bluuebunny/crossref_metadata_2025_split huggingface dataset:
909Testing ‘hardening hypotheses’ in 30 Global Adult Tobacco Survey countries: an ecological study
Authors: Sreeramareddy Chandrashekhar , Aye Saint His 
Published: September 2021

Abstract

Background
Evidence from high-income countries suggests “softening” but not “hardening” occurs when smoking prevalence decreases; however, evidence is lacking from developing countries.

Methods
We constructed heaviness of smoking index (HIS) based on cigarettes smoked per day (CPD) and time-to-first-cigarette (TTFC) and a score of 4-6 was high nicotine dependence; Hardcore smokers (HCS) are daily smokers who smoked within 30 minutes after waking up, smoke ≥10 cigarettes per day, have not made any quit attempts in 12 months, and have no intention to quit at all or during next 12 months; light smokers (&lt;10 CPD or occasional smokers). We plotted two-way linear prediction graphs using country-level data and estimated Spearmańs rank-correlation coefficient. On pooled data multi-level binary logistic regression analyses for HCS, high dependence and light smoker.

Results
Among men and women range (lowest vs. highest) of rates varied between countries and were lower among women. Daily smoking prevalence was moderately and positively correlated with hard-core smoking (Rsp=0.473), and high dependence (Rsp=0.384) but negatively correlated with light smoking (Rsp=-0.677). HCS and high dependence were associated with socio-economic factors but effect sizes were higher for women. Among GDP and tobacco control score showed protective effect for HCS and high dependence but increased risk for light smoking.

Conclusions
Positive relationship of daily smoking with HCS and high dependence and its negative relationship with light smoking is contrary to “hardening hypothesis”.

Key messages
Hardening may not happen in developing countries as well.
456Mode of delivery and urinary incontinence in middle age: longitudinal analysis of the SWAN cohort
Authors: Stephenson Nikki , DR Brenner , Metcalfe Amy 
Published: September 2021

Abstract

Background
Urinary Incontinence (UI) is the involuntary loss of urine. Multiparity increases risk of UI, but this risk differs by mode of delivery. This study evaluated the association of mode of delivery (vaginal/cesarean) and prevalence of urge, stress, and mixed UI in middle age.

Methods
Using longitudinal data (baseline through visit ten collected annually) from the SWAN (Study of Women Across the Nation) cohort, the association between mode of delivery and UI subtypes was examined. We employed conditional mixed-effect logistic regression modelling, adjusting for baseline age, race, parity, smoking, diabetes, marital status, income, and body mass index. Menopausal status, hormone-replacement therapy use, and hysterectomy status were considered as time-varying and subject-specific covariates. A composite variable of mode of delivery was created to account for total pregnancies per participant, and women who experienced only vaginal (n = 2110) or caesarean (n = 379) deliveries were included.

Results
For women delivering vaginally vs cesarean, the baseline mean age (years) was 46.0(95%CI:45.9-46.1) and 45.6(95%CI:45.3-45.9), and proportion of perimenopausal women was 46.7%(95%CI:44.6-48.9) and 41.6%(95%CI:36.8-46.7). Women who deliver vaginally vs cesarean had an odds ratio (95% confidence interval) of 0.93(0.61-1.41), 1.46(1.04-2.05), and 1.58(1.21-2.05) for urge, stress, and mixed UI respectively.

Conclusions
The present study found vaginal deliveries increased odds of stress and mixed UI in middle age, but not urge UI.

Key Messages
Women have the most contact with health-care systems right after delivery; this is the optimal timing for increased awareness of UI in middle age and provision of interventions, including pelvic floor therapy, for women delivering vaginally.
1384Factors related to neck and shoulder pain during the COVID-19 pandemic in Japan
Authors: Tanaka Sayo , Ohde Sachiko , Katanoda Kota , Abe Sarah Krull , Tabuchi Takahiro 
Published: September 2021

Abstract

Background
Shoulder stiffness is a common health issue in Japan. During the COVID-19 pandemic, people were forced to stay home which possibly escalated the development of shoulder stiffness. We aimed to assess associations of lifestyle changes and newly developed neck and shoulder pain (NSP) during the pandemic.

Methods
A cross-sectional study was conducted, analyzing the data from the Japan COVID-19 and Society Internet Survey (JACSIS), an internet survey conducted from August to September 2020. Data included sociodemographic, lifestyle and health measures related to NSP during the pandemic. Multivariable logistic regression models were fitted to calculate adjusted odds ratio (AOR) with 95% confidence interval (CI) for newly developed NSP with adjustment for lifestyle, physiological and psychosocial changes.

Results
After exclusion of participants with existing pain, 25,482 participants (12,673 male, 12,809 female) aged 15-79 years were included in the analysis. Of these, 4.1% reported newly developed NSP. Weight gain and long sedentary time were strongly associated with the NSP (AOR (95%CI): 2.4 (2.0-2.8) and 1.81 (1.4-2.3)). Stratified analyses of 1,751 students and 4,211 teleworkers showed significant associations (AOR (95%CI): 2.1 (1.4-2.8) and 2.5 (1.9-3.2)) compared to non-workers and non-teleworkers, respectively.

Conclusions
Students and teleworkers became prone to NSP during the pandemic. However, factors which were associated to pain did not differ during the pandemic compared with the previous studies.

Key messages
Preventive measures for NSP should be taken in students and teleworkers.
1482Comparative epidemiology analysis of major depressive disorder with DSM-5 and DSM-IV criteria in high-income countries
Authors: Thakur Shilpa , Tadwalkar Swarali 
Published: September 2021

Abstract

Background
Depression is a major contributor to the overall global burden of disease and one of the leading causes of disability worldwide. In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) there were a few changes in the inclusion criteria but there is a limited literature to quantify this change.

Methods
We conducted a literature review using PubMed and Clarivate’s Cortellis database from 1/1/2008 to 7/4/2020, to identify the country-specific total prevalence of MDD according to the DSM-5 and DSM-IV in nine high-income countries. In countries lacking published prevalence estimates according to DSM-5 criteria, we derived DSM-5 prevalence estimates by multiplying the country-specific DSM-IV data with the ratio of DSM-5 to DSM-IV prevalence in countries with comparable risk factors and healthcare access.

Results
Changes in the criteria between the DSM-IV and DSM-5, resulted in a substantial increase (30%) in the MDD patient counts across the countries under study ranging from 0.1 million patients in New Zealand to 5.8 million in United States.

Conclusions
Total prevalent cases of MDD increased after the introduction of DSM-5 criteria because of the changes in the inclusion criteria. Elimination of bereavement as the exclusion criteria was one of the key changes which resulted in more patients becoming eligible for the diagnosis and treatment of MDD.

Key messages
This analysis provides a comparative insight into the effect of change in the DSM-IV to DSM-5 diagnostic criteria on the MDD patient counts which is not reported frequently in the published literature.
540A simulation to evaluate HTLV-1 screening for pregnant women in prevention of adult T-cell leukemia
Authors: Tomoya Takiguchi , Nishino Yoshikazu , Fukui Keisuke , Koriyama Chihaya , Itabashi Kazuo 
Published: September 2021

Abstract

Background
In Japan, the nation-wide screening program of pregnant women for HTLV-1 infection was launched in 2010 to prevent mother-to-child transmission. It is difficult to assess the effect of the screening program on adult T-cell leukemia (ATL) prevention by observational study because ATL develops after long-term (about 50 years) latency in HTLV-1 carriers. Thus, we assessed the effect of the screening using computer simulation.

Methods
We constructed our model that simulates lifetime history of the children born to HTLV-1 carrier mothers. Lifetime risks of ATL among the children in unscreened group and screened group were estimated employing Monte Carlo simulation. We developed three scenarios for the risk estimation of ATL in screened groups, each making different assumptions for the choice of feeding methods (formula feeding, short-term breast-feeding, and long-term breast-feeding).

Results
Our simulation revealed that lifetime risk of ATL among the children born to HTLV-1 carrier mothers was 1.19 % in unscreened group and 0.21 to 0.27 % in screened groups.

Conclusions
In Japan, it is estimated that there were 1,363 pregnant women with HTLV-1 infection in 2016 (Sekizawa 2018). From this figure, the estimated annual number of ATL patients prevented by the screening is 12.6 to 13.5.

Key message
HTLV-1 screening in pregnant women for one year is estimated to reduce the number of ATL among their children by about 13 in Japan.
306Association between polypharmacy and mortality in the community-dwelling older population: a data linkage study
Authors: Van der Heyden Johan , Berete Finaba , Devleesschauwer Brecht , De Ridder Karin , Bruyère Olivier , Renard Françoise , Charafeddine Rana 
Published: September 2021

Abstract

Background
Literature findings on the association between polypharmacy and mortality in older people are not consistent. Appropriate tools, making use of linkages, are helpful to investigate this further.

Methods
Data of participants of the Belgian Health Interview Survey 2013 aged ≥ 65 years (n = 1950) were linked with billing data and 5 year’s mortality follow-up information. Polypharmacy was defined as concomitant use of ≥ 5 medicines in the past 24 hours or ≥ 5 recent prescriptions of reimbursed medicines. The impact of polypharmacy on mortality was assessed through mortality rate ratios (MRR) from a Poisson regression model adjusting for gender, age, multimorbidity, functional limitations and health care use, and including interactions.

Results
The prevalence of polypharmacy was 38,3%. Age and disability status were effect modifiers in the association between polypharmacy and mortality. Whereas polypharmacy was significantly associated with mortality among people aged 65-79 years (MRR 2.52; 95% CI 1.67-3.80), this was not so for the 80 + (MRR 1.46; 95% CI 0.93-2.29). Polypharmacy was a mortality predictor among people with no/moderate functional limitations (MRR 2,29; 95% CI 1.61-3.25), but not for those with severe functional limitations (MRR 1,22; 95% CI 0.67-2.34).

Conclusions
By linking health interview survey, billing and mortality data further insights can be gained on the association between polypharmacy and mortality.

Key messages
A critical evaluation of polypharmacy in older people below 80 years and in people without severe functional limitations may reduce mortality in these population groups.
211Real-World Data Assessment Plan for a Heat-Not-Burn Tobacco Product: Proof of Concept
Authors: van der Plas Angela , Hankins Matthew , Heremans Annie 
Published: September 2021

Abstract

Focus of Presentation
Real-world data (RWD) is readily available in Japan through multiple sources. Considering the crucial need to substantiate the beneficial effects of switching from cigarette smoking to heat-not-burn (HNB) products, both at the individual and population levels, the use of RWD seems a viable option.
For instance, ecological studies using RWD have assessed the impact of population-level interventions such as smoking bans and their effects on smoking-related diseases and their endpoints
As a proof of concept, ecological analyses were performed to assess the rates of chronic obstructive pulmonary disease (COPD) exacerbations and acute Ischemic Heart Disease (IHD) hospitalizations before and after the introduction of and HNB product in the Japanese market.

Findings
Hospital admissions associated with ICD codes for COPD and IHD from 2008 to 2019—5 years before and 4 years after the introduction of the target HNB product in the Japanese market—were retrieved from the MDV database. Referrals were below those predicted from pre-launch trends.

Conclusions
The use of RWD in assessment of HNB products is viable for ecological studies with the well-known caveats. Their use in exposure-specific studies will become feasible once the systematic collection of exposure to tobacco products and use history is guaranteed. This will greatly increase the range and robustness of the evidence base.

Key messages
The use of RWD is a practical way of assessing the impact of HNB products in the population as a whole.
1168Are there non-linear alcohol–health relationships?: Review of observational studies employing enhanced causal methods
Authors: Visontay Rachel , Sunderland Matthew , Slade Tim , Wilson Jack , Mewton Louise 
Published: September 2021

Abstract

Focus of Presentation
Research has long found ‘J-shaped’ relationships between alcohol consumption and certain health outcomes, indicating a protective effect of moderate consumption. However, methodological limitations in most studies hinder causal inference. While enhanced methods for data analysis (e.g. G-methods) and alternative observational designs (e.g. Mendelian Randomisation) have been developed, they are not commonly applied to alcohol–health research. This presentation will report on a systematic review of observational studies that employ improved approaches to mitigate confounding in characterising alcohol–long-term health relationships (PROSPERO registration: CRD42020185861).

Findings
MEDLINE, PsycINFO, Embase and SCOPUS were searched in May 2020, yielding 16 published manuscripts reporting on cancer, diabetes, dementia, mental health, cardiovascular health, mortality, HIV seroconversion, and musculoskeletal health. Study findings were qualitatively synthesised. A variety of functional forms were found, including reverse J/J-shaped relationships for prostate cancer and related mortality, dementia risk, mental health, and certain lipids. However, most outcomes were only evaluated by a single study, and few studies provided information on the role of alcohol consumption pattern.

Conclusions/Implications
More research employing enhanced causal inference methods is urgently required to accurately characterise alcohol–long-term health relationships. Those studies that have been conducted find a variety of linear and non-linear functional forms, with results tending to be discrepant even within specific health outcomes.

Key messages
A systematic review found that those studies of alcohol–long-term health relationships employing enhanced causal methods are too few and inconsistent to establish whether non-linear alcohol–health relationships exist.
319Congenital cytomegalovirus education, translation and prevention
Authors: Waight Emma , Swinburn Katherine , Shand Antonia , Hui Lisa , Daly Kate , Rawlinson William , Jones Cheryl , Badawi Nadia , Smithers-Sheedy Hayley 
Published: September 2021

Abstract

Focus of Presentation
Congenital cytomegalovirus (CMV) is a known cause of sensorineural hearing loss, cerebral palsy and other disabilities. International consensus guidelines (2017) and the Australasian Society of Infectious Diseases (2014) recommend all pregnant women be provided with information on CMV and strategies to reduce their risk of infection. Here we describe the multifaceted strategies implemented to date to promote uptake of these guidelines.

Findings
At policy level, we influenced national clinical practice standards through input into new CMV prevention recommendations by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and Department of Health, which sparked state public health campaigns. At the intervention level, we presented hospital in-services, podcasts and webinars and developed an e-learning course for midwives. In collaboration with the Department of Health &gt;11,000 pamphlets were disseminated to NSW GPs. At the community level, we developed patient information and media resources. During a recent month-long campaign, our cCMV video had &gt;62,000 views, CMV content on social media had &gt;1.4M total impressions, &gt;77,000 total engagements and &gt;200,000 viewed CMV awareness pieces via television/radio/print.

Conclusions/Implications
Implementation of congenital CMV practice guidelines provide an important opportunity to prevent neurodevelopmental disability. Collaborations between families, clinicians, researchers, professional bodies and health departments are essential to drive translation.

Key messages
A multifaceted approach in implementing congenital CMV practice guidelines gives the opportunity to reach numerous stakeholders including policymakers, health professionals and expectant mothers.
1102Assessing variability among health care facilities in delivering chronic disease management in Kenya
Authors: Wami Welcome Mkhululi , Asiki Gershim , Kyobutungi Catherine Kyobutungi , Otieno Peter 
Published: September 2021

Abstract

Background
Non-communicable diseases (NCDs) account for an estimated 71% of global deaths. In Kenya, 31% of mortality is attributed to chronic illnesses and half of these are premature deaths. The study aimed to assess variation in the capacity of health facilities in Kenya in delivering NCDs diagnosis or management: diabetes, cardiovascular disease, chronic respiratory disease, and cervical cancer screening.

Methods
A cross-sectional survey of 258 facilities was conducted between June–December 2019. Service-specific indicators: basic equipment, diagnostics, trained staff and guidelines, and essential medicines were captured using a structured questionnaire and summarised as domain scores. All results were weighted to account for the national distribution of facilities.

Results
More than half of the facilities (60%; 95% CI: 51-70%) had all basic functioning equipment, and only 29% (95% CI: 25-33%) had trained staff and guidelines for diagnosis or management of mental illnesses. Despite this, 54% (95% CI: 46-53%) of all facilities had diagnostic capacity to detect these NCDs. Furthermore, 53% (95% CI: 49-56%) of the facilities across all levels of care had medicines for managing hypertension and diabetes. The overall readiness score for NCDs diagnosis or management was 47% (95% CI: 43–51%) and varied significantly across the levels of care.

Conclusions
A wide variation in basic resource capacity to diagnose or manage NCDs was noted between levels of care. A gap in the capacity of health facilities to manage chronic illnesses exists across all levels of care in Kenya.

Key messages
To meet the recommended chronic illnesses management targets, there is a need to strengthen the existing capacity of the health system and bridge the gap across levels of care.
1400Central but not general obesity is positively associated with risk of hyperhomocysteinemia in middle-aged women
Authors: Wang Yingying 
Published: September 2021

Abstract

Background
Obesity and homocysteine (Hcy) are two important risk factors for cardiovascular disease (CVD); however, there were conflicting results for the relationship between them. Our study is to explore the associations of general and central obesity with hyperhomocysteinemia (HHcy) in middle-aged women.

Methods
The current analysis was based on data from 11007 women aged 40-60 years. Height, weight, and waist circumference (WC) were measured and serum homocysteine was determined. Multiple logistic regression models were used to assess the associations of the risk of hyperhomocysteinemia (HHcy, Hcy&gt;15μmol/L) with BMI and WC.

Results
13.71% women had HHcy. The prevalences of BMI-based general obesity and WC-based central obesity were 11.17% and 22.88%, respectively. Compared with non-obese women, the mean serum Hcy concentration was significantly higher in WC-based central obese women (P = 0.002), but not in BMI-based general obese women (P &gt; 0.05). In the multiple logistic regression models, central obesity was positively related to the risk of HHcy (OR = 1.30, 95%CI=1.10 to 1.52), while general obesity was inversely related to the risk of HHcy (OR = 0.82, 95%CI=0.72 to 0.93 and OR = 0.71,95% CI = 0.57 to 0.89).

Conclusions
Central obesity was positively, while general obesity was negatively related to the risk of HHcy. Menopause showed no effect modification on these associations.

Key messages
Homocysteine; Central obesity; Menopause; Cardiovascular Disease
778Risk of 27 cancer types in relation to tobacco smoking: cohort study involving 229,028 Australians
Authors: Weber Marianne , Sarich Peter , Vaneckova Pavla , Wade Stephen , Banks Emily , Egger Sam , Ngo Preston , Joshy Grace , Goldsbury David , Yap Sarsha , Vassallo Amy , Feletto Eleonora , Larksonen Maarit , Grogan Paul , O'Connell Dianne , Canfell Karen 
Published: September 2021

Abstract

Background
Tobacco smoke is a known carcinogen and the magnitude of smoking-related cancer risk varies according to time and population. Local, contemporary evidence can drive appropriate tobacco control. We provide comprehensive cancer risk estimates related to smoking in the population-based, New South Wales (NSW) 45 and Up Study.

Methods
We estimated smoking-related hazard ratios (HR) for cancer using Cox proportional hazards regression using linked questionnaire (2006-2009) and incident cancer data (n ≥ 50 cases per cancer type), from the NSW Cancer Registry (to December 2013) (via CHeReL).

Results
Of 18,475 cancers among 229,028 participants aged ≥45 years, current smokers had significantly increased risks of cancers of the lung, larynx, head and neck, oesophagus, liver, bladder, pancreas, stomach, colorectum, and cancers with unknown primary site, compared to never-smokers; lung cancer risk was markedly elevated, including for current-smokers of 1-5 cigarettes/day (HR = 9.25, 95%CI=5.2-16.6), increasing to 38.39 (26.2-56.2) for current-smokers of &gt; 30 cigarettes/day. Quitting substantively decreased cancer risk compared to continued smoking, with lung cancer risk decreasing with decreasing age at quitting (p(trend)&lt;0.05), however risks remained elevated for those quitting aged &gt;25 compared to never-smokers (1.73, 1.1-2.6 for age 26-30 years). An estimated 20% of current-smokers in Australia will get lung cancer during their lifetime versus 1.6% of never-smokers.

Conclusions
Smoking-attributable cancer risks in Australia are significant, comparable to contemporary risks from other developed nations.

Key messages
Smokers – including “light” smokers – are at high cancer risk, with ∼one-fifth of Australian lifetime smokers developing lung cancer. Quitting is beneficial. Continued investment in tobacco control is essential.