bluuebunny/crossref_metadata_2025_split huggingface dataset:
Socioeconomic differences in contact reduction in the first COVID-19-wave in Germany (CoMoLo-study)
Authors: Beese F , Wachtler B , Haller S , Koschollek C , Pfoertner T-K , Hoebel J 
Published: October 2022

Abstract

Background
The COVID-19 pandemic has led to physical distancing measures across a range of countries to control the spread of the virus. Evidence referring to contact dynamics in different socioeconomic populations is still sparse and may contribute to the explaining of socioeconomic inequality of infections.

Methods
Data came from two early COVID-19 hotspots in Germany using the CORONA-MONITORING-lokal study (CoMoLo). The sample (n = 3,637) was restricted to working age (18-67 years). We calculated the association of individual education and occupation status (low, middle, high) and self-reported private and professional contact reductions. Using weighting factors (adaptation to local age, gender and education distribution), we performed multivariate Poisson regressions (prevalence ratios; PR) with different sets of covariates: hotspot, age, sex, country of birth, household size, contact level before physical distancing measures and home office.

Results
The descriptive analyses show a clear socioeconomic gradient in private (low education: 70,0%; middle: 79,1%; high: 86,2%) and professional contact reductions (low education: 54,6%; middle: 61,3; high: 77,2%). The multivariate analyses confirm these associations, with a stronger gradient for professional contacts (private contact reduction: PR low vs. high education = 0,83 [KI:0.74-0.93]; professional contact reduction: PR low vs. high education = 0,75 [KI:0.64-0.89]) as well as for professional contact reduction when occupational status is considered instead of education.

Conclusions
Our results show disadvantages in groups with lower educational or occupational status in private and professional contact reductions in the first pandemic wave. This might result in a higher risk of infection. Preventive measures that a) adequately explain the importance of contact restrictions and b) facilitate the implementation of these reductions seem necessary to better protect structurally disadvantaged people during epidemics.

Key messages
• Groups with lower educational or occupational status were less likely of being able to reduce their private and professional contacts in the first wave of the pandemic.
• Socioeconomic differences were more pronounced in professional contact reduction compared to private contact reduction.
Prevalence of blood-borne viral and sexually transmitted infections among homeless people in Berlin
Authors: Steffen G , Weber C , Cawley C , Leicht A , Sarma N , Jansen K , Kröger S , Kajikhina K , Zimmermann R , Bremer V 
Published: October 2022

Abstract

Background
Risk factors associated with precarious living conditions make people experiencing homelessness (PEH) also highly vulnerable for blood-borne viral and sexually transmitted infections (BBVSTI) and tuberculosis (TB). The number of PEH in Germany is rising, yet little data is available on the infectious burden among this population. A pilot study assessed the prevalence of BBVSTI, TB, behaviours and access to medical services among PEH.

Methods
We recruited PEH from April-June 2021 in five low-threshold medical services in Berlin. Behavioural data was collected via questionnaire-based interviews. Serological/molecular testing from venous blood samples was performed for Hepatitis B (HBV), Hepatitis C (HCV), HIV, syphilis and TB and from urine for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT).

Results
Of 216 participants, 88% (191/216) were male and 73% (158/215) were born abroad. Mean age was 41 years (range 19-68). No health insurance was reported by 57% (123/216) and previous incarceration by 71% (153/214). Of all, 53% (114/216) injected drugs in the last 30 days, and 41% (89/216) reported unprotected sex in the last 12 months. Prevalence of active HBV was 1.9% (4/212), of active HCV 15.9% (34/213), and of HIV 2.8% (6/213). No active TB was diagnosed, while 14.4% (31/216) tested positive for latent TB infection. Active syphilis was found in 1.4% (3/212), NG in 2.0% (4/197), CT in 3.0% (6/197), and serological evidence of HBV vaccination in 26% (56/212). While 44% (96/216) of participants were ever tested for HCV, 71% (36/51) of those with HCV antibodies knew about their infection, 36% (13/36) of them reported previous/current treatment.

Conclusions
Burden of HCV and HIV was high among PEH in Berlin, and risk behaviours were frequently reported. There is a need to improve access to regular health care, accompanied by low-threshold prevention offers in cooperation with drug and homeless services. A nationwide expansion of the study is planned.

Key messages
• High burden of Hepatitis C and HIV among people experiencing homelessness in Berlin, Germany.
• Access of people experiencing homelessness to regular health care needs improvement, accompanied by low-threshold prevention offers in cooperation with drug and homeless services.
Oral Contraceptive Use and Breast Cancer Risk According to Molecular Subtypes Status: A Meta-Analysis
Authors: van Weers S , Hrzic R , Elands RJJ 
Published: October 2022

Abstract

Background
Breast cancer is a heterogeneous disease with distinct molecular signatures of disease etiology, evidenced by the joint expression of molecular tumor markers. Differential effects of oral contraceptive use on breast cancer risk by molecular subtypes have been reported. This is the first meta-analysis to investigate associations between oral contraceptive use and subsequent breast cancer risk stratified by combined estrogen receptor (ER) and progesterone receptor (PR) status alongside the Luminal A and B subtypes, which additionally consider the human epidermal growth factor receptor 2 (HER2) status.

Methods
A systematic review and meta-analysis of case-control and cohort studies was conducted in PubMed and Web of Science. The odds ratios (ORs) were summarized using a random-effects model.

Results
Eleven studies met the inclusion criteria for qualitative and quantitative analysis. Random effects meta-analyses revealed significant risk increasing effects for ever-users of oral contraception on ER-PR- breast cancer compared to never-users (OR = 1.30, 95% CI; 1.07 to 1.56, p &lt; 0.01). Ever-use of oral contraception was not associated with breast cancer risk when stratified by the ER+PR+ breast cancer subtype (OR = 1.00, 95% CI; 0.86 to 1.16, p = 0.99). Data on Luminal A and B subtypes was limited and not suggestive for associations with breast cancer risk in ever-users of OCs compared to never-users. Furthermore, a significant increased risk of ER-PR- breast cancer was observed for OC use duration of &gt; 4 years compared to never-users (OR = 1.74, 95% CI: 1.15 to 2.63, p &lt; 0.01).

Conclusions
The current state of the evidence suggests that OC use longer than 4 years is associated with an increased breast cancer risk, pertaining to the estrogen and progesterone double negative breast cancer subtype. Large-scale prospective observational studies including more comprehensive molecular signature of breast cancer aetiology, including HER2 status, are needed.

Key messages
• The use of oral contraception was associated with estrogen and progesterone receptor double negative breast cancer, but not hormone receptive positive cancer.
• This is the first meta-analysis to investigate oral contraceptive use and associations with breast cancer risk by combined estrogen and progesterone receptor status.
Work outcomes of breast cancer survivors who returned to work after treatment: CANTO cohort
Authors: Ruiz-de-Azua G , Kousignian I , Vaz-Luis I , Caumette E , Di Meglio A , Havas J , Martin E , Martin AL , Dumas A , Menvielle G 
Published: October 2022

Abstract

Background
As survival rates among breast cancer patients improve there is an increasing need to address breast cancer survivors’ (BCS) issues, professional life being a key aspect. Return to work (RTW) of BCS has been largely studied, but studies on job maintenance and its determinants are scarce. We aim to study job maintenance after RTW and the associated factors among BCS.

Methods
We used data from the CANTO cohort, a French prospective cohort of BCS. We included 1643 BCS aged &lt;57 at diagnosis (dx) who returned to work two years after dx. We excluded self-employed BCS. Using multinomial logistic models, we assessed the association between activity status one year after they return to work. (i.e. active, sick leave, or unemployed, retired or invalidity) and sociodemographic, clinical, health status and work-related factors.

Results
Overall, 87% of BCS were active, 10% were on sick leave and 3% were on unemployment, retirement or invalidity one year after they return to work. In the fully adjusted model being on sick leave was associated with stage III at dx (OR: 1.89, 95% CI: 1.11-3.22), being severely fatigued at the moment of returning to work (OR: 1.53, 1.04-2.27), and having workplace accommodations (OR: 1.79, 1.14-2.81). The unemployed, retired, invalidity status was negatively associated with professional life being more than or as important as one’s personal life (OR: 0.51, 0.26-0.98) and being &lt;50 years old (OR: 0.51, 0.27-0.96), and positively associated with having a fixed-term contract (OR: 2.69, 1.39-5.18) and working for a small company (OR: 2.73, 1.24-6.02).

Conclusions
A non-negligible proportion of BCS are non-active one year after they return to work. While clinical factors are associated with sick leave, work related factors are associated with the unemployed, retired, and invalidity status. RTW should not be regarded as the ultimate goal and future policies should focus on ensuring people are ready to return to work and maintain their jobs.

Key messages
• A non-negligible proportion of breast cancer survivors are non-active one year after they return to work.
• Future policies should ensure job maintenance along with return to work.
Social inequality in health behaviours in cohabitating individuals with CVD
Authors: Sørensen JB , Friis K , Nissen NK , Maribo T , Nielsen BK , Mejdahl CT , Thomsen AML 
Published: October 2022

Abstract

Background
Despite a decrease in mortality rates CVD remains the leading cause of morbidity and mortality in Europe. Health behavioural risk factors, low socioeconomic status and cohabitation status are all associated with CVD. However, little is known about social inequality in health behaviour among cohabitating individuals with CVD. Thus, the aim of this study was to examine social inequality in health behaviour among cohabitating individuals with CVD.

Methods
Register data on CVD were linked with self-reported health behaviour from the Danish 2017 population-based health survey ‘How are you?'. In total, 2,443 survey participants aged 45 years and above were registered with CVD. Daily smoking was assessed using a single question about smoking habits. Physical inactivity was categorised as less than 30 minutes of physical activity at least six days per week. Respondents with a BMI ≥ 30 were considered obese. Unhealthy diet was assessed using the Diet Quality Score. Moderate risk alcohol consumption was categorised as exceeding the Danish Health Authority’s recommendations. Self-reported educational attainment was used as a marker of social position and was categorised as low (0-10 years), medium (11-15 years) or high (≥ 15 years). Sociodemographic differences in health behaviour were compared using adjusted logistic regression models with health behaviours as dependent variables and adjusted for sex, age, ethnic background, time since initial CVD diagnosis and multimorbidity.

Results
Cohabitating individuals with CVD and low educational attainment had higher adjusted odds for daily smoking (3.31), physical inactivity (2.10), unhealthy diet (6.37) and obesity (2.55) than cohabitating individuals with CVD and high educational attainment. However, they also had lower adjusted odds for moderate risk alcohol intake (0.35).

Conclusions
Social inequality in daily smoking, physical inactivity, unhealthy diet and obesity was found among cohabitating individuals with CVD.

Key messages
• Social inequality in health behaviour was found among cohabitating individuals with CVD. Thus, low educational attainment affects CVD risk profile regardless of cohabitation status.
• Social inequality in health behaviour among cohabitating individuals with CVD should be addressed in public health strategies, targeted secondary prevention, treatment and rehabilitation.
A review of European and international phthalates regulation: focus on daily use products
Authors: Monti M , Fasano M , Palandri L , Righi E 
Published: October 2022

Abstract

Background
Phthalates are known endocrine disruptors used in a wide range of industrial and household products. With globalization and interdependency of the supply chain, the control of toxic substances in daily use products has become more challenging. Many countries have implemented laws and policies to limit their use, although these regulations are neither unified nor seem adequate, as studies suggest that more vulnerable populations (children, pregnant women) are exposed to phthalates that should be restricted.

Methods
For seven of the most used phthalates - bis(2-Ethylhexyl) phthalate (DEHP), Butylbenzyl phthalate (BBP), Dibutyl phthalate (DBP), Diisobutyl phthalate (DIBP), diisononyl phthalate (DINP), diisodecyl phthalate (DIDP), Di-n-octyl phthalate (DNOP) - we performed an online research on institutional sites and dedicated Agencies of the three largest world economies (European Union (EU), United States of America (USA), China) to analyze their uses and bans, focusing on Food Contacts Materials (FCM), cosmetics, toys and childcare articles.

Results
In the EU area DEHP, BBP, DBP and DIBP are not allowed in toys and childcare articles above 0,1% by weight. All the seven phthalates are also severely restricted in FCM, and mostly banned as cosmetic components. In the USA, there is no formal prohibition to their use in cosmetics but phthalates are mostly limited in FCM. In China, the limit for DBP, BBP, DEHP, DNOP, DINP, DIDP in plastic toys is 0,1% of the material composition; regarding cosmetics DEHP, BBP and DBP are prohibited.

Conclusions
We found substantial differences in the international legislation. Though there is essential agreement on toys and childcare articles legislation, there are many discrepancies about FCM and cosmetics. Further research is needed to compare the regulation with data about concentrations of these ubiquitous elements, to underline the real exposure and risk in different populations and to improve knowledge and safety on this matter.

Key messages
• Phthalates, known endocrine disruptors, in daily use products are a matter of concern.
• Coordinated international laws to prevent exposure, especially in vulnerable populations, are needed.
Guidelines for outsourcing collective catering services in the Friuli Venezia Giulia region
Authors: Barocco G , Palei M , Croci E , Savoia A , Mauro M , Stuto F 
Published: October 2022

Abstract

Issue
Many stakeholders involved in collective catering services (CCS) of schools, hospitals, elderly care homes, and workplaces of the autonomous region of Friuli Venezia Giulia (ARFVG) have reported some non-compliance with the nutritional, environmental or social standards required by public administrations (PA) procurement contracts (PC), which included the recommendations of the WHO, EU, Ministry of Health, and Ministry of the Environment (MHE).

Description of the problem
The ARFVG prevention plans have set the goal to overcome the critical issues of the regional CCS which serve over 10% of the population (130,000 meals a day). Between 2019 and 2021, a multidisciplinary group of experts from health services and from the association of 215 regional municipalities developed the guidelines (GL) for outsourcing of CCS. The aim was to support PA in the drafting of PC, evaluation of offers and verification of contractual performance. Reference was made to Dir. 2014/24/EU, EU green public procurement criteria for food, catering services and vending machines, the national lines for CCS of MHE. The GL are characterized by the integration between the tender document models and the 8 qualification areas detailed in: restructuring; supplies; environmental impact and sustainability; production processes; personnel qualification and training; nutritional standards; customer satisfaction; and verification and research of quality.

Results
Two regional central purchasing bodies have already used the GL to draft the PC for school CCS of 26 municipalities and for the whole hospital CCS of RAFVG. The application of guidelines in PC has introduced homogeneous high level qualification and verification standards for the CCS of the RAFVG.

Lessons
To ensure the application of food, nutritional, environmental and social policies in CCS, it is essential to activate networks between professionals from different sectors in order to share tools to achieve the common sustainable development goals.

Key messages
• To integrate food, nutritional, environmental and social regional policies into collective catering services, it is essential to apply systemic tools shared by all Public Administrations.
• Central purchasing bodies have the potential to introduce homogeneous and shared high level qualification and verification standards for collective catering services.
The effect of Kefir consumption on blood pressure some blood parameters in hypertensive individuals
Authors: Ozyazgan Tokay A , Pehlivan E 
Published: October 2022

Abstract

Aim
In this study is to examine the effect of kefir consumption on blood pressure, some blood parameters and anthropometric measurements in hypertensive individuals.

Methods
The study is a randomized controlled clinical trial. The mean systolic blood pressure in hypertensive individuals was taken as 145.2±19.2. The minimum sample size was determined as 30 for each group with a 95% CI and 80% power. The study was conducted by face-to-face interviews with a total of 100 volunteers, 35 male, 65 female, aged 18 and over, who were hypertensive and volunteered to participate in the study and applied to the internal medicine outpatient clinics of Akçadag Public Hospital between September 2020 and May 2021. The experimental (n = 42) and control (n = 58) groups that the patients are randomly assigned into, the experimental group was ensured to consume 250 ml/day kefir for 28 days. During the study, The study was completed with 56 volunteers. At the beginning of the study and the end of 4 weeks, blood samples, blood pressure, pulse and anthropometric measurements of the individuals were taken.

Results
When the anthropometric measurements were compared, the body weight, body mass index, waist circumference, and hip circumference of the individuals in the experimental group decreased significantly at the end of the study. There was no significant difference between the experimental and control groups in terms of glycemic parameters. While no significant change was observed in the lipid profile in the experimental group, total and LDL cholesterol levels decreased in the control group. There was no statistically significant difference in kidney function parameters in both groups. In addition, at the end of the study, there was no significant change in diastolic blood pressure and pulse in the experimental group, but systolic blood pressure decreased significantly.

Conclusions
Regularly kefir consumption has positive effects on systolic hypertension and weight control.

Key messages
• Regular daily consumption of kefir reduces systolic blood pressure and provides weight control.
• Regular daily consumption of kefir did not lead to an effective result on blood and kidney parameters.
HTA supporting clinical practice: the case of surgical repair of thoracoabdominal aortic aneurysms
Authors: Vigezzi GP , Guddemi A , Bucci D , Colucci S , La Fauci D , Calsolaro R , Foglia E , Chiesa R , Bertoglio L , Odone A 
Published: October 2022

Abstract

Background
Thoracoabdominal aortic aneurysms (TAAAs) are defined as those aortic aneurysms involving renovisceral arteries. They account for around 10% of aortic aneurysms, and their treatment is burdened by considerable mortality and morbidity. Open surgical repair has been practised as the standard of care since the 1950s. In 2001 endovascular repair was introduced to reduce treatment invasiveness, and the technology is still evolving. The potential benefits of endovascular repair over open surgery should be carefully weighed in a multidimensional framework.

Methods
We applied the Health Technology Assessment (HTA) framework (EUnetHTA core model with 9 dimensions) to conduct a report comparing the two technologies. A multidisciplinary working group was established. We derived and pooled: i) secondary data derived from systematic literature reviews, and ii) original data from IRCCS San Raffaele Hospital, Milan, a national referral centre for TAAA (qualitative and economic data).

Results
Endovascular repair resulted superior to the traditional open surgery in terms of efficacy and safety, as justified by the meta-analysis we performed. Despite the higher costs, a significant impact on budget and slightly lower cost-effectiveness, the endovascular protheses’ adoption could provide conspicuous benefits in terms of social and ethical dimensions without affecting long-term organisational and legal aspects.

Conclusions
The multi-criteria decision analysis carried out from a hospital point of view shows that there is no significant difference (final score endovascular repair 0.68 vs open surgery 0.63) between the two procedures considering all the dimensions. Still, the endovascular repair is slightly superior to the open surgery in terms of safety, effectiveness, social, ethical, legal, and organisational impact. From the policy maker’s point of view, technologies with a score superior to 0.6 are equally valuable, and the final decision should be left to the clinicians.

Key messages
• Further research is needed to compare endovascular prostheses and open surgery’s long-term population benefits, balancing clinical, economic, organisational and patient-related outcomes.
• HTA methodology offers substantial support to compare in-use technologies, informing clinicians’ and decision-makers’ choices to strengthen healthcare provision equity and preparedness.