bluuebunny/crossref_metadata_2025 huggingface dataset:
Can “Focused Deterrence” Produce More Effective Ethics Codes? An Experimental Study
Authors: Rorie Melissa , West Matthew
Published: July 2020

The current study draws from the literature on “direct deterrence” programs as a framework for preventing corporate crime. Direct deterrence programs focus on reducing crime by communicating the likelihood and severity of sanctions to potential offenders. We believe a similar strategy may be useful when designing ethics codes. Ethics codes are the most commonly applied aspect of corporate internal compliance programs, yet evidence supporting their effectiveness is mixed and rigorous evaluation of their impact rare. Here, we employed an experimental design to examine how the content of ethics codes impact ethical decisions. Results suggest that the presence of an ethics code can increase compliance, but that supervisors also play a critical role. Implications for research and internal compliance programs are discussed.
Post-earthquake cordons and their implications
Authors: Underwood Greg , Orchiston Caroline , Shrestha Shakti R
Published: July 2020

Cordons provide a useful, but challenging risk-management tool for protecting public safety in a post-earthquake environment. There is limited literature on the purpose, complexities, and societal implications of post-earthquake cordons. Using evidence primarily from the 2011 Christchurch earthquake, and observations from the 2009 L’Aquila earthquake, this exploratory study identifies and highlights the various avenues of consideration involved in cordon establishment. This study shows that a cordon brings about complex challenges, pertaining to housing, law, economy, social welfare, governance, civil liberties, and health. We find that cordons can support both short-term and long-term recovery processes. Three themes emerge: (1) the tensions between minimizing risk for public health and safety and constraining the rights of the public and private parties; (2) the roles, rights, and relationships between government and private sectors; and (3) the balancing of short-term benefits of cordons against longer term impacts to the wider post-earthquake community. This exploratory study of the challenges, complexities and consequences associated with cordons over short, medium, and long terms may inform cordon-related decisions and improve outcomes for communities following an earthquake.
Iron chelation rescues hemolytic anemia and skin photosensitivity in congenital erythropoietic porphyria
Authors: Blouin Jean-Marc , Ged Cécile , Lalanne Magalie , Lamrissi-Garcia Isabelle , Morice-Picard Fanny , Costet Pierre , Daher Raêd , Moreau-Gaudry François , Bedel Aurélie , Puy Hervé , Gouya Laurent , Karim Zoubida , Richard Emmanuel
Published: July 2020

Congenital erythropoietic porphyria (CEP) is an inborn error of heme synthesis resulting from uroporphyrinogen III synthase (UROS) deficiency and the accumulation of nonphysiological porphyrin isomer I metabolites. Clinical features are heterogeneous among patients with CEP but usually combine skin photosensitivity and chronic hemolytic anemia, the severity of which is related to porphyrin overload. Therapeutic options include symptomatic strategies only and are unsatisfactory. One promising approach to treating CEP is to reduce the erythroid production of porphyrins through substrate reduction therapy by inhibiting 5-aminolevulinate synthase 2 (ALAS2), the first and rate-limiting enzyme in the heme biosynthetic pathway. We efficiently reduced porphyrin accumulation after RNA interference–mediated downregulation of ALAS2 in human erythroid cellular models of CEP disease. Taking advantage of the physiological iron-dependent posttranscriptional regulation of ALAS2, we evaluated whether iron chelation with deferiprone could decrease ALAS2 expression and subsequent porphyrin production in vitro and in vivo in a CEP murine model. Treatment with deferiprone of UROS-deficient erythroid cell lines and peripheral blood CD34+-derived erythroid cultures from a patient with CEP inhibited iron-dependent protein ALAS2 and iron-responsive element–binding protein 2 expression and reduced porphyrin production. Furthermore, porphyrin accumulation progressively decreased in red blood cells and urine, and skin photosensitivity in CEP mice treated with deferiprone (1 or 3 mg/mL in drinking water) for 26 weeks was reversed. Hemolysis and iron overload improved upon iron chelation with full correction of anemia in CEP mice treated at the highest dose of deferiprone. Our findings highlight, in both mouse and human models, the therapeutic potential of iron restriction to modulate the phenotype in CEP.
Expansions and contractions in gene families of independently-evolved blood-feeding insects
Authors: Freitas Lucas , Nery Mariana F.
Published: July 2020

Background

The blood-feeding behavior evolved multiple times in Insecta lineages and it represents an excellent opportunity to study patterns of convergent molecular evolution regarding this habit. In insects the expansion of some gene families is linked with blood-feeding behavior, but a wide study comparing the evolution of these gene families among different lineages is still missing. Here we gathered genomic data from six independently-evolved hematophagous lineages, aiming to identify convergent expansions and/or contractions of gene families in hematophagous lineages of insects.

Results

We found four rapidly evolving gene families shared by at least two hematophagous independently-evolved lineages, including a heat-shock and a chemosensory protein. On the expression of these four rapidly evolving gene families we found more genes expressed in mated individuals compared with virgin individuals in rapidly-expanded families and more genes expressed in non-blood-feeding individuals compared with blood-feeding individuals in rapidly-contracted families.

Conclusion

Our results reveal a new set of candidate genes to be explored in further analysis to help the development of new strategies to deal with blood-feeding vectors and also presents a new perspective to study the evolution of hematophagy identifying convergent molecular patterns.
Dynamic light caused less photosynthetic suppression, rather than more, under nitrogen deficit conditions than under sufficient nitrogen supply conditions in soybean
Authors: Li Yu-Ting , Li Ying , Li Yue-Nan , Liang Ying , Sun Qiang , Li Geng , Liu Peng , Zhang Zi-Shan , Gao Hui-Yuan
Published: July 2020

Background

Plants are always exposed to dynamic light. The photosynthetic light use efficiency of leaves is lower in dynamic light than in uniform irradiance. Research on the influence of environmental factors on dynamic photosynthesis is very limited. Nitrogen is critical for plants, especially for photosynthesis. Low nitrogen (LN) decreases ribulose-1,5-bisphosphate carboxylase/oxygenase (Rubisco) and thus limits photosynthesis. The decrease in Rubisco also delays photosynthetic induction in LN leaves; therefore, we hypothesized that the difference of photosynthetic CO2 fixation between uniform and dynamic light will be greater in LN leaves compared to leaves with sufficient nitrogen supply.

Results

To test this hypothesis, soybean plants were grown under low or high nitrogen (HN), and the photosynthetic gas exchange, enzyme activity and protein amount in leaves were measured under uniform and dynamic light. Unexpectedly, dynamic light caused less photosynthetic suppression, rather than more, in LN leaves than in HN leaves. The underlying mechanism was also clarified. Short low-light (LL) intervals did not affect Rubisco activity but clearly deactivated fructose-1,6-bisphosphatase (FBPase) and sedoheptulose-1,7-bisphosphatase (SBPase), indicating that photosynthetic induction after a LL interval depends on the reactivation of FBPase and SBPase rather than Rubisco. In LN leaves, the amount of Rubisco decreased more than FBPase and SBPase, so FBPase and SBPase were present in relative excess. A lower fraction of FBPase and SBPase needs to be activated in LN leaves for photosynthesis recovery during the high-light phase of dynamic light. Therefore, photosynthetic recovery is faster in LN leaves than in HN leaves, which relieves the photosynthetic suppression caused by dynamic light in LN leaves.

Conclusions

Contrary to our expectations, dynamic light caused less photosynthetic suppression, rather than more, in LN leaves than in HN leaves of soybean. This is the first report of a stress condition alleviating the photosynthetic suppression caused by dynamic light.
Fluid expansion improve ventriculo-arterial coupling in preload-dependent patients: a prospective observational study
Authors: Huette Pierre , Abou-Arab Osama , Longrois Dan , Guinot Pierre-Grégoire
Published: July 2020

Background

The objectives of the present study was to evaluate the effect of fluid challenge (FC) on ventriculo-arterial (V-A) coupling, its determinants: arterial elastance and ventricular elastance, and ability to predict fluid responsiveness.

Methods

Thirty patients admitted to cardio-thoracic ICU in whom the physician decided to perform FC were included. Arterial pressure, cardiac output, arterial elastance, and ventricular elastance, were measured before and after FC with 500 ml of lactated Ringer’s solution. Fluid responders were defined as patients with more than a 15% increase in stroke volume. V-A coupling was evaluated by the arterial elastance to ventricular elastance ratio.

Results

Twenty-three (77%) of the 30 patients included in the study were fluid responders. Before FC, responders had higher arterial elastance and arterial elastance to ventricular elastance ratio. FC significantly increased mean arterial pressure, stroke volume and cardiac output, and significantly decreased systemic vascular resistance, arterial elastance and consequently the arterial elastance to ventricular elastance ratio. Changes in arterial elastance were correlated with changes in stroke volume, systemic vascular resistance, and arterial compliance. Baseline arterial elastance to ventricular elastance ratio over 1.4 predicted fluid responsiveness (area under the curve [95% confidence interval]: 0.84 [0.66–1]; p < 0.0001).

Conclusions

Fluid responsiveness patients had V-A coupling characterized by increase arterial elastance to ventricular elastance ratio, in relation to an increase arterial elastance. Fc improved the V-A coupling ratio by decreasing arterial elastance without altering ventricular elastance. Arterial elastance changes were related to those of systemic vascular resistance (continue component) and of arterial compliance (pulsatile component).
A novel G6PD deleterious variant identified in three families with severe glucose-6-phosphate dehydrogenase deficiency
Authors: Tong Yongqing , Liu Bei , Zheng Hongyun , Bao Anyu , Wu Zegang , Gu Jian , Tan Bi-Hua , McGrath Mary , Kane Shriya , Song Chunhua , Li Yan
Published: July 2020

Background

Glucose-6-phosphate dehydrogenase deficiency (D-G6PD) is an X-linked recessive disorder resulted from deleterious variants in the housekeeping gene Glucose-6-phosphate 1-dehydrogenase (G6PD), causing impaired response to oxidizing agents. Screening for new variations of the gene helps with early diagnosis of D-G6PD resulting in a reduction of disease related complications and ultimately increased life expectancy of the patients.

Methods

One thousand five hundred sixty-five infants with pathological jaundice were screened for G6PD variants by Sanger sequencing all of the 13 exons, and the junctions of exons and introns of the G6PD gene.

Results

We detected G6PD variants in 439 (28.1%) of the 1565 infants with pathological jaundice. In total, 9 types of G6PD variants were identified in our cohort; and a novel G6PD missense variant c.1118 T > C, p.Phe373Ser in exon 9 of the G6PD gene was detected in three families. Infants with this novel variant showed decreased activity of G6PD, severe anemia, and pathological jaundice, consistent with Class I G6PD deleterious variants. Analysis of the resulting protein’s structure revealed this novel variant affects G6PD protein stability, which could be responsible for the pathogenesis of D-G6PD in these patients.

Conclusions

High rates of G6PD variants were detected in infants with pathological jaundice, and a novel Class I G6PD deleterious variants was identified in our cohort. Our data reveal that variant analysis is helpful for the diagnosis of D-G6PD in patients, and also for the expansion of the spectrum of known G6PD variants used for carrier detection and prenatal diagnosis.
A nomogram model to predict death rate among non-small cell lung cancer (NSCLC) patients with surgery in surveillance, epidemiology, and end results (SEER) database
Authors: Jia Bo , Zheng Qiwen , Wang Jingjing , Sun Hongyan , Zhao Jun , Wu Meina , An Tongtong , Wang Yuyan , Zhuo Minglei , Li Jianjie , Yang Xue , Zhong Jia , Chen Hanxiao , Chi Yujia , Zhai Xiaoyu , Wang Ziping
Published: July 2020

Background

This study aimed to establish a novel nomogram prognostic model to predict death probability for non-small cell lung cancer (NSCLC) patients who received surgery..

Methods

We collected data from the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute in the United States. A nomogram prognostic model was constructed to predict mortality of NSCLC patients who received surgery.

Results

A total of 44,880 NSCLC patients who received surgery from 2004 to 2014 were included in this study. Gender, ethnicity, tumor anatomic sites, histologic subtype, tumor differentiation, clinical stage, tumor size, tumor extent, lymph node stage, examined lymph node, positive lymph node, type of surgery showed significant associations with lung cancer related death rate (P < 0.001). Patients who received chemotherapy and radiotherapy had significant higher lung cancer related death rate but were associated with significant lower non-cancer related mortality (P<0.001). A nomogram model was established based on multivariate models of training data set. In the validation cohort, the unadjusted C-index was 0.73 (95% CI, 0.72–0.74), 0.71 (95% CI, 0.66–0.75) and 0.69 (95% CI, 0.68–0.70) for lung cancer related death, other cancer related death and non-cancer related death.

Conclusions

A prognostic nomogram model was constructed to give information about the risk of death for NSCLC patients who received surgery.
Network-based identification of biomarkers for colon adenocarcinoma
Authors: Hu Fuyan , Wang Qing , Yang Zhiyuan , Zhang Zeng , Liu Xiaoping
Published: July 2020

Background

As one of the most common cancers with high mortality in the world, we are still facing a huge challenge in the prevention and treatment of colon cancer. With the rapid development of high throughput technologies, new biomarkers identification for colon cancer has been confronted with the new opportunities and challenges.

Methods

We firstly constructed functional networks for each sample of colon adenocarcinoma (COAD) by using a sample-specific network (SSN) method which can construct individual-specific networks based on gene expression profiles of a single sample. The functional genes and interactions were identified from the functional networks, respectively.

Results

Classification and subtyping were used to test the function of the functional genes and interactions. The results of classification showed that the functional genes could be used as diagnostic biomarkers. The subtypes displayed different mechanisms, which were shown by the functional and pathway enrichment analysis for the representative genes of each subtype. Besides, subtype-specific molecular patterns were also detected, such as subtype-specific clinical and mutation features. Finally, 12 functional genes and 13 functional edges could serve as prognosis biomarkers since they were associated with the survival rate of COAD.

Conclusions

In conclusion, the functional genes and interactions in the constructed functional network could be used as new biomarkers for COAD.
Relationship between parenting measures and parents and child psychopathological symptoms: a cross-sectional study
Authors: Bellina Monica , Grazioli Silvia , Garzitto Marco , Mauri Maddalena , Rosi Eleonora , Molteni Massimo , Brambilla Paolo , Nobile Maria
Published: July 2020

Background

Increasing evidence suggests a complex role of family influences, such as the exposure to parent psychopathology through parenting behavior, in parent-to-child psychopathology transmission. Parenting behaviour could represent a relevant target of psychoeducative intervention. Given these premises, we aimed to evaluate homotypic and heterotypic relationships between parent and child psychopathology, mediated by parenting behaviours, taking into account the constructs of parent and offspring internalizing and externalizing psychopathology.

Methods

Internalizing and externalizing symptoms in 272 clinically-referred subjects (mean age = 14.5 ± 2.3; F = 23.5%) and their parents (mothers n = 272, fathers n = 242) were assessed through the Child Behavior Checklist and the Adult Self Report; four areas of parenting behaviours were investigated through the Family Life Questionnaire. Multiple mediation models were built, considering mother and father psychopathology scales as independent variables, parenting measures and family functioning as mediators (Affirmation, Rules, Discipline and Special Allowances), child psychopathology scales as dependent variables and demographic variables as covariates.

Results

Regression models showed a significant effect of maternal internalizing symptomatology on child externalizing behavioral problems; high levels of maternal pathology predicted high levels of children’s psychopathology. A total mediating effect of parenting measures was found: high levels of internalizing symptoms in mothers predicted low levels of affirmation, which in turn predicted high levels of externalizing psychopathology in children.

Conclusions

Our study results confirmed the existence of interdependent links between mothers’ psychiatric symptomatology, parenting behaviour and offspring outcomes, specifically in an Italian context. On a clinical and rehabilitation basis, this work offers suggestions about parenting practices, specifically maternal, involved in the maintenance of child psychopathology.
Mental health status among family members of health care workers in Ningbo, China, during the coronavirus disease 2019 (COVID-19) outbreak: a cross-sectional study
Authors: Ying Yuchen , Ruan Liemin , Kong Fanqian , Zhu Binbin , Ji Yunxin , Lou Zhongze
Published: July 2020

Background

To date, the psychological impact of COVID-19 epidemic among family members of health care workers (HCWs) in China has been neglected. This cross-sectional study investigates the mental health status and related factors in families of HCWs employed in designated hospitals in Ningbo, China.

Methods

Family members of HCWs in five designated hospitals in Ningbo, China, were recruited in February, 2020 for this study. Demographic variables, COVID-19-related events in the lives of the participants, knowledge of COVID-19, and the working status of family members (that is, HCWs) were collected using online self-administered questionnaires. Mental health status was assessed using the Chinese versions of the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Multivariable logistic regression analyses were performed to identify the main factors associated with the mental health conditions.

Results

In total, 845 participants completed the questionnaires correctly (95.80% response rate). The prevalence of anxiety and depression symptoms were respectively 33.73% (95% CI: 30.53–36.92%) and 29.35% (95% CI: 26.27–32.43%) when a cut-off score of 5 was used for GAD-7 and PHQ-9. Risk factors for anxiety symptoms included more time (hours) spent thinking about the COVID-19, and whether or not family members (that is, HCWs) had direct contact with confirmed or suspected COVID-19 patients while high participants’ self-reported safety scores for HCW’s protective equipment was a protective factor. More time (hours) spent thinking about COVID-19, longer average working time per week worked by family members (that is, HCWs), and being parents and other next of kin of HCWs were risk factors for depressive symptoms. Compared to participants who were HCWs, participants who were private sector workers were more likely to develop depressive symptoms, while government or institutional employees were less likely to suffer from depressive symptoms.

Conclusions

Psychological responses to COVID-19 have been dramatic among family members of HCWs during the rising phase of the outbreak. Our findings provide strong evidence to examine and attend to the mental health of this population during the COVID-19 epidemic.
Prevalence of accelerometer-measured physical activity in adolescents in Fit Futures – part of the Tromsø Study
Authors: Beldo Sigurd K. , Morseth Bente , Christoffersen Tore , Halvorsen Peder A. , Hansen Bjørge H. , Furberg Anne-Sofie , Ekelund Ulf , Horsch Alexander
Published: July 2020

Background

Previous studies show large variations in physical activity (PA) levels among adolescents. However, the number of studies is limited and even fewer studies have assessed PA in adolescents by accelerometer devices. This study aimed to describe accelerometer-measured PA levels in adolescents in a population-based cohort in Northern Norway.

Methods

In 611 students aged 16–17 years attending the Fit Futures Study, PA was measured by Actigraph GT3X for seven consecutive days. PA was expressed as total PA volume (counts per minute, CPM), time spent in intensity zones, steps per day, and fulfilment of WHO recommendation (i.e. accumulation of 60 min or more of at least moderate intensity PA per day). Potential correlates of PA such as sex, socioeconomic status, study program, self-perceived health, and PA variations by weekday versus weekend were also examined.

Results

16% of the girls and 25% of the boys fulfilled current WHO-recommendations. Total PA volume (CPM) was higher in boys than in girls (353 (SD 130) versus 326 (SD 114) CPM, p < 0.05). PA levels differed with study program and increased with better self-perceived health, but were not associated with socioeconomic status. Both boys and girls were more active on weekdays than weekends (altogether; 350 (SD 124) versus 299 (SD 178) CPM, p < 0.05).

Conclusions

In this cohort of adolescents, less than 25% of 16–17-year-old boys and girls fulfilled the WHO recommendations. The levels of physical activity in 16–17-year-old adolescents are similar to previous data reported in adults.
Serum levels of interleukins and S100A8/A9 correlate with clinical severity in patients with dermatomyositis-associated interstitial lung disease
Authors: Lou Yueyan , Zheng Yu , Fan Bijun , Zhang Liyan , Zhu Feng , Wang Xiaodong , Chen Zhiwei , Tan Xiaoming , Wei Qing
Published: July 2020

Background

Dermatomyositis (DM) is a systemic autoimmune inflammatory disorder that affects primarily skin, muscle and lung, frequently associated with interstitial lung disease (ILD). The objective of this study is to investigate the association between serum cytokines and clinical severity in patients with DM-ILD.

Methods

Serum samples of 30 healthy controls, 14 DM patients without ILD and 40 DM patients with ILD were collected. Serum S100A8/A9 levels were analyzed by enzyme-linked immunosorbent assay (ELISA) and levels of interleukins were measured by cytometric beads array (CBA). Then we performed multivariate logistic regression analysis to determine factors independently associated with ILD development.

Results

Serum IL-4, IL-6 and S100A8/A9 levels were significantly higher in DM patients with ILD than those in healthy controls (p = 0.0013, 0.0017 and < 0.0001, respectively). Serum IL-10 level of patients was dramatically lower than that in controls (p = 0.0001). In DM patients, the levels were significantly higher in patients with A/SIP than in those with CIP (p = 0.0046, 0.0339 and 0.0133) or without ILD (p = 0.0165, 0.0370 and < 0.0001). IL-4 (r = 0.1171, p = 0.0040), IL-6 (r = 0.1174, p = 0.0040) and IL-10 (r = − 0.1829, p = 0.0003) were significantly correlated with S100A8/A9 in DM-ILD patients. S100A8/A9 was significantly correlated with high-resolution computed tomography (HRCT) (r = 0.1642, p = 0.0157) and lung function (DLCO%: r = − 0.2066, p = 0.0061, FVC%: r = − 0.2156, p = 0.0050). Moreover, logistic regression analysis revealed that S100A8/A9 levels were independently associated with ILD development in DM patients (p = 0.004).

Conclusions

Serum level of S100A8/A9 may be a valuable predictor for assessing the clinical severity of DM-ILD patients. Serum IL-4, IL-6 and IL-10 levels were highly correlated with S100A8/A9, so these cytokines may play a synergistic effect on the progression of DM-ILD.
The effect of knee joint rotation in the sagittal and axial plane on the measurement accuracy of coronal alignment of the lower limb
Authors: Moon Hyun-Soo , Choi Chong-Hyuk , Jung Min , Lee Dae-Young , Kim Jung-Hwan , Kim Sung-Hwan
Published: July 2020

Background

Although the measurement of coronal alignment of the lower limb on conventional full-length weight-bearing anteroposterior (FLWAP) radiographs was reported to be influenced by the knee joint rotation, no comparative analysis was performed considering the effects of knee joint rotation on the sagittal and axial planes simultaneously using the three-dimensional images while taking into account the actual weight-bearing conditions. The aim of this study was to investigate the effect of knee joint rotation on the measurement accuracy of coronal alignment of the lower limb on the FLWAP radiograph.

Methods

Radiographic images of 90 consecutive patients (180 lower limbs) who took both the FLWAP radiograph and the EOS image were retrospectively reviewed. The relationship among delta values of mechanical tibiofemoral angle (mTFA) between the FLWAP radiographs and the EOS images (ΔmTFA), knee flexion/extension angle (sagittal plane rotation) on the EOS images, and patellar rotation (axial plane rotation) on the FLWAP radiographs were analyzed. Further, subgroup analysis according to each direction of knee joint rotation was performed.

Results

There was a significant correlation between ΔmTFA and sagittal plane rotation (r = 0.368, P <  0.001), whereas axial plane rotation was not correlated. In the analysis according to the direction, statistically significant correlation was observed only in the knee flexion group (r = 0.399, P <  0.001). The regression analysis showed a significant linear relationship between ΔmTFA and sagittal plane rotation (r2 = 0.136, P <  0.001). Additional subgroup analysis in patients with the patellar rotation greater than 3% showed a similar result of a linear relationship between ΔmTFA and sagittal plane rotation (r2 = 0.257, P <  0.001), whereas no statistically significant relationship was found in patients with the patellar rotation less than 3%.

Conclusion

The measurement accuracy of coronal alignment of the lower limb on the FLWAP radiographs would be influenced by knee flexion, specifically when there is any subtle rotation of the knee joint in the axial plane. A strict patellar forward position without axial plane rotation of the knee could provide accurate results of the measurement even if there is a fixed flexion contracture of the knee.
Analysis of primary oral and oropharyngeal squamous cell carcinoma in inhabitants of Beijing, China—a 10-year continuous single-center study
Authors: Bai Xue-Xiao , Zhang Jie , Wei Li
Published: July 2020

Background

This study aimed to describe some of the characteristics of the inhabitants of Beijing with oral and oropharyngeal squamous cell carcinoma (OSCC) who had received treatment at the Stomatology Hospital of Peking University and to analyze the survival rate and the prognostic factors of patients following surgical treatment.

Methods

Data for 603 consecutive cases with primary OSCC between 2004 and 2013 were obtained from the Stomatology Hospital of Peking University. Clinical data including age, sex, living district, primary tumor site, TNM stage, history of drinking and smoking, pathological differentiation, treatment, and survival were retrospectively analyzed.

Results

The male:female ratio was 1.1:1. The frequency of site involvement in descending order was tongue (34.3%), gingiva (25.0%), buccal mucosa (13.8%), oral floor (9.0%), oropharynx (8.5%), lip (6.3%) and palate (3.2%). Female OSCC patients tended to be significantly older than men with OSCC (P < 0.05). The percentage of patients with TNM stage III–IV OSCC was 52.4%. The results revealed that 65.3% of male patients and only 6.3% of female patients smoked or drank. The overall 5-year survival rate was 64%. Female patients had a worse prognosis than male patients. Among the patients who received surgery, tumor size and lymph node involvement were independent prognostic factors. Smoking and drinking were not prognostic factors.

Conclusion

Among the Beijing inhabitants who were diagnosed with OSCC and treated in our hospital in the past 10 years, more than half were in the advanced stage, and the cancer stage was the main prognostic factor of oral cancer. Therefore, the recognition of oral cancer should be strengthened, and early detection and treatment of OSCC should be achieved to improve the survival rate.
Grand Duchy of Luxembourg: a case study of a national master patient index in production since five years
Authors: Vaccaroli Raffaella , Markus Frédéric , Danhardt Samuel , Zimmermann Heiko , Wisniewski Francois , Lucas Pascale , Barge Hervé
Published: July 2020

Background

Unequivocal identification of patients is a precondition for a safe medical journey through different information systems (ISs) and software applications that are communicating and exchanging interoperable data. A master patient index (MPI) can facilitate this task. Being a repository of patient identity traits, a MPI allows an accurate surveillance of the patients’ “medical identities”. Up to 2014, the Grand Duchy of Luxembourg did not possess a MPI. Here, we describe our experience in the establishment of a national MPI for the Grand Duchy of Luxembourg.

Methods

The different steps that were used to establish the MPI system are described. Firstly, through the identification of the suitable application and, secondly, through the implementation of the MPI to the eHealth national platform and its connection to the national health care system. In parallel to the first two phases, the identity management policies were defined and implemented.

Results

Since 2014, when the MPI was integrated to the eHealth platform, we observed a continuous increase of identity profiles. At the latest update (31 December 2018), 2.418.336 identity profiles have been counted, including almost the totality of Luxembourgish residents (95.2%) as well as all the cross-border workers that are affiliated to the Luxembourgish social security system. An analysis of the identification domains connected to the platform highlighted a yearly increase in the usage rate of the identities by external applications (currently representing 70%). The evaluation of the quality of information contained in each identity profile showed low rejection rates (0.2%), indicating a high quality and a good level of completeness in regards to the required identity traits.

Conclusions

This paper presents the current state of patient identity management in Luxembourg and discusses how this synergistically supports the functioning of the national electronic health record (EHR) known as DSP (from the French Dossier de Soins Partagé) and the Luxemburgish health care system. The here described national MPI has refined the identification of patients, leading to an improvement of their safety during their medical journey. Nevertheless, the application regularly undergoes updates to better meet the current requirements of the Luxembourgish health system.
Health professionals’ perceptions of colorectal cancer patients’ treatment burden and their supportive work to ameliorate the burden – a qualitative study
Authors: Husebø Anne Marie Lunde , Karlsen Bjørg , Husebø Sissel Eikeland
Published: July 2020

Background

Support is pivotal for patients in managing colorectal cancer treatment, as they might be overwhelmed by the burden of treatment. There is scarce knowledge regarding health professionals’ perceptions of colorectal cancer patients’ burdens and supportive needs. The study aims to describe health professionals’ perspectives on treatment burden among patients receiving curative surgical treatment for colorectal cancer during the hospital stay and how they support patients to ameliorate the burden.

Methods

This study has a descriptive and explorative qualitative design, using semi-structured interviews with nine health professionals recruited from a gastrointestinal-surgery ward at a university hospital in Norway. Data were analysed by using systematic text condensation.

Results

Data analysis identified the themes “capturing patients’ burdens of colorectal cancer treatment” and “health professionals’ support to ameliorate the burden”. Patients with colorectal cancer had to face burdens related to a challenging emotional situation, treatment complications and side effects, and an extensive need for information. A trusting patient-carer relationship was therefore perceived as the essence of health professionals’ support. Health professionals focused their support on safeguarding patients, motivating patients to self-manage, and involving family and peers as supporters. Patients’ journey characteristics and illness severity challenged health professionals’ supportive work.

Conclusion

Support from health professionals includes providing patients emotional support and relevant treatment-related information and motivating patients for early post-surgical mobilisation. Health professionals should be aware of identifying colorectal cancer patients’ information needs according to the specific treatment stages, which may ameliorate the burden of colorectal cancer treatment and enable patients to self-manage.
Feasibility and desirability of scaling up Community–based Health Insurance (CBHI) in rural communities in Uganda: lessons from Kisiizi Hospital CBHI scheme
Authors: Kakama Alex A. , Namyalo Prossy K. , Basaza Robert K.
Published: July 2020

Background

Community-based Health Insurance (CBHI) schemes have been implemented world over as initial steps for national health insurance schemes. The CBHI concept developed out of a need for financial protection against catastrophic health expenditures to the poor after failure of other health financing mechanisms. CBHI schemes reduce out-of-pocket payments, and improve access to healthcare services in addition to raising additional revenue for the health sector. Kisiizi Hospital CBHI scheme which was incepted in 1996, has 41,500 registered members, organised in 210 community associations known as ‘Bataka’ or ‘Engozi’ societies. Members pay annual premiums and a co-payment fee before service utilisation. This study aimed at exploring the feasibility and desirability of scaling up CBHI in Rubabo County, with specific objectives of: exploring community perceptions and determining acceptability of CBHI, identifying barriers, enablers to scaling up CBHI and documenting lessons regarding CBHI expansion in a rural community.

Methods

Explorative study using qualitative methods of Key informant interviews and Focus Group Discussions (FGDs). Seventeen key informant interviews, three focus group discussions for scheme members and three for non-scheme members were conducted using a topic guide. Data was analysed using thematic approach.

Results

Scaling up Kisiizi Hospital CBHI is desirable because: it conforms to the government social protection agenda, society values, offers a comprehensive benefits package, and is a better healthcare financing alternative for many households. Scaling up Kisiizi Hospital CBHI is largely feasible because of a strong network of community associations, trusted quality healthcare services at Kisiizi Hospital, affordable insurance fees, trusted leadership and management systems. Scheme expansion faces some obstacles that include: long distances and high transport costs to Kisiizi Hospital, low levels of knowledge about health insurance, overlapping financial priorities at household level and inability of some households to pay premiums.

Conclusions

CBHI implementation requires the following considerations: conformity with society values and government priorities, a comprehensive benefits package, trusted quality of healthcare services, affordable fees, trusted leadership and management systems.
What is the right sequencing approach? Solo VS extended family analysis in consanguineous populations
Authors: Alfares Ahmed , Alsubaie Lamia , Aloraini Taghrid , Alaskar Aljoharah , Althagafi Azza , Alahmad Ahmed , Rashid Mamoon , Alswaid Abdulrahman , Alothaim Ali , Eyaid Wafaa , Ababneh Faroug , Albalwi Mohammed , Alotaibi Raniah , Almutairi Mashael , Altharawi Nouf , Alsamer Alhanouf , Abdelhakim Marwa , Kafkas Senay , Mineta Katsuhiko , Cheung Nicole , Abdallah Abdallah M. , Büchmann-Møller Stine , Fukasawa Yoshinori , Zhao Xiang , Rajan Issaac , Hoehndorf Robert , Al Mutairi Fuad , Gojobori Takashi , Alfadhel Majid
Published: July 2020

Background

Testing strategies is crucial for genetics clinics and testing laboratories. In this study, we tried to compare the hit rate between solo and trio and trio plus testing and between trio and sibship testing. Finally, we studied the impact of extended family analysis, mainly in complex and unsolved cases.

Methods

Three cohorts were used for this analysis: one cohort to assess the hit rate between solo, trio and trio plus testing, another cohort to examine the impact of the testing strategy of sibship genome vs trio-based analysis, and a third cohort to test the impact of an extended family analysis of up to eight family members to lower the number of candidate variants.

Results

The hit rates in solo, trio and trio plus testing were 39, 40, and 41%, respectively. The total number of candidate variants in the sibship testing strategy was 117 variants compared to 59 variants in the trio-based analysis. We noticed that the average number of coding candidate variants in trio-based analysis was 1192 variants and 26,454 noncoding variants, and this number was lowered by 50–75% after adding additional family members, with up to two coding and 66 noncoding homozygous variants only, in families with eight family members.

Conclusion

There was no difference in the hit rate between solo and extended family members. Trio-based analysis was a better approach than sibship testing, even in a consanguineous population. Finally, each additional family member helped to narrow down the number of variants by 50–75%. Our findings could help clinicians, researchers and testing laboratories select the most cost-effective and appropriate sequencing approach for their patients. Furthermore, using extended family analysis is a very useful tool for complex cases with novel genes.
Identification of a three-long noncoding RNA prognostic model involved competitive endogenous RNA in kidney renal clear cell carcinoma
Authors: Zhang Di , Zeng Song , Hu Xiaopeng
Published: July 2020

Background

Long noncoding RNA (lncRNA) is generally identified as competing endogenous RNA (ceRNA) that plays a vital role in the pathogenesis of kidney renal clear cell carcinoma (KIRC), the most common subtype of renal cell carcinoma with poor prognosis and unclear pathogenesis. This study established a novel ceRNA network and thus identified a three-lncRNA prognostic model in KIRC patients.

Methods

Differentially expressed genes (DEGs) were screened out from The Cancer Genome Atlas (TCGA) database. The lncATLAS was applied to determine the differentially expressed lncRNAs (DElncRNAs) of the cytoplasm. The miRcode, miRDB, miRTarBase, and TargetScan databases were utilized to predict the interactions of DElncRNAs, DEmiRNAs, and DEmRNAs. Cytoscape was used to construct the ceRNA network. Then, a lncRNA prognostic model (LPM) was constructed based on ceRNA-related lncRNA that was significantly related to overall survival (OS), and its predictive ability was evaluated. Moreover, an LPM-based nomogram model was constructed. The significantly different expression of genes in the LPM was validated in an independent clinical cohort (N = 21) by quantitative RT-PCR.

Results

A novel ceRNA regulatory network, including 73 lncRNAs, 8 miRNAs, and 21 mRNAs was constructed. Functional enrichment analysis indicated that integral components of membrane and PI3K–Akt signaling pathway represented the most significant GO terms and pathway, respectively. The LPM established based on three lncRNAs (MIAT, LINC00460, and LINC00443) of great prognostic value from the ceRNA network was proven to be independent of conventional clinical parameters to differentiate patients with low or high risk of poor survival, with the AUC of 1-, 5- and 10-year OS were 0.723, 0.714 and 0.826 respectively. Furthermore, the nomogram showed a better predictive value in KIRC patients than individual prognostic parameters. The expression of MIAT and LINC00460 was significantly upregulated in the KIRC samples, while the expression of LINC00443 was significantly downregulated compared with the adjacent normal samples in the clinical cohort, TCGA, and GTEx.

Conclusion

This LPM based on three-lncRNA could serve as an independent prognostic factor with a tremendous predictive ability for KIRC patients, and the identified novel ceRNA network may provide insight into the prognostic biomarkers and therapeutic targets of KIRC.
A national model of remote care for assessing and providing opioid agonist treatment during the COVID-19 pandemic: a report
Authors: Crowley Des , Delargy Ide
Published: July 2020

Background

Health services globally are struggling to manage the impact of COVID-19. The existing global disease burden related to opioid use is significant. Particularly challenging groups include older drug users who are more vulnerable to the effects of COVID-19. Increasing access to safe and effective opioid agonist treatment (OAT) and other harm reduction services during this pandemic is critical to reduce risk. In response to COVID-19, healthcare is increasingly being delivered by telephone and video consultation, and this report describes the development of a national model of remote care to eliminate waiting lists and increase access to OAT in Ireland.

Purpose and findings

The purpose of this initiative is to provide easy access to OAT by developing a model of remote assessment and ongoing care and eliminate existing national waiting lists. The Irish College of General Practitioners in conjunction with the National Health Service Executive office for Social Inclusion agreed a set of protocols to enable a system of remote consultation but still delivering OAT locally to people who use drugs.

This model was targeted at OAT services with existing waiting lists due to a shortage of specialist medical staff. The model involves an initial telephone assessment with COVID-risk triage, a single-patient visit to local services to provide a point of care drug screen and complete necessary documentation and remote video assessment and ongoing management by a GP addiction specialist. A secure national electronic health link system allows for the safe and timely delivery of scripts to a designated local community pharmacy.

Conclusion

The development of a remote model of healthcare delivery allows for the reduction in transmission risks associated with COVID-19, increases access to OAT, reduces waiting times and minimises barriers to services. An evaluation of this model is ongoing and will be reported once completed. Fast adaptation of OAT delivery is critical to ensure access to and continuity of service delivery and minimise risk to our staff, patients and community. Innovative models of remote healthcare delivery adapted during the COVID-19 crisis may inform and have important benefits to our health system into the future.
Functional dependence and the mental dimension of quality of life in Hemodialysis patients: the PROHEMO study
Authors: Gutiérrez-Peredo Gabriel Brayan , Martins Márcia Tereza Silva , da Silva Fernanda Albuquerque , Lopes Marcelo Barreto , Lopes Gildete Barreto , Lopes Antonio Alberto
Published: July 2020

Background

Functional dependence is highly prevalent in maintenance hemodialysis (MHD) settings. Also, poor health-related quality of life (HRQoL) and high levels of depressive symptoms have been reported by MHD patients. We investigated associations between functional status and mental aspects of quality of life in Brazilian MHD patients.

Methods

Cross sectional study of 235 patients enrolled in two of the four participating MHD clinics of the Prospective Study of the Prognosis of Chronic Hemodialysis Patients (PROHEMO) in Salvador, BA, Brazil. Data were collected from September 2016 to August 2017. The Katz’s questionnaire was used for basic activities of daily living (ADL) and the Lawton-Brody’s questionnaire for instrumental activities of daily living (IADL). ADL and IADL scores were combined to create 3 functional status groups: highly dependent (n = 47), moderately dependent (n = 109) and independent (n = 82). The validated Brazilian version of the Kidney Disease Quality of Life Short Form (KDQOL-SF) was used for scores of two distinct HRQoL measures, i.e., the mental component summary (MCS) and the 5-item mental health inventory (MHI-5). We used linear regression to estimate differences in scores with adjustment for possible confounders: months of dialysis, age, gender, other sociodemographic variables, body mass index, type of vascular access, dialysis dose by Kt/V, laboratory variables (albumin, blood hemoglobin, calcium, phosphorus, urea, creatinine and parathyroid hormone) and nine comorbid conditions.

Results

Mean age was 51.2 ± 12.4 yr (median age = 51.0 yr), 59.1% were male, 93.2% were non-White. The prevalence of self-reported functional status differed by age: 54.4% for age < 45 yr, 67.8% for age 45–60 yr and 73.9% for age ≥ 60 yr. Using functionally independent as reference, lower scores were observed for highly dependent patients in MCS (difference: -4.69, 95% CI: -8.09, -0.29) and MHI-5 (difference: -5.97, 95% CI: -8.09, -1.29) patients. These differences changed slightly with extensive adjustments for covariates.

Conclusions

Our results call attention to a high prevalence of functional dependence in younger and older MHD patients. The results suggest that the lower self-reported mental quality of life in functionally dependent MHD patients cannot be explained by differences in age and comorbidities.