Cancer incidence estimates for 2022 & projection for 2025: Result from National Cancer Registry Programme, India

Background & objectives: Information on recent cancer statistics is important for planning, monitoring and evaluating cancer control activities. This article aims to provide an update on the cancer incidence estimates in India by sex, age groups and anatomical sites for the year 2022. Methods: The National Cancer Registry Programme Report 2020, reported the cancer incidence from 28 Population-Based Cancer Registries (PBCRs) for the years 2012-2016. This was used as the basis to calculate cancer estimates in India. Information pertaining to the population at risk was extracted from the Census of India (2001 and 2011) for the estimation of age–sex stratified population. PBCRs were categorised into the respective State and regions of the country to understand the epidemiology of cancer. The age-specific incidence rate for each specific anatomical site of cancer was applied to the estimated population to derive the number of cancer cases in India for 2022. Results: The estimated number of incident cases of cancer in India for the year 2022 was found to be 14,61,427 (crude rate:100.4 per 100,000). In India, one in nine people are likely to develop cancer in his/her lifetime. Lung and breast cancers were the leading sites of cancer in males and females, respectively. Among the childhood (0-14 yr) cancers, lymphoid leukaemia (boys: 29.2% and girls: 24.2%) was the leading site. The incidence of cancer cases is estimated to increase by 12.8 per cent in 2025 as compared to 2020. Interpretation & conclusions: The cancer incidence is continuing to increase in India. The new estimates will be helpful in planning cancer prevention and control activities through the intervention of early detection, risk reduction and management.

Systematic Reviews and Meta-Analysis: A Guide for Beginners

Systematic reviews involve the application of scientific methods to reduce bias in review of literature. The key components of a systematic review are a well-defined research question, comprehensive literature search to identify all studies that potentially address the question, systematic assembly of the studies that answer the question, critical appraisal of the methodological quality of the included studies, data extraction and analysis (with and without statistics), and considerations towards applicability of the evidence generated in a systematic review. These key features can be remembered as six ‘A’; Ask, Access, Assimilate, Appraise, Analyze and Apply. Meta-analysis is a statistical tool that provides pooled estimates of effect from the data extracted from individual studies in the systematic review. The graphical output of meta-analysis is a forest plot which provides information on individual studies and the pooled effect. Systematic reviews of literature can be undertaken for all types of questions, and all types of study designs. This article highlights the key features of systematic reviews, and is designed to help readers understand and interpret them. It can also help to serve as a beginner’s guide for both users and producers of systematic reviews and to appreciate some of the methodological issues.

Correction of CT radiation dose index and study on fast conversion factor / 中华放射医学与防护杂志

Objective:To explore the influence of different size related parameters of common CT scanned body parts on body-specific dose estimate (SSDE) , in order to establish rapid conversion factors for SSDE.Methods:A total of 189 clinical cases were collected from 6 common CT scanned body parts, including head, nasal bone, sinus, neck, chest, abdomen and pelvis, at Beijing Tongren Hospital, Capital Medical University from March 8 to May 10, 2021. Batch-processing of image was carried out by using Matlabcode. The axial images′area, anteroposterior (AP) dimension, lateral (LAT) dimension and average CT values were calculated. The conversion factors for estimating body-specific dose values were obtained from the real effective diameter ( De) and water equivalent diameter ( Dw) of the clinical cases, and the differences in values were compared between SSDE ED and SSDE WED. Based on the information on AP, LAT, AP + LAT, estimated De, the real De and Dw obtained in clinical practices, the SSDE rapid correction factors for adult body parts were established. The convenient conversion relation between Dw and De was obtained. Based on the correction factors for Dw, the relative errors of the correction factors for various sizes related parameters were compared. Results:The SSDE fast conversion factors for the real De of the 6 body parts were 1.01, 1.01, 1.01, 0.97, 1.28, 1.32, and those for Dw were 0.87, 0.97, 0.98, 0.99, 1.42, 1.36, respectively. The relative errors of different conversion factors ranged from 0.68% to 18.05%. The conversion factors for abdomen and pelvis had the smallest difference, and those for AP and LAT of the chest had the smallest error. The differences between CTDI vol, SSDE ED and SSDE WED in sinus, chest and abdomen were statistically significant ( tsinus=2.44, 4.23, tchest=17.67, 17.00, tabdomen and pelvis =17.93, 18.75, P<0.05) . The differences between CTDI vol and SSDE WED in head, nasal bone, were statistically significant ( t=-22.27, 2.80, P<0.05) , but not with SSDE ED ( P>0.05) . The difference between CTDI vol and SSDE ED in neck was statistically significant ( t=-3.06, P<0.05) but without statistical insignificance in camparison with SSDE WED ( P>0.05) . Conclusions:SSDE WED can be used to accurately evaluate the body-specific dose estimatates, and different size related parameters can be selected for correction in different scanned body parts. The rapid conversion factor can be easily used in clinical practice to improve the accuracy of estimated radiation dose.

Estimativa da necessidade de radioterapia externa no Brasil baseada em critérios epidemiológicos / Optimal utilization of radiotherapy in Brazil according to local epidemiological data

Esta tese teve como objetivo estimar a necessidade de radioterapia no Brasil a partir de dados epidemiológicos locais. O estudo foi desenvolvido em duas etapas que consistiram na estimativa de casos incidentes e, posteriormente, na classificação dos casos registrados nos Registros Hospitalares de Câncer (RHC) para integrar as árvores de decisão para o emprego do tratamento radioterápico conforme evidências e diretrizes clínicas de tratamento. As estimativas de casos incidentes em 2018 foram calculadas a partir de dados de Registros de Câncer de Base Populacional (RCBP) selecionados de acordo com critérios internacionais de qualidade e de dados corrigidos para causas mal definidas e não específicas na causa básica dos óbitos registrados no Sistema de Informação de Mortalidade (SIM) no período de 2007 a 2016. Foram calculadas razões de incidência/mortalidade (I/M) anuais para cada topografia, estratificadas por sexo e faixa etária nos RCBP selecionados. As razões I/M para 2018 foram estimadas para as regiões brasileiras a partir de modelos multiníveis de Poisson a partir de uma abordagem longitudinal com efeito aleatório no RCBP. As razões estimadas foram aplicadas ao número de óbitos ocorridos em 2018 por tipo de câncer, também corrigido para causas mal definidas e não específicas na causa básica, registrados no SIM. As distribuições dos dados por estadiamento obtidas a partir do RHC foram combinadas às frequências relativas por tipo de câncer incidente e aos dados das árvores de decisão do projeto Collaboration for Cancer Outcomes Research and Evaluation (CCORE) para uso da radioterapia. As estimativas de necessidade foram calculadas por tipo de câncer e para o conjunto das neoplasias, exceto pele não melanoma. Foram realizadas análises de sensibilidade para avaliar a relevância dos dados locais na estimativa de necessidade. O número necessário de equipamentos de radioterapia para atender os casos que se beneficiariam do tratamento em algum momento no curso da doença foi calculado e a análise da cobertura da oferta foi realizada. Para o Brasil, em 2018, foram estimados 506.462 casos novos de câncer, exceto pele não melanoma. Diferenças regionais nas razões I/M e no padrão de casos incidentes foram identificadas, podendo estar relacionadas a fatores socioeconômicos. Foi estimado que 53,55% dos casos novos no Brasil teriam necessidade de tratamento radioterápico. A maior necessidade de radioterapia foi identificada para o Norte: 55,32%, com um peso expressivo do câncer do colo do útero, tanto pela incidência como pelo número de casos em estágios avançados, para os quais a radioterapia é considerada tratamento de escolha. Para atender aos casos com necessidade de radioterapia no Brasil, foram estimados 497 equipamentos de radioterapia externa, sendo o déficit estimado em 114 para 2018 no país. Os maiores déficits foram observados para o Norte e para a rede assistencial do SUS. Em conclusão, o emprego de parâmetros internacionais não se mostrou adequado para a realidade brasileira. O planejamento de recursos para a assistência oncológica no Brasil demanda estimativas confiáveis baseadas nas necessidades locais para que as inequidades não sejam ainda mais agravadas.

This thesis aimed to estimate the need for radiotherapy in Brazil based on local epidemiological data. The study was developed in two stages which consisted of estimating incident cases and, later, classifying the cases registered in the Hospital Cancer Registries (RHC) to integrate decision trees for the use of radiotherapy according to evidence and clinical treatment guidelines. The estimates of incident cases in 2018 were calculated based on data from Population-Based Cancer Registries (RCBP) selected according to international quality criteria and from data corrected for ill-defined and non-specific causes in the underlying cause of deaths recorded in the System of Mortality Information (SIM) from 2007 to 2016. Annual incidence/mortality ratios (I/M) were calculated for each topography, stratified by sex and age group in the selected RCBP. The I/M ratios for 2018 were estimated for Brazilian regions using multilevel Poisson models from a longitudinal approach with random effect on the RCBP. The estimated reasons were applied to the number of deaths that occurred in 2018 by type of cancer, also corrected for ill-defined and non-specific causes in the underlying cause, recorded in the SIM. The staging data distributions obtained from the RHC were combined with the relative frequencies by type of incident cancer and data from the Collaboration for Cancer Outcomes Research and Evaluation (CCORE) project decision trees for radiotherapy use. Optimal utilization rates were estimated by type of cancer and for the set of tumors, except for non-melanoma skin. Sensitivity analyzes were performed to assess the relevance of local data in estimating the need. The number of radiotherapy equipment needed to attend to cases that would benefit from treatment at some point in the course of the disease was calculated and the analysis of the offer coverage was performed. For Brazil, in 2018, 506,462 new cases of cancer were estimated, except for non-melanoma skin. Regional differences in I/M ratios and in the pattern of incident cases were identified, which may be related to socioeconomic factors. It was estimated that 53.55% of new cases in Brazil would need radiotherapy. The greatest need for radiotherapy was identified for the North: 55.32%, with an expressive weight of cervical cancer, both in terms of incidence and the number of cases in advanced stages, for which radiotherapy is considered the treatment of choice. To meet the need for radiotherapy in Brazil, 497 external radiotherapy equipment were estimated, with an estimated deficit of 114 for 2018 in the country. The greatest deficits were observed for the North and for the SUS care network. In conclusion, the use of international parameters was not adequate for the Brazilian reality. The planning of resources for cancer care in Brazil requires reliable estimates based on local needs so that inequities are not further aggravated.

Burden of syphilis in Brazil and federated units, 1990-2016: estimates from the Global Burden of Disease Study 2019

ABSTRACT Background: Syphilis is a chronic infectious disease that has created challenging situations for humanity for centuries. Transmission can occur sexually or vertically, with great repercussions on populations, particularly among women and children. The present study presents information on the main burden imposed by syphilis generated by the Global Burden of Disease (GBD) Study 2019 for Brazil and its 27 federated units. Methods: We described the metrics of incidence, deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs), standardized by age and per 100,000 inhabitants, from 1990 to 2019, and we compared the disease burden between the years 1990 and 2019. Results: In Brazil, the disease burden increased between 2005 and 2019 for all metrics. Although a higher incidence of syphilis was found among women in 2019, DALYs [YLLs (males: 15.9%; females: 21.8%), YLDs (males: 25.0%; females: 50.0%), and DALYs (males: 16.2%; females: 22.4%)] were higher among men. In 2019, the highest DALY rate per 100,000 inhabitants was observed in individuals aged above 50 years. The State of Maranhão presented the highest values of DALYs {1990: 165.2 [95% uncertainty interval (UI) 96.2-264.4]; 2005: 43.8 [95% UI 30.3-62.4]; 2019: 29.1 [95% UI 19.8-41.1]} per 100,000 inhabitants in the three years analyzed. Conclusions: The burden of syphilis has increased in recent years. Men presented higher DALYs, although the incidence of the disease was higher in women. Syphilis affects a large number of people across all age groups, causing different degrees of disability and premature death (DALYs).

Fertility trends during successive novel infectious disease outbreaks: Zika and COVID-19 in Brazil / Tendências de fecundidade durante sucessivas epidemias de doenças infecciosas novas: Zika e COVID-19 no Brasil / Tendencias de fecundidad durante los sucesivos brotes de nuevas enfermedades infecciosas: Zika y COVID-19 en Brasil

This study aims to estimate fertility trends in Brazil in the 2010s and early 2020s during a period of back-to-back novel infectious disease outbreaks - Zika virus and COVID-19. We use Brazilian Ministry of Health and Association of Civil Registrar data from 2011-2021 to measure general fertility rates at the national and state levels. We also used seasonal ARIMA model to forecast fertility rates by month and state in 2021 and compared these forecasts with observed fertility rates. We find that fertility rates were steady over 2011-2015 with no statistically significant variation, followed by a sharp decline during the Zika outbreak in 2016 followed by a return to pre-Zika levels after the end of the epidemic. Furthermore, to evaluate the effect of the COVID-19 pandemic, we make comparisons with observed and forecast rates from 2020-2021, showing that declines were generally larger for observed than for forecast rates, yet statistically insignificant. We argue that the resurgence of the COVID-19 pandemic in 2021 might lead to further declines, as women might have not had enough time to adjust rebound from either the effects of the Zika epidemic. We also discuss the importance of timely availability of live births data during a public health crisis with immediate consequences for fertility rates.

O objetivo desta contribuição de dados é estimar as tendências de fecundidade no Brasil nos anos 2010 e início dos anos 2020 durante epidemias consecutivas de doenças infecciosas novas, ou seja, Zika vírus e COVID-19. Utilizamos dados do Ministério da Saúde e do Registro Civil Nacional de 2011-2021 para calcular as taxas mensais de fecundidade nos níveis nacional e estadual. Também utilizamos o modelo ARIMA sazonal para prever taxas de fecundidade por mês e por estado em 2021, e comparamos essas previsões com as taxas de fecundidade observadas. Encontramos que as taxas de fecundidade eram estáveis entre 2011 e 2015, sem variação significativa, seguido por um declínio abrupto durante o surto de Zika em 2016, e seguido por sua vez por um retorno aos níveis pré-Zika depois do fim da epidemia. Além disso, para avaliar o efeito da pandemia de COVID-19, comparamos as taxas observadas e previstas de 2020-2021, mostrando que as quedas geralmente eram maiores nas taxas observadas do que nas previstas, porém sem significância estatística. Argumentamos que o recrudescimento da pandemia de COVID-19 em 2021 poderá levar a mais quedas nas taxas, na medida em que as mulheres não tenham tido tempo suficiente para reagir e se ajustarem aos efeitos da epidemia de Zika. Também discutimos a importância da disponibilidade oportuna de dados sobre nascidos vivos durante uma crise de saúde pública com consequências imediatas para as taxas de fecundidade.

El objetivo de esta aportación de datos es estimar las tendencias de fecundidad en Brasil en la década de 2010 y principios de 2020, durante el período de brotes consecutivos de nuevas enfermedades infecciosas -ZIKV y COVID-19. Se usaron datos procedentes del Ministerio de Salud y del Registro Civil Nacional (ARPEN) desde 2011-2021 para calcular mensualmente las tasas de fecundidad en nivel nacional y en el estado. Se utilizó el ARIMA estacional para pronosticar las tasas de fecundidad por mes y estado en 2021, y se compararon estas predicciones con las tasas de fecundidad observadas. Encontramos que las tasas de fecundidad se mantuvieron estables entre 2011 y 2015, sin variaciones significativas, seguido de un fuerte descenso durante el brote de Zika en 2016, para posteriormente volver a los niveles anteriores al Zika tras el fin de la epidemia. Asimismo, con el fin de evaluar el efecto de la pandemia de COVID-19, hicimos comparaciones con lo observado y la previsión de tasas desde 2020-2021, que muestran que los descensos fueron en general mayores para los índices observados que para los previstos, aunque insignificantes desde el punto de vista estadístico. Sostenemos que el resurgimiento de la pandemia de COVID-19 en 2021 podría provocar nuevos descensos, ya que las mujeres podrían no haber tenido suficiente tiempo para adaptarse a los efectos de la epidemia de Zika. También se discute la importancia de disponer a tiempo de los datos de los nacidos vivos durante una crisis de salud pública con consecuencias inmediatas para las tasas de fecundidad.

Categorical Analysis on Mental Health Status of the people of Kerala during the COVID-19 Pandemic using the Proportional Odds Model

Background: Covid-19 pandemic forced people to get confined to social isolation and maintain social distancing which affected their mental health. The study aims at understanding the impact on the mental health status of people in Kerala, based on their demographic profile and the psychological issues faced during the Covid-19 lockdown. Methodology: The study included 700 respondents from various districts of Kerala telephonic and mailed questionnaires for the period of December 2020 - May 2021. Ordered logit model is used for the econometric analysis using R software. Results: The overall mental health status of an individual is affected by various reasons which are taken as various categories for the analysis. As a result of log odds estimated, Covid-19 patients are more disposed to mental health issues. Male respondents had a positive impact on mental health issues and unmarried people of all gender are disturbed with lockdown distress. Almost all occupational categories taken into account are more or less shaken with the pandemic except those with proper job security including Government and PSU workforces. Psychological, physical well-being is affected by the pandemic lockdown overall mental health system of people of Kerala. Conclusion: Covid-19 pandemic have affected the overall mental health of the people regardless of age and profession which can be more or less solved by the individuals themselves through yoga, meditation, exercise, reading books, gardening, cooking, virtual contacts with friends and family, getting enough sleep, etc. which helps tocan keep the mind relaxed and stable.

Calculation of water equivalent diameter based on anteroposterior localizer CT images / 南方医科大学学报

To explore a method for calculating water equivalent diameter () based on localizer CT images for calculation of the size specific dose estimates (SSDE).GE Revolution CT and LightSpeed VCT were used to scan CT dose index phantoms 16 cm and 32 cm in diameter at the tube voltages of 80, 100 and 120 kV to obtain the axial image and anteroposterior localizer radiograph. According to the definition of CT Hounsfield unit, the axial images were used to calculate the conversion factors that convert the phantom thickness to water equivalent thickness. The gray value of the localizer radiograph and the water equivalent thickness were calibrated with a linear equation, and the parameters of the calibration were used to calculate the water equivalent thickness. The method was verified using 2 CT dose index phantoms and in 22 patients undergoing chest and abdominal CT examination.Comparison of the water equivalent diameter () based on the localizer radiograph and axial image of the 2 phantoms showed that the percentage difference between from the axial images and from the localizer radiograph was below 3%. The trend of variations with location in the two methods was sonsistent. The difference in in intermediate region of interest between the axial image and the localizer radiograph from the 22 patients was below 6.6%. With the mean in the ROI, the maximum percentage difference was 7.5%.Calibration of the gray value of the localizer radiograph and the water equivalent thickness using the axial image and localizer radiograph of CT dose index phantoms allows quick calculation of the SSDE based on the parameters of calibration.

Mulheres que fizeram aborto no Município do Rio de Janeiro, Brasil: aplicação de um modelo hierárquico bayesiano / Mujeres que abortaron en el Municipio de Río de Janeiro, Brasil: aplicación de un modelo jerárquico bayesiano / Women who have undergone abortion in the city of Rio de Janeiro, Brazil: application of a Bayesian hierarchical model

Resumo: Estimativas de mulheres que fizeram aborto provocado em localidades cujas leis são restritivas ainda são escassas na literatura científica, e a não coincidência de estimativas oriundas dos métodos hoje em uso clama pela aplicação de métodos inovadores, como novos métodos indiretos. Tal necessidade é especialmente aguda nas áreas mais densamente povoadas, como as capitais brasileiras, dada a magnitude do fenômeno e os danos e riscos daí decorrentes. O artigo objetiva estimar o número de mulheres que fez aborto provocado no Município do Rio de Janeiro, Brasil, em 2011, por meio de um modelo hierárquico bayesiano. Ele foi aplicado aos dados de um inquérito domiciliar que subsidiou a utilização do método network scale-up, no Município do Rio de Janeiro, um modelo hierárquico bayesiano utilizando as informações indiretas baseadas na rede de contatos dos participantes selecionados de forma aleatória da população. Das 1.758.145 mulheres de 15-49 anos residentes no Município do Rio de Janeiro (13.025; ICr95%: 10.635; 15.748) mulheres fizeram aborto provocado em 2011, resultando numa incidência acumulada média de 7,41 (ICr95%: 6,05; 8,96) para cada 1.000 mulheres de 15-49 anos. O estudo de autovalidação do modelo permitiu identificar padrões de subestimação em subpopulações estigmatizadas com baixa visibilidade social, como mulheres fizeram aborto provocado. O abortamento provocado é uma prática recorrente entre as mulheres no Município do Rio de Janeiro. Novos métodos de estimação indireta podem contribuir para a apreensão mais precisa do evento, considerando o contexto de ilegalidade, e contribuir para formulação de políticas de saúde.

Resumen: Las estimaciones de mujeres que tuvieron un aborto provocado en localidades cuyas leyes son restrictivas todavía son escasas en la literatura científica, y la no coincidencia de las estimaciones procedentes de los métodos hoy en uso reclama urgentemente la aplicación de métodos innovadores, como los nuevos métodos indirectos. Tal necesidad es especialmente acuciante en las áreas más densamente pobladas, como las capitales brasileñas, dada la magnitud del fenómeno y los daños y riesgos derivados de allí. El artículo tiene como objetivo estimar el número de mujeres que realizaron un aborto provocado en el Municipio de Río de Janeiro, Brasil, en 2011, a partir de un modelo jerárquico bayesiano. Este se aplicó a los datos de una encuesta domiciliaria que fomentó la utilización del método network scale-up, en el Municipio de Río de Janeiro, un modelo jerárquico bayesiano utilizando información indirecta, basada en la red de contactos de los participantes seleccionados de forma aleatoria en la población. De las 1.758.145 mujeres de 15-49 años, residentes en el Municipio de Río de Janeiro, 13.025 (ICr95%: 10.635; 15.748) mujeres tuvieron un aborto provocado en 2011, resultando en una incidencia acumulada media de 7,41 (ICr95%: 6,05; 8,96) para cada 1.000 mujeres de 15-49 años. El estudio de autovalidación del modelo permitió identificar patrones de subestimación en subpoblaciones estigmatizadas con baja visibilidad social, como las mujeres que tuvieron un aborto provocado. El aborto provocado es una práctica recurrente entre mujeres en el municipio de Río de Janeiro. Nuevos métodos de estimación indirecta pueden contribuir a la aprehensión más precisa de este evento, considerando el contexto de ilegalidad, y contribuir a la formulación de políticas de salud.

Abstract: Estimates of number of women who have undergone induced abortion in jurisdictions with restrictive abortion laws are still scarce in the scientific literature, and the disparate estimates from currently used methods call for the application of innovative estimation techniques such as new indirect methods. This need is especially acute in more densely populated areas, such as Brazil's state capitals, given the magnitude of unsafe abortions and the resulting risks and harms. The article aims to estimate the number of women who had induced abortions in the city of Rio de Janeiro in 2011, based on a Bayesian hierarchical model. The model was applied to data from a household survey that supported the use of the network scale-up method in the city of Rio de Janeiro, a Bayesian hierarchical model using indirect information based on the contact networks of randomly selected participants from the general population. Among the 1,758,145 women 15-49 years of age living in the city of Rio de Janeiro, 13,025 women (95%CrI: 10,635; 15,748) had induced abortions in 2011, resulting in a mean cumulative incidence of 7.41 (95%CrI: 6.05; 8.96) for every 1,000 women 15-49 years of age. The model's self-validation process identified patterns of underestimation in stigmatized subpopulations with low social visibility, such as women who have undergone induced abortion. Induced abortion is a common practice among women in the city of Rio de Janeiro. New indirect estimation methods can contribute to more precise measurement of this event, considering the context of illegality, and thereby contribute to appropriate health policies.

Comparison of estimates and time series stability of Korea Community Health Survey and Korea National Health and Nutrition Examination Survey / 한국역학회지

OBJECTIVES: In South Korea, there are two nationwide health surveys conducted by the Korea Centers for Disease Control and Prevention: the Korea Community Health Survey (KCHS) and Korea National Health and Nutrition Examination Survey (KNHANES). The two surveys are directly comparable, as they have the same target population with some common items, and because both surveys are used in various analyses, identifying the similarities and disparities between the two surveys would promote their appropriate use. Therefore, this study aimed to compare the estimates of six variables in KCHS and eight variables in KNHANES over a six-year period and compare time series stability of region-specific and sex- and age-specific subgroup estimates. METHODS: Data from adults aged 19 years or older in the 2010-2015 KCHS and KNHANES were examined to analyze the differences of estimates and 95% confidence interval for self-rated health, current smoking rate, monthly drinking rate, hypertension diagnosis rate, diabetes diagnosis rate, obesity prevalence, hypertension prevalence, and diabetes prevalence. The variables were then clustered into subgroups by city as well as sex and age to assess the time series stability of the estimates based on mean square error. RESULTS: With the exception of self-rated health, the estimates taken based on questionnaires, namely current smoking rate, monthly drinking rate, hypertension diagnosis rate, and diabetes diagnosis rate, only differed by less than 1.0%p for both KCHS and KNHANES. However, for KNHANES, estimates taken from physical examination data, namely obesity prevalence, hypertension prevalence, and diabetes prevalence, differed by 1.9-8.4%p, which was greater than the gap in the estimates taken from questionnaires. KCHS had a greater time series stability for subgroup estimates than KNHANES. CONCLUSIONS: When using the data from KCHS and KNHANES, the data should be selected and used based on the purpose of analysis and policy and in consideration of the various differences between the two data.

Comparison of estimates and time series stability of Korea Community Health Survey and Korea National Health and Nutrition Examination Survey / 한국역학회지

OBJECTIVES: In South Korea, there are two nationwide health surveys conducted by the Korea Centers for Disease Control and Prevention: the Korea Community Health Survey (KCHS) and Korea National Health and Nutrition Examination Survey (KNHANES). The two surveys are directly comparable, as they have the same target population with some common items, and because both surveys are used in various analyses, identifying the similarities and disparities between the two surveys would promote their appropriate use. Therefore, this study aimed to compare the estimates of six variables in KCHS and eight variables in KNHANES over a six-year period and compare time series stability of region-specific and sex- and age-specific subgroup estimates.METHODS: Data from adults aged 19 years or older in the 2010-2015 KCHS and KNHANES were examined to analyze the differences of estimates and 95% confidence interval for self-rated health, current smoking rate, monthly drinking rate, hypertension diagnosis rate, diabetes diagnosis rate, obesity prevalence, hypertension prevalence, and diabetes prevalence. The variables were then clustered into subgroups by city as well as sex and age to assess the time series stability of the estimates based on mean square error.RESULTS: With the exception of self-rated health, the estimates taken based on questionnaires, namely current smoking rate, monthly drinking rate, hypertension diagnosis rate, and diabetes diagnosis rate, only differed by less than 1.0%p for both KCHS and KNHANES. However, for KNHANES, estimates taken from physical examination data, namely obesity prevalence, hypertension prevalence, and diabetes prevalence, differed by 1.9-8.4%p, which was greater than the gap in the estimates taken from questionnaires. KCHS had a greater time series stability for subgroup estimates than KNHANES.CONCLUSIONS: When using the data from KCHS and KNHANES, the data should be selected and used based on the purpose of analysis and policy and in consideration of the various differences between the two data.

Size-specific dose estimation for chest CT examination in pediatric and adult patients / 中华放射医学与防护杂志

Objective To compare the differences in radiation doses from CT scanning between children of different age groups and adult patients by using both traditional radiation dose assessment parameters and size-specific dose estimates (SSDE).Methods A total of 406 patients undergoing lung CT examination were studied.They were sampled retrospectively and continuously from the Union Hospital and divided into six groups by age distritution (0-2,3-6,7-10,11-14,15-18,＞18 years old).The CTDIvol and DLP values were randomly sampled using MATLAB platform-based dicom data software.The SSDE and water equivalent diameter were also calculated according to the AAPM 220 Report.The differences in radiation doses from lung CT scaning between children and adult patients were analysed.Results The CTDIvol values for all age groups were significantly lower than the SSDE values.The differences were statistically significant (t =-36.36,-32.83,-30.36,-28.74,-23.89,P＜0.05).The SSDE values were 137％,94％,79％,57％ and 42％ higher than the CTDIvol values,respectively.The CTDIvol values for the adult group were also lower than the SSDE values,and the difference was statistically significant (t=-21.92,P＜0.05),and the SSDE value was about 41％ higher than the CTDIvol value.With the increased age,CTDIvol value,DLP value,Dw value and SSDE value for children of all age groups gradually increased and were significantly smaller than those for the adult group.The difference was statistically significant (F=63.39,203.28,89.27,103.44,P＜0.05).The conversion coefficient f for all age groups decreased significantly with age,which was significantly higher than that for the adult group,and the difference was statistically significant (F =109.83,P ＜ 0.05).Conclusions In lung CT scanning,the CTDIvol value significantly underestimated the radiation doses to children as compared to adults.CTDIvol values are more easily underestimated for younger patients.The SSDE method allows for more accurate reflection of the radiation doses to different patients,taking into account differences in the examined patient size.

Quality of death counts and adult mortality registration in Suriname and its main regions / Qualidade dos registros de óbitos e estimativas de mortalidade adulta no Suriname e regiões / Calidad de los recuentos de registros de muerte y mortadlidad adulta en Surinam y sus principales regiones

Suriname statistical office assumes that mortality data in the country is of good quality and does not perform any test before producing life table estimates. However, lack of data quality is a concern in the less developed areas of the world. The primary objective of this article is to evaluate the quality of death counts registration in the country and its main regions from 2004 to 2012 and to produce estimates of adult mortality by sex. We use data from population, by age and sex, from the last censuses and death counts from the Statistical office. We use traditional demographic methods to perform the analysis. We find that the quality of the death count registration in Suriname and its central regions is reasonably good. We also find that population data can be considered good. The results reveal a small difference in the completeness for males and females and that for the sub-national population the choice of method has implication on the results. To sum up, data quality in Suriname is better than in most countries in the region, but there are considerable regional differences as observed in other locations.

O Instituto de Estatística do Suriname assume que os dados de mortalidade no país são de boa qualidade e não realiza nenhum teste antes de produzir estimativas da tabela de vida. No entanto, a falta de qualidade dos dados é uma preocupação nas áreas menos desenvolvidas do mundo. O objetivo principal deste artigo é avaliar a qualidade do registro de óbitos no país e suas principais regiões, entre 2004 e 2012, e produzir estimativas de mortalidade adulta por sexo. Utilizamos dados populacionais, por idade e sexo, dos últimos censos e contagem de mortes do Centro Nacional de Estatística. Para realizar a análise, foram empregados métodos demográficos tradicionais. Concluímos que a qualidade do registro de óbitos no Suriname e em suas regiões centrais é razoável. Também mostramos que os dados de registro da população podem ser considerados bons. Os resultados revelam uma pequena diferença no grau de cobertura do registro de óbitos para homens e mulheres e que, para as regiões, a escolha do método tem implicações nos resultados. Em suma, a qualidade dos dados no Suriname é melhor do que na maioria dos países da região, mas há diferenças regionais consideráveis, como observado em outros lugares.

La oficina de estadísticas de Surinam supone que los datos de mortalidad en el país son de buena calidad y no hace ninguna prueba antes de producir estimaciones de la tabla de vida. Sin embargo, la falta de calidad de datos es una preocupación en las zonas menos desarrolladas del mundo. El objetivo principal de este artículo es evaluar la calidad del registro de recuentos de defunciones en el país y sus principales regiones entre 2004 y 2012 y producir estimaciones de mortalidad de adultos por sexo. Utilizamos datos de la población, por edad y sexo, de los últimos censos y recuentos de muertes de la oficina de Estadística. Utilizamos métodos demográficos tradicionales para realizar el análisis. Encontramos que la calidad del registro del recuento de defunciones en Surinam y sus regiones centrales es de razonable a buena. Asimismo, hallamos que los datos de población pueden considerarse también buenos. Los resultados revelan una pequeña diferencia en la integridad para hombres y mujeres y que para la población subnacional la elección del método tiene implicaciones en los resultados. En resumen, la calidad de los datos en Surinam es mejor que la de la mayoría de los países de la región, pero existen diferencias regionales considerables, como también se observa en otros lugares.

Sources of bias in genetic association studies in cattle: A review / Fuentes de sesgo en estudios de asociación genética en ganado bovino: Revisión de literatura / Fontes de viés nos estudos de associação genética em bovinos: Revisão da literatura

Abstract Background: Genetic association studies have been increasingly used in cattle breeding programs. However, inconsistent results -such as positive, negative, or absence of association- across studies restrain reproducibility and proper implementation, propitiating the occurrence of bias. Objective: To identify and classify potential sources of bias and determine possible strategies to avoid it in genetic association studies in cattle. Source of bias in genetic association studies: Genetic and genomic sources of bias include effects associated with the gene loci governing expression. Sampling-related and statistical biases are related with factors such as stratification and database size. Strategies to correct bias in genetic association studies: Correction strategies differ in nature. Genetic and genomic strategies are based on determining the appropriate approach to obtain and report the genetic information. Sampling-related and statistical strategies are based on grouping individuals with certain traits that lead to a reduction in heterogeneity. Conclusion: It is necessary to consider the methodology used in previous studies to establish a hierarchy of sources of bias and facilitate decisions on the use of tools to reduce inconsistencies in the results of future studies.

Resumen Antecedentes: Los estudios de asociación genética son cada vez más usados en los programas de mejoramiento genético. Sin embargo, resultados inconsistentes de los estudios -como positivos, negativos o ausencia de asociación- restringen la reproducibilidad y su aplicación adecuada, propiciando la aparición de sesgos. Objetivo: Identificar y clasificar las fuentes potenciales de sesgo y determinar posibles estrategias para evitarlo en estudios de asociación genética en ganado. Fuentes de sesgo en estudios de asociación genética: Las fuentes genéticas y genómicas de sesgo incluyen los efectos asociados con la expresión que gobierna los loci. Los sesgos estadísticos y de muestreo están relacionados con factores como la estratificación y el tamaño de la base de datos. Estrategias para corregir sesgos en estudios de asociación genética: Las estrategias de corrección difieren en naturaleza. Las estrategias genéticas y genómicas se basan en determinar el enfoque apropiado para obtener la información genética. Las estrategias estadísticas y relacionadas con el muestreo se basan en la agrupación de individuos con ciertos rasgos que conducen a una reducción de la heterogeneidad. Conclusión. Se deben considerar las metodologías utilizadas en estudios previos para jerarquizar las fuentes de sesgo y facilitar las decisiones sobre el uso de herramientas para reducir inconsistencias en resultados futuros.

Resumo Antecedentes: Nos programas de criação de bovinos, os estudos de associação genética têm sido cada vez mais utilizados. No entanto, resultados inconsistentes, como positivos, negativos ou ausência de associação entre os estudos, restringem a reprodutibilidade e sua adequada implementação, propiciando o aparecimento de viés. Objetivo: Identificar e classificar potenciais fontes de viés e determinar estratégias possíveis para evitá-lo nos estudos de associação genética em bovinos. Fonte de viés em estudos de associação genética: Fontes genéticas e genômicas do viés incluem os efeitos associados aos genes que relacionam a expressão. Os vícios estatísticos e de amostragem estão relacionados a fatores como a estratificação e o tamanho do banco de dados. Estratégias para corrigir os viéses nos estudos de associação genética: As estratégias de correção diferem na natureza. As estratégias genéticas e genômicas são baseadas na determinação da abordagem apropriada para obter e relatar a informação genética. As estratégias estatísticas e de amostragem baseiam-se no agrupamento de indivíduos com certos traços que levam a uma redução na heterogeneidade. Conclusão: É necessário considerar a metodologia utilizada em estudos anteriores para estabelecer uma hierarquia de fontes de viés e facilitar decisões sobre o uso de ferramentas para reduzir inconsistências nos resultados de estudos futuros.

Prevalence and risk factors of mild chronic renal failure in HIV-infected patients: influence of female gender and antiretroviral therapy

ABSTRACT Background In people living with HIV, much is known about chronic kidney disease, defined as a glomerular filtration rate under 60 mL/min. However, there is scarce data about prevalence and risk factors for milder impairment (60-89 mL/min). Objective The present study aims to assess the influence of sex, antiretroviral therapy, and classical risk factors on the occurrence of mild decreased renal function in a large Spanish cohort of HIV-infected patients. Methods Cross-sectional, single center study, including all adult HIV-1-infected patients under antiretroviral treatment with at least two serum creatinine measures during 2014, describing the occurrence of and the risk factors for mildly decreased renal function (eGFR by CKD-EPI creatinine equation of 60-89 mL/min). Results Among the 4337 patients included, the prevalence rate of mildly reduced renal function was 25%. Independent risk factors for this outcome were age older than 50 years (OR 3.03, 95% CI 2.58-3.55), female sex (OR 1.23, 95% CI 1.02-1.48), baseline hypertension (OR 1.57, 95% CI 1.25-1.97) or dyslipidemia (OR 1.48, 95% CI 1.17-1.87), virologic suppression (OR 1.88, 95% CI 1.39-2.53), and exposure to tenofovir disoproxil-fumarate (OR 1.67, 95% CI 1.33-2.08) or ritonavir-boosted protease-inhibitors (OR 1.19, 95% CI 1.03-1.39). Conclusions Females and patients over 50 seem to be more vulnerable to renal impairment. Potentially modifiable risk factors and exposure to tenofovir disoproxil-fumarate or ritonavir-boosted protease-inhibitors are present even in earlier stages of chronic kidney dysfunction. It remains to be determined whether early interventions including antiretroviral therapy changes (tenofovir alafenamide, cobicistat) or improving comorbidities management will improve the course of chronic kidney disease.

Aumento da carga de dengue no Brasil e unidades federadas, 2000 e 2015: análise do Global Burden of Disease Study 2015 / Increase in the burden of dengue in Brazil and federated units, 2000 and 2015: analysis of the Global Burden of Disease Study 2015

RESUMO: Objetivo: Descrever as principais métricas sobre dengue geradas pelo Global Burden of Disease (GBD) Study 2015, para o Brasil e suas 27 unidades federadas, nos anos de 2000 e 2015. Métodos: As métricas descritas foram: taxas de incidência e de mortalidade por dengue, padronizadas por idade, years of life lost (YLL), years lived with disability (YLD) e disability adjusted life years (DALY) (frequência absoluta e taxas padronizadas por idade). As métricas estimadas foram apresentadas com intervalos de incerteza (II 95%) para 2000 e 2015, acompanhadas da variação relativa percentual. Resultados: Verificou-se aumento de 232,7% no número de casos e de 639,0% no número de mortes entre os anos de 2000 e 2015 no país. A taxa de incidência variou 184,3% e a taxa de mortalidade mostrou-se baixa, mas com aumento de 500,0% no período avaliado. As taxas de YLL, YLD e DALY aumentaram 420,0, 187,2 e 266,1%, respectivamente. Em 2015, DALY foi semelhante entre mulheres e homens (21,9/100.000). O DALY aumentou mais que o dobro em todas as unidades da federação. Conclusão: O aumento acentuado de dengue ao longo dos anos associa-se à introdução e/ou circulação de um ou mais sorotipos do vírus e crescente proporção de pacientes acometidos pela forma grave da doença. Apesar da baixa taxa de mortalidade, a dengue contribui para considerável perda de anos saudáveis de vida no Brasil por acometer elevado número de pessoas, de todas as faixas etárias, ocasionando algum grau de incapacidade durante a infecção sintomática, e em razão dos óbitos, principalmente, em crianças.

ABSTRACT: Objective: To describe the main metrics on dengue generated by Global Burden of Disease (GBD) Study 2015, for Brazil and its 27 federated units, in the years 2000 and 2015. Methods: The metrics described were: incidence and mortality rates by dengue, standardized by age, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY) (in absolute frequency and age-standardized rates). The estimated metrics were presented with uncertainty intervals (UI 95%) for the years 2000 and 2015, accompanied by the relative percentages of changes. Results: The number of cases increased 232.7% and the number of deaths increased 639.0% between 2000 and 2015 in the country. The incidence rate varied 184.3% and the mortality rate was low, but with an increase of 500.0% in the period evaluated. The YLL, YLD, and DALY rates increased 420.0, 187.2, and 266.1%, respectively. In 2015, DALY was similar among women and men (21.9/100,000). The DALY increased more than double in all the Brazilian federated units. Conclusion: The marked increase in dengue over the years is associated with the introduction and/or circulation of one or more serotypes of the transmitter virus and an increasing proportion of patients affected by the severe form of the disease. Despite the low mortality rate of the disease in comparison between the years of study, the disease contributes to the loss of healthy years of life in Brazil as it affects a large number of people, from all age groups, causing some degree of disability during the infection and deaths, especially, in children.

Comparison of Telbivudine and Entecavir therapy on estimates of glomerular filtration rate in patients with hepatitis B virus-related compensated cirrhosis / 中华传染病杂志

Objective To compare the impact of Telbivudine (LDT) and Entecavir (ETV) administration on estimates of glomerular filtration rate for anti-viral therapy in patients with hepatitis B virus (HBV)-related compensated cirrhosis by an open, prospective randomized controlled study.Methods Patients with HBV-related compensated cirrhosis at clinic or hospitalized in Shaoxing Municipal Hospital from January 2012 to June 2013 were included.A total of 170 patients were randomly divided into LDT (600 mg/d) or ETV (0.5 mg/d) groups at a ratio of 1∶1 according to the random number table method.All patients were treated for more than 36 months.The LDT group was optimized according to the roadmap.Patients with poor response or resistance in both treatment group were added with Adefovir dipivoxil (ADV) 10 mg/d for optimal treatment.The clinical outcome, creatinine (CR), estimated glomerular filtration rate (eGFR) of patients before and after 36 months of treatment were compared between two groups.All categorical data were analyzed using chi-square test and data accorded with normal distribution were compared by t test.Results After 36 months of treatment, the virological and biochemical responses in LDT group and ETV group were similar.The mean CR levels at month 24 and 36 in LDT group were (74.25±22.98) μmol/L and (70.72±24.75) μmol/L, respectively, which were both lower than baseline level ([83.09±17.68] μmol/L, t=2.811 and 3.145, respectively, both P<0.01).The mean CR levels at month 36 between two groups were statistically different (t=3.431, P=0.001).The mean eGFR levels at month 12, 24 and 36 in LDT group were all significantly lower than that at baseline (t=3.976,8.297 and 10.629, respectively, all P<0.01).The mean eGFR levels at month 24 and 36 between two groups were statistically different (t=9.684 and 15.019, respectively, both P<0.01).A total of 64 patients including 34 in LDT group and 30 in ETV group had mild nephritic injury at baseline.The mean eGFR in patients with mild nephritic injury at baseline in LDT group at month 12, 24 and 36 were significantly different compared to baseline (t=6.098,10.191 and 14.378, respectively, all P<0.01).The mean eGFR level at month 36 in ETV group had statistical difference compared to baseline (t=2.058, P<0.05).The mean eGFR levels at months 12, 24 and 36 were all statistical different between two groups (all P<0.01).The mean eGFR levels at month 24 and 36 in the optimized group were superior to ETV group (P<0.01).Conclusions In patients with HBV-related compensated cirrhosis, LDT and ETV treatment have similar clinical efficacy.LDT is more effective in protecting nephritic function than ETV.

La calidad de los datos de mortalidad del Censo 2010 de Argentina

OBJETIVO: evaluar las variables disponibles en el censo de población de 2010 para Argentina en lo que a mortalidad refiere.MÉTODOS: Con base en métodos indirectos de estimación demográfica se ofrece una lectura de la calidad de estas estadísticas en comparación con censos previos y estadísticas vitales.RESULTADOS: La comparación de las tasas de mortalidad infantil y adulta con las tasas calculadas a partir de los nacimientos y las defunciones permite dilucidar, en principio, que estos datos no revelan problemas serios de calidad o cobertura y que el nivel (y la tendencia) indicado por las fuentes es ampliamente compatible.DISCUSIÓN: a pesar de que los resultados parecen mostrar coherencia, la posibilidad de detectar y cuantificar los errores se mantiene como un punto ciego del artículo hasta tanto no se publique la totalidad de la información necesaria para realizar un examen cabal, dado el universo limitado de publicaciones por parte del Instituto Nacional de Estadística y Censos.CONCLUSIONES: las estimaciones de población en cuanto a mortalidad son consistentes con los datos del censo previo de 2001 y con las series de nacimientos y muertes del período intercensal a nivel total del país.

OBJECTIVE: to evaluate the available variables of mortality from the last population census in Argentina.METHODS:it is based on indirect estimation methods which provide a reading of the quality of these statistics in comparison with previous censuses and vital statistics.RESULTS:The rates of child and adult mortality compared with birth and death rates show that this data does not reveal serious problems of quality or coverage and the level (and trend) indicated by the sources is widely supported.DISCUSION:although the results seem to show consistency, the ability to detect and quantify the errors remains a blind spot until all of the necessary information is published for a thorough examination, given the limited universe of publications by the National Institute of Statistics of Argentina.CONCLUSION:the mortality population estimates are consistent with previous census data from 2001 and with estimates of births and deaths from the intercensal period.

An imputation-based method to reduce bias in model parameter estimates due to non-random censoring in oncology trials

In oncology trials, patients are withdrawn from study at the time when progressive disease (PD) is diagnosed, which is defined as 20% increase of tumor size from the minimum. Such informative censoring can lead to biased parameter estimates when nonlinear mixed effects models are fitted using NONMEM. In this work, we investigated how empirical Bayes estimates (EBE) could be exploited to impute missing tumor size observations and partially correct biases in the parameter estimates. 50 simulated datasets, each consisting of 100 patients, were generated based on the published model. From the simulated dataset, censoring due to PD diagnosis has been implemented. Using the post-hoc EBEs acquired from fitting the censored datasets using NONMEM, imputed values were generated from the tumor size model. Model fitting was carried out using censored and imputed datasets. Parameter estimates using both datasets were compared with true values. Tumor growth rate and cell kill rate were approximately 28% and 16% underestimated when fitted using the censored dataset, respectively. With the imputed datasets, relative biases of tumor growth rate and cell kill rate decreased to about 6% and 0%, respectively. Our work demonstrates that using EBEs acquired from fitting the model to the censored dataset and imputing the unknown tumor size observations with individual predictions beyond the PD time point is a viable option to solve the bias associated with structural parameter estimates. This approach, however, would not be helpful in getting better estimates of variance parameters.

Comparison of CTDIvol and SSDE in evaluating the radiation dose of abdominal CT scan / 中华放射医学与防护杂志

Objective To compare the difference between volume computed tomography dose index (CTDIvol) and size-specific dose estimates (SSDE) in evaluating the radiation dose of abdominal CT scan.Methods Abdominal CT scan were performed on 180 patients with a Philips 256-slices spiral CT.The anterior-posterior dimension (AP) and lateral dimension (LAT) of each patients were measured at the level of left renal vein, and the effective diameter (ED) and SSDE were calculated with recorded CTDIvol Patients were categorized into 3 groups depending on body mass index (BMI): group A, BMI ＜ 20.0 kg/m2;group B, 20.0-24.9 kg/m2;group C, BMI ＞ 24.9 kg/m2.The differences between CTDIvoland SSDE of 180 patients and three different BMI groups were compared respectively.Results There was a significant difference between CTDIvol and SSDE of the 180 patients (t =-13.354, P ＜ 0.01), CTDIvol and SSDE were (9.91 ± 2.91) and (14.01 ± 2.82) mGy, respectively.For group A, CTDIvol and SSDE were (7.96 ± 1.83) and (12.83 ± 2.52) mGy, respectively (t =-8.417, P ＜ 0.01).Group B, CTDIvol and SSDE were (9.28 ± 1.76) and (13.62 ±2.18) mGy, respectively (t =-15.051, P ＜ 0.01).Group C, CTDIvol and SSDE were (12.19 ± 3.65) and (15.39 ± 3.47) mGy, respectively (t =-4.535, P ＜ 0.01).In addition, the mean percentage values of difference between CTDIvol and SSDE for the three groups were 62.83％, 47.80％, 28.40％, respectively, which meant CTDIvol underestimated the radiation dose compared to SSDE.With the BMI increasing, the values of difference between CTDIvol and SSDE decreased.Conclusions SSDE can be used to estimate the radiation dose of abdominal CT scan for a given size person.