bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Prevalence of Multiple Sclerosis in Liguria region, Italy, using the capture–recapture method
Authors: Ponzio M , Amicizia D , Brichetto G , Tacchino A , Piazza MF , Paganino C , Trucchi C , Astengo M , Battaglia MA , Ansaldi F 
Published: October 2021

Abstract

Background
In recent years, there has been a growing interest in developing methods based on health administrative databases to estimate prevalence of chronic diseases, hoping that this would lead to more precise and reliable estimates. The capture-recapture method can be used to improve the prevalence of a disease reducing the bias of case underestimation.

Objective
To assess the prevalence of multiple sclerosis (MS) in the Liguria region in Italy using routinely collected healthcare data.

Methods
Data from three sources collected in Liguria Health Authority (A.Li.Sa.) databases - hospital discharge records, drug-dispensing records, disease-specific payment exemptions from copayment to health care - and a capture-recapture method with log-linear models were used to estimate the prevalence of MS. The accuracy of the case-finding algorithm was tested using a sample of people residents in Liguria Region with a definite diagnosis of MS extracted from clinical records of Liguria AISM Rehabilitation Service as reference standard.

Results
The case-finding algorithm to capture people with MS from routinely collected healthcare data used in our study found an observed crude prevalence of MS in Liguria region on 31 December 2017, of 202.4 cases per 100,000 inhabitants (95% CI: 195.3-209.5). After linkage to clinical data, the algorithm showed a sensitivity of 82.7%, with 22.1% of MS cases undetected on capture-recapture models. Consequently, the capture-recapture method prevalence estimate of 259.7 per 100,000 inhabitants (95% CI: 251.7-267.8) suggest that this region constitutes a high-risk area for MS.

Conclusions
Our initial study of crude MS prevalence showed an overall regional prevalence of MS of 202.4 cases per 100,000, capture-recapture analysis would add another 20%, to those figures. This method could be considered a good alternative to the population-based study design for estimating the prevalence of MS.

Key messages
Studies based on routinely collected healthcare data could help estimate the prevalence of chronic disease. To reduce the bias of case underestimation, the capture–recapture method can be useful.
Nitrites and nitrates from food additives and cancer risk: results from the NutriNet-Santé cohort
Authors: Chazelas E , Pierre F , Druesne-Pecollo N , Gigandet S , Srour B , Huybrechts I , Julia C , Kesse-Guyot E , Deschasaux-Tanguy M , Touvier M 
Published: October 2021

Abstract

Nitrates and nitrites occur naturally in water and soil and are commonly ingested from water and dietary sources. They are also frequently used as food additives mainly in processed meats. Experimental data consistently suggest their involvement in carcinogenesis but human data is still limited. The aim was to investigate the relationship between nitrate and nitrite intakes and the risk of cancer in a large prospective cohort with detailed and up-to-date dietary assessment. Overall, 101,056 adults from the French NutriNet-Santé cohort study (2009-ongoing) were included. Consumption of nitrites and nitrates was evaluated using repeated 24h dietary records, linked to a comprehensive food composition database which includes details of commercial names/brands of industrial products. Prospective associations between nitrite and nitrate exposures and the risk of cancer were assessed by multivariable Cox hazard models. During follow-up, 3311 first incident cancer cases were diagnosed. Compared with non-consumers, higher consumers of nitrates as food additives had higher risk of breast cancer (HR = 1.24 (1.03-1.48), P = 0.02); this was more specifically observed for potassium nitrate e252, P = 0.01). Higher consumers of nitrites as food additives, and specifically for sodium nitrite (e250), had a higher risk of prostate cancer (HR = 1.58 (1.14-2.18), P = 0.008 and HR = 1.62 (1.17-2.25), P = 0.004, respectively). No significant association was observed for nitrates and nitrites from natural sources. In this large prospective cohort, nitrates as food additives were positively associated with breast cancer risk and nitrites as food additives were positively associated with prostate cancer risk. While these results need confirmation in other large-scale prospective studies, they provide new insights in a context of lively debate around the ban of nitrite additives in food products.

Key messages
Nitrates as food additives were positively associated with breast cancer risk. Nitrites as food additives were positively associated with prostate cancer risk.
Organization of specialized outpatient care in the context of integrated healthcare networks
Authors: de Andrade AT , Shimocomaqui GB , Santos LKO , Eshriqui I , Paresque MAC 
Published: October 2021

Abstract

Problem/Issue
The Specialized Outpatient Care (SOC) organization is a worldwide concern, aiming to ensure integrality and equity of health care.

Description of the problem
Implantation of SOC services regionalized and integrated in a healthcare network coordinated by Primary Care (PC) seems to be a potential strategy to restore balance between demand and supply by SOC. The “Health Care Planning” (HCP) method, proposes a population-based management SOC model with horizontal and collaborative relation between SOC and PC, different from the conventional model focused on medical specialties. Thus, SOC assumes three functions besides assistance: educational, research and supervisory. In 2018, the PlanificaSUS project started the implantation of this model in 25 regions of 19 Brazilian states. Each region chose one SOC service and one priority line of care, based on local epidemiological indicators. Workshops and tutoring activities were conducted and SOC teams were trained based on the continuous care cycle, in an inter-professional and collaborative way.

Results
Priority lines of care were chosen as follows: maternal and child (n = 17); elderly health (n = 1); mental health (n = 1); and hypertension and diabetes (n = 6). Each SOC service mapped PC services in region, defined evidence-based clinical guidelines in the healthcare network and organized SOC portfolio, composed of multi-professional team, equipment and physical structure. Team training was concluded in 19 SOC services, in which educational function was introduced with PC through a risk stratification course. This course was based on common clinical guideline between PC and SOC, contributing to shared and resolutive care.

Lessons
The proposed model for SOC organization could be a potential strategy to integrate SOC with PC in different settings, in spite of important challenges, such as: covid-19 pandemic, necessity local health managers' protagonism and politics to support SOC integration in healthcare network.

Key messages
Organization of SOC integrated in healthcare networks must be promoted to ensure integrality, equity and longitudinally of shared and resolutive care. Population-based management and a horizontal and collaborative relation between SOC and PC should be encouraged to improve quality and effectiveness of care in the healthcare network.
What can Europe learn from HCP knowledge and attitudes towards hepatitis A vaccination in the US?
Authors: Herrera-Restrepo O , Ghaswalla P , Davis K , Sweeney C , Davenport E , Andani A , Buck PO 
Published: October 2021

Abstract

Background
An estimated &gt;100 million new hepatitis A (hepA) infections occur annually worldwide. Centres for disease control and prevention reported 38795 hepA cases in the US since 2016, and 4475 outbreak-confirmed cases in Europe between 2016-2018. HepA outbreaks resulted mainly from person-to-person contact, especially among homeless, illegal drug users (IDU) and men who have sex with men (MSM). In 2020, we surveyed US health care providers (HCPs) to understand their knowledge and attitudes towards hepA vaccination in these populations at higher risk of infection and complications.

Methods
This was a cross-sectional, web-based survey of 400 HCPs (primary care providers, nurse practitioners, gastroenterologists, internal medicine and infectious disease specialists [IDs], emergency room physicians [ERs]) who had recommended and/or administered hepA vaccines to ≥ 19-year-olds.

Results
85% of 371 HCPs reported recommending hepA vaccine to homeless, 87% of 393 to IDU and 83% of 397 to MSM, although vaccination may not actually occur after recommendation. Results varied by specialty, 16% fewer ERs than IDs reported recommending the vaccine in these at-risk populations. Moreover, 64%, 75% and 71% of all (400) HCPs reported extremely important that homeless, IDU and MSM, respectively, get vaccinated for hepA, while 6%, 7% and 8% of all HCPs reported this as slightly, or not important. Reasons for not recommending hepA vaccine to homeless, IDU and MSM included uncertainty on guidelines (reported by 22/56, 24/50 and 29/66 HCPs, respectively) and low risk of infection (reported by 20/56, 30/50 and 27/66 HCPs, respectively).

Conclusions
Despite recent hepA outbreaks and strengthened recommendations for vaccination in at-risk populations, knowledge gaps persist among US HCPs. This survey may motivate European countries to reinforce national hepA vaccination recommendations and, in parallel, consider efforts to raise vaccination awareness.

Funding
GlaxoSmithKline Biologicals SA

Key messages
Education on hepatitis A vaccination recommendations in at-risk populations is needed. Health care providers’ vaccination knowledge plays a critical role to control the hepatitis A outbreak in the US and preventing hepatitis A in Europe.
Increase in the influenza vaccination rates in Portugal: comparing 2020-2021 to the last 10 years
Authors: Guedes L , Figueiredo AL , Afonso AL , Couto ML , Natividade A , Gouveia AJ , Saldanha MG , Sousa MF , Oliveira P , Martinho C 
Published: October 2021

Abstract

Background
Annual influenza vaccine uptake is recommended by the Portuguese General-Directorate of Health to certain priority groups. In 2020, amidst the COVID-19 pandemic, some exceptional measures were adopted to operationalize the Portuguese influenza vaccination campaign, like the extension and phasing of the vaccination period. No major changes were introduced in the vaccination of healthcare workers. In Baixo Tâmega health cluster (Portugal), it was perceived that these workers' vaccine uptake had markedly increased in 2020-2021. This study aims to compare their influenza vaccination coverage rates in 2020-2021 to the last 10 seasons.

Methods
A cross-sectional study of the vaccine uptake among the health workers of Baixo Tâmega health cluster was developed. A descriptive analysis was carried out, calculating annual influenza vaccination coverage rates from 2010-2011 to 2020-2021, in doctors, nurses and other health workers. Inferential analysis was performed through chi-squared tests in IBM SPSS Statistics 27.0.1.0., considering significant p-values&lt;0.05.

Results
The difference between health workers 2020-2021's influenza coverage rate and the last season's average rates was 22.81%. Before 2020-2021, average vaccination coverage rates were 51.60% (standard deviation 7.34%, 44.26-58.94%), 60.44% (standard deviation 4.12%, 56.32-64.56%) and 51.20% (standard deviation 7.66%, 43.54-58.86%), in doctors, nurses and other health workers, respectively. In 2020-2021, vaccination rates significantly increased to 79.34%, 79.52% and 74.24% in doctors, nurses and others, respectively (p &lt; 0.001).

Conclusions
Influenza vaccination uptake increased in 2020-2021 among health workers. Further studies should be developed to evaluate this tendency on a larger scale and to better understand its associated factors, which could have been unstructured awareness-raising campaigns, perception of protection against COVID-19 or avoidance of COVID-19-like symptoms and coinfection.

Key messages
Influenza vaccination coverage rates increased in 2020-2021 among the healthcare workers of a Portuguese health cluster. The COVID-19 pandemic may have contributed to the increase in the influenza vaccination coverage rates.
Vaccination coverage after the introduction of mandatory law: results from an Italian Southern Region
Authors: Di Martino G , Di Giovanni P , Cedrone F , D'Addezio M , Meo F , Scampoli P , Staniscia T 
Published: October 2021

Abstract

Background
Over the latest decades, Europe has been facing the spreading of vaccine hesitancy. This growing phenomenon has resulted in decreasing vaccination coverage all over Europe, particularly in Italy for measles, mumps and rubella. In order to face up this problem, in 2017 Italy introduced compulsory vaccination against 10 different infectious diseases: diphtheria, tetanus, pertussis, polio, hepatitis B, haemophilus influenzae B (all included in the hexavalent vaccine), measles, mumps, rubella (included in the MMR vaccine) and chickenpox (from the 2017 cohort). The aim of this study was to evaluate vaccination coverages in 2019 in Abruzzo, an Italian Southern Region, after the introduction of compulsory vaccinations.

Methods
In this study the following indicators were taken into account: vaccination coverages at 24 months of age (2017 cohort of birth), vaccination coverages at 36 month of age (2016 cohort), vaccination coverages at 5/6 years of age (2013 and 2014 cohorts) and vaccination coverages at 16 and 18 years of age (2001 and 2003 cohorts). Vaccination coverage rates were calculated as the number of vaccinated patients for each disease over the total number of patients born in the year considered.

Results
At the end of 2019, the 2017 cohort reached 95% coverage for all vaccinations except for chickenpox (87.9%). Conversely, the 2016 cohort showed low rates for MMR and chickenpox, up to 90.8% and 52.1% respectively. Additionally, 2013 and 2014 teenager cohorts showed coverage rates lower than 95% for all the compulsory vaccinations.

Conclusions
After two years of mandatory vaccination law in Italy, vaccination coverages have reached the 95% threshold only among patients of 24 months of age. Older cohorts still show inadequate vaccination coverages despite the introduction of mandatory vaccination law. Health services at regional level should develop policies and strategies aiming to improve vaccination coverages and to reach herd immunity.

Key messages
After the introduction on mandatory vaccination, vaccination coverages reached the 95% threshold only among patients of 24 months of age. Health services should develop strategies aiming to improve vaccination coverages.
Video Game addiction among a Tunisian cohort of adolescents: Incidence and associated factors
Authors: Bannour R , Zammit N , Ben Fredj S , Ghammem R , El Echi A , Mlouki I , Maatoug J , Ghannem H 
Published: October 2021

Abstract

Background
The concept of Video Game addiction is not yet recognized in the scientific literature. However, several authors suggest relating excessive video game attachment to addiction behavior, especially among adolescents. The aim of the study is to determine the incidence of video game addiction and its associated risk factors among high school students during the 2018/2019 school year in the governorate of Sousse.

Methods
A prospective longitudinal study with a one-year follow-up was conducted among 404 high school students enrolled in four high schools randomly selected from the governorate of Sousse. The same questionnaire was self-administered to participants in their classrooms in 2017/2018 and then in 2018/2019. The Arabic version of the ‘Game Addiction Scale for Adolescents' was used to detect possible video game addiction.

Results
The mean age of participants was 16.4 ± 1.1 years. Girls represented 66.8% of the sample. During the 2018/2019 school year, 25 adolescent became addicted to video games, with an incidence rate of 6.2%. This incidence was of 10.4% among boys and 4.1% among girls (p = 0.012). Smoking, experimenting cannabis and inhalants were significantly associated with the transition to video game addiction with odds ratio of 3.3 [1.1-9.5], 8.0 [1.9-34.3] and 12.1 [2.5-57.6] respectively.

Conclusions
The current study highlights the extent of video game addiction among adolescents in the governorate of Sousse. A comprehensive approach to prevent and manage cross addictions must be implemented in the schools of Tunisia.

Key messages
Incidence of video game addiction is high in high-school adolescents of Sousse. Comprehensive prevention program targeting behavioral addictions and substances use is required in Tunisia.
COVID-19 outbreaks in places of worship worldwide: a systematic review
Authors: Peano A , Bert F , Lo Moro G , Previti C , Scaioli G , Siliquini R 
Published: October 2021

Abstract

Background
Since the beginning of the CoViD-19 pandemic, scientific community raised concerns about mass gatherings: religious ones in particular could become the perfect soil for the Sars-CoV-2 transmission due to the environmental conditions (e.g. not-ventilated worship hall, no distance between attendees, physical contact). Thus, this systematic review aimed to explore CoViD-19 outbreaks in places of worship worldwide.

Methods
A systematic search of three electronic databases (PubMed, Scopus and Embase) was performed, including years 2020 and 2021 until March, 29th. Criteria of inclusion were articles published in English, French, Italian, Spanish or Portuguese, dealing with CoViD-19 outbreaks reported in churches, mosques, synagogues and other places of worship, regardless of region or religion. Pilgrimages were excluded.

Preliminary Results
Out of 7655 articles found, 36 were included, for more than 50 outbreaks reported. The number of persons involved in each cluster varied from units to several thousands, while the geographic distribution displayed reports mainly concerned about East and Southeast Asia (65%), Europe (15%) and North America (15%), referring to gatherings carried out in the first semester of 2020, in particular in February and March. The most involved religions were the main monotheistic ones (i.e. Christianity, Islam and Judaism), although the eastern religions played an important role too.

Conclusions
In reason of religious gatherings, places of worship had had an important role in the virus transmission, becoming the first cause of contagion in several countries especially during the first wave of the pandemic, because of the absence of social distancing, masks use, danger awareness and, in some cases, poor hygiene conditions or CoViD-19 denial. Although there was a different risk associated with different religions, this systematic review highlighted how important is to evaluate worship-related outbreaks as a major public health concern.

Key messages
50+ worship-relate clusters with a variable range of persons involved were reported principally from Asia, Europe and North America. The main monotheistic religions were more implicated. Places of worship became the first cause of contagion in several countries especially during the first wave of the pandemic: these outbreaks should be considered as public health concerns.
EU-PEARL: Changing the paradigm of clinical trials in Europe
Authors: Cash-Gibson L , Pericàs JM , Spiertz C , van de Ketterij E , Molero E , Patalano F , Kalra D , Ussi A , Van Dessel A , Genescà J 
Published: October 2021

Abstract

Issue
Recently, innovative clinical trial designs have been proposed, which have the potential to revolutionize clinical research. Whereas classical trials mostly evaluate only one investigational drug, platform trials embed various trials under a shared master protocol to enable the evaluation of multiple interventions for a disease or condition. Platform trials have mostly been used to evaluate cancer therapies, but also recently for COVID-19. The EU Patient-cEntric clinicAl tRial pLatforms (EU-PEARL) project aims to expand the use of platform trials as the backbone of drug development.

Description of Issue
EU-PEARL is a Innovative Medicines Initiative 2 Joint Undertaking funded project (2019-2023), and a strategic public and private sector alliance, which aims to support the transformation of the classical trial approach into a cross-company collaborative, multi-compound platform, centred around patients, not diseases. How to operationalize and sustain this? A multi-stakeholder, mixed-methods approach is taken, focused around the concept of an integrated research platform (IRP), i.e., a common enabling framework for platform trials. The IRP will be established as a sustainable and scalable global solution, consisting of an infrastructure, workflows, and guidance on how to meet complex regulatory, ethical, legal, statistical and data requirements. Lessons from COVID-19 trials will be incorporated.

Results
A disease-agnostic IRP is being developed, as well as four disease specific IRPs in four areas of high public health relevance, i.e. major depressive disorder, tuberculosis, non-alcoholic steatohepatitis, and neurofibromatosis.

Lessons
Multi-stakeholder, multi-sector and multi-disciplinary collaborations are challenging in practice, but rewarding in outcomes. Given the complexity of setting-up these novel trials, clear communication and standardized terminology must be established, as well as continual awareness building of their components, challenges and benefits.

Key messages
EU-PEARL intends to stage the clinical trials of the future, which will be more adaptive, efficient and patient-centred by design and outcome. EU-PEAR&Lacute;s efforts aim to contribute to timely societal access to affordable medicines and address unmet health needs.
Blm helicase facilitates rapid replication of repetitive DNA sequences in earlyDrosophiladevelopment
Authors: Ruchert Jolee M , Brady Morgan M , McMahan Susan , Lacey Karly J , Latta Leigh C , Sekelsky Jeff , Stoffregen Eric P 
Published: October 2021

AbstractThe absence of functional BLM DNA helicase, a member of the RecQ family of helicases, is responsible for the rare human disorder Bloom Syndrome, which results in developmental abnormalities, DNA repair defects, genomic instability, and a predisposition to cancer. In Drosophila melanogaster, the orthologous Blm protein is essential during early development when the embryo is under the control of maternal gene products. We show that lack of functional maternal Blm during the syncytial cell cycles of Drosophila embryonic development results in severe nuclear defects and lethality. Amongst the small fraction of embryos from Blm mutant mothers that survive to adulthood, a prominent sex-bias favors the class that inherits less repetitive DNA content, which serves as an endogenous source of replication stress. This selection against repetitive DNA content reflects a role for Blm in facilitating replication through repetitive sequences during the rapid S-phases of syncytial cell cycles. During these syncytial cycles, Blm is not required for complex DNA double-strand break repair; however, the progeny sex-bias resulting from the absence of maternal Blm is exacerbated by repetitive DNA sequences and by the slowing of replication fork progression, suggesting that the essential role for Blm during this stage is to manage replication fork stress brought about by impediments to fork progression. Additionally, our data suggest that Blm is only required to manage this replication stress during embryonic development, and likely only during the early, rapid syncytial cell cycles, and not at later developmental stages. These results provide novel insights into Blm function throughout development.