The aim of this study was to investigate incidence trend of childhood type 1 diabetes in Shanghai, a megalopolis in east China. We established a population-based retrospective registry for the disease in the city's registered population during 1997-2011 and collected 622 incident type 1 diabetes in children aged 0-14 years. Standardized incidence rates and 95 % CI were estimated by applying the capture-recapture method and assuming Poisson distribution. Incidence trend was analyzed using the Poisson regression model. The mean annual incidence of childhood type 1 diabetes was 3.1 per 100,000 person-years. We did not observe significant difference in incidence between boys and girls. The incidence is unstable and had a mean annual increase 14.2 % per year during the studied period. A faster annual increase was observed in boys, warmer seasons, and in the outer regions of the city. If present trends continue, the number of new type 1 diabetes cases will double from 2016 to 2020, and prevalent cases will sextuple by 2025. Our results showed the incidence of childhood type 1 diabetes was rising rapidly in Shanghai. More studies are needed to analyze incidence changes in other regions of China for appropriate allocation of healthcare resources.

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Objective. To develop a method to allow a hospital to compare its performance using its entire patient population to the outcomes of very similar patients treated elsewhere. Data Sources/Setting. Medicare claims in orthopedics and common general, gynecologic, and urologic surgery from Illinois, New York, and Texas from 2004 to 2006. Study Design. Using two example "focal" hospitals, each hospital's patients were matched to 10 very similar patients selected from 619 other hospitals. Data Collection/Extraction Methods. All patients were used at each focal hospital, and we found the 10 closest matched patients from control hospitals with exactly the same principal procedure as each focal patient. Principal Findings. We achieved exact matches on all procedures and very close matches for other patient characteristics for both hospitals. There were few to no differences between each hospital's patients and their matched control patients on most patient characteristics, yet large and significant differences were observed for mortality, failure-to-rescue, and cost. Conclusion. Indirect standardization matching can produce fair audits of quality and cost, allowing for a comprehensive, transparent, and relevant assessment of all patients at a focal hospital. With this approach, hospitals will be better able to benchmark their performance and determine where quality improvement is most needed. Key Words. Quality of care, outcomes research, health care research, costThe aim of this paper was to develop a new tool for examining how well hospitals treat their patients and to aid hospitals in identifying subgroups of patients displaying especially good or bad outcomes compared to matched patients treated at other hospitals. We will base this evaluation on a new approach we call indirect standardization matching (ISM).

Postpartum depression is associated with adverse consequences for mother and offspring. The heritable ABO blood group has been associated with multiple diseases, including mental illness and diabetes. We explored the association of ABO blood group and postpartum depressive symptoms (PPDS) in a population-based cohort of pregnant Chinese women. From 2010 to August 2012, we recruited 8842 pregnant women with a mean age of 28.5 years (SD: 2.94) and mean body mass index of 22.4kg/m (SD: 3.45) in Tianjin, China. We used the Mainland Chinese version of the Edinburgh Postnatal Depression Scale after delivery with a cutoff score of 10 to define PPDS. Odds ratios (ORs) and 95% confidence intervals (CIs) for PPDS were obtained using binary logistic regression. Of 8842 women, 8.5% (n = 747) developed PPDS. Compared to those with blood group B, women with blood groups A, AB or O had a higher odds of PPDS (adjusted ORs: 1.23 (95% CI: 1.13-1.40), 1.31 (95% CI: 0.98-1.74), and 1.30(95% CI:1.03-1.60), respectively). Blood group B was associated with reduced odds of PPDS in pregnant Chinese women. If replicated in other studies, non-blood group B may be a useful risk factors for PPDS in Chinese pregnant women.

IntroductionSpecimen adequacy is a crucial preanalytical factor affecting accuracy and usefulness of test result. The aim of this study was to determine the frequency and reasons for rejected haematology specimens, preanalytical variables which may affect specimen quality, and consequences of rejection, and provide suggestions on monitoring quality indicators as to obtain a quality improvement.Materials and methodsA cross-sectional survey was conducted and a questionnaire was sent to 1586 laboratories. Participants were asked to provide general information about institution and practices on specimen management and record rejections and reasons for rejection from 1st to 31st July.ResultsA total survey response rate was 56% (890/1586). Of 10,181,036 tubes received during the data collection period, 11,447 (0.11%) were rejected, and the sigma (σ) was 4.6. The main reason for unacceptable specimens was clotted specimen (57%). Rejected specimens were related to source department, container type, container material type, transportation method and phlebotomy personnel. The recollection of 84% of the rejected specimens was required. The median specimen processing delay in inpatient, outpatient and emergency department were 81.0 minutes, 57.0 minutes and 43.3 minutes, respectively.ConclusionsOverall, rejection rate was a slightly lower than previously published data. In order to achieve a better quality in the preanalytical phase, haematology laboratories in China should pay more attention on training for phlebotomy and sample transportation, identify main reasons for clotted specimen and take effective measures. The platform in the study will be helpful for long-term monitoring, but simplification and modification should be introduced in the following investigation.

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The number of blastomeres of human day 3 embryos is one of the most important criteria for evaluating embryo viability. However, due to the transparency and overlap of blastomeres, it is a challenge to recognize blastomeres automatically using a single embryo image. This study proposes an approach based on least square curve fitting (LSCF) for automatic blastomere recognition from a single image. First, combining edge detection, deletion of multiple connected points, and dilation and erosion, an effective preprocessing method was designed to obtain part of blastomere edges that were singly connected. Next, an automatic recognition method for blastomeres was proposed using least square circle fitting. This algorithm was tested on 381 embryo microscopic images obtained from the eight-cell period, and the results were compared with those provided by experts. Embryos were recognized with a 0 error rate occupancy of 21.59%, and the ratio of embryos in which the false recognition number was less than or equal to 2 was 83.16%. This experiment demonstrated that our method could efficiently and rapidly recognize the number of blastomeres from a single embryo image without the need to reconstruct the three-dimensional model of the blastomeres first; this method is simple and efficient.

The imprecision performance of HbA1c tests has been improved in these 5 years with the change in IQC practice, but it is still disappointing in China. Therefore, laboratories should actively find existing problems and take action to promote performance of HbA1c measurements.