to avoid adverse events.
Chrono-nutrition and post-bariatric weight loss: insights from the Portuguese ChronoWise cohort
Authors: Rodrigues J , Magalhães V , Santos M P , Reis C , Pichel F , Soares P , Santos J , Vilela S 
Published: October 2024

Abstract

Background
Post-bariatric weight loss varies substantially, and a large proportion of patients respond poorly. The literature highlights the importance of chrono-nutrition for weight regulation. This study aims to explore the chrono-related factors associated with poorer weight loss.

Methods
This study was conducted within the ChronoWise project, an ongoing prospective cohort study following patients undergoing bariatric surgery at the Santo António Local Health Unit, Porto. The sample included patients evaluated at both pre-surgery and 3 months post-surgery. Baseline information on meal timing was gathered through the Chrononutrition Profile-Questionnaire. The eating midpoint (midpoint between first and last meal) was calculated for work and free days. Chronotype was determined using the Munich Chronotype Questionnaire. Weight loss was expressed as the percent of total weight loss (%TWL = [(initial weight − current weight)/(initial weight)]×100). Chrono-related variables were compared according to %TWL (dichotomized by the median) using the Mann-Whitney test.

Results
Sixty patients were included (72% female; mean age 45±11.8). The mean baseline BMI was 44±5.6 kg/m2, which decreased to 35±5.3 kg/m2 at 3 months post-surgery, resulting in an average 20±3.9 %TWL. On free days, participants with lower %TWL tend to do the first meal later in the day (9h45 vs. 9h10, р=0.367), and later lunch on workdays (12h45 vs 12h30, р=0.531) compared with individuals with higher %TWL. Lower %TWL is typically observed in individuals having later eating midpoints (15h00 vs. 14h15 for workdays, р=0.011; 15h07 vs. 14h44 for free days, р=0.205). A later chronotype (3h37 vs 3h30, р=0.347) was also linked with poorer weight loss.

Conclusions
Eating later during the day and later chronotype may contribute to poorer post-bariatric weight loss. Funding: This work was supported by FCT - Fundação para a Ciência e Tecnologia [2021.01096.CEECIND, UIDB/04750/2020,LA/P/0064/2020&SGITR2023/EPIUnit].

Key messages
• Recognizing meal timing as a modifiable lifestyle factor may optimize current approaches by aligning food intake with circadian clock.
• A later chronotype, i.e. a behavioural expression of an individual’s internal circadian clock system as a preference for eveningness or later sleep timing, may negatively influence weight loss.
Accuracy of body weight perception: The Case of Türkiye
Authors: Baran Deniz E , Çelikay N , Kocadağ S 
Published: October 2024

Abstract

Background
Accuracy of body weight perception is defined as the extent to which an individual’s self-assessment of their body weight aligns with their actual body weight. Our study evaluates the accuracy of body weight perception, an important factor in preventing and managing obesity and overweight, according to sociodemographic factors.

Methods
This study utilizes data from the nationwide cross-sectional ‘Nutrition and Health Survey 2017’. The survey includes 12,266 participants who were interviewed face-to-face. Factors influencing the accuracy of body weight perception were evaluated using the chi-square test. Subsequently, the logistic regression models were constructed to assess factors that were statistically significant (p &lt; 0.05).

Results
The prevalence of obesity and overweight was found to be 36.3% and 71.5%, respectively. The accuracy of body weight perception was 39.2%, underestimation was 57.0%, and overestimation was 3.8%. There was no significant difference in accuracy of body weight perception between sexes (p = 0.94). According to logistic regression analysis (n = 12.168), accuracy of body weight perception was higher among individuals who were not overweight compared to those who were overweight (p &lt; 0.001, OR: 4.56, CI: 4.16-4.98), among those aged 15-44 compared to those aged 45 and over (p &lt; 0.001, OR: 1.47, CI: 1.35-1.60), among those with high school and higher education compared to those with middle school education or less (p &lt; 0.001, OR: 1.43, CI: 1.31-1.56), among unmarried individuals compared to married ones (p = 0.011, OR: 1.12, CI: 1.03-1.23), and in individuals with poor income status compared to good (p = 0.005, OR: 1.13, CI: 1.04-1.22).

Conclusions
In health promotion programs aiming to perceive body weight accurately, priority should be given to people with overweight, those with low education levels, married individuals, people aged 45 and over, and individuals with low income.

Key messages
• Accuracy of body weight perception is important in fighting obesity.
• Individuals with overweight, have a low level of education, are married, aged 45 and over, and have low income are misperceive their body weight to a greater extent.
Novel R package to quantify and monetize burden of disease attributable to air pollution and noise
Authors: Luyten A , Breitner S , Barbosa A , Kocbach Bølling A , Lepnurm M , Pauwels A , Rueda-López M J , Castro A 
Published: October 2024

Abstract

Background
Ambient air pollution and noise substantially impact public health and the economy. Different methods to quantify these impacts are described in the literature.

Objectives
Within the European project BEST-COST (Burden of disease-based methods for estimating the socio-economic cost of environmental stressors), we aim to develop an open-source R package to quantify and monetise the disease burden attributable to air pollution and noise, including the impact of social inequalities.

Methods
The developed code will allow for different calculation pathways including: single baseline health data vs. age-specific estimates from life tables; relative and absolute risk; scenario comparison based on the population attributable fraction vs. population impact fraction; single-pollutant vs. correlated exposures; and outdoor vs. indoor air pollution. Moreover, the package can digest a variety of input data formats for the exposure-response function (e.g. relative risk with fixed shape vs. user-defined function) and exposure data (e.g. population-weighted mean vs. categorical distribution, spatial data). Eligible impact metrics will include morbidity incidence and prevalence, number of deaths, years of life lost, and years lived with disability. Finally, the R package will enable quantifying social inequities (using a novel multiple deprivation index) and monetising the attributable disease burden (using a state-of-the-art approach).

Results
During development, the R package will be tested in BEST-COST case studies in 5 European countries (BE, EE, FR, NO, PT), compared with existing tools, and discussed with key users in a workshop. The final R package will be available on GitHub in 2026.

Conclusions
This tool will allow the quantification and monetisation of the health impact of air pollution and noise. The R package will be a flexible programming resource that can be used as a standalone or combined with existing tools to build a more solid basis for evidence-based policy making.

Key messages
• This open-source tool will allow the quantification and monetisation of the health impact of air pollution and noise, including the impact of social inequalities.
• The R package will be a flexible programming resource that can be used as a standalone or combined with existing tools to build a more solid basis for evidence-based policy making.
Impact of COVID-19 on cardiology and neurology services in a peripheral hospital in Northern Israel
Authors: Bernstine T , Spitzer S , Pleban R , Ron A , Armon-Omer A , Kains I , Hamudi J , Shahien R , Edelstein M 
Published: October 2024

Abstract

Background
The indirect impact of COVID-19 pandemic on clinical services remains incompletely described in secondary care hospitals outside major urban centers. We compared clinical outcomes before and during the pandemic in a disrupted service (Neurology) and a non-disrupted one (Cardiology) in a peripheral hospital in Israel, using Cerebral Vascular Accident (CVA) and ST-elevation myocardial infarction (STEMI) as clinical indicators, respectively.

Methods
We compared demographics, treatment and outcomes from CVA and STEMI patients who attended Ziv Medical Center, Israel, during the pandemic (15/3/2020-15/4/2022) and before (1/1/2018-14/3/2020), Using chi-square, t-test and Wilcoxon-Mann-Whitney tests.

Results
1029 CVA and 497 STEMI patients were included. Those who arrived during the pandemic were demographically comparable to those arriving before. Compared to pre-pandemic, intra-pandemic median time for CVA patients from arrival to imaging was longer (23 vs. 19 minutes, p = 0.001). However, timing from arrival to tissue Plasminogen Activator administration was similar (49 vs. 45 min, p = 0.61). The likelihood of transfer to another hospital was higher (20.3% vs. 14.4% p = 0.01) and median length of stay (LOS) was shorter (3 vs. 4 days, p &lt; 0.05). Among STEMI patients, median time from arrival to percutaneous coronary intervention during the pandemic was shorter than before (45 vs. 50 minutes p = 0.02) and median ejection fraction at discharge was higher (50% vs. 45% p = 0.02). Mean LOS was shorter (3.86 vs. 4.48 p = 0.01), and unplanned re-admission to the ED was less frequent (7.8% vs. 14.6% p = 0.01). No significant changes in mortality were observed.

Conclusions
Our data shows no major negative impact of the COVID-19 pandemic on CVA and STEMI outcomes, and possibly improved care in the less disrupted department. Follow-up qualitative studies with neurology and cardiology staff already in action to comprehend how quality of care was maintained during the crises.

Key messages
• In peripheral setting, COVID-19 hadn’t negatively impact Neurology or Cardiology acute clinical outcomes.
• The consequences of maintaining clinical performance when working under adverse conditions requires further research.
TB Care in Ukraine: Understanding Access Barriers at the Primary Healthcare Level
Authors: Boiko A , Snidevych U , Odrynskyi V , Duda M , Pavlenko P , Hinchey B , Avaliani N , Polomoshnova E , Samko M , Tokar A 
Published: October 2024

Abstract

Background
In the WHO European Region, Ukraine is a high-priority country for TB control, being one of nine globally with high rates of multidrug-resistant TB. The WHO emphasizes patient-centered TB care, prioritizing patients as key figures in the care continuum. Thus, our aim was to explore barriers impacting the accessibility of TB services for patients at the primary healthcare level (PHC) in Ukraine.

Methods
During December 2022-June 2023, a qualitative study was conducted across eight PHC facilities in the Kyiv, Odesa, Mykolayiv, and Volyn regions. The study comprised: 4 focus groups involving 27 family doctors, 16 in-depth interviews with managers and health authorities from regional and national levels, as well as 25 interviews with TB patients. All data was transcribed, manually coded and deductively analyzed.

Results
All participants highlighted the benefits for patients of providing TB care continuum at the PHC level, yet the program lacks clear requirements for training of family doctors and nurses. Overall family doctors perceived positively various TB training they received; but despite this, they expressed doubts and reported a lack of practical skills, affecting the quality of care provided. Patients highlighted several barriers in interacting with healthcare providers, including stigma and cases of dismissive behavior of healthcare workers, communication challenges, and breaches of patientś data confidentiality. Patients also mentioned self-stigma, and perceptions of family doctors as poorly trained in TB. Still, patients who received healthcare services from the same family doctor “during long time” positively described their experience with TB services too.

Conclusions
Establishing robust patient-provider interaction at the PHC level can help overcome persistent barriers to TB care continuum in Ukraine. To achieve this, a comprehensive TB training program tailored for PHC family doctors and nurses should be developed and implemented.

Key messages
• Expanding TB healthcare services to primary healthcare levels in Ukraine can be beneficial for patients. Training primary healthcare staff can enhance TB care quality.
• Establishing robust patient-provider interaction at the PHC level can help overcome persistent barriers to TB care continuum in Ukraine.
An interdisciplinary approach: Exploring the five dimensions of the tools deployed by EUVABECO
Authors: Billuart M , Van Loenhout J , Nasiadka L 
Published: October 2024

Abstract
To effectively address the complexities of vaccination across the EU, EUVABECO’s 14 partners are implementing a comprehensive, interdisciplinary approach. Twelve pilot projects will be implemented from September 2024 to August 2025 in six MS (BE, DE, EL, LV, LU, PL, PT). These pilots will test innovative tools across five domains-medical, social, industrial, modelling and forecasting, and digital-to optimize vaccination outcomes:
Medical/Clinical Tool: A decision support system that aids patients and healthcare professionals by providing current, evidence-based information tailored to individuals, thereby facilitating informed vaccination decisions.
Social Tool: Data linkage on an individual level, to enhance the targeting and monitoring of vaccine campaigns, and ensuring equitable access to vaccines, especially for vulnerable populations.
Industrial Tool: An electronic vaccine leaflet that boosts the flexibility and responsiveness of vaccine distribution by offering dynamic, real-time information in local languages to both healthcare providers and patients - regardless of the source and point of use of the vaccine.
Modelling and Forecasting Tool: A disease simulator that models infection dynamics and evaluates the impact of public health interventions, crucial for strategic planning and resource allocation.
Digital Tool: A citizen-held digital vaccination card that enables individuals to maintain a comprehensive, accessible record of their own vaccination histories, enhancing continuity of care across borders.
Impact of COVID-19 on Management, Quality and Satisfaction of Health Organizations
Authors: Gaspar T , Salado V , Faia-Correia M 
Published: October 2024

Abstract

The hospital health care professionals are the frontline fighting COVID-19 considering they are responsible for all the care provided to patients during all the time they spend at the hospital for diagnosis, treatment or recovering of the COVID-19 disease and other diseases. The purpose of this study was to determine the impact of COViD-19 at the hospital management level and, also, to understand how psychosocial environment, and satisfaction of Health Professionals were affected. A case study was performed in a Portuguese Hospital. Data were collected at one hospital under study at two different occasions: the first before the pandemic (November 2019) and the second almost two years after the pandemic started (November 2021). Regarding data collection, 37.0% of participants responded in the occasion 1 (n = 296) and 63.0% responded in the occasion 2 (n = 503). The instrument for the Assessment of Global Management of Health Organizations (AGMHO) Comparing timings pre and during pandemic COVID-19, it was found that the participants in the pre- COVID-19 era showed stronger organizational culture, higher quality of life, better psychosocial environment regarding content/leadership and higher job satisfaction when compared to the participants during pandemic COVID-19. On the other hand, participants in the second occasion were found to have higher psychosocial risks related to mental health when compared to participants in the pre- COVID-19 phase. The results obtained allow us to identify priorities in terms of promoting well-being and satisfaction of professionals and overall wellbeing of the health organization, namely intervention in leadership relationships and psychosocial risks at work related to the physical and psychological demands of work, stress management and a more active and involved role for the professional.

Key messages
• This knowledge facilitates labelling and prioritizing the promotion of well-being and satisfaction of professionals and overall wellbeing of the health organization.
• The product is a comprehensive diagnostic model of the factors influencing the results in health organizations.