[Correlation analysis of newly diagnosed coal worker's pneumoconiosis and GDP in Hubei Province from 2006 to 2015].

Objective: To analysis the distribution characteristics of coal worker's pneumoconiosis in Hubei Province during 2006-2010 (the 11th Five-Year Plan period) and 2011-2015 (the 12th Five-Year Plan period) , and its correlation with the gross domestic product (GDP) of Hubei Province from 1986 to 2015. Methods: In September 2019, the data of newly diagnosed coal worker's pneumoconiosis reported in Occupational Disease and Occupational Health Information Monitoring System from 2006 to 2015 and the GDP data from 1986 to 2015 in Hubei Province were collected. The distribution characteristics of time, region, enterprise size, industry and economic type of coal-worker's pneumoconiosis and its correlation with GDP were analyzed. Results: In 2006-2015, 3807 new cases of coal worker's pneumoconiosis were reported in Hubei Province. The time distribution generally ascended as a wave trend. The number of new cases reached its peak in 2013 (722 cases) . GDP growth continued between 1986-1995, 1996-2005 and 2006-2015, especially in 2006-2015. New cases of coal worker's pneumoconiosis were mainly distributed in Huangshi city, Yichang city and Enshi prefecture, accounting for 82.40% (3137/3807) of the total cases. The proportion of new cases in Huangshi city was higher than that in Yichang city and Enshi prefecture (χ(2)=272.66, 243.19, P<0.05) . New cases were mainly distributed in coal mining industry (3103 cases, 81.51%) , small-sized and medium (1675 cases, 44.00%) , and private enterprises (1621 cases, 42.58%) . The rank correlation (r(s)) of coal worker's pneumoconiosis in 2006-2015 with GDP in1986-1995, 1996-2005 and 2006-2015 were 0.157, 0.144, 0.200, respectively, and there were no significant differences (P>0.05) . Conclusion: The coalworker's pneumoconiosis in Hubei Province are mostly distributed in small and medium-sized private enterprises, and the regional distribution is concentrated in Huangshi city, Yichang city and Enshi prefecture. The concentration of cases is closely related to the number and energy production of local coal mines. There is no correlation between the growth of GDP and the distribution of cases.

[Method of dietary nutritional status assessment and its application in cohort study of nutritional epidemiology].

Minimizing the burden on study subjects and assessing the general dietary nutritional status as accurately as possible are the basis of a nutritional epidemiological cohort study in the general population. While introducing the main dietary nutrition assessment methods, this paper manly describes the basic contents and principles for the development of food frequency questionnaire, and briefly illustrates the problems and solutions for the development of area specific food frequency questionnaires by taking the example of Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort study. Finally, discusses preliminarily the necessity and possibility of developing a national food frequency questionnaire.

Relative deprivation, social exclusion, and quality of life among Chinese internal migrants.

OBJECTIVES: Factors contributing to diminishing quality of life (QOL) of migrants have been examined, but little is known about the impact of relative deprivation. This study aimed to clarify the effects of relative deprivation on QOL and mediating effects of social exclusion among Chinese internal migrants. STUDY DESIGN: This is a secondary data analysis of a nationally representative survey. METHODS: We obtained data from 14,816 internal immigrants, aged 15-59 years, throughout China using the 2014 China Migrants Dynamic Survey (CMDS). We measured relative deprivation via a modified Yitzhaki Index, social exclusion using a four-point Likert scale, and QOL using the Kessler Psychological Distress Short Scale, the Satisfaction with Life Scale, and a subscale of the 36-item Short-Form Health Survey. Survey data of 15,996 local residents were also retrieved and analyzed to make possible comparisons between the local and migrant population. Furthermore, we used descriptive and statistical analyses with data from the CMDS to identify relative deprivation and social exclusion. RESULTS: The results show relative deprivation both directly and indirectly influences Chinese internal migrants' QOL. Specifically, compared with the local population, relative deprivation triggers serious social exclusion (ß = 0.008, P < 0.001), ultimately deteriorating QOL. Social exclusion partially mediated the total effects of relative deprivation on mental illness (ß = 0.004, P < 0.001), self-rated health (ß = -0.285, P < 0.001), and life satisfaction (ß = -0.020, P < 0.001) among Chinese internal migrants. CONCLUSION: Relative deprivation significantly impacts QOL by exacerbating mental illness, eroding self-rated health, and inhibiting life satisfaction. Relative deprivation is significantly directly associated with various indicators of QOL and indirectly affects QOL through social exclusion. In addition, our results demonstrate that the relative deprivation theoretical approach and the modified Yitzhaki Index are worthy of future investigation in studies of migrants' health.

Differential Markov random field analysis with an application to detecting differential microbial community networks.

Micro-organisms such as bacteria form complex ecological community networks that can be greatly influenced by diet and other environmental factors. Differential analysis of microbial community structures aims to elucidate systematic changes during an adaptive response to changes in environment. In this paper, we propose a flexible Markov random field model for microbial network structure and introduce a hypothesis testing framework for detecting differences between networks, also known as differential network analysis. Our global test for differential networks is particularly powerful against sparse alternatives. In addition, we develop a multiple testing procedure with false discovery rate control to identify the structure of the differential network. The proposed method is applied to data from a gut microbiome study on U.K. twins to evaluate how age affects the microbial community network.

[Evaluation of economic outcomes of "hepatitis B vaccine event reported by media" in China, 2013].

Objective: To edentify the increased cost, the decreased benefits and effectiveness of hepatitis B vaccine event reported by media in 2013 in China both in Chinese nationwide and in Shenzhen. Methods: The decision analytic-Markov models were constructed. The cohort born in 2013 in nationwide and in Shenzhen were respectively introduced to the models. The vaccination coverage and the rates of antibody to hepatitis B surface antigen were determined as major parameters. The average costs and benefits per case, the effectiveness which included the numbers of hepatitis B virus (HBV) infection and the patients with HBV-related diseases, the average quality-adjusted life years (QALYs) per case were calculated from the medical-care and societal perspectives. The benefit cost ratio (BCR), ratio of the total costs and the net QALYs were as indicators of cost-benefit and cost-effectiveness analysis, respictively. Results: In nationwide, the BCRs decreased from 9.10 and 8.58 to 2.48 and 2.43, respectively, because the average costs increased to 6 796.60 yuan (RMB) and 8 451.45 yuan, and average benefits decreased to 6 799.57 yuan and 8 484.41 yuan, respectively, from the medical-care and societal perspectives. In Shenzhen, the BCRs decreased from 16.21 and 14.51 to 3.11 and 3.04 with the average costs of 5 244.88 yuan and 8 937.64 yuan, and average benefits of 5 248.11 yuan and 8 977.27 yuan. Totally, the increase of 2.1314 million and 181 hundreds of the HBV infectors occurred for the event in nationwide and in Shenzhen, respectively. Of all the infectors increased the most, the numbers of acute and chronic hepatitis B were 1 904 hundreds and 807 hundreds in nationwide, 794 and 395 in Shenzhen, espectively. The decreases of average QALY per case were 0.119 8 in nationwide and 0.090 6 in Shenzhen. The costs per averted a QALY increased from 6 231.90 yuan to 22 883.51 yuan in nationwide, from 3 567.25 yuan to 1 8571.49 yuan in Shenzhen (for medical-care perspective), from 8 252.79 yuan and 6 807.45 yuan to 29 091.92 yuan and 32 553.60 yuan (for societal perspective). Conclusion: The hepatitis B vaccine event reported by media in 2013 in China caused the costs increased, both benefits and the economic values obviously decreased.

[Economic evaluation and prediction of hepatitis B immunization strategy in Shenzhen, China].

Objective: To verify the costs, benefit and effectiveness of hepatitis B immunoprophylaxis strategies in Shenzhen during 2006-2030. Methods: The markov model was constructed to reflect the reality of the newborn vaccination and prevention of mother to child transmission (PMTCT) strategy, the cost, benefit and effectiveness during 2006-2015 and 2016-2030 was evaluated and predicted by the model. The model was constructed with the basic parameters such as the positive rate of hepatitis B surface antibody, perinatal HBV infection rate, the screening rate and positive rate of HBsAg of pregnant women, the utility value of hepatitis B and the parameters of markov model. and the coverage rates, vaccination fee of hepatitis B and the expenditures of patients with HB-related diseases.The costs were calculated from the payer, medical-care and all society perspective. The effectiveness and benefits of the strategy were evaluated and predicted by the numbers of HBV infection and the patients with HBV-related diseases prevented, life years (LYs), quality adjusted life years (QALYs), the net benefits (NBs) and benefit cost ratio (BCRs). Results: From the payer, medical-care and all society perspectives, the costs for the strategy were 153 million Yuan, 5.51 billion Yuan and 10.92 billion Yuan, respectively from 2006 to 2030 of which the forecast costs for 2016-2030 were 120 million Yuan, 3.87 billion yuan and 7.81 billion yuan. During the year 2006-2030, the numbers of HBV infection and the HBV-related diseases was 2.48 million, more than 1.335 million LYs and 1.619 million QALYs should be obtained from the strategy implemented. From medical-care and all society perspectives, NBs should be 88.68 billion yuan and 150.13 billion yuan with the BCRs of 17.08 and 14.75, respectively. Particularly, the NBs value of 22.37 billion yuan and 37.98 billion yuan and the BCR value of 14.62 and 13.20 was calculated for the past period, but the future NBs of 66.31 billion yuan and 112.15 billion yuan and BCR of 18.12 and 15.36 in the year 2016-2030. The further benefits were increased evidently in the future. Conclusion: The hepatitis B immunization in Shenzhen has a high economic effectivenee and benefits, and it is worth to invest sustainably.

Risk assessment of dengue fever in Zhongshan, China: a time-series regression tree analysis.

Dengue fever (DF) is the most prevalent and rapidly spreading mosquito-borne disease globally. Control of DF is limited by barriers to vector control and integrated management approaches. This study aimed to explore the potential risk factors for autochthonous DF transmission and to estimate the threshold effects of high-order interactions among risk factors. A time-series regression tree model was applied to estimate the hierarchical relationship between reported autochthonous DF cases and the potential risk factors including the timeliness of DF surveillance systems (median time interval between symptom onset date and diagnosis date, MTIOD), mosquito density, imported cases and meteorological factors in Zhongshan, China from 2001 to 2013. We found that MTIOD was the most influential factor in autochthonous DF transmission. Monthly autochthonous DF incidence rate increased by 36·02-fold [relative risk (RR) 36·02, 95% confidence interval (CI) 25·26-46·78, compared to the average DF incidence rate during the study period] when the 2-month lagged moving average of MTIOD was >4·15 days and the 3-month lagged moving average of the mean Breteau Index (BI) was ⩾16·57. If the 2-month lagged moving average MTIOD was between 1·11 and 4·15 days and the monthly maximum diurnal temperature range at a lag of 1 month was <9·6 °C, the monthly mean autochthonous DF incidence rate increased by 14·67-fold (RR 14·67, 95% CI 8·84-20·51, compared to the average DF incidence rate during the study period). This study demonstrates that the timeliness of DF surveillance systems, mosquito density and diurnal temperature range play critical roles in the autochthonous DF transmission in Zhongshan. Better assessment and prediction of the risk of DF transmission is beneficial for establishing scientific strategies for DF early warning surveillance and control.

Is resectable hepatocellular carcinoma a contraindication to liver transplantation? A novel decision model based on "number of patients needed to transplant" as measure of transplant benefit.

BACKGROUND & AIMS: Number-needed-to-treat is used in assessing the effectiveness of a health-care intervention, and reports the number of patients who need to be treated to prevent one additional bad outcome. Although largely used in medical literature, there are no studies measuring the benefit of liver transplantation (LT) over hepatic resection (HR) for hepatocellular carcinoma (HCC) in terms of "Number of patients needed to transplant (NTT)." EXCLUSION CRITERIA: Child-Turcotte-Pugh (CTP) Classes B-C, very large (>10 cm) and multi-nodular (>2 nodules) tumours, macroscopic vascular invasion and extra-hepatic metastases. STUDY POPULATION: 1028 HCC cirrhotic patients from one Eastern (n=441) and two Western (n=587) surgical units. Patient survival observed after HR by proportional hazard regression model was compared to that predicted after LT by the Metroticket calculator. The benefit obtainable from LT compared to resection was analysed in relationship with number of nodules (modelled as ordinal variable: single vs. oligonodular), size of largest nodule (modelled as a continuous variable), presence of microscopic vascular invasion (MVI), and time horizon from surgery (5-year vs. 10-year). RESULTS: 330 patients were beyond the Milan criteria (32%) and 597 (58%) had MVI. The prevalence of MVI was 52% in patients within Milan criteria and 71% in those beyond (p<0.0001). In the 5-year transplant benefit analysis, nodule size and HCC number were positive predictors of transplant benefit, while MVI had a strong negative impact on NTT. Transplantation performed as an effective therapy (NTT <5) only in oligonodular HCC with largest diameter >3cm (beyond conventional LT criteria) when MVI was absent. The 10-year scenario increased drastically the transplant benefit in all subgroups of resectable patients, and LT became an effective therapy (NTT <5) for all patients without MVI whenever tumor extension and for oligonodular HCC with MVI within conventional LT criteria. CONCLUSIONS: Based on NTT analysis, the adopted time horizon (5-year vs. 10-year scenario) is the main factor influencing the benefit of LT in patients with resectable HCC and Child A cirrhosis.

Bone surface topology mapping and its role in trabecular bone quality assessment using scanning confocal ultrasound.

INTRODUCTION: Quantitative ultrasound (QUS) has been used to assess non-invasively bone quality, in which ultrasound velocity (UV) is a primary acoustic property. METHODS: While UV calculation requires the tissue thickness in the ultrasound path, a bone surface topology mapping (STM) method was developed in this study for enhancing the accuracy of the UV measurement. STM accuracy was verified by both aluminum and a QUS heel phantom, indicating that the STM can determine the phantom thickness within 0.02 mm thickness error and the aluminum calibration step within 0.1 mm thickness error. STM performance was further evaluated using 25 cadaveric human calcanei samples. RESULTS: The UV calculations using STM had a significant better correlation to bone mineral density (BMD) (r = 0.75, p < 0.05), volume fraction (r = 0.72, p < 0.05) and modulus (r = 0.69, p < 0.05) than the UV with fixed thickness. The later correlation coefficients were r = 0.64 for BMD, r = 0.65 for volume fraction, and r = 0.58 for modulus. The nBUA value determined using STM was also highly correlated to BMD (r(2) = 0.74) and modulus (r(2) = 0.62). This was comparable to the correlation result for BUA (BMD: r(2) = 0.76; Modulus: r(2) = 0.64). CONCLUSION: These results suggested that STM technique in scanning ultrasound is capable of determining calcaneus bone thickness and hence enhancing the accuracy of UV measurement.

Selenoprotein P concentration in plasma is an index of selenium status in selenium-deficient and selenium-supplemented Chinese subjects.

Selenoprotein P, a selenium-rich plasma protein, is an index of selenium status in rats. Antibodies against human selenoprotein P were raised to study the protein and to develop a radioimmunoassay for it. A single collection of plasma from a healthy person in the United States contained 1.84 mumol selenium/L and was defined as containing 1 Unit (U) selenoprotein P/L. Removal of selenoprotein P from the reference plasma by an antibody column indicated that 0.81 mumol selenium/L, or 44% of the plasma selenium, was present as selenoprotein P. Work by others had determined that glutathione peroxidase accounted for 12% of plasma selenium. Stored plasma samples from selenium-deficient (Dechang County) and selenium-supplemented (Mianning County) populations in China were assayed for selenoprotein P. Boys aged 8-12 y had selenoprotein P concentrations of 0.10 +/- 0.04 U/L (n = 22) in Dechang and 0.39 +/- 0.17 U/L (n = 17) in Mianning. Supplementation with 100 micrograms selenium as selenate per day for 14 d raised those levels to 0.51 +/- 0.13 U/L in Dechang and to 0.76 +/- 0.27 U/L in Mianning. Similar results were obtained in men, and plasma selenium concentrations correlated with selenoprotein P concentrations. A study comparing indices of selenium status was conducted in the two counties. Selenoprotein P concentration in Dechang subjects (n = 79) was 36% of that in Mianning subjects (n = 117). For plasma glutathione peroxidase activity the value was 54%; for plasma selenium, 47%; and for whole blood selenium, 64%. We conclude that selenoprotein P is the major selenoprotein in human plasma and that its concentration is an index of selenium nutritional status that appears to be as sensitive as other indices in common use.