bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uncovering Prognostic Clinical Phenotypes in Children and Adolescents with SARS-CoV-2 Infection
Authors: Shi Y , Strobl R , Berner R , Armann J , Scheithauer S , Grill E 
Published: October 2024

Abstract

Background
Characterizing clinical phenotypes is important for classifying patients, predicting disease outcomes, and adapting treatment. We aimed to identify distinct clinical phenotypes among hospitalized children and adolescents with SARS-CoV-2 infection and to evaluate variations in prognosis across these phenotypes.

Methods
The DGPI (German Society of Pediatric Infectious Diseases) registry serves as a nationwide, prospective registry for children and adolescents hospitalized with a SARS-CoV-2 infection in Germany. We applied hierarchical clustering and integrated variables such as sex, SARS-CoV-2-related symptoms, pre-existing comorbidities, clinically relevant coinfection, and SARS-CoV-2 risk factors to describe distinct clinical phenotypes. Subsequently, we applied a multinomial logistic regression model to examine the association between these phenotypes and discharge status.

Results
The DGPI registry encompassed 6983 patients and facilitated the identification of six distinct phenotypes for children and adolescents with SARS-CoV-2. Phenotype A had a similar symptom pattern as the total sample. Predominant symptoms of patients with other phenotypes were gastrointestinal (95.9%, B), asymptomatic (95.9%, C), lower respiratory tract (49.8%, D), lower respiratory tract and ear, nose and throat (86.2% and 41.7%, E), and neurological (99.2%, F). Patients with phenotype C had lower odds of residual symptoms (OR: 0.10 [0.06, 0.15]) than those with phenotype A, whereas patients with phenotype D and E had higher odds of residual symptoms (OR: 1.33 [1.11, 1.59] and 1.91 [1.65, 2.21], respectively) than those with phenotype A. Patients with phenotype D were significantly more likely (OR: 4.00 [1.95, 8.19]) to have an unfavorable outcome, compared to patients with phenotype A.

Conclusions
We could show that the identified phenotypes could facilitate early risk assessment and aid in tailoring individualized patient management strategies.

Key messages
• Six distinct clinical phenotypes existed in children and adolescents with SARS-CoV-2 infection.
• Phenotypes could assist in risk evaluation and help personalize patient care.
Preventive interventions on vector-borne diseases related to climate change: an Umbrella review
Authors: Fevola G , Valz Gris A , Ricciardi W , Gualano M R 
Published: October 2024

Abstract

Background
Vector-borne diseases (VBDs) are a global challenge to public health, being influenced by ecological factors and climate change. Despite the several preventive public health interventions that can be implemented, the evidence of their impact is still fragmented. An organic overview of the current evidence can provide relevant information on the effectiveness of these actions.

Methods
We conducted an umbrella review following the PRIOR checklist. Relevant reviews were searched using PubMed and Cochrane databases. We considered eligible all systematic reviews published in English between 2013 and 2023, containing meta-analysis on public health interventions aimed at reducing incidence, prevalence, or the burden of disease of VBDs, without demographic restrictions.

Results
We screened 1971 records. 51 reviews were included. 38 reported outcomes targeting Malaria, 9 Dengue, 2 Yellow Fever, 1 Leishmaniasis,1 Zika, 1 Chikungunya, 1 Crimean-Congo haemorrhagic fever, 1 Lyme disease and 1 Schistosomiasis. Several interventions were assessed worldwide. 18 reviews considered chemoprophylaxis, 9 net/curtains, 8 vaccines, 6 repellents, 3 housing interventions, 2 community participation, 2 MTaT and 2 oral supplementations. Authors stated conclusions are favourable to the interventions assessed for the 73%, but the certainty level is mostly considered low.

Conclusions
Public health preventive interventions are fundamental in responding to the threat of VBDs, but their impact may vary depending on several factors. Further research must provide more effective interventions and strategies, with a cohesive presentation of their evidence.

Key messages
• Effective reduction of VBDs burden requires a combination of interventions that must be tailored to local ecological, social, and epidemiological factors.
• Evidence presented in this umbrella review can inform evidence-based policies and programs aimed at combating VBDs at local, national, and global levels.
Risk perception survey for healthcare-associated infections in a large teaching hospital in Rome
Authors: Paolini R , Fei G , Carlomagno L , De Santis A , Orlandi S , De Giusti M 
Published: October 2024

Abstract

Background
Healthcare-associated infections (HAIs) are the main complications of hospitalization. The goal of the study was to enhance awareness, improve risk perception, and facilitate measures to reduce the outcomes of HAIs. A bottom-up approach, in which the healthcare workers involved play a key role, can be adopted to decrease the spread of HAIs. Therefore, a survey was conducted in a large teaching hospital in Rome from 2019 to 2023, excluding 2020 due to COVID-19.

Methods
A longitudinal study was conducted in all integrated care departments with beds. The data was collected using a standardized, anonymous, self-administered questionnaire for healthcare workers. The questionnaire consisted of 61 items assessing socio-professional features, knowledge of HAIs, attitudes and barriers to hygiene compliance, self-analysis of professional behavior and advice for new interventions. The study lasted 21 days between November and December, which is considered a period of normal care activity. A multivariable logistic regression model was built. Statistical analyses were performed with STATA 18.0.

Results
There were 384 health workers respondents: female (67.7%) and nurses (56.5%). The most represented areas were internal medicine (37.9%) and surgery (27.3%). The correct frequency of perception of HAIs increased from 33.3% in 2019 to 36.3% in 2023. From 2022 to 2023, the multivariable model showed that physicians (OR 0.48, CI 95% 0.24-0.93, p-value 0.03) and elder staff (OR 1.02, CI 95%, 1.0-1.1, p-value 0.04) seemed to be more aware of the prevalence of HAIs in their ward.

Conclusions
Targeted training days were organized after the study to discuss the data collected. Staff awareness of the prevalence of HAIs in their ward is improving, even if it is complicated to quantify it by attending HAIs training events. The survey has been included as a corporate goal for 2024 as a useful tool to improve awareness of HAIs and to evaluate the effectiveness of ongoing training.

Key messages
• A bottom-up approach, in which healthcare workers assume a pivotal role, can be employed to reduce the spread of HAIs as it serves as a valuable tool to evaluate the efficacy of targeted training.
• The results indicate that the education of healthcare workers is a crucial factor in enhancing awareness of HAIs. Therefore, there is a need to improve the education of younger and non-medical staff.
Enhancing port preparedness in Germany in the event of infectious diseases – a best practice study
Authors: Frese M , Neumann J , Boldt M , Ehlers L , Dirksen-Fischer M , Gueye S , Bäßler J , Harth V , Heidrich J 
Published: October 2024

Abstract

Background
The maritime sector is exposed to specific risks in the area of communicable diseases. In Germany, five ports are designated to enforce the International Health Regulations (IHR) and must have certain core capacities to respond immediately to cross-border health threats. A joint external evaluation conducted by the World Health Organization (WHO) revealed a need to reinforce central structures in Germany. The overarching objective of the study is to harmonize and consolidate the requisite capacities for maritime health security.

Methods
Qualitative interviews (n = 35) at baseline were conducted with various stakeholders, including port medical services, port authorities and other stakeholders. The parameters to be analysed included specific activities and interfaces during infectious incidents, experience with past infection incidents, training and exercise, and the need for action. Furthermore, a document analysis was conducted, during which the existing contingency plans and standard operating procedures were reviewed.

Results
In essence, the initial challenges posed by the COVID-19 pandemic have led to the establishment of well-defined procedures and interfaces between the various stakeholders involved. There is a necessity for enhanced interpersonal communication between the various stakeholders and the implementation of sustainable training practices. Furthermore, greater transparency and standardisation of regulations in international health emergencies is desired.

Conclusions
Given the infrequency of cross-border infection incidents on board ships, targeted preparation within stakeholders is often given a lower priority than other work priorities. The participatory study design is intended to develop comprehensive concepts in collaboration with the IHR ports in the ongoing project. Subsequently, these concepts will be tested in tabletop exercises and incorporated into training formats for public health actors.

Key messages
• The qualitative interview study at baseline revealed a substantial need for sustained communication and training practices among stakeholders for infectious disease preparedness in German IHR ports.
• The document analysis revealed relevant differences in the extent and scope of contingency plans of German ports designated under the International Health Regulations.
Whooping cough – a recurrent epidemic
Authors: Coelho P , Torres C , Gonçalo J , Cordeiro E , Dantas M M , Pimentel J P 
Published: October 2024

Abstract

Background
Whooping cough (WC), or Pertussis, is a vaccine-preventable and highly contagious infectious disease. Although it has a relatively low fatality rate, approximately 13% of reported cases develop secondary bacterial pneumonia. This was because of several recurrent epidemics across Europe in the last decades, with the latest beginning in mid-2023 and still ongoing. The Central Region of Portugal is currently being affected, and this study aims to describe the current epidemic at the regional level.

Methods
Data from epidemiological inquiries of confirmed and probable cases of WC pertaining to the Central Region of Portugal from January 2020 till April 2024 was gathered from the mandatory report national epidemiological surveillance system (SINAVE). Both a temporal comparison of number of cases and a statistical space-time scan with permutation were conducted (software SaTScan v10.)

Results
A comparison by month of reported cases shows an increase in cases from September 2023 until December 2023 followed by an exponential increase from January 2024 until April 2024 denoting an ongoing epidemic. In the statistical space-time analysis of 107 reported cases between September 2023 and April 2024, 8 nonsignificant clusters were identified with different locations involved in non-overlapping periods.

Conclusions
The finding of several unrelated clusters, even though nonsignificant, during a short time period indicates that Pertussis transmission is ongoing at the local level probably through asymptomatic or barely symptomatic cases that act as reservoirs. Clinicians must hold a high clinical suspicion for a timely diagnosis, treatment and report and health authorities must reinforce control measures to limit the spread of this disease.

Key messages
• Pertussis remains a disease of significant concern recurrent outbreaks across Europe show that public health local authorities have an important role in timely management of cases and outbreaks.
• Local level transmission and intervention may play a pivotal role in the epidemiologic dynamic of Pertussis.
Unplanned emergency department attendances due to home and leisure accidents in the elderly Portugal
Authors: Alves T , Silva S , Braz P , Papadakaki M , Mexia R , Aniceto C , Matias-Dias C 
Published: October 2024

Abstract

Home and Leisure Accidents (HLA) have been identified as a relevant public health issue with individual, societal and economic consequences. So, common cause of injury-related morbidity and mortality, especially among older people. Evidence shows that most of HLA among the older ones are associated with identifiable and modifiable risk factors. However, more detailed information about the context and characteristics of such events is needed. This study aimed to characterize the occurrence of HLA in victims aged 65 and over related to hospital Emergency Department (ED) of the National Health Service in Portugal based on hospital records, through EVITA system. A descriptive analysis of the data was performed. Bivariate comparisons were performed using Pearson’s chi-square test with a significance level of 5%. In this analysis, the statistical program SPSS V.27 was used. During the 2022 year the older people aged 65 and over represented 25% of the total of attendances in the emergency department. In the 2022 year there were 70 452 HLA in people victims aged 65+, constituting 32% of hospital ED attendances by HLA (preliminary data). The results show that 65,9% of the attendances were amongst the age group of 75 years and beyond. More frequently reported in females (64,3%) than in males (35,6%), being these differences statistically significant (p &lt; 0,01). The summer season for both age groups had higher proportion of HLA. In both age groups 65-74 years and 75 years and over most of HLA occurred at home (65,2%; 68,8%), followed by outdoor spaces (12,2%; 6,7%), public area (3,4%; 13,6%) and transport area (9,2%; 5,5%), these differences were statistically significant (p &lt; 0,01). Regarding to the products/agents most involved in the HLA the “floor” was the leading category in age group 65-74 years (27,1%) and in the oldest 75 years and over (43,0%). Considering that globally HLA can be prevented, this information reinforces the importance of this problem and its magnitude.

Key messages
• The older people represented 25% of the total of attendances in the emergency department in the year in analysis. 13% of ED attendances occurred due to HLA.
• The National Injury Surveillance System provides information that allows to know the characteristics and circumstances of HLA that occur in older people.
Mapping barriers and bottlenecks for personalized preventive approaches in health systems worldwide
Authors: Scarsi N , Taha A , Farina S , Osti T , Russo L , Savoia C , Maio A , Villani L , Pastorino R , Boccia S 
Published: October 2024

Abstract

Over the past decades, the growing prevalence of chronic disease globally raised the public health need to plan tailored personalized preventive approaches, mainly through big data and -omic sciences. However, a conspicuous body of literature highlighted the existence of many barriers and bottlenecks hindering their actual implementation in real-word settings. From here, this scoping review of reviews aims to map all known barriers and bottlenecks to the implementation of personalized preventive approaches in European health systems and beyond. PubMed, Web of Science, Scopus and gray literature sources were consulted from 2017 to January 2023, identified barriers and bottlenecks were analyzed against the Consolidated Framework for Implementation Research (CFIR). Out of 11,602 records, 220 were deemed eligible for full-text screening, and a final sample of 34 review studies were extracted. Studies were mainly performed in USA 15 (44%) and UK 3 (9%), followed by Canada 2 (6%), India 2 (6%) and Italy 2 (6%). From our results, the lack of evidence on clinical utility, guidelines, specialized professionals, citizen trust and cultural issues are the most frequently reported barriers to the implementation of personalized preventive approaches worldwide. These in turn affect country specific policies and the applicability of such innovations across different populations, raising the risk of increasing health inequalities and discrimination concerns. Findings confirmed that most translational challenges pertain to primary and secondary prevention levels across several chronic diseases, with particular concerns for non-European ancestry individuals.

Key messages
• The identification of bottlenecks are informative of future precision public health interventions.
• Barriers reported in most of the studies suggest the need to establish a targeted agenda.
Health impact of the Serious Accidents Punishment Act in Korean occupational settings
Authors: Lee J , Yoon B , Oh J , Park H , Sim J , Yoon J 
Published: October 2024

Abstract

Background
Interrupted time series analysis serves as a valuable study design for assessing the efficacy of public health interventions implemented at a specific moment in time at the population level. We aim to elucidate the effects of the Serious Accidents Punishment Act implemented in February 2021 in Korea by analyzing changes in the incidence rates of occupational diseases.

Methods
The monthly data from patients with occupational diseases was extracted from the National Health Insurance Service Cohort database from 2011 to 2023. An Interrupted time series analysis with Poisson segmented regression was used to compare the rates before and after the Serious Accidents Punishment Act introduction in both outpatients and inpatients. Adjustments or stratification variables included sex, age, company size, and injury-related international classification of diseases codes (Injury, poisoning, and certain other consequences of external causes, S00-T88).

Results
Based on injury rates, men’s inpatient injury rates remained stable, but outpatient rates decreased after the act implementation, while women’s injury rates consistently declined in both inpatient and outpatient settings. The Interrupted time series regression analysis indicates that the Serious Accidents Punishment Act led to a significant reduction in both outpatient and inpatient injury rates for men and women, with a marked decline in outpatient rates and hospital admissions among women post-intervention.

Conclusions
The Interrupted time series regression results suggest that the Serious Accidents Punishment Act has been effective in reducing injury-related healthcare usage, highlighting the necessity of gender-specific interventions and the potential impact on lowering inpatient visits, although causality remains uncertain without further analysis.

Key messages
• The Serious Accidents Punishment Act significantly reduced occupational injury rates in Korea, especially among women, demonstrating effective public health intervention.
• Interrupted time series analysis reveals Serious Accidents Punishment Act’s impact on reducing healthcare usage for occupational injuries, highlighting the need for gender-specific approaches.
Loneliness and the prevalence of injuries, falls and fractures in older people
Authors: Ciochoń A , Kozela M , Pająk A 
Published: October 2024

Abstract

The feeling of being alone (loneliness) experienced by older people contributes to deterioration of health, reduced physical and mental fitness, or inability to continue life roles. Loneliness may lead to behaviors that increase the risk of accidents, falls, and fractures, which are particularly dangerous in old age. The aim of this study was to assess the relationship between loneliness and the prevalence of injuries, falls, and fractures in older people. The studied group consisted of 464 people (48% men), aged 62-86 years (mean: 71.6, SD: 6.3), who participated in the Polish part of the HAPIEE Study (Health Alcohol and Psychosocial Factors in Eastern Europe); random subsample examined in 2019-2020. Trained nurses interviewed respondents in their homes. The 3-item UCLA scale (range 3-9, cut-off point≥6) was used to assess loneliness. Data on injuries or accidents in previous 10 years, falls in previous 12 months, history of wrist, hip fracture or undergoing joint surgery/alloplastic was recorded. Multivariable logistic regression analysis was used. There were 460 participants included in the analysis. In 34 participants (7.3%) UCLA score was ≥6. In the previous 10 years, 95 respondents (20.5%) reported an injury or accident, 77 (16.6%) fell in previous 12 months. There were 6 (1.3%) respondents with history of hip fracture, 48 (10.3%) with history of wrist fracture, and 35 (7.5%) with history of joint surgery/alloplastic. No statistically significant relationship between loneliness and the prevalence of injuries, falls and fractures in older residents was found neither in the crude models nor after adjustment for covariates (age, sex, BMI, marital status, having offspring). Loneliness did not predict injuries, falls, and fractures in older urban residents. It seems that perception of being alone is weaker determinant of health as a measure not fully reflecting objective social isolation, which may actually have a greater impact on falls and injuries.

Key messages
• 1/5 of older people have experienced any injury or accident and 17% reported to have fallen in the previous year.
• Loneliness did not predict injuries, falls, and fractures in older urban residents.
Concept of a medical and public health cancer genomics platform
Authors: Specchia M L , Cozzolino M R , Cacciuttolo M G , Ammendolia A , Pastorino R , Boccia S 
Published: October 2024

Abstract

Background
This study aims to produce the concept of an open-access medical and public health cancer genomics platform aimed at aggregating and sharing documentation of ongoing initiatives and data resulting from the CAN.HEAL project, available for EU researchers, healthcare professionals, policy makers, citizens and patients.

Methods
The context (reference sector, stakeholders and research evidences), feasibility (privacy management and data processing), and platform’s end users were analysed; the CAN.HEAL project deliverables were listed and clustered; aspects related to the definition of the overall platform architecture and modules integration were studied.

Results
The project deliverables were catalogued into 8 categories which could be the platform’s cloud interface main labels: results from events, policy papers, newsletters, mapping results and reports, datasets, recommendations and guidelines, use cases, courses and training activities. To define the overall system architecture, the following key activities should be implemented: content management system choice, hosting configuration and setup of the development domain, content management system installation, development of HTML web pages, data entry, data visualisation and graphic layout, and test and debug. To the modules integration purposes the following items should be addressed: creation of a server analytics account; social network integration; activation of additional system for sending newsletters.

Conclusions
Cloud-based data platform allows to securely manage, integrate, analyse and share large datasets. Establishing an infrastructure to help researchers access, store and analyse large amounts of biological data is of paramount importance both to enable advances in research and support health policy making processes. The CAN.HEAL platform could help aligning clinical and population-based interventions for integrating the genome of Europe biobanking initiative into public health genomics for cancer.

Key messages
• Connecting healthcare data can support the challenge of accessing the relevant information needed for the policy and decision making processes to effectively promote population health and wellbeing.
• The set-up of a medical and public health cancer genomics platform promotes the effective translation of genome-based knowledge and technologies into public policy and health services.