Design und Qualitätskontrolle der zahnmedizinischen Untersuchung in der NAKO Gesundheitsstudie [Design and quality control of the oral health status examination in the German National Cohort (GNC)]

BACKGROUND: Caries and periodontitis are highly prevalent worldwide. Because detailed data on these oral diseases were collected within the framework of the German National Cohort (GNC), associations between oral and systemic diseases and conditions can be investigated. OBJECTIVES: The study protocol for the oral examination was designed to ensure a comprehensive collection of dental findings by trained non-dental staff within a limited examination time. At the mid-term of the GNC baseline examination, a first quality evaluation was performed to check the plausibility of results and to propose measures to improve the data quality. MATERIALS AND METHODS: A dental interview, saliva sampling and oral diagnostics were conducted. As part of the level‑1 examination, the number of teeth and prostheses were recorded. As part of the level‑2 examination, detailed periodontal, cariological and functional aspects were examined. All examinations were conducted by trained non-dental personnel. Parameters were checked for plausibility and variable distributions were descriptively analysed. RESULTS: Analyses included data of 57,967 interview participants, 56,913 level‑1 participants and 6295 level‑2 participants. Percentages of missing values for individual clinical parameters assessed in level 1 and level 2 ranged between 0.02 and 3.9%. Results showed a plausible distribution of the data; rarely, implausible values were observed, e.g. for measurements of horizontal and vertical overbite (overjet and overbite). Intra-class correlation coefficients indicated differences in individual parameters between regional clusters, study centres and across different examiners. CONCLUSIONS: he results confirm the feasibility of the study protocol by non-dental personnel and its successful integration into the GNC's overall assessment program. However, rigorous dental support of the study centres is required for quality management

Validierung des TeleForm Scan-Workflows in der NAKO Gesundheitsstudie am Beispiel des Fragebogens zur körperlichen Aktivität

Electronic data capture (EDC) is an important tool for the digitalisation of paper-based documents such as questionnaires and for the identification of errors before values are finally saved in a database. The data acquisition software TeleForm is one example for an EDC system which is used to digitise paper-based documents. TeleForm checks the data of the scanned document and gives indications of possibly incorrectly read data. In the German National Cohort (GNC) this software is among other things applied to digitalise questionnaires.The following questions are addressed in this article: Is the scan workflow referring to the questionnaires in the GNC and in particular the data acquisition software TeleForm (with the settings chosen for the GNC) reliable? How much loss of data quality is acceptable to reduce the amount of work? Can artificial intelligence replace human inspection sufficiently or will the latter continue to play an indispensable role in the scan workflow of the GNC in the future? By answering these questions, the strengths and the limitations of the scan workflow in the GNC using the TeleForm software will be discussed.The current work uses data collected in the GNC centre in Dusseldorf. 300 questionnaires on physical activity were validated and checked twice, first by the system TeleForm and second by a visual assessment. The data acquisition software TeleForm shows high error rates in interpreting free text fields as well as in reading handwritten numbers. Especially the digit "0" was misinterpreted most often.In order to save time and thus make work easier, some shortcomings must be remedied. This can be achieved, for example, by putting special emphasis on the expansion of the reading areas of TeleForm and on the improved reproduction and reading of numerical values.Die elektronische Datenerfassung (EDC) ist ein wichtiges Instrument zur Digitalisierung von papierbasierten Dokumenten wie beispielsweise Fragebögen. Ebenso ist es für die Identifizierung von Fehlern hilfreich, bevor die Werte endgültig in einer Datenbank gespeichert werden. Die Datenerfassungssoftware TeleForm ist ein Beispiel für ein EDC-System, das zur Digitalisierung von papierbasierten Dokumenten eingesetzt wird. TeleForm prüft die Daten des eingescannten Dokumentes und gibt Hinweise auf möglicherweise fehlerhaft gelesene Daten. In der NAKO Gesundheitsstudie wird diese Software unter anderem zur Digitalisierung von Fragebögen eingesetzt.In diesem Artikel werden die folgenden Fragen behandelt: Ist der Scan-Workflow bezogen auf die Fragebögen in der NAKO Gesundheitsstudie und insbesondere die Datenerfassungssoftware TeleForm (mit den für die NAKO gewählten Einstellungen) zuverlässig? Wieviel Verlust an Datenqualität ist akzeptabel, um den Arbeitsaufwand zu reduzieren? Kann künstliche Intelligenz die menschliche Überprüfung ausreichend ersetzen oder wird letztere auch in Zukunft eine unverzichtbare Rolle im Scan-Workflow der NAKO spielen? Durch die Beantwortung dieser Fragen sollen die Stärken und Grenzen des Scan-Workflows in der NAKO Gesundheitsstudie unter Verwendung der TeleForm-Software diskutiert werden.Die aktuelle Arbeit verwendet Daten, die im NAKO-Zentrum in Düsseldorf erhoben wurden. 300 Fragebögen zur körperlichen Aktivität wurden validiert und zweimal überprüft, zum einen durch das System TeleForm und zum anderen durch eine visuelle Kontrolle. Die Datenerfassungssoftware TeleForm zeigt hohe Fehlerquoten bei der Interpretation von Freitextfeldern sowie beim Lesen von handgeschriebenen Zahlen. Insbesondere die Ziffer "0" wurde am häufigsten falsch interpretiert.Um Zeit zu sparen und damit die Arbeit zu erleichtern, müssen einige Defizite behoben werden. Dies kann zum Beispiel durch die Erweiterung der Lesebereiche sowie die Verbesserung des Lesens von Zahlenwerten erzielt werden

The effect of air pollution when modified by temperature on respiratory health outcomes: A systematic review and meta-analysis.

Background: Respiratory diseases are a leading cause of mortality and morbidity, and are exacerbated by air pollution and temperature. Aim: To assess published literature on the effect of air pollution modified by temperature on respiratory mortality and hospital admissions. Methods: We identified 26,656 papers in PubMed and Web of Science, up to March 2021, and selected for analysis; inclusion criteria included observational studies, short-term air pollution, and temperature exposure. Air pollutants considered were particulate matter with a diameter of 2.5 μg/m3, and 10 μg/m3 (PM2.5, and PM10), ozone (O3), and nitrogen dioxide (NO2). A random-effects model was used for our meta-analysis. Results: For respiratory mortality we found that when the effect PM10 is modified by high temperatures there is an increased pooled Odds Ratio [OR, 95% Confidence Interval (CI)] of 1.021 (1.008 to 1.034) and for the effect of O3 the pooled OR is 1.006 (1.001–1.012) during the warm season. For hospital admissions, the effects of PM10 and O3 respectively, during the warm season found an increased pooled OR of 1.011 (0.999–1.024), and 1.015 (0.995–1.036). In our analysis for low temperatures, results were inconsistent. Conclusions: Exposure to air pollution when modified by high temperature is likely to increase the odds of respiratory mortality and hospital admissions. Analysis on the interaction effect of air pollution and temperature on health outcomes is a relatively new research field and results are largely inconsistent; therefore, further research is encouraged to establish a more conclusive conclusion on the strength and direction of this effect

Toxigenic penicillia spoiling frozen chicken nuggets

AbstractFrozen chicken nuggets are classified as pre-prepared frozen meals. These products are convenient to consumers as they are easy to prepare and allow for long storage by freezing. Over the years, spoilage of frozen food products caused by fungi has been a continual problem for the food industry since mold can develop when frozen foods are allowed to attain temperatures of −10°C, or above. The growth of fungi on the food surface results in economic losses and represents a hazard to public health due to the possibility of mycotoxin production. The aim of this study was to identify the species of filamentous fungi involved in the spoilage of frozen chicken nuggets and determine their ability to produce mycotoxins under laboratorial conditions. A total of 7 samples of frozen chicken nuggets were analyzed by dilution plating in potato dextrose agar (PDA). These products had been returned by customers due to visible mold growth on their surface. The predominant species found were Penicillium glabrum, Penicillium polonicum, Penicillium manginii, Penicillium crustosum, Penicillium commune, and Penicillium solitum. Analysis of the profile of secondary metabolites was carried out in HPLC after growing the isolates in Czapek yeast autolysate agar (CYA) and yeast extract agar and sucrose (YESA) and extracting the extrolites with a solution of ethyl acetate, dichloromethane, methanol, and formic acid. Some isolates of these species showed an ability to synthesize mycotoxins such as cyclopiazonic acid citreoviridin, roquefortine C, penitrem A, and verrucosidin under standard conditions. Considering the occurrence of fungal spoilage in frozen food and the potential hazard involved, more studies on psychrophilic fungi growth in foods stored at low temperatures are necessary

Airway inflammation in adolescents and elderly women: Chronic air pollution exposure and polygenic susceptibility.

BACKGROUND AND AIM: The fractional exhaled nitric oxide (FeNO) concentration in the exhaled breath is a biomarker for eosinophilic airway inflammation. We explored the interplay between chronic air pollution exposure and polygenic susceptibility to airway inflammation at different critical age stages. METHODS: Adolescents (15 yr) enrolled in the GINIplus/LISA birth cohorts (n = 2434) and 220 elderly women (75 yr on average) enrolled in the SALIA cohort with FeNO measurements available were investigated. Environmental main effects of the mean of ESCAPE land-use regression air pollutant concentrations within a time window of 15 years and main effects of the polygenic risk scores (PRS) using internal weights from elastic net regression of genome-wide derived single nucleotide polymorphisms were investigated. Furthermore, we examined gene-environment interaction (GxE) effects on natural log-transformed FeNO levels by adjusted linear regression models. RESULTS: While we observed no significant environmental and polygenic main effects on airway inflammation in either age group, we found robust harmful effects of chronic nitrogen dioxide (NO2) exposure in the GxE models for elderly women (16.2 % increase in FeNO, p-value = 0.027). Stratified analyses found GxE effects between the PRS and chronic NO2 exposure in never-smoker elderly women and in adolescents without any inflammatory respiratory conditions. CONCLUSIONS: FeNO measurement is a useful biomarker to detect higher risk of NO2-induced eosinophilic airway inflammation in the elderly. There was limited evidence for GxE effects on airway inflammation in adolescents or the elderly. Further GxE studies in subpopulations should be conducted to investigate the assumption that susceptibility to airway inflammation differs between age stages