bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vaccination, health information seeking, and ICT use among Estonians aged 50+ during COVID-19
Authors: Paimre M 
Published: October 2023

Abstract

Background
Vaccination is one of the most effective ways to protect oneself against Coronavirus. However, many people, including older adults, have refused to receive the vaccine. The study aimed to analyze relationships between vaccination intention, socioeconomic indicators, health status, choices in health behavior, health information (HI) seeking, and acceptance of ICTs for health purposes.

Methods
After the end of the first lockdown in 2020, a cross-sectional survey was conducted among 500 Estonians aged 50 and over.

Results
More than half (53.5%) of respondents were in favor of vaccination, less than a third (30.5%) were hesitant, and sixteen percent (16%) were opposed. There was a significant correlation between being male and having a higher education level with vaccination readiness. As the respondent felt the need for HI more often and searched the internet for HI more recently, the more likely they were to agree to be vaccinated (rho = .14, p &lt;.05). It was found that vaccination readiness and the need for a digital health application were positively correlated (rho = .25, p .01): the more such an application was needed, the more people agreed to be vaccinated. Uninterested and hesitant respondents used fewer HI sources than those interested in vaccination. Improved health behavior choices did not increase willingness to get vaccinated (e.g., eating healthier and exercising more). Vaccination readiness was also unrelated to health status.

Conclusions
At least in Estonia, many upper-middle-aged and older people use the internet and smart devices to get HI during a crisis. However, why these people don't make other health-conscious choices should be investigated. Planning health campaigns and vaccinations and/or tackling new health crises should consider the differences between people aged 50 and older.

Key messages
• In a time of crisis, the internet broadens the range of sources of health information.
• It is important for health campaigns to take into account the growing tendency of 50+ people to obtain HI from the internet.
E-health to improve integrated care for older people: communication insights from ValueCare
Authors: Raat H , Bally ELS , Vasiljev V , Zanutto O , Cheng D , Roozenbeek B , Dippel DWJ , van Grieken A , Mao Y 
Published: October 2023

Abstract

Background
Population aging poses challenges to high quality health and social care for older people in Europe. The Horizon 2020 ValueCare project (www.projectvaluecare.eu) develops, implements and evaluates an Information and Communication Technologies (ICTs) supported integrated health care solution. ValueCare aims to increase health-related quality of life of older people in Europe by a co-designed digital solution with end users. The project has seven pilot sites with unique social and cultural backgrounds: Athens, Greece; Coimbra, Portugal; Cork/Kerry, Ireland; Rijeka, Croatia; Rotterdam, the Netherlands; Treviso, Italy; and Valencia, Spain.

Methods
Taking this innovative practice as an ongoing research case, we will share important lessons learned in the designing, operationalization, and coordination of such a multidisciplinary project from a communication perspective. We will discuss the insights on the challenges and opportunities of designing and implementing innovative and robust digital solutions in various social contexts with different regulations.

Results
Recruiting participants was the most challenging task, especially during the pandemic. Different communication strategies were used to reach diverse participants to ensure inclusivity and diversity of the participants. We will discuss the communication aspects of ValueCare that can inspire future projects to consider communication perspectives in public health research and solutions.

Conclusions
The co-design approach increased the participation of end-users during the phase of development and implementation. Intense communication strategies were applied to engage older people and professionals in using the new care approach. ICT supported outcome-based integrated care has the potential to benefit the larger society in an equitable way.

Key messages
• Co-design may be applied to increase involvement of end-users during development and implementation of new care strategies.
• Intense communication strategies are needed to engage older people, informal caregivers and care professionals in the development and use of new care strategies.
Can we make better use of our operating theatres?
Authors: Peruzzi V , Campanile G , Maccari A , Cevenini G , Nante N 
Published: October 2023

Abstract

Background
The utilisation rate of operating theatres is one of the indicators of efficient management in a Hospital. Our analysis focuses on the percentage of room utilization for planned activity. The aim is to compare the results of the manual planning carried out by the Surgical Scheduling Office (SSC) with the one carried out automatically by the testing of a Decision Support System (DSS) management application based on the automatic analysis of factors involved in the creation of surgical scheduling.

Material and Methods
The study took place at the Hospital ‘Alta Valdelsa’ in Poggibonsi, Tuscany, Italy. It first saw the collection and cataloguing over a period of one month (Nov 2022), for each speciality, of the operating notes made by the SSC, taking into consideration the indications of the respective referring surgeons. From the surgical work pathway management system (ORMAWEB), the actual average operating times over the same period were then collected for each specialty. Finally, for comparison, the DSS worked out the best room scheduling according to an algorithm based on waiting lists, priorities, and operator surgical times.

Results
Following the manual planning of 143 scheduled operations, the planned utilization of the operating theatres was in most cases confirmed by the reality of the occupied room times extrapolated from ORMAWEB, with slight differences due to patient-dependent modifications. Out of a total of 350 hours available for surgical specialties, the manual operating notes predicted room occupancy for only 196 hours and 40 minutes, with a utilization rate of 56.3%. The DSS application, on the other hand, produced a possible schedule with a room occupancy of over 90%.

Conclusions
The study shows that the efficiency of the operating theatre could be significantly increased if the SSC were supported by a DSS application that uses totally objective criteria in the selection of patients to be operated on the waiting list.

Key messages
• The use of new applications in surgical path management can improve the efficiency of the operating theatre.
• Increased utilisation of surgical rooms results in better rationalisation of available resources of the Hospital.
Designing Dynamic Informed Consent For Public Health Research
Authors: Miranda P , Kaur J , Morita P P 
Published: October 2023

Abstract

Background
Current dynamic consent software available is not all tailored for public health research and lacks the appropriate data governance framework and mechanisms to be compliant with public health research requirements. This paper presents the UML modelling of the Dynamic Consent for Public Health (DC4PH), a dynamic consent platform being designed for the Canadian public health domain

Methods
The proposed platform incorporates data governance and public health stakeholders’ requirements into its design and is based on state-of-the-art standards and solutions. Diagrams created in UML reflect the mapped requirements and demonstrate the capabilities of our dynamic consent proposed data structure. We also incorporated private ledger entities in our modelling to provide an immutable log of dynamic consent for stakeholders and improve transparency and trust between them.

Results
A series of UML assets were created based on previous mapping of the public health research domain, public health principles, and data governance requirements. Use case diagrams for each type of user of the platform, state diagrams of key business objects vital for the platform's enhancement of traditional consent, and state diagrams of the actor's possible states. Flowchart of the core platform's functionalities, such as the dynamic consent approval process. And a class diagram of the proposed platform that incorporates all the previously mentioned domain mapping and binds it with optional private ledger properties.

Conclusions
This work offers a comprehensive and extensible UML design that is being used to develop the DC4PH platform. The paper concludes that the design has the potential to improve the efficiency and efficacy of informed consent collection in public health research projects of small or large scales while also being capable of complying with data governance requirements, healthcare standards, and ledger technologies.

Key messages
• Dynamic informed consent still lacks appropriate scrutiny over the underlining data structures utilized to store and manage dynamic consent.
• Our work proposes a design in Unified Modelling Language (UML), of dynamic informed consent based on public health's domain mapping, data governance and public health research requirements.
Leisure-time physical activity and gastric cancer risk: a pooled study within the StoP project
Authors: Pires Marafon D , Pastorino R , Mariani M , Osti T , Pelucchi C , La Vecchia C , Boccia S 
Published: October 2023

Abstract

Background
Although physical activity (PA) has been recognized as a favourable factor in the prevention of various diseases, including certain forms of cancer, the relationship between PA and gastric cancer (GC) is not yet fully comprehended. For this reason, this study aims provide data from a pooled analysis of case-control studies within the Stomach cancer Pooling (StoP) Project to estimate the association between leisure-time PA and the occurrence of GC.

Methods
Six case-control studies from StoP project collected data on leisure-time PA, for a total of 2,343 cases and 8,614 controls. Subjects were classified into three leisure-time PA categories, either none/low, intermediate or high, based on study-specific tertiles. We used a two-stage approach. Firstly, we applied multivariable logistic regression models to obtain study-specific odds ratios (ORs) and corresponding 95% confidence intervals (CIs) then, we used a random-effect models to obtain pooled effect estimates. Heterogeneity was assessed using Q and I2 statistics. We performed stratified analyses according to demographic, lifestyle and clinical covariates.

Results
The meta-analysis showed ORs of GC with no significant differences between intermediate vs low and high vs low PA level (OR 1.05 [95%CI 0.76-1.45]; OR 1.23 [95%CI 0.78-1.94], respectively). GC risk estimates did not strongly differ across strata of selected covariates except for age ≤ 55 years old (high vs low level: OR 0.72 [95%CI 0.55-0.94]).

Conclusions
An association between leisure time PA and GC, apart from some suggestion of decreased risk below age 55, was not found. This may reflect specific characteristics of GC at younger age, or the presence of a cohort effect mediating and interacting with socioeconomic determinants of GC.

Key messages
• An association between leisure time PA and GC, apart from some suggestion of decreased risk below age 55, was not found.
• GC risk estimates did not strongly differ across strata of selected covariates except for age ≤ 55 years old.
Life's Simple 7 for cardiovascular health is associated with cancer risk in the Moli-sani Study
Authors: onaccio M B , Di Castelnuovo A , Costanzo S , Martinez C F , Panzera T , Cerletti C , Donati M B , de Gaetano G , Iacoviello L 
Published: October 2023

Abstract

Background
Cardiovascular disease and cancer share modifiable risk factors and, potentially, molecular mechanisms of disease, as postulated by the “common soil” hypothesis. We examined whether the American Heart Association's Life's Simple 7 (LS7) metrics to assess and promote cardiovascular health, is associated with cancer risk, defined as first hospital admission for any cancer obtained through record linkage with hospital discharge forms.

Methods
Longitudinal analyses on 21,705 apparently cancer-free participants (mean age 55.2±11.6; 51.9% women) at cohort entry in the Moli-sani Study (2005-2010). Components of the LS7 include cigarette smoking, physical activity, diet, body mass index, blood pressure, cholesterol and glucose: each ideal CV health metric was assigned 2 points, and all points were summed to compute a CV health score ranging between 0 to 14 points. CV health scores were then classified as poor (0 to 6), average (7 to 9), and ideal (10 to 14).

Results
Over a median follow up of 13 y, a total of 1,918 hospital admissions for any cancer were recorded. The proportion of poor, intermediate and ideal CV health were respectively 33.2%, 47.6%, and 19.2%. In a multivariable-adjusted COX analysis controlled for known risk factors, participants in the ideal CV health category experienced 29% lower risk of cancer hospitalization (HR = 0.71; 95%CI 0.61-0.83) compared with the poor CV health category. These associations tended to be stronger in men (HR = 0.60; 95%CI 0.48-0.76) than in women (HR = 0.80; 95%CI 0.64-0.99), but were of the same magnitude in both the elderly (aged ≥65 y; HR = 0.74; 0.55-0.99) and younger participants (aged &lt;65 y; HR = 0.75; 95%CI 0.63-0.90).

Conclusions
Results from this large cohort of middle-aged and elderly Italians suggest that improving cardiovascular health could also reduce the future burden of cancer, supporting the hypothesis of a common soil of underlying risk factors for these two groups of diseases.

Key messages
• The Life’s Simple 7 metric initially developed to promote cardiovascular health is associated with future cancer risk in a large population of middle-aged and elderly Italians.
• These findings reinforce the notion of a “common soil” of underlying risk factors for cardiovascular disease and cancer, and support common public health strategies for prevention.
An increased risk for ischemic stroke in the short-term period following COVID-19 infection
Authors: Keinan Boker L , Libruder C , Hershkovitz Y , Ben Yaish S , Tanne D , Binyaminy B 
Published: October 2023

Abstract

Background
The association disclosed between COVID-19 infection and ischemic stroke (IS) raises concern. The exact risk periods, which were not consistent between studies, require further investigation.

Methods
We linked between two national databases: the national COVID-19 database and the Israeli National Stroke Registry. The self-controlled case series method was used to estimate the association between COVID-19 infection and a first IS. The study population included all Israeli residents who had both a first IS event and a first COVID-19 diagnosis during 2020. The date of the PCR test served to define the day of exposure, and the 28 days following it were categorized into three risk periods: days 1-7, 8-14, and 15-28. A relative incidence (RI) with a 95% confidence interval (95% CI) was calculated based on the incidence rate of events in a post-exposure period, compared to the incidence rate in a control period.

Results
From 01-January-2020 to 31-December-2020, 308,015 Israelis aged 18+ were diagnosed with COVID-19 and 9,535 were diagnosed with a first IS. Linking between the two databases, 555 persons had both diagnoses during 2020. The mean age of the study population was 71.5±13.7, 55.1% were males, 77.8% had hypertension, 73.7% had hyperlipidemia, 51.9% had diabetes, 28.5% had ischemic heart disease and 25.6% had atrial fibrillation. Comparing between the risk period and the control period, we found a very similar distribution of the cardiovascular risk factors. The risk for an acute IS was 3.3-fold higher in the first week following COVID-19 diagnosis, compared with a control period (RI = 3.3; 95% CI 2.3-4.6). The RI among males (RI = 4.5; 95% CI 2.9-6.8) was 2.2-fold higher compared to females. The increased risk did not last beyond the first week following exposure.

Conclusions
Physicians should be aware of the elevated risk for IS among patients experiencing COVID-19, particularly among men with high burden of cardiovascular risk factors.

Key messages
• Risk for an ischemic stroke is elevated in COVID-19 patients upon infection.
• This finding was particularly evident in men with cardiovascular risk factors.
Social inequality in mortality associated with neurodegeneration: a population-based study in Belgium
Authors: Dinneweth J , Gadeyne S 
Published: October 2023

Abstract

Background
Worldwide, population is ageing, leading to a growing burden of neurodegenerative diseases (NDDs) such as Alzheimer's Disease (AD), Parkinson's Disease (PD). Socioeconomic position (SEP) has shown a persistent negative relationship with mortality over the last decades. The most common indicators of SEP such as income, education, and occupational class have shown to significantly impact life expectancy and other mortality indicators. However, studies on the association between SEP and NDD mortality are rather scarce. Therefore, the aim of this study is to assess whether SEP is associated with NDD mortality, which is crucial in understanding and developing preventive interventions for these diseases.

Methods
A comparative analysis on SEP - in terms of income and education - and deaths associated with dementia and parkinsonism was performed, using log linear Poisson regression. Data consisted of the 2011 Belgian census linked to mortality data for the period 2011-2016.

Results
During the 2011-2016 study period, 34,700 Belgian inhabitants aged 65 or older died from an NDD (N = 1,883,182). We observed significantly higher mortality in the lowest educational- and income groups. Education had the strongest association in women, with 1.29 (CI 1.21-1.38) times the MRR in the lowest educated group compared to the highest. In men, income showed the strongest association with 1.11 (CI 1.04-1.18) times the MRR in the lowest income group compared to the highest. The biggest disparities were found in dementia mortality, generally negative association with SEP. For income, we observed a strong negative association on parkinsonism mortality, while we found a reversed pattern with education.

Conclusions
Our study provides evidence supporting the existence of socioeconomic disparities in mortality due to neurodegeneration. We found a strong negative association between SEP and NDD mortality, which varies between men and women and between several NDDs.

Key messages
• NDDs are rapidly becoming a major public health issue worldwide.
• Mortality from these diseases vary between different social groups, differentiated interventions are needed in order to reduce inequalities.
Mortality around the anniversary of a sibling’s death. Findings from Swedish register-data
Authors: Rostila M , Hiyoshi A , Berg L , Grotta A 
Published: October 2023

Abstract

Background
Studies have found that the death of a sibling is associated with adverse health in bereaved siblings. Anniversaries may trigger grief reactions and contribute to an acute deterioration of health and are exogenous to shared intergenerational characteristics and may provide an indication of a causal effect of bereavement. Previous studies have found anniversary effects following the loss of a child and parent. We examined whether mortality increases among adult siblings around the anniversary following sibling death.

Methods
This case-crossover study used Swedish register-based longitudinal data from 1990 to 2016, based on the entire population. Participants included all adults aged 18 to 65 years who experienced sibling death and subsequently died. Conditional logistic regression was used to quantify the association between the anniversary (or preanniversary and postanniversary periods) and mortality, controlling for time-invariant confounding. All analyses were stratified by sex of the bereaved. Further analyses will also be stratified by socio-demographic characteristics such as the sex of the deceased sibling, time since sibling death, age, marital status and cause of sibling death.

Results
The results show that the anniversary of a siblings’ death is not associated with an increased mortality risk in bereaved siblings. We rather found somewhat reduced mortality risks around the anniversary dates in men (OR 0.78 95% CI 0.55-1.10 for the period ranging from 2 days before up to the anniversary) and women (OR 0.44 95% CI 0.20-0.97 for the anniversary). Further analysis will scrutinize whether anniversary effects are found when the analysis are stratified by socio-demographic characteristics and cause of sibling death.

Conclusions
Anniversaries following sibling death might not trigger grief to the same extent as anniversaries following the death of a parent or child. Sibling bereavement may still have health consequences although not during anniversaries.

Key messages
• Anniversaries following sibling death might not trigger grief to the same extent as child and parental bereavement.
• Sibling bereavement may still have health consequences although not around anniversaries.
Impact of PFAS exposure on immune-mediated diseases and immune transcriptome in Czech adults
Authors: Rudzanová B , Vlaanderen J , Kalina J , Vespalcová H , Martyniuk C , Piler P , Zvonař M , Klánová J , Bláha L , Adamovský O 
Published: October 2023

Abstract

Background
Per- and polyfluoroalkyl substances (PFASs) are emerging environmental contaminants with multiple hazardous properties including immunomodulation potency. We aimed to investigate 1) the association between PFAS exposure and immune-mediated diseases (IMDs) and 2) the expression of genes associated with PFAS exposure in a population of Czech adults.

Methods
This study involved 309 adults from the Czech CELSPAC:YA cohort. The associations of serum concentrations of 9 PFAS with 9 IMDs were assessed by logistic regression. Furthermore, Bayesian kernel machine regression (BKMR) was used to estimate the effect of the PFAS mixture on IMDs. In cases of a statistically significant interaction of PFASs and sex, sex-stratified analyses were performed. To identify transcriptomic profiles, isolated RNA from peripheral mononuclear blood cells was sequenced (QuantSeq) and analysed. Significantly expressed genes associated with multiple PFASs (at least with 4 PFASs) were employed for enrichment analysis by Pathway Studio. All analyses were adjusted for relevant confounders (i.e., sex, age, BMI, smoking, education, and family history of IMDs).

Results
PFOA, PFOS, and PFUnDA were negatively associated with allergies. Similarly, BKMR modeling showed a negative tendency in the overall effect of PFAS mixture on IMDs. Results of the stratified analysis suggest sex to be an effect modifier in the association of PFOS and atopic eczema. Regarding transcriptomic analysis, 166 statistically significant genes were associated with multiple PFAS exposure. Enrichment analysis of these genes showed involvement of B cell signaling, specifically mechanisms involved in the production of antibody-secreting plasma cells.

Conclusions
Our results contribute to the body of literature that observes the immunomodulatory effect of PFAS exposure on the level of disease prevalence and further brought new information about underlying deregulatory mechanisms.

Key messages
• Our study showed an immunosuppressive effect of PFAS exposure on the level of prevalence of immune-mediated diseases, both for PFASs individually and as a mixture.
• Genome-wide transcriptomic analysis revealed the involvement of plasma cells as a potential key event of PFAS-induced immunomodulation.