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BACKGROUNDAlthough patients with malignant disease frequently use dietary supplements, the effects of these agents with regard to chemotherapy are unclear. Therefore, the authors investigated the influence of vitamin B12, folate, and nutritional supplements on chemotherapy‐induced toxicity.METHODSWomen with breast carcinoma were asked to complete a questionnaire that recorded their use of dietary supplements. Blood samples were obtained for the assessment of serum vitamin B12 and folate levels before and after the first cycle of chemotherapy and for weekly complete blood counts. Toxicity was evaluated by measuring absolute neutrophil counts and the frequency and severity of oral mucositis.RESULTSOf the 49 women who submitted questionnaires, 35 (71%) took a combined total of 165 supplements. Compared with patients in a previous study (performed in 1990), patients in the current study had dramatically increased serum folate levels. Initial neutrophil count, but not type of chemotherapy, patient age, or serum vitamin B12 level, was predictive of nadir absolute neutropenia and the decrease from initial neutrophil count to nadir (Nfall). After adjusting for initial neutrophil count, Nfall was found to be lower for women who were taking supplements compared with women who were not taking supplements (P = 0.01) and for women who were taking multivitamins (P = 0.01) or vitamin E (P = 0.03). Women with serum folic acid levels < 20 ng/mL had a smaller decrease in neutrophil count after chemotherapy than did women with higher folate levels (P = 0.04). No significant association between oral mucositis and initial neutrophil count, nadir neutrophil count, Nfall, age, vitamin B12 level, or folate level was found.CONCLUSIONSThe decrease in neutrophil count caused by chemotherapy was ameliorated by dietary supplementation with a multivitamin or vitamin E. In contrast, high serum folate levels were associated with the exacerbation of this decrease in neutrophil count. Cancer 2004. © 2004 American Cancer Society.

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Ecosystem balance is an important factor that affects healthy and sustainable urban development. The traditional cellular automata (CA) model considers only a few ecological factors, however, the MCR model can account for ecological factors. In previous studies, few ecological factors were added to the CA model. Thus, the minimal cumulative resistance (MCR) model is combined with the CA and Markov models for the simulation of urban expansion. To verify the reliability of the method, the Wuhan metropolitan area was selected as a representative urban area, and its expansion in the past and future was simulated. Firstly, seven influential factors were selected from the perspective of location theory. The transformation rules of the comprehensive resistance surface followed by the modified CA–Markov model were constructed on the basis of the MCR model. The expansion of the Wuhan metropolitan area in 2013 was simulated on the basis of the 1996 and 2006 maps of land-use status, and the kappa coefficient was used as an index to evaluate the accuracy of the proposed method. Then, the expansion of the Wuhan metropolitan area in 2020 was simulated. Finally, the simulation results obtained with and without the MCR model were compared and analysed from the macro- and micro levels. Results show that the prediction accuracy of the two models differed for ecological regions, such as woodlands and water bodies. The similarities between the regions that were overestimated and underestimated by the MCR-modified CA–Markov model and non-MCR model may be attributed to solution of the land-use transfer matrix with the Markov model. The accuracy of the MCR-modified CA–Markov model for predicting forests, water and other ecological regions was higher than that of the Markov model. Therefore, the proposed MCR-modified CA–Markov model has potential applications in environmentally-conscious urban expansion.