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Objective:To conduct a position evaluation of functional departments directors by means of Hay guide-chart profile (Hay) and international position evaluation (IPE) for heads of public hospital departments, and a comparative analysis of the results, for reference in reforming the performance-related pay system of the functional departments.Methods:From July to August of 2021, positions of ten functional department directors of a public tertiary general hospital were selected, and expert groups within and out of the hospital were invited for a position evaluation using both Hay and IPE. Cronbach α and intraclass correlation coefficient were used in the reliability and consistency evaluation. Technique for order preference by similarity to ideal solution (TOPSIS) was conducted to compare the differences between results of both methods, with the position value ranked by quartiles. Results:22 position evaluation forms were issued and 20 were recovered (12 for in-hospital experts and 8 for extramural experts). In Hay evaluation, the scores of medical affairs department and hospital head office were higher, averaging 757.30 and 727.21 respectively, and those of logistics management department were the lowest, being 279.94. In-hospital experts scored lower than those extramural experts on the posts of directors of scientific research management department, Party committee office and medical insurance department, while the scores of the directors of the hospital head office were higher than those extramural experts. In IPE evaluation, the position values of hospital head office and medical affairs department were the highest, averaging 680.25 and 621.00 respectively, and the score of the logistics management department was the lowest, being 365.05. In-hospital experts scored lower than those extramural experts on the posts of directors of Party committee office, scientific research management department and logistics management department, while the scores of the directors of the hospital head office were higher than those of extramural experts. The Cronbach α coefficients of position value scoring of functional department heads evaluated by two evaluation methods were 0.943 (Hay) and 0.800 (IPE) respectively. The hospital head office and medical affairs department ranked the first quartile, the Party committee office and nursing department ranked the second, while the medical insurance department and logistics department ranked the third and fourth respectively. In addition, the ranking differences of the information technology department, human resource department, financial department and scientific research management department were within one quartile. Conclusions:The position evaluation results of Hay and IPE are consistent, but the former is more sensitive. Ranking of position values by quartiles via TOPSIS can support the reform of performance-related pay system of functional departments of public hospitals.
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Objective:To investigate the feasibility of rectus muscle insertion measurement with anterior segment optical coherence tomography (AS-OCT) after corrective surgery of concomitant exotropia.Methods:A cross-sectional study was performed.Twenty-five eyes of 25 patients with concomitant exotropia were included in Shenyang Aier Eye Hospital from March 2018 to February 2019, and all patients received concomitant exotropic corrective surgery.The distance of limbus to rectus muscle insertion was measured before operation, at the beginning and at the end of operation with a caliper and at postoperative 2 weeks, 1 month, 3 months and 6 months with AS-OCT, respectively.Degree of strabismus was examined by the alternate prism cover test at 33 cm.The research followed the Declaration of Helsinki and the protocol was approved by a Medical Ethics Committee of Shenyang Aier Eye Hospital (No.2017KJB005). Written informed consent was obtained from the patients/custodians prior to any medical examination and treatment.Results:A total of 44 rectus muscles of 25 eyes with concomitant exotropia were measured, including 25 lateral rectus muscles and 19 medial rectus muscles.The detection rate of the muscle insertion by AS-OCT was low at 2 weeks and 1 month after surgery.The mean distance of limbus to lateral rectus muscle insertions was (12.30±1.40), (11.72±1.45) and (11.84±1.27)mm at the end of operation and postoperative 3 and 6 months, respectively, showing a significant difference among them (F=4.085, P=0.023), and the distance measured at the end of operation was significantly larger than that at postoperative 3 months (P=0.018). The mean distance of limbus tomedial rectus muscle insertion was (5.12±0.42), (5.56±0.61) and (5.28±0.57)mm at the end of operation, postoperative 3 and 6 months, respectively, and there was no significant difference among the three time points (F=3.912, P=0.055). The degree of strabismus of the patients at various time points after surgery were significantly reduced in comparison with that before surgery (all at P<0.05).Conclusions:AS-OCT can track the position of extraocular muscle insertions after concomitant exotropic corrective surgery.
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Enteric nervous system (ENS) is composed of intestinal submucosal and myenteric plexuses. ENS may independently regulate intestinal digestive and absorptive function, and it is also known as "the second brain" or gut brain. ENS has significant specificity relative to central nervous system (CNS) in properties and functional activities of neurons and neural circuits. ENS is connected with CNS through the feedback pathway (brain-gut-axis) of sympathetic and parasympathetic nerves and peripheral primary sensory afferent nerves to form the bidirectional brain-gut-axis, which may affect emotion, appetite and behavioral states of individuals. Gastrointestinal functional disorder (GIFD) induced by ENS dysfunction may not only cause abnormal gastrointestinal function but also has been implicated in cognitive and mood disorders, such as irritable bowel syndrome (IBS). GIFD would influence deeply the quality of life in patients. Nevertheless, in the worldwide, ENS has so far received much less attention as compared with CNS. The depth of research and scale of investment in ENS studies have been much lower than those in CNS studies. The situation in China is even more evident. From ENS research history, an outstanding problem is to ignore largely the unique properties of ENS and apply mechanically the hypotheses formed in CNS studies to ENS researches. In this review, the structure and function of ENS are briefly introduced, and the importance of extraordinary characteristics of ENS is illustrated by the problems encountered in our studies.
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Humans , Brain , China , Enteric Nervous System , Quality of LifeABSTRACT
Objective To investigate the protective effect of FLPNF and the improvement of glucose-stimulated insulin secretion against dexamethasone-induced apoptosis of islet cells. Methods INS-1 cells were treated with oligopeptide FLPNF and dexamethasone, either separately or in combination. Proliferation of INS-1 cells in each group was assessed with CCK-8 assay and the insulin secretion stimulated by glucose was detected by ELISA. The apoptotic condition of the cells was observed and assessed with TUNEL and the apoptosis rate of each group was detected using flow cytometry. The expression of major target protein molecules related to apoptosis and Glut2 was detected by Western blotting analysis. Results Dexamethasone inhibited the growth of INS-1 cells in the group treated with dexamethasone. Cell damage was obvious with observable nuclear shrinkage and nuclear rupture. In addition, apoptosis rate was found to be 40.6%±2.4%. The expression of the apoptosis-related protein Bcl-2 and Glut2 was significantly reduced, whereas that of Bax and caspase-3 was significantly increased. After the combined treatment of oligopeptide FLPNF and dexamethasone, the results were reversed, and the apoptosis rate declined to 27.2%±2.0% (P < 0.001), cell morphology was improved, and the expression of apoptosis-related protein molecules of islet cells and protein Glut2 was significantly improved. Conclusion FLPNF has the ability of protecting islet cells from dexamethasone-induced apoptosis and improving the glucose-stimulated insulin secretion of islet cells.
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Objective To observe the clinical efficacy of tendons layer overall release treatment by needle knife for the third lumbar transverse process syndrome (TLTPS). Methods Totally 66 cases of TLTPS patients were divided into control group and experimental groups by using random number table method, with 33 cases in each group. L3 spinous process opened 3 cm looking for tenderness. Control group received lumbar transverse pressure tender point knife release treatment. On the basis of control group, experimental group received tendons layer overall release treatment by needle knife. Both control group and experimental group received treatment once. VAS and ODI before treatment and after treatment of 1, 2 and 3 months were observed. Clinical efficacy was evaluated. Adverse reactions and complications were observed. Results The experimental group and control group lost 1 and 2 cases, respectively. Compared with before treatment, the VAS and ODI in both groups after treatment decreased (P<0.05). After treatment, the VAS and ODI in the experimental group were lower than those of the control group, with statistical significance (P<0.05). The total effective rate of clinical efficacy was 96.88% (31/32) in the experimental group and 93.55% (29/31) in the control group, with experimental group better than the control group (Z=-2.756, P=0.006). There were no adverse reactions or complications in both groups. Conclusion Tendons layer overall release treatment combined with lumbar transverse pressure tender point knife release treatment for TLTPS can significantly improve the clinical efficacy of TLTPS, with long effects.
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BACKGROUND: Studies have indicated that the abnormal expression of TACC3 is closely related to the occurrence and development of many kinds of tumors, and the expression of TACC3 is up-regulated in these tumors. Therefore, in vitro specific inhibition of TACC3 expression may become an important target for the treatment or intervention of tumor growth.OBJECTIVE: To investigate the mechanism by which TACC3 gene expression regulates cell proliferation and apoptosis in oral squamous cell carcinoma.METHODS: CD133+CD44+ oral squamous cell carcinoma cells were sorted from human oral squamous cell carcinoma cell line Cal-27 by immunomagnetic beads. In experimental group, the shRNA sequence of TACC3 was designed and synthesized, which was then trasnfected into CD133+CD44+ oral cancer stem cells by LipofectamineTM 2000. Empty vector-trasnfected (negative control) and untransfected cells were used as callsed. Forty-eight hours after the transfection, effects of TACC3 gene silencing on proliferation and apoptosis in vitro in CD133+CD44+ oral squamous cell carcinoma were detected by MTT, clone formation test, and TUNEL assay. Western blot assay was used to detect the effect of TACC3 gene silencing on Ki67, Bax and Bcl-2 protein expression in CD133+CD44+ oral squamous cell carcinoma.RESULTS AND CONCLUSION: (1) Cell proliferation. The proliferation rate and expression level of Ki67 were significantly lower in the experimental group than the negative control and untransfected groups (P < 0.05). (2) Clone formation. The clone formation ability in the experimental group was significantly lower than that in the negative control and untransfected groups (P < 0.05). (3) Cell apoptosis. TACC3 gene silencing caused an obvious decrease in Bcl-2 protein expression and a significant increase in Bax protein expression. These findings further confirmed that specific interference of TACC3 gene expression could inhibit the proliferation of CD133+CD44+ cells and promote the apoptosis.
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Objective:To prepare and identify the mouse anti-human monoclonal antibodies ( mAbs) using leukocytes as im-munogens. Methods: The mice were immunized using human peripheral blood leukocytes. Then, use of B lymphocyte hybridoma technology preparation of mAbs,followed screening by immunocytochemistry and limited dilution. The secreted mAbs were identified by immunoprecipitation,mass spectrometry,Western blot,ELISA and immunohistochemistry. Results:The 35 positive polyclonal cells were obtained,of which 11 strains secreted mAbs against S100A9. And one strain was used to prepare monoclonal antibody. The purified mAb against S100A9 were purified and identified as IgG1 subtype,with the titer,purity and affinity constant was 1∶3. 18×105,95% and 3. 54×108 L/mol,respectively. This mAb generally had 0. 12% crossed reactivity to S100A8 ,and showed little or no cross reactivity to S100A12 and S100A13. The prepared monoclonal antibodies can specifically recognizes the S100A9 antigen in human breast cancer tissues. Conclusion:Successful preparation of mAb against S100A9,which can secrete specific mAb against S100A9 protein with high titers and specificity have been established successfully,which laid the foundation for the immunology application.
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<p><b>OBJECTIVE</b>To determine the allelic sequences and genetic polymorphism of six short tandem repeats (STRs) loci on Y chromosome, including DYS441, DYS442, DYS443, DYS444, DYS445 and DYS446 in Chinese Korean ethnic males from Yanbian region of Jilin province, China, and to construct a preliminary database.</p><p><b>METHODS</b>Allele frequencies of the six STR loci in 205 Chinese Korean ethnic individuals were analyzed by multiplex polymerase chain reaction (PCR) and polyacrylamide gel electrophoresis (PAGE).</p><p><b>RESULTS</b>Respectively, 8, 7, 7, 5, 6 and 9 alleles were detected for each of the locus. Together they have formed 151 haplotypes, with a diversity of 0.9937.</p><p><b>CONCLUSION</b>The six STR loci included in this study were found to be highly polymorphic, and may provide useful markers for genetic analysis.</p>
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Humans , Male , Alleles , China , Chromosomes, Human, Y , Ethnicity , Genetics , Gene Frequency , Korea , Ethnology , Polymorphism, Genetic , Tandem Repeat SequencesABSTRACT
Objective To investigate the expression of lymphotoxin-β and its receptor in the skin of a mouse model of allergic contact dermatitis (ACD).Methods BALB/c female mice at 6 to 8 weeks of age were randomly divided into the experiment group (n =15) and normal control group (n =10).Topical 2,4-dinitrofluorobenzene (DNFB,0.5%) was used to establish a model of ACD in the experiment group followed by challenge with DNFB (0.2%) at the right external ear on the 6th day.The normal control mice remained untreated.The right external ear was resected from all of the mice 24 hours after the challenge and divided into 2 parts for the measurement of mRNA and protein expressions of lymphotoxin-β and lymphotoxin-βreceptor by fluorescence-based real-time quantitative PCR and immunohistochemistry,respectively.Results The median mRNA expression levels of lymphotoxin-β and lymphotoxin-β receptor were 3.630 and 1.148respectively in the experimental mice,with the interquartile range being 1.187 and 0.617 respectively,and were both 1.000 in the control mice with the interquartile range being both 0.000.There was a significant difference between the experimental and control group in the mRNA expression levels of lymphotoxin-β and lymphotoxin-β receptor (P < 0.01 ).Immunohistochemistry showed a significant increase in the expression of lymphotoxin-β and lymphotoxin-β receptor proteins in the experimental group compared with the control group (P < 0.01 ).Conclusion There is an increment in the mRNA and protein expressions of lymphotoxin-β and lymphotoxin-β receptor in the lesions of ACD in mice.
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<p><b>OBJECTIVE</b>To explore the solution of choosing the minimally invasive incision site for gluteal muscle contracture patient based on standard injection point of gluteal muscle.</p><p><b>METHODS</b>from September 2008 to August 2010, 25 patients (14 males and 11 females with an average of 16.5 years, ranging from 12 to 26 years) with injected gluteal muscle contracture were prospectively studied. The course of disease was from 6 to 12 years. Firstly, the connective skin Surface line from anterior superior iliac spine to coccyx (line AD) was delineated and the point (point O) was marked out as the standard gluteal muscle injection site which was on the one-third of the distance from the anterior superior iliac spine(point A) to the coccyx (point D). Secondly, the anterior and posterior edge lines of surface projection of the gluteal muscle contracture banding (line a, line p) were delineated. Thirdly, the distance from B to O and C to O (B is the point of intersection of line a and line AD,C is the point of intersection of line P and line AD)were measured which was the intersection of line a,p and line AD to point O. Lastly, the minimally invasive surgery was operformed via the skin entry of point C.</p><p><b>RESULTS</b>OB = (0 +/- 0.76) cm, OC = (2.86 +/- 0.78) cm, BC = (2.86 +/- 1.01) cm,the mean postoperative drainage was less than 10 ml,there was no nerve damage,hematoma and other complications. All patients achieved the function of squatting in 4 to 6 days.</p><p><b>CONCLUSION</b>The solution of choosing the minimally invasive incision site based on standard injection point of gluteal muscle has advantages of positioning precisely,handling easily, recoverying quickly, less trauma and safety, etc.</p>
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Adolescent , Adult , Child , Female , Humans , Male , Buttocks , Contracture , General Surgery , Injections, Intramuscular , Minimally Invasive Surgical Procedures , Muscle, Skeletal , General SurgeryABSTRACT
<p><b>BACKGROUND</b>Primary open angle glaucoma (POAG) is a common cause of irreversible blindness. The variable etiology of POAG poses significant challenges for treatment and rehabilitation. We analyzed a large POAG patient cohort during treatment to reveal possible causes of vision disorder, assess vision-related quality of life (VRQL), and to evaluate the efficacy of rehabilitative treatments.</p><p><b>METHODS</b>We analyzed the visional disturbances in 500 POAG patients (890 eyes) by regular ophthalmic examination and visual field examination using Humphrey 30° perimetry. Appropriate rehabilitative treatments for POAG were prescribed based on results of clinical examination and included correction of ametropia, health education, counseling, and the fitting of typoscopes. VRQL was assessed before and after treatment by a VRQL self-assessment questionnaire.</p><p><b>RESULTS</b>Scores on the VRQL self-assessment were significantly lower compared to healthy controls. The primary cause of the vision disturbances was ametropia (97.99%), and 51.61% of the ametropia eyes had not received appropriate correction. The secondary causes of visual impairment were glaucomatous neurodegeneration (26.29%), complicated cataract, or other accompanying eye diseases. The causes of the clinical low vision (44 patients) were glaucomatous neurodegeneration (32 eyes), fundus diseases (23 eyes), keratopathy (11 eyes), and other eye diseases (10 eyes). The VRQL scores of patients improved significantly after rehabilitation and the correction of ametropia (P < 0.01). Twenty-five patients with low vision were provided with typoscopes, and 21 (84%) experienced significant functional recovery, while the remaining low vision patients could see letter lines two or more levels lower (smaller) on visual charts in a near vision test.</p><p><b>CONCLUSIONS</b>Vision disorders in POAG patients are common and severe. Appropriate rehabilitation, especially the correction of ametropia, can significantly improve VRQL as revealed by the self-assessment of POAG patients.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Glaucoma, Open-Angle , Rehabilitation , Quality of Life , Surveys and Questionnaires , Vision Disorders , RehabilitationABSTRACT
Objective To analyze the genetic changes in peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) and to find the key molecular aberrations underlying its pathogenesis. Methods A total of 37 cases of PTCL-NOS were investigated by 1Mb resolution array comparative genomic hybridisation (Array-CGH), in which 9 cases were further studied by using a Tile path array-CGH. DNA extraction, clonality analysis and histologic review were conducted to exclude 6 cases with polyploidy and without obvious genetic imbalances from this study. Results In general, there was a considerable overlap in the CGH profiles in many PTCL-NOS cases. The most recurrent regions of genomic gains were lp36.13-1p36.32, 7q22.1, 7q36.1-7q36.3, 7q32.1-7q32.3, 7q22.1-7q34,9p11 .2-9q12 and 9q33.3-9q34.3. The most recurrent regions of genomic losses were 1p12-1p21.1 and 13q14.11-13q14.3. Conclusion Genomic gains and losses are frequently identified in PTCL-NOS with array-CGH, in which patients with multiple chromosomal alterations (≥6regions) have poor prognosis. These genomic profiles are broadly important to reveal a distinct subgroup with genetic alterations and to find the key genomic imbalance of PTCL-NOS.
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<p><b>OBJECTIVE</b>To summarize and analyze preventive strategies of secondary spinal cord injury caused by subaxial cervical trauma.</p><p><b>METHODS</b>From April 2004 to April 2009, 67 patients with secondary spinal cord injury caused by subaxial cervical trauma were retrospectively analyzed. There were 40 males and 20 females, with an average age of 40.5 years old ranging from 18 to 69 years. After admission the preventive strategies included using MP and GM-1, early decompression, and high pressure oxygen after operation. The neurological function was classified by Frankel, and the therapeutic effect was evaluated by total recovery rate and useful recovery rate. The total recovery rate was that the level of Frankel raise one or more grade, the useful recovery rate which included Frankel D, E was that the patient can walk by self or crutch, remaining some neurological deficits.</p><p><b>RESULTS</b>All patients were followed up for 1 to 3 years (averaged 1.5 years), the total recovery rate was 53.7% (36/67), the useful recovery rate was 35.8% (24/67). Seven patients was death, the death rate was 10.4% (7/67), 1 was aggravated, the aggravating rate was 1.5% (1/67).</p><p><b>CONCLUSION</b>As possible as using MP, GM-1, early decompression, and high pressure oxygen after operation can be effective strategies for preventing secondary spinal cord injury caused by subaxial cervical trauma.</p>
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Cervical Vertebrae , Wounds and Injuries , Decompression, Surgical , Hyperbaric Oxygenation , Retrospective Studies , Spinal Cord InjuriesABSTRACT
Objective In order to investigate the ability of flow cytometer (FCM) to diagnose malignant tumor and evaluate prognosis of tumors in salivary glands, the DNA ploidy and cell cycle had been analysed and the association of these parameters with histologic grades, lymph node metastasis were studied. Methods The fresh tissues of benign tumor, mixed tumor and malignant tumor were detected by FCM. Results DNA aneuploid has not been detected in benign tumors; 44 cases of mixed tumor has been detected with DNA aneuploid nd with high SPF; it suggests that these cases have malignant trend; most of malignant tumor were detected with high aneuploid. DI was not correlated with lymph node metastases, but correlated with histologic grades (P
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Aim To explore the characteristic of NO-cGMP signal pathway in the regulation of thoracic aortic relaxation in thyroxine-induced hypertensive rats.Methods Hyperthyroidism was induced by administering Lthyroxine(T4,0.5 mg?kg~-1,sc)daily for 16 days.Sham-treated euthyroid control rats received only vehicle saline for 16 days.SNAP,an NO donor,was used to define the differential relaxation in the thoracic aorta from euthyroid and hyperthyroid rats.To determine the mechanisms involved changes in NO-cGMP signal pathway in the regulation of aortic relaxation from hyperthyroid rats,BAY 41-2272(BAY)was used to activate soluble guanylate cyclase(sGC),ODQ was used to inhibit sGC,and 8-Br-cGMP was used to acti vate protein kinase G(PKG),respectively.Results Thyroid hormone excess for 16 days showed characteristic changes in body weight,heart rate and systolic blood pressure in rats.The body weight was significantly decreased,while heart rate,pulse pressure and systolic blood pressure were increased in T4-treated rats.SNAP caused relaxation in the aorta in both euthyroid and hyperthyroid rats.However,SNAP-induced aortic relaxation was significantly attennuated in hyperthyroid rats than in euthyroid rats.In the presence of ODQ,SNAP-induced aortic relaxation was blocked in both euthyroid and hyperthyroid rats.BAY and 8-BrcGMP-induced aortic relaxation was significantly attennuated in hyperthyroid rats than in euthyroid rats.Conclusion These data suggest that the attenuated effect of NO-cGMP signal pathway is involved in the regulation of aortic relaxation in the pathophysiology of hyperthyroidism,which may be related to the downregulation of sGC and PKG functions.
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The respiratory burst of neutrophils is an important response in inflammation. The alterations in extracellular pH per se is not a sufficient trigger to the respiratory burst in neutrophils. While neutrophils in respose to conventional agonists, the respiratory burst in neutrophils is affected by the alterations in extracellular pH, and there is a direct relationship between intracellular and extracellular pH. O-? 2 production in neutrophils is decreased while H 2O 2 production is increased at acidic pH. O-? 2 release in neutrophils is enhanced at weak alkaline pH. Na+/H+ exchanger plays an important role in the regulation of the respiratory burst of neutrophils.
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ObjectivesIntegrating electronic health records (EHR) data from several clinical sites offers great opportunities to improve estimation with a more general population compared to analyses based on a single clinical site. However, sharing patient-level data across sites is practically challenging due to concerns about maintaining patient privacy. The objective of this study is to develop a novel distributed algorithm to integrate heterogeneous EHR data from multiple clinical sites without sharing patient-level data. Materials and MethodsThe proposed distributed algorithm for binary regression can effectively account for between-site heterogeneity and is communication-efficient. Our method is built on a pairwise likelihood function in the extended Mantel-Haenszel regression, which is known to be statistically highly efficient. We construct a surrogate pairwise likelihood function through approximating the target pairwise likelihood by its surrogate. We show that the proposed surrogate pairwise likelihood leads to a consistent and asymptotically normal estimator by effective communication without sharing individual patient-level data. We study the empirical performance of the proposed method through a systematic simulation study and an application with data of 14,215 COVID-19 patients from 230 clinical sites at UnitedHealth Group Clinical Research Database. ResultsThe proposed method was shown to perform close to the gold standard approach under extensive simulation settings. When the event rate is <5%, the relative bias of the proposed estimator is 30% smaller than that of the meta-analysis estimator. The proposed method retained high accuracy across different sample sizes and event rates compared with meta-analysis. In the data evaluation, the proposed estimate has a relative bias <9% when the event rate is <1%, whereas the meta-analysis estimate has a relative bias at least 10% higher than that of the proposed method. ConclusionsOur simulation study and data application demonstrate that the proposed distributed algorithm provides an estimator that is robust to heterogeneity in event rates when effectively integrating data from multiple clinical sites. Our algorithm is therefore an effective alternative to both meta-analysis and existing distributed algorithms for modeling heterogeneous multi-site binary outcomes.
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ObjectiveFor multi-center heterogeneous Real-World Data (RWD) with time-to-event outcomes and high-dimensional features, we propose the SurvMaximin algorithm to estimate Cox model feature coefficients for a target population by borrowing summary information from a set of health care centers without sharing patient-level information. Materials and MethodsFor each of the centers from which we want to borrow information to improve the prediction performance for the target population, a penalized Cox model is fitted to estimate feature coefficients for the center. Using estimated feature coefficients and the covariance matrix of the target population, we then obtain a SurvMaximin estimated set of feature coefficients for the target population. The target population can be an entire cohort comprised of all centers, corresponding to federated learning, or can be a single center, corresponding to transfer learning. ResultsSimulation studies and a real-world international electronic health records application study, with 15 participating health care centers across three countries (France, Germany, and the U.S.), show that the proposed SurvMaximin algorithm achieves comparable or higher accuracy compared with the estimator using only the information of the target site and other existing methods. The SurvMaximin estimator is robust to variations in sample sizes and estimated feature coefficients between centers, which amounts to significantly improved estimates for target sites with fewer observations. ConclusionsThe SurvMaximin method is well suited for both federated and transfer learning in the high-dimensional survival analysis setting. SurvMaximin only requires a one-time summary information exchange from participating centers. Estimated regression vectors can be very heterogeneous. SurvMaximin provides robust Cox feature coefficient estimates without outcome information in the target population and is privacy-preserving.