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1.
J Xray Sci Technol ; 32(2): 323-338, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38306087

RESUMO

BACKGROUND: Interstitial lung disease (ILD) represents a group of chronic heterogeneous diseases, and current clinical practice in assessment of ILD severity and progression mainly rely on the radiologist-based visual screening, which greatly restricts the accuracy of disease assessment due to the high inter- and intra-subjective observer variability. OBJECTIVE: To solve these problems, in this work, we propose a deep learning driven framework that can assess and quantify lesion indicators and outcome the prediction of severity of ILD. METHODS: In detail, we first present a convolutional neural network that can segment and quantify five types of lesions including HC, RO, GGO, CONS, and EMPH from HRCT of ILD patients, and then we conduct quantitative analysis to select the features related to ILD based on the segmented lesions and clinical data. Finally, a multivariate prediction model based on nomogram to predict the severity of ILD is established by combining multiple typical lesions. RESULTS: Experimental results showed that three lesions of HC, RO, and GGO could accurately predict ILD staging independently or combined with other HRCT features. Based on the HRCT, the used multivariate model can achieve the highest AUC value of 0.755 for HC, and the lowest AUC value of 0.701 for RO in stage I, and obtain the highest AUC value of 0.803 for HC, and the lowest AUC value of 0.733 for RO in stage II. Additionally, our ILD scoring model could achieve an average accuracy of 0.812 (0.736 - 0.888) in predicting the severity of ILD via cross-validation. CONCLUSIONS: In summary, our proposed method provides effective segmentation of ILD lesions by a comprehensive deep-learning approach and confirms its potential effectiveness in improving diagnostic accuracy for clinicians.


Assuntos
Aprendizado Profundo , Doenças Pulmonares Intersticiais , Humanos , Tomografia Computadorizada por Raios X/métodos , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Pulmão/patologia , Estudos Retrospectivos
2.
BMC Oral Health ; 23(1): 617, 2023 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-37653402

RESUMO

BACKGROUND: Oral cancer is a significant public health concern worldwide. Early detection and prevention are crucial in reducing the morbidity and mortality rates associated with this disease. As future dental professionals, dental undergraduates play a vital role in promoting oral health and identifying potential oral cancer cases. METHODS: This study aimed to evaluate the level of oral cancer awareness, knowledge, attitudes, and practices among dental undergraduates in Malaysia. A total of 595 students from years 3, 4, and 5 in both public and private universities participated. RESULTS: The results showed that a higher percentage of dental undergraduates from private universities were aware of oral cancer and had satisfactory knowledge compared to those from public universities (p < 0.05). Moreover, 59.4% of respondents felt less confident in diagnosing oral cancer during routine dental practice, and 96.1% agreed on the need to increase public awareness of oral health. Interestingly, students from private universities exhibited higher levels of awareness and knowledge regarding oral cancer than those from public universities. CONCLUSIONS: To enhance oral cancer detection and prevention, it is essential to reinforce the current curriculum and provide training to improve diagnostic skills for every dental undergraduate. This will ensure that they are well-equipped with the necessary knowledge and competence to detect and prevent oral cancer effectively.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Neoplasias Bucais , Humanos , Faculdades de Odontologia , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/prevenção & controle , Estudantes , Emoções
3.
Zhongguo Zhong Yao Za Zhi ; 48(12): 3404-3408, 2023 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-37382023

RESUMO

Amid the modernization and internationalization of traditional Chinese medicine(TCM), the safety of TCM has attracted much attention. At the moment, the government, scientific research teams, and pharmaceutical enterprises have made great efforts to explore methods and techniques for clinical safety evaluation of TCM. Although considerable achievements have been made, there are still many problems, such as the non-standard terms of adverse reactions of TCM, unclear evaluation indicators, unreasonable judgment methods, lack of evaluation models, out-of-date evaluation standards, and unsound reporting systems. Therefore, it is urgent to further deepen the research mode and method of clinical safety evaluation of TCM. Based on the current national requirements for the life-cycle management of drugs, this study focused on the problems in the five dimensions of clinical safety evaluation of TCM, including normative terms, evaluation modes, judgment methods, evaluation standards, and reporting systems, and proposed suggestions on the development of a life-cycle clinical safety evaluation method that conformed to the characteristics of TCM, hoping to provide a reference for future research.


Assuntos
Avaliação de Medicamentos , Medicina Tradicional Chinesa , Medicina Tradicional Chinesa/normas , Avaliação de Medicamentos/métodos , Avaliação de Medicamentos/normas , Avaliação de Medicamentos/tendências , Indústria Farmacêutica/normas , Indústria Farmacêutica/tendências , Pesquisa/normas , Pesquisa/tendências , Humanos
4.
Appl Neuropsychol Child ; : 1-10, 2022 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-36519237

RESUMO

BACKGROUND: A fast and reliable neurocognitive assessment tool is required for pediatric patients with an intracranial space-occupying lesion (ICSOL). METHODS: A cross-sectional study was conducted on 41 pediatric patients having ICSOL. Cognitive abilities were assessed using both WISC-IV and CNS Vital Signs (CNS VS). All domains are compared to the normative data. Spearman's correlation analysis is performed between domains in two batteries. RESULTS: In the WISC-IV, CPI, PSI, and WMI are significantly lower than the normative level. In the CNS VS, NCI, Memory domains, Reaction Time, Social Acuity, and Sustained Attention are significantly lower. Six domains in the CNS VS, including Complex Attention, Sustained Attention, Cognitive Flexibility, Executive Function, Processing Speed, and Social Acuity, positively correlate to the PSI or CPI in the WISC-IV. Sixty percent (9/15) of domains in the CNS VS negatively correlate to the size of ISCOL. The FSIQ in the WISC-IV is significantly associated with patients' parent education level. CONCLUSION: Compared to the WISC-IV, CNS VS takes less time, but measures more domains. CNS VS is more sensitive to the size of ICSOL but is not affected by patients' parent education level. A healthy control group is warranted for interpreting the results in Chinese participants.

5.
BMC Health Serv Res ; 22(1): 260, 2022 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-35216586

RESUMO

BACKGROUND: Diabetic retinopathy (DR) has become a leading cause of global blindness as a microvascular complication of diabetes. Regular screening of diabetic retinopathy is strongly recommended for people with diabetes so that timely treatment can be provided to reduce the incidence of visual impairment. However, DR screening is not well carried out due to lack of eye care facilities, especially in the rural areas of China. Artificial intelligence (AI) based DR screening has emerged as a novel strategy and show promising diagnostic performance in sensitivity and specificity, relieving the pressure of the shortage of facilities and ophthalmologists because of its quick and accurate diagnosis. In this study, we estimated the cost-effectiveness of AI screening for DR in rural China based on Markov model, providing evidence for extending use of AI screening for DR. METHODS: We estimated the cost-effectiveness of AI screening and compared it with ophthalmologist screening in which fundus images are evaluated by ophthalmologists. We developed a Markov model-based hybrid decision tree to analyze the costs, effectiveness and incremental cost-effectiveness ratio (ICER) of AI screening strategies relative to no screening strategies and ophthalmologist screening strategies (dominated) over 35 years (mean life expectancy of diabetes patients in rural China). The analysis was conducted from the health system perspective (included direct medical costs) and societal perspective (included medical and nonmedical costs). Effectiveness was analyzed with quality-adjusted life years (QALYs). The robustness of results was estimated by performing one-way sensitivity analysis and probabilistic analysis. RESULTS: From the health system perspective, AI screening and ophthalmologist screening had incremental costs of $180.19 and $215.05 but more quality-adjusted life years (QALYs) compared with no screening. AI screening had an ICER of $1,107.63. From the societal perspective which considers all direct and indirect costs, AI screening had an ICER of $10,347.12 compared with no screening, below the cost-effective threshold (1-3 times per capita GDP of Chinese in 2019). CONCLUSIONS: Our analysis demonstrates that AI-based screening is more cost-effective compared with conventional ophthalmologist screening and holds great promise to be an alternative approach for DR screening in the rural area of China.


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Inteligência Artificial , China/epidemiologia , Análise Custo-Benefício , Retinopatia Diabética/diagnóstico , Humanos , Programas de Rastreamento , Anos de Vida Ajustados por Qualidade de Vida
6.
Front Med (Lausanne) ; 9: 1058464, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36698829

RESUMO

Objective: Sarcopenia is a syndrome of decreased muscle mass and deficits in muscle strength and physical function. We aimed to investigate the relationship between creatinine/cystatin C ratio (CCR) and sarcopenia and the prognostic value of CCR in hospitalized patients. Materials and methods: We searched for relevant studies in PubMed, EMBASE, and the Cochrane Database up to August 25, 2022. Meta-analyses were performed to evaluate the relationship between CCR and skeletal muscle [computed tomography-assessed skeletal muscle (CTASM), muscle strength, and physical performance], prognosis and important clinical outcomes in hospitalized adults. The pooled correlation coefficient, the area under the receiver operating characteristic (ROC) curves, and hazard ratio (HR) together with their 95% confidence intervals (CIs) were calculated. We also conducted subgroup analyses to explore the sources of heterogeneity. Results: A total of 38 studies with 20,362 patients were eligible. These studies were of moderate to high quality. Our results showed that CCR was significant correlations with all CTASM types (Fisher's Z ranged from 0.35 to 0.5; P values ranged from < 0.01 to 0.01), handgrip strength (Fisher's Z = 0.39; 95% CI, 0.32-0.45; P < 0.001) and gait speed (Fisher's Z = 0.25; 95% CI, 0.21-0.30; P < 0.001). The ROC curves suggested that CCR had good diagnostic efficacy (0.689; 95% CI, 0.632-0.746; P < 0.01) for sarcopenia. CCR can reliably predict mortality in hospitalized patients, which was confirmed by regression analysis of CCR as both continuous (HR 0.78; 95% CI, 0.72-0.84; P < 0.01) and categorical variables (HR 2.05; 95% CI, 1.58-2.66; P < 0.0001). In addition, less evidence showed that higher CCR was independently associated with a shorter duration of mechanical ventilation, reduced length of stay in the intensive care unit and hospital, less nutritional risk, and decreased complications in hospitalized patients. Conclusion: CCR could be a simple, economical, and effective screening tool for sarcopenia in hospitalized patients, and it is a helpful prognostic factor for mortality and other important clinical outcomes. Systematic review registration: https://inplasy.com/inplasy-2022-9-0097/, identifier INPLASY202290097.

7.
Ann Transl Med ; 9(18): 1420, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34733972

RESUMO

BACKGROUND: Chronic kidney disease caused by X-linked Alport syndrome (XLAS) is relatively rare. However, due to the nonspecific pathologic and clinical manifestations of this disease, it is easily misdiagnosed. Genetic testing is crucial in identifying suspected cases. In addition, the results of genetic testing are an important indicator of patient prognosis. This study demonstrated a novel pathogenic COL4A5 splicing site variant in a Chinese family with XLAS. METHODS: Targeted next generation sequencing (NGS) was performed to identify the gene variant in the family members, and the gene mutation site was confirmed by Sanger sequencing. We then further analyzed the consequences of this gene mutation on the translated protein of this variant using in silico and in vitro approaches. RESULTS: A novel splice region variant, c.1033-2(IVS 18) A>G, in COL4A5 intron 18 was identified in the affected family members. Sanger sequencing confirmed that this variant is segregated with disease. In silico analysis, this variant led to frame-shift and premature termination on the translation of the nucleic acid, and this result was verified by RNA splicing analysis in a cell model. Unexpectedly, we still observed positive immunohistology staining of collagen IV α5 in the glomerular basement membrane (GBM) of the index patient, which implied that another potential transcription or translation mechanism skipping the mutated site might exist. CONCLUSIONS: Our present finding expands the mutational spectrum for the COL4A5 gene associated with XLAS and highlights the genotype-phenotype correlations in this disease.

8.
Int J Clin Pract ; 75(12): e14865, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34523203

RESUMO

BACKGROUND: Evidence shows that simplified SOFA scoring system has better clinical practice. OBJECTIVE: This study aimed to validate and compare the scores acquired with simplified organ dysfunction criteria optimized for electronic health records (eSOFA), and simplified and accurate sequential organ failure assessment (sa-SOFA) for their accuracies in predicting the prognosis of septic patients. METHODS: This retrospective observational study was conducted at three major academic hospitals. Clinical data from 574 patients diagnosed with sepsis following the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)were retrospectively retrieved and analysed. Scores from the quick sequential organ failure assessment (qSOFA) and sequential organ failure assessment (SOFA) were used as reference scores. The area under the receiver operating characteristic curve (AUROC) was used to assess the performance of eSOFA and sa-SOFA scores in predicting in-hospital mortality. RESULTS: AUROC analysis demonstrated the predictability of the four scoring systems for sepsis surveillance, listed in descending order as: sa-SOFA, 0.790 (95% confidence interval [CI]: 0.754-0.822); SOFA, 0.774 (95% CI: 0.738-0.808); eSOFA, 0.729 (95% CI: 0.691-0.765); and qSOFA, 0.618 (95% CI: 0.577-0.658). Moreover, sa-SOFA and SOFA scores (Z = 1.950, P = .051) did not significantly differ from each other in discriminatory power, but the sa-SOFA score had a higher power than eSOFA score (P values < .001). CONCLUSION: sa-SOFA appeared to have performed better than eSOFA score for predicting in-hospital mortality in patients' sepsis. Further large prospective studies are needed to externally validate.


Assuntos
Escores de Disfunção Orgânica , Sepse , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva , Prognóstico , Curva ROC , Estudos Retrospectivos , Sepse/diagnóstico
9.
Nat Commun ; 12(1): 4673, 2021 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-34344871

RESUMO

Dynamically adapting the allocation of COVID-19 vaccines to the evolving epidemiological situation could be key to reduce COVID-19 burden. Here we developed a data-driven mechanistic model of SARS-CoV-2 transmission to explore optimal vaccine prioritization strategies in China. We found that a time-varying vaccination program (i.e., allocating vaccines to different target groups as the epidemic evolves) can be highly beneficial as it is capable of simultaneously achieving different objectives (e.g., minimizing the number of deaths and of infections). Our findings suggest that boosting the vaccination capacity up to 2.5 million first doses per day (0.17% rollout speed) or higher could greatly reduce COVID-19 burden, should a new wave start to unfold in China with reproduction number ≤1.5. The highest priority categories are consistent under a broad range of assumptions. Finally, a high vaccination capacity in the early phase of the vaccination campaign is key to achieve large gains of strategic prioritizations.


Assuntos
Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Alocação de Recursos para a Atenção à Saúde/métodos , Vacinação em Massa/métodos , Número Básico de Reprodução , COVID-19/epidemiologia , COVID-19/transmissão , China/epidemiologia , Prioridades em Saúde , Humanos , Incidência , Modelos Teóricos , SARS-CoV-2/imunologia , Cobertura Vacinal
10.
Biomed Environ Sci ; 34(5): 372-378, 2021 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-34059174

RESUMO

OBJECTIVE: To develop a preliminary subjective evaluation scale for assessing the built environments of China's Hygienic City Initiative and to evaluate its reliability and validity. METHODS: The initial items of the scale were determined based on a review of policy documents and consultations with experts. The final items of the scale were confirmed through individual interviews with residents combined with the discretetrend method, critical ratio method, correlation coefficient method, and factor analysis method. Then, the dimensions of the scale were determined using exploratory factor analysis (EFA). The Cronbach's α coefficient, split-half reliability coefficient, and confirmatory factor analysis (CFA) were used to assess the reliability and validity of the scale. RESULTS: A scale containing five dimensions with 22 items was established, including urban lifestyle, governance, basic functions, environmental sanitation, and amenities. The Cronbach's α coefficient of the scale was 0.876, and the split-half reliability coefficient was 0.796. The CFA results indicate that each inspection level was within the standard limit. CONCLUSION: The preliminarily subjective evaluation scale for assessing the built environments of China's Hygienic City Initiative demonstrates a high level of reliability and validity. Additional empirical studies should be carried out to further verify the value of the scale in terms of practical application.


Assuntos
Ambiente Construído/psicologia , Política de Saúde , Higiene , Satisfação Pessoal , Saúde da População Urbana , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Percepção , Reprodutibilidade dos Testes , Inquéritos e Questionários , Adulto Jovem
11.
BMC Nephrol ; 22(1): 181, 2021 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-34001037

RESUMO

BACKGROUND: The purpose of this study was to evaluate the clinical value of color and power doppler sonography (CPDS) when combined it with 99mTc-dimercaptosuccinic acid scintigraphy (DMSA) in assessment of acute pyelonephritis (APN) in infants. METHODS: A total of 79 children with APN admitted to our hospital from June 2016 to Jan 2019 were enrolled, including 52 boys and 27 girls, age range 1 month to 3 years old. All cases followed the diagnostic criteria for acute pyelonephritis and excluded anatomical abnormalities of urinary system. All 79 patients were examined by urinary ultrasonography (US), CPDS, and DMSA within 48 h of fever and analyzed the clinical value of combining the two methods in the assessment of APN in infants. RESULTS: Among 79 children, urinary ultrasonography revealed 2 cases of renal cortical echo changes, both located in the upper pole of the kidney, 24 cases of kidney enlargement, and 1 case of left kidney shrinkage. Ninety-five kidneys were shown to be diseased with DMSA, while 105 kidneys abnormal by CPDS. The sensitivity of CPDS was 69.4%, and the specificity was 38.1%. In children younger than 6 months, the sensitivity of CPDS was 56.9%, which was 84.2% in childeren between 6 months to 1 year, and 94.4% from 1 to 3 years old, respectively. The corresponding specificity of CPDS was 44.1, 26.7, and 35.7%. There was no significant correlation between CPDS levels and DMSA positive results. The abnormal rate of intermediate part in the kidneys was significantly lower than that in the upper and lower poles. Children with abnormal CPDS have a greater risk of renal scarring(p < 0.05). CONCLUSION: Abnormalities detected by CPDS in a cohort of infants with APN poorly correlated with DMSA findings. But the sensitivity of CPDS is highly age-related, it can be used as a non-invasive helpful tool for early diagnosis of acute pyelonephritis in infants older than 6 months old.


Assuntos
Rim/diagnóstico por imagem , Pielonefrite/diagnóstico por imagem , Compostos Radiofarmacêuticos , Ácido Dimercaptossuccínico Tecnécio Tc 99m , Ultrassonografia Doppler em Cores/métodos , Doença Aguda , Fatores Etários , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Cintilografia , Sensibilidade e Especificidade , Ultrassonografia/métodos
12.
BMC Med ; 19(1): 45, 2021 02 10.
Artigo em Inglês | MEDLINE | ID: mdl-33563270

RESUMO

BACKGROUND: All countries are facing decisions about which population groups to prioritize for access to COVID-19 vaccination after the first vaccine products have been licensed, at which time supply shortages are inevitable. Our objective is to define the key target populations, their size, and priority for a COVID-19 vaccination program in the context of China. METHODS: On the basis of utilitarian and egalitarian principles, we define and estimate the size of tiered target population groups for a phased introduction of COVID-19 vaccination, considering evolving goals as vaccine supplies increase, detailed information on the risk of illness and transmission, and past experience with vaccination during the 2009 influenza pandemic. Using publicly available data, we estimated the size of target population groups, and the number of days needed to vaccinate 70% of the target population. Sensitivity analyses considered higher vaccine coverages and scaled up vaccine delivery relative to the 2009 pandemic. RESULTS: Essential workers, including staff in the healthcare, law enforcement, security, nursing homes, social welfare institutes, community services, energy, food and transportation sectors, and overseas workers/students (49.7 million) could be prioritized for vaccination to maintain essential services in the early phase of a vaccination program. Subsequently, older adults, individuals with underlying health conditions and pregnant women (563.6 million) could be targeted for vaccination to reduce the number of individuals with severe COVID-19 outcomes, including hospitalizations, critical care admissions, and deaths. In later stages, the vaccination program could be further extended to target adults without underlying health conditions and children (784.8 million), in order to reduce symptomatic infections and/or to stop virus transmission. Given 10 million doses administered per day, and a two-dose vaccination schedule, it would take 1 week to vaccinate essential workers but likely up to 7 months to vaccinate 70% of the overall population. CONCLUSIONS: The proposed framework is general but could assist Chinese policy-makers in the design of a vaccination program. Additionally, this exercise could be generalized to inform other national and regional strategies for use of COVID-19 vaccines, especially in low- and middle-income countries.


Assuntos
Vacinas contra COVID-19/uso terapêutico , COVID-19/prevenção & controle , Pessoal de Saúde , Programas de Imunização/métodos , Seleção de Pacientes , Polícia , Adolescente , Idoso , COVID-19/epidemiologia , COVID-19/mortalidade , Criança , China/epidemiologia , Comorbidade , Teoria Ética , Feminino , Indústria Alimentícia , Prioridades em Saúde , Hospitalização , Humanos , Programas de Imunização/organização & administração , Lactente , Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Mortalidade , Casas de Saúde , Pandemias/prevenção & controle , Formulação de Políticas , Gravidez , SARS-CoV-2 , Meios de Transporte , Vacinação , Adulto Jovem
13.
Brief Bioinform ; 21(1): 171-181, 2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-30496347

RESUMO

Essential genes have attracted increasing attention in recent years due to the important functions of these genes in organisms. Among the methods used to identify the essential genes, accurate and efficient computational methods can make up for the deficiencies of expensive and time-consuming experimental technologies. In this review, we have collected researches on essential gene predictions in prokaryotes and eukaryotes and summarized the five predominant types of features used in these studies. The five types of features include evolutionary conservation, domain information, network topology, sequence component and expression level. We have described how to implement the useful forms of these features and evaluated their performance based on the data of Escherichia coli MG1655, Bacillus subtilis 168 and human. The prerequisite and applicable range of these features is described. In addition, we have investigated the techniques used to weight features in various models. To facilitate researchers in the field, two available online tools, which are accessible for free and can be directly used to predict gene essentiality in prokaryotes and humans, were referred. This article provides a simple guide for the identification of essential genes in prokaryotes and eukaryotes.

14.
Appl Health Econ Health Policy ; 18(1): 81-96, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31535352

RESUMO

BACKGROUND: The challenges of universal health coverage (UHC) in developing countries with a significant proportion of the labor force that works in the informal sector include administrative difficulties in recruiting, registering and collecting regular contributions in a cost-effective way. As most developing countries have a limited fiscal space to support the program in the long run, the fiscal sustainability of UHC, such as that in Indonesia, relies heavily on the contributions of its members. The failure of a large proportion of voluntary enrollees/self-enrolled members/informal sector workers (Peserta Mandiri/Pekerja Bukan Penerima Upah [PBPU] members) to pay their premiums may lead to the National Health Insurance System (NHIS) in Indonesia being unable to effectively deliver its services. OBJECTIVE: This study aims at exploring the important factors that affect the compliance behavior of informal sector workers (PBPU members) in regularly paying their insurance premium. This analysis may be a basis for designing effective measures to encourage payment sustainability in informal sector workers in the NHIS. METHOD: This study utilizes the survey data collected from three regional offices of the Indonesian Social Security Agency for Health (SSAH), which cover approximately 1210 PBPU members, to understand the relationship between members' characteristics and their compliance behavior regarding the premium payment. We applied an econometric analysis of a logit regression to statistically estimate which factors most affect their compliance behavior in paying the insurance premium. RESULTS: This study reveals that almost 28% of PBPU members do not pay their insurance premiums in a sustainable way. Our logistic regression statistically confirms that the number of household members, financial hardship, membership in other social protection arrangements, and the utilization of health services are negatively correlated with the compliance rate of informal sector workers in paying their insurance premium. For instance, people who experience financial hardship tend to have a 7.7 percentage point lower probability of routinely paying the premium. In contrast, households that work in agricultural sectors and have income stability, the cost of inpatient care incurred before joining the NHIS, a comprehensive knowledge of the SSAH's services, and the availability of health professionals are all positively correlated with regular premium payment. CONCLUSION: Although there is no single policy that can ensure that informal sector workers (PBPU members) regularly pay their premiums, this study recommends some policy interventions, including (1) flexibility in applying for a government subsidy for premiums (Penerima Bantuan Iuran [PBI]), especially for people who have financial hardship; (2) an intensive promotion of insurance literacy; (3) expanding the quantity and quality of healthcare services; and (4) tailor-made policies for ensuring the sustainability of premium payments for each regional division.


Assuntos
Setor Informal , Seguro/economia , Seguro/estatística & dados numéricos , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/estatística & dados numéricos , Cobertura Universal do Seguro de Saúde/economia , Cobertura Universal do Seguro de Saúde/estatística & dados numéricos , Adulto , Países em Desenvolvimento , Feminino , Humanos , Indonésia , Masculino , Pessoa de Meia-Idade
15.
PLoS One ; 10(3): e0123859, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25815819

RESUMO

Previous studies obtained mixed results regarding the association between collectivism and corruption. To make sense of the mixed results, the current research examined the moderating role of evaluation apprehension on the relationship between collectivism and corruption. Study 1, using a bribery scenario, indicated that collectivism facilitated corruption only when evaluation apprehension was low. Study 2, using a real money bribery game, confirmed the moderated model found in Study 1. Study 3 further demonstrated the different effects of vertical/horizontal collectivism on corruption. Our results suggest that a society may effectively combat corruption by increasing its social costs while, at the same time, retaining its collectivistic values.


Assuntos
Comportamento Cooperativo , Crime/psicologia , Economia Comportamental , Feminino , Jogos Experimentais , Humanos , Masculino , Adulto Jovem
16.
Zhongguo Zhong Yao Za Zhi ; 40(18): 3693-6, 2015 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-26983223

RESUMO

The safety of Chinese patent medicine has become a focus of social. It is necessary to carry out work on post-marketing clinical safety evaluation for Chinese patent medicine. However, there have no criterions to guide the related research, it is urgent to set up a model and method to guide the practice for related research. According to a series of clinical research, we put forward some views, which contained clear and definite the objective and content of clinical safety evaluation, the work flow should be determined, make a list of items for safety evaluation project, and put forward the three level classification of risk control. We set up a model of post-marketing clinical safety evaluation for Chinese patent medicine. Based this model, the list of items can be used for ranking medicine risks, and then take steps for different risks, aims to lower the app:ds:risksrisk level. At last, the medicine can be managed by five steps in sequence. The five steps are, collect risk signal, risk recognition, risk assessment, risk management, and aftereffect assessment. We hope to provide new ideas for the future research.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Medicamentos de Ervas Chinesas/efeitos adversos , Medicina Herbária/legislação & jurisprudência , Vigilância de Produtos Comercializados , Ensaios Clínicos como Assunto , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Medicamentos de Ervas Chinesas/química , Medicamentos de Ervas Chinesas/economia , Medicamentos de Ervas Chinesas/uso terapêutico , Medicina Herbária/economia , Humanos , Patentes como Assunto , Controle de Qualidade
17.
Int J Pharm ; 436(1-2): 291-8, 2012 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-22796030

RESUMO

Drug-loading transfersomes were prepared with itraconazole, a lipophilic drug, as a model drug to investigate the key factor affecting transfersomes quality and to evaluate their qualities. Drug-loading transfersomes were prepared using film dispersion method. The quality of transfersomes was evaluated by HPLC, transmission electron microscope, particle size analyzer and in vitro release. Itraconazole transfersomes was transparent solution in ivory white color with a mean entrapment efficiency of about 80%. The shape of hollow vesicles was spheroidal with the diameter of approximately 100 nm, and the zeta potential of 45 mV, which had a good transdermal effect. It can be concluded via single-factor investigation that the quality of transfersomes is significantly affected by solvent, salt ion concentration and homogenization pressure and so on. The preparation method obtained through screening and optimizing formulation and technology is feasible and the quality can be controlled.


Assuntos
Ácido Desoxicólico/química , Itraconazol/química , Lecitinas/química , Tensoativos/química , Administração Cutânea , Animais , Ácido Desoxicólico/administração & dosagem , Itraconazol/administração & dosagem , Lecitinas/administração & dosagem , Lipossomos , Ratos , Ratos Sprague-Dawley , Pele/anatomia & histologia , Pele/efeitos dos fármacos , Tensoativos/administração & dosagem
18.
J Virol Methods ; 179(2): 330-4, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22155579

RESUMO

Reverse transcription loop-mediated isothermal amplification (RT-LAMP), which is a visual assay for nucleic acids, is performed in a single step using one tube at 65 °C for 1.5 h. In this study, RT-LAMP was established as a method for the detection of enterovirus 71 (EV71). The detection limit of the assay was approximately 10 copies, and no cross-reactivity was noted with Coxsackievirus A16, echovirus, human rotavirus (HRV) or norovirus. This assay, which offers greater sensitivity at a lower cost compared with the conventional reverse transcription polymerase chain reaction (RT-PCR), was validated using 252 clinical specimens that had been confirmed by laboratory diagnosis using RT-PCR. Both methods produced the same results with 52 positive samples. The RT-LAMP-based assay does not require specialised equipment, and therefore, it can be performed conveniently during an outbreak or under field conditions. In brief, the RT-LAMP-based assay provided a simple, rapid and efficient method for the detection of EV71 nucleic acid under field conditions.


Assuntos
Enterovirus Humano A/isolamento & purificação , Infecções por Enterovirus/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Técnicas de Amplificação de Ácido Nucleico/métodos , Virologia/métodos , Adolescente , Criança , Pré-Escolar , Infecções por Enterovirus/virologia , Humanos , Lactente , Técnicas de Diagnóstico Molecular/economia , Sensibilidade e Especificidade , Temperatura , Virologia/economia
19.
Forensic Sci Int ; 219(1-3): 285.e1-5, 2012 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-22169166

RESUMO

Sex determination is a vital part of the medico-legal system but can be difficult in cases where the integrity of the body has been compromised. The purpose of this study was to develop a technique for sex assessment from measurements of the first lumber vertebrate. Twenty-nine linear measurements and five ratios were collected from 113 Chinese adult males and 97 Chinese adult females using digital three-dimensional anthropometry methods. By using discriminant analysis, we found that 23 linear measurements and two ratios identified sexual dimorphism (P<0.01), with predictive accuracy ranging from 57.1% to 86.6%. Using a stepwise method of discriminant function analysis, we found three dimensions predicted sex with 88.6% accuracy: (a) upper end-plate width (EPWu), (b) left pedicle height (PHl), and (c) middle end-plate depth (EPDm). This study shows that a single first lumber vertebra can be used for this purpose, and that the discriminant equation will help forensic determination of sex in the Chinese population.


Assuntos
Vértebras Lombares/anatomia & histologia , Determinação do Sexo pelo Esqueleto/métodos , Adulto , Povo Asiático , China , Análise Discriminante , Feminino , Antropologia Forense , Humanos , Imageamento Tridimensional , Vértebras Lombares/diagnóstico por imagem , Masculino , Tomografia Computadorizada Espiral
20.
Artigo em Chinês | MEDLINE | ID: mdl-22164500

RESUMO

A total of 80 cases of advanced schistosomiasis were selected and divided into an experiment group and a control group, 40 cases each group, by the random sampling method. The patients in the experiment group were administered with Jian-gan-le, and the patients in the control group received compound purple granules. In the experiment group, the curative rate was 25.0%, the improving rate was 70.0%, the inefficacy rate was 5%, and the efficiency rate was 95.0%. In the control group, the curative rate was 12.5%, the improving rate was 75%, the inefficacy rate was 12.5%. There was no statistic difference between the 2 groups (P all > 0.05). The expense was cheaper in the experiment group than in the control group.


Assuntos
Medicamentos de Ervas Chinesas/administração & dosagem , Esquistossomose/tratamento farmacológico , Efeitos Psicossociais da Doença , Medicamentos de Ervas Chinesas/economia , Feminino , Humanos , Masculino , Fitoterapia/economia , Esquistossomose/economia , Resultado do Tratamento
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