A scoring diagnostic system based on biparametric ultrasound features for prostate cancer risk assessment.

Background: Ultrasound has advantages in prostate cancer (PCa) detection and biopsy guidance but lacks a comprehensive quantitative evaluation model with multiparametric features. We aimed to construct a biparametric ultrasound (BU) scoring system for PCa risk assessment and to provide an option for clinically significant prostate cancer (csPCa) detection. Methods: From January 2015 to December 2020, 392 consecutive patients at Chongqing University Cancer Hospital who underwent BU (grayscale, Doppler flow imaging, and contrast-enhanced ultrasound) and multiparametric magnetic resonance imaging (mpMRI) before biopsy were retrospectively enrolled in the training set to construct the scoring system. From January 2021 to May 2022, 166 consecutive patients at Chongqing University Cancer Hospital were retrospectively enrolled in the validation set. The ultrasound system was compared with mpMRI, and the gold standard was a biopsy. The primary outcome was the detection of csPCa in any area with a Gleason score (GS) ≥3+4, and the secondary outcome was defined as a GS ≥4+3 and/or maximum cancer core length (MCCL) ≥6 mm. Results: Malignant association features in the nonenhanced biparametric ultrasound (NEBU) scoring system included echogenicity, capsule, and gland asymmetrical vascularity. In the biparametric ultrasound scoring system (BUS), the feature of contrast agent arrival time was added. In the training set, the area under the curves (AUCs) of the NEBU scoring system, BUS, and mpMRI were 0.86 [95% confidence interval (CI): 0.82-0.90], 0.86 (95% CI: 0.82-0.90), and 0.86 (95% CI: 0.83-0.90), respectively (P>0.05). Similar results were also observed in the validation set, in which the areas under the curves were 0.89 (95% CI: 0.84-0.94), 0.90 (95% CI: 0.85-0.95), and 0.88 (95% CI: 0.82-0.94), respectively (P>0.05). Conclusions: We constructed a BUS that showed efficacy and value for csPCa diagnosis as compared with mpMRI. However, in limited circumstances, the NEBU scoring system may also be an option.

Prevalence of mental disorders in the elderly population 5 years after the Lushan earthquake in Ya'an, China.

PURPOSE: This study aimed to explore the prevalence and distribution of mental disorders in the elderly population 5 years after the Lushan earthquake in Ya'an, China. METHODS: A multi-stage, group-matching random sampling method was adopted with 2579 elderly participants (≥ 60 years old) who were interviewed from January to May 2019. Preliminary screening was conducted using the scale by trained psychiatric nurses, followed by a diagnostic interview during the second stage using Chinese Version of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorder by trained psychiatrists. RESULTS: A total of 2561 participants were included in this study with complete data. The weighted lifetime prevalence of all mental disorders in the elderly was 16.2% (95% CI 15.3-17.1), and the weighted 12-month prevalence was 15.2% (95% CI 13.4-17.0). Depressive disorders, anxiety disorders, substance-related and addictive disorders were the most common mental disorders. The 12-month prevalence of all mental disorders were significantly higher in the elderly living alone, with chronic somatic disease, and being poor (P < 0.05). The 12-month prevalence of posttraumatic stress disorder (PTSD) was significantly higher in the elderly in extremely severely earthquake-affected areas (P < 0.001). CONCLUSION: The results of this study show that mental health status of the elderly in Ya'an area differ by socio-economic development, geographical location, and natural disasters. The social and economic development characteristics, the impact of major natural disasters (e.g., earthquakes), and population characteristics should be combined to formulate strategies and interventions to promote the mental health of the elderly.

Global burden of gallbladder and biliary diseases: A systematic analysis for the Global Burden of Disease Study 2019.

BACKGROUND AND AIM: Gallbladder and biliary diseases (GBDs) are one of the most prevalent medical issues in the digestive system. This study was designed to describe the characteristics of prevalence, death, and disability-adjusted life years (DALYs) of GBDs during 1990-2019 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. METHODS: Prevalence, death, and DALYs for GBDs in different locations, years, sex, and age groups were estimated using DisMod-MR 2.1 and a generic Cause of Death Ensemble Modeling approach. Countries and territories were categorized according to socio-demographic index (SDI) quintiles. RESULTS: The prevalence cases (127 345 732 to 193 493 378), death cases (82 430 to 124 941), and DALYs (4 604 821 to 6 352 738) of GBDs increased from 1990 to 2019. However, the age-standardized rates of indicators decreased over the 30-year period (prevalence, 2851.84 to 2350.78 per 100 000 population; death, 2.40 to 1.65 per 100 000 population; DALYs, 106.76 to 78.25 per 100 000 population). In 2019, the high and middle-high SDI regions had higher age-standardized prevalence rates, the low SDI region had the highest age-standardized death rate, and the middle SDI region had the highest DALYs and age-standardized DALYs rate of GBDs. Being female, older age, and high body mass index were important risk factors for the burden of GBDs. CONCLUSIONS: Globally, there were improvements in overall health with regard to GBDs over the 30 years. However, the prevention of GBDs should be promoted in middle, middle-high, and high SDI regions, while more medical resources should be provided to improve treatment levels in low SDI region.

The association of hospital research publications and clinical quality.

OBJECTIVE: To assess the quantity and impact of research publications among US acute care hospitals; to identify hospital characteristics associated with publication volumes; and to estimate the independent association of bibliometric indicators with Hospital Compare quality measures. DATA SOURCES: Hospital Compare; American Hospital Association Survey; Magnet Recognition Program; Science Citation Index Expanded. STUDY DESIGN: In cross-sectional studies using a 40% random sample of US Medicare-participating hospitals, we estimated associations of hospital characteristics with publication volumes and associations of hospital-linked bibliometric indicators with 19 Hospital Compare quality metrics. DATA COLLECTION/EXTRACTION METHODS: Using standardized search strategies, we identified all publications attributed to authors from these institutions from January 1, 2015 to December 31, 2016 and their subsequent citations through July 2020. PRINCIPAL FINDINGS: Only 647 of 1604 study hospitals (40.3%) had ≥1 publication. Council of Teaching Hospitals and Health Systems (COTH) hospitals had significantly more publications (average 599 vs. 11 for non-COTH teaching and 0.6 for nonteaching hospitals), and their publications were cited more frequently (average 22.6/publication) than those from non-COTH teaching (18.2 citations) or nonteaching hospitals (12.8 citations). In multivariable regression, teaching intensity, hospital beds, New England or Pacific region, and not-for-profit or government ownership were significant predictors of higher publication volumes; the percentage of Medicaid admissions was inversely associated. In multivariable linear regression, hospital publications were associated with significantly lower risk-adjusted mortality rates for acute myocardial infarction (coefficient -0.52, p = 0.01), heart failure (coefficient -0.74, p = 0.004), pneumonia (coefficient -1.02, p = 0.001), chronic obstructive pulmonary disease (coefficient -0.48, p = 0.005), and coronary artery bypass surgery (coefficient -0.73, p < 0.0001); higher overall Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings (coefficient 2.37, p = 0.04); and greater patient willingness to recommend (coefficient 3.38, p = 0.01). CONCLUSIONS: A minority of US hospitals published in the biomedical literature. Publication quantity and impact indicators are independently associated with lower risk-adjusted mortality and higher HCAHPS scores.

Comprehensive Quantitative Assessment of Lung Liquid Clearance by Lung Ultrasound Score in Neonates with No Lung Disease during the First 24 Hours.

OBJECTIVES: To comprehensively and quantitatively assess the process of lung liquid clearance using the lung ultrasound score. This study is to evaluate the whole healthy lungs of neonates during the first 24 h. METHODS: Lung ultrasound was performed in neonates with no respiratory symptoms within 3 h after birth, and scans were then repeated at 6 hours and 24 hours, respectively. The entire chest wall was divided into 12 regions. The lung ultrasound scores of the anterior, posterior, upper, and lower regions and sum of all regions were calculated according to the ultrasound pattern of each region examined. RESULTS: The total lung ultrasound score decreased gradually during the first 24 h, with the total lung ultrasound score at 6 h being significantly lower than that at <3 h (P < 0.05). At <3 h, B-lines were more abundant in the posterior chest than in the anterior chest (P < 0.05). At <3 h, B-lines were more abundant in the posterior chest than in the anterior chest (P < 0.05). At <3 h, B-lines were more abundant in the posterior chest than in the anterior chest (. CONCLUSION: Changes in the lung ultrasound score may quantitatively reflect the characteristics of different regions and processes of lung liquid clearance during the first 24 h.

The association of hospital teaching intensity with 30-day postdischarge heart failure readmission and mortality rates.

OBJECTIVE: To investigate risk-adjusted, 30-day postdischarge heart failure mortality and readmission rates stratified by hospital teaching intensity. DATA SOURCES AND STUDY SETTING: A total of 709 221 Medicare fee-for-service beneficiaries discharged from 3135 US hospitals between 1/1/2013 and 11/30/2014 with a principal diagnosis of heart failure. STUDY DESIGN: Hospitals were classified as Council of Teaching Hospitals and Health Systems (COTH) major teaching hospitals, non-COTH teaching hospitals, and nonteaching hospitals. Hospital teaching status was linked with MedPAR patient data and FY2016 Hospital Readmission Reduction Program penalties. Index hospitalization survival probabilities were estimated with hierarchical logistic regression and used to stratify index hospitalization survivors into severity deciles. Decile-specific models were estimated for 30-day postdischarge readmission and mortality. Thirty-day postdischarge outcomes were estimated by teaching intensity and penalty categories. PRINCIPAL FINDINGS: Averaged across deciles, adjusted 30-day COTH hospital readmission rates were, on a relative scale ([COTH minus nonteaching] ÷ nonteaching), 1.63 percent higher (95% CI: 0.89 percent, 2.25 percent) than at nonteaching hospitals, but their average adjusted 30-day postdischarge mortality rates were 11.55 percent lower (95% CI: -13.78 percent, -9.37 percent). Penalized COTH hospitals had the highest readmission rates of all categories (23.99 percent [95% CI: 23.50 percent, 24.49 percent]) but the lowest 30-day postdischarge mortality (8.30 percent [95% CI: 7.99 percent, 8.57 percent] vs 9.84 percent [95% CI: 9.69 percent, 9.99 percent] for nonpenalized, nonteaching hospitals). CONCLUSIONS: Heart failure readmission penalties disproportionately impact major teaching hospitals and inadequately credit their better postdischarge survival.

[Spatial Distribution and Pollution Assessment of As at a Small Scale in Agricultural Soils of the Karst Region].

The karst landforms in Guizhou are widely distributed, and the problem of soil arsenic (As) pollution is prominent in these areas because of the high environmental background levels. In order to study the distribution characteristics of As contents in agricultural soils with high background values of As, representative As polluted regions (typical karst region, semi-karst region) in southwestern Xingyi City of Guizhou Province were selected as the research objects, and the non-karst region served as the control group. Geostatistical analyses were then combined with GIS data to study the spatial variability and pollution conditions of As in agricultural soils. Furthermore, Moran's I statistic was used to analyze the spatial autocorrelation and directional characteristics of As at a small scale in the soil. The results showed that As contents in soils from different geomorphological regions were ranked as follows:typical karst region > semi-karst region > non-karst region. The arithmetic mean value and geometric mean value of As in agricultural soils in the typical karst region were 47.9 mg·kg-1 and 43.3 mg·kg-1, respectively. Meanwhile, the arithmetic mean value and geometric mean value of As in agricultural soils in the semi-karst region were 36.8 mg·kg-1 and 30.1 mg·kg-1, respectively. The As content in agricultural soils from these two regions was significantly higher than the background values of As in Guizhou. In addition, the standard exceedance rates of As in those two regions were 98.5% and 96.7%, respectively, thus demonstrating a high degree of As accumulation. In contrast, the standard exceedance rate of As in the non-karst region was only 6.7%. Among these three afore-mentioned landform types, the results of independent sample T tests showed that there were no significant differences in the content of As between agricultural soil and (natural) soil (P>0.05). The Moran's I coefficient of the As content in agricultural soil was 0.45, and the Z value was 11.61, thus suggesting that there was a significant positive spatial autocorrelation at the small scale (P<0.05), especially in the northeast-southwest direction, and the structural variation was dominant. The As polluted agricultural soils were generally at the slight pollution and mild pollution levels, which accounted for 27.10% and 29.02% of the samples, respectively. However, some regions were at the level of moderate pollution. The non-polluted samples accounted for 41.94% of the samples.

[Cd Accumulation and Risk Assessment for Arable Soils in the Karst Region of Northern Luodian, Guizhou].

Background levels of cadmium (Cd) in carbonate rock areas of Guizhou Province are high. In order to understand the characteristics of Cd in arable soils in these karst areas, the soils in the northern county of Luodian were selected as the study object. By comparing soils in non-karst areas, the distribution characteristics of soil Cd were studied by combining geostatistical analysis and GIS, and the potential ecological risk index and health risk were used to evaluate the potential level of risk to adults and children. The results show that the arable soil Cd content in this karst area is significantly higher than that in non-karst areas (P<0.05), with a geometric mean of 1.33mg·kg-1 and 0.27 mg·kg-1, respectively. In comparison, the geometric mean of soil Cd content in forested land in the same areas is 1.57mg·kg-1 and 0.22 mg·kg-1, respectively. Based on "soil pollution risk control standards", the Cd content of 90% and 22% of arable soil samples was higher than the risk screening value and the risk control value for karst and non-karst areas, respectively. The areas with medium and high Cd values were mainly distributed in the karst areas, presenting medium to strong ecological risks and extremely strong ecological risks, respectively. In contrast, the areas with the lowest Cd concentrations were distributed in the non-karst areas of Jiaoyan, presenting low potential ecological risk. The health risk assessment showed that the non-carcinogenic risk and carcinogenic risk of the three exposure pathways for adults and children in the karst areas are significantly higher than those in the non-karst areas, but the Cd content in the soil does not present non-carcinogenic and carcinogenic risks to local residents. Overall, the problem of Cd pollution in arable soils in the karst area of northern Luodian, Guizhou, is prominent. Therefore, the study of the risks posed by Cd pollution to the soil-plant-human system should be strengthened, and appropriate measures should be taken to prevent and control Cd pollution in the areas at risk.

Survey of Chinese persons managing depressive symptoms: Help-seeking behaviours and their influencing factors.

OBJECTIVES: To explore help-seeking behaviours of Chinese persons managing depressive symptoms and factors that influence these behaviours. METHODS: A survey of residents living in communities in Wuhan, China was conducted using stratified random sampling. The Patient Health Questionnaire (PHQ-2), the Actual Help-Seeking Questionnaire (AHSQ) and a socio-demographic questionnaire were completed by participants. Descriptive statistics were analyzed. A multiple linear regression model was used to explore factors associated with help-seeking behaviours. RESULTS: Of the 1785 respondents, 672 (37.6%) reported that they experienced depressive symptoms during the past year, and of these respondents, 517 (76.9%) indicated that they sought assistance. Among help-seeking sources utilized by participants, informal help was sought most frequently (72.9%), followed by hotline/Internet assistance (14.3%), mental health professionals (MHPs) (7.9%) and general physicians (GPs) (3.7%). The results of multilinear regression analysis showed that participants who were adults (aged 25-64 years), attended junior and high school (7-12 years education), and lived in urban areas were more likely to seek additional assistance for their depressive symptoms. CONCLUSION: Mental health promotion and education efforts are needed to improve the public's mental health literacy and to promote appropriate utilization of informal sources of assistance in managing depressive symptoms such as a hotline or the Internet. Further interventions need to be considered to reinforce use of social supports and mental health professionals, especially in rural areas.

Loneliness in Chinese older adults in primary care: prevalence and correlates.

BACKGROUND: Loneliness is a significant public health concern among older adults (OA) given its association with a wide range of adverse health outcomes. Primary care is an opportune setting to manage loneliness. However, the epidemiology of loneliness in Chinese OA treated in primary care remains unclear. The present study investigated the prevalence and correlates of loneliness in OA treated in Chinese primary care. METHODS: A total of 744 OA patients (65+ years) were consecutively recruited from 13 primary care clinics in Wuhan, China, and interviewed with a standardized questionnaire, concerning sociodemographic characteristics, lifestyle, relationships with family and others, physical health, and sensory impairments. Consistent with prior research on the construct, loneliness was measured with a single-item self-report question. Logistic regression was used to identify correlates of loneliness. RESULTS: Of primary care OA patients, 26.2% endorsed loneliness. Factors significantly and independently associated with loneliness included 75+ age group (odds ratio [OR]: 1.61, 95% confidence interval [CI]: 1.07, 2.44, P: 0.023), being illiterate (OR: 2.07, 95%CI: 1.26, 3.42, P: 0.004), unmarried (OR: 2.30, 95%CI: 1.40, 3.78, P: 0.001), living alone (OR: 4.37, 95%CI: 2.27, 8.41, P < 0.001), having fair and poor family (OR: 2.44, 95%CI: 1.48, 4.00, P < 0.001) and non-family relationships (OR: 1.75, 95%CI: 1.10, 2.78, P: 0.019), and ≥2 chronic medical conditions (OR: 2.91, 95%CI: 1.22, 6.95, P: 0.016). CONCLUSIONS: Loneliness is common in Chinese primary care OA. The high prevalence and many negative health consequences of loneliness for OA highlight the importance of routine screening, assessment, and interventions to reduce loneliness in the primary health-care setting.

Safety Culture and Mortality after Acute Myocardial Infarction: A Study of Medicare Beneficiaries at 171 Hospitals.

OBJECTIVES: To investigate the association between hospital safety culture and 30-day risk-adjusted mortality for Medicare patients with acute myocardial infarction (AMI) in a large, diverse hospital cohort. SUBJECTS: The final analytic cohort consisted of 19,357 Medicare AMI discharges (MedPAR data) linked to 257 AHRQ Hospital Survey on Patient Safety Culture surveys from 171 hospitals between 2008 and 2013. STUDY DESIGN: Observational, cross-sectional study using hierarchical logistic models to estimate the association between hospital safety scores and 30-day risk-adjusted patient mortality. Odds ratios of 30-day, all-cause mortality, adjusting for patient covariates, hospital characteristics (size and teaching status), and several different types of safety culture scores (composite, average, and overall) were determined. PRINCIPAL FINDINGS: No significant association was found between any measure of hospital safety culture and adjusted AMI mortality. CONCLUSIONS: In a large cross-sectional study from a diverse hospital cohort, AHRQ safety culture scores were not associated with AMI mortality. Our study adds to a growing body of investigations that have failed to conclusively demonstrate a safety culture-outcome association in health care, at least with widely used national survey instruments.

Intelligent identification of multi-level nanopore signatures for accurate detection of cancer biomarkers.

To achieve accurate detection of cancer biomarkers with nanopore sensors, the precise recognition of multi-level current blockage events (signature) is a pivotal problem. However, it remains rather a challenge to identify the multi-level current blockages of target biomarkers in nanopore experiments, especially for the nanopore analysis of serum samples. In this work, we combined a modified DBSCAN (Density-Based Spatial Clustering of Applications with Noise) algorithm with the Viterbi training algorithm of the hidden Markov model (HMM) to achieve intelligent retrieval of multi-level current signatures from microRNA in serum samples. The results showed that the developed intelligent data analysis method is highly efficient for processing the large-scale nanopore data, which facilitates future application of nanopores to the clinical detection of cancer biomarkers.

Hospital teaching intensity and mortality for acute myocardial infarction, heart failure, and pneumonia.

BACKGROUND: Under the Affordable Care Act, health care reimbursement will increasingly be linked to quality and costs. In this environment, teaching hospitals will be closely scrutinized, as their care is often more expensive. Furthermore, although they serve vital roles in education, research, management of complex diseases, and care of vulnerable populations, debate continues as to whether teaching hospitals deliver better outcomes for common conditions. OBJECTIVE: To determine the association between risk-standardized mortality and teaching intensity for 3 common conditions. RESEARCH DESIGN: Using CMS models, 30-day risk-standardized mortality rates were compared among US hospitals classified as Council of Teaching Hospital (COTH) members, non-COTH teaching hospitals, or nonteaching hospitals. These analyses were repeated using ratios of interns and residents to beds to classify teaching intensity. SUBJECTS: The study cohort included Medicare fee-for-service beneficiaries aged 66 years or older hospitalized in acute care hospitals during 2009-2010 for acute myocardial infarction (N = 342,145), heart failure (N = 647,081), or pneumonia (N = 598,366). OUTCOME MEASURE: The 30-day risk-standardized mortality rates for each condition, stratified by teaching intensity. RESULTS: For each diagnosis, compared with nonteaching hospitals there was a 10% relative reduction in the adjusted odds of mortality for patients admitted to COTH hospitals and a 6%-7% relative reduction for patients admitted to non-COTH teaching hospitals. These findings were insensitive to the method of classifying teaching intensity and only partially explained by higher teaching hospital volumes. CONCLUSIONS: Health care reimbursement strategies designed to increase value should consider not only the costs but also the superior clinical outcomes at teaching hospitals for certain common conditions.

Comparing teaching versus nonteaching hospitals: the association of patient characteristics with teaching intensity for three common medical conditions.

PURPOSE: To quantify the role of teaching hospitals in direct patient care, the authors compared characteristics of patients served by hospitals of varying teaching intensity. METHOD: The authors studied Medicare beneficiaries ≥ 66 years old, hospitalized in 2009-2010 for acute myocardial infarction, heart failure, or pneumonia. They categorized hospitals as nonteaching, teaching, or Council of Teaching Hospitals and Health Systems (COTH) members and performed secondary analyses using intern and resident-to-bed ratios. The authors used descriptive statistics, adjusted odds ratios, and linear propensity scores to compare patient characteristics among teaching intensity levels. They supplemented Medicare mortality model variables with race, transfer status, and distance traveled. RESULTS: Adjusted for comorbidities, black patients had 2.44 (95% confidence interval [CI] 2.36-2.52), 2.56 (95% CI 2.51-2.60), and 2.58 (95% CI 2.51-2.65) times the odds of COTH hospital admission compared with white patients for acute myocardial infarction, heart failure, and pneumonia, respectively. For patients transferred from another hospital's inpatient setting, the corresponding adjusted odds ratios of COTH hospital admission were 3.99 (95% CI 3.85-4.13), 4.60 (95% CI 4.34-4.88), and 4.62 (95% CI 4.16-5.12). Using national data, distributions of propensity scores (probability of admission to a COTH hospital) varied markedly among teaching intensity levels. Data from Massachusetts and California illustrated between-state heterogeneity in COTH utilization. CONCLUSIONS: Major teaching hospitals are significantly more likely to provide care for minorities and patients requiring transfer from other institutions for advanced care.Both are essential to an equitable and high-quality regional health care system.

[Study on quality assessment of Polygalae Radix based on HPLC-DAD fingerprint].

OBJECTIVE: To establish an HPLC fingerprint to evaluate the quality of Polygalae Radix, root xylem, and those collected in different growth ages or harvest time. METHOD: Separation was performed at 30 °C on a Kromasil C18 column (4.6 mm x 250 mm, 5 µm); the mobile phases was acetonitrile and 0.05% H3PO4 water in the gradient elution; the flow rate was set at 1.0 mL · min(-1) and the detection wavelength at 314 nm; the quality discriminant analyses were accomplished by means of similarity analysis, cluster analysis, principal component analysis and neural network model. RESULT: In 26 batches of Polygalae Radix, 24 batches fingerprint similarities were above 0.8. In 5 different growth or harvest time batches, 4 batches were above 0.8; in 8 batches root xylem samples, the similarities were all above 0.875. The similarity analysis was in accord with the quality discriminant analysis of cluster analysis, principal component analysis and neural network model. CONCLUSION: Fingerprint combined with chemical pattern recognition technique can effectively evaluate the quality of Polygalae Radix. The active substance species are all similar in cultivated, wild, different growth or harvest time Polygalae Radix and polygala root xylem, but the chromatography peak areas are different. The effective material contents are similar between wild and cultivated Polygalae Radix, but each chromatographic peak area of the root xylem is much smaller than that of Polygalae Radix. The chemical substance accumulation mainly depends on harvest month, but little growth time in Polygalae Radix.

[Quantitative risk assessment of Listeria monocytogenes in bulk cooked meat products].

OBJECTIVE: To conduct a quantitative risk assessment for Listeria monocytogenes in bulk cooked meat products in China. METHODS: The data on the contamination level of Listeria monocytogenes in cooked meat products was from national foodborne disease surveillance network, involving a total of 841 samples. All the samples were detected by a qualitative method and 97 samples among them were detected using a quantitative method. The intake data of cooked meats was from Chinese National Nutrition and Health Survey in 2002 and population data in the monitoring sites was collected from National Bureau of Statistics in 2008 to estimate the composition of the population of different ages, which would be the base of assessing the probability of listeriosis in the different subpopulations. Using @Risk software to estimate the risk of listeriosis caused by consuming deli meats for different subpopulation (0 - 4 years old, 5 - 64 years old and 65 years and older) by quantitative risk assessments which involved hazard identification, hazard characterization, exposure assessment and risk characterization and conduct sensitivity analysis. RESULTS: The contamination level of Listeria monocytogenes in the most of samples (96.08%, 808/841) was less than 3 MPN/g (0.5 lg MPN/g), and the average concentration of Listeria monocytogenes was -0.61 lg CFU/g (90%CI: -1.22 - 0.46 lg CFU/g). Estimated servings of cooked meat consumption for 0 - 4, 5 - 64 and 65 years and older were 5.52 × 10(9), 8.99 × 10(10), 1.01 × 10(10), respectively. Estimated number of cases (median) of listeriosis each year per million people caused by consuming cooked meats in young (0 - 4 years old), intermediate age (5 - 64 years old) and elderly (65 years and older) population were 5.53 × 10(-3), 1.72 × 10(-4), 7.57 × 10(-3), respectively. Results of sensitivity analysis showed that contamination level at retail, serving size of cooked meats, storage time at home, storage temperature and ERG at 5°C were positive factors for the risk of listeriosis (r value was 0.607, 0.408, 0.339, 0.259, 0.183 respectively, P < 0.05). CONCLUSION: Cooked meat products in bulk is a risk food, which could cause listeriosis. Contamination level of Listeria monocytogenes in cooked meat products in bulk is the top risk factor for the listeriosis.

Impact of the return to school on childhood asthma burden in New York State.

The public health impact of returning to school after vacations on children's asthma have not been well explored. In this study, we investigated the timing and magnitude of New York State asthma hospitalizations from 1991 to 2001. We used a generalized additive model to assess the risk associated with school return among children compared to adults and the elderly. Hospital admissions on the first day of school were compared to days following four school breaks. Exceedance admissions and both length and cost of hospital stay were estimated. A significant increase in hospital admissions for asthma (20% to 300%) was associated with school return after each break. The strongest associations were observed following summer vacation and for children age 5 to 11 years. Returning to school after vacations substantially increases the risk of hospital admissions for asthma in children, and this has considerable public health and economic impact.

[Exposure assessment of liver cancer attributed to dietary aflatoxins exposure in Chinese residents].

OBJECTIVE: To evaluate the risk of liver cancer attributed to dietary aflatoxins exposure in Chinese residents. METHODS: Mathematics model and "Margin of Exposure (MOE)" methods were employed in this study. The data used in mathematics model came from Joint FAO/WHO Expert Committee on Food Additives (JECFA) and the detection results of hepatitis B virus ( HBV) indicator in Chinese residents' blood sample in 2004. The data used in MOE model came from animal experiments, the fourth nutrition and health investigation among Chinese residents, and national inspection network for food contaminations. RESULTS: Mathematics model indicated that for those people who were exposed to aflatoxins at average level (665.43 ng/d), the liver cancer incidence rate resulting from aflatoxins exposure was 0.4033 per 100 thousand person years. For those people who were exposed to aflatoxins at a high level (97.5 percentile, 24 787.20 ng/d) the liver cancer incidence rate attributed to aflatoxins exposure was 15.0215 per 100 thousand person years. Results from the MOE method showed that for the people in whole country, urban and rural areas who were exposed to aflatoxins at average level (0.011 09, 0.008 13 and 0.012 49 microg x kg(-1) x d(-1) respectively), the MOE values for aflatoxins to cause liver cancer were 9017.1, 12 304.7 and 8006.4 respectively. For those people who were exposed to aflatoxins at a high level (97.5 percentile, 0.413 10, 0.289 30 and 0.489 50 microg x kg(-1) x d(-1) respectively), the MOE values for aflatoxins to cause liver cancer were 242.1, 345.7 and 204.3 for whole country, urban and rural areas, respectively. CONCLUSION: For the people whose dietary aflatoxins exposure at average level, the risk of liver cancer attributed to aflatoxins is middle. For the people whose dietary aflatoxins exposure at high level, this kind of risk should be high.

[Construction of recombinant fowlpox virus coexpressing HA gene from H5N1 avian influenza virus and chicken interleukin-2 gene and assessment of its protective efficacy].

The hemagglutinin (HA) gene from H5N1 avian influenza virus and the chicken interleukin 2 (chiIL-2) gene were inserted into a expressing vector p12LS to construct a recombinant transferring vector p12LSH5AIL2, in which HA gene under the control of the promoter Ps was in inverse tandem connection with the chiIL-2 gene under the control of the promoter PE/L. The p12LSH5AIL2 was then used to transfect the chicken embryo fibroblasts (CEF) pre-infected with a wild-type fowlpox virus 282E4 strain, to generate a recombinant fowlpox virus coexpressing the inserted HA and chiIL2 genes (rFPV-H5AIL2). The rFPV-H5AIL2 was obtained and purified by blue plaque screening on the CEF. The in vitro expression of HA gene by rFPV-H5AIL2 was detected in the recombinant fowlpox virus-infected CEFs with an indirect immunofluorescence assay, and the expression of the chiIL2 gene by rFPV-H5AIL2 was confirmed by detection of the chiIL2 mRNA by RT-PCR and by detection of chiIL2 by the indirect immunofluorescence assay. Experiments on SPF and commercial chickens demonstrated that the titer for HI antibodies induced by the rFPV-H5AIL2 was significantly higher than that by the rFPV-HA. The group immunized with the rFPV-H5AIL2 exhibited the similar ratios of protective efficacy and virus shedding as the group immunized with the rFPV-HA in SPF chicken. However, in commercial chicken, the group immunized with the rFPV-H5AIL2 generated significantly higher protection against H5N1 avian influenza virus challenge and lower virus shedding than the group immunized with the rFPV-HA. This study paved the way for further development of a new AIV recombinant vaccine.