bluuebunny/crossref_metadata_2025_split huggingface dataset:
1374International representation of authors, editors and research in neurology journals
Authors: Bojanic Teodora , Tan Aidan 
Published: September 2021

Abstract

Background
Published research informs international healthcare, yet only a few studies have assessed the representation of authors, editors, and research from developing countries in biomedical journals.

Methods
We reviewed all research articles published in five high-ranking peer-reviewed neurology journals (The Lancet Neurology, Acta Neuropathologica, Nature Reviews Neurology, Brain and Annals of Neurology) in 2010 and 2019 to determine the extent of contributions of authors, editors and research from developing countries, and the degree of international research collaboration between developed and developing countries.

Results
First authorship was attributed to authors from developing countries in only 2% (11/729) of research articles in 2010 and 3% (19/647) of research articles in 2019. All 144 editorial board members in 2019 were from developed countries. International research collaboration between developing and developed countries accounted for only 4% (30/729) of all research articles in 2010 and 6% (40/647) of all research articles in 2019.

Conclusions
Representation of authors, editors and research from developing countries is rare in high-ranking peer-reviewed neurology journals, and this has not improved over the past decade. Supporting high quality and contextually appropriate biomedical research now is necessary for developing countries to meet the rising healthcare needs of their populations in the future.

Key messages
Published research should reflect the diversity of global health. There is an urgent need for strategies to support high quality and contextually appropriate biomedical research in developing countries.
345Occupational heat stress and economic burden: evidence to support development of workplace heat management policies
Authors: Borg Matthew , Bi Peng , Xiang Jianjun , Anikeeva Olga 
Published: September 2021

Abstract

Background
The adverse effects of heat on workers’ health and work productivity are well documented. However, the resultant economic consequences and productivity loss are less understood. This review aims to summarize the retrospective and potential future economic burden of workplace heat exposure in the context of climate change.

Methods
Literature was searched from database inception to October 2020 using Embase, PubMed, and Scopus. Articles were limited to original human studies investigating costs from occupational heat stress in English.

Results
Twenty studies met the criteria. Eighteen studies estimated costs from heat-induced labor productivity loss. Predicted global costs from lost worktime, in US$, were 280 billion in 1995, 311 billion in 2010 (≈0.5% of GDP), 2.5 trillion in 2030 (&gt;1% of GDP) and up to 4.0% of GDP by 2100, with additional expenses after considering reduced work efficiency. Three studies estimated heat-related healthcare expenses from occupational injuries with averaged annual costs (US$) exceeding 1 million in Spain, 1 million in Guangzhou, China and 250,000 in Adelaide, Australia. Low- and middle-income countries and countries with warmer climates had greater losses as a proportion of GDP. Greater costs per worker were observed in outdoor industries, amongst males, and workers aged 25 to 44 years.

Conclusions
The estimated global economic burden of occupational heat stress is substantial. Climate change adaptation and mitigation strategies should be implemented to likely minimize future costs. Further research exploring the relationship between occupational heat stress and related expenses from lost productivity, decreased work efficiency and healthcare, and costs stratified by demographic factors, is warranted.

Key messages
The estimated retrospective and future economic burden from occupational heat stress is large. Responding to climate change is crucial to minimize this burden. Analyzing heat-attributable occupational costs may guide the development of workplace heat management policies and practices as part of global warming strategies.
533The psychosocial profiles of children aged 11-12 years who have self-harmed: A prospective cohort study
Authors: Borschmann Rohan , Mundy Lisa , Canterford Louise , Moreno-Betancur Margarita , Moran Paul , Allen Nicholas , Viner Russell , Degenhardt Louisa , Kosola Silja , Fedyszyn Izabela , Patton George 
Published: September 2021

Abstract

Background
Self-harm in very young people can be a clinically ominous event. While most studies to date have focused on self-harm during the teenage years, fewer studies have examined children aged 12 years or under. We aimed to estimate the incidence and correlates of recent self-harm in a population-based, non-treatment-seeking sample of primary school-aged children.

Methods
1059 children from 43 primary schools in Melbourne, Australia were interviewed at the age of 8 years (Wave 1), and followed up annually until the age of 11 years (Waves 2-4). Interviews covered a range of physical and mental health, social, educational and family domains, including (at Wave 4) self-harm during the previous 12 months.

Results
At Wave 4 (mean age: 11.9 years), a total of 28 children (3%; 18 girls [3%], 10 boys [2%]) reported self-harming during the previous 12 months. When compared with children who reported no self-harm, they were more likely to report depression, anxiety, poor emotional control, frequent bullying victimisation (including online bullying), truancy, recent alcohol consumption, and antisocial behaviour during Waves 1-3. They were also more likely to report having few friends.

Conclusions
Self-harm was reported by a proportion of community-dwelling children aged 11-12 years. As these children were more likely to report a range of other adverse behaviours, experiences and health conditions, clinicians should consider the possibility of prior self-harm when assessing children presenting with such behaviours and issues.

Key messages
The focus of intervention efforts aimed at preventing and reducing adolescent self-harm should extend to primary school-aged children, with a focus on mental health and peer relationships during the pubertal transition.
1283Licit and Illicit substances use among Brazilian youth population: a cross-sectional, nationwide study
Authors: Brito Emerson , Bessel Marina , Kops Natália , Souza Flávia Moreno , Wendland Eliana 
Published: September 2021

Abstract

Background
Psychoactive substances are increasing within the young population enhancing exposure to sexual risks, violence and mortality by preventable causes. Moreover, the use of these substances at this stage of life can be a predictor of abuse in adult live. Thus, this study aims to examine the patterns of drugs use in Brazilian young adults.

Methods
A cross sectional study was performed in all Brazilian capitals between September-2016 to December-2017. 8581 participants aged 16 to 25 years answered a structured interview with socio and behavioral questions. The sample was weighted in each capital by age range and sex.

Results
Alcohol (71.6%), cannabis (27.4%), and cocaine (9.9%) were the most common addictive substances experienced once in life in the sample. The regular use in the past 12 months was reported in 40.5%, 12.5% and 2.5%, respectively. Significant differences were observed between men and women in regular use of alcohol (48.7% and 32.5%, p&lt;.001), cannabis (18.8% and 6.3%, p&lt;.001) and cocaine (3.8% and 1.4%, p&lt;.001). Also observed high drug consumption regarding to low education level, upper class population and who had partner presence. Additionally, participants who had previous homosexual relationship had high rates of regular alcohol (65.9%) and cannabis use (22.6%).

Conclusions
Brazilian youth showed high rates of psychoactive substances use mainly alcohol and cannabis. Thus, knowledge about the patterns of alcohol and drugs use in this population is important to direct actions and prevent associated risks.

Key message
High rates of alcohol and cannabis use are reported in Brazilian youth population.
997Childhood pneumonia in the Eastern Highlands Province, Papua New Guinea: clinical predictors of severe disease
Authors: Britton Kathryn , Pomat William , Ford Rebecca , Sapura Joycelyn , Kave John , Nivio Birunu , Lehmann Clinical Deborah , Chan Jocelyn , Russell Fiona , Blyth Clinical Christopher 
Published: September 2021

Abstract

Background
Pneumonia is the leading cause of death in young children globally and is prevalent in the highlands of Papua New Guinea (PNG). We investigated clinical predictors of severe pneumonia to inform local treatment guidelines in this resource-limited setting.

Methods
Between 2013 and 2020, prospective studies were undertaken enrolling children &lt;5 years presenting with pneumonia to health-care facilities in Goroka Town, Eastern Highlands Province. Physical examination findings and blood cultures were collected. Logistic regression analyses were performed to determine predictors of hypoxaemia (oxygen saturation &lt;90% on presentation), bacteraemia and death.

Results
There were 2067 cases of pneumonia, hypoxaemia was detected in 36.1%. Bacteraemia was identified in 47/1943 (2.4%) blood cultures. Of 1444 children followed up, 18 (1.2%) died. Central cyanosis (odds ratio 3.82, 95% CI 2.55-5.71) and reduced breath sounds (2.77, 2.17-3.53) independently predicted hypoxaemia; altered consciousness (21.44, 3.91-117.48), bronchial breathing (10.49, 2.01-54.63) and apnoea (2.54, 1.26-5.14) independently predicted bacteraemia; and altered consciousness (20.95, 2.32-189.00), reduced skin turgor (14.43 (4.79-43.49) and central cyanosis (5.96, 2.13-16.66) independently predicted death.

Conclusions
In children with pneumonia in the PNG highlands, those with central cyanosis, apnoea, bronchial breathing, altered consciousness or reduced skin turgor are at greatest risk of severe outcomes. Ongoing training of health care workers is essential to ensure these signs are recognised and appropriate management promptly instituted.

Key messages
Prompt recognition of signs of severity is likely to lead to better outcomes for children in PNG with pneumonia. These findings will inform future modifications to local treatment guidelines.
1428Factors leading to institutionalization among the oldest old. Longitudinal findings from the AgeCoDe-AgeQualiDe study
Authors: Buczak-Stec Elzbieta , Hajek André , Wagner Michael , Scherer Martin , Maier Wolfgang , Riedel-Heller Steffi G. , König Hans-Helmut 
Published: September 2021

Abstract

Background
Due to the strong association between old age and the need for long-term care, the number of individuals in need for care is projected to increase noticeably. The aim of this study is to examine determinants of institutionalization nursing home admission among the oldest old longitudinally.

Methods
Longitudinal data were gathered from a multicenter prospective cohort study (“Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)”; AgeQualiDe). At baseline (2014), complete measures were available for 684 individuals. The average age was 88.9ys (85-100), 68% were female. Sociodemographic and health-related variables (e.g., depressive symptoms, functioning) were included in the regression model. Institutionalization was defined as a date of admission to a nursing home. Competing risk survival analysis was performed using death as a competing event (Fine and Gray model).

Results
During the follow-up of the study, altogether 104 individuals were institutionalized, 81 died. Based on the estimated subhazard ratios, the risk of institutionalization increased with functional decline sHR=0.62, 95% CI [0.56-0.69] in total sample. Moreover, cognitive decline was associated with an increased risk of institutionalization only in men (sHR=1.73, 95%CI [1.05-2.87]).

Conclusions
Our findings stress the importance of functional decline (for both sexes) and cognitive decline (only for men) for institutionalization among the oldest old.

Key messages
Preventing or at least postponing functional decline might help to delay as far as possible institutionalization.
187Racial discrimination, life stress and allostatic load in Aboriginal and Torres Strait Islander adults
Authors: Cave Leah , Cooper Matthew N. , Zubrick Stephen R. , Shepherd Carrington C.J. 
Published: September 2021

Abstract

Background
Increased allostatic load is linked with racial discrimination exposure, providing a mechanism for the biological embedding of racism as a psychosocial stressor. We undertook an examination of how racial discrimination interacts with socioecological, environmental and health conditions to affect multisystem dysregulation in a First Nations population.

Methods
We conducted latent class analysis (LCA) using indicators of life stress, socioeconomic background and physical and mental health from a nationally representative sample of Australian Aboriginal adults (N = 2 056). We used LCA with distal outcomes to estimate the effect of the latent class variable on our derived allostatic load index and conducted a stratified analysis to test whether allostatic load varied based on exposure to racial discrimination across latent classes.

Results
Our socioecological, environmental and health measures informed a four-class structure; ‘Low risk’ (30.8%), ‘Challenged but healthy’ (27.8%), ‘Mental health risk’ (24.0%) and ‘Multiple challenges’ (17.4%). Mean allostatic load was highest in ‘Multiple challenges’ compared to all other classes, both in those exposed (4.5; 95% CI: 3.9, 5.0) and not exposed (3.9; 95% CI: 3.7, 4.2) to racial discrimination. Allostatic load was significantly higher for those with exposure to racial discrimination in the ‘Multiple challenges’ class (t = 1.74, p=.04) and significantly lower in the ‘Mental health risk’ class (t=-1.67, p=.05).

Conclusions
Racial discrimination may not always modify physiological vulnerability to disease. Social and economic contexts must be considered when addressing the impact of racism, with a focus on individuals and sub-populations experiencing co-occurring life challenges.

Key messages
Racial discrimination can increase physiological dysregulation in Aboriginal and Torres Strait Islander adults with a profile of psychosocial stress and adverse health.
710Do exercise facilities moderate the effect of socioeconomic inequities in Body Mass Index?
Authors: Tejedor Luis Cereijo , Tosio Pedro Gullón , Cerrato David Valadés , Badland Hannah , Tejero Manuel Franco 
Published: September 2021

Abstract

Background
The influence of area-level socioeconomic status (SES) on Body Mass Index (BMI) and adiposity is well known. There is an unequal distribution of exercise facilities (EF), which is dependent on area-level SES. However, is unclear whether EF intervenes on the relationship between SES and BMI.

Methods
BMI data were obtained from baseline of the Heart Healthy Hoods Cohort. Overall, 1,258 (40-75 years old) residents of Madrid, Spain were recruited between 2017 and 2019. Area-level SES was calculated for each census section based on 7 indicators in 4 domains: education, welfare, employment and living conditions. Availability of EF was defined as the count of EF in a 1,000m street network buffer around participants’ census sections of residence. A five-step mediation analysis was carried out to quantify the effect of EF availability. Analysis of each specific path was carried out with multilevel regression model, adjusted by sex and population density.

Results
Increases in SES were associated with decreases in BMI (β=-0.723, IC95% -1.003; -0.444). Alike, increases on availability of EF were associated with decreases on BMI (β=-0.09, IC95% -0.132; -0.048). Multilevel regression confirmed availability of EF was a significant moderator between SES and BMI (β=-0.566, IC95% -0.959; -0.173). Thus, the indirect effect of EF on the association between SES on diabetes was -0.258.

Conclusions
Availability of exercise facilities moderate socioeconomic inequities in BMI.

Key messages
Increasing the availability of EF in disadvantaged areas may have the potential to moderate inequities related to body size.
882Relationship of Urban Sprawl with Overweight and Obesity: Roles of Physically-Active and Sedentary Travel Behaviours
Authors: Chandrabose Manoj , Owen Neville , Hadgraft Nyssa , Sugiyama Takemi 
Published: September 2021

Abstract

Background
Urban sprawl – low-density neighbourhood developments at the city’s periphery – is related to risk of overweight/obesity. Our mediation analysis examined the extent to which this relationship may be explained by physically-active and sedentary travel behaviours.

Methods
We analysed data from 2,465 metropolitan residents in the 2011-12 wave of the Australian Diabetes, Obesity and Lifestyle Study. Urban sprawl measure was geographic information system derived residential proximity to the major city centre. Self-reported weekly frequency of walking for transport (WT) and car driving duration (car use) were used as measures of physically-active and sedentary travel behaviours. Risk of overweight/obesity was calculated using objectively-measured body mass index (&gt; 25 kg/m2). Multi-level regression models and joint-significance mediation tests were used.

Results
Residing near the city centre was associated with higher levels of WT and lower levels of car use. For instance, compared to those living within 10km from the city centre, those living over 30km away had 57% lower WT frequency (p&lt;0.001) and 1.4 hours/week more car use (p=0.002). In turn, lower levels of WT and higher levels car use were associated with elevated overweight/obesity risk.

Conclusions
These analyses suggest that travel behaviors can be potential mediators in relationships of urban sprawl with overweight/obesity. Future studies are warranted to assess causality of these relationships.

Key messages
Urban planning policies need to consider these impacts of the expansion of urban sprawl and promote inner-city high-density development by encouraging more physically-active travel and less time spent sitting in cars to reduce the population burden of overweight/obesity.
1411Alcohol and tobacco use and risk of multiple myeloma: a case-control study
Authors: Cheah Simon , Milne Roger , Harrison Simon , English Dallas , Giles Graham 
Published: September 2021

Abstract

Background
Although responsible for significant mortality and morbidity, our knowledge of modifiable causes of multiple myeloma (MM) remains limited. This analysis of an Australian population-based case-control family study investigated associations between smoking and alcohol consumption and MM risk.

Methods
Incident cases (n = 789) of MM were recruited mainly via cancer registries in Victoria and NSW. The controls included in the analysis (n = 1,113) were either family members of cases (n = 696) or recruited as part of a similarly designed case-control family study of renal cancer (n = 417). Unconditional multivariable logistic regression was used to estimate ORs, 95% CIs and p-values for associations between alcohol- and tobacco-related exposures and risk of MM.

Results
Heavy drinkers of alcohol had lower MM risk compared with non-drinkers (OR = 0.68, 95% CI = 0.50 – 0.93), and there was an inverse dose-response relationship for alcohol intake (OR per 10g ethanol per day = 0.92, 95% CI: 0.86 – 0.99); there was no evidence of interaction with sex (p = 0.27). There was no evidence of association between smoking-related exposures and MM risk.

Conclusions
These findings extend the knowledge of MM risk factor epidemiology. Further research into the causality of the association of alcohol with MM risk and potential underlying mechanisms is recommended.

Key messages
We found alcohol consumption to be inversely associated with risk of multiple myeloma.
382Association between nutrient supplementation and depressive symptom in Pregnancy: a multicenter prospective cohort study
Authors: Chen Yunli , Jiang Yu 
Published: September 2021

Abstract

Background
There are few researches about the association between nutrient supplementation and depressive symptom in pregnancy in large prospective cohort studies.

Methods
In Chinese Pregnant Women Cohort Study (CPWCS), twenty-four hospitals distributed in 15 provinces in China were selected as centre sites. Related information were collected in the first, second and third trimester respectively. Nutrient supplements include folic acid, vitamin D, calcium, iron, docosahexaenoic acid (DHA), dietary fiber, and probiotics. Edinburgh postnatal depression scale (EPDS) was used to assess the mood of depression. Univariable and multivariable Generalized Estimating Equation were applied to analyze the association of nutrient supplementation and depressive symptom in pregnancy.

Results
A total of 5759 pregnant women were included in our study. Results showed that 93.3%(5374/5759), 92.8%(5189/5591) and 94.2%(4056/4307) women supplemented one or more nutrients in the first, second and third trimester separately. The detection rates of antenatal depression was 30.77%(1772/5759), 28.13%(1573/5591) and 28.44%(1225/4307) separately. Multivariable analyses suggested that supplementing one or more nutrients was significantly associated with depression (OR = 0.812, p = 0.013). When analyzed separately, depression was negatively related to vitamin D (OR = 0.850, p = 0.001), calcium (OR = 0.880, p = 0.006), and DHA (OR = 0.903, p = 0.040), but not associated with supplement of folic acid, dietary fiber, iron, or probiotics.

Conclusions
Depressive symptom is highly prevalent among Chinese pregnant women, and supplement of vitamin D, calcium, and DHA are preventive factors of depressive symptom in pregnancy.

Key message
About a third of Chinese pregnant women have depressive symptom, and supplement of vitamin D, calcium, and DHA are preventive factors of depressive symptom in pregnancy.
1474Meteorologically favourable zones for the activities of seasonal influenza A and B in Hong Kong
Authors: Chun Chong Ka , Sheung Kay , Chan Paul , Lee Tsz-cheung 
Published: September 2021

Abstract

Background
Compared with temperate regions, the seasonality of influenza A and B in tropics and subtropics differs, for example, there are two peaks of influenza A virus activities in the summer and winter months, while influenza B peaked only in the winter months in Hong Kong. Given a potential effect from meteorological factors, we aim to develop a set of meteorologically favorable zones to predict the upsurge of activities of both influenza types.

Methods
Weekly numbers of laboratory-confirmed influenza A and B cases from January 1, 2004 to December 31, 2019 from cases admitted to three local hospitals were obtained. Meteorology data such as ambient temperature and relative humidity were collected from the Hong Kong Observatory. We employed a supervised discretization approach, classification and regression tree to identify the meteorologically favourable zones that optimize the prediction of influenza epidemics.

Results
The trained and validated areas-under-receiver-operating-characteristic-curve (AUROC) for the meteorologically favorable zones at 2-week ahead were 0.764 and 0.754 with a prediction sensitivity of 0.784 and 0.769, specificity of 0.616 and 0.635 respectively, showing a good performance. The prediction performances were generally similar among hospital-based prediction and the AUROCs kept &gt;0.7 across all study sites.

Conclusions
The preliminary findings provide a support for developing a local-based risk alert for the upsurge of influenza activities in order to promote a public awareness of the influenza risk.

Key messages
While influenza seasonality in subtropics and tropics is not as strong as that in temperate regions, meteorological factors still crucial in predicting influenza epidemics.