Incidence and geographic distribution of endemic Burkitt lymphoma in northern Uganda revisited

Endemic Burkitt lymphoma (BL) is etiologically associated with Epstein-Barr virus and ecologically linked to Plasmodium falciparum malaria. However, these infections imperfectly correlate with BL epidemiology. To obtain recent epidemiological data, we studied district- and county-specific BL incidence and standardized incidence ratios using data collected from 1997 to 2006 at Lacor Hospital in northern Uganda, where studies were last done more than 30 years ago. Among 500 patients, median age was 6 years (interquartile range 5-8) and male-to-female ratio was 1.8:1. Among those known, most presented with abdominal (56%, M:F 1.4:1) vs. only facial tumors (35%, M:F 3.0:1). Abdominal tumors occurred in older (mean age: 7.0 vs. 6.0 years; p < 0.001) and more frequently in female children (68% vs. 50%; OR 2.2, 95% CI 1.5-3.5). The age-standardized incidence was 2.4 per 100,000, being 0.6 in 1-4 year olds, 4.1 in 5-9 year olds and 2.8 in 10-14 year olds and varied 3- to 4-fold across districts. The incidence was lower in districts that were far from Lacor and higher in districts that were close to Lacor. Although districts close to Lacor were also more urbanized, the incidence was higher in the nearby perirural areas. We highlight high-BL incidence and geographic variation in neighboring districts in northern Uganda. Although distance from Lacor clearly influenced the patterns, the incidence was lower in municipal than in surrounding rural areas. Jaw tumors were characterized by young age and male gender, but presentation has shifted away from facial to mostly abdominal.     

利用图谱匹配分割标注VHP数据集

利用TT脑图谱中丰富的结构信息,本文提出了一种自动分割脑图像的方法,并将其用于Visible Human数据集（VHD）的脑图像的分割,这种方法可分为两步,首先,将VHD中的脑图像和TT Atlas配准,通过图像和医学图谱的匹配,可以把图谱中存储的拓朴信息直接映射到ＶＨＤ,然后,利用这个预分割的模板对VHD脑图像进行模糊聚类分割,为自动将模板中的结构信息用于分割,本文利用Chamfer距离变换,提出了一中引入形状因子的FCM聚类算法。     

Public Health Emergency of International Concern (PHEIC) has Declared Twice in 2014; Polio and Ebola at the Top

BackgroundThe current Ebola outbreak in West Africa and the large scale wild Polio virus outbreak in several countries are the top most issues among international public health and scientific communities'' debates and concerns. These two outbreaks were judged to be declared as Public Health Emergency of International Concern (PHEIC) during 2014. This is the first time ever to have such circumstance of two PHEICs at the same time.DiscussionPHEIC, which has to be declared by WHO Director General after a recommendation of IHR Emergency Committee; is observed to start in countries with fragile health system and conflict areas. Then it rapidly spread to threaten the global public health. The year 2014 has uniquely witnessed declaration of two events as PHEIC according to IHR (2005); Polio and Ebola Virus Disease (EVD). Both outbreaks are caused by viruses such as H1N1 which was previously declared as PHEIC in 2009.SummaryPublic Health Emergencies of International Concern in 2014 occurred in countries with weak health systems and conflicts and threatening the whole globe. International collaborative work is required to contain the event and to mobilize resources/capacities between countries. Moreover, public health surveillance systems as core capacity for IHR (2005) should be strengthened in all countries with focus on those with limited capacity and ongoing conflicts. The ultimate aim is timely detection of potential PHEIC events in the future along with early preparedness and response plans.     

Incidence of Highly Pathogenic Avian Influenza H5N1 in Nigeria, 2005–2008

Outbreaks of highly pathogenic avian influenza (HPAI) H5N1 occurred in Nigeria between December 2005 and July 2008. We describe temporal and spatial characteristics of these outbreaks at State and Local Government Area (LGA) levels. A total of 25 of 37 States (67.6%; Exact 95% CI: 50.2–82.0%) and 81 of 774 LGAs (10.5%; Exact 95% CI: 8.4–12.8%) were affected by HPAI outbreaks over the period from 2005 to 2008. The incidence risk of HPAI outbreak occurrence at the State level was 5.6% (0.7–18.7%) for 2005, 50.0% (30.7–69.4%) for 2006, 54.5% (29.9–80.3%) for 2007 and 0% for 2008. Only very few LGAs experienced HPAI outbreaks within the affected States. The incidence risk of HPAI outbreak occurrence on a LGA level was 0.3% (0.0–0.9%) for 2005, 6.6% (4.9–8.6%) for 2006, 4.2% (2.9–6.0%) for 2007 and 0% for 2008. The mean period between farmers noticing HPAI outbreaks and reporting them to veterinary authorities, and between reporting HPAI outbreaks and the depopulation of infected premises, was for both 4.5 days; both periods also had medians of 1 day. We have estimated the spatially smoothed incidence risk for the whole outbreak period and identified the existence of a large corridor in the western part of Nigeria and a smaller corridor in south‐eastern part, where the risk of HPAI occurrence was lower than in the rest of the country. The effect of HPAI control policies on the outbreaks patterns are discussed, as well as possible reasons why HPAI did not become endemic in Nigeria.     

Aggravating conditions: Cynical hostility and neighborhood ambient stressors

This study is the first to investigate neighborhood clustering of a personality trait – cynical hostility (a sense of mistrust of others amplified by suspicious antagonism.) Cynical hostility increases physiological reactivity by influencing appraisal and coping when stressful events occur and that has been well established as a predictor of cardiovascular disease, inflammation, and all-cause mortality. The analysis examines the associations of a variety of neighborhood physical and social conditions (especially ambient stressors) with individual cynical hostility, controlling for individual sociodemographics. Data are from the Chicago Community Adult Health Survey, a clustered population-based study of 3105 adults. Variation by neighborhood in cynical hostility is larger than variation of other selected health outcomes, which are commonly studied using ecological methods or for other personality measures. Controlling for neighborhood context reduces the black/white cynical hostility disparity by one-third. A measure of neighborhood ambient stressors (notably noise) significantly predicts cynical hostility, even after individual characteristics are controlled, and the effect size is larger than for other contextual predictors. Health-related psychosocial and personality traits may both cluster in and be influenced by contemporaneous neighborhoods rather than mere exogenous results of genes or early life conditions. Health-relevant psychosocial characteristics may also mediate effects of neighborhood deleterious physical conditions, thereby influencing downstream health outcomes and social disparities therein. Because residential location and neighborhood physical conditions are both modifiable, research on how ambient stressors influence health psychology may be particularly fruitful for health policy and practice.     

徐州市区天主教信众心理健康状况调查

目的 调查徐州市区天主教信仰人群组成及心理健康状况,探讨宗教信仰与心理健康的关系.方法 采用随机整群抽样方法问卷调查江苏省徐州市天主信教人群.对信众的构成进行K-means聚类分析.结果 宗教信仰人群中老年居多,宗教信仰人群的心理异常率为37.6％,信仰天主教改善了人际敏感因子、忧郁因子、焦虑因子、敌对因子、偏执因子.强迫症因子也稍有变化.恐怖因子、精神病性因子未见明显变化,信众的躯体化因子高子常模水平.聚类分析揭示信众分老中青年3组,以女性为主,信教时间分20年左右和6～8年两组.结论 宗教信仰对改善信众的部分因子有帮助,而躯体化因子、恐怖和精神病性因子无改善,在控制宗教消极作用的前提下,信仰天主教可以改善心理健康状况,共建社会和谐.     

Nipah Virus Infection Outbreak with Nosocomial and Corpse-to-Human Transmission,Bangladesh

Active Nipah virus encephalitis surveillance identified an encephalitis cluster and sporadic cases in Faridpur, Bangladesh, in January 2010. We identified 16 case-patients; 14 of these patients died. For 1 case-patient, the only known exposure was hugging a deceased patient with a probable case, while another case-patient’s exposure involved preparing the same corpse for burial by removing oral secretions and anogenital excreta with a cloth and bare hands. Among 7 persons with confirmed sporadic cases, 6 died, including a physician who had physically examined encephalitis patients without gloves or a mask. Nipah virus–infected patients were more likely than community-based controls to report drinking raw date palm sap and to have had physical contact with an encephalitis patient (29% vs. 4%, matched odds ratio undefined). Efforts to prevent transmission should focus on reducing caregivers’ exposure to infected patients’ bodily secretions during care and traditional burial practices.