BACKGROUND The number of population-based studies on unclassified inflammatory bowel disease(IBD-U)is very limited.AIM To evaluate the long-term incidence,disease course and surgery rates of IBD-U in a prospective pop...BACKGROUND The number of population-based studies on unclassified inflammatory bowel disease(IBD-U)is very limited.AIM To evaluate the long-term incidence,disease course and surgery rates of IBD-U in a prospective population-based cohort.METHODSThe present study is a continuation of the well-established Veszprem IBD cohort with patient inclusion between1977 and 2018. Both in-hospital and outpatient records were collected. The source of age- and gender-specificdemographic data was derived from the Hungarian Central Statistical Office. Medical therapy, surgery and changein disease phenotype were analyzed.RESULTSData of 119 incident IBD-U patients were analyzed [male/female: 55/64;median age at diagnosis: 34 years(interquartile range: 24-47.5)]. Adjusted mean incidence rate was 0.76 (95%CI: 0.63-0.9)/105 person-years in the totalstudy period. Disease extent at diagnosis was extensive (pancolitis) in 56.3%. Twenty-two of 119 (18.5%) patientswere reclassified to Crohn’s disease during follow up, the probability of developing terminal ileum involvementwas 6.8%, while perianal disease developed in 5% (n = 6). The probability of receiving biological therapy in patientsdiagnosed after the year 2000 (n = 62), was 15.5% (SD: 4.8) at 5 years. The overall resective surgery rate was 16.8%.Segment resection was performed in 5.0% of the patients, and 11.8% underwent subtotal or total colectomy. Thecumulative probability of resective surgery was 7.6% (SD: 2.4) at 1 year, 9.3% (SD: 2.7) at 5 years, 13.5% (SD: 3.3) at10 years, and 18.5% (SD: 3.9) at 20 years.CONCLUSIONThese data extend our knowledge on the overall burden of IBD-U. Colonic involvement was extensive in a highproportion of IBD-U. Disease reclassification to Crohn’s disease was relatively high. High rates of biologicaltherapy and surgery rates support a relatively severe disease course of IBD-U.展开更多
Background:A milestone goal of the Healthy China Program(2019-2030)is to achieve 5-year cancer survival at 43.3%for all cancers combined by 2022.To assess the progress towards this target,we analyzed the updated survi...Background:A milestone goal of the Healthy China Program(2019-2030)is to achieve 5-year cancer survival at 43.3%for all cancers combined by 2022.To assess the progress towards this target,we analyzed the updated survival for all cancers combined and 25 specific cancer types in China from 2019 to 2021.Methods:We conducted standardized data collection and quality control for cancer registries across 32 provincial-level regions in China,and included 6,410,940 newly diagnosed cancer patients from 281 cancer registries during 2008-2019,with follow-up data on vital status available until December 2021.We estimated the age-standardized 5-year relative survival overall and by site,age group,and period of diagnosis using the International Cancer Survival Standard Weights,and quantified the survival changes to assess the progress in cancer control.Results:In 2019-2021,the age-standardized 5-year relative survival for all cancers combined was 43.7%(95%confidence interval[CI],43.6-43.7).The 5-year relative survival varied by cancer type,ranging from 8.5%(95%CI,8.2-8.7)for pancreatic cancer to 92.9%(95%CI,92.4-93.3)for thyroid cancer.Eight cancers had 5-year survival of over 60%,including cancers of the thyroid,breast,testis,bladder,prostate,kidney,uterus,and cervix.The 5-year relative survival was generally lower in males than in females.From 2008 to 2021,we observed significant survival improvements for cancers of the lung,prostate,bone,uterus,breast,cervix,nasopharynx,larynx,and bladder.The most significant improvement was in lung cancer.Conclusions:Progress in cancer control was evident in China.This highlights the importance of a comprehensive approach to control and prevent cancer.展开更多
Objective:Prostate cancer(PCa)patients might experience lower urinary tract symptoms as those diagnosed with benign prostatic hyperplasia(BPH).Some of them might be treated for their lower urinary tract symptoms inste...Objective:Prostate cancer(PCa)patients might experience lower urinary tract symptoms as those diagnosed with benign prostatic hyperplasia(BPH).Some of them might be treated for their lower urinary tract symptoms instead of PCa.We aimed to test the effect of PCa versus BPH on surgical outcomes after transurethral prostate surgery,namely complication and mortality rates.Methods:Within the American College of Surgeons National Surgical Quality Improvement Program database(2011-2016),we identified patients who underwent transurethral resection of the prostate,photoselective vaporization,or laser enucleation.Patients were stratified according to postoperative diagnosis(PCa vs.BPH).Univariable and multivariable logistic regression models evaluated the predictors of perioperative morbidity and mortality.A formal test of interaction between diagnosis and surgical technique used was performed.Results:Overall,34542 patients were included.Of all,2008(5.8%)had a diagnosis of PCa.The multivariable logistic regression model failed to show statistically significant higher rates of postoperative complications in PCa patients(odds ratio:0.9,95%confidence interval:0.7-1.1;p=0.252).Moreover,similar rates of perioperative mortality(p=0.255),major acute cardiovascular events(p=0.581),transfusions(p=0.933),and length of stay of more than or equal to 30 days(p=0.174)were found.Additionally,all tests failed to show an interaction between post-operative diagnosis and surgical technique used.Conclusion:Patients diagnosed with PCa do not experience higher perioperative morbidity or mortality after transurethral prostate surgery when compared to their BPH counterparts.Moreover,the diagnosis seems to not influence surgical technique outcomes.展开更多
Objective： Gastric cancer （GC） is one of the leading causes of death in China and other Asian countries. Recently, gastric endoscopy has become the main approach for GC screening, but the identification of high-ris...Objective： Gastric cancer （GC） is one of the leading causes of death in China and other Asian countries. Recently, gastric endoscopy has become the main approach for GC screening, but the identification of high-risk individuals remains a challenge in GC screening programs. Methods： There were 7,302 patients with chronic gastritis involved in this study. Endoscopic examinations were performed, and their demographic characteristics and lifestyle data were collected. Each possible associated factor of GC/premalignant and precursor lesions was evaluated by univariate and multivariate logistic regressions. Nomograms were used for visualization of those models, and receiver operating characteristic （ROC） curve analysis was used to present the predictive accuracy. Resu Its： We detected 8 （0.11% ） gastric adenocarcinomas, 17 （0.23 %） dysplasia cases, 14 （0.19%） hyperplasia cases, 52 （0.71%） intestinal metaplasia cases, 217 （2.97%） inflammatory lesions, 141 （1.93%） gastric ulcers, 10 （0.14%） atrophic gastritis cases, 1,365 （18.69%） erosive gastritis cases, and 5,957 （81.58%） superficial gastritis cases in 7,302 patients. The age （P〈0.001）, gender （P=0.086）, labor intensity （P=0.018） and leek food intake （P=0.143） were identified as independent predictive factors of GC/premalignant lesions possibility. The corresponding nomogram exhibited an area under the curve （AUC） [95% confidence interval （95% CI）] of 0.82 （0.74-0.89） for the modeling group and 0.80 （0.75-0.85） for the validation group. The age （P=0.002）, gender （P=0.024）, smoldng （P=0.002） and leek food intake （P=0.039） were independent predictive factors of precursor lesions possibility. The corresponding nomogram exhibited an AUC （95% CI） of 0.62 （0.60-0.65） for the modeling group and 0.61 （0.59-0.63） for the validation group. Conclusions： We identified several potential associated factors and provided a preclinical nomogram with the potential to predict the possibility of GC/premalignant and precursor lesions.展开更多
AIM To elucidate the prevalence and risk of mortality of nonalcoholic liver cirrhosis(LC) patients with coronary artery disease(CAD).METHODS The study cohort included newly diagnosed nonalcoholic LC patients age ≥ 40...AIM To elucidate the prevalence and risk of mortality of nonalcoholic liver cirrhosis(LC) patients with coronary artery disease(CAD).METHODS The study cohort included newly diagnosed nonalcoholic LC patients age ≥ 40 years old without a diagnosis of CAD from 2006 until 2011 from a longitudinal health insurance database. The mean follow-up period for the study cohort was 1152 ± 633 d. The control cohort was matched by sex, age, residence, and index date. Hazard ratios(HRs) were calculated using the Cox proportional hazard model and the Kaplan-Meier method. RESULTS After exclusion, a total of 3409 newly diagnosed nonalcoholic cirrhotic patients were identified from one million samples from the health insurance database. We found that CAD(5.1% vs 17.4%) and hyperlipidemia(20.6% vs 24.1%) were less prevalent in nonalcoholic LC patients than in normal subjects(all P < 0.001), whereas other comorbidities exhibited an increased prevalence. Among the comorbidities, chronic kidney disease exhibited the highest risk for mortality(adjusted HR(AHR) = 1.76; 95%CI: 1.55-2.00, P < 0.001). Ascites or peritonitis exhibited the highest risk of mortality among nonalcoholic cirrhotic patients(AHR = 2.34; 95%CI: 2.06-2.65, P < 0.001). Finally, a total of 170 patients developed CAD after a diagnosis of nonalcoholic LC. The AHR of CAD in nonalcoholic LC patients was 0.56(95%CI: 0.43-0.74, P < 0.001). The six-year survival rates for nonalcoholic LC patients with and without CAD were 52% and 50%, respectively(P = 0.012). CONCLUSION We conclude that CAD was less prevalent and associated with a reduced risk of mortality in nonalcoholic cirrhotic patients.展开更多
AIM： To assess the incidence of and risk factors for gallstone disease （GSD） among type 2 diabetics in Kinmen, Taiwan. METHODS： A screening program for GSD was performed by two specialists who employed real-time a...AIM： To assess the incidence of and risk factors for gallstone disease （GSD） among type 2 diabetics in Kinmen, Taiwan. METHODS： A screening program for GSD was performed by two specialists who employed real-time abdominal ultrasound to examine the abdominal region after patients had fasted for at least eight hours. Screening, which was conducted in 2001, involved 848 patients diagnosed with type 2 diabetes. After exclusion of 63 subjects with prevalent GSD, 377 participants without GSD were invited in 2002 for a second round of screening. A total of 281 （74.5%） subjects were re-examined. RESULTS： Among the 281 type 2 diabetics who had no GSD at the first screening, 10 had developed GSD by 2002. The incidence was 3.56% per year （95%CI： 1.78% per year-6.24% per year）. Using a Cox regression model, age （RR = 1.07, 95% CI： 1.00-1.14）, waist circumference （RR = 1.12, 95% CI： 1.01-1.29）, and ALT （RR = 1.13, 95%CI： 1.01-1.26） appeared to be significantly correlated with development of GSD. CONCLUSION： Older age is a known risk factor for the development of GSD. Our study shows that greater waist circumference and elevated ALT levels are also associated with the development of GSD among type 2 diabetics in Kinmen.展开更多
This review will describe the global patterns and trends of colorectal cancer survival,using data from the population-based studies or cancer registration.We performed a systematic search of China National Knowledge I...This review will describe the global patterns and trends of colorectal cancer survival,using data from the population-based studies or cancer registration.We performed a systematic search of China National Knowledge Infrastructure(CNKI),Wanfang Data,PubMed,Web of Science,EMBASE,and SEER and collected all population-based survival studies of colorectal cancer(up to June 2020).Estimates of observed and relative survival rates of colorectal cancer by sex,period,and country were extracted from original studies to describe the temporal patterns and trends from the late 1990s to the early 21st century.Globally,5-year observed survival rates were higher in Seoul,Republic of Korea(1993–1997;56.8%and 54.3%for colon and rectum cancers,respectively),Zhejiang province(2005–2010;52.9%for colon cancer),Tianjin(1991–1999;52.5%for colon cancer),Shanghai(2002–2006;50.0%for rectum cancer)of China,and in Japan(1993–1996,59.6%for colorectal cancer).Five-year relative survival rates of colorectal cancer in the Republic of Korea(2010–2014),Queensland,Australia(2005–2012),and the USA(2005–2009)ranked at relatively higher positions compared to other countries.In general,colorectal cancer survival rates are improving over time worldwide.Sex disparities in survival rates were also observed in the colon,rectum,and colorectal cancers in most countries or regions.The poorest age-specific 5-year relative survival rate was observed in patients>75 years of age.In conclusion,over the past 3 decades,colorectal cancer survival has gradually improved.Geographic variations,sex differences,and age gradients were also observed globally in colorectal cancer survival.Further studies are therefore warranted to investigate the prognostic factors of colorectal cancer.展开更多
Identification of carriers of fragile X syndrome(FXS) with the subsequent prenatal diagnosis and knowledge of FXS-associated genetic profiles are essential for intervention in specific populations. We report the resul...Identification of carriers of fragile X syndrome(FXS) with the subsequent prenatal diagnosis and knowledge of FXS-associated genetic profiles are essential for intervention in specific populations. We report the results of carrier screening of 39,458 East Asian adult women and prenatal diagnosis from 87 FXS carriers.The prevalence of FXS carriers and full mutation fetuses was estimated to be 1/581 and 1/3124 in East Asian populations, respectively. We confirmed the validity of the current threshold of CGG trinucleotide repeats for FMR1 categorization;the integral risks of full mutation expansion were approximately 6.0%,43.8%, and 100% for premutation alleles with 55—74, 75—89, and ≥ 90 CGG repeats, respectively. The protective effect of AGG(adenine-guanine-guanine nucleotides) interruption in East Asian populations was validated, which is important in protecting premutation alleles with 75—89 CGG repeats from full mutation expansion. Finally, family history was shown not an effective indicator for FXS carrier screening in East Asian populations, and population-based screening was more cost-effective. This study provides an insight into the largest carrier screening and prenatal diagnosis for FXS in East Asian populations to date. The FXSassociated genetic profiles of East Asian populations are delineated, and population-based carrier screening is shown to be promising for FXS intervention.展开更多
In this paper, we explore a novel ensemble method for spectral clustering. In contrast to the traditional clustering ensemble methods that combine all the obtained clustering results, we propose the adaptive spectral ...In this paper, we explore a novel ensemble method for spectral clustering. In contrast to the traditional clustering ensemble methods that combine all the obtained clustering results, we propose the adaptive spectral clustering ensemble method to achieve a better clustering solution. This method can adaptively assess the number of the component members, which is not owned by many other algorithms. The component clusterings of the ensemble system are generated by spectral clustering （SC） which bears some good characteristics to engender the diverse committees. The selection process works by evaluating the generated component spectral clustering through resampling technique and population-based incremental learning algorithm （PBIL）. Experimental results on UCI datasets demonstrate that the proposed algorithm can achieve better results compared with traditional clustering ensemble methods, especially when the number of component clusterings is large.展开更多
AIM: To examine an increased risk of esophageal adenocarcinoma is restricted to patients who develop Barrett's esophagus or whether esophagitis per se is a risk factor for adenocarcinoma.METHODS: A population-base...AIM: To examine an increased risk of esophageal adenocarcinoma is restricted to patients who develop Barrett's esophagus or whether esophagitis per se is a risk factor for adenocarcinoma.METHODS: A population-based cohort of patients with histological evidence of esophagitis without Barrett's esophagus was constructed using electronic pathology reports relating to all esophageal biopsies in Northern Ireland between 1993 and 1996. Person-years of followup and incident cases of esophageal cancer were calculated by linking the cohort to death files and the Northern Ireland Cancer Registry records. Standardized incidence ratios (SIR) were calculated for esophageal cancers (adenocarcinoma, squamous cell carcinoma (SCC), and histologically unspecified cancers).RESULTS: A total of 2 013 patients in the cohort provided 13 559 patient-years of follow-up (mean follow-up 6.7 years). None of the patients developed adenocarcinoma. Three patients developed SCC, and six developed histologically unspecified cancers. The SIR for all esophageal cancers and for SCC were 2.73 (95%CI 1.25-5.19) and 2.93 (95%CI 0.61-8.59), respectively. In a sensitivity analysis in which all unspecified esophageal cancers were treated as adenocarcinomas, the SIR for adenocarcinoma was 2.64 (0.97-5.75).CONCLUSION: The risk of adenocarcinoma is not elevated in patients with histological evidence of esophagitis without Barrett's esophagus; however, these patients may have a moderately increased risk of SCC.Further studies are required to confirm these findings,which suggest that Barrett's esophagus, not esophagitis,is the key precursor lesion in the development of adenocarcinoma.展开更多
AIM: To analyze the prevalence, length and predictors of hospitalization in the biological era in the populationbased inception cohort from Veszprem province.METHODS: Data of 331 incident Crohn's disease(CD) patie...AIM: To analyze the prevalence, length and predictors of hospitalization in the biological era in the populationbased inception cohort from Veszprem province.METHODS: Data of 331 incident Crohn's disease(CD) patients diagnosed between January 1, 2000 and December 31, 2010 were analyzed(median age at diagnosis: 28; IQR: 21-40 years). Both in- and outpatient records were collected and comprehensively reviewed.RESULTS: Probabilities of first CD-related hospitalization and re-hospitalization were 32.3%, 45.5%,53.7% and 13.6%, 23.9%, 29.8%, respectively after one, three and five years of follow-up in Kaplan-Meier analysis. First-year hospitalizations were related to diagnostic procedures(37%), surgery or disease activity(27% and 21%). Non-inflammatory disease behavior at diagnosis(HR = 1.32, P = 0.001) and perianal disease(HR = 1.47, P = 0.04) were associated with time to first CD-related hospitalization, while disease behavior change(HR = 2.38, P = 0.002) and need for steroids(HR = 3.14, P = 0.003) were associated with time to first re-hospitalization in multivariate analyses.Early CD-related hospitalization(within the year of diagnosis) was independently associated with need for immunosuppressives(OR = 2.08, P = 0.001) and need for surgeries(OR = 7.25, P < 0.001) during the disease course.CONCLUSION: Hospitalization and re-hospitalization rates are still high in this cohort, especially during the first-year after the diagnosis. Non-inflammatory disease behavior at diagnosis was identified as the pivotal predictive factor of both hospitalization and rehospitalization.展开更多
This prospective study was designed to examine the combined influence of insulin resistance（IR）and inflammatory biomarker levels on type 2 diabetes mellitus（T2DM）among 1,903Inner Mongolians.
The purpose of this study is to explore whether it is worthwhile to launch a routine diabetic retinopathy (DR) screening for blindness pre-vention among Chinese type 2 diabetes from different perspective based on the ...The purpose of this study is to explore whether it is worthwhile to launch a routine diabetic retinopathy (DR) screening for blindness pre-vention among Chinese type 2 diabetes from different perspective based on the popula-tion-based study in Kinmen, Taiwan. A total of 971 community dwelling adults previously di-agnosed with type 2 diabetes in 1991-1993 un-derwent DR screening in 1999-2002 by a panel of ophthalmologists using on-site indirect oph-thalmoscopy and 45-degree color fundus retinal photographs. The cost-benefit analysis is used to evaluate the DR screening. In terms of bene-fit-cost ratio, the different screening programs for DR could save New Taiwan Dollars (NTD) from 14.38 to 36.83 in discounted costs for each dollar incurred in different screening years from the societal viewpoint for Taiwan and save NTD from 0.81 to 1.80 in different screening years from health care payer’s perspective. The av-erage estimate of willingness-to-pay to translate into benefit yields NTD from 937.8 to 4,689 be- nefits per case due to DR screening in different screening years during 10-year follow-up. The net present value of the DR screening were NTD from -167,318 to -307,251.2 in different screening years. In conclusion, it is worthwhile to initial a routine DR screening of Chinese type 2 diabetes for blindness prevention from the societal per-spective but not from consumer decision based on the willingness-to-pay perspective.展开更多
At present,most total knee replacement(TKR)prostheses on the market are designed according to the sizes of Caucasians.However,extensive studies have indicated that human anatomies differ among different ethnicities.A ...At present,most total knee replacement(TKR)prostheses on the market are designed according to the sizes of Caucasians.However,extensive studies have indicated that human anatomies differ among different ethnicities.A number of reports have indicated that Chinese TKR patients do not match with available prostheses.In this study,computed tomography(CT)images of 52 knees of Chinese men and women were used for anthropometric measurements.Index and geometric measurements were definedand used for correlation analysis.Key parameters from the measurement results were identified.Detailed geometries of knees were measured as coordinates.A deformable three-dimensional(3D)knee modelbased on anatomical coordinates correlating with the identified key parameters was generated.A pros-thesis was then designed according to the analyzed results.Surface matching analysis,bone resectionanalysis,and cadaveric trials were conducted and compared with commercial products to validate theproposed design.The femoral component designed by this study resulted in the highest accuracy(rootmean square point-to-surface(RMS PS),(1.08±0.20)mm)and lowest amount of resected bone volume(27412mm^(3))in comparison with two commercial knee prostheses.This study suggests a new approachfor population-based patient-specific femoral prosthesis design With a single,easilty acquired dimen-sion-namely,epicondyle width(ECW)-as input,a patient-specific femoral prosthesis can be designed according to the analyzed measured data and manufactured by additive manufacturing(AM)methods.Meanwhile,the reconstructed femoral condylar surface was compared with the femoral condylar surfacein the original CT scanning data The average RMS PS distance of the reconstructed femoral condylar surface among all data was(1.10±0.18)mm,which is comparable to other statistical shape modeling methods using multiple radiographs as input data.There is a need to develop an anthropometric-based knee prosthesis for the Chinese population.Based on the anthropometry of the Chinese population,our new design fits Chinese patients better and reserves more bone volume compared with current commercial prostheses,which is an essential step toward AM for personalized knee prostheses.展开更多
Objective: To investigate the uptake rate of prostate specific antigen(PSA) testing among Hong Kong Chinese males aged 50 or above, and identify factors associated with the likelihood of undergoing a PSA test.Methods:...Objective: To investigate the uptake rate of prostate specific antigen(PSA) testing among Hong Kong Chinese males aged 50 or above, and identify factors associated with the likelihood of undergoing a PSA test.Methods: A population-based telephone survey was conducted in Hong Kong in 2007. The survey covered demographic information, perceived health status, use of complementary therapy, cancer screening behavior, perceived susceptibility to cancer and family history of cancer. Descriptive statistics, percentages and logistic regression analysis were used for data analysis.Results: A total of 1,002 men aged 50 or above took part in the study(response rate =67%), and the uptake rate of PSA testing was found to be 10%. Employment status, use of complementary therapy, perceiving regular visits to a doctor as good for health and the recommendations of health professionals were significant factors associated with PSA testing.Conclusion: The uptake rate of PSA testing in the study population was very low. Among all the factors identified, recommendations from health professionals had the strongest association with the uptake of PSA testing, and they should therefore take an active role in educating this population about cancer prevention and detection.展开更多
AIM： To describe an Internet-based data acquisition facility for a European 10-year clinical follow-up study project of a population-based cohort of inflammatory bowel disease （IBD） patients and to investigate the ...AIM： To describe an Internet-based data acquisition facility for a European 10-year clinical follow-up study project of a population-based cohort of inflammatory bowel disease （IBD） patients and to investigate the influence of demographic and disease related patient characteristics on response rates. METHODS： Thirteen years ago, the European Collaborative study group of IBD （EC-IBD） initiated a population-based prospective inception cohort of 2 201 uniformly diagnosed IBD patients within 20 well- described geographical areas in 11 European countries and Israel. For the 10-year follow-up of this cohort, an electronic patient questionnaire （ePQ） and electronic physician per patient follow-up form （ePpPFU） were designed as two separate data collecting instruments and made available through an Internet-based website. Independent demographic and clinical determinants of ePQ participation were analyzed using multivariate logistic regression.total number of 1 505 （64%） available IBD patients, originating from 13 participating centers from nine different countries, both ePQ and ePpPFU were completed. Patients older than 40 years at ePQ completion （OR： 1.53 （95% CI： 1.14-2.05）） and those with active disease during the 3 mo previous to ePQ completion （OR： 3.32 （95%CI： 1.57-7.03）） were significantly more likely to respond. CONCLUSION： An Internet-based data acquisition tool appeared successful in sustaining a unique Western- European and Israelian multi-center 10-year clinical follow-up study project in patients afflicted with IBD.展开更多
Background:Regular physical activity(PA) is an important behavior in improving sleep health.However,the short-term effects of PA on sleep are still controversial.This study aimed to verify the effect of different inte...Background:Regular physical activity(PA) is an important behavior in improving sleep health.However,the short-term effects of PA on sleep are still controversial.This study aimed to verify the effect of different intensities of PA practiced in different periods of the day on the subsequent sleep night in a population-based cohort of young adults.Methods::Prospective analyses were conducted for PA performed during the day and its effect on the following sleep night using data from the22-year follow-up of the 1993 Pelotas Birth Cohort in Brazil(mean age of participants-22.6 years).Wrist-worn accelerometry was usedto measure both PA and sleep parameters.Regarding intensity,we analyzed the sleep effect of light PA(LPA),moderate PA,and vigorous PA,stratified by sex.Sleep variables were sleep time window(STW;the difference between sleep onset and sleep end),total sleep time(TST;the sum of minutes classified as sleep in STW),and sleep percent(SP;SP=(TST/STW);expressed in percentage).We performed generalized estimating equations using Stata software.Results::The means of STW,TST,and SP were 443.6 min/day,371.1 min/day,and 84%,respectively.Time spent in moderate PA and vigorous PA in the morning and afternoon was not associated with sleep variables.Among men,10 min/day of morning LPA increased TST by2.56 min/day.Among women,10 min/day of morning LPA increased SP by 0.15 percentage points.Afternoon LPA also increased SP by 0.09 percentage points for women.Night PA seems to have an inverse effect on sleep variables for any intensity and both sexes.Conclusion::The effect of PA on sleep health is intrinsically related to the period of the day in which it is performed.The effect magnitude is different between sexes.For better sleep health,it is preferable that PA be performed during the day.展开更多
The use of the traditional American Joint Committee on Cancer(AJCC)staging system alone has limitations in predicting the survival of gingiva squamous cell carcinoma(GSCC)patients.We aimed to establish a comprehensive...The use of the traditional American Joint Committee on Cancer(AJCC)staging system alone has limitations in predicting the survival of gingiva squamous cell carcinoma(GSCC)patients.We aimed to establish a comprehensive prognostic nomogram with a prognostic value similar to the AJCC system.Methods:Patients were identified from SEER database.Variables were selected by a backward stepwise selection method in a Cox regression model.A nomogram was used to predict cancer-specific survival rates for 3,5 and 10 years in patients with GSCC.Several basic features of model validation were used to evaluate the performance of the survival model:consistency index(C-index),receiver operating characteristic(ROC)curve,calibration chart,net weight classification improvement(NRI),comprehensive discriminant improvement(IDI)and decision curve analysis(DCA).Results:Multivariate analyses revealed that age,race,marital status,insurance,AJCC stage,pathology grade and surgery were risk factors for survival.In particular,the C-index,the area under the ROC curve(AUC)and the calibration plots showed good performance of the nomogram.Compared to the AJCC system,NRI and IDI showed that the nomogram has improved performance.Finally,the nomogram's 3-year and 5-year and 10-year DCA curves yield net benefits higher than traditional AJCC,whether training set or a validation set.Conclusion:We developed and validated the first GSCC prognosis nomogram,which has a better prognostic value than the separate AJCC staging system.Overall,the nomogram of this study is a valuable tool for clinical practice to consult patients and understand their risk for the next 3,5 and 10 years.展开更多
BACKGROUND Gastric cancer remains a leading cause of cancer death worldwide.In Taiwan,gastric cancer is the sixth leading cause of cancer mortality in both males and females.AIM To evaluate secular trends in gastric c...BACKGROUND Gastric cancer remains a leading cause of cancer death worldwide.In Taiwan,gastric cancer is the sixth leading cause of cancer mortality in both males and females.AIM To evaluate secular trends in gastric cancer incidence according to age,sex,and Helicobacter pylori(H.pylori)treatment in Taiwan.METHODS In this population-based study,we used the national Taiwan Cancer Registry database.Annual percent changes in incidence rates were used to describe secular trends in incidence rates and sex ratios of gastric cancer in Taiwan.Pearson’s product-moment correlation coefficients were used to analyze the correlation between annual age-adjusted incidence rates and the annual number of patients treated with antibiotic therapy for H.pylori infection.RESULTS The annual percent changes showed continuously decreasing rates of gastric cancer among both males and females.However,the decreasing trends differed by sex,with an annual percent change of-2.58%in males and-2.14%in females.The age-specific incidence rates increased with age.Within the same age group,more recent time periods showed lower incidence rates than greater time periods.Similarly,the sex ratio was lower in later birth cohorts than in earlier birth cohorts.Age-adjusted incidence rates substantially decreased with increasing numbers of patients being treated with antibiotic therapy for H.pylori infection during 2005 to 2016(r=0.72).CONCLUSION We observed steadily decreasing trends with differential sex ratios in the incidence of gastric cancer in Taiwan.These results support H.pylori eradication programs in Taiwan.展开更多
There are few population-based data in investigating the impact of diabetes on chemotherapy adverse effects and treatment outcomes of non-metastatic breast cancer. The purpose of this study is to evaluate whether diab...There are few population-based data in investigating the impact of diabetes on chemotherapy adverse effects and treatment outcomes of non-metastatic breast cancer. The purpose of this study is to evaluate whether diabetes affects the patterns of use in chemotherapy, toxic effects of chemotherapy, and treatment outcomes for non-metastatic breast cancer in Taiwan. The study results can provide physicians for making a decision whether or not to use chemotherapy based on the individual patients＇ condition.展开更多
文摘BACKGROUND The number of population-based studies on unclassified inflammatory bowel disease(IBD-U)is very limited.AIM To evaluate the long-term incidence,disease course and surgery rates of IBD-U in a prospective population-based cohort.METHODSThe present study is a continuation of the well-established Veszprem IBD cohort with patient inclusion between1977 and 2018. Both in-hospital and outpatient records were collected. The source of age- and gender-specificdemographic data was derived from the Hungarian Central Statistical Office. Medical therapy, surgery and changein disease phenotype were analyzed.RESULTSData of 119 incident IBD-U patients were analyzed [male/female: 55/64;median age at diagnosis: 34 years(interquartile range: 24-47.5)]. Adjusted mean incidence rate was 0.76 (95%CI: 0.63-0.9)/105 person-years in the totalstudy period. Disease extent at diagnosis was extensive (pancolitis) in 56.3%. Twenty-two of 119 (18.5%) patientswere reclassified to Crohn’s disease during follow up, the probability of developing terminal ileum involvementwas 6.8%, while perianal disease developed in 5% (n = 6). The probability of receiving biological therapy in patientsdiagnosed after the year 2000 (n = 62), was 15.5% (SD: 4.8) at 5 years. The overall resective surgery rate was 16.8%.Segment resection was performed in 5.0% of the patients, and 11.8% underwent subtotal or total colectomy. Thecumulative probability of resective surgery was 7.6% (SD: 2.4) at 1 year, 9.3% (SD: 2.7) at 5 years, 13.5% (SD: 3.3) at10 years, and 18.5% (SD: 3.9) at 20 years.CONCLUSIONThese data extend our knowledge on the overall burden of IBD-U. Colonic involvement was extensive in a highproportion of IBD-U. Disease reclassification to Crohn’s disease was relatively high. High rates of biologicaltherapy and surgery rates support a relatively severe disease course of IBD-U.
基金supported by“National Key R&D Program of China”(grant numbers:2022YFC3600805,2020AAA0109500)the National Natural Science Foundation of China(grant number:82188102)+2 种基金the R&D Program of Beijing Municipal Education Commission(grant num-ber:KJZD20191002302)CAMS Initiative for Innovative Medicine(grant number:2021-1-I2M-012)Shenzhen High-level Hospital Con-struction Fund,Sanming Project of Medicine in Shenzhen(grant num-ber:SZSM202211011).
文摘Background:A milestone goal of the Healthy China Program(2019-2030)is to achieve 5-year cancer survival at 43.3%for all cancers combined by 2022.To assess the progress towards this target,we analyzed the updated survival for all cancers combined and 25 specific cancer types in China from 2019 to 2021.Methods:We conducted standardized data collection and quality control for cancer registries across 32 provincial-level regions in China,and included 6,410,940 newly diagnosed cancer patients from 281 cancer registries during 2008-2019,with follow-up data on vital status available until December 2021.We estimated the age-standardized 5-year relative survival overall and by site,age group,and period of diagnosis using the International Cancer Survival Standard Weights,and quantified the survival changes to assess the progress in cancer control.Results:In 2019-2021,the age-standardized 5-year relative survival for all cancers combined was 43.7%(95%confidence interval[CI],43.6-43.7).The 5-year relative survival varied by cancer type,ranging from 8.5%(95%CI,8.2-8.7)for pancreatic cancer to 92.9%(95%CI,92.4-93.3)for thyroid cancer.Eight cancers had 5-year survival of over 60%,including cancers of the thyroid,breast,testis,bladder,prostate,kidney,uterus,and cervix.The 5-year relative survival was generally lower in males than in females.From 2008 to 2021,we observed significant survival improvements for cancers of the lung,prostate,bone,uterus,breast,cervix,nasopharynx,larynx,and bladder.The most significant improvement was in lung cancer.Conclusions:Progress in cancer control was evident in China.This highlights the importance of a comprehensive approach to control and prevent cancer.
文摘Objective:Prostate cancer(PCa)patients might experience lower urinary tract symptoms as those diagnosed with benign prostatic hyperplasia(BPH).Some of them might be treated for their lower urinary tract symptoms instead of PCa.We aimed to test the effect of PCa versus BPH on surgical outcomes after transurethral prostate surgery,namely complication and mortality rates.Methods:Within the American College of Surgeons National Surgical Quality Improvement Program database(2011-2016),we identified patients who underwent transurethral resection of the prostate,photoselective vaporization,or laser enucleation.Patients were stratified according to postoperative diagnosis(PCa vs.BPH).Univariable and multivariable logistic regression models evaluated the predictors of perioperative morbidity and mortality.A formal test of interaction between diagnosis and surgical technique used was performed.Results:Overall,34542 patients were included.Of all,2008(5.8%)had a diagnosis of PCa.The multivariable logistic regression model failed to show statistically significant higher rates of postoperative complications in PCa patients(odds ratio:0.9,95%confidence interval:0.7-1.1;p=0.252).Moreover,similar rates of perioperative mortality(p=0.255),major acute cardiovascular events(p=0.581),transfusions(p=0.933),and length of stay of more than or equal to 30 days(p=0.174)were found.Additionally,all tests failed to show an interaction between post-operative diagnosis and surgical technique used.Conclusion:Patients diagnosed with PCa do not experience higher perioperative morbidity or mortality after transurethral prostate surgery when compared to their BPH counterparts.Moreover,the diagnosis seems to not influence surgical technique outcomes.
基金supported by the National Natural Science Foundation of China(Grant No.81302160 and 81272447)Beijing Natural Science Foundation ProgramScientific Research Key Program of Beijing Municipal Commission of Education(Grant No.KZ201410025024)
文摘Objective： Gastric cancer （GC） is one of the leading causes of death in China and other Asian countries. Recently, gastric endoscopy has become the main approach for GC screening, but the identification of high-risk individuals remains a challenge in GC screening programs. Methods： There were 7,302 patients with chronic gastritis involved in this study. Endoscopic examinations were performed, and their demographic characteristics and lifestyle data were collected. Each possible associated factor of GC/premalignant and precursor lesions was evaluated by univariate and multivariate logistic regressions. Nomograms were used for visualization of those models, and receiver operating characteristic （ROC） curve analysis was used to present the predictive accuracy. Resu Its： We detected 8 （0.11% ） gastric adenocarcinomas, 17 （0.23 %） dysplasia cases, 14 （0.19%） hyperplasia cases, 52 （0.71%） intestinal metaplasia cases, 217 （2.97%） inflammatory lesions, 141 （1.93%） gastric ulcers, 10 （0.14%） atrophic gastritis cases, 1,365 （18.69%） erosive gastritis cases, and 5,957 （81.58%） superficial gastritis cases in 7,302 patients. The age （P〈0.001）, gender （P=0.086）, labor intensity （P=0.018） and leek food intake （P=0.143） were identified as independent predictive factors of GC/premalignant lesions possibility. The corresponding nomogram exhibited an area under the curve （AUC） [95% confidence interval （95% CI）] of 0.82 （0.74-0.89） for the modeling group and 0.80 （0.75-0.85） for the validation group. The age （P=0.002）, gender （P=0.024）, smoldng （P=0.002） and leek food intake （P=0.039） were independent predictive factors of precursor lesions possibility. The corresponding nomogram exhibited an AUC （95% CI） of 0.62 （0.60-0.65） for the modeling group and 0.61 （0.59-0.63） for the validation group. Conclusions： We identified several potential associated factors and provided a preclinical nomogram with the potential to predict the possibility of GC/premalignant and precursor lesions.
基金Supported by Chung Shan Medical University Hospital,Taichung,Taiwan,No.CSH-2013-C-032
文摘AIM To elucidate the prevalence and risk of mortality of nonalcoholic liver cirrhosis(LC) patients with coronary artery disease(CAD).METHODS The study cohort included newly diagnosed nonalcoholic LC patients age ≥ 40 years old without a diagnosis of CAD from 2006 until 2011 from a longitudinal health insurance database. The mean follow-up period for the study cohort was 1152 ± 633 d. The control cohort was matched by sex, age, residence, and index date. Hazard ratios(HRs) were calculated using the Cox proportional hazard model and the Kaplan-Meier method. RESULTS After exclusion, a total of 3409 newly diagnosed nonalcoholic cirrhotic patients were identified from one million samples from the health insurance database. We found that CAD(5.1% vs 17.4%) and hyperlipidemia(20.6% vs 24.1%) were less prevalent in nonalcoholic LC patients than in normal subjects(all P < 0.001), whereas other comorbidities exhibited an increased prevalence. Among the comorbidities, chronic kidney disease exhibited the highest risk for mortality(adjusted HR(AHR) = 1.76; 95%CI: 1.55-2.00, P < 0.001). Ascites or peritonitis exhibited the highest risk of mortality among nonalcoholic cirrhotic patients(AHR = 2.34; 95%CI: 2.06-2.65, P < 0.001). Finally, a total of 170 patients developed CAD after a diagnosis of nonalcoholic LC. The AHR of CAD in nonalcoholic LC patients was 0.56(95%CI: 0.43-0.74, P < 0.001). The six-year survival rates for nonalcoholic LC patients with and without CAD were 52% and 50%, respectively(P = 0.012). CONCLUSION We conclude that CAD was less prevalent and associated with a reduced risk of mortality in nonalcoholic cirrhotic patients.
基金Supported by the grants from the Cheng Hsin Rehabilitation Medical Center, No. 93-25
文摘AIM： To assess the incidence of and risk factors for gallstone disease （GSD） among type 2 diabetics in Kinmen, Taiwan. METHODS： A screening program for GSD was performed by two specialists who employed real-time abdominal ultrasound to examine the abdominal region after patients had fasted for at least eight hours. Screening, which was conducted in 2001, involved 848 patients diagnosed with type 2 diabetes. After exclusion of 63 subjects with prevalent GSD, 377 participants without GSD were invited in 2002 for a second round of screening. A total of 281 （74.5%） subjects were re-examined. RESULTS： Among the 281 type 2 diabetics who had no GSD at the first screening, 10 had developed GSD by 2002. The incidence was 3.56% per year （95%CI： 1.78% per year-6.24% per year）. Using a Cox regression model, age （RR = 1.07, 95% CI： 1.00-1.14）, waist circumference （RR = 1.12, 95% CI： 1.01-1.29）, and ALT （RR = 1.13, 95%CI： 1.01-1.26） appeared to be significantly correlated with development of GSD. CONCLUSION： Older age is a known risk factor for the development of GSD. Our study shows that greater waist circumference and elevated ALT levels are also associated with the development of GSD among type 2 diabetics in Kinmen.
基金This work was supported by funding from the National Key Project of Research and Development Program of China(Grant No.2016YFC1302503)the National Key Basic Research Program of China“973 Program”(Grant No.2015CB554000).
文摘This review will describe the global patterns and trends of colorectal cancer survival,using data from the population-based studies or cancer registration.We performed a systematic search of China National Knowledge Infrastructure(CNKI),Wanfang Data,PubMed,Web of Science,EMBASE,and SEER and collected all population-based survival studies of colorectal cancer(up to June 2020).Estimates of observed and relative survival rates of colorectal cancer by sex,period,and country were extracted from original studies to describe the temporal patterns and trends from the late 1990s to the early 21st century.Globally,5-year observed survival rates were higher in Seoul,Republic of Korea(1993–1997;56.8%and 54.3%for colon and rectum cancers,respectively),Zhejiang province(2005–2010;52.9%for colon cancer),Tianjin(1991–1999;52.5%for colon cancer),Shanghai(2002–2006;50.0%for rectum cancer)of China,and in Japan(1993–1996,59.6%for colorectal cancer).Five-year relative survival rates of colorectal cancer in the Republic of Korea(2010–2014),Queensland,Australia(2005–2012),and the USA(2005–2009)ranked at relatively higher positions compared to other countries.In general,colorectal cancer survival rates are improving over time worldwide.Sex disparities in survival rates were also observed in the colon,rectum,and colorectal cancers in most countries or regions.The poorest age-specific 5-year relative survival rate was observed in patients>75 years of age.In conclusion,over the past 3 decades,colorectal cancer survival has gradually improved.Geographic variations,sex differences,and age gradients were also observed globally in colorectal cancer survival.Further studies are therefore warranted to investigate the prognostic factors of colorectal cancer.
基金supported by the National Natural Science Foundation of China(82071662,to Q.G.)。
文摘Identification of carriers of fragile X syndrome(FXS) with the subsequent prenatal diagnosis and knowledge of FXS-associated genetic profiles are essential for intervention in specific populations. We report the results of carrier screening of 39,458 East Asian adult women and prenatal diagnosis from 87 FXS carriers.The prevalence of FXS carriers and full mutation fetuses was estimated to be 1/581 and 1/3124 in East Asian populations, respectively. We confirmed the validity of the current threshold of CGG trinucleotide repeats for FMR1 categorization;the integral risks of full mutation expansion were approximately 6.0%,43.8%, and 100% for premutation alleles with 55—74, 75—89, and ≥ 90 CGG repeats, respectively. The protective effect of AGG(adenine-guanine-guanine nucleotides) interruption in East Asian populations was validated, which is important in protecting premutation alleles with 75—89 CGG repeats from full mutation expansion. Finally, family history was shown not an effective indicator for FXS carrier screening in East Asian populations, and population-based screening was more cost-effective. This study provides an insight into the largest carrier screening and prenatal diagnosis for FXS in East Asian populations to date. The FXSassociated genetic profiles of East Asian populations are delineated, and population-based carrier screening is shown to be promising for FXS intervention.
基金Supported by the National Natural Science Foundation of China (60661003)the Research Project Department of Education of Jiangxi Province (GJJ10566)
文摘In this paper, we explore a novel ensemble method for spectral clustering. In contrast to the traditional clustering ensemble methods that combine all the obtained clustering results, we propose the adaptive spectral clustering ensemble method to achieve a better clustering solution. This method can adaptively assess the number of the component members, which is not owned by many other algorithms. The component clusterings of the ensemble system are generated by spectral clustering （SC） which bears some good characteristics to engender the diverse committees. The selection process works by evaluating the generated component spectral clustering through resampling technique and population-based incremental learning algorithm （PBIL）. Experimental results on UCI datasets demonstrate that the proposed algorithm can achieve better results compared with traditional clustering ensemble methods, especially when the number of component clusterings is large.
基金Supported by The establishment of the NI Barrett's Register was assisted by a grant from the Ulster Cancer Foundation
文摘AIM: To examine an increased risk of esophageal adenocarcinoma is restricted to patients who develop Barrett's esophagus or whether esophagitis per se is a risk factor for adenocarcinoma.METHODS: A population-based cohort of patients with histological evidence of esophagitis without Barrett's esophagus was constructed using electronic pathology reports relating to all esophageal biopsies in Northern Ireland between 1993 and 1996. Person-years of followup and incident cases of esophageal cancer were calculated by linking the cohort to death files and the Northern Ireland Cancer Registry records. Standardized incidence ratios (SIR) were calculated for esophageal cancers (adenocarcinoma, squamous cell carcinoma (SCC), and histologically unspecified cancers).RESULTS: A total of 2 013 patients in the cohort provided 13 559 patient-years of follow-up (mean follow-up 6.7 years). None of the patients developed adenocarcinoma. Three patients developed SCC, and six developed histologically unspecified cancers. The SIR for all esophageal cancers and for SCC were 2.73 (95%CI 1.25-5.19) and 2.93 (95%CI 0.61-8.59), respectively. In a sensitivity analysis in which all unspecified esophageal cancers were treated as adenocarcinomas, the SIR for adenocarcinoma was 2.64 (0.97-5.75).CONCLUSION: The risk of adenocarcinoma is not elevated in patients with histological evidence of esophagitis without Barrett's esophagus; however, these patients may have a moderately increased risk of SCC.Further studies are required to confirm these findings,which suggest that Barrett's esophagus, not esophagitis,is the key precursor lesion in the development of adenocarcinoma.
文摘AIM: To analyze the prevalence, length and predictors of hospitalization in the biological era in the populationbased inception cohort from Veszprem province.METHODS: Data of 331 incident Crohn's disease(CD) patients diagnosed between January 1, 2000 and December 31, 2010 were analyzed(median age at diagnosis: 28; IQR: 21-40 years). Both in- and outpatient records were collected and comprehensively reviewed.RESULTS: Probabilities of first CD-related hospitalization and re-hospitalization were 32.3%, 45.5%,53.7% and 13.6%, 23.9%, 29.8%, respectively after one, three and five years of follow-up in Kaplan-Meier analysis. First-year hospitalizations were related to diagnostic procedures(37%), surgery or disease activity(27% and 21%). Non-inflammatory disease behavior at diagnosis(HR = 1.32, P = 0.001) and perianal disease(HR = 1.47, P = 0.04) were associated with time to first CD-related hospitalization, while disease behavior change(HR = 2.38, P = 0.002) and need for steroids(HR = 3.14, P = 0.003) were associated with time to first re-hospitalization in multivariate analyses.Early CD-related hospitalization(within the year of diagnosis) was independently associated with need for immunosuppressives(OR = 2.08, P = 0.001) and need for surgeries(OR = 7.25, P < 0.001) during the disease course.CONCLUSION: Hospitalization and re-hospitalization rates are still high in this cohort, especially during the first-year after the diagnosis. Non-inflammatory disease behavior at diagnosis was identified as the pivotal predictive factor of both hospitalization and rehospitalization.
基金supported by the National Natural Science Foundation of China[Grant No.81773509][Grant No.81102190]
文摘This prospective study was designed to examine the combined influence of insulin resistance（IR）and inflammatory biomarker levels on type 2 diabetes mellitus（T2DM）among 1,903Inner Mongolians.
文摘The purpose of this study is to explore whether it is worthwhile to launch a routine diabetic retinopathy (DR) screening for blindness pre-vention among Chinese type 2 diabetes from different perspective based on the popula-tion-based study in Kinmen, Taiwan. A total of 971 community dwelling adults previously di-agnosed with type 2 diabetes in 1991-1993 un-derwent DR screening in 1999-2002 by a panel of ophthalmologists using on-site indirect oph-thalmoscopy and 45-degree color fundus retinal photographs. The cost-benefit analysis is used to evaluate the DR screening. In terms of bene-fit-cost ratio, the different screening programs for DR could save New Taiwan Dollars (NTD) from 14.38 to 36.83 in discounted costs for each dollar incurred in different screening years from the societal viewpoint for Taiwan and save NTD from 0.81 to 1.80 in different screening years from health care payer’s perspective. The av-erage estimate of willingness-to-pay to translate into benefit yields NTD from 937.8 to 4,689 be- nefits per case due to DR screening in different screening years during 10-year follow-up. The net present value of the DR screening were NTD from -167,318 to -307,251.2 in different screening years. In conclusion, it is worthwhile to initial a routine DR screening of Chinese type 2 diabetes for blindness prevention from the societal per-spective but not from consumer decision based on the willingness-to-pay perspective.
文摘At present,most total knee replacement(TKR)prostheses on the market are designed according to the sizes of Caucasians.However,extensive studies have indicated that human anatomies differ among different ethnicities.A number of reports have indicated that Chinese TKR patients do not match with available prostheses.In this study,computed tomography(CT)images of 52 knees of Chinese men and women were used for anthropometric measurements.Index and geometric measurements were definedand used for correlation analysis.Key parameters from the measurement results were identified.Detailed geometries of knees were measured as coordinates.A deformable three-dimensional(3D)knee modelbased on anatomical coordinates correlating with the identified key parameters was generated.A pros-thesis was then designed according to the analyzed results.Surface matching analysis,bone resectionanalysis,and cadaveric trials were conducted and compared with commercial products to validate theproposed design.The femoral component designed by this study resulted in the highest accuracy(rootmean square point-to-surface(RMS PS),(1.08±0.20)mm)and lowest amount of resected bone volume(27412mm^(3))in comparison with two commercial knee prostheses.This study suggests a new approachfor population-based patient-specific femoral prosthesis design With a single,easilty acquired dimen-sion-namely,epicondyle width(ECW)-as input,a patient-specific femoral prosthesis can be designed according to the analyzed measured data and manufactured by additive manufacturing(AM)methods.Meanwhile,the reconstructed femoral condylar surface was compared with the femoral condylar surfacein the original CT scanning data The average RMS PS distance of the reconstructed femoral condylar surface among all data was(1.10±0.18)mm,which is comparable to other statistical shape modeling methods using multiple radiographs as input data.There is a need to develop an anthropometric-based knee prosthesis for the Chinese population.Based on the anthropometry of the Chinese population,our new design fits Chinese patients better and reserves more bone volume compared with current commercial prostheses,which is an essential step toward AM for personalized knee prostheses.
基金supported by the Chinese University of Hong Kong
文摘Objective: To investigate the uptake rate of prostate specific antigen(PSA) testing among Hong Kong Chinese males aged 50 or above, and identify factors associated with the likelihood of undergoing a PSA test.Methods: A population-based telephone survey was conducted in Hong Kong in 2007. The survey covered demographic information, perceived health status, use of complementary therapy, cancer screening behavior, perceived susceptibility to cancer and family history of cancer. Descriptive statistics, percentages and logistic regression analysis were used for data analysis.Results: A total of 1,002 men aged 50 or above took part in the study(response rate =67%), and the uptake rate of PSA testing was found to be 10%. Employment status, use of complementary therapy, perceiving regular visits to a doctor as good for health and the recommendations of health professionals were significant factors associated with PSA testing.Conclusion: The uptake rate of PSA testing in the study population was very low. Among all the factors identified, recommendations from health professionals had the strongest association with the uptake of PSA testing, and they should therefore take an active role in educating this population about cancer prevention and detection.
基金Supported by the European Commission as a fifth framework shared cost action (QLG4-CT-2000-01414)
文摘AIM： To describe an Internet-based data acquisition facility for a European 10-year clinical follow-up study project of a population-based cohort of inflammatory bowel disease （IBD） patients and to investigate the influence of demographic and disease related patient characteristics on response rates. METHODS： Thirteen years ago, the European Collaborative study group of IBD （EC-IBD） initiated a population-based prospective inception cohort of 2 201 uniformly diagnosed IBD patients within 20 well- described geographical areas in 11 European countries and Israel. For the 10-year follow-up of this cohort, an electronic patient questionnaire （ePQ） and electronic physician per patient follow-up form （ePpPFU） were designed as two separate data collecting instruments and made available through an Internet-based website. Independent demographic and clinical determinants of ePQ participation were analyzed using multivariate logistic regression.total number of 1 505 （64%） available IBD patients, originating from 13 participating centers from nine different countries, both ePQ and ePpPFU were completed. Patients older than 40 years at ePQ completion （OR： 1.53 （95% CI： 1.14-2.05）） and those with active disease during the 3 mo previous to ePQ completion （OR： 3.32 （95%CI： 1.57-7.03）） were significantly more likely to respond. CONCLUSION： An Internet-based data acquisition tool appeared successful in sustaining a unique Western- European and Israelian multi-center 10-year clinical follow-up study project in patients afflicted with IBD.
基金financed in part by the Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior-Brasil (CAPES) (Finance Code 001)by the Science and Technology Department of the Brazilian Ministry of Health,with resources transferred through the Brazilian National Council for Scientific and Technological Development (CNPq) (400943/2013-1)+1 种基金Helen Gon?alves (305759/2017-5),Ana Menezes (302029/ 2017-6),Fernando Barros,and Fernando C.Wehrmeister (309236/2018-5) received funding through a CNPq research productivity grantAndrea Wendt was funded by a CAPES PhD scholarship (Finance Code 001)。
文摘Background:Regular physical activity(PA) is an important behavior in improving sleep health.However,the short-term effects of PA on sleep are still controversial.This study aimed to verify the effect of different intensities of PA practiced in different periods of the day on the subsequent sleep night in a population-based cohort of young adults.Methods::Prospective analyses were conducted for PA performed during the day and its effect on the following sleep night using data from the22-year follow-up of the 1993 Pelotas Birth Cohort in Brazil(mean age of participants-22.6 years).Wrist-worn accelerometry was usedto measure both PA and sleep parameters.Regarding intensity,we analyzed the sleep effect of light PA(LPA),moderate PA,and vigorous PA,stratified by sex.Sleep variables were sleep time window(STW;the difference between sleep onset and sleep end),total sleep time(TST;the sum of minutes classified as sleep in STW),and sleep percent(SP;SP=(TST/STW);expressed in percentage).We performed generalized estimating equations using Stata software.Results::The means of STW,TST,and SP were 443.6 min/day,371.1 min/day,and 84%,respectively.Time spent in moderate PA and vigorous PA in the morning and afternoon was not associated with sleep variables.Among men,10 min/day of morning LPA increased TST by2.56 min/day.Among women,10 min/day of morning LPA increased SP by 0.15 percentage points.Afternoon LPA also increased SP by 0.09 percentage points for women.Night PA seems to have an inverse effect on sleep variables for any intensity and both sexes.Conclusion::The effect of PA on sleep health is intrinsically related to the period of the day in which it is performed.The effect magnitude is different between sexes.For better sleep health,it is preferable that PA be performed during the day.
基金supported by grants from National Natural Science Foundation of China(No.81702708)Natural Science Foundation of Hunan Province(No.2018JJ3862,No.2017JJ2392,and No.2019JJ50979)+1 种基金Scientific Research Project of Hunan Provincial Health Commission(No.B20180054)Changsha Science and Technology Project(No.kq1706072).
文摘The use of the traditional American Joint Committee on Cancer(AJCC)staging system alone has limitations in predicting the survival of gingiva squamous cell carcinoma(GSCC)patients.We aimed to establish a comprehensive prognostic nomogram with a prognostic value similar to the AJCC system.Methods:Patients were identified from SEER database.Variables were selected by a backward stepwise selection method in a Cox regression model.A nomogram was used to predict cancer-specific survival rates for 3,5 and 10 years in patients with GSCC.Several basic features of model validation were used to evaluate the performance of the survival model:consistency index(C-index),receiver operating characteristic(ROC)curve,calibration chart,net weight classification improvement(NRI),comprehensive discriminant improvement(IDI)and decision curve analysis(DCA).Results:Multivariate analyses revealed that age,race,marital status,insurance,AJCC stage,pathology grade and surgery were risk factors for survival.In particular,the C-index,the area under the ROC curve(AUC)and the calibration plots showed good performance of the nomogram.Compared to the AJCC system,NRI and IDI showed that the nomogram has improved performance.Finally,the nomogram's 3-year and 5-year and 10-year DCA curves yield net benefits higher than traditional AJCC,whether training set or a validation set.Conclusion:We developed and validated the first GSCC prognosis nomogram,which has a better prognostic value than the separate AJCC staging system.Overall,the nomogram of this study is a valuable tool for clinical practice to consult patients and understand their risk for the next 3,5 and 10 years.
文摘BACKGROUND Gastric cancer remains a leading cause of cancer death worldwide.In Taiwan,gastric cancer is the sixth leading cause of cancer mortality in both males and females.AIM To evaluate secular trends in gastric cancer incidence according to age,sex,and Helicobacter pylori(H.pylori)treatment in Taiwan.METHODS In this population-based study,we used the national Taiwan Cancer Registry database.Annual percent changes in incidence rates were used to describe secular trends in incidence rates and sex ratios of gastric cancer in Taiwan.Pearson’s product-moment correlation coefficients were used to analyze the correlation between annual age-adjusted incidence rates and the annual number of patients treated with antibiotic therapy for H.pylori infection.RESULTS The annual percent changes showed continuously decreasing rates of gastric cancer among both males and females.However,the decreasing trends differed by sex,with an annual percent change of-2.58%in males and-2.14%in females.The age-specific incidence rates increased with age.Within the same age group,more recent time periods showed lower incidence rates than greater time periods.Similarly,the sex ratio was lower in later birth cohorts than in earlier birth cohorts.Age-adjusted incidence rates substantially decreased with increasing numbers of patients being treated with antibiotic therapy for H.pylori infection during 2005 to 2016(r=0.72).CONCLUSION We observed steadily decreasing trends with differential sex ratios in the incidence of gastric cancer in Taiwan.These results support H.pylori eradication programs in Taiwan.
基金supported by the MST of Taiwan under Grant No.101-2221-E-008-125-MY3
文摘There are few population-based data in investigating the impact of diabetes on chemotherapy adverse effects and treatment outcomes of non-metastatic breast cancer. The purpose of this study is to evaluate whether diabetes affects the patterns of use in chemotherapy, toxic effects of chemotherapy, and treatment outcomes for non-metastatic breast cancer in Taiwan. The study results can provide physicians for making a decision whether or not to use chemotherapy based on the individual patients＇ condition.
