bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular detection of HEV in domestic pigs in Italy from Abruzzo and Molise regions
Authors: Scattolini S , Del Matto I , D'Angelantonio D , Rossi F , Chiaverini A , Piccioni R , Antoci S , Pomilio F , Migliorati G , Aprea G 
Published: October 2021

Abstract

Background
Hepatitis E virus (HEV) is a zoonotic pathogen transmitted through the faecal-oral route and it is responsible of disease in humans with more than 21.000 cases reported in the European Union (EU) over the last decade. It is a non-enveloped single stranded RNA virus that includes 8 genotypes; among these, genotypes 3 and 4 (HEV-3 and HEV-4) are the most prevalent in developed countries and infect both humans and some animal species such as domestic pigs. In this study, we investigated the prevalence of HEV in domestic pigs bred in Italy, in Abruzzo and Molise regions.

Methods
During the period October 2020-March 2021, 327 liver samples from individual pigs were analysed. In particular, 211 were collected in 1 slaughterhouse and originated from animals bred in Abruzzo in 8 different farms and 116 were collected in 7 slaughterhouses and originated from animals bred in Molise in 47 farms. The real time retro-transcriptase (RT)-polymerase chain reaction (PCR) technique was used to detect HEV by targeting the open reading frame (ORF) 3 region of the viral ribonucleic acid (RNA).

Results
None of the samples deriving from pigs bred in Abruzzo tested positive for the detection of HEV RNA. Instead, 4 samples from pigs bred in 2 different farms in Molise tested positive, showing a prevalence of 3.45%.

Conclusions
Pigs are considered important reservoirs for HEV virus. For this reason, it is opportune to investigate the role of these animals for better understanding their involvement in the human infection through the consumption of contaminated raw or undercooked pork-meat products. These findings need to be further investigated with in depth genomic characterization of positive RNA samples to highlight the role of the specific strains circulating in this region and to draw conclusions about connections between animals, potential contaminated food and human disease.

Key messages
The study paved the way for defining the role of pigs in the transmission of HEV virus to humans through the consumption of pork meat products. This study reports the prevalence of HEV in domestic pigs of Abruzzo and Molise regions, two Italian regions.
Vaccinations for migrants during and beyond the COVID-19 pandemic
Authors: Declich S , Dente MG , Tosti ME , De Ponte G , Marchetti G , Tavoschi L , Lopalco PL , Russo ML , Marceca M 
Published: October 2021

Abstract

Issue
Migrants have suboptimal vaccination coverage compared to the general population in destination countries due to several factors
-administrative barriers or lack of legal entitlements to health -health system barriers (language, lack of cultural sensitivity and community engagement capacity, vaccination costs) -lack of trust in the health system and misconceptions about vaccines due to misinformation or beliefs

Problem
Countries should develop national policies and ensure an inclusive, free of charge and proactive vaccination offer to migrants, irrespective of their legal status; and to extend this approach beyond the current pandemic and the sole COVID-19 vaccine

Results
To achieve COVID-19 global herd immunity all population groups, including migrants, needs to access vaccination. Tailored vaccination strategies, once devised, shall be applied to routine national vaccination plan to tackle health inequalities

Lessons
The following actions shall be implemented at national level
Action 1. Develop tailored and equitable approaches for PH vaccination services targeting migrants through:
-free of charge access -decentralization and outreach capacity of the health system -innovative service delivery models (mobile clinics, combined health services, mass vaccination) -health personnel and migrants participatory approach and engagement strategies
Action 2. Increase staff engagement through: -increasing health personnel's difference sensitivity -strengthening health personnel's communication capacities
Action 3. Increase migrants' health and vaccine literacy through:
-establishing vaccine literacy education programmes and strategies -offering health promotion educational interventions
Action 4. Monitor progress of inclusive vaccination offer by: -setting strategic goals, targets and indicators for national vaccination plans -expanding immunization information systems to monitor vaccination coverage, with appropriate disaggregation by migration status core variables

Key messages
Explicitly and proactively include migrants and displaced communities in vaccination plans and set up, test and implement new approaches in primary prevention and vaccination services. Extend this approach beyond the current pandemic and the sole COVID-19 vaccine in order to enhance preparedness to present and future health threats.
eLiteracy on covid among portuguese women: web-based survey study
Authors: Garcia T , Vareda R , Rachadell J 
Published: October 2021

Abstract

Background
Digital tools are recognized public health tools for literacy. Their effectiveness is relatively unknown - some studies describe 40% of adults with literacy levels below the necessary for optimal use. eLiteracy has been a buzzword during the pandemic, but we still don't understand who benefits from it. This study aims to understand the ability of women to identify and use COVID-19 online information and its link with knowledge and behavior

Methods
Web-based survey conducted on female adults. Coronavirus eHealth literacy scales measured skills to apply information (CoV-eHEALHS) and COVID-19−related knowledge, conspiracy beliefs, and adherence to protective behaviors (COVID-19 KAPs). Spearman correlation and Kruskal-Wallis tests were used to identify association between CoV-eHEALHS and COVID-19 KAP, and between these and age, income, and level of education

Results
Higher CoV-eHEALS were seen in higher level of education (χ2=17,03; p = 0,002), higher knowledge (β = 0,19; p = 0,000), lower conspiracy (β=-0,27; p = 0,000) and higher adherence to protective measures (β = 0,24; p = 0,000). Higher knowledge was seen in greater ages (β = 0,11; p = 0,000), higher education (χ2=36,40; p = 0,000) and greater income (χ2=19,96; p = 0,001). Lower conspiracy was seen in higher education (χ2=31,50; p = 0,000) and higher income (χ2=9,71; p = 0,046). Higher adherence to protective measures had no correlation with socioeconomical factors.

Conclusions
There was association between higher eHealth literacy and COVID-19 KAP, reinforcing public health stakeholders to invest on disseminating digital information. There were worse results in younger women of lower education and income, suggesting information should be adapted to this population

Key messages
Digitally disseminated information is important because of the association between higher eHealth literacy and knowledge and protective behavior. It should be adapted for younger women with lower levels of education and income to maximize results.
Challenges and solutions in adapting an AI-powered health management tool for South African
Authors: Kini N , Coltuneac C , Hartenstein V , Scholz J , Azadzoy H , O'Donnell L , Türk E 
Published: October 2021

Abstract

Background
Africa has the lowest density of healthcare workers in the world and artificial intelligence (AI) technology can assist doctors and patients to bridge that gap. This paper describes the 3 challenges we identified to adapt Ada, an AI-powered health management tool, to assist pregnant women and mothers in South Africa (SA).

Challenges and solutions
Localization
Maternal and child health challenges in SA differ from those in the West. We adapted Ada's knowledge base to account for regional differences in incidence and disease presentation. We optimized 51 maternal and pediatric health conditions.

Readability
An improved readability leads to better understanding of medical content. We calculated the readability score of Ada's consumer-facing medical content using the Automated Readability Index and deemed it too high (grade 11.0±1.8, range=5.8-17.5). Using Content Design London's Readability Guidelines, we reduced the readability score of Ada's content to below grade 8 (7.4±0.8, range=4.6-10.2) while maintaining medical accuracy.

Different approaches to AI
The majority of medical research is conducted in high-income countries and tends to recruit people with high literacy levels. This means the differences in underrepresented populations and low-income countries are not captured in medical research. When this data is applied to technology and AI, it can lead to bias. To reduce this bias, we use a white-box approach. This allows us to deliver solutions to meet the needs of a specific population. Using the expertise of medical doctors with clinical experience in low-income areas, we curated a medical knowledge base that was specific to our target population.

Conclusions
AI solutions can only improve health outcomes in low-income countries if they are designed and adapted with the needs of the local population in mind. By partnering with local health departments, AI health companies can assist doctors and patients to reduce the burden on vulnerable healthcare systems.

Key messages
White-box AI-approach makes it possible to build AI solutions that capture the differences in underrepresented populations and low-income countries. By partnering with local health departments, AI health companies can assist patients and doctors in reducing the burden on vulnerable healthcare systems.
Support for decision-making on sharing health data for research: are data counsellors relevant?
Authors: De Freitas C , Silva S , Machado H , Baptista MJ , Leão Teles E , Maia T , Amorim M 
Published: October 2021

Abstract

Background
The implications of sharing one's health data are far-reaching. Potential applications of health data range from the delivery of treatments tailored to individuals' characteristics to improvements in public health, while also posing concerns about privacy, social justice and equity. Making informed decisions about health data sharing thus requires thorough consideration of the scientific, ethical and personal implications of donations. This study assessed participants' preferences regarding decision-making about health data sharing for research, including the need for support by data counsellors.

Methods
This observational cross-sectional study includes 159 patients and 479 carers followed at two reference centres for rare diseases in a Portuguese academic hospital, between June 2019 and March 2020. Participants were asked about preferred modes of decision-making: deciding on their own, deciding with support from another person, or delegating the decision to someone else. Those who responded the last two options also reported who they would choose for support or delegation: family or friends; a data counsellor; a professional with no specific training on data counselling; other. Data were analysed using descriptive and inferential statistics.

Results
The majority of respondents would prefer to decide with support (62%), 37% would prefer to decide on their own and 1% would opt to delegate the decision of sharing health data. Among those who expressed a preference for support, 60% would like to rely on a data counsellor. Carers, older and higher educated participants, and those with upper white-collar occupations and who were satisfied with their own health were significantly more likely to select data counsellors as their preferred source of support when engaging in decision-making about health data sharing for research (p &lt; 0.05).

Conclusions
This study supports recommendations for the creation of a new professional specialty of health data counsellors.

Key messages
Most participants express the need for support in making decisions about health data sharing for research, with 60% preferring support from a data counsellor. As a new professional specialism, health data counselling can help to advance informed public participation in health research.
The Global use of Telemedicine in Tropical Medicine: Where we are after COVID-19?
Authors: Salvador FGF , Lapão LV 
Published: October 2021

Abstract

Issue
The use of Telemedicine (TM) to provide remote care is an important strategic resource for reducing inequalities in access to Public Health globally. Many countries with a high prevalence of Tropical Diseases (TD) have an insufficient number of physicians, but this potential for remote assistance is still largely untapped.

Description of the problem
A Scoping Review was combined with the SWOT technique (Strengths, Weaknesses, Opportunities, and Threats), which is a strategic analysis tool that enables action planning based on the evaluation of the interaction between the internal capacities of a process and external influencing factors. The SWOT analysis matrix of this study was based on a bibliographic research on the topic of TM applied to the clinical management of TD. It sought to obtain a characterization of the current global scenario, identifying (I) the contexts in which initiatives are being implemented and (II) the main gaps in the evidence. The objective is to subsidize action planning by healthcare systems, taking advantage of the expansion pandemic trend.

Results
A Scoping Review selected 41 studies. As strengths, the advances in the development of m-health tools for clinical and epidemiological monitoring of TD stood out, as well as some successful local experiences in implementing targeted TM systems. Among the weaknesses are infrastructure limitations and a lack of international cooperation initiatives. As for the opportunities, the context of the COVID-19 pandemic increased the importance of the topic on the health systems agenda and boosted investments in the sector. Regarding the threats, the scarcity of specific clinical guidelines and protocols and robust evidence on cost-effectiveness may be highlighted.

Lessons
The incorporation of TM in the qualification of clinical care for TD can have a relevant impact on the improvement of global public health indicators. The experience in such services is still scarce but represents an opportunity.

Key messages
There is a relevant potential in using Telemedicine to improve global access to Public Health in TD endemic areas. To support telemedicine there is the need to raise the awareness of managers, health workers and researchers about innovation in Tropical Diseases.
Comparing Digital Health Strategies and COVID-19 Response in European Union Member States
Authors: Rachadell J , Garcia T , Vareda R 
Published: October 2021

Abstract

Background
In 2019, Digital Health was on the agenda of the European Union (EU) and its Member States (MS), and the digital health transformation of both healthcare services and Public Health has been well underway for several years. The COVID-19 pandemic crisis required an unexpectedly quick adaptation of social norms and exerted great pressure on healthcare and public health systems. Although implemented strategies and results have varied, Digital Health tools emerged as a fundamental aspect of the pandemic fight across the EU.

Methods
The objective of this study was to determine and compare Digital Health Strategies and COVID-19 Response in EU MS 43% had no interoperability with other apps. We analyzed the 27 MS of the EU and determined several parameters relevant before and during the pandemic: 1 - Preexisting national digital health strategy in 2019; 2 - COVID-19 General Information Website; 3 - Real time updated COVID-19 online dashboard; 4 - Mobile application for contact tracing; 4.1 - Mobile app launch date; 4.2 - Interoperability with other mobile apps; 5 - Shift to telemedicine; 6 - Official public health communication through social media; 7 - Dedicated COVID-19 Information System for Public Health Workforce. Information from publicly available sources.

Results
All EU MS had a preexisting digital health strategy before the pandemic, developed a dedicated COVID-19 General Information Website and a COVID-19 dashboard with real-time updates on relevant statistics. The majority of MS (79%) developed a mobile app for contact tracing (43% had no interoperability with other apps), and of those that had not developed an app as of April 30th 2021, 50% had one under development. Most apps were launched in the first trimester of 2021. Other results were heterogeneous.

Conclusions
In some aspects, there is a clear convergence between EU MS in the deployment of digital health tools to fight the COVID-19 pandemic.

Key messages
All European Union Member States used digital health tools to fight the COVID-19 pandemic. The success of national level deployment of specific digital health tools must be assessed in order to develop a more integrated digital health response plan at the European level in the future.
Sex differences in psychosocial resources among people with chronic pain and with pain more seldom
Authors: Samulowitz A , Hensing G , Haukenes I , Bergman S , Grimby Ekman AE 
Published: October 2021

Abstract

Background
Despite the importance of psychosocial resources such as self-efficacy and social support for pain coping, sex differences in populations with and without chronic pain, and the impact of psychosocial resources on pain prospectively is sparsely examined.

Methods
Data from the Health Assets Project, a longitudinal cohort study with two data collections (2008 and 2009) in Sweden was used. We analyzed self-efficacy, emotional and instrumental social support among 1155 people with chronic pain and 2855 people with pain more seldom, including sex differences and the interaction between pain and sex. Among people with chronic pain we examined prospective associations between self-efficacy and social support in 2008 and pain in 2009. All regression models were analyzed unadjusted and adjusted for age, education and place of birth.

Results
People with chronic pain had lower psychosocial resources than people with pain more seldom (p&lt;.001). People with pain more seldom showed sex differences for all psychosocial resources (p&lt;.001), people with chronic pain did not show sex differences for instrumental social support. In addition, the interaction between sex and pain was significant for instrumental social support (p=.006, p=.005). Men with pain more seldom had the highest prevalence of low instrumental social support. High compared to low instrumental social support in 2008 was associated with lower odds of chronic pain in 2009, especially for women (OR = 2.2, 95%CI=1.19-4.28). The association between pain 2009 and the interaction between sex and high emotional social support was significant (p=.040). Women with high compared to low emotional support 2008 had 55% higher chance to have pain more seldom 2009, men had a 28% lower chance.

Conclusions
People with chronic pain showed less sex differences in psychosocial resources, compared to people with pain more seldom. In addition, for women, social support was associated with lower pain frequency during one-year follow-up.

Key messages
Men and women with chronic pain reported more alike on psychosocial resources than men and women with pain more seldom. For women only, both high instrumental and high emotional social support were associated with lower pain frequency during one-year follow-up.
Cardiovascular diseases as a reservoir for latent deaths from drug addiction (exemplified by Moscow)
Authors: Semyonova VG , Zubko AV , Sabgayda TP , Evdokushkina GN , Ivanova AE 
Published: October 2021

Abstract

The life expectancy gap between Russia and post-industrial countries is mainly due to mortality from diseases of the circulatory system (DCS), primarily in working ages, substantiating the need for a program to reduce cardiovascular mortality, currently implemented in Russia. In general, this program has resulted in a multiple reduction in cardiovascular mortality in Russia, however, in 2015-2017, Moscow turned out to be the absolute outsider among the Russian regions in DCS mortality among males of young and middle working ages and a contrastive outsider among females: in ages 15-29 mortality increased 4.4-fold among males and 3-fold among females; in ages 30-44 - 2.1-fold and 2.0-fold, respectively. The purpose of the study is to identify causes of the abnormal increase in mortality in Moscow in 2015-2017. The study shows that, first, the abnormal dynamics were due to cardiomyopathy, unspecified (CU) (I42. 9): the CU mortality in ages 15-44 increased 20-fold in males and 10-fold in females; in ages 45-59 - 7-fold and 8-fold, respectively, resulting in the highest ever CU mortality in Russia. Second, the CU deaths were usually sudden, not predated by a long-term treatment: admissions one month prior to death were registered in about 1% of cases in both sexes. Third, similar processes with the same reference point (2015) have been reported for drug poisoning, the rates of increase are comparable: about 10-fold in ages 15-29, 13 and 29-fold in ages 30-44 and 7.5 and 4-fold in ages 45-59, respectively. Fourth, numerous studies have shown that drug addiction (DA) leads to cardiovascular disorders, especially cardiomyopathies. Official data show that total DA mortality in Russia in the 2010s ranged from 3,752 to 5,581, which hardly corresponds to the actual scale of the problem because of underestimation of DA deaths due to their transferring to a latent form. In Moscow, DCS and cardiomyopathy, unspecified, in particular are one of the reservoirs for DA latent deaths.

Key messages
Drug addiction (DA) leads to cardiovascular disorders, especially cardiomyopathies. As to the capital, DCS, CU in particular, are one of the latent reservoirs of DA mortality.
Nutritional risk factors for SARS-CoV-2 infection: prospective study from the NutriNet-Santé cohort
Authors: Deschasaux-Tanguy M , Bourhis L , Druesne-Pecollo N , Esseddik Y , Galan P , Hercberg S , de Lamballerie X , Carrat F , Touvier M ,   SAPRIS-SERO study group, Paris, France
Published: October 2021

Abstract

Background
Many hypotheses were raised regarding a role of nutrition in COVID-19 (susceptibility to infection, disease severity) based on the importance of macronutrients, vitamins or minerals for a proper functioning of the immune system. Our objective was to study the associations between dietary intakes and the seroprevalence SARS-CoV-2 infection in a large population-based sample.

Methods
Our analyses included 7766 adults from the French NutriNet-Santé cohort who provided at least 6 valid 24h dietary records in the two years preceding the start of the COVID-19 pandemic in France (February 2020). An ELISA assay was used to detect anti-SARS-CoV-2 antibodies: 311 participants were positive and 7455, negative. Associations between dietary intakes and the seroprevalence of anti-SARS-CoV-2 antibodies were investigated using multi-adjusted logistic regressions.

Results
A lower seroprevalence of SARS-CoV-2 infection was associated to higher intakes of vitamin B9 (HR = 0.84 (0.72-0.98)), vitamin C (HR = 0.85 (0.75-0.97)), vitamin K (HR = 0.86 (0.74-0.99)), dietary fibres (HR = 0.84 (0.72-0.97)), and fruit and vegetables (HR = 0.84 (0.74-0.97)). Higher intakes of calcium (HR = 1.17 (1.01-1.35)) and dairy products (HR = 1.19 (1.06-1.33)) associated to a higher seroprevalence of SARS-CoV-2 infection. No association was observed with other food groups or nutrients or with the overall diet.

Conclusions
Based on exhaustive seroprevalence data in a large population-based sample, our results suggested that higher intakes of vitamin C, folates, vitamin K, dietary fibres and fruit and vegetables were associated with a lower susceptibility to SARS-CoV-2 infection.

Key messages
Higher intakes of vitamin C, folates, vitamin K, dietary fibres and fruit and vegetables were associated to a lower susceptibility to SARS-CoV-2 infection, assessed with exhaustive seroprevalence data. Beyond its established role in the prevention of non-communicable diseases, nutrition could also contribute to prevent some infectious diseases such as COVID-19.