bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mesenchymal Stem Cell Injection in Crohn’s Disease Strictures: A Phase I–II Clinical Study
Authors: Vieujean Sophie , Loly Jean-Philippe , Boutaffala Layla , Meunier Paul , Reenaers Catherine , Briquet Alexandra , Lechanteur Chantal , Baudoux Etienne , Beguin Yves , Louis Edouard 
Published: September 2021

Abstract

Background and Aim
Mesenchymal stem cells [MSCs] have anti-inflammatory and anti-fibrotic properties and could be a potential therapy for Crohn’s disease [CD] strictures. In this phase I–II pilot trial, we assessed safety and efficacy of local MSC injection to treat CD strictures.

Methods
CD patients with a short [less than 5 cm in length] non-passable stricture accessible by ileocolonoscopy were included. Allogenic bone-marrow derived MSCs were injected in the four quadrants of the stricture. Adverse events and clinical scores were evaluated at each follow-up visit and endoscopy and magnetic resonance enterography were performed at baseline, Week [W]12 and W48. The main judgement criterion for efficacy was the complete [defined by the ability to pass the ileocolonoscope] or partial [defined by a diameter increase] resolution of the stricture at W12. Second efficacy criteria included assessment of the stricture at W48 and evolution of clinical scores at W12 and W48.

Results
We performed 11 MSC injections in 10 CD patients [three primary and seven anastomotic strictures; one stricture injected twice]. MSC injections were well tolerated but four hospitalisations for occlusion were reported. At W12, five patients presented a complete or partial resolution of the stricture [two complete and three partial]. Seven patients were re-evaluated at W48 [one dilated, one operated, and one lost to follow-up] and four patients had a complete resolution. The evolution of clinical scores between W0, W12, and W48 was not statistically significant.

Conclusions
MSCs injection in CD stricture was well tolerated and may offer a benefit.
Mild Cognitive Impairment and Donepezil Impact Mitochondrial Respiratory Capacity in Skeletal Muscle
Authors: Morris Jill K , McCoin Colin S , Fuller Kelly N , John Casey S , Wilkins Heather M , Green Zachary D , Wang Xiaowan , Sharma Palash , Burns Jeffrey M , Vidoni Eric D , Mahnken Jonathan D , Shankar Kartik , Swerdlow Russell H , Thyfault John P 
Published: September 2021

Abstract
Alzheimer's Disease (ad) associates with insulin resistance and low aerobic capacity, suggestive of impaired skeletal muscle mitochondrial function. However, this has not been directly measured in AD. This study ( n = 50) compared muscle mitochondrial respiratory function and gene expression profiling in cognitively healthy older adults (CH; n = 24) to 26 individuals in the earliest phase of ad-related cognitive decline, mild cognitive impairment (MCI; n = 11) or MCI taking the ad medication donepezil (MCI + med; n = 15). Mitochondrial respiratory kinetics were measured in permeabilized muscle fibers from muscle biopsies of the vastus lateralis. Untreated MCI exhibited lower lipid-stimulated skeletal muscle mitochondrial respiration (State 3, ADP-stimulated) than both CH ( P = .043) and MCI + med (P = .007) groups. MCI also exhibited poorer mitochondrial coupling control compared to CH (P = .014). RNA sequencing of skeletal muscle revealed unique differences in mitochondrial function and metabolism genes based on both MCI status (CH vs MCI) and medication treatment (MCI vs MCI + med). MCI + med modified over 600 skeletal muscle genes compared to MCI suggesting donepezil powerfully impacts the transcriptional profile of muscle. Overall, skeletal muscle mitochondrial respiration is altered in untreated MCI but normalized in donepezil-treated MCI participants while leak control is impaired regardless of medication status. These results provide evidence that mitochondrial changes occur in the early stages of AD, but are influenced by a common ad medicine. Further study of mitochondrial bioenergetics and the influence of transcriptional regulation in early ad is warranted.
1443A causal mediation analysis of the effect of disability on mental health mediated by employment
Authors: Aitken Zoe , Simpson Julie , Bentley Rebecca , Kavanagh Anne 
Published: September 2021

Abstract

Background
There is evidence that disability acquisition causes a decline in mental health, but few studies have examined the causal mechanisms through which the effect operates. This study used a novel approach to mediation analysis to quantify interventional indirect effects through employment and income.

Methods
We used four waves of longitudinal data to compare self-reported mental health between working aged individuals who acquired a disability (n = 233) and those who remained disability-free (n = 5419). We conducted a causal mediation analysis quantifying interventional indirect effects of disability acquisition on mental health operating through two distinct mediators: employment status and income. We used multiple imputation with 50 imputed datasets to account for missing data.

Results
The total causal effect of disability acquisition on mental health was estimated to be a 4.8-point decline in mental health score (estimated mean difference: -4.8, 95% CI -7.0, -2.7). The interventional indirect effect through employment was estimated to be a 0.5-point difference (-0.5, 95% CI -1.0, 0.0), accounting for 10.6% of the total effect, whereas there was no evidence that income explained any of the effect.

Conclusion
This study estimated that disability-related mental health inequalities could be reduced by 10.6% if employment rates were the same for people with disabilities as those without. The results highlight the need to implement measures to enable people with disabilities to remain in employment and improve employment and vocational training opportunities for people who acquire a disability.
1321Marginal structural model of the causal role of hepatitis B vaccination in multiple sclerosis risk
Authors: Akhtar Saeed , El-Muzaini Hadeel , Alroughani Raed 
Published: September 2021

Abstract

Background
There are conflicting reports regarding the association between uptake of recombinant vaccine against hepatitis B virus (HBV) and risk of multiple sclerosis (MS). Most cohort or case-control studies found no significant short- or long-term increase in MS risk after immunization. Whereas others reported a significant increase in MS risk within three years of HBV vaccination. The present matched case-control study was conducted to test the hypothesis whether recombinant HBV vaccination status is causally associated with MS risk using targeted maximum likelihood estimation (TMLE) that uses data-adaptive flexible machine learning algorithms to estimate the causal parameters.

Methods
Confirmed 110 MS incident cases and age (± 5 years), gender and nationality matched (1:1) 110 community controls were enrolled. A pre-tested structured questionnaire was used to collect the data on demographics, environmental factors, comorbidities, history of vaccinations through face-to-face interviews both from cases and controls. We implemented case-control-weighted TMLE – a double robust, multistep procedure to estimate causal relative risk (RR), marginal odds ratio (OR) and population attributable fraction.

Results
This study demonstrated a non-specific protective effect of HBV vaccine against MS risk as estimated by TMLE (causal RR 0.63, 95% CI: 0.45-0.90; p = 0.004; marginal OR 0.43; 95% CI: 0.18-0.67; p = 0.006). The population attributable fraction was 20% (95% CI: 6%, 34%; p = 0.014))

Conclusions
Subject to inherent limitations of the case-control design, this study suggests a non-specific protective effect of recombinant HBV vaccination against MS risk. Future studies may contemplate to confirm these results.

Key message
Causal analysis showed a non-specific protective causal association between uptake of recombinant HBV vaccine and MS risk in the study population.
1250Grass pollen exposure and children’s asthma repeat admissions in Victoria, Australia
Authors: Batra Mehak , Newbigin Ed , Dharmage Shyamali C , Abramson Michael J , Erbas Bircan , Vicendese Don 
Published: September 2021

Abstract

Background
Paediatric asthma-related readmissions significantly challenge public health systems. As evidence suggests readmissions are possibly associated with ambient grass pollen levels, we sought to determine the relationship between grass pollen exposure and the risk of readmission for asthma among children in Victoria, Australia.

Methods
The Victorian Admitted Episodes Dataset 1st July 1997–30th June 2009 was used to identify primary admissions with a principal diagnosis of asthma for children aged 2-18 years. Total sample size was 48,068 admissions. Readmissions were defined as a subsequent admission within 28 days of index discharge. Multiple semi-parametric Poisson Generalized Additive Models were used to assess associations between the grass pollen season and daily grass pollen counts (lagged and cumulative) with repeat admissions, while controlling for meteorological factors and air pollutants.

Results
Readmissions totalled to 2,152 (4.47% of all admissions). Mean daily readmissions were 1.44 times higher during the grass pollen season (95%CI 1.03-2.02). Pollen season was associated with readmission only for the youngest age group (2-5), incident rate ratio 1.99 (95%CI 1.26-3.14). Daily readmission was non-linearly associated with same day pollen counts only for the 13-18-year age group. Lag 2 pollen counts were non-linearly associated with all daily readmissions for boys in gender-stratified and younger age groups (2-5, 6-12) in age-stratified analysis.

Conclusions
Grass pollen exposure was associated with higher readmission rates for paediatric asthma.

Key messages
Younger children and boys with severe or poorly controlled asthma need to be assessed for preventive therapies before the grass pollen season to reduce the repeat admissions.
577Inequalities in access to in vitro fertilisation treatment in France
Authors: Messaoud Khaoula Ben ,   Inequalities In Access To In Vitro Fertilisation Treatment In France Jean Bouyer,   Inequalities In Access To In Vitro Fertilisation Treatment In France Elise de La Rochebrochard
Published: September 2021

Abstract

Background
In vitro fertilisation (IVF) treatment is one of the most expensive infertility treatments. Cost has been described as a substantial barrier to access. In France all infertility treatments, including IVF, are fully reimbursed, but are there other barriers to access?

Methods
Based on the French national health insurance database that exhaustively records reimbursed healthcare, this cohort study included all women aged 18–49 years unsuccessfully treated with ovarian induction (first-line infertility treatment) between January–August 2016. Outcome was IVF access within 24 months of starting first-line treatment. Univariate and multivariate regressions explored age, disadvantaged social status, driving time to nearest IVF centre, and deprivation index of area of residence.

Results
Over 20,000 women unsuccessfully received first-line treatment. Almost 80% did not access IVF within 24 months.
After age 34, probability of access decreased. Disadvantaged social status and living in a disadvantaged area were associated with lower probability of accessing IVF. Driving time to the nearest IVF centre was not significantly associated with access.

Conclusions
Socio-economic barriers to access IVF exist despite full treatment reimbursement in France. To reduce health inequalities, we need to better understand the nature and patterns of these barriers among less socially advantaged people.

Key messages
After failure of first-line infertility treatment, only 20% of women access IVF although it is fully reimbursed in France.
Age, but most importantly socio-economic status, is a key determinant of access to IVF treatment.
Distance from nearest IVF centre does not appear significant in explaining access to treatment in France.
984A novel cost diary approach to analyse the financial burden of living with arthritis
Authors: Berkovic Danielle , Ayton Darshini , Briggs Andrew , Ackerman Ilana 
Published: September 2021

Abstract

Focus of Presentation
Amongst Australia’s working-age population with arthritis, financial distress is known to be high and contribute to poorer health outcomes. Yet the personal financial burden of living with arthritis is not well understood. Here we present initial findings from one of the first projects to measure personal financial distress as a determinant of health for individuals living with arthritis.

Findings
Participants aged 18-50 years detailed their arthritis-attributable out-of-pocket costs in an online consumer-informed cost diary; once a week, for six weeks, alongside a work productivity and financial distress scale. Costs were grouped into seven categories, including: direct medical appointments, allied health appointments, other health appointments, medications or supplements, symptom/pain management items, medical tests, and other expenses. Costs per individual per week ranged from $40.30 (AUD) to $25,789 (AUD). High costs were not linked to quality of care, demonstrated by one participant spending $495.00 (AUD) on chiropractic appointments across the six weeks. High levels of financial distress were associated with reduced work productivity, but were not associated with level of weekly expenditure.

Conclusions/Implications
Adults with arthritis experience financial hardship associated with their disease. Discussion of arthritis-related financial concerns should form part of shared clinical decision-making and education, to facilitate prioritisation of care that is evidence-based and feasible.

Key messages
These findings can be used to raise awareness of key fiscal issues relevant to adults with arthritis, and to educate clinicians about the wide-ranging impacts of arthritis beyond physical symptoms.
629Influenza-like illness surveillance in Australia: comparison of general practice data with laboratory-confirmed influenza notifications
Authors: Bernardo Carla , Gonzalez David , Stocks Nigel 
Published: September 2021

Abstract

Background
Influenza is a respiratory infection responsible for 645,000 annual deaths worldwide. Surveillance systems provide valuable data for monitoring influenza in order to detect outbreaks and guide public health responses. This study aimed to investigate the epidemiology of influenza-like illness (ILI) using two Australian general practice databases (MedicineInsight and the Australian Sentinel Practice Research Network (ASPREN)) and compare them with laboratory-confirmed influenza from the National Notifiable Diseases Surveillance System (NNDSS).

Methods
All patients who had a consultation in MedicineInsight general practices or ASPREN and all laboratory-confirmed influenza reported by the NNDSS between 2015-2017 were included. Weekly ILI rates per 1,000 consultations (MedicineInsight/ASPREN) were compared with influenza notifications (NNDSS).

Results
Data was consistent among sources, with higher cases in 2017, among women and patients aged 20-49 years. The peak rate in MedicineInsight almost doubled in 2017 compared to 2015, while in ASPREN it was less pronounced. MedicineInsight ILI curves more closely resembled NNDSS patterns (shape, the start of the season, peaks) than ASPREN, although both were highly correlated with NNDSS (r = 0.90 to 0.97 and r = 0.88 to 0.98, respectively).

Conclusions
MedicineInsight and ASPREN provided consistent ILI results, both resembling confirmed influenza epidemic curves, suggesting the potential use of routinely collected electronic medical records (MedicineInsight) in influenza surveillance. MedicineInsight provides comprehensive medical data, such as underlying conditions, medications prescribed and vaccination status, which could be used to improve accuracy on influenza detection.

Key messages
Electronic medical records could be used to monitor ILI in combination with ASPREN for effective early detection of outbreaks.
1214Coverage of maternal and child health in slums, rural and urban areas from 42 countries
Authors: Blumenberg Cauane , Costa Janaína Calu , Barros Aluisio J.D. , Victora Cesar G 
Published: September 2021

Abstract

Background
Rural populations are traditionally considered to have the lowest coverage on health interventions, but little is known about urban slums. Our aim was to analyse inequalities on the composite coverage index (CCI) – a weighted average of eight interventions on reproductive health, antenatal and delivery care, immunization and management of illnesses – according to place of residence in low- and middle-income countries.

Methods
We analysed the most recent Demographic and Health Surveys (2006-2018) from 42 countries. We estimated the CCI coverage according to the classification of the clusters women and children were living in (urban non-slums; urban slums; or rural areas). Slums were defined as clusters where at least 75% of the households did not have at least two of the following characteristics: access to improved water, access to basic sanitation, solid floor material, and sufficient rooms for sleeping.

Results
The CCI coverage ranged from 24% to 86% (median 63%), being higher in urban non-slums for all 42 countries. In 14 countries, the lowest CCI coverage was found in slums. The main drivers of the lowest estimates in slums were the coverage of care seeking for pneumonia, family planning, measles and DPT immunization, which were respectively 51%, 25%, 19%, and 15% lower in slums compared to rural areas.

Conclusions
It is important that public policies are designed in order to prioritise the urban poor populations, aiming to achieve an equitable coverage of essential health interventions.

Key messages
We studied a novel inequality dimension using national standardised surveys, expanding the assessment of the health situation according to the place of residence beyond a dichotomous approach (urban/rural). Investigating maternal and child health conditions in urban slums – a group that is often marginalised in urban areas – is very important to support the design of public policies that focus on those most in need.
1152Use of Facebook to recruit cohort study participants
Authors: Bruinsma Fiona , Lynch Brigid , Southey Melissa , Giles Graham , Milne Roger 
Published: September 2021

Abstract

Background
Social media is a relatively new means to recruit research participants.

Methods
The Australian Breakthrough Cancer (ABC) Study is a prospective cohort study that recruited people aged 40-74 years over 2014-2018. A range of recruitment methods, including ‘traditional’ (e.g. print media, electoral roll, word of mouth) and newer methods (i.e. social media, particularly Facebook) were used. Here we describe and compare these methods of recruitment.

Results
52,614 (66%) of ABC Study registrants indicated they had heard about the study via Facebook (36,672 clicked through from an advertisement for the study and 15,942 through users ‘sharing’ content). Overall, 51,586 (64%) participants (58% female, 42% male) completed baseline study components (online questionnaires and provided a DNA sample). 58% of Facebook registrants completed baseline components, compared with 75% of those recruited by traditional methods. The cost per acquisition using Facebook was $1.66 whereas the cost per acquisition using traditional methods (e.g. via the electoral roll) was up to $30. Facebook recruitment initially attracted more female registrants but targeted advertising dramatically increased the proportion of men.

Conclusions
Targeted advertising can be used to modify the types of respondents obtained via Facebook. Although the proportion completing baseline study components was lower than for traditional methods of recruitment, the cost per acquisition was cheaper making it feasible to recruit a larger number of participants to obtain the desired study size.

Key messages
Facebook is a viable and economical source of recruits to large prospective research studies.
184Are genetic risk factors clinically useful in prognostic models for type 2 diabetes mellitus?
Authors: Buss Vera Helen , Barr Margo , Varnfield Marlien , Harris Mark 
Published: September 2021

Abstract

Background
Many prognostic models exist for the prediction of type 2 diabetes mellitus. Some of these include genetic risk factors. The objective of this review was to investigate whether including genetic variables in prediction models for type 2 diabetes mellitus is clinically useful.

Methods
Studies were included if they reported on prognostic prediction models for type 2 diabetes mellitus. Seven medical and bioengineering databases were searched using terms regarding risk prediction and diabetes combined via Boolean operators. In studies including genetic variables, the c-statistics of genetic and non-genetic models were compared.

Results
Seventy-six studies published between 2002 and 2019 were included in the review. Twenty of these (published 2008 to 2019) included genetic variables, namely deleterious alleles and specific small nuclear polymorphisms. Study samples represented the general population. When comparing genetic to non-genetic models, one study reported a statistically significantly greater c-statistic for the genetic and four for the non-genetic models. Adding genetic risk factors to a clinical model did not substantially increase the predictive accuracy of any study.

Conclusions
The use of genetic data did not show any meaningful improvements in the predictive performance for the general population compared to clinical models. Studies using genetic data were often based on small sample sizes and not externally validated, raising concerns regarding potential overfitting and lack of generalisability.

Key messages
Currently, the clinical usefulness of genetic risk scores for type 2 diabetes mellitus seems quite limited.
844Considering child maltreatment in social inequalities of educational achievement: a whole-of-population data linkage study
Authors: Chittleborough Catherine , Schuch Helena , Pilkington Rhiannon , Montgomerie Alicia , Grant Janet , Petersen Julie , Lynch John 
Published: September 2021

Abstract

Background
Strategies aimed at reducing health inequalities include a focus on improving education, a key determinant of health and labour market outcomes. Studies have demonstrated that both early life socioeconomic disadvantage and child maltreatment result in poorer educational outcomes, but have not examined the effect of the combination of these adversities.

Methods
This study used de-identified, linked government administrative data from the South Australian Early Childhood Data Project on children born in South Australia who completed Year 5 National Assessment Program—Literacy and Numeracy (NAPLAN) during 2008-2015 (n = 61,445), and their corresponding birth, perinatal, school enrolment and child protection system data.

Results
Overall, 23.7% (95% CI 23.4-24.1) had a poor NAPLAN outcome (at or below national minimum standard on three or more of the five domains - reading, writing, spelling, grammar and punctuation, numeracy). This proportion was approximately double for children who experienced substantiated maltreatment compared to children who did not experience contact with the child protection system, irrespective of the social circumstances (parental education, employment, housing and area-level disadvantage) in which the child lived.

Conclusions
Social advantage is not sufficient to protect children from poor educational outcomes if they experience substantiated maltreatment. Interventions and services will need to focus on child maltreatment, in addition to socioeconomic factors, to improve educational outcomes in the population.

Key messages
Within each social group, from advantaged to disadvantaged children, the risk of poor NAPLAN outcomes was greater for children who had contact with the child protection system.