bluuebunny/crossref_metadata_2025_split huggingface dataset:
Injuries and deaths due to victim-activated improvised explosive devices, landmines and other explosive remnants of war in Nepal
Authors: Bilukha Oleg O , Laurenge Hugues , Danee Luhar , Subedi Krishna P , Becknell Kristin 
Published: February 2011

BackgroundFollowing more than a decade of civil conflict, Nepal is among the countries affected by landmines, victim-activated improvised explosive devices (IED) and other explosive remnants of war (ERW).ObjectivesTo assess the magnitude of injuries due to landmines, victim-activated IED and other ERW in Nepal and to describe epidemiological patterns and risk factors for these events.MethodsAnalysis of surveillance data on civilian injuries due to landmines, victim-activated IED and other ERW between July 2006 and June 2010. Data were collected through active community-based prospective surveillance.ResultsOf 307 total casualties, 94 (31%) were female and 169 (55%) were children under 18 years of age. The case–fatality ratio was 14%. The highest number of casualties was in the age group 10–14 years. 233 (76%) injuries were caused by victim-activated IED, 13 (4%) by landmines and 44 (14%) by other ERW. Two types of IED, sutali and socket bombs, caused the majority of injuries (28% and 31%, respectively). 117 (38%) of all injuries occurred in victims' homes and 152 (50%) occurred while victims were tampering with explosive devices.ConclusionsSubstantial numbers of civilians, including women and children, were injured and killed following implementation of the Comprehensive Peace Agreement in 2006. The government of Nepal and humanitarian organisations should continue their efforts to reach communities at highest risk through targeted interventions and nationwide media campaigns to convey the risks of tampering with explosive devices or suspicious objects.
Hypoglycaemia: current management and controversies
Authors: Choudhary Pratik , Amiel Stephanie A 
Published: February 2011

ABSTRACTHypoglycaemia is a major burden on patients and society and is often a barrier to the achievement of tight glycaemic control. Intact awareness of hypoglycaemia is crucial to recognising and treating hypoglycaemia before it becomes severe enough to impair consciousness. Repeated hypoglycaemia can lead to impaired awareness increasing the risk of severe hypoglycaemia up to sixfold. Hypoglycaemia is much less common in those with type 2 diabetes, the incidence increasing with longer duration of treatment with insulin, associated comorbidities, and in the elderly. Alcohol, advancing age and exercise may predispose to hypoglycaemia. Newer agents acting via the incretin axis are associated with low rates of hypoglycaemia. Intensification of therapy to achieve tight glucose control can increase the risk of hypoglycaemia in the outpatient as well as critical care setting. In some studies this has also been associated with increased mortality, although causality has not been proven. Insulin treated patients are currently restricted from driving heavy goods vehicles or public service vehicles, although it is unclear if those with diabetes have any higher rates of accidents than those without diabetes. Surveys show that professionals are poor at emphasising the Driver and Vehicle Licensing Agency recommendations for drivers with diabetes in the UK. At every visit, patients with diabetes on hypoglycaemic agents should be assessed for frequency, severity, and awareness of hypoglycaemia. The main therapeutic strategies for reducing hypoglycaemia are structured patient education, use of modern insulin analogues, insulin pumps, and continuous glucose monitoring. Transplantation of islets or whole pancreas is indicated in those with recurrent disabling hypoglycaemia.
Determinants of tetanus and sepsis among the last neonatal deaths at household level in a peri-urban area of India
Authors: Ghosh Rohini , Sharma Arun Kumar 
Published: February 2011

ABSTRACT

Background
India contributes to one quarter of the total number of newborn deaths in the world. Less explored are the causes of these deaths, and household factors and decision makers for antenatal and postnatal care and their association with neonatal mortality.

Objective
This study estimated neonatal mortality rate due to tetanus and sepsis (TS) and tried to identify the risk factors for TS in a peri-urban area of India characterised by a high level of infant and neonatal mortality rate.

Methods
An intensive cross-sectional study was conducted during January to March 2008. A structured interview schedule was developed, after reviewing major demographic and health studies done in India, to collect data from all women selected in the sample villages, situated at a distance of 3–5 km from a primary health centre.

Results
Of the 894 married women (&lt;50 years of age), 109 reported their last pregnancy outcome as neonatal death, and 84 cases of TS were noted. Using forward conditional stepwise logistic regression the risk factors of TS identified were women's age, socioeconomic score, antenatal care, pregnancy complications, and treatment after delivery during the neonatal period.

Conclusions
Independent of social class there is high prevalence of neonatal mortality. There is a close association between utilisation of health care services during pregnancy, postnatal period and neonatal deaths due to TS. It is argued that there is a need for a two pronged approach to reduce neonatal mortality due to TS: (1) to train traditional birth attendants, and expand the reach of existing antenatal care and childbirth facilities; and (2) to empower women to increase their awareness to take decisions about seeking proper medical assistance during pregnancy and childbirth.
Demographic Disparities in Patterns of Care and Survival Outcomes for Patients with Resected Gastric Adenocarcinoma
Authors: Stessin Alexander M. , Sherr David L. 
Published: February 2011

Abstract
Background: Several reports showed incomplete adoption of adjuvant radiotherapy (RT) for resectable gastric cancer since the publication of Intergroup 0116 trial results. The aims of this study were to identify demographic factors associated with omission of adjuvant RT and assess the impact of this omission on survival.
Methods: SEER database was queried for cases of resected gastric cancer. Multivariate analyses with logistic and Cox regressions were used to examine (a) likelihood of receiving adjuvant RT for different patient and county demographics and (b) effect of demographics on survival outcomes.
Results: A total of 7,348 patients met the study criteria. Adjuvant RT was used in 33.1% of cases diagnosed in 1998–2001 and in 45.3% of cases in 2002–2007 (P &lt; 0.001). Controlling for independent covariates, African Americans were 8.9% less likely to receive adjuvant RT than Caucasians or Asians (P &lt; 0.001). Correspondingly, overall survival rates were significantly lower for African Americans than other races (HR = 1.38, P &lt; 0.001). Furthermore, both the likelihood of receiving RT and the survival rates were significantly affected by county demographics: percent of population without high school education, percent of households below the poverty line, and median household income. Survival rates were highest among Asians, but this finding did not reflect more frequent use of RT.
Conclusions: Race and socioeconomic factors are significant predictors of treatment and survival outcomes for patients with resectable gastric cancer.
Impact: The findings of this and similar studies may aide the medical community in designing more effective strategies to ameliorate the standards of care nationwide. Cancer Epidemiol Biomarkers Prev; 20(2); 223–33. ©2011 AACR.
Smoking Concordance in Lung and Colorectal Cancer Patient-Caregiver Dyads and Quality of Life
Authors: Weaver Kathryn E. , Rowland Julia H. , Augustson Erik , Atienza Audie A. 
Published: February 2011

Abstract
Background: Distress may be heightened among members of cancer patient-caregiver dyads that are mismatched on smoking status (either the patient or caregiver smokes, but the other does not), negatively affecting quality of life (QoL). The purpose of this study was to examine associations between patient-caregiver smoking concordance, caregiver psychological adjustment, and caregiver and patient mental and physical QoL.
Methods: Lung and colorectal patient-caregiver dyads (N = 742) were identified from the Cancer Care Outcomes Research and Surveillance (CanCORS) and CanCORS Caregiver studies. The majority of the cancer patients were male (67.0%) with local (45.6%) or regional (12.9%) disease. The majority of the informal caregivers were females (78.6%), under 65 years of age (69.6%), and often spouses (57.8%) of the patients.
Results: Lung and colorectal cancer caregivers, who were members of dyads where one or both members continued to smoke, reported worse mental health QoL than nonsmoking dyads. For colorectal cancer patients, continuing to smoke when the caregiver did not was associated with worse mental health QoL compared with nonsmoking dyads. Dyad smoking was less strongly associated with physical QoL for both caregivers and patients.
Conclusion: Results highlight the importance of assessing smoking in both cancer patients and their caregivers and referring families to appropriate psychosocial and smoking cessation services.
Impact: This is the first study to show associations between cancer patient-caregiver smoking status and QoL for both dyad members. Future studies will need to confirm these associations longitudinally and investigate potential mechanisms linking dyad smoking and QoL. Cancer Epidemiol Biomarkers Prev; 20(2); 239–48. ©2010 AACR.
Effects of a Decision Support Intervention on Decisional Conflict Associated with Microsatellite Instability Testing
Authors: Hall Michael J. , Manne Sharon L. , Winkel Gary , Chung Daniel S. , Weinberg David S. , Meropol Neal J. 
Published: February 2011

Abstract
Background: Decision support to facilitate informed consent is increasingly important for complicated medical tests. Here, we test a theoretical model of factors influencing decisional conflict in a study examining the effects of a decision support aid that was designed to assist patients at high risk for hereditary nonpolyposis colorectal cancer (CRC) deciding whether to pursue the microsatellite instability (MSI) test.
Methods: Participants were 239 CRC patients at high familial risk for a genetic mutation who completed surveys before and after exposure to the intervention. Half of the sample was assigned to the CD-ROM aid and half received a brief description of the test. Structural equation modeling was employed to examine associations among the intervention, knowledge, pros and cons to having MSI testing, self-efficacy, preparedness, and decisional conflict.
Results: The goodness of fit for the model was acceptable [FIML, full information maximum likelihood, χ2 (df = 280) = 392.24; P = 0.00]. As expected, the paths to decisional conflict were significant for postintervention pros of MSI testing (t = −2.43; P &lt; 0.05), cons of MSI testing (t = 2.78; P &lt; 0.05), and preparedness (t = −7.27; P &lt; 0.01). The intervention impacted decisional conflict by increasing knowledge about the MSI test and knowledge exerted its effects on decisional conflict by increasing preparedness to make a decision about the test and by increases in perceived benefits of having the test.
Conclusion: Increasing knowledge, preparedness, and perceived benefits of undergoing the MSI test facilitate informed decision making for this test.
Impact: Understanding mechanisms underlying health decisions is critical for improving decisional support. Individuals with Lynch syndrome have an elevated lifetime risk of CRC. Risk of Lynch syndrome may be assessed with a tumor-based screening test (MSI testing or immunohistochemical tissue staining). Cancer Epidemiol Biomarkers Prev; 20(2); 249–54. ©2011 AACR.
Incident Cervical HPV Infections in Young Women: Transition Probabilities for CIN and Infection Clearance
Authors: Insinga Ralph P. , Perez Gonzalo , Wheeler Cosette M. , Koutsky Laura A. , Garland Suzanne M. , Leodolter Sepp , Joura Elmar A. , Ferris Daron G. , Steben Marc , Hernandez-Avila Mauricio , Brown Darron R. , Elbasha Elamin , Muñoz Nubia , Paavonen Jorma , Haupt Richard M. 
Published: February 2011

Abstract
Background: We describe transition probabilities for incident human papillomavirus (HPV) 16/18/31/33/35/45/52/58/59 infections and cervical intraepithelial neoplasia (CIN) 1 lesions.
Methods: Women ages 16 to 23 years underwent cytology and cervical swab PCR testing for HPV at approximately 6-month intervals for up to 4 years in the placebo arm of an HPV vaccine trial. The cumulative proportion of incident HPV infections with diagnosed CIN, clearing (infection undetectable), or persisting without CIN, were estimated.
Results: Most incident infections cleared, without detection of CIN, ranging at 36 months from 66.9% for HPV31 to 91.1% for HPV59. There was little variation in the 36-month proportion of incident HPV16, 18, and 31 infections followed by a CIN1 lesion positive for the relevant HPV type (range 16.7%–18.6%), with lower risks for HPV59 (6.4%) and HPV33 (2.9%). Thirty-six–month transition probabilities for CIN2 ranged across types from 2.2% to 9.1%; however, the number of events was generally too small for statistically significant differences to be seen across types for this endpoint, or CIN3.
Conclusions: Some incident HPV types appear more likely to result in diagnosed CIN1 than others. The relative predominance of HPV16, vis-à-vis some other high-risk HPV types (e.g., HPV33) in prevalent CIN2/3, appears more directly associated with relatively greater frequency of incident HPV16 infections within the population, than a higher risk of infection progression to CIN2/3.
Impact: Nearly all incident HPV infections either manifest as detectable CIN or become undetectable within 36 months. Some HPV types (e.g., 16 and 33) appear to have similar risk of CIN2/3 despite widely varied incidence. Cancer Epidemiol Biomarkers Prev; 20(2); 287–96. ©2011 AACR.
Higher Fecal Immunochemical Test Cutoff Levels: Lower Positivity Rates but Still Acceptable Detection Rates for Early-Stage Colorectal Cancers
Authors: Terhaar sive Droste Jochim S. , Oort Frank A. , van der Hulst René W.M. , van Heukelem Henk A. , Loffeld Ruud J.L.F. , van Turenhout Sietze T. , Ben Larbi Ilhame , Kanis Shannon L. , Neerincx Maarten , Räkers Mirre , Coupé Veerle M.H. , Bouman Anneke A. , Meijer Gerrit A. , Mulder Chris J.J. 
Published: February 2011

Abstract
Background: Adjusting the threshold for positivity of quantitative fecal immunochemical tests (FIT) allows for controlling the number of follow-up colonoscopies in a screening program. However, it is unknown to what extent higher cutoff levels affect detection rates of screen-relevant neoplasia. This study aimed to assess the effect of higher cutoff levels of a quantitative FIT on test positivity rate and detection rate of early-stage colorectal cancers (CRC).
Methods: Subjects above 40 years old scheduled for colonoscopy in 5 hospitals were asked to sample a single FIT (OC sensor) before colonoscopy. Screen-relevant neoplasia were defined as advanced adenoma or early-stage cancer (stage I and II). Positivity rate, sensitivity, and specificity were evaluated at increasing cutoff levels of 50 to 200 ng/mL.
Results: In 2,145 individuals who underwent total colonoscopy, 79 patients were diagnosed with CRC, 38 of which were with early-stage disease. Advanced adenomas were found in 236 patients. When varying cutoff levels from ≥50 to ≥200 ng/mL, positivity rates ranged from 16.5% to 10.2%. With increasing cutoff levels, sensitivity for early-stage CRCs and for screen-relevant neoplasia ranged from 84.2% to 78.9% and 47.1% to 37.2%, respectively.
Conclusions: Higher FIT cutoff levels substantially decrease test positivity rates with only limited effects on detection rates of early-stage CRCs. However, spectrum bias resulting in higher estimates of sensitivity than would be expected in a screening population may be present.
Impact: Higher cutoff levels can reduce strain on colonoscopy capacity with only a modest decrease in sensitivity for curable cancers. Cancer Epidemiol Biomarkers Prev; 20(2); 272–80. ©2010 AACR.
Circulating Sex Steroids during Pregnancy and Maternal Risk of Non-epithelial Ovarian Cancer
Authors: Chen Tianhui , Surcel Helja-Marja , Lundin Eva , Kaasila Marjo , Lakso Hans-Ake , Schock Helena , Kaaks Rudolf , Koskela Pentti , Grankvist Kjell , Hallmans Goran , Pukkala Eero , Zeleniuch-Jacquotte Anne , Toniolo Paolo , Lehtinen Matti , Lukanova Annekatrin 
Published: February 2011

AbstractBackground: Sex steroid hormones have been proposed to play a role in the development of non-epithelial ovarian cancers (NEOC) but so far no direct epidemiologic data are available.Methods: A case–control study was nested within the Finnish Maternity Cohort, the world's largest biorepository of serum specimens from pregnant women. Study subjects were selected among women who donated a blood sample during a singleton pregnancy that led to the birth of their last child preceding diagnosis of NEOC. Case subjects were 41 women with sex cord stromal tumors (SCST) and 21 with germ cell tumors (GCT). Three controls, matching the index case for age, parity at the index pregnancy, and date at blood donation were selected (n = 171). OR and 95% CI associated with concentrations of testosterone, androstenedione, 17-OH-progesterone, progesterone, estradiol, and sex hormone–binding globulin (SHBG) were estimated through conditional logistic regression.Results: For SCST, doubling of testosterone, androstenedione, and 17-OH-progesterone concentrations were associated with about 2-fold higher risk of SCST [ORs and 95% CI of 2.16 (1.25–3.74), 2.16 (1.20–3.87), and 2.62 (1.27–5.38), respectively]. These associations remained largely unchanged after excluding women within 2-, 4-, or 6-year lag time between blood donation and cancer diagnosis. Sex steroid hormones concentrations were not related to maternal risk of GCT.Conclusions: This is the first prospective study providing initial evidence that elevated androgens play a role in the pathogenesis of SCST.Impact: Our study may note a particular need for larger confirmatory investigations on sex steroids and NEOC. Cancer Epidemiol Biomarkers Prev; 20(2); 324–36. ©2010 AACR.
Metformin and the Incidence of Prostate Cancer in Patients with Type 2 Diabetes
Authors: Azoulay Laurent , Dell'Aniello Sophie , Gagnon Bruno , Pollak Michael , Suissa Samy 
Published: February 2011

Abstract
Background: Several in vitro studies have indicated that metformin may reduce the risk of prostate cancer; however, epidemiologic studies have been inconclusive. The objective of this study was to determine whether metformin decreases the risk of prostate cancer in patients with type 2 diabetes.
Methods: A nested case–control analysis was conducted within a population-based cohort from the UK General Practice Research Database. The cohort included patients over the age of 40 who were prescribed a first oral hypoglycemic agent (OHA) between 1988 and 2009. Cases of prostate cancer were matched up to ten controls on year of birth, date of cohort entry, and duration of follow-up. Adjusted rate ratios (RR) were estimated using conditional logistic regression.
Results: The cohort included 63,049 incident users of OHAs, in which 739 cases of prostate cancer were matched to 7,359 controls. Metformin use did not decrease the risk of prostate cancer (RR: 1.23, 95% CI: 0.99–1.52). In secondary analyses, prostate cancer risk was found to increase as a function of the number of metformin prescriptions received (one to seven prescriptions: RR: 1.05, 95% CI: 0.80–1.37; seven to eighteen prescriptions: RR: 1.29, 95% CI: 0.99–1.69; eighteen to thirty-six prescriptions: RR: 1.37, 95% CI: 1.04–1.81; more than thirty-six prescriptions: RR: 1.40, 95% CI: 1.03–1.89).
Conclusion: The results of this study indicate that metformin does not reduce the risk of prostate cancer in patients with type 2 diabetes.
Impact: The secondary analyses need to be interpreted with caution given the inverse association between type 2 diabetes and prostate cancer. Cancer Epidemiol Biomarkers Prev; 20(2); 337–44. ©2010 AACR.
Assessment of Type of Allergy and Antihistamine Use in the Development of Glioma
Authors: McCarthy Bridget J. , Rankin Kristin , Il'yasova Dora , Erdal Serap , Vick Nicholas , Ali-Osman Francis , Bigner Darell D. , Davis Faith 
Published: February 2011

Abstract
Background: Allergies have been associated with decreased risk of glioma; but, associations between duration and timing of allergies, and antihistamine use and glioma risk have been less consistent. The objective was to investigate this association by analyzing types, number, years since diagnosis, and age at diagnosis of allergies, and information on antihistamine usage, including type, duration, and frequency of exposure.
Methods: Self-report data on medically diagnosed allergies and antihistamine use were obtained for 419 glioma cases and 612 hospital-based controls from Duke University and NorthShore University HealthSystem.
Results: High- and low-grade glioma cases were statistically significantly less likely to report any allergy than controls (OR = 0.66, 95% CI: 0.49–0.87 and OR = 0.44, 95% CI: 0.25–0.76, respectively). The number of types of allergies (seasonal, medication, pet, food, and other) was inversely associated with glioma risk in a dose–response manner (P value for trend &lt; 0.05). Age at diagnosis and years since diagnosis of allergies were not associated with glioma risk. Oral antihistamine use was statistically significantly inversely associated with glioma risk, but when stratified by allergy status, remained significant only for those with high-grade glioma and no medically diagnosed allergy.
Conclusions: All types of allergies appear to be protective with reduced risk for those with more types of allergies. Antihistamine use, other than in relationship with allergy status, may not influence glioma risk.
Impact: A comprehensive study of allergies and antihistamine use using standardized questions and biological markers will be essential to further delineate the biological mechanism that may be involved in brain tumor development. Cancer Epidemiol Biomarkers Prev; 20(2); 370–8. ©2011 AACR.