Shooting for the Moon or Flying Too Near the Sun? Crossing the Value Rubicon in Precision Cancer Care

In his last two State of the Union addresses, President Barack Obama has focused on the need to deliver innovative solutions to improve human health, through the Precision Medicine Initiative in 2015 and the recently announced Cancer Moonshot in 2016. Precision cancer care has delivered clear patient benefit, but even for high-impact medicines such as imatinib mesylate (Glivec) in chronic myeloid leukaemia, the excitement at the success of this practice-changing clinical intervention has been somewhat tempered by the escalating price of this 'poster child' for precision cancer medicine (PCM). Recent studies on the costs of cancer drugs have revealed significant price differentials, which are a major causative factor behind disparities in the access to new generations of immunological and molecularly targeted agents. In this perspective, we will discuss the benefits of PCM to modern cancer control, but also emphasise how increasing costs are rendering the current approaches to integrating the paradigm of PCM unsustainable. Despite the ever increasing pressure on cancer and health care budgets, innovation will and must continue. Value-based frameworks offer one of the most rational approaches for policymakers committed to improving cancer outcomes through a public health approach.

Value creation in a reregulated market : Divestments, firms and dynamic processes

This thesis makes use of the unique reregulation of pharmaceutical monopoly in Sweden to critically examine intraindustry firm heterogeneity. It contributes to existing divestiture research as it studies the dynamism in between reconfigurations of value constellations and its effects on value creation of divested pharmacies. Because the findings showed that the predominant theory of intraindustry firm heterogeneity could not explain firm performance, the value constellation concept was applied as it captured the phenomena. A patterned finding informed how reconfigurations of value constellations in a reregulated market characterized by strict rules, regulations, and high competition did not generate additional value for firms on short term. My study unveils that value creation is hampered in situations where rules and regulations significantly affect firms’ ability to reconfigure their value constellations. The key practical implication is an alternative perspective on fundamental aspects of the reregulation and how policy-makers may impede firm performance and the intended creation of new value for not only firms but for society as a whole.

Analysis of the Bovespa Futures and Spot Indexes With High Frequency Data. Chinese Business Review

Data from the World Federation of Exchanges show that Brazil’s Sao Paulo stock exchange is one of the largest worldwide in terms of market value. Thus, the objective of this study is to obtain univariate and bivariate forecasting models based on intraday data from the futures and spot markets of the BOVESPA index. The interest is to verify if there exist arbitrage opportunities in Brazilian financial market. To this end, three econometric forecasting models were built: ARFIMA, vector autoregressive (VAR), and vector error correction (VEC). Furthermore, it presents the results of a Granger causality test for the aforementioned series. This type of study shows that it is important to identify arbitrage opportunities in financial markets and, in particular, in the application of these models on data of this nature. In terms of the forecasts made with these models, VEC showed better results. The causality test shows that futures BOVESPA index Granger causes spot BOVESPA index. This result may indicate arbitrage opportunities in Brazil.

Little Dairy on the Prairie: From Butter-makin' Women to High-tech Agriculture, July 10, 2008

In 2001, extensive archaeological excavations were conducted at the Oneida Cheese Factory in Jones County. The county is a microcosm of larger dairying trends found throughout northeast Iowa, the state's premier dairy-producing region, Jones County moved from homemade cheese and butter production by farm women, to the industrialization of the dairy farm and opening of cheese factories and butter creameries.A number of innovations affected the industry around the turn-of-the-twentieth century, including reliable butterfat testing, the introduction of ensilage (silos) that created year round milk production, and consolidation of the many local creameries into larger creamery organizations, such as the Diamond Creamery run by Henry D. Sherman of Jones County. Iowa's dairy industry of today looks very different from its heritage: consolidation and competition have drastically reduced the number of cows, dairy farms, and processing plants. In recent years, northeast Iowa has become the center of a movement to revitalize Iowa's dairy industry, particularly through the use of value-added strategies, such as niche markets and large regional co-operatives: the lessons from Iowa's dairying legacy are resurfacing as a solution to modern agricultural challenges.

Measuring, Modeling, and Forecasting Volatility and Correlations from High-Frequency Data

This dissertation contains four essays that all share a common purpose: developing new methodologies to exploit the potential of high-frequency data for the measurement, modeling and forecasting of financial assets volatility and correlations. The first two chapters provide useful tools for univariate applications while the last two chapters develop multivariate methodologies. In chapter 1, we introduce a new class of univariate volatility models named FloGARCH models. FloGARCH models provide a parsimonious joint model for low frequency returns and realized measures, and are sufficiently flexible to capture long memory as well as asymmetries related to leverage effects. We analyze the performances of the models in a realistic numerical study and on the basis of a data set composed of 65 equities. Using more than 10 years of high-frequency transactions, we document significant statistical gains related to the FloGARCH models in terms of in-sample fit, out-of-sample fit and forecasting accuracy compared to classical and Realized GARCH models. In chapter 2, using 12 years of high-frequency transactions for 55 U.S. stocks, we argue that combining low-frequency exogenous economic indicators with high-frequency financial data improves the ability of conditionally heteroskedastic models to forecast the volatility of returns, their full multi-step ahead conditional distribution and the multi-period Value-at-Risk. Using a refined version of the Realized LGARCH model allowing for time-varying intercept and implemented with realized kernels, we document that nominal corporate profits and term spreads have strong long-run predictive ability and generate accurate risk measures forecasts over long-horizon. The results are based on several loss functions and tests, including the Model Confidence Set. Chapter 3 is a joint work with David Veredas. We study the class of disentangled realized estimators for the integrated covariance matrix of Brownian semimartingales with finite activity jumps. These estimators separate correlations and volatilities. We analyze different combinations of quantile- and median-based realized volatilities, and four estimators of realized correlations with three synchronization schemes. Their finite sample properties are studied under four data generating processes, in presence, or not, of microstructure noise, and under synchronous and asynchronous trading. The main finding is that the pre-averaged version of disentangled estimators based on Gaussian ranks (for the correlations) and median deviations (for the volatilities) provide a precise, computationally efficient, and easy alternative to measure integrated covariances on the basis of noisy and asynchronous prices. Along these lines, a minimum variance portfolio application shows the superiority of this disentangled realized estimator in terms of numerous performance metrics. Chapter 4 is co-authored with Niels S. Hansen, Asger Lunde and Kasper V. Olesen, all affiliated with CREATES at Aarhus University. We propose to use the Realized Beta GARCH model to exploit the potential of high-frequency data in commodity markets. The model produces high quality forecasts of pairwise correlations between commodities which can be used to construct a composite covariance matrix. We evaluate the quality of this matrix in a portfolio context and compare it to models used in the industry. We demonstrate significant economic gains in a realistic setting including short selling constraints and transaction costs.

The role of emotions in value creation for families in pediatric health care

The purpose of this study was to analyze emotions related to a child’s critical illness from the perspective of the family and discuss the link those emotions might form with value creation. High quality service is of paramount importance in hospital care, especially when a child is diagnosed with critical illness. Through the analysis of patient family emotions and their triggers, the study was aiming to deepen the understanding of value creation for customer. Therefore, the research sought to find answers to the following three sub-questions: 1. What are the emotions experienced? 2. What triggers them? 3. How are the emotions linked to amelioration or aggravation of value for patient and family? The theoretical background of this research is built on two core concepts: emotions and value creation. As both concepts are wide and multifaceted, the research concentrates on viewing emotions from the applicable cognitive angle, identifying and categorizing emotions in a general level. Value creation is studied from the service perspective, discussing the possible relations between emotions and value creation. Moreover, the suitability of views regarding customer value co-creation to health care encounters is analyzed. Qualitative approach was selected as the most appropriate methodology for conducting the empirical research. The empirical data was collected from public blogs, for which a total of 18 blogs were reviewed. Five blogs were selected for the analysis, which had the intent of identifying the emotions experienced by patient families and deepening the knowledge of their role in value creation during health care service encounters. The empirical study of this research discovered a wide range of positive and negative emotions, which denotes that a severe life situation does not prevent the feeling of positive emotions. Furthermore, by combining the empirical findings to the theoretical background, this study concludes that recognizing and treating the patient family as a partner and value creator is essential. The high quality technical aspect of care is vital, but it is not the sole attribute for service quality, as the interpersonal communication plays a large role in the customer’s overall assessment of the health care performance. The patients and their families largely evaluate the service encounter based on their perceptions, thus emotions play a significant role. Depending on the service experience, value maybe created or destructed. Hence, this study posits emotion at the core of the service encounter, indicating towards the importance of active assessment of customer perceptions and the recognition of the emotional states

Children of Matter: Luxury Value Perceptions of Millennials in Higher Education in Europe

In recent years, the luxury market has entered a period of very modest growth, which has been dubbed the ‘new normal’, where varying tourist flows, currency fluctuations, and shifted consumer tastes dictate the terms. The modern luxury consumer is a fickle mistress. Especially millennials – people born in the 1980s and 1990s – are the embodiment of this new form of demanding luxury consumer with particular tastes and values. Modern consumers, and specifically millennials, want experiences and free time, and are interested in a brand’s societal position and environmental impact. The purpose of this thesis is to investigate what the luxury value perceptions of millennials in higher education are in Europe, seeing as many of the most prominent luxury goods companies in the world originate from Europe. Perceived luxury value is herein examined from the individual’s perspective. As values and value perceptions are complex constructs, using qualitative research methods is justifiable. The data for thesis has been gathered by means of a group interview. The interview participants all study hospitality management in a private college, and each represent a different nationality. Cultural theories and research on luxury and luxury values provide the scientific foundation for this thesis, and a multidimensional luxury value model is used as a theoretical tool in sorting and analyzing the data. The results show that millennials in Europe value much more than simply modern and hard luxury. Functional, financial, individual, and social aspects are all present in perceived luxury value, but some more in a negative sense than others. Conspicuous, status-seeking consumption is mostly frowned upon, as is the consumption of luxury goods for the sake of satisfying social requisites and peer pressure. Most of the positive value perceptions are attributed to the functional dimension, as luxury products are seen to come with a promise of high quality and reliability, which justifies any price premiums. Ecological and ethical aspects of luxury are already a contemporary trend, but perceived even more as an important characteristic of luxury in the future. Most importantly, having time is fundamental. Depending on who is asked, luxury can mean anything, just as much as it can mean nothing.

Identifying the Supports and Challenges of High School Latino English Language Learners

Two out of three English Language Learners (ELLs) graduate from secondary schools nationwide. Of the nearly five million ELLs in public schools, more than 70% of these students’ first language is Spanish. In order to understand and resolve this phenomena and in an effort to increase the number of graduates, this research examined what high school Latino ELLs identified as the major external and internal factors that support or challenge them on the graduation pathway. The study utilized a 32 quantitative and qualitative question student survey, as well as student focus groups. Both the survey and the focus groups were conducted in English and Spanish. The questions considered the following factors: 1) value of education; 2) expectations in achieving their long-term goals; 3) current education levels; 4) expectations before coming to the United States; 5) family obligations; and 6) future aspirations. The survey was administered to 159 Latino ELLs enrolled in grades 9-12. Research took place at three high schools that provide English for Speakers of Other Languages (ESOL) classes in a large school system in the Mid-Atlantic region. The three schools involved in the study have more than 1,500 ELLs. Two of the schools had large ESOL instructional programs, and one school had a comparatively smaller ESOL program. The majority of students surveyed were from El Salvador (72%) and Guatemala (12.6%). Using Qualtrics, an independent facilitator and a bilingual translator administered the online survey tool to the students during their ESOL classes. Two weeks later, the researcher hosted three follow-up focus groups, totaling 37 students from those students who took the survey. Each focus group was conducted at the three schools by the lead researcher and the translator. The purpose of the focus group was to obtain deeper insight on how secondary age Latino ELLs defined success in school, what they identified to be their support factors, and how previous and present experiences helped or hindered their goals. From the research findings, ten recommendations range from suggested policy updates to cross-cultural/equity training for students and staff; they were developed, stemming from the findings and what the students identified.

Conservation value, biodiversity value and methods of assessment in regenerating and human disturbed tropical forest

Although the value of primary forests for biodiversity conservation is well known, the potential biodiversity and conservation value of regenerating forests remains controversial. Many factors likely contribute to this, including: 1. the variable ages of regenerating forests being studied (often dominated by relatively young regenerating forests); 2. the potential for confounding on-going human disturbance (such as logging and hunting); 3. the relatively low number of multi-taxa studies; 4. the lack of studies that directly compare different historic disturbances within the same location; 5. contrasting patterns from different survey methodologies and the paucity of knowledge on the impacts across different vertical levels of rainforest biodiversity (often due to a lack of suitable methodologies available to assess them). We also know relatively little as to how biodiversity is affected by major current impacts, such as unmarked rainforest roads, which contribute to this degradation of habitat and fragmentation. This thesis explores the potential biodiversity value of regenerating rainforests under the best of scenarios and seeks to understand more about the impact of current human disturbance to biodiversity; data comes from case studies from the Manu and Sumaco Biosphere Reserves in the Western Amazon. Specifically, I compare overall biodiversity and conservation value of a best case regenerating rainforest site with a selection of well-studied primary forest sites and with predicted species lists for the region; including a focus on species of key conservation concern. I then investigate the biodiversity of the same study site in reference to different types of historic anthropogenic disturbance. Following this I investigate the impacts to biodiversity from an unmarked rainforest road. In order to understand more about the differential effects of habitat disturbance on arboreal diversity I directly assess how patterns of butterfly biodiversity vary between three vertical strata. Although assessments within the canopy have been made for birds, invertebrates and bats, very few studies have successfully targeted arboreal mammals. I therefore investigate the potential of camera traps for inventorying arboreal mammal species in comparison with traditional methodologies. Finally, in order to investigate the possibility that different survey methodologies might identify different biodiversity patterns in habitat disturbance assessments, I investigate whether two different but commonly used survey methodologies used to assess amphibians, indicate the same or different responses of amphibian biodiversity to historic habitat change by people. The regenerating rainforest study site contained high levels of species richness; both in terms of alpha diversity found in nearby primary forest areas (87% ±3.5) and in terms of predicted primary forest diversity from the region (83% ±6.7). This included 89% (39 out of 44) of the species of high conservation concern predicted for the Manu region. Faunal species richness in once completely cleared regenerating forest was on average 13% (±9.8) lower than historically selectively logged forest. The presence of the small unmarked road significantly altered levels of faunal biodiversity for three taxa, up to and potentially beyond 350m into the forest interior. Most notably, the impact on biodiversity extended to at least 32% of the whole reserve area. The assessment of butterflies across strata showed that different vertical zones within the same rainforest responded differently in areas with different historic human disturbance. A comparison between forest regenerating after selective logging and forest regenerating after complete clearance, showed that there was a 17% greater reduction in canopy species richness in the historically cleared forest compared with the terrestrial community. Comparing arboreal camera traps with traditional ground-based techniques suggests that camera traps are an effective tool for inventorying secretive arboreal rainforest mammal communities and detect a higher number of cryptic species. Finally, the two survey methodologies used to assess amphibian communities identified contrasting biodiversity patterns in a human modified rainforest; one indicated biodiversity differences between forests with different human disturbance histories, whereas the other suggested no differences between forest disturbance types. Overall, in this thesis I find that the conservation and biodiversity value of regenerating and human disturbed tropical forest can potentially contribute to rainforest biodiversity conservation, particularly in the best of circumstances. I also highlight the importance of utilising appropriate study methodologies that to investigate these three-dimensional habitats, and contribute to the development of methodologies to do so. However, care should be taken when using different survey methodologies, which can provide contrasting biodiversity patterns in response to human disturbance.

COMPREHENSIVE ELECTRICAL/OPTICAL/THERMAL CHARACTERIZATIONS OF HIGH POWER LIGHT EMITTING DIODES AND LASER DIODES

Thermal characterizations of high power light emitting diodes (LEDs) and laser diodes (LDs) are one of the most critical issues to achieve optimal performance such as center wavelength, spectrum, power efficiency, and reliability. Unique electrical/optical/thermal characterizations are proposed to analyze the complex thermal issues of high power LEDs and LDs. First, an advanced inverse approach, based on the transient junction temperature behavior, is proposed and implemented to quantify the resistance of the die-attach thermal interface (DTI) in high power LEDs. A hybrid analytical/numerical model is utilized to determine an approximate transient junction temperature behavior, which is governed predominantly by the resistance of the DTI. Then, an accurate value of the resistance of the DTI is determined inversely from the experimental data over the predetermined transient time domain using numerical modeling. Secondly, the effect of junction temperature on heat dissipation of high power LEDs is investigated. The theoretical aspect of junction temperature dependency of two major parameters – the forward voltage and the radiant flux – on heat dissipation is reviewed. Actual measurements of the heat dissipation over a wide range of junction temperatures are followed to quantify the effect of the parameters using commercially available LEDs. An empirical model of heat dissipation is proposed for applications in practice. Finally, a hybrid experimental/numerical method is proposed to predict the junction temperature distribution of a high power LD bar. A commercial water-cooled LD bar is used to present the proposed method. A unique experimental setup is developed and implemented to measure the average junction temperatures of the LD bar. After measuring the heat dissipation of the LD bar, the effective heat transfer coefficient of the cooling system is determined inversely. The characterized properties are used to predict the junction temperature distribution over the LD bar under high operating currents. The results are presented in conjunction with the wall-plug efficiency and the center wavelength shift.

Components and circuits for tunneling diode based high frequency sources

Terahertz (THz) technology has been generating a lot of interest because of the potential applications for systems working in this frequency range. However, to fully achieve this potential, effective and efficient ways of generating controlled signals in the terahertz range are required. Devices that exhibit negative differential resistance (NDR) in a region of their current-voltage (I-V ) characteristics have been used in circuits for the generation of radio frequency signals. Of all of these NDR devices, resonant tunneling diode (RTD) oscillators, with their ability to oscillate in the THz range are considered as one of the most promising solid-state sources for terahertz signal generation at room temperature. There are however limitations and challenges with these devices, from inherent low output power usually in the range of micro-watts (uW) for RTD oscillators when milli-watts (mW) are desired. At device level, parasitic oscillations caused by the biasing line inductance when the device is biased in the NDR region prevent accurate device characterisation, which in turn prevents device modelling for computer simulations. This thesis describes work on I-V characterisation of tunnel diode (TD) and RTD (fabricated by Dr. Jue Wang) devices, and the radio frequency (RF) characterisation and small signal modelling of RTDs. The thesis also describes the design and measurement of hybrid TD oscillators for higher output power and the design and measurement of a planar Yagi antenna (fabricated by Khalid Alharbi) for THz applications. To enable oscillation free current-voltage characterisation of tunnel diodes, a commonly employed method is the use of a suitable resistor connected across the device to make the total differential resistance in the NDR region positive. However, this approach is not without problems as the value of the resistor has to satisfy certain conditions or else bias oscillations would still be present in the NDR region of the measured I-V characteristics. This method is difficult to use for RTDs which are fabricated on wafer due to the discrepancies in designed and actual resistance values of fabricated resistors using thin film technology. In this work, using pulsed DC rather than static DC measurements during device characterisation were shown to give accurate characteristics in the NDR region without the need for a stabilisation resistor. This approach allows for direct oscillation free characterisation for devices. Experimental results show that the I-V characterisation of tunnel diodes and RTD devices free of bias oscillations in the NDR region can be made. In this work, a new power-combining topology to address the limitations of low output power of TD and RTD oscillators is presented. The design employs the use of two oscillators biased separately, but with the combined output power from both collected at a single load. Compared to previous approaches, this method keeps the frequency of oscillation of the combined oscillators the same as for one of the oscillators. Experimental results with a hybrid circuit using two tunnel diode oscillators compared with a single oscillator design with similar values shows that the coupled oscillators produce double the output RF power of the single oscillator. This topology can be scaled for higher (up to terahertz) frequencies in the future by using RTD oscillators. Finally, a broadband Yagi antenna suitable for wireless communication at terahertz frequencies is presented in this thesis. The return loss of the antenna showed that the bandwidth is larger than the measured range (140-220 GHz). A new method was used to characterise the radiation pattern of the antenna in the E-plane. This was carried out on-wafer and the measured radiation pattern showed good agreement with the simulated pattern. In summary, this work makes important contributions to the accurate characterisation and modelling of TDs and RTDs, circuit-based techniques for power combining of high frequency TD or RTD oscillators, and to antennas suitable for on chip integration with high frequency oscillators.

Common dyslipidemias, high lipoprotein(a) concentrations and endothelial function in the children of the STRIP study families

Extreme lipid values predisposing on illnesses are dyslipidemias. Dyslipidemias evolve in early childhood, but their significance or persistency is not well known. Common dyslipidemias may aggregate in the same families. This thesis is a part of the longitudinal randomized Special Turku coronary Risk factor Intervention Project STRIP, in which 1054 families with six months old children were randomized to a control or to an intervention group. The family lipid data from the first 11 years was used. Fasting samples at the age of five years defined the lipid phenotypes. The dyslipidemias coexisting in the parent and the child were studied. At the age of 11 years 402 children participated artery ultrasound studies. The significance of the childhood dyslipidemias and lipoprotein(a) concentration on endothelial function was evaluated with the flow mediated arterial dilatation test. Frequently elevated non-HDL cholesterol concentration from one to seven-year-old children associated to similar parental dyslipidemia that improved the predictive value of the childhood sample. The familial combinations were hypercholesterolemia (2.3%), hypertriglyceridemia (2.0%), familial combined hyperlipidemia (1.8%), and isolated low HDL-cholesterol concentration (1.4%). Combined hyperlipidemia in a parent predicted most frequently the child’s hyperlipidemia. High lipoprotein(a) concentration aggregated in some families and associated to childhood attenuated brachial artery dilatation. Hypercholesterolemia and high lipoprotein(a) concentration at five years of age predicted attenuated dilatation. This study demonstrated that parental dyslipidemias and high lipoprotein(a) concentration help to find early childhood dyslipidemias. The association of hypercholesterolemia and lipoprotein(a) concentration with endothelial function emphasizes the importance of the early recognition of the dyslipidemias.

ROC curves of obesity indicators have a predictive value for children hypertension aged 7-17 years

Objective: The aim of the study is to examine the distribution of integrated covariate and its association with blood pressure (BP) among children in Anhui province, China, and assess the predictive value of integrated covariate to children hypertension. Methods: A total of 2,828 subjects (1,588 male and 1,240 female) aged 7-17 years participated in this study. Height, weight, waistline, hipline and BP of all subjects were measured, obesity and overweight were defined by an international standard, specifying the measurement, the reference population, and the age and sex specific cut off points. High BP status was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) > 95th percentile for age and gender. Results: Our results revealed that the prevalence of children hypertension was 11.03%, the SBP and DBP of obesity group were significantly higher than that of normal group. Anthropometric obesity indices such as body mass index (BMI) were positively correlated with SBP and DBP. Integrated covariate had a better performance than the single covariate in the receiver-operating characteristic (ROC) curve, the cut-off value; the sensitivity and the specificity of the integrated covariate were 0.112, 0.577, 0.683, respectively. Conclusion: Integrated covariate is a simple and effective anthropometric index to identify childhood hypertension.

Bonafide, type-specific human papillomavirus persistence among HIV-positive pregnant women: predictive value for cytological abnormalities, a longitudinal cohort study

This study investigated the rate of human papillomavirus (HPV) persistence, associated risk factors, and predictors of cytological alteration outcomes in a cohort of human immunodeficiency virus-infected pregnant women over an 18-month period. HPV was typed through L1 gene sequencing in cervical smears collected during gestation and at 12 months after delivery. Outcomes were defined as nonpersistence (clearance of the HPV in the 2nd sample), re-infection (detection of different types of HPV in the 2 samples), and type-specific HPV persistence (the same HPV type found in both samples). An unfavourable cytological outcome was considered when the second exam showed progression to squamous intraepithelial lesion or high squamous intraepithelial lesion. Ninety patients were studied. HPV DNA persistence occurred in 50% of the cases composed of type-specific persistence (30%) or re-infection (20%). A low CD4+ T-cell count at entry was a risk factor for type-specific, re-infection, or HPV DNA persistence. The odds ratio (OR) was almost three times higher in the type-specific group when compared with the re-infection group (OR = 2.8; 95% confidence interval: 0.43-22.79). Our findings show that bonafide (type-specific) HPV persistence is a stronger predictor for the development of cytological abnormalities, highlighting the need for HPV typing as opposed to HPV DNA testing in the clinical setting.

Th1/Th2 Cytokine Profile and Its Diagnostic Value in Mycoplasma pneumoniae Pneumonia

Background: The levels of Th1/Th2 cytokine can alter in pathogenic infection in children with pneumonia. Objectives: To evaluate Th1/Th2 cytokine profile and its diagnostic value in M. pneumoniae pneumonia in children. Patients and Methods: Children with M. pneumoniae mono-infection and 30 healthy children were tested with cytokines assay. We used real time PCR to detect M. pneumoniae in children with pneumonia. Results: M. pneumoniae test was positive in 2188 (16.62%) out of 13161 pneumonia children. Children aged 5 - 9 years had the highest rate and summer was a season with high rate of M. pneumoniae incidence in Zhejiang province. During the course of study, in 526 pneumonia children with M. pneumoniae mono-infection and 30 healthy children cytokines assay was performed. IL-2 level of M. pneumoniae pneumonia children was lower than that of healthy children (median levels, pg/mL: IL-2: 3.2 vs. 5.7, P = 0.00), while IL-4, IL-10 and IFN-γ were higher than in healthy children (median levels, pg/mL: IL-4: 3.2 vs. 1.5, P = 0.00; IL-10: 5.6 vs. 2.5, P = 0.001; IFN-γ: 20.4 vs. 4.8, P = 0.001). Conclusions: IL-2 decreases and IL-4, IL-10 and IFN-γ increase in children with M. pneumoniae pneumonia, which has a promising prospect in diagnosis of this disease in clinical practice.