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Objective. While marked changes in the frequency of hepatobiliary malignancies, most notably hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC), have been observed in different populations, no such data have been reported for Germany. We aimed to provide epidemiological data on recent trends in liver-related mortality, specifically mortality from hepatobiliary malignancies, in Germany. Material and methods. We used incidence and mortality data to determine changes in the frequency of malignant and non-malignant liver disease in Germany over the past 30 years. Results. While overall liver disease mortality has slightly declined in Germany, deaths from hepatobiliary malignancies have declined in women, but remained constant in men. Among hepatobiliary malignancies, ICC stands out, because mortality has more than tripled both in men and women between 1998 and 2008. This is mirrored by a marked increase in new cases reported to local cancer registries, that is, incidence. Over the same time period, HCC and extrahepatic cholangiocarcinoma (ECC) have remained largely constant while gall bladder cancers (GBC) have declined twofold. The rapid rise in ICC is in line with finding from different regions worldwide, but in contrast to recent data from Denmark and France, two of Germany's direct neighbors. Conclusions. The incidence of and mortality from ICC are rising markedly in Germany. The risk factors underlying this trend are as yet unclear. [ABSTRACT FROM AUTHOR]

Background: Influenza vaccines are effective in decreasing hospitalizations and mortality related to influenza and its complications. However, the Vaccine Coverage Rate of influenza remains low and multifaceted efforts are required to improve it. The aim of this study was to assess the impact on influenza vaccine perception using a digital tool among outpatients and health care workers (HCWs)., Methods: A study was performed among outpatients and the HCWs of 23 hospital departments from 4 hospitals affiliated to Lyon university Hospitals (France), between October 2022 and February 2023. By scanning QR (Quick Response) codes, displayed on posters for patients, their companions, as well as in the letters sent to HCWs, users accessed anonymously to a web-application (ELEFIGHT®), which provided information on influenza and invited them to initiate a discussion on influenza prevention with their physicians during the consultation. Patients were also invited to complete a questionnaire regarding their perception of influenza vaccination before and after reading the information on ELEFIGHT®. The retention rate (RR = proportion of people who remain on the page for >2 s), the conversion rate (CR = proportion of people who click on the "Call-To-Action" button) and the absolute variation (difference in the perception before/after) and relative variation (absolute change as a percentage of the initial perception) in perception regarding influenza vaccination before and after consulting the application were calculated., Results: 3791 scans were performed by 3298 patients and/or their companions with a RR of 52% and a CR of 55.1% and 253 scans by 221 HCWs with a RR of 71.2% and a CR of 115.3%. Participants spent an average of 47 s on the application. The questionnaire on influenza vaccination perception was completed by 1533 participants (46.5%); 1390 (90.7%) maintained the same position (neutral, favorable or unfavorable) on this vaccination before and after consulting the application. The relative variations in favor of vaccination were + 7.2% (unfavorable then favorable) and + 19.8% (neutral then favorable)., Conclusion: This study suggests that a facilitated direct access to medical information through QR codes disseminated in health settings can help nudge people to foster their awareness of influenza and its prevention. Future deployments in a similar context or to other populations could be envisaged. Other vaccine-preventable and/or chronic diseases could also be the target of similar projects as part of public health programs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Nagham Khanafer, Florence Ader, Frédéric Berard, Françoise Bouhour, Roland Chapurlat, Sybil Charriere, Cyrille Confavreux, Gilles Devouassoux, Emmanuel Disse, Jean-Pierre Fauvel, Denis Fouque, Herve Ghesquieres, Sophie Hyvert, Anne Jolivot, Gilles Leboucher, Catherine Lombard, Géraldine Martin-Gaujard, Jean-Francois Mornex, Marc Nicolino, Nathalie Obadia, Gérald Raverot, Philippe Reix, Alain Ruffion, Pascal Seve, Eric Truy, Fabien Zoulim and Philippe Vanhems have no conflicts of interest related to this study to declare. Catherine Planckaert, Rym Bouhalila, Camille Mena and Nadège Trehet Mandel have been mandated and paid by the HCL. Sylvain Oudot, Margot Maligeay, Joséphine Clamens and Marie-Pierre Ayala are employed by Sanofi., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Exacerbations of chronic obstructive pulmonary disease (COPD) were reported less frequently during the COVID-19 pandemic. We report real-world data on COPD exacerbation rates before and during this pandemic., Methods: Exacerbation patterns were analysed using electronic medical records or claims data of patients with COPD before (2017-2019) and during the COVID-19 pandemic (2020 through early 2022) in France, Germany, Italy, the United Kingdom and the United States. Data from each country were analysed separately. The proportions of patients with COPD receiving maintenance treatment were also estimated., Results: The proportion of patients with exacerbations fell 45-78% across five countries in 2020 versus 2019. Exacerbation rates in most countries were reduced by >50% in 2020 compared with 2019. The proportions of patients with an exacerbation increased in most countries in 2021. Across each country, seasonal exacerbation increases seen during autumn and winter in pre-pandemic years were absent during the first year of the pandemic. The percentage of patients filling COPD prescriptions across each country increased by 4.53-22.13% in 2019 to 9.94-34.17% in 2021., Conclusion: Early, steep declines in exacerbation rates occurred in 2020 versus 2019 across all five countries and were accompanied by a loss of the seasonal pattern of exacerbation., Competing Interests: F.J. Martinez reports support for the present manuscript from Chiesi Farmaceutici S.p.A.; reports grants or contracts from AstraZeneca, Chiesi Farmaceutici S.p.A., GSK and Sanofi/Regeneron; reports consulting fees from AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici S.p.A., CSL Behring, GSK, Novartis, Polarean, Pulmatrix, Pulmonx, Sanofi/Regeneron, Sunovion, Teva, Theravance/Viatris and UpToDate®; reports payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from AstraZeneca and GSK; and reports participation on a Data Safety Monitoring Board or advisory board for GSK and Medtronic. A. Papi reports study support from Chiesi Farmaceutici S.p.A.; reports grants or contracts from Agenzia Italiana del Farmaco (AIFA), AstraZeneca, Chiesi Farmaceutici S.p.A., GSK and Sanofi; reports consulting fees from AstraZeneca, Avillion, Chiesi Farmaceutici S.p.A., Elpen Pharmaceuticals, GSK, Novartis, Roche and Sanofi; reports payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from AstraZeneca, Avillion, Chiesi Farmaceutici S.p.A., Edmond Pharma, Elpen Pharmaceuticals, GSK, IQVIA, Menarini, Mundipharma, Novartis, Sanofi and Zambon; and reports advisory board membership for AstraZeneca, Avillion, Chiesi Farmaceutici S.p.A., Elpen Pharmaceuticals, GSK, IQVIA, MSD, Novartis, Regeneron and Sanofi. T. Welte reports all support for the present manuscript from Chiesi Farmaceutici S.p.A.; reports consulting fees from AstraZeneca, Berlin-Chemie, Boehringer Ingelheim, Chiesi Farmaceutici S.p.A. and GSK; and reports payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from AstraZeneca, Berlin-Chemie, Boehringer Ingelheim, Chiesi Farmaceutici S.p.A. and GSK. He also reports a grant paid to his institution from the German Ministry of Research and Education. D. Singh reports consulting fees from Aerogen, AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici S.p.A., Cipla, CSL Behring, EpiEndo, Genentech, GSK, Glenmark, Gossamer Bio, Kinaset Therapeutics, Menarini, Novartis, Orion, Pulmatrix, Sanofi, Synairgen, Teva, Theravance Biopharma and Verona Pharma. D. Singh is also supported by the National Institute for Health Research Manchester Biomedical Research Centre. D.V. Galkin is an employee of Chiesi Farmaceutici S.p.A.; reports support for this manuscript from Chiesi Farmaceutici S.p.A.; and holds stock or stock options with GSK. A. Guasconi is an employee of Chiesi Farmaceutici S.p.A. S. Pirondi is an employee of Chiesi Farmaceutici S.p.A. and is on SiMEF Società Italiana di Medicina Farmaceutica Working Group on Observational Studies. G. Georges is an employee of Chiesi Farmaceutici S.p.A. J. Imperato and R. Hermans are employees of IQVIA and were on the consulting team that led the analysis of the real-world data for this manuscript. The authors report no other conflicts of interest in this work., (© 2024 Martinez et al.)

Coronavirus disease 2019 (COVID-19) is associated with coagulation activation and high incidence of venous thromboembolism (VTE) in severe patients despite routine thromboprophylaxis. Conflicting results exist regarding the epidemiology of VTE for unselected anticoagulated COVID-19 patients hospitalized in general wards. The aim of this study was to evaluate the prevalence of asymptomatic deep venous thrombosis (DVT) in unselected patients with COVID-19 recently hospitalized in general wards. We performed a systematic complete doppler ultrasound (CDU) at a median 4 days after admission in 42 consecutive COVID-19 patients hospitalized in general wards of our university hospital, irrespective of D-Dimer level, and retrospectively collected clinical, biological and outcome data from electronic charts. Thromboprophylaxis was systematically applied following a French national proposal. In our population, the prevalence of asymptomatic DVT was 19% (8/42 patients), with distal thrombosis in 7/8 cases and bilateral DVT in 4/8 cases. Symptomatic pulmonary embolism was detected in 4 (9.5%) patients, associated to DVT in one case. Compared to patients without DVT, patients with DVT were older and experienced poorer outcomes. In conclusion, prevalence of asymptomatic DVT is high in the first days of hospitalization of unselected COVID-19 patients in general wards and may be related to poor prognosis. Individualized assessment of thromboprophylaxis and early systematic screening for DVT is warranted in this context.

Objectives: The aim of this study was to evaluate and summarise features of currently and formerly available cone beam CT (CBCT) devices from 1996 to 2019. Additionally, a recommendation for standardised reporting of CBCT characteristics was provided., Methods and Materials: Information about the features of all available CBCT devices was obtained from the manufacturers' available data. Moreover, site visits to newly developed CBCT machines' manufacturers were performed in order to obtain relevant information., Results: A total of 279 CBCT models from 47 manufacturers located in 12 countries (Brazil, China, Denmark, Finland, France, Germany, Italy, Japan, Republic of Korea, Slovakia, Thailand, and USA) could be listed. Overall, wide variations in CBCT features and technical specifications were identified., Conclusions: CBCT in dentomaxillofacial radiology is a generic term applicable to a broad range of CBCT machines and features. Experimental outcomes and literature statements regarding radiation doses, imaging performance and diagnostic applicability of dental CBCT cannot be simply transferred from one CBCT model to another considering a wide variation in technical characteristics and clinical diagnostic performance. The information tabulated in the present study will be later provided on the International Association of DentoMaxilloFacial Radiology website (www.iadmfr.one).

Background: The COVID-19 pandemic is the greatest public health crisis of the last 100 years. Countries have responded with various levels of lockdown to save lives and stop health systems from being overwhelmed. At the same time, lockdowns entail large socioeconomic costs. One exit strategy under consideration is a mobile phone app that traces the close contacts of those infected with COVID-19. Recent research has demonstrated the theoretical effectiveness of this solution in different disease settings. However, concerns have been raised about such apps because of the potential privacy implications. This could limit the acceptability of app-based contact tracing in the general population. As the effectiveness of this approach increases strongly with app uptake, it is crucial to understand public support for this intervention., Objective: The objective of this study is to investigate the user acceptability of a contact-tracing app in five countries hit by the pandemic., Methods: We conducted a largescale, multicountry study (N=5995) to measure public support for the digital contact tracing of COVID-19 infections. We ran anonymous online surveys in France, Germany, Italy, the United Kingdom, and the United States. We measured intentions to use a contact-tracing app across different installation regimes (voluntary installation vs automatic installation by mobile phone providers) and studied how these intentions vary across individuals and countries., Results: We found strong support for the app under both regimes, in all countries, across all subgroups of the population, and irrespective of regional-level COVID-19 mortality rates. We investigated the main factors that may hinder or facilitate uptake and found that concerns about cybersecurity and privacy, together with a lack of trust in the government, are the main barriers to adoption., Conclusions: Epidemiological evidence shows that app-based contact tracing can suppress the spread of COVID-19 if a high enough proportion of the population uses the app and that it can still reduce the number of infections if uptake is moderate. Our findings show that the willingness to install the app is very high. The available evidence suggests that app-based contact tracing may be a viable approach to control the diffusion of COVID-19., (©Samuel Altmann, Luke Milsom, Hannah Zillessen, Raffaele Blasone, Frederic Gerdon, Ruben Bach, Frauke Kreuter, Daniele Nosenzo, Séverine Toussaert, Johannes Abeler. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 28.08.2020.)

The European Interreg Italy-France 2014-2020 Maritime Project SPlasH! (Stop to Plastics in H 2 O!) focused on the study of microplastics (MPs) in the marine port environment to evaluate their presence, abundance, and mechanisms of diffusion to the open sea. In the framework of this project, a worldwide review of 74 studies was carried out, providing an overview of MP investigation techniques, focusing on sampling strategies, laboratory methodologies, and identification of MPs collected in seawater, and specifically evaluating their applicability to the marine port environment. Nets were the most commonly used device for MP surface sampling, but their use can be difficult in narrow spaces within the port basins, and they must be coupled to discrete sampling devices to cover all port basins. In the laboratory, density separation (NaCl, ZnCl 2 , NaI, sodium lauryl sulfate (SLS)), filtration (polycarbonate, polyamide, glass, cellulose, ANOPORE inorganic membrane filters), sieving, visual sorting, and digestion methods (acidic, enzymatic, alkaline, oxidative) were used to separate MPs from seawater. Digestion becomes essential with water samples with great inorganic and organic loads as deriving from a port. Although many studies are based only on visual MP identification under a microscope, analytical identification techniques unequivocally determine the particle nature and the identity of the plastic polymers and are necessary to validate the visual sorting of MPs. Fourier-transform infrared spectroscopy (FTIR) is the most used analytical identification technique.

Background: Most longitudinal studies do not address potential selection biases due to selective attrition. Using empirical data and simulating additional attrition, we investigated the effectiveness of common approaches to handle missing outcome data from attrition in the association between individual education level and change in body mass index (BMI)., Methods: Using data from the two waves of the French RECORD Cohort Study (N = 7,172), we first examined how inverse probability weighting (IPW) and multiple imputation handled missing outcome data from attrition in the observed data (stage 1). Second, simulating additional missing data in BMI at follow-up under various missing-at-random scenarios, we quantified the impact of attrition and assessed how multiple imputation performed compared to complete case analysis and to a perfectly specified IPW model as a gold standard (stage 2)., Results: With the observed data in stage 1, we found an inverse association between individual education and change in BMI, with complete case analysis, as well as with IPW and multiple imputation. When we simulated additional attrition under a missing-at-random pattern (stage 2), the bias increased with the magnitude of selective attrition, and multiple imputation was useless to address it., Conclusions: Our simulations revealed that selective attrition in the outcome heavily biased the association of interest. The present article contributes to raising awareness that for missing outcome data, multiple imputation does not do better than complete case analysis. More effort is thus needed during the design phase to understand attrition mechanisms by collecting information on the reasons for dropout.

Rationale: Steady-state mild pulmonary hypertension is a risk factor for death in adults with sickle cell disease. Acute pulmonary hypertension has been reported during exercise and vasoocclusive pain crisis in these patients., Objectives: The aim of the present study was to evaluate changes in pulmonary pressures and cardiac biomarkers during severe acute chest syndrome and their associations with mortality., Methods: We prospectively evaluated 70 consecutive adults who received standardized treatment in our intensive care unit for a total of 84 episodes. At admission, cardiac biomarkers were measured. Transthoracic echocardiography was performed for pulmonary hypertension assessment via measurement of tricuspid regurgitant jet velocity and was repeated when possible after resolution., Measurements and Main Results: Tricuspid jet velocity was less than 2.5 m/second in 34 (40%) of the 84 episodes, 2.5 to 2.9 m/second in 19 (23%), and 3 m/second or greater in 31 episodes (37%). Cor pulmonale occurred in 11 (13%) episodes. Tricuspid jet velocity showed significant positive correlations with B-type natriuretic peptide (rho = 0.54, P < 0.01) and cardiac troponin I (rho = 0.42, P < 0.01). Pulmonary pressures increased compared with steady state then decreased after resolution. All five patients who required invasive ventilation and all four patients who died during the immediate hospital course had jet velocity values of 3 m/second or greater. Overall mortality was 12.9% (9 patients) and survival was significantly lower in patients whose jet velocity was 3 m/second or greater during at least one episode, compared with the other patients (P < 0.01)., Conclusions: Pulmonary pressures increase during severe acute chest syndrome, and pulmonary hypertension is associated with cardiac biomarker elevation and a higher risk of death.