bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in ambient particulate matter exposure and evaluation of its health relevance in Germany
Authors: Kienzler S , Plass D , Tobollik M , Wintermeyer D 
Published: October 2023

Abstract

Introduction
To evaluate the health relevance of fine particulate matter (PM2.5), it is necessary to assess the PM2.5 exposure of the populations. For this purpose, time series (2010-2021) for two PM2.5 indicators for Germany were developed: (1) the mean population-weighted PM2.5 exposure per year and (2) the proportion of the population exceeding the recent WHO air quality guideline value for PM2.5 of 5 µg/m3 (annual mean).

Methods
To calculate the two indicators for the period 2010-2021, nationwide modelled annual means of PM2.5 background concentrations were used. They were joined with spatial information on population density from the 2011 census. The population data were additionally scaled for each year according to the official population update. On this basis, the population could be assigned to different PM2.5 exposure classes per year.

Results
Over the years considered, the mean population-weighted PM2.5 exposure in Germany decreased by approximately 41 %: in 2021, the indicator value of 9.3 µg/m3 was significantly lower than in 2010 with 15.9 µg/m3. However, throughout the time series, almost 100 % of the German population was exposed to PM2.5 annual mean concentrations above the current WHO air quality guideline value.

Conclusions
Generally, the decreasing PM2.5 exposure of the German population is very positive. Measures taken in recent years to reduce emissions from stationary sources and the transport sector have contributed significantly to this development. On the other hand, the large proportion of the population above the WHO guideline value shows that the current annual average PM2.5 reduction is still far from being sufficient to protect human health. In fact, far-reaching measures are required to significantly reduce particulate matter concentrations in Germany.

Key messages
• The mean population-weighted particulate matter exposure in Germany has decreased significantly in recent years.
• The exposure reduction in Germany is still not sufficient. To protect human health, further and far-reaching measures are required to significantly reduce particulate matter concentrations in Germany.
Early-life droughts and cognitive performance among children in rural India
Authors: Pradella F , Gabrysch S , Van Ewijk R 
Published: October 2023

Abstract

Introduction
Organisms adapt to prenatal conditions in a way that prepares for similar postnatal circumstances. Fetal programming research has identified associations between various prenatal shocks and numerous health outcomes, yet the role of the postnatal environment for effect manifestation remains understudied. This is the first study to investigate the interplay of pre- and postnatal environmental conditions for cognitive health among school-aged children. We focus on nutrition, a cognitive health risk factor in both pre- and postnatal life.

Methods
Data from the 2007-2018 Annual Status of Education Report (ASER) on 5-16-year-olds from rural India (N = 4,589,590) were linked to University of Delaware rainfall data. As rural India heavily depends on rainfed agriculture, we exploit droughts - i.e. rainfall below the 20th percentile of the district-specific mean - as a quasi-experiment for nutritional shocks. Drought exposure is assigned based on birth year. We first test if prenatal drought exposure is associated with test scores, and then interact prenatal exposure with exposure in the first years of life, while controlling for household, district, birth year, and interview year.

Results
Our results show that prenatal drought exposure is associated with lower scores in math and reading, and a lower probability of being on track in school, particularly among 11-16 year-olds. Droughts in the first few years after birth, too, are associated with poorer scores. However, this effect is alleviated among adolescents who had previously experienced a drought prenatally.

Conclusions
Prenatal exposure to suboptimal conditions might mitigate the effects of similar shocks in early postnatal life for cognitive health. Future research on interactions between such pre- and postnatal factors is needed, e.g. to gain insights for resilience-building in face of the climate crisis.

Key messages
• The occurrence of droughts during the prenatal phase, as well as during the first few years after birth, lead Indian adolescents to perform worse in school.
• Prenatal circumstances prepare for postnatal ones. This explains our finding that the effects of droughts after birth are alleviated among those who had already been prenatally drought-exposed.
Social disconnectedness co-exists with health literacy and treatment burden in individuals with CVD
Authors: Christiansen J , Lasgaard M , Pedersen S S , Pedersen M H , Friis K 
Published: October 2023

Abstract

Background
Social disconnectedness (e.g., loneliness and social isolation) is associated with increased risk of morbidity and mortality, including cardiovascular disease (CVD). However, loneliness and social isolation do not merely increase the risk of incident CVD; rather, they seem to also aggravate the course of disease. Low health literacy and patient-perceived treatment burden are common among individuals with CVD, and may further impact health outcomes. Understanding the potential mechanisms linking social disconnectedness with CVD and disease prognosis is crucial for clinical practice. However, research investigating the associations between social disconnectedness, health literacy, and treatment burden in individuals with chronic disease remains sparse despite its apparent relevance.

Methods
This study used cross-sectional self-reported data from the 2017 Danish National Health Survey entitled ‘How are you?', investigating the associations of loneliness and social isolation with low health literacy and high treatment burden in individuals with CVD (n = 2,521; mean age = 65.7 years).

Results
Logistic regression analysis showed that loneliness and social isolation were associated with increased odds of low health literacy in terms of difficulties with ‘understanding health information’ and ‘engaging with healthcare providers'. Likewise, loneliness and social isolation were associated with high treatment burden.

Conclusions
Our findings showed that loneliness and social isolation coexist with low health literacy and high treatment burden in individuals with CVD. This is of concern as socially disconnected individuals already experience more health issues, and these factors could worsen their condition. Our findings underscore the importance of interventions in clinical care that counter social disconnectedness while considering the individual's health literacy and treatment burden.

Key messages
• Social disconnectedness coexists with low health literacy and high treatment burden in individuals with CVD. This reflects a potential accumulation of risk factors.
• The coexistence of social disconnectedness with low health literacy and high treatment burden highlight the need for efforts addressing social connections in the context of patient care.
Interventions to ameliorate negative psychosocial effects of the COVID-19 pandemic on the young
Authors: Wendel F , Rehfuess E , Jung-Sievers C 
Published: October 2023

Abstract

The psychosocial health of the young has been particularly affected by the pandemic. Containment measures have restricted social development, education and recreational activities, and may have increased sleep disturbances, symptoms of anxiety and depression. The objective of this study is to assess the effectiveness of interventions that seek to build resilience and to ameliorate negative psychosocial effects of the COVID-19 pandemic on children and adolescents. We conducted a systematic review and meta-analyses based on PRISMA guidelines and Cochrane recommendations. Literature searches were conducted in the databases MEDLINE, EMBASE, PsycINFO, CENTRAL, and COVID-19 specific databases of WHO and Cochrane. The searches retrieved 9957 records of which we included 13 RCTs for evidence synthesis. Included studies predominantly implemented online group sessions with either a psychological component, a physical activity component, or a combination of both. A meta-analysis of studies on anxiety (n = 7) and depressive symptoms (n = 5) provided evidence for a positive effect of interventions by reducing anxiety (SMD (95 % CI): -0.33 (-0.59; -0.06)) and depressive symptoms (-0.26 (-0.36; -0.16)) compared to control interventions. Studies also showed improvements in positive mental health outcomes, such as resilience (n = 2) and mental/psychological wellbeing (n = 2). Exploratory subgroup analyses suggested a greater effectiveness of interventions that are of higher frequency and duration, enable real-time personal interaction, and include a physical activity component. Psychosocial interventions are promising to prevent and mitigate anxiety and depressive symptoms and to enhance resilience and wellbeing among children and adolescents during the COVID-19 pandemic. Interventions in the school setting as well as interventions including a component of physical activity may be favorable particularly in individuals at risk.

Key messages
• Interventions can mitigate the negative psychosocial effects of the pandemic and build resilience among the young.
• Online group sessions, physical activity or psychological counseling seem to be effective strategies.
A longitudinal study on symptom profiles and risk factors in patients with post COVID-19 condition
Authors: Van Zon SKR , Ballering A V , Brouwer S , Rosmalen JGM 
Published: October 2023

Abstract

Background
To improve research and care for patients with post COVID-19 condition more insight into different subtypes of post COVID-19 condition and their risk factors is urgently needed. We aimed to identify risk factors of post COVID-19 condition in general and for specific symptom profiles.

Methods
This study is based on data collected within the Lifelines COVID-19 cohort (N = 76,503). Mean pre- and post-SARS-CoV-2 infection symptom scores were compared to classify post COVID-19 condition. Latent Profile Analysis was used to identify symptom profiles. Logistic and multinomial regression analyses were used to examine the association between demographic, lifestyle and health-related risk factors and post COVID-19 condition and symptom profiles, respectively.

Results
Of 3,465 participants having had COVID-19, 18.5% (n = 642) classified for post COVID-19 condition. Four symptom profiles were identified: muscle pain (55.6%), fatigue (14.3%), cardiorespiratory symptoms (5.6%), and ageusia/anosmia (24.5%). Female sex was a risk factor for the muscle pain (OR: 1.63; 95% CI: 1.26, 2.10) and fatigue (OR: 2.09; 95% CI: 1.24, 3.51) profiles. Being overweight or obese increased the risk for all profiles, except the fatigue profile. Having a chronic disease increased the risk for all profiles except the ageusia/anosmia profile, with the cardiorespiratory profile being only significant in case of multimorbidity. Being unvaccinated increased the risk of the ageusia/anosmia profile (OR: 2.45; 95% CI: 1.65, 3.79).

Conclusions
Findings from this study suggest that SARS-CoV-2 may trigger different pathophysiological mechanisms that may result in different subtypes of post COVID-19 condition. These subtypes have shared and unique risk factors. Further characterization of symptom profiles and quantification of the individual and societal impact of specific symptom profiles are pressing challenges for future research.

Key messages
• Our unique approach identified four symptom profiles characterised by 1) muscle pain, 2) fatigue, 3) cardiorespiratory symptoms, and 4) ageusia/anosmia.
• Shared and unique demographic, lifestyle and health-related risk factors were identified for the four symptom profiles.
Turning words into action: pro-environmental interest and personal commitment of different groups
Authors: Weitensfelder L , Lemmerer K , Poteser M , Wallner P , Hutter H-P 
Published: October 2023

Abstract

Background
Numerous models point to notable discrepancies between internal attitudes and environmental protection behaviour. Especially in regards to the high social value of climate protection, the question arises to what extent the commitment to environmental protection is not just a socially desirable “lip service”. A snap survey was conducted among participants of climate demonstrations in Vienna to find out whether they differ from other groups not only in their interest in environmental issues, but in particular in their personal commitment.

Methods
A total of 331 participants (below 16y) were surveyed (177 Fridays4Future participants, 41 visitors of non-climate-related mass events, 113 medical students). The survey regarding interest in climate and personal commitment to environmental protection was conducted using an 11-point Likert scale.

Results
Participants of the climate demonstrations described higher values regarding their interest in climate protection, their interest in environmental protection as well as their personal commitment to environmental protection. All differences between the pairwise mean-group comparisons were significant in the expected direction (lowest values: visitors of non-climate-related events; p &lt; 0.017). Results concerning flight renunciations already made showed large differences between the groups (Pearson Chi-Square: 71.913; df = 4; p &lt; 0.001): Around 5 times more participants of climate demonstrations than visitors to other mass events reported that they had already refrained from flying in the past year. In contrast, there were no differences with regard to the statement that they had not yet renounced flights, but intended to do so in the future.

Discussions
Differences with regard to renunciations already made indicate that values expressed by the groups are also mirrored in actual behaviour. Considering the magnitude of differences and control response our results are unlikely to be explained by socially desired response behaviour.

Key messages
• First short survey on to quantify group differences regarding refrainment of air travels.
• Climate activists showed considerably higher commitment regarding personal sacrifices.
Information on, and access to, healthcare services among refugees from Ukraine arriving in Norway
Authors: Helland Y , Hansen T M , Skogheim T S , Labberton A S 
Published: October 2023

Abstract

Background
The full-scale invasion in Ukraine has led to a sharp increase in the number of refugees coming to Norway, and a rapid upscaling of the asylum system, including temporary solutions, which may have led to poorer information and access to services. This study assesses received information about, and access to, health services in a sample of adult Ukrainian refugees in Norway.

Methods
Data were collected via a digital questionnaire (UKR-R survey, n = 731) in a cross-sectional study design between 28.10.22-31.01.23, via multiple physical contact points, including asylum reception centres, municipalities, non-profit organisations, as well as Facebook groups for refugees in Norway. Results for outcome measures were weighted by age and sex against all Ukrainian refugees registered with collective protection in Norway.

Results
Respondents (n = 731) were 83% female, most aged 30-39 years (36%) and 40-49 years (29%), 69% with higher education. Among those with long-term illnesses, health problems or disabilities, 48% reported usually needing health services 2-4 times per year, and 22% answered ‘5 or more'. Thirty-nine percent of all respondents had received information about the health services in Norway in a way that they could understand, while 49% answered ‘To some extent'. Most knew how to contact a doctor or other health professional if they needed help, either fully (49%) or to some extent (43%). Eighty-six percent had needed health care in Norway. Of these, 32% reported having received the health care they felt they needed, and 42% answered ‘To some extent'. More recent arrivals were less likely to report having received adequate information, to know how to contact health services, and that they had received the health care they felt they had needed.

Conclusions
There are indications of unmet or only partially met healthcare and information needs, especially among more recently arrived persons, representing potential for improvement.

Key messages
• Received information about, and access to health services, are acceptable, but with room for improvement, especially among those newly arrived.
• A large majority of the refugees reported need for health care in Norway. One out of four have not received the health care they felt they needed.
Risk of low birthweight and late antenatal care initiation in an ethnically diverse maternal cohort
Authors: Puthussery S , Tseng P , Li L 
Published: October 2023

Abstract

Background
Babies born with low birthweight (LBW,&lt; 2500 g) are vulnerable to infant mortality, restricted growth, poorer development, and long-term health complications. Antenatal care (ANC) can improve maternal and infant outcomes; women are recommended to have first antenatal visit by 10 weeks’ gestation. Ethnic minority women are significantly more likely to initiate ANC later than recommended gestational week compared to white women. This study examined associations between late ANC initiation (first appointment &gt;10 weeks gestation) and LBW in an ethnically diverse maternal cohort in the UK.

Methods
A retrospective cross sectional study using routinely collected anonymous data of singleton births during April 2015 - October 2022 from a large UK National Health Service maternity unit in an ethnically diverse area. Logistic regression models were used to examine associations between late ANC initiation and prevalence of low (&lt;2500 g); very low (VLBW, &lt;1500 g) and extremely low (ELBW, &lt;1000g) birth weight.

Results
Of 39,785 singleton births recorded, more than one third (34.6%) were to mothers from Black African, Black Caribbean, Indian, Pakistani, and Bangladeshi backgrounds. Birthweight was reported for 39,698 (99.78%) neonates; among them 8.9% had LBW, including 1.0% VLBW and 1.1% ELBW. More than one third (34.8%) of mothers had first appointment at &gt; 10 weeks, including 26% during 11-19 weeks and 8.8% at &gt; 20 weeks. Late ANC initiation was associated with increased risk of LBW for neonates: OR = 1.15 [95% CI: 1.07, 1.23] and 1.60 [1.44, 1.78] for ANC initiation at &gt; 10 weeks and ≥20 weeks respectively (vs ≤ 10 weeks). Mothers who started care at ≥ 20 weeks were 5.37 times (95% CI: 4.31, 6.70) more likely to have a baby born with ELBW (vs ≤ 10 weeks).

Conclusions
Neonates born to mothers who started antenatal care late in ethnically diverse neighborhoods are more likely to have low birthweight, highlighting the need for targeted primary and secondary interventions.

Key messages
• Neonates born to mothers who started antenatal care late in ethnically diverse neighborhoods are more likely to have low birthweight.
• Targeted programmes and services are needed to support mothers in ethnically diverse neighborhoods to start antenatal care on time.
Emetic and Diarrheal Toxins Detection and Typing of Bacillus cereus in Food and Human Milk in Italy
Authors: Magagna G , Abdul M E , Tilola M , Rossi F , Pezzotti E , Baratta M , Risso F M , Finazzi G , Filipello V , Losio M N 
Published: October 2023

Abstract

Background
Bacillus cereus, responsible for 1.4%-12% of all food poisoning outbreaks worldwide, produces several virulence factors, including toxins which are mainly found in raw and processed food, as starch-based and dairy products. It can cause two types of gastrointestinal diseases: emetic form, with nausea and vomiting which appears as soon as after food consumption, and diarrheal form, with abdominal cramps, which occurs after 8-16 h. Moreover, B. cereus is the most common pathogen in pasteurized human milk, a precious aid in neonatal care. The aim of this study was to investigate the prevalence of B. cereus toxins kinds using WGS and to detect in silico sequence types (ST) in isolates from food and human milk.

Methods
During B. cereus routine surveillance in Lombardy (Italy), a total of 41 isolates were collected from food (n = 16) and donor breast milk (n = 25) between 2022-2023, and then analysed with WGS. Libraries were prepared using the Illumina DNA Prep Kit and WGS was performed on the Illumina MiSeq. Using the BTyper tool, for each sample emetic and diarrheal toxins were identified and ST was assigned.

Results
All 41 isolates had at least one diarrheal toxin, specifically the nonhemolytic enterotoxin was found in all the isolates, the cytotoxin K was detected in 37% of isolates, and the hemolysin BL in 32%. Instead, the emetic toxin was found in only 3 samples isolated from food. Using in silico MLST, different STs were found with a higher prevalence of ST26 and ST144.

Conclusions
Diarrheal toxins were detected in all samples underling that B. cereus food infections play an important role in the public health and in the food industry. These aspects are even more significant when the pathogen is isolated from human breast milk, as it can induce severe infections in newborns.

Key messages
• The presence of B. cereus toxins in food and human milk underlines the importance of its ongoing monitoring and analysis.
• Human breast milk has a high risk of B. cereus contamination which is the most frequent cause for its discarding.
Open access as an intervention to improve outpatient waiting list
Authors: Zotti N , Di Serafino F , Civitelli S , Geminale G , Briani S , Luchini G , Tulipani A , Guercini J , Baggiani A 
Published: October 2023

Abstract

Background
Waiting list management is a critical aspect of health care facilities, representing the excess of demand that could be guaranteed in a specific time. The effective implementation of policies to govern waiting lists requires the adoption of adequate organizational booking structures to contain the risk of underuse of care services and maximize their ability to ensure compliance with the maximum waiting time for each priority class.

Methods
The study analyzes the Open Access model adopted by the Azienda Ospedaliero-Universitaria Pisana (AOUP). The model involves booking within 3 days and daily sliding of services monitored by a Regional masterplan, with supply evenly distributed throughout the week. Since Open Access model was implemented in June 2020, the study analyzes the effect of this between June 1, 2019 and May 31, 2021, regarding specialist visits and diagnostic tests.

Results
In the study time, the percentage of all guaranteed services within the national timeframe raised significantly from 84.02% to 93.56%. For example, rheumatology visit that went from 68% to 99%. Speaking of waiting time, allergology visit went from 96 days to 8 days and the pneumology visit from 82 days to 4 days. Visits that were already starting from times in line with priority also benefited from the methodology, such as the vascular surgery visit that went from 2 to 0 days.

Conclusions
Therefore, proper governance of waiting lists is crucial in the healthcare system since timely access to healthcare services is an essential right for citizens and has a significant impact on the management of healthcare services. However, there are no one-size-fits-all solutions for managing waiting lists, but complex actions need to be implemented. The importance of digital tools for waiting list management is emphasized and adequate control structures are needed to detect any ‘anomalies’ and verify the proper functioning of the system of access to care.

Key messages
• Efficient waitlist management safeguards citizens’ rights to access to care and proper governance.
• Control structures are crucial for effective management as a universal solution is unattainable.