Global Health System Resilience during Encounters with Stressors - Lessons Learnt from Cancer Services during the COVID-19 Pandemic.

AIMS: The protracted COVID-19 pandemic has overwhelmed health systems globally, including many aspects of cancer control. This has underscored the multidimensional nature of cancer control, which requires a more comprehensive approach involving taking a wider perspective of health systems. Here, we investigated aspects of health system resilience in maintaining cancer services globally during the COVID-19 pandemic. This will allow for health systems to be resilient to different types of system stressors/shocks in the future, to allow cancer care to be maintained optimally. MATERIALS AND METHODS: Using the World Health Organization health system framework (capturing aspects of service delivery, health workforce, information, medical products, vaccines and technologies, financing and governance and leadership), we carried out a comparative analysis of the impact of COVID-19 and the synthesis of the findings in responses in cancer care in 10 countries/jurisdictions across four continents comprising a wide diversity of health systems, geographical regions and socioeconomic status (China, Colombia, Egypt, Hong Kong SAR, Indonesia, India, Singapore, Sri Lanka, UK and Zambia). A combination of literature and document reviews and interviews with experts was used. RESULTS: Our study revealed that: (i) underlying weaknesses of health systems before the pandemic were exacerbated by the pandemic (e.g. economic issues in low- and middle-income countries led to greater shortage of medication and resource constraints compounded by inadequacies of public financing and issues of engagement with stakeholders and leadership/governance); (ii) no universal adaptive strategies were applicable to all the systems, highlighting the need for health systems to design emergency plans based on local context; (iii) despite the many differences between health systems, common issues were identified, such as the lack of contingency plan for pandemics, inadequate financial policies for cancer patients and lack of evidence-based approaches for competing priorities of cancer care/pandemic control. CONCLUSION: We identified four key points/recommendations to enhance the resilient capacity of cancer care during the COVID-19 pandemic and other system stressors: (i) effective pandemic control approaches in general are essential to maintain the continuity of cancer care during the emergency health crises; (ii) strong health systems (with sufficient cancer care resources, e.g. health workforce, and universal health coverage) are fundamental to maintain quality care; (iii) the ability to develop response strategies and adapt to evolving evidence/circumstances is critical for health system resilience (including introducing systematic, consistent and evidence-based changes, national support and guidance in policy development and implementation); (iv) preparedness and contingency plans for future public health emergencies, engaging the whole of society, to achieve health system resilience for future crises and to transform healthcare delivery beyond the pandemic.

LncRNA PROX1-AS1 promotes proliferation, invasion, and migration in prostate cancer via targeting miR-647.

Since this article has been suspected of research misconduct and the corresponding authors did not respond to our request to prove originality of data and figures, "LncRNA PROX1-AS1 promotes proliferation, invasion, and migration in prostate cancer via targeting miR-647, by C. Qian, C.-H. Liao, B.-F. Tan, Y.-F. Chen, B.-W. Dang, J.-L. Chen, C.-B. Liu, published in Eur Rev Med Pharmacol Sci 2020; 24 (6): 2938-2944-DOI: 10.26355/eurrev_202003_20658-PMID: 32271411" has been withdrawn. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/20658.

Managing the COVID-19 Pandemic as a National Radiation Oncology Centre in Singapore.

COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a global pandemic in March 2020. It has impacted the world medically, financially, politically and socially, with countries such as China and Italy adopting a full lockdown of their cities to mitigate the transmission. The current mortality rate is 5.4%, with 1 056 159 people infected worldwide. The disease is reminiscent of SARS in 2002, from which the healthcare system of Singapore has garnered many lessons and applied them in the current climate. As a result of the high transmissibility of the virus, hospitals in Singapore have reduced clinic loads and elective treatments to halt propagation of the virus and also to allow redistribution of healthcare workforce to the frontline. Cancer patients, who are often immunocompromised, are at risk of contracting the disease and becoming seriously ill. At the same time, delaying treatment such as radiotherapy in cancer patients can be detrimental. Here, we describe our experience as a large radiation oncology department in Singapore, including the challenges we encountered and how we managed our patient flow.

LncRNA PROX1-AS1 promotes proliferation, invasion, and migration in prostate cancer via targeting miR-647.

OBJECTIVE: Long noncoding RNAs (lncRNAs) act as an important role in many diseases. In this research, lncRNA PROX1-AS1 was explored to identify how it functioned in the development of prostate cancer (PC). PATIENTS AND METHODS: Real Time-quantitative Polymerase Chain Reaction (RT-qPCR) was utilized to detect PROX1-AS1 expression in PC patients. Then, MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay, colony formation assay, and transwell assay were performed to identify its function in PC cells. Furthermore, the potential mechanism was also explored using mechanism assays. RESULTS: PROX1-AS1 expression level was significantly higher in PC tissue samples and cell lines. Results of MTT assay, colony formation assay, and transwell assay showed that cell proliferation and invasion were inhibited through the silence of PROX1-AS1 in PC cells, while cell proliferation and invasion were promoted through the overexpression of PROX1-AS1 in PC cells. Furthermore, the expression of miR-647 was upregulated via the silence of PROX1-AS1 in PC cells, while the expression of miR-647 was downregulated via the overexpression of PROX1-AS1 in PC cells. Further mechanism assays showed that miR-647 was a direct target of PROX1-AS1 in PC. Correlation analysis showed that miR-647 expression was negatively correlated with PROX1-AS1 expression in PC tissues. CONCLUSIONS: Results above suggested that PROX1-AS1 could enhance cell proliferation and invasion of PC cells by sponging miR-647 and might be applied as a novel target for the treatment of PC.

Quaternized wood as sorbent for reactive dyes.

Various species of local wood modified with N-(3-chloro-2-hydroxypropyl)-trimethylammonium chloride showed sorption enhancement for hydrolyzed Reactive Blue 2 (HRB) compared to the untreated samples. The enthalpy of sorption of HRB on Simpoh (Dillenia suffruticosa) was found to be endothermic. Maximum sorption capacity calculated from the Langmuir isotherm was 250.0 mg/g. Under continuous flow conditions HRB could be successfully removed. Dye removal was a function of bed depth and flow rate. However, the bed depth service time model of Bohart and Adams was not applicable in the HRB-quaternized wood system. The modified wood was applied to a sample of industrial textile effluent, and it was found to be able to remove the color successfully under batch conditions.