bluuebunny/crossref_metadata_2025_split huggingface dataset:
1091Evaluation of symptom screening methods for tuberculosis: secondary analysis of Mongolian nationwide tuberculosis prevalence survey
Authors: Ichimura Yasunori , Purev Bayasgalan , Boldoo Tsolmon , Dambaa Naranzul , Sovd Tugsdelger 
Published: September 2021

Abstract

Background
Symptom screening for tuberculosis (TB) is a key component for identifying TB suspects and TB cases, particularly in resource-limited countries. This study aimed to evaluate the effectiveness of symptom screening using TB-related symptoms including the standard symptom screening criterion of chronic cough: cough for two weeks or more, to identify TB cases in the general population.

Methods
This study is a secondary analysis of the nationwide population-based, cross-sectional survey for TB prevalence in Mongolia in 2014-2015. Each TB-related symptom was compared between bacteriologically confirmed TB cases and bacteriologically negative participants.

Results
Of the 50,309 adults who received symptom screening, 248 were diagnosed as bacteriologically confirmed TB cases. The sensitivity and specificity of standard symptom screening of cough for two weeks or more were 20.6% and 95.3%, respectively. The higher sensitivity and lower specificity were reported in chronic sputum: sputum for two weeks or more (22.2% and 93.6%, respectively), in prolonged fever: fever for four days or more (21.4% and 95.0%, respectively), in weight loss (36.3% and 89.3%, respectively), in combination with standard symptom screening. TB cases had more chronic cough (OR 2.78, 95% CI: 1.83-4.22), chronic sputum (OR 1.67, 95% CI: 1.06-2.65), prolonged fever (OR 3.46, 95% CI: 1.90-6.28) and “weight loss” (OR 3.73, 95% CI: 2.77-5.02).

Conclusions
The addition of TB-related symptoms, namely, chronic sputum, fever and weight loss to the standard symptom screening criterion, may facilitate the detection of more TB cases efficiently.

Key messages
The utility of TB-related symptom screening may improve detection of TB cases.
572Randomized Controlled Trial Investigating the Effect of an Educational Intervention on Paternal Postpartum Depression Risk
Authors: Ichinose Yuichi , Urayama Kevin , Okamura Makoto , Sugiura Naomi , Suto Maiko , Sasaki Hatoko , Takehara Kenji 
Published: September 2021

Abstract

Background
Postpartum paternal depression (PPPD) is under-acknowledged worldwide compared to maternal depression, despite PPPD prevalence being reported to be just as high. Although PPPD has clear health consequences, even on other family members, preventive methods have been under-studied. We investigated the association between an educational intervention and risk of PPPD.

Methods
We performed a parallel-group, randomized controlled trial in an obstetrics clinic in Japan that included expecting fathers and their pregnant partners at 28-32 weeks gestation. The intervention comprised an educational booklet created for fathers that was distributed during pregnancy. For the primary outcome, Edinburg Postnatal Depression Scale (EPDS) was administered at one and three months post-delivery, and EPDS of 8 or greater was considered at risk for depression.

Results
In total, the intervention and control groups comprised 286 and 282 couples, respectively. At follow-up, depressive symptoms were observed in 7.2% of fathers in the intervention group and 9.8% in the control group (odds ratio [OR] = 0.71, 95% confidence interval [CI] = 0.36-1.36). Logistic regression in an adjusted analysis showed a reduced, but non-significant risk of PPPD (odds ratio=0.61, 95% confidence interval=0.31-1.20).

Conclusions
In the first PPPD intervention study of its kind in Japan, our study suggests that distributing the educational booklet to fathers may be helpful in general, but may not be enough to significantly influence the risk of a major condition like PPPD.

Key messages
A more personalized preventive approach beyond the simple administration of a booklet may be necessary to significantly impact PPPD occurrences.
1042Trends in area-level socioeconomic inequalities of lung cancer mortality by age group in Japan: 1995-2014
Authors: Ito Yuri , Fukui Keisuke , Kondo Naoki , Katanoda Kota , Nakaya Tomoki , Sobue Tomotaka 
Published: September 2021

Abstract

Background
During the long-term economic recession, health inequalities have been concerned in Japan. Among cancer mortality rates, the widest socioeconomic inequalities of municipal mortality was observed in lung cancer. Our aim was to examine the trends in the inequality by sex and age group.

Methods
We used the areal deprivation index (ADI) to determine area-level socio-economic position at the municipality level. We calculated age-standardised lung cancer mortality rate by sex, age group (&lt;60/60-74/75+) and ADI quintile group using the vital statistics data. Joinpoint regression models were applied to estimate the average annual percentage changes for the last five years. We also calculated absolute index and relative index of inequalities.

Results
Among men, a clear socioeconomic gradient in lung cancer mortality was observed for all age groups, but among women, ‘J-shape’ gradients in which Q2 or Q3 had the lowest mortality were observed. For women aged 60-74 years, increasing trends of mortality were observed in more deprived groups (Q3-Q5). Men over 75 years showed noticeably decreasing trends in mortality, while women showed no decrease. Absolute inequalities in women were smaller than those in men, but relative inequalities showed widening trends for all age groups.

Conclusions
We identified widening area-level gaps in all age groups and stable/increasing trends in lung cancer mortality of the 60-74 year age group.

Key messages
It is important to monitor mortality trends and their gaps of lung cancer mortality among deprivation groups to identify vulnerable subpopulations in order to help tackle the health inequalities.
1464Application of Webinars for popularizing Occupational Health Epidemiology during the Covid-19 Pandemic in India
Authors: Jain Rajiv Kumar 
Published: September 2021

Abstract

Focus of Presentation
The process and results of popularizing Occupational Health Epidemiology amongst Occupational Health practitioners in India during the covid-19 Pandemic in India through Webinars

Findings
The 25 webinars of average duration of 90 minutes, with contents relating to Covid-19 Epidemiology in India, generated immense interest amongst Occupational Health Practitioners with reference to innovative methods of data collection, analysis of data, results dissemination and integration of results in occupational Health practice during pandemic of Covid-19 in India.

Conclusions/Implications
Occupational Health Epidemiology is a neglected discipline in India. Innovative method of use of webinars amongst Occupational Health practitioners can be used for popularizing the methods, data analysis and results dissemination etc. It is expected that this interest shall be sustained in Post Pandemic period and the discipline of Occupational Health Epidemiology will get its rightful place amongst Occupational Health practitioners in India leading to research initiatives and application of results in the practice of Occupational Health in India.
1492Ordering the chaos: The global clustering of COVID-19 incidence and mortality
Authors: Jayaraj Vivek Jason , Rampal Sanjay , Ng Chiu-Wan , Chong Diane Woei Quan 
Published: September 2021

Abstract

Background
The propagation of COVID-19 has been dynamic across countries and time. We utilised a temporal clustering approach in exploring trends of incidence and mortality across 202 countries.

Methods
COVID-19 case and death data between 1 January 2020 and 30 April 2021 were extracted from open-source data repositories. A partitional clustering algorithm, using Euclidean distances and partition around medoids, was utilised in exploring 14-day incidence and mortality rates across 202 countries. Inter-cluster comparisons were carried out using the 14-day incidence and mortality rates across clusters.

Results
Country-specific trends of incidence and mortality across the study period were agglomerated into one of six clusters. The overall trend of incidence and mortality during this period peaked between November 2020 and January 2021. However, four of the six clusters have an upward trajectory. Countries in cluster four, mostly situated in Europe, reported the highest overall incidence of 192 cases per 100,000 population (95% CI: 166, 220). Countries in cluster three, a mix of countries from South America, Eastern Europe, and Africa, were observed to have the highest overall mortality rate of 32 deaths per 1,000,000 population (95% CI: 23, 45).

Conclusions
The high global burden of disease and inequity in vaccine access highlights the need for a consolidated global effort in mitigating the pandemic.

Key messages
Increasing trajectories of incidence and mortality in Asia, South America, and Africa suggest that the worst of the pandemic may be ahead of us.
757Using smartphone technology to characterise associations between respiratory symptoms and pollen
Authors: Jones Penelope , Johnston Fay , Koolhof Iain , Gasparrini Antonio , Wheeler Amanda , Williamson Grant , Lucani Christopher , Campbell Sharon , Bowman David , Cooling Nick 
Published: September 2021

Abstract

Background
Pollen is a well-established trigger of asthma and allergic rhinoconjunctivitis, yet key gaps in our understanding remain. These include knowledge of concentration thresholds for symptoms, exposure-response associations through time, and the potential for interactions with other environmental stressors such as air pollution. Smartphone technology offers an opportunity to address these challenges using large datasets that capture individual symptoms in real time.

Methods
We analysed 44,820 symptom reports logged by 2,272 users of the AirRater app over four years to evaluate associations between daily respiratory symptoms and atmospheric concentrations of pollen in Tasmania, Australia. We used case time series, a novel methodology developed for app-sourced data. We adjusted for seasonality and meteorology and tested for interactions with particulate pollution (PM2.5).

Results
There was a non-linear association between pollen concentrations and respiratory symptoms for up to three days following exposure. Risk ratios (RR) were greatest on the same day, for total pollen increased steeply to a RR of 1.31 (95% CI: 1.26-1.37) at a concentration of 50 grains/m3 before plateauing. Associations with individual pollen taxa showed similar non-linear trends. There was an interaction with PM2.5, with effect estimates significantly higher when PM2.5 was &gt;50 µg/m3 (p for interaction &lt; 0.001).

Conclusions
The association between respiratory symptoms and airborne pollen was non-linear, greatest in magnitude on the day of exposure, and synergistic with air pollution.

Key messages
Smartphone symptom tracking offers a useful means of assessing dose-response relationships in environmental epidemiology.
182Higher preference for spicy foods increases the risk of central obesity: a prospective cohort study
Authors: Jung Candidate Sukyoung , Park Sohyun 
Published: September 2021

Abstract

Background
Central obesity, characterized by high waist circumference (WC), has been independently associated with higher chronic diseases and mortality risk. To date, controversial evidence is available concerning the beneficial effects of spicy foods on central obesity. We aimed to prospectively examine the association between preference for spicy foods and incident central obesity in Korean adults aged 40 and over.

Methods
We included 6,042 participants free of central obesity at baseline. Central obesity was defined as having WC ≥ 90 cm for men and ≥ 85 cm for women. As an exposure, preference for spicy foods was measured using a five-scale response option from the lowest to the highest preference and a Cox proportional hazard model was used to estimate the hazard ratios (HR) with confidence intervals (CI) for central obesity.

Results
During 45,654 person-years (median 9 years) of follow-up, 1,778 incident central obesity cases occurred. Compared to the lowest preference for spicy foods, the highest preference for spicy foods was associated with greater central obesity risk (HR = 1.43, 95% CI = 0.99-2.05, p trend=0.002). No interaction existed between preference for spicy foods and gender on central obesity incidence (p interaction &gt; 0.05).

Conclusions
Appreciated for spicy foods was associated with an excess risk of central obesity incidence in Korean adults aged 40 years and older.

Key messages
These findings may provide informative evidence on primary prevention of central obesity, particularly for populations with a higher preference for spicy foods.
955Risk of drowning: the Japan Collaborative Cohort (JACC) Study
Authors: Kimura Takashi , Ikehara Satoyo , Tamakoshi Akiko 
Published: September 2021

Abstract

Background
In Japan, the unintentional drowning mortality rate among the elderly is exceptionally high. However, the risk factors for drowning in Japan are not fully understood. This study aims to explore the risk factors of drowning in Japan.

Methods
This study used data from the Japan Collaborative Cohort Study, a prospective cohort aged 40–79 years initiated 1988-1990. A total of 86,298 individuals (35,984 men and 50,314 women) completed a self-administered questionnaire and were mainly followed up by the end of 2009. We calculated hazard ratios (HRs) and 95% confidence intervals (95%CIs) for drowning according to age, body mass index, drinking habits, medical history, marital status, and years of education.

Results
A total of 194 drownings occurred during a median follow-up period of 18.9 years. The multivariable HRs (95%CIs) of drowning were 0.21 (0.10–0.45) for aged &lt;50 years, 0.37 (0.21-0.65) for 50–59 years compared with 60–69 years, 3.08 (1.39–6.85) for bereaved compared with married, 3.39 (1.19-9.66) for with medical history of stroke compared without, and 3.18 (1.39–7.30) for current drinker with ≥69.0g ethanol/day compared with never drinker in men, 0.20 (0.09-0.43) for aged &lt;50 years and 3.39 (1.19-9.66) for 50-59 years in women.

Conclusions
Younger people were found to have a lower risk of drowning. For men, bereavement, history of stroke, and current heavy drinking were found to have higher risk of drowning.

Key messages
In Japan, bereavement, a history of stroke, and heavy drinking among men found to have higher risk of drowning
1139Predictors of Unintended Pregnancy among Indian women: An analysis from NFHS-IV Survey
Authors: Kishun Jai 
Published: September 2021

Abstract

Background
Low levels of women’s decision-making over control of sexual intercourse, contraceptive use, domestic violence with intimate partners not only have impact on socioeconomic and cultural aspects but also on unintended pregnancies. Which create serious public health issues associated with physical, reproductive and mental health consequences. This study explores associations between domestic violence, maternity and sociodemographic characteristics with unintended pregnancies

Methods
Total 32428 married women aged between 15-49 years, who responded on current pregnancy wanted were observed in NFHS-IV (2015-16) survey data. Out of these, 3,842 found eligible for this study. Logistic regressions used for analysis using SPSS23 software.

Results
Mean age of 3,842 women respondents were 25.27 ± 4.97 years. 12.3% of them were unintended pregnancies. Women aged between 25-34 years (OR = 1.21, 95% CI: 0.99-1.48) and 35-49 years (OR = 1.50, 95% CI: 1.02-2.21) were more likely to have unintended pregnancy than 15–24 years. Working women were 7% (OR = 0.93, 95% CI: 0.73-1.18) less likely to have unintended pregnancy than not working. Women never used contraception were 1.4 times more likely to have unintended pregnancy. Ever face domestic violence were 1.71 times (OR = 1.71, 95% CI: 1.40-2.10) more likely to have unwanted pregnancy.

Conclusions
Sociodemographic disparities need to be addressed to promote reproductive health and welfare services. Preventing physical violence by intimate partners against women, could reduce unintended pregnancy.

Key messages
Improving women’s status through educational and occupational initiatives could contribute to reducing physical violence and incidence of unintended pregnancies
655Association between Crohn's disease onset and oral hygiene: a Japanese multicenter case-control study
Authors: Kondo Kyoko , Ohfuji Satoko , Watanabe Kenji , Yamagami Hirokazu , Fukushima Wakaba , Ito Kazuya , Suzuki Yasuo , Hirota Yoshio 
Published: September 2021

Abstract

Background
The prevalence of Crohn’s disease is increasing in Japan, but risk factors for this disease have yet to be characterized. A recent study using mice, indicated that Klebsiella strains in the oral cavity may be associated with inflammatory bowel disease. We investigated the association between oral hygiene and Crohn’s disease onset.

Methods
We conducted a multicenter case-control study and compared oral hygiene in 69 patients with newly diagnosed Crohn’s disease to that in 113 control patients (patients with other diseases matched for institution, age, and sex). The exposure variables were number of teeth, use of dentures, implant treatment, and frequency of brushing. A conditional logistic model was used to calculate odds ratios and 95% confidence intervals of these factors for Crohn’s disease onset.

Results
The decreased odds ratios of brushing teeth were observed with increasing daily frequency (trend for p = 0.039), with 0.52 (0.20–1.33) for twice daily brushings and 0.26 (0.07–0.97) for three or more daily brushings, (reference category: brushing no or once a day). No other oral hygiene factors were associated with the onset of Crohn's disease.

Conclusions
Our findings suggest that frequent brushing may have a protective association with the development of Crohn's disease.

Key messages
This result may provide a clue to the possible involvement of oral bacteria in the development of inflammatory bowel disease.
368Evaluation of myostatin as a possible regulator of the skeletal muscle-cortical bone interaction in adults
Authors: Kuriyama Nagato , Ozaki Etsuko , Koyama Teruhide , Matsui Daisuke , Watanabe Isao , Inaba Masaaki , Yamada Shinsuke , Horii Motoyuki , Uehara Ritei 
Published: September 2021

Abstract

Background
Bone mass was recently reported to be related to skeletal muscle mass in humans, and a decrease in cortical bone is a risk factor for osteoporosis. Since circulating myostatin is a factor that primarily controls muscle metabolism, this study examined the role of myostatin in blood in bone mass-skeletal muscle mass interactions.

Methods
The subjects were 375 middle-aged community residents with no history of osteoporosis or sarcopenia who participated in a health check-up. The subjects were divided into those with low cortical bone thickness (LCT) or low cancellous bone density (LBD) and those with normal values (NCT/NBD). Bone metabolism markers (BAP, TRACP-5b, etc.), skeletal muscle mass, serum myostatin levels, and lifestyle, were then compared between the groups.

Results
The percentage of diabetic participants and blood HbA1c, TRACP-5b, and myostatin levels were significantly higher, and the frequency of physical activity, skeletal muscle mass, grip strength, and leg strength were significantly lower in the LCT group than in the NCT group. The odds ratio of high myostatin in the LCT group compared with the NCT group was significant (2.26) even after adjusting for related factors. Significant differences were observed in the same items between the LBD and NBD groups as between the LCT and NCT groups, with no significant differences in skeletal muscle mass and serum myostatin levels. The serum myostatin level was significantly negatively correlated with cortical bone thickness and skeletal muscle mass.

Conclusions
Myostatin may regulate bone-skeletal muscle interactions and serve as a surrogate marker of cortical bone metabolism.

Key messages
The interaction between bone and skeletal muscle is reported to be important for preserving the activity of bone and muscle metabolism. Herein, we report for the first time that myostatin may regulate bone-skeletal muscle interactions and serve as a surrogate marker of cortical bone metabolism in adults.
512Challenges and opportunities to appropriate antibiotic prescribing: a survey of clinicians’ perceptions in Australia
Authors: Laka Mah , Milazzo Adriana , Merlin Tracy 
Published: September 2021

Abstract

Background
Emerging antibiotic resistance is significant threat to global public health. There is evidence on sub-optimal prescribing as a contributing factor to antibiotic resistance. This study aimed to identify behavioral determinants of antibiotic prescribing that may help design effective interventions.

Methods
A cross-sectional survey was undertaken with clinicians (hospital and primary care) in Australia from June–October 2019. Multivariate logistic regression was used to determine if clinicians’ characteristics, and guidelines’ use, are associated with barriers of appropriate antibiotic prescribing.

Results
Inappropriate prescribing behavior is not limited to clinicians’ practices, but also relate to patients’ expectation and clinical culture. Lack of data for evidence-based decision-making and diagnostic uncertainty contribute to sub-optimal antibiotic prescribing. Different care settings and clinicians’ experience influence perceptions of whether unavailability of information, delay in diagnostic results and patient expectations regarding treatment led to inappropriate prescribing behavior. Respondents in primary care and with less experience were more likely to consider that patient demands (primary care: OR 1.76, 95%CI 1.34–2.68 & experience (1-10 years): OR 1.34, 95%CI 1.07–1.59) and lack of data required for decision-making (primary care: OR 1.59, 95%CI 1.09–2.10 & experience (1-10 years): OR 1.63, 95%CI 1.13–1.87) are barriers to appropriate prescribing.

Conclusions
A complex network of social, contextual and clinical factors influence prescribing practices. A holistic approach addressing clinicians’ practices, setting requirements and patient expectations must be considered.

Key messages
For optimal antibiotic prescribing, there is a need to focus on contextual requirements, shared decision-making and availability of relevant information at point-of-care.