Publications from 2017

@article{RN15603b,

title = {A new paradigm for Aedes spp. surveillance using gravid ovipositing sticky trap and NS1 antigen test kit},

author = {S M Lau and T H Chua and W Y Sulaiman and S Joanne and Y A Lim and S D Sekaran and K Chinna and B Venugopalan and I Vythilingam},

doi = {10.1186/s13071-017-2091-y},

issn = {1756-3305},

year  = {2017},

date = {2017-01-01},

journal = {Parasit Vectors},

volume = {10},

number = {1},

pages = {151},

abstract = {BACKGROUND: Dengue remains a serious public health problem in Southeast Asia and has increased 37-fold in Malaysia compared to decades ago. New strategies are urgently needed for early detection and control of dengue epidemics. METHODS: We conducted a two year study in a high human density dengue-endemic urban area in Selangor, where Gravid Ovipositing Sticky (GOS) traps were set up to capture adult Aedes spp. mosquitoes. All Aedes mosquitoes were tested using the NS1 dengue antigen test kit. All dengue cases from the study site notified to the State Health Department were recorded. Weekly microclimatic temperature, relative humidity (RH) and rainfall were monitored. RESULTS: Aedes aegypti was the predominant mosquito (95.6%) caught in GOS traps and 23% (43/187 pools of 5 mosquitoes each) were found to be positive for dengue using the NS1 antigen kit. Confirmed cases of dengue were observed with a lag of one week after positive Ae. aegypti were detected. Aedes aegypti density as analysed by distributed lag non-linear models, will increase lag of 2-3 weeks for temperature increase from 28 to 30 degrees C; and lag of three weeks for increased rainfall. CONCLUSION: Proactive strategy is needed for dengue vector surveillance programme. One method would be to use the GOS trap which is simple to setup, cost effective (below USD 1 per trap) and environmental friendly (i.e. use recyclable plastic materials) to capture Ae. aegypti followed by a rapid method of detecting of dengue virus using the NS1 dengue antigen kit. Control measures should be initiated when positive mosquitoes are detected.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15555b,

title = {A prospective evaluation of plasma phospholipid fatty acids and breast cancer risk in the EPIC study},

author = {V Chajes and N Assi and C Biessy and P Ferrari and S Rinaldi and N Slimani and G M Lenoir and L Baglietto and M His and M C Boutron-Ruault and A Trichopoulou and P Lagiou and M Katsoulis and R Kaaks and T Kuhn and S Panico and V Pala and G Masala and H B Bueno-de-Mesquita and P H Peeters and C Gils and A Hjartaker and K Standahl Olsen and R Borgund Barnung and A Barricarte and D Redondo-Sanchez and V Menendez and P Amiano and M Wennberg and T Key and K T Khaw and M A Merritt and E Riboli and M J Gunter and I Romieu},

doi = {10.1093/annonc/mdx482},

issn = {0923-7534},

year  = {2017},

date = {2017-01-01},

journal = {Ann Oncol},

volume = {28},

number = {11},

pages = {2836-2842},

abstract = {Background: Intakes of specific fatty acids have been postulated to impact breast cancer risk but epidemiological data based on dietary questionnaires remain conflicting. Materials and methods: We assessed the association between plasma phospholipid fatty acids and breast cancer risk in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition study. Sixty fatty acids were measured by gas chromatography in pre-diagnostic plasma phospholipids from 2982 incident breast cancer cases matched to 2982 controls. Conditional logistic regression models were used to estimate relative risk of breast cancer by fatty acid level. The false discovery rate (q values) was computed to control for multiple comparisons. Subgroup analyses were carried out by estrogen receptor (ER) and progesterone receptor expression in the tumours. Results: A high level of palmitoleic acid [odds ratio (OR) for the highest quartile compared with the lowest OR (Q4-Q1) 1.37; 95% confidence interval (CI), 1.14-1.64; P for trend = 0.0001, q value = 0.004] as well as a high desaturation index (DI16) (16:1n-7/16:0) [OR (Q4-Q1), 1.28; 95% C, 1.07-1.54; P for trend = 0.002, q value = 0.037], as biomarkers of de novo lipogenesis, were significantly associated with increased risk of breast cancer. Levels of industrial trans-fatty acids were positively associated with ER-negative tumours [OR for the highest tertile compared with the lowest (T3-T1)=2.01; 95% CI, 1.03-3.90; P for trend = 0.047], whereas no association was found for ER-positive tumours (P-heterogeneity =0.01). No significant association was found between n-3 polyunsaturated fatty acids and breast cancer risk, overall or by hormonal receptor. Conclusion: These findings suggest that increased de novo lipogenesis, acting through increased synthesis of palmitoleic acid, could be a relevant metabolic pathway for breast tumourigenesis. Dietary trans-fatty acids derived from industrial processes may specifically increase ER-negative breast cancer risk.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15575b,

title = {A study of physicians' experiences with recommending HPV vaccines to adolescent boys},

author = {L P Wong and Z Edib and H Alias and S M Mohamad Shakir and R N A Raja Muhammad Yusoff and I C Sam and G D Zimet},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28641049},

doi = {10.1080/01443615.2017.1317239},

issn = {1364-6893 (Electronic) 

0144-3615 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {J Obstet Gynaecol},

volume = {37},

number = {7},

pages = {937-943},

abstract = {Assessing physicians' experiences in HPV vaccine recommendation and delivery to adolescent boys is essential to providing an understanding of the issues of vaccine acceptance and an insight for policymakers to enhance HPV vaccinations among adolescent boys. Between January and April 2014 a mail survey was conducted using physicians in Malaysia known to provide either one or both HPV vaccine (Gardasil and Cervarix) immunisation services. A total of 357 completed questionnaires were received (response rate 22.5%). Of these, 335 physicians see adolescent boys aged 11 to 18 years old in their practice. Only 26.3% (n = 88) recommended the HPV vaccine to these boys. A total of 46.6% (n = 41) have successfully given the HPV vaccine to adolescent boys. A lack of proper guidelines from the health authorities regarding the recommendation of HPV vaccine to the boys (37.2%) and a lack of awareness of the availability of the vaccine for boys (32.8%) were the most commonly cited reasons for non-recommendation. Impact statement Recommending the HPV vaccine for adolescent boys remains a challenge for physicians. Our study provides evidence of challenges and barriers faced by Malaysian physicians who recommend the HPV vaccines (Gardasil and Cervarix) in their practices. In this study, physicians reported HPV vaccine uptake by adolescent boys was very poor. A lack of proper guidelines from the health authorities regarding the recommendation of HPV vaccine to boys and a lack of awareness of the availability of the vaccine for boys were the most commonly cited reasons for non-recommendation. Physicians viewed that support and encouragement from the health authorities are needed to promote the recommendation of the HPV vaccine to adolescent boys. Physicians were also of the opinion that the lay public should be educated about the availability of the HPV vaccine for boys, and its benefits, safety and efficacy, and the high susceptibility of boys to getting HPV infections. The findings provide insights that could be helpful to policymakers or high-level decision-makers of the potential strategies to enhance HPV uptake among adolescent boys.},

keywords = {},

pubstate = {published},

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@article{RN15615b,

title = {A systematic review of psychometric testing of instruments that measure intention to work with older people},

author = {C C Che and N N Hairi and M C Chong},

doi = {10.1111/jan.13265},

issn = {0309-2402},

year  = {2017},

date = {2017-01-01},

journal = {J Adv Nurs},

volume = {73},

number = {9},

pages = {2049-2064},

abstract = {AIMS: To review systematically the psychometric properties of instruments used to measure intention to work with older people. BACKGROUND: Nursing students are part of the future healthcare workforce; thus, being aware of their intention to work with older people would give valuable insights to nursing education and practice. Despite a plethora of research on measuring intention to work with older people, a valid and reliable instrument has not been identified. DESIGN: A systematic literature review of evidence and psychometric properties. DATA SOURCES: Eight database searches were conducted between 2006 - 2016. REVIEW METHODS: English articles were selected based on inclusion and exclusion criteria. The COSMIN checklist was used to assess instruments reporting a psychometric evaluation of validity and reliability. RESULTS: Of 41 studies identified for full text review, 36 met the inclusion criteria. Seven different types of instruments were identified for psychometric evaluation. Measures of reliability were reported in eight papers and validity in five papers. Evidence for each measurement property was limited, with each instrument demonstrating a lack of information on measurement properties. Based on the COSMIN checklist, the overall quality of the psychometric properties was rated as poor to good. CONCLUSION: No single instrument was found to be optimal for use. Studies of high methodological quality are needed to properly assess the measurement properties of the instruments that are currently available. Until such studies are available, we recommend using existing instruments with caution.},

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pubstate = {published},

tppubtype = {article}

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@article{RN15636b,

title = {Adherence to the WCRF/AICR Dietary Recommendations for Cancer Prevention and Risk of Cancer in Elderly from Europe and the United States: A Meta-Analysis within the CHANCES Project},

author = {N Jankovic and A Geelen and R M Winkels and B Mwungura and V Fedirko and M Jenab and A K Illner and H Brenner and J M Ordonez-Mena and J C Kiefte Jong and O H Franco and P Orfanos and A Trichopoulou and P Boffetta and A Agudo and P H Peeters and A Tjonneland and G Hallmans and H B Bueno-de-Mesquita and Y Park and E J Feskens and L C Groot and E Kampman},

doi = {10.1158/1055-9965.Epi-16-0428},

issn = {1055-9965},

year  = {2017},

date = {2017-01-01},

journal = {Cancer Epidemiol Biomarkers Prev},

volume = {26},

number = {1},

pages = {136-144},

abstract = {BACKGROUND: It is unknown whether dietary recommendations for cancer prevention are applicable to the elderly. We analyzed WCRF/AICR recommendations in cohorts of European and U.S. adults ages 60 years and above. METHODS: Individual participant data meta-analysis included 362,114 participants (43% women), from seven prospective cohort studies, free from cancer at enrollment. The WCRF/AICR diet score was based on: (i) energy-dense foods and sugary drinks, (ii) plant foods, (iii) red and processed meat, and (iv) alcoholic drinks. Cox proportional hazards regression was used to examine the association between the diet score and cancer risks. Adjusted, cohort-specific HRs were pooled using random-effects meta-analysis. Risk advancement periods (RAP) were calculated to quantify the time period by which the risk of cancer was postponed among those adhering to the recommendations. RESULTS: After a median follow-up of 11 to 15 years across cohorts, 70,877 cancer cases were identified. Each one-point increase in the WCRF/AICR diet score [range, 0 (no) to 4 (complete adherence)] was significantly associated with a lower risk of total cancer [HR, 0.94; 95% confidence interval (CI), 0.92-0.97], cancers of the colorectum (HR, 0.84; 95% CI, 0.80-0.89) and prostate (HR, 0.94; 95% CI, 0.92-0.97), but not breast or lung. Adherence to an additional component of the WCRF/AICR diet score significantly postponed the incidence of cancer at any site by 1.6 years (RAP, -1.6; 95% CI, -4.09 to -2.16). CONCLUSIONS: Adherence to WCRF/AICR dietary recommendations is associated with lower risk of cancer among older adults. IMPACT: Dietary recommendations for cancer prevention are applicable to the elderly. Cancer Epidemiol Biomarkers Prev; 26(1); 136-44. (c)2016 AACR.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15538b,

title = {Adipokines and inflammation markers and risk of differentiated thyroid carcinoma: The EPIC study},

author = {L Dossus and S Franceschi and C Biessy and A S Navionis and R C Travis and E Weiderpass and A Scalbert and I Romieu and A Tjonneland and A Olsen and K Overvad and M C Boutron-Ruault and F Bonnet and A Fournier and R T Fortner and R Kaaks and K Aleksandrova and A Trichopoulou and C La Vecchia and E Peppa and R Tumino and S Panico and D Palli and C Agnoli and P Vineis and H B A Bueno-de-Mesquita and P H Peeters and G Skeie and R Zamora-Ros and M D Chirlaque and E Ardanaz and M J Sanchez and J Ramon Quiros and M Dorronsoro and M Sandstrom and L M Nilsson and J A Schmidt and K T Khaw and K K Tsilidis and D Aune and E Riboli and S Rinaldi},

doi = {10.1002/ijc.31172},

issn = {0020-7136},

year  = {2017},

date = {2017-01-01},

journal = {Int J Cancer},

abstract = {Other than the influence of ionizing radiation and benign thyroid disease, little is known about the risk factors for differentiated thyroid cancer (TC) which is an increasing common cancer worldwide. Consistent evidence shows that body mass is positively associated with TC risk. As excess weight is a state of chronic inflammation, we investigated the relationship between concentrations of leptin, adiponectin, C-reactive protein, interleukin (IL)-6, IL-10 and tumor necrosis factor (TNF)-alpha and the risk of TC. A case-control study was nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study and included 475 first primary incident TC cases (399 women and 76 men) and 1,016 matched cancer-free cohort participants. Biomarkers were measured in serum samples using validated and highly sensitive commercially available immunoassays. Odds ratios (ORs) of TC by levels of each biomarker were estimated using conditional logistic regression models, adjusting for BMI and alcohol consumption. Adiponectin was inversely associated with TC risk among women (ORT3vs.T1 = 0.69, 95% CI: 0.49-0.98},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15594b,

title = {Advanced Stage at Presentation Remains a Major Factor Contributing to Breast Cancer Survival Disparity between Public and Private Hospitals in a Middle-Income Country},

author = {Y C Kong and N Bhoo-Pathy and S Subramaniam and N Bhoo-Pathy and N A Taib and S Jamaris and K Kaur and M H See and G F Ho and C H Yip},

doi = {10.3390/ijerph14040427},

issn = {1660-4601},

year  = {2017},

date = {2017-01-01},

journal = {Int J Environ Res Public Health},

volume = {14},

number = {4},

abstract = {Background: Survival disparities in cancer are known to occur between public and private hospitals. We compared breast cancer presentation, treatment and survival between a public academic hospital and a private hospital in a middle-income country. Methods: The demographics, clinical characteristics, treatment and overall survival (OS) of 2767 patients with invasive breast carcinoma diagnosed between 2001 and 2011 in the public hospital were compared with 1199 patients from the private hospital. Results: Compared to patients in the private hospital, patients from the public hospital were older at presentation, and had more advanced cancer stages. They were also more likely to receive mastectomy and chemotherapy but less radiotherapy. The five-year OS in public patients was significantly lower than in private patients (71.6% vs. 86.8%). This difference was largely attributed to discrepancies in stage at diagnosis and, although to a much smaller extent, to demographic differences and treatment disparities. Even following adjustment for these factors, patients in the public hospital remained at increased risk of mortality compared to their counterparts in the private hospital (Hazard Ratio: 1.59; 95% Confidence Interval: 1.36-1.85). Conclusion: Late stage at diagnosis appears to be a major contributing factor explaining the breast cancer survival disparity between public and private patients in this middle-income setting.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15604b,

title = {Alone and Lonely: A Case Report on Elder Abuse in Malaysia},

author = {R Sooryanarayana and C Wan Yuen and N N Hairi},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28283379},

doi = {10.1016/j.jamda.2017.01.018},

issn = {1538-9375 (Electronic) 

1525-8610 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {J Am Med Dir Assoc},

volume = {18},

number = {5},

pages = {447},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15618b,

title = {Are interventions to increase the uptake of screening for cardiovascular disease risk factors effective? A systematic review and meta-analysis},

author = {A T Cheong and S M Liew and E M Khoo and N F Mohd Zaidi and K Chinna},

doi = {10.1186/s12875-016-0579-8},

issn = {1471-2296},

year  = {2017},

date = {2017-01-01},

journal = {BMC Fam Pract},

volume = {18},

number = {1},

pages = {4},

abstract = {BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death globally. However, many individuals are unaware of their CVD risk factors. The objective of this systematic review is to determine the effectiveness of existing intervention strategies to increase uptake of CVD risk factors screening. METHODS: A systematic search was conducted through Pubmed, CINAHL, EMBASE and Cochrane Central Register of Controlled Trials. Additional articles were located through cross-checking of the references list and bibliography citations of the included studies and previous review papers. We included intervention studies with controlled or baseline comparison groups that were conducted in primary care practices or the community, targeted at adult populations (randomized controlled trials, non-randomized trials with controlled groups and pre- and post-intervention studies). The interventions were targeted either at individuals, communities, health care professionals or the health-care system. The main outcome of interest was the relative risk (RR) of screening uptake rates due to the intervention. RESULTS: We included 21 studies in the meta-analysis. The risk of bias for randomization was low to medium in the randomized controlled trials, except for one, and high in the non-randomized trials. Two analyses were performed; optimistic (using the highest effect sizes) and pessimistic (using the lowest effect sizes). Overall, interventions were shown to increase the uptake of screening for CVD risk factors (RR 1.443; 95% CI 1.264 to 1.648 for pessimistic analysis and RR 1.680; 95% CI 1.420 to 1.988 for optimistic analysis). Effective interventions that increased screening participation included: use of physician reminders (RR ranged between 1.392; 95% CI 1.192 to 1.625, and 1.471; 95% CI 1.304 to 1.660), use of dedicated personnel (RR ranged between 1.510; 95% CI 1.014 to 2.247, and 2.536; 95% CI 1.297 to 4.960) and provision of financial incentives for screening (RR 1.462; 95% CI 1.068 to 2.000). Meta-regression analysis showed that the effect of CVD risk factors screening uptake was not associated with study design, types of population nor types of interventions. CONCLUSIONS: Interventions using physician reminders, using dedicated personnel to deliver screening, and provision of financial incentives were found to be effective in increasing CVD risk factors screening uptake.},

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pubstate = {published},

tppubtype = {article}

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@article{RN15571b,

title = {Association between elder abuse and poor sleep: A cross-sectional study among rural older Malaysians},

author = {R M Yunus and S W Wazid and N N Hairi and W Y Choo and F M Hairi and R Sooryanarayana and S N Ahmad and I A Razak and D Peramalah and S A Aziz and Z L Mohamad and R Mohamad and Z M Ali and A Bulgiba},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28686603},

doi = {10.1371/journal.pone.0180222},

issn = {1932-6203 (Electronic) 

1932-6203 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {PLoS One},

volume = {12},

number = {7},

pages = {e0180222},

abstract = {OBJECTIVES: To examine the association between elder abuse and poor sleep using a Malay validated version of Pittsburgh Sleep Quality Index (PSQI). DESIGN: This study was divided into two phases. Phase I tested the construct validity and reliability of the Malay version of PSQI. Phase II was a population-based, cross-sectional study with a multi-stage cluster sampling method. Home-based interviews were conducted by trained personnel using a structured questionnaire, to determine exposure and outcome. SETTING: Kuala Pilah, a district in Negeri Sembilan which is one of the fourteen states in Malaysia. PARTICIPANTS: 1648 community-dwelling older Malaysians. RESULTS: The Malay version of PSQI had significant test re-test reliability with intra-class correlation coefficients of 0.62. Confirmatory factor analyses revealed that one factor PSQI scale with three components (subjective sleep quality, sleep latency, and sleep disturbances) was most suitable. Cronbach's Alpha was 0.60 and composite reliability was 0.63. PSQI scores were highest among neglect (4.11), followed by physical (4.10), psychological (3.96) and financial abuse (3.60). There was a dose-response relationship between clustering of abuse and PSQI scores; 3.41, 3.50 and 3.84 for "no abuse", "1 type of abuse" and "2 types or more". Generalized linear models revealed six variables as significant determinants of sleep quality-abuse, co-morbidities, self-rated health, income, social support and gait speed. Among abuse subtypes, only neglect was significantly associated with poor sleep. CONCLUSION: The Malay PSQI was valid and reliable. Abuse was significantly associated with poor sleep. As sleep is essential for health and is a good predictor for mortality among older adults, management of abuse victims should entail sleep assessment. Interventions or treatment modalities which focus on improving sleep quality among abuse victims should be designed.},

keywords = {},

pubstate = {published},

tppubtype = {article}

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@article{RN15607b,

title = {Association of psychological distress and work psychosocial factors with self-reported musculoskeletal pain among secondary school teachers in Malaysia},

author = {E N Zamri and F M Moy and V C Hoe},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28234933},

doi = {10.1371/journal.pone.0172195},

issn = {1932-6203 (Electronic) 

1932-6203 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {PLoS One},

volume = {12},

number = {2},

pages = {e0172195},

abstract = {BACKGROUND: Musculoskeletal pain is common among teachers. Work-related psychosocial factors are found to be associated with the development of musculoskeletal pain, however psychological distress may also play an important role. OBJECTIVES: To assess the prevalence of self-reported low back pain (LBP), and neck and/or shoulder pain (NSP) among secondary school teachers; and to evaluate the association of LBP and NSP with psychological distress and work-related psychosocial factors. METHODS: This was a cross-sectional study conducted among teachers in the state of Penang, Malaysia. The participants were recruited via a two stage sampling method. Information on demographic, psychological distress, work-related psychosocial factors, and musculoskeletal pain (LBP and NSP) in the past 12 months was collected using a self-administered questionnaire. Poisson regression was used to estimate the prevalence ratio (PR) for the associations between psychological distress and work-related psychosocial factors with LBP and NSP. RESULTS: The prevalence of self-reported LBP and NSP among 1482 teachers in the past 12 months was 48.0% (95% Confidence Interval (CI) 45.2%, 50.9%) and 60.1% (95% CI 57.4%, 62.9%) respectively. From the multivariate analysis, self-reported LBP was associated with teachers who reported severe to extremely severe depression (PR: 1.71, 95% CI 1.25, 2.32), severe to extremely severe anxiety (1.46, 95% CI 1.22, 1.75), high psychological job demand (1.29, 95% CI 1.06, 1.57), low skill discretion (1.28, 95% CI 1.13, 1.47) and poorer mental health (0.98, 95% CI 0.97, 0.99). Self-reported NSP was associated with mild to moderate anxiety (1.18, 95% CI 1.06, 1.33), severe to extremely severe anxiety (1.25, 95% CI 1.09, 1.43), low supervisory support (1.13, 95% CI 1.03, 1.25) and poorer mental health (0.98, 95% CI 0.97, 0.99). CONCLUSIONS: Self-reported LBP and NSP were common among secondary school teachers. Interventions targeting psychological distress and work-related psychosocial characteristics may reduce musculoskeletal pain among school teachers.},

keywords = {},

pubstate = {published},

tppubtype = {article}

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@article{RN15645b,

title = {Associations between lifestyle factors and an unhealthy diet},

author = {H P Fransen and J M A Boer and J W J Beulens and G A Wit and H B Bueno-de-Mesquita and J Hoekstra and A M May and P H M Peeters},

doi = {10.1093/eurpub/ckw190},

issn = {1101-1262},

year  = {2017},

date = {2017-01-01},

journal = {Eur J Public Health},

volume = {27},

number = {2},

pages = {274-278},

abstract = {Background: : Unhealthy dietary patterns have been associated with other unhealthy lifestyle factors such as smoking and physical inactivity. Whether these associations are similar in high- and low-educated individuals is currently unknown. Methods: We used information of the EPIC-NL cohort, a prospective cohort of 39 393 men and women, aged 20-70 years at recruitment. A lifestyle questionnaire and a validated food frequency questionnaire were administered at recruitment (1993-97). Low adherence to a Mediterranean-style diet was used to determine an unhealthy dietary pattern. Lifestyle-related factors included body mass index, waist circumference, smoking status, physical activity level, dietary supplement use and daily breakfast consumption. Multivariate logistic regression analyses were performed for the total population and by strata of educational level. Results: In total 30% of the study population had an unhealthy dietary pattern: 39% in the lowest educated group and 20% in the highest educated group. Physical inactivity, a large waist circumference, no dietary supplement use and skipping breakfast were associated with an unhealthy dietary pattern in both low and high educated participants. Among low educated participants, current smokers had a greater odds of an unhealthy diet compared with never smokers: OR 1.42 (95% CI: 1.25; 1.61). This association was not observed in the high educated group. Conclusions: Most associations between lifestyle-related factors and unhealthy diet were consistent across educational levels, except for smoking. Only among low educated participants, current smokers reported an unhealthier dietary pattern in comparison to never smokers. These results can be used in the development of targeted health promotion strategies.},

keywords = {},

pubstate = {published},

tppubtype = {article}

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@article{RN15557b,

title = {Attitudes towards Zika screening and vaccination acceptability among pregnant women in Malaysia},

author = {L P Wong and H Alias and J Hassan and S AbuBakar},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28886944},

doi = {10.1016/j.vaccine.2017.08.074},

issn = {1873-2518 (Electronic) 

0264-410X (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Vaccine},

volume = {35},

number = {43},

pages = {5912-5917},

abstract = {The aim of this study was to examine the willingness of pregnant women to have prenatal screening for the Zika virus (ZIKV). Secondly, the study also assessed the acceptability of a hypothetical Zika vaccination and its association with the health belief model (HBM) constructs. A cross-sectional study was conducted from 4th October to 11th November 2016, among pregnant women who attended antenatal care at the University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. The majority (81.8%) was willing to be tested for ZIKV and 78% felt that their spouse would be willing to be tested for ZIKV. A total of 94% expressed a willingness to receive a Zika vaccination if available. The participants expressed high perceived benefits of a ZIKV vaccination. Although many have a high perception of the severity of ZIKV, the proportion with a strong perception of their susceptibility to ZIKV was low. In the multivariate analysis of all the HBM constructs, cue-to-action, namely physician recommendation (odds ratio [OR]=2.288; 95% confidence interval [CI] 1.093-4.793) and recommendation from friends or relatives (OR=4.030; 95% CI 1.694-9.587), were significantly associated with a willingness to be vaccinated against ZIKV. The favourable response to a Zika vaccination implies that more research attention has to be given to develop a vaccine against ZIKV. Should the vaccine be available in the future, publicity and healthcare providers would play a vital role in ensuring vaccine uptake among pregnant women.},

keywords = {},

pubstate = {published},

tppubtype = {article}

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@article{RN15605b,

title = {Awareness, Facilitators, and Barriers to Policy Implementation Related to Obesity Prevention for Primary School Children in Malaysia},

author = {C Chan and F M Moy and J N Lim and M Dahlui},

doi = {10.1177/0890117117695888},

issn = {0890-1171},

year  = {2017},

date = {2017-01-01},

journal = {Am J Health Promot},

pages = {890117117695888},

abstract = {PURPOSE: To assess the awareness, facilitators, and barriers to policy implementation related to obesity prevention for primary school children. DESIGN: A cross-sectional study administered using an online questionnaire. SETTING: Conducted in 447 primary schools in a state in Malaysia. PARTICIPANTS: One school administrator from each school served as a participant. MEASURES: The questionnaires consisted of 32 items on awareness, policy implementation, and facilitators and barriers to policy implementation. ANALYSIS: Descriptive analysis was used to describe the awareness, facilitators, and barriers of policies implementation. Association between schools' characteristics and policy implementation was assessed using logistic regression. RESULTS: The majority (90%) of school administrators were aware of the policies. However, only 50% to 70% of schools had implemented the policies fully. Reported barriers were lack of equipment, insufficient training, and limited time to complete implementation. Facilitators of policy implementation were commitment from the schools, staff members, students, and canteen operators. Policy implementation was comparable in all school types and locality; except the policy on "Food and Drinks sold at the school canteens" was implemented by more rural schools compared to urban schools (odds ratio: 1.74, 95% confidence interval: 1.13-2.69). CONCLUSION: Majority of the school administrators were aware of the existing policies; however, the implementation was only satisfactory. The identified barriers to policy implementation were modifiable and thus, the stakeholders should consider restrategizing plans in overcoming them.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15546b,

title = {Awareness, perception and barriers to seeking information from online academic databases and medical journals as sources of information},

author = {L P Wong and S M Mohamad Shakir and W T Tong and H Alias and N Aghamohammadi and K Arumugam},

url = {https://www.ncbi.nlm.nih.gov/pubmed/29035606},

doi = {10.1080/17538157.2017.1364248},

issn = {1753-8165 (Electronic) 

1753-8157 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Inform Health Soc Care},

pages = {1-13},

abstract = {Medical students' use of online medical journals as a source of information is crucial in the learning pathway to become medical doctors. We conducted a cross-sectional survey study among University medical students between December 2012 and March 2013 to assess their awareness, perceived usefulness, practices, and barriers to seeking information from online academic databases and medical journals. The response rate was 67.53%. The majority of the students knew of the availability of online academic databases and medical journals. The mean score for awareness (4.25 of possible 11.0), perceived usefulness (13.95 of possible 33.0), and practice (10.67 of possible 33.0) were low. The mean barrier score toward using online academic databases and medical journals was 25.41 (of possible 45.0). Multivariate findings showed that significant barriers associated with overall usage of online databases and medical journals were 1) not knowing where or how to locate databases and 2) unsureness of using the Boolean operators. Availability of full text subscriptions was found to be an important factor in using online databases. Study findings highlighted the need to increase awareness of academic databases' availability and increase training on ways to search online academic databases and medical journals.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15628b,

title = {Biomarkers of folate and vitamin B12 and breast cancer risk: report from the EPIC cohort},

author = {M Matejcic and J Batlle and C Ricci and C Biessy and F Perrier and I Huybrechts and E Weiderpass and M C Boutron-Ruault and C Cadeau and M His and D G Cox and H Boeing and R T Fortner and R Kaaks and P Lagiou and A Trichopoulou and V Benetou and R Tumino and S Panico and S Sieri and D Palli and F Ricceri and H B Bueno-de-Mesquita and G Skeie and P Amiano and M J Sanchez and M D Chirlaque and A Barricarte and J R Quiros and G Buckland and C H Gils and P H Peeters and T J Key and E Riboli and B Gylling and A Zeleniuch-Jacquotte and M J Gunter and I Romieu and V Chajes},

url = {https://www.ncbi.nlm.nih.gov/pubmed/27905104},

doi = {10.1002/ijc.30536},

issn = {1097-0215 (Electronic) 

0020-7136 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Int J Cancer},

volume = {140},

number = {6},

pages = {1246-1259},

abstract = {Epidemiological studies have reported inconsistent findings for the association between B vitamins and breast cancer (BC) risk. We investigated the relationship between biomarkers of folate and vitamin B12 and the risk of BC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Plasma concentrations of folate and vitamin B12 were determined in 2,491 BC cases individually matched to 2,521 controls among women who provided baseline blood samples. Multivariable logistic regression models were used to estimate odds ratios by quartiles of either plasma B vitamin. Subgroup analyses by menopausal status, hormone receptor status of breast tumors (estrogen receptor [ER], progesterone receptor [PR] and human epidermal growth factor receptor 2 [HER2]), alcohol intake and MTHFR polymorphisms (677C \> T and 1298A \> C) were also performed. Plasma levels of folate and vitamin B12 were not significantly associated with the overall risk of BC or by hormone receptor status. A marginally positive association was found between vitamin B12 status and BC risk in women consuming above the median level of alcohol (ORQ4-Q1 = 1.26; 95% CI 1.00-1.58; Ptrend = 0.05). Vitamin B12 status was also positively associated with BC risk in women with plasma folate levels below the median value (ORQ4-Q1 = 1.29; 95% CI 1.02-1.62; Ptrend = 0.03). Overall, folate and vitamin B12 status was not clearly associated with BC risk in this prospective cohort study. However, potential interactions between vitamin B12 and alcohol or folate on the risk of BC deserve further investigation.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15567b,

title = {Blood Metabolic Signatures of Body Mass Index: A Targeted Metabolomics Study in the EPIC Cohort},

author = {M Carayol and M F Leitzmann and P Ferrari and R Zamora-Ros and D Achaintre and M Stepien and J A Schmidt and R C Travis and K Overvad and A Tjonneland and L Hansen and R Kaaks and T Kuhn and H Boeing and U Bachlechner and A Trichopoulou and C Bamia and D Palli and C Agnoli and R Tumino and P Vineis and S Panico and J R Quiros and E Sanchez-Cantalejo and J M Huerta and E Ardanaz and L Arriola and A Agudo and J Nilsson and O Melander and B Bueno-de-Mesquita and P H Peeters and N Wareham and K T Khaw and M Jenab and T J Key and A Scalbert and S Rinaldi},

doi = {10.1021/acs.jproteome.6b01062},

issn = {1535-3893},

year  = {2017},

date = {2017-01-01},

journal = {J Proteome Res},

volume = {16},

number = {9},

pages = {3137-3146},

abstract = {Metabolomics is now widely used to characterize metabolic phenotypes associated with lifestyle risk factors such as obesity. The objective of the present study was to explore the associations of body mass index (BMI) with 145 metabolites measured in blood samples in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Metabolites were measured in blood from 392 men from the Oxford (UK) cohort (EPIC-Oxford) and in 327 control subjects who were part of a nested case-control study on hepatobiliary carcinomas (EPIC-Hepatobiliary). Measured metabolites included amino acids, acylcarnitines, hexoses, biogenic amines, phosphatidylcholines, and sphingomyelins. Linear regression models controlled for potential confounders and multiple testing were run to evaluate the associations of metabolite concentrations with BMI. 40 and 45 individual metabolites showed significant differences according to BMI variations, in the EPIC-Oxford and EPIC-Hepatobiliary subcohorts, respectively. Twenty two individual metabolites (kynurenine, one sphingomyelin, glutamate and 19 phosphatidylcholines) were associated with BMI in both subcohorts. The present findings provide additional knowledge on blood metabolic signatures of BMI in European adults, which may help identify mechanisms mediating the relationship of BMI with obesity-related diseases.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15533b,

title = {Breast cancer survivors: return to work and wage loss in selected hospitals in Malaysia},

author = {T T Su and M Azzani and F L Tan and S Y Loh},

url = {https://www.ncbi.nlm.nih.gov/pubmed/29209834},

doi = {10.1007/s00520-017-3987-y},

issn = {1433-7339 (Electronic) 

0941-4355 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Support Care Cancer},

abstract = {PURPOSE: This study aimed, firstly, to assess the determinants of return to work (RTW), secondly, to explore the amount of annual wage loss, and finally, to discover the determinants of wage loss among breast cancer (BC) survivors. METHODS: A cross-sectional study design was used in this research. The data was collected via interview using a validated questionnaire. Logistic regression models were developed to discover the significant determinants of RTW and of wage loss among BC survivors. RESULTS: A total of 256 BC survivors were included in this study. The analysis showed that there was a 21% loss of or reduction in mean income within 1 year after diagnosis. The significant predictors of RTW are being a government employee, having reduced wages or wage loss, and if the case had been diagnosed 1 year or more ago. Being a private sector employee and having a late stage of cancer was a barrier to RTW. The main risk factors for reduced wages or wage loss were belonging to the age group of 40-59 years, being of Chinese or Indian ethnicity, having low educational status, and not returning to work. However, belonging to the higher monthly income group (earning \> RM 2000) is a protective factor against the risk of reduced wages or wage loss. CONCLUSIONS: Non-RTW and wage loss after diagnosis of BC may result in the survivors experiencing a significant financial burden. Assessment of these patients is becoming more crucial because more women participate in the workforce in Malaysia nowadays and because BC is managed using multiple treatment modalities with their consequences could lead to long absences from work.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15550b,

title = {Catastrophic Health Expenditure Among Colorectal Cancer Patients and Families: A Case of Malaysia},

author = {M Azzani and A Yahya and A C Roslani and T T Su},

doi = {10.1177/1010539517732224},

issn = {1010-5395},

year  = {2017},

date = {2017-01-01},

journal = {Asia Pac J Public Health},

volume = {29},

number = {6},

pages = {485-494},

abstract = {This study aimed to estimate the cost of colorectal cancer (CRC) management and to explore the prevalence and determinants of catastrophic health expenditure (CHE) among CRC patients and their families arising from the costs of CRC management. Data were collected prospectively from 138 CRC patients. Patients were interviewed by using a structured questionnaire at the time of the diagnosis, then at 6 months and 12 months following diagnosis. Simple descriptive methods and multivariate binary logistic regression were used in the analysis. The mean cost of managing CRC was RM8306.9 (US$2595.9), and 47.8% of patients' families experienced CHE. The main determinants of CHE were the economic status of the family and the likelihood of the patient undergoing surgery. The results of this study strongly suggest that stakeholders and policy makers should provide individuals with financial protection against the consequences of cancer, a costly illness that often requires prolonged treatment.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15612b,

title = {Circulating copper and zinc levels and risk of hepatobiliary cancers in Europeans},

author = {M Stepien and D J Hughes and S Hybsier and C Bamia and A Tjonneland and K Overvad and A Affret and M His and M C Boutron-Ruault and V Katzke and T Kuhn and K Aleksandrova and A Trichopoulou and P Lagiou and P Orfanos and D Palli and S Sieri and R Tumino and F Ricceri and S Panico and H B Bueno-de-Mesquita and P H Peeters and E Weiderpass and C Lasheras and C Bonet Bonet and E Molina-Portillo and M Dorronsoro and J M Huerta and A Barricarte and B Ohlsson and K Sjoberg and M Werner and D Shungin and N Wareham and K T Khaw and R C Travis and H Freisling and A J Cross and L Schomburg and M Jenab},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28152549},

doi = {10.1038/bjc.2017.1},

issn = {1532-1827 (Electronic) 

0007-0920 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Br J Cancer},

volume = {116},

number = {5},

pages = {688-696},

abstract = {BACKGROUND: Copper and zinc are essential micronutrients and cofactors of many enzymatic reactions that may be involved in liver-cancer development. We aimed to assess pre-diagnostic circulating levels of copper, zinc and their ratio (Cu/Zn) in relation to hepatocellular carcinoma (HCC), intrahepatic bile duct (IHBD) and gall bladder and biliary tract (GBTC) cancers. METHODS: A nested case-control study was conducted within the European Prospective Investigation into Cancer and Nutrition cohort. Serum zinc and copper levels were measured in baseline blood samples by total reflection X-ray fluorescence in cancer cases (HCC n=106, IHDB n=34, GBTC n=96) and their matched controls (1:1). The Cu/Zn ratio, an indicator of the balance between the micronutrients, was computed. Multivariable adjusted odds ratios and 95% confidence intervals (OR; 95% CI) were used to estimate cancer risk. RESULTS: For HCC, the highest vs lowest tertile showed a strong inverse association for zinc (OR=0.36; 95% CI: 0.13-0.98},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15588b,

title = {Coexistence of Colorectal Adenomas and Coronary Calcification in Asymptomatic Men and Women},

author = {K E Yun and Y Chang and S Rampal and Y Zhang and J Cho and H S Jung and C W Kim and C Jeong and M Cainzos-Achirica and D Zhao and R Pastor-Barriuso and H Shin and E Guallar and S Ryu},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28471937},

doi = {10.1097/MCG.0000000000000824},

issn = {1539-2031 (Electronic) 

0192-0790 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {J Clin Gastroenterol},

abstract = {GOALS: Because of shared risk factors between clinically manifest cardiovascular disease and colorectal cancer, we hypothesized the coexistence of subclinical atherosclerosis measured by coronary artery calcium (CAC) and colorectal adenoma (CRA) and that these 2 processes would also share common risk factors. BACKGROUND: No study has directly compared the risk factors associated with subclinical coronary atherosclerosis and CRA. STUDY: This was a cross-sectional study using multinomial logistic regression analysis of 4859 adults who participated in a health screening examination (2010 to 2011; analysis 2014 to 2015). CAC scores were categorized as 0, 1 to 100, or \>100. Colonoscopy results were categorized as absent, low-risk, or high-risk CRA. RESULTS: The prevalence of CAC\>0, CAC 1 to 100 and \>100 was 13.0%, 11.0%, and 2.0%, respectively. The prevalence of any CRA, low-risk CRA, and high-risk CRA was 15.1%, 13.0%, and 2.1%, respectively. The adjusted odds ratios (95% confidence interval) for CAC\>0 comparing participants with low-risk and high-risk CRA with those without any CRA were 1.35 (1.06-1.71) and 2.09 (1.29-3.39), respectively. Similarly, the adjusted odds ratios (95% confidence interval) for any CRA comparing participants with CAC 1 to 100 and CAC\>100 with those with no CAC were 1.26 (1.00-1.6) and 2.07 (1.31-3.26), respectively. Age, smoking, diabetes, and family history of CRC were significantly associated with both conditions. CONCLUSIONS: We observed a graded association between CAC and CRA in apparently healthy individuals. The coexistence of both conditions further emphasizes the need for more evidence of comprehensive approaches to screening and the need to consider the impact of the high risk of coexisting disease in individuals with CAC or CRA, instead of piecemeal approaches restricted to the detection of each disease independently.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15609b,

title = {Coffee, tea and melanoma risk: findings from the European Prospective Investigation into Cancer and Nutrition},

author = {S Caini and G Masala and C Saieva and M Kvaskoff and I Savoye and C Sacerdote and O Hemmingsson and B Hammer Bech and K Overvad and A Tjonneland and K E Petersen and F R Mancini and M C Boutron-Ruault and I Cervenka and R Kaaks and T Kuhn and H Boeing and A Floegel and A Trichopoulou and E Valanou and M Kritikou and G Tagliabue and S Panico and R Tumino and H B Bueno-de-Mesquita and P H Peeters and M B Veierod and R Ghiasvand and M Lukic and J R Quiros and M D Chirlaque and E Ardanaz and E Salamanca Fernandez and N Larranaga and R Zamora-Ros and L Maria Nilsson and I Ljuslinder and K Jirstrom and E Sonestedt and T J Key and N Wareham and K T Khaw and M Gunter and I Huybrechts and N Murphy and K K Tsilidis and E Weiderpass and D Palli},

doi = {10.1002/ijc.30659},

issn = {0020-7136},

year  = {2017},

date = {2017-01-01},

journal = {Int J Cancer},

volume = {140},

number = {10},

pages = {2246-2255},

abstract = {In vitro and animal studies suggest that bioactive constituents of coffee and tea may have anticarcinogenic effects against cutaneous melanoma; however, epidemiological evidence is limited to date. We examined the relationships between coffee (total, caffeinated or decaffeinated) and tea consumption and risk of melanoma in the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is a multicentre prospective study that enrolled over 500,000 participants aged 25-70 years from ten European countries in 1992-2000. Information on coffee and tea drinking was collected at baseline using validated country-specific dietary questionnaires. We used adjusted Cox proportional hazards regression models to calculate hazard ratios (HR) and 95% confidence intervals (95% CI) for the associations between coffee and tea consumption and melanoma risk. Overall, 2,712 melanoma cases were identified during a median follow-up of 14.9 years among 476,160 study participants. Consumption of caffeinated coffee was inversely associated with melanoma risk among men (HR for highest quartile of consumption vs. non-consumers 0.31, 95% CI 0.14-0.69) but not among women (HR 0.96, 95% CI 0.62-1.47). There were no statistically significant associations between consumption of decaffeinated coffee or tea and the risk of melanoma among both men and women. The consumption of caffeinated coffee was inversely associated with melanoma risk among men in this large cohort study. Further investigations are warranted to confirm our findings and clarify the possible role of caffeine and other coffee compounds in reducing the risk of melanoma.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15591b,

title = {Comparison of general obesity and measures of body fat distribution in older adults in relation to cancer risk: meta-analysis of individual participant data of seven prospective cohorts in Europe},

author = {H Freisling and M Arnold and I Soerjomataram and M G O'Doherty and J M Ordonez-Mena and C Bamia and E Kampman and M Leitzmann and I Romieu and F Kee and K Tsilidis and A Tjonneland and A Trichopoulou and P Boffetta and V Benetou and H B A Bueno-de-Mesquita and J M Huerta and H Brenner and T Wilsgaard and M Jenab},

doi = {10.1038/bjc.2017.106},

issn = {0007-0920},

year  = {2017},

date = {2017-01-01},

journal = {Br J Cancer},

volume = {116},

number = {11},

pages = {1486-1497},

abstract = {BACKGROUND: We evaluated the associations of anthropometric indicators of general obesity (body mass index, BMI), an established risk factor of various cancer, and body fat distribution (waist circumference, WC; hip circumference, HC; and waist-to-hip ratio, WHR), which may better reflect metabolic complications of obesity, with total obesity-related and site-specific (colorectal and postmenopausal breast) cancer incidence. METHODS: This is a meta-analysis of seven prospective cohort studies participating in the CHANCES consortium including 18 668 men and 24 751 women with a mean age of 62 and 63 years, respectively. Harmonised individual participant data from all seven cohorts were analysed separately and alternatively for each anthropometric indicator using multivariable Cox proportional hazards models. RESULTS: After a median follow-up period of 12 years, 1656 first-incident obesity-related cancers (defined as postmenopausal female breast, colorectum, lower oesophagus, cardia stomach, liver, gallbladder, pancreas, endometrium, ovary, and kidney) had occurred in men and women. In the meta-analysis of all studies, associations between indicators of adiposity, per s.d. increment, and risk for all obesity-related cancers combined yielded the following summary hazard ratios: 1.11 (95% CI 1.02-1.21) for BMI, 1.13 (95% CI 1.04-1.23) for WC, 1.09 (95% CI 0.98-1.21) for HC, and 1.15 (95% CI 1.00-1.32) for WHR. Increases in risk for colorectal cancer were 16%, 21%, 15%, and 20%, respectively per s.d. of BMI, WC, HC, and WHR. Effect modification by hormone therapy (HT) use was observed for postmenopausal breast cancer (Pinteraction\<0.001), where never HT users showed an approximately 20% increased risk per s.d. of BMI, WC, and HC compared to ever users. CONCLUSIONS: BMI, WC, HC, and WHR show comparable positive associations with obesity-related cancers combined and with colorectal cancer in older adults. For postmenopausal breast cancer we report evidence for effect modification by HT use.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15558b,

title = {Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study},

author = {K Y Lee and W A Wan Ahmad and E V Low and S Y Liau and L Anchah and S Hamzah and H B Liew and R B Mohd Ali and O Ismail and T K Ong and M A Said and M Dahlui},

doi = {10.1371/journal.pone.0184410},

issn = {1932-6203},

year  = {2017},

date = {2017-01-01},

journal = {PLoS One},

volume = {12},

number = {9},

pages = {e0184410},

abstract = {INTRODUCTION: The increasing disease burden of coronary artery disease (CAD) calls for sustainable cardiac service. Teaching hospitals and general hospitals in Malaysia are main providers of percutaneous coronary intervention (PCI), a common treatment for CAD. Few studies have analyzed the contemporary data on local cardiac facilities. Service expansion and budget allocation require cost evidence from various providers. We aim to compare the patient characteristics, procedural outcomes, and cost profile between a teaching hospital (TH) and a general hospital (GH). METHODS: This cross-sectional study was conducted from the healthcare providers' perspective from January 1st to June 30th 2014. TH is a university teaching hospital in the capital city, while GH is a state-level general hospital. Both are government-funded cardiac referral centers. Clinical data was extracted from a national cardiac registry. Cost data was collected using mixed method of top-down and bottom-up approaches. Total hospitalization cost per PCI patient was summed up from the costs of ward admission and cardiac catheterization laboratory utilization. Clinical characteristics were compared with chi-square and independent t-test, while hospitalization length and cost were analyzed using Mann-Whitney test. RESULTS: The mean hospitalization cost was RM 12,117 (USD 3,366) at GH and RM 16,289 (USD 4,525) at TH. The higher cost at TH can be attributed to worse patients' comorbidities and cardiac status. In contrast, GH recorded a lower mean length of stay as more patients had same-day discharge, resulting in 29% reduction in mean cost of admission compared to TH. For both hospitals, PCI consumables accounted for the biggest proportion of total cost. CONCLUSIONS: The high PCI consumables cost highlighted the importance of cost-effective purchasing mechanism. Findings on the heterogeneity of the patients, treatment practice and hospitalization cost between TH and GH are vital for formulation of cost-saving strategies to ensure sustainable and equitable cardiac service in Malaysia.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15590b,

title = {Complementary and alternative medicine (CAM) use and delays in presentation and diagnosis of breast cancer patients in public hospitals in Malaysia},

author = {N M Mohd Mujar and M Dahlui and N A Emran and I Abdul Hadi and Y Y Wai and S Arulanantham and C C Hooi and N A Mohd Taib},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28448541},

doi = {10.1371/journal.pone.0176394},

issn = {1932-6203 (Electronic) 

1932-6203 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {PLoS One},

volume = {12},

number = {4},

pages = {e0176394},

abstract = {Complementary and alternative medicine (CAM) is widely used among the breast cancer patients in Malaysia. Delays in presentation, diagnosis and treatment have been shown to impact the disease prognosis. There is considerable use of CAM amongst breast cancer patients. CAM use has been cited as a cause of delay in diagnosis and treatments in qualitative studies, however there had not been any confirmatory study that confirms its impact on delays. The purpose of this study was to evaluate whether the use of CAM among newly diagnosed breast cancer patients was associated with delays in presentation, diagnosis or treatment of breast cancer. This multi-centre cross-sectional study evaluating the time points of the individual breast cancer patients' journey from first visit, resolution of diagnosis and treatments was conducted in six public hospitals in Malaysia. All newly diagnosed breast cancer patients from 1st January to 31st December 2012 were recruited. Data were collected through medical records review and patient interview by using a structured questionnaire. Complementary and alternative medicine (CAM) was defined as the use of any methods and products not included in conventional allopathic medicine before commencement of treatments. Presentation delay was defined as time taken from symptom discovery to first presentation of more than 3 months. The time points were categorised to diagnosis delay was defined as time taken from first presentation to diagnosis of more than 1 month and treatment delay was defined as time taken from diagnosis to initial treatment of more than 1 month. Multiple logistic regression was used for analysis. A total number of 340 patients participated in this study. The prevalence of CAM use was 46.5% (n = 158). Malay ethnicity (OR 3.32; 95% CI: 1.85, 5.97) and not interpreting symptom as cancerous (OR 1.79; 95% CI: 1.10, 2.92) were significantly associated with CAM use. The use of CAM was associated with delays in presentation (OR 1.65; 95% CI: 1.05, 2.59), diagnosis (OR 2.42; 95% CI: 1.56, 3.77) and treatment of breast cancer (OR 1.74; 95% CI: 1.11, 2.72) on univariate analyses. However, after adjusting with other covariates, CAM use was associated with delays in presentation (OR 1.71; 95% CI: 1.05, 2.78) and diagnosis (OR 2.58; 95% CI: 1.59, 4.17) but not for treatment of breast cancer (OR 1.58; 95% CI: 0.98, 2.55). The prevalence of CAM use among the breast cancer patients was high. Women of Malay ethnicity and not interpreting symptom as cancerous were significantly associated with CAM use. The use of CAM is significantly associated with delay in presentation and resolution of diagnosis. This study suggests further evaluation of access to breast cancer care is needed as poor access may cause the use of CAM. However, since public hospitals in Malaysia are heavily subsidized and readily available to the population, CAM use may impact delays in presentation and diagnosis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15526b,

title = {Consequences of Elder Abuse and Neglect: A Systematic Review of Observational Studies},

author = {R M Yunus and N N Hairi and W Y Choo},

url = {https://www.ncbi.nlm.nih.gov/pubmed/29333999},

doi = {10.1177/1524838017692798},

issn = {1552-8324 (Electronic) 

1524-8380 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Trauma Violence Abuse},

pages = {1524838017692798},

abstract = {This article presents the results of a systematic review of the consequences of elder abuse and neglect (EAN). A systematic search was conducted in seven electronic databases and three sources of gray literature up to January 8, 2016, supplemented by scanning of citation lists in relevant articles and contact with field experts. All observational studies investigating elder abuse as a risk factor for adverse health outcomes, mortality, and health-care utilization were included. Of 517 articles initially captured, 19 articles met our inclusion criteria and were analyzed. Two reviewers independently performed abstract screening, full-texts appraisal, and quality assessment using the Newcastle-Ottawa Scale. Across 19 studies, methodological heterogeneity was a prominent feature; seven definitions of EAN and nine measurement tools for abuse were employed. Summary of results reveals a wide range of EAN outcomes, from premature mortality to increased health-care consumption and various forms of physical and psychological symptoms. Higher risks of mortality emerged as the most credible outcome, while the majority of morbidity outcomes originated from cross-sectional studies. Our findings suggest that there is an underrepresentation of older adults from non-Western populations and developing countries, and there is a need for more population-based prospective studies in middle- and low-income regions. Evidence gathered from this review is crucial in upgrading current practices, formulating policies, and shaping the future direction of research.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15578b,

title = {Consumption of Fish Is Not Associated with Risk of Differentiated Thyroid Carcinoma in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study},

author = {R Zamora-Ros and J Castaneda and S Rinaldi and V Cayssials and N Slimani and E Weiderpass and K K Tsilidis and M C Boutron-Ruault and K Overvad and A K Eriksen and A Tjonneland and T Kuhn and V Katzke and H Boeing and A Trichopoulou and C La Vecchia and A Kotanidou and D Palli and S Grioni and A Mattiello and R Tumino and V Sciannameo and E Lund and S Merino and E Salamanca-Fernandez and P Amiano and J M Huerta and A Barricarte and U Ericson and M Almquist and J Hennings and M Sandstrom and H B Bueno-de-Mesquita and P H Peeters and K T Khaw and N J Wareham and J A Schmidt and A J Cross and E Riboli and A Scalbert and I Romieu and A Agudo and S Franceschi},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28592517},

doi = {10.3945/jn.117.247874},

issn = {1541-6100 (Electronic) 

0022-3166 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {J Nutr},

volume = {147},

number = {7},

pages = {1366-1373},

abstract = {Background: Differentiated thyroid cancer (TC) is the most common endocrine cancer. Fish can be an important source of iodine and other micronutrients and contaminants that may affect the thyroid gland and TC risk.Objective: We prospectively evaluated the relations between the consumption of total fish and different fish types and shellfish and TC risk in the EPIC (European Prospective Investigation into Cancer and Nutrition) study.Methods: EPIC is a cohort of \>500,000 men and women, mostly aged 35-70 y, who were recruited in 10 European countries. After a mean follow-up of 14 y, 748 primary differentiated TC cases were diagnosed; 666 were in women and 601 were papillary TC. Data on intakes of lean fish, fatty fish, fish products, and shellfish were collected by using country-specific validated dietary questionnaires at recruitment. Multivariable Cox regression was used to calculate HRs and 95% CIs adjusted for many potential confounders, including dietary and nondietary factors.Results: No significant association was observed between total fish consumption and differentiated TC risk for the highest compared with the lowest quartile (HR: 1.03; 95% CI: 0.81, 1.32; P-trend = 0.67). Likewise, no significant association was observed with the intake of any specific type of fish, fish product, or shellfish. No significant heterogeneity was found by TC subtype (papillary or follicular tumors), by sex, or between countries with low and high TC incidence.Conclusion: This large study shows that the intake of fish and shellfish was not associated with differentiated TC risk in Europe, a region in which iodine deficiency or excess is rare.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15542b,

title = {Correction to: The effectiveness of a life style modification and peer support home blood pressure monitoring in control of hypertension: protocol for a cluster randomized controlled trial},

author = {T T Su and H A Majid and A M Nahar and N A Azizan and F M Hairi and N Thangiah and M Dahlui and A Bulgiba and L J Murray},

url = {https://www.ncbi.nlm.nih.gov/pubmed/29110641},

doi = {10.1186/s12889-017-4862-y},

issn = {1471-2458 (Electronic) 

1471-2458 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {BMC Public Health},

volume = {17},

number = {1},

pages = {864},

abstract = {After publication of the article [1], it has been brought to our attention that the methodology outlined in the original article was not able to be fully carried out. The article planned a two armed randomized control trial. However, due to a lower response than expected and one housing complex dropping out from the study, the method was changed to pre- and post-intervention with no control group. All other methods were conducted as outlined in the original article.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15584b,

title = {Cost of elective percutaneous coronary intervention in Malaysia: a multicentre cross-sectional costing study},

author = {K Y Lee and T K Ong and E V Low and S Y Liow and L Anchah and S Hamzah and H B Liew and R M Ali and O Ismail and W A W Ahmad and M A Said and M Dahlui},

doi = {10.1136/bmjopen-2016-014307},

issn = {2044-6055},

year  = {2017},

date = {2017-01-01},

journal = {BMJ Open},

volume = {7},

number = {5},

pages = {e014307},

abstract = {OBJECTIVES: Limitations in the quality and access of cost data from low-income and middle-income countries constrain the implementation of economic evaluations. With the increasing prevalence of coronary artery disease in Malaysia, cost information is vital for cardiac service expansion. We aim to calculate the hospitalisation cost of percutaneous coronary intervention (PCI), using a data collection method customised to local setting of limited data availability. DESIGN: This is a cross-sectional costing study from the perspective of healthcare providers, using top-down approach, from January to June 2014. Cost items under each unit of analysis involved in the provision of PCI service were identified, valuated and calculated to produce unit cost estimates. SETTING: Five public cardiac centres participated. All the centres provide full-fledged cardiology services. They are also the tertiary referral centres of their respective regions. PARTICIPANTS: The cost was calculated for elective PCI procedure in each centre. PCI conducted for urgent/emergent indication or for patients with shock and haemodynamic instability were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES: The outcome measures of interest were the unit costs at the two units of analysis, namely cardiac ward admission and cardiac catheterisation utilisation, which made up the total hospitalisation cost. RESULTS: The average hospitalisation cost ranged between RM11 471 (US$3186) and RM14 465 (US$4018). PCI consumables were the dominant cost item at all centres. The centre with daycare establishment recorded the lowest admission cost and total hospitalisation cost. CONCLUSIONS: Comprehensive results from all centres enable comparison at the levels of cost items, unit of analysis and total costs. This generates important information on cost variations between centres, thus providing valuable guidance for service planning. Alternative procurement practices for PCI consumables may deliver cost reduction. For countries with limited data availability, costing method tailored based on country setting can be used for the purpose of economic evaluations. REGISTRATION: Malaysian MOH Medical Research and Ethics Committee (ID: NMRR-13-1403-18234 IIR).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15601b,

title = {Depression, distress and self-efficacy: The impact on diabetes self-care practices},

author = {C Devarajooh and K Chinna},

doi = {10.1371/journal.pone.0175096},

issn = {1932-6203},

year  = {2017},

date = {2017-01-01},

journal = {PLoS One},

volume = {12},

number = {3},

pages = {e0175096},

abstract = {The prevalence of type 2 diabetes is increasing in Malaysia, and people with diabetes have been reported to suffer from depression and diabetes distress which influences their self-efficacy in performing diabetes self-care practices. This interviewer administered, cross sectional study, conducted in the district of Hulu Selangor, Malaysia, involving 371 randomly selected patients with type 2 diabetes, recruited from 6 health clinics, aimed to examine a conceptual model regarding the association between depression, diabetes distress and self-efficacy with diabetes self-care practices using the partial least square approach of structural equation modeling. In this study, diabetes self-care practices were similar regardless of sex, age group, ethnicity, education level, diabetes complications or type of diabetes medication. This study found that self-efficacy had a direct effect on diabetes self-care practice (path coefficient = 0.438, p\<0.001). Self-care was not directly affected by depression and diabetes distress, but indirectly by depression (path coefficient = -0.115, p\<0.01) and diabetes distress (path coefficient = -0.122, p\<0.001) via self-efficacy. In conclusion, to improve self-care practices, effort must be focused on enhancing self-efficacy levels, while not forgetting to deal with depression and diabetes distress, especially among those with poorer levels of self-efficacy.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15539b,

title = {Determinants for cardiovascular disease health check questionnaire: A validation study},

author = {A T Cheong and K Chinna and E M Khoo and S M Liew},

doi = {10.1371/journal.pone.0188259},

issn = {1932-6203},

year  = {2017},

date = {2017-01-01},

journal = {PLoS One},

volume = {12},

number = {11},

pages = {e0188259},

abstract = {BACKGROUND: To improve individuals' participation in cardiovascular disease (CVD) screening, it is necessary to understand factors that influence their intention to undergo health checks. This study aimed to develop and validate an instrument that assess determinants that influence individuals' intention to undergo CVD health checks. METHODS: The concepts and items were developed based on findings from our prior exploratory qualitative study on factors influencing individuals' intention to undergo CVD health checks. Content validity of the questionnaire was assessed by a panel of six experts and the item-level content validity index (I-CVI) was determined. After pretesting the questionnaire was pilot tested to check reliability of the items. Exploratory factor analysis was used to test for dimensionality using a sample of 240 participants. RESULTS: The finalized questionnaire consists of 36 items, covering nine concepts. The I-CVI for all items was satisfactory with values ranging from 0.83 to 1.00. The exploratory factor analysis showed that the number of factors extracted was consistent with the theoretical concepts. Correlations values between items ranged from 0.30 to 0.85 and all the factor loadings were more than 0.40, indicating satisfactory structural validity. All concepts showed good internal consistency, Cronbach's alpha values ranged 0.66-0.85. CONCLUSIONS: The determinants for CVD health check questionnaire has good content and structural validity, and its reliability was established. It can be used to assess determinants influencing individuals' intention to undergo CVD health checks.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15711b,

title = {Dietary and lifestyle determinants of acrylamide and glycidamide hemoglobin adducts in non-smoking postmenopausal women from the EPIC cohort},

author = {M Obon-Santacana and L Lujan-Barroso and H Freisling and C Cadeau and G Fagherazzi and M C Boutron-Ruault and R Kaaks and R T Fortner and H Boeing and J Ramon Quiros and E Molina-Montes and S Chamosa and J M Castano and E Ardanaz and K T Khaw and N Wareham and T Key and A Trichopoulou and P Lagiou and A Naska and D Palli and S Grioni and R Tumino and P Vineis and M S De Magistris and H B Bueno-de-Mesquita and P H Peeters and M Wennberg and I A Bergdahl and H Vesper and E Riboli and E J Duell},

url = {https://www.ncbi.nlm.nih.gov/pubmed/26850269},

doi = {10.1007/s00394-016-1165-5},

issn = {1436-6215 (Electronic) 

1436-6207 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Eur J Nutr},

volume = {56},

number = {3},

pages = {1157-1168},

abstract = {PURPOSE: Acrylamide was classified as 'probably carcinogenic' to humans in 1994 by the International Agency for Research on Cancer. In 2002, public health concern increased when acrylamide was identified in starchy, plant-based foods, processed at high temperatures. The purpose of this study was to identify which food groups and lifestyle variables were determinants of hemoglobin adduct concentrations of acrylamide (HbAA) and glycidamide (HbGA) in 801 non-smoking postmenopausal women from eight countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. METHODS: Biomarkers of internal exposure were measured in red blood cells (collected at baseline) by high-performance liquid chromatography/tandem mass spectrometry (HPLC/MS/MS) . In this cross-sectional analysis, four dependent variables were evaluated: HbAA, HbGA, sum of total adducts (HbAA + HbGA), and their ratio (HbGA/HbAA). Simple and multiple regression analyses were used to identify determinants of the four outcome variables. All dependent variables (except HbGA/HbAA) and all independent variables were log-transformed (log2) to improve normality. Median (25th-75th percentile) HbAA and HbGA adduct levels were 41.3 (32.8-53.1) pmol/g Hb and 34.2 (25.4-46.9) pmol/g Hb, respectively. RESULTS: The main food group determinants of HbAA, HbGA, and HbAA + HbGA were biscuits, crackers, and dry cakes. Alcohol intake and body mass index were identified as the principal determinants of HbGA/HbAA. The total percent variation in HbAA, HbGA, HbAA + HbGA, and HbGA/HbAA explained in this study was 30, 26, 29, and 13 %, respectively. CONCLUSIONS: Dietary and lifestyle factors explain a moderate proportion of acrylamide adduct variation in non-smoking postmenopausal women from the EPIC cohort.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15622b,

title = {Dietary flavonoid intake and colorectal cancer risk in the European prospective investigation into cancer and nutrition (EPIC) cohort},

author = {R Zamora-Ros and D K Barupal and J A Rothwell and M Jenab and V Fedirko and I Romieu and K Aleksandrova and K Overvad and C Kyro and A Tjonneland and A Affret and M His and M C Boutron-Ruault and V Katzke and T Kuhn and H Boeing and A Trichopoulou and A Naska and M Kritikou and C Saieva and C Agnoli and M Santucci Magistris and R Tumino and F Fasanelli and E Weiderpass and G Skeie and S Merino and P Jakszyn and M J Sanchez and M Dorronsoro and C Navarro and E Ardanaz and E Sonestedt and U Ericson and L Maria Nilsson and S Boden and H B Bueno-de-Mesquita and P H Peeters and A Perez-Cornago and N J Wareham and K T Khaw and H Freisling and A J Cross and E Riboli and A Scalbert},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28006847},

doi = {10.1002/ijc.30582},

issn = {1097-0215 (Electronic) 

0020-7136 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Int J Cancer},

volume = {140},

number = {8},

pages = {1836-1844},

abstract = {Flavonoids have been shown to inhibit colon cancer cell proliferation in vitro and protect against colorectal carcinogenesis in animal models. However, epidemiological evidence on the potential role of flavonoid intake in colorectal cancer (CRC) development remains sparse and inconsistent. We evaluated the association between dietary intakes of total flavonoids and their subclasses and risk of development of CRC, within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. A cohort of 477,312 adult men and women were recruited in 10 European countries. At baseline, dietary intakes of total flavonoids and individual subclasses were estimated using centre-specific validated dietary questionnaires and composition data from the Phenol-Explorer database. During an average of 11 years of follow-up, 4,517 new cases of primary CRC were identified, of which 2,869 were colon (proximal = 1,298 and distal = 1,266) and 1,648 rectal tumours. No association was found between total flavonoid intake and the risk of overall CRC (HR for comparison of extreme quintiles 1.05, 95% CI 0.93-1.18; p-trend = 0.58) or any CRC subtype. No association was also observed with any intake of individual flavonoid subclasses. Similar results were observed for flavonoid intake expressed as glycosides or aglycone equivalents. Intake of total flavonoids and flavonoid subclasses, as estimated from dietary questionnaires, did not show any association with risk of CRC development.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15606b,

title = {Differences in Perceived Severity of Zika Virus Infection and Dengue Fever and its Influence on Mosquito Control Practices in Malaysia},

author = {L P Wong and H Alias and N Aghamohammadi and I C Sam and S AbuBakar},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28238029},

doi = {10.1007/s10900-017-0326-7},

issn = {1573-3610 (Electronic) 

0094-5145 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {J Community Health},

volume = {42},

number = {5},

pages = {854-864},

abstract = {The aims of this study were to explore the differences in (1) the perception of severity towards ZIKV infection and dengue fever, and (2) mosquito control practices before and after the ZIKV outbreak were declared a Public Health Emergency of International Concern (PHEIC). Data were collected between Feb to May 2016 using a computer-assisted telephone interviewing system. The median scale score for perceived severity of ZIKV was 3 (interquartile range [IQR] 1-5) versus 4 (IQR 3-5) for dengue (P \< 0.001). The scores for mosquito control practices before and after ZIKV was declared a PHEIC were similar, at 4 (IQR 3-5). Multivariate analysis revealed that participants with a higher score for perception of severity of ZIKV were more likely to report greater mosquito control practices after the declaration of the PHEIC (OR 1.822 [95% CI 1.107-2.998]). The emerging ZIKV pandemic requires concerted efforts to enhance mosquito control practices among the Malaysian public. Efforts to improve public mosquito control practices should focus on enhancing the perception of the severity of ZIKV.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15561b,

title = {DNA methylation and exposure to ambient air pollution in two prospective cohorts},

author = {M Plusquin and F Guida and S Polidoro and R Vermeulen and O Raaschou-Nielsen and G Campanella and G Hoek and S A Kyrtopoulos and P Georgiadis and A Naccarati and C Sacerdote and V Krogh and H Bas Bueno-de-Mesquita and W M Monique Verschuren and S Sayols-Baixeras and T Panni and A Peters and Dgaj Hebels and J Kleinjans and P Vineis and M Chadeau-Hyam},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28843141},

doi = {10.1016/j.envint.2017.08.006},

issn = {1873-6750 (Electronic) 

0160-4120 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Environ Int},

volume = {108},

pages = {127-136},

abstract = {Long-term exposure to air pollution has been associated with several adverse health effects including cardiovascular, respiratory diseases and cancers. However, underlying molecular alterations remain to be further investigated. The aim of this study is to investigate the effects of long-term exposure to air pollutants on (a) average DNA methylation at functional regions and, (b) individual differentially methylated CpG sites. An assumption is that omic measurements, including the methylome, are more sensitive to low doses than hard health outcomes. This study included blood-derived DNA methylation (Illumina-HM450 methylation) for 454 Italian and 159 Dutch participants from the European Prospective Investigation into Cancer and Nutrition (EPIC). Long-term air pollution exposure levels, including NO2, NOx, PM2.5, PMcoarse, PM10, PM2.5 absorbance (soot) were estimated using models developed within the ESCAPE project, and back-extrapolated to the time of sampling when possible. We meta-analysed the associations between the air pollutants and global DNA methylation, methylation in functional regions and epigenome-wide methylation. CpG sites found differentially methylated with air pollution were further investigated for functional interpretation in an independent population (EnviroGenoMarkers project), where (N=613) participants had both methylation and gene expression data available. Exposure to NO2 was associated with a significant global somatic hypomethylation (p-value=0.014). Hypomethylation of CpG island's shores and shelves and gene bodies was significantly associated with higher exposures to NO2 and NOx. Meta-analysing the epigenome-wide findings of the 2 cohorts did not show genome-wide significant associations at single CpG site level. However, several significant CpG were found if the analyses were separated by countries. By regressing gene expression levels against methylation levels of the exposure-related CpG sites, we identified several significant CpG-transcript pairs and highlighted 5 enriched pathways for NO2 and 9 for NOx mainly related to the immune system and its regulation. Our findings support results on global hypomethylation associated with air pollution, and suggest that the shores and shelves of CpG islands and gene bodies are mostly affected by higher exposure to NO2 and NOx. Functional differences in the immune system were suggested by transcriptome analyses.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15579b,

title = {E-Cigarette Users' Attitudes on the Banning of Sales of Nicotine E-Liquid, Its Implication on E-Cigarette Use Behaviours and Alternative Sources of Nicotine E-Liquid},

author = {L P Wong and H Alias and N Agha Mohammadi and A Ghadimi and V C W Hoe},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28589268},

doi = {10.1007/s10900-017-0374-z},

issn = {1573-3610 (Electronic) 

0094-5145 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {J Community Health},

volume = {42},

number = {6},

pages = {1225-1232},

abstract = {The banning of sales of nicotine e-liquid in e-cigarette shops has been implemented in several states in Malaysia. The distribution of nicotine e-liquid can only be allowed by licensed pharmacies or registered medical practitioners. This study aimed to evaluate e-cigarette users' responses to the control policy in a cross-sectional survey of 851 e-cigarette users by utilizing a self-report questionnaire that assessed (1) attitudes on regulation policy of e-cigarette banning; (2) e-cigarette use behaviors; and (3) sources of e-liquid after the regulation policy has been implemented. Participants from the state of Selangor where the banning policy was implemented were surveyed. The majority (95.8%) opposed the banning and believed e-cigarettes should be sold to anyone aged 18 years or above as with tobacco cigarettes, only a minority believed that nicotine e-liquid should only be available for sale over the counter in pharmacy stores (14.6%) and in clinics with a doctor's prescription (11.8%). The majority (44.2%) reported that they would continue their e-cigarette use as before the banning policy, while 20% plan to completely stop e-cigarette usage without replacing it with any alternatives. The vast majority (87.9%) was still able to obtained nicotine e-liquid from e-cigarette shops in spite of the ban and the second most common source was from online purchase (63.1%). The sales of nicotine e-liquid from black-market were evidenced as many reported obtaining zero nicotine e-liquid from the black market (54.4%). Self- or home-made (30.8%) nicotine e-liquid was also reported. Majority of respondents that self-made e-liquid were from the average monthly income group (below MYR3000). Obtaining nicotine from the pharmacy was least preferred (21.4%). Provision of professional advice to nicotine e-liquid users along with the ban may lessen the likelihood of users switching to tobacco cigarettes or other nicotine alternatives. Banning of sales of nicotine e-liquid in e-cigarette shops resulted in a boom in the black market supplying nicotine e-liquid and, self- or home-made nicotine e-liquid. Enforcing regulations and monitoring black market sales is warranted. Efforts to educate e-cigarette users of the danger of sourcing nicotine e-liquid from the black market and self- or home-made nicotine e-liquid are essential.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15704b,

title = {Effect of multi-strain probiotics (multi-strain microbial cell preparation) on glycemic control and other diabetes-related outcomes in people with type 2 diabetes: a randomized controlled trial},

author = {S Firouzi and H A Majid and A Ismail and N A Kamaruddin and M Y Barakatun-Nisak},

doi = {10.1007/s00394-016-1199-8},

issn = {1436-6207},

year  = {2017},

date = {2017-01-01},

journal = {Eur J Nutr},

volume = {56},

number = {4},

pages = {1535-1550},

abstract = {AIM: Evidence of a possible connection between gut microbiota and several physiological processes linked to type 2 diabetes is increasing. However, the effect of multi-strain probiotics in people with type 2 diabetes remains unclear. This study investigated the effect of multi-strain microbial cell preparation-also refers to multi-strain probiotics-on glycemic control and other diabetes-related outcomes in people with type 2 diabetes. DESIGN: A randomized, double-blind, parallel-group, controlled clinical trial. SETTING: Diabetes clinic of a teaching hospital in Kuala Lumpur, Malaysia. PARTICIPANTS: A total of 136 participants with type 2 diabetes, aged 30-70 years, were recruited and randomly assigned to receive either probiotics (n = 68) or placebo (n = 68) for 12 weeks. OUTCOMES: Primary outcomes were glycemic control-related parameters, and secondary outcomes were anthropomorphic variables, lipid profile, blood pressure and high-sensitivity C-reactive protein. The Lactobacillus and Bifidobacterium quantities were measured before and after intervention as an indicator of successful passage of the supplement through gastrointestinal tract. STATISTICAL ANALYSIS: Intention-to-treat (ITT) analysis was performed on all participants, while per-protocol (PP) analysis was performed on those participants who had successfully completed the trial with good compliance rate. RESULTS: With respect to primary outcomes, glycated hemoglobin decreased by 0.14 % in the probiotics and increased by 0.02 % in the placebo group in PP analysis (p \< 0.05, small effect size of 0.050), while these changes were not significant in ITT analysis. Fasting insulin increased by 1.8 microU/mL in placebo group and decreased by 2.9 microU/mL in probiotics group in PP analysis. These changes were significant between groups at both analyses (p \< 0.05, medium effect size of 0.062 in PP analysis and small effect size of 0.033 in ITT analysis). Secondary outcomes did not change significantly. Probiotics successfully passed through the gastrointestinal tract. CONCLUSION: Probiotics modestly improved HbA1c and fasting insulin in people with type 2 diabetes.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15535b,

title = {Efficacy of Rebamipide in Organic and Functional Dyspepsia: A Systematic Review and Meta-Analysis},

author = {M H Jaafar and S Z Safi and M P Tan and S Rampal and S Mahadeva},

doi = {10.1007/s10620-017-4871-9},

issn = {0163-2116},

year  = {2017},

date = {2017-01-01},

journal = {Dig Dis Sci},

abstract = {OBJECTIVE: The role of gastritis in dyspepsia remains controversial. We aimed to examine the efficacy of rebamipide, a gastric mucosal protective agent, in both organic and functional dyspepsia. DESIGN: A systematic review and meta-analysis was performed. The following databases were searched using the keywords ("rebamipide" OR "gastroprotective agent*" OR "mucosta") AND ("dyspepsia" OR "indigestion" OR "gastrointestinal symptoms"): PubMed, Wed of Science, Embase, CINAHL, Cochrane Clinical Trials Register. The primary outcome was dyspepsia or upper GI symptom score improvement. Pooled analysis of the main outcome data were presented as risk ratio (RR) for dichotomous data and standardized mean difference (SMD) for continuous data. RESULTS: From an initial 248 records, 17 randomised controlled trial (RCT) publications involving 2170 subjects (1224 rebamipide, 946 placebo/control) were included in the final analysis. Twelve RCTs were conducted in subjects with organic dyspepsia (peptic ulcer disease, reflux esophagitis or NSAID-induced gastropathy) and five RCTs were conducted in patients with functional dyspepsia (FD). Overall, dyspepsia symptom improvement was significantly better with rebamipide compared to placebo/control drug (RR 0.77, 95% CI = 0.64-0.93; SMD -0.46, 95% CI = -0.83 to -0.09). Significant symptom improvement was observed both in pooled RR and SMD in subjects with organic dyspepsia (RR 0.72, 95% CI = 0.61-0.86; SMD -0.23, 95% CI = -0.4 to -0.07), while symptom improvement in FD was observed in pooled SMD but not RR (SMD -0.62, 95% CI = -1.16 to -0.08; RR 1.01, 95% CI = 0.71-1.45). CONCLUSION: Rebamipide is effective in organic dyspepsia and may improve symptoms in functional dyspepsia.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15534b,

title = {Ehrlichia and Anaplasma Infections: Serological Evidence and Tick Surveillance in Peninsular Malaysia},

author = {F X Koh and K L Kho and M G Kisomi and L P Wong and A Bulgiba and P E Tan and Y A L Lim and Q N H Nizam and C Panchadcharam and S T Tay},

doi = {10.1093/jme/tjx204},

issn = {0022-2585},

year  = {2017},

date = {2017-01-01},

journal = {J Med Entomol},

abstract = {Little information is available on human anaplasmosis and ehrlichiosis in Southeast Asia despite increasing reports of the detection of Anaplasma spp. and Ehrlichia spp. in the ticks. We report herein the serological findings against the tick-borne pathogens in a group of animal farm workers (n = 87) and indigenous people (n = 102) in Peninsular Malaysia. IgG antibodies against Ehrlichia chaffeensis were detected from 29.9% and 34.3% of farm workers and indigenous people, respectively, using commercial indirect immunofluorescence assays. Comparatively, only 6.9% of the indigenous people but none of the animal farm workers were seropositive to Anaplasma phagocytophilum. A polymerase chain reaction (PCR) assay targeting the 16S rRNA gene of Anaplasmataceae was used to identify Anaplastamataceae in ticks collected from various locations adjacent to the areas where the serological survey was conducted. In this study, a total of 61.5% of ticks infesting farm animals, 37.5% of ticks infesting peri-domestic animals in rural villages, 27.3% of ticks collected from wildlife animals, and 29.1% of questing ticks collected from forest vegetation were positive for Anaplasmataceae DNA. Sequence analyses of 16S rRNA gene region (238 bp) provide the identification for Anaplasma marginale, Anaplasma bovis, Anaplasma platys, A. phagocytophilum, and Anaplasma spp. closely related to Candidatus Cryptoplasma californiense in ticks. E. chaffeensis DNA was not detected from any ticks, instead, Ehrlichia sp. strain EBm52, Ehrlichia mineirensis and Candidatus Ehrlichia shimanensis are the only Ehrlichia sp. identified from cattle ticks in this study. Further investigation is required to ascertain the occurrence of zoonotic transmission of Ehrlichia and Anaplasma infections in Peninsular Malaysia.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15625b,

title = {Endometrial cancer risk prediction including serum-based biomarkers: results from the EPIC cohort},

author = {R T Fortner and A Husing and T Kuhn and M Konar and K Overvad and A Tjonneland and L Hansen and M C Boutron-Ruault and G Severi and A Fournier and H Boeing and A Trichopoulou and V Benetou and P Orfanos and G Masala and C Agnoli and A Mattiello and R Tumino and C Sacerdote and H B Bueno-de-Mesquita and P H Peeters and E Weiderpass and I T Gram and O Gavrilyuk and J R Quiros and J Maria Huerta and E Ardanaz and N Larranaga and L Lujan-Barroso and E Sanchez-Cantalejo and S T Butt and S Borgquist and A Idahl and E Lundin and K T Khaw and N E Allen and S Rinaldi and L Dossus and M Gunter and M A Merritt and I Tzoulaki and E Riboli and R Kaaks},

doi = {10.1002/ijc.30560},

issn = {0020-7136},

year  = {2017},

date = {2017-01-01},

journal = {Int J Cancer},

volume = {140},

number = {6},

pages = {1317-1323},

abstract = {Endometrial cancer risk prediction models including lifestyle, anthropometric and reproductive factors have limited discrimination. Adding biomarker data to these models may improve predictive capacity; to our knowledge, this has not been investigated for endometrial cancer. Using a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, we investigated the improvement in discrimination gained by adding serum biomarker concentrations to risk estimates derived from an existing risk prediction model based on epidemiologic factors. Serum concentrations of sex steroid hormones, metabolic markers, growth factors, adipokines and cytokines were evaluated in a step-wise backward selection process; biomarkers were retained at p \< 0.157 indicating improvement in the Akaike information criterion (AIC). Improvement in discrimination was assessed using the C-statistic for all biomarkers alone, and change in C-statistic from addition of biomarkers to preexisting absolute risk estimates. We used internal validation with bootstrapping (1000-fold) to adjust for over-fitting. Adiponectin, estrone, interleukin-1 receptor antagonist, tumor necrosis factor-alpha and triglycerides were selected into the model. After accounting for over-fitting, discrimination was improved by 2.0 percentage points when all evaluated biomarkers were included and 1.7 percentage points in the model including the selected biomarkers. Models including etiologic markers on independent pathways and genetic markers may further improve discrimination.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15633b,

title = {Epidemiological Differences Between Localized and Nonlocalized Low Back Pain},

author = {D Coggon and G Ntani and K Walker-Bone and K T Palmer and V E Felli and R Harari and L H Barrero and S A Felknor and D Gimeno and A Cattrell and S Vargas-Prada and M Bonzini and E Solidaki and E Merisalu and R R Habib and F Sadeghian and M M Kadir and S S Warnakulasuriya and K Matsudaira and B Nyantumbu and M R Sim and H Harcombe and K Cox and L M M Sarquis and M H Marziale and F Harari and R Freire and N Harari and M V Monroy and L A Quintana and M Rojas and E C Harris and C Serra and J M Martinez and G Delclos and F G Benavides and M Carugno and M M Ferrario and A C Pesatori and L Chatzi and P Bitsios and M Kogevinas and K Oha and T Freimann and A Sadeghian and R J Peiris-John and N Sathiakumar and A R Wickremasinghe and N Yoshimura and H L Kelsall and V C W Hoe and D M Urquhart and S Derrett and D McBride and P Herbison and A Gray and E J Salazar Vega},

doi = {10.1097/brs.0000000000001956},

issn = {0362-2436},

year  = {2017},

date = {2017-01-01},

journal = {Spine (Phila Pa 1976)},

volume = {42},

number = {10},

pages = {740-747},

abstract = {STUDY DESIGN: A cross-sectional survey with a longitudinal follow-up. OBJECTIVES: The aim of this study was to test the hypothesis that pain, which is localized to the low back, differs epidemiologically from that which occurs simultaneously or close in time to pain at other anatomical sites SUMMARY OF BACKGROUND DATA.: Low back pain (LBP) often occurs in combination with other regional pain, with which it shares similar psychological and psychosocial risk factors. However, few previous epidemiological studies of LBP have distinguished pain that is confined to the low back from that which occurs as part of a wider distribution of pain. METHODS: We analyzed data from CUPID, a cohort study that used baseline and follow-up questionnaires to collect information about musculoskeletal pain, associated disability, and potential risk factors, in 47 occupational groups (office workers, nurses, and others) from 18 countries. RESULTS: Among 12,197 subjects at baseline, 609 (4.9%) reported localized LBP in the past month, and 3820 (31.3%) nonlocalized LBP. Nonlocalized LBP was more frequently associated with sciatica in the past month (48.1% vs. 30.0% of cases), occurred on more days in the past month and past year, was more often disabling for everyday activities (64.1% vs. 47.3% of cases), and had more frequently led to medical consultation and sickness absence from work. It was also more often persistent when participants were followed up after a mean of 14 months (65.6% vs. 54.1% of cases). In adjusted Poisson regression analyses, nonlocalized LBP was differentially associated with risk factors, particularly female sex, older age, and somatizing tendency. There were also marked differences in the relative prevalence of localized and nonlocalized LBP by occupational group. CONCLUSION: Future epidemiological studies should distinguish where possible between pain that is limited to the low back and LBP that occurs in association with pain at other anatomical locations. LEVEL OF EVIDENCE: 2.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15560b,

title = {Erratum to: Validation of verbal autopsy: determination of cause of deaths in Malaysia 2013},

author = {S S Ganapathy and K Yi Yi and M A Omar and M F M Anuar and C Jeevananthan and C Rao},

doi = {10.1186/s12889-017-4687-8},

issn = {1471-2458},

year  = {2017},

date = {2017-01-01},

journal = {BMC Public Health},

volume = {17},

number = {1},

pages = {687},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15593b,

title = {Erratum: Wong, L.P., et al. The Self-Regulation Model of Illness: Comparison between Zika and Dengue and Its Application to Predict Mosquito Prevention Behaviours in Malaysia, a Dengue-Endemic Country Int. J. Environ. Res. Public Health 2016, 13, 1210},

author = {L P Wong and H Alias and N Aghamohammadi and I C Sam and S Abu Bakar},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28422053},

doi = {10.3390/ijerph14040433},

issn = {1660-4601 (Electronic) 

1660-4601 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Int J Environ Res Public Health},

volume = {14},

number = {4},

abstract = {n/a.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15582b,

title = {Evaluation of awareness \& utilisation of clinical practise guideline for management of adult Dengue infection among Malaysia doctors},

author = {M I Ariff and A Yahya and R Zaki and R Sarimin and I M Mohamed Ghazali and B S Gill and Z Suli and M A Mohd Yusof and N Ahmad Lutfi and S L Thye and F Ismail and M Mahmud and R Bakri},

doi = {10.1371/journal.pone.0178137},

issn = {1932-6203},

year  = {2017},

date = {2017-01-01},

journal = {PLoS One},

volume = {12},

number = {5},

pages = {e0178137},

abstract = {Clinical Practice Guideline (CPG) provides evidence-based guidance for the management of Dengue Infection in adult patients. A cross sectional study was conducted to evaluate awareness and utilization of CPG among doctors in public or private hospitals and clinics in Malaysia. Doctors practicing only at hospital Medical and Emergency Departments were included, while private specialist clinics were excluded in this study. A multistage proportionate random sampling according to region (Central, Northern, Southern, Eastern, Sabah and Sarawak) was performed to select study participants. The overall response rate was 74% (84% for public hospitals, 82% for private hospitals, 70% for public clinics, and 64% for private clinics). The CPG Awareness and Utilization Feedback Form were used to determine the percentage in the study. The total numbers of respondent were 634 with response rate of 74%. The mean lengths of service of the respondent were 13.98 (11.55).A higher percentages of doctors from public facilities (99%) were aware of the CPG compared to those in private facilities (84%). The percentage of doctors utilising the CPG were also higher (98%) in public facilities compared to private facilities (86%). The percentage of Medical Officer in private facilities that utilizing the CPG were 84% compares to Medical Officer in public facilities 98%. The high percentage of doctors using the CPG in both public (97%) and private (94%) hospitals were also observed. However, only 69% of doctors in private clinics utilised the CPG compared to doctors in public clinics (98%). Doctors in both public and private facilities were aware of the dengue CPG. However, most doctors in private clinic were less likely to utilise the CPG. Therefore, there is a need to increase the level of CPG utilisation especially in private clinics.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15599b,

title = {Exposure to bacterial products lipopolysaccharide and flagellin and hepatocellular carcinoma: a nested case-control study},

author = {V Fedirko and H Q Tran and A T Gewirtz and M Stepien and A Trichopoulou and K Aleksandrova and A Olsen and A Tjonneland and K Overvad and F Carbonnel and M C Boutron-Ruault and G Severi and T Kuhn and R Kaaks and H Boeing and C Bamia and P Lagiou and S Grioni and S Panico and D Palli and R Tumino and A Naccarati and P H Peeters and H B Bueno-de-Mesquita and E Weiderpass and J M Castano and A Barricarte and M J Sanchez and M Dorronsoro and J R Quiros and A Agudo and K Sjoberg and B Ohlsson and O Hemmingsson and M Werner and K E Bradbury and K T Khaw and N Wareham and K K Tsilidis and D Aune and A Scalbert and I Romieu and E Riboli and M Jenab},

doi = {10.1186/s12916-017-0830-8},

issn = {1741-7015},

year  = {2017},

date = {2017-01-01},

journal = {BMC Med},

volume = {15},

number = {1},

pages = {72},

abstract = {BACKGROUND: Leakage of bacterial products across the gut barrier may play a role in liver diseases which often precede the development of liver cancer. However, human studies, particularly from prospective settings, are lacking. METHODS: We used a case-control study design nested within a large prospective cohort to assess the association between circulating levels of anti-lipopolysaccharide (LPS) and anti-flagellin immunoglobulin A (IgA) and G (IgG) (reflecting long-term exposures to LPS and flagellin, respectively) and risk of hepatocellular carcinoma. A total of 139 men and women diagnosed with hepatocellular carcinoma between 1992 and 2010 were matched to 139 control subjects. Multivariable rate ratios (RRs), including adjustment for potential confounders, hepatitis B/C positivity, and degree of liver dysfunction, were calculated with conditional logistic regression. RESULTS: Antibody response to LPS and flagellin was associated with a statistically significant increase in the risk of hepatocellular carcinoma (highest vs. lowest quartile: RR = 11.76, 95% confidence interval = 1.70-81.40; P trend = 0.021). This finding did not vary substantially by time from enrollment to diagnosis, and did not change after adjustment for chronic infection with hepatitis B and C viruses. CONCLUSIONS: These novel findings, based on exposures up to several years prior to diagnosis, support a role for gut-derived bacterial products in hepatocellular carcinoma development. Further study into the role of gut barrier failure and exposure to bacterial products in liver diseases is warranted.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15573b,

title = {Factors associated with online victimisation among Malaysian adolescents who use social networking sites: a cross-sectional study},

author = {M J Marret and W Y Choo},

doi = {10.1136/bmjopen-2016-014959},

issn = {2044-6055},

year  = {2017},

date = {2017-01-01},

journal = {BMJ Open},

volume = {7},

number = {6},

pages = {e014959},

abstract = {OBJECTIVE: To determine the prevalence of online interpersonal victimisation and its association with patterns of social networking site (SNS) use, offline victimisation, offline perpetration and parental conflict among Malaysian adolescents using SNS. METHODS: A cross-sectional study of students from randomly selected public secondary schools in the state of Negeri Sembilan was conducted using an anonymous self-administered questionnaire. The questionnaire examined patterns of SNS use and included measures of online victimisation, online perpetration, offline victimisation and parental conflict. A response rate of 91% from a total of 1634 yielded a sample of 1487 students between 15 years and 16 years of age. RESULTS: Ninety-two per cent of respondents had used at least one SNS. More than half of SNS users (52.2%) reported experiences of online victimisation over the past 12 months. Boys were significantly more likely to experience online harassment compared with girls (52.2% vs 43.3%, p\<0.001). There were no significant gender differences in experiences of unwanted sexual solicitation. Adolescents who engaged in perpetration behaviours online had almost six times higher odds of reporting frequent online victimisation compared with online behaviours involving personal disclosure. There was a significant dose-response relationship between engagement in multiple types of online behaviour and the risk of frequent online victimisation. Both online and offline perpetrations were associated with an increased risk of victimisation. Those who were victimised offline or experienced parental conflict were twice as likely to report online victimisation. CONCLUSION: Interventions to prevent online electronic aggression should target perpetration behaviour both online and offline. Youth should be equipped with skills in communication and decision-making in relationships that can be applied across a spectrum of contexts both online and offline.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15595b,

title = {Fruit and vegetable intake and prostate cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)},

author = {A Perez-Cornago and R C Travis and P N Appleby and K K Tsilidis and A Tjonneland and A Olsen and K Overvad and V Katzke and T Kuhn and A Trichopoulou and E Peppa and M Kritikou and S Sieri and D Palli and C Sacerdote and R Tumino and H B A Bueno-de-Mesquita and A Agudo and N Larranaga and E Molina-Portillo and E Ardanaz and M D Chirlaque and C Lasheras and P Stattin and M Wennberg and I Drake and J Malm and J A Schmidt and K T Khaw and M Gunter and H Freisling and I Huybrechts and D Aune and A J Cross and E Riboli and T J Key},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28419475},

doi = {10.1002/ijc.30741},

issn = {1097-0215 (Electronic) 

0020-7136 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Int J Cancer},

volume = {141},

number = {2},

pages = {287-297},

abstract = {Several dietary factors have been studied in relation to prostate cancer; however, most studies have not reported on subtypes of fruit and vegetables or tumor characteristics, and results obtained so far are inconclusive. This study aimed to examine the prospective association of total and subtypes of fruit and vegetable intake with the incidence of prostate cancer overall, by grade and stage of disease, and prostate cancer death. Lifestyle information for 142,239 men participating in the European Prospective Investigation into Cancer and Nutrition from 8 European countries was collected at baseline. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). After an average follow-up time of 13.9 years, 7,036 prostate cancer cases were identified. Compared with the lowest fifth, those in the highest fifth of total fruit intake had a significantly reduced prostate cancer risk (HR = 0.91; 95% CI = 0.83-0.99; p-trend = 0.01). No associations between fruit subtypes and prostate cancer risk were observed, except for citrus fruits, where a significant trend was found (HR = 0.94; 95% CI = 0.86-1.02; p-trend = 0.01). No associations between total and subtypes of vegetables and prostate cancer risk were observed. We found no evidence of heterogeneity in these associations by tumor grade and stage, with the exception of significant heterogeneity by tumor grade (pheterogeneity \<0.001) for leafy vegetables. No significant associations with prostate cancer death were observed. The main finding of this prospective study was that a higher fruit intake was associated with a small reduction in prostate cancer risk. Whether this association is causal remains unclear.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15564b,

title = {Genetic Variants Related to Longer Telomere Length are Associated with Increased Risk of Renal Cell Carcinoma},

author = {M J Machiela and J N Hofmann and R Carreras-Torres and K M Brown and M Johansson and Z Wang and M Foll and P Li and N Rothman and S A Savage and V Gaborieau and J D McKay and Y Ye and M Henrion and F Bruinsma and S Jordan and G Severi and K Hveem and L J Vatten and T Fletcher and K Koppova and S C Larsson and A Wolk and R E Banks and P J Selby and D F Easton and P Pharoah and G Andreotti and L E B Freeman and S Koutros and D Albanes and S Mannisto and S Weinstein and P E Clark and T E Edwards and L Lipworth and S M Gapstur and V L Stevens and H Carol and M L Freedman and M M Pomerantz and E Cho and P Kraft and M A Preston and K M Wilson and J M Gaziano and H S Sesso and A Black and N D Freedman and W Y Huang and J G Anema and R J Kahnoski and B R Lane and S L Noyes and D Petillo and L M Colli and J N Sampson and C Besse and H Blanche and A Boland and L Burdette and E Prokhortchouk and K G Skryabin and M Yeager and M Mijuskovic and M Ognjanovic and L Foretova and I Holcatova and V Janout and D Mates and A Mukeriya and S Rascu and D Zaridze and V Bencko and C Cybulski and E Fabianova and V Jinga and J Lissowska and J Lubinski and M Navratilova and P Rudnai and N Szeszenia-Dabrowska and S Benhamou and G Cancel-Tassin and O Cussenot and H B Bueno-de-Mesquita and F Canzian and E J Duell and B Ljungberg and R T Sitaram and U Peters and E White and G L Anderson and L Johnson and J Luo and J Buring and I M Lee and W H Chow and L E Moore and C Wood and others},

doi = {10.1016/j.eururo.2017.07.015},

issn = {0302-2838},

year  = {2017},

date = {2017-01-01},

journal = {Eur Urol},

volume = {72},

number = {5},

pages = {747-754},

abstract = {BACKGROUND: Relative telomere length in peripheral blood leukocytes has been evaluated as a potential biomarker for renal cell carcinoma (RCC) risk in several studies, with conflicting findings. OBJECTIVE: We performed an analysis of genetic variants associated with leukocyte telomere length to assess the relationship between telomere length and RCC risk using Mendelian randomization, an approach unaffected by biases from temporal variability and reverse causation that might have affected earlier investigations. DESIGN, SETTING, AND PARTICIPANTS: Genotypes from nine telomere length-associated variants for 10 784 cases and 20 406 cancer-free controls from six genome-wide association studies (GWAS) of RCC were aggregated into a weighted genetic risk score (GRS) predictive of leukocyte telomere length. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Odds ratios (ORs) relating the GRS and RCC risk were computed in individual GWAS datasets and combined by meta-analysis. RESULTS AND LIMITATIONS: Longer genetically inferred telomere length was associated with an increased risk of RCC (OR=2.07 per predicted kilobase increase, 95% confidence interval [CI]:=1.70-2.53, p\<0.0001). As a sensitivity analysis, we excluded two telomere length variants in linkage disequilibrium (R(2)\>0.5) with GWAS-identified RCC risk variants (rs10936599 and rs9420907) from the telomere length GRS; despite this exclusion, a statistically significant association between the GRS and RCC risk persisted (OR=1.73, 95% CI=1.36-2.21, p\<0.0001). Exploratory analyses for individual histologic subtypes suggested comparable associations with the telomere length GRS for clear cell (N=5573},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15585b,

title = {Genetic variation in the ADIPOQ gene, adiponectin concentrations and risk of colorectal cancer: a Mendelian Randomization analysis using data from three large cohort studies},

author = {K Nimptsch and M Song and K Aleksandrova and M Katsoulis and H Freisling and M Jenab and M J Gunter and K K Tsilidis and E Weiderpass and H B Bueno-De-Mesquita and D Q Chong and M K Jensen and C Wu and K Overvad and T Kuhn and M Barrdahl and O Melander and K Jirstrom and P H Peeters and S Sieri and S Panico and A J Cross and E Riboli and B Van Guelpen and R Myte and J M Huerta and M Rodriguez-Barranco and J R Quiros and M Dorronsoro and A Tjonneland and A Olsen and R Travis and M C Boutron-Ruault and F Carbonnel and G Severi and C Bonet and D Palli and J Janke and Y A Lee and H Boeing and E L Giovannucci and S Ogino and C S Fuchs and E Rimm and K Wu and A T Chan and T Pischon},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28550647},

doi = {10.1007/s10654-017-0262-y},

issn = {1573-7284 (Electronic) 

0393-2990 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Eur J Epidemiol},

volume = {32},

number = {5},

pages = {419-430},

abstract = {Higher levels of circulating adiponectin have been related to lower risk of colorectal cancer in several prospective cohort studies, but it remains unclear whether this association may be causal. We aimed to improve causal inference in a Mendelian Randomization meta-analysis using nested case-control studies of the European Prospective Investigation into Cancer and Nutrition (EPIC, 623 cases, 623 matched controls), the Health Professionals Follow-up Study (HPFS, 231 cases, 230 controls) and the Nurses' Health Study (NHS, 399 cases, 774 controls) with available data on pre-diagnostic adiponectin concentrations and selected single nucleotide polymorphisms in the ADIPOQ gene. We created an ADIPOQ allele score that explained approximately 3% of the interindividual variation in adiponectin concentrations. The ADIPOQ allele score was not associated with risk of colorectal cancer in logistic regression analyses (pooled OR per score-unit unit 0.97, 95% CI 0.91, 1.04). Genetically determined twofold higher adiponectin was not significantly associated with risk of colorectal cancer using the ADIPOQ allele score as instrumental variable (pooled OR 0.73, 95% CI 0.40, 1.34). In a summary instrumental variable analysis (based on previously published data) with higher statistical power, no association between genetically determined twofold higher adiponectin and risk of colorectal cancer was observed (0.99, 95% CI 0.93, 1.06 in women and 0.94, 95% CI 0.88, 1.01 in men). Thus, our study does not support a causal effect of circulating adiponectin on colorectal cancer risk. Due to the limited genetic determination of adiponectin, larger Mendelian Randomization studies are necessary to clarify whether adiponectin is causally related to lower risk of colorectal cancer.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15620b,

title = {Helicobacter pylori infection, chronic corpus atrophic gastritis and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort: A nested case-control study},

author = {J Huang and U Zagai and G Hallmans and O Nyren and L Engstrand and R Stolzenberg-Solomon and E J Duell and K Overvad and V A Katzke and R Kaaks and M Jenab and J Y Park and R Murillo and A Trichopoulou and P Lagiou and C Bamia and K E Bradbury and E Riboli and D Aune and K K Tsilidis and G Capella and A Agudo and V Krogh and D Palli and S Panico and E Weiderpass and A Tjonneland and A Olsen and B Martinez and D Redondo-Sanchez and M D Chirlaque and P Hm Peeters and S Regner and B Lindkvist and A Naccarati and E Ardanaz and N Larranaga and M C Boutron-Ruault and V Rebours and A Barre and H B Bueno-de-Mesquita and W Ye},

doi = {10.1002/ijc.30590},

issn = {0020-7136},

year  = {2017},

date = {2017-01-01},

journal = {Int J Cancer},

volume = {140},

number = {8},

pages = {1727-1735},

abstract = {The association between H. pylori infection and pancreatic cancer risk remains controversial. We conducted a nested case-control study with 448 pancreatic cancer cases and their individually matched control subjects, based on the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, to determine whether there was an altered pancreatic cancer risk associated with H. pylori infection and chronic corpus atrophic gastritis. Conditional logistic regression models were applied to calculate odds ratios (ORs) and corresponding 95% confidence intervals (CIs), adjusted for matching factors and other potential confounders. Our results showed that pancreatic cancer risk was neither associated with H. pylori seropositivity (OR = 0.96; 95% CI: 0.70, 1.31) nor CagA seropositivity (OR = 1.07; 95% CI: 0.77, 1.48). We also did not find any excess risk among individuals seropositive for H. pylori but seronegative for CagA, compared with the group seronegative for both antibodies (OR = 0.94; 95% CI: 0.63, 1.38). However, we found that chronic corpus atrophic gastritis was non-significantly associated with an increased pancreatic cancer risk (OR = 1.35; 95% CI: 0.77, 2.37), and although based on small numbers, the excess risk was particularly marked among individuals seronegative for both H. pylori and CagA (OR = 5.66; 95% CI: 1.59, 20.19, p value for interaction \< 0.01). Our findings provided evidence supporting the null association between H. pylori infection and pancreatic cancer risk in western European populations. However, the suggested association between chronic corpus atrophic gastritis and pancreatic cancer risk warrants independent verification in future studies, and, if confirmed, further studies on the underlying mechanisms.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15572b,

title = {Hepatitis B and C virus infection and diabetes mellitus: A cohort study},

author = {Y S Hong and Y Chang and S Ryu and M Cainzos-Achirica and M J Kwon and Y Zhang and Y Choi and J Ahn and S Rampal and D Zhao and R Pastor-Barriuso and M Lazo and H Shin and J Cho and E Guallar},

doi = {10.1038/s41598-017-04206-6},

issn = {2045-2322},

year  = {2017},

date = {2017-01-01},

journal = {Sci Rep},

volume = {7},

number = {1},

pages = {4606},

abstract = {The role of hepatitis virus infection in glucose homeostasis is uncertain. We examined the associations between hepatitis B virus (HBV) or hepatitis C virus (HCV) infection and the development of diabetes in a cohort (N = 439,708) of asymptomatic participants in health screening examinations. In cross-sectional analyses, the multivariable-adjusted odds ratio for prevalent diabetes comparing hepatitis B surface antigen (HBsAg) (+) to HBsAg (-) participants was 1.17 (95% CI 1.06-1.31; P = 0.003). The corresponding odds ratio comparing hepatitis C antibodies (HCV Ab) (+) to HCV Ab (-) participants was 1.43 (95% CI 1.01-2.02},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15600b,

title = {Impact of adjuvant chemotherapy on survival of women with T1N0M0, hormone receptor negative breast cancer},

author = {N T Bhoo-Pathy and S Inaida and S Tanaka and N A Taib and C H Yip and M Saad and K Kawakami and N Bhoo-Pathy},

doi = {10.1016/j.canep.2017.03.007},

issn = {1877-7821},

year  = {2017},

date = {2017-01-01},

journal = {Cancer Epidemiol},

volume = {48},

pages = {56-61},

abstract = {BACKGROUND: The benefit of adjuvant chemotherapy in women with T1N0M0 breast cancers is unclear. While gene expression-based prognostic assays may aid management of women with early estrogen receptor (ER) positive tumors, therapeutic decision-making in women with early stage ER negative tumors remains fraught with difficulties. We investigated the association between adjuvant chemotherapy and overall survival in women with T1N0M0, hormone receptor negative breast cancers. METHOD: All newly diagnosed breast cancer patients with node-negative and hormone receptor negative tumors measuring\</=2cm at the University Malaya Medical Centre (Malaysia) from 1993 to 2013 were included. Mortality of patients with and without adjuvant chemotherapy were compared and adjusted for possible confounders using propensity score. RESULTS: Of 6732 breast cancer patients, 341 (5.1%) had small (\</=2cm), node-negative and hormone receptor negative tumors at diagnosis. Among them, only 214 (62.8%) received adjuvant chemotherapy. Five-year overall survival was 88.1% (95% confidence interval (CI): 82.0%-94.2%) for patients receiving chemotherapy and 89.6% (95% CI: 85.1%-94.1%) for patients without chemotherapy. Chemotherapy was not associated with survival following adjustment for age, ethnicity, tumor size, tumor grade, HER2 status, lympho-vascular invasion, type of surgery and radiotherapy administration. However, chemotherapy was associated with a significant survival advantage (adjusted hazard ratio: 0.35, 95%CI: 0.14-0.91) in a subgroup of women with high-grade tumors. CONCLUSION: Adjuvant chemotherapy does not appear to be associated with a survival benefit in women with T1N0M0, hormone receptor negative breast cancer except in those with high-grade tumors.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15530b,

title = {Impact of prediagnostic smoking and smoking cessation on colorectal cancer prognosis: a meta-analysis of individual patient data from cohorts within the CHANCES consortium},

author = {J M Ordonez-Me and V Walter and B Schottker and M Jenab and M G O'Doherty and F Kee and B Bueno-de-Mesquita and P H M Peeters and B H Stricker and R Ruiter and A Hofman and S Soderberg and P Jousilahti and K Kuulasmaa and N D Freedman and T Wilsgaard and A Wolk and L M Nilsson and A Tjonneland and J R Quiros and F J B Duijnhoven and P D Siersema and P Boffetta and A Trichopoulou and H Brenner},

url = {https://www.ncbi.nlm.nih.gov/pubmed/29244072},

doi = {10.1093/annonc/mdx761},

issn = {1569-8041 (Electronic) 

0923-7534 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Ann Oncol},

abstract = {Background: Smoking has been associated with colorectal cancer (CRC) incidence and mortality in previous studies and might also be associated with prognosis after CRC diagnosis. However, current evidence on smoking in association with CRC prognosis is limited. Patients and methods: For this individual patient data meta-analysis, sociodemographic and smoking behavior information of 12,414 incident CRC patients (median age at diagnosis: 64.3 years), recruited within 14 prospective cohort studies among previously cancer-free adults, was collected at baseline and harmonized across studies. Vital status and causes of death were collected for a mean follow-up time of 5.1 years following cancer diagnosis. Associations of smoking behavior with overall and CRC-specific survival were evaluated using Cox regression and standard meta-analysis methodology. Results: A total of 5,229 participants died, 3,194 from CRC. Cox regression revealed significant associations between former (hazard ratio (HR)=1.12; 95%-confidence interval (CI)=1.04-1.20) and current smoking (HR = 1.29; 95%CI=1.04-1.60) and poorer overall survival compared with never smoking. Compared with current smoking, smoking cessation was associated with improved overall (HR\<10years=0.78; 95%CI=0.69-0.88; HR\>/=10years=0.78; 95%CI=0.63-0.97) and CRC-specific survival (HR\>/=10years=0.76; 95%CI=0.67-0.85). Conclusion: In this large meta-analysis including primary data of incident CRC patients from 14 prospective cohort studies on the association between smoking and CRC prognosis, former and current smoking were associated with poorer CRC prognosis compared with never smoking. Smoking cessation was associated with improved survival when compared with current smokers. Future studies should further quantify the benefits of non-smoking, both for cancer prevention and for improving survival among CRC patients, in particular also in terms of treatment response.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15574b,

title = {Impact of Time Since Last Childbirth on Survival of Women with Premenopausal and Postmenopausal Breast Cancers},

author = {N Balakrishnan and S H Teo and S Sinnadurai and N T Bhoo Pathy and M H See and N A Taib and C H Yip and N Bhoo Pathy},

doi = {10.1007/s00268-017-4081-9},

issn = {0364-2313},

year  = {2017},

date = {2017-01-01},

journal = {World J Surg},

volume = {41},

number = {11},

pages = {2735-2745},

abstract = {BACKGROUND: Reproductive factors are associated with risk of breast cancer, but the association with breast cancer survival is less well known. Previous studies have reported conflicting results on the association between time since last childbirth and breast cancer survival. We determined the association between time since last childbirth (LCB) and survival of women with premenopausal and postmenopausal breast cancers in Malaysia. METHOD: A historical cohort of 986 premenopausal, and 1123 postmenopausal, parous breast cancer patients diagnosed from 2001 to 2012 in University Malaya Medical Centre were included in the analyses. Time since LCB was categorized into quintiles. Multivariable Cox regression was used to determine whether time since LCB was associated with survival following breast cancer, adjusting for demographic, tumor, and treatment characteristics. RESULTS: Premenopausal breast cancer patients with the most recent childbirth (LCB quintile 1) were younger, more likely to present with unfavorable prognostic profiles and had the lowest 5-year overall survival (OS) (66.9; 95% CI 60.2-73.6%), compared to women with longer duration since LCB (quintile 2 thru 5). In univariable analysis, time since LCB was inversely associated with risk of mortality and the hazard ratio for LCB quintile 2, 3, 4, and 5 versus quintile 1 were 0.53 (95% CI 0.36-0.77), 0.49 (95% CI 0.33-0.75), 0.61 (95% CI 0.43-0.85), and 0.64 (95% CI 0.44-0.93), respectively; P trend = 0.016. However, this association was attenuated substantially following adjustment for age at diagnosis and other prognostic factors. Similarly, postmenopausal breast cancer patients with the most recent childbirth were also more likely to present with unfavorable disease profiles. Compared to postmenopausal breast cancer patients in LCB quintile 1, patients in quintile 5 had a higher risk of mortality. This association was not significant following multivariable adjustment. CONCLUSION: Time since LCB is not independently associated with survival in premenopausal or postmenopausal breast cancers. The apparent increase in risks of mortality in premenopausal breast cancer patients with a recent childbirth, and postmenopausal patients with longer duration since LCB, appear to be largely explained by their age at diagnosis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15598b,

title = {Interactions Between Genome-Wide Significant Genetic Variants and Circulating Concentrations of 25-Hydroxyvitamin D in Relation to Prostate Cancer Risk in the National Cancer Institute BPC3},

author = {V I Dimitrakopoulou and R C Travis and I M Shui and A Mondul and D Albanes and J Virtamo and A Agudo and H Boeing and H B Bueno-de-Mesquita and M J Gunter and M Johansson and K T Khaw and K Overvad and D Palli and A Trichopoulou and E Giovannucci and D J Hunter and S Lindstrom and W Willett and J M Gaziano and M Stampfer and C Berg and S I Berndt and A Black and R N Hoover and P Kraft and T J Key and K K Tsilidis},

doi = {10.1093/aje/kww143},

issn = {0002-9262},

year  = {2017},

date = {2017-01-01},

journal = {Am J Epidemiol},

volume = {185},

number = {6},

pages = {452-464},

abstract = {Genome-wide association studies (GWAS) have identified over 100 single nucleotide polymorphisms (SNPs) associated with prostate cancer. However, information on the mechanistic basis for some associations is limited. Recent research has been directed towards the potential association of vitamin D concentrations and prostate cancer, but little is known about whether the aforementioned genetic associations are modified by vitamin D. We investigated the associations of 46 GWAS-identified SNPs, circulating concentrations of 25-hydroxyvitamin D (25(OH)D), and prostate cancer (3,811 cases, 511 of whom died from the disease, compared with 2,980 controls-from 5 cohort studies that recruited participants over several periods beginning in the 1980s). We used logistic regression models with data from the National Cancer Institute Breast and Prostate Cancer Cohort Consortium (BPC3) to evaluate interactions on the multiplicative and additive scales. After allowing for multiple testing, none of the SNPs examined was significantly associated with 25(OH)D concentration, and the SNP-prostate cancer associations did not differ by these concentrations. A statistically significant interaction was observed for each of 2 SNPs in the 8q24 region (rs620861 and rs16902094), 25(OH)D concentration, and fatal prostate cancer on both multiplicative and additive scales (P \</= 0.001). We did not find strong evidence that associations between GWAS-identified SNPs and prostate cancer are modified by circulating concentrations of 25(OH)D. The intriguing interactions between rs620861 and rs16902094, 25(OH)D concentration, and fatal prostate cancer warrant replication.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15646b,

title = {Interventions for preventing elder abuse: applying findings of a new Cochrane review},

author = {P R Baker and D P Francis and N N Mohd Hairi and S Othman and W Y Choo},

doi = {10.1093/ageing/afw186},

issn = {0002-0729},

year  = {2017},

date = {2017-01-01},

journal = {Age Ageing},

volume = {46},

number = {3},

pages = {346-348},

abstract = {There is evidence that elder abuse is a significant public health problem that is destined to grow as population age. Countries are considering how best to act and this requires an understanding of the complex causal mechanisms contributing to its occurrence and the identification of effective interventions which can potentially make a difference. Previously, a high quality synthesis of evidence for policy and practice has been missing. In this paper, we describe a new Cochrane review of interventions to prevent the occurrence or reoccurrence of elder abuse. Overall, the quality of the evidence available for decision making is very low and there is little to guide practice. Amongst the interventions, there is some evidence that teaching coping skills to family carers of persons with dementia might make the situation better. We argue that poor quality and wasteful research needs to be avoided, and front-line agencies be supported in undertaking comparative evaluation of their services.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15602b,

title = {Is universal HLA-B*15:02 screening a cost-effective option in an ethnically diverse population? A case study of Malaysia},

author = {H Y Chong and Z Mohamed and L L Tan and D B C Wu and F H Shabaruddin and M Dahlui and Y D Apalasamy and S R Snyder and M S Williams and J Hao and L H Cavallari and N Chaiyakunapruk},

doi = {10.1111/bjd.15498},

issn = {0007-0963},

year  = {2017},

date = {2017-01-01},

journal = {Br J Dermatol},

volume = {177},

number = {4},

pages = {1102-1112},

abstract = {BACKGROUND: A strong association has been documented between HLA-B*15:02 and carbamazepine-induced severe cutaneous adverse reactions (SCARs) in Asians. Human leucocyte antigen testing is potentially valuable in many countries to facilitate early recognition of patient susceptibility to SCARs. OBJECTIVES: To determine the cost-effectiveness of universal HLA-B*15:02 screening in preventing carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis in an ethnically diverse Malaysian population. METHODS: A hybrid model of a decision tree and Markov model was developed to evaluate three strategies for treating newly diagnosed epilepsy among adults: (i) carbamazepine initiation without HLA-B*15:02 screening (current practice); (ii) universal HLA-B*15:02 screening prior to carbamazepine initiation; and (iii) alternative treatment [sodium valproate (VPA)] prescribing without HLA-B*15:02 screening. Base-case analysis and sensitivity analyses were performed over a lifetime time horizon. Incremental cost-effectiveness ratios were calculated. RESULTS: Both universal HLA-B*15:02 screening and VPA prescribing were dominated by current practice. Compared with current practice, universal HLA-B*15:02 screening resulted in a loss of 0.0255 quality-adjusted life years (QALYs) at an additional cost of 707 U.S. dollars (USD); VPA prescribing resulted in a loss of 0.2622 QALYs at an additional cost of USD 4127, owing to estimated differences in antiepileptic treatment efficacy. CONCLUSIONS: Universal HLA-B*15:02 screening is unlikely to be a cost-effective intervention in Malaysia. However, with the emergence of an ethnically diverse population in many other countries, this may render HLA-B*15:02 screening a viable intervention when an increasing proportion of the population is at risk and an equally effective yet safer antiepileptic drug is available.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15551b,

title = {Long-term Exposure to Ambient Air Pollution and Incidence of Brain Tumor: the European Study of Cohorts for Air Pollution Effects (ESCAPE)},

author = {Z J Andersen and M Pedersen and G Weinmayr and M Stafoggia and C Galassi and J T Jorgensen and J N Sommar and B Forsberg and D Olsson and B Oftedal and G M Aasvang and P Schwarze and A Pyko and G Pershagen and M Korek and U De Faire and C G Ostenson and L Fratiglioni and K T Eriksen and A H Poulsen and A Tjonneland and E Vaclavik Brauner and P H Peeters and B Bueno-de-Mesquita and A Jaensch and G Nagel and A Lang and M Wang and M Y Tsai and S Grioni and A Marcon and V Krogh and F Ricceri and C Sacerdote and E Migliore and R Vermeulen and R Sokhi and M Keuken and K Hoogh and R Beelen and P Vineis and G Cesaroni and B Brunekreef and G Hoek and O Raaschou-Nielsen},

doi = {10.1093/neuonc/nox163},

issn = {1522-8517},

year  = {2017},

date = {2017-01-01},

journal = {Neuro Oncol},

abstract = {Background: Epidemiological evidence on the association between ambient air pollution and brain tumor risk is sparse and inconsistent. Methods: In 12 cohorts from six European countries, individual estimates of annual mean air pollution levels at the baseline residence were estimated by standardized land-use regression models developed within the ESCAPE and TRANSPHORM projects: particulate matter (PM) \</= 2.5, \</= 10, and 2.5-10 mum in diameter (PM2.5, PM10, and PMcoarse), PM2.5 absorbance, nitrogen oxides (NO2 and NOx) and elemental composition of PM. We estimated cohort-specific associations of air pollutant concentrations and traffic intensity with total, malignant and nonmalignant brain tumor, in separate Cox regression models, adjusting for risk factors, and pooled cohort-specific estimates using random-effects meta-analyses. Results: Of 282,194 subjects from 12 cohorts, 466 developed malignant brain tumors during 12 years of follow-up. Six of the cohorts had also data on nonmalignant brain tumor, where among 106,786 subjects, 366 developed brain tumor: 176 nonmalignant and 190 malignant. We found a positive, statistically non-significant association between malignant brain tumor and PM2.5 absorbance (Hazard Ratio and 95% Confidence Interval: 1.67; 0.89-3.14 per 10 -5/m 3), and weak positive or null associations with the other pollutants. Hazard ratio for PM2.5 absorbance (1.01; 0.38-2.71 per 10 -5/m 3) and all other pollutants were lower for nonmalignant than for malignant brain tumors. Conclusion: We found suggestive evidence of an association between long-term exposure to PM2.5 absorbance indicating traffic-related air pollution and malignant brain tumors, and no association with overall or nonmalignant brain tumors.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15547b,

title = {Long-Term Exposure to Ambient Air Pollution and Incidence of Postmenopausal Breast Cancer in 15 European Cohorts within the ESCAPE Project},

author = {Z J Andersen and M Stafoggia and G Weinmayr and M Pedersen and C Galassi and J T Jorgensen and A Oudin and B Forsberg and D Olsson and B Oftedal and G Marit Aasvang and G Aamodt and A Pyko and G Pershagen and M Korek and U De Faire and N L Pedersen and C G Ostenson and L Fratiglioni and K T Eriksen and A Tjonneland and P H Peeters and B Bueno-de-Mesquita and M Plusquin and T J Key and A Jaensch and G Nagel and A Lang and M Wang and M Y Tsai and A Fournier and M C Boutron-Ruault and L Baglietto and S Grioni and A Marcon and V Krogh and F Ricceri and C Sacerdote and E Migliore and I Tamayo-Uria and P Amiano and M Dorronsoro and R Vermeulen and R Sokhi and M Keuken and K Hoogh and R Beelen and P Vineis and G Cesaroni and B Brunekreef and G Hoek and O Raaschou-Nielsen},

doi = {10.1289/ehp1742},

issn = {0091-6765},

year  = {2017},

date = {2017-01-01},

journal = {Environ Health Perspect},

volume = {125},

number = {10},

pages = {107005},

abstract = {BACKGROUND: Epidemiological evidence on the association between ambient air pollution and breast cancer risk is inconsistent. OBJECTIVE: We examined the association between long-term exposure to ambient air pollution and incidence of postmenopausal breast cancer in European women. METHODS: In 15 cohorts from nine European countries, individual estimates of air pollution levels at the residence were estimated by standardized land-use regression models developed within the European Study of Cohorts for Air Pollution Effects (ESCAPE) and Transport related Air Pollution and Health impacts - Integrated Methodologies for Assessing Particulate Matter (TRANSPHORM) projects: particulate matter (PM) \</=2.5mum, \</=10mum, and 2.5-10mum in diameter (PM2.5, PM10, and PMcoarse, respectively); PM2.5 absorbance; nitrogen oxides (NO2 and NOx); traffic intensity; and elemental composition of PM. We estimated cohort-specific associations between breast cancer and air pollutants using Cox regression models, adjusting for major lifestyle risk factors, and pooled cohort-specific estimates using random-effects meta-analyses. RESULTS: Of 74,750 postmenopausal women included in the study, 3,612 developed breast cancer during 991,353 person-years of follow-up. We found positive and statistically insignificant associations between breast cancer and PM2.5 hazard ratio (HR)=1.08 [95% confidence interval (CI): 0.77, 1.51] per 5 mug/m(3), PM10 [1.07 (95% CI: 0.89, 1.30) per 10 mug/m(3)], PMcoarse[1.20 (95% CI: 0.96, 1.49 per 5 mug/m(3)], and NO(2) [1.02 (95% CI: 0.98, 1.07 per 10 mug/m(3)], and a statistically significant association with NOx [1.04 (95% CI: 1.00, 1.08) per 20 mug/m(3)},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15540b,

title = {Low Lifetime Risk of Contralateral Breast Cancer in a Middle-Income Asian Country: Evidence to Guide Post-treatment Surveillance},

author = {M H See and N Bhoo-Pathy and S Jamaris and A Kiran and D G Evans and C H Yip and N A Taib},

url = {https://www.ncbi.nlm.nih.gov/pubmed/29124356},

doi = {10.1007/s00268-017-4319-6},

issn = {1432-2323 (Electronic) 

0364-2313 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {World J Surg},

abstract = {BACKGROUND: The rate of contralateral risk-reducing mastectomy (CRRM) is increasing in the West with controversial evidence of improved survival in early breast cancer patients. Although uptake of CRRM in Asia appears low, the trends may rise, and there is currently an urgent need to provide evidence for informed decision-making in clinical practice. This study aims to determine the risk of contralateral breast cancer (CBC) and its associated factors in an Asian setting. METHOD: A total of 2937 newly diagnosed patients with stage I and stage II breast cancer in University Malaya Medical Centre between Jan 1993 to Dec 2012 were included in the study. Multinomial logistic regression analysis allowing death to compete with CBC as a study outcome was used; patients with unilateral breast cancer who were alive were taken as reference. A stepwise backward regression analysis including age at diagnosis, ethnicity, family history of breast cancer, TNM stage, hormonal receptor status, HER2 status, chemotherapy, radiotherapy, and hormone therapy was conducted. RESULTS: Fifty women developed CBC, over a median follow-up of 6 years. The 5- and 10-year cumulative risk of contralateral breast cancer was 1.0% (95% CI 0.6-1.4%) and 2.8% (95% CI 2.0-3.6%), respectively. Young age at diagnosis of first cancer, positive family history, and stage I disease were independent predictors of CBC. DISCUSSION: The current study suggests that the risk of CBC is very low in a Southeast Asian setting. Any recommendations or practice of CRRM should be reviewed with caution and patients must be counseled appropriately.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15614b,

title = {Measuring health literacy in Asia: Validation of the HLS-EU-Q47 survey tool in six Asian countries},

author = {T V Duong and A Aringazina and G Baisunova and Nurjanah and T V Pham and K M Pham and T Q Truong and K T Nguyen and W M Oo and E Mohamad and T T Su and H L Huang and K Sorensen and J M Pelikan and S Van Broucke and P W Chang},

doi = {10.1016/j.je.2016.09.005},

issn = {0917-5040},

year  = {2017},

date = {2017-01-01},

journal = {J Epidemiol},

volume = {27},

number = {2},

pages = {80-86},

abstract = {BACKGROUND: Health literacy has been increasingly recognized as one of the most important social determinants for health. However, an appropriate and comprehensive assessment tool is not available in many Asian countries. This study validates a comprehensive health literacy survey tool European health literacy questionnaire (HLS-EU-Q47) for the general public in several Asian countries. METHODS: A cross-sectional survey based on multistage random sampling in the target countries. A total of 10,024 participants aged \>/=15 years were recruited during 2013-2014 in Indonesia, Kazakhstan, Malaysia, Myanmar, Taiwan, and Vietnam. The questionnaire was translated into local languages to measure general health literacy and its three domains. To evaluate the validity of the tool in these countries, data were analyzed by confirmatory factor analysis, internal consistency analysis, and regression analysis. RESULTS: The questionnaire was shown to have good construct validity, satisfactory goodness-of-fit of the data to the hypothetical model in three health literacy domains, high internal consistency (Cronbach's alpha \>0.90), satisfactory item-scale convergent validity (item-scale correlation \>/=0.40), and no floor/ceiling effects in these countries. General health literacy index score was significantly associated with level of education (P from \<0.001 to 0.011) and perceived social status (P from \<0.001 to 0.016), with evidence of known-group validity. CONCLUSIONS: The HLS-EU-Q47 was a satisfactory and comprehensive health literacy survey tool for use in Asia.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15611b,

title = {Mediterranean diet and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition cohort},

author = {E Molina-Montes and M J Sanchez and G Buckland and H B Bueno-de-Mesquita and E Weiderpass and P Amiano and P A Wark and T Kuhn and V Katzke and J M Huerta and E Ardanaz and J R Quiros and A Affret and M His and M C Boutron-Ruault and P H Peeters and W Ye and M Sund and H Boeing and K Iqbal and B Ohlsson and E Sonestedt and A Tjonneland and K E Petersen and R C Travis and G Skeie and C Agnoli and S Panico and D Palli and R Tumino and C Sacerdote and H Freisling and I Huybrechts and K Overvad and A Trichopoulou and C Bamia and E Vasilopoulou and N Wareham and K T Khaw and A J Cross and H A Ward and E Riboli and E J Duell},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28170373},

doi = {10.1038/bjc.2017.14},

issn = {1532-1827 (Electronic) 

0007-0920 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Br J Cancer},

volume = {116},

number = {6},

pages = {811-820},

abstract = {BACKGROUND: The Mediterranean diet (MD) has been proposed as a means for cancer prevention, but little evidence has been accrued regarding its potential to prevent pancreatic cancer. We investigated the association between the adherence to the MD and pancreatic cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. METHODS: Over half a million participants from 10 European countries were followed up for over 11 years, after which 865 newly diagnosed exocrine pancreatic cancer cases were identified. Adherence to the MD was estimated through an adapted score without the alcohol component (arMED) to discount alcohol-related harmful effects. Cox proportional hazards regression models, stratified by age, sex and centre, and adjusted for energy intake, body mass index, smoking status, alcohol intake and diabetes status at recruitment, were used to estimate hazard ratios (HRs) associated with pancreatic cancer and their corresponding 95% confidence intervals (CIs). RESULTS: Adherence to the arMED score was not associated with risk of pancreatic cancer (HR high vs low adherence=0.99; 95% CI: 0.77-1.26, and HR per increments of two units in adherence to arMED=1.00; 95% CI: 0.94-1.06). There was no convincing evidence for heterogeneity by smoking status, body mass index, diabetes or European region. There was also no evidence of significant associations in analyses involving microscopically confirmed cases, plausible reporters of energy intake or other definitions of the MD pattern. CONCLUSIONS: A high adherence to the MD is not associated with pancreatic cancer risk in the EPIC study.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15613b,

title = {Metabolic syndrome among non-obese adults in the teaching profession in Melaka, Malaysia},

author = {S C Lee and N N Hairi and F M Moy},

doi = {10.1016/j.je.2016.10.006},

issn = {0917-5040},

year  = {2017},

date = {2017-01-01},

journal = {J Epidemiol},

volume = {27},

number = {3},

pages = {130-134},

abstract = {BACKGROUND: Non-obese individuals could have metabolic disorders that are typically associated with elevated body mass index (BMI), placing them at elevated risk for chronic diseases. This study aimed to describe the prevalence and distribution of metabolically obese, non-obese (MONO) individuals in Malaysia. METHODS: We conducted a cross-sectional study involving teachers recruited via multi-stage sampling from the state of Melaka, Malaysia. MONO was defined as individuals with BMI 18.5-29.9 kg/m(2) and metabolic syndrome. Metabolic syndrome was diagnosed based on the Harmonization criteria. Participants completed self-reported questionnaires that assessed alcohol intake, sleep duration, smoking, physical activity, and fruit and vegetable consumption. RESULTS: A total of 1168 teachers were included in the analysis. The prevalence of MONO was 17.7% (95% confidence interval [CI], 15.3-20.4). Prevalence of metabolic syndrome among the normal weight and overweight participants was 8.3% (95% CI, 5.8-11.8) and 29.9% (95% CI, 26.3-33.7), respectively. MONO prevalence was higher among males, Indians, and older participants and inversely associated with sleep duration. Metabolic syndrome was also more prevalent among those with central obesity, regardless of whether they were normal or overweight. The odds of metabolic syndrome increased exponentially from 1.9 (for those with BMI 23.0-24.9 kg/m(2)) to 11.5 (for those with BMI 27.5-29.9 kg/m(2)) compared to those with BMI 18.5-22.9 kg/m(2) after adjustment for confounders. CONCLUSIONS: The prevalence of MONO was high, and participants with BMI \>/=23.0 kg/m(2) had significantly higher odds of metabolic syndrome. Healthcare professionals and physicians should start to screen non-obese individuals for metabolic risk factors to facilitate early targeted intervention.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15596b,

title = {Moderate alcohol consumption is associated with lower chronic disease burden expressed in disability-adjusted life years: a prospective cohort study},

author = {J W J Beulens and H P Fransen and E A Struijk and J M A Boer and G A Wit and N C Onland-Moret and J Hoekstra and H B Bueno-de-Mesquita and P H M Peeters and A M May},

doi = {10.1007/s10654-017-0247-x},

issn = {0393-2990},

year  = {2017},

date = {2017-01-01},

journal = {Eur J Epidemiol},

volume = {32},

number = {4},

pages = {317-326},

abstract = {The relation of alcohol consumption with disease burden remains debated partly due to opposite associations with cardiovascular disease (CVD) and cancer. The relation of alcohol consumption with disease burden expressed in disability-adjusted life years (DALYs) summarizes opposing associations of alcohol consumption on chronic diseases. This study aimed to investigate the association of alcohol consumption with chronic disease burden expressed in DALYs based on individual-participant data. The study was a prospective study among 33,066 men and women from the EPIC-NL cohort. At baseline, alcohol consumption was assessed with a validated food-frequency questionnaire. Participants were followed for occurrence of and mortality from chronic diseases and DALYs were calculated. After 12.4 years follow-up, 6647 disease incidences and 1482 deaths were documented, resulting in 68,225 healthy years of life lost (6225 DALYs). Moderate drinkers (women 5-14.9 g/day, men 5-29.9 g/day) had a lower chronic disease burden (mean DALYs -0.27; 95% CI -0.43; -0.11) than light drinkers (0-4.9 g/day), driven by a lower disease burden due to CVD (-0.18: -0.29; -0.06) but not cancer (-0.05: -0.16; 0.06). The associations were most pronounced among older participants (\>/=50 years; -0.32; -0.53; -0.10) and not observed among younger women (-0.08; -0.43; 0.35), albeit non-significant (pinteraction \> 0.14). Substantial drinking (women 15-29.9 g/day, men 30-59.9 g/day) compared to light drinking was not associated with chronic disease burden. Our results show that moderate compared to light alcohol consumption was associated with living approximately 3 months longer in good health. These results were mainly observed among older participants and not seen among younger women.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15631b,

title = {Mortality among elder abuse victims in rural Malaysia: A two-year population-based descriptive study},

author = {Mph R M Yunus and PhD N N Hairi and PhD W Y Choo and PhD F M Hairi and Mph R Sooryanarayana and Md S N Ahmad and Md I Abdul Razak and BSc D Peramalah and Mph S Abdul Aziz and Mph Z L Mohammad and Md R Mohamad and Mph Z Mohd Ali and PhD A Bulgiba},

url = {https://www.ncbi.nlm.nih.gov/pubmed/27841737},

doi = {10.1080/08946566.2016.1260083},

issn = {1540-4129 (Electronic) 

0894-6566 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {J Elder Abuse Negl},

volume = {29},

number = {1},

pages = {59-71},

abstract = {Our study aims at describing mortality among reported elder abuse experiences in rural Malaysia. This is a population-based cohort study with a multistage cluster sampling method. Older adults in Kuala Pilah (n = 1,927) were interviewed from November 2013 to May 2014. Mortality was traced after 2 years using the National Registration Department database. Overall, 139 (7.2%) respondents died. Fifteen (9.6%) abuse victims died compared to 124 (7.0%) not abused. Mortality was highest with financial abuse (13%), followed by psychological abuse (10.8%). There was a dose-response relationship between mortality and clustering of abuse: 7%, 7.7%, and 14.0% for no abuse, one type, and two types or more, respectively. Among abuse victims, 40% of deaths had ill-defined causes, 33% were respiratory-related, and 27% had cardiovascular and metabolic origin. Results suggest a link between abuse and mortality. Death proportions varied according to abuse subtypes and gender.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15616b,

title = {No association of alcohol use and the risk of ulcerative colitis or Crohn's disease: data from a European Prospective cohort study (EPIC)},

author = {M M Bergmann and V Hernandez and W Bernigau and H Boeing and S S Chan and R Luben and K T Khaw and F Schaik and B Oldenburg and B Bueno-de-Mesquita and K Overvad and D Palli and G Masala and F Carbonnel and M C Boutron-Ruault and A Olsen and A Tjonneland and R Kaaks and V Katzke and E Riboli and A R Hart},

doi = {10.1038/ejcn.2016.271},

issn = {0954-3007},

year  = {2017},

date = {2017-01-01},

journal = {Eur J Clin Nutr},

volume = {71},

number = {4},

pages = {512-518},

abstract = {BACKGROUND/OBJECTIVES: The role of long-term alcohol consumption for the risk of developing ulcerative colitis (UC) and Crohn's disease (CD) is unclear. For the first time, to prospectively assess the role of pre-disease alcohol consumption on the risk of developing UC or CD. SUBJECTS/METHODS: Nested within the European Prospective Investigation into Cancer and Nutrition (EPIC-IBD), incident UC and CD cases and matched controls where included. At recruitment, participants completed validated food frequency and lifestyle questionnaires. Alcohol consumption was classified as either: non-use, former, light (0.5 and 1 drink per week), below the recommended limits (BRL) (1 and 2 drinks per day), moderate (2.5 and 5 drinks per day), or heavy use (\>2.5 and \>5 drinks per day) for women and men, respectively; and was expressed as consumption at enrolment and during lifetime. Conditional logistic regression was applied adjusting for smoking and education, taking light users as the reference. RESULTS: Out of 262 451 participants in six countries, 198 UC incident cases/792 controls and 84 CD cases/336 controls were included. At enrolment, 8%/27%/32%/23%/11% UC cases and 7%/29%/40%/19%/5% CD cases were: non-users, light, BRL, moderate and heavy users, respectively. The corresponding figures for lifetime non-use, former, light, BRL, moderate and heavy use were: 3%/5%/23%/44%/19%/6% and 5%/2%/25%/44%/23%/1% for UC and CD cases, respectively. There were no associations between any categories of alcohol consumption and risk of UC or CD in the unadjusted and adjusted odds ratios. CONCLUSION: There was no evidence of associations between alcohol use and the odds of developing either UC or CD.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15543b,

title = {Nurses' perceptions of barriers and facilitators and their associations with the quality of end-of-life care},

author = {E Omar Daw Hussin and L P Wong and M C Chong and P Subramanian},

url = {https://www.ncbi.nlm.nih.gov/pubmed/29076190},

doi = {10.1111/jocn.14130},

issn = {1365-2702 (Electronic) 

0962-1067 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {J Clin Nurs},

abstract = {AIMS AND OBJECTIVES: To examine nurses' perceptions of barriers to and facilitators of end-of-life care, as well as their association with the quality of end-of-life care. BACKGROUND: Often, dying patients and their families receive their care from general nurses. The quality of end-of-life care in hospital wards is inadequate. METHOD: A self-administered questionnaire was completed by 553 nurses working in a tertiary teaching hospital in Malaysia. RESULTS: The barrier with the highest mean score was "dealing with distressed family members." The facilitator with the highest mean score was "providing a peaceful and dignified bedside scene for the family once the patient has died." With regard to barrier and facilitator categories, the barrier category with the highest total mean score was patient-related barriers and the facilitator category with the highest total mean score concerned facilitators related to healthcare professionals. In the multivariate analysis, age, patient family-related barriers and healthcare professional-related facilitators significantly predict the quality of end-of-life care. CONCLUSION: The results of this study suggest that there is an urgent need to overcome barriers related to the patient and family members that hinder the quality of care provided for dying patients, as well as to enhance and implement the facilitators related to healthcare providers. In addition, there is also a need to enhance the quality of end-of-life care provided by younger nurses through end-of-life care courses and training. RELEVANCE TO CLINICAL PRACTICE: Helping nurses overcome barriers and implement facilitators may lead to enhanced quality of care provided for dying patients.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15569b,

title = {Nut intake and 5-year changes in body weight and obesity risk in adults: results from the EPIC-PANACEA study},

author = {H Freisling and H Noh and N Slimani and V Chajes and A M May and P H Peeters and E Weiderpass and A J Cross and G Skeie and M Jenab and F R Mancini and M C Boutron-Ruault and G Fagherazzi and V A Katzke and T Kuhn and A Steffen and H Boeing and A Tjonneland and C Kyro and C P Hansen and K Overvad and E J Duell and D Redondo-Sanchez and P Amiano and C Navarro and A Barricarte and A Perez-Cornago and K K Tsilidis and D Aune and H Ward and A Trichopoulou and A Naska and P Orfanos and G Masala and C Agnoli and F Berrino and R Tumino and C Sacerdote and A Mattiello and H B Bueno-de-Mesquita and U Ericson and E Sonestedt and A Winkvist and T Braaten and I Romieu and J Sabate},

doi = {10.1007/s00394-017-1513-0},

issn = {1436-6207},

year  = {2017},

date = {2017-01-01},

journal = {Eur J Nutr},

abstract = {PURPOSE: There is inconsistent evidence regarding the relationship between higher intake of nuts, being an energy-dense food, and weight gain. We investigated the relationship between nut intake and changes in weight over 5 years. METHODS: This study includes 373,293 men and women, 25-70 years old, recruited between 1992 and 2000 from 10 European countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Habitual intake of nuts including peanuts, together defined as nut intake, was estimated from country-specific validated dietary questionnaires. Body weight was measured at recruitment and self-reported 5 years later. The association between nut intake and body weight change was estimated using multilevel mixed linear regression models with center/country as random effect and nut intake and relevant confounders as fixed effects. The relative risk (RR) of becoming overweight or obese after 5 years was investigated using multivariate Poisson regressions stratified according to baseline body mass index (BMI). RESULTS: On average, study participants gained 2.1 kg (SD 5.0 kg) over 5 years. Compared to non-consumers, subjects in the highest quartile of nut intake had less weight gain over 5 years (-0.07 kg; 95% CI -0.12 to -0.02) (P trend = 0.025) and had 5% lower risk of becoming overweight (RR 0.95; 95% CI 0.92-0.98) or obese (RR 0.95; 95% CI 0.90-0.99) (both P trend \<0.008). CONCLUSIONS: Higher intake of nuts is associated with reduced weight gain and a lower risk of becoming overweight or obese.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15610b,

title = {Osteoprotegerin and breast cancer risk by hormone receptor subtype: a nested case-control study in the EPIC cohort},

author = {R T Fortner and D Sarink and H Schock and T Johnson and A Tjonneland and A Olsen and K Overvad and A Affret and M His and M C Boutron-Ruault and H Boeing and A Trichopoulou and A Naska and P Orfanos and D Palli and S Sieri and A Mattiello and R Tumino and F Ricceri and H B Bueno-de-Mesquita and P H Peeters and C H Van Gils and E Weiderpass and E Lund and J R Quiros and A Agudo and M J Sanchez and M D Chirlaque and E Ardanaz and M Dorronsoro and T Key and K T Khaw and S Rinaldi and L Dossus and M Gunter and M A Merritt and E Riboli and R Kaaks},

doi = {10.1186/s12916-017-0786-8},

issn = {1741-7015},

year  = {2017},

date = {2017-01-01},

journal = {BMC Med},

volume = {15},

number = {1},

pages = {26},

abstract = {BACKGROUND: Circulating osteoprotegerin (OPG), a member of the receptor activator of nuclear factor kappa-B (RANK) axis, may influence breast cancer risk via its role as the decoy receptor for both the RANK ligand (RANKL) and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL). Circulating OPG and breast cancer risk has been examined in only one prior study. METHODS: A case-control study was nested in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. A total of 2008 incident invasive breast cancer cases (estrogen receptor (ER)+},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15623b,

title = {Outcome after neoadjuvant chemotherapy in Asian breast cancer patients},

author = {L Y Lim and H Miao and J S Lim and S C Lee and N Bhoo-Pathy and C H Yip and N A Taib and P Chan and E Y Tan and S H Lim and G H Lim and E Woo and Y S Tan and J A Lee and M Wong and P H Tan and K W Ong and F Y Wong and Y S Yap and M Hartman},

doi = {10.1002/cam4.985},

issn = {2045-7634},

year  = {2017},

date = {2017-01-01},

journal = {Cancer Med},

volume = {6},

number = {1},

pages = {173-185},

abstract = {We aim to identify clinicopathologic predictors for response to neoadjuvant chemotherapy and to evaluate the prognostic value of pathologic complete response (pCR) on survival in Asia. This study included 915 breast cancer patients who underwent neoadjuvant chemotherapy at five public hospitals in Singapore and Malaysia. pCR following neoadjuvant chemotherapy was defined as 1) no residual invasive tumor cells in the breast (ypT0/is) and 2) no residual invasive tumor cells in the breast and axillary lymph nodes (ypT0/is ypN0). Association between pCR and clinicopathologic characteristics and treatment were evaluated using chi-square test and multivariable logistic regression. Kaplan-Meier analysis and log-rank test, stratified by other prognostic factors, were conducted to compare overall survival between patients who achieved pCR and patients who did not. Overall, 4.4% of nonmetastatic patients received neoadjuvant chemotherapy. The median age of preoperatively treated patients was 50 years. pCR rates were 18.1% (pCR ypT0/is) and 14.4% (pCR ypT0/is ypN0), respectively. pCR rate was the highest among women who had higher grade, smaller size, estrogen receptor negative, human epidermal growth factor receptor 2-positive disease or receiving taxane-based neoadjuvant chemotherapy. Patients who achieved pCR had better overall survival than those who did not. In subgroup analysis, the survival advantage was only significant among women with estrogen receptor-negative tumors. Patients with poor prognostic profile are more likely to achieve pCR and particularly when receiving taxane-containing chemotherapy. pCR is a significant prognostic factor for overall survival especially in estrogen receptor-negative breast cancers.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15621b,

title = {Outdoor air pollution and risk for kidney parenchyma cancer in 14 European cohorts},

author = {O Raaschou-Nielsen and M Pedersen and M Stafoggia and G Weinmayr and Z J Andersen and C Galassi and J Sommar and B Forsberg and D Olsson and B Oftedal and N H Krog and G M Aasvang and A Pyko and G Pershagen and M Korek and U De Faire and N L Pedersen and C G Ostenson and L Fratiglioni and M Sorensen and K T Eriksen and A Tjonneland and P H Peeters and H B Bueno-de-Mesquita and M Plusquin and T J Key and A Jaensch and G Nagel and B Foger and M Wang and M Y Tsai and S Grioni and A Marcon and V Krogh and F Ricceri and C Sacerdote and E Migliore and I Tamayo and P Amiano and M Dorronsoro and R Sokhi and I Kooter and K Hoogh and R Beelen and M Eeftens and R Vermeulen and P Vineis and B Brunekreef and G Hoek},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28006861},

doi = {10.1002/ijc.30587},

issn = {1097-0215 (Electronic) 

0020-7136 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Int J Cancer},

volume = {140},

number = {7},

pages = {1528-1537},

abstract = {Several studies have indicated weakly increased risk for kidney cancer among occupational groups exposed to gasoline vapors, engine exhaust, polycyclic aromatic hydrocarbons and other air pollutants, although not consistently. It was the aim to investigate possible associations between outdoor air pollution at the residence and the incidence of kidney parenchyma cancer in the general population. We used data from 14 European cohorts from the ESCAPE study. We geocoded and assessed air pollution concentrations at baseline addresses by land-use regression models for particulate matter (PM10 , PM2.5 , PMcoarse , PM2.5 absorbance (soot)) and nitrogen oxides (NO2 , NOx ), and collected data on traffic. We used Cox regression models with adjustment for potential confounders for cohort-specific analyses and random effects models for meta-analyses to calculate summary hazard ratios (HRs). The 289,002 cohort members contributed 4,111,908 person-years at risk. During follow-up (mean 14.2 years) 697 incident cancers of the kidney parenchyma were diagnosed. The meta-analyses showed higher HRs in association with higher PM concentration, e.g. HR = 1.57 (95%CI: 0.81-3.01) per 5 mug/m(3) PM2.5 and HR = 1.36 (95%CI: 0.84-2.19) per 10(-5) m(-1) PM2.5 absorbance, albeit never statistically significant. The HRs in association with nitrogen oxides and traffic density on the nearest street were slightly above one. Sensitivity analyses among participants who did not change residence during follow-up showed stronger associations, but none were statistically significant. Our study provides suggestive evidence that exposure to outdoor PM at the residence may be associated with higher risk for kidney parenchyma cancer; the results should be interpreted cautiously as associations may be due to chance.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15548b,

title = {Physical activity, mediating factors and risk of colon cancer: insights into adiposity and circulating biomarkers from the EPIC cohort},

author = {K Aleksandrova and M Jenab and M Leitzmann and B Bueno-de-Mesquita and R Kaaks and A Trichopoulou and C Bamia and P Lagiou and S Rinaldi and H Freisling and M Carayol and T Pischon and D Drogan and E Weiderpass and P Jakszyn and K Overvad and C C Dahm and A Tjonneland and M C Bouton-Ruault and T Kuhn and E Peppa and E Valanou and C La Vecchia and D Palli and S Panico and C Sacerdote and C Agnoli and R Tumino and A May and J Vulpen and K Benjaminsen Borch and S Oluwafemi Oyeyemi and J R Quiros and C Bonet and M J Sanchez and M Dorronsoro and C Navarro and A Barricarte and B Guelpen and P Wennberg and T J Key and K T Khaw and N Wareham and N Assi and H A Ward and D Aune and E Riboli and H Boeing},

doi = {10.1093/ije/dyx174},

issn = {0300-5771},

year  = {2017},

date = {2017-01-01},

journal = {Int J Epidemiol},

volume = {46},

number = {6},

pages = {1823-1835},

abstract = {Background: There is convincing evidence that high physical activity lowers the risk of colon cancer; however, the underlying biological mechanisms remain largely unknown. We aimed to determine the extent to which body fatness and biomarkers of various biologically plausible pathways account for the association between physical activity and colon cancer. Methods: We conducted a nested case-control study in a cohort of 519 978 men and women aged 25 to 70 years followed from 1992 to 2003. A total of 713 incident colon cancer cases were matched, using risk-set sampling, to 713 controls on age, sex, study centre, fasting status and hormonal therapy use. The amount of total physical activity during the past year was expressed in metabolic equivalent of task [MET]-h/week. Anthropometric measurements and blood samples were collected at study baseline. Results: High physical activity was associated with a lower risk of colon cancer: relative risk \>/=91 MET-h/week vs \<91 MET-h/week = 0.75 [95% confidence interval (CI): 0.57 to 0.96]. In mediation analyses, this association was accounted for by waist circumference: proportion explained effect (PEE) = 17%; CI: 4% to 52%; and the biomarkers soluble leptin receptor (sOB-R): PEE = 15%; 95% CI: 1% to 50% and 5-hydroxyvitamin D (25[OH]D): PEE = 30%; 95% CI: 12% to 88%. In combination, these factors explained 45% (95% CI: 20% to 125%) of the association. Beyond waist circumference, sOB-R and 25[OH]D additionally explained 10% (95% CI: 1%; 56%) and 23% (95% CI: 6%; 111%) of the association, respectively. Conclusions: Promoting physical activity, particularly outdoors, and maintaining metabolic health and adequate vitamin D levels could represent a promising strategy for colon cancer prevention.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15586b,

title = {Plasma microRNAs as biomarkers of pancreatic cancer risk in a prospective cohort study},

author = {E J Duell and L Lujan-Barroso and N Sala and S Deitz McElyea and K Overvad and A Tjonneland and A Olsen and E Weiderpass and L T Busund and L Moi and D Muller and P Vineis and D Aune and G Matullo and A Naccarati and S Panico and G Tagliabue and R Tumino and D Palli and R Kaaks and V A Katzke and H Boeing and H B A Bueno-de-Mesquita and P H Peeters and A Trichopoulou and P Lagiou and A Kotanidou and R C Travis and N Wareham and K T Khaw and J Ramon Quiros and M Rodriguez-Barranco and M Dorronsoro and M D Chirlaque and E Ardanaz and G Severi and M C Boutron-Ruault and V Rebours and P Brennan and M Gunter and G Scelo and G Cote and S Sherman and M Korc},

doi = {10.1002/ijc.30790},

issn = {0020-7136},

year  = {2017},

date = {2017-01-01},

journal = {Int J Cancer},

volume = {141},

number = {5},

pages = {905-915},

abstract = {Noninvasive biomarkers for early pancreatic ductal adenocarcinoma (PDAC) diagnosis and disease risk stratification are greatly needed. We conducted a nested case-control study within the Prospective Investigation into Cancer and Nutrition (EPIC) cohort to evaluate prediagnostic microRNAs (miRs) as biomarkers of subsequent PDAC risk. A panel of eight miRs (miR-10a, -10b, -21-3p, -21-5p, -30c, -106b, -155 and -212) based on previous evidence from our group was evaluated in 225 microscopically confirmed PDAC cases and 225 controls matched on center, sex, fasting status and age/date/time of blood collection. MiR levels in prediagnostic plasma samples were determined by quantitative RT-PCR. Logistic regression was used to model levels and PDAC risk, adjusting for covariates and to estimate area under the receiver operating characteristic curves (AUC). Plasma miR-10b, -21-5p, -30c and -106b levels were significantly higher in cases diagnosed within 2 years of blood collection compared to matched controls (all p-values \<0.04). Based on adjusted logistic regression models, levels for six miRs (miR-10a, -10b, -21-5p, -30c, -155 and -212) overall, and for four miRs (-10a, -10b, -21-5p and -30c) at shorter follow-up time between blood collection and diagnosis (\</=5 yr, \</=2 yr), were statistically significantly associated with risk. A score based on the panel showed a linear dose-response trend with risk (p-value = 0.0006). For shorter follow-up (\</=5 yr), AUC for the score was 0.73, and for individual miRs ranged from 0.73 (miR-212) to 0.79 (miR-21-5p).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15580b,

title = {Pre-diagnostic copper and zinc biomarkers and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition cohort},

author = {M Stepien and M Jenab and H Freisling and N P Becker and M Czuban and A Tjonneland and A Olsen and K Overvad and M C Boutron-Ruault and F R Mancini and I Savoye and V Katzke and T Kuhn and H Boeing and K Iqbal and A Trichopoulou and C Bamia and P Orfanos and D Palli and S Sieri and R Tumino and A Naccarati and S Panico and H B A Bueno-de-Mesquita and P H Peeters and E Weiderpass and S Merino and P Jakszyn and M J Sanchez and M Dorronsoro and J M Huerta and A Barricarte and S Boden and B Guelpen and N Wareham and K T Khaw and K E Bradbury and A J Cross and L Schomburg and D J Hughes},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28575311},

doi = {10.1093/carcin/bgx051},

issn = {1460-2180 (Electronic) 

0143-3334 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Carcinogenesis},

volume = {38},

number = {7},

pages = {699-707},

abstract = {Adequate intake of copper and zinc, two essential micronutrients, are important for antioxidant functions. Their imbalance may have implications for development of diseases like colorectal cancer (CRC), where oxidative stress is thought to be etiologically involved. As evidence from prospective epidemiologic studies is lacking, we conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort to investigate the association between circulating levels of copper and zinc, and their calculated ratio, with risk of CRC development. Copper and zinc levels were measured by reflection X-ray fluorescence spectrometer in 966 cases and 966 matched controls. Multivariable adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated using conditional logistic regression and are presented for the fifth versus first quintile. Higher circulating concentration of copper was associated with a raised CRC risk (OR = 1.50; 95% CI: 1.06, 2.13; P-trend = 0.02) whereas an inverse association with cancer risk was observed for higher zinc levels (OR = 0.65; 95% CI: 0.43, 0.97; P-trend = 0.07). Consequently, the ratio of copper/zinc was positively associated with CRC (OR = 1.70; 95% CI: 1.20, 2.40; P-trend = 0.0005). In subgroup analyses by follow-up time, the associations remained statistically significant only in those diagnosed within 2 years of blood collection. In conclusion, these data suggest that copper or copper levels in relation to zinc (copper to zinc ratio) become imbalanced in the process of CRC development. Mechanistic studies into the underlying mechanisms of regulation and action are required to further examine a possible role for higher copper and copper/zinc ratio levels in CRC development and progression.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15537b,

title = {Pre-operative parameters do not reliably identify post-operative respiratory risk in children undergoing adenotonsillectomy},

author = {S Thavagnanam and S Y Cheong and K Chinna and A M Nathan and J A Bruyne},

url = {https://www.ncbi.nlm.nih.gov/pubmed/29168911},

doi = {10.1111/jpc.13789},

issn = {1440-1754 (Electronic) 

1034-4810 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {J Paediatr Child Health},

abstract = {AIM: Adenotonsillectomy is performed in children with recurrent tonsillitis or obstructive sleep apnoea. Children at risk of post-operative respiratory complications are recommended to be monitored in paediatric intensive care unit (PICU). The aim of the study is to review the risk factors for post-operative complications and admissions to PICU. METHODS: A review of medical records of children who underwent adenotonsillectomy between January 2011 and December 2014 was performed. Association between demographic variables and post-operative complications were examined using chi-square and Mann-Whitney tests. RESULTS: A total of 214 children were identified, and of these, 19 (8.8%) experienced post-operative complications. Six children (2.8%) had respiratory complications: hypoxaemia in four and laryngospasm requiring reintubation in a further two. Both of the latter patients were extubated upon arrival to PICU and required no escalation of therapy. A total of 13 (6.1%) children had non-respiratory complications: 8 (3.7%) had infection and 5 (2.3%) had haemorrhage. A total of 26 (12.1%) children were electively admitted to PICU and mean stay was 19.5 (SD +/- 13) h. No association between demographic characteristics, comorbid conditions or polysomnographic parameters and post-operative complications were noted. A total of 194 (90.7%) children stayed only one night in hospital (median 1 day, range 1-5 days). CONCLUSION: The previously identified risk factors and criteria for PICU admission need revision, and new recommendations are necessary.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15629b,

title = {Prediagnostic circulating concentrations of plasma insulin-like growth factor-I and risk of lymphoma in the European Prospective Investigation into Cancer and Nutrition},

author = {A Perez-Cornago and P N Appleby and S Tipper and T J Key and N E Allen and A Nieters and R Vermeulen and S Roulland and D Casabonne and R Kaaks and R T Fortner and H Boeing and A Trichopoulou and C La Vecchia and E Klinaki and L Hansen and A Tjonneland and F Bonnet and G Fagherazzi and M C Boutron-Ruault and V Pala and G Masala and C Sacerdote and P H Peeters and H B Bueno-de-Mesquita and E Weiderpass and M Dorronsoro and J R Quiros and A Barricarte and D Gavrila and A Agudo and S Borgquist and A H Rosendahl and B Melin and N Wareham and K T Khaw and M Gunter and E Riboli and P Vineis and R C Travis},

url = {https://www.ncbi.nlm.nih.gov/pubmed/27870006},

doi = {10.1002/ijc.30528},

issn = {1097-0215 (Electronic) 

0020-7136 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Int J Cancer},

volume = {140},

number = {5},

pages = {1111-1118},

abstract = {Insulin-like growth factor (IGF)-I has cancer promoting activities. However, the hypothesis that circulating IGF-I concentration is related to risk of lymphoma overall or its subtypes has not been examined prospectively. IGF-I concentration was measured in pre-diagnostic plasma samples from a nested case-control study of 1,072 cases of lymphoid malignancies and 1,072 individually matched controls from the European Prospective Investigation into Cancer and Nutrition. Odds ratios (ORs) and confidence intervals (CIs) for lymphoma were calculated using conditional logistic regression. IGF-I concentration was not associated with overall lymphoma risk (multivariable-adjusted OR for highest versus lowest third = 0.77 [95% CI = 0.57-1.03]},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15536b,

title = {Prevalence and sociodemographic correlates of cervicovaginal human papillomavirus (HPV) carriage in a cross-sectional, multiethnic, community-based female Asian population},

author = {S P Khoo and N Bhoo-Pathy and S H Yap and M K Anwar Shafii and N Hairizan Nasir and J Belinson and S Subramaniam and P P Goh and M Zeng and H D Tan and P Gravitt and Y L Woo},

doi = {10.1136/sextrans-2017-053320},

issn = {1368-4973},

year  = {2017},

date = {2017-01-01},

journal = {Sex Transm Infect},

abstract = {OBJECTIVES: Cervical cancer is a largely preventable disease, and the strategic implementation of a cervical cancer prevention programme is partly dependent on the impact of human papillomavirus (HPV) infection interpreted within the context of the country's sociodemographic attributes. The objective of this study is to determine the prevalence of cervicovaginal HPV infection among a healthy, community-based, multiethnic Malaysian population. The HPV prevalence was subsequently correlated to the individual's sociodemographics and sexual/reproductive history. Of significance, the observed prevalence captured was in a birth cohort not included in the national school-based HPV vaccination programme. METHODS: This was a cross-sectional study where 1293 healthy women aged between 18 and 60 years were recruited via convenience sampling from five community-based clinics in Selangor, Malaysia. Cervicovaginal self-samples were obtained and DNA was extracted for HPV detection and genotyping. A comprehensive questionnaire was administered to determine the sociodemographics and behavioural patterns of participants. RESULTS: The median age at enrolment was 37 years old (IQR: 30-47). In total, 86/1190 (7.2%) of the samples collected were positive for HPV infection, with the highest HPV prevalence (11.9%) detected in the subgroup of 18-24 years old. The top three most prevalent HPV genotypes were HPV 16, 52 and 58. The independent risk factors associated with higher rates of HPV infection included Indian ethnicity, widowed status and women with partners who are away from home for long periods and/or has another sexual partner. CONCLUSIONS: The overall prevalence of HPV infection in this Malaysian multiethnic population was 7.2%, with 6.5% being high-risk genotypes. The top three most common high-risk HPV types were HPV 16, 52 and 58. This information is important for the planning of primary (HPV vaccination) and secondary (screening) cervical cancer prevention programmes in Malaysia.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15554b,

title = {Psychometric Properties of the Malay Version of the Dutch Eating Behaviour Questionnaire (DEBQ) in a Sample of Malaysian Adults Attending a Health Care Facility},

author = {K Subramaniam and W Y Low and K Chinna and K F Chin and S Krishnaswamy},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28951691},

doi = {10.21315/mjms2017.24.4.8},

issn = {1394-195X (Print) 

1394-195X (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Malays J Med Sci},

volume = {24},

number = {4},

pages = {64-73},

abstract = {OBJECTIVE: This study aims to investigate the psychometric properties of the Malay version of the Dutch Eating Behaviour Questionnaire (DEBQ) among Malaysian adults. METHOD: The Malay version of the DEBQ instrument was administered to 398 outpatients (269 women and 129 men) at the University of Malaya Medical Centre (UMMC). Confirmatory Factor Analysis (CFA) was conducted to study the construct validity of the instrument. Composite reliability coefficient, Raykov's rho, was used to determine the internal consistency. RESULTS: The proposed three-factor structure for the DEBQ instrument was appropriate, although three items (Items 21, 14 and 27) showed problematic loadings with inappropriate model fit and were removed. The modified version had an appropriate model fit chi(2)/df = 2.129},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15529b,

title = {Quantitative analysis of intraventricular flow-energetics and vortex in ischaemic hearts},

author = {B T Chan and H K Yeoh and Y M Liew and S Dokos and A Al Abed and K H Chee and Y F Abdul Aziz and G Srinivasaiah Sridhar and K Chinna and E Lim},

url = {https://insights.ovid.com/crossref?an=00019501-900000000-99119},

doi = {10.1097/mca.0000000000000596},

issn = {0954-6928},

year  = {2017},

date = {2017-01-01},

journal = {Coron Artery Dis},

abstract = {OBJECTIVE: This study investigated the intraventricular flow dynamics in ischaemic heart disease patients. PATIENTS AND METHODS: Fourteen patients with normal ejection fraction and 16 patients with reduced ejection fraction were compared with 20 healthy individuals. Phase-contrast MRI was used to assess intraventricular flow variables and speckle-tracking echocardiography to assess myocardial strain and left ventricular (LV) dyssynchrony. Infarct size was acquired using delayed-enhancement MRI. RESULTS: The results obtained showed no significant differences in intraventricular flow variables between the healthy group and the patients with normal ejection fraction group, whereas considerable reductions in kinetic energy (KE) fluctuation index, E' (P\<0.001) and vortex KE (P=0.003) were found in the patients with reduced ejection fraction group. In multivariate analysis, only vortex KE and infarct size were significantly related to LV ejection fraction (P\<0.001); furthermore, vortex KE was correlated negatively with energy dissipation, energy dissipation index (r=-0.44},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15597b,

title = {Rickettsial seropositivity in the indigenous community and animal farm workers, and vector surveillance in Peninsular Malaysia},

author = {K L Kho and F X Koh and L I Hasan and L P Wong and M G Kisomi and A Bulgiba and Q N Nizam and S T Tay},

doi = {10.1038/emi.2017.4},

issn = {2222-1751},

year  = {2017},

date = {2017-01-01},

journal = {Emerg Microbes Infect},

volume = {6},

number = {4},

pages = {e18},

abstract = {Rickettsioses are emerging zoonotic diseases that are often neglected in many countries in Southeast Asia. Rickettsial agents are transmitted to humans through exposure to infected arthropods. Limited data are available on the exposure of indigenous community and animal farm workers to the aetiological agents and arthropod vectors of rickettsioses in Peninsular Malaysia. Serological analysis of Rickettsia conorii and Rickettsia felis was performed for 102 individuals from the indigenous community at six rural villages and 87 workers from eight animal farms in Peninsular Malaysia in a cross-sectional study. The indigenous community had significantly higher seropositivity rates for R. conorii (P\<0.001) and R. felis (P\<0.001), as compared to blood donors from urban (n=61). Similarly, higher seropositivity rates for R. conorii (P=0.046) and R. felis (P\<0.001) were noted for animal farm workers, as compared to urban blood donors. On the basis of the sequence analysis of gltA, ompA and ompB, various spotted fever group rickettsiae closely related to R. raoultii, R. heilongjiangensis, R. felis-like organisms, R. tamurae, Rickettsia sp. TCM1, R. felis, Rickettsia sp. LON13 and R. hulinensis were identified from tick/flea samples in animal farms, indigenous villages and urban areas. This study describes rickettsial seropositivity of the Malaysian indigenous community and animal farm workers, and provides molecular evidence regarding the presence of rickettsial agents in ticks/fleas infesting domestic animals in Peninsular Malaysia.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15802b,

title = {Sedation scoring and managing abilities of intensive care nurses post educational intervention},

author = {V Ramoo and K L Abdullah and P S Tan and L P Wong and Y P Chua and L Y Tang},

url = {https://www.ncbi.nlm.nih.gov/pubmed/25913373},

doi = {10.1111/nicc.12180},

issn = {1478-5153 (Electronic) 

1362-1017 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Nurs Crit Care},

volume = {22},

number = {3},

pages = {141-149},

abstract = {BACKGROUND: Inappropriate sedation assessment can jeopardize patient comfort and safety. Therefore, nurses' abilities in assessing and managing sedation are vital for effective care of mechanically ventilated patients. AIMS AND OBJECTIVES: This study assessed nurses' sedation scoring and management abilities as primary outcomes following educational interventions. Nurses' perceived self-confidence and barriers to effective sedation management were assessed as secondary outcomes. DESIGN: A post-test-only quasi-experimental design was used. Data were collected at 3 and 9 months post-intervention. METHODS: A total of 66 nurses from a 14-bed intensive care unit of a Malaysian teaching hospital participated. The educational interventions included theoretical sessions, hands-on sedation assessment practice using the Richmond Agitation Sedation Scale, and a brief sedation assessment tool. Nurses' sedation scoring and management abilities and perceived self-confidence level were assessed at both time points using self-administered questionnaires with case scenarios. Sedation assessment and management barriers were assessed once at 9 months post-intervention. RESULTS: Median scores for overall accurate sedation scoring (9 months: 4.00; 3 months: 2.00},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15566b,

title = {Self-rated health and all-cause and cause-specific mortality of older adults: Individual data meta-analysis of prospective cohort studies in the CHANCES Consortium},

author = {C Bamia and P Orfanos and H Juerges and B Schottker and H Brenner and R Lorbeer and M Aadahl and C E Matthews and E Klinaki and M Katsoulis and P Lagiou and H B A Bueno-de-Mesquita and S Eriksson and U Mons and K U Saum and R Kubinova and A Pajak and A Tamosiunas and S Malyutina and J Gardiner and A Peasey and L C Groot and T Wilsgaard and P Boffetta and A Trichopoulou and D Trichopoulos},

doi = {10.1016/j.maturitas.2017.06.023},

issn = {0378-5122},

year  = {2017},

date = {2017-01-01},

journal = {Maturitas},

volume = {103},

pages = {37-44},

abstract = {OBJECTIVES: To evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as "at-least-good". STUDY DESIGN: Individual data on SRH and important covariates were obtained for 424,791 European and United States residents, \>/=60 years at recruitment (1982-2008), in eight prospective studies in the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). In each study, adjusted mortality ratios (hazard ratios, HRs) in relation to SRH were calculated and subsequently combined with random-effect meta-analyses. MAIN OUTCOME MEASURES: All-cause, cardiovascular and cancer mortality. RESULTS: Within the median 12.5 years of follow-up, 93,014 (22%) deaths occurred. SRH "fair" or "poor" vs. "at-least-good" was associated with increased mortality: HRs 1.46 (95% CI 1.23-1.74) and 2.31 (1.79-2.99), respectively. These associations were evident: for cardiovascular and, to a lesser extent, cancer mortality, and within-study, within-subgroup analyses. Accounting for lifestyle, sociodemographic, somatometric factors and, subsequently, for medical history explained only a modest amount of the unadjusted associations. Factors favourably associated with SRH were: sex (males), age (younger-old), education (high), marital status (married/cohabiting), physical activity (active), body mass index (non-obese), alcohol consumption (low to moderate) and previous morbidity (absence). CONCLUSION: SRH provides a quick and simple tool for assessing health and identifying groups of elders at risk of early mortality that may be useful also in clinical settings. Modifying determinants of favourably rating health, e.g. by increasing physical activity and/or by eliminating obesity, may be important for older adults to "feel healthy" and "be healthy".},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15562b,

title = {Single-species versus dual-species probiotic supplementation as an emerging therapeutic strategy for obesity},

author = {G Karimi and R Jamaluddin and N Mohtarrudin and Z Ahmad and H Khazaai and M Parvaneh},

doi = {10.1016/j.numecd.2017.06.020},

issn = {0939-4753},

year  = {2017},

date = {2017-01-01},

journal = {Nutr Metab Cardiovasc Dis},

volume = {27},

number = {10},

pages = {910-918},

abstract = {BACKGROUND AND AIM: Recent studies have reported beneficial effects of specific probiotics on obesity. However, the difference in the anti-obesity effects of probiotics as single species and dual species is still uncertain. Therefore, we aimed to compare the efficacy of single and dual species of bacteria on markers of obesity in high-fat diet-induced obese rats. METHODS AND RESULTS: A total of 40 male Sprague-Dawley rats were assigned to one of five groups of varying diets as follows: standard diet, high fat diet (HFD), HFD supplemented with Lactobacillus casei strain Shirota, HFD supplemented with Bifidobacterium longum and HFD supplemented with a mixture of these two bacterial species. After 15 weeks of supplementation, the animals were examined for changes in body weight, body fat, total count of bacteria in fecal, blood serum lipid profile, leptin, adiponectin and inflammatory biomarkers. Histological analysis of the liver and adipose tissue was performed and the hepatic mRNA expression levels of genes related to lipid metabolism were measured. It was found that probiotic supplementation of either B. longum or a mixture of B. longum and LcS bacteria significantly reduced weight and triglycerides in the HFD groups. Supplementation of B. longum bacteria showed better results in terms of modulating leptin level, fat mass, adipocyte size and lipoprotein lipase expression, as well as increasing adiponectin and peroxisome proliferator-activated receptors-gamma expression compared to dual species of bacteria. No significant differences were observed in the total count of fecal bacteria, glucose and inflammatory biomarker levels between supplemented groups. CONCLUSIONS: B. longum supplementation in obesity was more beneficial in metabolic profile changes than the mixture species.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15549b,

title = {Staggering the dose of sugammadex lowers risks for severe emergence cough: a randomized control trial},

author = {S L P and M M Miskan and Z C Y and R A Zaki},

url = {https://www.ncbi.nlm.nih.gov/pubmed/29020936},

doi = {10.1186/s12871-017-0430-3},

issn = {1471-2253 (Electronic) 

1471-2253 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {BMC Anesthesiol},

volume = {17},

number = {1},

pages = {137},

abstract = {BACKGROUND: Cough on emergence has been reported as a common adverse reaction with sugammadex reversal. We investigated if staggering the dose of sugammadex will reduce emergence cough in a single-center, randomized, double-blinded study. METHODS: A hundred and twenty ASA 1-3 adults were randomly reversed with 1 mg/kg sugammadex prior to extubation followed by another 1 mg/kg immediately after extubation (staggered group), single dose of 2 mg/kg sugammadex (single bolus group) or neostigmine 0.02 mg/kg with glycopyrrolate (neostigmine group). RESULTS: We found 70% of patients (n = 28) reversed with single boluses of sugammadex had Grade 3 emergence cough compared to 12.5% (n = 5) in the staggered sugammadex group and 17.5% (n = 7) in the neostigmine group (p \< 0.001). Besides cough, emergence agitation also appeared highest in the single bolus sugammadex group (n = 14, 35%},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15712b,

title = {Sugar-sweetened beverage intake and its associations with cardiometabolic risks among adolescents},

author = {D A Loh and F M Moy and N L Zaharan and M Y Jalaludin and Z Mohamed},

doi = {10.1111/ijpo.12108},

issn = {2047-6302},

year  = {2017},

date = {2017-01-01},

journal = {Pediatr Obes},

volume = {12},

number = {1},

pages = {e1-e5},

abstract = {BACKGROUND: Investigations on sugar-sweetened beverage (SSB) intake and cardiometabolic risks among Asians are scant. OBJECTIVES: This study aimed to examine associations between SSB intake and cardiometabolic risks among Malaysian adolescents. METHODS: Anthropometric data, blood pressure (BP), fasting blood glucose (FBG), lipid profiles and insulin levels measured involved 873 adolescents (aged 13 years). SSB intake, dietary patterns and physical activity level (PAL) were self-reported. RESULTS: Mean SSB consumption was 177.5 mL day(-1) with significant differences among ethnicities (Malay, Chinese, Indians and Others) (p \< 0.05). SSB intake was deleteriously associated with increased waist circumference, elevated triglycerides, FBG, insulin, insulin resistance and low HDL-cholesterol, independent of PAL, body mass index and dietary patterns. Significant U-shaped and inverse trends were noted between SSB intake and LDL-cholesterol and BP, respectively. CONCLUSION: Sugar-sweetened beverage intake was unfavourably associated with cardiometabolic health outcomes among young adolescents. Concerted efforts towards healthy hydration are imperative to mitigate risk of cardiometabolic events.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15587b,

title = {Survival rates and predictors of survival among colorectal cancer patients in a Malaysian tertiary hospital},

author = {B A Magaji and F M Moy and A C Roslani and C W Law},

doi = {10.1186/s12885-017-3336-z},

issn = {1471-2407},

year  = {2017},

date = {2017-01-01},

journal = {BMC Cancer},

volume = {17},

number = {1},

pages = {339},

abstract = {BACKGROUND: Colorectal cancer is the third most commonly diagnosed malignancy and the fourth leading cause of cancer-related death globally. It is the second most common cancer among both males and females in Malaysia. The economic burden of colorectal cancer is likely to increase over time owing to its current trend and aging population. Cancer survival analysis is an essential indicator for early detection and improvement in cancer treatment. However, there was a scarcity of studies concerning survival of colorectal cancer patients as well as its predictors. Therefore, we aimed to determine the 1-, 3- and 5-year survival rates, compare survival rates among ethnic groups and determine the predictors of survival among colorectal cancer patients. METHODS: This was an ambidirectional cohort study conducted at the University Malaya Medical Centre (UMMC) in Kuala Lumpur, Malaysia. All Malaysian citizens or permanent residents with histologically confirmed diagnosis of colorectal cancer seen at UMMC from 1 January 2001 to 31 December 2010 were included in the study. Demographic and clinical characteristics were extracted from the medical records. Patients were followed-up until death or censored at the end of the study (31st December 2010). Censored patients' vital status (whether alive or dead) were cross checked with the National Registration Department. Survival analyses at 1-, 3- and 5-year intervals were performed using the Kaplan-Meier method. Log-rank test was used to compare the survival rates, while Cox proportional hazard regression analysis was carried out to determine the predictors of 5-year colorectal cancer survival. RESULTS: Among 1212 patients, the median survival for colorectal, colon and rectal cancers were 42.0, 42.0 and 41.0 months respectively; while the 1-, 3-, and 5-year relative survival rates ranged from 73.8 to 76.0%, 52.1 to 53.7% and 40.4 to 45.4% respectively. The Chinese patients had the lowest 5-year survival compared to Malay and Indian patients. Based on the 814 patients with data on their Duke's staging, independent predictors of poor colorectal cancer (5-year) survival were male sex (Hazard Ratio [HR]: 1.41; 95% CI: 1.12, 1.76), Chinese ethnicity (HR: 1.41; 95% CI: 1.07,1.85), elevated (\>/= 5.1 ng/ml) pre-operative carcino-embryonic antigen (CEA) level (HR: 2.13; 95% CI: 1.60, 2.83), Duke's stage C (HR: 1.68; 95% CI: 1.28, 2.21), Duke's stage D (HR: 4.61; 95% CI: 3.39, 6.28) and emergency surgery (HR: 1.52; 95% CI: 1.07, 2.15). CONCLUSIONS: The survival rates of colorectal cancer among our patients were comparable with those of some Asian countries but lower than those found in more developed countries. Males and patients from the Chinese ethnic group had lower survival rates compared to their counterparts. More advanced staging and late presentation were important predictors of colorectal cancer survival. Health education programs targeting high risk groups and emphasizing the importance of screening and early diagnosis, as well as the recognition of symptoms and risk factors should be implemented. A nationwide colorectal cancer screening program should be designed and implemented to increase early detection and improve survival outcomes.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15570b,

title = {Tall height and obesity are associated with an increased risk of aggressive prostate cancer: results from the EPIC cohort study},

author = {A Perez-Cornago and P N Appleby and T Pischon and K K Tsilidis and A Tjonneland and A Olsen and K Overvad and R Kaaks and T Kuhn and H Boeing and A Steffen and A Trichopoulou and P Lagiou and M Kritikou and V Krogh and D Palli and C Sacerdote and R Tumino and H B Bueno-de-Mesquita and A Agudo and N Larranaga and E Molina-Portillo and A Barricarte and M D Chirlaque and J R Quiros and P Stattin and C Haggstrom and N Wareham and K T Khaw and J A Schmidt and M Gunter and H Freisling and D Aune and H Ward and E Riboli and T J Key and R C Travis},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28701188},

doi = {10.1186/s12916-017-0876-7},

issn = {1741-7015 (Electronic) 

1741-7015 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {BMC Med},

volume = {15},

number = {1},

pages = {115},

abstract = {BACKGROUND: The relationship between body size and prostate cancer risk, and in particular risk by tumour characteristics, is not clear because most studies have not differentiated between high-grade or advanced stage tumours, but rather have assessed risk with a combined category of aggressive disease. We investigated the association of height and adiposity with incidence of and death from prostate cancer in 141,896 men in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. METHODS: Multivariable-adjusted Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). After an average of 13.9 years of follow-up, there were 7024 incident prostate cancers and 934 prostate cancer deaths. RESULTS: Height was not associated with total prostate cancer risk. Subgroup analyses showed heterogeneity in the association with height by tumour grade (P heterogeneity = 0.002), with a positive association with risk for high-grade but not low-intermediate-grade disease (HR for high-grade disease tallest versus shortest fifth of height, 1.54; 95% CI, 1.18-2.03). Greater height was also associated with a higher risk for prostate cancer death (HR = 1.43, 1.14-1.80). Body mass index (BMI) was significantly inversely associated with total prostate cancer, but there was evidence of heterogeneity by tumour grade (P heterogeneity = 0.01; HR = 0.89, 0.79-0.99 for low-intermediate grade and HR = 1.32, 1.01-1.72 for high-grade prostate cancer) and stage (P heterogeneity = 0.01; HR = 0.86, 0.75-0.99 for localised stage and HR = 1.11, 0.92-1.33 for advanced stage). BMI was positively associated with prostate cancer death (HR = 1.35, 1.09-1.68). The results for waist circumference were generally similar to those for BMI, but the associations were slightly stronger for high-grade (HR = 1.43, 1.07-1.92) and fatal prostate cancer (HR = 1.55, 1.23-1.96). CONCLUSIONS: The findings from this large prospective study show that men who are taller and who have greater adiposity have an elevated risk of high-grade prostate cancer and prostate cancer death.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15577b,

title = {Techniques of monitoring blood glucose during pregnancy for women with pre-existing diabetes},

author = {F M Moy and A Ray and B S Buckley and H M West},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28602020},

doi = {10.1002/14651858.CD009613.pub3},

issn = {1469-493X (Electronic) 

1361-6137 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Cochrane Database Syst Rev},

volume = {6},

pages = {CD009613},

abstract = {BACKGROUND: Self-monitoring of blood glucose (SMBG) is recommended as a key component of the management plan for diabetes therapy during pregnancy. No existing systematic reviews consider the benefits/effectiveness of various techniques of blood glucose monitoring on maternal and infant outcomes among pregnant women with pre-existing diabetes. The effectiveness of the various monitoring techniques is unclear. OBJECTIVES: To compare techniques of blood glucose monitoring and their impact on maternal and infant outcomes among pregnant women with pre-existing diabetes. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 November 2016), searched reference lists of retrieved studies and contacted trial authors. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-RCTs comparing techniques of blood glucose monitoring including SMBG, continuous glucose monitoring (CGM) or clinic monitoring among pregnant women with pre-existing diabetes mellitus (type 1 or type 2). Trials investigating timing and frequency of monitoring were also included. RCTs using a cluster-randomised design were eligible for inclusion but none were identified. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed study eligibility, extracted data and assessed the risk of bias of included studies. Data were checked for accuracy. The quality of the evidence was assessed using the GRADE approach. MAIN RESULTS: This review update includes at total of 10 trials (538) women (468 women with type 1 diabetes and 70 women with type 2 diabetes). The trials took place in Europe and the USA. Five of the 10 included studies were at moderate risk of bias, four studies were at low to moderate risk of bias, and one study was at high risk of bias. The trials are too small to show differences in important outcomes such as macrosomia, preterm birth, miscarriage or death of baby. Almost all the reported GRADE outcomes were assessed as being very low-quality evidence. This was due to design limitations in the studies, wide confidence intervals, small sample sizes, and few events. In addition, there was high heterogeneity for some outcomes.Various methods of glucose monitoring were compared in the trials. Neither pooled analyses nor individual trial analyses showed any clear advantages of one monitoring technique over another for primary and secondary outcomes. Many important outcomes were not reported.1. Self-monitoring versus standard care (two studies, 43 women): there was no clear difference for caesarean section (risk ratio (RR) 0.78, 95% confidence interval (CI) 0.40 to 1.49; one study, 28 women) or glycaemic control (both very low-quality), and not enough evidence to assess perinatal mortality and neonatal mortality and morbidity composite. Hypertensive disorders of pregnancy, large-for-gestational age, neurosensory disability, and preterm birth were not reported in either study.2. Self-monitoring versus hospitalisation (one study, 100 women): there was no clear difference for hypertensive disorders of pregnancy (pre-eclampsia and hypertension) (RR 4.26, 95% CI 0.52 to 35.16; very low-quality: RR 0.43, 95% CI 0.08 to 2.22; very low-quality). There was no clear difference in caesarean section or preterm birth less than 37 weeks' gestation (both very low quality), and the sample size was too small to assess perinatal mortality (very low-quality). Large-for-gestational age, mortality or morbidity composite, neurosensory disability and preterm birth less than 34 weeks were not reported.3. Pre-prandial versus post-prandial glucose monitoring (one study, 61 women): there was no clear difference between groups for caesarean section (RR 1.45, 95% CI 0.92 to 2.28; very low-quality), large-for-gestational age (RR 1.16, 95% CI 0.73 to 1.85; very low-quality) or glycaemic control (very low-quality). The results for hypertensive disorders of pregnancy: pre-eclampsia and perinatal mortality are not meaningful because these outcomes were too rare to show differences in a small sample (all very low-quality). The study did not report the outcomes mortality or morbidity composite, neurosensory disability or preterm birth.4. Automated telemedicine monitoring versus conventional system (three studies, 84 women): there was no clear difference for caesarean section (RR 0.96, 95% CI 0.62 to 1.48; one study, 32 women; very low-quality), and mortality or morbidity composite in the one study that reported these outcomes. There were no clear differences for glycaemic control (very low-quality). No studies reported hypertensive disorders of pregnancy, large-for-gestational age, perinatal mortality (stillbirth and neonatal mortality), neurosensory disability or preterm birth.5.CGM versus intermittent monitoring (two studies, 225 women): there was no clear difference for pre-eclampsia (RR 1.37, 95% CI 0.52 to 3.59; low-quality), caesarean section (average RR 1.00, 95% CI 0.65 to 1.54; I(2) = 62%; very low-quality) and large-for-gestational age (average RR 0.89, 95% CI 0.41 to 1.92; I(2) = 82%; very low-quality). Glycaemic control indicated by mean maternal HbA1c was lower for women in the continuous monitoring group (mean difference (MD) -0.60 %, 95% CI -0.91 to -0.29; one study, 71 women; moderate-quality). There was not enough evidence to assess perinatal mortality and there were no clear differences for preterm birth less than 37 weeks' gestation (low-quality). Mortality or morbidity composite, neurosensory disability and preterm birth less than 34 weeks were not reported.6. Constant CGM versus intermittent CGM (one study, 25 women): there was no clear difference between groups for caesarean section (RR 0.77, 95% CI 0.33 to 1.79; very low-quality), glycaemic control (mean blood glucose in the 3rd trimester) (MD -0.14 mmol/L, 95% CI -2.00 to 1.72; very low-quality) or preterm birth less than 37 weeks' gestation (RR 1.08, 95% CI 0.08 to 15.46; very low-quality). Other primary (hypertensive disorders of pregnancy, large-for-gestational age, perinatal mortality (stillbirth and neonatal mortality), mortality or morbidity composite, and neurosensory disability) or GRADE outcomes (preterm birth less than 34 weeks' gestation) were not reported. AUTHORS' CONCLUSIONS: This review found no evidence that any glucose monitoring technique is superior to any other technique among pregnant women with pre-existing type 1 or type 2 diabetes. The evidence base for the effectiveness of monitoring techniques is weak and additional evidence from large well-designed randomised trials is required to inform choices of glucose monitoring techniques.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15581b,

title = {The Association of Workplace Exposures on Quality of Life in Small and Medium Enterprises Workers: A Cross-Sectional Study in Four ASEAN Countries},

author = {M Isahak and M Y Loh and I H Susilowati and O Kaewboonchoo and K Harncharoen and N Mohd Amin and N P Toai and W Y Low and P Ratanasiripong},

doi = {10.1177/1010539517699060},

issn = {1010-5395},

year  = {2017},

date = {2017-01-01},

journal = {Asia Pac J Public Health},

volume = {29},

number = {4},

pages = {315-327},

abstract = {Quality of life is associated with several factors, including personal living styles and working conditions. This article aims to investigate the factors associated with quality of life among small and medium enterprises (SME) workers in 4 countries of the Association of Southeast Asian Nations (ASEAN), namely Malaysia, Indonesia, Thailand, and Vietnam. A total of 2014 workers from food and textile industries were asked to answer a questionnaire about their sociodemographic characteristics, working environment and conditions, and quality of life. Results from showed that lifestyle (ie, alcohol intake and exercising), working characteristics (ie, shift work, working hours, and working days) and workplace conditions were associated with SME workers' quality of life (ie, physical, psychological, social, and environmental domain). Among the 16 types of workplace conditions, "sitting on the chair" and "slippery floor" most affect their quality of life . It is important for these variables to be taken into account in promoting workers' well-being and quality of life.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15576b,

title = {The associations between VDR BsmI polymorphisms and risk of vitamin D deficiency, obesity and insulin resistance in adolescents residing in a tropical country},

author = {R Rahmadhani and N L Zaharan and Z Mohamed and F M Moy and M Y Jalaludin},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28617856},

doi = {10.1371/journal.pone.0178695},

issn = {1932-6203 (Electronic) 

1932-6203 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {PLoS One},

volume = {12},

number = {6},

pages = {e0178695},

abstract = {BACKGROUND: The vitamin D receptor (VDR) gene is expressed abundantly in different tissues; including adipocytes and pancreatic beta cells. The rs1544410 or BsmI single nucleotide polymorphism (SNP) in the intronic region of the VDR gene has been previously associated with vitamin D levels, obesity and insulin resistance. AIMS: This study was aimed to examine the association between BsmI polymorphism and risk of vitamin D deficiency, obesity and insulin resistance in adolescents living in a tropical country. METHODS: Thirteen-year-old adolescents were recruited via multistage sampling from twenty-three randomly selected schools across the city of Kuala Lumpur, Malaysia (n = 941). Anthropometric measurements were obtained. Obesity was defined as body mass index higher than the 95th percentile of the WHO chart. Levels of fasting serum vitamin D (25-hydroxyvitamin D (25(OH)D)), glucose and insulin were measured. HOMA-IR was calculated as an indicator for insulin resistance. Genotyping was performed using the Sequenom MassARRAY platform (n = 807). The associations between BsmI and vitamin D, anthropometric parameters and HOMA-IR were examined using analysis of covariance and logistic regression. RESULT: Those with AA genotype of BsmI had significantly lower levels of 25(OH)D (p = 0.001) compared to other genotypes. No significant differences was found across genotypes for obesity parameters. The AA genotype was associated with higher risk of vitamin D deficiency (p = 0.03) and insulin resistance (p = 0.03) compared to GG. The A allele was significantly associated with increased risk of vitamin D deficiency compared to G allele (adjusted odds ratio (OR) = 1.63 (95% Confidence Interval (CI) 1.03-2.59},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15559b,

title = {The prevalence and correlates of elder abuse and neglect in a rural community of Negeri Sembilan state: baseline findings from The Malaysian Elder Mistreatment Project (MAESTRO), a population-based survey},

author = {R Sooryanarayana and W Y Choo and N N Hairi and K Chinna and F Hairi and Z M Ali and S N Ahmad and I A Razak and S A Aziz and R Ramli and R Mohamad and Z L Mohammad and D Peramalah and N A Ahmad and T Aris and A Bulgiba},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28864485},

doi = {10.1136/bmjopen-2017-017025},

issn = {2044-6055 (Electronic) 

2044-6055 (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {BMJ Open},

volume = {7},

number = {8},

pages = {e017025},

abstract = {BACKGROUND: As Malaysia is fast becoming an ageing nation, the health, safety and welfare of elders are major societal concerns. Elder abuse is a phenomenon recognised abroad but less so locally. This paper presents the baseline findings from the Malaysian Elder Mistreatment Project (MAESTRO) study, the first community-based study on elder abuse in Malaysia. DESIGN: Cross-sectional study, analysing baseline findings of a cohort of older adults. SETTING: Kuala Pilah district, Negeri Sembilan state, Malaysia. OBJECTIVES: To determine the prevalence of elder abuse among community dwelling older adults and its associated factors. PARTICIPANTS: A total of 2112 community dwelling older adults aged 60 years and above were recruited employing a multistage sampling using the national census. PRIMARY AND SECONDARY OUTCOME MEASURES: Elder abuse, measured using a validated instrument derived from previous literature and the modified Conflict Tactic Scales, similar to the Irish national prevalence survey on elder abuse with modification to local context. Factors associated with abuse and profiles of respondents were also examined. RESULTS: The prevalence of overall abuse was reported to be 4.5% in the past 12 months. Psychological abuse was most common, followed by financial, physical, neglect and sexual abuse. Two or more occurrences of abusive acts were common, while clustering of various types of abuse was experienced by one-third of abused elders. Being male (adjusted OR (aOR) 2.15, 95% CI 1.23 to 3.78), being at risk of social isolation (aOR 1.96, 95% CI 1.07 to 3.58), a prior history of abuse (aOR 3.28, 95% CI 1.40 to 7.68) and depressive symptomatology (aOR 7.83, 95% CI 2.88 to 21.27) were independently associated with overall abuse. CONCLUSION: Elder abuse occurred among one in every 20 elders. The findings on elder abuse indicate the need to enhance elder protection in Malaysia, with both screening of and interventions for elder abuse.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15531b,

title = {Thresholds for decision-making: informing the cost-effectiveness and affordability of rotavirus vaccines in Malaysia},

author = {T Loganathan and C W Ng and W S Lee and R C W Hutubessy and S Verguet and M Jit},

doi = {10.1093/heapol/czx166},

issn = {0268-1080},

year  = {2017},

date = {2017-01-01},

journal = {Health Policy Plan},

abstract = {Cost-effectiveness thresholds (CETs) based on the Commission on Macroeconomics and Health (CMH) are extensively used in low- and middle-income countries (LMICs) lacking locally defined CETs. These thresholds were originally intended for global and regional prioritization, and do not reflect local context or affordability at the national level, so their value for informing resource allocation decisions has been questioned. Using these thresholds, rotavirus vaccines are widely regarded as cost-effective interventions in LMICs. However, high vaccine prices remain a barrier towards vaccine introduction. This study aims to evaluate the cost-effectiveness, affordability and threshold price of universal rotavirus vaccination at various CETs in Malaysia. Cost-effectiveness of Rotarix and RotaTeq were evaluated using a multi-cohort model. Pan American Health Organization Revolving Fund's vaccine prices were used as tender price, while the recommended retail price for Malaysia was used as market price. We estimate threshold prices defined as prices at which vaccination becomes cost-effective, at various CETs reflecting economic theories of human capital, societal willingness-to-pay and marginal productivity. A budget impact analysis compared programmatic costs with the healthcare budget. At tender prices, both vaccines were cost-saving. At market prices, cost-effectiveness differed with thresholds used. At market price, using 'CMH thresholds', Rotarix programmes were cost-effective and RotaTeq were not cost-effective from the healthcare provider's perspective, while both vaccines were cost-effective from the societal perspective. Using other CETs, both vaccines were not cost-effective at market price, from the healthcare provider's and societal perspectives. At tender and cost-effective prices, rotavirus vaccination cost approximately 1 and 3% of the public health budget, respectively. Using locally defined thresholds, rotavirus vaccination is cost-effective at vaccine prices in line with international tenders, but not at market prices. Thresholds representing marginal productivity are likely to be lower than those reflecting human capital and individual preference measures, and may be useful in determining affordable vaccine prices.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15647b,

title = {Time-dependent risk and predictors of venous thromboembolism in breast cancer patients: A population-based cohort study},

author = {J S Brand and E Hedayati and N Bhoo-Pathy and J Bergh and P Hall and K Humphreys and J F Ludvigsson and K Czene},

doi = {10.1002/cncr.30364},

issn = {0008-543x},

year  = {2017},

date = {2017-01-01},

journal = {Cancer},

volume = {123},

number = {3},

pages = {468-475},

abstract = {BACKGROUND: Venous thromboembolism (VTE) is a serious complication of cancer and its treatment. The current study assessed the risk and clinical predictors of VTE in breast cancer patients by time since diagnosis. METHODS: This Swedish population-based study included 8338 breast cancer patients diagnosed from 2001 to 2008 in the Stockholm-Gotland region with complete follow-up until 2012. Their incidence of VTE was compared with the incidence among 39,013 age-matched reference individuals from the general population. Cox and flexible parametric models were used to examine associations with patient, tumor, and treatment characteristics, accounting for time-dependent effects. RESULTS: Over a median follow-up of 7.2 years, 426 breast cancer patients experienced a VTE event (cumulative incidence, 5.1%). The VTE incidence was 3-fold increased (hazard ratio [HR], 3.28; 95% confidence interval [CI], 2.87-3.74) in comparison with the incidence in the general population and was highest 6 months after diagnosis (HR, 8.62; 95% CI, 6.56-11.33) with a sustained increase in risk thereafter (HR at 5 years, 2.19; 95% CI, 1.80-2.67). Independent predictors of VTE included the following: older age, being overweight, preexisting VTE, comorbid disease, tumor size \> 40 mm, progesterone receptor (PR)-negative status, more than 4 affected lymph nodes, and receipt of chemo- and endocrine therapy. The impact of chemotherapy was limited to early-onset VTE, whereas comorbid disease and PR-negative status were more strongly associated with late-onset events. CONCLUSIONS: This study confirms the long-term risk of VTE in breast cancer patients and identifies a comprehensive set of clinical risk predictors. Temporal associations with patient, tumor, and treatment characteristics provide insight into the time-dependent etiology of VTE. Cancer 2017;123:468-475. (c) 2016 American Cancer Society.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15619b,

title = {Triglyceride to HDL-C Ratio is Associated with Insulin Resistance in Overweight and Obese Children},

author = {N A Iwani and M Y Jalaludin and R M Zin and M Z Fuziah and J Y Hong and Y Abqariyah and A H Mokhtar and W M Wan Nazaimoon},

doi = {10.1038/srep40055},

issn = {2045-2322},

year  = {2017},

date = {2017-01-01},

journal = {Sci Rep},

volume = {7},

pages = {40055},

abstract = {The purpose of this study was to investigate the usefulness of triglyceride to hdl-c ratio (TG:HDL-C) as an insulin resistance (IR) marker for overweight and obese children. A total of 271 blood samples of obese and overweight children aged 9-16 years were analysed for fasting glucose, lipids and insulin. Children were divided into IR and non-insulin resistance, using homeostasis model assessment (HOMA). The children were then stratified by tertiles of TG: HDL-C ratio. The strength between TG:HDL-C ratio and other parameters of IR were quantified using Pearson correlation coefficient (r). Odds ratio was estimated using multiple logistic regression adjusted for age, gender, pubertal stages and IR potential risk factors. Children with IR had significantly higher TG:HDL-C ratio (2.48) (p = 0.01). TG:HDL-C ratio was significantly correlated with HOMA-IR (r = 0.104, p \< 0.005) and waist circumference (r = 0.134, p \< 0.001). Increasing tertiles of TG:HDL-C ratio showed significant increase in mean insulin level (p = 0.03), HOMA-IR (p = 0.04) and significantly higher number of children with acanthosis nigricans and metabolic syndrome. The odds of having IR was about 2.5 times higher (OR = 2.47; 95% CI 1.23, 4.95; p = 0.01) for those in the highest tertiles of TG:HDL-C ratio. Hence, TG:HDL-C may be a useful tool to identify high risk individuals.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15608b,

title = {Use of physical restraint: Nurses' knowledge, attitude, intention and practice and influencing factors},

author = {F Eskandari and K L Abdullah and N Z Zainal and L P Wong},

doi = {10.1111/jocn.13778},

issn = {0962-1067},

year  = {2017},

date = {2017-01-01},

journal = {J Clin Nurs},

volume = {26},

number = {23-24},

pages = {4479-4488},

abstract = {AIMS AND OBJECTIVES: To investigate the knowledge, attitude, intention and practice of nurses towards physical restraint and factors influencing these variables. BACKGROUND: A literature review showed a lack of studies focused on the intention of nurses regarding physical restraint throughout the world. Considering that very little research on physical restraint use has been carried out in Malaysia, assessment of nurses' knowledge, attitude, intention and practice is necessary before developing a minimising programme in hospitals. DESIGN: A cross-sectional study was used. METHODS: A questionnaire to assess the knowledge, attitude, intention and practice was completed by all nurses (n = 309) in twelve wards of a teaching hospital in Kuala Lumpur. RESULTS: Moderate knowledge and attitude with strong intention to use physical restraint were found among the nurses. Less than half of nurses considered alternatives to physical restraint and most of them did not understand the reasons for the physical restraint. Nurses' academic qualification, read any information source during past year and nurses' work unit showed a significant association with nurses' knowledge. Multiple linear regression analysis found knowledge, attitude and intention were significantly associated with nurses' practice to use physical restraint. CONCLUSION: This study showed some important misunderstandings of nurses about using physical restraint and strong intention regarding using physical restraint. Findings of this study serve as a supporting reason for importance of educating nurses about the use of physical restraint. RELEVANCE TO CLINICAL PRACTICE: Exploring the knowledge, attitude, intention and current practice of nurses towards physical restraint is important so that an effective strategy can be formulated to minimise the use of physical restraints in hospitals.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15545b,

title = {Using best-worst scaling to rank factors affecting vaccination demand in northern Nigeria},

author = {S Ozawa and C Wonodi and O Babalola and T Ismail and J Bridges},

url = {https://www.ncbi.nlm.nih.gov/pubmed/29037575},

doi = {10.1016/j.vaccine.2017.09.079},

issn = {1873-2518 (Electronic) 

0264-410X (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Vaccine},

volume = {35},

number = {47},

pages = {6429-6437},

abstract = {BACKGROUND: Understanding and ranking the reasons for low vaccination uptake among parents in northern Nigeria is critical to implement effective policies to save lives and prevent illnesses. This study applies best-worst scaling (BWS) to rank various factors affecting parents' demand for routine childhood immunization. METHODS: We conducted a household survey in Nahuche, Zamfara State in northern Nigeria. Nearly two hundred parents with children under age five were asked about their views on 16 factors using a BWS technique. These factors focused on known attributes that influence the demand for childhood immunization, which were identified from a literature review and reviewed by a local advisory board. The survey systematically presented parents with subsets of six factors and asked them to choose which they think are the most and least important in decisions to vaccinate children. We used a sequential best-worst analysis with conditional logistic regression to rank factors. RESULTS: The perception that vaccinating a child makes one a good parent was the most important motivation for parents in northern Nigeria to vaccinate children. Statements related to trust and social norms were ranked higher in importance compared to those that highlighted perceived benefits and risks, healthcare service, vaccine information, or opportunity costs. Fathers ranked trust in the media and views of their leaders to be of greatest importance, whereas mothers placed greater importance on social perceptions and norms. Parents of children without routine immunization ranked their trust in local leaders about vaccines higher in considerations, and the media's views lower, compared to parents with children who received routine immunization. CONCLUSIONS: Framing immunization messages in the context of good parenting and hearing these messages from trusted information sources may motivate parental uptake of childhood vaccines. These results are useful to policymakers to prioritize resources in order to increase awareness and demand for childhood immunization.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15592b,

title = {Vaccine hesitancy among parents in a multi-ethnic country, Malaysia},

author = {F S Mohd Azizi and Y Kew and F M Moy},

url = {https://www.ncbi.nlm.nih.gov/pubmed/28434687},

doi = {10.1016/j.vaccine.2017.04.010},

issn = {1873-2518 (Electronic) 

0264-410X (Linking)},

year  = {2017},

date = {2017-01-01},

journal = {Vaccine},

volume = {35},

number = {22},

pages = {2955-2961},

abstract = {BACKGROUND: Vaccine hesitancy is a threat in combating vaccine-preventable diseases. It has been studied extensively in the Western countries but not so among Asian countries. OBJECTIVES: To assess the test-retest reliability of the Parent Attitudes about Childhood Vaccines (PACV) questionnaire in Malay language; to determine the prevalence of vaccine hesitancy among parents and its associations with parents' socio-demographic characteristics. METHODS: Forward and backward translation of PACV in Malay language was carried out. The reliability of the Malay-PACV questionnaire was tested among parents with children. The same questionnaire was used to study vaccine hesitancy among parents in a tertiary hospital in Kuala Lumpur. Information pertaining to socio-demographic characteristics, sources of information regarding vaccination and vaccine hesitancy were collected. Associations between vaccine hesitancy with socio-demographic factors were tested using Multivariable Logistic Regression. RESULTS: The Spearman correlation coefficient and Cronbach alpha for total PACV was 0.79 (p\<0.001) and 0.79 respectively. The intra-class correlation coefficients of the subscales ranged from 0.54 to 0.90 demonstrating fair to excellent reliability. A total of 63 (11.6%) parents were noted to be vaccine hesitant. In the univariate analyses, vaccine hesitancy was associated with unemployed parents, parents who were younger, had fewer children and non-Muslim. In the multivariate model, pregnant mothers expecting their first child were four times more likely to be vaccine hesitant compared to those who already had one or more children (aOR: 3.91, 95% CI: 1.74-8.79) and unemployed parents were also more likely to be vaccine hesitant (aOR: 1.97, 95% CI: 1.08-3.59). The internet (65.6%) was the main source of information on vaccination followed by brochures (56.9%). CONCLUSION: The Malay-PACV questionnaire is reliable to be used. The prevalence of vaccine hesitancy among the multi-ethnic Malaysians was comparable with other populations. Pregnant mothers expecting their first child and unemployed parents were found to be more vaccine hesitant.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15563b,

title = {Validation of verbal autopsy: determination of cause of deaths in Malaysia 2013},

author = {S S Ganapathy and K Yi Yi and M A Omar and M F M Anuar and C Jeevananthan and C Rao},

doi = {10.1186/s12889-017-4668-y},

issn = {1471-2458},

year  = {2017},

date = {2017-01-01},

journal = {BMC Public Health},

volume = {17},

number = {1},

pages = {653},

abstract = {BACKGROUND: Mortality statistics by age, sex and cause are the foundation of basic health data required for health status assessment, epidemiological research and formation of health policy. Close to half the deaths in Malaysia occur outside a health facility, are not attended by medical personnel, and are given a lay opinion as to the cause of death, leading to poor quality of data from vital registration. Verbal autopsy (VA) is a very useful tool in diagnosing broad causes of deaths for events that occur outside health facilities. This article reports the development of the VA methods and our principal finding from a validation study. METHODS: A cross sectional study on nationally representative sample deaths that occurred in Malaysia during 2013 was used. A VA questionnaire suitable for local use was developed. Trained field interviewers visited the family members of the deceased at their homes and conducted face to face interviews with the next of kin. Completed questionnaires were reviewed by trained physicians who assigned multiple and underlying causes. Reference diagnoses for validation were obtained from review of medical records (MR) available for a sample of the overall study deaths. RESULTS: Corresponding MR diagnosis with matched sample of the VA diagnosis were available in 2172 cases for the validation study. Sensitivity scores were good (\>75%) for transport accidents and certain cancers. Moderate sensitivity (50% - 75%) was obtained for ischaemic heart disease (64%) and cerebrovascular disease (72%). The validation sample for deaths due to major causes such as ischaemic heart disease, pneumonia, breast cancer and transport accidents show low cause-specific mortality fraction (CSMF) changes. The scores obtained for the top 10 leading site-specific cancers ranged from average to good. CONCLUSION: We can conclude that VA is suitable for implementation for deaths outside the health facilities in Malaysia. This would reduce ill-defined mortality causes in vital registration data, and yield more accurate national mortality statistics.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15672b,

title = {Validity and reliability of the Malay version multidimensional scale of perceived social support (MSPSS-M) among teachers},

author = {S C Lee and F M Moy and N N Hairi},

doi = {10.1007/s11136-016-1348-9},

issn = {0962-9343},

year  = {2017},

date = {2017-01-01},

journal = {Qual Life Res},

volume = {26},

number = {1},

pages = {221-227},

abstract = {PURPOSE: The multidimensional scale of perceived social support (MSPSS) was developed to measure perceived social support. It has been translated and culturally adapted among natives literate in the Malay language. However, its psychometric properties for teachers who are majority females and married have not been assessed. METHODS: This was a cross-sectional study conducted among the public secondary school teachers in the central region of Peninsular Malaysia from May to July 2013. A total of 150 and 203 teachers were recruited to perform exploratory factor analysis and confirmatory factor analysis (CFA), respectively. Reliability testing was evaluated on 141 teachers via internal consistency and two-week interval test-retest. RESULTS: The 12-item three-factor structure of MSPSS-M was revised to 8-item two-factor structure. The revised MSPSS-M demonstrated excellent fit in CFA with adequate divergent and convergent validity and good factor loadings (0.80-0.90). The revised MSPSS-M also displayed good internal consistency with Cronbach's alpha of 0.91, 0.93 and 0.92 and good test-retest reliability with intraclass correlation of 0.89, 0.88 and 0.88 in the total scale, family and friends factors, respectively. CONCLUSION: The revised 8-item MSPSS-M is a reliable and valid tool for assessment of perceived social support among teachers.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN15565b,

title = {Willingness to use pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Malaysia: findings from a qualitative study},

author = {A Bourne and M Cassolato and C K Thuan Wei and B Wang and J Pang and S H Lim and I Azwa and I Yee and G Mburu},

doi = {10.7448/ias.20.1.21899},

issn = {1758-2652},

year  = {2017},

date = {2017-01-01},

journal = {J Int AIDS Soc},

volume = {20},

number = {1},

pages = {21899},

abstract = {BACKGROUND: Men who have sex with men (MSM) continue to be disproportionately affected by HIV in Malaysia. Recent success has been observed within demonstration projects examining the efficacy of HIV pre-exposure prophylaxis (PrEP), an antiretroviral -based medication taken by HIV-negative men to prevent sero-conversion. In order for such promising findings to be translated in real-world settings, it is important to understand the acceptability of PrEP, including perceived barriers to access or uptake. METHODS: As part of a larger mixed-methods study exploring acceptability and willingness to use PrEP among MSM in Malaysia, 19 men took part in audio-recorded focus group discussions hosted by a community-based HIV organization and facilitated by a trained researcher. Discussions focussed on awareness and potential information management, general perceptions of PrEP and potential motivations or barriers to the use of PrEP, including those at the personal, social, health system or structural level. Data were transcribed verbatim and underwent a detailed thematic analysis. RESULTS: Rather than perceiving PrEP as a replacement for condoms in terms of having safer sex, many participants viewed it as an additional layer protection, serving as a crucial barrier to infection on occasions where condom use was intended, but did not occur. It was also perceived as more valuable to "at-risk" men, such as those in HIV sero-discordant relationships or those with a higher number of sexual partners. Elements of discussion tended to suggest that some men taking PrEP may be subject to stigma from others, on the assumption they may be promiscuous or engage in high-risk sexual behaviours. CONCLUSIONS: This qualitative study indicates that, broadly speaking, PrEP may be acceptable to MSM in Malaysia. However, in order for its potential to be realized, and uptake achieved, educative interventions are required to inform the target population as to the efficacy and potential, positive impact of PrEP. Given concerns for how those taking it may be stigmatized, it is crucial that the use of PrEP is presented as a responsible course of action, and one of a range of strategies that men can use to keep themselves safe from HIV.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}