Establishment and development of national community-based collaborative innovation demonstration areas to achieve the control target of hepatitis B in China.

BACKGROUND: The major infectious diseases of hepatitis B has constituted an acute public health challenge in China. An effective and affordable HBV control model is urgently needed. A national project of Community-based Collaborative Innovation HBV (CCI-HBV) demonstration areas has optimized the existing community healthcare resources and obtained initial results in HBV control. METHODS: Based on the existing community healthcare network, CCI-HBV project combined the community health management and health contract signing service for long-staying residents in hepatitis B screening. Moreover, HBV field research strategy was popularized in CCI-HBV areas. After screening, patients with seropositive results were enrolled in corresponding cohorts and received treatment at an early stage. And the uninfected people received medical supports including health education through new media, behavior intervention and HBV vaccinations. In this process, a cloud-based National Information Platform (NIP) was established to collect and store residents' epidemiological data. In addition, a special quality control team was set up for CCI project. RESULTS: After two rounds of screening, HBsAg positive rate dropped from 5.05% (with 5,173,003 people screened) to 4.57% (with 3,819,675 people screened), while the rate of new HBV infections was 0.28 per 100 person-years in the fixed cohorts of 2,584,322 people. The quality control team completed PPS sampling simultaneously and established the serum sample database with 2,800,000 serum samples for unified testing. CONCLUSIONS: CCI-HBV project has established a large-scale field research to conduct whole-population screening and intervention. We analyzed the HBsAg prevalence and new infection rate of HBV in the fixed population for the epidemic trend and intervention effect. The purpose of CCI-HBV project is to establish and evaluate a practical model of grid management and field strategy, to realize the new goal to control hepatitis B in China. To provide policymakers with a feasible model, our results are directly applicable. TRIAL REGISTRATION: The project was funded by the Major Projects of Science Research for the 11th and 12th five-year plans of China, entitled "The prevention and control of AIDS, viral hepatitis and other major infectious diseases", Grant Nos. 2009ZX10004901, 2011ZX10004901, 2013ZX10004904, 2014ZX10004007 and 2014ZX10004008.

Possibilistic classification by support vector networks.

In many real-world classification problems, the available information is often uncertain. In order to effectively describe the inherent vagueness and improve the classification performance, this paper proposes a novel possibilistic classification algorithm using support vector machines (SVMs). Based on possibility theory, the proposed algorithm aims at finding a maximal-margin fuzzy hyperplane by solving a fuzzy mathematical optimization problem Moreover, the decision function of the proposed approach is generalized such that the values assigned to the data vectors fall within a specified range and indicate the membership grade of these data vectors in the positive class. The proposed algorithm retains the advantages of fuzzy set theory and SVM theory. The proposed approach is more robust for handling data corrupted by outliers. Moreover, the structural risk minimization principle of SVMs enables the proposed approach to effectively classify the unseen data. Furthermore, the proposed algorithm has additional advantage of using vagueness parameter v for controlling the bounds on fractions of support vectors and errors. The extensive experiments performed on benchmark datasets and real applications demonstrate that the proposed algorithm has satisfactory generalization accuracy and better describes the inherent vagueness in the given dataset.

Carboxymethyl chitosan has sensitive two-way CO2-responsive hydrophilic/hydrophobic feature.

Carboxymethyl chitosans (CMC) with various degrees of carboxymethyl substitution were prepared and investigated on their changes in water solubility in response to bubbling of CO2 or N2 as a function of the relative concentrations of COOH and NH2 side groups. When having similar concentrations of COOH and NH2, the produced CMC was water soluble at pH 10 and consecutively experienced peculiar dissolution-to-precipitation-to-dissolution during bubbling of CO2, and experienced reverse dissolution-to-precipitation-to-dissolution process during subsequently bubbling of N2. With the concentration of COOH much higher than that of NH2, the water soluble CMC at pH 10 exhibited no phase changes in response to bubbling of CO2 and N2. This newly developed CMC solution system with novel CO2 responsive amphiphilic feature has a potential use as a CO2 switchable surfactant to control interface of mixtures of hydrophilic and hydrophobic species in emulsification/demulsification applications.

[Time trends, estimates and projects for breast cancer incidence and mortality in China].

OBJECTIVE: Using comprehensive available data on women breast cancer in China, to describe the mortality trends from late 1970s, estimate and project the profile in 2000 and 2005, and to aim to provide a reference for clinic, basic research and prevention and control strategy making for breast cancer in China. METHODS: Using Joinpoint model, the mortality trends were analyzed on the basis of routine surveillance data. Combining with the data from the second national mortality survey and several cancer registries, using the log-linear model (based on Poisson distribution), the breast cancer profile in 2000 and 2005 were estimated and projected. RESULTS: Although there was a slight decline in mortality between early 1970s and 1990s, the age-specific mortality rates among young and middle age women increased dramatically which followed a continuing increase trend on both rates and absolute numbers, in both urban and rural areas in recent 15 years. Compared with 2000, there are 470 thousands more new breast cancer cases and 130 thousands more deaths from breast cancer in 2005. CONCLUSION: Due to the double effects of both increasing risk factors and population growth and ageing, breast cancer will be one of the most extensively increasing cancers in Chinese women. The prevention and control of breast cancer will be of great emphasis for future cancer control strategy in China.

Estimates of cancer incidence in China for 2000 and projections for 2005.

Knowledge of the incidence of cancer is a fundamental requirement of rational planning and monitoring of cancer control programs. The lack of national-level information systems on health indicators in China means that estimation methods are required. Estimates and projections of national level cancer mortality have been previously made using sample surveys of deaths. Using these mortality data, incidence rates in 2000 and 2005 were estimated by means of the ratio of cancer cases/deaths (by site, age, and sex) in good quality cancer registries in China. A total of 2.1 million cancer cases were estimated for the year 2000 (1.3 million in men, 0.8 million in women), with the most common sites being lung, liver, and stomach in men, and breast, lung, and stomach in women. The total number of new cases is expected to increase by 14.6% by 2005, primarily as a result of population growth and aging. In addition, the rising rates of lung cancer incidence (in both sexes) and breast cancer mean that there will be much greater increases in the number of cases at these two sites (27% for lung cancer in men, 38% for lung and breast cancer in women). These two cancers are now the priorities for cancer prevention, early detection, and therapy in China.

[Mortality time trends and the incidence and mortality estimation and projection for lung cancer in China].

BACKGROUND: Using the most comprehensive available data on lung cancer incidence and mortality in China, the mortality time trends were described and the incidence and mortality profile in 2000 and 2005 were estimated and projected, so as to provide evidence and reference for clinic, basic research and making prevention and control strategy for lung cancer in China. METHODS: The Joinpoint model was used to analyze the lung cancer mortality trends during 1987-1999, based on data reported to WHO from the Ministry of Health in China. Combined with the data from the second national mortality survey in 1990-1992 and the lung cancer incidence and mortality data from several cancer registries in China which involved in Cancer Incidence in Five Continents, the 8th version, using the log-linear model (based on Poisson distribution), the incidence and mortality profile for lung cancer in 2000 and 2005 in China were estimated and projected. RESULTS: The age-standardized mortality rates increased during the study period, especially in rural areas (the expected annual percentage changes were 2.7% in men and 3.6% for women, both were statistically significant) and showed among almost all age groups (above age 15). From 2000 to 2005, there would be 0.101 million more lung cancer deaths (from 327643 in 2000 to 428936 in 2005) and 0.116 million more new incident cases (from 381487 in 2000 to 497908 in 2005). CONCLUSIONS: Due to the double effects from both changes in the risk factors for the disease and the population growth and aging, lung cancer is becoming one of the most common and increasing malignant neoplasmin China . The prevention and control for this disease will be theemphasis for future cancer control strategy of China in which tobacco control is critically important .

China's evolving health care market: how doctors feel and what they think.

This paper reports on a questionnaire survey and 12 focus groups conducted among doctors in three provinces of China, namely Guangdong, Shanxi, and Sichuan. The survey (N = 720) and focus group participants were drawn from both rural and urban areas, as well as public and private sectors, in equal numbers The aim was to gauge how Chinese doctors feel about themselves and what they think of the Chinese health care system. We found low satisfaction levels with own income (8%), job (27%), skill (30%), and other important aspects of their professional life. The health care system received only 32% approval rating. Quality of care and patient safety issues were major concerns, especially in the growing but poorly regulated private sector. The public sector came under criticism for its high fees and bad service quality. The feedback point to the need for an appropriate regulatory framework to guide the development of China's evolving health care market. A revitalized medical profession that is fully engaged in the reform process could also significantly impact the success of ongoing health care reform efforts.

Sources of information on the burden of cancer in China.

Three data sources for the information on cancer in China are described in this paper: (i) mortality data from national retrospective surveys (1973-75 and 1990-92); (ii) mortality data obtained through special research projects (CHIS, DSP and mortality survey in 1986-89); and (iii) incidence and mortality data from cancer registries. Different combinations of mortality and incidence data can be used to estimate the pattern or burden of cancer in China. Registration of cancer incidence and mortality in China should be standardized and expanded, in order to enhance availability of accurate data for estimating cancer burden in China.

Overview of the gene ontology task at BioCreative IV.

Gene ontology (GO) annotation is a common task among model organism databases (MODs) for capturing gene function data from journal articles. It is a time-consuming and labor-intensive task, and is thus often considered as one of the bottlenecks in literature curation. There is a growing need for semiautomated or fully automated GO curation techniques that will help database curators to rapidly and accurately identify gene function information in full-length articles. Despite multiple attempts in the past, few studies have proven to be useful with regard to assisting real-world GO curation. The shortage of sentence-level training data and opportunities for interaction between text-mining developers and GO curators has limited the advances in algorithm development and corresponding use in practical circumstances. To this end, we organized a text-mining challenge task for literature-based GO annotation in BioCreative IV. More specifically, we developed two subtasks: (i) to automatically locate text passages that contain GO-relevant information (a text retrieval task) and (ii) to automatically identify relevant GO terms for the genes in a given article (a concept-recognition task). With the support from five MODs, we provided teams with >4000 unique text passages that served as the basis for each GO annotation in our task data. Such evidence text information has long been recognized as critical for text-mining algorithm development but was never made available because of the high cost of curation. In total, seven teams participated in the challenge task. From the team results, we conclude that the state of the art in automatically mining GO terms from literature has improved over the past decade while much progress is still needed for computer-assisted GO curation. Future work should focus on addressing remaining technical challenges for improved performance of automatic GO concept recognition and incorporating practical benefits of text-mining tools into real-world GO annotation. DATABASE URL: http://www.biocreative.org/tasks/biocreative-iv/track-4-GO/.

A comparison of the sources of cancer mortality in China.

OBJECTIVE: To compare the validity of mortality data from available sources in China. MATERIALS, METHODS: Two large-scale surveys have provided accurate national-level rates; the most recent involved deaths occurring in a random 10% sample of the population during 1990-1992. Since then, the only readily available sources are two on-going surveillance systems, which provide annual estimates of mortality--the "Disease Surveillance Points" (DSP) sample survey, and that established by the Center of Health Information and Statistics (CHIS) of the ministry of health, the results of which are published by WHO. They were compared with respect to the representativeness of the populations covered and the rates obtained. RESULTS: Neither source covers a random sample of the Chinese population, with respect to age group, sex, and urban-rural residence, although the DSP population is the more representative of the national population in this respect. Sex and region (urban/rural) specific age-standardized mortality rates from the CHIS dataset were, however, closer to those from the (1990-1992) national survey, than those calculated from DSP data. CONCLUSIONS: The CHIS data is the preferred source for estimation of national mortality, and study of time trends, but requires appropriate weighting (by age, sex, rural/urban residence). The within-stratum estimates are more stable than those of DSP, because of its larger sample size.

Time trends in cancer mortality in China: 1987-1999.

A first analysis of time trends in cancer mortality in China at the national level is presented. Using a joinpoint regression model, based on data from a national mortality routine reporting system in China (CHIS), time trends in mortality for 9 major cancers are analyzed. Between 1987 and 1999, the age-standardized mortality rates for all cancers combined declined slightly in rural areas but have increased since 1996 in urban areas. The mortality rates for cancers in oesophagus, stomach, cervix uteri, leukaemia (except for urban males after 1996) and nasopharynx declined, while lung cancer and female breast cancer showed significant increasing trends in both urban and rural areas and for both sexes. Cancers of the colon-rectum and liver had different trends in mortality in urban and rural populations. The trends in age-specific mortality rates suggest some different trends in the younger population, which may presage future overall trends, for example, increasing mortality from cancer of the cervix. The observed trends primarily reflect the dramatic changes in socioeconomic circumstances and lifestyles in China in the last 2 decades. Tobacco smoking remains a major problem, with increases in mortality from lung cancer. The improvements in socioeconomic status, diet and nutrition may be responsible for the declining risk of some cancers (oesophagus, stomach and nasopharynx), while increasing the risk for others (breast and colon-rectum). Screening programs (especially for cervix cancer), and more available and better facilities for cancer therapy, may have helped to reduce mortality for several cancers. The large increases in the absolute number of deaths that resulted from the increasing and aging population are much more important in determining the future cancer burden than any changes due to change in risk, emphasizing the increasing importance of cancer as a health problem in the 21st century in China.