Cancer risk in relatives of BRCA1/2 pathogenic variant carriers in a large series of unselected patients with breast cancer

Objective:The spectrum and risk of cancer in relatives of BRCA1/2 pathogenic variant carriers in the Chinese population have not been established.Methods:A family history of cancer in 9903 unselected breast cancer patients was retrospectively analyzed.BRCA1/2 status was determined for all patients and relative risks(RRs)were calculated to evaluate cancer risk in relatives of the patients.Results:The incidences of breast cancer in female relatives of BRCA1 carriers,BRCA2 carriers,and non-carriers were 33.0%,32.2%,and 7.7%,respectively.The corresponding incidences of ovarian cancer were 11.5%,2.4%,and 0.5%,respectively.The incidences of pancreatic cancer in male relatives of BRCA1 carriers,BRCA2 carriers,and non-carriers were 1.4%,2.7%,and 0.6%,respectively.The corresponding incidences of prostate cancer were 1.0%,2.1%,and 0.4%,respectively.The risks of breast and ovarian cancers in female relatives of BRCA1 and BRCA2 carriers were significantly higher than female relatives of non-carriers(BRCA1:RR=4.29,P<0.001 and RR=21.95,P<0.001;BRCA2:RR=4.19,P<0.001 and RR=4.65,P<0.001,respectively).Additionally,higher risks of pancreatic and prostate cancers were noted in male relatives of BRCA2 carriers than non-carriers(RR=4.34,P=0.001 and RR=4.86,P=0.001,respectively).Conclusions:Female relatives of BRCA1 and BRCA2 carriers are at increased risk for breast and ovarian cancers,and male relatives of BRCA2 carriers are at increased risk for pancreatic and prostate cancers.

Estimation of Distribution Function Based on Presmoothed Relative-Risk Function

In this article, the lifetime data subjecting to right random censoring is considered. Nonparametric estimation of the distribution function based on the conception of presmoothed estimation of relative-risk function and the properties of the estimator by using methods of numerical modeling are discussed. In the model under consideration, the estimates were compared using numerical methods to determine which of the estimates is actually better.

Disease Risks of Childhood Obesity in China

Objective To estimate the relative risks of dyslipidemia, hypertension, diabetes mellitus, and metabolic syndromes among overweight and obese Chinese children compared with their normal weight counterparts. Methods Overweight and obesity were defined by age- and sex-specific BMI classification reference for Chinese children and adolescents. Pediatric metabolic syndrome （MetS） and each risk factor for MetS were defined using the criteria for US adolescents. Definition of hyper-TC, LDL, and dyslipidemia for adults was applied as well. General linear model factor analysis and chi-square test were used to compare the difference in metabolic indicators among normal weight, overweight, and obese groups. Multiple logistic regression analysis was performed to estimate the odds ratio of metabolic abnormalities between obesity, overweight, and normal weight children, after adjustment for living area, family economic level, age, sex, and daily exercise time and TV watching time, as well as different dietary indices in the model. Results Significant increases in blood lipids, glucose, and blood pressure were found among overweight and obese children as compared with their counterparts with normal weight. By applying WGOC-recommended BMI classification, the risks for hypertriglyceridemia, low HDL and dyslipidemia among overweight children were 1.9, 1.4, and 1.5 times, and was 3.3, 1.5, and 1.8 times among obese groups compared to their counterparts with normal weight after adjustment for age, sex, region, socioeconomic status, physical activity, and dietary intakes. The overweight and obese children （15-17.9 years） had a high-risk of developing hypertension, which was 2.3 and 2.9 times higher than their counterparts with normal weight. Above 90% obese adolescents had abdominal obesity, while less than 1% normal weight ones had abdominal obesity. No obese adolescents were free from any risk factors for MetS, while 36.9% of normal weight adolescents were from the risk factors. 83.3% obese boys and all obese girls had metabolic syndrome, while only 15.5% normal weight boys and 18.8% normal weight girls had metabolic syndrome. Four risk factors for metabolic syndrome were found in 8.3% obese boys while none in normal weight boys and girls. The prevalence of MetS among normal weight, overweight, and obesity groups was 1.5%, 18.3%, and 38.1% respectively. Conclusion The cardiovascular disease （CVD） risk factors are clustered in obese Chinese children. Our observations strongly suggest that efforts should be made to prevent the onset of overweight and its associated diseases during early childhood.

Identification of new genetic risk factors for prostate cancer

There is evidence that a substantial part of genetic predisposition to prostate cancer （PCa） may be due to lower penetrance genes which are found by genome-wide association studies. We have recently conducted such a study and seven new regions of the genome linked to PCa risk have been identified. Three of these loci contain candidate susceptibility genes： MSMB, LMTK2 and KLK2/3. The MSMB and KLK2/3 genes may be useful for PCa screening, and the LMTK2 gene might provide a potential therapeutic target. Together with results from other groups, there are now 23 germline genetic variants which have been reported. These results have the potential to be developed into a genetic test. However, we consider that marketing of tests to the public is premature, as PCa risk can not be evaluated fully at this stage and the appropriate screening protocols need to be developed. Follow-up validation studies, as well as studies to explore the psychological implications of genetic profile testing, will be vital prior to roll out into healthcare.

UTILITY BASIS OF CONSUMPTION AND INVESTMENT DECISIONS IN A RISK ENVIRONMENT

Using expectations regarding utilities to make decisions in a risk environment hides a paradox,which is called the expected utility enigma.Moreover,the mystery has not been solved yet;an imagined utility function on the risk-return plane has been applied to establish the mean-variance model,but this hypothetical utility function not only lacks foundation,it also holds an internal contradiction.This paper studies these basic problems.Through risk preference VNM condition is proposed to solve the expected utility enigma.How can a utility function satisfy the VNM condition?This is a basic problem that is hard to deal with.Fortunately,it is found in this paper that the VNM utility function can have some concrete forms when individuals have constant relative risk aversion.Furthermore,in order to explore the basis of mean-variance utility,an MV function is founded that is based on the VNM utility function and rooted in underlying investment activities.It is shown that the MV function is just the investor's utility function on the risk-return plane and that it has normal properties.Finally,the MV function is used to analyze the laws of investment activities in a systematic risk environment.In doing so,a tool,TRR,is used to measure risk aversion tendencies and to weigh risk and return.

Smoking increases risk of tooth loss: A meta-analysis of the literature

AIM: To quantitatively evaluate the impact of smoking on tooth loss.METHODS: We performed a Pub Med search to identify published articles that investigated the risk of tooth loss by smoking, from which RRs and their variance with characteristics of each study were extracted. The random-effects models were used to derive a pooled effect across studies. Potential sources of heterogeneity on the characteristics of the study and their influence on the pooled effect size were investigated using metaregression models. RESULTS: We identified 24 studies containing a total of 95973 participants for analysis. The pooled RR of ever-smokers compared with never- smokers was 1.73(95%CI: 1.60-1.86, P < 0.001). In meta-regression analysis, only the mean age of participants alone was identified as a statistically significant source of heterogeneity. The effect of smoking on tooth loss was stronger when the mean age of study participants was higher, indicating possible enhancement of tooth loss due to aging by smoking. RR was significantly lower in former smokers(1.49, 95%CI: 1.32-1.69, P < 0.001) than in current smokers(2.10, 95%CI: 1.87-2.35, P < 0.001), indicating the substantial benefit of smoking cessation for reducing the risk of tooth loss.CONCLUSION: Smoking is an independent risk factor for tooth loss regardless of many other confounders. Smoking cessation may attenuate this effect.

A Cohort Model for Ash Mortality Risk Due to Potential Emerald Ash Borer Infestation

Emerald ash borer (Agrilus planipennis Fairmaire) (Coleoptera: Buprestidae) is a phloem-feeding beetle native to Asia that is causing widespread mortality of ash trees in eastern North America. In this study, we quantify ash mortality risk associated with potential anthropogenic-induced introduction of Emerald Ash Borer (EAB) in North Dakota. The cohort model is calibrated with data from Ohio using weighting across factors—proximity to existing ash stands, campgrounds, roads and rails—to get a more accurate assessment of overall ash mortality risk. These factors are known to be associated with introduction of EAB to unaffected areas. Two protocols, a) “detection trees” and b) EAB traps are utilized to investigate EAB presence. Ash mortality risk maps such as the ones produced here may guide the placement of traps. Although North Dakota regions of high density ash tree stands are few, the resulting relative ash mortality risk map displays: a) very high risk areas around the Turtle Mountains and Theodore Roosevelt National Park and b) regions of high relative risk along the main riparian corridors. The applicability of risk maps such as the one developed may aid in assessing areas that may require significant monitoring.

Evaluating the Health Risks of Pneumonia from Airborne Bacterial Communities Using 16S rDNA Sequences of Pneumonia-related Pathogens

Objective Airborne microbial communities include a significant number of uncultured and poorly characterized bacteria.No effective method currently exists to evaluate the health risks of such complex bacterial populations,particularly for pneumonia.Methods We developed a method to evaluate risks from airborne microorganisms,guided by the principle that closer evolutionary relationships reflect similar biological characteristics,and thus used16 S rDNA sequences of 10 common pneumonia-related bacterial pathogens.We calculated a risk of breath-related(Rbr)index of airborne bacterial communities and verified effectiveness with artificial flora and a clinical project.Results We suggested applying Rbr80 to evaluate the health risks of airborne bacterial communities that comprise 80% of dominant operational taxonomic units(OTUs).The feasibility of Rbr80 was confirmed by artificial flora and by pneumonia data from a hospital.A high Rbr80 value indicated a high risk of pneumonia from airborne bacterial communities.Conclusion Rbr80 is an effective index to evaluate the pneumonia-associated risk from airborne bacteria.Values of Rbr80 greater than 15.40 are considered high risk.

A newfangled study using risk silhouette and uncertainty approximation for quantification of acyclovir in diverse formulation

Risk assessment and uncertainty approximation are two major and important parameters that need to be adopted for the development of pharmaceutical process to ensure reliable results.Additionally,there is a need to switch from the traditional method validation checklist to provide a high level of assurance of method reliability to measure quality attribute of a drug product.In the present work,evaluation of risk profile,combined standard uncertainty and expanded uncertainty in the analysis of acyclovir were studied.Uncertainty was calculated using cause-effect approach,and to make it more accurately applicable a method was validated in our laboratory as per the ICH guidelines.While assessing the results of validation,the calibration model was justified by the lack of fit and Levene＇s test.Risk profile represents the future applications of this method.In uncertainty the major contribution is due to sample concentration and mass.This work demonstrates the application of theoretical concepts of calibration model tests,relative bias,risk profile and uncertainty in routine methods used for analysis in pharmaceutical field.

Clues from networks:quantifying relational risk for credit risk evaluation of SMEs

Owing to information asymmetry,evaluating the credit risk of small-and mediumsized enterprises(SMEs)is difficult.While previous studies evaluating the credit risk of SMEs have mostly focused on intrinsic risk generated by SMEs,our study considers both intrinsic and relational risks generated by neighbor firms’publicly available risk events.We propose a framework for quantifying relational risk based on publicly available risk events for SMEs’credit risk evaluation.Our proposed framework quantifies relational risk by weighting the impact of publicly available risk events of each firm in an interfirm network—considering the impact of interfirm network type,risk event type,and time dependence of risk events—and combines the relational risk score with financial and demographic features to evaluate SMEs credit risk.Our results reveal that relational risk score significantly improves both discrimination and granting performances of credit risk evaluation of SMEs,providing valuable managerial and practical implications for financial institutions.

Prevalence of Metabolic Obese Normal Weight and Related Risk Factors in South China

[Objectives]Metabolic obese normal weight(MONW)is becoming one of the pubic problems which are threatening human health.Whereas,MONW was facing a great challenge for limited attention,especially for the female in China.The aim of this research was to estimate the prevalence of MONW and its related risk components in South China.[Methods]A community-based cross-sectional study was performed on 3349 residents aged 18-93 years in The First Affiliated Hospital of Jinan University,Guangzhou,China,in 2019.Data was collected by physical examination data which included physical measurements and laboratory examinations.[Results]In all subjects,55%were females(M/F=1509/1840).The prevalence of MONW was 16.09%(0.04%for male,16.05%for female,P<0.001).The prevalence increased significantly with increasing age in both genders(P<0.001).The binary logistic regression analysis shows that among the risk factors with MONW,age,BMI,gender,systolic pressure,hypertension[Male:ORs=2.56,95%CI(1.23,5.32);Female:ORs=2.88,95%CI(1.76,4.71)]and hypertriglyceridemia[Male:ORs=3.23,95%CI(1.67,6.19);Female:ORs=2.57,95%CI(1.64,4.03)]were found to be statistically significant.The level of ALT in MONW group was(27.88±15.85)in male and(24.33±15.75)in female,which were significantly higher than those in the non-MetS group.[Conclusions]The prevalence of MONW was pretty high.We considered MONW be significantly associated with the increase of ALT.Female gender,advanced age,and elevated ALT were independent risk factors for MONW.It was high time that the government should raise the public attention toward metabolic function in normal weight population.Effective prevention and treatment strategies for MONW and its risk factors should be developed targeting different ages and genders.

Assessment of Radon Concentrations inside Residential Buildings and Estimation of the Dose in the City of Kaya, Burkina Faso

Colorless, incessant radon gas is notably the second most important cause of lung cancer after smoking in smokers and the first cause in non-smokers. Having little effect in the atmosphere, radon gas accumulates in confined spaces. Therefore, the determination of radon concentrations inside residential buildings is very important to improve the health of the inhabitants. The objective of this research is to measure the concentration of radon in indoor air in residential areas of the city of Kaya and to assess the absorbed dose, the effective dose and the relative risk of lung cancer. In this study, the CORENTIUM AIR THINGS digital radon detector is used to determine the radon concentration in twenty-one houses in Kaya. The CORENTIUM AIR THINGS digital radon detector has been placed in each residential building for a minimum period of one week and the concentration values are read every 24 hours. This research revealed that the average concentration of radon was 28.47 Bq/m3 in the residential areas of Kaya. The radon concentration in a house has been found to exceed 100 Bq/m3, which is the level authorized by the World Health Organization (WHO). In the long term, the absorbed dose varies from 0.118 mSv to 4.975 mSv and the effective dose is between 0.229 mSv and 12.002 mSv. In the short term, the absorbed dose varies between 0.095 mSv to 5.001 mSv and the effective dose is between 0.283 mSv to 11.935 mSv. The mean lung cancer relative risk (CPRR) from indoor exposure was 1.026. There is a need to raise awareness among the population of the city of Kaya on this issue and to take measures to reduce radon in homes when the concentrations are above the limit recommended by the WHO.

Silicosis in Automobile Foundry Workers: A 29-Year Cohort Study

Objectives The purposes were to determine the relationship between silicosis among foundry workers and their cumulative exposure to silica dust, and to establish a regression model to predict the risk for developing silicosis by a given length of employment and air concentrations of silica at worksites. Methods A 29-year cohort study was conducted, including all those employed for more than one year during January 1, 1980 to December 31, 1996 and all members of the cohort were followed-up to December 3 1, 2008. In total, 2 009 workers of an automobile foundry in Shiyan, Hubei province were recruited in the study, 1 300 at eight worksites including sand preparation, cast shakeout, and finishing, melting, moulding, core-making, overhead crane operation and pouring as exposed group, and the other 709 auxiliary workers at the same factory, such as electricians, inspectors, fitters, and so on, as control group. Person-years of observation were calculated by persons observed and years followed-up for each of them. Person-year incidence of silicosis and its relative risk （RR） or odds ratio （OR） and 95% confidence intervals （CI） among the workers were estimated, adjusted for relevant factors with logistic regression model using SPSS version 15.0 software. Results Totally, 2 009 workers were followed-up for 37 151 person-years and 48 cases of silicosis were found, with an overall incidence of 1.34 per thousand, 2.02 per thousand in exposed group, and 0.15 per thousand in control one. Risk of silicosis was significantly higher in the exposed group than that in the control one （RR=13.13, 95% CI 3.18-54.13）, higher in men than that in women （RR=13.92, 95% CI 1.92-100.93）. Risks of silicosis varied by job, highest in those exposed to cast shakeout and finishing （RR=28.14, 95% CI 6.43-123.11）, followed by those exposed to pouring （RR-22.23, 95% CI 5.01-98.55） in the foundry. Average length of employment at onset of silicosis was 25.94 years, and silicosis incidence increased with length of employment. Average age at onset of silicosis was 47.83 years old. The risk of silicosis in workers with pulmonary tuberculosis was 2.57 folds as those without it （P〈0.01）. Ten deaths were recorded in those with silicosis, with a case-fatality rate of 20.83 percent three of them died of lung cancer, three of liver cancer, two of ischemic heart disease, and two of other diseases as their immediate causes of death. Incidence of silicosis in foundry workers positively correlated with their cumulative silica exposure （OR-3.00, 95% CI 2.34-3.83）. Risks of silicosis increased by 4.38 folds with an increase of 1 mg/m^3-year of cumulative silica exposure, and by 3.79 folds with smoking, respectively, adjusted for alcohol drinking and age. Based on a logistic regression model fitted, incidence of silicosis is expected to be 44.6 per thousand for those with daily exposure to silica of 4.18 mg/m^3 in average for 30 years, and if incidence of silicosis is expected to be less than 1 per thousand, daily exposure to silica should be controlled below 0.2 mg/m^3 for those with 20 years of employment, or below 0.1 mg/m^3 for those with 30 or 40 years of silica exposure. Conclusions At present, foundry workers in China still face high risk of developing silicosis. For lowering occurrence of silicosis in exposed workers, it seems necessary that current occupational exposure limits for silica at worksites in China should be reexamined and silica dust control measures be strengthend.

Active tuberculosis in inflammatory bowel disease patients under treatment from an endemic area in Latin America

BACKGROUND There has been an increase in cases of inflammatory bowel disease(IBD)in recent years.There is also greater access and availability of immunosuppressive and biological agents,which increase the risk of opportunistic infection despite improving the quality of life and promoting mucosal healing.Tuberculosis(TB)remains a public health problem,and it has a high incidence in several countries.Therefore,knowledge of the risk of developing TB in patients with IBD is important.AIM To evaluate the risk of active TB in patients with IBD under treatment from an endemic area in Latin America.METHODS A standard questionnaire included demographic variables,clinical aspects of IBD disease,history of active TB during treatment,active TB characteristics and evolution,initial screening and results and time from the start of anti-tumor necrosis factor alpha(TNFα)to TB development.RESULTS Azathioprine,anti-TNFα and the combination of these two drugs were associated with a higher risk of active TB incidence.The TNFα blockers increased the relative risk of developing active TB compared to other treatments.All four multivariable models showed that the use of TNFα blockers alone or in combination with azathioprine was an important risk factor for the incidence of active TB.After adjustment for sex,age,type of IBD and latent TB,anti-TNFα with azathioprine increased the relative risk to 17.8 times more than conventional treatment.Late TB,which was diagnosed 3 mo after the start of anti-TNFα,was the most frequent.CONCLUSION Treatment with anti-TNFα increased the risk of active TB in IBD patients from an endemic area in Latin America.This risk was increased when anti-TNFα was combined with azathioprine.The time from the beginning of the treatment to the active TB diagnosis suggests a new TB infection.

Spatial Modeling and Mapping of Tuberculosis Using Bayesian Hierarchical Approaches

Global spread of infectious disease threatens the well-being of human, domestic, and wildlife health. A proper understanding of global distribution of these diseases is an important part of disease management and policy making. However, data are subject to complexities by heterogeneity across host classes. The use of frequentist methods in biostatistics and epidemiology is common and is therefore extensively utilized in answering varied research questions. In this paper, we applied the hierarchical Bayesian approach to study the spatial distribution of tuberculosis in Kenya. The focus was to identify best fitting model for modeling TB relative risk in Kenya. The Markov Chain Monte Carlo (MCMC) method via WinBUGS and R packages was used for simulations. The Deviance Information Criterion (DIC) proposed by [1] was used for models comparison and selection. Among the models considered, unstructured heterogeneity model perfumes better in terms of modeling and mapping TB RR in Kenya. Variation in TB risk is observed among Kenya counties and clustering among counties with high TB Relative Risk (RR). HIV prevalence is identified as the dominant determinant of TB. We find clustering and heterogeneity of risk among high rate counties. Although the approaches are less than ideal, we hope that our formulations provide a useful stepping stone in the development of spatial methodology for the statistical analysis of risk from TB in Kenya.

Heart Rate Distribution and Cause-specific Death in General Population of South China

Objectives To analyses heart rate （HR） distribution of healthy adults in the south China community and evaluate relative risk of HR to total cause of death and cardiac cerebral vascular death. Methods Analytical data come from the baseline survey and follow-up visits in the PRC-USA Collaborative Study of Cardiovascular Epidemiology in urban and rural samples of Guangzhou. The baseline survey was initiated in 1983 and 1984, and rescanned in 1987 and 1988. Since 1991 Follow-up visits for endpoint events were carried once every two years. Average follow-up year was 16.2 from baseline to 2000. People excluded from cardiac cerebral vascular disease, diabetes and other various chronic diseases were regarded as ＂healthy adults＂. Heart rates of these subjects were measured on resting electrocardiogram. Endpoint evens include： total cause of death, first attack of coronary disease and cerebral vascular events. SAS software was used for analysis. Cox Proportional Hazards model was used to evaluate the impact of HR on total death and cardiac cerebral vascular disease. Results A total of 4570 men and women aged 35-55 years from urban and rural Guangzhou were investigated. 3493 healthy subjects were enrolled in the analysis, including 1694 men and 1799 women. Mean oftheHRis （67.9 ±10.6） beats/min （bpm） in the whole population, （66.3±10.7）bpm in men and （69.3± 10.4） in women. The 52 percentile of the HR was 51 in men and 54 in women. The 952 percentile of the HR was 85 in men and 88 in women. Single correlation analysis showed there was negative relationship between age and HR, but it was only statistical significant in female. Analysis with Cox Proportional Hazards model show that HR 〈 50 bpm tops the risk of total causes of death （1.725）and HR 50-59 bpm decreased the risk of total causes of death （0.843）. Relative risk of cardiac cerebral vascular events exceeds 1 when HR 〈 50 and 〉90 bpm （1.486 and 7.008 respectively）. It was less than 1 in other groups but there was no significant difference between each group. Conclusions Traditional normal range of HR in adult should be adjusted. In certain extent lower HR is advantageous to decrease cardiac cerebral vascular events, total causes of death and has better prognosis.

Meta-analysis with zero-event studies:a comparative study with application to COVID-19 data

Background:Meta-analysis is a statistical method to synthesize evidence from a number of independent studies,including those from clinical studies with binary outcomes.In practice,when there are zero events in one or both groups,it may cause statistical problems in the subsequent analysis.Methods:In this paper,by considering the relative risk as the effect size,we conduct a comparative study that consists of four continuity correction methods and another state-of-the-art method without the continuity correction,namely the generalized linear mixed models(GLMMs).To further advance the literature,we also introduce a new method of the continuity correction for estimating the relative risk.Results:From the simulation studies,the new method performs well in terms of mean squared error when there are few studies.In contrast,the generalized linear mixed model performs the best when the number of studies is large.In addition,by reanalyzing recent coronavirus disease 2019(COVID-19)data,it is evident that the double-zero-event studies impact the estimate of the mean effect size.Conclusions:We recommend the new method to handle the zero-event studies when there are few studies in a meta-analysis,or instead use the GLMM when the number of studies is large.The double-zero-event studies may be informative,and so we suggest not excluding them.

Study on the correlation between ambient environment-meteorological factors and the number of visits of acute otitis media,Lanzhou,China

To investigate the correlation between environmental-meteorological factors and daily visits for acute otitis media(AOM)in Lanzhou,China.Methods:Data were collected in 2014e2016 by the Departments of Otolaryngology-Head and Neck Surgery at two hospitals in Lanzhou.Relevant information,including age,sex and visiting time,was collected.Environmental data included air quality index,PM10,PM2.5,O3,CO,NO2 and SO2,and meteorological data included daily average temperature(T,C),daily mean atmospheric pressure(AP,hPa),daily average relative humidity(RH,%)and daily mean wind speed(W,m/s).The SPSS22.0 software was used to generate Spearman correlation coefficients in descriptive statistical analysis,and the R3.5.0 software was used to calculate relative risk(RR)and to obtain exposure-response curves.The relationship between meteorological-environmental parameters and daily AOM visits was summarized.Results:Correlations were identified between daily AOM visits and CO,O3,SO2,CO,NO2,PM2.5 and PM10 levels.NO2,SO2,CO,AP,RH and T levels significantly correlated with daily AOM visits with a lag exposure-response pattern.The effects of CO,NO2,SO2 and AP on daily AOM visits were significantly stronger compared to other factors(P<0.01).O3,W,T and RH were negatively correlated with daily AOM visits.The highest RR lagged by 3e4 days.Conclusions:The number of daily AOM visits appeared to be correlated with short-term exposure to mixed air pollutants and meteorological factors from 2014 through 2016 in Lanzhou.

Analysis of Length of Stay (LOS) Data from the Medical Records of Tertiary Care Hospital in Saudi Arabia for Five Diagnosis Related Groups: Application of Cox Prediction Model

Background: One of the main objectives of hospital managements is to control the length of stay (LOS). Successful control of LOS of inpatients will result in reduction in the cost of care, decrease in nosocomial infections, medication side effects, and better management of the limited number of available patients’ beds. The length of stay (LOS) is an important indicator of the efficiency of hospital management by improving the quality of treatment, and increased hospital profit with more efficient bed management. The purpose of this study was to model the distribution of LOS as a function of patient’s age, and the Diagnosis Related Groups (DRG), based on electronic medical records of a large tertiary care hospital. Materials and Methods: Information related to the research subjects were retrieved from a database of patients admitted to King Faisal Specialist Hospital and Research Center hospital in Riyadh, Saudi Arabia between January 2014 and December 2016. Subjects’ confidential information was masked from the investigators. The data analyses were reported visually, descriptively, and analytically using Cox proportional hazard regression model to predict the risk of long-stay when patients’ age and the DRG are considered as antecedent risk factors. Results: Predicting the risk of long stay depends significantly on the age at admission, and the DRG to which a patient belongs to. We demonstrated the validity of the Cox regression model for the available data as the proportionality assumption is shown to be satisfied. Two examples were presented to demonstrate the utility of the Cox model in this regard.

Impact of mTOR gene polymorphisms and gene-tea interaction on susceptibility to tuberculosis

BACKGROUND mTOR gene is a key component of the PI3K/Akt/mTOR signaling pathway,and its dysregulation is associated with various diseases.Several studies have demonstrated that tea drinking is a protective factor against tuberculosis(TB).This study was designed to explore five single nucleotide polymorphisms(SNPs)of mTOR in the Han population of China to determine how their interactions with tea drinking affect susceptibility to TB.AIM To investigate if the polymorphisms of mTOR gene and the gene-tea interaction are associated with susceptibility to TB.METHODS In this case-control study,503 patients with TB and 494 healthy controls were enrolled by a stratified sampling method.The cases were newly registered TB patients from the county-level centers for disease control and prevention,and the healthy controls were permanent residents from Xin'ansi Community,Changsha city.Demographic data and environmental exposure information including tea drinking were obtained from the study participants.We genotyped five potentially functional SNP sites(rs2295080,rs2024627,rs1057079,rs12137958,and rs7525957)of mTOR gene and assessed their associations with the risk of TB using logistic regression analysis,and marginal structural linear odds models were used to estimate the gene-environment interactions.RESULTS The frequencies of four SNPs(rs2295080,rs2024627,rs1057079,and rs7525957)were found to be associated with susceptibility to TB(P<0.05).Genotypes GT(OR 1.334),GG(OR 2.224),and GT+GG(OR 1.403)at rs2295080;genotypes CT(OR 1.562)and CT+TT(OR 1.578)at rs2024627,genotypes CT(OR 1.597),CC(OR 2.858),and CT+CC(OR 1.682)at rs1057079;and genotypes CT(OR 1.559)and CT+CC(OR 1.568)at rs7525957 of mTOR gene were significantly more prevalent in TB patients than in healthy controls.The relative excess risk of interaction between the four SNPs(rs2295080,rs2024627,rs1057079,and rs7525957)of mTOR genes and tea drinking were found to be-1.5187(95%CI:-1.9826,-1.0547,P<0.05),-1.8270(95%CI:-2.3587,-1.2952,P<0.05),-2.3246(95%CI:-2.9417,-1.7076,P<0.05)and-0.4235(95%CI:-0.7756,-0.0714,P<0.05),respectively,which suggest negative interactions.CONCLUSION The polymorphisms of mTOR(rs2295080,rs2024627,rs1057079,and rs7525957)are associated with susceptibility to TB,and there is a negative interaction between each of the four SNPs and tea drinking.