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Article ; Online: Covid-19: statutory means of scrutinizing workers' deaths and disease.

Agius, R M

2020 Volume 70, Issue 7, Page(s) 515–522

Abstract: Background: By law, covid-19 disease and deaths in workers may lead to coroners' inquests and/or Health and Safety Executive (HSE) investigations.: Aims: This study assesses the adequacy of these statutory means to yield recommendations for ... ...

Abstract	Background: By law, covid-19 disease and deaths in workers may lead to coroners' inquests and/or Health and Safety Executive (HSE) investigations. Aims: This study assesses the adequacy of these statutory means to yield recommendations for prevention of acquiring covid-19 infection from work. Methods: Covid-19 guidance from the chief coroner and the HSE was appraised, including using Office for National Statistics (ONS) data. Practitioners were asked to estimate the likelihood that covid-19 disease may have arisen from 'near-miss' scenarios. Data from the judiciary and the HSE were analysed. Results: The coroners' guidance allowed a wider range of reports of death than did the HSE and conformed better with ONS data on covid-19 mortality by occupation. In the practitioner survey, 62 respondents considered a higher likelihood that reported covid-19 cases would have arisen from the scenario deemed unreportable as a 'dangerous occurrence' by HSE than the reportable scenario (P < 0.001). On average there was only one coroner's report to prevent future death from occupational disease every year in England and Wales. The HSE dealt with a yearly average of 1611 reports of work-related disease including 104 on biological agents, but has received about 9000 covid-19 reports. Conclusions: Current HSE guidance for reporting work-related covid-19 may miss many thousands of cases and needs further iteration. Coroners have very limited experience of inquiry into occupational disease caused by biological agents compared with the HSE. Concerns regarding national policy such as on protective equipment warrant a full public inquiry.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Cause of Death ; Coronavirus Infections/diagnosis ; Coronavirus Infections/mortality ; Coronavirus Infections/prevention & control ; Coroners and Medical Examiners ; Disease Notification ; Humans ; Occupational Diseases/diagnosis ; Occupational Diseases/mortality ; Occupational Diseases/prevention & control ; Occupational Exposure/adverse effects ; Occupational Exposure/analysis ; Occupational Exposure/prevention & control ; Occupational Health ; Pandemics/prevention & control ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/mortality ; Pneumonia, Viral/prevention & control ; SARS-CoV-2 ; United Kingdom/epidemiology
Keywords	covid19
Language	English
Publishing date	2020-09-15
Publishing country	England
Document type	Journal Article
ZDB-ID	1103950-4
ISSN	1471-8405 ; 0962-7480
ISSN (online)	1471-8405
ISSN	0962-7480
DOI	10.1093/occmed/kqaa165
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Article ; Online: A review of the pathophysiology and evidence-based management of varicoceles and pelvic congestion syndrome.

Galea, Matteo / Brincat, Mark R / Calleja-Agius, Jean

Human fertility (Cambridge, England)

2023 Volume 26, Issue 6, Page(s) 1597–1608

Abstract: Pelvic congestion syndrome (PCS) in females and varicoceles in males may be regarded as closely related conditions since the main pathophysiological cause for both processes is pelvic venous insufficiency. Varicoceles are more prevalent amongst sub- ... ...

Abstract	Pelvic congestion syndrome (PCS) in females and varicoceles in males may be regarded as closely related conditions since the main pathophysiological cause for both processes is pelvic venous insufficiency. Varicoceles are more prevalent amongst sub-fertile males, with an approximate incidence of 15% in the general male population. PCS is commonly diagnosed amongst premenopausal multiparous women, representing one of the leading causes of chronic pelvic pain. Both conditions appear to be predominantly left-sided and are associated with oxidative stress and pro-inflammatory cascades with subsequent effects on fertility. Clinical examination and pelvic ultrasonography play an essential role in the assessment of varicoceles, PCS and chronic pelvic pain. Venography is generally considered as a gold-standard procedure for both conditions. There is still much debate on how these conditions should be managed. This review article provides a comparative analysis of the underlying pathophysiological mechanisms of both PCS and varicoceles, their impact on fertility, as well as their clinical management.
MeSH term(s)	Male ; Humans ; Female ; Varicocele/complications ; Embolization, Therapeutic/adverse effects ; Embolization, Therapeutic/methods ; Pelvic Pain/diagnosis ; Pelvic Pain/etiology ; Pelvic Pain/therapy ; Pelvis ; Venous Insufficiency/complications ; Venous Insufficiency/therapy
Language	English
Publishing date	2023-05-16
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2086960-5
ISSN	1742-8149 ; 1464-7273
ISSN (online)	1742-8149
ISSN	1464-7273
DOI	10.1080/14647273.2023.2212846
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Article: Covid-19: statutory means of scrutinizing workers' deaths and disease

Agius, R. M.

Occup Med (Lond)

Abstract: BACKGROUND: By law, covid-19 disease and deaths in workers may lead to coroners' inquests and/or Health and Safety Executive (HSE) investigations AIMS: This study assesses the adequacy of these statutory means to yield recommendations for prevention of ... ...

Abstract	BACKGROUND: By law, covid-19 disease and deaths in workers may lead to coroners' inquests and/or Health and Safety Executive (HSE) investigations AIMS: This study assesses the adequacy of these statutory means to yield recommendations for prevention of acquiring covid-19 infection from work METHODS: Covid-19 guidance from the chief coroner and the HSE was appraised, including using Office for National Statistics (ONS) data Practitioners were asked to estimate the likelihood that covid-19 disease may have arisen from 'near-miss' scenarios Data from the judiciary and the HSE were analysed RESULTS: The coroners' guidance allowed a wider range of reports of death than did the HSE and conformed better with ONS data on covid-19 mortality by occupation In the practitioner survey, 62 respondents considered a higher likelihood that reported covid-19 cases would have arisen from the scenario deemed unreportable as a 'dangerous occurrence' by HSE than the reportable scenario (P < 0 001) On average there was only one coroner's report to prevent future death from occupational disease every year in England and Wales The HSE dealt with a yearly average of 1611 reports of work-related disease including 104 on biological agents, but has received about 9000 covid-19 reports CONCLUSIONS: Current HSE guidance for reporting work-related covid-19 may miss many thousands of cases and needs further iteration Coroners have very limited experience of inquiry into occupational disease caused by biological agents compared with the HSE Concerns regarding national policy such as on protective equipment warrant a full public inquiry
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #780420
Database	COVID19

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Article ; Online: Covid-19

Agius, R M

Occupational Medicine

statutory means of scrutinizing workers’ deaths and disease

2020 Volume 70, Issue 7, Page(s) 515–522

Abstract: Abstract Background By law, covid-19 disease and deaths in workers may lead to coroners’ inquests and/or Health and Safety Executive (HSE) investigations. Aims This study assesses the adequacy of these statutory means to yield recommendations for ... ...

Abstract	Abstract Background By law, covid-19 disease and deaths in workers may lead to coroners’ inquests and/or Health and Safety Executive (HSE) investigations. Aims This study assesses the adequacy of these statutory means to yield recommendations for prevention of acquiring covid-19 infection from work. Methods Covid-19 guidance from the chief coroner and the HSE was appraised, including using Office for National Statistics (ONS) data. Practitioners were asked to estimate the likelihood that covid-19 disease may have arisen from ‘near-miss’ scenarios. Data from the judiciary and the HSE were analysed. Results The coroners’ guidance allowed a wider range of reports of death than did the HSE and conformed better with ONS data on covid-19 mortality by occupation. In the practitioner survey, 62 respondents considered a higher likelihood that reported covid-19 cases would have arisen from the scenario deemed unreportable as a ‘dangerous occurrence’ by HSE than the reportable scenario (P < 0.001). On average there was only one coroner’s report to prevent future death from occupational disease every year in England and Wales. The HSE dealt with a yearly average of 1611 reports of work-related disease including 104 on biological agents, but has received about 9000 covid-19 reports. Conclusions Current HSE guidance for reporting work-related covid-19 may miss many thousands of cases and needs further iteration. Coroners have very limited experience of inquiry into occupational disease caused by biological agents compared with the HSE. Concerns regarding national policy such as on protective equipment warrant a full public inquiry.
Keywords	Public Health, Environmental and Occupational Health ; covid19
Language	English
Publisher	Oxford University Press (OUP)
Publishing country	uk
Document type	Article ; Online
ZDB-ID	1103950-4
ISSN	1471-8405 ; 0962-7480
ISSN (online)	1471-8405
ISSN	0962-7480
DOI	10.1093/occmed/kqaa165
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Identifying CLL patients at high risk of atrial fibrillation on treatment using machine learning.

Parviz, Mehdi / Agius, Rudi / Rotbain, Emelie Curovic / Vainer, Noomi / Aarup, Kathrine / Niemann, Carsten U

Leukemia & lymphoma

2024 Volume 65, Issue 4, Page(s) 449–459

Abstract: An increased risk of developing atrial fibrillation (AF) has been observed in patients with chronic lymphocytic leukemia (CLL) who were treated with ibrutinib and other BTK inhibitors. Previous studies have explored the prevalence of AF in CLL and the ... ...

Abstract	An increased risk of developing atrial fibrillation (AF) has been observed in patients with chronic lymphocytic leukemia (CLL) who were treated with ibrutinib and other BTK inhibitors. Previous studies have explored the prevalence of AF in CLL and the risk of developing AF at time of diagnosis. However, the interaction between treatment type with other risk factors on risk of developing atrial fibrillation at the time of treatment initiation has not been investigated. This becomes particularly crucial in CLL, as there is often a substantial time gap between diagnosis and treatment, unlike many other cancers. We propose a treatment-aware approach using predictive modeling to identify the risk factors associated with AF at time of treatment initiation. Moreover, the model provides treatment-dependent risk factors by including the interaction between the treatment types and other risk factors. The results demonstrated that the treatment-aware modeling including interactions outperformed currentrisk scores.
MeSH term(s)	Humans ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/etiology ; Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis ; Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy ; Leukemia, Lymphocytic, Chronic, B-Cell/epidemiology ; Machine Learning ; Protein Kinase Inhibitors/adverse effects
Chemical Substances	Protein Kinase Inhibitors
Language	English
Publishing date	2024-01-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	1042374-6
ISSN	1029-2403 ; 1042-8194
ISSN (online)	1029-2403
ISSN	1042-8194
DOI	10.1080/10428194.2023.2299737
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Article ; Online: Association between a polygenic lipodystrophy genetic risk score and diabetes risk in the high prevalence Maltese population.

Zammit, Maria / Agius, Rachel / Fava, Stephen / Vassallo, Josanne / Pace, Nikolai Paul

Acta diabetologica

2024 Volume 61, Issue 5, Page(s) 555–564

Abstract: Background: Type 2 diabetes (T2DM) is genetically heterogenous, driven by beta cell dysfunction and insulin resistance. Insulin resistance drives the development of cardiometabolic complications and is typically associated with obesity. A group of ... ...

Abstract	Background: Type 2 diabetes (T2DM) is genetically heterogenous, driven by beta cell dysfunction and insulin resistance. Insulin resistance drives the development of cardiometabolic complications and is typically associated with obesity. A group of common variants at eleven loci are associated with insulin resistance and risk of both type 2 diabetes and coronary artery disease. These variants describe a polygenic correlate of lipodystrophy, with a high metabolic disease risk despite a low BMI. Objectives: In this cross-sectional study, we sought to investigate the association of a polygenic risk score composed of eleven lipodystrophy variants with anthropometric, glycaemic and metabolic traits in an island population characterised by a high prevalence of both obesity and type 2 diabetes. Methods: 814 unrelated adults (n = 477 controls and n = 337 T2DM cases) of Maltese-Caucasian ethnicity were genotyped and associations with phenotypes explored. Results: A higher polygenic lipodystrophy risk score was correlated with lower adiposity indices (lower waist circumference and body mass index measurements) and higher HOMA-IR, atherogenic dyslipidaemia and visceral fat dysfunction as assessed by the visceral adiposity index in the DM group. In crude and covariate-adjusted models, individuals in the top quartile of polygenic risk had a higher T2DM risk relative to individuals in the first quartile of the risk score distribution. Conclusion: This study consolidates the association between polygenic lipodystrophy risk alleles, metabolic syndrome parameters and T2DM risk particularly in normal-weight individuals. Our findings demonstrate that polygenic lipodystrophy risk alleles drive insulin resistance and diabetes risk independent of an increased BMI.
MeSH term(s)	Humans ; Male ; Female ; Middle Aged ; Diabetes Mellitus, Type 2/genetics ; Diabetes Mellitus, Type 2/epidemiology ; Cross-Sectional Studies ; Lipodystrophy/genetics ; Lipodystrophy/epidemiology ; Adult ; Malta/epidemiology ; Multifactorial Inheritance ; Genetic Predisposition to Disease ; Prevalence ; Insulin Resistance/genetics ; Risk Factors ; Aged ; Obesity/genetics ; Obesity/complications ; Obesity/epidemiology ; Body Mass Index ; Genetic Risk Score
Language	English
Publishing date	2024-01-27
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1097676-0
ISSN	1432-5233 ; 0940-5429
ISSN (online)	1432-5233
ISSN	0940-5429
DOI	10.1007/s00592-023-02230-9
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Article: Patterns in Oral Hygiene and Dietary Habits in School Children during the COVID-19 Pandemic.

Agius, Anne-Marie / Gatt, Gabriella / Cortes, Arthur R G / Attard, Nikolai J

International journal of clinical pediatric dentistry

2023 Volume 16, Issue 2, Page(s) 205–210

Abstract: ... oral hygiene and healthy dietary habits of children.: How to cite this article: Agius A-M, Gatt G, Cortes ...

Abstract	Aim: To assess oral hygiene and dietary patterns in school children participating in a school-based preventive oral health program during the COVID-19 pandemic. Materials and methods: In this cross-sectional study, an anonymous questionnaire exploring oral hygiene and dietary patterns during the COVID-19 pandemic was completed by parents of school children. Data were compared among different schools, school years, and between genders using nonparametric tests. Associations among further nominal and categorical variables related to oral hygiene and dietary habits were also assessed using the chi-square test. Results: Only 26% ( Clinical significance: Within the limitations of this study, the present significant findings observed during the pandemic support the importance of school programs in promoting oral hygiene and healthy dietary habits of children. How to cite this article: Agius A-M, Gatt G, Cortes ARG,
Language	English
Publishing date	2023-07-14
Publishing country	India
Document type	Journal Article
ISSN	0974-7052
ISSN	0974-7052
DOI	10.5005/jp-journals-10005-2397
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Article ; Online: Prediction of clinical outcome in CLL based on recurrent gene mutations, CLL-IPI variables, and (para)clinical data.

Parviz, Mehdi / Brieghel, Christian / Agius, Rudi / Niemann, Carsten U

Blood advances

2022 Volume 6, Issue 12, Page(s) 3716–3728

Abstract: A highly variable clinical course, immune dysfunction, and a complex genetic blueprint pose challenges for treatment decisions and the management of risk of infection in patients with chronic lymphocytic leukemia (CLL). In recent years, the use of ... ...

Abstract	A highly variable clinical course, immune dysfunction, and a complex genetic blueprint pose challenges for treatment decisions and the management of risk of infection in patients with chronic lymphocytic leukemia (CLL). In recent years, the use of machine learning (ML) technologies has made it possible to attempt to untangle such heterogeneous disease entities. In this study, using 3 classes of variables (international prognostic index for CLL [CLL-IPI] variables, baseline [para]clinical data, and data on recurrent gene mutations), we built ML predictive models to identify the individual risk of 4 clinical outcomes: death, treatment, infection, and the combined outcome of treatment or infection. Using the predictive models, we assessed to what extent the different classes of variables are predictive of the 4 different outcomes, within both a short-term 2-year outlook and a long-term 5-year outlook after CLL diagnosis. By adding the baseline (para)clinical data to CLL-IPI variables, predictive performance was improved, whereas no further improvement was observed when including the data on recurrent genetic mutations. We discovered 2 main clusters of variables predictive of treatment and infection. Further emphasizing the high mortality resulting from infection in CLL, we found a close similarity between variables predictive of infection in the short-term outlook and those predictive of death in the long-term outlook. We conclude that at the time of CLL diagnosis, routine (para)clinical data are more predictive of patient outcome than recurrent mutations. Future studies on modeling genetics and clinical outcome should always consider the inclusion of several (para)clinical data to improve performance.
MeSH term(s)	Humans ; Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis ; Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy ; Leukemia, Lymphocytic, Chronic, B-Cell/genetics ; Mutation ; Prognosis
Language	English
Publishing date	2022-04-25
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2915908-8
ISSN	2473-9537 ; 2473-9529
ISSN (online)	2473-9537
ISSN	2473-9529
DOI	10.1182/bloodadvances.2021006351
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Article ; Online: Artificial intelligence models in chronic lymphocytic leukemia - recommendations toward state-of-the-art.

Agius, Rudi / Parviz, Mehdi / Niemann, Carsten Utoft

Leukemia & lymphoma

2021 Volume 63, Issue 2, Page(s) 265–278

Abstract: Artificial intelligence (AI), machine learning and predictive modeling are becoming enabling technologies in many day-to-day applications. Translation of these advances to the patient's bedside for AI assisted interventions is not yet the norm. With ... ...

Abstract	Artificial intelligence (AI), machine learning and predictive modeling are becoming enabling technologies in many day-to-day applications. Translation of these advances to the patient's bedside for AI assisted interventions is not yet the norm. With specific emphasis on CLL, here, we review the progress of prognostic models in hematology and highlight sources of stagnation that may be limiting significant improvements in prognostication in the near future. We discuss issues related to performance, trust, modeling simplicity, and prognostic marker robustness and find that the major limiting factor in progressing toward state-of-the-art prognostication within the hematological community, is not the lack of able AI algorithms but rather, the lack of their adoption. Current models in CLL still deal with the 'average' patient while the use of patient-centric approaches remains absent. Using lessons from research areas where machine learning has become an enabling technology, we derive recommendations and propose methods for achieving state-of-the-art predictions in modeling health data, that can be readily adopted by the CLL modeling community.
MeSH term(s)	Algorithms ; Artificial Intelligence ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis ; Leukemia, Lymphocytic, Chronic, B-Cell/therapy ; Machine Learning
Language	English
Publishing date	2021-10-06
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1042374-6
ISSN	1029-2403 ; 1042-8194
ISSN (online)	1029-2403
ISSN	1042-8194
DOI	10.1080/10428194.2021.1973672
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Article: La « crise des pilules » en France : les femmes ont-elles davantage consulté un.e gynécologue afin d’accéder plus facilement au DIU ?

Le Guen, M / Agius, R / Panjo, H / Moreau, C

Revue d'epidemiologie et de sante publique

2020 Volume 68, Issue 6, Page(s) 347–355

Abstract: Background: In December 2012, a media controversy about negative side-effects of oral contraceptives on women's health, also called "pill scare", broke out in France. While several analyses highlighted a change in women's contraceptive practices ... ...

Title translation	The French "pill scare": Did women go to a gynecologist more often to have an easier access to the IUD?
Abstract	Background: In December 2012, a media controversy about negative side-effects of oral contraceptives on women's health, also called "pill scare", broke out in France. While several analyses highlighted a change in women's contraceptive practices following this media controversy, no analysis has been conducted to determine the possible changes in their choices of health professionals and its repercussions on their contraceptive use. Methods: Our study is based on data from three population-based cross-sectional surveys conducted in 2010, 2013 and 2016 (Fecond 2010, Fecond 2013 and Baromètre Santé 2016) that collected information on women's contraceptive practices and the specialties of the health professionals having prescribed the methods they were using. Results: Between 2010 and 2016, women went to a gynecologist or a midwife more often than to a general practitioner for prescription of a reversible contraceptive method. However, their changes in visiting prescribers did not explain the changes in their contraceptive practices observed over the period. In 2016, access to health professional remained largely dependent on women's socio-demographic characteristics: older ones and those from a more privileged social background or living in urban areas were more likely to consult a gynecologist for prescription of their contraceptive method. On the other hand, consultations of midwives for contraceptive prescription were more frequent among women with children and among those who relied on public health insurance alone. Conclusion: Following the "pill scare" that occurred in France in December 2012, the decision by some women to use the IUD instead of the pill led them to change health professionals, and also led practitioners to change their prescribing practices.
MeSH term(s)	Adolescent ; Adult ; Attitude to Health ; Contraception/methods ; Contraception/psychology ; Contraceptives, Oral, Hormonal/administration & dosage ; Contraceptives, Oral, Hormonal/adverse effects ; Cross-Sectional Studies ; Deception ; Female ; France/epidemiology ; Gynecology/ethics ; Gynecology/statistics & numerical data ; Gynecology/trends ; Health Services Accessibility/ethics ; Health Services Accessibility/statistics & numerical data ; Healthcare Disparities/trends ; History, 21st Century ; Humans ; Intrauterine Devices ; Mass Media/ethics ; Middle Aged ; Office Visits/statistics & numerical data ; Office Visits/trends ; Public Opinion ; Tablets ; Young Adult
Chemical Substances	Contraceptives, Oral, Hormonal ; Tablets
Language	French
Publishing date	2020-11-06
Publishing country	France
Document type	Historical Article ; Journal Article
ZDB-ID	199128-0
ISSN	0398-7620
ISSN	0398-7620
DOI	10.1016/j.respe.2020.10.003
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