bluuebunny/crossref_metadata_2025_split huggingface dataset:
796Is Mindfulness a more effective intervention than Psychoeducation for reducing Bipolar Disorder-related symptoms of depression?
Authors: Bowe Steven , Foley Fiona , Fletcher Kathryn , Thomas Neil , Michalak Erin , Berk Lesley , Berk Michael , Cotton Sue , Engel Lidia , Johnson Sheri L. , Jones Steven , Kyrios Michael , Lapsley Sara , Mihalopoulos Cathrine , Perich Tania , Murray Greg 
Published: September 2021

Abstract

Background
The primary objective is to test the effectiveness of a novel online quality of life (QoL) intervention tailored for people with late stage (≥ 10 episodes) bipolar disorder (BD) compared with psychoeducation. Relative to early stage individuals, this late stage group may not benefit as much from existing psychosocial treatments.

Methods
An NH&MRC funded international RCT to compare the effectiveness of two 5-week adjunctive online self-management interventions: Mindfulness for Bipolar 2.0 and an active control (Psychoeducation for Bipolar). A total of 300 participants were recruited primarily via social media channels. Evaluations occurred at pre- and post- treatment, and at 3- and 6- months follow-up. A secondary outcome measure was BD-related symptoms (depression). A longitudinal analysis was conducted using random effects mixed models.

Results
Preliminary results suggest no change in mean QIDS_total over time (p = 0.891). Nor does there appear to be a difference in groups (B coeff= 0.47, 95%CI (-0.60, 1.55), p = 0.613) and no difference in intervention groups over time (p = 0.828).

Conclusions
The effectiveness of a novel QoL focused, mindfulness based, online guided self-help intervention for late stage BD does not appear to have been any more effective than a psychoeducation intervention for reducing depression.

Key messages
There may be no significant benefit from using a mindfulness based, online guided self-help intervention over a psychoeducation intervention to reduce the BD symptoms of depression in late stage Bipolar disorder.
1048Characteristics of ST-Elevation Myocardial Infarction (STEMI) patients in Asia Pacific: findings from the ASPECT collaboration
Authors: Chih HuiJun , Brennan Angela , Yeo KK , Chan Mark , Yan Bryan , Duffy Stephen , Nguyen Hoai , Loi Do Doan , Fong Alan , Reid Christopher ,   on behalf of the ASPECT collaborators
Published: September 2021

Abstract

Background
The Asia Pacific Evaluation of Cardiovascular Therapies (ASPECT) Collaboration was established to better understand the characteristics of patients undergoing PCI and cardiac interventions across the Asia Pacific region, including STEMI. The aim of this study was to compare STEMI patient characteristics across Asia Pacific (AP) countries in order to understand regional differences.

Methods
Each site across Australia, Singapore, Malaysia, Vietnam and Hong Kong provided de-identified individual patient data. Comparison of characteristics by sites were performed using one-way ANOVA, Kruskal-Wallis or Chi-squared tests, using Stata 14.2.

Results
Of the 12,620 cases, there were more males (p &lt; 0.001) and the average of patients’ age ranged from 55 (Malaysia) to 68 (Vietnam) years old. Family history of coronary artery disease was not common amongst Hong Kong (1%) and Singaporean (12%) patients, and most patients did not have history of congestive heart failure, peripheral vascular disease or coronary artery bypass grafting. History of dyslipidaemia varied significantly among patients in Malaysia (98%) and Vietnam (12%) (p &lt; 0.001). About 37% of the Malaysian patients had previous myocardial infarction, which is greater than twice of other cohorts (p &lt; 0.001). Most cohort had either normal or mild ejection fraction (EF) but 40% of the Singaporean patients had severely reduced EF (p &lt; 0.001).

Conclusions
Patient characteristics varied significantly across AP countries. On-going analyses will focus on the impact of varying patient characteristics on clinical outcomes.

Key messages
As characteristics varied, prevention and procedural strategies need to be adapted carefully. Additional input from other AP countries will better inform these strategies.
838Thriving in adversity: positive child development despite early disadvantage in a whole-of-population data linkage study
Authors: Chittleborough Catherine , Brown Thomas , Schuch Helena , Kalamkarian Anna , Pilkington Rhiannon , Montgomerie Alicia , Mittinty Murthy , Lynch John 
Published: September 2021

Abstract

Background
Experiencing socioeconomic disadvantage, poor health, or child maltreatment in early life has negative effects on child development. However, we know little about children who have good developmental outcomes despite experiencing adversity.

Methods
This study used de-identified, linked government administrative data from the South Australian Early Childhood Data Project: specifically Australian Early Development Census (AEDC) data for all South Australian born children in their first year of school in 2009, 2012 and 2015 (n = 47,179) and their corresponding birth, perinatal, school enrolment, hospital admission, emergency department presentation, public housing and child protection data. Latent class analyses constructed multidimensional measures of socioeconomic, health, and maltreatment adversities experienced from birth to age 5.

Results
Overall, 49.8% (95% CI 49.2-50.4) of children were on track on all five AEDC domains, but this ranged from 53.7% among children who did not experience high levels of adversity to 13.5% among children with high levels of all three adversities.

Conclusions
Among children who experienced high levels of two or three early adversity types, approximately 1 in 5 were developmentally on track. Understanding characteristics of these children who thrive, against the odds, will help identify intervention opportunities to improve child development.

Key messages
Compared with children who did not experience high levels of adversity, each additional adversity reduced the likelihood of being developmentally on track by approximately 10% to 15%. Children experiencing socioeconomic or maltreatment adversity were less likely to be developmentally on track than children experiencing health adversity.
541A Nationwide Evaluation of International Standards and Commonly-used Growth Charts for Predicting Adverse Perinatal Outcomes
Authors: Choi Stephanie , Gordon Adrienne , Hilder Lisa , Henry Amanda , Hyett Jon A. , Brew Bronwyn K. , Joseph Farmey , Jorm Louisa , Chambers Georgina M 
Published: September 2021

Abstract

Background
Abnormal fetal growth is a risk factor for perinatal mortality and morbidity. There is considerable debate about the choice and performance of growth charts to classify newborns as small or large for gestational age (SGA and LGA) as a proxy for the at-risk infants. Several international charts have been proposed to be adopted worldwide. We aim to evaluate the performance of commonly-used growth charts (including international INTERGROWTH-21st-standards) for predicting adverse outcomes among SGA and LGA babies.

Methods
A population cohort of 2.4 million singleton births (24+0–40+6 weeks) delivered in Australia, 2004–2013. Performance was evaluated by prevalence, relative risk and diagnostic accuracy for adverse outcome based on AUC.

Results
There was wide variation in SGA and LGA classification across charts. For example, compared to other charts, the INTERGROWTH-21st-standards classified half of the number of term-SGA babies (prevalence: 3-4% vs. 7-10%) (&lt;10th-centile) and double the number of LGA babies (prevalence: 24-25% vs. 8-18%) (&gt;90th-centile), resulting in a smaller cohort of term-SGA at higher-risk of adverse outcome, and a larger LGA cohort with lower-risk of adverse outcome. All charts performed poorly for detecting adverse outcomes (AUC range for a composite outcome: 0.49-0.68) and across birthweight centiles.

Conclusions
Significant differences in the classification of newborns and the chart performance raises concerns about whether the INTERGROWTH-21st-standards are applicable to a multi-ethnic population such as Australia.

Key messages
Significant differences in the classification of newborns and the relatively poor predictive ability of growth charts means that over reliance on infant size alone may misclassify, and thus miss at-risk infants.
53Women with syphilis notification in pregnant women who lose their baby, belém/pa, 2017 and 2018
Authors: Costa Josué , Flores Rute Leila dos Reis , Silva Veronilce Borges da , Neves Eula Oliveira Santos das , Cruz Carlos Gustavo Paes Barreto da , Maciel Ana Maria Teixeira Rico , Purificação Ana Cláudia Santos 
Published: September 2021

Abstract

Background
Syphilis is a chronic systemic infectious disease that is subject to acute outbreaks and latency periods when left untreated. It is an infectious disease produced by a bacteria, Treponema pallidum, of predominantly sexual transmission. The inclusion of syphilis in pregnancy as a sexually transmitted infection with compulsory notification is justified by its high prevalence rate and high vertical transmission rate, which ranges from 30% to 100% without adequate treatment. Congenital syphilis is a result of the hematogenous spread of Treponema pallidum, an untreated or inadequately treated pregnant woman, through the placenta, which causes miscarriages or child and fetal deaths. Our objective was to draw an epidemiological profile of women, living in Belém / PA, notified by syphilis during pregnancy and who developed infant or fetal death in 2017 and 2018.

Methods
This is a descriptive epidemiological study. Two information systems were used, the Mortality Information System (MIS) and the Notification Record Information System (NRIS). At MIS, all child and fetal deaths of residents of Belém in 2017 and 2018 were selected. In NRIS, we selected all cases of pregnant women notified by syphilis in 2017 and 2018, also resident in the municipality. Subsequently, the two banks were compared to verify whether pregnant women notified for syphilis evolved with infant or fetal death. Data were analyzed according to age, race, education, gestational period, length of treatment of pregnant women, whether the partner was treated and the type of death of the children.

Results
We found 32 women with reports of syphilis in pregnant women, of whom 81% developed fetal death and 19% had infant death. 63% were between 20 and 29 years old, 88% were brown, 75% were in the third trimester of pregnancy when they were notified, 25% had incomplete elementary school and 25% had incomplete high school. 72% were treated with 7,200,000 IU of Penicillin G Benzathine. 59% of cases were not performed in the treatment of the partner.

Conclusions
Most of these women are young, poorly educated, and despite appropriate treatment, their partners have not been treated and may have been reinfected and passed on the infection to their children.

Key messages
Syphilis in pregnant women; Hild and fetal death
54Project to encourage mandatory reporting of public health diseases
Authors: Costa Josué , Flores Rute Leila dos Reis , Silva Veronilce Borges da , Neves Eula Oliveira Santos das , Cruz Carlos Gustavo Paes Barreto da , Maciel Ana Maria Teixeira Rico , Purificação Ana Cláudia Santos 
Published: September 2021

Abstract

Background
Compulsory notification means official communication to health authorities about the occurrence of a disease or health problem that can be made by any citizen or health professional in order to adopt relevant intervention measures. An early suspicion of any disease can prevent complications and even the death of a patient. When we talk about notifiable diseases, it can mean avoiding hundreds or even thousands of deaths. Thus, our goal is to encourage compulsory notification of diseases of interest to the health of the population.

Methods
This project plans to make available to all public and private health services in the municipality and to all levels of attention, table stickers and banners with case definitions of the most common diseases in our municipality and of interest to public health. These diseases are dengue and Chikungunya fever, acute Chagas disease, meningococcal disease, leptospirosis, measles and whooping cough. The table stickers will be distributed at the doctor and nursing office for consultation of health professionals during patient care. The banners will be displayed in common areas of health services.

Results
The project is still in the process of approval by the health department, but it is expected that there will be an increase in the number of notifications and a decrease in the number of cases notified later. Early suspicion and reporting means that the patient can receive appropriate treatment in a timely manner and which control measures can be used quickly to prevent outbreaks or epidemics.

Conclusions
This project is expected to be approved quickly by the health department and can be implemented in all public and private health services in the municipality. Believe that the benefits can be seen in a short period of time, because with the closest information from professionals and the population, the suspicion will be faster.

Key messages
Compulsory notification; Diseases
1447Gastric histopathology by Helicobacter pylori cagA status in Arctic Canada
Authors: Cromarty Taylor , Quilty Douglas , Assi Ali , Girgis Safwat , van Zanten Sander Veldhuyzen , Goodman Karen ,   CANHelp Working Group
Published: September 2021

Abstract

Background
Our community-driven projects address concerns of Canadian Arctic Indigenous communities about Helicobacter pylori (Hp) infection, responsible for elevated gastric cancer mortality in the region. Community research partners wished to learn whether bacterial characteristics determine severity of Hp-related disease in their communities. We aimed to describe gastric histopathology by cagA genotype of Hp isolated from residents of 7 Indigenous communities in the Northwest Territories and Yukon.

Methods
Participants underwent gastroscopy with 5-6 biopsies taken for histopathological assessment and 2 biopsies taken for tissue culture during 2008-2017. We used multiple PCR reactions and DNA sequence analysis to classify Hp genotypes as cagA+ or cagA-. A single pathologist used the updated Sydney classification system to grade severity of 5 gastric pathology outcomes: Hp density; chronic gastritis; active gastritis; atrophy; and intestinal metaplasia. We estimated prevalence of each outcome with 95% confidence intervals (CI) by gastric subsite and cagA status.

Results
Of 262 Hp isolates assessed, 142 (54%) were cagA+. Prevalence of moderate-high Hp density, severe chronic gastritis, moderate-severe active gastritis, atrophy, and metaplasia were (%[CI]): respectively, 78[70-85], 44[36-53], 65[56-72], 55[46-63], 25[18-33] in cagA+ participants and 61[52-70], 35[27-44], 31[23-40], 32[23-41], 8[4-15] in cagA- participants. cagA+ participants had higher prevalence of all outcomes in antrum and corpus.

Conclusion
Hp-infected Indigenous residents of Arctic Canada who harbored cagA-positive strains had higher prevalence of more severe gastric pathology than those with cagA-negative strains.

Key messages
Community-driven research answers questions posed by those who bear the disease burden.
274Early adversity scale for schizophrenia (EAS-SZ) constructed and validated using linked register data
Authors: Di Prinzio Patsy , Björk Jonas , Morgan Vera 
Published: September 2021

Abstract

Background
A range of adversities have been implicated as risks for schizophrenia. Adversities often cluster, with synergistic impact, which may vary by age of exposure. We expand on current understanding, and propose a method for ranking combinations of adversities associated with risk of schizophrenia, to derive a risk prediction measure.

Methods
We used prospectively collected data for 430,000 children born 1980–2001 in Western Australia, and their parents. Follow up continued until 2015 using linked State registers, identifying 1,620 children with schizophrenia. Five domains of adversity exposure to age 10 were considered. Using Cox modeling of a 40% training data subset, we categorised adversity exposure by associated rates of schizophrenia. Firstly, for each domain separately, numerous constructs of adversity exposure were screened for independent association with schizophrenia. Those with p &lt; =0.2 were combined, using augmented backwards elimination, to define a minimal domain set of jointly associated constructs. Combination was summarised as the linear predictor corresponding to the optimum Cox model. Secondly, these domain summaries were combined with each other to form a global Cox model, predictive of association with schizophrenia.
Harrell’s Concordance was calculated using a 30% assessment sample which did not overlap with our training sample. Prognostic categories were defined and tested.

Results
Harrell’s Concordance was 0.655. Dose response was observed.

Conclusions
Our scale combines many adversity measures into a single construct. It displays dose response and predicts association considerably above chance.

Key messages
EAS-SZ allows a range of adversity exposure profiles to be ranked according to association with schizophrenia.
777Teaching evidence-based medicine using authentic assessment the Whack-a-mole project
Authors: Diug Basia , Howard Bethany , Harvey Kenneth 
Published: September 2021

Abstract

Introduction
Authentic assessments facilitate student’s application of complex problem-solving skills and knowledge to real-world tasks. The whack-a-mole (WAM) project includes key critical thinking, biostatistics and epidemiology skills as well as elements of complexity and creativity skills that are particularly important when teaching evidence-based medicine to health professionals. Complementary and alternative medicines (CAMs) provide the current context as they are widely used in the Australian population making them an important subject amongst primary health care professional and policy makers.

Aim
To report student perceptions and learning after completion of the real-world authentic assessment WAM.

Methods
WAM required students to choose, document, investigate, identify, critically appraise and report on a complementary medication for sale in Australia. A total 464 students enrolled in a 3rd Biomedical Science capstone unit completed the WAM project report and video assessments in teams. Data on student perceptions was collected using an online questionnaire and analysed using SPSS 25 and NVIVO 11.

Results
The average overall mark for the WAM assessment was 52/60 (86%). 116 students (25%) completed the online questionnaire of which 92% of students indicated the whack-a-mole project changed their perceptions of complementary medicine and/or the regulation of goods and services in Australia. The majority of students found no (43%) or insufficient (55%) evidence to support product claims. These findings were supported by qualitative feedback.

Conclusion
Students applied the principles of EBM to the WAM project and in doing so altered their perceptions of CAM, regulation and scientific evidence.

Key messages
Authentic assessments play a key role in engaging student in real-world problem solving to advance their critical thinking and evidence-based medicine.
1046Physical activity and sitting time in relation to breast cancer risk: A Mendelian randomization analysis
Authors: Dixon-Suen Suzanne , Lewis Sarah J. , Martin Richard M. , Boyle Terry , Giles Graham G. , English Dallas R. , Milne Roger L. , Lynch Brigid M. ,   on behalf of the Breast Cancer Association Consortium
Published: September 2021

Abstract

Background
Greater physical activity (PA) and less sitting time (ST) have been associated with lower breast cancer (BC) risk in observational studies, but causality is undetermined. Mendelian randomization (MR) investigates causality by using genotype to simulate randomized trials within observational data. A recent summary-data MR study assessed PA and BC by estrogen-receptor (ER) status. We aimed to examine PA and ST in relation to invasive BC risk overall and by molecular subtype.

Methods
We performed two-sample MR using individual-level Breast Cancer Association Consortium data from 125,684 women (69,869 cases), and summary-level UK Biobank genetic data for the exposure (n = 91,105). We used imputed single nucleotide polymorphisms (SNPs) previously associated (p &lt; 5x10-8) with accelerometer-measured PA (n-SNPs=5) or ST (n = 6). We estimated odds ratios (OR) from inverse-variance weighted MR.

Results
Greater PA was associated with lower risk of BC (OR = 0.48;95%CI=0.30-0.78 per standard deviation [SD] in activity). Estimates were inverse for all subtypes, particularly ER + (OR=0.45; 95%CI=0.25-0.83), PR + (OR=0.43;95%CI=0.22-0.85), and HER2 + (OR = 0.48; 95%CI=0.26-0.89). Greater ST was associated with higher risk of hormone-receptor-negative tumours, particularly triple-negative (ER-/PR-/HER2-) (OR = 2.04; 95%CI=1.06-3.93 per SD in ST). Estimates overall and for most other subtypes were elevated but had wide CIs crossing null. Sensitivity analyses (weighted-median MR and MR-Egger) did not suggest strong pleiotropic effects for either exposure.

Conclusions
Greater PA and lower ST reduces risk of all breast cancers, and hormone-receptor negative tumours, respectively. More widespread adoption of active lifestyles will lower burden from the most common cancer in women.

Key messages
More active and less sedentary lifestyles reduce risk of breast cancer.
463Association of physical activity with obstructive sleep opena
Authors: Duan Miss Xueru ,   Murui Zheng,   Hai Deng,   Xudong Liu
Published: September 2021

Abstract

Background
Obstructive sleep apnea (OSA) is the most common sleep disorder in clinical practice, which leads to impaired quality of life and is associated with adverse health outcomes. Due to limitations of continuous positive airway pressure (CPAP), the gold standard treatment for OSA, studies have recommended lifestyle interventions such as physical activity to prevent OSA. This study was to investigate the association of physical activity with OSA risk among adult Chinese.

Methods
9733 participants aged 35-74 years were selected from baseline survey of the Guangzhou Heart Study. OSA was ascertained by using Berlin Questionnaire and the physical activity, including leisure-time physical activity (LTPA), occupational activity and transport activity, was measured with modified Global Physical Activity Questionnaire. Principal component analysis was used to extract the patterns of LTPA with varimax orthogonal transformation. Odds ratio (OR) with 95% confidence interval (95% CI) was calculated by using logistic regression method.

Results
For all participants, LTPA (High vs. Inactive, OR: 0.81, 95% CI: 0.64 - 1.03), occupational activity (Vigorous vs. Retirement, OR:1.28, 95% CI: 0.93 - 1.75) and transport activity (High vs. Retirement, OR: 1.05, 95% CI: 0.69 - 1.60) were not associated with OSA risk after considering potential confounders. Any specific component of LTPA and two LTPA patterns were not associated with OSA risk, either. Stratified analysis yielded similar nonsignificant association of OSA risk with three dimensions of physical activity in both retirement group and non-retirement group.

Conclusion
This study found that three dimensions of physical activity, including LTPA, transport activity and occupational activity, were not associated with any risk of OSA. Future studies with longitudinal design are needed.

Key message
Physical activity may not decrease the risk of obstructive sleep apena.