bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of COVID-19 on School of Medicine students’ performance: an interrupted time series study
Authors: Palladino R , Affinito G , Triassi M 
Published: October 2021

Abstract

Background
The COVID-19 pandemic has profoundly challenged the whole educational system. Shifting towards emergency remote teaching (ERT) has raised questions about its quality and effectiveness, especially for those university students enrolled on courses including interactive learning and clerkship modules as well. Therefore, we employed an interrupted time series analysis, to assess the impact of lockdown (March 2020) and subsequent shifting to ERT on exam enrollments and performance for students at the School of Medicine of the University “Federico II” of Naples, one of the largest universities nationwide, between January 2017 and February 2021.

Methods
We extracted data from 49 course modules within 14 courses of study offered by the School. Multilevel linear models were employed to account for the hierarchical structure of the data (multiple exam sessions within each module). Model covariates were time, term, course of study, and gender.

Results
In the summer term 2020 there was a 23% increase in students enrolled on exams, as compared with the previous year (2019: 16,237; 2020: 20,091), with a 0.92% (SD 0.04) pass rate and an average mark of 26.39 (SD 2.64), as compared with the 0.89% (SD 0.78) pass rate and an average mark of 26.50 (SD 2.55) for the previous year. Considering the whole study period, we found that for the winter term following the national lockdown (March 2020) there was a 0.38 increase in the pass rate (coeff. 0.38; 95%CI 0.04,0.71), as compared with the period before the lockdown, which however was not sustained over time (slope change: -0.04; 95%CI -0.09, 0.00). No differences were found when considering changes in the average exam mark (step change: -1.38; 95%CI -2.83,0.07, slope change: 0.03; 95%CI -0.01,0.06).

Conclusions
Although students promoted the online examination method as part of the ERT considering the increase in enrollment and the initial increase in pass rate, this change was not sustained by an improvement in their performance.

Key messages
The shifting toward emergency remote teaching as educational system response to COVID-19 in Italy has increased exam enrollment but not students’ performance at School of Medicine. Ensuring high quality of teaching during emergencies is fundamental. Mixed-methods follow-up studies should be conducted to evaluate students’ perception and identify ways for quality improvement.
The effect of temperature on the dynamics of the COVID-19 pandemic: the BERLIN example
Authors: Yapar D , Yanik C , Ozkan S 
Published: October 2021

Abstract

Background
Studies have shown, ambient temperature can affect the transmission and survival of coronaviruses. This study aimed to determine whether the number of COVID-19 cases and 14-day fatality rates (FR) in Berlin are associated with temperature.

Methods
Within the scope of this study, a total of 240 days of Berlin belonging to the dates 28.08.20- 24.04.21 were examined. Daily highest temperature, lowest temperature, daily average temperature, number of daily cases, number of deaths were accessed free from the berlin.de and weather.com site. In addition, the incubation period of COVID-19 was assumed to be 14 days, and the fatality rates of 14 days and the average temperatures of these days were calculated. The relationship between the data was evaluated with the Spearman correlation test.

Results
When the 240 days are examined, the average daily temperature varies between -7.5- 23.5 °C, the fatality rates of 14 days vary between 0- 7,3%. The period with the highest fatality rate of 14 days is between 29.1.21-11.2.21 (FR = 7.3%) and the average temperature of this period (-1.8 °C) is the 14 days with the lowest average temperature. Very strongly negative relationship (r = -0.920; p &lt; 0.001) was determined between FR and 14-day average temperature. It was noted that as the daily temperature decreased, the number of deaths per day (r = -0.695; p &lt; 0.001) and the number of daily cases (r = -0.296; p &lt; 0.001) increased. 1 °C decrease in temperature was associated with an increase in daily new deaths by 1.29 (B = -1.29, 95% CI: -1.55, -0.1.09; p &lt; 0.001, Adj. R2 = 0.3).

Conclusions
Our analysis results showed that the number of COVID-19 daily cases and 14-day fatality rate increased with a low temperature in the Berlin sample.

Key messages
Temperature showed a negative correlation between COVID-19 fatality rate. Further evaluation may be required globally with more data to determine temperature and COVID-19 cases.
Risk factors for admission to ICU among COVID-19 patients: A 6-month observational study in Spain
Authors: Arana-Aragón BM , Rueda-Nieto S , San Lázaro-Campillo I , Monteagudo JF , Zapata-Castaño N , Fernández-Paniagua L , Baumela-Puertas A , Torres-Cantero AM 
Published: October 2021

Abstract

Background
Admission to the Intensive Care Unit (ICU) is one of the most used indicators to estimate the magnitude of the current COVID-19 pandemic. This study was performed to assess the relationship between demographic, lifestyles and comorbidity factors on the severity of patients with SARS-CoV2 infection.

Methods
An observational study including data from the regional surveillance dataset on acute respiratory infections from September 2020 to February 2021 in one large tertiary hospital in Murcia, Spain. Demographic, clinical and lifestyle factors were collected. A descriptive analysis was carried out using SPSS. Chi-square tests were performed to assess the relationship between comorbidities and lifestyle factors. Binary logistic regression was calculated to estimate the probability of being admitted to ICU. Analysis were adjusted by sex, age, and lifestyle factors.

Results
Overall, 906 patients with COVID-19 were identified. The mean age was 64.3 years (SD = 16.5 years), and 523 of the patients were male (57.7%). A total of 104 (11.5%) patients required admission to ICU and 142 (15.7%) died during the hospitalisation process. The average length of stay at the hospital was 8 days (SD = 6). Acute renal failure (OR = 7.7; 95% CI: 1.7-33.0), being a smoker (OR = 7.02; 95% CI: 2.7-19, 0) and suffering from obesity (OR = 3.5; 95% CI: 1.2-10.3) were the main risk factors associated with admission to ICU.

Conclusions
Acute renal failure, obesity, and smoking were strongly associated with both severity and admission to intensive care among patients with COVID-19 infection. More research needs to be done to assess the role of these underlying factors in the severity of COVID-19 infections.

Key messages
The design of predictive models for ICU admission during the COVID-19 pandemic should be promoted. Features associated to vulnerability in COVID-19 patients must be identified.
Change of life habits and applying barrier measures after exposure to COVID-19, Mahdia (Tunisia)
Authors: Ben Youssef F , Sfar H , Omri N , Mlouki I , Jendoubi Med Hedi , El Mhamdi S 
Published: October 2021

Abstract

Introduction
The COVID-19 pandemic is causing considerable lifestyle changes through barriers measures, lockdown and social distancing. These changes include: Preoccupation with Covid-19 pandemic news, sleep disturbances and eating habits changes.

Aim
To assess the lifestyle changes after exposure to a risk of coronavirus contamination.

Methods
We conducted a cross sectional study during November and December 2020 among adults tested for COVID-19 in Mahdia (Tunisia).To assess the life habits changes (sleep, physical exercises and diet), the compliance with barrier measures and preoccupation with COVID-19 pandemic news, a reliable tool was developed and pretested by experts at the department of Preventive and Community Medicine

Results
A total of 277 participants were enrolled, the average age was 34.32 years ± 13.7. Among them 60.8% were women (sex-ratio = 0.51).Almost two thirds 62.2% were tested positive for Covid-19. Doctors presented 29.2% of the respondents. Among the study sample, 38.6% lived with elderly people. Approximately three quarters 77.8% reported an improvement in compliance with barrier measures. The majority 92.1% respected more the social distancing. As for hand washing and for mask wearing, 87.7% said to wash their hands more, and 95.3% were more concerned about wearing masks. A life habits change was observed among 16.7% of the respondents. Almost half of the participants 45.5% increased their physical activity, while 76.2% tried to get a healthy diet. Sleep disorders were registered among 48.7% of respondents. Preoccupation with the COVID news was observed in approximately half of the participants (57.8%).

Conclusions
The COVID19 pandemic affected different aspects of our lives. Research related to lifestyle, social and behavioral studies are as important as those related to medical and biological science.

Key messages
A life habits change was observed among 16.7% of the respondent, sleep disorder were registered among 48.7%, and 77.8% reported and improvement in applying barrier measures. Research related to lifestyle, social and behavioral studies are as important as those related to medical and biological science.
The Impact of Covid-19 Pandemic on Family Cohesion. Results from an International Study
Authors: Tsoutsi V , Dikeos D , Papadakaki M 
Published: October 2021

Abstract

Introduction
The lives and relationships of many have been influenced by changes imposed by Covid-19, especially the strict lockdown which was imposed during the first months of the pandemic. The aim of the current study was to document how the pandemic affects family relations.

Methods
Participants from 46 countries were asked to complete an online survey including the Penn State Worry Questionnaire (PSWQ) and the newly devised Athens family cohesion scale (AFCS), comparing the periods before and during the pandemic.

Results
Two-thirds of the participants (N = 481) were women; mean age 36.7 ±14.6 years old. Mean score of the PSWQ was 50.6 ±13.1. Worsening of family cohesion was reported by 22% of the participants, while 40.7% reported a better family cohesion after the pandemic started. Total score of AFCS was correlated negatively with PSWQ by linear regression analysis of AFCS on sex, age and PSWQ (beta= -0.058 ±0.023, p = 0.012), showing that family cohesion was better the lower the worry. Change of family cohesion was not found to be correlated to PSWQ nor to total score of AFCS.

Conclusions
Family cohesion during the pandemic seems to be related to the level of worry of the reporting individual; in the majority of cases family cohesion did not change (neither improved nor deteriorated) during the lockdown.

Key messages
Family cohesion generally is unchanged under strict situations such as the lockdown. Family cohesion is related to the levels of worry as reflected in the Penn State Worry Questionnaire.
HTA of novel biocontainment systems for ambulance transport: public health implications
Authors: Corradi M , Cattaneo A , Plicco C , Bossi E 
Published: October 2021

Abstract

Background
Biocontainment systems in healthcare settings are intended to ensure isolation of contagious or potentially contagious patients so as to protect healthcare providers and control infection spread. The need for safe and effective biocontainment systems has emerged during the COVID-19 outbreak. In particular, transport of potentially contagious patients poses technical, logistical and medical challenges that are to be addressed to protect population health and enable safe healthcare services delivery.

Methods
As novel biocontainment systems become available it is important to assess their operational effectiveness and safety and to define their organizational impact. We applied the Health Technology Assessment (HTA) framework to evaluate a novel rigid bio-containment system (Billy-Cab) integrated with the stretcher support, for ambulance transport of contagious patients.

Results
We applied the EUnetHTA core model to conduct an HTA report of Billy-Cab. A multi-disciplinary working group was established. We assessed available biocontainment under the nine dimensions of the EUnetHTA core model. We derived and pooled: 1) original data derived from clinical practice, 2) secondary data derived from systematic reviews of the literature, conducted according to the PRISMA guidelines, 3) original data derived from validated questionnaires, 4) economic original data.

Conclusions
Preliminary data allow to conclude selected biocontainment systems are effective in ensuring infection control during ambulance transport, with manageable organizational impact. In addition, the use biocontainment systems positively influence healthcare professionals' attitudes and performances. The HTA methodology offers substantial support to evaluate the introduction of innovative technologies during health emergencies and beyond.

Key messages
Selected biocontainment systems are effective in ensuring infection control during ambulance transport. HTA is to be applied to evaluate the introduction of innovative technologies during health emergencies and beyond.
Association of health professionals with Burnout Syndrome in Veracruz, Mexico
Authors: Villegas Dominguez J , Cruz Ramirez MZ , Yepez Ricardez MI , Quintana Neria A , Juventino Dorantes IC , Marquez Celedonio FG 
Published: October 2021

Abstract

Background
Inside the COVID19 pandemic, health personnel have modified their daily way of working, for which they have been exposed to greater risks that could facilitate the presence of burnout in them.

Objective
To determine the association of health professionals with burnout syndrome in Boca del Rio, Mexico.

Methods
This study was observational, cross-sectional, prospective, and analytical, during the period February-April 2021. Subjects residing from Boca del Rio, Mexico, older than 18 years with a formal job, were included. To measure the Burnout Syndrome, the MBI (Maslach Burnout Inventory) questionnaire was used, which measures emotional exhaustion, depersonalization and personal fulfillment. A non-probability sampling was carried out.

Results
240 subjects were included, 113 (54.6%) men, 110 (45.8%) married and 117 (48.75%) from the health area. The general prevalence of burnout was 10%. The factors associated with Burnout were being a professional with an OR of 8.68 (95% CI 2.53-30.21), as well as the male sex who registered an OR of 2.63 (95% CI 1.08-6.44), both with p values &lt;0.05. The work seniority resulted with values of p &gt; 0.05. Being health personnel, registered OR of 31.7 (CI95% 14.2-73.2) for emotional exhaustion at high level, OR of 11.8 (CI95% 6.15-23.4) for depersonalization at high level and OR of 0.3 (CI 95% 0.2-0.5) for personal fulfillment at a high level, all of the above with a value of p &lt; 0.05

Conclusions
being a health worker during the COVID19 pandemic increases the probability of suffering from burnout

Key messages
Being a health worker during the COVID19 pandemic increases the probability of suffering from burnout. Being a health person increases emotional fatigue, depersonalization and reduces forgiving fulfillment.
Brazil: The impact of the epicenter of the COVID-19 pandemic among medical doctors
Authors: Guimarães-Teixeira E , Machado MH , Freire N , Tardim J , Murta J , Rocha AC , Cunha D , Parente V 
Published: October 2021

Abstract

Health-care workers (HCWs) on the frontlines of the 2019 Coronavirus Disease 2019 (COVID-19) have a high risk of acquiring and dying from the disease. Brazil is a country with high morbimortality and ranks highest in general mortality from COVID-19. A large proportion of medical doctors (MDs) is dying, impacting in the workforce. As part of the research by Fiocruz on working conditions among HCWs, we have conducted this study of death among MDs. We analyzed data from Federal Council of Medicine, the only national platform with details about deaths in MDs. A broad search of other sources, including the Ministry of Health, was done, but unfortunately, the data does not exist. A total of 622 MDs died from March 2020 to March 2021: 87.6% male and 75% over age 60. The Southeast had the highest percentage (34.7%), followed by the Northeast (27.2%), and rankings by state showed Rio de Janeiro (15.8%), followed by São Paulo, Pará, Paraná and Paraíba, totalizing 50.1%. The specialties with highest mortality were gynecology (12.2%), pediatrics (10.0%), internal medicine (9.3%), general surgery (7.8%) and cardiology (7.6%). May 2020 was the month of worst mortality (16.9%) followed by July and June. A slow decline was observed until October, when Brazil begun to experience the “second wave”. The vaccination of MDs began at the end of January 2021 and has not been sufficient time to evaluate the impact on morbimortality. The results of a study of 50 professional categories are under analysis and will be published soon as well as a study of “invisible” HCWs, who do not have specific training but are essential to supporting health care system, from primary care units to high-complexity hospitals. We hope that the results of these studies will improve links among managers, those who define public policies, and union leaders, achieving better workplace and living conditions, minimizing health and socioeconomic disparities.

Key messages
This study is about death by COVID-19 among medical doctors in Brazil, as part of a large one on professional categories, essentials to supporting health care system, conducted by FIOCRUZ. This stdy is part of a large one on professional categories, essentials to supporting health care system, conducted by FIOCRUZ.
Female mortality associated with HIV-infection: social context
Authors: Ivanova AE , Semyonova VG , Zubko AV 
Published: October 2021

Abstract

Against the background of the increased HIV-associated mortality in Russia, more negative trends are being registered in females. However, the social grounds for these dynamics are yet to be investigated. The study used official Rosstat mortality statistics and the European standard population to calculate age-specific and standardized indicators of HIV-associated mortality. To analyze socio-demographic status of HIV-related deaths, the authors used the Moscow Death Information System (RFS-EMIAS), based on data from medical death certificates issued by medical organizations in Moscow. In Russia, for over 15 years, until 2019, the increased HIV-associated mortality had remained unchanged with higher rates registered in females. The gender mortality ratio suggests that young people aged 15-30 are the least advantaged population group with similar female and male death rates. Regional differences in HIV-associated mortality in Russia are huge adding up to 10-fold. HIV-unfavorable and relatively advantaged regions hardly differ in gender distribution, meaning that factors determining HIV-related epidemiological situation in the region are universal without any gender specifics. Medical status of HIV patients: a combination of socially-significant pathology (Hepatitis C, drug addiction, Tuberculosis) with delayed treatment are closely related to the social status: usually, low education, unemployment or employment in low-skilled labor, and loneliness. The socio-demographic profile of HIV-associated deaths is gender-neutral without any significant differences between sexes in terms of education, unemployment or loneliness. The results may suggest that HIV-infection is a filter, more significant in terms of the risk of getting sick and falling victim of HIV-infection rather than gender specifics. Grounds for negative dynamics in the female HIV-associated mortality are rather determined by other factors than socio-demographic status.

Key messages
The socio-demographic profile of HIV-associated deaths is gender-neutral without any significant differences between sexes in terms of education. Grounds for negative dynamics in the female HIV-associated mortality are rather determined by other factors than socio-demographic status.
An age grouped time-varying compartmental model for CoViD-19 vaccination strategy
Authors: Cartocci A , Messina G , Nante N , Cevenini G , Barbini P 
Published: October 2021

Abstract

Background
Compartmental models are the simplest in the mathematical study of infectious disease dynamics. Using an age-stratified compartmental model allows us to understand which population groups to target and to what extent to act, in order to achieve predefined goals in line with policy and/or health choices. In fact, the vaccination strategies of most countries are age dependent. With this study we want to show that the optimal vaccination strategy should be different depending on the type of health or social objective to be achieved.

Methods
A time varying susceptible-infected-recovered-deceased (SIRD) compartmental models, stratified into ten age groups of ten years was developed on Italian data. An optimal vaccination strategy was obtained minimizing deaths or infectious starting from April 11, 2021, considering the total doses due to Italy by the European contract for each type of vaccine from April to June. The efficacy of each vaccine and the days between administration and the beginning of immunization were also considered.

Results
On April 11, about 75% of over-80 Italian population have received at least the first dose of vaccine. Concerning the minimization of death, the model gives the priority to the older people (&gt;60-year-old). This confirms the Italian vaccination strategy by completing the remaining vaccinations of over-80s and then vaccinating those between 60 and 80. Instead, if the priority were to reduce the infected, the model would recommend vaccinating the most of over-80s and the classes aged 20-30 and 40-60.

Conclusions
In conclusion, the use of this model can help to vary vaccine strategies by adopting targeted approaches to effectively achieve specific objective. For example, given the different age destination of some vaccine types, a good vaccination strategy might have been to vaccinate the over 90s with one type of vaccine to protect them from high risk of death while simultaneously vaccinating younger people to contain the spread.

Key messages
The modelling approach is an excellent decision support tool for pandemic containment. The compartmentalized model stratified by age allows to act more efficiently on subpopulations.