bluuebunny/crossref_metadata_2025_split huggingface dataset:
A pilot study to examine research subjects' perception of participating in research in the emergency department
Authors: Paradis Carmen , Phelan Michael P , Brinich Margaret 
Published: August 2010

Study objectivesThe emergency department (ED) provides an arena for patient enrolment into a variety of research studies even for non-critically ill patients. Given the types of illness, time constraints and sense of urgency that exists in the ED environment, concern exists about whether research subjects in the ED can provide full consent for participation. We sought to identify enrolled research subjects' perspectives on the informed consent process for research conducted in the ED.MethodsThis was a prospective, observational study of ED subjects, 18 years or older, who had been approached to participate in research in the ED and who were judged to have decision-making capacity. Exclusions were critical illness and refusal to participate. Subjective were followed up within 1 week after enrolling using structured phone interviews by trained interviewers.ResultsDuring the study period, 229 eligible patients were approached to participate in both a target study and this study. Of these, 66% (150/229) agreed to participate in this study, at least to the extent of allowing us access to their demographic data. The study participant group was similar in terms of gender to this particular ED's patient population but had significantly more African-Americans and persons older than 45.ConclusionDespite rigorous time constraints and rapid throughput times, the majority of subjects who consented to research participation in the ED felt that they were sufficiently informed and had adequate time to decide to participate.
Comparison of occupational exposure assessment methods in a case–control study of lead, genetic susceptibility and risk of adult brain tumours
Authors: Bhatti Parveen , Stewart Patricia A , Linet Martha S , Blair Aaron , Inskip Peter D , Rajaraman Preetha 
Published: August 2010

ObjectivesThere is great interest in evaluating gene–environment interactions with chemical exposures, but exposure assessment poses a unique challenge in case–control studies. Expert assessment of detailed work history data is usually considered the best approach, but it is a laborious and time-consuming process. We set out to determine if a less intensive method of exposure assessment (a job exposure matrix (JEM)) would produce similar results to a previous analysis that found evidence of effect modification of the association between expert-assessed lead exposure and risk of brain tumours by a single nucleotide polymorphism in theALADgene (rs1800435).MethodsWe used data from a study of 355 patients with glioma, 151 patients with meningioma and 505 controls. Logistic regression models were used to examine associations between brain tumour risk and lead exposure and effect modification by genotype. We evaluated Cohen's κ, sensitivity and specificity for the JEM compared to the expert-assessed exposure metrics.ResultsAlthough effect estimates were imprecise and driven by a small number of cases, we found evidence of effect modification between lead exposure andALADgenotype when using expert- but not JEM-derived lead exposure estimates. κ Values indicated only modest agreement (<0.5) for the exposure metrics, with the JEM indicating high specificity (∼0.9) but poor sensitivity (∼0.5). Disagreement between the two methods was generally due to having additional information in the detailed work history.ConclusionThese results provide preliminary evidence suggesting that high quality exposure data are likely to improve the ability to detect genetic effect modification.
Radiation doses from global fallout and cancer incidence among reindeer herders and Sami in Northern Finland
Authors: Kurttio Päivi , Pukkala Eero , Ilus Taina , Rahola Tua , Auvinen Anssi 
Published: August 2010

ObjectivesPeople in the Arctic regions are one of the most heavily exposed population from the global fallout from atmospheric atomic bomb testing of the 1950s and 1960s due to their diet rich in reindeer meat in which radionuclides accumulate. We estimated the effect of the radioactive fallout and ethnicity on the cancer incidence in Northern Finland.MethodsA cohort of the Arctic population in Finland (n=34 653) was identified through the Population Register Centre with grouping by reindeer herding status, ethnicity and radiation exposure. Annual average radiation doses, based on137Cs whole-body measurements, were assigned by birth year, gender and reindeer herder status. Incident cancer cases of a priori selected cancer types in the study cohort during 1971–2005 were identified from the Finnish Cancer Registry.ResultsA total of 2630 cancer cases were observed versus 3073 expected on the basis of incidence rates in Northern Finland (standardised incidence ratio (SIR) was 0.86 with 95% CI of 0.82 to 0.89). For the indigenous Sami people SIR was even lower, 0.60 (95% CI 0.50 to 0.71). None of the cancer sites was significantly associated with the lifetime cumulative radiation dose. The SIR for the combined group of radiation-related cancer sites increased with the cumulative radiation dose received before 15 years of age (p=0.004).ConclusionDespite the low overall cancer incidence in the Arctic population and ethnic Sami people in Finland and lack of association between the lifetime cumulative radiation exposure from global radioactive fallout and cancer incidence, we found some indication of an increased cancer risk associated with radiation exposure received during childhood. Potential underestimation and misclassification of the radiation dose may affect the results and the findings should be interpreted with caution.
Blood lead at currently acceptable levels may cause preterm labour
Authors: Vigeh Mohsen , Yokoyama Kazuhito , Seyedaghamiri Zahrabigom , Shinohara Atsuko , Matsukawa Takehisa , Chiba Momoko , Yunesian Masoud 
Published: August 2010

ObjectivesAlthough occupational and environmental exposures to lead have been dramatically reduced in recent decades, adverse pregnancy outcomes have been observed at ‘acceptable’ levels of blood lead concentrations (≤10 μg/dl).MethodologyBlood samples were collected from 348 singleton pregnant women, aged 16–35 years, during the first trimester of pregnancy (8–12 weeks) for lead measurement by inductively coupled plasma–mass spectrometry. Subjects were followed up and divided into two groups (preterm and full-term deliveries) according to duration of gestation.ResultsThe average (range) and geometric means of blood lead levels were 3.8 (1.0–20.5) and 3.5 μg/dl, respectively. Blood lead level was significantly (p<0.05) higher in mothers who delivered preterm babies than in those who delivered full-term babies (mean±SD: 4.46±1.86 and 3.43±1.22 μg/dl, respectively). Logistic regression analysis demonstrated that a 1 unit increase in blood lead levels led to an increased risk of preterm birth (OR 1.41, 95% CI 1.08 to 1.84).ConclusionAdverse pregnancy outcomes may occur at blood lead concentrations below the current acceptable level.
Incidence of extrapleural malignant mesothelioma and asbestos exposure, from the Italian national register
Authors: Marinaccio Alessandro , Binazzi Alessandra , Di Marzio Davide , Scarselli Alberto , Verardo Marina , Mirabelli Dario , Gennaro Valerio , Mensi Carolina , Merler Enzo , De Zotti Renata , Mangone Lucia , Chellini Elisabetta , Pascucci Cristiana , Ascoli Valeria , Menegozzo Simona , Cavone Domenica , Cauzillo Gabriella , Nicita Carmela , Melis Massimo , Iavicoli Sergio 
Published: August 2010

ObjectivesThe epidemiology of extrapleural malignant mesothelioma is rarely discussed and the risk of misdiagnosis and the very low incidence complicate the picture. This study presents data on extrapleural malignant mesothelioma from the Italian National Mesothelioma Register (ReNaM).MethodsReNaM works on a regional basis, searching for cases and interviewing subjects to investigate asbestos exposure. Classification and code criteria for certainty of diagnosis and exposure modalities are set by national guidelines. Between 1993 and 2004, 681 cases were collected. Incidence measures and exposure data refer to the ReNaM database. Age-standardised rates were estimated by the direct method using the Italian resident population in 2001. Correlations between the incidence of pleural and non-pleural malignant mesothelioma for the 103 Italian provinces were analysed.ResultsStandardised incidence rates (Italy, 2004, per million inhabitants) were 2.1 and 1.2 cases for the peritoneal site (in men and women, respectively), 0.2 cases for the tunica vaginalis testis, and 0.1 in the pericardial site, varying widely in different parts of the country. Mean age at diagnosis for all extrapleural malignant mesothelioma cases was 64.4 years and the men/women ratio was 1.57:1. Median latency was over 40 years for all extrapleural sites combined. The correlation between pleural and peritoneal mesothelioma was 0.71 (Pearson's r coefficient, p<0.001). Modalities of exposure to asbestos fibres were investigated for 392 cases.ConclusionsThe rarity of the disease, the low specificity of diagnosis and difficulties in identifying the modalities of asbestos exposure call for caution in discussing aetiological factors other than asbestos.
Ozone, heat and mortality: acute effects in 15 British conurbations
Authors: Pattenden Sam , Armstrong Ben , Milojevic Ai , Heal Mathew R , Chalabi Zaid , Doherty Ruth , Barratt Ben , Kovats R Sari , Wilkinson Paul 
Published: August 2010

BackgroundAcute associations between mortality and ozone are largely accepted, though recent evidence is less conclusive. Evidence on ozone–heat interaction is sparse. We assess effects of ozone, heat, and their interaction, on mortality in Britain.MethodsAcute effects of summer ozone on mortality were estimated using data from 15 conurbations in England and Wales (May–September, 1993–2003). 2-day means of daily maximum 8-h ozone were entered into case series analyses, controlling for particulate matter with aerodynamic diameter of <10 μm, natural cubic splines of temperature, and other factors. Heat effects were estimated, comparing adjusted mortality rates at 97.5th and 75th percentiles of 2-day mean temperature. A separate model employed interaction terms to assess whether ozone effects increased on ‘hot days’ (where 2-day mean temperature exceeded the whole-year 95th percentile). Other heat metrics, and non-linear ozone effects, were also examined.ResultsAdverse ozone and heat effects occurred in nearly all conurbations. The mean mortality rate ratio for heat effect across conurbations was 1.071 (1.050–1.093). The mean ozone rate ratio was 1.003 per 10 μg/m3ozone increase (95% CI 1.001 to 1.005). On ‘hot days’ the mean ozone effect reached 1.006 (1.002–1.009) per 10 μg/m3, though ozone–heat interaction was significant in London only. On substituting maximum for mean temperature, the overall ozone effect reduced to null, though evidence remained of effects on hot days, particularly in London. An estimated ozone effect threshold was below current guidelines in ‘mean temperature’ models.ConclusionWhile heat showed robust effects on summer mortality, estimates for ozone depended upon the modelling of temperature. However, there was some evidence that ozone effects were worse on hot days, whichever temperature measure was used.
The impact of ill health on exit from paid employment in Europe among older workers
Authors: van den Berg Tilja , Schuring Merel , Avendano Mauricio , Mackenbach Johan , Burdorf Alex 
Published: August 2010

ObjectiveTo determine the impact of ill health on exit from paid employment in Europe among older workers.MethodsParticipants of the Survey on Health and Ageing in Europe (SHARE) in 11 European countries in 2004 and 2006 were selected when 50–63 years old and in paid employment at baseline (n=4611). Data were collected on self-rated health, chronic diseases, mobility limitations, obesity, smoking, alcohol use, physical activity and work characteristics. Participants were classified into employed, retired, unemployed and disabled at the end of the 2-year follow-up. Multinomial logistic regression was used to estimate the effect of different measures of ill health on exit from paid employment.ResultsDuring the 2-year follow-up, 17% of employed workers left paid employment, mainly because of early retirement. Controlling for individual and work related characteristics, poor self-perceived health was strongly associated with exit from paid employment due to retirement, unemployment or disability (ORs from 1.32 to 4.24). Adjustment for working conditions and lifestyle reduced the significant associations between ill health and exit from paid employment by 0–18.7%. Low education, obesity, low job control and effort–reward imbalance were associated with measures of ill health, but also risk factors for exit from paid employment after adjustment for ill health.ConclusionPoor self-perceived health was strongly associated with exit from paid employment among European workers aged 50–63 years. This study suggests that the influence of ill health on exit from paid employment could be lessened by measures targeting obesity, problematic alcohol use, job control and effort–reward balance.
What is the best strategy to reduce the burden of occupational asthma and allergy in bakers?
Authors: Meijster Tim , Warren Nick , Heederik Dick , Tielemans Erik 
Published: August 2010

RationaleInsight into the effectiveness of intervention strategies will help realise a decrease in the occupational disease burden from (allergic) respiratory diseases in the bakery population.ObjectivesTo use a simulation model to assess the impact of different intervention strategies on the disease burden of the bakery population over time.MethodsA recently developed dynamic population based model was used to prospectively evaluate the impact on disease burden resulting from different intervention strategies. We distinguished interventions based on exposure reductions for flour dust and fungal α-amylase, health surveillance combined with reduction in exposure, and pre-employment screening.Main ResultsThe impact of most interventions on disease burden was limited, generally less than 50% for lower respiratory symptoms and disabling occupational asthma. Only the rigorous health surveillance strategy, identifying workers who are sensitised or report upper respiratory symptoms and decreasing their individual exposures by 90% shortly after diagnosis, resulted in a decrease of almost 60% in disease burden after 20 years.ConclusionsThis study demonstrates that different intervention strategies have substantially different impacts on the burden of disease. The time window during which changes occur differs considerably between strategies. This information can assist policy makers in their choice of intervention and gives guidance for achievable reductions in disease burden.
Mortality from diabetes and ischaemic heart disease in textile workers
Authors: Zanardi Francesca , Harris E Clare , Brown Terry , Rice Simon , Palmer Keith T , Coggon David 
Published: August 2010

BackgroundTo explore explanations for elevated mortality from diabetes among male garment manufacturers and repairers in England and Wales during 1979-1990, analysis was extended by 10 years, looking also at other textile workers and at deaths from ischaemic heart disease (IHD).MethodsData on some 3.5 million deaths were used to compute proportional mortality ratios (PMRs) for diabetes and IHD, standardised for age and social class, in 10 textile-associated job groups, with additional analyses by place of birth for 1993–2000.ResultsMale mortality from diabetes was elevated in nine of the 10 textile jobs, with overall PMRs of 147 (95% CI 131 to 165) during 1979–90 and 170 (95% CI 144 to 199) during 1991–2000. Proportional mortality from IHD was also consistently high. Female mortality from both diseases was close to that for other occupations. In both sexes, mortality from diabetes and IHD was increased among people born in the Indian subcontinent (PMRs 353 and 139 in men; 262 and 130 in women). In men, the proportion of deceased textile workers born in the Indian subcontinent (11.4%) was much higher than for all occupations (1.8%), but not in women (1.1% vs 0.7%). PMRs for male textile workers standardised for place of birth were lower but still significantly elevated (133, 95% CI 110 to 159 for diabetes; 109, 95% CI 105 to 114 for IHD).ConclusionsNo obvious occupational hazard explains the increased risk specific to men across a wide range of textile occupations. One possible explanation is uncontrolled residual confounding related to place of birth. This could be tested through suitably designed morbidity surveys.
Fast and specific detection of moderate long-term changes in occupational blood exposures
Authors: Chaillol Isabelle , Ecochard René , Denis Marie-Agnès , Iwaz Jean , Khoueiry Phrem , Bergeret Alain 
Published: August 2010

ObjectivesHospital surveillance systems have been established to monitor occupational blood exposures. We compare short-term monitoring with long-term monitoring of data analysis over 11 years and 21 institutions to identify variations in the number of reported exposures.MethodsShort-term monitoring examines the current number of exposures compared to their average over previous years. Long-term monitoring detects trends over several years by various exposure characteristics (place, staff, procedure, etc) through estimating rates of change and using the best linear unbiased predictors (BLUPs) to prevent artefactual trends due to the many categories for each characteristic. Graphical representations of estimated rates help detect change and differences in rates of change.ResultsAnnual monitoring allowed detection of significant changes in the number of reported exposures. Long-term monitoring identified moderate trends over time. The BLUP corrected the estimate of each specific annual rate of change and allowed all other rates to reduce the random variability around the mean change for more specificity. League tables showed significant increases or decreases compared to no change. League tables for two-by-two comparisons allowed reliable comparisons between estimates of the rates of change, although with spurious ranking. Funnel plots enabled quick detection of changes in trends within specified confidence intervals. Long-term trends agreed with the dominant type of annual changes over the 11 years but were not as sensitive.ConclusionsThe two methods have different uses. Both are helpful for assessing short-term sudden and long-term minor changes in number of exposures, possibly reflecting the success or otherwise of introducing specific safety devices or guidelines.
Workplace smoking restrictions in China: results from a six county survey
Authors: Ma Jiemin , Apelberg Benjamin J , Avila-Tang Erika , Yang Gonghuan , Ma Shaojun , Samet Jonathan M , Stillman Frances A 
Published: August 2010

ObjectiveTo determine the coverage of smoking restriction policies in indoor workplaces in China and to assess the relationships between these restrictive policies and secondhand smoke (SHS) exposure and smoking behaviours.MethodsA cross-sectional household survey was conducted in six counties in Sichuan, Jiangxi and Henan provinces in 2004. Using a standardised questionnaire, information on demographic characteristics, knowledge, attitudes and behaviours related to smoking and SHS exposure was collected through face-to-face interviews by trained local investigators among 12 036 respondents. Of respondents, 2698 individuals worked mainly indoors and were included in data analysis.ResultsOnly 28.5% of respondents reported that indoor workplaces had a smoke-free policy. Even when respondents reported smoke-free policies, 41.1% smokers reported that they were non-compliant with policies and smoked at work. In addition, 32.0% of non-smokers reported being exposed to SHS at work despite smoke-free policies. Non-smokers who reported no smoking restriction policies were 3.7 times more likely to be exposed to SHS than those working in smoke-free workplaces (adjusted OR 3.7, 95% CI 1.3 to 10.1). On average, respondents complying with smoke-free policies smoked 3.8 fewer cigarettes than those reporting no policies in their workplaces at a marginally non-significant level (p=0.06) (adjusted mean difference −3.8, 95% CI −8.0 to 0.5).ConclusionsIn China, few workplaces have implemented policies to restrict smoking, and, even in workplaces that have policies, workers report exposure to SHS while at their places of employment. Many workers report a lack of compliance with smoke-free policies. China needs better implementation of SHS policies to promote compliance. Working to improve implementation of smoke-free policies would promote cessation since Chinese smokers who were compliant with these efforts reported smoking fewer cigarettes per day.
MULTIRESOLUTION CONTROL OF CURVES AND SURFACES WITH A SELF-SIMILAR MODEL
Authors: HNAIDI HOUSSAM , GUÉRIN ERIC , AKKOUCHE SAMIR 
Published: August 2010

This paper presents two self-similar models that allow the control of curves and surfaces. The first model is based on IFS (Iterated Function Systems) theory and the second on subdivision curve and surface theory. Both of these methods employ the detail concept as in the wavelet transform, and allow the multiresolution control of objects with control points at any resolution level.In the first model, the detail is inserted independently of control points, requiring it to be rotated when applying deformations. In contrast, the second method describes details relative to control points, allowing free control point deformations.Modeling examples of curves and surfaces are presented, showing manipulation facilities of the models.
Predictors of Incident Heart Failure in a Large Insured Population
Authors: Goyal Abhinav , Norton Catherine R. , Thomas Tracy N. , Davis Robert L. , Butler Javed , Ashok Varun , Zhao Liping , Vaccarino Viola , Wilson Peter W.F. 
Published: August 2010

Background—
Studies on the incidence and predictors of heart failure (HF) are often restricted to elderly persons or identify only inpatient cases.

Methods and Results—
We determined the incidence and predictors of new HF diagnosed in either outpatient or inpatient settings, among 359 947 women and men (age ≥18 years) insured by Kaiser Permanente Georgia at any time during calendar years 2000 to 2005. Subjects were free of HF at baseline, and incident HF was identified with ICD-9 codes (1 inpatient or 2 outpatient HF visits). We developed multivariable Cox models to assess the association of antecedent factors (coronary heart disease, hypertension, diabetes mellitus, atrial fibrillation, and valvular heart disease) with incident HF. Separate models were created for each sex and for newly diagnosed HF in outpatient or inpatient settings. There were 4001 incident HF cases (50% women and 48% in subjects <65 years old), during 1 015 794 person-years of follow-up. The incidence rate of HF was greater in men than in women (4.24 versus 3.68 per 1000 person-years) but was stable across the study interval in both sexes. Two thirds of incident HF cases from this population occurred in outpatients. These 5 antecedent factors and age yielded excellent discrimination for incident HF in both outpatients and inpatients and in both sexes (C >0.85 in all models).

Conclusions—
Common modifiable risk factors accurately discriminate women and men at risk for HF diagnosed in either outpatient or inpatient settings. Approximately two thirds of new HF cases in our insured population were diagnosed in outpatients; more research is needed to characterize these subjects and their prognosis.