bluuebunny/crossref_metadata_2025_split huggingface dataset:
747Incidence of anencephaly in the Czech Republic: Long-term population based study
Authors: Sipek Antonin , Gregor Vladimir , Klaschka Jan , Maly Marek , Sipek Antonin 
Published: September 2021

Abstract

Background
Anencephaly is a lethal anomaly of the central nervous system from the group of neural tube defects. The main goal of our study was to evaluate the incidence of anencephaly (and its possible trends) during the 53 years period.

Methods
For this study, we used data from the National Registry of Congenital Anomalies of the Czech Republic. We analysed the incidence of anencephaly in births and in prenatally diagnosed cases during the 1964-2016 period. We also evaluated maternal age in these cases. The statistical analysis was performed by Poisson regression and Fisher's exact test.

Results
During the study period there were 6 891 062 children born in the Czech Republic. Among those, 1232 children were born with anencephaly. Another 966 cases of anencephaly were diagnosed during prenatal diagnosis and these pregnancies were electively terminated, the total number of anencephaly cases was 2198. The total incidence of anencephaly significantly decreased during the study period (p = 0.0136). The incidence in births decreased significantly as well (p &lt; 0.001). We found statistically higher incidence of anencephaly in elder mothers (42 years and over).

Conclusions
Gradual implementation of ultrasound prenatal diagnostics started in the 80s of the last century and lead to a very significant decrease in the incidence of anencephaly cases in births. Additionally, the total incidence of anencephaly decreased significantly as well.

Key messages
Incidence of anencephaly in births decreased rapidly with gradual implementation of population wide ultrasound screening.
432Recurrent stillbirth: a population-based study from South Australia
Authors: Smithers Lisa , Lamont Kathleen , Bhattacharya Sohinee 
Published: September 2021

Abstract

Background
In high-income countries, stillbirth is a relatively rare event occurring in &lt; 1% of pregnancies. Recurrent stillbirth is even rarer. Our objective was to explore the prevalence of stillbirth and recurrent stillbirth, factors associated with stillbirth and whether a stillbirth in first pregnancy influences the time to subsequent pregnancy.

Methods
This population-based study involved routinely-collected administrative data on singleton births in South Australia from 1998 to 2015 (n = 333,785). Stillbirth was defined as pregnancies &gt;20 weeks gestation or weighing &gt;400 grams. Univariable and multivariable logistic regression was used to explore associations between sociodemographic factors and stillbirth. Cox proportional hazard was used to explore time to pregnancy.

Results
0.7% of all first pregnancies and 0.6% of all second pregnancies were stillbirths. Of women in their second pregnancy, &lt;10 experienced recurrent stillbirth. In univariable analyses, higher odds of stillbirth in second pregnancies were associated with younger and older maternal age (&lt;20 or ≥ 40 years), being single, unemployed, smoking, shorter inter-pregnancy intervals and numerous medical conditions (e.g. diabetes or hypertension). Multivariable models were unstable due to too few data. The hazard ratio for women who previously experienced a stillbirth compared with livebirth was 1.14 (95%CI 0.39, 3.32).

Conclusions
Studying recurrent stillbirth is especially difficult due to the rare nature of the problem, limiting progress on developing evidence-based advice for women who experience stillbirth in their first pregnancy.

Key messages
Recurrent stillbirth is challenging to study due to the rareness of the problem but could be addressed by careful pooling of large administrative datasets.
1065Diesel exposure and bladder cancer in contemporary Western Australian miners
Authors: Sodhi-Berry Nita , Franklin Peter , Peters Susan , Reid Alison , Musk Arthur (Bill) , Fritschi Lin , Vermeulen Roel , de Klerk Nicholas 
Published: September 2021

Abstract

Background
Diesel engine exhaust (DEE) is classified as a potential carcinogen for bladder cancer in humans by the International Agency for Research on Cancer. We aimed to compare bladder cancer incidence in Western Australian miners against the general population and determine if there was an association with DEE, measured as Elemental Carbon.

Methods
A whole-of-population cohort of 218,846 Western Australian miners employed during 1996-2013 was followed-up until June-2017. DEE exposure data was derived from work histories and collated with administrative State-wide cancer and death data. Standardised Incidence Ratios (SIRs) were calculated to compare rates with the general population. A nested case-control study design with matching on attained age was used. Conditional logistic regression was done to calculate Odds Ratios (ORs) for cumulative Elemental Carbon exposure (unlagged and 15-year lagged), after adjusting for smoking pack-years.

Results
Ninety cases (88 males) were observed and 180,377 controls selected. Miners had lower bladder cancer incidence than the general population (Observed=90; Expected=135.60; SIR:0.66, 95%CI:0.53-0.80). Within miners, DEE exposure was not found to be statistically significantly associated with bladder cancer (unlagged: OR = 0.75, 95%CI: 0.43-1.31; and 15-year lagged: OR = 0.59, 95%CI:0.25-1.40), after adjusting for smoking pack-years (unlagged and lagged OR:1.02, 95%CI:1.01-1.03).

Conclusions
Miners had lower risk of bladder cancer than the general population. DEE exposure was not associated with bladder cancer in this nested case-control study of contemporary Western Australian miners.

Key messages
Diesel engine exhaust was not found to be associated with bladder cancer in miners.
791Health Promotion in High School curriculum: Brazil and Canada
Authors: Souza Israel 
Published: September 2021

Abstract

Focus of Presentation
Searching on documents about High School (or Secondary) education we found some differences in both curriculum, Brazil and Canada. High School in Brazil has three year (grade 10 to 12). In other hand, High School in Canada has four years (grade 9 to 12). The main focus of this work is a comparison about how “health promotion” appears in High School curriculum in Brazil and Ontario-CA, in especial at Physical Education curriculum.

Findings
In Brazilian High School, Physical Education curriculum is mandatory. However the key-words “health” appears 11 times in a federal document (Ministry of Education) with 241 pages. Key-words like “health promotion” appear one time and “social determinants” none. Ontario-CA have a Health and Physical Education curriculum. In this case, the key-words “health” appears more than 1000 times in a province document (Ministry of Education) with 224 pages. Key-words like “health promotion” appear 14 times and “social determinants” 3 times.

Conclusions/Implications
Text Physical Education curriculum in Brazil need to emphasize “health promotion” contents as a life condition and physical literacy and health literacy. Meantime, Ontario-CA curriculum show a few content about “social determinants” which is a core concept in “health promotion” studies.

Key messages
Text High School curriculum need emphasize “health promotion” and “social determinants” as a core concept for a physical literacy and health literacy.
775Should pain scales be combined
Authors: Stanhope Jessica , Weinstein Philip 
Published: September 2021

Abstract

Background
Pain is often measured by asking people to rate their pain intensity at its worst, on average, and at its least, for the last 7 days using numeric rating scales. The three ratings are summed to produce a composite measure. The validity and reliability of this composite measure has not been examined using modern psychometric methods in any population. We examined the validity and reliability of this pain intensity measure for use with professional musicians, university music and science students, and university staff, all of whom had reported experiencing musculoskeletal symptoms in the last 7 days.

Methods
Data were collected using a questionnaire survey. The validity and reliability of the composite pain measure were examined using Rasch analysis. Differential item functioning was examined for age, gender, student status, musician status, and socioeconomic status.

Results
While the data fit one of the Rasch models, after several response categories were collapsed, differential item functioning was present. There was no solution found that fit one of the Rasch models, without differential item functioning.

Conclusions
Despite the recommendation for the three number ratings scales for pain to be combined, using Rasch analysis showed that this was not a valid approach for our study population. Our findings highlight the importance of using Rasch analysis to examine the utility of measures.

Key messages
Rasch analysis is a useful method for investigating the validity and reliability of scales. Combining pain ratings cannot be assumed to produce a valid and reliable measure.
169Folic acid intake and dementia - a 27-year global longitudinal study
Authors: Suzuki Norie , Shirai Yoshiro , Abe Chisato , Imai Tomoko , Sezaki Ayako , Miyamoto Keiko , Kawase Fumiya , Inden Ayaka , Kato Takumi , Sanada Masayo , Shimokata Hiroshi 
Published: September 2021

Abstract

Background
Folate deficiency increases serum homocysteine and may cause cognitive impairment. However, there have been no international longitudinal studies that examined the association between folic acid intake and dementia. We investigated the longitudinal association between folate intake and the prevalence of dementia using global data during 27 years.

Methods
Prevalence of Alzheimer’s disease and other dementias and folic acid intake by country were obtained from the Global Burden of Disease (GBD) 2017 database. The longitudinal associations between folic acid intake and prevalence of dementia was examined using linear mixed effect model during 27 years from 1990 to 2017 in 151countries with populations of 1 million or greater. The effects of folic acid, year and interaction of folic acid and year were estimated controlling for covariates including socio-economic variables and life-style variables.

Results
Fixed effects of folic acid was highly significant (mean and SE; -33.1±7.1, p &lt; 0.001) and interaction of folic acid and survey year was also significant (0.90±0.13, p &lt; 0.001). Slope of folic acid for dementia prevalence was significant in 1990 and the slope has decreased with the year and has become not significant after 2011.

Conclusions
Folic acid was associated with the prevalence of dementia, but weakened over the years.

Key messages
Although folic acid intake has been associated with the of dementia, the risk of dementia may be increasingly related to factors other than nutrition.
167Epidemiology of food choking deaths in Japan: Time trends and regional variations
Authors: Taniguchi Yuta , Iwagami Masao , Sakata Nobuo , Watanabe Taeko , Abe Kazuhiro , Tamiya Nanako 
Published: September 2021

Abstract

Background
We aimed to investigate the nationwide epidemiology of food choking deaths in Japan.

Methods
Using Japan Vital Statistics death data (2006-2016), we identified food choking deaths based on the 10th revision of the International Statistical Classification of Diseases code W79 (Inhalation and ingestion of food causing obstruction of respiratory tract). The demographics of people with food choking deaths; temporal trend of food choking deaths by the year (overall and by age group) and the day of year; and prefecture variations, were reported.

Results
52,366 people experienced food choking deaths (median age, 82 years, 53% were men, and 57% occurred at home). The highest number of food choking deaths occurred in January 1, 2, and 3, in that order; and lowest in June. Despite a constant total number of cases at around 4000 yearly, the incidence proportion declined from 16.2 to 12.1 per 100,000 population from 2006 to 2016 among people aged 75-84 years. The proportion peaked at 53.5 (2008) and decreased to 43.6 (2016) among people aged ≥85 years. Prefecture variations occurred in the number of food choking deaths, highest in Niigata and lowest in Kyoto.

Conclusions
The results suggest targets (by age group, region, and day of the year) for the prevention of food choking deaths. Time trends and regional variations may be related to the consumption of Japanese rice cake (mochi), known as a major cause of food suffocation in Japan.

Key messages
The number of food choking deaths in Japan was highest on New Year’s Day.
1204Modelling impact of targeted hepatitis B treatment for culturally and linguistically diverse populations in Australia
Authors: Taye Belaynew , Valery Patricia , Clark Paul 
Published: September 2021

Abstract

Background
Antiviral treatment gap in culturally and linguistically diverse (CALD) populations may be a barrier progress in national elimination. Using modelling, we estimated and predicted the impact of antiviral treatment and migration on HBV burden, and HBV-related mortality in CALD populations in Australia.

Methods
We developed a dynamic, deterministic mathematical model using three antiviral treatment scale-up scenarios - the baseline treatment, intermediate treatment scale-up (80% of eligible by 2030), and optimistic scale-up (20% of all HBV by 2022) to predict the incidence of HBV infection, liver cirrhosis, hepatocellular carcinoma, and HBV-related mortality in four groups of people according to their country of birth.

Results
The number of chronic HBV cases will remain similar, and HBV-related morbidity and mortality will increase if the baseline approach is followed to 2030. Implementing an optimistic treatment scale-up could reduce the number of new cases of liver cirrhosis (30% in European-born, and 40% in Asia-Pacific-born) by 2030. Following the optimistic scale-up approach, the incidence of HCC decreased by 30% and a 15%-25% reduction in HCC-related mortality could be achieved in the four population subgroups by 2030.

Conclusions
Following the current antiviral treatment coverage, HBV elimination targets in migrants may not be achieved. A rapid treatment scale-up approach reduces HBV incidence, liver cirrhosis and HCC.

Key messages
Targeted antiviral treatment for migrants with HBV using rapid scale-up reduces HBV-related disease and mortality and contributes to achievement of national elimination targets.
1397Clinical status of consulting COVID 19 cases and fatal outcome in a Cameroon regional hospital
Authors: Nighie Ketina Hirma Tchio , Ateudjieu Jerome 
Published: September 2021

Abstract

Background
Due to its high attack rate, COVID 19 is responsible for a high number of deaths despite its relatively low lethality rate. This study was conducted to assess the relationship between time to consultation, presence of respiratory complications at hospital admission and fatal outcome of COVID 19 cases.

Methods
This was a case control design study which collected data from records of all COVID 19 patients admitted in Bafoussam Regional Hospital from March 2020 to April 2021. The association between the delay in seeking care, dyspnoea and blood oxygen level at admission, and fatal outcome was assessed by estimating crude and adjusted odd ratio.

Results
Of 400 included patients, 239 (59.75%) were male, 84 (23.73%) health professionals and 144 (36.0%) aged 64 years and above. The mean duration of hospitalization was 11.39 days and 120 (30.0%) admitted patient died. Seeking care during or before the end of the first day of symptom onset significantly reduced the risk (Adjusted (A) OR = 0.4 (0.16-0.98)) of fatal outcome, whereas waiting three (AOR=0.6(0.31-1.16))or seven days (AOR=0.91(0.47-1.75)) did not change this risk. Dyspnoea (AOR=2.71(1.38-5.29)) or oxygen level &lt;95% (AOR=22.87(2.99-174.76)) significantly increased the risk of fatal outcome.

Conclusions
Health interventions contributing for early detection and connection of COVID 19 cases to care before respiratory complications occur are expected to reduce mortality in COVID 19 patients.
1289Decline in duration, satisfaction and sleep quality among informal caregivers of stroke survivors, 18-months post-stroke
Authors: Teixeira Phd Filipa , Moura Ana , Alves Elisabete 
Published: September 2021

Abstract

Background
Data on stroke caregivers’ sleep is scarce. We aimed to assess changes in duration, satisfaction and sleep quality among informal caregivers of stroke survivors.

Methods
Informal caregivers (n = 126) of stroke survivors hospitalized between September 2018 and August 2019 in the 12 Stroke Units of the North of Portugal were invited to participate in the study, 18 months’ post-stroke. Sociodemographic and sleep characteristics (duration, satisfaction and quality) were collected through structured questionnaires. Odds ratios and 95% confidence intervals (95%CI) were estimated through logistic regression, adjusted for age and sex. Answers to open-ended questions were synthetized using content analysis.

Results
Due to care provision, informal caregivers reported sleeping, on average (SD), significantly less hours (7.0 (1.7) vs. 6.4 (1.8); p &lt; 0.001). Since its beginning, caregivers’ satisfaction with their sleep decreased approximately 30%. Changes in sleep quality, namely difficulties in falling asleep and constant interruptions during sleep, were reported by almost 70% of caregivers. Only 6.4% described the prescription of medication to sleep after beginning care provision. Participants who returned to work (adjusted OR = 0.34; 95%CI:0.16-0.76) and with a monthly income above 1000€ (adjusted OR = 0.29; 95%CI:0.13-0.66) were less likely to report changes in sleep quality.

Conclusions
A decline in duration, satisfaction and sleep quality of informal caregivers of stroke survivors, 18 months’ post-stroke, was observed. Changes in sleep quality revealed socioeconomic inequalities, highlighting the need to prevent adverse health outcomes related to sleep disturbance.

Key messages
Sleep health dimensions of stroke caregivers should be considered an additional dimension of the post-stroke care services.
1481Epidemiology of membranous nephropathy in thirteen Asia-Pacific nations using an incidence-to-prevalence model
Authors: Thakur Shilpa , Isherwood Alison 
Published: September 2021

Abstract

Background
Primary membranous nephropathy (PMN) is the leading cause of nephrotic syndrome. Several studies conducted in Asia-Pacific region report the incidence of PMN. However, there is a paucity of peer-reviewed published prevalence data for this condition.

Methods
A literature review was conducted using PubMed and Clarivate’s Cortellis database from 1/1/1980 to 1/11/2019) to identify country-specific, age- and gender-specific diagnosed incidence rates and observed survival data-point inputs for use in our incidence- prevalence model. For countries lacking published incidence data, logical extrapolations were made, applying the incidence from countries based on comparable geography and healthcare access.

Results
The diagnosed prevalence of PMN varies substantially between the countries under study, from 15 per million population (PMP), in the Philippines to 277 PMP in China in 2021. The number of diagnosed prevalent cases of PMN in the countries under study will increase by 21% over 2021-2031 with highest growth in Vietnam (34%) and lowest in Australia (9%).

Conclusions
The prevalence of PMN is expected to increase over the next ten years due to population aging, changes in population size, and improvements in survival in the countries under study. Limited registry and published prevalence data for these countries is highlighting the need for increasing awareness and research for this rare disease.

Key messages
This study provides the insights into the current and future trends in the prevalence of PMN in next 10-years (2021-2031) which was otherwise not reported in the published literature
1433Community Health Workers for non-communicable diseases: a systematic review and meta-analysis
Authors: Thapa Rajshree , Thrift Amanda , Mishra Shiva Raj , Zaman Sojib Bin , Zengin Ayse 
Published: September 2021

Abstract

Background
We evaluated the effectiveness of various community health workers (CHWs)-led interventions for several non-communicable diseases (NCD) risk-factors in both low- to middle-income countries (LMICs) and high-income countries (HICs).

Methods
We included interventions by CHWs targeting the uptake of services for NCDs and conducted meta-analyses of randomized controlled trials. Net differences in blood pressure (BP), glycated hemoglobin (HbA1c), fasting blood glucose, triglycerides, low-density lipoprotein-cholesterol (LDL-C) cholesterol, and body mass index (BMI) were calculated between intervention and control groups .

Results
Seventy-three studies were included. CHWs-led interventions were effective in reducing systolic BP -2.94 mmHg [95% CI: -4.28 to -1.59; I2=73%], diastolic BP -1.59 mmHg [-2.54 to -0.64; 81% ], HbA1c% -0.31 [-0.45 to -0.17; 52%], and triglycerides -8.32 mg/dl [-13.54 to -3.10; 0.0%]. The mean change in HbA1c% was detectable in studies undertaken in HICs [-0.35 (-0.45 to -0.1)] but not in LMICs [-0.03 (-0.21 to 0.15)]. Interventions targeting diabetes were also effective in reducing systolic BP by -2.30 mmHg (-4.22 to -0.38). There was no evidence that these interventions reduced BMI or LDL-C.

Conclusions
Engagement of CHWs is an effective strategy to reduce BP. They are also effective in reducing HbA1c and triglycerides in HICs; but further research is needed in LMICs. It also appears that interventions led by CHWs may be effective in reducing more than one risk factor simultaneously.

Key messages
Engaging CHWs is an important strategy to combat the growing burden of hypertension.
377Smoking, blood pressure, and body mass index to estimate healthy life expectancy: NIPPON DATA90
Authors: Tsukinoki Rumi , Hayakawa Takehito , Kadota Aya , Murakami Yoshitaka , Miura Katsuyuki , Okayama Akira , Okamura Tomonori , Ueshima Hirotsugu ,   the NIPPON DATA90 Research Group
Published: September 2021

Abstract

Background
Healthy life expectancy (HLE) is an important measure of an ageing society. We estimated HLE based on combinations of smoking, blood pressure (BP), and body mass index (BMI) in the Japanese population using a multistate life table.

Methods
A nationwide cohort study of Japan was performed using NIPPON DATA90 (N = 6,676) with the Katz Activities of Daily Living Index as the HLE endpoint. Combinations of smoking (non-smokers and smokers), BP (2018 ESC/ESH Guidelines classification), and BMI (underweight, normal, and overweight) were developed, and the group-specific HLEs were calculated using a multistate life table.

Results
At age 65, smokers had shorter HLE than non-smokers for all BMI and BP groups. The HLE of men who were overweight, hypertensive (Grade 2 or 3), and smokers was 14.05 years (95% confidence interval: 15.77-21.36); in contrast, the HLE of men who were normal weight, normotensive, and non-smokers was 19.04 years (16.46-21.61). Among all BMI and smoking status groups, HLE decreased linearly as BP increased regardless of sex. The HLE distribution showed a slight inverted U-shape as BMI increased in both sexes.

Conclusions
This study showed that HLE at age 65 was considerably shorter in smokers and individuals with higher BP. Furthermore, both underweight and overweight had modest effects on HLE at age 65.

Key messages
HLE was considerably shorter in smokers and individuals with higher BP. In addition, both underweight and overweight had modest effects on HLE.