bluuebunny/crossref_metadata_2025_split huggingface dataset:
1431Dietary patterns and diet quality of Portuguese children and adolescents: the UPPER project
Authors: Moraes Milena , Oliveira Bruno , Afonso Cláudia , Santos Cristina , Torres Duarte , Lopes Carla , Miranda Renata , Rauber Fernanda , Antoniazzi Luiza , Levy Renata , Rodrigues Sara 
Published: September 2021

Abstract

Background
Based on a classification that considers the nature, extent and purpose of food processing, this study aims to identify dietary patterns (DPs) and their associations with diet quality.

Methods
Sample from the 2015-2016 National Food, Nutrition and Physical Activity Survey (n = 1153;3-17y). Dietary intake from 2 non-consecutive 24h-recalls. Foods classified by NOVA system into 42 subgroups from 4 groups: unprocessed/minimally processed (G1), processed culinary ingredients (G2), processed (G3) and ultra-processed (UPF) (G4). Percentage of grams related to total daily grams consumed were considered to identify DPs by latent class analysis. Adjusted linear regressions were performed to test association with nutritional indicators.

Results
Subjects followed 3 DPs: “Unhealthy” (51%), “Traditional” (36%), and “Dairy” (13%). Consumption in NOVA groups/subgroups differentiated them: “Unhealthy”, high in G4 and low in G1; “Traditional”, high in G1, G2 and G3, but also some subgroups from G4; and “Dairy”, high in milk, yogurt and milk-based beverages from G1 or G4 and low in most G3 subgroups. Energy from UPF represented 39% in “Unhealthy” and 34-35% in “Traditional” and “Dairy”. Compared to “Traditional” DP, “Unhealthy” was higher in free sugars, and lower in fibre, vitamin A, vitamin C, folates, sodium, potassium, magnesium, and iron. “Dairy” had lower total energy, energy density, fats and sodium, and higher carbohydrates, potassium, calcium, phosphorus and magnesium.

Conclusions
“Unhealthy” had the worst nutrient profile, although all DPs presented significant consumption of UPF. This should be considered in food-based interventions and school-feeding policies.

Key messages
Half of Portuguese &lt;18 years presented an “Unhealthy” DP.
352Postpartum diet quality: A cross-sectional analysis from the Australian longitudinal study on women’s health
Authors: Martin Julie , Joham Anju , Mishra Gita , Hodge Allison , Moran Lisa , Harrison Cheryce 
Published: September 2021

Abstract

Background
Reproductive-aged women are at high risk of developing obesity, and diet quality is a potential modifiable risk factor. There is limited research exploring postpartum diet quality.

Methods
Using data from the Australian Longitudinal Study on women’s Health of women, who reported having previously given birth, we investigated the association between time since childbirth and diet quality, and differences in energy, macronutrients, micronutrient intake, and diet quality assessed by the dietary guideline index (DGI) in women stratified by time from last childbirth, early (≤6 months; n = 558) and late (7–12 months; n = 547), and others (&gt;12 months post childbirth; n = 3434).

Results
From this cohort, 4539 participants completed a food frequency questionnaire and were included in this analysis. Overall, diet quality was higher in early and late postpartum women (mean DGI score 89.8±10.5 and 90.0±10.2, respectively) compared to others (&gt;12 months post childbirth), (85.2±11.7; p &lt; 0.001). Factors positively associated with diet quality included higher education, physical activity, health provider support, and vitamin and/or mineral supplement use. Conversely, increasing time from childbirth (&gt;12 months), smoking compared with non-smoking and medium income level compared with no income was negatively associated with diet quality.

Conclusions
A lower diet quality in women &gt;12 months post childbirth may be reflective of increased pressures, balancing childrearing and return to work responsibilities. This highlights the need to support women beyond the postpartum period to improve modifiable factors associated with weight gain, including diet quality, to optimize health and reduce chronic disease risk.

Key messages
Diet quality; nutrition; obesity; prevention; postpartum; reproductive; women
832Detecting spatial clusters of human salmonellosis in Victoria
Authors: Morgan Hannah , Cutcher Zoe , Firestone Simon , Stevenson Mark , Stylianopoulos Anastasia , Arnold Anna-Lena , Pfeiffer Caitlin 
Published: September 2021

Abstract

Focus of Presentation
‘Cluster Tracker’ is an automated tool for spatial cluster detection of notifiable disease data collected by the Department of Health (DH), Victoria. The tool combines R statistical software and a SaTScan cluster detection algorithm (prospective space-time permutation scan statistic) to detect notifiable disease case clusters in Victoria and is presently implemented for salmonellosis (categorised by type and/or MLVA). The objective of the tool is to conduct an initial screening of case data to improve the prioritisation of salmonellosis cases for epidemiological investigation.

Findings
The Cluster Tracker tool parameters have been validated using historical data from 2017-2018, comparing DH outbreak and cluster investigations identified by usual surveillance activities with clusters detected by the Cluster Tracker tool. Parameter selection considered cluster detection agreement and disagreement, disease-specific epidemiological characteristics, and operational requirements. The Cluster Tracker tool was able to provide closely-aligned agreement with existing DH outbreak and cluster investigations using the validated parameters.

Implications
This automated spatial cluster detection tool complements existing desktop surveillance of salmonellosis notifications to enhance public health decision making, and serves as an example of how spatial methods can improve real-time surveillance.

Key messages
Advanced spatial statistical tools have a role alongside traditional methods to make better use of limited epidemiological capacity and improve the timeliness and prioritisation of surveillance activities for notifiable diseases.
1470Relationship between dietary fibre to carbohydrate ratio and mortality risk in the NHANES
Authors: Morimoto Nobuhisa , Urayama Kevin , Tanaka Akira , Ai Masumi 
Published: September 2021

Abstract

Background
The evidence is inconsistent regarding associations between relative proportions of macronutrient intake and disease risk, potentially due to limitation in accounting for differential effects of simple sugars and dietary fibre, typically grouped as “carbohydrates.”

Methods
We performed an analysis comprising subjects enrolled in the National Health and Nutrition Examination Survey between 1999 and 2004 to examine the association between the ratio of dietary fibre to carbohydrate intake (FC-R) measure and mortality risk. Subjects were followed through 2011. We categorized subjects based on tertile cutpoints of FC-R, and compared their nutrient intake. We performed Cox proportional hazards regression to estimate hazard ratios (HR) with 95% confidence intervals (95% CI), adjusting for demographic, health history, and lifestyle and dietary factors.

Results
Among the 6,761 participants (48% males; mean age 57.0 years), 1339 deaths were observed during follow-up. The high FC-R group had the lowest caloric and carbohydrate intake, but the highest protein intake. Increasing values of FC-R was significantly associated with reduced mortality risk (HR 0.95, 95% CI 0.93, 0.97), while percent calories from carbohydrate showed no association. Compared to the low FC-R group, higher FC-R groups showed a trend towards a reduction in mortality risk after adjusting for potential confounders (high group: HR 0.66, 95% CI 0.57, 0.78).

Conclusions
Our findings support the protective effect of fibre in reducing mortality risk. Mechanisms of the association between FC-R and mortality warrant further investigation.

Key messages
Individuals with higher FC-R diets had lower mortality risk in a large population study.
1344Interbirth interval and maternal anaemia in 21 sub-Saharan African countries: a multinational cross-sectional study
Authors: Mruts Kalayu Brhane , Tessema Gizachew Assefa , Gebremedhin Amanuel Tesfay , Scott Jane , Pereira Gavin 
Published: September 2021

Abstract

Background
Anaemia is a global public health problem, which disproportionately affects women in sub-Saharan Africa (SSA). The causes of anaemia are multifactorial, and a short interbirth interval has been identified as a potentially modifiable risk factor. However, the current evidence for the association between interbirth interval and maternal anaemia remains inconclusive. Hence, this study aimed at examining the association between the interbirth interval and maternal anaemia in SSA.

Methods
We conducted a multinational cross-sectional study of interbirth interval (time between two singleton live births) and maternal anaemia for 21 SSA countries using the most recent nationally representative Demographic and Health Surveys, 2010-2017. Modified Poisson regression models were used to estimate the relative risk (RR) and 95% confidence intervals (CIs) after adjusting for confounding variables.

Results
There were 81,693 women included in the study (89.2% nonpregnant, 10.8% pregnant and 32.2% postpartum). Overall, 36.9% of women had anaemia (36.0% of non-pregnant, 44.3% pregnant, and 38.7% of postpartum women). Compared to a 24-35 months interbirth interval, maternal anaemia was not associated with short (&lt;24 months) interbirth intervals (aRR 1.01, 95% CI; 0. 98, 1.04) or long (≥60 months) interbirth interval (aRR 1.00, 95% CI 0.96, 1. 04).

Conclusions
Our finding revealed insufficient evidence that both short and long birth intervals were associated with the risk of maternal anaemia in SSA.

Key messages
It is unlikely that the high prevalence of maternal anaemia in SSA can be reduced by avoiding short nor long interbirth intervals.
1293Identifying Shared Symptoms and Comorbidities to Inform Risk Reduction Strategies Across Prevalent Neurological disorders
Authors: Nag Nupur , Lin Xin , Jelinek George , Neate Sandra , Levin Michele 
Published: September 2021

Abstract

Background
The global burden of neurological disorders continues to grow. Many have a long disease course and symptoms that can impact daily living and reduce quality of life. Common symptoms are reported across neurological disorders, however, have not been assessed in detail. Assessment of shared symptoms and conditions across neurological disorders may provide insight into similar risk reduction and disease management opportunities.

Methods
Data from an Australian cohort (n = 192,091) were analysed. Log-binomial regression assessed shared symptoms and comorbidities in ten pre-defined categories across people with Alzheimer’s disease (AD), stroke, motor neuron disease (MND), multiple sclerosis (MS), or Parkinson’s disease (PD). Then, to identify sub-categories of symptoms and conditions that were driving the shared associations across disorders.

Results
Positive associations shared across neurological disorders were observed for cancers, digestive system, mental health, kidney and urinary, lung and breathing, and other conditions, categories. Bladder and urinary problems, incontinence, fatigue, muscle weakness, depression, and sleep apnoea, were associated with at least 3 of 5 neurological disorders.

Conclusions
Six overarching symptoms and condition categories were shared across neurological disorders. Bladder and urinary problems, incontinence, fatigue, muscle weakness, depression, and sleep apnoea were associated across most neurological disorders.

Key messages
Shared symptoms and conditions were identified across five neurological disorders. These findings may inform risk prevention and disease management strategies with broad applicability.
683Data envelopment analysis for predicting pre-diabetes for primary disease prevention
Authors: Nakamura Sho , Narimatsu Hiroto 
Published: September 2021

Abstract

Background
Identifying a population at risk of risks is imperative for primary disease prevention and allows the promotion of health maintenance in a healthy population. Previous studies on hypertension and dyslipidemia using data envelopment analysis (DEA) showed that populations at risk of risks could be identified using this method. In this study, we extended DEA to include pre-diabetes.

Methods
A retrospective cohort study was conducted using specific health check-up data from 2008 to 2013. DEA efficiency scores were calculated for healthy subjects with baseline glycated hemoglobin (HbA1c) &lt;5.7%. Odds ratios (ORs) for pre-diabetes onset within 3 years were analyzed.

Results
Among 1,501 subjects, with 373 cases of disease onset (24.9%), the OR for the incidence of pre-diabetes (on the basis of a 0.1-point increase in the efficiency score) was 0.77 (90% confidence interval [CI] 0.68–0.86, p &lt; 0.0002). After adjusting for age and sex, the OR was 0.66 (90% CI 0.58–0.75, p &lt; 0.0001). Furthermore, for the subgroup with no conventional diabetes risk factors, the adjusted OR was 0.50 (90% CI 0.38–0.67, p = 0.0001).

Conclusions
We showed that the DEA efficiency score can help identify a pre-diabetes population at risk of risks. Further studies to validate these findings would be worthwhile for optimizing primary preventative measures.

Key messages
DEA was assessed for its ability to evaluate the risk of pre-diabetes. Results showed that an efficiency score could predict pre-diabetes onset and demonstrated the feasibility of applying this analysis in primary preventive healthcare.
1486Preference for person-centered care model, perceptions of family physicians and patients of East Mediterranean Region
Authors: Nanji Kashmira , Qidwai Waris , Khoja Tawfik A M , Rawaf Salman 
Published: September 2021

Abstract

Background
Person-centered care is one of the vital components of a health care system and signifies the concept of health promotion and disease prevention. This study aimed to identify the perceptions of patients and physicians regarding person-centered care in the Eastern Mediterranean Region (EMR).

Methods
A cross-sectional study was conducted in six countries of EMR during June 2019 to August 2019. In first phase, 190 family physicians (FPs) practicing for atleast six months were recruited. In the next phase, the recruited FPs then approached their patients aged more than 18 years. Multinomial regression analysis was conducted using SPSS version 20.

Results
Of a total of 300 patients, 25% were aged 40 years or above and the majority 56% were females. Among physicians, 62.8% were between 25 to 35 years and 88% had a postgraduate training in Family Medicine. Thirty six percent of patients and 62.6% of physicians, preferred a person-centered care model of care. Among physicians, field of specialization (ORadj= 0.7; 95% C.I: 0.3-0.9) and regularity in continuing medical education sessions (ORadj= 0.3; 95% C.I: 0.1-0.5) while, among patients, educational status was significantly associated with preference for person-centered care model.

Conclusions
The transition towards person centered care model has already started and most care providers endorse it. However, there is a need to apply this approach consistently, keeping the cultural aspects in mind.

Key messages
There is a need for intensive research on the development of integrated primary care models to improve access to person-centered care.
237Spatial distribution and correlates of HIV prevalence in South Africa
Authors: Ncayiyana Jabulani , Bell Griffin , Solomon Ari , Emch Micheal 
Published: September 2021

Abstract

Background
South Africa has a high HIV prevalence and generalized HIV epidemic. It is now well established that the HIV epidemic and its drivers are highly heterogeneous, even in generalized HIV epidemic settings.

Methods
This study uses data from South African HIV/AIDS, Behavioural Risks, Sero-status, and Mass Media Impact (SABSSM), 2005, 2008 and 2012 surveys. To identify spatial clusters, we used the spatial scan statistic method in SaTScan, assuming discrete Poisson distributions. Poisson regression models were used to explore the municipality-level correlates of HIV prevalence and a logistic regression model was used to determine individual-level correlates of HIV infection.

Results
Between 2005 and 2012, There was significant geographical variation in estimated HIV prevalence (range = &lt;1.0%–27.5%). Eight, five and six significant overlapping high-risk spatial clusters of high HIV prevalence were detected in 2005, 2008 and 2012, respectively. HIV prevalence is clustered in the central and north-eastern regions of South Africa. Living in municipalities with high percentage of black South Africans, higher poverty index, higher population aged 25-49, and higher early sexual debut were associated with HIV prevalence, while living in municipalities with higher percentage male circumcision and a high percentage married were associated with low risk of HIV. Logistic regression revealed race, sex and mobility as correlates of HIV infection.

Conclusions
HIV prevalence is highly spatially heterogenous and affected by various municipal-level factors.

Key messages
Identification of the spatial clusters of HIV prevalence and contextual factors should inform targeted interventions that are necessary to bringing HIV infections under control.
89Factors associated with pneumococcal nasopharyngeal carriage: a systematic review
Authors: Neal Eleanor , Chan Jocelyn , Russell Fiona M. , Nguyen Cattram. D 
Published: September 2021

Abstract

Background
Pneumococcal disease is a major contributor to global childhood morbidity and mortality. Pneumococcal carriage is a prerequisite for pneumococcal disease. Identifying factors associated with pneumococcal carriage can aid public health intervention programs. It is unknown if risk factors for pneumococcal carriage differ between low, middle, and high-income countries. We present preliminary findings of our systematic review of factors associated with pneumococcal carriage in community settings, in all ages.

Methods
A systematic search for pneumococcal nasopharyngeal carriage studies, published in English before July 2019. Two researchers independently reviewed studies that described factors associated with pneumococcal nasopharyngeal carriage. Study quality was assessed using the NIH Study Quality Assessment Tools. Results are presented as narrative summaries due to heterogeneity amongst factor definitions.

Results
Preliminary results are shown. Sixty-seven studies were included. 49% were conducted in high-income countries. Pneumococcal prevalence ranged from 0.3%-97%, 2.6%-89.6%, 14%-73%, 1.6%-82.4% in low-, lower-middle, upper-middle, and high-income classifications. Age, respiratory tract infection symptoms, living with young children, poverty, exposure to smoke, and season were positively associated with pneumococcal carriage in all income classifications.

Conclusions
Pneumococcal carriage prevalence was highest in low-income classifications. Pneumococcal carriage is associated with similar factors across income classifications. Differences in prevalence of risk factors associated with pneumococcal carriage by income classification may contribute to differences in carriage prevalence by income classifications.

Key messages
Pneumococcal carriage is considered a prerequisite for pneumococcal disease. Pneumococcal carriage prevalence is highest in low-income countries, however preliminary results suggest risk factors for carriage may be similar across income classifications.
90Factors associated with pneumococcal carriage in children and adults in Fiji, using four cross-sectional surveys
Authors: Neal Eleanor , Nguyen Cattram , Ratu Felista Tupou , Dunne Eileen , Kama Mike , Ortika Belinda , Boelsen Laura , Kado Joseph , Tikoduadua Lisi , Devi Rachel , Tuivaga Evelyn , Reyburn Rita , Catherine Satzke A. , Rafai Eric , Kim Mulholland E. , Russell Fiona 
Published: September 2021

Abstract

Background
Pneumococcal disease is preceded by carriage of pneumococci. We describe factors associated with pneumococcal nasopharyngeal carriage in Fiji, using data from annual (2012-2015) cross-sectional surveys, pre- and post-introduction of ten-valent pneumococcal conjugate vaccine (PCV10).

Methods
Infants (5-8 weeks), toddlers (12-23 months), children (2-6 years), and their caregivers participated. Pneumococci were detected using lytA qPCR, with molecular serotyping by microarray. We used logistic regression to determine predictors of carriage and density.

Results
There were 8,109 participants. Pneumococcal carriage was associated with: years post-PCV10 introduction (global P&lt;0.001), iTaukei ethnicity (aOR 2.74 [95% CI 2.17-3.45] P&lt;0.001); young age (global P&lt;0.001); urban residence (aOR 1.45 [95% CI 1.30-2.57] P&lt;0.001); living with &gt;2 children &lt;5 years (aOR 1.42 [95% CI 1.27-1.59] P&lt;0.001); poverty (aOR 1.44 [95% CI 1.28-1.62] P&lt;0.001); and upper respiratory tract infection (URTI) symptoms (aOR 1.77 [95% CI 1.57-2.01] P&lt;0.001). Factors associated with PCV10 and non-PCV10 carriage were similar to those associated with overall carriage. Additionally, PCV10 carriage was associated with PCV10 vaccination (0.58 [95% CI 0.41-0.82] P=0.002) and cigarette smoke exposure (aOR 1.21 [95% CI 1.02-1.43] P=0.031. Non-PCV10 carriage was not associated with years post-PCV10 introduction.

Conclusions
Introduction of PCV10 reduced the odds of overall and PCV10 pneumococcal carriage in Fiji. ITaukei ethnicity was positively associated with carriage after adjustment for PCV10.

Key messages
PCV10 introduction was associated with reduced odds of overall and PCV10 pneumococcal carriage in Fiji. Despite high and similar PCV10 coverage rates, iTaukei ethnicity is positively associated with pneumococcal carriage, compared with Fijian of Indian Descent populations.
1193Developing a Multifactorial Prognostic Index in Relapsing Onset Multiple Sclerosis and Clinically Isolated Syndrome
Authors: Ngwa Valery Fuh 
Published: September 2021

Abstract

Background
Disease course in multiple sclerosis (MS) is characterised by relapses and worsening of disability. This study aims to create, from available clinical, genetic, and environmental factors; a multifactorial prognostic index (MPI) to predict disease course in MS.

Methods
We analysed prospectively assessed MS cases (N = 253) with 2858 repeated measurements over 10-years. Of the 253 cases, N = 219 were diagnosed as relapsing-onset, while N = 34 remained as clinically isolated syndrome by the 10th-year review. Cox regression models with Least Absolute Shrinkage and Selection Operator were used to select potential genetic, clinical, and environmental factors that are predictive of relapses and/or worsening of disability. Multivariate Cox regression models with leave-one-out cross-validation were used to construct a MPI, from which robust dynamic predictions were obtained by landmarking. The predictive performance at diagnosis was evaluated using the Kullback-Leibler and Brier prediction error curves.

Results
The MPI predicted a quadratic time-dynamic disease course in terms of relapses (HR = 2.16, CI: 1.74-2.68; C-index=0.85) and worsening of disability (HR = 2.74, CI: 2.00-3.76; C-index=0.76). The Kullback-Leibler and Brier dynamic prediction error curves showed reasonable performance for both short- (≤5-years from diagnosis) and long-term (&gt;5-years from diagnosis) prognostications, respectively.

Conclusions
The MPI provided reliable information that is relevant for long-term prognostication and may be used as a selection criterion or risk stratification tool for clinical trials.

Key messages
Using relevant clinical, environmental, and genotype data, we have created a MPI for people living with MS and clinically isolated syndrome.