bluuebunny/crossref_metadata_2025_split huggingface dataset:
An analysis of the implementation of a hybrid renewable-energy system in a building by considering the reduction in electricity price subsidies and the reliability of the grid
Authors: Al Hasibi Rahmat Adiprasetya , Haris Abdul 
Published: October 2023

Abstract
This article discusses the implementation of a hybrid renewable-energy system to satisfy the electricity requirements of a building. The analysis is based on optimization calculations performed using HOMER software. The components of the simulated hybrid renewable-energy system include photovoltaics, generators powered by biogas, converters and a grid. The input data utilized by the HOMER software are derived from measurements and surveys. The electric load curve is obtained through measurements at the location of the case study. Through surveys, parameters pertaining to the components of the hybrid renewable-energy system were gathered. The analysis was carried out using two sensitivity variables, namely electricity price and grid reliability. On the basis of these two sensitivity variables, optimal system configuration, net present cost, energy cost, return on investment, internal rate of return and payback period were analysed. The results of the analysis indicated that reducing subsidies, which results in higher electricity prices, provided opportunities for economically competitive hybrid renewable-energy systems. With electricity prices of US$0.094/kWh, the return of investment and the internal rate of return increased to 15% and 19%, respectively, and the payback period decreased to 5.3 years. When a hybrid renewable-energy system is implemented in regions with low grid reliability, the same phenomenon occurs.
Genotype–Phenotype Characterization of Serial Mycobacterium tuberculosis Isolates in Bedaquiline-Resistant Tuberculosis
Authors: Brown Tyler S , Tang Linrui , Omar Shaheed Vally , Joseph Lavania , Meintjes Graeme , Maartens Gary , Wasserman Sean , Shah N Sarita , Farhat Maha R , Gandhi Neel R , Ismail Nazir , Brust James C M , Mathema Barun 
Published: October 2023

Abstract

Background
Emerging resistance to bedaquiline (BDQ) threatens to undermine advances in the treatment of drug-resistant tuberculosis (DRTB). Characterizing serial Mycobacterium tuberculosis (Mtb) isolates collected during BDQ-based treatment can provide insights into the etiologies of BDQ resistance in this important group of DRTB patients.

Methods
We measured mycobacteria growth indicator tube (MGIT)–based BDQ minimum inhibitory concentrations (MICs) of Mtb isolates collected from 195 individuals with no prior BDQ exposure who were receiving BDQ-based treatment for DRTB. We conducted whole-genome sequencing on serial Mtb isolates from all participants who had any isolate with a BDQ MIC &gt;1 collected before or after starting treatment (95 total Mtb isolates from 24 participants).

Results
Sixteen of 24 participants had BDQ-resistant TB (MGIT MIC ≥4 µg/mL) and 8 had BDQ-intermediate infections (MGIT MIC = 2 µg/mL). Participants with pre-existing resistance outnumbered those with resistance acquired during treatment, and 8 of 24 participants had polyclonal infections. BDQ resistance was observed across multiple Mtb strain types and involved a diverse catalog of mmpR5 (Rv0678) mutations, but no mutations in atpE or pepQ. Nine pairs of participants shared genetically similar isolates separated by &lt;5 single nucleotide polymorphisms, concerning for potential transmitted BDQ resistance.

Conclusions
BDQ-resistant TB can arise via multiple, overlapping processes, including transmission of strains with pre-existing resistance. Capturing the within-host diversity of these infections could potentially improve clinical diagnosis, population-level surveillance, and molecular diagnostic test development.
The value of BAME health professional networks in tackling vaccine hesitancy
Authors: Latif S 
Published: October 2023

Abstract
This presentation discusses the findings from a Black, Asian and ethnic minority (BAME) Health Professional Leadership Engagement Session hosted by England's CMO between national health and care system leaders and the leadership of BAME health and care professional networks in England. The aim was to use an asset based approach, engage with the health professional networks both as citizens and as trusted sources of their communities, to acknowledge their contributions, to actively listen to concerns and issues, and develop sustainable solutions to address Covid vaccine hesitancy and improve uptake in the BAME communities in England.
Three questions were posed to selected professional representatives of BAME networks:
1. What are the underlying factors/ key concerns responsible for reduced uptake of the COVID-19 vaccine within your communities?
2. What examples of good practice regarding increasing uptake of COVID-19 vaccine would you like to highlight?
3. What can we, as leaders, collectively do to help address underlying factors/ key concerns?
Key insights included: a need to understand how the disproportionate impact of Covid on BAME communities is underpinned by different levels of acculturation and a variety of experiences; how conspiracy theories such as vaccine causing infertility can target important cultural expectations such as child bearing; the collective impact of years of historical injustices and health inequalities compounding what we see manifested as COVID-19 vaccine hesitancy.Some examples of good practice cited were around collective leadership, focusing on the younger BAME generations, role of social media, the role of the BAME health professional networks, leveraging the power of existing relationships and through representation in decision making and engagement. A set of recommendations were shared with health system leaders.
The impact of post COVID-19 condition on
health-related quality of life, fatigue and mental well-being
Authors: Brus I , Spronk I , Haagsma J A , de Groot A , Tieleman P , Biere-Rafi S , Polinder S 
Published: October 2023

Abstract

Background
This cross-sectional study aimed to compare symptoms, health-related quality of life (HRQoL), fatigue, mental well-being, and determinants of diminished HRQoL, between patients with post COVID-19 condition categorized by time since acute infection.

Methods
We performed an online survey and analyzed responses of 10,194 adult respondents with a confirmed or suspected COVID-19 infection, who experienced persisting symptoms ≥3 months after initial infection. The most debilitating symptoms and health outcomes were studied separately for respondents 3-6, 7-9, 10-12, 13-18, 19-24, and &gt;24 months after acute infection.

Results
At each time period, fatigue, sensory-processing problems, and concentration problems were the most debilitating symptoms reported by respondents, although the proportion of respondents who reported these symptoms differed significantly between time periods. Respondents 3-6 months post-acute infection had the lowest HRQoL (median EQ-5D utility score: 0.59), the highest fatigue level (median score: 110.0) and the highest proportion with a likely depressive disorder (32.4%), whereas respondents 13-18 months post-infection had the highest HRQoL (0.65), the lowest fatigue level (106.0), and the second lowest proportion with a likely depressive disorder (25.0%) (p = 0.000-0.007). Younger age, female gender, lower level of education, not having paid work before COVID-19, comorbidity, and not being vaccinated, seemed to be determinants for worse HRQoL.

Conclusions
Regardless of time since infection, respondents considered fatigue, sensory processing problems and concentration problems the most debilitating symptoms. They experienced a low HRQoL and severe fatigue, even more than two years after acute COVID-19 infection. Respondents 3-6m post-infection had the worst health outcomes, whereas respondents 13-18m post-infection had the best outcomes, indicating that, at least for a subgroup of patients, health status may improve over time.
General practitioners’ knowledge, perception and experience on Long Covid: a cross-sectional study in Belgium and Malta
Authors: Moreels S , Bensemmane S , De Schreye R , Cuschieri S 
Published: October 2023

Abstract

Background
Over 10% of Covid-19 infected people experience persistent symptoms (Long Covid). As most Long Covid cases are in patients with a mild acute Covid-19 infection, primary health care and general practitioners (GPs) are at the forefront in their care. This study investigated GPs’ knowledge, perception and experience on Long Covid at cross-country level.

Methods
A cross-sectional study targeting GPs was conducted in Belgium and Malta during mid-2022. An online survey on Long Covid was disseminated. Descriptive and logistic regression analyses were performed.

Results
The survey was completed by 150 GPs (105 for Belgium, 45 for Malta). In both countries, most GPs reported insufficient scientific knowledge and information on Long Covid diagnosis and treatment. Accessibility to educational material was limited and an awareness-rising campaign was seen as merited, especially by Maltese GPs (OR = 6.81, 95%CI [1.49;31.12]). For diagnosing Long Covid, 54.7% reported the requirement of a positive Covid-19 test, more among Belgian than Maltese GPs (64.3% vs 45.2%, p = 0.036). To assess Long Covid, GPs applied diagnostic criteria by themselves (47.3%) in combination with persistent symptoms. 76.0% GPs reported caring for Long Covid patients, irrespective of practice type and GPs’ country, sex or age (p = 0.353; p = 0.241; p = 0.194; p = 0.058). Although most GPs (94.7%, p = 0.291) stated that Long Covid patients should follow multidisciplinary approach, only 29.8% of them reported to care for these patients by multidisciplinary cooperation and 48.3% by themselves/GP colleagues.

Conclusions
GPs frequently provide care to Long Covid patients and GPs’ care showed similarities at cross-country level. Although GPs perceived lack of scientific knowledge and educational material on Long Covid, similar diagnostic criteria were noted. Across Europe, uniform evidence-based guidelines, scientific support and training for GPs must be a priority to empower GPs in their Long Covid approach.
Impact of COVID-19 pandemic on care for chronic diseases in deprived and non-deprived neighbourhoods
Authors: Sana S , de Schepper EIT , van Pelt S , Magnee T , Bindels PJE , Denktas S , Kocken P L 
Published: October 2023

Abstract

Background
Due to stringent lock-down measures imposed during COVID-19 pandemic the access to the primary care dropped significantly. This study aims to investigate the impact on GP consultations for diabetes mellitus (DM) and COPD during the pandemic.

Methods
In an observational study from January 2018-June 2022, anonymized medical records of 379.567 patients in Rotterdam, were analyzed for the impact on DM and COPD consultations during the lockdown (March-May 2020) and after the lockdown (June 2020-June 2022) compared to pre-pandemic levels.

Results
The study included 34.270 DM and 11.570 COPD patients. Until the COVID-19 pandemic, the patients living in deprived neighborhoods had comparisonly on average a higher number of consultations for DM (RR = 1.81, 95%CI=1.76-1.86) and COPD (RR = 1.48 95%CI=1.39-1.58). During the stringent lock-down there was almost same significant drop in both neighbourhoods in consultations for DM (RR = 0.85, 95%CI=0.79-0.92) and COPD (RR = 0.72, 95%CI=0.61-0.86). After the lockdown, the consultations for DM were higher and the HbA1c measurements were normalized compared to pre-pandemic levels in both neighbourhoods, (RR = 1.11, 95%CI=1.05-1.17) and (RR = 0.96, 95%CI=0.91-1.01) respectively. Conversely, the consultations for COPD and spirometry measurements remained significantly lower after the lockdown compared to pre-pandemic levels, (RR = 0.72, 95%CI=0.65-0.80) and (RR = 0.26, 95%CI=0.20-0.34) respectively. Surprisingly, the mean HbA1c value in the study population was significantly lower in the months after the lock-down (RR = 0.96, 95%CI=0.94-0.98) turning back to higher normal value at the end of 2021.

Conclusions
The recovery of primary care for chronic diseases after the lockdown phase was much faster for DM than for the COPD patients. The positive effect of lockdown on HbA1c was unfortunately temporary. More research is needed to know whether the decrease in chronic care has led to extra morbidity or mortality after 2 years of pandemic.

Key messages
• Diabetes mellitus’ care recovered soon for both deprived and non-deprived neighbourhoods after a significant drop during the lockdown. Lockdown seems to have a positive effect on disease management.
• The significant delay in chronic care for COPD patients in both deprived and non-deprived neighbourhoods for almost two years, raises questions about the adverse health effects due to this delay.
The Robert Koch Institute's cross-sectoral efforts to address climate change and health
Authors: Taylor A , Kümpfel R 
Published: October 2023

Abstract
The Robert Koch Institute (RKI) is Germany's national public health institute (NPHI). It recognises that climate change poses a significant threat to the health and wellbeing of people and that as an NPHI it has an important role to play. To reflect this, we have been strengthening our work on climate change and health in the institute, particularly in the last 18 months, guided by the “IANPHI Roadmap for Action on Health and Climate Change” amongst other resources. At the RKI, we see that our contribution on climate change and health is part of efforts together with an extensive landscape of actors, each with their own disciplinary and sector-specific expertise and resources. We have therefore been exploring our possible sector-specific contribution and further developing our cross-sectoral working in line with the institute's strategy for climate change and health. The RKI is also already underway with specific cross-sectoral exchange and projects on climate change and health. This includes taking part in the cross-sectoral German national agencies’ network on climate adaptation, carrying out a comprehensive and ambitious situation report on the evidence base on climate change and health in Germany, as well as through a cross-sectoral programme to develop new measurable climate adaptation goals as part of the German Adaptation strategy for Climate Change. This presentation will share how the RKI is developing and implementing its cross-sectoral contribution on climate change and health, and will include some lessons learnt and suggestions for how other health actors might be able to apply this learning for their own work.
The presentation aims to:
• illustrate how cross-sectoral work can be implemented and how use of the “health argument” can help with this;
• stimulate thinking on how other health actors, including in the audience, might be able to engage in cross-sectoral working in their own fields and organisations.
Foresight in public health: application and challenges
Authors: Berghuis-Mutubuki E , Moye Holz D , Hilderink H 
Published: October 2023

Abstract

Background
Foresight studies in the field of public health are limited. However, in the context of increasing uncertainty and complexity, such as with the COVID-19 pandemic, there is growing need to anticipate future trends and to plan for them. Foresight provides the tools to explore possible futures and develop policy strategies. Despite its value, foresight is an underused methodology. Hence, the aim of this study is to illustrate how foresight can be applied in public health, and how to deal with the associated challenges.

Methods
We describe the six-steps that are part of foresight methodology. In step 1 we discuss how to formulate study objectives. We illustrate in step 2, the application of the conceptual model and the DESTEP tool to identify and rank driving forces. We then discuss time horizon and spatial distribution, in step 3. In step 4, we discuss scenario logics. Finally in steps 5 and 6, we discuss the types of scenarios and tools for analyses. Possible challenges encountered when applying foresight methodology are drawn from the experiences and lessons learnt from the PHIRI project.

Results
Challenges during application of the foresight six-steps approach included difficulties in formulating research objectives, developing a conceptual model, identifying most important future trends, developing systematic, consistent and plausible scenarios with clear messages for policy makers. Understanding the concept of uncertainty was especially difficult, both in formulating scenarios and policy messages.

Conclusions
Understanding of foresight concepts and their relation to each other is difficult. Support from foresight experts, conducting foresight exercises and publication of tutorial papers on foresight can enhance understanding.

Key messages
• Foresight methodology is a valuable tool to explore possible futures with a diverse group of stakeholders.
• Foresight promotes the development of policies that are appropriate and robust in their implementation in changing times.
Professionals’ views on interventions to reduce and prevent problematic alcohol use in older adults
Authors: van den Bulck FAE , Knijff R , Crutzen R , van de Mheen D , Bovens RHLM , van de Goor LAM , Stutterheim S E , Rozema A D 
Published: October 2023

Abstract

Background
Interventions to address problematic alcohol use in older adults are needed as alcohol use is highly prevalent among those over 55 years of age. For interventions to be most effective, their working elements should be leveraged. However, understanding of working elements specifically in interventions for older adults is limited. The aim of this study was to understand how (i.e., which elements), in which context, and why (which mechanisms) interventions are successful in preventing or reducing (problematic) alcohol use among older adults, from the perspective of professionals providing these interventions.

Methods
Guided by a Realist Evaluation approach, an existing Initial Program Theory (IPT) on working elements in alcohol interventions, was tested by conducting semi-structured interviews with professionals (N = 20). These professionals provide interventions targeting alcohol use across several contexts: with or without practitioner involvement; in-person or not; and in an individual or in a group setting. Data were coded and links between contexts, elements, mechanisms and outcomes were sought for in order to confirm, refute or refine the IPT.

Results
Several general working elements were found: 1) pointing out the risks and consequences of drinking behavior, 2) paying attention to abstinence, 3) contact with peers, 4) personalized content and 5) providing support. We also found context-specific working elements:1) personalized content and conversations in interventions with practitioners, 2) safety, trust and feeling connected in in-person interventions and 3) sharing experiences and tips in group interventions.

Conclusions
Findings are in general in line with the IPT. Our findings emphasize the need for social contacts and support for older adults. The mechanisms awareness and accessibility were important contributors to positive interventions outcomes. Further research should study the perspective of older adults and their relatives on interventions.

Key messages
• Social contacts and support are needed in interventions to reduce and prevent problematic alcohol use in older adults.
• Awareness and accessibility are important contributors to positive interventions outcomes in interventions to reduce and prevent problematic alcohol use in older adults.
Complementing traditional care with digital therapeutics for chronic non-communicable disease management
Authors: Buttigieg S 
Published: October 2023

Abstract
We will examine the role of digital therapeutics in diabetes care, where we will discuss how Digital Therapeutics can supplement face-to-face consultations by facilitating data exchange between patients and healthcare professionals, improving disease monitoring, and promoting patient empowerment. In the context of mental health, we will present evidence supporting the effectiveness of computer-assisted cognitive behaviour therapy (CCBT) as a valuable adjunct to treatment as usual (TAU) in primary care settings. Throughout the presentation, we will highlight the importance of integrating digital therapeutics into existing healthcare systems and addressing barriers to their adoption, such as socio-demographic disparities and healthcare professional attitudes through tools such as regulatory frameworks and reimbursement pathways. By exploring the complementary role of digital therapeutics in chronic NCD management, we aim to encourage dialogue on the potential synergies between traditional care and digital interventions to improve patient outcomes and inform public health policy.
Cost-effectiveness analysis of Next generation sequencing tests in critically ill pediatric patients
Authors: Nurchis M C , Heidar Alizadeh A , Raspolini G M , Altamura G , Santoli G , Pascucci D , Damiani G 
Published: October 2023

Abstract

Rare genetic diseases in the pediatric population constitute an urgent global public health issue; overall, more than 300 million people are affected worldwide. Next Generation Sequencing techniques, as Whole genome sequencing (WGS) and Whole exome sequencing (WES), have proven to be significantly supportive in diagnosing these complex conditions. The aim is to evaluate the cost-effectiveness of WGS versus WES in pediatric patients with suspected genetic disorders. A Bayesian Markov model was calibrated among this target population, comparing WGS to WES. Model parameters were retrieved from the scientific literature. Costs and benefits were discounted at a rate of 3%. A lifetime time horizon and the National Health Service perspective was chosen. The Eurozone threshold, ranging from €30,000 to €50,000, was adopted. Markov Chain Monte Carlo was used as the simulation method for Bayesian inference. Uncertainty was explored through a probabilistic sensitivity analysis (PSA) and a value of information analysis (VOI), illustrated through Cost-Effectiveness Acceptability Curve (CEAC) and Expected Value of Perfect Information (EVPI). Results were reported as Incremental Cost-Effectiveness Ratio (ICER), expressed as euros per additional diagnosis. The base case findings highlighted that WGS was cost-effective with an ICER of €31,973. The CEAC showed that for all thresholds over the ICER, WGS had the highest probability of being cost-effective. The EVPI per patient was estimated to be €6,535 on a threshold of €50,000/diagnosis. In addition to being cost-effective, WGS could allow early genetic diagnosis shortening the diagnostic odyssey. The use of WGS in the diagnostic workup has the potential to revolutionise personalised medicine and to play a significant role in achieving SDG 3 by providing personalised healthcare, identifying genetic risk factors for diseases, and informing public health policies for a target population that represents the human capital of the future.

Key messages
• This analysis informs that WGS is cost-effective and possibly cost-saving in the long term.
• WGS could be implemented in the diagnostic workup of children with suspected rare disorders.