bluuebunny/crossref_metadata_2025_split huggingface dataset:
1511CIMmH, an mHealth Comprehensive Intervention Model for esophageal cancer patients: A Multi-center RCT Protocol
Authors: Xu He , Guo Yan , Zeng Yu , Li Yiran , Zhu Mengting 
Published: September 2021

Abstract

Background
Post-esophagectomy patients often experience a clinically relevant deterioration of quality of life after esophagectomy due to malnutrition, impaired exercise capacity, and psychological problems. The widespread use of mobile health (mHealth) has been increasingly promising for interdisciplinary healthcare givers to deliver efficient and potential cost-effective interventions in cancer patients. However, comprehensive interventions delivered by mHealth with a rigorous design of randomized controlled trial in post-esophagectomy patients were scarce.

Methods
This study developed the first comprehensive intervention model by mHealth with a parallel RCT design, providing nutrition, physical exercise, and psychological support for post-esophagectomy patients. A total of 120 patients will be randomized into the intervention group or the control group receiving treatment as usual. Participants in the intervention group will receive the 3-month intervention of the CIMmH program via the enhanced WeChat platform and by specialists (offline). The online program includes nutrition guidelines, physical exercise instructions, and psychological courses. All participants will be assessed at baseline, 1, and 3 months after esophagectomy. The primary outcomes are health-related QOL, weight, and physical fitness measured by 6-minute walking distance. Secondary outcomes include nutritional biomarkers, body composition, strength, interleukin-6, depressive symptoms, anxiety, and coping.

Discussion
This study is among the first efforts to innovatively develop a comprehensive intervention program to prompt rehabilitation in post-esophagectomy patients. Once proven effective, CIMmH could be integrated into the management of post-esophagectomy patients.

Key messages
Esophageal cancer, QOL, Nutrition, Physical exercise, Psychological support, mHealth
821Surrounding greenness is associated with slower biological ageing based on epigenetics
Authors: Xu Rongbin , Li Shuai , Li Shanshan , Abramson Michael , Hopper John , Guo Yuming 
Published: September 2021

Abstract

Background
High surrounding greenness has many health benefits, but few studies have evaluated these from the perspective of epigenetics.

Methods
We derived Horvath’s DNA methylation age (DNAmAge), Hannum’s DNAmAge, PhenoAge, and GrimAge from DNA methylation data measured from peripheral blood samples of 479 Australian women in 130 families. The DNA methylation age acceleration (DNAmAgeAC) was calculated as the residuals after regressing DNAmAge on chronological age. Greenness was represented by the satellite-derived Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) within 300m, 500m, 1000m and 2000m surrounding participants’ home addresses. The greenness-DNAmAgeAC association was evaluated using a within-sibship design fitted by linear mixed effect models, adjusting for familial clustering and important covariates.

Results
Our analyses based on the whole sample suggested that the greenness-DNAmAgeAC association was only statistically significant for GrimAge acceleration. Each inter-quartile range (IQR) increase in NDVI within 1000m was associated with 0.59 (95% CI: 0.18, 1.01) year decrease in GrimAge acceleration. Greenness was also inversely associated with GrimAge’s three DNA methylation based components (cystatin-C, growth differentiation factor 15, and smoking pack-years). For participants at higher 50% area-level socioeconomic status (SES), each IQR increase in NDVI within 1000m was associated with 1.24 (95%CI: 0.39, 2.09) year and 0.79 (95%CI: 0.29, 1.30) year decrease in Hannum’s DNAmAgeAC and GrimAge acceleration, respectively.

Conclusions
Higher surrounding greenness was associated with slower biological aging measured by GrimAge acceleration and Hannun’s DNAmAgeAC in Australian women, particularly among those who lived in areas at higher SES.

Key messages
Epigenetics provides a potential mechanism for why surrounding greenness is an important health issue for community construction.
506Mathematical modelling of the transmission of Neisseria gonorrhoeae in men who have sex with men
Authors: Xu Xianglong , Chow Eric P.F , Shen Mingwang , Ong Jason J. , Hoebe Christian JPA , Williamson Deborah , Hocking Jane , Fairley Christopher K , Zhang Lei 
Published: September 2021

Abstract

Background
There is controversy about what sexual practices or secretions (e.g. saliva) transmit Neisseria gonorrhoeae in men who have sex with men (MSM). To date, no studies have modelled potential transmission when one sexual practice follows another in the same sexual encounter or the role of sexual secretions in transmission.

Methods
We developed eight compartmental models to examine three additional transmission routes: (1) oral sex followed by anal sex (or vice versa); (2) using saliva as a lubricant for penile-anal sex, and (3) oral sex followed by oral-anal sex (rimming) or vice versa. For comparison, we used a baseline model that did not include any of these three transmission routes. The seven other models added one of the additional transmission routes or combinations of the three of them to the baseline model.

Results
The baseline model could replicate infection at the single anatomical site but underestimated infection at more than one anatomical site (‘multi-site infection’). When we added the three transmission routes to the baseline model, oral sex followed by anal sex or vice versa could replicate the prevalence of multi-site infection. The other two transmission routes alone or together could not replicate multi-site infection without the inclusion of oral sex followed by anal sex.

Conclusions
Our model suggests sexual practices that involve oral followed by anal sex (or vice versa) may be important for explaining the high proportion of multi-site infection.

Key messages
For Neisseria gonorrhoeae transmission, additional transmission routes are necessary to replicate multi-site infection.
1197Identification of insulin signaling pathway-related circulating circRNAs as novel biomarkers of type 2 diabetes
Authors: Yan Yu-xiang , Lu Ya-Ke , Chu Xi , Sun Yue , Dong Jing 
Published: September 2021

Abstract

Background
The underlying molecular mechanism of type 2 diabetes (T2D) and insulin resistance is that abnormalities occur in the complex insulin signaling pathway. Circular RNAs (circRNAs) are involved in the development of diseases by regulating gene expression and become promising novel biomarkers for diseases. This study screened and validated the insulin signaling pathway-related circulating circRNAs, which are associated with T2D.

Methods
Based on circRNA microarray, candidate circRNAs involved in the insulin PI3K/Akt signaling pathway were selected and validated by RT-qPCR. The association between circRNAs and T2D and their clinical significance were further assessed by logistic regression model, correlation analysis and ROC curve in a large cohort. The miRNA targets of validated circRNAs was verified by dual-luciferase reporter assay.

Results
A total of 370 upregulated circRNAs and 180 downregulated circRNAs were differentially expressed between new T2D cases and controls. hsa_circ_0063425, hsa_circ_0056891 and hsa_circ_0104123 were selected as candidate circRNAs for validation. Low expressed circ_0063425 and hsa_circ_0056891 were independent predictors of T2D, impaired fasting glucose (IFG) and insulin resistance. The two-circRNA panel had a high diagnostic accuracy for discriminating T2D and IFG from healthy controls. miR-19a-3p and miR-1-3p were identified as the miRNA targets of hsa_circ_0063425 and hsa_circ_0056891, respectively. Significantly positive correlations were found between the expression levels of AKT and hsa_circ_0063425, PI3K and hsa_circ_0056891, in the total sample and subgroups stratified by glucose levels.

Conclusion
hsa_circ_0063425 and hsa_circ_0056891 are valuable circulating biomarkers for early detection of T2D, which may be involved in regulation of PI3K/AKT signaling.

Key messages
Insulin signaling pathway-related circulating circRNAs was identification as novel biomarkers of type 2 diabetes.

Keywords
circRNA; type 2 diabetes; insulin signaling; biomarker.
1438Dynamics of inter-farm transmission of highly pathogenic avian influenza integrating vehicle movements and phylogenetic information
Authors: Yoo Dae-sung , Chul Chun Byung 
Published: September 2021

Abstract

Background
Highly pathogenic avian influenza (HPAI), a zoonotic infectious disease, has been considered a severe threat to public health. The fundamental prevention and control strategy against HPAI includes minimizing the outbreaks of poultry holdings where the virus primarily spreads through animal trade and poultry production associated vehicle movement (PPVM). However, very few attempts have been made to elucidate the association between PPVM and HPAI transmission compared to studies on poultry trade. Therefore, our study aimed to elucidate the role of PPVM on HPAI transmission.

Methods
We performed network analysis using PPVM data based on a global positioning system (GPS), with phylogenetic information of the HPAI virus for reliable estimation. Moreover, the contribution of PPVM to HPAI infection was estimated by Bayesian inference.

Results
The network analysis revealed that the connection via PPVM between the same genetic group of infected premises (IPs) was more prevalent than that of different genotype IPs. Moreover, the similarity of farm poultry species and the overlapped integrators between inter-linked IPs was associated with potential transmission route formation. Additionally, the contribution of PPVM among phylogenetically clustered IPs was estimated to have 28.25% of HPAI infections in IPs on average.

Conclusions
HPAI control strategies including targeted movement restriction and standstill should be established against the HPAI transmission via PPVM.

Key messages
This is a solid and novel study depicting the need for combining epidemiological analysis with data regarding molecular epidemiology of pathogens.
962Adolescent Alcohol Use Trajectories: A Prospective Study of Risk Factors and Adulthood AUD Outcomes
Authors: Yuen Wing See , Chan Gary , Clare Philip , Bruno Raimondo , Boland Veronica , Aiken Alexandra , Kypri Kypros , Horwood John , McCambridge Jim , Degenhardt Louisa , Slade Tim , Wadolowski Monika , Hutchinson Delyse , Najman Jake , McBride Nyanda , Mattick Richard , Peacock Amy 
Published: September 2021

Abstract

Background
Adolescents often display heterogenous trajectories of alcohol use. Initiation and escalation of drinking may be an important predictor of later harms. Previous attempts to conceptualise these trajectories lacked adjustment for known confounders of adolescent drinking, which our study has aimed to address by modelling dynamic changes in drinking whilst adjusting for parent, child, and peer factors.

Methods
Survey data from a longitudinal cohort of Australian adolescents (n = 1813) were used to model latent class alcohol use trajectories over five annual follow-ups (Mage=13.9 and 17.8 years). Regression models determined whether child, parent, and peer factors at baseline (Mage =12.9 years) predicted trajectory membership and whether trajectories predicted self-reported symptoms of AUD in early adulthood (Mage =18.8 years).

Results
We identified a four-class solution: abstaining (n = 352); late-onset moderate drinking (n = 503); early-onset moderate drinking (n = 663); and early-onset heavy drinking (n = 295). Alcohol-specific household rules reduced risk of early-onset heavy drinking compared to late-onset moderate drinking (RRR: 0.31; 99.5% CI: 0.11, 0.83), whereas substance-using peers increased this risk (RRR: 3.43; 99.5% CI: 2.10, 5.62). Early-onset heavy drinking increased odds of meeting criteria for AUD in early adulthood (OR: 7.68; 99.5% CI: 2.41, 24.47).

Conclusions
Our study provides evidence that early initiation and heavy alcohol use throughout adolescence is associated with increased risk of alcohol-related harm compared to recommended maximum levels of consumption (late-onset, moderate drinking).

Key messages
Parenting factors and peer influences in early adolescence should be considered to reduce risk of early initiation and heavy drinking, which in turn reduces risk of later harm.
1472Spatial clusters and affecting factors on Alzheimer's disease death in South Korea
Authors: Yum Sujin , Hong Kwan , Kim Jeehyun , Gomez Raquel Elizabeth Gomez , Chun Byung Chul 
Published: September 2021

Abstract

Background
The prevalence of dementia is increasing worldwide; and dementia deaths are also increasing. In South Korea, deaths from Alzheimer's disease (AD) ranked 9th in the 2018 cause of death statistics, and the ranking has risen.

Methods
We collected 2009 to 2018 AD deaths and related data from Statistics Korea and Community Health Survey. SaTScan software was used for detecting and evaluating the clusters with high risk in AD deaths, and R version 4.0.3 was used for mapping and analysis of affecting factors.

Results
A total of 39,412 people died from AD during 10 years in Korea, 7.7 per 100,000 inhabitants. While 98.7% of deaths were above-65 age, the proportion of under 65 was also rising. The global Moran index of 10 years’ AD deaths was 0.2 (P &lt; 0.01), and the clusters were detected primarily in southern rural region. According to the spatial regression analysis, AD deaths in 2018 were increased in area with lower dementia screening rate, long-term care workers, and higher home-care service usage rate in long-term care, inhabitants educated about dementia.

Conclusions
Some clusters of AD deaths were identified, and they were influenced by institutional factors. It is necessary that the local government considers characteristics of each region when implementing the dementia policies.

Key messages
AD deaths in South Korea were increasing from 2009 to 2018, and their clusters were observed in southern regions. AD deaths in 2018 were influenced by dementia-related policies.
71Advanced Environmental Epidemiology for Health and Climate Research
Authors: Zhang Ying 
Published: September 2021

Abstract

Focus and outcomes for participants
The symposium will focus on insights and applications of advanced environmental epidemiology methods in health and climate research. The symposium will help the participants

Rationale for the symposium, including for its inclusion in the Congress
Climate change is the greatest health challenge in the 21st century. The most recent Lancet Countdown report (Watts et al. 2019) and the MJA-Lancet Countdown Australian reports (Zhang et al. 2018; Beggs et al. 2019) on health and climate change research have once again highlighted the global vulnerability to health risks from climate change. Epidemiology plays an important role in informing policy to protect the public’s health from a changing climate. However, limited research has been conducted in the field, which may be due to the methodological challenges to conducting research in climate change epidemiology (Xun et al. 2010). However, there are opportunities for advancing epidemiological research in the context of climate change, as highlighted in the recent paper published in the American Journal of Epidemiology (Anderson et al. 2019). The proposed symposium aligns precisely with the conference theme on methodological innovations in epidemiology and the need for epidemiologists who are keen to address non-traditional epidemiological health risks to support decision-making under a changing climate. This symposium will be a timely event to build capacity needed to address more extreme weather events and disasters related to climate change in Australia and globally.

Presentation program (90 minutes)
The symposium will have 6 presentations, 15 minutes each including Q&A.

Names and short biography of presenters
861Mendelian randomization on habitual coffee intake and plasma lipid profile: evidence from UK Biobank
Authors: Zhou Ang , Hyppönen Elina 
Published: September 2021

Abstract

Background
Long-term heavy coffee consumption may adversely affect individuals’ cardiovascular disease (CVD) risk. As hyperlipidemia is a well-established contributor to CVD, we investigated the association between habitual coffee intake and plasma lipid profile.

Methods
We used data from up to 362,571 UK Biobank participants to examine associations between coffee intake and plasma lipid profiles, including LDL-C, HDL-C, total-C, triglycerides, ApoA1 and ApoB. Inverse variance weighted mendelian randomization (MR) was used to interrogate the causal nature of coffee-lipid associations, complemented by pleiotropy-robust methods, including MR-median, MR-Mode, MR-PRESSO and MR-Egger.

Results
We observed positive dose-dependent associations between self-reported coffee intake and plasma concentration of LDL-C, ApoB and total-C, with the highest lipid levels seen among participants drinking &gt;6 cups/day (Plinear trend≤1.97E-57 for all). Genetic instrument for coffee intake was robustly associated with self-reported intake in the UK Biobank (F-statistic = 416). One cup increase in genetically instrumented intake was associated with 0.07 mmol/L (95%CI 0.03 to 0.12), 0.02 g/L (95%CI 0.01 to 0.03), and 0.09 mmol/L (95%CI 0.04 to 0.14) increase in LDL-C, ApoB, and total-C, respectively. Pleiotropy-robust methods provided largely consistent results albeit with greater imprecision when using MR-Egger.

Conclusions
Our phenotypic and genetic analysis consistently suggests that long-term heavy coffee consumption can lead to unfavourable lipid profile, which could potentially increase individuals’ risk for CVD. Individuals with elevated cholesterol may need to reduce their daily coffee intake.

Key messages
Our study provides evidence that long-term heavy coffee consumption can lead to unfavourable lipid profile.
Validation of the Giannella Risk Score for the Prediction of Infection by Carbapenemase-producing Enterobacteriaceae in the Pediatric Population
Authors: Garazzino Silvia , Balletto Elisa , Licciardi Francesco , Denina Marco , Carraro Francesca , Contino Amalia , Palmero Candida , Ugolotti Elisabetta , Silvestro Erika , Castagnola Elio 
Published: September 2021

Background:
Despite efforts made to prevent the spread of multi–drug-resistant bacteria, carbapenemase-producing Enterobacteriaceae (CPE) has become one of the most dangerous threat worldwide. However, data on the epidemiology of CPE and on the correlation between CPE colonization and infection are scanty. The objectives of this study were first to describe the epidemiologic characteristics of colonizations and invasive CPE infections in the pediatric population, and second, to apply the Giannella Risk Score (GRS) to the pediatric population for the assessment of the risk of invasive CPE infection in patients with already known colonization.

Methods:
Pediatric patients with evidence of colonization by CPE were retrospectively enrolled. For each colonized patient, the subsequent development of an infection by CPE was then assessed for a 90-day period after the first CPE isolation; GRSs were compared between patients who had developed any type of CPE infection and those without infection.

Results:
A total of 215 patients (113 males and 102 females) with at least 1 isolation of CPE during hospitalization were analyzed. Median age was 5.6 years [interquartile range (IQR), 1.89–12.2 years]. Overall, 28 CPE infections (13%) were documented: 23 blood stream infections and 5 complicated urinary tract infections. The 30-day mortality of invasive CPE infections was 34.8%. The GRS values in patients with any CPE infection were statistically higher than in noninfected patients: median GRS 9 (IQR, 4–12.5) versus 4 (IQR, 2–4), respectively; P < 0.0001. The analysis of the receiver operating characteristic curves identified a GRS cut-off value ≥8 as the best predictor of CPE infection. The likelihood ratio of the results was <2 and the informedness of the test had a value <0.50.

Conclusions:
Our study confirms that the spread of CPE is an impelling problem also in the pediatric population, with a high mortality rate of invasive infections. However, the application of the GRS appears to be poorly informative in the pediatric setting; it might sometimes help to identify patients at very low-risk of CPE infection, in whom it is reasonable to spare targeted antimicrobial treatments.
Pharmacological treatments of neuropathic pain: real-life comparisons using propensity score matching
Authors: Moisset Xavier , Pagé M. Gabrielle , Pereira Bruno , Choinière Manon 
Published: September 2021

Abstract
Studies comparing different drug treatments for chronic neuropathic pain (NP) are very limited. We, therefore, examined 4 recommended treatments, namely, antidepressants (duloxetine, venlafaxine, and tricyclic antidepressants), antiepileptics (gabapentine and pregabalin), weak opioids, and strong opioids, among patients with NP evaluated before first visit in a tertiary pain treatment centre and 6 months later. Patients with both a clinical diagnosis of NP and a DN4 score ≥3/7 were selected from patients enrolled in the Quebec Pain Registry. Each participant was assigned an inverse weighting of the probability of receiving any NP treatment, taking into account their age, sex, baseline pain intensity, pain duration, pain catastrophizing tendency, education level, employment, and comedications at 6-month follow-up (M6). Patients were considered as improved if they presented at least a 30% reduction on average pain intensity at M6 compared with baseline. A total of 944 patients completed both baseline and M6 evaluations. Overall, 23.0% of patients were significantly improved for pain intensity at M6. There was no significant difference in proportions patients taking or not antidepressants, gabapentinoids, or weak opioids. Among patients taking strong opioids (N = 288), 13.9% (N = 40/288) were improved vs 27.0% (177/656) of those who were not on opioids (P < 0.004). Inverse probability of treatment weighting confirmed that the proportion of patients who improved was significantly lower among those taking strong opioids compared with those who did not (P < 0.001). In conclusion, long-term use of strong opioids is a treatment suited for a limited proportion of patients with chronic NP.