bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimated excess mortality figures in the year 2020-2021 in casentino municipalities (Italy)
Authors: Gennari M , Fratini M , Nante N , Vigiani N 
Published: October 2022

Abstract

Background
In 2020, the total deaths from all causes were the highest ever recorded in Italy since World War II (15.6% excess), with peaks during Sars-Cov2 waves and reductions in periods of national lockdown. On the contrary, in 2021, the total number of deaths from all causes reduced compared to the previous year. Analysing local mortality data, our study aims to assess whether, in the Casentino Valley (Arezzo, Tuscany), an excess of deaths from all causes occurred between January 2020 and December 2021 compared to the five years 2015-2019.

Methods
We used the official mortality data from the Italian Institute of Statistics (ISTAT), and that are published in the Table of deaths by the municipality on March 2, 2022. From this database, we extrapolated all deaths from all causes between January 1, 2020, and December 31, 2021, in the 10 municipalities of Casentino. The data collected were processed using Microsoft Excel 2016 software. We then distinguished by total per month, gender, and age group and then compared these data with the previous five years’ average by calculating the percentage change.

Results
Overall, both the years 2020 and 2021, it is shown an increase in the deaths percentages compared to the previous five-year period, respectively 5.66% and 8.07%. In particular, there is an excess of mortality in November and December 2020. The increase in mortality is more remarkable for males (13% in 2020 and 20% in 2021). The highest percentage increase was recorded in 2021 for the 75-84 age group (+15%) and in 2020 for males over 85 (+29%).

Conclusions
The data analysed confirms the excess mortality in 2020-2021 compared to the average of the previous 5 years in Casentino. There are peaks in November and December 2020, corresponding with the second wave of Sars Cov2 infection. The results obtained establish the basis for subsequent analyses that will verify the correlation of mortality peaks with the incidence of Sars-Cov2 cases in the territory studied.

Key messages
• Between January 1, 2020, and December 31, 2021 there was an excess of all-cause mortality in our area.
• This excess mortality appears to be related to peaks in Sars-Cov2 infection.
Covid-19 Hospitalization Costs Assessment in an Italian Covid Hospital
Authors: Scattaglia M , Campobasso GA , Cremona A , Morandi M , Gianino MM 
Published: October 2022

Abstract

Introduction
Many consequences resulted from the breakout of the COVID-19 pandemic in Europe, which have disrupted our economic, social and medical world. This allowed us to measure and assess the hospitalisation costs regarding the COVID-19 disease at Martini Hospital in Turin, one of the hospitals entirely committed to the COVID-19 care, between January and June 2021.

Methods
In this single center retrospective study, we collected and analysed cost data on patients admitted at Martini Hospital in the time frame of January-June 2021 and compared the analysis with the same period in 2020, at a time when the hospital was not dedicated to Covid-19 patients. Cost data included full-time and temporary employees salaries, drugs, medical and non-medical supplies and equipment and facility utilities. We then estimated the cost per treated COVID-19 episode, in comparison with the cost per any desease including Covid-19.

Results
The first 6 months of 2021 registered 2,136 hospital discharges, while same period in 2020 counted 4376. The mean duration of the hospital stay was 7,67 days in 2020 and 12,83 in 2021. The average charge per treated episode doubled (+52,5%) from Euros 8997 in 2020 to Euros 19026 in 2021. The mean revenue increased of 35% from Euros 3280 in 2020 to Euros 5041 in 2021. This is due to the major complexity of care required for Covid patients. As it is, in 2021 the average complexity index of 2.13 while in 2020 it was 1.39.

Conclusions
Clinical management and treatment of COVID-19 economically strain the European health-care systems. The study of COVID-19 treatment costs, and their differences between 2020 and 2021 suggests an economic challenge for the entire Italian health system and emphasises the necessity to avoid the recurrence of such an economic impact by implementing effective infection prevention and control policies.

Key messages
• The Covid-19 pandemic has been straining both the European health and economic systems.
• Studying the Covid-19 expenditures allows to frame unexpected new challenges regarding health-care systems.
Is it really possible to leave sars-cov-2 outside the door?
Authors: Bocci BM , De Palma I , Amodeo D , Cevenini G , Nante N , Messina G 
Published: October 2022

Abstract

Background
In this historical period, it has become very important to live in healthy environments. By using everyday objects, cross-contamination is possible because of prolonged microbial persistence on surfaces. UV-C irradiation is an environmentally friendly method to disinfect objects as no harmful chemicals or heat are involved. This study aims to determine the virucidal activity, against SARS-CoV-2, of UV-C irradiation occurring in a designed UV device, ‘Purity Capsule'.

Methods
An experimental study was performed in September 2020. The ‘Purity capsule’ has an 11 W lamp (3.5W UV-C) positioned in the centre of the device. The lamp has a dome covered with a reflective, protective coating. Three metal carriers were placed at the maximum distance from the UV-C lamp in three different positions and tested at 30 and 60 seconds 3 times. The carriers were inoculated with 100 µL of SARS-CoV-2 viral suspension with a concentration of 106.5 TCID50 /mL. After treatment, laboratory procedures were used to transfer the treated virus from carriers to multiwell plates. The samples were compared with positive controls (not exposed to UV-C light) after incubation, at 37 °C in 5% COÕ · in a humidified atmosphere, for 3 days. The residual viral activity was tested by assessing the 50% infectious dose per tissue culture (TCID50%).

Results
Tests performed at 30 seconds of UV-C irradiation show an average viral reduction of 4.0 Log10 (99.99%). All three tests performed at 60 seconds reached the maximum measurable log10 viral reduction: 5.0 Log10 (99.999%).

Conclusions
The study assessed the effectiveness of the device in significantly reducing the viral load on all carriers regardless exposure time and distance from the UV-C light source, with no impact on the level of environmental pollution.

Key messages
• UV-C light has the property of inactivating viral growth; its physical approach is considered a good compromise between cost and effectiveness.
• The device was effective in disinfecting all small everyday objects tested.
Management of vaccine-related issues during a pandemic emergency: activation of a referral center
Authors: Cintori C , Diegoli G , Mattei G , Belloli G , Viale P , Attard L , Marconi L , Lugli C , Azzalini D , Artoni C 
Published: October 2022

Abstract

Issue
Vaccine hesitancy (VH) and the challenges faced by healthcare workers (HWs) in evaluating the complex risk-benefit ratio of vaccines’ threaten the effectiveness of vaccination policy. The threat is enhanced when new vaccines are adopted during a pandemic emergency. In Italy, the Emilia-Romagna Region (ERR) created a specialized referral board called Vax-Consilium (VC) to support and guide HWs.

Description of the problem
During a pandemic emergency, rapid and appropriate vaccine implementation is necessary to protect fragile individuals and to encourage vaccine adherence among exposed groups. Challenges in the realm of vaccination emerge, especially when dealing with patients with a complex medical history or previous vaccine adverse events. HWs were able to consult VC via a standardized digital form after obtaining the patient’s informed consent. After a multidisciplinary and evidence-based evaluation, VC provided a conclusive report on the individual vaccine risk-benefit analysis. No cost is charged to the patient.

Results
During the anti-COVID-19 vaccination campaign in 2021, 148 interrogations were submitted to VC: 121 were evaluated, whereas 27 were withdrawn by the HWs or rejected because of insufficient documentation. Mean patient age was 44 years. No absolute contraindication was found, whereas in 23 cases VC recommended immunization with a different vaccine. The disciplines most frequently involved were neurology, angiology and cardiology.

Lessons
VC implementation in EER proved highly effective. Indeed, during the pandemic, anti-COVID-19 vaccination coverage reached &gt;90%. In addition, DTaP-polio-HBV-HIb and MMR vaccination coverage reached &gt;95%. VC proved to be a high-quality public health service. Not only was citizens’ trust in the healthcare system enhanced and was VH reduced, but HWs knowledge improved even in cases not considered in national and international guidelines.

Key messages
• A specialized referral board (Vax-Consilium) could be an effective tool for enhancing citizens’ trust in vaccines.
• A specialized referral board (Vax-Consilium) contributes to lowering VH and supporting HWs decision-making process.
Don’t be scared to touch! Effectiveness of a new disinfection technology based on Ag ions & Zeolite
Authors: Peruzzi V , Amodeo D , De Palma I , Messina G 
Published: October 2022

Abstract

Background
Disinfection of contact surfaces has become common practice since the two-year Covid-19 pandemic. The transmission of microbial agents has long been the focus of public health and hygiene awareness campaigns. Indeed, the development of new disinfection technologies and approaches is attracting considerable interest in the scientific community. Mixed plastic powders with antimicrobial properties and silver ions that compromise the metabolism of microorganisms could reduce the contamination of the contact surfaces. We aimed to evaluate an inorganic antimicrobial agent (IAA) based on Ag ions and zeolite mixed in a resin.

Methods
This experimental study was carried out at the University of Siena, Italy. Different objects were produced in two versions: i) with an IAA mixed in plastic resin; ii) with a standard plastic mixture. To the eye, the two versions were indistinguishable and were randomly contaminated with the hands of several operators. After the hand contamination, T0, we sampled the objects using RODAC plates at T1 (1h) and T2 (6h), incubating at 36 °C for 48 hours. Comparisons of the biocidal effect were made at T1 and T2. Statistical analysis was carried out with Stata.

Results
The mean level of contamination of the objects made with standard plastic were, respectively 50 CFU (SD 36.5) at T1 and 20 CFU (SD 13.6) at T2. In comparison, the objects made with IAA resin showed a mean level of contamination of 10 CFU (SD 5.9) at T1 and 6 CFU (SD3.6) at T2. The objects made with IAA resin have shown a mean percentage reduction of contamination of 79.5% at T1 and 78.3% at T2.

Conclusions
IAA resin reduced contamination on objects that came into contact with hands. Antimicrobial plastic blends, are a valuable aid in counteracting the spread of infection related to contact with surfaces and fomites. The public health system could support and raise awareness for using these innovative materials for everyday applications and in healthcare facilities.

Key messages
• Inorganic antimicrobial agent based on Ag ions and Zeolite mixed in a resin are efficient in reducing the contamination on different items in a real-life context.
• Public health system have to support and sensitize to production with inorganic materials with proven antimicrobial properties.
Impact of the pandemic on surgical oncology in Piedmont, Italy: a retrospective observational study
Authors: Ragusa P , Lo Moro G , Aglietta M , Airoldi M , Comandone A , Previti C , Bert F , Siliquini R 
Published: October 2022

Abstract

Background
To prevent the spread of SARS-CoV-2, containment measures were implemented leading to huge healthcare changes worldwide. This study aimed to describe the impact of COVID-19 pandemic on surgical oncology healthcare in a large Italian sample.

Methods
A retrospective observational study included 99651 patients admitted to the hospitals of Piedmont (Northern Italy) to undergo oncological surgery, provided in ordinary hospitalization. We compared data of 2020 with 2016-2019 mean values. Data were stratified by tumor site, year, month and admission way. Chi-squared tests were used to assess differences in the percentage of admission modes between 2020 and 2016-2019.

Results
An overall reduction in oncological surgery (-12.3%) was observed in 2020 (n = 17923) compared to the mean of period 2016-2019 (n = 20432). A relevant decrease began in March (-11%), continued in April (-18%) and peaked in May (-26%). There was a greater reduction in surgery of breast (-19.2%), bladder (-17.5%), colorectal (-16.5%), kidney (-14.2%), prostate (-14%). Little or no difference was observed for liver (-5.2%), body of uterus (-0.54%), ovary (-0.07%), lymphoma (+4.5%). There was a marked reduction of non-emergency admissions (-13.6%), in particular for some tumor sites: colorectal (-19.4%), breast (-19.4%), bladder (-18.7%). The overall volume of surgeries following an emergency access was unchanged (-0.3%). The proportion of hospitalizations with emergency access increased (p &lt; 0.001).

Conclusions
Our results highlight the burden of the reduction in cancer surgery in 2020 and the risk of delays in diagnosis and treatment for time-dependent conditions. For cancers that can be diagnosed early thanks to screening, the reduction in surgery is likely to be an indirect consequence of discontinuing screening activities. Therefore, further studies are needed to assess, as soon as data are available, the trend in 2021, and to compare our results with those reported in other European countries.

Key messages
• The COVID-19 pandemic caused a significant decline in cancer surgeries in 2020 in Piedmont, Italy. It is necessary to compare our results with those reported in other European countries.
• These results show an increase in the proportion of oncological surgical admissions following emergency access in 2020 compared to the average for 2016-2019.
Impact of COVID-19 pandemic on population-based cancer screening: Interrupted Time Series Analysis
Authors: Pereira Godinho Simões JDG , Pita Ferreira P , Pinto de Carvalho C , Pinto Leite P , Peralta-Santos A 
Published: October 2022

Abstract

Early evidence suggests that the COVID-19 pandemic may have reduced the proportion of individuals submitted to cervical, colorectal and breast cancer screening. However, the recovery from the pandemic impact was very heterogeneous. We aim to explore the impact of the pandemic on cancer screening and estimate the time to recover lost screening opportunities in Portugal. We used an interrupted time series to analyze the impact of the pandemic on the implementation of cancer screening. The study population was the eligible individuals screened for cervical, colorectal and breast cancer by month and health region between 2018 and 2021. We used Poisson regression with health region random effects to estimate the trend before and after the first lockdown (March 2020) and the impact of the first lockdown. We predicted the counterfactual evolution without a pandemic to estimate lost screening opportunities. The first lockdown resulted in 93,1% (95%CI 92,9-93,2), 89,4% (95%CI 89,2-89,5) and 84,1% (95%CI 83,8-84,3) decrease in the proportion of expected cervical, colorectal and breast cancer screening tests. Nonetheless, we document an increased trend difference between pre and post lockdown of 6,0% (95%CI 5,9-6,0) and 5,3% (95%CI 5,3-5,4), 3,7% (95%CI 3,6-3,7) per month. However, by December 2021, there are still many lost screening opportunities due to the pandemic - 293k cervical cytology tests (42,2% less than expected), 247k fecal occult blood tests (28,7%) and 388k mammograms (38,4%). The first lockdown resulted in an abrupt decrease in cancer screening. However, we document an increase in the cancer screening trend after the pandemic. Nevertheless, there are still considerable lost screening opportunities after 2 years.

Key messages
• The pandemic caused a massive disruption in cancer screening. Although there was an increase in screening trends after the first lockdown, 2 years later, many lost screening opportunities remain.
• Population-based screenings need to increase the outputs to account for lost screening opportunities due to the pandemic.
Response to the COVID-19 pandemic in the legally deprived population of liberty in Cali (Colombia)
Authors: Torres Agredo M , Tamayo J , Mina E , Luna L , Guerrero-Jaramillo P , Benavides-Cordoba V 
Published: October 2022

Abstract

With the COVID-19 pandemic, the challenge of reducing the transmission of the disease has led to new challenges in decision-making. The vulnerability of persons deprived of liberty led to the design of contagion mitigation alternatives. Since February 2020, at the Villahermosa Penitentiary and Prison Center in Cali, the Secretaría de Salud Pública (SSP) began a series of actions that intensified on March 11, when the WHO declared COVID -19 as a pandemic. The SSP, in an articulated work; configured a series of strategies aimed at mitigating the impact and speed of contagion, infectious disease doctors and internists were also summoned who provided recommendations and contributed to decision-making. An intervention model was designed, which was guided by two main processes: promotion and prevention actions and service provision actions. The articulated work and the high commitment of the actors involved, the development of strategies for biosecurity, hygiene, isolation, rapid detection, and, above all, immediate control of symptoms and medical care on-site with adjustments that allowed managing patients inside the institution; It has meant that to date mortality is below 1% and that for the time being the situation is under control.

Key messages
• The humanization of health service provision is essential to achieve effective results.
• The rapid and articulated responses made it possible to maintain a mortality of less than 1% in this population.
Religious pilgrimage and COVID-19. An observational report in Italy from contact tracing activities
Authors: Ferraro F , Frisicale EM , Rapiti A , Marotta C , Bonfigli S , Angeloni U , Maraglino F , Rezza G 
Published: October 2022

Abstract

Issue/Problem
Religious Mass Gathering (MG) represent one of public health challenges for Health Authorities due to potential spread of communicable diseases. This is much more true during a pandemic as COVID-19. Surveillance is crucial to prevent further spreading of infectious disease related to a religious MG.

Description of the problem
During international contact tracing activities an increase of reporting of COVID-cases with a travel history to a Catholic shrine in Europe was observed, despite travel restrictions put in place. In order to promote public health actions as risk communication, a risk evaluation was conducted. A descriptive analysis was carried out: personal and vaccination data were collected; for cases, date and type of positive tests, date of symptoms’ onset were collected; for high-risk contacts, date and type of negative tests at the end of follow-up were collected. Frequencies were calculated.

Results
Six journeys back from Medjugorje were identified, with at least one positive case. All trips took place between 18/09/2021 and 29/10/2021. 31 positive cases out of 160 travellers were identified, with number of cases per travel ranging from 1 to 11.

Lessons
Religious MG represent an important global health issue. Even though a specific surveillance was not activated, international contact tracing activities turned out a great source of epidemic intelligence and consequent surveillance and control activities led to risk assessment and communication actions.

Key messages
• In the pandemic context, where travel restrictions were put in place, surveillance for Religious MG should be always implemented.
• Cooperation among all the stakeholders involved as Church, travel agency, Regional Health Systems and Government Bodies has to be promoted for specific surveillance in religious MG events.
A study on determinants of COVID-19 knowledge and preventive practices among Polish schools teachers
Authors: Molas-Biesiada A , Gańczak M , Biesiada D , Kalinowski P , Michalska J , Piechowicz K , Stoliński M , Komorzycka J 
Published: October 2022

Abstract

Background
Sufficient knowledge and preventive practices are crucial to control the spread of SARS-CoV-2. To date, some data regarding these issues have been reported among different professions, whereas such information is inaccessible in teachers.

Methods
An institution-based cross-sectional study was conducted between May-June 2021 in 3 randomly selected Polish provinces, in 26 schools. An anonymous, self-administered questionnaire which included 10 questions related to COVID-19 knowledge and 13 questions about preventive practices was used. Each correct answer to the question about COVID-19 knowledge was given 1 point and question about preventive practices was given 1 to 3 point (max. 11 and 39 points respectively). Bi- and multivariable logistic regression models were fitted to identify the predictors of COVID-19 knowledge; simple/multiple linear regression analyses were done for factors associated with practices.

Results
464 teachers were included (response rate was 55%), 92% females, mean age 45.6±10.2 years. The average COVID-19 knowledge score was 6.6±3.76 points; in 77% of teachers the knowledge level was &gt;50%. The mean of preventive practices score was 15.8±1.78 points; 204 (55.1%, 95% CI 50.0% to 60.2%) respondents scored above the mean score of preventive practices. Wearing a mask (β: 0.09 95%CI 0.00-0.03), washing hands (β: 0.09 95%CI 0.00-0.02), avoiding crowds (β: 0.12 95%CI 0.01-0.07), and avoiding visiting relatives (β: 0.10 95%CI 0.00-0.07) were significantly associated (p &lt; 0.05) with knowledge about COVID-19. Knowledge was the strongest predictor of avoiding crowds (β coefficient = 0.12).

Conclusions
Significant number of school teachers had inadequate COVID-19 knowledge and were poorly engaged in COVID-19 preventive practices. As knowledge level strongly influences adequate preventive behavior, additional educational intervention is urgently needed for teachers to help them better manage the pandemic at the school setting.

Key messages
• This study assessed COVID-19 knowledge and preventive practices, as well as related determinants among primary school teachers.
• This study assessed the attitudes of primary school teachers towards the Covid-19 pandemic.