bluuebunny/crossref_metadata_2025_split huggingface dataset:
Covid-19 vaccination in a teaching hospital in Rome: preliminary results from a retrospective study
Authors: Pascucci D , Nurchis MC , Castrini F , Sapienza M , Vetrugno G , Staiti D , Cambieri A , Ricciardi W , Damiani G , Laurenti P 
Published: October 2021

Abstract

Healthcare workers (HCWs) are on the frontline fight against the ongoing pandemic with an increased risk of infection from COVID-19. As of December 27, 2020, approximately 89,879 COVID-19 cases had been reported among HCWs in Italy. Vaccination plans recommend that initial supplies of COVID-19 vaccine be allocated to HCWs because their early protection is crucial to preserve capacity to care for patients. The aim of this study is threefold: to investigate the factors influencing the likelihood towards vaccination, to estimate the vaccine efficacy (VE) in a hospital setting and to assess the frequency of adverse reactions (AR). This retrospective study was conducted in an Italian teaching hospital from December 28, 2020 to March 31, 2021 (before the introduction of mandatory vaccination for HCWs). A total of 6,649 individuals was included. HCWs were divided into physicians, nurses and other HCWs. Univariate analyses and a multivariate logistic regression were run with an alpha of 0.05. VE was estimated as the proportionate reduction in disease attack rate between the unvaccinated and vaccinated. Out of 6,649 HCWs, 5,162 were fully vaccinated against COVID-19. Among the selected job categories, 82% of physicians, 79% of nurses and 68% of other HCWs were vaccinated. The findings of the logistic regression depicted that the 41-60 years old age class, compared with the youngest age class, was statistically significant (OR 1.17, 95% CI 1.03-1.33) in influencing vaccination, as well as being nurses (OR 0.80, 95% CI 0.69-0.92) or other HCWs (OR 0.45, 95% CI 0.39-0.52) in comparison with physicians. VE equaled 92.83% (p &lt; 0.05). The frequency of serious and not serious AR was 0.03% and 2.9%, respectively. Sustaining and boosting COVID-19 vaccination campaigns is effective for preventing SARS-CoV-2 infection in real-world conditions. COVID-19 vaccination among HCWs is a critical public health measure to safeguard HCWs themselves, patients and the hospital community.

Key messages
In light of the encouraging efficacy and safety of COVID-19 vaccination, it represents an essential strategy to protect HCWs themselves, their patients and the hospital community. Despite the introduction of mandatory vaccination, policy-makers should set up tailored strategies of clear communication to reduce reluctancy to vaccination among HCWs.
Comparison of SARS-CoV-2 RNA clearance between elderly and young patients with COVID-19
Authors: Zemni I , Bennasrallah C , Dhouib W , Ben Hassine D , Ben Fredj M , Kacem M , Abroug H , Klii R , Bouanene I , Belguith Sriha A 
Published: October 2021

Abstract

Background
The SARS-CoV-2 outbreak in 2020 caused a highly transmissible disease with a significant impact on the elderly. Understanding viral clearance duration of COVID-19 is important to tailor prevention strategies to this vulnerable category. We aimed to investigate the SARS-CoV-2 infection duration and associated factors to prolonged viral clearance among elderly people comparatively to young people.

Methods
We conducted a cohort study of asymptomatic and mild forms of COVID-19 patients admitted to the designated national COVID-19 center in Monastir, Tunisia. Patients included in the study were divided into two cohorts: (elderly group: ≥ 60 years old) and (young group: &lt; 60 years old) and were followed up to their RNA viral conversion. Stratified cox regression was performed to determine associated factors with prolonged viral SARS-CoV-2 RNA clearance in elderly subgroups.

Results
The study included a total of 289 patients with asymptomatic and mild forms of COVID-19. The median term of viral shedding was 20 days (IQR; 16 - 32 days) for the young group, and 21 days (IQR; 17 - 33 days) for the elderly group. The stratified cox regression showed that Age ≥ 60 was an associated factor to prolonged viral shedding in male sex (HR (Hazard Ratio): 1.91; 95% CI: 1.19 - 3.07) and patients with comorbidities (HR:1.68; 95% CI: 1.02 - 2.75) especially diabetics (HR: 2.06; 95% CI: 1.01 - 4.21).

Conclusions
This study, focused on the factors associated with a prolonged duration of viral RNA clearance in elderly with COVID-19. These Potential factors will help planners to chalk out effective strategies among this vulnerable category.

Key messages
Old age is associated with a prolonged duration of viral RNA clearance in specific subgroups. Identifying these subgroups is important to know how prioritize preventive strategies in elderly.
Validation of the 12-item HIV-stigma scale adapted for use among Tunisian COVID-19 patients
Authors: Mlouki I , Zammit N , Ben Fredj S , Ghammem R , El Echi A , Bannour R , Bennasrallah C , Maatoug J , Ghannem H 
Published: October 2021

Abstract

Background
Although, there is a rapidly accumulating body of studies on the various aspects of COVID-19, little interest was given to develop valid specific scales measuring COVID-19-related stigma. The current study aims to testvalidity and reliability ofa modified version of the 12-item HIV Stigma Scale, adapted for adults with COVID-19 infection living in the region of Sousse (Tunisia).

Methods
A cross sectional study was conducted among patients with COVID-19 infection between November and December 2020. The 12-item HIV stigma scale was translated in Arabic and then adapted to the Tunisian context. A preliminary version with twenty items covering the four dimensions of COVID-19 stigma was tested (Personalised stigma, disclosure concerns, concerns with public attitudes and negative self-image). The psychometric evaluation included internal consistency as well as principal component analysis (PCA).

Results
Responses of 346 COVID-19 patients were obtained.Among participants, 60.4% were women with a median age of 40 years (interquartile range, 30 to 54.5 years). Evidence for internal validity was supported by a PCA, suggesting a three factor solution with fourteen items. The 14-item scale demonstrated good internal consistency. The global Cronbach'sα was 0.91, with values of 0.94, 0.93 and 0.98 for social stigma, negative self-image and disclosure concerns respectively.

Conclusions
The results suggest construct validity and reliability of the 14-item stigma scale measuring three aspects related to COVID-19 infection in Tunisia.

Key messages
The 14-item stigma scale is a good psychometric tool to be used in assessing COVID-19 related stigma in Tunisia. Monitoring COVID-19 stigma with a valid and reliable would guide its prevention actions.
Smoking cessation adherence:recurrent cardiovascular events after five years of first manifestation
Authors: Bannour R , Abroug H , EL Hraiech A , Mehrez O , Ben fredj M , Zemni I , Bennasrallah C , Kacem M , Sriha A 
Published: October 2021

Abstract

Background
Smoking is an established risk factor for cardiovascular events, such as myocardial infarction, stroke and cardiovascular death. Although the harmful effects of smoking on health are widely known. Smoking is highly addictive and cessation can be extremely difficult, even after a life-threatening vascular event.

Objective
The present study aimed to assess the relation between smoking status and risk of recurrent Cardiovascular events 5 years after the first hospitalization for acute coronary syndrome.

Methods
A cross sectional study was conducted in the Smoking Cessation Service at University Hospital of Monastir, Tunisia during February 2020. The smoking status and recurrent cardiovascular events were assessed 5 years after the first hospitalization for acute coronary syndrome by phone call among patients attended the tobacco cessation consultation. The statistical analysis was conducted with SPSS software, version 21.0. A p value of &lt; 0.05 was considered statistically significant.

Results
A total of 112 patients were included in our study. All participants were male and the mean age was 56 ±10 years. Most patients (67%) had a high level of nicotine dependence. The rate of smoking abstinence declined from 35.7% at one year to 21.1% at 5 years. During the study period, 4 patients died(3.5%) and 17 (15.17%) had a recurrent cardiovascular event. The recurrent cardiovascular event occurred more in smoking patients but the difference was not significant.

Conclusions
Smoking cessation after a first cardiovascular event should be a key objective for both patients and physicians to reduce the risk for recurrent vascular events. More efforts are needed to maintain smoking cessation in patients at very high cardiovascular risk.

Key messages
Smoking cessation consultation can increase adherence to smoking cessation and helps in reducing the excess risk of recurrent cardiovascular events. Smoking is highly addictive and cessation can be extremely difficult, even after a life-threatening vascular event.
Virulence and antibiotic resistance of Klebsiella pneumoniae strains isolated from wastewater
Authors: Cornacchia A , Centorotola G , Saletti MA , Ciarrocchi A , Marfoglia C , Manzulli V , Galante D , Rodrigues C , Brisse S , Pomilio F 
Published: October 2021

Abstract

Background
Multidrug-resistant Klebsiella pneumoniae (Kp) strains are considered a global public health threat. The aim of the present study was to assess the occurrence of resistant and virulent Kp in Italian environmental wastewater, in order to evaluate the contribution of wastewater as reservoir of virulent and multidrug-resistant bacteria.

Methods
Forty samples of wastewater were collected in six sampling sessions from June to November 2018 in Central Italy and processed to detect Kp. All the presumptive Kp colonies isolated were identified by MALDI-TOF MS (Bruker Daltonics, Germany), then the genome sequences of all the confirmed Kp were obtained using Illumina Sequencing. Finally, characterization of virulence and resistance genes was performed in silico using the BIGSdb-Kp database provided by the Institut Pasteur (http://bigsdb.web.pasteur.fr).

Results
Kp was detected in 32 out of 40 samples (80%) and all strains were confirmed as Kp by MALDI-TOF MS. Genotyping analysis showed that besides the native bla-SHV, bla-LEN, bla-OKP genes linked to β-lactams resistance, gyr and par genes, involved in quinolone resistance, and no other resistance genes were detected. Regarding virulence, all strains carried the fimbriae encoding gene mrk, associated with adhesion and biofilm formation. The ferric aerobactin receptor iutA was harbored by 3 strains (9.4%). The siderophore Yersiniabactin locus (ybtS, ybtX, ybtQ, ybtP, ybtA, irp2 irp1, ybtU, ybtT, ybtE, fyuA), essential for iron scavenging, is carried by 7 out of 32 strains (21.9%).

Conclusions
Our results showed a high prevalence of Kp in wastewater that also harbored several resistance and virulence genes. These results make interesting to investigate more about wastewater as hot spots of enrichment, recombination, genetic exchange and selection of antibiotic resistant “super-bugs” that persisting and surviving in the environment could be a health risk for humans and animals.

Key messages
Wastewater could play a role as Klebsiella pneumoniae reservoir of virulence and resistance genes that can disseminate into wildlife and reach humans. It’s necessary a “one health” approach to deeply investigate about the presence of superbugs bacteria in the environment and the possible risks for human health.
Changing epidemiology and trends in incidence of oesophageal cancer in England, 1985-2017
Authors: Chimba C , Bannister P , Memon A 
Published: October 2021

Abstract

Background
The incidence of oesophageal cancer has been steadily increasing over the past 30 years in many countries. The UK has the highest incidence of oesophageal adenocarcinoma in the world which is associated with obesity and gastro-oesophageal reflux disease. The study aimed to determine trends in the incidence of oesophageal cancer in England between 1985-2017.

Methods
Individual-level data for patients diagnosed with oesophageal cancer in England were obtained from the Office for National Statistics/Public Health England. The national population-based cancer registry data were analysed to determine changes in oesophageal cancer incidence (ICD-10 code: C15) by sex, age (0-49, 50+) and histological subtype. Percentage change in incidence rates was calculated using the change in average annual incidence rate from the first (1985-89) to the last time period (2015-17).

Results
During the 33-year study period, 199,489 cases of oesophageal cancer were registered in England (63.5% males, 36.5% females) with adenocarcinoma accounting for 50.9% of cases. The average annual number of cases increased from 4595/year in 1985-89 to 7612/year in 2015-17. The average annual incidence rates increased by 42%, from 9.7/100,000 in 1985-89 to 13.8/100,000 in 2015-17. The incidence of adenocarcinoma increased by 77%, from 4.6/100,000 in 1985-89 to 8.1/100,000 in 2015-17. The incidence of squamous-cell carcinoma was unchanged. The steepest increase in adenocarcinoma was observed in males (more than two-folds as compared to females).

Conclusions
Over the study period, there was an increase in the incidence of oesophageal cancer in England. The largest increase was seen in rates of adenocarcinoma. Considering obesity has a strong temporal association with oesophageal adenocarcinoma, further research is needed to understand the biological mechanisms of this association to inform public health efforts to reduce the prevalence of obesity.

Key messages
Further research and analysis of routinely collected data on histological subtypes of oesophageal cancer can provide insight into the increasing trend in incidence. Considering the strong association between obesity and oesophageal adenocarcinoma, this research highlights the benefits of reducing the prevalence of obesity.
Has the national fall in smoking rate in Ireland been replicated in cancer patients? a 5-year report
Authors: Bhardwaj N , Fox P , Frazer K , Lyons A , Doherty K , Fitzpatrick P 
Published: October 2021

Abstract

Background
Population smoking rates are falling in Ireland, however many cancer patients continue smoking post diagnosis, despite its association with poorer treatment and clinical outcomes. As part of a feasibility study of smoking cessation for cancer patients in Ireland, a review of smoking rates in cancer patients was undertaken.

Methods
The Hospital Inpatient Enquiry system (HIPE), a national database which collects administrative, demographic & clinical data on discharges from public hospitals in Ireland, provided data (2014-2018) on smoking status of adult discharges with a cancer diagnosis (overall, breast, lung, cervical and head & neck (H&N). Smoking trends were compared with Healthy Ireland data (2015-2018), from a national survey for adults on health & wellbeing.

Results
During 2014-18, current smoking rose for all cancers (10.5%-11.4%), cervical cancer (11%-19.8%) and initially (2014-2016) for H&N (3%-12.7%) and lung (24.7%-27.2%), which dropped to 7.6% and 24% respectively in 2018; breast was stable at 6 ± 0.6%. Rates are lower than the general population (23%-20%). During 2014-17, past smoking rates demonstrated an upward trend among all cancers and specific cancers, with the highest prevalence among lung (30.3-39%) and lowest among breast (7.3-11%); comparative general population data was 23-28%. Current smoking rates for all cancers were highest among 50-59-year-olds (14-16%), which contrasts with the general population (24-35 years at 32-28%). Current and past smoking rates for all cancers were consistently higher among males, similar to the general population.

Conclusions
HIPE data is limited by duplicate episodes of care, and it is recognised that smoking documentation may be an underestimate. However, it is useful to analyse trends, as these limitations should be stable over the 5-year study period. Rates remain high; our further research will document barriers and facilitators to smoking cessation among cancer patients.

Key messages
Smoking rates in cancer patients are high despite proven benefits of smoking cessation. Supportive smoking cessation services as part of routine cancer care are indicated.
Quantifying the burden of premature mortality at national level in France in 2016
Authors: Haneef R , Constantinou P , Rachas A , Ghosn W , Kudjawu Y , Grave C , Torres M , Fayad M , Ung A , Bonaldi C 
Published: October 2021

Abstract

Background
Efforts to accurately measure premature mortality are important to monitor the impact of diseases and injuries on population health and to set policy priorities. This is an ongoing study with a strong collaboration between Santé Publique France and the French National Health Insurance, whose main objective is to provide the first national estimates of Years of Life Lost (YLLs) for all causes of death in France.

Methods
The French national health data system (SNDS) contains detailed nationwide causes of death data, reported using ICD-10 codes. We used the underlying cause, as defined by the Center for Epidemiology on Medical Causes of deaths, of all deaths for year 2016 (the last year available). For this preliminary study without redistribution of ill-defined deaths (IDDs), national sex-specific life expectancy tables were used to estimate YLLs by age class, sex, and cause of death categories at national level. We identified and quantified IDDs and also compared YLLs to crude mortality.

Results
In 2016, we estimated approximately 7.3 million YLLs (586,519 registered deaths), of which 35.1% were due to neoplasms, 17.8% to cardiovascular diseases (respectively 34.5% and 17.3% in men; 35.8% and 18.4% in women) and 10.3% to injuries (4.9% among people aged 65 or more at time of death; 34.5% among people aged 25-44). Approximately 27% of the deaths registered were IDDs, representing approximately 1.8 million YLLs.

Conclusions
These preliminary results confirm the importance of YLLs as a metric to target preventive strategies according to age. Moreover, by quantifying IDDs, we highlight that data gaps are important even in settings with highly developed health information systems. Next steps include applying an IDD redistribution methodology, aspirational life table and computing subnational YLLs. The French collaborative initiative should address those gaps and propose national and subnational burden metrics in the following months.

Key messages
Methodological and data requirements to compute YLLs constitute a challenge even in settings with developed health information systems, highlighting the need of national institutional collaborations. Highlight data gaps in terms of ill-defined deaths in mortality database.
Participation in Population-based Research: A Qualitative, Intersectional Perspective
Authors: Merz S , Jaehn P , Holmberg C 
Published: October 2021

Abstract

Background
Intersectionality scholarship in public health research aims at making visible the interrelated and co-dependent nature of the social determinants of health and illness. Research examining participation in population-based studies has not yet fully integrated this perspective into the analysis such that social heterogeneity remains largely hidden. The interdisciplinary research project AdvanceRecruitment focuses on participation in the German National Cohort (GNC) from an intersectional perspective to examine which individual and collective factors determine a decision for or against participation.

Methods
A selective sampling strategy was employed to recruit interview participants (n = 73) according to age, participation, gender and geographical location from the overall GNC study sample. Individual GNC study centres were responsible for recruitment. Qualitative, semi-structured interviews with both participants (n = 61) and non-participants (n = 12) explored their motivations to participate, decision-making processes and experiences at the study centre. Interviews were recorded, transcribed verbatim and analysed through thematic and intersectional analyses.

Results
Rationales for or against study participation do not primarily vary according to identity-based criteria such as gender or age, but are shaped by a complex assemblage of individual health action, personal biography, experiences of illness and vulnerability, possibilities for social inclusion, available resources and cultural capital. These factors can be better understood through their interrelation in an integrative analysis.

Discussion
Intersectional approaches allow for a nuanced, complex understanding of study participation which should be considered when developing strategies for recruitment.

Key messages
Intersectionality contributes to a more nuanced, complex understanding of study participation. Intersectional approaches can aid the development of strategies for recruitment.
Impact of Haemophilus influenza immunization on hospitalized acute respiratory infections
Authors: Ben Fredj M , Dhouib W , Bennasrallah C , Abroug H , Zemni I , Ben Hassine D , Kacem M , Bouanene I , Belguith Sriha A 
Published: October 2021

Abstract

Background
Immunization is the most cost-effective measure to combat communicable diseases in childhood. Haemophilus influenza (Hib) vaccine was included in the Tunisian expanded program of immunization for the first time in 2002 (Hib Vaccine monovalent) and is currently combined with the pneumococcal vaccine(Hib vaccine pentavalent combination) since April 2019. We aimed to assess impact of Hib vaccine on Respiratory Infection(RI) admissions in children aged up to 3 years.

Methods
It was a cohort study from January 1, 2002 to December 31, 2013. All Respiratory Infection (RI) admissions in children aged up to 3 years in the university hospital of Monastir(Tunisia) were enrolled.

Results
Admissions for RI represented 17.6% (CI95%: 17.3-18.1) of all communicable diseases hospitalizations (n = 6 061/34 289). The median age was 22 years (IQR: 3-52). Admission for Pneumonia with Streptococcus Pneumoniae (SP) increased significantly during study period (b = 25.9 (p &lt; 0.0001)) especially in children up to 5 years old (b = 10.6) and in elderly (b = 6.0). Among children up to 3 years old, the Crude incidence rate per 100,000 for Hib pneumonia admission were 11.6 in Non-Vaccinated Cohort (NVC), 10.6 in Vaccinated Cohort (VC) by protocol 1 (Hib Vaccine monovalent) and 0.80 in VC by protocol 2 (Hib vaccine pentavalent combination).The relative risk reduction was 99% for protocol 2 (p &lt; 0.001).

Conclusions
Admissions for RI in a tertiary level hospital were common with an increasing trend. The Hib immunization program, in particular the second protocol (pentavalent combination), has had a positive impact on the reduction of related acute diseases.

Key messages
The Hib immunization program, has had a positive impact on the reduction of related acute diseases. The “Hib vaccine pentavalent combination “is more efficient than “Hib Vaccine monovalent”.