bluuebunny/crossref_metadata_2025_split huggingface dataset:
914Progress towards achieving the 2020 goals for Neglected Tropical Diseases in the Asia-Pacific region
Authors: Nery Susana Vaz 
Published: September 2021

Abstract

Focus and outcomes for participants
Neglected tropical diseases (NTDs) are a group of communicable diseases caused by a variety of infectious agents including virus, bacteria and parasites. They are prevalent in 149 countries in the tropics and affect more than one billion people living in disadvantaged communities, further limiting their social and economic development. For several NTDs, including the ones that are the focus of this symposium, the main strategy for control consists of preventive chemotherapy: the large-scale administration of drugs to entire communities or specific population groups, without prior individual diagnosis.
In this symposium we will present the progress made in several countries in the Asia-Pacific region towards the control of 5 NTDs (lymphatic filariasis, scabies, schistosomiasis, soil-transmitted helminths and trachoma) largely through the scale-up of preventive chemotherapy. We will also describe the contribution of operational research to optimise control and elimination of these infections.
At the end of the symposium, participants will be able to:

Rationale for the symposium, including for its inclusion in the
In 2012 the World Health Organization endorsed ambitious targets towards control and elimination of NTDs. to be reached by the end of 2020. Although not all of those targets will be reached there was remarkable progress in coverage of preventive chemotherapy worldwide with millions of doses of medications such as albendazole, ivermectin and ddiethylcarbamazine distributed annually or bi-annually to populations at risk. In early 2020 WHO released the new roadmap for NTDs, that sets new targets to achieve by 2030. Developed with extensive stakeholder consultation this roadmap aims to build on the momentum created since 2012 to further advance the progress made against NTDs. This symposium will review the current burden of NTDs in the region, summarise the successes achieved and present evidence from operational research that is contributing to the achievement of the WHO targets.

Presentation program

Names of presenters
Associate Professor Susana Vaz Nery, The Kirby Institute – University of New South Wales
Professor John Kaldor, The Kirby Institute – University of New South Wales
Associate Professor Colleen Lau, Research School of Population Health – Australian National University
Professor Andrew Steer, Murdoch Children's Research Institute
Professor Vicente J Belizario, College of Public Health, University of the Philippines Manila

Names of facilitator or chair
Associate Professor Susana Vaz Nery
906Can mammographic density add value to the Gail model in risk-stratifying women in BreastScreen Australia?
Authors: Velentzis Louiza , Procopio Pietro , Carr Sarah , Devereux Lisa , Mann Bruce , James Paul , Lee Grant , Wellard Cameron , Arzhaeva Yulia , Nickson Carolyn 
Published: September 2021

Abstract

Background
There is significant interest in personalised, risk-based breast cancer screening. This requires high quality risk assessment. The ‘Gail model’ risk assessment tool has been validated on over 40,000 BreastScreen Australia participants. We assess whether adding mammographic density (MD) information improves risk stratification on that cohort.

Methods
We used questionnaire data, baseline MD readings (using AutoDensity) and linked screening and cancer registry records from 40,158 BreastScreen Australia participants aged 50–69 years (via the lifepool cohort). We investigated incident invasive breast cancer rates by quintiles of Gail model scores, MD, and combinations of Gail and MD.

Results
Gail scores and MD values were weakly correlated (r≤0.02). Gail and MD were each strong predictors of incident breast cancer, but stronger predictors when used in combination. For example, the odds ratio for incident invasive breast cancer was 3.6 (95%CI 2.5-6.3) for the 17% of women in the upper two quintiles of both Gail and MD scores compared to the 17% of women in the lower two quintiles of both scores. In comparison, the odds ratio for breast cancer between same-size (each 17%) upper and lower groups for Gail score alone was 2.5 (95%CI 1.8-3.4), and for MD 1.9 (95%CI 1.2-2.9).

Conclusions
Combining Gail and MD categories improves risk stratification on BreastScreen Australia participants, compared to using Gail or MD alone.

Key messages
While questionnaire data and MD measures are each strong predictors of future invasive breast cancer among BreastScreen Australia participants, risk prediction is stronger when questionnaire and MD measures are combined.
1189Sociodemographic, clinical and morbidity factors associated with COVID 19 mortality : A retrospective observational study
Authors: Verma Anjana 
Published: September 2021

Abstract

Background
The mortality from COVID 19 in India is low, as compared to western countries, but the steady increase in number of cases is a worrying sign. The objectives of this study were to identify and quantify the association between sociodemographic and clinical characteristics with mortality in patients with COVID-19 at a tertiary care hospital in Udaipur, Rajasthan.

Material and methods
This retrospective observational study involved 824 patients hospitalized for COVID 19 at a tertiary hospital in Udaipur, who were discharged or who died. Electronic medical records were accessed and information about age, gender, residence, religion, socioeconomic status, history of exposure, clinical characteristics on admission, co morbidities and outcomes (discharged or died). Associations between mortality and baseline characteristics were determined as hazard ratios (HR) calculated using Cox regression model.

Results
Mortality was 5.82% in our study. The mean age was 48.14 ± 16.2 years. The median time from time of admission to discharge was 8 days (IQR 5–11), whereas the median time to death was 5 days (IQR 4–10). The variables found to be associated with higher mortality were age (HR 1.17; 95% CI % 1.15-1.24), residing in urban area (HR 1.29; 95% CI 1.17–2.15), diabetes mellitus (HR 1.3; CI 1.02-5.57) and patients having both Diabetes and Hypertension (HR 2.4; CI 1.69-3.14).

Conclusion
Sociodemographic variables and comorbidities impact the mortality among COVID 19 patients. The variables most clearly associated with a greater hazard of death were older age, urban area, diabetes and having both diabetes and hypertension.
370Measuring pneumococcal conjugate vaccine impact in a low-resource setting with minimal baseline data
Authors: Mollendorf Claire von , Lim Ruth , Choummanivong Molina , Sychareun Vanphanom , Vilivong Keoudomphone , Lai Jana Y.R. , Chan Jocelyn , Dunne Eileen M. , Phommachanh Sysavanh , Moore Kerryn , Ortika Belinda D. , Gray Amy , Weaver Rupert , Mayxay Mayfong , Phetsouvanh Rattanaphone , Datta Siddhartha S. , Fox Kimberley , Newton Paul N. , Kim Mulholland E. , Nguyen Cattram D. , Dance David A.B. , Satzke Catherine , Xeuatvongsa Anonh , Russell Fiona M. 
Published: September 2021

Abstract

Background
We aimed to measure 13-valent pneumococcal conjugate vaccine (PCV13) impact on various pneumococcal endpoints with minimal baseline data.

Methods
PCV13 was introduced in October 2013 in Lao People’s Democratic Republic. We implemented studies to evaluate PCV13 impact: retrospective record review of pneumonia cases for three years pre-PCV13; prospective study of acute respiratory infection (ARI) for 4.5 years post-PCV to demonstrate effectiveness against hypoxic pneumonia; invasive pneumococcal disease (IPD) surveillance (2004-2019); carriage in children hospitalised with ARI (2013-2019); and community carriage surveys pre- and two years post-PCV13.

Results
Annual incidence of hospitalized pneumonia pre-PCV13 in children 2-59 months was 1,530 (95% confidence interval [CI] 1,477-1,584) per 100,000. Vaccine effectiveness against hypoxic pneumonia was 37% (95% CI 6-57%). In children &lt;5 years, 85% (11/13) of IPD cases were due to PCV13 serotypes pre-PCV13, and 43% (3/7) post-PCV13; and in individuals ≥5 years, 61% (27/44) and 42% (17/40), respectively. In hospitalised children, vaccine type carriage prevalence reduced from 20.0% (95% CI 15.2-24.9%) in 2013 to 12.8% (95% CI 8.5-17.1%) in 2019 with increasing vaccine coverage. Results were consistent with community carriage studies.

Conclusions
Despite limited baseline data in Laos, we found evidence of PCV13 impact using a variety of methods. Our approach could be used in similar settings to augment existing WHO guidelines.

Key messages
A combination of methods may be useful to determine the impact of vaccine introduction in countries with limited surveillance.
1210Understanding the effect of Helicobacter pylori infection on gastroesophageal reflux disease and Barrett’s oesophagus
Authors: Wang Miss Sabrina , Dashti Ghazaleh , Hodge Allison , Kendall Bradley , Dixon-Suen Suzanne , Giles Graham , Milne Roger , English Dallas 
Published: September 2021

Abstract

Background
Helicobacter pylori (H.pylori) infection causes atrophic gastritis and gastric cancer. Ironically, decreased gastric acid production in those with atrophic gastritis might reduce harmful gastroesophageal refluxate, thereby reducing gastroesophageal reflux disease (GERD) and Barrett’s oesophagus (BE) risk.

Methods
In two nested case-control studies with 425 GERD and 169 BE cases, we compared sex-specific GERD and BE risk in H.pylori seronegative participants with seropositive participants. Where seronegativity was associated with increased BE risk, we quantified the effect mediated by GERD using a Monte Carlo simulation-based g-computation approach to estimate interventional effects. Moreover, we classified participants into gastritis types using serum pepsinogen-I and gastrin-17 data.

Results
For men, H.pylori seronegativity was associated with 1.69-fold (CI:1.03-2.75) and 2.14-fold (CI:1.18-3.88) higher odds for GERD and BE respectively. Five (33%) out of the 15 per 1000 excess BE risk from being seronegative was mediated by GERD. No association was observed for women. Among those seropositive, the proportion with atrophic antral gastritis was higher for men than for women (68% vs 56%; p = 0.015).

Conclusions
H.pylori seronegativity was associated with increased GERD and BE risk for men but not women, which could be partly explained by the higher proportion of H.pylori-associated atrophic antral gastritis in men. Evidence of GERD mediating seronegativity’s effect on BE supports this explanation.

Key messages
Whilst H.pylori infection might reduce GERD and BE risk, this is potentially a by-product of atrophic gastritis, a risk factor for gastric cancer. Treating GERD could partly reduce the excess BE risk for seronegative individuals.
1259Adherence to healthy diet reduces mortality associated with systemic inflammation
Authors: Wang Yoko , Page Amanda , Gill Tiffany , Melaku Yohannes Adama 
Published: September 2021

Abstract

Background
Systemic inflammation is a precursor of many chronic diseases that contributes to morbidity and mortality. In this study, we examined the joint association of systemic inflammation and diet quality with all-cause mortality.

Methods
A total of 27,305 adults (mean age = 50 years, male: 50.6%) from the National Health and Nutrition Examination Survey (1999-2010 and 2015-2018) were included in the study. A serum inflammatory marker, C-reactive protein (CRP), was measured. The Healthy Eating Index-2015 (HEI-15) was computed. Multivariable logistic regression analysis was used to determine the cross-sectional association between HEI-15 and inflammation. Multivariable Cox proportional hazard models were performed to assess the risk of all-cause mortality associated with the joint classification of inflammation and diet quality.

Results
In the cross-sectional study, a higher tertile of HEI-15 was associated with reduced odds of inflammation (OR = 0.85, 95% CI: 0.78-0.93) in all participants. Similar results were observed in obese and non-obese groups. In the prospective study (median follow-up = 9.4 years), a higher adherence to HEI-15 was associated with a reduced risk of mortality. Compared to non-obese group, obese participants with high levels of inflammation had a higher risk of all-cause mortality (HR = 1.26, 95% CI: 1.08-1.47; HR = 1.60, 95% CI: 1.19-2.17, respectively).

Conclusions
A higher adherence to HEI-15 was associated with reduced inflammation. Higher diet quality may reduce mortality risks associated with inflammation, particularly in non-obese groups and obese participants with moderate inflammation.

Key messages
Adhering to a high quality diet may mitigate the mortality risk associated with increased inflammation.
658Familial aggregation of melanoma by anatomic site of occurrence
Authors: Ward Sarah , Drill Esther N , Begg Colin B 
Published: September 2021

Abstract

Background
Evidence is emerging that melanoma has distinct etiologic pathways and subtypes, characterized by factors like anatomic site. For example, older men have more head and neck melanomas, and younger women more leg melanomas. Family history is a strong risk factor and familial risk genes have been identified. We therefore aimed to investigate familial aggregation of melanoma from an etiologic heterogeneity perspective, to determine whether melanoma subtypes aggregate within families.

Methods
Using population-level linked health data, we examined the extent to which melanomas in first-degree relatives (FDRs) of cases shared the same body site of occurrence. FDR-pairs diagnosed with melanoma were identified using the Western Australian Cancer Registry and genealogical Family Connections System. Site was categorized as head/neck, trunk/arms, or legs. We identified 1,006 pairs of tumours from 677 family pairs and used Chi-Squared tests to evaluate familial aggregation by site. Degrees of etiologic heterogeneity of individual site-pairs were characterized by site concordance odds ratios.

Results
Familial aggregation by site was statistically significant (P = 0.01). However, only the site pairings of head/neck versus trunk/arms showed strong evidence of familial concordance (OR = 1.7, 95% CI 1.1-1.7). Trends were broadly similar in same-sex pairs.

Conclusions
Results show modest evidence of familial aggregation of melanoma by site, with overall evidence of aggregation but inconsistent patterns between sites.

Key messages
Strong etiologic differences in incidence between anatomic sites for age and sex may be more strongly influenced by non-genetic factors, such as familial patterns of sun exposure.
761Characterisation and clustering of diseases by their association with well-known risk factors
Authors: Webster Anthony , Gaitskell Kezia , Turnbull Iain , Cairns Ben , Clarke Robert 
Published: September 2021

Abstract

Background
Data-driven classifications are improving statistical power, refining prognoses, and improving our understanding of autoimmune, respiratory, infectious, and neurological diseases. Classifications have used molecular information, age of incidence, and sequences of disease onset (“disease trajectories”). Here we consider whether associations with easily-measured established risk factors such as height and BMI can usefully characterise disease.

Methods
UK Biobank data and their linked hospital episode statistics were used to study 172 common age-related diseases. A proportional hazards model was used to estimate associations with potential risk-factors and to adjust for well-known confounders. Diseases were compared and hierarchically clustered using novel but rigorous multivariate statistical methods.

Results
For diseases affecting both sexes, over 38% can be uniquely identified by their associations with risk factors. Equivalent diseases often clustered adjacently. After an FDR multiple-testing adjustment, roughly 5% have statistically significant differences. Similar remarks applied to several symptoms of unknown cause. Many clustered diseases are associated with a shared, known pathogenesis, others suggest likely but unconfirmed causes.

Conclusions
Risk factors for disease can be surprisingly precise and can be used to cluster diseases in a meaningful way. Risk factors for men and women may differ for some diseases. Several symptoms of unknown cause have disease-specific, statistically significant risk factors.

Key messages
Big datasets and modern statistics are providing new insights into the relationships between diseases and their associations with risk-factors. Diseases can be identified and clustered by their associations with well-known risk factors.
97Effectiveness of baby-friendly workplace support interventions on exclusive breastfeeding in Kenya: a propensity score-weighted analysis
Authors: Kimani-Murage Elizabeth , Wilunda Calistus , Zerfu Tadesse , Macharia Teresia , Kamande Eva , Gacheru Peter , Donfouet Hermann , Kiige Laura , Jabando Susan , Dinga Lynette , Samburu Betty , Atinda Joyce , Lilford Richard , Griffiths Paula , Jackson Debra , Begin France , Moloney Grainne 
Published: September 2021

Abstract

Background
Exclusive breastfeeding (EBF) during the first six months of life is crucial for optimising child’s growth, development and survival. Mother’s employment may hinder optimal breastfeeding. We assessed the effectiveness of a workplace support intervention on EBF in Kenya.

Methods
This quasi-experimental study employing a pre-post intervention design was conducted between 2016 and 2018 on an agricultural farm in Kericho County. The intervention targeted pregnant/breastfeeding women residing on the farm and consisted of: day-care centers, sensitization on available workplace baby-friendly policies, and home-based nutritional counselling of pregnant and breastfeeding women. The effect of the interventions on EBF was estimated using propensity score weighting.

Results
The study included 223 and 146 mother-infant dyads in the non-treated (pre-intervention) and treated (intervention) groups, respectively. The prevalence of EBF was 20.2% in the non-treated group and 80.8% in the treated group; corresponding to a 4-fold increased probability of EBF (RR 3.99; 95% CI 2.95–5.15). In age-stratified results, the effect of the interventions was stronger among children aged 3-5 months (RR 8.13; 95% CI 4.23–15.64) than among those aged &lt; 3 months (RR 2.79; 95% CI 2.09–3.73).

Conclusions
The baby-friendly workplace support intervention promoted EBF especially beyond three months in this setting.

Key messages
Maintaining EBF while working is more likely when employers provide the support that women need to do so. Workplace policies and programmes to support women to combine work with breastfeeding are needed.
385Prospective associations between serum homocysteine, folate, vitamin B12 and risk of metabolic syndrome
Authors: Woo Hye Won , Shin Min-Ho , Kim Yumi , Choi Bo-Youl , Kim M-iKyung 
Published: September 2021

Abstract

Background
Both elevated homocysteine (Hcy) and metabolic syndrome (MetS) are associated with cardio-metabolic disease. However, the potential causality in the association between Hcy and MetS is unclear, and there is uncertainty about the importance of serum level of folate and vitamin B12 for MetS. The aim of this study was to determine the prospective associations between serum homocysteine, folate and vitamin B12, and incidence of MetS in a community-based cohort of Korean adults aged ≥ 40 years.

Methods
We measured serum Hcy, folate and vitamin B12 in 2,895 participants (1,187 men and 1,708 women) who did not have MetS. During follow-up (10,043 person-years), 471 MetS cases were newly diagnosed.

Results
Higher Hcy levels were positively associated with risk of MetS (adjusted incidence rate ratio, IRR 1.87; 95% CI, 1.07–3.25 for ≥15 compared with &lt;10 μmol/L of Hcy in men; IRR 1.81; 95% CI, 1.06–3.08 for ≥10 compared with &lt;5 μmol/L of Hcy in women). However, serum folate was not associated with MetS, and higher serum vitamin B12 levels were associated with a statistically significant protection of MetS in men only (IRR 0.61; 95% CI, 0.42–0.90; P for trend=0.0082 in the highest tertile).

Conclusions
Hcy levels were positively associated in men and women, and serum vitamin B12 was inversely associated with risk of MetS in men but not in women. Serum folate do not seem to be a protective marker for MetS.

Key messages
Our results extend previously reported associations of Hcy with MetS, and the absence of associations of folate with MetS.
930Development and feasibility of a mHealth supported Comprehensive Intervention Model (“CIMmH”) for esophageal cancer patients
Authors: Xu He , Xv He , Guo Yan 
Published: September 2021

Abstract

Background
Esophageal cancer patients often experience a clinically relevant deterioration of quality of life (QoL) after esophagectomy due to malnutrition, lack of physical exercise, and psychological problems. This study aims to evaluate the feasibility and efficacy of a comprehensive intervention model using the mHealth system (CIMmH) on the mobile platform that offers accessible nutritional, exercise, and psychosocial support to esophageal cancer patients after esophagectomy.

Methods
Twenty esophageal cancer patients were invited to join the CIMmH for 12 weeks. The CIMmH included an online component and an offline consultation component. The participants were assessed before surgery and at 1-month and 3-month intervals after esophagectomy. QoL, depressive symptoms, anxiety, stress, nutrition, and physical fitness were measured.

Results
Sixteen out of 20 (80%) completed the program. One month after esophagectomy, the global health scale significantly decreased while fatigue, pain, and dyspnea increased. At the 3-month follow-up, only pain, difficulty with eating, dry mouth and trouble with talking were significantly worse than the baseline. All other dimensions in the QoL returned to the preoperative level. Weight and BMI were reduced throughout the study and no significant changes were observed in physical fitness. Depressive symptoms significantly increased one month after surgery.

Conclusions
The CIMmH had good feasibility and demonstrated encouraging preliminary efficacy for enhancing recovery after surgery among esophageal cancer patients in China.

Key messages
Esophageal cancer, Quality of life, Nutrition, Physical exercise, Psychological support, Mobile Health (mHealth)