bluuebunny/crossref_metadata_2025_split huggingface dataset:
What's on the menu? An eco-nutrition analysis of foodservice options
Authors: O'Sullivan E , O’Brien K , Douglas F E , McCartney D , Kirwan L B 
Published: October 2023

Abstract

Foodservice plays a critical role in shaping consumer food choices, and can have significant implications on public health and environmental impact. Foodservice options in the UK are often high in calories, salt, and saturated fat, and contribute significantly to greenhouse gas emissions (GHGe). This study provides a quantitative analysis of foodservice options at a catering site in the UK from both an environmental and nutrition perspective. Analysis was conducted on 110 food offerings from October 2022 to March 2023. Nutrition was analysed using energy, protein and HFSS scores. Environmental impact was analysed using the Nutritics Foodprint system. Statistical analysis was conducted using IBM SPSS V28. 76% of food offerings were categorised as ‘healthy'. Main meals and breakfast meal categories contained the highest average calories and protein per serving. 69% (n = 76) of the food offerings were classified as sustainable (C02 eq., &lt;1kg), the mean carbon foodprint of offerings was 0.48kg Co2 eq/kg, and the mean water foodprint of offerings was 84.3L/per 100g. Meal offerings categorised as ‘main meals’ were more likely to have an unsustainable E grade (82%, n = 9) than offerings in other categories (p&lt;.001). As the carbon foodprint of a meal increased, so did protein (r = .560, p&lt;.001), energy (r = .568 p &lt;.001) and serving size (p &lt;.001, r = .346). No relationship was observed between nutrient profiling method and environmental impact. Main meal category contained a higher number of unhealthy options compared to other categories. Meals with a higher environmental impact had higher energy and protein content and larger serving sizes, but the nutrient profiling method used was not significantly associated with environmental impact. The relationship between environmental impact and nutritional adequacy is therefore not straightforward. The results of this study provide an insight into the role of innovative technologies in menu design.

Key messages
• Main meals represented a higher number of unhealthy options, and were identified as a focus for reformulation for this site.
• Foodprint can enable an evidence based analysis of the nutrition and environmental impact of food offerings across foodservice sites.
Co-producing a new tool to inform policy development in the field of physical activity promotion
Authors: Messing S , Gelius P , Abu-Omar K , Beck F , Geidl W , Grüne E , Marzi I , Tcymbal A , Reimers A , Pfeifer K 
Published: October 2023

Abstract

Background
While there are several approaches to collect data on physical activity (PA) promotion policies, some governments require more in-depth overviews to inform policy development. Recently, the German Federal Ministry of Health expressed its interest in collecting detailed data on target group specific PA promotion, as relevant competences are distributed across a wide range of political levels and sectors.

Methods
Based on relevant national and international guidelines, the TARGET:PA tool was co-produced by researchers and ministry officials. It includes (1) PA recommendations, (2) national prevalence rates, (3) recommendations for PA promotion, and data on national (4) routine practices, (5) pilot projects and (6) policies. In a first study, data were collected for children and adolescents in Germany using desk research, semi-structured interviews and secondary data analysis.

Results
A policy brief was developed. Results showed that 46% of the 3-6-year-olds fulfil WHO recommendations but only 15% of the 11-17-year-olds, and that girls are less active than boys. Currently, no valid surveillance data are available for children under the age of three. An overview of routine practices for PA promotion was compiled, and experts critically assessed their effectiveness, reach and durability. Overall, 339 target group specific projects for PA promotion were found, with 22 classified as examples of good practice. Relevant national PA policies were identified across different sectors and settings.

Conclusions
The TARGET:PA tool supports the translation of research evidence into policy action as it is target group specific, has a unique focus on routine practices, and systematically identifies policy gaps. Starting in 2023, it will serve as a conceptual basis for the three additional PA policy briefs tendered by the German government. While developed to specifically suit the German context, it has the potential to be adapted to other countries and health behaviours.

Key messages
• The TARGET:PA tool was co-produced by researchers and government officials to inform policy development in the field of physical activity promotion.
• The tool is target group specific, has a unique focus on routine practices, systematically identifies policy gaps, and has the potential to be adapted to other countries and health behaviors.
Patient experience with primary health care during the COVID-19 pandemic in Bulgaria
Authors: Rohova M , Dimova A 
Published: October 2023

Abstract

Background
The COVID-19 pandemic has had a profound impact on the primary healthcare experience of patients. Restricted access, delays in routine services, postponed checkups owing to safety concerns led to disruptions in care, missed diagnoses, and delays in treatment. This study investigates primary care service obstacles faced by patients during the COVID-19 pandemic in Bulgaria.

Methods
A national cross-sectional survey was conducted between November and December 2021 by a poll agency using an online self-administered questionnaire with 800 respondents. Binomial logistic regression was used to examine the association between sociodemographic variables and issues related to the availability of primary care services.

Results
Around 32% (95% CI 28-35%; p &lt; 0.001) of the respondents reported obstacles related to the primary care, and 25% (95% CI 22-38%; p &lt; 0.001) postponed a visit to the general practitioner due to accessibility and availability issues or fear of infection. The most prevalent obstacle cited by patients was a refusal of a referral for specialized care (26%), followed by a refusal of an out-of-hours or weekend consultation in case of urgent need (25%). Home visits and routine examinations were also denied to patients, albeit less frequently. The multivariable analyses found associations between gender, health status, education, and impediments by obtaining primary care services. The odds of facing obstacles rose as self-rated health deteriorated (OR = 6.0, p &lt; 0.001). The likelihood of experiencing availability issues increased with educational level (OR = 6.2, p &lt; 0.001). Women were 1.6 times more likely (p = 0.009) to report difficulties with primary care.

Conclusions
The COVID-19 pandemic has created significant barriers for many patients to access primary healthcare services. In addition, it has highlighted the need for a primary healthcare system that is resilient and capable of maintaining its essential functions during public health emergencies.

Key messages
• Primary health care has a crucial role in supporting patients during public health emergencies.
• The health system needs resilient primary health care that can adapt to swiftly changing conditions.
COVID-19 impact on viral hepatitis in Italy: a time-series analysis
Authors: Russotto A , Cornio A R , Vicentini C , Zotti C M 
Published: October 2023

Abstract

Background
Worldwide there has been a sharp decrease in the number of notified cases of any type of viral hepatitis during the pandemic period. This study aims to investigate the impact of COVID-19 on viral hepatitis in Italy.

Methods
This was a retrospective study that analysed data extracted from the “Integrated Epidemiological System of Acute Viral Hepatitis” (SEIEVA) online platform from 1994 to 2022 in the Piedmont region of Northern Italy. Descriptive statistics were used to compare data from the pandemic period (2020-2022) to three years of pre-pandemic period (2017-2019). Second, a univariate ARIMA temporal forecast model based on the years 1994-2019 was built to predict how many cases should have been registered in the pandemic period. The Wilcoxon test was performed to detect if there was a statistically significant difference between the observed and predicted values.

Results
The time elapsed between the onset of symptoms and the serological test, potentially indicative of challenges related to hospital access, was delayed by a couple of days (median 7, 2-12 IQR) in the three-year period 2020-2022 compared to 2017-2019 (median 5, 3-9 IQR). The same occurred considering the time between the positive test and the epidemiological interview (median 6, 3-16 IQR vs median 4, 2-9 IQR). Although the ARIMA forecasting model confirmed a downward trend, the observed values of notified cases were lower than expected. A statistically significant difference was found between predicted and observed values (p = 0.004).

Conclusions
Although it is difficult to assess the impact of COVID-19 on the transmission of viral hepatitis, the results of this study suggest a lower accuracy of the surveillance. It will be important to restore the previous levels of attention and investigation, monitoring the trend in the coming years. The World Health Organization's goal is the eradication of viral hepatitis. COVID-19 may have slowed down the process.

Key messages
• It is important to keep up the level of attention towards viral hepatitis, which seems to have decreased following the COVID-19 pandemic.
• It will be important to pay attention to the trend of notified cases in the coming years to establish more precisely the level of impact of the pandemic.
Flu vaccination ‘influenced’ by Covid-19: Italy experience
Authors: Iannaccone R , Dragoni L , Messina G , Nante N 
Published: October 2023

Abstract

Background
During last decades, National Health System has guaranteed free flu vaccination to the ‘fragile’ population. However, the population's compliance with this prophylactic procedure has never been optimal, reaching only in a few years and only in some regions the percentage considered satisfactory of 70% of people at risk. The Covid-19 pandemic has greatly raised the public's awareness of diseases of an infectious nature, respiratory in particular, among which influenza occupies a prominent role. We aimed to assess whether that compliance is increased as a result of Covid-19.

Methods
From epicenter.iss.it, influenza vaccination coverage rates of the Italian population both as a whole and of individual regions from 1999 to 2022 were obtained. In particular, comparisons were made between data for the pre-Covid (2017-2019) and post-Covid (2020-2022) three-year periods.

Results
The comparison revealed an increase in influenza vaccine coverage nationwide over the last three-year period (2020-2022). An average of the values from 1999 to 2017 of 15.22% of the population, an average of the pre-Covid three-year period (2017-2019) of 16.3%, not deviating from the national average of previous years, and an average of the post-Covid three-year period (2020-2022) of 22.1% was developed. A 35.58% increase in influenza vaccine coverage in the general population in Italy between the two three-year periods could be ascertained, which was the subject of special attention.

Conclusions
The Covid-19 pandemic has raised awareness among the population toward the usefulness of vaccination and not only toward the anti-SARS-CoV2 one. Influenza vaccination adherence has increased over the past three years. We plan to investigate whether compliance particularly affects those at higher risk who should be the main recipients.

Key messages
• The population after the covid 19 pandemic has become more aware of the usefulness of vaccination, not just the SARS-CoV2 vaccination.
Assessment of breastfeeding-related healthcare and their association with breastfeeding motivation
Authors: Kaseliene S , Jonkiene G 
Published: October 2023

Abstract

Background
Breastfeeding (BF) is one of the best ways to ensure healthy growth and development for newborns. However, for successful BF, mothers often need knowledge, assistance, and support from the healthcare professionals. The aim of the study is to evaluate the attitudes of Lithuanian mothers towards BF related healthcare services and their associations with BF motivation.

Methods
Data was collected in June 2022 using a quantitative research method by anonymous questionnaire survey. 572 Lithuanian mothers who carried to a full-term and gave birth to a healthy baby were interviewed between the 2nd-6th month postpartum (response rate 38.9%). BF motivation was evaluated by 24 items scale, developed by Kestler-Peleg et al. BF related healthcare services were evaluated by the Ten steps to successful BF scale which consists of 22 items. The sum scores of the scales, means, and standard deviations (SD) were calculated. Relationships between evaluation of health care services and motivation were determined by Spearman's correlation coefficient.

Results
The respondents rated BF related healthcare services as average (65.3 (SD 20.1) out of 110 points). The services provided by healthcare professionals in the first hours after birth were rated the best (3.76 (SD 1.1) out of 5 points), BF services related to the help of health care professionals to successfully breastfeed the baby in the future the worst (2.40 (SD 1.0) out of 5 points). A weak positive but statistically significant correlations were found between the evaluation of the provided healthcare services related to BF and BF motivation: as the evaluation scores of BF related services increased, women's BF motivation also increased (P &lt; 0.001).

Conclusions
The respondents rated the healthcare related to BF as average, especially services that can determine successful long-term BF. Improving the quality of health care services related to BF can lead to greater motivation and success among women in BF their babies.

Key messages
• Mothers of infants aged 2-6 months rated health care related to BF in Lithuania as average.
• A weak positive but statistically significant correlations were found between motivation to breastfeed and assessment of BF related healthcare services.
Mother's health prior to pregnancy and eligibility for earnings-related parental leave benefits
Authors: Heshmati A , Dunlavy A , Mussino E , Fritzell S , Juárez S P 
Published: October 2023

Abstract

Background
Parental leave generosity is protective for mothers’ mental health in the postpartum period and beyond. Strong work requirements exist for parents to receive more generous benefits which might penalise individuals who, due to poor health, have a weak labour market attachment. The aim of the study was to examine whether mothers with poor health prior to pregnancy are less likely to be eligible for more generous benefits in Sweden.

Methods
We used total population registers to study first-time mothers aged 25-45 years who were resident in Sweden and gave birth between 1 January 2009 and 30 September 2013 (n = 151,452). We performed logistic regressions to assess the association between health one and two consecutive years prior to pregnancy (to evaluate chronicity) and eligibility for earnings-related parental leave benefits.

Results
Mothers who were admitted to hospital or received specialist outpatient care for any health condition in the year prior to pregnancy were less likely to be eligible for earnings-related benefits (OR 0·79, 95%CI 0·76-0·83) compared to healthy mothers, with the likelihood reduced further among those with chronic health issues (OR 0·64, 95%CI 0·62-0·68). Findings were driven by mothers with mental health conditions (OR 0·22, 95%CI 0·20-0·23 for the year prior to pregnancy and OR 0·16, 95%CI 0.15-0·18 for chronic conditions).

Conclusions
Mothers with prior health conditions, and in particular mental disorders, are less likely to benefit from the protective health effect of parental leave as they may not meet the eligibility requirements for more generous remunerations.

Key messages
• Mothers with prior health conditions are less likely to benefit from the protective health effect of parental leave as they may not meet the eligibility requirements for more generous entitlements.
• The work requirement for parental leave benefits may invertedly increase health inequalities in society.
Targeted Hygiene reduces surface transmission and infection risk for respiratory viruses
Authors: Ackerley L , Jung Y , Cooper S , Upson S , Gent L , Buckley C , Spitzer M E , Sexton J D , Reynolds K A , Wilson A M 
Published: October 2023

Abstract

Background
In public spaces, the importance of surface contamination in the transmission of respiratory viruses has been debated. This study aimed to compare the spread of a surrogate virus in a hotel lobby before and after a Targeted Hygiene intervention, and to quantify the reduction in risk of infection from respiratory diseases.

Methods
In a working hotel lobby, 13 fomites were seeded with a bacteriophage (Phi-X174) tracer at 8 am; 4 hours later 25 surfaces were swabbed to determine baseline tracer distribution and contamination levels. This was then repeated with the addition of a pre-determined Targeted Hygiene intervention performed 2 hours after seeding. Four replicate baseline and intervention trials were conducted, and data were compared for statistically significant (p &lt; 0.05) differences. Risk of infection was estimated via Quantitative Microbial Risk Assessment modelling.

Results
Following the Targeted Hygiene intervention there was a significant reduction in the spread of the tracer (contamination of 13% of sampled surfaces vs. 50% at baseline). Tracer concentrations (PFU/site) were significantly lower overall (9.1E+02 PFU vs. 5.8E+04 PFU, p &lt; 0.0001), including surfaces that had not been disinfected. Our model estimates that the risk of infection from common respiratory viruses via surface transmission was reduced by 97%.

Conclusions
Extensive spread of surface contamination can occur in a hotel lobby in as little as 4 hours. This study demonstrates how a Targeted Hygiene intervention can significantly disrupt the journey of the germ, even on surfaces not cleaned and disinfected, resulting in a consequent reduction of infection risk via surface transmission of common respiratory infections. This demonstrates the value of carrying out effective hygiene interventions to those managing commercial spaces.

Key messages
• Targeted Hygiene can significantly reduce the spread of respiratory pathogens via surface transmission, providing a means for facilities managers to achieve high standards using a targeted approach.
• The Targeted Hygiene approach can significantly reduce the risk of infection from common respiratory viruses via surface transmission in public spaces.
Neutrophil-specific ORAI1 Calcium Channel Inhibition Reduces Pancreatitis-associated Acute Lung Injury
Authors: Niu Mengya , Zhang Xiuli , Wu Zengkai , Li Bin , Bao Jingpiao , Dai Juanjuan , Yang Zihan , Zeng Yue , Li Liang , Pandol Stephen , Sutton Robert , Wen Li 
Published: October 2023

Abstract
Acute pancreatitis is initiated within pancreatic exocrine cells and sustained by dysregulated systemic inflammatory responses mediated by neutrophils. Store-operated Ca2+ entry (SOCE) through ORAI1 channels in pancreatic acinar cells triggers acute pancreatitis, and ORAI1 inhibitors ameliorate experimental acute pancreatitis, but the role of ORAI1 in pancreatitis-associated acute lung injury has not been determined. Here, we showed mice with pancreas-specific deletion of Orai1 (Orai1ΔPdx1, ∼70% reduction in the expression of Orai1) are protected against pancreatic tissue damage and immune cell infiltration, but not pancreatitis-associated acute lung injury, suggesting the involvement of unknown cells that may cause such injury through SOCE via ORAI1. Genetic (Orai1ΔMRP8) or pharmacological inhibition of ORAI1 in murine and human neutrophils decreased Ca2+ influx and impaired chemotaxis, reactive oxygen species production, and neutrophil extracellular trap formation. Unlike pancreas-specific Orai1 deletion, mice with neutrophil-specific deletion of Orai1 (Orai1ΔMRP8) were protected against pancreatitis- and sepsis-associated lung cytokine release and injury, but not pancreatic injury in experimental acute pancreatitis. These results define critical differences between contributions from different cell types to either pancreatic or systemic organ injury in acute pancreatitis. Our findings suggest that any therapy for acute pancreatitis that targets multiple rather than single cell types is more likely to be effective.
COVID-19 Recovery: Consistent Absence of Cerebrospinal Fluid Biomarker Abnormalities in Patients With Neurocognitive Post-COVID Complications
Authors: Kanberg Nelly , Grahn Anna , Stentoft Erika , Bremell Daniel , Yilmaz Aylin , Studahl Marie , Nilsson Staffan , Schöll Michael , Gostner Johanna M , Blennow Kaj , Zetterberg Henrik , Padmanabhan Nikhil , Cohen Rachel , Misaghian Salvia , Romero Daniel , Campbell Christopher , Mathew Anu , Wang Mingyue , Sigal George , Stengelin Martin , Edén Arvid , Gisslén Magnus 
Published: October 2023

Abstract

Background
To investigate evidence of residual viral infection, intrathecal immune activation, central nervous system (CNS) injury, and humoral responses in cerebrospinal fluid (CSF) and plasma in patients recovering from coronavirus disease 2019 (COVID-19), with or without neurocognitive post-COVID condition (PCC).

Methods
Thirty-one participants (25 with neurocognitive PCC) underwent clinical examination, lumbar puncture, and venipuncture ≥3 months after COVID-19 symptom onset. Healthy volunteers were included. CSF and plasma severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid and spike antigen (N-Ag, S-Ag), and CSF biomarkers of immune activation and neuronal injury were analyzed.

Results
SARS-CoV-2 N-Ag or S-Ag were undetectable in all samples and no participant had pleocytosis. We detected no significant differences in CSF and plasma cytokine concentrations, albumin ratio, IgG index, neopterin, β2M, or in CSF biomarkers of neuronal injury and astrocytic damage. Furthermore, principal component analysis (PCA1) analysis did not indicate any significant differences between the study groups in the marker sets cytokines, neuronal markers, or anti-cytokine autoantibodies.

Conclusions
We found no evidence of ongoing viral replication, immune activation, or CNS injury in plasma or CSF in patients with neurocognitive PCC compared with COVID-19 controls or healthy volunteers, suggesting that neurocognitive PCC is a consequence of events suffered during acute COVID-19 rather than persistent viral CNS infection or residual CNS inflammation.
Build Forward Fairer: Covid-19, Lessons Learned
Authors: Kjaerum Morten 
Published: October 2023

Abstract
The article discusses the importance of adopting a human rights-based approach in addressing the lessons learned from the Covid-19 pandemic. The article highlights the case of a human rights-based hospital in Sweden that actively reached out to vulnerable individuals in the community during the pandemic, emphasizing how the human rights-based approach contributes to building trust and thereby realizing the right to life and health. Based on this example it explores the need for a human rights-based approach in crisis management including climate-induced disasters. The article emphasizes the interconnectedness of all human rights and the need for economic prioritizations that align with social justice commitments. It highlights the role of institutions, legal frameworks, and collaborative efforts at various levels to ensure the realization of human rights and the principle of ‘leave no one behind’. The article concludes by advocating for the integration of human rights principles into legislation, policies, and actions to build a fairer and more resilient society.