bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined Overview on Diverticular Assessment:a new score for the management of diverticular disease
Authors: Nasi G , Tursi A , Di Mario F , Lammert F , Poskus T , Reichert MC , Regula J , Bonovas S , Sapienza M , Brandimarte G 
Published: October 2022

Abstract

Background
Diverticulosis is increasing worldwide as a public health problem. The Combined Overview on Diverticular Assessment (CODA) score, merging Diverticular Inflammation and Complication Assessment (DICA) and few clinical parameters, may reliably predict the occurrence of acute diverticulitis and surgery due to complications. Thus, the aim of the study is to confirm the value of DICA classification and to develop and validate the CODA endoscopic-clinical score.

Methods
A number of 2198 patients, at the first diagnosis of diverticulosis/diverticular disease were enrolled in a multicentre, prospective, international cohort study. Participants were scored according to DICA classifications. A 3-year follow-up was performed. Survival methods for censored observation were used to develop and validate the CODA score for predicting diverticulitis and surgery.

Results
The 3-year cumulative probability of diverticulitis and surgery was ≤4%, and ≤0.7% in CODA A; &lt;10%and &lt;2.5% in CODA B; &gt;10%and &gt;2.5% in CODA C, respectively. The 3-year cumulative probability of diverticulitis and surgery was of 3.3% (95% CI 2.5% to 4.5%) in DICA 1, 11.6% (95% CI 9.2% to 14.5%) in DICA 2 and 22.0% (95% CI 17.2% to 28.0%) in DICA 3 (p &lt; 0.001), and 0.15% (95% CI 0.04% to 0.59%) in DICA 1, 3.0% (95% CI 1.9% to 4.7%) in DICA 2 and 11.0% (95% CI 7.5% to 16.0%) in DICA 3 (p &lt; 0.001), respectively. The CODA score showed optimal discrimination capacity in predicting the risk of surgery in the development (cstatistic: 0.829; 95%CI 0.811 to 0.846) and validation cohort (c-statistic: 0.943; 95% CI 0.905 to 0.981).

Conclusions
DICA endoscopic classification was confirmed to have a significant predictive value in terms of acute diverticulitis occurence/recurrence and risk of surgery. CODA score could provide a new risk stratification tool useful for everyday clinical practice and also with a significant public health impact in terms of treatment effectiveness and decision making.

Key messages
• DICA endoscopic classification of diverticular disease is a clear predictor of the outcome of diverticulosis/diverticular disease.
• The CODA score, combining DICA and few clinical parameters, may reliably predict the occurence of acute diverticulitis and surgery due to complications.
Higher VTE in a Roma population attributed to raised genetic risk and gene-environmental interaction
Authors: Natae S , Sándor J , Ádány R , Fiatal S 
Published: October 2022

Abstract

Background
Interactions between genetic and environmental risk factors (GxE) contribute to an increased risk of venous thromboembolism (VTE). Understanding how these factors interact provides insight for the early identification of at-risk groups within a population and creates an opportunity to apply appropriate preventive and curative measures.

Objective
To estimate and compare GxE for VTE risk in the general Hungarian and Roma populations.

Methods
The study was based on data extracted from a database consisting the results obtained previously in a three pillars complex health survey. DNA was genotyped for rs121909567 (SERPINC1), rs1799963 (F2), rs2036914 (F11), rs2066865 (FGG), rs6025 (F5), and rs8176719 (ABO) polymorphisms. Multivariable linear regression analysis was applied to test the impact of GxE on VTE risk.

Results
Interestingly, the rs121909567 (SERPINC1) SNP was not present in the general population, however the risk allele frequency was 1.4% among Roma, which might suggest a founder effect in this minority. The risk of VTE was higher among depressive Roma subjects who carried the risk variant of rs2036914 (β = 0.819, p = 0.02); however, not for the general subjects. The joint presence of high level of LDL-C and rs2066865 increased the VTE risk only among Roma (β = 0.389, p = 0.002). A multiplicative interaction between rs8176719 and cancer was identified and higher for the Roma population (β = 0.370, p &lt; 0.001). The VTE risk increased in the Roma population (β = 0.280, p = 0.001) but was higher in the general population (β = 0.423, p = 0.001) as a result of the multiplicative interaction between CAD and rs2036914 (F11).

Conclusions
rs121909567 (SERPINC1) was confirmed as a founder mutation in the Roma population. As a result of higher genetic load and GxE interactions, the minority Roma population is at higher risk of VTE than the general Hungarian population.

Key messages
• Our study revealed some evidence on the burden of the joint presence of genetic and environmental risk factors on VTE.
• A marginalized and segregated Roma community could need due attention for the prevention and control of CVDs.
HBM4EU feasibility studies: Lessons learned in combining health and human biomonitoring studies
Authors: Elonheimo HM , Uusitalo K , Moore S , Andersson A-M , Wirkner K , Kolossa-Gehring M , Stewart L , Lermen D , Tolonen H 
Published: October 2022

Abstract

Background
The European Human Biomonitoring Initiative (HBM4EU) is a program protecting humans from the health effects of chemicals. The goal of HBM4EU is to make use of human biomonitoring (HBM) to assess human exposure to chemicals in Europe to better understand the associated health effects for citizens and to improve chemical risk assessment. Harmonisation and sustainable implementation of the HBM programme across Europe are important aims. In parallel to HBM studies, health examination surveys (HESs), dietary surveys, and disease specific health surveys are conducted in many European countries. In HESs, information collected by questionnaire(s) is supplemented with physical examinations and analysis of biomarkers from biological samples. HBM and HES use similar sample and data collection methods and infrastructures hence combining the two is being explored.

Methods
Within HBM4EU, three feasibility studies (Finland, Germany, and UK/England) were conducted to evaluate opportunities and obstacles in combining HBM and health studies. We describe the contents and differences of these feasibility studies, and discuss the matters of shared benefits, obstacles, and lessons learned.

Results
Benefits of combining HBM and HESs include the use of shared infrastructures, participants receiving additional health information from HES, and higher participation rates. Obstacles can be encountered when obtaining ethical approval and during time-consuming and complicated preparatory phases. Recruitment of participants and low participation rates are common concerns and designing participant-friendly questionnaires is important. Unexpected events such as the COVID-19 pandemic can cause challenges to studies. Furthermore, experiences from several countries demonstrated that long-term funding for combined studies can be difficult to obtain.

Conclusions
In the future, incorporating HBM modules into HESs can provide a feasible and cost-effective method to conduct HBM studies.

Key messages
• The European Human Biomonitoring Initiative (HBM4EU) protects humans from the health effects of chemicals in Europe. HBM4EU uses human biomonitoring (HBM) to evaluate human exposure to chemicals.
• In addition to HBM studies, health examination surveys (HESs) are conducted. In the future, incorporating HBM modules into HESs can provide a feasible and cost-effective method to conduct HBM studies.
Temperature related infectious disease mortality among infants and seasonality in Sweden, 1868-1892
Authors: Junkka J , Hiltunen M 
Published: October 2022

Abstract

Background
Climate conditions, such as ambient temperature, are crucial to infants’ vulnerability to infectious diseases. However, little is known about how climate conditions, such as temperature and seasonality, affects infectious disease mortality among infants in high mortality settings. The aim was to investigate the association between ambient temperature, seasonality and cause-specific infant mortality.

Methods
We applied a retrospective study design using parish register data from Sweden covering the period 1868-1892 in combination with daily temperature data. Population data and temperature data were combined in a time-series dataset, accounting the number of deaths per day by age group. Mortality due to water- and foodborn diseases, airborne infectious diseases, and other causes were modelled as a function of temperature exposure in the previous 14 days using distributed lagged non-linear models.

Results
We found that airborne infectious disease mortality was not related to cold temperatures but rather to seasonality. At the 1st of february IIR was 2.98 (CI 1.30 - 6.85). The summer mortality peak due to water- and foodborne infections were associated with high temperatures and not with seasonality. At + 20 °C (the 99th percentile temperature exposure) IRR was 5.52 (CI 3.13-9.74).

Conclusions
The increased vulnerability to infectious diseases of infants at high temperatures is a significant future risk, given the expected global warming in the coming decades.

Key messages
• Airborne infectious disease mortality was related to seasonality while water- and foodborne infectious diseases were related to high temperatures.
• The increased vulnerability to infectious diseases of infants at high temperatures is a significant future risk, given the expected global warming in the coming decades.
Education in Urban Health: the experience of Public Health residents in an Italian high school
Authors: Cadeddu C , Zjalic D , Lanza TE , Nachira L , Perilli A , Paladini A , Lombardi GS , Di Russo M , Ricciardi W , Damiani G 
Published: October 2022

Abstract

Background
Urban health has become an increasingly important aspect of Public Health curriculum for residents as people living in urban areas will substantially rise in the next 30 years so will their impact on health. Residents are both contributors and partners in creating sustainable solutions for their growing cities and can be involved in this aim as individual learners and also educators for younger students.

Objectives
A group of 15 Italian residents in Public Health were involved in creating and delivering 4 lessons on urban health to 319 students at Nomentano High School in Rome during spring 2022. After the 4th lesson, semi-structured interviews were conducted with the residents in order to assess perceptions, acceptance, barriers and facilitators of the experience. Data was gathered anonymously and analyzed using standard qualitative methods.

Results
All the residents answered the interview. Almost all reported the experience as highly impactful for training, team building, and increase in accountability. Most of residents also felt more confident on the topic of urban health and more involved in concrete actions for tackling pollution and climate change after delivering the lessons. Most perceived barriers mentioned were difficulties interacting with students, especially during the first two lessons, and their compliance. The opportunity to give lessons in the high school setting facilitated direct contact with students and better feedback was received.

Conclusions
Giving responsibility and leadership roles to Public Health residents and involving them in the education of younger students could improve their self-confidence and feelings of value and helpfulness, especially for urban health and climate change issues sensed by youth. Further experiences in other settings, specialties, and countries could be valuable to notice differences related to age groups and personal involvement.

Key messages
• The involvement of Public Health residents in education on urban health is highly impactful and well perceived for their personal growth.
• This kind of experience is applicable to other relevant topics in Public Health.
Safer school with near-UVA technology: novel applications for Environmental Hygiene
Authors: Bosco R , Amodeo D , De Palma I , Cevenini G , Messina G 
Published: October 2022

Abstract

Background
Schools are crowded places where outbreaks can occur. Systems capable of disinfecting air and surfaces could reduce the risk of transmission of infectious diseases.

Aim
to evaluate the effectiveness of a near-UVA (nUVA) LED ceiling lamp in improving environmental hygiene.

Methods
This cross-sectional study was conducted for 2 weeks between November and December 2020 in a kindergarten in Siena, Italy. Four ceiling lamps with LED wavelength of 405 nm were mounted on the room ceiling. The distance of the lamps from the floor was 2.70 m and 2.0 m from the desks. We preliminary selected 12 points in different sites of the room by measuring their irradiance values. We randomly sampled between 8 and 12 pairs of Petri Dishes (PD) daily during the study, incubated at 22 and 36C°, at different irradiation times: 8, 12 or 36 hours. Paired controls were used before using the lamps (at time T0), which were automatically switched ON overnight and compared with treatment (at time T1). Air sampling was also performed at T0 and T1. Statistical analysis was performed with Stata 14. Significance was set at 95% (p &lt; 0.05).

Results
520 PDs were used in the study: 130 PDs at T0 matched at T1 incubated at 36 °C and as many at 22 °C. The mean level of contamination at T0 was respectively 249 CFU (95 % CI 193.1 - 305.0) at 36 °C and 535.2 CFU (374.3 - 696.1) at 22 °C. The reduction was significant (p &lt; 0.05) at T1: we had 87.4 CFU (56.3 - 118.6), equal to 65%, at 36C° and 149.6 CFU (83.7 - 215.4), equal to 72%, at 22C°. Different values were recorded stratifying for dose (irradiance per exposition time). A significant mean percentage reduction of air contamination was 95.3% (98.4 - 92.3).

Conclusions
The system was able to improve the environmental hygiene of the kindergarten. The advantage of using this technology in the presence of people is very important in the context of controlling environmental contamination.

Key messages
• Near-UVA are efficient in reducing the contamination level significantly in a real-life context, on the surfaces and of the air.
• Crowded places favour germ outbreaks. Hygiene control is essential to reduce the risk of transmission of infectious diseases.
Digital coping of parents in conflict-affected communities: a path to maintain health and well-being
Authors: Shapira S , Yeshua Katz D , Braun-Lewensohn O 
Published: October 2022

Abstract

Background
Mobile apps such as WhatsApp have become significant resources for information and social support in times of crisis. Little is known about the role WhatsApp groups play in the context of living in conflict-affected regions. Living in such areas is associated with myriad mental health impacts, and recent studies have identified parents of young children as highly vulnerable in this regard. The study’s aim was to examine parents’ digital coping with political violence in southern Israel.

Methods
In-depth interviews were conducted with 21 parents of young children (&lt;17) residing in communities near the Israel-Gaza border and who are members of local online parents’ groups on WhatsApp. Data were analyzed to answer questions regarding the benefits and disadvantages that parents assign to online groups; and regarding the role of digital communication in maintaining health and well-being.

Results
The findings reveal that online groups are often discussed as a shared and ubiquitous coping resource that supports mental health and well-being. Parents report they use the group to share ways to deal with the situation effectively and exchange social support, and as a space that facilitates community cohesion. Furthermore, during escalations, members perceived the group as the most trustworthy source of information. The groups’ continuous availability had drawbacks as well. Some participants pointed to digital stress caused by the fear of missing out on information, or by information overload.

Conclusions
Our results demonstrate the effectiveness of digital environments in helping parents cope with a collective stressor: a particularly worthy goal given that social media apps now constitute the primary online connection for most individuals. This has broad impacts on health promotion efforts for mental health issues related to political violence as well as other large-scale health crises such as the COVID-19 pandemic.

Key messages
• Digital environments can serve as a platform for successful coping with collective stressors.
• Health practitioners should consider drawbacks when planning digital support efforts.
The development of new Electronic Health Record Exchange Format Use Cases - an evaluating perspective
Authors: Trunner K , Leuprecht E , Stradner A , Pinto C , Franconi S , Melgara M , Boumpaki A , Soares F , Liapi G 
Published: October 2022

Abstract

The EU-funded X-eHealth project aims to lay the foundations for a common framework for medical imaging, discharge letters, laboratory results and rare diseases to advance an interoperable Common European Health Data Space for citizens and healthcare providers in accordance with privacy and cybersecurity regulations. To ensure sustainability of the project, it is crucial to assess whether X-eHealth is achieving its planned objectives and delivers tangible results. A key challenge in evaluating project outcomes lies in the partial lack of visibility of direct impacts due to a time lag of effects or attribution problems (i.e., identifying the main cause of a particular impact). In X-eHealth, we address this problem by defining a framework of Key Performance Indicators (KPI) that allows the monitoring of project outcomes. In addition, qualitative interviews with a focus on the following questions are conducted towards the end of the project to complement the evaluation:
• Does X-eHealth advance the integration process of eHealth services in Europe?
• Will X-eHealth lead to increased use of the new European Electronic Health Record Exchange Format (EEHRxF) specifications?
Although final results are not yet available, we expect X-eHealth to have a positive impact at all stakeholder levels by accelerating the implementation of EEHRxF through the harmonisation of health data, thus providing patients, health professionals and institutions with increased quality, safety and efficiency. There is little evidence to analyse the impact of eHealth policy interventions. For this reason, the present evaluation makes a significant contribution to impact research in this area. X-eHealth highlights the importance of international cooperation in creating a common framework for the future development of digital health in the EU. The continuous evaluation, moreover, facilitates a more efficient management of resources through KPI observance and the implementation of project results.

Key messages
• X-eHealth aims to accelerate the implementation of the European eHealth Record exchange Format (EEHRxF) through the standardisation and harmonisation of health data.
• By evaluating and monitoring the project processes, it is possible to ensure the progress of the project and to measure the potential impacts of the outcomes on stakeholders and other target groups.
Trauma support in your pocket
Authors: Thell M , Edvardsson K , Warner G 
Published: October 2022

Abstract

Background
Research indicates that technological approaches to the delivery of trauma-based support can help address structural and perceptual barriers. Yet, there is a lack of research on digital trauma support for children and adolescents. A systematic review of trauma apps identified 2 of 69 were for children, of which neither were evidence based. The aim of this project was to develop a trauma support app, co-designed with and for children and young people, based on a community-based group support program called Teaching Recovery Techniques.

Methods
In a series of workshops utilising the Design Studio method, a team of 7 young people between 14-20 years (3 boys and 4 girls) co-created the app. The team were recruited via youth organisations and self-reported having experienced (undisclosed) trauma. The techniques presented in the manual have been prioritised via stepwise consideration of content session by session. Prototypes were developed based on the generated ideas and shared with the team for feedback.

Results
Contributions of the young people to the design can be considered in three categories: mechanics, dynamics and aesthetics. Mechanics are the rules and interactions that inform the structure of the app. Dynamics refers to what the user can actually see, e.g. the outcome when the user presses a button. Aesthetics relate to the desirable emotional responses evoked in the user when they interact with the app. Beyond influence on basic aesthetics, such as fonts and symbols, the young people actively contributed to the user experience and gave great consideration to the emotional responses that could be evoked.

Conclusions
Young people with personal experience of trauma can actively engage in the development of a digital trauma intervention. Design Studio was an effective method for the co-creation process, enabling the generating and converging of young peoples’ ideas.

Key messages
• Co-creating an app for trauma support with youth with experience of trauma was a feasible process for both researchers and youth.
• Using Design Studio, a collaborative workshop method, facilitated the co-creative process, allowing the youth to contribute to the mechanics, dynamics and aesthetics factors of the app.
Technology-aided community engagement for exercise promotion: a mixed-methods systematic review
Authors: Raspolini GM , Riccardi MT , Damiani G 
Published: October 2022

Abstract

Background
This review aims to provide an overview of evidence on feasibility and effectiveness in diverse populations of eHealth physical activity (PA) community engagement (CE) interventions. Increasing global PA levels would have a substantial positive impact on population health. Given their diffusion, eHealth technologies may address certain barriers to PA and reach wide audiences. The most recent Italian guidelines on PA highlight inequalities in health, which can be addressed using CE models. The potential scalability of successful eHealth CE interventions and the scarcity of previous reviews on the topic are reasons which convinced us to work on this paper.

Methods
This mixed-methods systematic review utilized the Joanna Briggs Institute methodologies. Primary quantitative outcome measures were minutes of PA per week. Qualitative outcome measures included self-efficacy and user engagement. Data were processed using a segregated convergent design. A narrative summary and a meta-aggregation were performed for synthesizing quantitative and qualitative data respectively. Only the interventions where CE principles were fulfilled were analyzed.

Results
Quantitative evidence supported effectiveness and feasibility of interventions to improve PA outcomes and related proxy indicators across studied populations. Qualitative findings suggest the utility of peer-support and that from other health care providers.

Conclusions
Implementing CE in future PA interventions will be critical for producing an effective digital application with the potential for considerable impact in the real world. If supported by central governments and the European Union, entities such as primary care hubs and local health units with their professionals and CE capabilities may play the key role in implementing evidence.

Key messages
• eHealth PA CE interventions work better when peer support takes place.
• Health systems could pursue these prevention strategies for population health gains.