bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reduction in Neurological Disease Hospitalization Rate During Covid-19 Pandemic in Abruzzo
Authors: D'Addezio M , Di Giovanni P , Cedrone F , Di Martino G , Meo F , Scampoli P , Staniscia T 
Published: October 2021

Abstract

Background
As a consequence of the Covid-19 outbreak, Italy has adopted unprecedented preventive measures such as large-scale application of social isolation and hospital rearrangements. These measures have led to difficulty in managing diseases and hospitalizations, particularly acute and severe conditions such as neurological morbidities. The aim of the present analysis is to investigate the change in hospital admissions for neurological diseases over the first nine months of 2020 in Abruzzo region.

Methods
Data were obtained from the Hospital Discharge Records of all Abruzzo. We analyzed all the hospitalizations included in Major Diagnostic Categories 1 (neurological diseases). First, we distinguished both between public or private hospitalizations and ordinary or day-hospital admissions. Second, we compared the first nine months of 2020 with a mean of the same months in the two previous years. Finally, we calculated the variable percentage.

Results
A huge reduction in MCD 1 series hospitalizations was observed in each subgroup. Specifically, ordinary regimen had a peak of -47,3% in April. Day-hospital admissions were the most affected by Covid-19 with a peak of more than 90% in April both in public and private hospitals. The largest reduction occurred in private hospitals, both in ordinary (-75% in April) and DH admissions (-93,8% in March).

Conclusions
Despite the severity of the diseases included in MDC 1 (i.e. ischemic stroke, intracranial hemorrhage), a significant decline was detected in hospital admissions in Abruzzo. Subsequently, a high number of subjects might have not received the necessary health assistance leading to an increase in mortality and morbidity for these severe pathologies. Additionally, patients might have avoided seeking hospital care in response to the fear of contagion triggered either by media or as a result of the stay-at-home government recommendations.

Key messages
An alarming reduction in all types of hospitalizations for neurological diseases occurred over the first months of pandemic in Abruzzo. Greater management efforts are needed to reduce the morbidity and mortality rates associated with the reduced hospital admissions during the pandemic.
An emerging innovative UV disinfection technology: virucide activity on SARS-CoV-2
Authors: Messina G , Della Camera A , Ferraro P , Amodeo D , Falcone V , Corazza A , Nante N , Cevenini G 
Published: October 2021

Abstract

Background
Surface sanitation is one of the key points to reduce the risk of transmission both in healthcare and other public spaces. UV-C is already used in hospital and laboratory's disinfection procedure furthermore some recent studies show effectiveness on SARS-CoV-2. UV-C may be generated by Lamps and Light Emitting Diode, but novel sources are emerging. The aim of the study was to test a device having UV chips for inactivating SARS-CoV2.

Methods
The descriptive study was conducted in the period between June and July 2019, in laboratories of the University of Siena and of the scientific park of Toscana life sciences. The device, shaped in a rectangular box, contained six UV chips (10 mW each, with a peak at 264nm nm ranging from 260 to 350 nm) placed in the bottom. Central and short side long positions were tested expecting different dose levels. Each experiment was conducted in triplicate, with and without the device lid, at 3, 6 and 10 minutes. All repetitions were tested for SARS-CoV-2 having a virus suspension of 10^7.2.

Results
The zones with the higher value of irradiance (max 187.9 µW/cm2) were near the corners of the box, while the lowest (min 61.9 µW/cm2) near one of the long sides. The light distribution was almost symmetrical. The tests revealed a viral charge reduction from an initial concentration of virus suspension of 10^7.2 TCID50/mL, of more than 99.9% after 3 minutes of UV exposure; at 6 minutes, the minimum Log10 attenuation value was over 5 Log10(99,999%); the maximum detectable attenuation value of Log10 = 5.7 was measured at 10 minutes.

Conclusions
This device is the first one which introduces this novel UV chip source, similarly it is the first time it was tested against the SARS-CoV-2. Objects that need to be disinfected may benefit of such devices according a proper exposition time for homogeneous disinfections of the surfaces.

Key messages
Implementation of cleaning and disinfection devices has been shown to reduce Sars-cov-2 infection incidence. In the hospital sanitation field, but also in public places and homes, using viable alternatives as UV-C can contribute to the reduction of pandemic spread.
Access to health services for non-Covid-19 causes during the pandemic. A literature review
Authors: Vázquez ML , Vargas I , Oliver A , Espinel V , Ronda E , Sanz-Barbero B , Diaz E , Pujolar G 
Published: October 2021

Abstract

Background
Negative effects of the Covid-19 pandemic on access to care for other diseases are currently at debate.

Aim
To review existing literature on care access for non-Covid-19 conditions since the pandemic onset.

Methods
Scoping review using various databases (Medline, VHL, Web of Science, 2020/21). Terms used: ‘access', ‘health services', ‘Covid-19'. Out of 4,060 identified articles, 37 were selected after reviewing and assessing titles, abstracts and full text. Aday and Andersen's framework guided the analysis.

Results
Of selected articles, 21 analyse impact on health services use; 8 on performance; 8 on access barriers. Most analyse specific services during early pandemic stages through register review, showing an initial decline in use with inconsistent results on recovery. Some indicate increased complexity of treated patients and treatment delays. Studies surveying professionals analyse the impact on services performance or clinical practice, reporting a decrease in consultations/interventions for diverse pathologies and response implementation (e.g. telemedicine), but not how they affected access. Few studies focus on social inequalities in use, showing a greater reduction in low-income or ethnic minority users. Studies on unmet needs, access or barriers based on user surveys or qualitative methods are scarce, focused on a pathology or clinical area. Particularly in Spain, studies analyse impact on use of emergency, primary care and cancer diagnosis, and on emergency and cardiology services functioning. Studies based on user surveys are lacking: only a qualitative study analysed access difficulties for chronic patients in confinement. Methodological weaknesses are identified.

Conclusions
Although currently emerging, studies analysing the pandemic impact on equal access to care for non-Covid-19 conditions are scarce, limited in focus and methodology, especially in Spain. Comprehensive medium/long-term impact assessments, including analysis of causes, are needed.

Key messages
Research is lacking on the impact of the COVID-19 pandemic on healthcare access, particularly for vulnerable groups. Further evidence is needed to improve health systems resilience in the future.
Determinants of healthcare workers’ willingness to receive the influenza vaccine in Tunisia
Authors: Cherif I , Kharroubi G , Bouabid L , Gharbi A , Boukthir A , Ben Alaya N , Ben Salah A , Bettaieb J 
Published: October 2021

Abstract

Background
Influenza is a contagious respiratory disease that may lead to severe illness. Given their frequent contact with ill individuals, healthcare workers (HCWs) are at elevated risk of developing influenza and of transmitting the disease to their patients. We aimed in this study to assess flu vaccination intention among Tunisian HCWs and to identify its determinants.

Methods
A cross sectional study was conducted among Tunisian HCWs with direct patient contact during the 2018-2019 influenza season. Participants were recruited in primary and secondary healthcare facilities according to a self-weighted multistage sampling. Factors associated with influenza vaccination intention were assessed using a multivariate logistic regression analysis.

Results
In this study, 1231 HCWs were enrolled with a mean age of 44.5±9.3 years and a sex ratio equal to 0.25. Among respondents, 43.1% (95% CI: [40.0-45.8]) declared their willingness to receive the IV if recommended for HCWs and provided for free. Participants who received the IV during the 2018-2019 influenza season ((ORa=34.42 [16.41-72.21]), who knew that IV is indicated annually for HCWs (ORa=1.66 [1.21-2.30]), who had high confidence regarding IV efficacy (ORa=1.99 [1.48-2.68]), who believed that IV should be mandatory for HCWs (ORa=2,36 [1.76-3.18]) and that HCWs' vaccination against influenza is important in order to protect patients (ORa=1.92 [1.37-2.69]) were more likely to be willing to receive the IV. However, nurses were less likely to be willing to receive the vaccine than physicians (ORa=0.66 [0.44-0.98]).

Conclusions
Less than half of participants reported their willingness to receive the IV. Our results suggest that flu vaccination acceptance is associated with higher IV uptake and with favorable attitudes regarding influenza vaccination. This highlights the need to implement regular flu awareness campaigns in healthcare facilities aiming to encourage vaccination among HCWs.

Key messages
Majority of healthcare workers reported their unwillingness to receive the influenza vaccine. Educating health personnel about the benefits of influenza vaccination to themselves and their patients is necessary.
Increasing cultural competence through experience-based learning: Preventing child Injury in Israel
Authors: Daudi L , Luder A , Spitzer-Shohat S , Rudolf M CJ 
Published: October 2021

Abstract

Background
Future practitioners need to learn to communicate with culturally diverse patients, understand their perspectives on disease and provide individually tailored guidance. SHABI (Keeping our Children Safe in Hebrew) is a program set up with a dual purpose of improving families' home-safety and providing students with experience-based learning. 11 medical/nursing students twice visited 135 families who were recruited in an emergency-room following unintentional injury of a preschool child on May 2019-March 2020. 50% of families were ultra-Orthodox Jews, 11% Arab, and 28% had ≥3 children ≤5 years old. Training included child injury prevention, communication skills and insights on religious communities led by a local ultra-Orthodox Rabbi and head of Arab municipal social services.

Objective
To examine SHABI's impact on students' cultural competence, evaluated through student interviews 8 months after baseline, their written reports after home visits (n = 233), parent interview calls (n = 212) and change in observed home safety assessed by a checklist 4 months later (n = 233).

Results
Students reported that training helped them to culturally adapt the visits, and that the home visits increased their understanding of cultural and religious groups with whom they had little familiarity. Students worried that they would be perceived as judgmental, but parents reported they were sensitive, and the visits were beneficial. Following the first visit, 64% of parents reported increased awareness about home safety and 59% that the visit improved home safety. Effectiveness of student skills were confirmed by observed 15% improvement in home-safety after 4 months.

Conclusions
This experience-based learning helped to develop students' self-perceived cultural competence and improve families' home safety. SHABI may serve as a model of how students can learn to engage with disadvantage populations after a medical encounter, promoting their skills while benefitting families.

Key messages
Participating in experience-based learning and engaging with diverse populations developed cultural competence and benefited local populations. The SHABI program presents a feasible model to introduce into healthcare education.
Magnitude, risk factors of addictive behaviors among school students in Southern Tunisia
Authors: Baklouti M , Ben Ayed H , Maamri H , Ketata N , Jdidi J , Kassis M , Feki H , Dammak J 
Published: October 2021

Abstract

Background
The use of addictive product is an important public health problem rapidly spreading around the world threatening the users, their families and environments, causing serious health problems and devastating societies in psychological and economical terms. During adolescence, these substances are harmful to health, affecting the developing of brain. This study aimed at investigating the prevalence, the determinants and the impact of addictive behaviors (AB) among school students (SS).

Methods
This was a cross-sectional study including a three-stage randomized sample of 1210 SS from different public schools of Southern Tunisia, on April 2021, using an anonymous self-administered questionnaire. AB were defined as the consumption of at least one of the following products: tobacco, illicit drugs and alcohol.

Results
Overall, 723 SS were females (59.8%), with a sex ratio (Male/Female) of 2.3. The average age was 15.64±2.05 years. In total, 793 cases (65.5%) were from rural areas. The prevalence of addictive behaviors was 18.7% (225). It was 13.9% (168) for current smoking, 3.1% (37) for alcohol consumption and 1.7% (20) for illicit drug use. Factors independently associated with AB in logistic multivariate analysis were male gender (Adjusted Odds Ratio (AOR)=10.2;p&lt;0.001), secondary school studies (AOR=1.5;p=0.008), age ≥14 years (AOR=2.5;p&lt;0.01) and living alone or sharing home with friend (AOR=2.29;p=0.004). These AB had statistically negative impact on SS, notably for low school marks and academic failure (OR = 2.5;p=0.01 and OR = 1.66;p=0.002, respectively). Moreover, the perceived stress scale was statistically higher among SS with AB (OR = 1.4;p=0.03).

Conclusions
Addictive behaviors among SS were alarmingly prevalent in Southern Tunisia, which was correlated with socio-demographic, cultural and educational factors. New preventive and therapeutic strategies should be urgently initiated to ensure a safe educational and psychological environment for SS.

Key messages
Addictive behaviors among SS were alarmingly prevalent in Southern Tunisia. Addictive behaviors among SS were correlated with socio-demographic, cultural and educational factors.
The dispersive velocity of compressional waves in magmatic suspensions
Authors: Carrara Alexandre , Lesage Philippe , Burgisser Alain , Annen Catherine , Bergantz George W 
Published: October 2021

SUMMARYThe geophysical detection of magma bodies and the estimation of the dimensions, physical properties and the volume fraction of each phase composing the magma is required to improve the forecasting of volcanic hazards and to understand transcrustal magmatism. We develop an analytical model to calculate P waves velocity in a three-phase magma consisting of crystals and gas bubbles suspended in a viscous melt. We apply our model to calculate the speed of sound as a function of the temperature in three magmas with different chemical compositions, representative of the diversity that is encountered in arc magmatism. The model employs the coupled phase theory that explicitly accounts for the exchanges of momentum and heat between the phases. We show that the speed of sound varies nonlinearly with the frequency of an acoustic perturbation between two theoretical bounds. The dispersion of the sound in a magma results from the exchange of heat between the melt and the dispersed phases that affects the magnitude of their thermal expansions. The lower bound of the sound speed occurs at low frequencies for which all the constituents can be considered in thermal equilibrium, whereas the upper bound occurs at high frequencies for which the exchange of heat between the phases may be neglected. The presence of gas in a magma produces a sharp decrease in the velocity of compressional waves and generates conditions in which the dispersion of the sound is significant at the frequencies usually considered in geophysics. Finally, we compare the estimates of our model with the ones from published relationships. Differences are largest at higher frequencies and are &lt;10 per cent for typical magma.
An application of the ecological model to sexual harassment in informal areas of Cairo, Egypt
Authors: Hassan Rasha , Roushdy Rania , Sieverding Maia 
Published: October 2021

Summary
Street-based sexual harassment is a prevalent but understudied form of gender-based violence that restricts women’s access to public spaces. Drawing on adaptations of the ecological model that identify the root causes of gender-based violence in patriarchy, in this study, we explore the causes of street harassment in informal areas of Greater Cairo. Our analysis is based on qualitative interviews and focus groups with male and female youth aged 13–29 years, parents of youth and community leaders in two informal areas. We supplement the qualitative data with descriptive analysis of a representative, 2016 survey of youth in informal areas of Cairo that measured experiences with and attitudes toward harassment. Harassment was prevalent in the study areas, and respondents tended to place the blame for harassment at the individual level of the ecological model, particularly women’s behavior. However, there were also community- and societal-level factors that contributed to the prevalence of harassment. Patriarchal norms and stigmatization of women who are harassed reinforced victim-blaming, such that most young women were afraid to report experiences of harassment due to social censure. In this context, educational or awareness raising interventions are unlikely to be effective in combating harassment, which is widely acknowledged to be a problem. Rather, interventions are needed along the different levels of the ecological model to target peer group and community norms that encourage harassment, address harassment in schools and strengthen reporting mechanisms.
Pre-exposure prophylaxis (PrEP) in Australia: are there challenges facing sexual health promotion?
Authors: Dunn Matthew , Barnett Anthony , McKay Fiona H 
Published: October 2021

Abstract
Pre-exposure prophylaxis (PrEP) for HIV refers to the daily use of antiretroviral medications by HIV uninfected persons to block a potential HIV infection. There is evidence to show that as the use of PrEP increases, the use of other safer sex practices such as condoms decreases, which may lead to an increase in sexually transmitted infections (STIs). This study aimed to explore whether PrEP had caused any challenges for organizations undertaking sexual health promotion activities in Australia. In-depth, semi-structured interviews were conducted with 17 participants (15 males, 2 females) who were purposively sampled from a range of HIV advocacy and health promotion settings. These included publicly funded HIV/AIDS councils and organizations representing people living with HIV/AIDS. Guided by an exploratory, inductive approach, the interviews were analyzed using thematic analysis. Three themes were constructed from the data analysis. First, organizations in different jurisdictions came to support PrEP in different ways, and this influenced the way organizations engaged with PrEP and the messaging that they disseminated to their community. Second, organizations faced some barriers to promoting PrEP, with the most significant being overcoming decades of HIV prevention campaigns that focused on barrier methods only. Third, there were social benefits to PrEP, such as shifting the onus of preventing HIV transmission from HIV positive to HIV negative people. PrEP is a highly effective biomedical intervention to reduce HIV transmission, and future challenges include designing campaigns for those at risk for HIV transmission outside the MSM community.
Developing a health promoting university in Trinity College Dublin—overview and outline process evaluation
Authors: Darker Catherine D , Mullin Martina , Doyle Louise , Tanner Michelle , McGrath David , Doherty Lena , Dreyer-Gibney Katrin , Barrett Emer M , Flynn Deirdre , Murphy Patricia , Ivers Jo-Hanna H , Burke Eilish , Ryan Michele , McCarron Mary , Murphy Paula , Sheils Orla , Hevey David , Leen Aisling , Keogh Leah , Walls Breda , Bennett Annemarie E , Petersen Freja , Nolan Ann , Barry Joe M 
Published: October 2021

Summary
Higher Education Institutions (HEIs) have the potential to impact positively on the health and wellbeing of their staff and students. Using and expanding on the ‘health promoting university’ (HPU) platform within HEIs, this article provides a description of ‘Healthy Trinity’, which is an initiative underway in Trinity College Dublin, the University of Dublin. First, Healthy Trinity is contextualized in background literature including international and national policy and practice. Second, an overview of Healthy Trinity is provided including its vision and goals. Third, the article describes the steps taken relating to the identification of stakeholders and use of a network and a co-lead model. Within this approach, the article describes a partnership approach whereby responsibilities regarding health and wellbeing are shared by individuals and the institution. Fourth, the design and implementation of Healthy Trinity is discussed by taking a ‘settings approach’, in which the emphasis for change is placed on individual behaviours, environment, policy and organizational culture. Consideration is given to the interplay between intervention, implementation strategy and context for successful systemic implementation. The fifth element presented is the early-stage challenges encountered during implementation, such as the need to secure recurrent funding and the importance of having a direct input to the governance of the University to enable systemic change. The sixth and final component of the article is an outline of Healthy Trinity’s intention to utilize a process evaluation of the early implementation phases of this complex intervention within a settings approach. Potential deliverables and impacts of this HPU initiative are presented and discussed.
Formation of keto-type ceramides in palmoplantar keratoderma based on biallelic KDSR mutations in patients
Authors: Pilz Robert , Opálka Lukáš , Majcher Adam , Grimm Elisabeth , Van Maldergem Lionel , Mihalceanu Silvia , Schäkel Knut , Enk Alexander , Aubin François , Bursztejn Anne-Claire , Brischoux-Boucher Elise , Fischer Judith , Sandhoff Roger 
Published: October 2021

Abstract
Functional skin barrier requires sphingolipid homeostasis; 3-ketodihydrosphingosine reductase or KDSR is a key enzyme of sphingolipid anabolism catalyzing the reduction of 3-ketodihydrosphingosine to sphinganine. Biallelic mutations in the KDSR gene may cause erythrokeratoderma variabilis et progressive-4, later specified as PERIOPTER syndrome, emphasizing a characteristic periorifical and ptychotropic erythrokeratoderma. We report another patient with compound heterozygous mutations in KDSR, born with generalized harlequin ichthyosis, which progressed into palmoplantar keratoderma. To determine whether patient-associated KDSR mutations lead to KDSR substrate accumulation and/or unrecognized sphingolipid downstream products in stratum corneum (SC), we analyzed lipids of this and previously published patients with non-identical biallelic mutations in KDSR. In SC of both patients, we identified ‘hitherto’ unobserved skin ceramides with an unusual keto-type sphingoid base in lesional and non-lesional areas, which accounted for up to 10% of the measured ceramide species. Furthermore, an overall shorter mean chain length of free and bound sphingoid bases was observed—shorter mean chain length of free sphingoid bases was also observed in lesional psoriasis vulgaris SC, but not generally in lesional atopic dermatitis SC. Formation of keto-type ceramides is probably due to a bottle neck in metabolic flux through KDSR and a bypass by ceramide synthases, which highlights the importance of tight intermediate regulation during sphingolipid anabolism and reveals substrate deprivation as potential therapy.