bluuebunny/crossref_metadata_2025_split huggingface dataset:
Birth defects and associated antenatal care factors related with 1st trimester of pregnancy
Authors: Zile-Velika I , Ebela I , Rumba-Rozenfelde I 
Published: October 2022

Abstract

Background
Ultrasound (US) can help monitor normal fetal development and screen for any potential problems. The prenatal detection of fetal anomalies allows for optimal perinatal management.

Aim
The aim was to assess congenital anomalies at births and their associated antenatal care factors.

Methods
Data source - Health Care Monitoring Datalink (HCMD), including two data sources: Medical Birth Register and ambulatory care data provided by public and private health care providers about US. Screening was detected by specific manipulation code: 50694 - routine US screening in the 1st trimester of pregnancy. All singleton birth in 2018 (n = 12955) were included in the data analysis. OR (odds ratio) were calculated. Multiple regression model was adjusted for mother age, gestational age, living area and antenatal care factors.

Results
The mean mother age was 30.3 (SD 5.4) and gestational age 39.3 (SD 1.8). The use of ICD-10 code O28 - abnormal findings on antenatal screening of mother - was observed in a small number of cases. 2.4% (n = 305) abnormal findings on antenatal screening of mother were detected at ambulatory care visits. From these cases 7.5% (n = 23) were diagnosed congenital anomalies at birth. Totally 2.8% (n = 362) of births were registered congenital anomalies. Congenital anomalies at birth have higher and statistically significant odds of invasive diagnostic methods in pregnancy (OR = 2.0; 95%CI 1.2-3.6; p &lt; 0.01) and abnormal findings on US screening (OR = 2.6; 95%CI 1.7-4.2; p &lt; 0.001). Slightly higher frequency of congenital anomalies at birth but not statistically significant (p &gt; 0.05) were observed for 1st trimester genetic screening (OR = 1.5), preterm deliveries (OR = 1.4) and living in urban area (OR = 1.3).

Conclusions
Pregnancy outcome as congenital anomalies at birth related with higher maternal screening examinations prenatally. Further studies are needed to analyze the efficiency of US examinations for early prenatal detection of congenital anomalies.

Key messages
Providers’ Experience with Artificial Intelligence-Based System During the COVID-19 Pandemic
Authors: Lintz J 
Published: October 2022

Abstract

Background
As the pandemic continues to spread worldwide, many of healthcare facilities are exploring new methods to keep their patients safe from potential hospital-acquired infections (HAIs) during the pandemic. This study explored the attitudes about artificial intelligence (AI) among providers who utilized AI-based hand hygiene monitoring system (HHMS) at a rural medical center during the pandemic.

Methods
A self-administered questionnaire was mailed to 48 healthcare providers at a rural medical center in north Texas, with a 75% percent response rate (n = 36). The survey collected information on providers attitudes about AI-based HHMS use. In addition, the study also examined the relationship between provider’s well-being and the level of satisfaction with the AI-based HHMS use. The lessons learned from this study will be used to determine important factors to consider when attempting to advance and expand AI technologies in rural healthcare settings.

Results
Results revealed that the integration of AI technology within the existing electronic health record (EHR) system remains a challenge for many providers. Plus, the lack of user-centered design approaches to incorporate the AI tool into existing workflows has reduced providers satisfaction about the new technology.

Conclusions
The findings suggested that although AI technology has great promise to reduce the number of hospital-acquired infections (HAIs), successfully implement of an AI-based tool that meets the expectations of users requires significant levels of consolidation to ensure that it fits within the existing workflows and is accepted by users.

Key messages
• AI application indirectly affects the well-being of providers, particularly in rural healthcare settings.
• A better AI application interface design that meets the expectations of providers is needed.
Thyroid cancer incidence in the female population of Georgia by regions and municipalities
Authors: Abesadze N , Tkeshelashvili V , Kereselidze M , Kvanchakhadze R , Beruchashvili T 
Published: October 2022

Abstract

Background
According to the NCDC (Tbilisi, Georgia), in 2015-2019, thyroid cancer ranked second in the cancer structure of cancer in Georgia. Additional studies are needed to identify the thyroid cancer incidence by regions and municipalities of Georgia.

Methods
E-dBase of cancer population registry for 2015-2019 (52,178 cancer cases), Tbilisi registry database for 2002-2004 (33,478 deaths from all causes), methodology recommended by IARC (Lyon) and UICC (Geneva), SEER program and 2014 Georgian census data were used in the study. Standardized cancer incidence and mortality rates (ASR, TASR, AAR, SRR, CR64, CR74, SIR, SMR, PIR, 95% CI) were calculated.

Results
Ranking and proportion of thyroid cancer in female population of Georgia in 2015-2019 according to the regions and municipalities, its age specifics and dynamics were determined. Incidence of thyroid cancer in women in Tbilisi (ASR=52.4%000; AAR=64.1%000), compared to Georgia (ASR=34.4%000; AAR=41.0%000), indicates that Tbilisi is the geographically highest prevalence zone for this site cancer and the highest levels were observed in the 25-69 age group (TASR25-69 - Georgia = 110.8%000, Tbilisi = 190.1%000). In dynamics, the incidence of thyroid cancer in the 27-year period (2015-2019 vs 1988-1992) according to the SIR, increased by 66.4%. According to the cumulative risk index (CR64, CR74), the municipalities, where the risk of developing thyroid cancer is almost 1.5 times higher than the total rate in Georgia, were identified. According to the PIR, the ratio of thyroid cancer to the share of thyroid cancer in the structure of cancer in the regions of Georgia (including Tbilisi) showed that the proportion of thyroid cancer in Tbilisi (PIR=117.7) is 17.7% higher compared to proportion of total thyroid cancer in Georgia.

Conclusions
It is recommended that the epidemiological map of thyroid cancer incidence be used in planning national, regional, and municipal preventive programs.

Key messages
• It is recommended to continue study in this direction: retrospective review of histological and histochemical features of each case of thyroid cancer.
• It is recommended: to conduct molecular (oncogenes) studies in conjunction with histological and histochemical studies.
Key issues for implementation of Genomics in Healthcare: a Policy Brief
Authors: Costa A , Merchant A , Lopes MF , Konopko M , Cardoso ML , Sitjà X , Bourbon M , Scollen S , Vicente A 
Published: October 2022

Abstract

Issue/problem
Healthcare (HC) can significantly benefit from genomic information for earlier, accurate diagnosis, effective personalized treatment with less adverse events, and accurate profiling of individuals for disease prevention. However, European countries are currently at variable maturity stages regarding the implementation of genomic medicine (GM) in healthcare, hindering the equitable delivery of personalized medicine to citizens across borders.

Description of the problem
The European 1+Million Genomes Initiative (1+MG) aims to provide cross-border access to quality genomic information and related clinical data, to advance data-driven research and HC solutions to benefit citizens. This initiative is encouraging countries to develop national GM strategies, but guidance for successful implementation is needed. In this context, the Beyond 1 Million Genomes, a supporting action to the 1+MG initiative, organized three Country Exchange Visits (CEV) to discuss critical issues, share experiences and best practices, for the implementation of sustainable GM strategies in healthcare.

Results
The United Kingdom, Estonia and Finland, which have advanced GM programs, hosted CEV describing progress and lessons learnt. Representatives of 1+MG signatory countries participated in these events and were able to present country level progress. The resulting Policy Brief (PB) captures key issues discussed at the CEVs, with real-life examples, and proposes policy recommendations for the successful implementation of GM in European healthcare systems.

Lessons
Sustainable GM implementation in HC systems requires: 1) Patient and citizens trust and engagement; 2) Sustainable infrastructure and data regulation, with solid ethical and legal frameworks; 3) Capacity building of healthcare professionals; 4) A strong ecosystem involving all stakeholders, and encouraging synergies between healthcare, research and industry to promote continuous innovation.

Key messages
• The implementation of GM in healthcare will take countries further towards making personalized medicine a reality, with remarkable health and socioeconomic benefits for patients and healthcare systems.
• Promoting cooperation, capacity building and sharing of best practices is crucial to reduce asymmetries between countries, which constrains effective and equitable cross-border personalized medicine.
Health Emergency and Disaster Risk Management During the COVID-19 Pandemic: A Case Study from Italy
Authors: Lamberti-Castronuovo A , Parotto E , Ragazzoni L , Valente M 
Published: October 2022

Abstract

Background
The COVID-19 pandemic has profoundly impacted societies, influencing countries’ Health Emergency and Disaster Risk Management (H-EDRM) systems. By taking Italy as a case study, this research aimed to investigate the response to the pandemic focusing on challenges, response strategies, lessons learned and implications for H-EDRM, with an emphasis on health workforce, health services delivery and logistics.

Methods
This was a retrospective observational study using qualitative methodology. Data was collected via semi-structured interviews and analyzed according to the H-EDRM framework. Multiple interviewees were selected to obtain a holistic perspective on the Italian pandemic response. Stakeholders from five sectors (policymaking, hospital, primary care, third sector, lay community) from three of the most impacted Italian regions (Piemonte, Lombardia, Veneto) were interviewed, reaching 15 interviewees in total.

Results
With regard to human resources, the main themes concerned the shortage of personnel, inadequate training, poor occupational health, and lack of multidisciplinarity. Regarding health services delivery, interviewees reported weakness of public health, hospital, and primary care systems. With regard to logistics, the following themes emerged: inadequate infrastructures, shortage of supplies, issues with transportation systems, and weak communication channels. Lessons learned stressed the importance of considering pragmatic disaster preparedness and the need for cultural and structural reforms.

Conclusions
Implications that emerged from this study can inform advancements in disaster management in Italy.
Acknowledgments: This study was conducted in collaboration with the Department of Public Health and Health Policy, Hiroshima University, Japan and funded by the World Health Organization Kobe Centre for Health Development (WKC-HEDRM-K21001).
*ALC and EP are both first authors

Key messages
• Findings show that great interconnection of sectors is key in overcoming challenges and for future disaster preparedness.
• Lessons learned contribute to translating the H-EDRM precepts into practice.
Home care for vulnerable populations with special needs during a disaster in Germany
Authors: Ewers M , Lehmann Y , Köhler M 
Published: October 2022

Abstract

Background
In Europe, too, the risk of natural, technical, or man-made disasters and public health emergencies has been growing for some time. The situation of vulnerable populations with special needs receiving intensive home care such as people of all ages with oxygen therapy, peritoneal dialysis, parenteral nutrition etc. is rarely considered in this context. This issue is addressed by the sub-project “Safety and Nursing” of the AUPIK consortium on “Maintenance of home care infrastructure in crisis and disasters” funded by the German Federal Ministry of Education and Research.

Methods
Starting in April 2020, a systematic literature analysis was carried out, focussing on home care of populations with special needs during disasters. This was supplemented by an online survey with nurses and care workers (n = 101) and semi-structured interviews with managers of specialized home care services (n = 8). The survey data were analysed with descriptive statistics, the interview data with content analysis; results were cross-checked with the literature.

Results
Home care providers are at best prepared for everyday tasks; even minor disruptions have far-reaching consequences. Although the impact of disasters such as large-scale and prolonged power cuts are hard to imagine, the experience with the COVID-19 pandemic and other current events (e.g., floods, heat waves) could at least raise awareness of the problem. However, there is hardly any preparation for disasters in home care yet, but there are high expectations of support from civil protection organisations or local authorities. That these, in turn, are not prepared to deal with populations with special needs in intensive home care, is overlooked.

Conclusions
Home care infrastructure in Germany is currently inadequately prepared in terms of concept, staff, and equipment to care for vulnerable populations with special needs during disasters. Initiatives to improve disaster preparedness in home and long-term care are overdue.

Key messages
• The situation of vulnerable populations with special needs during a disaster is a pressing public health and disaster nursing issue which needs to be considered more carefully.
• Public health nursing and health services research must contribute substantially to improving disaster preparedness in all health sectors and for all populations.
True death toll of COVID-19 in Georgia: estimates of the number of deaths from COVID-19
Authors: Shakhnazarova M 
Published: October 2022

Abstract

Problem
Georgia, in terms of Covid-19 attributed mortality, ranks 8th in the World.

Description
In Georgia, there are no routinely conducted autopsies of the deceased. The identification of causes of death is based on the physician’s clinical decision. Absence of autopsies, lack of experience with Covid-19, are key issues of Covid-19 death certification. Considering COVID-19 as a primary cause of death led to over-reporting of COVID mortality among patients with severe comorbidities. This affects the identification of underlying cause of death (UCOD) and leads to misclassifications.

Results
2021 mortal cases with Covid-19 as the UCOD, were analyzed. Cases were grouped by the interval between testing and death: &lt;1 day - 170 cases (1.5%), 2-44 days - 9468 cases (83.5%), 45+ days - 1694 cases (15%). The group of cases with time intervals of 2-44 days, was sub-grouped according to causes mentioned in death certificates: A - only U07 is indicated, B - U07&any chain-of-event condition (pneumonia, respiratory distress, respiratory failure, etc.), C - U07& 1 or more significant contributing conditions (diabetes, stroke, etc.). According to the analysis in the group, 2-44 days distribution was: A - 6%; B - 81%; C - 13%. U07 cases in groups A and C without any respiratory conditions mentioned were defined as ‘unlikely’ COVID-19 death (19% of total). From groups with time intervals of &lt; 1 and 45+ days (1864) 72 cases were randomly selected for in-depth analysis by a panel of experts, using additional medical records. Out of these cases, the panel of experts considered 80%, as ‘non-COVID-19’ deaths.

Lessons
If ‘unlikely’ and ‘non-COVID-19’ deaths aren't counted, the number of deaths is reduced by 29.5%. Lack of duration of a disease represents a limitation. A similar revision of all/2-44 day’s interval COVID-19-related deaths is required to get a real number. Conduction of a verbal autopsy is necessary. Training on coding causes of death and existing regulations is important.

Key messages
• There is an over-registration of COVID-19 as a UCOD.
• The lack of knowledge of death certification of cases with severe comorbidities and accidents leads to over estimates.
Tobacco control is integral to global COVID-19 response: an opportunity to accelerate toward SDGs
Authors: Chen DTH 
Published: October 2022

Abstract

Issue
Tobacco use intersects with the COVID-19 pandemic not only in terms of health consequences, but also on public health systems, economies, and the environment.

Description of the problem
The global tobacco supply contributes significantly to environmental pollution of the natural ecosystems. The damage is compounded by tobacco consumption and its resultant waste, which leaves a significant carbon footprint on the environment, undermining the planet’s ecological stability and intensifying climate change. Furthermore, tobacco use exacerbates inequalities and adds burdens to COVID-19-related mortality, which are major challenges to recovery from the COVID-19 pandemic.

Results
he pandemic has provided a chance to combat tobacco use and accelerate efforts to alleviate these challenges and accelerate progress toward Sustainable Development Goals (SDGs). The MPOWER measures from the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) can play an integral part to boost sustainable and equitable COVID-19 recovery — Monitor tobacco use (article 20); Protection from tobacco smoke (article 8); Offer help for tobacco cessation (article 14); Warn about the dangers of tobacco (article 11); Enforcing bans on tobacco advertising, promotion, and sponsorship (TAPS) (article13); and Raise tobacco taxes (article 6).

Lessons
To accelerate recovery, it is critical to call for actions for governments and policy-makers to strengthen synergies and policy actions to emphasise tobacco control across equity, public health, climate actions, and counteract against the tobacco industry during and beyond COVID-19 as global authorities pledge to achieve the SDGs.

Key messages
• Global authorities must create better synergies on policies with a prime focus on reinforcing tobacco control to recover from the pandemic.
• The WHO FCTC MPOWER measures can play an integral part in COVID-19 recovery to fight tobacco use and accelerate progress toward SDGs.
Epidemiology of covid-19 in Mongolia: descriptive findings
Authors: Amartsengel O , Khishigjargal D , Glushkova N , Lkhagvasuren K 
Published: October 2022

Abstract

Background
Mongolia is a landlocked country, and has been divided into 21 provinces plus the capital city Ulaanbaatar. In our country, Covid-19 was the first internal case (15 Nov 2020) and the first wave of pandemic occurred (peak at 14 Jun 2021) ten months later on World’s first case and wave. The second and third waves were also delayed by two months, but the fourth wave occurred just in parallel (peak on 17 Jan 2022).

Methods
This study was a retrospective cross-sectional study. We have compared incidence rate (IR) and case-fatality rates (CFR) in provinces by age groups based on publicly available data reported by MoH from January to December of 2021.

Results
CFR in Mongolia was low (average 0.23%), and had a clear dynamic to drop from beginning to the present time (for I wave-0.49, and II-0.42, III-0.23, IV-0.04 correspondently). At the beginning of the III waves, we vaccinated 68.7% of the total population, and in the fourth wave, CFR significantly decreased. IR had two peaks: in the age group 30-34 (250.6) and over 85 (248.9). There was a strong correlation between age and morbidity. Up to age group 40-44 (0.12 %), there was a deliberate increase of CFR, further up to 65-69 ages (2.7%) gradual increase, and from age group 70-74 CFR rapidly increases reaching 10.5% at age group over 85. IR was higher in men aged 65 years and over. CFR was significantly higher in Ulaanbaatar city and Umnugovi province morbidity due to Covid-19 not being registered.

Conclusions
Vaccination in Mongolia was a key factor in declining fatality. Umnugovi province is crucial for exports to China, so we suppose, government decisions strongly affected in fatality rate in this province, in terms of the evacuation of severely diseased patients to the capital.

Key messages
• Vaccination is played important role in COVID-19 epidemiology.
• Burden of Covid-19 need to be investigated deeply in association with political decisions.
USCA service utilization in the city of Florence (Italy) during the COVID-19 pandemic
Authors: Buscemi P , Velpini B , Cosma C , Milani C , Landi R , Innocenti M , Baggiani L , Nerattini M , Lorini C , Bonaccorsi G 
Published: October 2022

Abstract

Background
In order to support primary care during the first pandemic wave (March 2020), the Italian Government instituted multiprofessional health teams called “USCA” (Special Continuity Care Units), which ensured continuity of care for COVID-19 patients who do not need hospitalization. The aim of our study was to compare the volumes of USCA service utilization in Florence (Tuscany, Italy) during the peak of home visits of three pandemic waves.

Methods
This single-center study followed a retrospective cross-sectional design. The USCA of the Heath District of Florence served a population of 366,190 people. The following data were collected: home medical visits, nursing home (NH) visits, visits in health-care hotels. The peak periods of three epidemic waves were considered in the analyses: the second wave (23 October - 20 November 2020), the third wave (25 March - 22 April 2021), and the Omicron period (27 December 2021 - 6 February 2022). The maximum 7-day moving averages of the daily number of visits during the three periods were calculated. Relative percent differences for visits comparing the considered periods were computed.

Results
Home visits during the third pandemic wave increased by 14% compared to the second wave (second wave: N = 1370, third wave: N = 1562), while a decrease was observed during the Omicron period (Omicron vs third wave: -21%; peak value: 41 vs 60). Visits in health-care hotels during the third wave doubled compared to the second wave. After the start of the COVID-19 vaccination campaign, NH visits steeply declined (third wave vs second wave: -95%; N = 323 vs 15; peak value= 14 vs 2 visits per day). During the Omicron period, NH visits increased by almost four times compared to the third wave period.

Conclusions
The USCA service utilization was significant in all the analyzed periods. In a pandemic context, it is necessary to strengthen primary care services such as USCA, which have proved to respond to rapidly changing health needs.

Key messages
• The USCA service is an innovative model of integrated home care that has proved to respond to rapidly changing health needs during all phases of the COVID-19 pandemic.
• The USCA service utilization was significant during all phases of the pandemic. The USCA service has introduced new ways of working and new relationships between services in primary care.