bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of pT1 CRC detected on the colorectal cancer screening programme (Basque Country. Spain)
Authors: Idigoras Rubio I , Azpiazu Maseda C E , Portillo Villares I , Sainz de Rozas Aparicio I , Bilbao Iturribarria I , Sanchez Garcia G , Ballester L L 
Published: October 2023

Abstract

Background
The Bowel Cancer Screening Programme (BCSP) started in 2009 with faecal immunochemical test (FIT, with cut-off 20µg/g faeces) every 2 years (for 50-69 year- olds). 2.518.715 people were invited until 2021. Participation rate was 70.4% with 5.3% positive rate and 92.7% adherence to colonoscopy. Colorectal cancer (CRC) detection rate was 2.28 ‰ with 70.6% found in initial stage. The PT1 (stage I) represented 40% of the total cancer detected (4,050 in the overall period).

Objectives
To compare the characteristics and management of pT1 CRC.

Methods
Retrospective cohort study including pT1 CRC Stage I diagnosed after colonoscopy in positive FIT from 2009-2017. Variables: sex, age groups, endoscopic and surgical treatment, CRC recurrence and survival. Chi-square, Logistic Regression, SPSS v.23.

Results
Of the 1,523 CRC detected, 585 were detected as pT1 and I stage (38.4%). 73.4% in men and by age group 59% over 60 years-old. 48.5% were treated with surgery and 51.5% with endoscopic resection. No significant differences were found adjusted by sex and age regardless of treatment. In 57.6% of patients under surgery, CRC was not reported by pathological analysis. All cases followed up by colonoscopy with variability in the number of surveillances over time. 4.1% (24) had CRC recurrence with 87% detected in the surveillance, no significant differences regardless of the treatment. 1.5% (9) died due to CRC progression.

Conclusions
Apart from the high number of CRC detected in early stages by the screening Programme, an important number of cases are reported as pT1 CRC. Endoscopic resection is one of the treatments of choice without significant impact either in recurrence of neoplasia or mortality. However, surgical procedure shows overtreatment because of the high number of cases without CRC after the procedure. Therefore, endoscopic resection could be the main choice to treat pT1 CRC.

Key messages
• Endoscopic resection is one of the treatment of choice without impact in recurrence for the pT1 CRC detected through the BCSP.
• The Basque BCSP obtains excellent participation rate, reflected in early detection and treatment of pre and malignant lesions.
The care trajectories leading to emergency dialysis start: a qualitative study
Authors: Raffray M , Vigneau C , Laude L , Campéon A , Bayat S 
Published: October 2023

Abstract

Introduction
Emergency dialysis start (EDS) is an important issue to understand and tackle in Chronic Kidney Disease (CKD) care. Late referral, absent previous nephrology care and higher comorbidity scores have been associated with EDS. However, how those factors happen and contribute to EDS remains unexplored. We conducted a qualitative study in France to identify and describe the mechanisms that shape the trajectories that lead to EDS, using patients, GPs and nephrologists perspectives.

Methods
Three groups of participants were recruited in Brittany, north-west France: Patients who started dialysis in emergency between 2017 and 2019, GPs and nephrologists. Maximum variation sampling approach was used based on patients’ socio-economic profiles and GPs’ and nephrologists’ years and settings of practice. Semi-structured interviews were conducted between 2017 and 2020. A crossed thematic analysis between the 3 groups of transcripts was performed, informing how EDS trajectories come to be.

Results
Twenty patients, 12 GPs and 18 nephrologists were interviewed. Five themes were identified: 1) Learning about dialysis, 2) Dialysis and nephrology care representations: a) an unacceptable biographical disruption, b) a dreadful invasive machinery, c) a straw that breaks the camel's back, 3) The gap between the “illness” perceived and the “disease” treated, 4) Slipping through the primary care prevention net, 5) the unavoidable unpredictability of CKD course.

Conclusions
This study shows how EDS is, in part, the results of an interplay between patients’ constructed representations of dialysis, relation with the medical sphere and CKD physiopathology. The results suggests a need for evaluation of kidney replacement therapy education programs and reinforcement of psychological care. Finally, results support ambitious mass prevention campaign focused on kidney health to counter the persistent negative representation of dialysis and seal off prevention cracks.

Key messages
• Emergency dialysis start is the result of an interplay between patients’ constructed representations of dialysis, relation with the medical sphere and CKD physiopathology.
• Evaluation of kidney replacement therapy education programs and reinforcement of psychological care as well as an ambitious prevention campaign focused on kidney health could contribute to reduce EDS.
English validation of the Living with long term conditions scale
Authors: Ambrosio L , Hislop-Lennie K , Serrano-Fuentes N , Driessens C , Portillo M C 
Published: October 2023

Abstract

Background
The English version of the living with long term conditions (LwLTCs) scale is a comprehensive person-centred measure that evaluates the complex process of living with long term conditions.

Objectives
To present the psychometric properties of the LwLTCs scale in an English-speaking population in people with different long term conditions.

Methods
An observational and cross-sectional study, with a convenience sample of 577 people living with osteoarthritis, diabetes mellitus type 2, chronic kidney disease, chronic obstructive pulmonary disease, chronic heart failure, and Parkinson's disease. Data collection was conducted between December 2021 and June 2022 across the United Kingdom via primary care surgeries and voluntary organisations. Psychometric properties including feasibility, internal consistency, confirmatory factor analysis, reproducibility, and content validity were tested.

Results
44.7% were female, the age range was 37-97 years (98 ± 9.65), 71.1% were married and 76.4% were retired. Internal consistency was excellent for the total score (ordinal alpha =0.90) but confirmatory factor analysis showed that the fit of the 5-domain structure improved significantly if items 2, 5, 10, 16, 18 and 23 were removed and item 24 reallocated.

Conclusions
This is the first validation study of the LwLTCs scale in an English-speaking population living with different long term conditions. Having a reliable and valid healthcare and social care outcome measure is essential to identify comprehensive and complex needs of people living with long term conditions. A shorter version of the LwLTCs scale is recommended to facilitate the implementation of person-centred pathways and more comprehensive care plans and evaluation in the national healthcare system.

Key messages
• Innovative comprehensive scale to evaluate the daily living.
• Reliable and valid health and social care outcome measure.
Prescription Trends for Hepatocellular Carcinoma Drugs are mirrored by Online Searches
Authors: Berning P , Schroer A E , Dzaye O 
Published: October 2023

Abstract

Background
Hepatocellular Carcinoma (HCC) is a major contributor to cancer-related deaths globally. Advancements in immune and molecular therapies have led to more targeted and safer systemic treatments for advanced and unresectable HCC, replacing the use of non-specific chemotherapies. This study aims to provide an overview of online search and prescription activity of drugs used for HCC.

Methods
Data from IQVIA National Prescription Audit, a comprehensive audit of nearly all monthly US prescription information, was collected from 2017 to 2022 for FDA-approved HCC drugs. Online searches for these drugs were analyzed for visual and quantitative (Spearman's) correlation.

Results
Online searches for HCC drugs in the US increased 1.17-fold between the first quarter(Q1) 2017 and Q4 2022, while prescriptions increased 5.93-fold during this period. Across first line therapies, lenvatinib was most used with a 27.62-fold increase(Q1 2019-Q4 2022), paralleled by a 1.52-fold increase in online searches. Sorafenib use, however, steeply declined by 17.56-fold(Q1 2019-Q4 2022). For second-line and later treatments, cabozantinib was most frequently applied with 3.04-fold increase and 1.62-fold rise in online searches(Q1 2017-Q4 2022). Immunotherapy prescriptions and online searches for pembrolizumab have surged from Q1 2017-Q4 2022, with an increase of 8.03-fold and 1.37-fold, respectively. Lenvatinib (r = 0.90), cabozantinib (r = 0.67), and pembrolizumab (r = 0.54) had the highest correlations between online searches and prescriptions, and all three showed increasing trends. Oncologists(72.40%) were the largest users of the across specialties in 2022, followed by physician assistants/nurse practitioners(16.53%).

Conclusions
Over a 5-year period, the utilization of HCC drugs in the US increased and prescription patterns changed due to positive trial results and guideline changes. There was a positive correlation between online searches and prescription trends for HCC drugs.

Key messages
• High correlation levels between online searches and prescriptions for HCC drugs with increasing usage.
• Online search data can mirror prescriptions trends for HCC drugs.
Perceived stress and psychosomatic complaints in Swedish youth
Authors: Brolin Låftman S , Östberg V 
Published: October 2023

Abstract

Background
Psychosomatic complaints are common in youth, and are often assumed to reflect stress. Previous studies have reported associations between perceived stress and psychosomatic complaints. The current study extends this research by examining the longitudinal links between perceived stress and psychosomatic complaints.

Methods
The data was derived from two survey waves of the Swedish cohort study Futura01, with participants aged ∼17-18 in 2019 (t1) who were followed up in 2022 (t2; n = 2708). Perceived stress was measured by Cohen's Perceived Stress Scale (PSS-4). Psychosomatic complaints were captured by three items on the frequency of stomach ache, headache and sleeping problems, which were added to an index. Sex stratified linear regression analyses were performed, controlling for parental education and parental country of birth, based on information from official registers. The longitudinal analyses were carried out using the first difference (FD) approach, regressing the change in psychosomatic complaints on the change in perceived stress.

Results
Females reported higher levels of stress and of psychosomatic complaints than males at both time points. There were cross-sectional associations between perceived stress and psychosomatic complaints at t1 (females: b = 0.40, 95% CI 0.36, 0.45; males: b = 0.33, 95% CI 0.29, 0.38) and at t2 (females: b = 0.40, 95% CI 0.36, 0.45; males: b = 0.33, 95% CI 0.29, 0.38). The FD analyses showed that increases in perceived stress were associated with increases in psychosomatic complaints (females: b = 0.19, 95% CI 0.15, 0.23; males: b = 0.19, 95% CI 0.14, 0.23).

Conclusions
This study provides further empirical support for the assumption that psychosomatic complaints can be regarded as stress-related. Decreasing stress and strengthening young people's resources and strategies to cope with stress may thereby help to reduce the risk of developing psychosomatic complaints.

Key messages
• Psychosomatic complaints are responsive to perceived stress and can thus be regarded as stress-related.
• Reducing stress and strengthening coping resources may increase well-being in youth.
Building a score of climate change mitigation potential in national food-based dietary guidelines
Authors: Aguirre Sánchez L , Teschner R , Lalchandani N , El Maohub Y , Suggs L S 
Published: October 2023

Abstract

Background
The food sector contributes to a third of global Greenhouse gas emissions. Food-based dietary guidelines (FBDG) are policy tools that provide food advice compatible with health. There is a growing effort to include environmental sustainability in dietary guidelines, but less is known about the extent to which different countries include dietary recommendations with climate change mitigation potential.

Methods
Based on a systematic review and quantitative content analysis of food-based dietary guidelines (FBDG), a Dietary Climate Mitigation (DCM) score was developed to assess and rank the climate change mitigation potential of dietary guidelines at three levels: food life cycle, dietary patterns, and food groups. To avoid an overestimation of recommendations with relatively lower climate mitigation potential, the overall DMC score assigns higher weights to the dietary patterns and food groups sub-scores, compared to the food life cycle sub-score.

Results
Of the selected 92 countries, 38 mention environmental sustainability in their dietary guidelines. The Dietary Climate Mitigation (DCM) score ranged 4-84 (median 31.14 IQR 19.71-39.14, score range 0-100). Scores were significantly higher in high-income countries, dietary guidelines published after 2010, and those that explicitly address environmental sustainability. The highest scores are those from Belgium-Flemish, Australia, Zambia, Israel, Spain, Netherlands, Seychelles, Denmark, Sweden, and United Kingdom. Food advice with high climate mitigation potential are less frequent than advice with relatively lower mitigation potential.

Conclusions
Future dietary guidelines can be more aligned to health and climate goals if they factor in the differential environmental footprints of food choices. Explicit inclusion of environmental considerations in dietary advice has grown, yet most guidelines can still evolve from pro-environmental (intent-based), to environmentally significant (impact-based) food advice.

Key messages
• While there is a growth in dietary guidelines that mention environmental sustainability, most countries have still a low coverage of food recommendations with high climate mitigation potential.
• To be compatible with planetary health, dietary guidelines can benefit from an impact-weighted approach to dietary advice.
Prenatal particulate matter exposure is linked with neurobehavioral development in early life
Authors: Cosemans C , Sleurs H , Madhloum N , Alfano R , Verheyen L , Vanbrabant K , Nawrot T S , Plusquin M 
Published: October 2023

Abstract

Background
Particulate matter (PM) is a major environmental health concern and there is growing evidence that early exposure to PM can have adverse effects on neurobehavioral development in children, including attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). In this study, we hypothesized that prenatal PM2.5 exposure is linked with changes in neurobehavioral development in early life.

Methods
This study was part of the prospective ENVIRONAGE birth cohort and included 85 mother-newborn pairs. The Neonatal Behavioral Assessment Scale (NBAS) was administered to 1-2-month-olds to evaluate newborn's behavior. In addition, 392 children aged 4-6 years of the ENVIRONAGE cohort were included. The Strengths and Difficulties Questionnaire (SDQ) was used to assess the child's behavior. PM2.5 concentrations were determined by a high-resolution spatial-temporal method based on the maternal residential address. Multiple linear and multinomial logistic regression models were used to link prenatal PM2.5 exposure and neurobehavioral development in newborns and children, respectively.

Results
A 5 µg/m3 increase in PM2.5 concentration in early pregnancy was linked with lower scores for the NBAS range of state cluster (-0.22; 95% CI: -0.42 to -0.02; p = 0.03) in newborns aged 1-2 months old, as well as with higher odds of a child having peer problems (OR 3.90; 95% CI: 1.39 to 10.88; p = 0.01), higher total difficulties scores (OR 1.67; 95% CI: 1.01 to 2.78; p = 0.047), and abnormal prosocial behavior (OR 0.49; 95% CI: 0.25 to 0.98; p = 0.04) at age 4-6 years.

Conclusions
This study provides indications that prenatal PM2.5 exposure influences neurobehavioral development, both in newborns and in early childhood. This evidence suggests that reducing exposure to PM2.5 during pregnancy may be an important public health strategy for promoting optimal neurodevelopment in early life.

Key messages
• In utero PM2.5 exposure is related to changes in neurobehavior in newborns.
• Prenatal PM2.5 exposure is linked with higher chances of abnormal behavior in children aged 4-6 years old.
Exploring the Role of Active Assisted Living in the Continuum of Care for Older Adults
Authors: Bin Noon G , Hanjahanja-Phiri T , Dave H , Fadrique L X , Morita P P , Teague J 
Published: October 2023

Abstract

Background and objectives
Active Assisted Living (AAL) refers to internet-connected systems designed to improve quality of life, aid in independence, and create healthier lifestyles. As the population of older adults grows, there is a pressing need for additional supports in their daily lives and for non-intrusive, continuous, adaptable, and reliable health monitoring tools. AAL has great potential to support these efforts, but additional work is required to address the feasibility of the integration of AAL into care. The objective of this project is to address core issues with AAL system implementation, including user concerns, data governance, and clinical considerations.

Methods
To understand the concerns and opportunities regarding AAL, 18 group interviews were held with stakeholders representing different parts of an AAL ecosystem. Each group comprising several participants from the same organization. These were categorized as (1) care organizations, (2) tech developers, (3) tech integrators, and (4) potential care recipients or patient advocacy groups. Thematic analysis was then performed to identify key concerns.

Results
AAL systems may lead to improved support for care recipients through more comprehensive monitoring and alerting, greater confidence in aging-in-place, and increased care recipient empowerment. However, participants also raised concerns regarding the management and monetization of data emerging from AAL systems, as well as general accountability and liability.

Conclusions
Better role definition is needed regarding who can access data and who is responsible for acting on it. It is important for stakeholders to understand the trade-off between using AAL technologies in care settings and their costs, including loss of patient privacy and control.

Key messages
• AAL has excellent potential to support confidence in aging-in-place for older adults and their caregivers.
• It is critical to acknowledge the trade-off inherent in smart technology use between utility, cost, and encroachment on privacy.
Dual Factor Model: exploring different social sources and loneliness of adolescents in Luxembourg
Authors: Lopes Ferreira J , Mendes F G , Catunda C 
Published: October 2023

Abstract

Background
The Dual Factor Model (DFM) of mental health incorporates both subjective well-being (SWB) and psychopathology symptoms, proposing a more comprehensive approach to mental health. As such, four groups can be distinguished in accordance with the level of SWB and psychopathology symptoms: 1. complete mental health; 2. incomplete mental health; 3. incomplete mental illness; 4. complete mental illness. Social support and loneliness are known to influence both SWB and psychopathology symptoms. The aim of this study is to explore the odds of different sources of support and loneliness in the different mental health groups, as proposed by the DFM, in adolescents in Luxembourg.

Methods
A total of 7201 adolescents aged 11 to 18-years old participated in the 2022 Health Behaviour in School-Aged Children in Luxembourg. In order to categorize the DFM mental health groups, SWB was measured using the WHO-5 Index and anxiety symptomatology (GAD-2) was used for psychopathology symptoms. Social support (from family, peers, teacher and classmates) and loneliness were analyses using a multinomial logistic regression, adjusting for age, gender, family affluence and family composition.

Results
Adolescents who perceive a low (in comparison to good) classmate support and teacher support and feel lonely have an increasing chance of being in the Incomplete Mental Health, Incomplete Mental Illness and Complete Mental Illness (e.g. classmate support: OR = 1.69, OR = 2.19 and OR = 2.79, respectively).

Discussion
The lack of support from the school sources and feeling loneliness are the most important factors increasing the probability to be part of the Complete Mental Illness group. Prevention strategies should focus on improving the school setting conditions. School is a privileged place for health promotion, offering a comprehensive, sustained and effective means of intervention for the target population.

Key messages
• In Luxembourg, the four groups of the Dual Factor Model of mental health vary according to the source and level of support and loneliness.
• Low classmate and teacher support as well as feeling of loneliness contributes to Complete Mental Illness (low SWB and moderate to high symptomology of anxiety) in adolescents, in Luxembourg.
Transnational prenatal care among migrant women giving birth in Montreal, Canada
Authors: Merry L , KIM Y N , Urquia M L , Goulet J , Villadsen S , Gagnon A J 
Published: October 2023

Abstract

Background
Given the number of barriers that migrant women confront while accessing maternity care in receiving countries, it is expected that they may engage in and rely on transnational healthcare to maintain their health and well-being during pregnancy. The objective of this study was to estimate the prevalence and identify predictors of transnational prenatal care (TPC) (i.e., prenatal care from a healthcare professional in more than one country) among migrant women from low- and middle-income countries (LMICs) who gave birth in Montreal, Canada.

Methods
We conducted a secondary analysis (n = 2595 women) using data from the Migrant-Friendly Maternity Care (MFMC) - Montreal project. The MFMC study used a cross-sectional design. Data were gathered from recently-arrived (&lt; 8 years) migrant women from LMICs via medical record review and interview-administration of the MFMC questionnaire postpartum during the period of March 2014-January 2015 in three hospitals, and February-June 2015 in one hospital. We used logistic regression modelling to identify socio-demographic, migration, health, and perceptions of care variables significantly associated to TPC (referent group were women who only received prenatal care in Canada).

Results
Four percent of women reported receiving TPC. Sixty-one percent of TPC women were from the Middle East/North Africa (vs. 42% among no-TPC women); top source countries were Tunisia, Algeria, Morocco, Lebanon, Egypt and Iran. Predictors of TPC included: ‘Not living with the father of the baby’ (AOR = 4.8, 95%CI 2.4, 9.8), ‘having negative perceptions of pregnancy care in Canada (general experiences)’ (AOR = 1.2, 95%CI 1.1, 1.3) and younger maternal age (AOR = 1.1, 95%CI 1.0, 1.1).

Conclusions
Migrant women may be motivated to return to the home country for healthcare during pregnancy due to a need for family and social support and/or to overcome access barriers and negative pregnancy care experiences in the receiving country.

Key messages
• To reduce the potential for harm and to ensure a continuity of care, healthcare providers should inquire about care, support and other services received outside of the country during pregnancy.
• Migrant women seeking care in their home country may address inadequacies regarding support and cultural preferences in prenatal care delivered in the receiving-country.