应用匹配矩阵、因子分析和聚类分析法研究冠心病痰瘀证候特征

目的研究冠心病痰瘀证候与临床四诊信息的相互关系,为其分类及规范化诊断提供参考。方法采用匹配矩阵、因子分析和聚类分析法,对200例冠心病患者痰证、瘀证、痰瘀互阻证及非痰非瘀证46项临床症状进行相关性分析。结果冠心病不同痰瘀证候舌、脉象与非痰非瘀证之间存在明显差异;中医病机脏腑定位于心和肾,以心气虚为主,兼肾气虚,痰证患者尚多伴脾气虚;在46项临床症状中,仅15项症状在痰证、瘀证和痰瘀互阻证中相伴出现频率较高。除共有的本虚证外,痰证的主要临床症状为白腻苔和滑脉,尚见胸脘痞满和腹胀等;瘀证则以紫舌、舌生瘀斑为主,尚见痛有定处;痰瘀互阻证则兼上述两种证候的主要症状。结论综合应用匹配矩阵、因子分析和聚类分析法,可以获得有关冠心病不同痰瘀证候主要临床特征及脏腑定位的信息,对冠心病不同痰瘀证候辨证及其分类研究具有一定的意义。     

Persistent variations in average height between countries and between socio-economic groups: an overview of 10 European countries

Primary objectives: This paper aims to provide an overview of variations in average height between 10 European countries, and between socio-economic groups within these countries.

Data and methods: Data on self-reported height of men and women aged 20-74 years were obtained from national health, level of living or multipurpose surveys for 1987-1994. Regression analyses were used to estimate height differences between educational groups and to evaluate whether the differences in average height between countries and between educational groups were smaller among younger than among older birth cohorts.

Results: Men and women were on average tallest in Norway, Sweden, Denmark and the Netherlands and shortest in France, Italy and Spain (range for men: 170-179 cm; range for women: 160-167 cm). The differences in average height between northern and southern European countries were not smaller among younger than among older birth cohorts. In most countries average height increased linearly with increasing birth-year (≈0.7-0.8cm/5 years for men and ≈0.4cm/5 years for women). In all countries, lower educated men and women on average were shorter than higher educated men (range of differences: 1.6-3.0 cm) and women (range of differences: 1.2-2.2 cm). In most countries, education-related height differences were not smaller among younger than among older birth cohorts.

Conclusions: The persistence of international differences in average height into the youngest birth cohorts indicates a high degree of continuity of differences between countries in childhood living conditions. Similarly, the persistence of education-related height differences indicates continuity of socio-economic differences in childhood living conditions, and also suggests that socio-economic differences in childhood living conditions will continue to contribute to socio-economic differences in health at adult ages.     

基于THE和QS评价指标的医学学科排名体系构建

目的：分析医学学科国际排名的影响因素，为我国医学学科发展提供参考。方法：在THE、QS排名指标的基础上，构建新的医学学科排名指标体系，运用统计学软件SPSS 24.0分析100所高水平医学大学的类型、特征，揭示不同类型大学的优势、劣势。结果：教育教学是各类型大学学科发展核心，亚洲大学国际化水平偏低，科研论文在THE和QS排名中作用有限，国内大学享有较好的国际声誉。结论：在我国医学学科建设中，应注重教学品质，重视高质量科研成果的产出，加快国际交流与合作、继续提升国际声誉。     

Spatial learning in a virtual reality-based task is altered in very preterm children

Very preterm births prevent a complete development of the nervous system. The hippocampus is especially vulnerable in this population since the perinatal period is critical for its growth and development. Learning and memory abilities, like spatial memory, depend on the hippocampal integrity. In this study we applied virtual-reality-based tasks to assess spatial memory in a sample of 20 very preterm children of 7 and 8 years of age. Two different conditions of difficulty were used. Very preterm children performed poorly in the task in comparison with the control group. They committed more errors than controls searching for the rewarded positions. However, no significant differences were observed in the mean speed, an index of the motor abilities and joystick handling. These results suggest that the hippocampal function is affected in this sample. Nevertheless, other variables to consider are discussed.     

A novel region-based level set method initialized with mean shift clustering for automated medical image segmentation

Appropriate initialization and stable evolution are desirable criteria to satisfy in level set methods. In this study, a novel region-based level set method utilizing both global and local image information complementarily is proposed. The global image information is extracted from mean shift clustering without any prior knowledge. Appropriate initial contours are obtained by regulating the clustering results. The local image information, as extracted by a data fitting energy, is employed to maintain a stable evolution of the zero level set curves. The advantages of the proposed method are as follows. First, the controlling parameters of the evolution can be easily estimated by the clustering results. Second, the automaticity of the model increases because of a reduction in computational cost and manual intervention. Experimental results confirm the efficiency and accuracy of the proposed method for medical image segmentation.     

Effects of buffer size and shape on associations between the built environment and energy balance

Uncertainty in the relevant spatial context may drive heterogeneity in findings on the built environment and energy balance. To estimate the effect of this uncertainty, we conducted a sensitivity analysis defining intersection and business densities and counts within different buffer sizes and shapes on associations with self-reported walking and body mass index. Linear regression results indicated that the scale and shape of buffers influenced study results and may partly explain the inconsistent findings in the built environment and energy balance literature.     

Small area estimation of obesity prevalence and dietary patterns: A model applied to Rio de Janeiro city,Brazil

We propose the use of previously developed small area estimation techniques to monitor obesity and dietary habits in developing countries and apply the model to Rio de Janeiro city. We estimate obesity prevalence rates at the Census Tract through a combinatorial optimization spatial microsimulation model that matches body mass index and socio-demographic data in Brazil's 2008–9 family expenditure survey with Census 2010 socio-demographic data. Obesity ranges from 8% to 25% in most areas and affects the poor almost as much as the rich. Male and female obesity rates are uncorrelated at the small area level. The model is an effective tool to understand the complexity of the problem and to aid in policy design.