bluuebunny/crossref_metadata_2025_split huggingface dataset:
886Serum folate and risk of disabling dementia: Community-based nested case-control study
Authors: Kishida Rie , Yamagishi Kazumasa , Maruyama Koutatsu , Ikeda Ai , Kubota Yasuhiko , Hayama-Terada Mina , Muraki Isao , Shimizu Yuji , Umesawa Mitsumasa , Cui Renzhe , Imano Hironori , Sankai Tomoko , Okada Takeo , Kitamura Akihiko , Kiyama Masahiko , Iso Hiroyasu 
Published: September 2021

Abstract

Background
Folate regulates homocysteine metabolism and high blood homocysteine level has been associated with risk of dementia. Accordingly, serum folate is hypothesized to decrease the risk of dementia but epidemiological evidence, especially for Japanese, is scant. The aim of this study was to examine associations between serum folate and risk of disabling dementia within a Japanese cohort over 20 years of follow-up.

Methods
We performed an intracohort case-control study nested in a community-based cohort, the Circulatory Risk in Communities Study (CIRCS), involving 13934 Japanese individuals aged 40-84 years at the baseline period of 1984-2005. Serum folate was measured in 511 cases of incident disabling dementia, and in 1022 controls whose age (±1 years), sex, area, and baseline year were matched with the cases. The diagnosis of disabling dementia was performed by attending physicians under the National Long-Term Care Insurance System in Japan. Conditional odds ratios of disabling dementia according to quintiles of serum folate were calculated using conditional logistic regression models.

Results
Serum folate was inversely associated with risk of disabling dementia. The multivariate odds ratios (95% confidence intervals) were 0.62(0.43-0.88), 0.71(0.49-1.00), 0.63(0.43-0.91), and 0.51(0.34-0.76) for persons with the second, third, fourth, and highest quintiles of serum folate, respectively, compared with the lowest quintiles (P for trend = 0.19).

Conclusions
Low serum folate level was associated with increased risk of disabling dementia among Japanese.

Key messages
e Low folate intake may have an adverse effect on developing dementia.
704The preventable future burden of cancer in Australia
Authors: Laaksonen Maarit A , Canfell Karen , MacInnis Robert , Arriaga Maria E , Hull Peter , Banks Emily , Giles Graham G , Mitchell Paul , Cumming Robert G , Byles Julie E , Magliano Dianna J , Shaw Jonathan , Gill Tiffany K , Hirani Vasant , Marker Julie , McCullough Susan , Klaes Elizabeth , Connah David , Velentzis Louiza S , Vajdic Claire M 
Published: September 2021

Abstract

Background
Estimates of the future burden of invasive cancer attributable to current modifiable causal exposures can guide cancer prevention.

Methods
We linked pooled data from seven Australian cohort studies (N = 367,058) to national cancer and death registries, and estimated exposure-cancer and exposure-death associations using adjusted proportional hazards models. We estimated exposure prevalence from contemporary national health surveys and calculated population attributable fractions (PAFs) and 95% confidence intervals, using advanced methods accounting for competing risk of death.

Results
Current levels of past and current smoking explain 36.1% (95%CI 33.2%-38.9%), body fatness 13.6% (10.9%-16.2%) and alcohol consumption exceeding two drinks/day 2.3% (1.0%-3.6%) of cancers causally related to these exposures, corresponding to 210,000, 81,300 and 14,800 cancers in Australia in the next 10 years, respectively. Ever smoking is the leading modifiable cause of lung (82.1%), bladder (49.8%), oesophageal (42.8%), liver (39.8%), head and neck (35.6%), and pancreatic (21.3%) cancer burden. Body fatness is the leading modifiable cause of corpus uteri (42.5%), gastric cardia (33.6%), renal cell (29.1%), thyroid (20.1%), colorectal (12.6%) and postmenopausal breast (12.6%) cancer burden. The absolute numbers of cancers in the next 10 years attributable to smoking are highest for lung cancer (114,000). The numbers of cancers attributable to body fatness and alcohol are highest for colorectal cancer (23,000 and 9,900, respectively).

Conclusions
More reliable advanced methods demonstrate large proportions and numbers of cancers are preventable by modifying behaviours.

Key messages
Ever smoking and body fatness are the leading causes of preventable future burden of causally related cancers in Australia.
951Can cancer-related health literacy predict cancer preventive behaviours?
Authors: Lee Patricia Chiaotzu , Mao Ayan , Dong Pei , Wang Kun , Qiu Wuqi 
Published: September 2021

Abstract

Background
Health literacy has direct relevance to outcomes in patients with cancer. An adequate level of health literacy may increase uptake of screening and other supportive cancer prevention programs, which may contribute to improved outcomes. However, existing literature is limited in measuring cancer-specific health literacy and its role in cancer prevention. This study aims to investigate the relationship between cancer-related health literacy and cancer preventive behaviours through a population survey in Beijing, China.

Methods
A cross-sectional design was utilised to collect survey data such as respondents’ sociodemographic characteristics, cancer-related health literacy, cancer status and cancer prevention behaviours. Logistic regression modelling was applied to identify significant sociodemographic predictors for cancer literacy. Multinomial logistic regression analysis was further performed to determine the association between cancer-related health literacy and cancer preventive behaviours after adjusting for effects from sociodemographic variables.

Results
The findings confirmed that cancer-related health literacy was significant in predicting participants’ cancer preventive behaviours, including individual’s cancer information seeking behaviour, intention to participate in cancer screenings, early diagnosis and treatments. In addition, the results also showed that respondents’ gender, age, education, household income, residential region and cancer status were significantly associated with their levels of cancer-related health literacy.

Conclusions/Key messages
The results of this study have provided useful evidence on the importance of applying cancer-related health literacy to predict individual’s cancer preventive behaviours. The study has also identified the variations in cancer literacy between different sub-population groups. Future studies can develop targeted health promotion and education campaigns for more effective cancer prevention.
633Poorly controlled diabetes is a predictor of colorectal cancer survival
Authors: Li Ming , Roder David 
Published: September 2021

Abstract

Background
Epidemiological studies have shown diabetes associated with increased risk of colorectal cancer. This study investigates the impact of a pre-cancer diabetes-related hospitalization record on colorectal cancer survival.

Methods
A retrospective cohort of 13190 colorectal cancer patients recorded on the South Australian Cancer Registry in 2003-2013 were examined. Diabetes-related hospitalization histories were obtained using linked inpatient data. Colorectal cancer deaths were available for 2003-2013. The association of survival from colorectal cancer with diabetes-related hospitalization history was assessed using competing risk analysis, adjusting for sociodemographic factors and cancer stage at diagnosis.

Results
2765 patients with colorectal cancer (26.5%) had a history of hospital admission for diabetic complications, the most common being multiple complications (32%), followed by kidney and eye complications. The 5- and 10-year cancer survival probabilities were 63% and 56% in those with a diabetes complication history, significantly lower than 66% and 60% for patients without these complications (adjusted sub hazard ratio 1.11, 95% CI 1.02-1.20). Risk of colorectal cancer death was lower when theses diabetes-related hospitalizations were earlier than the year of cancer diagnosis - i.e., adjusted SHR 0.80, 95% CI 0.66-0.97 for 3-5 and 0.76, 95% CI 0.59-0.98 for 6+ years before the cancer diagnosis compared with same-year hospitalizations.

Conclusions
Colorectal cancer patients with a history of diabetes-related hospitalization have poorer survival, particularly if these hospitalizations were in the same year as the cancer diagnosis.

Key messages
Poorly controlled diabetes histories predict increased risk of colorectal cancer mortality.
1444Housing disadvantage in childhood and health: A systematic review
Authors: Li Yuxi , Singh Ankur , Alfonzo Ludmila , Bentley Rebecca 
Published: September 2021

Abstract

Background
Housing has been recognised as one of the important determinants of health outcomes. However, little is known of the contribution of these pathways to children’s health and wellbeing and their pattern of health throughout life. This review aims to provide a synthesis of longitudinal studies linking experiences of disadvantaged housing in childhood to health outcomes.

Methods
A literature search was performed on four databases including Medline, EMBASE, PsycINFO, and Web of Science from 2000 to 2020. Peer-reviewed longitudinal studies assessing the association between housing disadvantage in childhood and subsequent physical and mental health were included. The methodological quality of selected studies was appraised using the ROBINS-I tool. A narrative synthesis was developed due to study heterogeneity.

Results
Forty-five cohort studies were included, and no randomised controlled trial met the inclusion criteria. The majority of the studies was evaluated to have a moderate risk of bias. Across the studies, while many relationships remained mixed, consistent evidence of detrimental impact was identified between: poor housing conditions and mortality; inadequate heating and respiratory illness; frequent residential moves and psychiatric mortality and morbidity. Little evidence is found between overcrowding in childhood and health outcomes.

Conclusions
Evidence from longitudinal studies indicates that poor housing experience in childhood may impact health later in life.

Key messages
The findings stressed housing as a key social determinant of child health, and interventions designed to mitigate housing disadvantage may have significant health gains across the life span
976Screening for cervical cancer with Human Papillomavirus testing: stand-alone is preferable over co-testing with cytology
Authors: Liang Linda , Einzmann Thomas , Zeissig Sylke Ruth , Franzen Arno , Schwarzer Katja , Schauberger Gunther , Schriefer Dirk , Radde Kathrin , Ikenberg Hans , Snijders Peter JF , Meijer Chris JLM , Kirkpatrick Charles J , Koelbl Heinz , Blettner Maria , Klug Stefanie J 
Published: September 2021

Abstract

Background
Cervical cancer screening can be conducted with cytology and Human Papillomavirus (HPV) testing but few studies have compared the latter directly to concomitant testing (co-testing). We compared these strategies to determine appropriate screening.

Methods
Within a randomised population-based cohort study conducted around Mainz, Germany, eligible women (≥30 years) were screened via Pap smear, liquid-based cytology (LBC) and HPV testing (HC2) and HPV genotyped post hoc (PCR). These tests formed three strategies: cytology (Pap or LBC) and HPV (HC2 or PCR) stand-alone and co-testing. Screen positives and 5% negative women were invited to colposcopy. Absolute and relative sensitivity, specificity, false positive rates (FPR) and number needed to colposcopy to detect one lesion (NNC) were calculated. Estimates were crude and verification bias-adjusted using stratified sampling with bootstrapped confidence intervals.

Results
Of 2,627 screened women, cytology stand-alone demonstrated lowest sensitivities (47%) and highest specificities (97%-99%) while HPV stand-alone demonstrated higher sensitivities (79%-95%) but lower specificities (94%-95%). Co-testing increased sensitivity (84%-99%) but not specificity (92%-95%). Relative sensitivities were similar between crude and adjusted estimates, with greater detection via HPV-based strategies. Specificity of co-testing with LBC relative to HPV stand-alone was near unity (0.99, 95% CI 0.99-1.00) but significantly lower than unity with Pap co-testing. FPR and NNC were greatest under co-testing.

Conclusions
HPV stand-alone screening in women over 30 years appears appropriate over co-testing as a screening strategy.

Key messages
Co-testing for cervical cancer does not appear to add any benefit in detection and may introduce unnecessary harms compared to HPV stand-alone screening.
291Serum albumin levels reversed the impact of higher resting heart rate on cardiovascular mortality
Authors: Liu Yiwei 
Published: September 2021

Abstract

Background
Higher resting heart rate (RHR) has been proved as a risk factor for all-cause and cardiovascular disease (CVD) mortality. However, few studies discussed its synergy with other markers on mortality prediction. Our study focused on whether the impact of RHR on CVD mortality is affected by serum albumin (SA) in Japanese general population.

Methods
We followed 8,307 participants without history of CVD from a Japanese general population. We divided participants according to quartiles of RHR [Q1(&lt;62), Q2(62-68), Q3(69-76), and Q4(&gt;76)], then we used Cox proportional hazard model adjusting for age, gender, BMI, blood glucose, blood pressure, anti-hypertensive treatment, total cholesterol, smoking and alcohol drinking status for estimating CVD mortality. Furthermore, we stratified the participants according to median value of SA (4.4 mg/dL) to conduct subgroup analysis.

Results
During a 29-year follow-up, 1,030 deaths due to CVD were detected. Compared to Q1 group, hazard ratios [95% confidence interval] in each RHR group for CVD mortality was Q2: 0.87 [0.74-1.04], Q3: 1.01 [0.85-1.20], Q4: 0.98 [0.83-1.16]. In lower SA group, Q2: 0.90[0.72-1.13], Q3: 0.99 [0.80-1.25], Q4: 1.27 [1.03-1.58], meanwhile in higher SA group, Q2: 0.83 [0.63-1.09], Q3: 0.99 [0.77-1.29], Q4: 0.65 [0.49-0.85].

Conclusions
Higher RHR was associated with increased risk for CVD mortality in individuals with lower SA, meanwhile the reversed relationship shown in those with higher SA.

Key messages
The impact of RHR on CVD mortality might be influenced by SA in a Japanese general population.
536Patterns of change in lifestyle behaviours following childbirth
Authors: Makama Maureen , Lim Siew , Hill Briony , Skouteris Helen , Teede Helena , Boyle Jacqueline , Hodge Allison , Earnest Arul , Moran Lisa 
Published: September 2021

Abstract

Background
Lifestyle behaviours may worsen following childbirth due to barriers such as time constraints and reduced prioritization of personal health. We therefore aimed to assess the patterns of change in weight and lifestyle behaviours following childbirth in a longitudinal community-based cohort.

Methods
Data from surveys 3 and 5 (ages 25-30 and 31-36 years) of the 1973-8 birth cohort of the Australian Longitudinal Study on Women’s Health were used. We assessed changes in weight, energy intake, diet (diet quality, macronutrients and micronutrients), physical activity and sitting time in parous women compared to those who remained nulliparous by survey 5 using one-way analysis of covariance.

Results
Of 4927 nulliparous women at survey 3, 2503 became parous by survey 5. Over 6 years, parous women had an increase in weight (1 kg; 95%CI 0.50, 1.54), higher energy intake (833.3 kJ/day; 95%CI 706.07, 960.52), better diet quality (1.4 units; 95%CI 0.81, 2.08), lower physical activity (-370.5 METmin/day; 95%CI -427.07, -313.87) and less sitting time (-1.8 hours/day; 95%CI -1.93, -1.60) than nulliparous women on adjusted analyses. On stratification of parity, the improvement in diet quality was only present in primiparous women and sitting time decreased with higher parity.

Conclusion
There is a worsening in weight and some lifestyle behaviours following childbirth in Australian women. While higher parity was associated with further decreases in sitting time, improvements in diet quality were not maintained.

Key message
Women need support to maintain healthy lifestyle behaviours amidst the challenges of caring for children, particularly with increasing family size.
943Impact of maternal factors, pregnancy complications, and birth outcomes on the neonate metabolome
Authors: Mansell Toby , Collier Fiona , Ellul Susan , Burgner David , Saffery Richard ,   Barwon Infant Study Investigator Team
Published: September 2021

Abstract

Background
Metabolic health in early life is critical for healthy development and can have long-lasting ramifications of risk of disease into adulthood. While many exposures during pregnancy are linked to altered fetal development and/or risk of disease in adult offspring, the molecular mechanisms underpinning these associations are poorly characterised. We aimed to describe the association between pregnancy/birth exposures and neonate metabolomics profile.

Methods
Metabolomics in cord blood plasma from 912 neonates in the Barwon Infant Study was quantified using the Nightingale Health NMR platform. Questionnaire and clinical data collected included maternal anthropometry, pregnancy complications, mode of delivery and infant anthropometry at birth. Linear regression models were used to investigate the relationship between these factors and 70 neonate metabolomics measures.

Results
Infant sex, gestational age, birth weight, and exposure to labour during birth were associated with differences across a wide range of metabolites. Exposure to gestational diabetes was associated with increased ketone bodies (acetoacetate and 3-hydroxybutyrate), and this relationship persisted after adjustment for other maternal and pregnancy exposures including maternal BMI. Maternal BMI was modestly associated with increased neonate triglycerides and inflammation.

Conclusions
Birth outcomes show compelling evidence for wide-spread differences in neonate metabolites in cord blood serum, and exposure to gestational diabetes is associated with increased ketone bodies. Further work is required to understand the biological processes underpinning these relationships and to determine if differences in metabolites persist later into childhood.

Key messages
Sex, gestational age, birthweight and exposure to labour are linked to metabolomics differences in cord blood plasma. Gestational diabetes is associated with increased neonate ketone bodies.
765The impact of childhood hearing loss on language and psychosocial outcomes: The LOCHI study
Authors: Marnane Vivienne , Marnane Vivienne , Dillon Harvey , Seeto Mark 
Published: September 2021

Abstract

Background
The Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study is a prospective study commenced in 2005 that was aimed to examine the effect of age of hearing loss identification and intervention on outcomes for children with hearing loss, such as language and psychosocial development. Permanent childhood hearing loss has a significant impact on child development.

Methods
450 children identified with permanent sensorineural hearing loss prior to 3 years of age in New South Wales, Queensland and Victoria completed comprehensive speech, language and audiological assessments at defined age intervals. Multiple regression analysis and structural equation modelling (SEM) were completed to determine factors influencing outcomes at 5 and 9 years of age.

Results
Regression models indicated outcomes were significantly influenced by age of hearing loss intervention, nonverbal cognitive ability, maternal education level and communication mode. A significant predictive effect of early language skill was seen on later language development. SEM found that the impact of age of hearing loss intervention on language outcomes was mediated by its effect on cognitive development and speech perception. Language ability influenced psychosocial development.

Conclusions
Early identification and intervention of hearing loss improves language and psychosocial development, via its influence on cognitive development and speech perception.

Key messages
Early hearing loss identification and intervention improves language and psychosocial development for children with permanent sensorineural hearing loss. Evidence from the LOCHI study has guided clinical management guidelines of children with hearing loss.
1365Does pain self-efficacy influence initial bending following exercise in adults with chronic low back pain?
Authors: McManus Fiona , Pranata Adrian , Simpson Julie A. , Farragher Joshua , Crofts Samuel , Wu Wen , Bryant Adam 
Published: September 2021

Abstract

Background
Differences in pain self-efficacy between individuals with chronic low back pain (CLBP) may partly explain why response to exercise varies. The aim of this study was to determine if pain self-efficacy influences initial forward bending following an exercise intervention in adults with CLBP.

Methods
A total of 69 adults (18-65 years old) with moderate-severe CLBP-related disability who presented to a primary care physiotherapy clinic in Melbourne, Australia underwent baseline assessment of pain self-efficacy, pain intensity and kinesiophobia, prior to participation in one of two 12-week exercise interventions. Two outcome measures (lumbar and hip flexion range of motion (ROM) over the first quarter of forward bending from stance), were assessed at baseline, 6 and 12-weeks. Multiple linear mixed-effects modelling was performed for each outcome measure.

Results
For every 10-point increase in baseline pain self-efficacy, lumbar flexion ROM during initial bending decreased by an estimated mean 0.51 (95% CI: -1.41, 0.39) and 0.94 (95% CI: -1.75, -0.13) degrees at 6 and 12-weeks, respectively. Similarly, hip flexion ROM during initial bending decreased by an estimated mean 1.64 (95% CI: -3.70, 0.41) and 1.43 (95% CI: -3.34, 0.48) degrees at 6 and 12-weeks, respectively, per 10-point increase in baseline pain self-efficacy.

Conclusions
Pain self-efficacy did not influence initial forward bending following a 12-week exercise intervention. As the exercises were not targeted to improve bending, further research is required to verify these findings.

Key message
Pain self-efficacy may not explain variations in initial forward bending following an exercise intervention in adults with CLBP.
113Social gradient in health literacy among primary healthcare users in Cyprus
Authors: Middleton Nicos , Andreou Nicolas , Papastavrou Evridiki , Middleton Nicos 
Published: September 2021

Abstract

Background
From a notion concentrated on the ability to understand health information, health literacy (HL) has become a broad concept, considered a critical determinant of community health. The HLS-EU-measures perceived HL based on a theoretical model of the concept.

Methods
This study explored the metric properties of the tool in a new European setting among a convenience sample of 300 healthcare users in a state General Hospital, including the construct and known-group validity by social position and health-related behaviours.

Results
While factor analysis did not reveal the 12 theoretical subscales, there was a meaningful 3-factor structure (52.1% variance): “access to information”, “prevention and health promotion” and “user-provider interaction”. The postulated four cognitive skills (access, understand, appraise, apply) were evident within each domain (healthcare, prevention, health promotion), and vice versa. Overall, HL was problematic in 50.7% of participants with a steep gradient by social position. Alcohol consumption and physical activity were associated with HL, but not being overweight (mean BMI 26.8, SD: 5.2) or smoking (45.6% current or past smokers), which were generally prevalent.

Conclusions
HLS-EU-Q47 supports at least partly the theoretical construct of HL. The social gradient supports the criterion validity of the tool and highlights an important aspect of health inequality.

Key messages
HLS-EU-Q47 is a valid measure of perceived health literacy
There was a steep gradient in low health literacy by social position