bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterization of antibody response in asymptomatic and symptomatic SARS-CoV-2 infection
Authors: Marchi S 
Published: October 2021

Abstract

Background
SARS-CoV-2 pandemic is causing high morbidity and mortality burden worldwide. Mechanism of infection, protection or rapid evolution until fatal outcome of the disease remains poorly understood. To elucidate the dynamics of humoral response in SARS-CoV-2 asymptomatic and symptomatic infections, we performed a study to investigate the time course of antibody response in hospitalized COVID-19 patients and asymptomatic SARS-CoV-2 infected subjects.

Methods
Serum samples were collected from 42 hospitalized COVID-19 patients at 6 different time points (hospital admission, day 2, day 6, day 12-14, day 18-20, day 27-30) and from 25 asymptomatic subjects at 3 different time points (at the time of positive swab, 2 months, 6 months). Samples were tested by commercial ELISA for SARS-CoV-2 spike (S) protein IgA, IgM, and IgG and nucleoprotein (NP) IgG, and by micro-neutralization assay.

Results
In patients, titres increased for all antibody classes including neutralizing antibody from day 6 to day 18-20 but at day 27-30 started to decline. A high correlation between S and NP antigens and among antibody classes was found. No significant difference in antibody titres at baseline and by peak antibody level was found between recovered and deceased. 64.0% of asymptomatic subjects were negative to any antibody at any time point. Asymptomatic subjects with positive antibody level had titres well below patients, and neutralizing antibodies were found only in 2 subjects (8.0%).

Conclusions
Our results highlight that COVID-19 patients produce an antibody response to SARS-CoV-2 regardless the outcome. The peak is reached by 3 weeks from hospital admission followed by a sharp decrease. On the contrary, only few asymptomatic subjects develop antibodies at detectable levels, though lower compared to COVID-19 patients. Since neutralizing antibodies were rarely produced, this finding raises the question about the protection of these subjects against reinfection.

Key messages
COVID-19 patients produce an antibody response to SARS-CoV-2 which does not differ between recovered and deceased. Only few asymptomatic SARS-CoV-2 infected subjects develop antibodies and neutralizing antibodies were rarely produced.
Public health policies to tackle the growing burden of multimorbidity: a global agenda
Authors: Galea Gauden 
Published: October 2021

Abstract
The paper will provide a global perspective on current public health policies to tackle the growing burden of multimorbidity both in high-income and low-resource settings. Specifically, over the past two decades, there have been multiple stepwise approaches to non-communicable diseases (NCDs), the development of a process to link the prevention and control of NCDs to health systems, the compilation of evidence linking NCDs to the global development agenda, the implementation of life-course approaches to the prevention of multimorbidity around the world.
COVID-19 passes and public health law: Considerations for surveillance and social justice
Authors: Lingri D , Petelos E , Zeegers D , Valaris S , Favaretti C 
Published: October 2021

Abstract
The first panellist will focus on the jurists view on the legislative proposal on DCC, discuss proportionality of measure, incl. key considerations for DCC and PLF data combinations. A basic overview on the differences between vaccination, certificates, immunity passports and other passes, and the key characteristics of the DCC will be provided. Feasibility in terms of implementing acts across EU Member-States will be elaborated upon, incl. both potential expiry and revocation, as well as potential remedies in case of emerging issues, i.e., right to DCC, but no vaccine, strong contraindication against vaccination, known issues of reduced immunity despite vaccination, etc.
Critical aspects with relevance for both the European and the global dimensions, i.e., GDPR and data transfer agreements, secondary use of health data, human-rights' issues, implications for vulnerable groups, etc., will also be discussed.
Assessing policies for the implementation of new technological interventions to combat COVID-19
Authors: Prainsack Barbara 
Published: October 2021

Abstract
The second panelist will discuss policy and politics, incl. the role expert bodies and instruments of the European Union, assessing the role of the European Commission and the exchange frameworks with Member-States. In the context of elaboration on how optimal strategies for assessing the impact of new health technology and for evidence-informed policymaking, the role the European Group on Ethics in Science and New Technologies (EGE) will be discussed in more detail, as the independent expert group and multi-disciplinary body appointed by the President of the European Commission to advises on all policies where ethical, societal and fundamental rights issues intersect with the development of science and new technologies. Furthermore, broad long-term implications for globalisation and the relation of the EU to third countries will be examined, as will the significance of such measures for the European Union's Global Health Agenda, and the implications for future decision-making and policies in developing countries too.
COVID-19 registration in people with intellectual disabilities in Dutch long-term care facilities
Authors: Koks-Leensen M , Schalk B , Bakker-van Gijssel E , Cuypers M , van den Bemd M , Nägele M , Naaldenberg J , Leusink GL 
Published: October 2021

Abstract
This study aims to present a nationwide registration of COVID-19 in people with ID living in residential settings, in order to provide insight in COVID-19 epidemiology in this vulnerable group. In a health crisis as the current worldwide COVID-19 pandemic, it is crucial to gain knowledge about the new infectious disease and its effects on health. Identifying risk groups is important for adequate preventative measures and policy-making. People with ID generally have poorer health than others in the general population, with higher prevalence of co-morbidities, risk factors such as obesity, and higher excess mortality rates for infectious diseases. However, there is little reliable knowledge about specific risks and consequences of COVID-19 in the ID population as compared with the general population. To increase this knowledge a nationwide registration system for data on people with ID was set up in Dutch long term care facilities. The registration covered more than 6500 patients with (suspected) Covid-19 infection observed in 2020 and registration is still ongoing. Organizations registered data of their patients with either suspected or confirmed COVID-19 infection, regarding sociodemographics, medical history and COVID-19 infection characteristics. People with ID are vulnerable to COVID-19 at a younger age compared to people in the general population. Case fatality rate was 3-4 times higher among people with ID compared to the general population, and mortality was already higher in younger age groups (40 years and older). Their living circumstances matter: in group home living circumstances more infected people with ID were observed. The etiology of the ID, especially Down syndrome, is an unfavorable predictor. According to these findings, people with ID proved to be vulnerable for COVID-19. Policy makers and care providers should adequately account for this increased vulnerability of the ID population.
Evolution of Primary Health Care appointments in mainland Portugal in 2020
Authors: Gomes FA 
Published: October 2021

Abstract

Background
The COVID-19 pandemic has had an impact on the Portuguese Health Care System. During the first months of the pandemic, there was a great reduction in the number of health rendering services. (1) The aim of this study is to analyse the evolution of Primary Health Care appointments in mainland Portugal, during the whole year of 2020 and to compare it to the period of 2015-2019. The type of appointment and the number of users will also be characterized.

Methods
An observational, descriptive-retrospective, longitudinal, quantitative study was performed. ‘Portal da Transparência' was used as the source of free access data about the Portuguese National Health Service.

Results
The results which are here presented are comparing the year 2020 to the average of 2015-2019. In mainland Portugal, in 2020, there were 7% more Primary Health Care appointments (PHCA). Although there were less PHCA during the first five months of 2020, there was a rise in the number of PHCA since June 2020. In 2020, 59% were distance PHCA, a rise of 113% compared to the average of 2015-2019. There was a fall of 38% on presential PHCA in 2020. The number of presential PHCA was inferior in each month of 2020, in comparison to the homologous month of the average of 2015-2019. The month with less presential PHCA was April 2020 (less 72% than the average of 2015-2019). Regarding domiciliary PHCA, there was a 36% reduction.In mainland Portugal, the number of Primary Health Care users with, at least, one face-to-face or distance PHCA, in 2020 was 6,661,927, 3% less than the average of 2015-2019.

Conclusions
The transition from presential PHCA to distance PHCA that occurred in 2020 due to the COVID-19 pandemic allowed the follow-up of most of the patients. However, there is a need to assess if distance PHCA are as effective as presential PHCA and which are its effects in communities' health.
(1) Vieira A et al. Excesso de mortalidade, mortalidade colateral e resposta dos serviços de saúde em Portugal em tempos de COVID-19

Key messages
In 2020, in mainland Portugal, there was an increase on distance Primary Health Care appointments and a decrease on presential ones. Its impact on population’s health should be assessed.
Comparing health outcomes of care experienced children to children not in care in Scotland 2009-2016
Authors: Allik M , Brown D , Leyland AH , Henderson M 
Published: October 2021

Abstract

Background
Internationally, there is little quantitative evidence on how the health of children who have experienced social care compares to children in the general population. Invariably, available evidence suggests that care experience is related to poorer health, but often this is based on small sample sizes or without comparison to children who have not been in care. The Children's Health in Care in Scotland (CHiCS) study provides the first Scotland-wide evidence on health outcomes of care experienced children (CEC) compared to children in the general population (CGP).

Methods
We undertook an individual level administrative data linkage of social care, morbidity, prescribing, death and birth records from August 2009 to July 2016. The CEC cohort was defined as all school-age children who were in social care in 2009/2010 (n = 13,831) and the CGP cohort includes school-age children who were not in care (n = 649,771). Age-standardized rates per 1000 person-years were calculated for hospitalisation by cause, prescription types and cause of death for both cohorts.

Results
Initial results show that CEC experienced higher average rates of mortality, prescriptions, and different types of hospitalisations during the study period (not adjusted). There are substantial differences in the types of prescriptions and reasons for hospital admission between the cohorts; CEC are more likely to be prescribed antidepressants (rate of 260.2 per 1000 person-years for CEC compared to 114.4 for GCP) and to attend psychiatric outpatient appointments (rate of 163.2 compared to 32.6). Care experienced young women have higher rates of medical abortions (rate of 11.3 compared to 6.1).

Conclusions
The results from this study indicate that CEC are more likely to contact the health services, particularly for mental and sexual/reproductive health reasons, and these problems may track into adulthood. Interventions to reduce inequalities in health for CEC should focus on these areas.

Key messages
CEC had higher rates of mortality, prescriptions, and hospitalisations during the study period. CEC are more likely to contact the health services for mental and sexual/reproductive health reasons.
The Integrated Local Plan for Health Promotion of the Lombardy Region:a planning tool for prevention
Authors: Olivadoti S , Calloni L , Capriulo AP , Celata C 
Published: October 2021

Abstract

Issue
The Health Protection Agencies (ATS) of the Lombardy Region play a role in the governance through the technical-methodological support to achieve health objectives. Through Local Health Promotion Plans (PIL), ATS are tasked with programming campaigns for health promotion and prevention of NCDs at the territorial level, following regional (PRP) and national (PNP) guidelines. The PIL foster the integration of different sectors and activate non-health policies, through networks and stakeholders from different territories. The COVID-19 pandemic has further highlighted the need for an integrated and, intersectorial plan able to promote the development of partnerships, in order to focus more on the social and environmental determinants of health. This strategy guarantees responses to the needs of the population during an emergency, as well as equitable and sustainable prevention programs.

Description of the problem
As part of its planning activities, each ATS defines and annually updates the PIL according to a methodology consistent with the regional situation and, based on analyses of health and the equity context. Implementation of the PIL is part of the prevention performance indicators and it is monitored at the regional level through collaborative work networks encompassing, research, training and sharing of best practices.

Results
The comparative reading of the 8 PIL makes it possible to identify the contents defined in the various territories, highlighting of intersectorial relations present at the regional level. The mapping of interventions clearly highlights the settings in which the greatest number of resources are invested (school and work), thus becoming a tool for planning action programs in subsequent years.

Lessons
In addition to being a planning tool, the PIL allows the sharing of the local health profile and priorities with all territorial actors, becoming one of the tools in which the Health Profile is declined.

Key messages
The analysis of PIL is the starting point for the systemization of good practices, identifying possible organizational synergies and the preventive effects of the actions and programs implemented. Comparative reading of PIL allows for benchmarking of health promotion interventions.
Cross-domain collaboration: the Dutch Combined Lifestyle Intervention
Authors: Bekker M , Wagemakers A 
Published: October 2021

Abstract

Background
In the Netherlands, the policy-making process to realize funding for the Combined Lifestyle Intervention (CLI) by health insurance lasted twelve years. Since January 2019, the health care components of the CLI are covered by the Health Insurance Act. We aimed to identify policy design decisions, processes and implementation willingness and capacity of stakeholders.

Methods
We conducted an institutional policy analysis using backward mapping. We composed a timeline (2007-2019) based on public documents and interviewed 22 key stakeholders, representing policy-making institutions, care professions, health insurers and CLI-owners.

Results
Three main design decisions (out of 15) are: 1) including lifestyle coaching in the CLI.; 2) excluding the physical activity component for funding by health insurance and 3) health insurers and municipalities having own policies, resulting in a variety of contracts with health care providers and local differences in the CLI offer.
Decision-making was mainly based on scientific evidence. However, not all stakeholders were represented in policy-making. The CLI requires collaboration between care professionals and lifestyle coaches, a new profession linking the medical and social domain. Vested and new stakeholders faced competing interests, which tempered their willingness and capacity to implement the CLI.

Conclusions
The CLI sets a new standard - at the interface of indicated and selective prevention - by incorporating (non-medicalised) lifestyle coaching. Although the CLI is embedded in a single insurance-based scheme (instead of across domains), it institutionalizes cross-domain collaboration without providing the necessary resources. Collaborative prevention requires cross-domain trusting implementation networks, including vested stakeholders, field innovators and citizens, to avoid conflicts, and build adaptive and responsive prevention policies.

Key messages
Interventions in the field of prevention require incentives for collaboration based on cross-domain trusting implementation networks. Politics around collaborative prevention requires a balanced stakeholder level playing field to avoid conflicts around vested interests and to facilitate stable responsive prevention policies.
Impact of the COVID-19 pandemic on emergency healthcare utilization: a cohort study
Authors: Chou YC , Yen YF , Chu DC , Hu HY 
Published: October 2021

Abstract

Background
Emergency department (ED) crowding is a burden on public health, so understanding the characteristics of frequent ED users is a key concern of the healthcare system and policy makers. This study aims to examine the characteristics and healthcare-seeking behaviors in frequent ED users before and during the COVID-19 pandemic.

Methods
A retrospective observational study was conducted on ED users aged 18 years and over admitted to Taipei City Hospital in February 2019-January2020 (before pandemic) and February 2020-January2021 (during pandemic) (N = 120,011). Frequent and ED users were defined as patients with four or more ED visits in a year. Multivariate logistic regression was used to identify the predictors of frequent ED use before and during the COVID-19 pandemic.

Results
Monthly emergency department visits were significantly lower during the pandemic (by 10.1-26.8%). Frequent ED patients had shorter lengths of stay in the ED during the pandemic (212.5 vs.233.9 minutes; P &lt; 0.0001). The proportion of ED patients receiving chest CT examination during the pandemic has increased by 0.5-0.6%. After adjusting for sociodemographic factors, triage status, mode of arrival, and copayment exemption, patients with a triage status of level 4-5 (AOR=1.60, 95% CI: 1.13-2.28), diagnosis of pneumonia (AOR=1.85, 95% CI: 1.07-3.17), giddiness (AOR=2.85, 95% CI: 1.82-4.45), dyspnea (AOR=1.85, 95% CI: 1.00-3.39), or chronic kidney disease (AOR=5.05, 95% CI: 2.66-9.59) were more likely to be frequent ED visitors during the pandemic.

Conclusions
Since SAR-CoV-2 is highly contagious, it is imperative to educate non-emergent patients to utilize outpatient medical services rather than emergency medical services to reduce the risk of COVID-19 outbreaks at the ED.

Key messages
This study found that the utilization of emergent medical services during the COVID-19 pandemic significantly decreased by 10.1%–26.8% compared to before the COVID-19 pandemic. The lengths of stay in frequent ED users during the COVID-19 pandemic were significantly shorter than that in frequent ED users before the COVID-19 pandemic.
Changes of perceived risk and mental well-being during two waves of COVID-19 pandemic in Czechia
Authors: Dalecká A , Šlachtová H , Tomášková H , Maďar R , Skýbová D 
Published: October 2021

Abstract

Background
The COVID-19 pandemic has been negatively affecting many people's daily life. The strict preventive measures might have contributed to psychological distress, fear and fatigue. Therefore, it is crucial to build trust and ensure effective communication from the government to maintain public awareness. This study focuses on the comparative analysis of public health risk perception of COVID-19 during the pandemic.

Methods
The questionnaire surveys were conducted online during the first (April 2020) and second (November-December 2020) waves of the pandemics. The health risk concerns, perceived mental well-being and compliance with the adopted measures of the population were evaluate for potential development in time. The impact of age, gender and socio-demographic factors were tested. The average values of the 5-point Likert scale were tested for differences by Mann-Whitney and Kruskal-Wallis tests on the significance level 5% and analyzed using the SW STATA v.15.

Results
From a sample of 9,168 (1st survey) and 1,042 (2nd survey) Czech respondents aged 40 years, respectively 45 years in average, the present results showed that individual health concerns increased with age, while descending trend toward younger age was observed in terms of mental health. The perceived risk of COVID-19 substantially elevated over the observed period (p &lt; 0.001) as well as compliance with the measures (p &lt; 0.001). Further, 27% of the respondents self-evaluated their mental health as bad or very bad that was analysed as a significantly worsening (p &lt; 0.001). Moreover, 66% of respondents evaluated communication of the government as unsatisfactory that was in relation with a low compliance with measures.

Conclusions
This study contributes to understanding the development of the risk perception as a public response to COVID-19 pandemic. A divergence among the generation was observed. More focused communication of government might be required to enhance public trust.

Key messages
Compliance with the measures substantially elevated over the pandemics that is in relation with low government trust. Mental well-being has been significantly worsened over the COVID-19 pandemics.
Environment related practices for emergency response to infectious disease outbreak on cruise ships
Authors: Chrysikou E , Hernandez Garcia E , Savvopoulou E , Haldane J , Satoh H 
Published: October 2021

Abstract

Issue/problem
COVID-19 pandemic halted cruise operations globally. This project explored strategies and measures that could be adopted internationally for mitigating a disease outbreak on-board of a cruise ship by bringing evidence-based recommendations for an emergency response against current COVID-19 outbreak and future infectious threats.

Description of the problem
Research took place in October 2020-March 2021. Methods comprised of: a) consultation sessions with five international experts on public health, epidemiology, tourism and cruise management, b) both systematic and narrative literature reviews. Present guidance analysed why cruise ships promote an opportunistic environment for infectious outbreaks, along with a strategy for reducing the risks among passengers and crew.

Results
Results were organised under four main themes: a) advice on surface interactions and virus viability; b) prevention and control measures; c) suggestions on short and long term responses; d) advice on thermal and ventilation conditions and how they affect virus transmission. The guidance was very similar to other built environment contexts, ignoring the particularities of sociospatial interactions in cruise ships. Moreover, there was limited provision for the wellbeing and mental health during the outbreak.

Lessons
This project summarised recommendations for the preparedness of cruise ships during a pandemic from ports, off-board and on-board measures to repatriation. Demonstrated the importance of spatial characteristics in the preparedness of a ship. Pointed the effect pandemic can have upon crew and passengers. This needs to be taken into account when operations restart. Cruise experience would have to change due to covid-19, especially when social activity on board has to be restricted. The importance of future studies focusing on how this change will impact cruise industry arose, including crew hygiene, safety and supporting mental health during outbreaks.

Key messages
Multi-disciplinary approach on providing a set of recommendations for emergency response to infectious disease outbreak on cruise ships including environmental preparedness. Actions should include also the mental health of crew and passengers on copying with stress during infectious outbreaks.