Population-based study: breast cancer mortality trend in women in the state of Paraná from 2000 to 2017

Objective: Breast cancer is one of the main challenges in Brazilian public health due to the high associated mortality. Mortality has different patterns according to age group, usually increasing with age. The demographic stability in Paraná, with the growth of the elderly population, has a direct impact on the epidemiology of this disease. This study aimed to assess, on a population-based basis, the rates and trends of mortality from breast cancer among the age groups of women in the state of Paraná from 2000 to 2017. Methods: A statistical descriptive retrospective series study was carried out to analyze, on a population-based basis, the trend in breast cancer mortality rates among the age groups of women in the state of Paraná, from 2000 to 2017. The trend analysis of annual mortality rates was carried out through the software and simple linear regression models. Results: The population-based analysis showed that women aged 45­54 and 55­64 years had the highest number of deaths during the study period. However, when calculating the mortality rates by age group, it was observed that the mortality pattern increases proportionally to the longevity of the female population in the state. Trend analyses indicated an upward trend in mortality among women aged 25­34 years throughout the study period. The same trend was observed in women aged 35­44 years, but in a shorter period, from 2005 to 2017. Conclusion: Mortality rates, per 100,000 women, were directly proportional to age, increasing with age, indicative of greater mortality from the disease in elderly women. There was a trend of increasing mortality, with statistical significance, in the age groups from 25 to 34 and 35 to 44. The others were considered stable trends.

Comparisons of dose distributions between IMPT and VMAT for pancreatic cancer / 中华放射医学与防护杂志

Objective:To compare dose distributions of hypofractionated radiotherapy for pancreatic cancer between IMPT and VMAT.Methods:Ten pancreatic cancer cases were included in this retrospective study. Photon (Edge) and proton (Proteus?PLUS) plans were designed by Eclipse and RayStation TPS, respectively. All plans were transferred to MIM system for extraction of parameters, which included Dmin, Dmean and Dmax of PTV, conformity index (CI), new conformity index (nCI), homogeneity index (HI), gradient index (GI), coverage, Dmax and dose-volume of the organs at risk (OARs). Results:There was no significant difference in CI between the two groups. The higher PTV Dmin, Dmean, Dmax, D98%, D2%, HI, coverage and the better GI, D2 cmwere found in VMAT ( t/ Z=-4.63-5.32, P<0.05). The lower 10%_PD was found in IMPT ( t=-7.47, P<0.05). Regarding the OARs, Dmax of the intestine, stomach, and duodenum and Dmean of the left kidney were similar between two groups without significant difference ( P>0.05). The D5 cm 3 of the intestine, D10 cm 3 of the stomach, D5 cm 3 and D10 cm 3 of the duodenum, D2/3 of the left kidney, Dmean and D2/3 of the right kidney were lower in IMPT than those in VMAT ( t/ Z=-8.12--2.60, P<0.05). However, the Dmax and D0.35 cm 3 of the spinal cord were higher in IMPT than those in VMAT ( t=7.30, 6.77, P<0.05). Conclusions:Both of hypofractionated radiotherapy plans of pancreatic cancer designed by VMAT and IMPT could meet clinical needs. No significant difference was found in Dmax of the adjacent gastrointestinal tracts between the two groups. While IMPT had the advantage over VMAT in the case of lower dose-volumes of the gastrointestinal tracts. Nevertheless, less protections of the OARs in front of the tumor volume could be provided by IMPT compared with VMAT.

Fatores associados à insatisfação com a Imagem Corporal em adultos: análise seccional do ELSA-Brasil / Factors associated with body image dissatisfaction in adults: a cross-sectional analysis of the ELSA-Brasil Study

Resumo O objetivo deste artigo é avaliar a associação entre imagem corporal e variáveis sociodemográficas e comportamentos de saúde, por sexo masculino e feminino. Analisou-se dados de 6.289 mulheres e 5.188 homens, entre 35 e 59 anos, participantes da linha de base do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) com a utilização da regressão multinomial. Entre as mulheres, a chance de insatisfação por se sentirem magras foi mais alta entre as com menor escolaridade e as que consumiam frutas semanalmente. A prática de atividade física moderada reduziu em 50% a chance deste tipo de insatisfação. Graus mais elevados de insatisfação por estar acima do peso foram observados entre as casadas, as que praticam atividade física leve e as ex-fumantes. Homens com nível médio de escolaridade e consumo excessivo de álcool tiveram em torno de 50% de chances mais elevadas de insatisfação por baixo peso, posto que a prática de atividade física leve ou moderada elevou essa chance em 75% e 94%, respectivamente. Entre os homens, a prática de atividade física leve e moderada também aumentam a chance de insatisfação por estarem acima do peso. Esses achados contribuem para reforçar que hábitos e comportamentos não saudáveis podem influenciar a insatisfação da imagem corporal com padrões diferenciados, segundo sexo.

Abstract The aim of this article is to assess the association between body image dissatisfaction and sociodemographic and health behaviors, according to sex. Data were analyzed for 6,289 women and 5,188 men (35-59 years), participants in the baseline of the Longitudinal Study of Adult Health (ELSA-Brasil), using multinomial regression. The odds of dissatisfaction due to feeling underweight were higher among in women with low schooling and those who only consumed fruit weekly. Moderate physical activity reduced this type of dissatisfaction by 50%. Higher odds of dissatisfaction due to overweight were seen in married women, those who practiced light physical activity, and former smokers. Men with secondary schooling and excessive alcohol consumption showed 50% higher odds of dissatisfaction due to underweight, while light or moderate physical activity increased the odds by 75% and 94%, respectively. Among men, light and moderate physical activity were also associated with increased odds of dissatisfaction due to overweight. These findings corroborate that unhealthy habits and behaviors can influence body image dissatisfaction with different patterns between women and men.

Desempeño del sistema de vigilancia colombiano durante la pandemia de COVID-19: evaluación rápida de los primeros 50 días / Performance of the Colombian surveillance system during the COVID-19 pandemic: A rapid evaluation of the first 50 days

Introducción. La pandemia de COVID es un desafío para la vigilancia en salud pública y una oportunidad para evaluar sus fortalezas y debilidades en aras de mejorar la respuesta. Objetivo. Evaluar el desempeño del sistema de vigilancia en salud pública colombiano durante los primeros 50 días de la pandemia de COVID-19 en el país. Materiales y métodos. Se analizaron los datos publicados entre el 6 de marzo y el 24 de abril de 2020 por el Instituto Nacional de Salud y la Organización Mundial de Salud (OMS). Se consideraron en la evaluación: i) la calidad de los datos según la ley de Benford y ii) la oportunidad de la información, medida como la diferencia en fechas entre los datos generados en el Instituto Nacional de Salud y los recogidos en el informe situacional de la OMS. La variabilidad en el cumplimiento de la ley de Benford se evaluó con los valores de p en las pruebas de razón del logaritmo de la verosimilitud, ji al cuadrado o exacta de Moreno. Resultados. Hasta el 24 de abril hubo 4.881 casos de COVID-19 en Colombia. En la mayoría de los primeros 50 días se cumplió la ley de Benford, excepto en los primeros días de la epidemia. La diferencia entre los informes del Instituto Nacional de Salud y la OMS ha dependido, en gran medida, de la diferencia en los horarios de cierre de la información. Conclusión. En general, el sistema de vigilancia en salud pública colombiano cumplió con la ley de Benford, lo cual sugiere que hubo calidad en los datos. En futuros estudios que comparen el desempeño de los departamentos y distritos se podrá mejorar el diagnóstico de la vigilancia en salud pública del país.

Introduction: The COVID pandemic is a challenge for public health surveillance and an opportunity to assess its strengths and weaknesses to improve the response. Objective: To evaluate the performance of the Colombian public health surveillance system during the first 50 days of the COVID-19 pandemic in the country. Materials and methods: We analyzed the data published between March 6 and April 24, 2020, by the Instituto Nacional de Salud and the World Health Organization (WHO). We evaluated: i) the quality of the data according to the fulfillment of Benford's law, and ii) the timeliness of the information measured as the difference in dates between the data generated by the Instituto Nacional de Salud and WHO's situational reports. We assessed the fulfillment of Benford's law using the p values of the log-likelihood ratio, the chi square or Moreno's exact tests. Results: Until April 24 there were 4,881 cases of COVID-19 in Colombia. During most of the first 50 days of the pandemic, Benford's law was fulfilled except the first days of the epidemic. The difference between Instituto Nacional de Salud and WHO reports largely depends on the different reporting times. Conclusion: In general, the Colombian public health surveillance system fulfilled Benford's law suggesting that there was quality in the data. Future studies comparing the performance of the departments and districts will improve the diagnosis of the Colombian surveillance system.

Evaluación comparativa de la vigilancia en salud pública de COVID-19 en Colombia: primer semestre / Benchmarking of public health surveillance of COVID-19 in Colombia: First semester

Introducción. La vigilancia en salud pública y las decisiones sanitarias recomendadas son fundamentales para el manejo adecuado de la pandemia de SARS-CoV-2. Objetivo. Hacer una evaluación comparativa del desempeño de los departamentos colombianos de este atributo del sistema de vigilancia con base en la calidad de los datos y construir la clasificación nacional según el desempeño. Materiales y métodos. Se analizaron los casos acumulados publicados por el Instituto Nacional de Salud entre el 6 de marzo y el 1° de septiembre de 2020. Para la comparación, los análisis consideraron el día en que se diagnosticó el primer caso como la primera fecha de análisis de cada departamento. El cumplimiento de la ley de Benford se evaluó con los valores de p en las pruebas de razón del logaritmo de la verosimilitud o ji al cuadrado. Se completó el análisis del atributo de calidad del dato con la letalidad observada en cada departamento, y se estableció la clasificación según el desempeño. Resultados. La ciudad de Bogotá y el departamento del Valle del Cauca tuvieron un desempeño óptimo en la vigilancia en salud pública durante todo el periodo observado. Los datos sugieren que los departamentos de Antioquia, Nariño y Tolima tuvieron una buena contención y una adecuada vigilancia en salud pública después de la apertura económica iniciada el 1° de junio de 2020. Conclusión. Se obtuvo una clasificación de los departamentos y de Bogotá según la calidad de los datos de vigilancia en salud pública. Los mejores cinco entes territoriales pueden ser casos de estudio para determinar los elementos asociados con el buen desempeño.

Introduction: Public health surveillance together with good sanitary decisions is essential for the proper management of the SARS-CoV-2 pandemic. Objective: To compare the performance of Colombian departments based on the quality of the data and to build the national ranking. Materials and methods: We analyzed the accumulated cases published between March 6 and September 1, 2020, by the Instituto Nacional de Salud. To achieve comparability, the analyses considered the day the first case was diagnosed as the first analysis date for each department. The fulfillment of Benford's law was assessed with p-values in the log-likelihood ratio or chi-square tests. The analysis was completed with the lethality observed in each department and then the performance ranking was established. Results: Bogotá and Valle del Cauca had optimal public health surveillance performance all along. The data suggest that Antioquia, Nariño, and Tolima had good containment and adequate public health surveillance after the economic opening beginning on June 1, 2020. Conclusion: We obtained the ranking of the departments regarding the quality of public health surveillance data. The best five departments can be case studies to identify the elements associated with good performance.

Distribución de temperatura y salinidad en campañas oceanográficas recientes en el Pacífico Tropical Oriental de Costa Rica

Introducción: Para Costa Rica, los estudios realizados en el Pacífico Tropical Este o PTE son importantes ya que se relacionan con el Corredor Marino del Pacífico Este Tropical, el cual es un esfuerzo de conservación multinacional. El presente estudio describe los parámetros físicos de temperatura del mar y salinidad del océano de las masas de agua que rodean a la Isla del Coco y su entorno, el PTE, a través del análisis de perfiles de CTD obtenidos durante campañas hidrográficas realizadas entre el año 2008 y el 2012; y comparar los resultados de los datos in-situ con los del reanálisis del modelo HYCOM-NCODA. Métodos: Se compilaron los resultados de 8 diferentes campañas científicas a la Isla del Coco de abril de 2008, marzo de 2009, abril de 2010, julio de 2011 y marzo de 2012. También se analizan las campañas de octubre de 2010 y marzo de 2011 en donde se realizó un transecto latitudinal y un transecto longitudinal en las aguas del Pacífico Tropical Este de Costa Rica. En julio de 2012 se realizaron 3 transectos latitudinales en las aguas en torno a la Isla del Coco. Las mediciones se hicieron por medio de un CTD, instrumento utilizado para determinar la conductividad, temperatura y presión de la columna de agua, entre otras variables. Resultados: Se observó la presencia de Agua Superficial Tropical en los primeros 50m de profundidad, con temperaturas superiores a 25°C y salinidades menores 33psu y Agua Sub-superficial Sub-tropical bajo los 60m con temperaturas menores a 25°C y salinidades alrededor de las 35ups. La zona de transición entre ellas se presentó entre los 50-60m. Los resultados de la temperatura del mar y la salinidad de los transectos analizados reflejan las condiciones climáticas y atmosféricas observadas, en donde se nota que las variaciones estacionales en el PTE están fuertemente influenciadas por la migración meridional de la Zona de Convergencia Inter-Tropical. Conclusiones: El estudio mostró que los datos del reanálisis del modelo de circulación general HYCOM-NCODA son comparables con los resultados de los perfiles del CTD en el PTE. La distribución de la temperatura de los muestreos tiende a ser similar a los datos del modelo oceánico y las principales diferencias se dan en la capa profunda para la salinidad, por lo que el modelo HYCOM es capaz de reproducir las características observadas en el PTE de temperatura y salinidad y puede ser usado para estudiar la dinámica tropical oceánica, en regiones más extensas y en otras épocas del año.

Introduction: In Costa Rica, studies done in the Eastern Tropical Pacific or ETP are important because of their interaction/relationship with the Eastern Tropical Pacific Seascape, a known multinational conservation initiative. The present study describes the physical parameters of sea temperature and salinity around Cocos Island and its environment, the ETP, using CTD profiles. Methods: Data were obtained in April 2008, March 2009, April 2010, July 2011 and March 2012 near this island. Latitudinal and longitudinal transects were also done during October 2010 and March 2011 in a broader Costa Rican ETP region. In July 2012, three latitudinal transects were done around Cocos Island. Records were obtained using a CTD, measuring conductivity, temperature and pressure, among other variables. Results: Tropical Surface Water was observed in the upper 50m, showing temperatures above 25°C and salinities below 33psu. Below the surface waters, Subsurface Subtropical Water was detected below a 60m depth, showing temperatures colder than 25°C and salinities around 35psu. The transition between these waters was around 50-60m in depth. Temperature and salinity results were related with the atmosphere conditions observed, in which ETP variability was strongly influenced by the Inter Tropical Convergence Zone migration. Conclusions: This study also showed that reanalysis data from the HYCOM-NCODA general circulation model are comparable and in a good agreement with the CTD profiles. Temperature and salinity HYCOM data also reproduced, in general terms, the main characteristics of CTD data, having some small differences in the deeper levels. This reanalysis data set could also be used to study the tropical ocean dynamics, in wider ETP regions and for different seasons.

A metrics method for cellular network structure / 中国组织工程研究

BACKGROUND: Communication between cells is indispensable in a multicellular organism society. Many cells communicate with each other, forming a complex cellular network structure. It is very important to measure and evaluate the relevant attribute values of cellular network structure. OBJECTIVE: To propose a metrics method of cellular network structure based on a complex network. METHODS: Based on literature research and practical application, the metrics framework of cellular network structure was established. The structure of cellular network was measured in the aspects of the degree of node, the degree distribution of cellular network, the average path length of cellular network and the cluster coefficient of cellular network. A small experiment was taken as an example to verify the validity of the method. RESULTS AND CONCLUSION: In the degree distribution of cellular networks, the degree values of most cell nodes are relatively small, and only a small number of cell nodes have higher degree values. The more obvious power-law distribution of the degree distribution P(k) of cell nodes indicates the more reasonable structure of the cellular network as well as the more normal cellular network. At the same time, many cellular network structures have smaller average path lengths. The larger cluster coefficient of the cellular network indicates the higher aggregation characteristics of the cellular network. Generally speaking, the tighter the cell network structure is, the more obvious the clustering characteristics of the cell network structure are, and the more normal the cellular network is.

The Influence of Facial Asymmetry on Stress Distributions in Temporomandibular Joints for Patients with Mandibular Prognathism / 医用生物力学

Objective To explore the effects of facial asymmetry on stress distributions in temporomandibular joints (TMJs) for patients with mandibular prognathism. Methods Eight 3D maxillofacial models were established in MIMICS based on cone-beam CT of 4 mandibular prognathism patients with asymmetry and 4 mandibular prognathism patients without asymmetry. Muscle forces and boundary conditions corresponding to the unilateral occlusion (unilateral molar chewing) were applied on the models in ABAQUS. The maximum and the minimum principal stresses of TMJ were chosen for analysis. Results There were significant differences in the maximum and minimum principal stresses at the condyles between the mandibular prognathism patients with and without facial asymmetry under unilateral occlusions (P<0-05). Compared with patients without facial asymmetry, the stresses on the condyle in patients with asymmetry increased by 2-3 times, and the stresses on articular fossa increased by 5-7 times. Among the mandibular prognathism patients with asymmetry, the stresses of the ipsilateral TMJ in patients with temporomandibular disorder (TMD) were significantly higher than those in patients without TMD. Conclusions Facial asymmetry increased the stresses of the articular fossa and condyle in patients with mandibular prognathism. TMD would cause greater stresses in ipsilateral TMJ of the mandibular prognathism patient with asymmetry. Therefore, different treatment strategies should be considered for mandibular prognathism with facial asymmetry.

Development of Models for Rainfall Intensity- duration-frequency for Akure, South-west, Nigeria

The rainfall Intensity-Duration-Frequency (IDF) relationship is widely used for adequate estimation of rainfall intensity over a particular catchment. A 25 year daily rainfall data were collected from Nigerian Meteorological Agency (NIMET) Abuja for Akure station. Twenty five year annual maximum rainfall amounts with durations of 5, 10, 15, 20, 30, 45, 60, 90, 120, 180, 240, 300 and 420 minutes were extracted and subjected to frequency analysis using the excel solver software wizard. A total of six (6) return period specific and one (1) general IDF models were developed for return periods of 2, 5, 10, 25, 50 and 100 years using Gumbel Extreme Value Type-1 and Log Pearson Type -3 distributions. Anderson Darling goodness of fit test was used to ascertain the best fit probability distribution. The R2 values range from 0.982 to 0.985 for GEVT -1 and 0.978 to 0.989 for Log Pearson type -3 while the Mean Squared Error from 33.56 to 156.50 for GEVT -1 and 43.01 to 150.63 Log Pearson Type III distributions respectively. The probability distribution models are recommended for the prediction of rainfall intensities for Akure metropolis.

Relationship between Tissue Distributions of Modified Wuzi Yanzong Prescription () in Rats and Meridian Tropism Theory / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between tissue distributions of modified Wuzi Yanzong prescription (, MWP) in rats and meridian tropism theory.</p><p><b>METHODS</b>A high-performance liquid chromatography with Fourier transform-mass spectrometry (HPLC-FT) method was used to identify the metabolites of MWP in different tissues of rats after continued oral administration of MWP for 7 days. The relationship between MWP and meridian tropism theory was studied according to the tissue distributions of the metabolites of MWP in rats and the relevant literature.</p><p><b>RESULTS</b>Nineteen metabolites, mainly flavanoid compounds, were detected in the different rat tissues and classified to each herb in MWP. Further, it was able to establish that the tissue distributions of the metabolites of MWP were consistent with the descriptions of meridian tropism of MWP available in literature, this result might be useful in clarifying the mechanism of MWP on meridian tropism. In the long run, these data might provide scientific evidence of the meridian tropism theory to further promote the reasonable, effective utilization, and modernization of Chinese medicine.</p><p><b>CONCLUSION</b>The tissue distributions of MWP in vivo were consistent with the descriptions of meridian tropism of MWP.</p>

Epidemiological characteristics and pathogenic analysis of bacillary dysentery in Zhengzhou city from 2004 to 2016 / 天津医药

Objective To understand the epidemic and etiological characteristics of bacillary dysentery and provide scientific evidence for the prevention strategies. Methods The surveillance data and serotyping of bacillary dysentery in Zhengzhou city from 2004 to 2016 were analyzed by descriptive epidemiological method.Results A total of 29 284 cases of bacillary dysentery were reported in Zhengzhou from 2004-2016.The average annual incidence was 31.28 per 100 000 and decreased annually(χ2=103.60,P<0.001).The peak season was from May to October.The incidence was higher in city than that of county,and male was higher than female.The majority of the bacillary dysentery cases was children under 3 years old, and scattered children were the main population at risk.A total of 385 Shigella strains were isolated and identified from 2004 to 2016, and 72.35% (280 strains) of strains were Shigella flexneri. F2a subtype was dominated, but the detective rate of Shigella sonnei was increased gradually. Conclusion Bacillary dysentery is still one of important infectious diseases in Zhengzhou,comprehensive measures should be taken to decrease the incidence including health education in targeted area and people in epidemic season.

Central limit theorem: the cornerstone of modern statistics / 대한마취과학회지

According to the central limit theorem, the means of a random sample of size, n, from a population with mean, µ, and variance, σ², distribute normally with mean, µ, and variance, σ²/n. Using the central limit theorem, a variety of parametric tests have been developed under assumptions about the parameters that determine the population probability distribution. Compared to non-parametric tests, which do not require any assumptions about the population probability distribution, parametric tests produce more accurate and precise estimates with higher statistical powers. However, many medical researchers use parametric tests to present their data without knowledge of the contribution of the central limit theorem to the development of such tests. Thus, this review presents the basic concepts of the central limit theorem and its role in binomial distributions and the Student's t-test, and provides an example of the sampling distributions of small populations. A proof of the central limit theorem is also described with the mathematical concepts required for its near-complete understanding.

Characteristics of spatiotemporal distribution on severe fever with thrombocytopenia syndrome in Henan province / 中华流行病学杂志

Objective To explore the characteristics regarding temporal,spatial and spatiotemporal distribution on severe fever with thrombocytopenia syndrome (SFTS) in Henan province.Methods Surveillance data related to SFTS was collected in Henan province,from year 2014 to 2016.Descriptive method was used to analyze the distribution of SFTS.1.7.0 software related to the Public health geographic information system (PHGIS),was applied to draw the spatial distribution map of SFTS.Chi-square test was used to compare the different incidence rates.Results A total of 2 781 SFTS cases,including 34 deaths,were reported in Henan province from 2014 to 2016,with an average annual fatality rate as 1.22％.There were statistically significant differences for the incidence rates of SFTS between different years (P＜0.01).Cases were mainly concentrated from April to October,which accounted for 96.66％ of the total number,with the incidence peak seen in May.Incidence rates of SFTS in spring,summer,autumn were higher than that in winter.The cases were scattering around in 26 counties of 8 cities.Xinyang city reported 2 714 cases,accounting for 97.59％ of the total number of cases in the province.The average annual incidence rate in Xinyang city was 17.22 per 100 000,much higher than that for the whole Henan province (0.98 per 100 000),with statistically significant difference (P＜0.01).Six counties reported having death cases,that accounted for 23.08％ of the total number of counties,reported to have death cases.Two kinds of incidence patterns of SFTS were noticed in Henan province,with aggregation in some local regions or sporadic in individual counties.The number of counties with reporting cases increased annually.The epidemic area was expanding and gradually spreading from south to north areas of the province.Conclusions SFTS was characterized with both temporal and spatial clusters in Henan province.Effective prevention and control measures should be made in accordance with the spatiotemporal distribution and the trend on SFTS.

Characteristics of spatiotemporal distribution on severe fever with thrombocytopenia syndrome in Henan province / 中华流行病学杂志

Objective To explore the characteristics regarding temporal,spatial and spatiotemporal distribution on severe fever with thrombocytopenia syndrome (SFTS) in Henan province.Methods Surveillance data related to SFTS was collected in Henan province,from year 2014 to 2016.Descriptive method was used to analyze the distribution of SFTS.1.7.0 software related to the Public health geographic information system (PHGIS),was applied to draw the spatial distribution map of SFTS.Chi-square test was used to compare the different incidence rates.Results A total of 2 781 SFTS cases,including 34 deaths,were reported in Henan province from 2014 to 2016,with an average annual fatality rate as 1.22％.There were statistically significant differences for the incidence rates of SFTS between different years (P＜0.01).Cases were mainly concentrated from April to October,which accounted for 96.66％ of the total number,with the incidence peak seen in May.Incidence rates of SFTS in spring,summer,autumn were higher than that in winter.The cases were scattering around in 26 counties of 8 cities.Xinyang city reported 2 714 cases,accounting for 97.59％ of the total number of cases in the province.The average annual incidence rate in Xinyang city was 17.22 per 100 000,much higher than that for the whole Henan province (0.98 per 100 000),with statistically significant difference (P＜0.01).Six counties reported having death cases,that accounted for 23.08％ of the total number of counties,reported to have death cases.Two kinds of incidence patterns of SFTS were noticed in Henan province,with aggregation in some local regions or sporadic in individual counties.The number of counties with reporting cases increased annually.The epidemic area was expanding and gradually spreading from south to north areas of the province.Conclusions SFTS was characterized with both temporal and spatial clusters in Henan province.Effective prevention and control measures should be made in accordance with the spatiotemporal distribution and the trend on SFTS.

Monitoring the Paraguayan epidemiological dengue surveillance system (2009-2011) using Benford's law

ABSTRACT Introducción. El dengue es la principal arbovirosis en el mundo. En Paraguay reapareció en 1988-1989, y en el 2011 se produjo uno de los mayores brotes epidémicos. Objetivo. Evaluar el desempeño del sistema de vigilancia epidemiológica del dengue en Paraguay entre 2009 y 2011. Materiales y métodos. Se hizo un estudio ecológico basado en datos secundarios de la vigilancia epidemiológica. Con base en la distribución esperada según la ley de Benford, se analizaron los casos notificados de la enfermedad; para tal fin, se usaron los primeros y segundos dígitos de los registros globales y estratificados por regiones, estaciones, densidad poblacional, indicadores de las condiciones de la vivienda y número de cabezas de ganado bovino. Resultados. El sistema de vigilancia epidemiológica se desempeñó mejor durante los periodos no epidémicos, y en los departamentos donde existen mejores condiciones de vivienda y pocas cabezas de ganado bovino. Conclusión. Dadas las diferencias de desempeño, se recomendó que el sistema mantenga la alerta incluso cuando no se espere un mayor número de casos. El método propuesto para evaluar la notificación de casos es fácil de transferir al personal operativo.

RESUMEN Introduction: Dengue is the most widespread arbovirus worldwide. In Paraguay, it reappeared in 1988-1989, with one of the largest epidemic outbreaks occurring in 2011. Objective: To evaluate the performance of the dengue epidemiological surveillance system in Paraguay between 2009 and 2011. Materials and methods: We conducted an ecological study with secondary epidemiological surveillance data. We analyzed notified cases of the disease based on the distribution expected by Benford's law. To this end, we used the first and second digits from the global records stratified by region, season, population density, indicators of housing conditions and heads of cattle. Results: The epidemiological surveillance system performed better during non-epidemic periods and in the states with better housing conditions and fewer heads of cattle. Conclusion: Given that a difference in the performance existed, we recommended that the system remains operating at the same high alert level even during periods when fewer cases are expected. The technology used by the method proposed to monitor the notification of cases is easy to transfer to operational staff.

Study on the epidemiological characteristics and influencing factors of scrub typhus in the autumn-winter natural foci, from 2006 to 2013 / 中华流行病学杂志

Objective To investigate the spatiotemporal expansion and risk factors of scrub typhus (ST) in Shandong,Jiangsu and Anhui provinces.Methods Based on the reported cases in Shandong and Jiangsu from 2006 to 2013,and Anhui from 2008 to 2013 epidemiological characteristics of ST and associated environmental factors were analyzed,using the panel negative binomial regression model.Results A total of 2 968,2 331 and 3 447 ST cases were respectively reported in Shandong,Jiangsu and Anhui during 2006-2013,with the average annual incidence rates as 0.39,0.38 and 0.94 per 100 000 population.Uptrend in Shandong and Jiangsu,but a slight rollback seen in Anhui were observed.Expansion of natural foci was found in the 3 provinces,with affected counties accounted for 38.0％,48.2％ and 46.5％ in Shandong,Jiangsu and Anhui,respectively in 2013.Cases were clustered in autumn but with a peak of single epidemic appeared in October or November,in all the 3 provinces.More female and elderly patients were seen,than in the other age groups,in all the 3 provinces.Majority of the cases were farmers,with an increasing trend in incidence,in all these provinces,followed by housekeepers in Shandong and preschool children in Anhui.The risk factors of transmission in all the 3 provinces were negatively associated with the monthly precipitation,and showing an "inverted-U" pattern in association with monthly temperature.A positive relationship between the risk of transmission and monthly relative humidity was found in Shandong and Jiangsu provinces.However,an "inverted-U" pattern between the risk of transmission and the monthly sunshine hour,appeared in Shandong and Anhui provinces.The incidence of Scrub typhus in Shandong was also positively related to the coverage of forest.Conclusion Surveillance programs and health education measures should focus on the warm and moist areas in all the 3 provinces,and also on forestry areas in Shandong.Health education and prevention on mite-bite should be targeted,especially on high-risk populations as the elderly and farmers,in the 3 provinces.Housekeepers in Shandong and children in Anhui should also be under special concern.

Study on the epidemiological characteristics and influencing factors of scrub typhus in the autumn-winter natural foci, from 2006 to 2013 / 中华流行病学杂志

Objective To investigate the spatiotemporal expansion and risk factors of scrub typhus (ST) in Shandong,Jiangsu and Anhui provinces.Methods Based on the reported cases in Shandong and Jiangsu from 2006 to 2013,and Anhui from 2008 to 2013 epidemiological characteristics of ST and associated environmental factors were analyzed,using the panel negative binomial regression model.Results A total of 2 968,2 331 and 3 447 ST cases were respectively reported in Shandong,Jiangsu and Anhui during 2006-2013,with the average annual incidence rates as 0.39,0.38 and 0.94 per 100 000 population.Uptrend in Shandong and Jiangsu,but a slight rollback seen in Anhui were observed.Expansion of natural foci was found in the 3 provinces,with affected counties accounted for 38.0％,48.2％ and 46.5％ in Shandong,Jiangsu and Anhui,respectively in 2013.Cases were clustered in autumn but with a peak of single epidemic appeared in October or November,in all the 3 provinces.More female and elderly patients were seen,than in the other age groups,in all the 3 provinces.Majority of the cases were farmers,with an increasing trend in incidence,in all these provinces,followed by housekeepers in Shandong and preschool children in Anhui.The risk factors of transmission in all the 3 provinces were negatively associated with the monthly precipitation,and showing an "inverted-U" pattern in association with monthly temperature.A positive relationship between the risk of transmission and monthly relative humidity was found in Shandong and Jiangsu provinces.However,an "inverted-U" pattern between the risk of transmission and the monthly sunshine hour,appeared in Shandong and Anhui provinces.The incidence of Scrub typhus in Shandong was also positively related to the coverage of forest.Conclusion Surveillance programs and health education measures should focus on the warm and moist areas in all the 3 provinces,and also on forestry areas in Shandong.Health education and prevention on mite-bite should be targeted,especially on high-risk populations as the elderly and farmers,in the 3 provinces.Housekeepers in Shandong and children in Anhui should also be under special concern.

Aplicación de un modelo de un acelerador Elekta Precise basado en Monte Carlo para la evaluación de la respuesta de detectores de estado sólido / Application of an Elekta Precise lineal accelerator model based on Monte Carlo to evaluate the solid state detectors response

En el trabajo se realizó el análisis de la respuesta de diferentes detectores de estado sólido a partir de un modelo de Monte Carlo de un acelerador lineal Elekta Precise, para los haces de energías de 6 MV y 15 MV. Para ello se realizaron simulaciones con el código EGSnrc. Se calculó la dosis depositada en un maniquí de agua voxelizado con su superficie a 100 cm de la fuente, empleando los valoresóptimos de energía media y FWHM del haz primario de electrones para este modelo. A partir de la dosis depositada en el maniquí se construyeron las curvas de dosis en profundidad y perfiles de dosis a diferentes profundidades. Las curvas se compararon con valores medidos para cada detector empleado en un arreglo experimental similar a la simulación realizada, aplicando criterios de aceptabilidad basados en intervalos de confianza. De forma adicional se analizó para cada caso la dosis en función del tamaño de campo. Se obtuvo una buena correspondencia entre las simulaciones y las mediciones, encontrándose todos los resultados dentro de los márgenes de tolerancia.

The evaluation of the solid state detectors response based on a Monte Carlo model of an Elekta Precise lineal accelerator, was done in this work for the beam energies of 6 y 15 MV. Simulations were performed using the EGSnrc code. Employing the optimal values of mean energy and FWHM from the primary electron beam, deposited dose in a voxelized water phantom at 100 cm of source to surface distance was calculated. Depth dose curves and lateral dose profi les were obtained. Comparison between simulations and the experimental values obtained for each detector, were done using acceptability criteria based on confi dence limits. Additionally outputs factors were analyzed in each one of the study cases. Good agreement between simulations and measurements were reached.

Application of a Monte Carlo linac model in routine verifications of dose calculations / Aplicación de un modelo de Monte Carlo de un acelerador lineal en la verificación de los cálculos dosimétricos de rutina

The analysis of some parameters of interest in radiotherapy Medical Physics based on an experimentally validated Monte Carlo model of an Elekta Precise lineal accelerator was performed for 6 and 15 MV photon beams. The simulations were performed using the EGSnrc code. As reference for simulations, the values of the previously obtained optimal beam parameters (energy and FWHM) were used. Deposited dose calculations in water phantoms were done, on typical complex geometries commonly are used in acceptance and quality control tests, such as irregular and asymmetric fields. Parameters such as MLC scatter, maximum opening or closing position, and the separation between them were analyzed from calculations in water. Similarly simulations were performed on phantoms obtained from CT studies of real patients, making comparisons of the dose distribution calculated with EGSnrc and the dose distribution obtained from the computerized treatment planning systems used in routine clinical plans. All the results showed a great agreement with measurements, fi nding all of them within tolerance limits. These results allowed the possibility of using the developed model as a robust verifi cation tool for validating calculations in very complex situations, where the accuracy of the available TPS could be questionable.

El análisis de algunos parámetros de interés en la física médica de la radioterapia, basado en un modelo de Monte Carlo de un acelerador Elekta Precise, fue realizado en este trabajo para los haces de fotones de 6 y 15 MV. Las simulaciones se realizaron con el código EGSnrc. Como referencia para las simulaciones, se emplearon los parámetros óptimos (energía y FWHM) previamente calculados. Los cálculos de la dosis absorbida se realizaron con maniquíes de agua sobre geometrías complejas, comúnmente empleadas en las pruebas de aceptación y control de calidad en la clínica. Parámetros de interés como la dispersión en las MLC, máxima posición de apertura o cierre y la separación entre estas se analizaron a partir de los cálculos en agua. De forma similar se realizaron cálculos en maniquíes construidos a partir de los estudios tomográficos, y comparaciones con los resultados reportados por el sistema de planifi cación en dichos casos. Los resultados obtenidos evidenciaron una gran concordancia con las mediciones, encontrándose dentro de los límites de tolerancias reportados. Estos resultados crean la base para el empleo del modelo de Monte Carlo como una herramienta robusta para la verificación y validación de los cálculos de dosis en situaciones de gran complejidad, donde la exactitud de los sistemas de planificación es cuestionable.

Modelización del tiempo de hospitalización en lesiones por tránsito / Modelling length of hospital stay in motor victims

Objetivo. Analizar los factores sociodemográficos y de las lesiones causadas por accidentes de tránsito que influyen en el tiempo de hospitalización de las víctimas. Material y métodos. Muestra transversal de 17 932 eventos de tránsito ocurridos en España entre 2000 y 2007. Se estimaron diferentes modelos de regresión para identificar y medir la influencia de los factores. Resultados. Los hombres tienen un tiempo medio de hospitalización 41% mayor al de las mujeres. La duración de la estancia hospitalaria media aumenta cinco veces cuando existen fracturas. Las lesiones en las extremidades inferiores, la cabeza y el abdomen se asocian con mayores duraciones hospitalarias. Conclusiones. El sexo de la víctima, su edad, la posición que ocupaba en el vehículo en el momento del evento, el tipo de vehículo causante y el tipo y zona de la lesión influyen significativamente en la duración de la estancia hospitalaria.

Objective. To analyze which socio-demographic and other factors related to motor injuries affect the length of hospital recovery stay. Materials and methods. In the study a sample of 17 932 motor accidents was used. All the crashes occurred in Spain between 2000 and 2007. Different regression models were fitted to data to identify and measure the impact of a set of explanatory regressors. Results. Time of hospital stay for men is on average 41% larger than for women. When the victim has a fracture as a consequence of the accident, the mean time of hospital stay is multiplied by five. Injuries located in lower extremities, the head and abdomen are associated with greater hospitalization lengths. Conclusions. Gender, age and type of victim, as well as the location and nature of injuries, are found to be factors that have significant impact on the expected length of hospital stay.