bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge of public health informatics among Italian medical residents: design and preliminary validation of a questionnaire
Authors: D’Aloisio Francesco , Bragazzi Nicola Luigi , Bridgewood Charlie , Poletto Marco , Guicciardi Stefano , Zanobini Patrizio , D’Ambrosio Angelo , Bianchi Francesco Paolo , Quattrone Filippo , Barbara Andrea 
Published: April 2023

Background: public health requires strong information skills and competencies, as it is information-intensive and information-driven. Public health informatics has been defined as the “systematic application of information, computer science, and technology to public health practice, research, and learning”. New information and communication technologies offer unprecedented opportunities, such as linking smart-phones and mobiles devices to web based tools for data collection, enabling and enhancing participatory epidemiology. However, being an emerging discipline, despite its potential and importance, public health informatics is often neglected and overlooked, being rarely offered as course. The present study was designed as a pilot study, with the aim of designing and validating a questionnaire on the knowledge of public health informatics among medical residents in public health in Italy.
Methods and Results: thirty-two Italian residents in public health volunteered to take part into the study. Mean age of the sample was 31.44±2.23 years, most responders were males (68.8%), from northern Italy (53.1%), at the third year of residency (34.4%) and currently doing practical training at the clinical management staff/hospital directorate (34.4%). Other places of training were the Prevention Department (21.9%), the Institute of Hygiene (18.8%), the local health units and the territory (12.5%), the occupational health service (6.3%) and the Regional Health Agency (3.1%). Cronbach’s alpha coefficient yielded a value of 0.909, demonstrating excellent psychometric properties of the instrument.
Conclusion: in conclusion, the developed questionnaire seems to be an appropriate and useful tool to detect gaps concerning knowledge, education and practices of public health informatics among residents in public health.
Realizing the Prospects of the Demographic Dividend in Selected Arab Countries
Authors: Youssef Hala , Elden Nesreen Mohamed Kamal , Ali Hala Abou 
Published: April 2023

Background: For most Arab countries, the coming ten years will reveal a real challenge with their changing age structure. Currently, a demographic window of opportunity is unlocked in many of those countries with the increase in the fraction of population in the working-age. Hence, the study investigates the relation between population growth and dependency ratio as demographic indicators and the per capita growth domestic product (GDP).
Methods: A time-series analysis model was developed for Egypt and Morocco versus the Republic of Korea as an economically empowered country that had the same initial conditions in the early sixties. Data exploited are drawn from the World Bank and OECD databases. We adopt an income per capita growth model to analyze the role of demographic factors, mainly working-age share.
Results There is a significant relationship between GDP per capita and the proportion of working age population. A significant long-run association between dependency ratio and per capita GDP is confirmed. The reduction of dependency load contributes to GDP per capita growth throughout the study duration by an annual rate of about 9 and 2 percent in Egypt and Morocco, respectively.
Conclusion: The decline in the dependency ratio, or alternatively, the raise in the working age population has a favorable impact on economic growth. The paper presents supporting evidence to scale up the effect of age structure alteration and to realize the demographic dividend in the studied countries.
An observational study on the effects of early and late risk factors on the development of childhood obesity in the South of Italy
Authors: Squeri Raffaele , Genovese Cristina , Palamara Maria Angela Rita , Trimarchi Giuseppe , Ceccio Concetta , Donia Vittoria , Pecoraro Maria , La Monica Giuseppa , La Fauci Vincenza 
Published: April 2023

Background: Child obesity is today one of the greatest health emergencies, on such a large scale as to be considered a global epidemic by the WHO and, unfortunately, Italy holds the worst European record.
Methods: We conducted an observational study to investigate the effects of early and late risk factors on the development of primary childhood obesity. We collected anthropometric parameters, information about early risk markers and late risk factors on a sample of 280 children from March 2016 to December 2017.
Results: Statistically significant associations emerged between: child's BMI and education level of the mother (p<0.001) and the father (p<0.05); level of parents' education and qualitative variables (subjects’ physical activity level (p<0.05), consumption of carbonated beverages (p<0.05), fruit juices (p <0.05) and snacks (p<0.05); BMI and the presence or absence of a family history of obesity, DM and cardiovascular diseases. Significant linear correlations were found between weight classification (overweight/obese) and the consumption of carbonated drinks (p<0.05), snack consumption (p<0.05), physical activity levels (p<0.001) and duration of sleep in the afternoon (p<0.05).
Conclusions: In our sample we found incorrect eating habits to be frequently linked to a low level of parental education; particularly for the mother, the main childcare provider.
Early feeding and growth pattern in infants: Using a three-variate longitudinal model derived from Gaussian copula function
Authors: Angali Kambiz Ahmadi , Loeloe Mohammad Sadegh , Akhoond Mohammad Reza , Daneshkhah Alireza , Borazjani Fatemeh 
Published: April 2023

Background: The Gaussian copula model was used to generate joint distributions for continuous longitudinal variables on infant types of feeding and longitudinal measures of height, weight and head circumference
Methods: The study was performed longitudinally in rural areas of southern part of Iran, on children from birth to 9 months of age. Out of 319 infants with serial anthropometric measurements from birth, and 2, 4, 6, 7 and 9 months old, 120 were included. Infants were divided into three groups (breast fed, formula fed and both milk types). A three-variate longitudinal model including Copula function was used to estimate the effect of feeding on growth pattern. All the analyses were performed using SAS version 9.4 (Proc NLmix).
Results: Ninety infants (75%) were breastfed, sixteen (13.3%) were formula fed and fourteen (11.7%) had combined feeding. Copula model showed that, breast fed children had a better weight gain (β=0.627 95% CI 0.217-1.038 P = 0.003), height (β=2.603 95% CI 1.023-4.183 P = 0.001) and head circumference (β=0.8 95% CI 0.069- 1.531 P = 0.0) as compared to formula fed children. R2 for Copula model was (wt=0.52, ht=0.96, hc=0.84).
Conclusions: Implication of Copula model was easy to perform. Estimation of the parameters in copula model indicated that, breast milk consumption had a positive effect on the growth of infants.
Methods and introductory results of the Greek national health and nutrition survey - HYDRIA
Authors: Martimianaki Georgia , Naska Androniki , Papatesta Maria Eleni , Peppa Eleni , Orfanos Philippos , Trichopoulou Antonia 
Published: April 2023

Background: According to a large prospective cohort study (with baseline examination in the 1990s) and smaller studies that followed, the population in Greece has been gradually deprived of the favorable morbidity and mortality indices recorded in the 1960s. The HYDRIA survey conducted in 2013-14 is the first nationally representative survey, which collected data related to the health and nutrition of the population in Greece.
Methods: The survey sample consists of 4011 males (47%) and females aged 18 years and over. Data collection included interviewer-administered questionnaires on personal characteristics, lifestyle choices, dietary habits and medical history; measurements of somatometry and blood pressure; and, blood drawing. Weighting factors were applied to ensure national representativeness of results.
Results: Three out of five adults in Greece reported suffering of a chronic disease, with diabetes mellitus and chronic depression being the more frequent ones among older individuals. The population is also experiencing an overweight/obesity epidemic, since seven out of 10 adults are either overweight or obese. In addition, 40% of the population bears indications of hypertension. Smoking is still common and among women the prevalence was higher in younger age groups. Social disparities were observed in the prevalence of chronic diseases and mortality risk factors (hypertension, obesity, impaired lipid profile and high blood glucose levels).
Conclusion: Excess body weight, hypertension, the smoking habit and the population’s limited physical activity are the predominant challenges that public health officials have to deal with in formulating policies and designing actions for the population in Greece.
A survey on Biostatisticians Serving in the Italian Ethics Committees
Authors: Baldi Ileana , Azzolina Danila , Chiffi Daniele , Barrella Teresa , Martinato Matteo , Berchialla Paola , Gregori Dario 
Published: April 2023

Background. Italian ethics committees (ECs) have the responsibility for evaluating and monitoring clinical research.
Methods. An electronic survey targeted to the biostatisticians operating in the 95 ECs in Italy, was launched in November 2016. Several aspects were explored such as education, job title, training in biostatistics and experience in the evaluation of protocols within the EC.
Results. Seventy case report forms were returned (74%), and the response rate was highest for ECs located in the South (78%) and lowest in the North (51%). The biostatisticians in the respondent ECs were prevalently male, aged 50-60 years, with postgraduate education in medical specialties and statistics. The annual workload varied depending on the type of institution and geographical area, with an annual median number of protocols examined ranging from 80 in hospital ECs to 198 in university hospital ECs, and from 80 to 108, in the South and the Centre, respectively. Of these, 40% were observational study protocols. The EC biostatisticians proposed to reject 5% of protocols and to suspend with the request of clarification or amendments 10%. Only 61% and 79% of these opinions, respectively, were regarded as binding by the other EC members.
Conclusion. The biostatistician will not be able to play a significant role in the EC as long as the required skill-set remains vague and his/her opinion on a protocol is underrated.
Willingness to pay for vaccination against hepatitis b and its determinants: the case study of an industrial district of Pakistan
Authors: Sardar Azeem , Yaseen Muhammad Rizwan , Abbas Azhar , Waqas Muhammad , Gill Basir Afzaal 
Published: April 2023

Willingness to pay (WTP) for vaccination of hepatitis disease is a good measure to monetize the physical effects of a disease into monetary values. Therefore, the present study aims to find the willingness to pay for self-paid vaccines for hepatitis and its determinants in an industrial district Faisalabad, Pakistan. Primary data was collected from 200 nonpatients of hepatitis which were personally interviewed by using convenient sampling method.
A scenario was presented to the selected respondents by using CVM technique. The respondents were randomly assigned to pre-chosen payment bids defined on the basis of prevailing market rates for vaccination at the time of survey. The multivariate linear regression was used to find the determinants of WTP. The results show that females are slightly more willing to pay as compared to males. The variables like age, income and awareness about hepatitis have positive impact on WTP for vaccination of hepatitis disease. About 57.3 percent people belonging to low income group wanted vaccination free of cost in Pakistan.Government should launch free vaccination programs for the most vulnerable group (poor) and must launch awareness campaign to increase knowledge about disease.
Validity and reliability of a new instrument for the evaluation of dental collaboration in disabled people
Authors: Sparabombe Scilla , Guerra Fabrizio , Maruotti Antonello , De Sanctis Renato , Di Giorgio Gianni , Palaia Gaspare , Romeo Umberto , Barbato Ersilia 
Published: April 2023

Background: nowadays, oral health in people with disabilities is an important topic. The phsychological and behavioural problems of these people, their difficulties with environmental adaptations and the absence of any traditional communication determine the compliance needed for treatment The aim of this work was to test the validity and reliability of an original questionnaire that could become an instrument assessing the individual features in people with mental retardation and other developmental disabilities at the time of dental treatment.
Methods: it was created a questionnaire with standardised answers regarding four specific areas: neuropsychology, emotional-affect, autonomy and environmental resources. The questionnaire was completed by 63 patients from three different institutes (two rehabilitation institutes and an Institute of Dentistry for patients with special needs). To analyse the answers, each item was transformed into a numeric value. A value of 1 was displayed as the minimum while 4 represented full possession of the considered skills. A total of 17 variables were analysed with descriptive statistics and multivariate analysis. Internal consistency reliability was measured using Cronbach’s alpha. Furthermore, an analysis on convergent/discriminant validity was provided.
Results: all variables were positively correlated. The most significant were “guidance”, “communication”, “sociability”, “view”, “hearing” and “feeding”. Items like “self-control”, “equanimity”, “problematic behaviour”, “extroversion” and “autonomy” offered vague and less significant information in identifying the patient’s collaboration level. Variables like “evaluation by the compiler about the patient’s collaboration”, “previous dental experiences” and “attendant” were confirmed. Cronbach’s alpha was 0.77 (standardized result), which meet the a priori criterion of 0.90≥alpha≥0.70.
Conclusions: the instrument was statistically tested and seems to be adequate to estimate the collaboration level of disabled patients. It is called CLEQ (Collaboration Level Evaluation Questionnaire). Further trials are warranted to confirm its validity and benefits.
Factors associated with adverse events following immunization in Albanian children: An analysis of the national database of adverse events after immunization
Authors: Mehmeti Irsida , Nelaj Erida , Tomini Eugena , Simaku Artan , Bino Silva 
Published: April 2023

Background: Adverse events following immunization are a major concern which is influencing vaccination coverage all over the world. It is therefore important to evaluate the reporting of this events and factors associated with their occurrence in order to prevent them.
Methods: The national database of adverse events following immunization in Albanian children was de-identified and transferred to the IBM® SPSS version 21. (SPSS Inc, USA). Every medical information was re-entered using the Medical Dictionary for Regulatory Activities (MedDRA) terms. The dose-based reporting rates are calculated always taking in consideration the number of administered vaccines instead of the number of distributed ones, which is an advantage of the Albanian reporting system
Results: During a thirteen year period (2003-2015) there have been 307 AEFI cases reported for a total of 7,713,325 doses of vaccines administered. That regarded 106 females and 134 males. Most of the events have been reported during 2004. Most of thecases were non-serious (78,8%). Most of the cases were treated at ambulatory setting (72.55), followed by hospital treatment (24.3%) and no treatment (2.6%). Most of the cases were recorded in infants aged < 4 months.
Conclusion: During the 13 year period, there were no severe events. The completeness and accuracy of information in the Albanian vaccine safety surveillance system still need to improve.
Co-occurence of risky driving behaviours and associations with seatbelt and helmet use - a descriptive cross-sectional study among young adults
Authors: Kritsotakis George , Papadakaki Maria , Tumwesigye Raymond 
Published: April 2023

Background: Greece exhibits one of the highest rates of deaths and injuries due to motor vehicle crashes in young adults in Europe. The personal, social and financial cost is still very high as road traffic crashes account for 65.8% of all deaths among young people aged 10-24 years, with prominent gender differences that are not fully explained yet.
Methods: using a descriptive cross-sectional study design, we examined the associations of seatbelt and helmet use with the likelihood of manifesting multiple driving violations (fail to stop at STOP signs, running red traffic lights, driving towards the wrong direction, illegal overtaking, speeding, cellphone use while driving, driving under the influence of alcohol) in a sample of 536 1st year university students in Greece. A ‘Risky Driving Index’ score (RDI) was produced by summing the frequencies of all behaviours (range 0-28).
Results: only 8.8% of the students reported not performing any of the driving violations, whereas 8.6% engaged in all 7 of them when driving (male: 11.5%; female: 1.9%; score>8, male: 31.7%; female: 8.1%). Male, but not female participants, who never used seatbelts and helmets, reported significantly higher RDI scores with evidence of a dose-response effect in the increase. In adjusted logistic regression models, those who never used (vs regular use) seat belt ‘as drivers’ and ‘as rear seat passengers’ had increased odds of being in the higher score category of RDI (OR=5.239 95%CI=1.280-21.441 and OR=6.782 95%CI=1.891-24.324, respectively).
Conclusion: young male drivers and riders, but not their female counterparts, that do not take typical safety measures (seatbelt and helmet use), reported more illegal and risky driving behaviours. Preventive interventions using a gender-informed approach are needed to address co-occurring risk driving behaviours.
A web-based surveillance model of eosinophilic meningitis: future prediction and distribution patterns
Authors: Aekphachaisawat Noppadol , Sawanyawisuth Kittisak , Phitsanuwong Chalongchai , Khamsai Sittichai , Chattakul Paiboon , Chomtmongkol Verajit , Tiamkao Somsak , Limpawattana Panita , Senthong Vichai , Chindaprasirt Jarin , Ngamjarus Chetta 
Published: April 2023

Background: web-based surveillance is a useful tool for predicting future cases of various emerging infectious diseases. There are limited data available on web-based surveillance and patterns of distribution of eosinophilic meningitis (EOM), which is an emerging infectious disease in various countries around the world.
Methods: this study applied web-based surveillance to the prediction of EOM incidence and the analysis of its distribution pattern by using a national database, which may be used for future prevention and control. The number cases of EOM in each month over a period of 12 years (between 2006 to 2017) from Loei province were retrieved from the National Disease Surveillance (Report 506) website, operated by Thailand's Public Health Center.
Results: we developed autoregressive integrated moving average (ARIMA) models and seasonal ARIMA (SARIMA) models. The best model was used for predicting numbers of future cases. The forecast values from the SARIMA (1, 1, 2)(0,1,1)6 model were close to actual values and were the most valid, as they had the lowest RMSE and AIC. The predictive model for future cases of EOM was related to previous numbers of EOM cases over the past eight months. The disease exhibited a seasonal pattern during the study period.
Conclusions: web-based surveillance can be used for future prediction of EOM, that the predictive model applied here was valid, and that EOM exhibits a seasonal pattern.
QuantiFERON-TB Gold Plus evaluation for latent tuberculosis infection among Italian healthcare workers: a cross-sectional study
Authors: Coppeta Luca , Baldi Savino , Somma Giuseppina , Tursi Elisabetta , Policardo Sara , Baldi Ottavia , Lieto Piergiorgio , Pietroiusti Antonio , Magrini Andrea 
Published: April 2023

Background: healthcare workers (HCWs) are at higher risk of being exposed to tuberculosis (TB). The aim of this study was to estimate LTBI prevalence and evaluate associated risk factors among Italian HCWs using a new generation IGRA test, Quantiferon Plus (QTF-Plus), providing also an analytical evaluation of this test.
Methods: this cross-sectional study was conducted during the annual health surveillance program performed in 2017, evaluating 1470 HCWs of a teaching hospital in Rome, tested with QTF-Plus. A standardized questionnaire was collected for multivariate risk analysis. The independent variables associated with a higher frequency of LTBI were tested in a multivariate logistic regression model.
Results: LTBI was diagnosed in 50 out of 1470 (3.4%) of HCWs. The male gender and age>40 years were significantly associated with the risk of LTBI. The levels of interferon-γ were significantly lower in subjects with a recent conversion than in those with an older positivity. Moreover, interferon-γ values exceeding 8 IU/ml were recorded in 8 out of 35 remote subjects but in no recent subjects. The concordance between TB1 and TB2 results was 88%, while in 6 out of 50 subjects we found a discrepancy.
Conclusion: the LTBI condition among Italian HCWs was very low. In subjects with discordant outcomes between TB1 and TB2, especially when the test values are close to the cut-off, is recommended a repetition of the test to confirm its positivity.
Key words: tuberculosis, latent tuberculosis infection, interferon-gamma release assay, quantiferon plus, healthcare workers
A Support Vector Regression Approach for Three–Level Longitudinal Data
Authors: Moqaddasi Amiri Mohammad , Tapak Leili , Faradmal Javad 
Published: April 2023

Background: Longitudinal data structure is frequently observed in health science. This introduces correlation to the data that needs to be handled in modelling process. Recently, machine learning approaches have been introduced in the context of longitudinal data for prediction of the response variable purpose. In this paper a mixed-effects least squares support vector regression model is presented for three-level longitudinal data. In the proposed model, multiple random-effect terms are used for considering the existing correlation structures in longitudinal data. The proposed model is flexible in modelling (non-)linear and complex relationships between predictors and response, while it takes into account the hierarchical structure of data and is computationally efficient.
Methods Both random intercept and random trend models with a special correlation structure of errors are illustrated. A real data example on human Brucellosis rate is analysed and two simulation studies are performed to illustrate the proposed model. The fitting and generalisation performance of the proposed model are investigated and compared with the ordinary least squares support vector regression and linear mixed-effects models.
Results: Based on the human Brucellosis rate example and two simulation studies, the proposed models had the best performance in generalisation. Also, the fitting performances of the proposed models were better than that of the classic models.
Conclusion: Our study revealed that in the presence of nonlinear relationship between covariates and outcome, the proposed MLS-SVR model has the best fitting and generalisation performance and can capture correlation of the data.