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Reflections on four decades of physical activity epidemiology

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Journal of Sport and Health Science 2024年第5期13卷 608-610页

作者： Barbara Sternfeld David R.Jacobs Jr. Division of Research Kaiser Permanente Northern CaliforniaOaklandCA 94610USA Division of epidemiology and Community Health School of Public HealthUniversity of MinnesotaMinneapolisMN 55454USA

In 1985,Public Health Reports published a series of papers prepared for a workshop sponsored by the Centers for Disease Control and Prevention(CDC).1 Building on the seminal work of Jeremy Morris and Ralph Paffenbarger Jr.,who were among the first to use epidemiological methods to study physical activity(PA),2,3 the workshop itself was the result of a growing scientific understanding of the importance of“physical fitness and exercise for improving the health of the public”.

关键词： semi workshop Ralph

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

Plant-based dietary patterns and risk of esophageal cancer:A prospective cohort study spanning 17 years

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Chinese Journal of Cancer Research 2024年第1期36卷 36-45页

作者： Xiaorui Zhang Feifan He Jiayue Li Ru Chen Xinqing Li Li Li Fen Liu Shaoming Wang Wenqiang Wei Department of epidemiology and Health Statistics School of Public HealthBeijing Municipal Key Laboratory of Clinical EpidemiologyCapital Medical UniversityBeijing 100069China National Central Cancer Registry office National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Cancer epidemiology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

Objective: Plant-based diets have multiple health benefits for cancers;however, little is known about the association between plant-based dietary patterns and esophageal cancer(EC).This study presents an investigation of the prospective associations among three predefined indices of plant-based dietary patterns and the risk of EC.Methods: We performed endoscopic screening for 15,709 participants aged 40-69 years from two high-risk areas of China from January 2005 to December 2009 and followed the cohort until December 31, 2022. The overall plant-based diet index(PDI), healthful plant-based diet index(h PDI), and unhealthful plant-based diet index(u PDI), were calculated using survey responses to assess dietary patterns. We applied Cox proportional hazard regression to estimate the multivariable hazard ratios(HRs) and 95% confidence intervals(95% CIs) of EC across 3plant-based diet indices and further stratified the analysis by subgroups.Results: The final study sample included 15,184 participants in the cohort. During a follow-up of 219,365person-years, 176 patients with EC were identified. When the highest quartile was compared with the lowest quartile, the pooled multivariable-adjusted HR of EC was 0.50(95% CI, 0.32-0.77) for h PDI. In addition, the HR per 10-point increase in the h PDI score was 0.42(95% CI, 0.27-0.66) for ECs. Conversely, u PDI was positively associated with the risk of EC, and the HR was 1.80(95% CI, 1.16-2.82). The HR per 10-point increase in the u PDI score was 1.90(95% CI, 1.26-2.88) for ECs. The associations between these scores and the risk of EC were consistent in most subgroups. These results remained robust in sensitivity analyses.Conclusions: A healthy plant-based dietary pattern was associated with a reduced risk of EC. Emphasizing the healthiness and quality of plant-based diets may be important for preventing the development of EC.

关键词： Esophageal cancer diet dietary pattern epidemiology nutrition prospective cohort study

Disease and Economic Burden of Kashin-Beck Disease—China,2021

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China CDC weekly 2024年第2期6卷 40-44页

作者： Silu Cui Wenjun Que Zhe Jiao Qing Deng Xufeng Zhang Yanhong Cao Ning Liu Ailin Li Alphonse Sowanou Zhe Li Tuo Wang Yang Li Jun Yu Junrui Pei NHC Key Laboratory of Etiology and epidemiology(Harbin Medical University) Key Laboratory of Etiology and EpidemiologyEducation Bureau of Heilongjiang ProvinceInstitute of Kashin-Beck Disease ControlCenter for Endemic Disease ControlChinese Center for Disease Control and PreventionHarbin Medical UniversityHarbin CityHeilongjiang ProvinceChina NHC Key Laboratory of Etiology and epidemiology(Harbin Medical University) Heilongjiang Provincial Key Laboratory of Trace Elements and Human HealthKey Laboratory of Etiology and EpidemiologyEducation Bureau of Heilongjiang ProvinceInstitute of Endemic Fluorosis ControlCenter for Endemic Disease ControlChinese Center for Disease Control and PreventionHarbin Medical UniversityHarbin CityHeilongjiang ProvinceChina

What is already known about this topic?Kashin-Beck disease(KBD)is a chronic and degenerative osteoarthropathy characterized by cartilage degeneration.It is an endemic disease that is highly prevalent among the Chinese population and poses a significant health risk.What is added by this report?This is the first national report on the economic burden of KBD in China.According to the data from 2021,KBD has caused significant disease and economic burdens.The most substantial reduction in healthy life expectancy was observed among patients with degree II severity and those aged 60 years and older,resulting in a total indirect economic burden of 112.74 million Chinese Yuan(CNY).What are the implications for public health practice?The results of this study will contribute to informing the development of tailored prevention and control strategies by the government.These strategies will include targeted policies and recommendations for appropriate healthcare and financial subsidies,which will be based on the demographic characteristics of the endemic areas.

关键词： prevention degeneration burden

Low Selenium and Low Protein Exacerbate Myocardial Damage in Keshan Disease by Affecting the PINK1/Parkin-mediated Mitochondrial Autophagy Pathway

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Current Medical Science 2024年第1期44卷 93-101页

作者： Li-wei ZHANG Hong-qi FENG Song-bo FU Dian-jun SUN Center for Endemic Disease Control Chinese Center for Disease Control and PreventionHarbin Medical UniversityNHC Key Laboratory of Etiology and Epidemiology(Harbin Medical University)Key Lab of Etiology and EpidemiologyEducation Bureau of Heilongjiang ProvinceHarbin 150086China

Objective Keshan disease(KD)is a myocardial mitochondrial disease closely related to insufficient selenium(Se)and protein intake.PTEN induced putative kinase 1(PINK1)/Parkin mediated mitochondrial autophagy regulates various physiological and pathological processes in the body.This study aimed to elucidate the relationship between PINK1/Parkin-regulated mitochondrial autophagy and KD-related myocardial injury.Methods A low Se and low protein animal model was established.One hundred Wistar rats were randomly divided into 5 groups(control group,low Se group,low protein group,low Se+low protein group,and corn from KD area group).The JC-1 method was used to detect the mitochondrial membrane potential(MMP).ELISA was used to detect serum creatine kinase MB(CK-MB),cardiac troponin I(cTnI),and mitochondrial-glutamicoxalacetic transaminase(M-GOT)levels.RT-PCR and Western blot analysis were used to detect the expression of PINK1,Parkin,sequestome 1(P62),and microtubule-associated proteins1A/1B light chain 3B(MAP1LC3B).Results The MMP was significantly decreased and the activity of CK-MB,cTnI,and M-GOT significantly increased in each experimental group(low Se group,low protein group,low Se+low protein group and corn from KD area group)compared with the control group(P<0.05 for all).The mRNA and protein expression levels of PINK1,Parkin and MAP1LC3B were profoundly increased,and those of P62 markedly decreased in the experimental groups compared with the control group(P<0.05 for all).Conclusion Low Se and low protein levels exacerbate myocardial damage in KD by affecting the PINK1/Parkin-mediated mitochondrial autophagy pathway.

关键词： Keshan disease low selenium and low protein myocardial mitochondrial injury PTEN induced putative kinase 1(PINK1)/Parkin mitochondrial autophagy

epidemiology of stomach cancer

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World Journal of Gastroenterology 2022年第12期28卷 1187-1203页

作者： Milena Ilic Irena Ilic Department of epidemiology Faculty of Medical SciencesUniversity of KragujevacKragujevac 34000Serbia Faculty of Medicine University of BelgradeBelgrade 11000Serbia

Despite a decline in incidence and mortality during the last decades,stomach cancer is one of the main health challenges worldwide.According to the GLOBOCAN 2020 estimates,stomach cancer caused approximately 800000 deaths(accounting for 7.7%of all cancer deaths),and ranks as the fourth leading cause of cancer deaths in both genders combined.About 1.1 million new cases of stomach cancer were diagnosed in 2020(accounting for 5.6%of all cancer cases).About 75%of all new cases and all deaths from stomach cancer are reported in Asia.Stomach cancer is one of the most lethal malignant tumors,with a five-year survival rate of around 20%.There are some well-established risk factors for stomach cancer:Helicobacter pylori infection,dietary factors,tobacco,obesity,and radiation.To date,the most important way of preventing stomach cancer is reduced exposure to risk factors,as well as screening and early detection.Further research on risk factors can help identify various opportunities for more effective prevention.Screening programs for stomach cancer have been implemented in a few countries,either as a national or opportunistic screening of high-risk individuals only.Generally,due to its high aggressiveness and heterogeneity,stomach cancer still remains a severe global health problem.

关键词： Stomach cancer epidemiology Incidence Mortality Survival Predictive factors Prevention

Association between body mass index and in vitro fertilization/intra-cytoplasmic sperm injection outcomes: An analysis of 15,124 normal ovarian responders in China

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中华医学杂志(英文版) 2024年第7期137卷 837-845页

作者： Zheng Danlei Wang Yuanyuan Chen Lixue Zeng Lin Li Rong Department of Obstetrics and Gynecology Center for Reproductive Medicine Peking University Third Hospital Beijing 100191 China Research Center of Clinical epidemiology

Background: High body mass index (BMI) results in decreased fecundity, and women with high BMI have reduced rates of clinical pregnancy and live birth inin vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI). Meanwhile, ovarian responses show great heterogeneity in patients with a high BMI. This study aimed to analyze the effects of a high BMI on IVF/ICSI outcomes in the Chinese female with normal ovarian response.Methods: We performed a retrospective cohort study comprising 15,124 patients from the medical record system of the Reproductive Center of Peking University Third Hospital, with 3530 (23.3%) in the overweight group and 1380 (9.1%) in the obese group, who had a normal ovarian response (5-15 oocytes retrieved) and underwent fresh embryo transfer (ET) cycles from January 2017 to December 2018, followed by linked frozen-thawed embryo transfer (FET) cycles from January 2017 to December 2020. Cumulative live birth rate (CLBR) was used as the primary outcome. Furthermore, a generalized additive model was applied to visually illustrate the curvilinear relationship between BMI and the outcomes. We used a decision tree to identify the specific population where high BMI had the greatest effect on IVF/ICSI outcomes.Results: High BMI was associated with poor IVF/ICSI outcomes, both in cumulative cycles and in separate fresh ET or FET cycles. In cumulative cycles, compared with the normal weight group, obesity was correlated with a lower positive pregnancy test rate (adjusted odds ratio [aOR]: 0.809, 95% confidence interval [CI]: 0.682-0.960), lower clinical pregnancy rate (aOR: 0.766, 95% CI: 0.646-0.907), lower live birth rate (aOR: 0.706, 95% CI: 0.595-0.838), higher cesarean section rate (aOR: 2.066, 95% CI: 1.533-2.785), and higher rate of large for gestational age (aOR: 2.273, 95% CI: 1.547-3.341). In the generalized additive model, we found that CLBR declined with increasing BMI, with 24 kg/m2 as an inflection point. In the decision tree, BMI only made a difference in the population aged ≤34.5 yea

关键词： Obesity Body mass index In vitro fertilization Live birth Decision trees Normal ovarian response

epidemiology, clinical characteristics, and treatment of severe fever with thrombocytopenia syndrome

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Infectious Medicine 2022年第1期1卷 40-49页

作者： Jia-Chen Li Jing Zhao Hao Li Li-Qun Fang Wei Liu State Key Laboratory of Pathogen and Biosecurity Beijing Institute of Microbiology and EpidemiologyBeijing100071China

Severe fever with thrombocytopenia syndrome(SFTS)is an emerging tick-borne infectious disease caused by a novel phlebovirus(SFTS virus,SFTSV)in the family Phenuiviridae of the order Bunyavirales.The disease causes a wide spectrum of clinical signs and symptoms,ranging from mild febrile disease accompanied by thrombocy-topenia and/or leukocytopenia to hemorrhagic fever,encephalitis,multiple organ failure,and death.SFTS was first identified in China and was subsequently reported in South Korea and Japan.The case-fatality rate ranges from 2.7%to 45.7%.Older age has been consistently shown to be the most important predictor of adverse disease outcomes.Older age exacerbates disease mainly through dysregulation of host immune cells and uncontrolled inflammatory responses.Tick-to-human transmission is the primary route of human infection with SFTSV,and Haemaphysalis longicornis is the primary tick vector of SFTSV.Despite its high case-fatality rate,vaccines and an-tiviral therapies for SFTS are not currently available.The therapeutic efficacies of several antiviral agents against SFTSV are currently being evaluated.Ribavirin was initially identified as a potential antiviral therapy for SFTS but was subsequently found to inefficiently improve disease outcomes,especially among patients with high viral loads.Favipiravir(T705)decreased both time to clinical improvement and mortality when administered early in patients with low viral loads.Anti-inflammatory agents including corticosteroids have been proposed to play therapeutic roles.However,the efficacy of other therapeutic modalities,such as convalescent plasma,is not yet clear.

关键词： SFTS epidemiology Transmission Risk factors Treatment

Cervical cancer prevention in China: where are we now, and what's next?

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Cancer Biology & Medicine 2024年第3期21卷 213-217页

作者： Huijiao Yan Qiankun Wang Youlin Qiao School of Population Medicine and Public Health Chinese Academy of Medical Sciences and Peking Union Medical CollegeBejing 100730China Department of Cancer epidemiology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBejing 100021China

Cervical cancer(CC) epidemiology CC, the fourth most frequently diagnosed malignancy in women worldwide, is a major global health challenge, particularly in low-resource regions. Approximately 88.1% of the 604,000 CC new cases occurred in low-and middle-income countries in 2020, and more than 90% of the 342,000 CC deaths occurred in low-and middle-income countries in 2020~1.

关键词： prevention Cervical epidemiology