Spatiotemporal assessment of groundwater quality and quantity using geostatistical and ensemble artificial intelligence tools.

The study investigated the spatiotemporal relationship between surface hydrological variables and groundwater quality/quantity using geostatistical and AI tools. AI models were developed to estimate groundwater quality from ground-based measurements and remote sensing images, reducing reliance on laboratory testing. Different Kriging techniques were employed to map ground-based measurements and fill data gaps. The methodology was applied to analyze the Maragheh aquifer in northwest Iran, revealing declining groundwater quality due to industrial. discharges and over-extraction. Spatiotemporal analysis indicated a relationship between groundwater depth/quality, precipitation, and temperature. The Root Mean Square Scaled Error (RMSSE) values for all variables ranged from 0.8508 to 1.1688, indicating acceptable performance of the semivariogram models in predicting the variables. Three AI models, namely Feed-Forward Neural Networks (FFNNs), Support Vector Regression (SVR), and Adaptive Neural Fuzzy Inference System (ANFIS), predicted groundwater quality for wet (June) and dry (October) months using input variables such as groundwater depth, temperature, precipitation, Normalized Difference Vegetation Index (NDVI), and Digital Elevation Model (DEM), with Groundwater Quality Index (GWQI) as the target variable. Ensemble methods were employed to combine the outputs of these models, enhancing performance. Results showed strong predictive capabilities, with coefficient of determination values of 0.88 and 0.84 for wet and dry seasons. Ensemble models improved performance by up to 6% and 12% for wet and dry seasons, respectively, potentially advancing groundwater quality modeling in the future.

Decomposing socioeconomic inequalities in dental caries among Chinese adults: findings from the 4th national oral health survey.

OBJECTIVE: This cross-sectional study aimed to investigate socioeconomic inequalities in dental caries among adults (35 years and older) in China and explore the contributions of various factors to these inequalities. METHODS: This study included 10,983 adults (3,674 aged 35-44 years, 3,769 aged 55-64 years and 3,540 aged 65-74 years) who participated in the 4th National Oral Health Survey (2015-2016) in China. Dental caries status was evaluated by the decayed, missing and filled teeth (DMFT) index. Concentration indices (CIs) were applied to quantify the different degrees of socioeconomic-related inequality in DMFT, decayed teeth with crown or root caries (DT), missing teeth due to caries or other reasons (MT), and filled teeth without any primary or secondary caries (FT) among adults of different age groups. Decomposition analyses were conducted to identify the determinants and their associations with inequalities in DMFT. RESULTS: The significant negative CI indicated that DMFT for the total sample were concentrated among socioeconomically disadvantaged adults (CI = - 0.06; 95% confidence interval [CI], - 0.073 to - 0.047). The CIs for DMFT for adults aged 55-64 and 65-74 years were - 0.038 (95% CI, - 0.057 to - 0.018) and - 0.039 (95% CI, - 0.056 to - 0.023), respectively, while the CI for DMFT for adults aged 35-44 years was not statistically significant (CI = - 0.002; 95% CI, - 0.022 to 0.018). The concentration indices of DT were negative and concentrated in disadvantaged populations, while FT showed pro-rich inequalities in all age groups. Decomposition analyses showed that age, education level, toothbrushing frequency, income and type of insurance contributed substantially to socioeconomic inequalities, accounting for 47.9%, 29.9%, 24.5%,19.1%, and 15.3%, respectively. CONCLUSION: Dental caries was disproportionately concentrated among socioeconomically disadvantaged adults in China. The results of these decomposition analyses are informative for policy-makers attempting to develop targeted health policy recommendations to reduce dental caries inequalities in China.

Prognostic risk assessment model and drug sensitivity analysis of colon adenocarcinoma (COAD) based on immune-related lncRNA pairs.

PURPOSE: The aim of this study was to identify and screen long non-coding RNA (lncRNA) associated with immune genes in colon cancer, construct immune-related lncRNA pairs, establish a prognostic risk assessment model for colon adenocarcinoma (COAD), and explore prognostic factors and drug sensitivity. METHOD: Our method was based on data from The Cancer Genome Atlas (TCGA). To begin, we obtained all pertinent demographic and clinical information on 385 patients with COAD. All lncRNAs significantly related to immune genes and with differential expression were identified to construct immune lncRNA pairs. Subsequently, least absolute shrinkage and selection operator and Cox models were used to screen out prognostic-related immune lncRNAs for the establishment of a prognostic risk scoring formula. Finally, We analysed the functional differences between subgroups and screened the drugs, and establish an individual prediction nomogram model. RESULTS: Our final analysis confirmed eight lncRNA pairs to construct prognostic risk assessment model. Results showed that the high-risk and low-risk groups had significant differences (training (n = 249): p < 0.001, validation (n = 114): p = 0.022). The prognostic model was certified as an independent prognosis model. Compared with the common clinicopathological indicators, the prognostic model had better predictive efficiency (area under the curve (AUC) = 0.805). Finally, We have analysed highly differentiated cellular pathways such as mucosal immune response, identified 9 differential immune cells, 10 sensitive drugs, and establish an individual prediction nomogram model (C-index = 0.820). CONCLUSION: Our study verified that the eight lncRNA pairs mentioned can be used as biomarkers to predict the prognosis of COAD patients. Identified cells, drugs may have an positive effect on colon cancer prognosis.

A Practical Assessment of the Disinfectant Efficacy of UV Light with and without Ozone Using a Novel Transfer Hatch in a Research Animal Facility.

Most in vivo animal research and breeding using mice and rats in China takes place in facilities under barrier conditions. Items being moved across the barrier are typically disinfected using UV radiation in a transfer hatch. However, the time periods necessary for this disinfection technique are inefficient, and disinfection is frequently incomplete, especially if concealed surfaces are present. The current study used a newly developed transfer hatch incorporating both UV and ozone disinfection to examine disinfection efficacy against 4 bacteria species (Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii). Disinfection trials used UV and ozone, applied separately and in combination, for up to 30 min. Separate and combined treatments were also tested with a UV barrier. We found that if UV radiation has direct contact with surfaces, it is an efficient disinfection method. However, where surfaces are concealed by a UV barrier, UV radiation performs relatively poorly. The results of this study indicate that a combination of UV and ozone produces the most effective disinfection and is markedly quicker than current disinfection times for UV applied on its own. This novel transfer hatch design therefore allows more complete and efficient disinfection, improves workflow, and reduces barrier breaches by pathogens that may affect animal health and welfare and compromise research outcomes.

Chinese Consensus Report on Family-Based Helicobacter pylori Infection Control and Management (2021 Edition).

OBJECTIVE: Helicobacter pylori infection is mostly a family-based infectious disease. To facilitate its prevention and management, a national consensus meeting was held to review current evidence and propose strategies for population-wide and family-based H. pylori infection control and management to reduce the related disease burden. METHODS: Fifty-seven experts from 41 major universities and institutions in 20 provinces/regions of mainland China were invited to review evidence and modify statements using Delphi process and grading of recommendations assessment, development and evaluation system. The consensus level was defined as ≥80% for agreement on the proposed statements. RESULTS: Experts discussed and modified the original 23 statements on family-based H. pylori infection transmission, control and management, and reached consensus on 16 statements. The final report consists of three parts: (1) H. pylori infection and transmission among family members, (2) prevention and management of H. pylori infection in children and elderly people within households, and (3) strategies for prevention and management of H. pylori infection for family members. In addition to the 'test-and-treat' and 'screen-and-treat' strategies, this consensus also introduced a novel third 'family-based H. pylori infection control and management' strategy to prevent its intrafamilial transmission and development of related diseases. CONCLUSION: H. pylori is transmissible from person to person, and among family members. A family-based H. pylori prevention and eradication strategy would be a suitable approach to prevent its intra-familial transmission and related diseases. The notion and practice would be beneficial not only for Chinese residents but also valuable as a reference for other highly infected areas.

The economic benefits of increased sugar-free chewing gum in China: a budget impact analysis.

BACKGROUND: To analyze the potential cost savings in dental care associated with increased sugar-free gum (SFG) use among Chinese teenagers and adults. METHODS: The amount of SFG chewed per year and decayed, missing and filled teeth (DMFT) was collected from a cross-sectional survey to create a dose-response curve assumption. A cost analysis of dental restoration costs was carried out. A budget impact analysis was performed to model the decrease in DMFT and the subsequent cost savings for dental care. Three different scenarios for the increase in the number of SFG were calculated. RESULTS: The average cost savings per person in the Chinese population due to increasing SFG use ranged from 45.95 RMB (6.94 USD) per year to 67.41 RMB (10.19 USD) per year. It was estimated that 21.51-31.55 billion RMB (3.25-4.77 billion USD) could be saved annually if all SFG chewers among Chinese teenagers and adults chewed SFG regularly. CONCLUSION: This study suggests that dental care costs could be significantly reduced if SFG use increased in the Chinese population.

Socioeconomic-related inequality in dental care utilization among preschool children in China.

OBJECTIVES: This study aimed to investigate socioeconomic-related inequality in dental care service utilization in the past 12 months among Chinese preschool children and to explore the contribution of various factors to this inequality. METHOD: A total of 40 305 children aged 3-5 years from 372 kindergartens who participated in the Fourth National Oral Health Survey in China were included in the final analysis. The method of data weighting in complex sampling was adopted to make the samples more representative. Erreygers-corrected concentration index (EI) was used to measure socioeconomic-related inequality in dental care service utilization. The horizontal inequality index (HI) was employed to analyse horizontal inequality. Decomposition analyses were conducted to explore the contributions of income level, need variables (dmft, caregiver-evaluated oral health status and toothache experience) and nonneed variables (caregiver education level, residential location, age, and sex) to the inequality of health service utilization. RESULT: The utilization of oral health services within the past 12 months among the high-, middle- and low-income groups was 17.4% (95% CI: 15.6-19.3), 13.6% (95% CI: 12.2-15.1) and 9.4% (95% CI: 8.1-11.0) respectively. The concentration curve was below the line of equality, and the EI and HI were 0.072 and 0.078, respectively, indicating that dental care utilization in children aged 3-5 years was concentrated in those who were better off. The contribution of the need variables to socioeconomic-related inequality in dental services was minimal, and most dental care utilization inequality could be explained by household income, caregiver education attainment and urban-rural disparities, accounting for 32.0%, 49.4% and 20.4% respectively. CONCLUSION: This study reveals the existence of pro-rich inequality in dental care utilization among preschool children in China. The decomposition analysis suggests that income, caregiver education background and urban-rural disparities are the main factors contributing to this outcome. Equity-oriented policies and programmes are needed to achieve equitable dental care utilization.

Gender difference in unmet need for assistance with activities of daily living among disabled seniors in China : a cross-sectional study.

OBJECTIVES: This study explores the gender difference in unmet need for assistance with activities of daily living among older adults with disabilities in China. DESIGN: Logistic regression analysis was employed to examine the gender difference and identify influential factors among disabled male and female seniors. SETTING: 23 provinces throughout China. PARTICIPANTS: A total of 1700 disabled seniors were included in the analysis. RESULTS: Of 1700 respondents, 619 (36.4%) were disabled male seniors. Overall, the possibility of unmet need for activity of daily living assistance among disabled female seniors was significantly lower than that among male group (OR 0.728; 95% CI 0.559 to 0.948) than males. Family care resources, economic status and loneliness were influential factors among disabled seniors regardless of genders. Furthermore, disabled female seniors from rural area (p=0.011), whose primary caregiver was willing to take care of them (p=0.022), whose community could provide daily life service (p=0.002) were more likely to have unmet need. Meanwhile, disabled female seniors whose community could provide medical service(p=0.001) were less likely to report unmet need. CONCLUSIONS: The study showed that disabled male seniors were more likely to experience unmet need compared with female ones. Reducing unmet need for assistance with activities of daily living among disabled seniors and existing gender disparities therefore requires not only universal strategy, but also targeted policies which should be made or modified for disabled seniors of different genders.

Urban-rural differences in catastrophic health expenditure among households with chronic non-communicable disease patients: evidence from China family panel studies.

BACKGROUND: The prevalence of chronic non-communicable diseases (NCDs) challenges the Chinese health system reform. Little is known for the differences in catastrophic health expenditure (CHE) between urban and rural households with NCD patients. This study aims to measure the differences above and quantify the contribution of each variable in explaining the urban-rural differences. METHODS: Unbalanced panel data were obtained from the China Family Panel Studies (CFPS) conducted between 2012 and 2018. The techniques of Fairlie nonlinear decomposition and Blinder-Oaxaca decomposition were employed to measure the contribution of each independent variable to the urban-rural differences. RESULTS: The CHE incidence and intensity of households with NCD patients were significantly higher in rural areas than in urban areas. The urban-rural differences in CHE incidence increased from 8.07% in 2012 to 8.18% in 2018, while the urban-rural differences in CHE intensity decreased from 2.15% in 2012 to 2.05% in 2018. From 2012 to 2018, the disparity explained by household income and self-assessed health status of household head increased to some extent. During the same period, the contribution of education attainment to the urban-rural differences in CHE incidence decreased, while the contribution of education attainment to the urban-rural differences in CHE intensity increased slightly. CONCLUSIONS: Compared with urban households with NCD patients, rural households with NCD patients had higher risk of incurring CHE and heavier economic burden of diseases. There was no substantial change in urban-rural inequality in the incidence and intensity of CHE in 2018 compared to 2012. Policy interventions should give priority to improving the household income, education attainment and health awareness of rural patients with NCDs.

Composition and risk assessment of perioperative patient safety incidents reported by anesthesiologists from 2009 to 2019: a single-center retrospective cohort study.

BACKGROUND: Patient safety incident (PSI) reporting has been an important means of improving patient safety and enhancing organizational quality control. Reports of anesthesia-related incidents are of great value for analysis to improve perioperative patient safety. However, the utilization of incident data is far from sufficient, especially in developing countries such as China. METHODS: All PSIs reported by anesthesiologists in a Chinese academic hospital between September 2009 and August 2019 were collected from the incident reporting system. We reviewed the freeform text reports, supplemented with information from the patient medical record system. Composition analysis and risk assessment were performed. RESULTS: In total, 847 PSIs were voluntarily reported by anesthesiologists during the study period among 452,974 anesthetic procedures, with a reported incidence of 0.17%. Patients with a worse ASA physical status were more likely to be involved in a PSI. The most common type of incident was related to the airway (N = 208, 27%), followed by the heart, brain and vascular system (N = 99, 13%) and pharmacological incidents (N = 79, 10%). Those preventable incidents with extreme or high risk were identified through risk assessment to serve as a reference for the implementation of more standard operating procedures by the department. CONCLUSIONS: This study describes the characteristics of 847 PSIs voluntarily reported by anesthesiologists within eleven years in a Chinese academic hospital. Airway incidents constitute the majority of incidents reported by anesthesiologists. Underreporting is common in China, and the importance of summarizing and utilizing anesthesia incident data should be scrutinized.

24-Hour Serial Spirometric Assessment of Once-Daily Fluticasone Furoate/Umeclidinium/Vilanterol Versus Twice-Daily Budesonide/Formoterol in Patients with COPD: Analysis of the FULFIL Study.

INTRODUCTION: Few studies have utilized 24-h serial spirometry to compare the effects of inhaled chronic obstructive pulmonary disease (COPD) therapies on lung function. The FULFIL study previously reported significant lung function improvements with once-daily single-inhaler fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) versus twice-daily single-inhaler budesonide/formoterol (BUD/FOR) in patients with symptomatic COPD at risk of exacerbations. METHODS: This prespecified analysis evaluated 24-h serial spirometry data from a subgroup of 406 patients in FULFIL. BUD/FOR twice-daily dosing was maintained during 24-h spirometry. A post hoc analysis evaluated serial forced expiratory volume in 1 s (FEV1) at day 1 and week 24 by disease severity at screening (FEV1 < 50% predicted and no moderate or severe exacerbation in prior year, FEV1 < 50% predicted and ≥ 1 moderate or severe exacerbation in prior year, and FEV1 ≥ 50% and < 80% predicted and ≥ 2 moderate or ≥ 1 severe exacerbations in prior year). RESULTS: Odds of achieving a ≥ 100-mL increase from baseline in FEV1 within the first 6 h post dose on day 1 were significantly greater with FF/UMEC/VI than BUD/FOR [odds ratio 2.79 (95% confidence interval 1.56-4.98); p < 0.001]. FF/UMEC/VI led to greater improvements in weighted mean FEV1 over 0-6, 0-12, 0-24, and 12-24 h on day 1 and at week 24, with the greatest between-group differences at week 24 (range 196-210 mL; all p < 0.001). Significant between-treatment differences in FEV1 and forced vital capacity (FVC) in favor of FF/UMEC/VI versus BUD/FOR were seen at all time points at week 24 (FEV1 range 156-231 mL, all p < 0.001; FVC range 139-309 mL, all p ≤ 0.002). Serial FEV1 results were consistent irrespective of disease severity at screening. CONCLUSION: These findings further demonstrate sustained lung function benefits with once-daily FF/UMEC/VI single-inhaler triple therapy in patients with symptomatic COPD at risk of exacerbations across a range of disease severities.

Global, regional and national burden of gout, 1990-2017: a systematic analysis of the Global Burden of Disease Study.

OBJECTIVES: The burden of gout has been increasing globally. However, little is known about the global, regional and national distribution and time trend of this disease. We present a comprehensive analysis of the Global Burden of Disease Study 2017 on gout burden estimates for 195 countries or territories between 1990 and 2017. METHODS: Age-standardized prevalence and disability-adjusted life-years of gout were reported between 1990 and 2017 in 195 countries and territories, and associations between these estimates and sociodemographic index (SDI) were further explored. Total and annual percent change between 1990 and 2017 were calculated to quantify the time trends of gout burden. RESULTS: Age-standardized prevalence rates (95% uncertainty interval) per 100 000 persons were 790.90 (706.10-881.90) and 253.49 (225.69-284.02) in 2017 in males and females, respectively. The annual percent change in age-standardized prevalence (males, 0.22%; females, 0.38%) and disability-adjusted life-years (males, 0.21%; females, 0.38%) of gout increased every year from 1990 to 2017, globally. The highest increase was detected in high-SDI countries, especially in high-income North America. A non-linear association was observed between burden of gout and SDI, with the lowest estimates of gout burden when SDI value was about 0.6. High BMI was the leading risk factor for the burden of gout. CONCLUSION: These study results suggest a globally rising trajectory of gout burden between 1990 and 2017. More effective interventions, such as detailed and intensive dietary managements and other prevention strategies for reducing obesity, should be carried out to reverse this trend, especially in females and high-SDI countries.

Characterization of the Aroma-Active Compounds in Commercial Fragrant Rapeseed Oils via Monolithic Material Sorptive Extraction.

Commercial fragrant rapeseed oil (CFRO), from roasted and hot-pressed seeds, is enjoyed in China for its unique aroma. However, the characteristic of aroma-active compounds in CFRO is still unclear. In this study, a new odor monolithic material sorptive extraction method was established to trap volatiles from rapeseed oil. Thirty CFROs were investigated using this method coupled with gas chromatography-mass spectrometry. A total of 29 volatile compounds were identified by gas chromatography-olfactometry including pyrazines, alcohols, aldehydes, ketones, and sulfur compounds. Further, 2,5-dimethylpyrazine (peanut-like), 3-ethyl-2,5-dimethylpyrazine (roasted nut-like), dimethyl trisulfide (cabbage-like), 4-isothiocyanato-1-butene (pungent and pickle-like), butyrolactone (caramel-like), and benzyl nitrile (pungent and sulfur-like) are affirmed as the key odorants for the overall aroma of CFRO, owing to their odor activity values ≥1. This work provides a new insight on acquiring aroma-active compounds from rapeseed oil in a more time-effective process compared to conventional methods. Futhermore, this novel approach is applicable in the field of food flavor.

Utilization willingness of institutional care between disabled and non-disabled seniors: evidence from Jiangsu, China.

BACKGROUND: Due to rapidly growing number of old adults and diminishing supportive functions of family in China, the issue of willingness to use institutional care is of high priority, especially for disabled seniors. The objective of this study is to compare the willingness of institutional care and its determinants between disabled and non-disabled seniors in China. METHODS: 2493 seniors (60+) were randomly selected from a cross-sectional study conducted in three urban districts and three rural counties in Jiangsu Province. Binary logistic regression model was employed to examine differences towards the preference for institutional care between two subgroups, and to identify factors associated with willingness of institutional care between disabled and non-disabled seniors. RESULTS: Of 2493 respondents, 402 (16.1%) were disabled seniors. Overall, 14.2% of the participants had willingness for institutional care in Jiangsu, China. The willingness for institutional care among non-disabled seniors (OR = 0.513; 95%CI 0.387-9.680) was significantly lower than that among disabled ones. The preference for institutional care of both disabled and non-disabled seniors was associated with household income. The willingness of institutional care was also related to age, education and living arrangement among disabled seniors. Meanwhile, non-disabled seniors who had non-communicable diseases were found to be more likely to choose elder care in institution. CONCLUSIONS: Our findings indicated that the willingness for institutional care among disabled seniors was significantly higher than that among non-disabled ones. Household income was determinant of utilization willingness for institutionalization both in disabled and non-disable seniors. Different policies should be made or modified for disabled and non-disabled seniors separately.

Population Pharmacokinetic Analysis of Fluticasone Furoate/Umeclidinium/Vilanterol via a Single Inhaler in Patients with COPD.

A population pharmacokinetic analysis was conducted from a subset of samples obtained from the Lung Function and Quality of Life Assessment in Chronic Obstructive Pulmonary Disease with Closed Triple Therapy trial to characterize the pharmacokinetics of fluticasone furoate, umeclidinium, and vilanterol in patients with symptomatic COPD following treatment with fluticason furoate-umeclidinium-vilanterol combined in a single inhaler. This was a randomized, double-blind, double-dummy study comparing 24 weeks of once-daily triple therapy (fluticason furoate-umeclidinium-vilanterol, 100 µg/62.5 µg/25 µg; Ellipta inhaler) with twice-daily dual therapy (budesonide/formoterol 400 µg/12 µg; Turbuhaler). The analyses were conducted in a subset of 74 patients who received fluticason furoate-umeclidinium-vilanterol and provided serial or sparse samples. Monte Carlo simulations and a model-based estimation approach both indicated that systemic drug concentrations of fluticasone furoate, umeclidinium, and vilanterol after administration of fluticason furoate-umeclidinium-vilanterol triple combination therapy from a single inhaler were within the ranges observed following administration of these drugs as monotherapy (fluticasone furoate, umeclidinium, and vilanterol) or as dual-combination therapy (fluticasone furoate/vilanterol or umeclidinium/vilanterol).

Once-Daily Triple Therapy in Patients with Advanced COPD: Healthcare Resource Utilization Data and Associated Costs from the FULFIL Trial.

INTRODUCTION: Chronic obstructive pulmonary disease is associated with a high healthcare resource and cost burden. Healthcare resource utilization was analyzed in patients with symptomatic chronic obstructive pulmonary disease at risk of exacerbations in the FULFIL study. Patients received either once-daily, single inhaler triple therapy (fluticasone furoate/umeclidinium/vilanterol) 100 µg/62.5 µg/25 µg or twice-daily dual inhaled corticosteroid/long-acting beta agonist therapy (budesonide/formoterol) 400 µg/12 µg. METHODS: FULFIL was a phase III, randomized, double-blind, double-dummy, multicenter study. Unscheduled contacts with healthcare providers were recorded by patients in a daily electronic diary; the costs of healthcare resource utilization were calculated post hoc using UK reference costs. RESULTS: Over 24 weeks, slightly fewer patients who received fluticasone furoate/umeclidinium/vilanterol (169/911; 18.6%) required contacts with healthcare providers compared with budesonide/formoterol (180/899; 20.0%). Over 52 weeks in an extension population, fewer patients who received fluticasone furoate/umeclidinium/vilanterol required unscheduled contacts with healthcare providers compared with budesonide/formoterol (25.2% vs. 32.7%). Non-drug costs per treated patient per year were lower in the fluticasone furoate/umeclidinium/vilanterol group than the budesonide/formoterol group over 24 and 52 weeks (£653.80 vs. £763.32 and £749.22 vs. £988.03, respectively), with the total annualized cost over 24 weeks being slightly greater for fluticasone furoate/umeclidinium/vilanterol than budesonide/formoterol (£1,289.35 vs. £1,267.45). CONCLUSIONS: This healthcare resource utilization evidence suggests that, in a clinical trial setting over a 24- or 52-week timeframe, non-drug costs associated with management of a single inhaler fluticasone furoate/umeclidinium/vilanterol are lower compared with twice-daily budesonide/formoterol. TRIAL REGISTRATION: ClinicalTrials.gov number: NCT02345161. FUNDING: GSK.

Psychometric characteristics of the 360° feedback scales in professionalism and interpersonal and communication skills assessment of surgery residents in China.

AIMS: The aim of the study was to test the psychometric characteristics of the 360° evaluation instrument for assessing residents' competency in professionalism, interpersonal and communication skills, and develop a feasible, valid, and reliable multisource feedback (MSF) program for surgery residents to address this gap. METHODS: We carried out an MSF assessment of 149 surgery residents at 19 hospitals all over China. MSF assessment includes 6 surveys with 21, 21, 21, 26, 14, and 15 items and these surveys were developed to assess surgery residents by attending doctor, resident self, peer, nurse, patient, and office staff, respectively, using a 5-point agreement scale with an "unable-to-evaluate" category. Reliability was assessed by Cronbach alpha. Exploratory factor analysis was used to assess validity and determine which items grouped together into scales. RESULTS: A total of 2384 questionnaires were analyzed in this study. The internal consistency reliability of the instruments was a Cronbach alpha of 0.932, 0.936, 0.914, 0.916, 0.939, and 0.903 for attending doctor, resident self, nurse, patient, resident peer, and office staff surveys, respectively. On the attending, resident self, resident peer, nurse, office staff, and patient surveys, the factor analysis identified 2 factors of professionalism and interpersonal and communication skills accounting for 75.62%, 74.81%, 72.65%, 73.38%, 76.11%, and 63.89% of the variance, respectively. Some items, such as Demonstrates respect for my "Sexual Orientation," "Religion," and "Disability," in different surveys had high unable-to-evaluate rates (more than 10%). CONCLUSIONS: The data suggest that these instruments developed to assess surgery residents are feasible to administer and provide valid and reliable evidence. Some items in survey need to be adjusted keeping in mind the Chinese culture.

[Values of computed tomography angiogram in non-cardiac surgery planning and cardiac risk assessment of coronary atherosclerosis during perioperative period].

OBJECTIVE: To explore the values of detecting coronary atherosclerosis by computed tomography angiogram (CTA) on non-cardiac surgery planning and cardiac risk assessment of coronary atherosclerosis during perioperative period. METHODS: A total of 89 patients with suspected coronary heart disease (CHD) scheduled for non-cardiac surgery underwent coronary CTA to evaluate luminal stenosis and calculate calcification score. There were 56 males and 33 females with a mean age of 65.1 years. Operative sites included chests (n = 29), abdomens and pelvis (n = 26), large vessels (n = 3), bones and joints (n = 19) and other regions (n = 12). Reasons of abandoned or postponed surgery were documented to analyze the influence of CTA results on surgery planning. Cardiac events were recorded to assess the correlation with coronary atherosclerosis. RESULTS: Among them, 75 patients (84.27%) were diagnosed as atherosclerosis while 10 patients (11.24%) were negative; 2 patients had coronary artery bypass and another 2 had stent implantation. According to the results of CTA, 12 operations (13.48%) were canceled and 8 (8.98%) postponed after interventions. Severe stenosis of coronary lumen had significant effects on surgery planning (P = 0.003) while calcification score did not. In patients undergoing surgery as scheduled or after intervention, 1 had atrial fibrillation at post-operation. CONCLUSION: For the patients with suspected CHD scheduled for non-cardiac surgery, severity of coronary stenosis may greatly influence surgery planning. Preoperative coronary CTA may decrease the incidence of cardiac events during perioperative period.

Quantitative assessment of the association between XRCC6 C1310G polymorphism and cancer risk.

X-ray cross-complementing group 6 (XRCC6) plays an important role in the DNA double-strand breaks repair and the maintenance of genomic integrity. XRCC6 C1310G polymorphism may be involved in the development of cancer through increasing genomic damages. However, studies investigating the relationship between XRCC6 C1310G polymorphism and cancer risk yielded contradictory results. To shed some light on these inconsistent findings, a meta-analysis was performed to clarify the effect of XRCC6 C1310G polymorphism on the susceptibility of cancer. A systemic literature search of PubMed, EMBASE, and China National Knowledge Infrastructure databases was conducted from their inception to September 26, 2012. The association between XRCC6 C1310G and cancer risk was assessed by the pooled odds ratio (OR) with 95 % confidence intervals (95 % CI) calculated by meta-analysis. A total of 15 eligible studies (4,642 cancer cases and 6,059 controls) were identified. Overall, there was obvious evidence for an association between XRCC6 C1310G polymorphism and increased risk of cancer under two genetic comparisons (GG vs. CC: fixed-effect OR 1.35, 95 % CI 1.10-1.66, I (2) = 17.0 %; GG vs. CG/CC: fixed-effect OR 1.25, 95 % CI 1.02-1.53, I (2) = 0.0 %). Subgroup analysis indicated that the association was significant in Asians (G vs. C: random-effect OR 1.13, 95 % CI 1.01-1.26, I (2) = 51.3 %; GG vs. CC: fixed-effect OR 1.43, 95 % CI 1.14-1.81, I (2) = 0.0 %; GG vs. CG/CC: fixed-effect OR 1.37, 95 % CI 1.09-1.72, I (2) = 0.0 %), but not in Europeans. Data from the current meta-analysis support the existence of an association between XRCC6 C1310G polymorphism and cancer risk in Asians. Studies with larger sample size are needed to further evaluate the influence of XRCC6 C1310G polymorphism on susceptibility of various cancers.

[Assessment of intraventricular mechanical synchrony in systole by tissue synchronization imaging in normal subjects].

OBJECTIVE: To evaluate intraventricular mechanical synchrony in systole by real-time tri-plane tissue synchronization imaging (TSI). METHODS: Real-time tri-plane TSI was performed in 20 normal subjects, and the apical 4-chamber, 2-chamber and long-axis views of the left ventricular (LV) were obtained simultaneously. The data were post-processed offline, and a TSI surface map of LV colorized according to the time-to-positive peak systolic velocity (TTP) was generated to reflect the segment TTP semi-quantitatively. The segmental TTP of the six-basal and six-mid segments of LV was measured and compared. RESULTS: The myocardium was color-coded mainly by well-distributed green, and only a small portion displayed yellow or red color in the apical area; the TTP showed no significant differences between the segments measured (P>0.05). CONCLUSIONS: In normal subjects, the long-axis systolic motions of the LV are highly synchronized. TSI allows immediate visual identification of intraventricular mechanical synchrony and quantitative measurement of regional TTP.