Using the chronic obstructive pulmonary disease (COPD) medical records from January 1st to December 31st of 2013 and the Meteorological observation data, the air pollution data in the same time periods, generalized ad...Using the chronic obstructive pulmonary disease (COPD) medical records from January 1st to December 31st of 2013 and the Meteorological observation data, the air pollution data in the same time periods, generalized additive models were used to quantitatively analyze the relationship between COPD hospitalizations and temperature with controlling the confounding effects of time trend, meteorological factors and air pollution index (AQI). Results showed: variable temperature in 24 h (BT), 3d lagged minimum temperature (Tm3) and 5d lagged diurnal maximum temperature and minimum temperature range (Tc5) have different effects on COPD hospitalizations. When BT is between -4.4°C and -0.7°C, the relative risk (RR) increases to 1.0207 (95% CI: 1.0074 - 1.0342)with every 1°C increase in BT;when Tm3 is between -3.6°C and 3.2°C, the relative risk (RR) increases to 1.0118 (95% CI: 1.0015 - 1.0222)with every 1°C increase in Tm3, and when Tm3 is greater than 20.5°C, the relative risk (RR) increases to 1.0069 (95% CI: 1.0005 - 1.0133) with every 1°C increase in Tm3;when Tc5 is between 0.9°C and 8.6°C, if the Tc5 increases 1°C, the relative risk (RR) increases to 1.0125 (95% CI: 1.0066 - 1.0185. There are different effects for weather in different seasons on COPD hospitalizations: in autumn and winter, it is mainly of little BT and heavy air pollution weather;in spring, the large Tc5 weather is a main feature, and in summer, it’s mainly of high temperature and low pressure weather. The results help to provide some guidance on COPD forecasting services.展开更多
Objectives The purposes were to determine the relationship between silicosis among foundry workers and their cumulative exposure to silica dust, and to establish a regression model to predict the risk for developing s...Objectives The purposes were to determine the relationship between silicosis among foundry workers and their cumulative exposure to silica dust, and to establish a regression model to predict the risk for developing silicosis by a given length of employment and air concentrations of silica at worksites. Methods A 29-year cohort study was conducted, including all those employed for more than one year during January 1, 1980 to December 31, 1996 and all members of the cohort were followed-up to December 3 1, 2008. In total, 2 009 workers of an automobile foundry in Shiyan, Hubei province were recruited in the study, 1 300 at eight worksites including sand preparation, cast shakeout, and finishing, melting, moulding, core-making, overhead crane operation and pouring as exposed group, and the other 709 auxiliary workers at the same factory, such as electricians, inspectors, fitters, and so on, as control group. Person-years of observation were calculated by persons observed and years followed-up for each of them. Person-year incidence of silicosis and its relative risk （RR） or odds ratio （OR） and 95% confidence intervals （CI） among the workers were estimated, adjusted for relevant factors with logistic regression model using SPSS version 15.0 software. Results Totally, 2 009 workers were followed-up for 37 151 person-years and 48 cases of silicosis were found, with an overall incidence of 1.34 per thousand, 2.02 per thousand in exposed group, and 0.15 per thousand in control one. Risk of silicosis was significantly higher in the exposed group than that in the control one （RR=13.13, 95% CI 3.18-54.13）, higher in men than that in women （RR=13.92, 95% CI 1.92-100.93）. Risks of silicosis varied by job, highest in those exposed to cast shakeout and finishing （RR=28.14, 95% CI 6.43-123.11）, followed by those exposed to pouring （RR-22.23, 95% CI 5.01-98.55） in the foundry. Average length of employment at onset of silicosis was 25.94 years, and silicosis incidence increased with length of employment. Average age at onset of silicosis was 47.83 years old. The risk of silicosis in workers with pulmonary tuberculosis was 2.57 folds as those without it （P〈0.01）. Ten deaths were recorded in those with silicosis, with a case-fatality rate of 20.83 percent three of them died of lung cancer, three of liver cancer, two of ischemic heart disease, and two of other diseases as their immediate causes of death. Incidence of silicosis in foundry workers positively correlated with their cumulative silica exposure （OR-3.00, 95% CI 2.34-3.83）. Risks of silicosis increased by 4.38 folds with an increase of 1 mg/m^3-year of cumulative silica exposure, and by 3.79 folds with smoking, respectively, adjusted for alcohol drinking and age. Based on a logistic regression model fitted, incidence of silicosis is expected to be 44.6 per thousand for those with daily exposure to silica of 4.18 mg/m^3 in average for 30 years, and if incidence of silicosis is expected to be less than 1 per thousand, daily exposure to silica should be controlled below 0.2 mg/m^3 for those with 20 years of employment, or below 0.1 mg/m^3 for those with 30 or 40 years of silica exposure. Conclusions At present, foundry workers in China still face high risk of developing silicosis. For lowering occurrence of silicosis in exposed workers, it seems necessary that current occupational exposure limits for silica at worksites in China should be reexamined and silica dust control measures be strengthend.展开更多
Applied statisticians are often confronted with statistical inference problems dealing with situations in which there appear to be no data,or data of only limited usefulness.For example,when attempting to find a confi...Applied statisticians are often confronted with statistical inference problems dealing with situations in which there appear to be no data,or data of only limited usefulness.For example,when attempting to find a confidence interval for a binomial proportion,the sample may contain no successes.Such a scenario could be encountered when attempting to estimate the incidence of an extremely rare side effect associated with the administration of a newly developed drug.In this article,we use examples for our experiences working with scientific investigators and describe several scenarios in which there appeared to be no useful data,or data of only limited usefulness.We describe the methods we prefer for analyzing the data in these situations and illustrate their application using the actual data from the investigations we participated in.展开更多
Background: ELI-P-Complex is the most advanced diagnostic test designed to assess whether the female body is ready (or unready) for the normal pregnancy course and for giving birth to a healthy child. ELI-P-Complex en...Background: ELI-P-Complex is the most advanced diagnostic test designed to assess whether the female body is ready (or unready) for the normal pregnancy course and for giving birth to a healthy child. ELI-P-Complex enables the perceived abnormalities to be individually treated even prior to the pregnancy planning, thus minimizing the risk of gestational and delivery-related complications. This prospective study shows the effectiveness of ELI-P-Complex testing during preconception care in women with a history of adverse pregnancy outcomes (APO). Methods: The data were reviewed from 4519 women with a history of APO and who planned to get pregnant. Following randomization, subjects of Group A were tested with ELI-P-Complex and treated before the pregnancy based on the results obtained. Group B subjects were not examined using the ELI- P-Complex test and were prepared for pregnancy in accordance with the standard strategy of pre- conception care [1]. Results: In Group A, gestational complications (GC) were revealed in 20% of women compared to 88.7% of Group B subjects;the relative risk (RR) of GC was 11.67 (95% CI: 9.9851 to 13.6392;P < 0.0001). APO was reported in 12% of Group A subjects vs. 38.1% of Group B ones;RR of APO was 5.8908 (95% CI: 4.9365 to 7.0296;P < 0.0001). Absolutely healthy children were born from 88.1% of Group A subjects compared to 50.3% of Group B ones;RR was 7.9601 (95% CI: 6.6110 to 9.5845;P < 0.0001). The positive predictive value, sensitivity, and specificity of the test for GC were 93.82% (95% CI: 92.72% to 94.80%), 93.17% (95% CI: 92.03% to 94.20%), and 92.62% (95% CI: 91.31% to 93.78%), respectively. Conclusions: The use of ELI-P-Complex for examination and further preconception care in women with a history of APO considerably reduces GC, improves pregnancy outcomes, and increases chances of giving birth to a healthy child.展开更多
文摘Using the chronic obstructive pulmonary disease (COPD) medical records from January 1st to December 31st of 2013 and the Meteorological observation data, the air pollution data in the same time periods, generalized additive models were used to quantitatively analyze the relationship between COPD hospitalizations and temperature with controlling the confounding effects of time trend, meteorological factors and air pollution index (AQI). Results showed: variable temperature in 24 h (BT), 3d lagged minimum temperature (Tm3) and 5d lagged diurnal maximum temperature and minimum temperature range (Tc5) have different effects on COPD hospitalizations. When BT is between -4.4°C and -0.7°C, the relative risk (RR) increases to 1.0207 (95% CI: 1.0074 - 1.0342)with every 1°C increase in BT;when Tm3 is between -3.6°C and 3.2°C, the relative risk (RR) increases to 1.0118 (95% CI: 1.0015 - 1.0222)with every 1°C increase in Tm3, and when Tm3 is greater than 20.5°C, the relative risk (RR) increases to 1.0069 (95% CI: 1.0005 - 1.0133) with every 1°C increase in Tm3;when Tc5 is between 0.9°C and 8.6°C, if the Tc5 increases 1°C, the relative risk (RR) increases to 1.0125 (95% CI: 1.0066 - 1.0185. There are different effects for weather in different seasons on COPD hospitalizations: in autumn and winter, it is mainly of little BT and heavy air pollution weather;in spring, the large Tc5 weather is a main feature, and in summer, it’s mainly of high temperature and low pressure weather. The results help to provide some guidance on COPD forecasting services.
文摘Objectives The purposes were to determine the relationship between silicosis among foundry workers and their cumulative exposure to silica dust, and to establish a regression model to predict the risk for developing silicosis by a given length of employment and air concentrations of silica at worksites. Methods A 29-year cohort study was conducted, including all those employed for more than one year during January 1, 1980 to December 31, 1996 and all members of the cohort were followed-up to December 3 1, 2008. In total, 2 009 workers of an automobile foundry in Shiyan, Hubei province were recruited in the study, 1 300 at eight worksites including sand preparation, cast shakeout, and finishing, melting, moulding, core-making, overhead crane operation and pouring as exposed group, and the other 709 auxiliary workers at the same factory, such as electricians, inspectors, fitters, and so on, as control group. Person-years of observation were calculated by persons observed and years followed-up for each of them. Person-year incidence of silicosis and its relative risk （RR） or odds ratio （OR） and 95% confidence intervals （CI） among the workers were estimated, adjusted for relevant factors with logistic regression model using SPSS version 15.0 software. Results Totally, 2 009 workers were followed-up for 37 151 person-years and 48 cases of silicosis were found, with an overall incidence of 1.34 per thousand, 2.02 per thousand in exposed group, and 0.15 per thousand in control one. Risk of silicosis was significantly higher in the exposed group than that in the control one （RR=13.13, 95% CI 3.18-54.13）, higher in men than that in women （RR=13.92, 95% CI 1.92-100.93）. Risks of silicosis varied by job, highest in those exposed to cast shakeout and finishing （RR=28.14, 95% CI 6.43-123.11）, followed by those exposed to pouring （RR-22.23, 95% CI 5.01-98.55） in the foundry. Average length of employment at onset of silicosis was 25.94 years, and silicosis incidence increased with length of employment. Average age at onset of silicosis was 47.83 years old. The risk of silicosis in workers with pulmonary tuberculosis was 2.57 folds as those without it （P〈0.01）. Ten deaths were recorded in those with silicosis, with a case-fatality rate of 20.83 percent three of them died of lung cancer, three of liver cancer, two of ischemic heart disease, and two of other diseases as their immediate causes of death. Incidence of silicosis in foundry workers positively correlated with their cumulative silica exposure （OR-3.00, 95% CI 2.34-3.83）. Risks of silicosis increased by 4.38 folds with an increase of 1 mg/m^3-year of cumulative silica exposure, and by 3.79 folds with smoking, respectively, adjusted for alcohol drinking and age. Based on a logistic regression model fitted, incidence of silicosis is expected to be 44.6 per thousand for those with daily exposure to silica of 4.18 mg/m^3 in average for 30 years, and if incidence of silicosis is expected to be less than 1 per thousand, daily exposure to silica should be controlled below 0.2 mg/m^3 for those with 20 years of employment, or below 0.1 mg/m^3 for those with 30 or 40 years of silica exposure. Conclusions At present, foundry workers in China still face high risk of developing silicosis. For lowering occurrence of silicosis in exposed workers, it seems necessary that current occupational exposure limits for silica at worksites in China should be reexamined and silica dust control measures be strengthend.
文摘Applied statisticians are often confronted with statistical inference problems dealing with situations in which there appear to be no data,or data of only limited usefulness.For example,when attempting to find a confidence interval for a binomial proportion,the sample may contain no successes.Such a scenario could be encountered when attempting to estimate the incidence of an extremely rare side effect associated with the administration of a newly developed drug.In this article,we use examples for our experiences working with scientific investigators and describe several scenarios in which there appeared to be no useful data,or data of only limited usefulness.We describe the methods we prefer for analyzing the data in these situations and illustrate their application using the actual data from the investigations we participated in.
文摘Background: ELI-P-Complex is the most advanced diagnostic test designed to assess whether the female body is ready (or unready) for the normal pregnancy course and for giving birth to a healthy child. ELI-P-Complex enables the perceived abnormalities to be individually treated even prior to the pregnancy planning, thus minimizing the risk of gestational and delivery-related complications. This prospective study shows the effectiveness of ELI-P-Complex testing during preconception care in women with a history of adverse pregnancy outcomes (APO). Methods: The data were reviewed from 4519 women with a history of APO and who planned to get pregnant. Following randomization, subjects of Group A were tested with ELI-P-Complex and treated before the pregnancy based on the results obtained. Group B subjects were not examined using the ELI- P-Complex test and were prepared for pregnancy in accordance with the standard strategy of pre- conception care [1]. Results: In Group A, gestational complications (GC) were revealed in 20% of women compared to 88.7% of Group B subjects;the relative risk (RR) of GC was 11.67 (95% CI: 9.9851 to 13.6392;P < 0.0001). APO was reported in 12% of Group A subjects vs. 38.1% of Group B ones;RR of APO was 5.8908 (95% CI: 4.9365 to 7.0296;P < 0.0001). Absolutely healthy children were born from 88.1% of Group A subjects compared to 50.3% of Group B ones;RR was 7.9601 (95% CI: 6.6110 to 9.5845;P < 0.0001). The positive predictive value, sensitivity, and specificity of the test for GC were 93.82% (95% CI: 92.72% to 94.80%), 93.17% (95% CI: 92.03% to 94.20%), and 92.62% (95% CI: 91.31% to 93.78%), respectively. Conclusions: The use of ELI-P-Complex for examination and further preconception care in women with a history of APO considerably reduces GC, improves pregnancy outcomes, and increases chances of giving birth to a healthy child.
