BackgroundResearchers in the medical sciences prefer employing Cox model for survival analysis. In some cases, however, parametric methods can provide more accurate estimates. In this study, we used Weibull model to analyze the prognostic factors in patients with gastric cancer and compared with Cox.MethodsWe retrospectively studied 1715 patients with gastric cancer. Age at diagnosis, gender, family history, past medical history, tumor location, tumor size, eradicative degree of surgery, depth of tumor invasion, combined evisceration, pathologic stage, histologic grade and lymph node status were chosen as potential prognostic factors. Weibull and Cox model were performed with hazard rate and Akaike Information Criterion (AIC) to compare the efficiency of models.ResultsThe results from both Weibull and Cox indicated that patients with the past history of having gastric cancer had the risk of death increased significantly followed by poorly differentiated or moderately differentiated in histologic grade. Eradicative degree of surgery, pathologic stage, depth of tumor invasion and tumor location were also identified as independent prognostic factors found significant. Age was significant only in Weibull model.ConclusionFrom the results of multivariate analysis, the data strongly supported the Weibull can elicit more precise results as an alternative to Cox based on AIC.
This study aims to identify the landscape ecological determinants related to Oncomelania hupensis distribution, map the potential high risk of O. hupensis habitats at the microscale, and assess the effects of two environmental control strategies. Sampling was performed on 242 snail sites and 726 non-snail sites throughout Qianjiang City, Hubei Province, China. An integrated approach of landscape pattern analysis coupled with multiple logistic regression modeling was applied to investigate the effects of environmental factors on snail habitats. The risk probability of snail habitats positively correlated with patch fractal dimension (FD), paddy farm land proportion, and wetness index but inversely correlated with categorized normalized difference vegetation index (NDVI) and elevation. These findings indicate that FD can identify irregular features (e.g., irrigation ditches) in plain regions and that a moderate NDVI increases the microscale risk probability. Basing on the observed determinants, we predicted a map showing high-risk areas of snail habitats and simulated the effects of conduit hardening and paddy farming land rotation to dry farming land. The two approaches were confirmed effective for snail control. These findings provide an empirical basis for health professionals in local schistosomiasis control stations to identify priority areas and promising environmental control strategies for snail control and prevention.
Immunodiagnostic tests are commonly used in the diagnosis for schistosomiasis japonica in field situation. Their diagnostic effect, however, has never been evaluated in a systematic way. We set out to review the value of tests including enzyme-linked immunosorbent assay (ELISA) and indirect hemagglutination assay (IHA) in the diagnosis of schistosomiasis japonica. A comprehensive search was conducted in order to identify all possible studies achieving the inclusion criteria. We undertook a meta-analysis of diagnostic ability that compared ELISA with IHA for the diagnosis of schistosomiasis japonica. Original articles were searched in Pubmed, Science Citation Index Expanded, Cochrane Library, Proquest and China National Knowledge Infrastructure. Data extractions were conducted independently by two reviewers. Summary receiver operating characteristic curves were used to summarize overall test performance. Funnel plot was used to analyze publication bias. Finally, 16 studies met inclusion criteria. In all studies combined, the diagnostic odds ratio (DOR) for IHA was 8.689 (95%CI 7.671 to 9.842) and ELISA was 3.691 (95%CI 3.018 to 4.515). The DOR for IHA was better than that for ELISA. IHA demonstrated TPR* = 0.721 and ELISA showed TPR* = 0.633. IHA performance was superior to that of ELISA. Nevertheless, difference of the accuracy between the two methods for diagnosis of schistosomiasis japonica has no statistical significance as shown by the result of Z test. We found that both IHA and ELISA can be used to rule in or rule out the diagnosis.
ObjectivesWe compared the patterns of medically attended injuries between children with and without disabilities and explored the residential environment risks in five counties of Hubei Province in the People's Republic of China by a 1∶1 matched case-control study based on the biopsychosocial model of the International Classification of Functioning, Disability and Health – ICF.Methods1201 children aged 1–14 with disabilities and 1201 their healthy counterparts matched as having the same gender, same age, and lived in the same neighborhood were recruited in our study. Characteristics of injuries in the past 12 months were compared between children with and without disabilities. The associations among disability status, home environment factors and injuries were examined in logistic regression analysis taking into account sociodemographic factors.ResultsChildren with disabilities had a significantly higher prevalence of injury than children without disabilities (10.2% vs. 4.4%; P<.001). The two groups differed significantly in terms of number of injury episodes, injury place and activity at time of injury. Falls were the leading mechanism of injury regardless of disability status. Most of the injury events happened inside the home and leisure activities were the most reported activity when injured for both groups. The univariate OR for injury was 4.46 (2.57–7.74) for the disabled children compared with the non-disabled children. Disabled children whose family raised cat/dog(s) were 76% more likely to be injured during the last 12 months (OR = 1.76; 95% CI = 1.02, 3.02),comparing with those whose family did not have any cat/dog. And for children without disabilities, those whose family had cat/dog(s) were over 3 times more likely to having injuries comparing with those whose family did not have any cat/dog.ConclusionsChildren with disabilities had a significantly increased risk for injury. Interventions to prevent residential injury are an important public health priority in children with disabilities.
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