bluuebunny/crossref_metadata_2025_split huggingface dataset:
The challenge of monitoring climate changes and its consequences in North Macedonia
Authors: Petrovski K , Kjosevska E , Memeti S , Petrovski M 
Published: October 2021

Abstract

Background
The aim of the paper is to assess how well prepared are the public and the public institutions for developing a digital climate change monitoring system.

Methods
A descriptive-analytical method and cross-sectional study were applied. Literature from the UNDP, Green Climate Fund (GCF), European Commission and the WHO was used. An on-line survey with 101 participants was conducted to evaluate the level of public interest on tackling climate change, and establishing an inter-institutional integrated system (IIIS) for monitoring climate change.

Results
The Government has appointed a National Body for Cooperation with the GCF in order to strengthen the capacity of the state for strategic engagement. Decreasing rainfall, cold and heat waves imply that the country is vulnerable to natural disasters, such as droughts, floods and forest fires. Furthermore, the survey shows that 81,2% of the respondents think that climate changes have a negative impact on their health, whereas 70,3% consider that the public is not sufficiently informed about climate changes and the state of the ecosystem. 58,4% are not familiar with any steps being taken against climate change. Only 5% know about the development of an IIIS for monitoring climate change. 38,6% say they would participate in the work of the IIIS.

Conclusions
The IIIS should be developed with the aim to connect key institutions that would create a strong hub aimed at researching and preventing diseases caused by climate changes. Including the public in the IIIS could help pinpoint local problems. If the establishment of an IIIS yields good results, it could grow into an international monitoring system. Implementing the General Data Protection Regulation and using proper safeguards would be crucial in protecting the gathered and exchanged data. This research will help develop the IIIS to be the first of its kind in the country, with the potential to prevent climate change related diseases, as well as disasters.

Key messages
The mutual effort of the society as a whole, including the government, NGO’s, the public and private sectors is the only way we can battle the growing threat of climate change. Creating a digital, centralized integrated international and inter-institutional digital tools is the best weapon for monitoring the climate change and its consequences.
Public health strategies to combat opioid epidemic in the United States: A systematic review
Authors: Balidemaj F 
Published: October 2021

Abstract

Background
The opioid epidemic in the United States is a national public health crisis. Driven by an increase in availability of pharmaceutical opioids and by an increase in their consumption, specifically, for pain treatment, more so in the past twenty years, it has led to an economic cost of prescription opioid abuse, overdose, and dependence in the United States estimated to be 78.5 billion USD. The purpose of this systematic review was to identify and evaluate public health strategies that contribute towards combatting the opioid crisis.

Methods
Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, a search was conducted of the PubMed database for articles in English language that analyzed the most effective ways to regulate health markets to decrease the opioid crisis in the United States.

Results
The initial search yielded 2397 titles, of which 15 full-text articles were ultimately selected for inclusion in this systematic review. The review identified four categories in overcoming this epidemic nationwide, including required improvement in patient utilization of and access to safe and effective treatment options for opioid abuse and overdose, addressing the stigma correlated with opioid use, considering appropriate use of abuse deterrent formulations (ADF) along with patient education, and improving prescribing practices via utilization of drug monitoring programs, CDC opioid prescribing guidelines and provider continuing education.

Conclusions
Attempts to combat the opioid epidemic have been made, and the state and federal governments have only recently started to understand the magnitude of the seriousness of this public health crisis. While the methods with promising improvement of the situation have been identified, implementing them has shown to be a challenge. Continued application is needed, while considering possible new steps that could help reinforce their utilization further.

Key messages
Attempts to combat the opioid epidemic have been made, and the state and federal governments have only recently started to understand the magnitude of the seriousness of this public health crisis. The methods with promising improvement of the opioid crisis situation have been identified, however utilizing and implementing the existing public health strategies has shown to be a challenge.
Health of older people in places and work-related outcomes: are all health indicators equal?
Authors: Murray ET , Shelton N , Norman P , Head J 
Published: October 2021

Abstract

Background
Health has been posited as an explanation for why older people who live in more disadvantaged areas have worse work-related outcomes. The policy implication being that if a higher proportion of older persons in a place had better health, those labour markets would be better for everyone. No literature exists on this topic.

Methods
Data was used from 428,646 members of the Office for National Statistics Longitudinal Study (LS) who were 16-74y at the 2011 census and had information on employment status, economic activity and occupational socioeconomic classification. Generalised Structural Equation Modelling was used to examine whether each of the three work-related outcomes were equally related to nine 2011 local authority district (LAD)-level older adult health indicators.

Results
In age-adjusted analysis, all nine LAD-level health indicators (modelled in terciles) were associated with all three work outcomes. However, strengths of association varied both across and within each outcome. For example, the strongest associations were for being ‘sick or disabled' versus ‘In employment'. If an LS member lived in the ‘unhealthiest' versus ‘healthiest' third of LADs, associations varied between a high of 2.74 higher odds (95% CI: 2.53,2.95) for long-term illness and a low of 2.10 higher odds (1.89,2.32) for disease-free life expectancy at age 50y. The weakest associations were for part-time versus full-time employment: ranging from life expectancy at birth at 1.29 (1.21,1.38) to healthy-life expectancy at age 50y: 1.18 (1.10,1.27). Adjustment for individual health reduced, but did not eliminate, associations. Sensitivity analysis showed robustness to area health indicators being assessed for sub-groups of older people (ages 50-64 & 65-74), genders and a reduced sample of older persons (50-74y) only.

Conclusions
Health of older people in places is associated with work outcomes of people in those places; both the older people themselves and the wider community.

Key messages
At a place level, health and work outcomes are linked. Strengths of association between place-level health and work outcomes will depend on the health measure used.
Space-time analysis of pulmonary tuberculosis hospitalizations in mainland Portugal (2002-2016)
Authors: Almeida Santos J , Nunes C 
Published: October 2021

Abstract

Background
Tuberculosis (TB) imposes a great pressure on healthcare resources, particularly in terms of hospital-based treatment and extended hospitalization. Understanding the space-time clustering of pulmonary TB (PTB) hospitalizations leads to a richer knowledge to assist decision makers in Public Health to develop strategic interventions to reduce these hospitalizations. Our objective was to identify space-time clusters of PTB hospitalizations at municipality level in mainland Portugal.

Methods
Ecologic study using data from nationwide hospitalization database of Portugal. All patients with a diagnosis of PTB (primary or secondary) and reference to place of residence were included in the study (n = 22760). Space-time analysis was used to define clusters with high rates of hospitalizations at the municipality level between 2002 and 2016.

Results
Overall hospitalization rate was 17.7/105population/year, with hospitalization rates decreasing by 64.9% during this period (2002:29.4/105; 2016:9.6/105). Space-time analysis of the overall period identified five different clusters, with the clusters in Lisboa and Porto metropolitan areas presenting the highest hospitalization rates (51.5/105 and 43.6/105population, respectively). In a more recent period (2011-2016), were identified four clusters with Lisboa metropolitan area and a northeast rural region presenting the highest hospitalization rates (27.6/105 and 46.2/105population, respectively).

Conclusions
PTB hospitalization rates in continental Portugal presented a constant decrease between 2002 and 2016. We identified a cluster of PTB hospitalizations in a rural region of northeast mainland Portugal, an area where the incidence of TB is below 20/105population. A closer look is needed to understand the reasons behind this high number of hospitalizations. Our results show that space-time analysis can be a resource to monitor the dynamic of the disease and identify possible areas needing Public Health intervention.

Key messages
Pulmonary tuberculosis hospitalizations are decreasing in mainland Portugal, with the two major urban areas (Lisboa and Porto) presenting the clusters with highest hospitalization rates. A cluster of hospitalizations for pulmonary tuberculosis was identified in a rural region in the northeast of mainland Portugal, an area with a low incidence of tuberculosis.
Illegal drug sales in the mirror of the dark web marketplace
Authors: Vlassov V , Meilahs P , Soshnikov S , Idrisov B 
Published: October 2021

Abstract

Background
Studies of the epidemiology of substance use are problematic by the disorder's nature and the illegal character of the substances' turnover. For safety, the illegal substances' markets had moved to the Internet, to the less transparent darknet part. The objective of this study was to get estimates for the Russian drug market using data collected at dark net market ‘Hydra', get the amounts of drugs offered, the relative frequency of offers, and the regional distribution of the market activities. We analyze the relationship between estimates of the illegal drug market with traditional indicators of drug use disorders on the next stage.

Methods
We use two types of data: 1) Deep Web Black Market data; 2) Official Russian statistical indicators related to drug use. We use Python program via VPN service to extract data. R software was employed for statistical analysis to build the maps of drug offerings and sales by the regions of Russia. Er use the descriptive statistics and correlation analysis to compare the estimates with the state statistics.

Results
Using the estimates of sales for the drug classes in grams by region (per 100000 population), we mapped the data and found that there is a correlation with the registered drug users and drug-related deaths. There is no Hydra sales of opiates in some regions indicating that older supply channels are still active. Total drug sales and offers championed by cannabis, opiates/opioids, cocaine, amphetamines and the other drugs in smaller amounts. There is a significant correlation between the supply of opiates in regions of Russia and the official incidence of fatal drug poisoning (r = 0.41; p = 0.003), and the number of HIV positive injected drug users (r = 0.47; p = 0.002).

Key messages
Analysis of the deep internet sales of drugs helps assess the situation with the illegal drug supply in the regions of Russia. Data on deep internet sales of drugs should not substitute the other sources of data.
The economic burden of coronary artery disease: A systematic review
Authors: Lanza-León P , Sánchez-Ruiz L , Cantarero-Prieto D , Blázquez-Fernández C , Moreno-Mencía P , Pérez-Hernández F , de la Torre JM , Cayón-de las Cuevas J 
Published: October 2021

Abstract

Background
Although mortality has decreased in recent decades and patient survival rates have increased, cardiovascular disease remains one of the leading causes of mortality and morbidity in developed countries these days. The purpose of this study is to analyze the available literature that describes the economic burden of coronary artery disease and to compare costs. The study is framed in the Horizon 2020 project “A patient-centered early risk prediction, prevention, and intervention platform to support the continuum of care in coronary artery disease (CAD) using eHealth and artificial intelligence - TIMELY”.

Methods
A systematic literature review has been carried out using various databases such as PubMed, Web of Science, Cochrane Library and Scopus. Precisely, a 5-year retrospective horizon has been considered until the present (April 2021). In all databases, terms related to “Coronary artery disease” and “Cost*” were combined.

Results
113 publications were primary located. After examining the titles based on the eligibility criteria, 16 articles were selected. Of these, 5 articles were excluded because they did not meet the inclusion criteria. Therefore, a final set of 11 selected studies were considered in this review. The costs included in the review correspond, mainly, to direct healthcare costs. Our results affirm that the highest costs are derived from the possible adverse effects (€41,450, approx.).

Conclusions
The figures presented in this literature review will provide a good framework to quantify these costs for both economic experts and researchers and political decision-makers, both nationally and internationally.

Key messages
The costs included in the review correspond, mainly, to direct healthcare costs. The highest costs are derived from the possible adverse effects.
Study of rs10177833 polymorphism in SLC4A5 gene and salt sensitivity in Bulgarian population
Authors: Georgieva Tz , Kuzova E , Arsova St , DImbareva D , Georgieva R , Duleva V 
Published: October 2021

Abstract

High sodium intake is associated with increased blood pressure and and increased risk of cardiovascular disease (CVD). Among the countries of the European Union, Bulgaria ranks first in mortality from CVD. Genetically determined salt sensitivity is present in 50% of the hypertensive and 26% of the normotensive population, posing a major public health problem. The present study was conducted within the National Program for Prevention of Chronic Non-Communicable Diseases 2014 - 2020 to assess the sodium intake of the population in Bulgaria. 36 normotensive participants are included in the study. DNA from each volunteers was isolated and genotyped for rs10177833 (A&gt;C) in SLC4A5 gene by TaqMan SNP genotyping assay. To determine the 24-hour urinary excretion of sodium in the subjects, a random sample was taken from each participant. Sodium concentration was determined by atomic absorption spectrometry. A WHO protocol has been used to recalculate sodium excretion (Protocol for Sodium Determination in 24-hour Urine Samples). Eighteen of total of 35 participants had wild AA genotype (51.43%), thirteen were heterozygotes (37.14%) and four were carriers of two polymorphic C alleles (11.43%). The frequency of A allele of rs10177833 (A&gt;C) in SLC4A5 gene was 70%, whereas polymorphic C allele was only 30%. The correlation analysis showed negative statistical significant relationship between rs10177833 in SLC4A5 gene and sodium concentration (in milligrams) in 24 - hours urine (r = -0.365, p = 0.031). Also the holders of CC genotype had significant lower values of Na compared to these with wild AA genotype (p = 0.01) and compared to heterozygotes (p = 0.019). In conclusion, we found a clear relationship between the polymorphic variant rs10177833 in SLC4A5 gene and the concentration of sodium in urine in Bulgarian normotensives. The tendency of association was found between the studied polymorphic variant and blood pressure values, which should be studied in a large number of participants

Key messages
Increasing the population's awareness of health risks with increased salt consumption. Regular monitoring of salt consumption.
Fast WGS source attribution of Listeria monocytogenes outbreak in a sheep flock in Abruzzo region
Authors: De Angelis M , Sulli N , Salucci S , Torresi M , Centorotola G , Ciarrocchi A , Marfoglia C , Pisegna ON , Pomilio F , Cornacchia A 
Published: October 2021

Abstract

Background
Listeriosis is a life-threatening disease in human as well as animals, cows and sheep are the most sensible to the disease. Correlation to feed is well documented (silage). Some clonal complexes (CCs) are more virulent than others and frequently involved in animal and human listeriosis. Whole genome sequencing (WGS) and in silico CCs identification and core genome multilocus sequence typing (cgMLST) determination are the best way to characterize isolates and confirm connection between clinical strains and source of contamination. This work aimed to demonstrate the advantages of using WGS to find the source of Listeria monocytogenes (Lm), causing an outbreak in an ovine farm in Abruzzo region.

Methods
Lm was detected according to ISO 11290-1:2017. Serogroup was determined by multiplex PCR. WGS data were obtained using Illumina platform. Sequences were used to assess CCs and cgMLST according to BIGSdb Pasteur platform. Two brain samples and 1 lymph node from 2 sheep, one sample of silage (15 analytical portion), and 1 sample of hay were tested.

Results
Lm was detected in all animal specimens and in 2 analytical portions of feed (silage) tested. Out of 35 colonies detected 28 were identified as Lm (27 serogoup IVb and 1 sample of silage serogroup IIa). Five colonies were selected for WGS (one from each animal brain, one from the lymph node and one from each positive analytical portion of silage), among them only one colony from the silage showed the same CC of the strains isolated from sheep (CC1). cgMLST revealed no allelic distances between these strains.

Conclusions
CC1 is the main virulent clone among Lm isolates often involved in human and animal outbreak. Feed may be a vehicle for Lm and could be the outbreak source. Cases ceased after removing the silage. Use of WGS is a definitive help in source attribution when feed is available and the sampling is done in a correct manner.

Key messages
Silage can be cause of listeriosis in livestock. WGS can improve source attribution of outbreaks detecting the relatedness of the strains and improving the epidemiological investigation in case of outbreak.
Sickness absence and disability pension within different employment status in multiple sclerosis
Authors: Machado A , Murley C , Hillert J , Alexanderson K , Friberg E 
Published: October 2021

Abstract

Introduction
Limitations associated with Multiple Sclerosis (MS) can restrain work capacity and productivity, reducing the possibility to remain in work. Whilst access to sickness compensation might be an option, transitions to other types of employment, such as self-employment, might be considered. We aim to investigate the association of Sickness Absence (SA) and Disability Pension (DP) with employment status among people with multiple sclerosis (PwMS) before and after MS diagnosis compared with people without MS.

Methods
A prospective longitudinal study was conducted using Swedish register data of 2,779 MS patients diagnosed with MS in 2008-2012 in working ages (20-59 years) and 13,863 population-based matched references. Levels of SA and DP one year before and four years after MS diagnosis were analyzed. Risk of annual SA and DP levels of more than 180 days were compared among the MS patients and references and, their different types of employment, by means of Cox proportional hazard models and adjusted for socio-demographic variables and SA and DP before MS diagnosis.

Results
In general, people with MS had higher levels of SA and DP before and shortly after MS diagnosis compared to references. PwMS showed a significantly higher probability of reaching over 180 days of SA (Hazard Ratio [HR]=4.89, 95% Confidence interval [CI]=4.43-5.40) and over 180 days of DP (HR = 6.31, 95% CI = 5.46-7.30)) than the references, regardless of type of employment. Moreover, when compared to employed references, self-employed PwMS had similar likelihood to reach over 180 days of SA than employed PwMS, (HR = 4.27, 95% CI = 3.81-4.77) and (HR = 3.83, 95% CI = 2.73-5.38), respectively. In contrast, self-employed references showed less probability (HR = 0.49, 95% CI = 0.31-0.78) to reach over 180 days of SA compared to the employed references.

Conclusions
In contrast to references, employed and self-employed PwMS had similar probabilities of reaching over 180 days of SA.

Key messages
This study emphasizes that in Sweden also self-employed have access to sickness compensation, independently of employment status condition. Access to sickness compensation is utilized by PwMS.
Benchmarking between two different hospitals on health risk management in the covid-19 emergency
Authors: Nasi G , Brandimarte G , Marrone R , Sponzilli A , Sorbara D , Benedetti P , Grande D , Brando C , D'Avino A , Parrocchia S 
Published: October 2021

Abstract

Iusse
The strategies adopted during COVID19 emergencies by two different hospitals in the Lazio Region are presented: S. Maria Goretti Hospital (SMGH) directly managed by the ASL Latina, hub and centre of the Emergency Department, and Cristo Re Classified Hospital (CRH), accredited in the territory of the ASL Roma1.

Description of the problem
SMGH has been identified as COVID19 Intervention Hospital. CRH initially was a No-COVID support structure, then included in the COVID19 network. During the COVID19 emergency, the directors of both hospitals had to simultaneously ensure activity as usual, COVID19 recovery and risk management.

Results
SMGH, while continuing the emergency, oncological, pregnancy, paediatrics and outpatient activities, COVID19 patients was isolated on 7 different floors/areas. Moreover was defined: chain of command; clinical admission criteria; COVID19 multi-professional and support teams, roles, skills and specific training; health surveillance; environmental hygiene, safety paths/procedures, vaccinal center and much more. CRH, while continuing minimum programmed activities to reduce waiting lists, in the first epidemic phase was created 4 tensile structures for Pre-triage and COVID pathways, respiratory isolation area for supsected patient; transfer admission for emergency networks, clean-dirty pathway. Moreover in the second phase, was activated beds of COVID19 network and 4 technical beds OBI; the ‘Walk-in' for antigenic testing, with molecular confirmation &lt;24h and infectious counselling; multi-disciplinary and specialist support teams, training courses, health surveillance, vaccinal center and much more.

Lessons
During COVID19 pandemic, risk management skills linked to the technical-organisational strategy of hospital directors, making it possible to reprogramme their structure in a short period of time with flexibility and resilience of the whole organization.

Key messages
Specific skills and roles, both hygienic and organizational, are essential to risk management in hospitals during epidemic emergencies. The multidisciplinarity, flexibility and modularity of the hospital structure are the organizational bases in cases of pandemics.