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BACKGROUND: Electronic health (e-health) tools may support patients' self-management of chronic kidney disease. We aimed to identify preferences of patients with chronic kidney disease, caregivers and health care providers regarding content and features for an e-health tool to support chronic kidney disease self-management. METHODS: A patient-oriented research approach was taken, with 6 patient partners (5 patients and 1 caregiver) involved in study design, data collection and review of results. Patients, caregivers and clinicians from across Canada participated in a 1-day consensus workshop in June 2018. Using personas (fictional characters) and a cumulative voting technique, they identified preferences for content for 8 predetermined topics (understanding chronic kidney disease, diet, finances, medication, symptoms, travel, mental and physical health, work/school) and features for an e-health tool. RESULTS: There were 24 participants, including 11 patients and 6 caregivers, from across Canada. The following content suggestions were ranked the highest: basic information about kidneys, chronic kidney disease and disease progression; reliable information on diet requirements for chronic kidney disease and comorbidities, renal-friendly foods; affordability of medication, equipment, food, financial resources and planning; common medications, adverse effects, indications, cost and coverage; symptom types and management; travel limitations, insurance, access to health care, travel checklists; screening and supports to address mental health, cultural sensitivity, adjusting to new normal; and support to help integrate at work/school, restrictions. Preferred features included visuals, the ability to enter and track health information and interact with health care providers, "on-the-go" access, links to resources and access to personal health information. INTERPRETATION: A consensus workshop developed around personas was successful for identifying detailed subject matter for 8 predetermined topic areas, as well as preferred features to consider in the codevelopment of a chronic kidney disease self-management e-health tool. The use of personas could be applied to other applications in patient-oriented research exploring patient preferences and needs in order to improve care and relevant outcomes.
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Subjects with mild cognitive impairment (MCI) have an increased risk of developing Alzheimer's disease (AD), and their functional brain networks are presumably already altered. To test this hypothesis, we compared magnetoencephalography (MEG) eyes-closed resting-state recordings from 29 MCI subjects and 29 healthy elderly subjects in the present exploratory study. Functional connectivity in different frequency bands was assessed with the phase lag index (PLI) in source space. Normalized weighted clustering coefficient (normalized Cw) and path length (normalized Lw), as well as network measures derived from the minimum spanning tree [MST; i.e., betweenness centrality (BC) and node degree], were calculated. First, we found altered PLI values in the lower and upper alpha bands in MCI patients compared to controls. Thereafter, we explored network differences in these frequency bands. Normalized Cw and Lw did not differ between the groups, whereas BC and node degree of the MST differed, although these differences did not survive correction for multiple testing using the False Discovery Rate (FDR). As an exploratory study, we may conclude that: (1) the increases and decreases observed in PLI values in lower and upper alpha bands in MCI patients may be interpreted as a dual pattern of disconnection and aberrant functioning; (2) network measures are in line with connectivity findings, indicating a lower efficiency of the brain networks in MCI patients; (3) the MST centrality measures are more sensitive to detect subtle differences in the functional brain networks in MCI than traditional graph theoretical metrics.
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OBJECTIVES: Human Cell Division Cycle 20 (CDC20) homolog is a crucial target of the spindle assembly checkpoint. It is an activator of the Anaphase-Promoting Complex/Cyclosome (APC/C) which promotes anaphase onset and mitotic exit through the ubiquitination of securin and cyclin B1. Overexpression of CDC20 was previously reported in oral squamous cell carcinoma (OSCC). Here, we propose to explore the clinicopathological significance of CDC20 overexpression and its potential use as a prognostic marker in OSCC. METHODS: Using tissue microarray technology, we analyzed CDC20 expression in 65 primary OSCC tissues by immunohistochemistry. Statistical analysis was performed to evaluate the clinicopathological and prognostic significance of CDC20 expression in OSCC. RESULTS: Of the 65 cases of patients with OSCC studied, 37 (56.9%) showed high CDC20 protein expression. No clinicopathological features were correlated with CDC20 expression. Importantly, in univariable analysis, OSCC patients with higher CDC20 protein expression showed significantly shorter cancer-specific survival rate (P = 0.018). Multivariable analysis identified high CDC20 expression as an independent prognostic factor (P = 0.032). CONCLUSION: High CDC20 expression is associated with poor prognosis in OSCC and may be used to identify high-risk OSCC patients and may serve as a therapeutic target.