bluuebunny/crossref_metadata_2025_split huggingface dataset:
425Artificial Intelligence Approaches to Type 2 Diabetes Risk Prediction and Exploration of Predictive Factors
Authors: Ooka Tadao , Yokomichi Hiroshi , Yamagata Zentaro 
Published: September 2021

Abstract

Background
Major barriers exist in incorporating artificial intelligence into epidemiology, particularly in data interpretation. Thus, we examined the application of highly interpretable machine-learning methods— Random Forest (RF) and Sparse Logistic Regression (SLR)— to a large-scale health check-up dataset, examining the advantages of creating prediction models using these.

Methods
This study involved 392,791 participants who underwent healthcare checkups in Japan from 1999 to 2018. Participants who received diabetes treatment, or had an HbA1c level of 6.5% or higher, were excluded. The objective variable examined was type 2 diabetes onset over five years. Each prediction model was created using 26 health status items over three consecutive years. We examined three analytical methods to compare their predictive powers: RF, SLR, and a multivariate stepwise logistic regression (MSLR) as a conventional method. Variable Importance (VI) was calculated in the RF analysis, with Standard Regression Coefficients (SRC) being calculated in the SLR and MSLR analyses.

Results
Predictive accuracy is highest in the SLR model (AUC:0.955), followed by the RF model (AUC:0.949), and then the MSLR model (AUC:0.939). The RF model measures blood glucose, HbA1c, height, red blood cells, and aspartate transaminase with a higher predictive power. In the SLR model, HbA1c, blood glucose, systolic blood pressure, HDL-Cholesterol, and age have higher SRC.

Conclusions
Machine learning techniques enable more accurate diabetes risk predictions than existing methods and suggest new ways of identifying associated predictors.

Key messages
Applying machine-learning methods to health check-up data achieves a high accuracy in predicting type 2 diabetes while maintaining data interpretability.
313Long-acting bronchodilators and risk of acute coronary syndrome
Authors: Parkin Lianne , Williams Sheila , Sharples Katrina , Barson David , Horsburgh Simon , Jackson Rod , Dummer Jack 
Published: September 2021

Abstract

Background
There is concern that long-acting bronchodilators (long-acting muscarinic antagonists [LAMAs]) and long-acting beta2-agonists [LABAs]) may further increase the already elevated risk of cardiovascular events in patients with chronic obstructive pulmonary disease (COPD). Guidelines recommend stepwise escalation from one to two long-acting bronchodilators in patients with uncontrolled symptoms, but information about the impact of this treatment intensification on acute coronary syndrome (ACS) risk is limited.

Methods
We undertook a nested case-control study using national administrative data to estimate the risk of ACS in users of dual LAMA and LABA therapy, and users of LABA monotherapy, relative to users of LAMA monotherapy. The underlying study cohort comprised patients aged &gt;45 years who initiated long-acting bronchodilator therapy for COPD between 2006 and 2013 (n = 83,417). Cases were patients diagnosed with fatal or non-fatal ACS after cohort entry (n = 5,399). Up to 10 controls per case, matched by age, sex, date of cohort entry, and COPD severity, were randomly selected from the study cohort using risk set sampling. Odd ratios and 95% confidence intervals were estimated using conditional logistic regression.

Results
Relative to current use of LAMA monotherapy, the adjusted odds ratios for current use of dual LAMA and LABA therapy, and of LABA monotherapy, were 1.28 (95% CI 1.13–1.44) and 1.0 (95% CI 0.91–1.10), respectively.

Conclusions
Use of two long-acting bronchodilators rather than LAMA monotherapy, is associated with a higher risk of ACS, while the risks associated with LAMA and LABA monotherapy are comparable.

Key messages
The clinical benefit of adding a second long-acting bronchodilator to LAMA or LABA monotherapy is modest and, at the same time, is associated with an increased risk of ACS in a patient group already at high risk.
1014Maternal educational qualification and child’s birth weight: Findings from Office for National Statistics Longitudinal Study
Authors: Pikhartova Jitka , Stuchbury Rachel , Shelton Nicola 
Published: September 2021

Abstract

Background
Lower maternal education was found to be associated with lower child’s birthweight which in turn was a possible risk factor for later poor health. Presented research aims to assess the association between maternal education and singleton’s birthweight in large UK data, accounting for characteristics such child’s gender, parity, maternal age, partnership status, ethnicity, and household socioeconomic characteristics.

Methods
Using England and Wales Office for National Statistics Longitudinal Study (ONS-LS), data from over 240,000 children born since 1981 to ONS-LS sample mothers were used. Maternal education was derived into 3 categories (below secondary, complete secondary education, degree and higher).

Results
Crude analysis confirmed significant association between the level of education and birthweight in each Census cohort (p &lt; 0.001). In adjusted models, the education gradient was partly explained but remained strongly significant, and substantially increased over the years: for example, the birthweight difference between those with below secondary educated mothers and those with degree increased from 29 to 92 grams (p for change&lt;0.001).

Conclusions
Our findings support previous evidence using different, usually smaller, population samples. Children of mothers with no or low qualification are more prone to be born with lower birthweight leading potentially into health disadvantages in their later life. Our results suggest that the inequalities in birth weight increased over the last 35 years.

Key messages
Low levels of maternal education predicts low birthweight in children.
1459Socioeconomic position influence on the early-life individual exposome in the Italian NINFEA birth cohort
Authors: Pizzi Costanza , Moccia Chiara , Moirano Giovenale , d'Errico Antonio , Maule Milena , Fossati Serena , Lioret Sandrine , Calas Lucinda , Richiardi Lorenzo 
Published: September 2021

Abstract

Background
Early exposure to unhealthy lifestyles and environmental risk factors is known to affect health throughout the life-course. There is also evidence that the exposure patterns are influenced by the socioeconomic position (SEP).

Methods
We use the data of the Turin participants of the Italian NINFEA birth cohort (n∼2500) to study how family SEP drives the early life exposome. SEP at birth is measured through the EHII (Equivalized Household Income Indicator), while the exposome includes urban environment, diet and lifestyle exposures measured during infancy. We use standard regression models to evaluate the effect of EHII on each exposome variable accounting for multiple comparison and potential confounders (Drivers-Exposome Wide Association Study – DExWAS) and the hierarchical clustering on the principal components approach to identify groups with similar exposure pattern.

Results
The DExWAS show that low EHII is associated with lower consumption of fruit and vegetables, lower levels of NO2, building and facilities densities, traffic, walkability and connectivity index, higher land-use diversity index, and higher exposure to pets. The hierarchical cluster analysis identifies three groups, with subjects belonging to the cluster characterized by higher level of urban environment risk factors and a healthier diet having a higher mean EHII.

Conclusions
These SEP-early life exposome analyses will be replicated in several European birth cohorts participating in the H2020 ATHLETE and LifeCycle projects.

Key messages
In the Italian city of Turin children from low SEP family are exposed to higher levels of environmental risk factors and unhealthy lifestyles during infancy.
1225Symptoms of depression and anxiety in Dutch adults during and before the COVID-19 pandemic
Authors: Qi Yuwei , Lepe Alexander , Almansa Josué , Ots Patricia , de Kroon Marlou L.A. , de Winter Andrea F. , Cok Vrooman J. , Reijneveld Sijmen A. , Brouwer Sandra 
Published: September 2021

Abstract

Background
The COVID-19 pandemic may impact mental health outcomes differentially based on an inidivdual’s capital, i.e. resources used to maintain and enhance health. This study examined changes in depression and anxiety symptoms before and during the pandemic, and assessed their association with different elements of capital.

Methods
Data from 65,854 individuals (Mage=50.4, SDage=12.0) from the Lifelines COVID-19 cohort were used. Baseline mental health symptoms were on average measured 4.7 (SD = 1.1) years before the first COVID-19 measurement wave (T1), and subsequent waves were (bi)weekly (March 30 — August 05, 2020). Mental health symptom trajectories were estimated using a two-part Latent Class Growth Analysis (cutoff=2 symptoms), and class membership was predicted by several elements of economic (education, income, and occupation) and person capital (neuroticism).

Results
Most individuals were unlikely to report □2 symptoms of depression (80.6%) and anxiety (75.9%), but small stable-high classes for both conditions were identified (1.6% and 6.7%, respectively). Compared to T0, T1 showed increases in the mean number of symptoms (Mdep_t0=4.1 vs Mdep_t1=4.7, Manx_t0=4.2 vs Manx_t1=4.3) and probability of reporting symptoms (Probdep_t0=0.65 vs Probdep_t1=0.96, Probanx_t0=0.70 vs Probanx_t1=0.92). Lower income (ORdep=1.10; 95%CI:1.05-1.16; ORanx=1.05; 95%CI:1.02-1.07) and higher neuroticism (ORdep=1.10; 95%CI:1.09-1.11; ORanx=1.08; 95%CI:1.08-1.09) increased the odds of being in both stable-high classes. Low education increased the odds of being in the stable-high depression class (ORdep=1.46; 95%CI:1.07-1.99), and higher occupation increased the odds of being in the stable-high anxiety class (ORanx=1.06; 95%CI:1.03-1.09).

Conclusion
Overall, a minority of individuals, who generally possessed less capital, reported an increase in symptoms of depression or anxiety.

Key message
Inidividuals with less capital, i.e. resources, generally experienced more symptoms of depression and anxiety, which stresses the importance of devoting more resources to improve their mental health.

Keywords
Longitudinal studies, Social epidemiology/determinants, Mental health
735Dynamics and Determinants of Birth Spacing in India
Authors: Sahu Priyanka , Pandey C.M. , Mishra Shambhavi 
Published: September 2021

Abstract

Background
Birth spacing is an important determinant of the high fertility populations and has a strong bearing on maternal and infant health. The birth interval is composed of three major components namely postpartum amenorrhoea (PPA), waiting time to conception and gestation. To manage the high fertility in India, the present study is aimed to investigate the differential pattern of duration of birth interval components with respect to various socio demographic, child mortality, family planning services etc.

Methods
The data for this analysis was taken from National Family Health Survey 2015-16 (NFHS-4), provides information on population, health and nutrition for India and each State / Union territory. It gathered information from 601,509 households from overall India.

Results
Cox’ regression explores infant mortality, lactation, use of contraceptive devices, son preference and religion are found significant (P &lt; 0.01) factors on the dynamics of birth interval components After adjustment of the effects of other explanatory variables, duration of breast feeding (P &lt; 0.01), infant mortality (P &lt; 0.01) and family income (P &lt; 0.05) are found to have their significant impacts on the variation of PPA whereas death of previous child in infancy (P &lt; 0.01), sex of previous child (P &lt; 0.05), lactation (P &lt; 0.01), education of mother (P &lt; 0.05), and use of effective contraceptives have are found to be significant factors influencing the duration of waiting time to conception.

Conclusions
Among the determinants, infant mortality, lactation and religion have significant impacts on both duration variables in the Cox’s stepwise regression models.

Key messages
To control the growth of population, birth spacing must be maintained.
716A study of clinical and trichoscopic evaluation of diffuse hair loss in adult females
Authors: Sahu Priyanka , Pandey C.M. , Bhatia Shibani 
Published: September 2021

Abstract

Background
Hair fall is a major concern to the patient leading to angst, psychological distress and decrease in quality of life style, more so in female. The aim of the study is to evaluate diffuse hair loss (DHL) in adult females & find the underlying causes.

Methods
This was an observational, prospective time bound hospital-based study including clinical and trichoscopic evaluation of DHL in women. 222 adult women who had DHL of 4 or more weeks were studied. Detailed history was taken and clinical examination was performed. Laboratory investigations like Hb, Iron Profile, Thyroid Panel was also noted. Trichogram, trichoscopy was performed for perfect visualization of hairs.

Results
Among the subjects, 95 women were diagnosed as having female pattern hair loss (FPHL), 89 as telogen effluvium, 24 as chronic telogen effluvium (CTE) while 14 had FPHL and TE both. Mean age of females was 33.92 ± 5.46 years. Majority, 145 (65.3%) of the patients were in the age group of 31-40 years. Stress (18%) and PCOD (15%) were the most common precipitating factors. Majority (75.3 %) females with TE have positive hair pull test. Brown peripilar sign (PPS) and white PPS was present in 15.8% and 8.1% women respectively.

Conclusions
The common causes for DHL are FPHL, TE, CTE and FPHL with TE.

Key messages
Along with definitive treatment, understanding of the cause of hair loss by the patient goes a long way in appropriate beneficial lifestyle modification and holistic management.
626Epidemiology of facial injuries in the context of fatal family violence in the Victorian population
Authors: Sarkar Reena , Ozanne-Smith Joan , Bassed Richard 
Published: September 2021

Abstract

Background
The oral cavity is reported to be a key focus of physical injury in family violence (FV). Our purpose is to explore the potential opportunity for dentists to assist in the prevention of serious injuries in FV. This paper aims to describe the patterns of orofacial injuries in FV homicides.

Methods
All FV homicides in Victoria, Australia January 2006-December 2018, were identified amongst closed cases of assaults screened for eligible victim-offender relationships. Epidemiologic trends in FV in the Victorian population over the 12-year period were determined. Sociodemographic, interpersonal, incident and injury characteristics including ICD-10 coding were studied and compared across facial and non-facial injury FV subgroups.

Results
There was a non-significant downward trend in FV homicide over the period. Of 170 adult cases, 150 were included for facial injury analysis. Of these, 117 (78%) showed orofacial injuries in the 12-year period. Two-step cluster analysis revealed blunt force and threat to breathing injury mechanisms to be significantly associated with facial FV and sharp force with nonfacial FV. Among the additional 26 child homicides, descriptive analysis elucidated patterns in 20 cases eligible for facial injury analysis. Coding limitations were found for the FV homicide cases.

Conclusions
This population study reports significant involvement of the orofacial region in the FV homicide population during the 12-year study period, potentially informing dental practice and the related policy framework in Victoria and internationally.

Key messages
The significant involvement of the orofacial region in FV homicides may inform optimal intervention outcomes in FV in Victoria.
1196Trajectories of disability throughout adolescence and labour force status as a young adult
Authors: Shields Marissa , King Tania , Dimov Stefanie , Kavanagh Anne , Spittal Matthew 
Published: September 2021

Abstract

Background
Young people with disabilities have poorer labour force outcomes than their peers without disabilities. Existing studies typically assess disability at one time point, obscuring potential variation in the experience of disability over time. This study aimed to identify trajectories of disability during childhood/adolescence and assess associations between trajectory membership and labour force status in young adulthood.

Methods
Group-based trajectory modeling was applied to disability status information from Waves 2-7 (age 4/5 to 16/17 years) of the Longitudinal Study of Australian Children; labour force participation (employed, unemployed, not in the labour force (NILF)) was measured at Wave 8 (18/19 years). Two logistic regression models assessed the relationship between trajectory group membership and labour force participation, adjusted for confounders.

Results
Four trajectory groups were identified: low (75.5% of cohort), low increasing (9.7%), high decreasing (10.9%), and consistently high (3.9%) prevalence of disability. Compared to individuals in the low trajectory (reference group), individuals in the consistently high trajectory had increased odds of being NILF at age 18/19 years (AOR 3.48, 95%CI 2.14, 5.68). Individuals in the low increasing trajectory had increased odds of unemployment at age 18/19 years compared to the reference group (AOR 2.93, 95%CI 1.91-4.48).

Conclusions
Results suggest that early experiences of disability among young Australians may differentially impact future labour force outcomes.

Key messages
Additional supports to prepare young people for the labour force should focus on individuals with consistently high or increasing prevalence of disability trajectories.
800A census approach to monitoring child development - informing policy and practice beyond survey samples
Authors: Sincovich Alanna , Brinkman Sally 
Published: September 2021

Abstract

Background
The Sustainable Development Agenda calls for population monitoring of children’s development. A census approach, as implemented in Pacific Island Countries (PICs), offers advantages beyond nationally representative survey samples in informing local policy and practice.

Methods
A census approach was employed in Kiribati, Samoa, Tonga, and Tuvalu to collect information from caregivers and teachers on the development of every child aged 3-5 years. Funded by the Global Partnership for Education through the Pacific Early Age Readiness and Learning Program, data were collected from 2013-17 using the early Human Capability Index (eHCI), a population measure of holistic child development.

Results
Locally, whole-of-country data collection in Kiribati (n = 8339), Samoa (n = 12191), Tonga (n = 6214), and Tuvalu (n = 549) enabled empowerment and mobilisation of communities to support children’s development through use of their own data. Nationally, a census approach provided reliable information on the magnitude of inequality within and across populations, understanding of development amongst sub-populations and minority groups, and the interplay between geographic and socioeconomic position and children’s development, together, highlighting what was working well and where extra supports were needed.

Conclusions
In PICs, information collected through implementation of the eHCI national census was able to inform a progressive universalist approach to policy and service delivery, including provision of the right mix of universal and targeted services needed to support populations.

Key messages
A census approach to monitoring child development can inform policy and practice in ways not otherwise possible via survey sampling, particularly in contexts where population estimates and weighting are not available/accurate.
1047Epidemiology of different Cancers in Rural Jodhpur (India)
Authors: Singh Garima , Raghav Pankaja 
Published: September 2021

Abstract

Background
Cancer is the second leading cause of death in India accounting for nearly 9.6 million deaths in 2018. Crude annual incidence rate of all cancers together in Rajasthan has increased from 1990 to 2016 from 58.8 to 72.6 per lakh population. Few studies done are based on hospitals and pathology centres, but the data is limited. Community based study is required to know the true burden and trend of cancer prevalent in the region.

Methods
A sampling frame was prepared from all the blocks in rural Jodhpur, one block was selected by simple random sampling. Then another sampling frame was prepared by enlisting the villages in the selected block, one third villages were selected by simple random sampling.

Results
Based on interim analysis, 25 villages have been surveyed till date, with the population of 57,856. We found 91 (0.16%) cancer patients, out of which burden of Oral cancer (19,20.87%) was highest followed by Breast cancer (17,19.31%), Laryngeal cancer (10,10.98%), Primary brain tumours (6,6.59%) respectively. Other cancers were Oesophageal cancer (5) Colorectal cancer (5) Cervical cancer (4) Leukemia (4) Bone tumours (4) Stomach cancer (4) Intestinal cancer (3) Pharyngeal cancer (3) Urinary bladder cancer (1) Thyroid cancer (1) Uterus cancer (1) Lung cancer (1) Renal cell carcinoma (1) Hepatocellular carcinoma (1) and Skin Cancer (1).Tobacco and Opium consumption were found to be associated with Oral and Laryngeal cancer.

Conclusions
According to the World Cancer Report 2020, Lung cancer is the leading cause of mortality followed by Breast cancer Colorectal cancer, Prostate cancer, Stomach cancer and Cervical cancer which is different from the pattern of Western India.

Key messages
This study highlights the common cancers and the need to have a public health approach to identify or create awareness for quick treatment.
357Infant pacifier sanitization and risk of food allergy: the Barwon Infant Study
Authors: Soriano Victoria , Koplin Jennifer , Forrester Mike , Peters Rachel , O'Hely Martin , Dharmage Shyamali , Wright Rosemary , Ranganathan Sarath , Burgner David , Thompson Kristie , Dwyer Terence , Vuillermin Peter , Ponsonby Anne-Louise 
Published: September 2021

Abstract

Background
Environmental microbial exposure and human gut microbiota play a role in development of the immune system and susceptibility to food allergy. Pacifier use has been inconsistently associated with allergy, but the association between sanitization and food allergy is unknown. We investigated the association between infant pacifier use, with a consideration of sanitization, and food allergy at age 1 in the Barwon Infant Study (BIS).

Methods
Questionnaire data were collected prospectively from pregnant mothers from the Barwon region of south-east Australia at baseline and at infant ages 1, 6, and 12 months. Pacifier sanitization was defined as the joint exposure of a pacifier and cleaning methods (antiseptic, mouth, tap water, boiling). Challenge-proven food allergy was determined at age 1.

Results
Any pacifier use at 6 months was associated with food allergy (aOR, 1.94; 95% CI, 1.04-3.61), but not at other ages. This overall association was driven by the joint exposure pacifier-antiseptic use (aOR, 5.90; 95% CI, 2.18-15.97) compared to no pacifier use. Among pacifier users, pacifier-antiseptic was still associated with food allergy (aOR, 3.88; 95% CI, 1.55-9.72) when compared to pacifier-no antiseptic use. Further, increased use of pacifier-antiseptic at 0, 1 or 2 interviews over the first 6 months was associated with higher food allergy risk (ptrend=0.005).

Conclusions
Joint exposure to antiseptics and pacifiers at 6 months increased the odds of food allergy, showing a trend with increased use over time.

Key messages
This is the first report of pacifiers used with antiseptic being positively associated with challenge-proven food allergy.