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Effectiveness of colorectal cancer screening integrating non-genetic and genetic risk: a prospective study based on UK Biobank data

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Cancer Biology & Medicine 2024年第8期21卷 712-723页

作者： Yu Zhang Chao Sheng Zhangyan Lyu Hongji Dai Fangfang Song Fengju Song Yubei Huang Kexin Chen Department of epidemiology and biostatistics Key Laboratory of Molecular Cancer Epidemiology Key Laboratory of Prevention and Control of Human Major Diseases Ministry of Education National Clinical Research Center for Cancer Tianjin Medical University Cancer Institute and Hospital Tianjin Medical University

Objective: Few studies have evaluated the benefits of colorectal cancer(CRC) screening integrating both non-genetic and genetic risk factors. Here, we aimed to integrate an existing non-genetic risk model(QCancer-10) and a 139-variant polygenic risk score to evaluate the effectiveness of screening on CRC incidence and ***: We applied the integrated model to calculate 10-year CRC risk for 430,908 participants in the UK Biobank, and divided the participants into low-, intermediate-, and high-risk groups. We calculated the screening-associated hazard ratios(HRs) and absolute risk reductions(ARRs) for CRC incidence and mortality according to risk ***: During a median follow-up of 11.03 years and 12.60 years, we observed 5,158 CRC cases and 1,487 CRC deaths, respectively. CRC incidence and mortality were significantly lower among screened than non-screened participants in both the intermediateand high-risk groups [incidence: HR: 0.87, 95% confidence interval(CI): 0.81±0.94; 0.81, 0.73±0.90; mortality: 0.75, 0.64±0.87; 0.70, 0.58±0.85], which composed approximately 60% of the study population. The ARRs(95% CI) were 0.17(0.11±0.24) and 0.43(0.24±0.61), respectively, for CRC incidence, and 0.08(0.05±0.11) and 0.24(0.15±0.33), respectively, for mortality. Screening did not significantly reduce the relative or absolute risk of CRC incidence and mortality in the low-risk group. Further analysis revealed that screening was most effective for men and individuals with distal CRC among the intermediate to high-risk ***: After integrating both genetic and non-genetic factors, our findings provided priority evidence of risk-stratified CRC screening and valuable insights for the rational allocation of health resources.

关键词： Colorectal cancer incidence mortality polygenic risk score screening

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Exclusive breastfeeding greater than 50%, success of education in a university hospital in Bogotá: Case-control study

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World Journal of Clinical Pediatrics 2024年第1期13卷 23-30页

作者： Marcela Murillo Galvis Sofia Ortegon Ochoa Clara Eugenia Plata García Maria Paula Valderrama Junca Dayanna Alejandra Inga Ceballos Daniel Mauricio Mora Gómez Claudia M Granados Martin Rondón Department of Pediatrics Hospital Universitario San IgnacioBogotá110111Colombia Department of Clinical epidemiology and biostatistics Pontifica Universidad JaverianaBogotá110111Colombia

BACKGROUND Maintenance rates of exclusive breastfeeding(EBF)worldwide are low,thus,one of the objectives of the summary of policies on breastfeeding(BF)in world nutrition goals for 2025 are that at least 50%of infants under six months of age receive EBF that *** Objective of this study is to document the rates of EBF in children born in San Ignacio University Hospital(HUSI)and identify factors associated with *** To document the percentages of EBF in those that were born at HUSI and identify factors associated to their *** This is a study of cases and controls in an analytic,retrospective cohort that took children born alive between January 2016 and January 2019 at HUSI located in the city of Bogotá,*** Receiving information about BF at HUSI was able to maintain EBF up until 4 mo(OR=1.65;95%CI:1.02-2.66).The presence of gynecologic and obstetric comorbidities(OR=0.32;95%CI:0.12-0.83),having mastitis(OR=0.56;95%CI:0.33-0.94),and receiving information from mass media(OR=0.52;95%CI:0.31-0.84)are factors associated with not maintaining *** Receiving education at a Women-and Child-Friendly Institution was the only significant factor to achieve EBF until 4 mo,with a frequency greater than the one reported in the country,which matches multiple studies where counseling and individualized support on BF achieve this *** about BF and early detection of obstetric/gynecologic complications must be strengthened among the healthcare staff in charge of mothers during ***,strategies must be promoted to continue BF such as creating milk banks with the objective of increasing BF rates even when mothers return to work.

关键词： Breastfeeding Women-and Child-Friendly Institutional Strategy Strategies Adherence Education

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Intertwined depressive and cognitive trajectories and the risk of dementia and death in older adults:a competing risk analysis

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General Psychiatry 2024年第2期37卷 207-215页

作者： Ziyang Ren Lirong Nie Yushan Du Jufen Liu Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health Peking UniversityBeijingChina Department of epidemiology and biostatistics School of Public HealthPeking UniversityBeijingChina

Background Depressive symptoms and cognitive impairment often interact,rendering their associations *** date,their joint trajectories and associations with dementia and death remain *** To explore the interactions between depressive symptoms and cognitive function,their developmental trajectories and the associations with all-cause dementia,Alzheimer’s disease(AD)and all-cause death in older *** Data were from the Health and Retirement *** symptoms and cognitive function were measured using the 8-item Centre for Epidemiologic Studies Depression Scale and the Telephone Interview of Cognitive Status,***-cause dementia and AD were defined by self-reported or proxy-reported physician ***-cause death was determined by *** restricted cubic spline,group-based trajectory modelling and subdistribution hazard regression were *** Significant interactions between depressive symptoms and cognitive function in 2010 in their association with new-onset all-cause dementia and AD from 2010 to 2020 were found,especially in women(p for interaction<0.05).Independent trajectory analysis showed that emerging or high(vs no)depressive trajectories and poor or rapidly decreased cognitive trajectories(vs very good)from 1996 to 2010 were at significantly higher risk of subsequent all-cause dementia,AD and all-cause death.15 joint trajectories of depressive symptoms and cognitive function from 1996 to 2010 were determined,where rapidly decreased cognitive function was more common in those with no depressive *** with older adults with the trajectory of no depressive symptoms and very good cognitive function,those with the trajectory of no depressive symptoms but rapidly decreased cognitive function were much more likely to develop new-onset all-cause dementia and death,with subdistribution hazard ratios(95%confidence intervals)of 4.47(2.99 to 6.67)and 1.84(1.43 to 2.36),especially in wome

关键词： death analysis rendering

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Preliminary assessment of the data appropriateness of electronic health records for real-world studies:A survey of hospitals in a developing region in China

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Chinese Medical Journal 2024年第9期137卷 1130-1131页

作者： Yuelin Yu Lin Zhuo Ruogu Meng Wanqian Guo Yuanyuan Chen Yunjing Zhang Ying Chen Hongjing Shi Zhi Lin Siyan Zhan Shengfeng Wang Department of epidemiology and biostatistics School of Public HealthPeking UniversityBeijing 100191China Research Center of Clinical epidemiology Peking University Third HospitalBeijing 100191China National Institute of Health Data Science Peking UniversityBeijing 100191China Health Science Center Peking UniversityBeijing 100191China

To the Editor:Assessment of data appropriateness is a process to answer whether electronic health records(EHRs)from routine healthcare practices couldt intended study purposes,for example,available to be proceeded,with enough individual records,with relevant information able to be extracted from records,etc.[1-3]This has been increasingly underscored as a prerequisite when using EHRs(one important type of real-world data[RWD])for scientic purposes.[4-6]Although controversies remain on the denitions,types and assessment methods of the dimensions of RWD appropriateness,the latest ofcial guidelines(i.e.,from the *** and Drug Administration[FDA][4]and China National Medical Products Administration[NMPA][6])suggest that the assessment start from a preliminary stage on variable existence,and subsequently deepen into the issue of data value(such as missing value,outliers,etc.),as the preliminary assessment is the foundation of the overall RWD appropriateness.[7]Little is known about the appropriateness of EHRs in developing regions,which feature high visit volumes and a great number of ***,this study aimed to preliminarily investigate RWD appropriateness from hospitals in developing regions from the perspective of core variables’comparison.

关键词： electronic dimensions records

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Healthy life expectancy with cardiovascular disease among Chinese rural population based on the prospective cohort study

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Journal of Geriatric Cardiology 2024年第08期 799-806页

作者： Feng JIANG Xiao-Tian LIU Ze HU Wei LIAO Shuo-Yi LI Rui-Fang ZHU Zhen-Xing MAO Jian HOU Sohail Akhtar Fayaz Ahmad Tahir Mehmood Chong-Jian WANG Department of epidemiology and biostatistics College of Public Health Zhengzhou University Department of Mathematics and Statistics The University of Haripur School of Natural Sciences National University of Sciences and Technology

BACKGROUND Limited research has explored the impact of cardiovascular disease(CVD) on healthy life expectancy(HLE)especially in resource-limited areas. This study aimed to investigate the association between CVD and HLE in Chinese rural *** This study included 11,994 participants aged 45 years and older from the baseline and follow-up surveys of the Henan rural cohort study. Healthy status was measured via a Visual Analogue Scale. The multistate Markov model was applied to estimate the association between CVD and transitions in health, unhealthiness and death. Gender-specific total life expectancy,HLE and unhealthy life expectancy were calculated by the multistate life table *** During a mean follow-up time of 3.85(3.84–3.86) years, there were 588 deaths recorded. For individuals with CVD,the risk of switching from health to unhealthiness status was increased by 71% [hazard ratio(HR) = 1.71, 95% CI: 1.42–2.07], the chance of recovery was reduced by 30%(HR = 0.70, 95% CI: 0.60–0.82). Men aged 45 years without CVD could gain an extra 7.08(4.15–10.01) years of HLE and lose 4.00(1.60–6.40) years of unhealthy life expectancy compared to their peers with CVD, respectively. The corresponding estimates among women were 8.62(5.55–11.68) years and 5.82(2.59–9.04) years, *** This study indicated that CVD was significantly associated with poorer health status and lower HLE among Chinese rural population. It is an important public health policy to adopt targeted measures to reduce the CVD burden and enhance the quality of life and HLE in resource-limited areas.

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Cautionary Remarks When Testing Agreement between Two Raters for Continuous Scale Measurements: A Tutorial in Clinical epidemiology with Implementation Using R

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Open Journal of epidemiology 2024年第1期14卷 56-74页

作者： Mohamed M. Shoukri Department of epidemiology and biostatistics Schulich School of Medicine and Dentistry University of Western Ontario London Canada

Background: When continuous scale measurements are available, agreements between two measuring devices are assessed both graphically and analytically. In clinical investigations, Bland and Altman proposed plotting subject-wise differences between raters against subject-wise averages. In order to scientifically assess agreement, Bartko recommended combining the graphical approach with the statistical analytic procedure suggested by Bradley and Blackwood. The advantage of using this approach is that it enables significance testing and sample size estimation. We noted that the direct use of the results of the regression is misleading and we provide a correction in this regard. Methods: Graphical and linear models are used to assess agreements for continuous scale measurements. We demonstrate that software linear regression results should not be readily used and we provided correct analytic procedures. The degrees of freedom of the F-statistics are incorrectly reported, and we propose methods to overcome this problem by introducing the correct analytic form of the F statistic. Methods for sample size estimation using R-functions are also given. Results: We believe that the tutorial and the R-codes are useful tools for testing and estimating agreement between two rating protocols for continuous scale measurements. The interested reader may use the codes and apply them to their available data when the issue of agreement between two raters is the subject of interest.

关键词： Limits of Agreement Pitman and Morgan Tests Test of Parallelism The Arcsine Variance Stabilizing Transformation Sample Size Estimation

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Healthy life expectancy with cardiovascular disease among Chinese rural population based on the prospective cohort study

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Journal of geriatric cardiology : JGC 2024年第8期21卷 799-806页

作者： Feng Jiang Xiao-Tian Liu Ze Hu Wei Liao Shuo-Yi Li Rui-Fang Zhu Zhen-Xing Mao Jian Hou Sohail Akhtar Fayaz Ahmad Tahir Mehmood Chong-Jian Wang Department of epidemiology and biostatistics College of Public Health Zhengzhou University Zhengzhou China. Department of Mathematics and Statistics The University of Haripur Haripur Pakistan. School of Natural Sciences National University of Sciences and Technology Islamabad Pakistan.

BACKGROUND:Limited research has explored the impact of cardiovascular disease (CVD) on healthy life expectancy (HLE) especially in resource-limited areas. This study aimed to investigate the association between CVD and HLE in Chinese rural population.METHODS:This study included 11,994 participants aged 45 years and older from the baseline and follow-up surveys of the Henan rural cohort study. Healthy status was measured via a Visual Analogue Scale. The multistate Markov model was applied to estimate the association between CVD and transitions in health, unhealthiness and death. Gender-specific total life expectancy, HLE and unhealthy life expectancy were calculated by the multistate life table method.RESULTS:During a mean follow-up time of 3.85 (3.84-3.86) years, there were 588 deaths recorded. For individuals with CVD, the risk of switching from health to unhealthiness status was increased by 71% [hazard ratio (HR) = 1.71, 95% CI: 1.42-2.07], the chance of recovery was reduced by 30% (HR = 0.70, 95% CI: 0.60-0.82). Men aged 45 years without CVD could gain an extra 7.08 (4.15-10.01) years of HLE and lose 4.00 (1.60-6.40) years of unhealthy life expectancy compared to their peers with CVD, respectively. The corresponding estimates among women were 8.62 (5.55-11.68) years and 5.82 (2.59-9.04) years, respectively.CONCLUSIONS:This study indicated that CVD was significantly associated with poorer health status and lower HLE among Chinese rural population. It is an important public health policy to adopt targeted measures to reduce the CVD burden and enhance the quality of life and HLE in resource-limited areas.

关键词： Healthy cardiovascular life

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Using Pearson’s System of Curves to Approximate the Distributions of the Difference between Two Correlated Estimates of Signal-to-Noise Ratios: The Cases of Bivariate Normal and Bivariate Lognormal Distributions

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Open Journal of Statistics 2024年第3期14卷 207-227页

作者： Mohamed M. Shoukri Department of epidemiology and biostatistics Schulich School of Medicine and Dentistry University of Western Ontario London Ontario Canada

Background: The signal-to-noise ratio (SNR) is recognized as an index of measurements reproducibility. We derive the maximum likelihood estimators of SNR and discuss confidence interval construction on the difference between two correlated SNRs when the readings are from bivariate normal and bivariate lognormal distribution. We use the Pearsons system of curves to approximate the difference between the two estimates and use the bootstrap methods to validate the approximate distributions of the statistic of interest. Methods: The paper uses the delta method to find the first four central moments, and hence the skewness and kurtosis which are important in the determination of the parameters of the Pearsons distribution. Results: The approach is illustrated in two examples;one from veterinary microbiology and food safety data and the other on data from clinical medicine. We derived the four central moments of the target statistics, together with the bootstrap method to evaluate the parameters of Pearsons distribution. The fitted Pearsons curves of Types I and II were recommended based on the available data. The R-codes are also provided to be readily used by the readers.

关键词： Signal-to-Noise Ratio Bivariate Distributions Bootstrap Methods Delta Method Pearson System of Curves

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Associations of daily sedentary behavior,physical activity,and sleep with irritable bowel syndrome:A prospective analysis of 362,193 participants

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Journal of Sport and Health Science 2024年第1期13卷 72-80页

作者： Xu Gao Sifan Tian Ninghao Huang Gang Sun Tao Huang Department of Occupational and Environmental Health Sciences School of Public HealthPeking UniversityBeijing 100191China Department of epidemiology and biostatistics School of Public HealthPeking UniversityBeijing 100191China Department of Gastroenterology and Hepatology First Medical Center of People's Liberation Army General HospitalBeijing 100853China

Background:Irritable bowel syndrome(IBS)substantially affects quality of life and requires early *** study aimed to elucidate the relationships between IBS and daily behaviors,including sedentary behavior(SB),physical activity(PA),and *** particular,it seeks to identify healthy behaviors to reduce IBS risk,which previous studies have rarely ***:Daily behaviors were retrieved from self-reported data of 362,193 eligible UK Biobank *** cases were determined by self-report or health care data according to RomeⅣ***:A total of 345,388 participants were IBS-free at baseline,during a median follow-up of 8.45 years,19,885 incident IBS cases were *** examined individually,SB and shorter(≤7 h/day)or longer(>7 h/day)sleep duration were each positively associated with increased IBS risk,and PA was associated with lower IBS *** isotemporal substitution model suggested that replacing SB with other activities could provide further protective effects against IBS *** people sleeping≤7 h/day,replacing 1 h of SB with equivalent light PA,vigorous PA,or sleep was associated with 8.1%(95%confidence interval(95%CI):0.901-0.937),5.8%(95%CI:0.896-0.991),and 9.2%(95%CI:0.885-0.932)reduced IBS risk,*** people sleeping>7 h/day,light and vigorous PA were associated with a 4.8%(95%CI:0.926-0.978)and a 12.0%(95%CI:0.815-0.949)lower IBS risk,*** benefits were mostly independent of genetic risk for ***:SB and unhealthy sleep duration are risk factors for IBS.A promising way to mitigate IBS risk for individuals sleeping≤7 h/day and for those sleeping>7 h/day appears to be by replacing SB with adequate sleep or vigorous PA,respectively,regardless of the genetic predisposition of IBS.

关键词： Irritable bowel syndrome Isotemporal substitution model Physical activity Sedentary behavior Sleep

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Changes on Stroke Burden Attributable to Ambient Fine Particulate Matter in China

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Biomedical and Environmental Sciences 2024年第8期37卷 823-833页

作者： Jingyu Wang Yan Wang Xiaohua Liang Keyong Huang Fangchao Liu Shufeng Chen Xiangfeng Lu Jianxin Li Department of epidemiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Key Laboratory of Cardiovascular epidemiology Chinese Academy of Medical SciencesBeijing 100037China Department of Clinical epidemiology and biostatistics Children’s Hospital of Chongqing Medical UniversityNational Clinical Research Center for Child Health and DisordersMinistry of Education Key Laboratory of Child Development and DisordersChongqing Key Laboratory of Pediatric Metabolism and Inflammatory DiseaseChongqing 400016China

Objective In recent decades,China has implemented a series of policies to address air *** aimed to assess the health effects of these policies on stroke burden attributable to ambient fine particulate matter(PM_(2.5)).Methods Joinpoint regression was applied to explore the temporal tendency of stroke burden based on data from the Global Burden of Disease 2019 *** The age-standardized rates of disability-adjusted life year(DALY)for stroke attributable to ambient PM2.5 in China,increased dramatically during 1990-2012,subsequently decreased at an annual percentage change(APC)of-1.98[95% confidence interval(CI):-2.26,-1.71]during *** ischemic stroke(IS),the age-standardized DALY rates doubled from 1990 to 2014,and decreased at an APC of-0.83(95%CI:-1.33,-0.33)during *** hemorrhage(ICH)showed a substantial increase in age-standardized DALY rates from 1990 to 2003,followed by declining trends,with APCs of-1.46(95%CI:-2.74,-0.16)during 2003-2007 and-3.33(95%CI:-3.61,-3.06)during 2011-2019,***,the age-standardized DALY rates for subarachnoid hemorrhage(SAH)generally declined during *** Our results clarified the dynamic changes of the ambient PM_(2.5)-attributable stroke burden in China during 1990-2019,highlighting the health effects of air quality improvement policies.

关键词： Ambient fine particulate matter Stroke Disease burden Temporal trend Policy

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