bluuebunny/crossref_metadata_2025_split huggingface dataset:
66Adverse birth outcomes associated with ambient air pollution at levels below air quality guidelines
Authors: Melody Shannon , Wills Karen , Knibbs Luke , Ford Jane , Venn Alison , Johnston Fay 
Published: September 2021

Abstract

Background
Gaps exist concerning the relationship between maternal exposure to air pollution and birth outcomes, including the importance of low-level exposure. We aimed to explore the association between maternal exposure to ambient nitrogen dioxide (NO2) and fine particulate matter (PM2.5) and selected birth outcomes in Victoria, Australia.

Methods
We included all births occurring in Victoria, Australia from 1st March 2012 to 31st December 2015 using routinely collected government data. Outcomes included birthweight, small for gestational age (SGA), term low birth weight (tLBW), large for gestational age, and spontaneous preterm birth. Annual ambient NO2 and PM2.5 was assigned to maternal residence at birth. Maternal, meteorological and temporal variables were included in final log-binomial models.

Results
There were 285,594 births. Average annual ambient NO2 exposure was 6.0 parts per billion (ppb, IQR 3.9 ppb) and PM2.5 was 6.9 µg/m3 (IQR 1.3). IQR increases in ambient NO2 and PM2.5 were associated with fetal growth restriction, including decrements in birth weight, increased risk of SGA and tLBW. Women with gestational diabetes and hypertensive disorders of pregnancy had greater decrements in birth weight associated with exposure.

Conclusions
Maternal exposure to low-level ambient air pollution at levels below national and international air quality guidelines was associated with fetal growth restriction.

Key messages
Exposure to low-level ambient air pollution was associated with fetal growth restriction and women with obstetric complications were more susceptible.
These findings may inform iterative revisions of air quality guidelines.
111“Place standard” depicts the social gradient in the neighbourhood environment in Cyprus
Authors: Middleton Nicos , Kleopa Daphne , Panayiotou Andrie , Kaifa Chrystalla , Nicolaou Christiana , Kouta Christiana 
Published: September 2021

Abstract

Background
Census data, GIS, surveys and audits are used to profile “place”, each with shortcomings. There are several “neighbourhood environment” tools, including the “Place Standard” a policy and advocacy tool developed in Scotland. “Place” is not a strong feature in the public health agenda in Cyprus.

Methods
In an internet survey, participants rated 14 features of their neighborhood environment. Exploratory factor, cluster and regression analysis were used to explore the dimensionality of the concept, neighborhood profiles and differences according to individual and area-level characteristics.

Results
With the exception of safety (M = 4.4, SD = 1.7 on a 1: large to 7: little improvement), 492 participants (mean age 42, 50% residents for &gt;10 years) from 266 postcodes (33% islandwide) did not rate other features favourably. A clear dimensionality of Built, Physical, Social and Service environment supports the construct validity of the tool. People who rated their neighbourhood lower on a social position ladder were consistently more likely to rate all contextual neighrbourhood features less favourably. The social gradient was evident according to individual and area measures of socio-economic disadvantage and appeared stronger in terms of the built than the social environment.

Conclusions
The “place standard” shows good metric properties and captures the variability ad inequity in the neighbourhood environment.

Key messages
The “Place Standard” can be used to profile the context of health inequalities.
Evidence of a social gradient across all features with larger differences in terms of the built environment.
217Using excess heat factor to measure effect of heatwave severity on foodborne disease incidence
Authors: Milazzo Adriana 
Published: September 2021

Abstract

Background
This study aims to analyse the distribution characteristics of ideal cardiovascular health (ICH) metrics status of the oldest-old and centenarians, and also to explore the relationships with disability and quality of life.

Methods
1002 centenarians and 798 oldest-old were included in the analysis. ICH, disability and quality of life were assessed according to standard methods.

Results
The median number of ICH metrics among centenarians and oldest-old were 4 (4-5) and 3(3-5) respectively. The highest proportion of ICH metrics at ideal levels were glucose (90.2%), BMI (89.8%), and smoking (89.4%), the lowest proportion of ICH metrics at ideal level was blood pressure (8.3%). The disability rates of BADL and IADL decreased with the number of ICH metrics. BADL disability changed from 100.0% to 73.2%, and the IADL disability rate dropped from 100% to 80.0%. BADL disability rate decreased from 45.0% to 25.3% and IADL disability decreased from 100.0% to 57.1% among the oldest-old. The EQ-5D vas, EQ-5D score showed increasing trend along with the number of ICH metrics (p &lt; 0.05). Compared with centenarians who had only 0-2 ICH metrics, the ORs for BADL disability were 0.82, 0.66, 0.52, 0.44, and the ORs for IADL disability were 0.74, 0.65, 0.58, 0.41 for those with 3, 4, 5, ≥6 ICH metrics.

Conclusions
ICH metrics of centenarians and oldest-old were at a relatively good level, and there was a strong and independent inverse relationship between ICH metrics with both disability and lower quality of life.

Key messages
This was the first survey about the distribution of ICH metrics and association with both disability and quality of life based on elderly aged over 80 years old. The results highlighted the importance of cardiovascular prevention even at 80 years and over, which made up for the evidence gap based on this age group.
1127Uncontrolled hypertension among patients with comorbidities in sub-Saharan Africa; pooled analysis using individual participant data
Authors: Mohamed Shukri 
Published: September 2021

Abstract

Background
Despite the numerous studies on hypertension, the current literature reveals little about the relationship between patient comorbidities and uncontrolled hypertension in sub-Saharan Africa (SSA). We aimed to assess the associations between body size, dyslipidemia, diabetes and uncontrolled hypertension.

Methods
We harmonised and pooled individual-level data from 25 cross-sectional studies. We did a meta-analysis of individual participant data to assess the association between uncontrolled hypertension with body size, diabetes and dyslipidemia using a logistic regression while adjusting for potential confounders.

Results
The pooled dataset included 107,339 participants, of whom 64,811 were women and 42,528 were men. The pooled prevalence of uncontrolled hypertension (UHTN) among those on treatment was (3,449) 59.89%. The UHTN estimate ranged from 47.0% in Malawi to 80.0% in Guinea. Significant association were noted between UHTN and diabetes for all countries. The overall pooled estimate for UHTN among patients with diabetes was OR = 1.49 (95% CI 1.30 to 1.67). All countries had significant associations between UHTN and central obesity except for Gambia, Kenya and Tanzania. Study participants from Uganda with central obesity had the highest likelihood of UHTN OR = 1.14 (95% CI 0.38 to 1.89). All countries had significant associations between UHTN and general obesity except for Kenya, Tanzania and Uganda.

Conclusions
The prevalence of uncontrolled hypertension among patients with comorbidities is high in SSA.

Key messages
Effective strategies to improve blood pressure control among patients with chronic comorbidities are needed.
439Reproducibility and relative validity of dietary patterns in older New Zealand adults
Authors: Mumme Karen , Conlon Cath , Hurst Pamela von , Jones Beatrix , Seymour Jamie de , Stonehouse Welma , Heath Anne-Louise , Coad Jane , Haskell-Ramsey Crystal , Beck Kathryn 
Published: September 2021

Abstract

Background
Valid and reproducible dietary patterns (DP) are necessary to assess relationships between diet and disease. This study, Researching Eating, Activity, and Cognitive Health (REACH), assessed the reproducibility and relative validity of DPs derived from a food frequency questionnaire (FFQ) in older New Zealand adults.

Methods
Participants (n = 294, 70±3yrs, 37% male), completed two identical 109-item FFQs to assess reproducibility. A 4-day food record (4DFR) was used to assess relative validity. After collapsing data into 57 food groups, DPs were derived using principal component analysis. Agreement of DP loadings were assessed using Tucker’s congruence coefficient. Agreement between derived DP scores from the FFQs and 4-DFR were assessed using Spearman correlation coefficients, weighted kappa statistic, and Bland-Altman analysis.

Results
Three similar DPs (‘Mediterranean style’, ‘Western’ and ‘prudent’) were identified from each dietary assessment tool. Congruence coefficients between DP loadings ranged from 0.66-0.80 (reproducibility) and 0.54-0.75 (validity). Correlations of DP scores ranged from 0.47-0.59 (reproducibility) and 0.33-0.43 (validity) (all P&lt;0.001); weighted kappa scores ranged from 0.40-0.48 (reproducibility) and 0.27-0.37 (validity); limits of agreement from ±1.79 to ± 2.09 (reproducibility) and ±2.09 to ± 2.27 (validity); a negative slope of bias was seen in the ‘prudent’ pattern for reproducibility and validity (P&lt;0.001).

Conclusions
The FFQ derived DPs demonstrated acceptable reproducibility and relative validity and can be used to examine associations between DPs and health outcomes in older New Zealand adults.

Key Message
Valid DPs improve evidence for assessing DP and health outcome associations.
1159Inequities in on-time childhood vaccination: Evidence from sub-Saharan Africa
Authors: Mutua Martin 
Published: September 2021

Abstract

Introduction
Vaccination coverage has improved over the past decade but inequalities persist; the poorest, least educated, and rural communities are left behind. Programming has focused on increasing coverage and reaching the hardest to reach children but vaccination timeliness is equally important as delays leave children vulnerable to infections. This study examines the levels and inequities of on-time vaccination in the sub-Saharan African (SSA) region.
Methods: The most recent Demographic and Health Surveys or Multiple Indicator Clusters Surveys since 2000 from SSA were used to assess on-time vaccination and inequalities by household wealth, maternal education, and place of residence. Inequalities were quantified using slope index of inequality and concentration index.

Results
The analysis included 153,632 children aged 12-36 months from 40 SSA countries. Median on-time vaccination coverage was below 50% in all four sub-regions. Differences in on-time vaccination were observed by place of residence in Southern (20.8 pp, 95%CI (0.8; 40.8)), West (17.5 pp, 95%CI (5.1; 29.9)), and Eastern (20.9 pp, 95%CI (6.5; 35.2)) regions. Wealth-related inequities were observed in Southern (22.6 pp, 95%CI (4.0; 41.2)), West (30.6 pp, 95%CI (19.1; 42.1)), and Eastern (26.1 pp, 95%CI (8.2; 44.0)) regions. Significant education-related differences in on-time vaccination were observed in West (20.7 pp, 95%CI (10.9; 30.5)), and Eastern (21.2 pp, 95%CI (7.0; 35.4)) regions.

Conclusions
On-time vaccination coverage was low in all sub-regions and nearly all countries. Inequalities in on-time immunization by household wealth, place of residence, and education existed in most countries. Concrete strategies to improve levels of timeliness are needed
647Use of menopausal hormone therapy before and after ovarian cancer diagnosis and ovarian cancer survival
Authors: Na Nina Renhua , Jordan Susan J , Obermair Andreas , Webb Penelope M ,   for the OPAL Study Group
Published: September 2021

Abstract

Background
Menopausal hormone therapy (MHT) use before ovarian cancer (OvCa) diagnosis has been suggested to improve survival but data on type, duration and use after treatment for OvCa are scarce.

Methods
We investigated MHT use and OvCa survival among participants with newly diagnosed OvCA in the Ovarian cancer Prognosis And Lifestyle (OPAL) Study. Analysis of pre-diagnosis use was restricted to 661 post-menopausal women and analysis of post-diagnosis use included 254 women aged ≤55-years. We used multivariable Cox proportional hazards regression to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between MHT and OvCa-specific survival. We used propensity score-based approaches to account for potential bias due to confounding by indication.

Results
Approximately 14% of post-menopausal women were current/recent users of oestrogen-only (7%) or oestrogen-progestin/unknown MHT (E-P=7%) at the time of diagnosis. In the pre-diagnosis analysis, E-P use was associated with better survival (HR = 0.60, 95%CI=0.37-0.98; HR = 0.93, 95%CI=0.79-1.09 per 5-years/use). The association between oestrogen-only MHT and survival was weaker and non-significant (HR = 0.74, 95%CI=0.47-1.16). Among women ≤55-years at diagnosis, the HR was 0.91 (95%CI=0.50-1.67) for new use after diagnosis regardless of type; and 0.89 (95%CI 0.51-1.54) for any use post-diagnosis compared to never users. Propensity-score-based methods showed similar estimates.

Conclusions
Pre-diagnosis MHT use is associated with better ovarian cancer survival. Post-diagnosis MHT use might also improve survival for women younger than 55-years, even after accounting for bias due to confounding by indication.

Key messages
Menopausal hormone therapy may be considered to manage menopausal symptoms in women with ovarian cancer.
1255Associations between select lifestyle behaviours and quality of life based on MS phenotype
Authors: Nag Nupur , Yu Maggie , Simpson-Yap Steve , Neate Sandra , Schmidt Hollie 
Published: September 2021

Abstract

Background
Multiple sclerosis (MS) comprises progressive and non-progressive phenotypes, both presenting with symptoms that may reduce quality of life (QoL). Lifestyle behaviours, including diet, exercise, and wellness activities, are associated with higher QoL, however little is known about differences by MS phenotype. We assessed associations between lifestyle behaviours and QoL, between progressive vs non-progressive MS.

Methods
Self-reported cross-sectional data from the iConquerMS study (n = 1,109) were analysed. Lifestyle behaviours were queried via tick-box options for diet-type, supplement use, and wellness activities; and physical activity via Godin-Shephard Leisure-Time Physical Activity Questionnaire. QoL was queried via Neuro-QoL. Linear regression, adjusted for age, sex, BMI, education, disability, and MS duration, was used to assess associations and moderation analyses to assess differences between MS phenotypes.

Results
Diet-type, physical activity, and wellness activities were associated with specific QoL subdomains. Only associations between diet and physical activity, with QoL subdomains, differed between phenotypes. Anti-inflammatory diets were associated with a 1.5-point increase in mobility in progressive MS. In non-progressive MS, high physical activity was associated with a 3.6-point decrease in depression, and a 4.2-, 2.3- and 3.0-point increase in positive affect, fine motor skills, and social participation, respectively.

Conclusions
Specific lifestyle behaviours were associated with QoL subdomains. Associations between diet and physical activity with QoL differed between MS phenotype.

Key messages
Specific lifestyle behaviours are associated with higher QoL. Lifestyle interventions for MS management should consider disease course.
74Relationship of higher-level functional capacity on long-term mortality in Japanese population: NIPPON DATA90
Authors: Nagata Hideki , Miura Katsuyuki , Tanaka Sachiko , Kadota Aya , Hayakawa Takehito , Takashima Naoyuki , Kita Yoshikuni , Kondo Keiko , Okayama Akira , Okamura Tomonori , Ueshima Hirotsugu 
Published: September 2021

Abstract

Background
Little is known about the relationships between higher-level functional capacity (HLFC) and mortality, and its gender difference.

Methods
NIPPON DATA90 is the cohort study of the National Cardiovascular Survey of Japan in 1990. We followed up 1824 Japanese adults over 65 years who were independent in basic activities of daily living in 1995 until 2010. HLFC was measured in 1995 using the total score and 3 subscales (instrumental activities of daily living [IADL], intellectual activity, social role) by the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). The association of HLFC to mortality was evaluated by adjusted hazard ratio (HR) and 95% confidence interval (CI) using the Cox proportional hazard model.

Results
During average 12.2-year follow-up, 836 participants (45.8%) died. Participants with impaired total TMIG-IC score showed significantly higher risk of mortality (adjusted HR 1.37; 95%CI 1.14-1.66) compared with normal participants, even after adjusting for other variables. The corresponding HR was significant only in women (HR 1.42; 95% CI 1.10-1.83). Among the 3 subscales, only impaired social role showed significantly higher risk of mortality (HR 1.37; 95%CI 1.12-1.67) in men. In contrast, IADL and intellectual activity showed significantly higher risk in women (HR 1.51; 95%CI 1.16-1.96) (HR 1.46; 95%CI 1.19-1.80).

Conclusions
Impaired HLFC was related to higher risk of long-term mortality in Japanese elderly at baseline. Especially among women, IADL and intellectual activity were important predictors, whereas social role was important in men.

Key messages
Impaired HLFC was related to long-term mortality in Japanese elderly.
1371Ambient air pollution and adverse birth outcomes: a systematic synthesis of meta-analyses of epidemiological studies
Authors: Nyadanu Sylvester Dodzi , Dunne Jennifer , Tessema Gizachew Assefa , Mullins Ben , Duko Bereket , Pereira Gavin 
Published: September 2021

Abstract

Background
We conducted the first umbrella review of meta-analyses on the association between in utero exposure to ambient air pollution and adverse birth outcomes.

Methods
We systematically searched for meta-analyses on criteria air pollutants (NO2, CO, O3, SO2, and PM2.5 and PM10) and adverse birth outcomes (preterm birth, stillbirth, reduced birth weight, low birth weight, and small-for-gestational age) from PubMed, CINAHL, Scopus, MEDLINE/Ovid, EMBASE/Ovid, Web of Science, systematic reviews repositories, electronic grey literature, and references on 21st September 2020 with weekly alerts thereafter. We graded the overall direction and confidence of cause-and-effect as per our pre-specified protocol (Doi:10.3390/ijerph17228658).

Results
Sixteen (16) meta-analyses, pooling 192 unique primary studies with moderate (9.0%) overlap qualified for the final synthesis. Consistent positive associations were reported between whole pregnancy exposure to PM2.5/PM10 and birth weight reduction and between CO/SO2 and low birth weight and were graded as strong ( ++). There were less consistent associations between whole pregnancy PM2.5/NO2 exposures with PTB, and for all criteria pollutants with stillbirth, hence graded moderate (+). Evidence for associations with trimester specific exposures were also moderate (+). However, meta-analyses observed high heterogeneity, high imprecision, and lacked experimental studies. Consequently, taken together, the current observations indicate ‘probable evidence’ of causation.

Conclusions
Current observations indicate ‘probable evidence’ of causation. Further studies with standardised designs would help elucidate reasons for heterogeneity of associations.

Key messages
In the absence of randomised controlled trials, the strong observational evidence for associations between ambient air pollution and adverse birth outcomes warrants adoption of the precautionary principle.
622Low birthweight prediction is not improved by repeated measures of gestational weight: the BOSHI study
Authors: Oba Mari S , Murakami Yoshitaka , Sato Michihiro , Murakami Takahisa , Iwama Noriyuki , Ishikuro Mami , Obara Taku , Imai Yutaka , Hoshi Kazuhiko , Ohkubo Takayoshi , Metoki Hiroto 
Published: September 2021

Abstract

Background
Both pre-pregnancy body mass index and total weight gain during pregnancy are known risk factors for perinatal outcomes. However, little is known if repeated measurements of gestational weight gain can be utilized in the prediction of perinatal outcomes. We examined whether repeated measures of gestational weight improve the prediction of low infant birthweight.

Methods
Using data from the BOSHI study, we developed prediction models with low infant birthweight (&lt;2500 g) as the outcome and gestational weight gain as the exposure of interest. A prediction model (Model 1) using only baseline values (pre-pregnancy body mass index) as the exposure was compared with a model using baseline and the last weight measurement (Model 2) and a model using baseline and trimester-specific measurements (Model 3). Model performance was assessed using c-statistics, Brier scores, and calibration plots.

Results
Among women who experienced full-term deliveries and had measured weights, the proportion of low infant birthweights was 5%. The c-statistics of Model 1, Model 2, and Model 3 were 0.78, 0.81, and 0.83, respectively. Other assessments were relatively unchanged. The extent of predictive performance improvement depends not only on the exposure-outcome associations but correlations among exposure measurements.

Conclusions
The inclusion of repeated gestational weight measurements in a model for predicting low infant birthweight only produced a marginal improvement in predictive performance.

Key messages
The prediction of low infant birthweight is not substantially improved by using repeated measurements of gestational weight.
428Prevalence and forms of Intimate Partner Violence in WLWHA and HIV negative women in Umuahia
Authors: Odini Franklin , Emma-Ukaegbu Uloaku , Nwamoh Uche 
Published: September 2021

Abstract

Background
Intimate Partner Violence (IPV) is the range of sexually, psychologically and physically coercive acts used against adult and adolescent women by a current or former male partner. IPV is the commonest form of violence against women and one of the most pervasive human rights abuses against women. The UN reported that 1 in 3 women had experienced physical/sexual violence at some point in their lives and 2 in 3 victims of intimate partner homicide are women.
This study is aimed at determining the prevalence and forms of IPV affecting WLWHA and HIV negative women in Umuahia, Nigeria.

Methods
A comparative cross-sectional study involving 200 WLWHA and 200 HIV negative women in Umuahia using systematic random sampling method. An interviewer-administered questionnaire was deployed for data collection. Data analysis was done using IBM SPSS.

Results
A total of 115 (57.5%) WLWHA compared to 73 (36.5%) of the HIV negative women had suffered from any form of IPV. Furthermore, a higher proportion of WLWHA suffered emotional (50.0%), physical (39.0%) and sexual (28.5%) IPV, compared to 31.5%, 17.5% and 12.0% respectively for HIV negative women.

Conclusion
IPV occurs in both groups of women but much higher in WLWHA. Primary prevention interventions aimed at prevention and reduction should be instituted especially amongst WLWHA. Health care settings should be equipped to ensure a comprehensive response whenever IPV is detected.

Keywords
Intimate Partner Violence, Prevalence, Forms.