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  1. Article ; Online: Multimorbidity in middle-aged women and COVID-19: binary data clustering for unsupervised binning of rare multimorbidity features and predictive modeling.

    Benny, Dayana / Giacobini, Mario / Costa, Giuseppe / Gnavi, Roberto / Ricceri, Fulvio

    BMC medical research methodology

    2024  Volume 24, Issue 1, Page(s) 95

    Abstract: Background: Multimorbidity is typically associated with deficient health-related quality of life in mid-life, and the likelihood of developing multimorbidity in women is elevated. We address the issue of data sparsity in non-prevalent features by ... ...

    Abstract Background: Multimorbidity is typically associated with deficient health-related quality of life in mid-life, and the likelihood of developing multimorbidity in women is elevated. We address the issue of data sparsity in non-prevalent features by clustering the binary data of various rare medical conditions in a cohort of middle-aged women. This study aims to enhance understanding of how multimorbidity affects COVID-19 severity by clustering rare medical conditions and combining them with prevalent features for predictive modeling. The insights gained can guide the development of targeted interventions and improved management strategies for individuals with multiple health conditions.
    Methods: The study focuses on a cohort of 4477 female patients, (aged 45-60) in Piedmont, Italy, and utilizes their multimorbidity data prior to the COVID-19 pandemic from their medical history from 2015 to 2019. The COVID-19 severity is determined by the hospitalization status of the patients from February to May 2020. Each patient profile in the dataset is depicted as a binary vector, where each feature denotes the presence or absence of a specific multimorbidity condition. By clustering the sparse medical data, newly engineered features are generated as a bin of features, and they are combined with the prevalent features for COVID-19 severity predictive modeling.
    Results: From sparse data consisting of 174 input features, we have created a low-dimensional feature matrix of 17 features. Machine Learning algorithms are applied to the reduced sparsity-free data to predict the Covid-19 hospital admission outcome. The performance obtained for the corresponding models are as follows: Logistic Regression (accuracy 0.72, AUC 0.77, F1-score 0.69), Linear Discriminant Analysis (accuracy 0.7, AUC 0.77, F1-score 0.67), and Ada Boost (accuracy 0.7, AUC 0.77, F1-score 0.68).
    Conclusion: Mapping higher-dimensional data to a low-dimensional space can result in information loss, but reducing sparsity can be beneficial for Machine Learning modeling due to improved predictive ability. In this study, we addressed the issue of data sparsity in electronic health records and created a model that incorporates both prevalent and rare medical conditions, leading to more accurate and effective predictive modeling. The identification of complex associations between multimorbidity and the severity of COVID-19 highlights potential areas of focus for future research, including long COVID and intervention efforts.
    MeSH term(s) Humans ; COVID-19/epidemiology ; Female ; Multimorbidity ; Middle Aged ; Italy/epidemiology ; Cluster Analysis ; SARS-CoV-2 ; Severity of Illness Index ; Hospitalization/statistics & numerical data ; Quality of Life ; Cohort Studies ; Machine Learning
    Language English
    Publishing date 2024-04-24
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2041362-2
    ISSN 1471-2288 ; 1471-2288
    ISSN (online) 1471-2288
    ISSN 1471-2288
    DOI 10.1186/s12874-024-02200-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Hospitalisation for herpes zoster in people with and without diabetes: A 10-year-observational study.

    Giorda, Carlo B / Picariello, Roberta / Tartaglino, Barbara / Nada, Elisa / Romeo, Francesco / Costa, Giuseppe / Gnavi, Roberto

    Diabetes research and clinical practice

    2024  Volume 210, Page(s) 111603

    Abstract: Aims: This study explores the association between Herpes Zoster (HZ) hospitalizations and diabetes in Piedmont, Italy from 2010 to 2019. Focusing on the burden of HZ hospitalizations in diabetic and non-diabetic groups, it aims to identify risk factors ... ...

    Abstract Aims: This study explores the association between Herpes Zoster (HZ) hospitalizations and diabetes in Piedmont, Italy from 2010 to 2019. Focusing on the burden of HZ hospitalizations in diabetic and non-diabetic groups, it aims to identify risk factors in diabetics to enhance prevention strategies.
    Methods: In a two-phase study, we first compared age-standardized HZ hospitalization rates between diabetic and non-diabetic individuals from 2010 to 2019. We then examined hospitalization risk factors for HZ within a diabetic patient cohort managed by regional diabetes clinics.
    Results: Of 3,423 HZ hospitalizations in 2010-2019, 17.9 % (613 cases) were diabetic patients, who exhibited higher hospitalization rates (15.9 to 6.0 per 100,000) compared to non-diabetese individuals. Among diabetics subjects risk factors for HZ hospitalization included age over 65, obesity (BMI > 30), and poor glycemic control (HbA1c > 8.0 %). These patients had a 40 % increased rehospitalization risk and a 25 % higher risk of severe complications, such as stroke and myocardial infarction, post-HZ.
    Conclusions: Diabetes markedly increases HZ hospitalization rates, rehospitalization, and complication risks. These findings underscore the need for preventive strategies, especially improved glycemic control among high-risk diabetic patients, to inform public health policies and clinical practices aimed at mitigating HZ's impact on this population.
    MeSH term(s) Humans ; Retrospective Studies ; Herpes Zoster/epidemiology ; Herpesvirus 3, Human ; Diabetes Mellitus/epidemiology ; Hospitalization
    Language English
    Publishing date 2024-03-08
    Publishing country Ireland
    Document type Observational Study ; Journal Article
    ZDB-ID 632523-3
    ISSN 1872-8227 ; 0168-8227
    ISSN (online) 1872-8227
    ISSN 0168-8227
    DOI 10.1016/j.diabres.2024.111603
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Equity in the recovery of elective and oncological surgery volumes after the COVID-19 lockdown: a multicentre cohort study in Italy.

    Di Girolamo, Chiara / Onorati, Roberta / Landriscina, Tania / Gnavi, Roberto / Cesaroni, Giulia / Calandrini, Enrico / Bisceglia, Lucia / Fanizza, Caterina / Spadea, Teresa

    International journal for equity in health

    2024  Volume 23, Issue 1, Page(s) 57

    Abstract: Background: The COVID-19 pandemic has had, and still has, a profound impact on national health systems, altering trajectories of care and exacerbating existing inequalities in health. Postponement of surgeries and cancellation of elective surgical ... ...

    Abstract Background: The COVID-19 pandemic has had, and still has, a profound impact on national health systems, altering trajectories of care and exacerbating existing inequalities in health. Postponement of surgeries and cancellation of elective surgical procedures have been reported worldwide. In Italy, the lock-down measures following the COVID-19 pandemic caused cancellations of surgical procedures and important backlogs; little is known about potential social inequalities in the recovery process that occurred during the post-lockdown period. This study aims at evaluating whether all population social strata benefited equally from the surgical volumes' recovery in four large Italian regions.
    Methods: This multicentre cohort study covers a population of approximately 11 million people. To assess if social inequalities exist in the recovery of eight indicators of elective and oncological surgery, we estimated Risk Ratios (RR) through Poisson models, comparing the incidence proportions of events recorded during COVID-19 (2020-21) with those in pre-pandemic years (2018-19) for each pandemic period and educational level.
    Results: Compared to 2018-19, volumes of elective surgery showed a U-shape with the most significant drops during the second wave or the vaccination phase. The recovery was socially unequal. At the end of 2021, incidence proportions among highly educated people generally exceeded the expected ones; RRs were 1.31 (95%CI 1.21-1.42), 1.24 (95%CI 1.17-1.23), 1.17 (95%CI 1.08-1.26) for knee and hip replacement and prostatic surgery, respectively. Among low educated patients, RR remained always < 1. Oncological surgery indicators showed a similar social gradient. Whereas volumes were preserved among the highly educated, the low educated were still lagging behind at the end of 2021.
    Conclusions: Surgical procedures generally returned to pre-pandemic levels but the low educated experienced the slowest recovery. An equity-oriented appraisal of trends in healthcare provision should be included in pandemic preparedness plans, to ensure that social inequalities are promptly recognised and tackled.
    MeSH term(s) Humans ; COVID-19 ; Cohort Studies ; Communicable Disease Control ; Pandemics ; Italy/epidemiology
    Language English
    Publishing date 2024-03-15
    Publishing country England
    Document type Multicenter Study ; Journal Article
    ZDB-ID 2092056-8
    ISSN 1475-9276 ; 1475-9276
    ISSN (online) 1475-9276
    ISSN 1475-9276
    DOI 10.1186/s12939-024-02127-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Correction to: Increased incidence of type 1 diabetes in 2 years of COVID‑19 pandemic.

    Giorda, Carlo Bruno / Gnavi, Roberto / Tartaglino, Barbara / Manti, Roberta / Migliardi, Alessandro / Favella, Lucia / Ferro, Silvia / Rabbone, Ivana

    Acta diabetologica

    2023  Volume 60, Issue 5, Page(s) 719

    Language English
    Publishing date 2023-03-15
    Publishing country Germany
    Document type Published Erratum
    ZDB-ID 1097676-0
    ISSN 1432-5233 ; 0940-5429
    ISSN (online) 1432-5233
    ISSN 0940-5429
    DOI 10.1007/s00592-023-02072-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: An update on the incidence of type 1 diabetes during the COVID-19 pandemic years.

    Giorda, Carlo Bruno / Gnavi, Roberto / Tartaglino, Barbara / Favella, Lucia / Romeo, Francesco / Migliardi, Alessandro / Ferro, Silvia / Rabbone, Ivana

    Diabetes, obesity & metabolism

    2023  Volume 25, Issue 10, Page(s) 3068–3070

    MeSH term(s) Humans ; Diabetes Mellitus, Type 1/epidemiology ; Incidence ; COVID-19/epidemiology ; Pandemics
    Language English
    Publishing date 2023-07-03
    Publishing country England
    Document type Letter ; Research Support, Non-U.S. Gov't
    ZDB-ID 1454944-x
    ISSN 1463-1326 ; 1462-8902
    ISSN (online) 1463-1326
    ISSN 1462-8902
    DOI 10.1111/dom.15182
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Hepatocellular carcinoma in a large cohort of type 2 diabetes patients.

    Giorda, Carlo B / Picariello, Roberta / Tartaglino, Barbara / Nada, Elisa / Costa, Giuseppe / Manti, Roberta / Monge, Luca / Gnavi, Roberto

    Diabetes research and clinical practice

    2023  Volume 200, Page(s) 110684

    Abstract: Aims: To elucidate the current burden of hepatocellular carcinoma (HCC) in type 2 diabetes (DM2) with a focus on the associated clinical determinants.: Methods: Incidence of HCC between 2009 and 2019 in the diabetic and general population was ... ...

    Abstract Aims: To elucidate the current burden of hepatocellular carcinoma (HCC) in type 2 diabetes (DM2) with a focus on the associated clinical determinants.
    Methods: Incidence of HCC between 2009 and 2019 in the diabetic and general population was calculated from regional administrative and hospital databases. Potential determinants of the disease were evaluated with a follow-up study.
    Results: In the DM2 population, the incidence resulted in 8.05 cases per 10,000 yearly. This rate was three times higher than that of the general population. 137,158 patients with DM2 and 902 HCC were found for the cohort study. The survival of HCC patients was 1/3 of that of cancer-free diabetic controls. Age, male sex, alcohol abuse, previous viral hepatitis B and C, cirrhosis, low platelet count, elevated GGT/ALT, higher BMI and HbA1c levels were associated with HCC occurrence. Diabetes therapy was not adversely associated with HCC development.
    Conclusion: Incidence of HCC in DM2 is more than tripled compared to the general population with high mortality. These figures are higher than those expected from the previous evidence. In parallel with known risk factors for liver disease, such as viruses and alcohol, insulin-resistance characteristics are associated with a higher probability of HCC.
    MeSH term(s) Humans ; Male ; Carcinoma, Hepatocellular/epidemiology ; Carcinoma, Hepatocellular/etiology ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/drug therapy ; Liver Neoplasms/epidemiology ; Liver Neoplasms/etiology ; Cohort Studies ; Follow-Up Studies ; Risk Factors ; Liver Cirrhosis/epidemiology ; Incidence
    Language English
    Publishing date 2023-04-24
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 632523-3
    ISSN 1872-8227 ; 0168-8227
    ISSN (online) 1872-8227
    ISSN 0168-8227
    DOI 10.1016/j.diabres.2023.110684
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: COVID-19 and Health Outcomes in People with Multiple Sclerosis: A Population-Based Study in Italy.

    Gnavi, Roberto / Eboli, Ilenia / Alboini, Paolo Emilio / D'Alfonso, Sandra / Picariello, Roberta / Costa, Giuseppe / Leone, Maurizio

    Life (Basel, Switzerland)

    2023  Volume 13, Issue 5

    Abstract: People with multiple sclerosis (PWMS) are at high risk of being affected by the disruption of health services that occurred during the COVID-19 pandemic months. The aim of this study was to evaluate the effect of the pandemic on the health outcomes of ... ...

    Abstract People with multiple sclerosis (PWMS) are at high risk of being affected by the disruption of health services that occurred during the COVID-19 pandemic months. The aim of this study was to evaluate the effect of the pandemic on the health outcomes of PWMS. PWMS and MS-free residing in Piedmont (north-west of Italy) were identified from electronic health records and linked with the regional COVID-19 database, the hospital-discharge database, and the population registry. Both cohorts (9333 PWMS and 4,145,856 MS-free persons) were followed-up for access to swab testing, hospitalisation, access to the Intensive Care Unit (ICU), and death from 22 February 2020 to 30 April 2021. The relationship between the outcomes and MS was evaluated using a logistic model, which was adjusted for potential confounders. The rate of swab testing was higher in PWMS, but the positivity to infection was similar to that of MS-free subjects. PWMS had a higher risk of hospitalisation (OR = 1.74; 95% IC, 1.41-2.14), admission to ICU (OR = 1.79; 95% IC, 1.17-2.72), and a slight, albeit not statistically significant, increase in mortality (OR = 1.28; 95% IC, 0.79-2.06). Compared to the general population PWMS with COVID-19 had an increased risk of hospitalization and admission to the ICU; the mortality rate did not differ.
    Language English
    Publishing date 2023-04-27
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662250-6
    ISSN 2075-1729
    ISSN 2075-1729
    DOI 10.3390/life13051089
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: L’epidemiologia a supporto delle priorità di intervento: il caso del diabete a Torino.

    Gnavi, Roberto / Piccariello, Roberta / Pilutti, Silvia / Di Monaco, Roberto / Oleandri, Salvatore / Costa, Giuseppe

    Epidemiologia e prevenzione

    2021  Volume 44, Issue 5-6 Suppl 1, Page(s) 172–178

    Abstract: Objectives: to describe the epidemiology of diabetes within the city of Turin (Piedmont Region, Northern Italy) and to present the process initiated by the city network of diabetes care for the improvement of prevention and treatment of the disease.: ... ...

    Title translation Epidemiology in support of intervention priorities: the case of diabetes in Turin (Piedmont Region, Northern Italy).
    Abstract Objectives: to describe the epidemiology of diabetes within the city of Turin (Piedmont Region, Northern Italy) and to present the process initiated by the city network of diabetes care for the improvement of prevention and treatment of the disease.
    Design: ecological study based on administrative database.
    Setting and participants: residents in Turin from 2016 to 2018.
    Main outcome measures: incidence and prevalence of diabetes, percentage of glycosylated haemoglobin testing, and case-fatality.
    Results: in the considered three-year period (2016-2018), the cumulative incidence of diabetes was 11.5 x1,000; as of 31.12.2018 the prevalence was 5.9%. 77% had performed at least one measurement of glycated haemoglobin during the previous year, and the case-fatality was 12.6% in the three-year period. The standardized prevalence per statistical zone varied from a minimum of 2% (95%CI 1.2-3.3) to a maximum of 10.2% (95%CI 9.1-11.4). The highest values were recorded in the most deprived city areas. The geographical distribution of incidence, varying between 5.1 x1,000 (95%CI 2.7-10.0) e 19.4 x1,000 (95%CI 15.8-24.0), reproduces the geography of prevalence, as well as the percentage of measurement of glycated haemoglobin, while the variability of the fatality rate is more modest without an obvious geographic pattern.
    Conclusions: diabetes occurs most frequently in the most deprived areas of the city, but the response of the health care system is adequate and equitable. Sharing of these results with the city health authorities and the diabetologists has led to identify as a priority interventions for the reduction of unhealthy behaviours, and for the improvements of patient care pathway, starting form the most disadvantaged areas of the city. A process of listening and involvement of all actors potentially interested in the prevention and treatment of diabetes has been started.
    MeSH term(s) Diabetes Mellitus/epidemiology ; Diabetes Mellitus/therapy ; Humans ; Incidence ; Italy/epidemiology ; Prevalence
    Language Italian
    Publishing date 2021-01-08
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 1038112-0
    ISSN 1120-9763
    ISSN 1120-9763
    DOI 10.19191/EP20.5-6.S1.P172.087
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Increased incidence of type 1 diabetes in 2 years of COVID-19 pandemic.

    Giorda, Carlo Bruno / Gnavi, Roberto / Tartaglino, Barbara / Manti, Roberta / Migliardi, Alessandro / Favella, Lucia / Ferro, Silvia / Rabbone, Ivana

    Acta diabetologica

    2022  Volume 60, Issue 4, Page(s) 587–589

    MeSH term(s) Humans ; COVID-19/epidemiology ; Diabetes Mellitus, Type 1/epidemiology ; Incidence ; Pandemics
    Language English
    Publishing date 2022-12-17
    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/s00592-022-01986-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Instructive lessons from the analysis of assistance in diabetes during the first phase of COVID-19 pandemic.

    Giorda, Carlo B / Picariello, Roberta / Landriscina, Tania / Tartaglino, Barbara / Nada, Elisa / Doglio, Marella / Romeo, Francesco / Gnavi, Roberto

    Acta diabetologica

    2022  Volume 59, Issue 6, Page(s) 861–864

    MeSH term(s) COVID-19/epidemiology ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus/therapy ; Humans ; Pandemics ; SARS-CoV-2
    Language English
    Publishing date 2022-02-19
    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/s00592-022-01855-6
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