bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of vitamin supplements and risk of total cancer and cardiovascular disease among the Japanese general population: A population-based survey
Authors: Hara Azusa , Sasazuki Shizuka , Inoue Manami , Shimazu Taichi , Iwasaki Motoki , Sawada Norie , Yamaji Taiki , Ishihara Junko , Iso Hiroyasu , Tsugane Shoichiro ,   the Japan Public Health Center-Based Prospective Study Group
Published: August 2011

AbstractBackgroundDespite the popular use of vitamin supplements and several prospective cohort studies investigating their effect on cancer incidence and cardiovascular disease (CVD), scientific data supporting their benefits remain controversial. Inconsistent results may be partly explained by the fact that use of supplements is an inconsistent behavior in individuals. We examined whether vitamin supplement use patterns affect cancer and CVD risk in a population-based cohort study in Japan.MethodsA total of 28,903 men and 33,726 women in the Japan Public Health Center-based Prospective Study cohort, who answered questions about vitamin supplement use in the first survey from 1990-1994 and the second survey from 1995-1998, were categorized into four groups (never use, past use, recent use, and consistent use) and followed to the end of 2006 for cancer and 2005 for CVD. Sex-specific hazard ratios (HRs) and 95% confidence intervals (95% CIs) were used to describe the relative risks of cancer and CVD associated with vitamin supplement use.ResultsDuring follow-up, 4501 cancer and 1858 CVD cases were identified. Multivariate adjusted analysis revealed no association of any pattern of vitamin supplement use with the risk of cancer and CVD in men. In women, consistent use was associated with lower risk of CVD (HR 0.60, 95% CI 0.41-0.89), whereas past (HR 1.17, 95% CI 1.02-1.33) and recent use (HR 1.24, 95% CI 1.01-1.52) were associated with higher risk of cancer.ConclusionsTo our knowledge, this is the first prospective cohort study to examine simultaneously the associations between vitamin supplement use patterns and risk of cancer and CVD. This prospective cohort study demonstrated that vitamin supplement use has little effect on the risk of cancer or CVD in men. In women, however, consistent vitamin supplement use might reduce the risk of CVD. Elevated risk of cancer associated with past and recent use of vitamin supplements in women may be partly explained by preexisting diseases or unhealthy background, but we could not totally control for this in our study.
Age-disparity, sexual connectedness and HIV infection in disadvantaged communities around Cape Town, South Africa: a study protocol
Authors: Delva Wim , Beauclair Roxanne , Welte Alex , Vansteelandt Stijn , Hens Niel , Aerts Marc , du Toit Elizabeth , Beyers Nulda , Temmerman Marleen 
Published: August 2011

Abstract

Background
Crucial connections between sexual network structure and the distribution of HIV remain inadequately understood, especially in regard to the role of concurrency and age disparity in relationships, and how these network characteristics correlate with each other and other risk factors. Social desirability bias and inaccurate recall are obstacles to obtaining valid, detailed information about sexual behaviour and relationship histories. Therefore, this study aims to use novel research methods in order to determine whether HIV status is associated with age-disparity and sexual connectedness as well as establish the primary behavioural and socio-demographic predictors of the egocentric and community sexual network structures.

Method/Design
We will conduct a cross-sectional survey that uses a questionnaire exploring one-year sexual histories, with a focus on timing and age disparity of relationships, as well as other risk factors such as unprotected intercourse and the use of alcohol and recreational drugs. The questionnaire will be administered in a safe and confidential mobile interview space, using audio computer-assisted self-interview (ACASI) technology on touch screen computers. The ACASI features a choice of languages and visual feedback of temporal information. The survey will be administered in three peri-urban disadvantaged communities in the greater Cape Town area with a high burden of HIV. The study communities participated in a previous TB/HIV study, from which HIV test results will be anonymously linked to the survey dataset. Statistical analyses of the data will include descriptive statistics, linear mixed-effects models for the inter- and intra-subject variability in the age difference between sexual partners, survival analysis for correlated event times to model concurrency patterns, and logistic regression for association of HIV status with age disparity and sexual connectedness.

Discussion
This study design is intended to facilitate more accurate recall of sensitive sexual history data and has the potential to provide substantial insights into the relationship between key sexual network attributes and additional risk factors for HIV infection. This will help to inform the design of context-specific HIV prevention programmes.
EXACT: EXercise or Advice after ankle fraCTure. Design of a randomised controlled trial
Authors: Beckenkamp Paula R , Lin C Christine , Herbert Robert D , Haas Marion , Khera Kriti , Moseley Anne M ,   the EXACT Team
Published: August 2011

Abstract

Background
Ankle fractures are common. Management of ankle fractures generally involves a period of immobilisation followed by rehabilitation to reduce pain, stiffness, weakness and swelling. The effects of a rehabilitation program are still unclear. However, it has been shown that important components of rehabilitation programs may not confer additional benefits over exercise alone. The primary aim of this trial is to determine the effectiveness and cost-effectiveness of an exercise-based rehabilitation program after ankle fracture, compared to advice alone.

Methods/Design
A pragmatic randomised trial will be conducted. Participants will be 342 adults with stiff, painful ankles after ankle fracture treated with immobilisation. They will be randomly allocated using a concealed randomisation procedure to either an Advice or Rehabilitation group. Participants in the Advice group will receive verbal and written advice about exercise at the time of removal of immobilisation. Participants in the Rehabilitation group will be provided with a 4-week rehabilitation program that is designed, monitored and progressed by a physiotherapist, in addition to verbal and written advice. Outcomes will be measured by a blinded assessor at 1, 3 and 6 months. The primary outcomes will be activity limitation and quality-adjusted life years.

Discussion
This pragmatic trial will determine if a rehabilitation program reduces activity limitation and improves quality of life, compared to advice alone, after immobilisation for ankle fracture.
Protocol for the Cognitive Interventions and Nutritional Supplements (CINS) trial: A randomized controlled multicenter trial of a brief intervention (BI) versus a BI plus cognitive behavioral treatment (CBT) versus nutritional supplements for patients with long-lasting muscle and back pain
Authors: Reme Silje E , Tveito Torill H , Chalder Trudie , Bjørkkjær Tormod , Indahl Aage , Brox Jens I , Fors Egil , Hagen Eli M , Eriksen Hege R 
Published: August 2011

AbstractBackgroundBrief intervention programs are clinically beneficial, and cost efficient treatments for low back pain, when offered at 8-12 weeks, compared with treatment as usual. However, about 30% of the patients do not return to work. The European Guidelines for treatment of chronic low back pain recommends Cognitive Behavioral Therapy (CBT), but conclude that further research is needed to evaluate the effectiveness of CBT for chronic low back pain.Methods/DesignThe aim of the multicenter CINS trial (Cognitive Interventions and Nutritional Supplements) is to compare the effectiveness of 4 different interventions; Brief Intervention, Brief Intervention and CBT, Brief Intervention and nutritional supplements of seal oil, and Brief Intervention and nutritional supplements of soy oil. All participants will be randomly assigned to the interventions. The nutritional supplements will be tested in a double blind design. 400 patients will be recruited from a population of chronic low back pain patients that have been sick listed for 2-10 months. Four outpatient clinics, located in different parts of Norway, will participate in recruitment and treatment of the patients.The Brief Intervention is a one session cognitive, clinical examination program based on a non-injury model, where return to normal activity and work is the main goal, and is followed by two booster sessions. The CBT is a tailored treatment involving 7 sessions, following a detailed manual. The nutritional supplements consist of a dosage of 10 grams of either soy or seal oil (capsules) per day for 3 months, administered in a double blind design. All patients will be followed up with questionnaires after 3, 6 and 12 months, while sick leave data will be collected up to at least 24 months after randomization. The primary outcome of the study is sick leave and will be based on register data from the National Insurance Administration. Secondary outcomes include self-reported data on disability, pain, and psychological variables.ConclusionsTo our knowledge, the CINS trial will be the largest, randomized trial of psychological and nutritional interventions for chronic low back pain patients to date. It will provide important information regarding the effectiveness of CBT and seal oil for chronic low back pain patients.Trial Registrationhttp://www.clinicaltrials.gov, with registration numberNCT00463970.
Spatial epidemiology and spatial ecology study of worldwide drug-resistant tuberculosis
Authors: Liu Yunxia , Jiang Shiwen , Liu Yanxun , Wang Rui , LI Xiao , Yuan Zhongshang , Wang Lixia , Xue Fuzhong 
Published: August 2011

Abstract

Background
Drug-resistant tuberculosis (DR-TB) is a major public health problem caused by various factors. It is essential to systematically investigate the epidemiological and, in particular, the ecological factors of DR-TB for its prevention and control. Studies of the ecological factors can provide information on etiology, and assist in the effective prevention and control of disease. So it is of great significance for public health to explore the ecological factors of DR-TB, which can provide guidance for formulating regional prevention and control strategies.

Methods
Anti-TB drug resistance data were obtained from the World Health Organization/International Union Against Tuberculosis and Lung Disease (WHO/UNION) Global Project on Anti-Tuberculosis Drug Resistance Surveillance, and data on ecological factors were collected to explore the ecological factors for DR-TB. Partial least square path modeling (PLS-PM), in combination with ordinary least squares (OLS) regression, as well as geographically weighted regression (GWR), were used to build a global and local spatial regression model between the latent synthetic DR-TB factor ("DR-TB") and latent synthetic risk factors.

Results
OLS regression and PLS-PM indicated a significant globally linear spatial association between "DR-TB" and its latent synthetic risk factors. However, the GWR model showed marked spatial variability across the study regions. The "TB Epidemic", "Health Service" and "DOTS (directly-observed treatment strategy) Effect" factors were all positively related to "DR-TB" in most regions of the world, while "Health Expenditure" and "Temperature" factors were negatively related in most areas of the world, and the "Humidity" factor had a negative influence on "DR-TB" in all regions of the world.

Conclusions
In summary, the influences of the latent synthetic risk factors on DR-TB presented spatial variability. We should formulate regional DR-TB monitoring planning and prevention and control strategies, based on the spatial characteristics of the latent synthetic risk factors and spatial variability of the local relationship between DR-TB and latent synthetic risk factors.
InN nanorods prepared with CrN nanoislands by plasma-assisted molecular beam epitaxy
Authors: Liu Kuang-Wei , Chang Shoou-Jinn , Young Sheng-Joue , Hsueh Tao-Hung , Hung Hung , Mai Yu-Chun , Wang Shih-Ming , Chen Kuan-Jen , Wu Ya-Ling , Chen Yue-Zhang 
Published: August 2011

AbstractThe authors report the influence of CrN nanoisland inserted on growth of baseball-bat InN nanorods by plasma-assisted molecular beam epitaxy under In-rich conditions. By inserting CrN nanoislands between AlN nucleation layer and the Si (111) substrate, it was found that we could reduce strain form Si by inserting CrN nanoisland, FWHM of the x-ray rocking curve measured from InN nanorods from 3,299 reduced to 2,115 arcsec. It is due to the larger strain from lattice miss-match of the film-like InN structure; however, the strain from lattice miss-match was obvious reduced owing to CrN nanoisland inserted. The TEM images confirmed the CrN structures and In droplets dissociation from InN, by these results, we can speculate the growth mechanism of baseball-bat-like InN nanorods.
Regulation of the arachidonic acid mobilization in macrophages by combustion-derived particles
Authors: Fritsch-Decker Susanne , Both Tanja , Mülhopt Sonja , Paur Hanns-Rudolf , Weiss Carsten , Diabaté Silvia 
Published: August 2011

Abstract

Background
Acute exposure to elevated levels of environmental particulate matter (PM) is associated with increasing morbidity and mortality rates. These adverse health effects, e.g. culminating in respiratory and cardiovascular diseases, have been demonstrated by a multitude of epidemiological studies. However, the underlying mechanisms relevant for toxicity are not completely understood. Especially the role of particle-induced reactive oxygen species (ROS), oxidative stress and inflammatory responses is of particular interest.
In this in vitro study we examined the influence of particle-generated ROS on signalling pathways leading to activation of the arachidonic acid (AA) cascade. Incinerator fly ash particles (MAF02) were used as a model for real-life combustion-derived particulate matter. As macrophages, besides epithelial cells, are the major targets of particle actions in the lung murine RAW264.7 macrophages and primary human macrophages were investigated.

Results
The interaction of fly ash particles with macrophages induced both the generation of ROS and as part of the cellular inflammatory responses a dose- and time-dependent increase of free AA, prostaglandin E2/thromboxane B2 (PGE2/TXB2), and 8-isoprostane, a non-enzymatically formed oxidation product of AA. Additionally, increased phosphorylation of the mitogen-activated protein kinases (MAPK) JNK1/2, p38 and ERK1/2 was observed, the latter of which was shown to be involved in MAF02-generated AA mobilization and phosphorylation of the cytosolic phospolipase A2. Using specific inhibitors for the different phospolipase A2 isoforms the MAF02-induced AA liberation was shown to be dependent on the cytosolic phospholipase A2, but not on the secretory and calcium-independent phospholipase A2. The initiation of the AA pathway due to MAF02 particle exposure was demonstrated to depend on the formation of ROS since the presence of the antioxidant N-acetyl-cysteine (NAC) prevented the MAF02-mediated enhancement of free AA, the subsequent conversion to PGE2/TXB2 via the induction of COX-2 and the ERK1/2 and JNK1/2 phosphorylation. Finally we showed that the particle-induced formation of ROS, liberation of AA and PGE2/TXB2 together with the phosphorylation of ERK1/2 and JNK1/2 proteins was decreased after pre-treatment of macrophages with the metal chelator deferoxamine mesylate (DFO).

Conclusions
These results indicate that one of the primary mechanism initiating inflammatory processes by incinerator fly ash particles seems to be the metal-mediated generation of ROS, which triggers via the MAPK cascade the activation of AA signalling pathway.
Computerized clinical decision support systems for drug prescribing and management: A decision-maker-researcher partnership systematic review
Authors: Hemens Brian J , Holbrook Anne , Tonkin Marita , Mackay Jean A , Weise-Kelly Lorraine , Navarro Tamara , Wilczynski Nancy L , Brian Haynes R ,   the CCDSS Systematic Review Team
Published: August 2011

Abstract

Background
Computerized clinical decision support systems (CCDSSs) for drug therapy management are designed to promote safe and effective medication use. Evidence documenting the effectiveness of CCDSSs for improving drug therapy is necessary for informed adoption decisions. The objective of this review was to systematically review randomized controlled trials assessing the effects of CCDSSs for drug therapy management on process of care and patient outcomes. We also sought to identify system and study characteristics that predicted benefit.

Methods
We conducted a decision-maker-researcher partnership systematic review. We updated our earlier reviews (1998, 2005) by searching MEDLINE, EMBASE, EBM Reviews, Inspec, and other databases, and consulting reference lists through January 2010. Authors of 82% of included studies confirmed or supplemented extracted data. We included only randomized controlled trials that evaluated the effect on process of care or patient outcomes of a CCDSS for drug therapy management compared to care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive.

Results
Sixty-five studies met our inclusion criteria, including 41 new studies since our previous review. Methodological quality was generally high and unchanged with time. CCDSSs improved process of care performance in 37 of the 59 studies assessing this type of outcome (64%, 57% of all studies). Twenty-nine trials assessed patient outcomes, of which six trials (21%, 9% of all trials) reported improvements.

Conclusions
CCDSSs inconsistently improved process of care measures and seldomly improved patient outcomes. Lack of clear patient benefit and lack of data on harms and costs preclude a recommendation to adopt CCDSSs for drug therapy management.
Computerized clinical decision support systems for acute care management: A decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes
Authors: Sahota Navdeep , Lloyd Rob , Ramakrishna Anita , Mackay Jean A , Prorok Jeanette C , Weise-Kelly Lorraine , Navarro Tamara , Wilczynski Nancy L , Brian Haynes R ,   the CCDSS Systematic Review Team
Published: August 2011

Abstract

Background
Acute medical care often demands timely, accurate decisions in complex situations. Computerized clinical decision support systems (CCDSSs) have many features that could help. However, as for any medical intervention, claims that CCDSSs improve care processes and patient outcomes need to be rigorously assessed. The objective of this review was to systematically review the effects of CCDSSs on process of care and patient outcomes for acute medical care.

Methods
We conducted a decision-maker-researcher partnership systematic review. MEDLINE, EMBASE, Evidence-Based Medicine Reviews databases (Cochrane Database of Systematic Reviews, DARE, ACP Journal Club, and others), and the Inspec bibliographic database were searched to January 2010, in all languages, for randomized controlled trials (RCTs) of CCDSSs in all clinical areas. We included RCTs that evaluated the effect on process of care or patient outcomes of a CCDSS used for acute medical care compared with care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive.

Results
Thirty-six studies met our inclusion criteria for acute medical care. The CCDSS improved process of care in 63% (22/35) of studies, including 64% (9/14) of medication dosing assistants, 82% (9/11) of management assistants using alerts/reminders, 38% (3/8) of management assistants using guidelines/algorithms, and 67% (2/3) of diagnostic assistants. Twenty studies evaluated patient outcomes, of which three (15%) reported improvements, all of which were medication dosing assistants.

Conclusion
The majority of CCDSSs demonstrated improvements in process of care, but patient outcomes were less likely to be evaluated and far less likely to show positive results.
Computerized clinical decision support systems for chronic disease management: A decision-maker-researcher partnership systematic review
Authors: Roshanov Pavel S , Misra Shikha , Gerstein Hertzel C , Garg Amit X , Sebaldt Rolf J , Mackay Jean A , Weise-Kelly Lorraine , Navarro Tamara , Wilczynski Nancy L , Haynes R Brian ,   the CCDSS Systematic Review Team
Published: August 2011

Abstract

Background
The use of computerized clinical decision support systems (CCDSSs) may improve chronic disease management, which requires recurrent visits to multiple health professionals, ongoing disease and treatment monitoring, and patient behavior modification. The objective of this review was to determine if CCDSSs improve the processes of chronic care (such as diagnosis, treatment, and monitoring of disease) and associated patient outcomes (such as effects on biomarkers and clinical exacerbations).

Methods
We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews database, Inspec, and reference lists for potentially eligible articles published up to January 2010. We included randomized controlled trials that compared the use of CCDSSs to usual practice or non-CCDSS controls. Trials were eligible if at least one component of the CCDSS was designed to support chronic disease management. We considered studies 'positive' if they showed a statistically significant improvement in at least 50% of relevant outcomes.

Results
Of 55 included trials, 87% (n = 48) measured system impact on the process of care and 52% (n = 25) of those demonstrated statistically significant improvements. Sixty-five percent (36/55) of trials measured impact on, typically, non-major (surrogate) patient outcomes, and 31% (n = 11) of those demonstrated benefits. Factors of interest to decision makers, such as cost, user satisfaction, system interface and feature sets, unique design and deployment characteristics, and effects on user workflow were rarely investigated or reported.

Conclusions
A small majority (just over half) of CCDSSs improved care processes in chronic disease management and some improved patient health. Policy makers, healthcare administrators, and practitioners should be aware that the evidence of CCDSS effectiveness is limited, especially with respect to the small number and size of studies measuring patient outcomes.