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1
Lacasse, Yves, Victor M. Montori, Claude Lanthier, and François Maltis. "The Validity of Diagnosing Chronic Obstructive Pulmonary Disease from a Large Administrative Database." Canadian Respiratory Journal 12, no. 5 (2005): 251–56. http://dx.doi.org/10.1155/2005/567975.
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BACKGROUND: Health authorities create and maintain administrative databases. Despite the potential advantages of these databases, the validity of the information they include must be considered.OBJECTIVE: To examine the validity of diagnosing chronic obstructive pulmonary disease (COPD) from a large administrative database.METHODS: Physician services and prescription claims data related to COPD and asthma were extracted from the Quebec universal medical insurance register (Régie de l'assurance-maladie du Québec; RAMQ) from the period of April 1, 1994 to March 31, 1999. Before obtaining the data, criteria for the validity of the COPD diagnosis in the database were formulated based on the epidemiology of COPD in the province. The extent to which the database satisfied these criteria are described within the present paper.RESULTS: For patients aged 65 years or older, COPD was two times more prevalent in the RAMQ database than in the 1994/1995 National Population Health Survey. One in three patients with a RAMQ-diagnosis of COPD also had a RAMQ-diagnosis of asthma, and 47% of patients aged 65 years or older with a RAMQ-diagnosis of COPD did not fill any prescription for beta-2-agonists. In addition, 42% of patients with a RAMQ-diagnosis of COPD who never had a RAMQ-diagnosis of asthma appeared only once with that diagnosis in the database. Of all patients aged 65 years or older with a RAMQ-diagnosis of COPD, 37% and 23% met the operational definitions of 'possible COPD' and 'probable COPD', respectively.CONCLUSIONS: Most RAMQ-diagnoses of COPD lack validity; therefore, the validity of database diagnoses should be routinely ascertained before using administrative databases in clinical and health services research.
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Frank, Daniel. "Evaluation of Czech SME participation in the FP7 in the period October 2007 – October 2011." Ergo 7, no. 2 (September 1, 2012): 16–22. http://dx.doi.org/10.2478/v10217-012-0006-y.
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Small and medium enterprises (SMEs) in the CR have the opportunity to use grants of many national and European funds and programmes to support their research and other activities. One of the important resources for the implementation of SMEs research and development activities is FP7. The article based on statistical data of E-CORDA database (database of FP7 grants) for the period 2007 to 2011 briefl y summarizes the participation of Czech SMEs in the FP7, compares the SMEs participation share and SMEs received fi nancial support share in terms of regions of the CR and EU countries referring to participation and obtained fi nancial support of other FP7 participants. The contribution analyses Czech SMEs participation in FP7 thematic priorities, presents the regional scope of SMEs in FP7 in the CR and compares the participation and fi nancial success rate of SMEs from the CR with the success rate of SMEs from other EU countries. Essential attention is given to the use of specifi c tools for SMEs in “Research for the Benefi t of SMEs“ Priority in Capacities Specifi c Programme, further to the national project preparation support infrastructure and to the barriers of the Czech SMEs participation in FP7.
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Kubátová, A. "Collection of food relevant microscopic fungi under the Czech national programme of protection of genetic resources of economically significant microorganisms – a short report." Czech Journal of Food Sciences 28, No. 1 (February 18, 2010): 79–82. http://dx.doi.org/10.17221/235/2009-cjfs.
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A unique project exists in the Czech Republic, namely the Czech National Programme of Protection of Genetic Resources of Economically Significant Microorganisms and Tiny Animals (NPPGR), which includes nineteen Czech collections of microorganisms (bacteria, fungi), viruses, and tiny animals. It is fully financed by the Ministry of Agriculture of the Czech Republic. Under this Programme, the Culture Collection of Fungi (CCF) in Prague maintains 293 fungal strains, 225 of which are food and feed relevant fungi (e.g. toxigenic <I>Aspergillus flavus, Penicillium verrucosum</I>, and <I>Fusarium sporotrichioides</I>). The main aims of the Programme are to provide adequate protection of the microbial genetic resources that are of importance to the agriculture and food industries, to provide strains (free of charge) for the research and educational purposes, and to support the cooperation between Czech and foreign institutions. A database of all microorganisms is accessible online.
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Cheng, Wei-Jen, Chih-Chao Chiang, Meng-Ting Peng, Yu-Tung Huang, Jhen-Ling Huang, Shang-Hung Chang, Hsuan-Tzu Yang, Wei-Chun Chen, Jong-Jen Kuo, and Tsong-Long Hwang. "Chronic Obstructive Pulmonary Disease Increases the Risk of Mortality among Patients with Colorectal Cancer: A Nationwide Population-Based Retrospective Cohort Study." International Journal of Environmental Research and Public Health 18, no. 16 (August 19, 2021): 8742. http://dx.doi.org/10.3390/ijerph18168742.
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Background: Colorectal cancer (CRC) is the third leading cause of cancer-related deaths in Taiwan. Chronic obstructive pulmonary disease (COPD) is associated with CRC mortality in several population-based studies. However, this effect of COPD on CRC shows no difference in some studies and remains unclear in Taiwan’s population. Methods: We conducted a retrospective cohort study using Taiwan’s nationwide database. Patients newly diagnosed with CRC were identified from 2007 to 2012 via the Taiwan Cancer Registry dataset and linked to the National Health Insurance research database to obtain their medical records. Propensity score matching (PSM) was applied at a ratio of 1:2 in COPD and non-COPD patients with CRC. The 5-year overall survival (OS) was analyzed using the Cox regression method. Results: This study included 43,249 patients with CRC, reduced to 13,707 patients after PSM. OS was lower in the COPD group than in the non-COPD group. The adjusted hazard ratio (aHR) for COPD was 1.26 (95% confidence interval (CI), 1.19–1.33). Moreover, patients with CRC plus preexisting COPD showed a higher mortality risk in all stage CRC subgroup analysis. Conclusions: In this 5-year retrospective cohort study, patients with CRC and preexisting COPD had a higher mortality risk than those without preexisting COPD, suggesting these patients need more attention during treatment and follow-up.
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Wong, Melisa L., Timothy L. McMurry, George J. Stukenborg, Amanda B. Francescatti, Carla Amato-Martz, Jessica R. Schumacher, Caprice Christian Greenberg, et al. "Comparison of comorbidity measures to predict postoperative lung cancer survival in the National Cancer Database (AFT-03)." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 6519. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.6519.
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6519 Background: Comprehensive assessment of comorbidity in cancer registries is critical for comparative effectiveness research. The National Cancer Database (NCDB) measures comorbidity with a diagnosis code-based Charlson Comorbidity Index (CCI) abstracted from discharge abstracts or billing face sheets. However, the prognostic performance of this code-based CCI has not been compared with a medical chart-based CCI or individual comorbid conditions in a nationally representative sample of patients with lung cancer. Methods: Through a special study of the NCDB, cancer registrars performed chart abstraction for 18 perioperative comorbid conditions for 9,640 randomly selected patients with stage I-III non-small cell lung cancer resected in 2006-07 at 1,150 Commission on Cancer-accredited facilities. We compared the prognostic performance of the NCDB code-based categorical CCI (0, 1, 2+), special study chart-based continuous CCI, and individual comorbid conditions in 3 separate Cox proportional hazards models for 5-year postoperative overall survival. All models adjusted for demographic and clinical characteristics. Results: Median age was 67 (IQR 60-74). The most common comorbidities were COPD (40%) and CAD (21%). Five-year postoperative overall survival was 55.5%. Agreement between the code- and chart-based CCIs was 51.9% with the code-based CCI underestimating comorbidity for 36.2% patients. The model including individual comorbid conditions had the best prognostic performance (R2 0.196, C index 0.654). COPD, CAD, CHF, dementia, diabetes, moderate/severe renal and liver disease, peripheral vascular disease, psychiatric disorder, and substance abuse were independently associated with decreased survival. The chart-based CCI model (R2 0.189, C index 0.650) predicted postoperative survival better than the code-based CCI model (R2 0.181, C index 0.645). Conclusions: The NCDB code-based CCI underestimates comorbidity in patients with surgically resected lung cancer. The chart-based CCI and data on individual comorbid conditions improved prognostic performance and would be valuable additions to the NCDB to strengthen comparative effectiveness research.
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Liao, Yen-Nung, Wen-Long Hu, Hsuan-Ju Chen, and Yu-Chiang Hung. "The Use of Chinese Herbal Medicine in the Treatment of Chronic Obstructive Pulmonary Disease (COPD)." American Journal of Chinese Medicine 45, no. 02 (January 2017): 225–38. http://dx.doi.org/10.1142/s0192415x17500148.
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In Oriental countries, combinations of Chinese herbal products (CHPs) are often utilized as therapeutic agents for chronic obstructive pulmonary disease (COPD). The effects of CHPs on COPD have been previously reported. This study aimed to analyze the frequency of prescription and usage of CHPs in patients with COPD in Taiwan. In this nationwide population-based cross-sectional study, 19,142 patients from a random sample of one million individuals in the Longitudinal Health Insurance Database 2000 (LHID 2000) of the National Health Insurance Research Database (NHIRD) were enrolled from 2000 to 2011. The multiple logistic regression method was used to evaluate the adjusted odds ratios for the utilization of CHPs. For patients with COPD, there was an average of 6.31 CHPs in a single prescription. The most frequently prescribed CHP for COPD was Xiao-Qing-Long-Tang (XQLT) (2.6%), and the most commonly used combination of two formula CHPs was XQLT with Ma-Xing-Gan-Shi-Tang (MXGST) (1.28%). The most commonly used single CHP for COPD was Bulbus Fritillariae (3.65%), and the most commonly used combination of two single CHPs was Bulbus Fritillariae with Puerariae Lobatae (1.09%). These results provide information regarding personalized therapies and may promote further clinical experiments and pharmacologic research on the use of CHPs for the management of COPD. Furthermore, we found that TCM usage was more prevalent among men, younger, manual workers, residents of Northern Taiwan, and patients with chronic bronchitis and asthma. This information on the distribution of TCM usage around the country is valuable to public health policymakers and clinicians.
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Zasina, Adrian. "Językoznawstwo korpusowe. Empiryczne podejście w badaniach humanistycznych." Dziennikarstwo i Media 9 (April 17, 2019): 169–78. http://dx.doi.org/10.19195/2082-8322.9.13.
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Corpus linguistics. An empirical approach to humanities researchThe aim of the article is to shed light on the methodology of corpus research in the humanities, primarily in linguistics. Corpus linguistics emerged in the late 1970s and early 1980s, focusing on electronic language corpora. Corpora are collections of various types of texts written and spoken gathered in a computer database which makes it possible to automatically search for text units in their natural context. There are various types of corpora depending on the type of study. The first corpora were compiled for the English language, although more and more languages are acquiring their national corpora, like the National Corpus of the Polish Language, the Czech National Corpus or the National Corpus of the Russian Language.
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Baillargeon, Jacques, Randall James Urban, Wei Zhang, Mohammed Fathi Zaiden, Zulqarnain Javed, Melinda Sheffield-Moore, Yong-Fang Kuo, and Gulshan Sharma. "Testosterone replacement therapy and hospitalization rates in men with COPD." Chronic Respiratory Disease 16 (September 11, 2018): 147997231879300. http://dx.doi.org/10.1177/1479972318793004.
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Testosterone deficiency is common in men with chronic obstructive pulmonary disease (COPD) and may exacerbate their condition. Research suggests that testosterone replacement therapy (TRT) may have a beneficial effect on respiratory outcomes in men with COPD. To date, however, no large-scale nationally representative studies have examined this association. The objective of the study was to assess whether TRT reduced the risk of respiratory hospitalizations in middle-aged and older men with COPD. We conducted two retrospective cohort studies. First, using the Clinformatics Data Mart—a database of one of the largest commercially insured populations in the United States—we examined 450 men, aged 40–63 years, with COPD who initiated TRT between 2005 and 2014. Second, using the national 5% Medicare database, we examined 253 men, aged ≥66 years, with COPD who initiated TRT between 2008 and 2013. We used difference-in-differences (DID) statistical modeling to compare pre- versus post-respiratory hospitalization rates in TRT users versus matched TRT nonusers over a parallel time period. DID analyses showed that TRT users had a greater relative decrease in respiratory hospitalizations compared with nonusers. Specifically, middle-aged TRT users had a 4.2% greater decrease in respiratory hospitalizations compared with nonusers (−2.4 decrease vs. 1.8 increase; p = 0.03); and older TRT users had a 9.1% greater decrease in respiratory hospitalizations compared with nonusers (−0.8 decrease vs. 8.3 increase; p = 0.04). These findings suggest that TRT may slow disease progression in patients with COPD. Future studies should examine this association in larger cohorts of patients, with particular attention to specific biological pathways.
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Wu, Chia-Che, Kun-Ming Rau, Wei-Chieh Lee, Meng-Che Hsieh, Jia-Sin Liu, Yen-Yang Chen, and Harvey Yu-Li Su. "Presence of Chronic Obstructive Pulmonary Disease (COPD) Impair Survival in Lung Cancer Patients Receiving Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor (EGFR-TKI): A Nationwide, Population-Based Cohort Study." Journal of Clinical Medicine 8, no. 7 (July 12, 2019): 1024. http://dx.doi.org/10.3390/jcm8071024.
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The emergence of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) caused a paradigm shift in the treatment of non-small cell lung cancer (NSCLC). Although several clinicopathologic factors to predict the response to and survival on EGFR-TKI were recognized, its efficacy has not been confirmed for patients with underlying pulmonary disease, such as chronic obstructive pulmonary disease (COPD). We conducted the study to evaluate the impact of COPD on survival for NSCLC patients that underwent EGFR-TKI treatment. The nationwide study obtained clinicopathologic data from the National Health Insurance Research Database in Taiwan between 1995 and 2013. Patients receiving EGRR-TKI were divided into COPD and non-COPD groups, and adjusted for age, sex, comorbidities, premium level and cancer treatments. Overall survival (OS) and progression-free survival (PFS) were calculated by Kaplan–Meier analysis. In total, 21,026 NSCLC patients were enrolled, of which 47.6% had COPD. After propensity score (PS) matching, all covariates were adjusted and balanced except for age (p < 0.001). In the survival analysis, the median OS (2.04 vs. 2.28 years, p < 0.001) and PFS (0.62 vs. 0.69 years, p < 0.001) of lung cancer with COPD were significantly worse than those without COPD. Lung cancer patients on EGFR-TKI treatment had a worse survival outcome if patients had pre-existing COPD.
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Kao, Li-Ting, Kuo-Chen Cheng, Chin-Ming Chen, Shian-Chin Ko, Ping-Jen Chen, Kuang-Ming Liao, and Chung-Han Ho. "Burden of Healthcare Utilization among Chronic Obstructive Pulmonary Disease Patients with and without Cancer Receiving Palliative Care: A Population-Based Study in Taiwan." International Journal of Environmental Research and Public Health 17, no. 14 (July 10, 2020): 4980. http://dx.doi.org/10.3390/ijerph17144980.
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Chronic obstructive pulmonary disease (COPD) is a chronic disease that burdens patients worldwide. This study aims to discover the burdens of health services among COPD patients who received palliative care (PC). Study subjects were identified as COPD patients with ICU and PC records between 2009 and 2013 in Taiwan’s National Health Insurance Research Database. The burdens of healthcare utilization were analyzed using logistic regression to estimate the difference between those with and without cancer. Of all 1215 COPD patients receiving PC, patients without cancer were older and had more comorbidities, higher rates of ICU admissions, and longer ICU stays than those with cancer. COPD patients with cancer received significantly more blood transfusions (Odds Ratio, OR: 1.66; 95% C.I.: 1.11–2.49) and computed tomography scans (OR: 1.88; 95% C.I.: 1.10–3.22) compared with those without cancer. Bronchoscopic interventions (OR: 0.26; 95% C.I.: 0.07–0.97) and inpatient physical restraints (OR: 0.24; 95% C.I.: 0.08–0.72) were significantly more utilized in patients without cancer. COPD patients without cancer appeared to receive more invasive healthcare interventions than those without cancer. The unmet needs and preferences of patients in the life-limiting stage should be taken into consideration for the quality of care in the ICU environment.
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Chen, Ying, Richard Hayward, Carolyn A. Chew-Graham, Richard Hubbard, Peter Croft, Keith Sims, and Kelvin P. Jordan. "Prognostic value of first-recorded breathlessness for future chronic respiratory and heart disease: a cohort study using a UK national primary care database." British Journal of General Practice 70, no. 693 (February 10, 2020): e264-e273. http://dx.doi.org/10.3399/bjgp20x708221.
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BackgroundBreathlessness is a common presentation in primary care.AimTo assess the long-term risk of diagnosed chronic obstructive pulmonary disease (COPD), asthma, ischaemic heart disease (IHD), and early mortality in patients with undiagnosed breathlessness.Design and settingMatched cohort study using data from the UK Clinical Practice Research Datalink.MethodAdults with first-recorded breathlessness between 1997 and 2010 and no prior diagnostic or prescription record for IHD or a respiratory disease (‘exposed’ cohort) were matched to individuals with no record of breathlessness (‘unexposed’ cohort). Analyses were adjusted for sociodemographic and comorbidity characteristics.ResultsIn total, 75 698 patients (the exposed cohort) were followed for a median of 6.1 years, and more than one-third subsequently received a diagnosis of COPD, asthma, or IHD. In those who remained undiagnosed after 6 months, there were increased long-term risks of all three diagnoses compared with those in the unexposed cohort. Adjusted hazard ratios for COPD ranged from 8.6 (95% confidence interval [CI] = 6.8 to 11.0) for >6–12 months after the index date to 2.8 (95% CI = 2.6 to 3.0) for >36 months after the index date; asthma, 11.7 (CI = 9.4 to 14.6) to 4.3 (CI = 3.9 to 4.6); and IHD, 3.0 (CI = 2.7 to 3.4) to 1.6 (CI = 1.5 to 1.7). Risk of a longer time to diagnosis remained higher in members of the exposed cohort who had no relevant prescription in the first 6 months; approximately half of all future diagnoses were made for such patients. Risk of early mortality (all cause and disease specific) was higher in members of the exposed cohort.ConclusionBreathlessness can be an indicator of developing COPD, asthma, and IHD, and is associated with early mortality. With careful assessment, appropriate intervention, and proactive follow-up and monitoring, there is the potential to improve identification at first presentation in primary care in those at high risk of future disease who present with this symptom.
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Yen, Yu-Shu, Dorji Harnod, Cheng-Li Lin, Tomor Harnod, and Chia-Hung Kao. "Long-Term Mortality and Medical Burden of Patients with Chronic Obstructive Pulmonary Disease with and without Subsequent Stroke Episodes." International Journal of Environmental Research and Public Health 17, no. 7 (April 8, 2020): 2550. http://dx.doi.org/10.3390/ijerph17072550.
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Background: We used the Taiwan National Health Insurance Research Database (NHIRD) to determine the differences in mortality and medical burden between patients with chronic obstructive pulmonary disease (COPD) with and without stroke. Methods: We enrolled participants aged ≥20 years and defined four subgroups in this study, namely patients with COPD (International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9 CM): 491, 492, 494, and 496), patients with COPD with stroke (ICD-9 CM: 430–438), with COPD without stroke, and comparison subgroups. We calculated the hazard ratios and 95% CIs for all-cause mortality risk, average duration of hospitalization, and frequency of medical visits in these subgroups after adjustments were made for age, sex, and comorbidities. All participants were followed until the date of death, the date they were censored, the date they withdrew from the NHIRD, or 31 December, 2013. Results: In total, 9.70% (men vs. women, 11.19% vs. 8.28%) of patients with COPD developed subsequent stroke during the 14 year follow-up. After a stroke, the risk of mortality exhibited a 2.66- to 5.05-fold increase, especially in the younger ones. COPD with stroke was also a leading factor in the increase in the average number of hospitalization days and frequency of medical visits. Conclusion: The mortality risk of patients with COPD is considerably increased by stroke independent of the other effects of COPD. Moreover, the average number of hospitalization days and frequency of medical visits dramatically increased in patients with COPD after stroke.
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Huang, Tang-Hsiu, Chiung-Zuei Chen, Hung-I. Kuo, Hong-Ping Er, and Sheng-Hsiang Lin. "Enhanced risk of traumatic brain injury in patients with chronic obstructive pulmonary disease." Journal of Investigative Medicine 68, no. 4 (December 31, 2019): 846–55. http://dx.doi.org/10.1136/jim-2019-001207.
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This study tests our hypothesis that patients with chronic obstructive pulmonary disease (COPD) have an increased risk of traumatic brain injury (TBI).In this nationwide retrospective cohort study, we used a subset of Taiwan’s National Health Insurance Research Database, involving 1 million randomly selected beneficiaries. Patients with newly diagnosed COPD between 2000 and 2008 were identified. They were subgrouped as ‘COPDAE+’ (if they had severe acute exacerbation of COPD during the follow-ups) or ‘COPDAE−’ (if they had no acute exacerbation), and were frequency matched with randomly selected subjects without COPD (the ‘non-COPD’ group). Baseline differences were balanced by the inverse probability of treatment weighting based on the propensity score. For each patient, the risk of TBI during the subsequent 5 years was determined. The competing risk of death was controlled.We identified 3734 patients in ‘COPDAE+’, and frequency matched them with 11,202 patients in ‘COPDAE−’ and 11,202 subjects in ‘non-COPD’. Compared with those in ‘non-COPD’, patients in ‘COPDAE+’ and ‘COPDAE−’ had an increased risk of TBI: the adjusted HR for ‘COPDAE+’ was 1.50, 95% CI 1.31 to 1.73, and that for ‘COPDAE−’ was 1.21, 95% CI 1.09 to 1.34. The highest risk was observed in the ‘COPDAE+’ group that aged <65 (the adjusted HR was 1.92; 95% CI 1.39 to 2.64).COPD has been linked to complications beyond the respiratory system. In this study we showed that COPD is associated with an increased risk of TBI.
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Broz, Ludek, and Tereza Stöckelová. "The culture of orphaned texts." Aslib Journal of Information Management 70, no. 6 (November 19, 2018): 623–42. http://dx.doi.org/10.1108/ajim-03-2018-0063.
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Purpose The purpose of this paper is to contribute to the body of knowledge on how research evaluation in different national and organisational contexts affects, often in unintended ways, research and publication practices. In particular, it looks at the development of book publication in the social sciences and humanities (SSH) in the Czech Republic since 2004, when a performance-based system of evaluation was introduced, up to the present. Design/methodology/approach The paper builds upon ethnographic research complemented by the analysis of Czech science policy documents, data available in the governmental database “Information Register of R&D results” and formal and informal interviews with expert evaluators and other stakeholders in the research system. It further draws on the authors’ own experience as scholars, who have also over the years participated in a number of evaluation procedures as peers and experts. Findings The number of books published by researchers in SSH based at Czech institutions has risen considerably in reaction to the pressure for productivity that is inscribed into the evaluation methodology and has resulted in the rise of in-house publishing by researchers’ own research institution, “fake internationalisation” using foreign low-quality presses as the publication venue, and the development of a culture of orphaned books that have no readers. Practical implications In the Czech Republic robust and internationally harmonised bibliometric data regarding books would definitely help to create a form of research evaluation that would stimulate meaningful scholarly book production. At the same time, better-resourced and better-designed peer review evaluation is needed. Originality/value This is the first attempt to analyse in detail the conditions and consequences the Czech performance-based research evaluation system has for SSH book publication. The paper demonstrates that often discussed harming of SSH and book-writing in particular by performance-based IF-centred research evaluation does not necessarily manifest in declining numbers of publications. On the contrary, the number of books published may increase at the cost of producing more texts of questionable scholarly quality.
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Porta, Ana Sofia, Nyanjok Lam, Paul Novotny, and Roberto Benzo. "Low income as a determinant of exercise capacity in COPD." Chronic Respiratory Disease 16 (November 18, 2018): 147997231880949. http://dx.doi.org/10.1177/1479972318809491.
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Exercise capacity (EC) is a critical outcome in chronic obstructive lung disease (chronic obstructive pulmonary disease (COPD)). It measures the impact of the disease and the effect of specific interventions like pulmonary rehabilitation (PR). EC determines COPD prognosis and is associated with health-care utilization and quality of life. Field walking tests and cardiopulmonary exercise test (CPET) are two ways to measure EC. The 6-minute walking test (6MWT) is the commonest and easiest field test. CPET has the advantage of assessing maximal aerobic capacity. Determinants of EC include age, gender, breathlessness, and lung function. Previous research suggests that socioeconomic status (SES), a meaningful factor in COPD, may also be associated with EC. However, those findings have not been replicated. We aimed to determine whether SES is an independent factor associated with EC in COPD. For this analysis, we used the National Emphysema Treatment Trial (NETT) database. NETT was a multicenter clinical trial where severe COPD patients were randomized to lung volume reduction surgery or medical therapy. Measures used were taken at baseline, postrehabilitation. Patients self-reported their income and were divided in two groups whether it was less or above US$30,000. Patients with a lower income had worse results in 6MWT ( p < 0.0001). We found an independent association between income and the 6MWT in patients with severe COPD after adjusting for age, gender, lung function, dyspnea, and living conditions ( p < 0.0007). One previous publication stated the relationship between income and EC. Our research confirms and extends previous publications associating EC with income by studying a large and well characterized cohort of severe COPD patients, also addressing EC by two different methods (maximal watts and 6MWT). Our results highlight the importance of addressing social determinants of health such as income when assessing COPD patients.
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Asche, Carl V., Diana I. Brixner, Craig S. Conoscenti, David C. Young, Hemal Shah, and Phillips Amy. "ASSESSMENT OF PHYSICIAN PRESCRIBING FOR PRIMARY CARE PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IN A NATIONAL ELECTRONIC MEDICAL RECORD (EMR) RESEARCH DATABASE." Chest 130, no. 4 (October 2006): 175S. http://dx.doi.org/10.1378/chest.130.4_meetingabstracts.175s-b.
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Yeo, Yohwan, Dong Wook Shin, Kyungdo Han, Sang Hyun Park, Keun-Hye Jeon, Jungkwon Lee, Junghyun Kim, and Aesun Shin. "Individual 5-Year Lung Cancer Risk Prediction Model in Korea Using a Nationwide Representative Database." Cancers 13, no. 14 (July 13, 2021): 3496. http://dx.doi.org/10.3390/cancers13143496.
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Early detection of lung cancer by screening has contributed to reduce lung cancer mortality. Identifying high risk subjects for lung cancer is necessary to maximize the benefits and minimize the harms followed by lung cancer screening. In the present study, individual lung cancer risk in Korea was presented using a risk prediction model. Participants who completed health examinations in 2009 based on the Korean National Health Insurance (KNHI) database (DB) were eligible for the present study. Risk scores were assigned based on the adjusted hazard ratio (HR), and the standardized points for each risk factor were calculated to be proportional to the b coefficients. Model discrimination was assessed using the concordance statistic (c-statistic), and calibration ability assessed by plotting the mean predicted probability against the mean observed probability of lung cancer. Among candidate predictors, age, sex, smoking intensity, body mass index (BMI), presence of chronic obstructive pulmonary disease (COPD), pulmonary tuberculosis (TB), and type 2 diabetes mellitus (DM) were finally included. Our risk prediction model showed good discrimination (c-statistic, 0.810; 95% CI: 0.801–0.819). The relationship between model-predicted and actual lung cancer development correlated well in the calibration plot. When using easily accessible and modifiable risk factors, this model can help individuals make decisions regarding lung cancer screening or lifestyle modification, including smoking cessation.
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Kašparová, Jaroslava. "Personal Libraries in the National Museum – a Valuable Source of Information on the History of Book Culture in the 19th Century and the Early 20th Century." Acta Musei Nationalis Pragae – Historia litterarum 63, no. 3-4 (2019): 105–13. http://dx.doi.org/10.2478/amnpsc-2018-0014.
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Book collections from the 19th century and the first half of the 20th century preserved in the NM are among the richest and most interesting book collections of the Czech Republic. Research into personal book collections of the NM within the NAKI project (2012–2015), including besides the historical book collection also books from the 19th and 20th centuries, has provided valuable information on the history of the entire book culture. The PROVENIO database is an important source of information and knowledge in terms of book owners and ownership provenance, library history, bibliophilia and the reception by readers, as well as the history of book binding, book publishing houses and book trade of the given period.
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Luo, Ching-Shan, Ching-Chi Chi, Yu-Ann Fang, Ju-Chi Liu, and Kang-Yun Lee. "Influenza vaccination reduces dementia in patients with chronic obstructive pulmonary disease: a nationwide cohort study." Journal of Investigative Medicine 68, no. 4 (January 14, 2020): 838–45. http://dx.doi.org/10.1136/jim-2019-001155.
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This study aimed to explore the protective potential of influenza vaccination against occurrence of dementia in patients with chronic obstructive pulmonary disease (COPD), who are expected to be more vulnerable to influenza infection. This nationwide retrospective cohort study enrolled patients with COPD (aged ≥60 years) from 1 January 2001 to 31 December 2012 by using the Taiwan National Health Insurance Research Database. By applying time-dependent Cox proportional hazard model, we used multivariate analysis to calculate the adjusted HR (aHR) with 95% CI of dementia in relation to influenza vaccination among patients with COPD. Besides, patients were partitioned into four groups according to the vaccination number (unvaccinated, 1, 2–3 and ≥4 total vaccinations) to investigate the dose-response effect of vaccinations on the dementia incidence. This cohort study included 19 848 patients with COPD, and 45% of them received influenza vaccination. The aHR of dementia was 0.68 (95% CI: 0.62 to 0.74, p<0.001) comparing vaccinated patients with unvaccinated ones. Furthermore, there was a trend of dementia risk reduction with the vaccination number. For patients who received 2–3 vaccinations, the aHR was 0.81 (95% CI: 0.73 to 0.90), and for those received 4 vaccinations, the aHR was 0.44 (95% CI: 0.40 to 0.50), with p for trend <0.001. In conclusion, annual influenza vaccination can reduce the risk of dementia in patient with COPD in a dose-dependent manner.
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Su, Vincent, Diahn-Warng Perng, Ting-Chun Chou, Yueh-Ching Chou, Yuh-Lih Chang, Chia-Chen Hsu, Chia-Lin Chou, Hsin-Chen Lee, Tzeng-Ji Chen, and Po-Wei Hu. "Mucolytic Agents and Statins Use is Associated with a Lower Risk of Acute Exacerbations in Patients with Bronchiectasis-Chronic Obstructive Pulmonary Disease Overlap." Journal of Clinical Medicine 7, no. 12 (December 4, 2018): 517. http://dx.doi.org/10.3390/jcm7120517.
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Background: Bronchiectasis-chronic obstructive pulmonary disease (COPD) overlap (BCO) is a neglected area of trials, and it is not covered by guidelines for clinical practice. Methods: Using the National Health Insurance Research Database of Taiwan, COPD patients with or without bronchiectasis from 2000 to 2009 were enrolled as the BCO and COPD alone cohorts, respectively. Patients followed for <28 days, diagnosed with COPD who were not prescribed with COPD medications, and those diagnosed with bronchiectasis who did not receive a chest X-ray or computed tomography were excluded. The primary endpoints were acute exacerbations and mortality. Results: There were 831 patients in the BCO cohort and 3321 patients in the COPD alone cohort, covering 3763.08 and 17,348.95 person-years, respectively, from 2000 to 2011. The BCO cohort had higher risk for exacerbations (adjusted hazard ratio (HR) 2.26, 95% confidence interval (CI) 1.94–2.63) and mortality (HR 1.46, 95% CI 1.24–1.73) than the COPD alone cohort. In the patients overall, the use of statins, macrolides, and mucolytic agents was associated with significantly lower risks of acute exacerbations (statins, HR 0.37, 95% CI 0.29–0.46; macrolides, HR 0.65, 95% CI 0.45–0.93; mucolytic agents, HR 0.68, 95% CI 0.59–0.78). Statins were associated with a significantly lower risk of mortality (HR 0.32, 95% CI 0.25–0.41). In the BCO group, statins and mucolytic agents use was associated with significantly lower risks of acute exacerbations (statins, HR 0.44, 95% CI 0.29–0.65; mucolytic agents, HR 0.58, 95% CI 0.45–0.75). Conclusion: Statins and mucolytic agents use may lower risk of acute exacerbation in patients with BCO.
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Chen, Cheng-Hsin, Chih-Cheng Lai, Ya-Hui Wang, Cheng-Yi Wang, Hao-Chien Wang, Chong-Jen Yu, and Likwang Chen. "The Impact of Sepsis on the Outcomes of COPD Patients: A Population-Based Cohort Study." Journal of Clinical Medicine 7, no. 11 (October 27, 2018): 393. http://dx.doi.org/10.3390/jcm7110393.
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This study aims to identify the impact of new-onset sepsis in patients with chronic obstructive pulmonary disease (COPD) including the effects on acute exacerbations, pneumonia and mortality. Using the National Health Insurance Research Database of Taiwan, all patients with COPD older than 40 years between 1988 and 2010 were recruited. After propensity score matching, each of the 8774 COPD patients with and without sepsis were identified to have similar characteristics. The primary outcome was severe exacerbations of COPD, with a severe exacerbation being defined as a patient requiring hospital admission or an emergency department visit due to COPD. The secondary outcomes were pneumonia, serious pneumonia, and all-cause mortality. The post-index overall cumulative incidence rates of total acute exacerbations were 11.2/person-years in the sepsis group and 6.2/person-years in the non-sepsis group (adjusted hazard ratio (HR) = 1.38, 95% confidence interval (CI), 1.38–1.40). The sepsis group also had higher risks of severe exacerbations (adjusted HR = 2.05, 95% CI, 2.02–2.08), severe exacerbations requiring hospitalization (adjusted HR = 2.30, 95% CI, 2.24–2.36), and severe exacerbations leading to an emergency room visit (adjusted HR = 1.91, 95% CI, 1.87–1.94). Regarding the effect on secondary outcomes, the sepsis group had higher risks of mortality (incidence rate: 23.7/person-years vs. 11.34/person-years, adjusted HR = 2.27, 95% CI, 2.14–2.41), pneumonia (incidence rate: 26.41 per person-days vs. 10.34 per person-days, adjusted HR = 2.70, 95% CI, 2.5–2.91), and serious pneumonia (incidence rate: 5.84 per person-days vs. 1.98 per person-days, adjusted HR = 2.89, 95% CI, 2.5–3.33) compared with the non-sepsis group. Sepsis survivors among patients with COPD had a higher risk of severe exacerbations, pneumonia, serious pneumonia, and mortality compared to patients with COPD without sepsis.
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Petruželka, Benjamin, and Miroslav Barták. "Primary drug-related crime in the Czech Republic from a geographical perspective: study of urban, suburban and rural differences." GeoScape 14, no. 2 (December 1, 2020): 134–42. http://dx.doi.org/10.2478/geosc-2020-0012.
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Abstract Illicit drug use and drug-related crime constitute a significant issue and create large economic and societal costs both at national and regional level. The aim of this article is to examine the differences in primary drug-related crime between urban, suburban and rural local police departments in Czechia. The primary drug-related crime rate in local police departments was constructed from the data collected in the national crime database and the geographical classification of these departments was taken from previous research. To analyze the differences among urban, suburban and rural departments, we used the general linear model. The models with measures that were not standardized for the number of inhabitants were all significant, while not all the models with standardized measures were significant. Overall primary drug-related crime, unauthorized production and other handling of illicit drugs and possession of illicit drugs models with standardized measures showed no significant differences between departments. The cultivation of plants model with standardized measure shows an increase in the predicted values of independent variables in suburban and rural departments compared to urban departments. Our research results show that local urban police departments are not related to higher rates of standardized primary drug-related crime, although there are differences in specific drug law offences. It suggests that drug-related issues are prevalent in all types of departments, however, the specific issues differ between them. Conclusions: The research showed that standardized primary drug-related crime rate in urban departments is not higher than in suburban or rural local police departments.
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Romanenko, Olena. "SLAVIC COMMUNITIES IN AUSTRALIA: THE HISTORICAL BACKGROUND AND THE CURRENT SITUATION." Naukovì zapiski Nacìonalʹnogo unìversitetu "Ostrozʹka akademìâ". Serìâ Ìstoričnì nauki 1 (December 17, 2020): 14–23. http://dx.doi.org/10.25264/2409-6806-2020-31-14-23.
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Migration to the Australian continent has ancient origins. On 1 January 1901, the Federation of the Commonwealth of Australia included six former colonies: New South Wales, Victoria, South Australia, Tasmania, Queensland, and Western Australia. The British origin had 78% of those who were born overseas. The immigration was high on the national agenda. The most ambitious nation-building plan based on immigration was adopted in Australia in the post-World War II period. The shock of the war was so strong that even old stereotypes did not prevent Australians from embarking on immigration propaganda with the slogan “Populate or Perish”. In the middle 1950s, the Australian Department of Immigration realized that family reunion was an important component of successful settlement. In 1955 the Department implemented “Operation Reunion” – a scheme was intended to assist family members overseas to migrate to the continent and reunite with the family already living in Australia. As a result, 30000 people managed to migrate from countries such as Bulgaria, Czechoslovakia, Hungary, Poland, Romania, the Soviet Union, and the former Yugoslavia under this scheme. Today Australia’s approach to multicultural affairs is a unique model based on integration and social cohesion. On governmental level, the Australians try to maintain national unity through respect and preservation of cultural diversity. An example of such an attitude to historical memory is a database created by the Department of Home Affairs (DHA). For our research, we decided to choose information about residents of East-Central European origin (Ukraine-born, Poland-born, and Czech Republic-born citizens) in Australia, based on the information from the above mentioned database. The article provides the brief historical background of Polish, Ukrainian and Czech groups on the Continent and describes the main characteristics of these groups of people, such as geographic distribution, age, language, religion, year of arrival, median income, educational qualifications, and employment characteristics.
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Yeh, Jun-Jun, Yu-Feng Wei, Cheng-Li Lin, and Wu-Huei Hsu. "Association of asthma–chronic obstructive pulmonary disease overlap syndrome with coronary artery disease, cardiac dysrhythmia and heart failure: a population-based retrospective cohort study." BMJ Open 7, no. 10 (October 2017): e017657. http://dx.doi.org/10.1136/bmjopen-2017-017657.
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ObjectivesPatients with asthma–chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) and cardiovascular diseases (CVDs) share common risk factors. However, the association between ACOS and the incidence of CVDs has not been reported. This study investigated the relationship between CVDs and ACOS in the general population.SettingData were obtained from Taiwan’s National Health Insurance Research Database for the period 2000 to 2010.ParticipantsThe ACOS cohort comprised patients (n=5814) who had received a diagnosis of asthma and COPD. The non-ACOS cohort comprised patients who had not received a diagnosis of asthma or COPD and were matched to the ACOS cohort (2:1) by age, sex and index date (n=11 625).Primary and secondary outcome measuresThe cumulative incidence of CVDs—coronary artery disease (CAD), cardiac dysrhythmia (CD) and heart failure (HF)—was calculated. Cox proportional regression analysis was employed to examine the relationship between ACOS and CVDs.ResultsAfter adjustment for multiple confounding factors—age, sex, comorbidities and medications—patients with ACOS were associated with a significantly higher risk of CVDs; the adjusted HRs (aHRs; 95% CI) for CAD, CD and HF were 1.62 (1.50 to 1.76), 1.44 (1.30 to 1.61) and 1.94 (1.73 to 2.19), respectively, whereas those of beta-blockers treatment for CAD, CD and HF were 1.19 (0.92 to 1.53), 0.90 (0.56 to 1.45) and 0.82 (0.49 to 1.38). The aHR of atenolol treatment for CD was 1.72 (1.01 to 2.93). The aHRs (95% CIs) of ACOS without acute exacerbation of COPD (AE-COPD) for CAD, CD and HF were 1.85 (1.70 to 2.01), 1.57 (1.40 to 1.77) and 2.07 (1.82 to 2.35), respectively.ConclusionACOS was associated with higher CVD risk, even without the presence of previous comorbidities or AE-COPD. No significant differences in CVD events were observed in the ACOS cohort using beta-blockers, except for those using atenolol for treating CD.
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Kiss, Igor, Zbynek Bortlicek, Bohuslav Melichar, Alexandr Poprach, Jana Halamkova, Rostislav Vyzula, Ladislav Dusek, and Tomas Buchler. "Comparison of efficacy and toxicity of bevacizumab in combination with chemotherapy in the first, second, and third or higher line of treatment for metastatic colorectal carcinoma (mCRC): Data from the Czech multi-institutional registry." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e14622-e14622. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e14622.
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e14622 Background: Data from the Czech national registry of patients treated with targeted therapies for mCRC were analyzed retrospectively to compare treatment outcomes for bevacizumab in combination with chemotherapy in the 1st, 2nd and 3rd line of treatment. Methods: The database was launched in 2005 as a clinical registry of patients with mCRC treated with bevacizumab. Epidemiological and clinical data are entered by all Czech comprehensive cancer centers administering targeted therapy. In total, 4487 mCRC patients who received bevacizumab combined with chemotherapy in either 1st line (n=3990, 88.9%), 2nd line (n=386, 8.6%), or 3rd and higher line (n=111, 2.5%) had evaluable data and were included in the present analysis. Survival was calculated using the Kaplan-Meier method, and the differences were assessed using the log-rank test. Results: Statistically significant differences were observed in the efficacy of combination chemotherapy with bevacizumab between the treatment lines. The objective response rate (ORR) in the 1st, 2nd, and 3rd/higher line was 42.9%, 34.0% and 8.3%; (p<0.001) respectively. Similarly, in the 1st, 2nd, and 3rd/higher line median progression free survival (mPFS) was 11.3 months (95% CI 11.0-11.7 months), 9.5 months (95% CI 8.2-10.9 months) , and 7.3 months (95% CI 5.9-8.7 months; p<0.001), and median overall survival (mOS) was 28.4 months (95% CI 27.1-29.8 months), 25.9 months (95% CI 19.4-32.4 months), and 15.0 months (95% CI 10.7-19.3 months; p<0.001), respectively. The spectrum of the most common adverse events was comparable in the 1st, 2nd, or 3rd/higher line, and incidence of adverse events was similar at 11.6%, 8.8% and 8.1%, respectively. Conclusions: The efficacy of bevacizumab in combination with chemotherapy decreased when administered in later lines of treatment for mCRC while the incidence and spectrum of toxicities remains unchanged.
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Trojan, Jakub. "Integrating AR services for the masses: geotagged POI transformation platform." Journal of Hospitality and Tourism Technology 7, no. 3 (August 1, 2016): 254–65. http://dx.doi.org/10.1108/jhtt-07-2015-0028.
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Purpose The purpose of this paper is to propose the platform for effective transformation of points of interests (POIs) into augmented reality (AR), specifically into the three major software tools – Junaio, Layar and Wikitude. The objective is to facilitate the creation of POIs for common users of these programs and, thus, encourage the general public to participate in the formation of a new concept of applications using AR and location-based services. Design/methodology/approach The subject of this study was analysis of methods used for POI dynamisation under the context of location-based services. This paper suggests methodology based on database format transformation. It is focused on the creation of platform for automated geotagged POI transformation into AR. Findings The research results in prototype of online platform which is capable to automatically transform geotagged POI to three major AR applications. It discusses also the model implementation of this platform in Czech national tourist authority. Research limitations/implications The paper presents a proof-of-concept of dynamisation and transformation of an unspecified number of POIs stored in a simple table database and their transformation into the AR. Practical implications Services of AR are brought for the masses to effectively dynamise tourist information. Social implications Results could make the process of multimedialising data (POIs) more suitable for masses. Originality/value This paper presents a proof-of-concept of dynamisation and transformation of an unspecified number of POIs stored in a simple table database and their transfer into the three major AR applications.
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Kotlyarov, Stanislav N., and Anna A. Kotlyarova. "Role of lipid metabolism and systemic inflammation in the development of atherosclerosis in animal models." I.P. Pavlov Russian Medical Biological Herald 29, no. 1 (March 15, 2021): 134–46. http://dx.doi.org/10.23888/pavlovj2021291134-146.
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Systemic inflammation makes a significant contribution to the pathogenesis of atherosclerosis and has been the subject of numerous studies. Works aiming to analyze the mechanisms of atherosclerosis development often include experiments on animals. A primary task of such research is the characterization, justification, and selection of an adequate model.
Aim. To evaluate the peculiarities of lipid metabolism and systemic inflammation in chronic obstructive pulmonary disease (COPD) in the development of atherosclerosis in animal models.
Materials and Methods. Analyses of cross-links between species-specific peculiarities of lipid metabolism and the immune response, as well as a bioinformatic analysis of differences in Toll-like receptor 4 (TLR4) in mice, rats, and rabbits in comparison with its human homolog, were carried out. A search for and analysis of the amino acid sequences of human, mouse, rat, and rabbit TLR4 was performed in the International database GenBank of National Center of Biotechnical Information and in The Universal Protein Resource (UniProt) database. Multiple alignments of the TLR4 amino acid sequences were implemented in the Clustal Omega program, version 1.2.4. Reconstruction and visualization of molecular phylogenetic trees were performed using the MEGA7 program according to the Neighbor-Joining and Maximum Parsimony methods.
Results. Species-specific differences of the peculiarities of lipid metabolism and the innate immune response in humans, mice, and rabbits were shown that must be taken into account in analyses of study results.
Conclusion.Disorders in lipid metabolism and systemic inflammation mediated by the innate immune system participating in the pathogenesis of atherosclerosis in COPD possess species-specific differences that should be taken into account in analyses of study results.
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Bureš, Vladimír. "Meta-analysis of business-related research in the former Warsaw Pact and the Soviet Union countries." Baltic Journal of Management 12, no. 1 (January 3, 2017): 6–24. http://dx.doi.org/10.1108/bjm-01-2016-0009.
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Purpose Research focussed on various issues or perspectives of business can be considered as an important driving force for business development. The purpose of this paper is to identify the main topics and trends associated with business-related research conducted in Belarus, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Russia, Slovakia and Ukraine. The study results contribute to a context-aware explanation of the dynamics of business-oriented research in individual countries. Design/methodology/approach This study both quantitatively and semantically analyses 6,166 abstracts indexed and abstracted in the Scopus database. Three main research questions and associated hypotheses are investigated. Three text-mining techniques were applied in the analysis of available resources, namely, word clustering, collocation statistics and correspondence analysis. Findings There is a growing trend in the quantity of business-related research publications associated with each country. Similarly, there is an increasing internationalisation and intensification process of research networks. It is possible to identify both general and specific business topics that are investigated in individual countries. Research limitations/implications The time spans investigated do not always correspond with the main events occurring at the national level. From the semantic analysis perspective, the shortage of records for specific time periods prevents a valid semantic analysis, and the results are dependent on the quality of the abstracts provided by the authors. The study results might be used as support for funding decisions or context-aware evaluation of research outcomes at both institutional and national level. Originality/value This study provides a unique insight into the development and mutual comparison of business-related research in the countries investigated.
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Hung, Shih-Kai, Yi-Chun Chen, Wen-Yen Chiou, Chun-Liang Lai, Moon-Sing Lee, Yuan-Chen Lo, Liang-Cheng Chen, et al. "Irradiation enhanced risks of hospitalised pneumonopathy in lung cancer patients: a population-based surgical cohort study." BMJ Open 7, no. 9 (September 2017): e015022. http://dx.doi.org/10.1136/bmjopen-2016-015022.
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ObjectivePulmonary radiotherapy has been reported to increase a risk of pneumonopathy, including pneumonitis and secondary pneumonia, however evidence from population-based studies is lacking. The present study intended to explore whether postoperative irradiation increases occurrence of severe pneumonopathy in lung cancer patients.Design, setting and participantsThe nationwide population-based study analysed the Taiwan National Health Insurance Research Database (covered >99% of Taiwanese) in a real-world setting. From 2000 to 2010, 4335 newly diagnosed lung cancer patients were allocated into two groups: surgery-RT (n=867) and surgery-alone (n=3468). With a ratio of 1:4, propensity score was used to match 11 baseline factors to balance groups.Interventions/exposure(s)Irradiation was delivered to bronchial stump and mediastinum according to peer-audited guidelines.Outcome(s)/measure(s)Hospitalised pneumonia/pneumonitis-free survival was the primary end point. Risk factors and hazard effects were secondary measures.ResultsMultivariable analysis identified five independent risk factors for hospitalised pneumonopathy: elderly (>65 years), male, irradiation, chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD). Compared with surgery-alone, a higher risk of hospitalised pneumonopathy was found in surgery-RT patients (HR, 2.20; 95% CI, 1.93–2.51; 2-year hospitalised pneumonia/pneumonitis-free survival, 85.2% vs 69.0%; both p<0.0001), especially in elderly males with COPD and CKD (HR, 13.74; 95% CI, 6.61–28.53; p<0.0001). Unexpectedly, we observed a higher risk of hospitalised pneumonopathy in younger irradiated-CKD patients (HR, 13.07; 95% CI, 5.71–29.94; p<0.0001) than that of elderly irradiated-CKD patients (HR, 4.82; 95% CI, 2.88–8.08; p<0.0001).ConclusionsA high risk of hospitalised pneumonopathy is observed in irradiated patients, especially in elderly males with COPD and CKD. For these patients, close clinical surveillance and aggressive pneumonia/pneumonitis prevention should be considered. Further investigations are required to define underlying biological mechanisms, especially for younger CKD patients.
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Setiawan, Fathurrahman, Matthieu Lemaire, Hyunsuk Lee, Peng Zhang, and Deokjung Lee. "VVER-1000 BENCHMARK INTERPRETATION WITH MONTE CARLO CODE MCS." EPJ Web of Conferences 247 (2021): 10006. http://dx.doi.org/10.1051/epjconf/202124710006.
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An interpretation of the NEA-1517/82 benchmark from the SINBAD shielding database has been conducted with the MCS Monte Carlo code developed at the Ulsan National Institute of Science and Technology (UNIST) and the ENDF/B-VII.1 nuclear data library. The NEA-1517/82 benchmark corresponds to experiments on a VVER-1000 critical mock-up (thermal reactor with hexagonal fuel lattice) inside the LR-0 research reactor operated by the Nuclear Research Institute (NRI) in the Czech Republic. A new 3D model of the VVER-1000 mock-up core is developed for MCS based on the SINBAD documentation. The model includes the top and bottom parts of fuel pins, the spacer grids and core components: baffle, barrel, downcomer, tank, reactor pressure vessel (RPV) and concrete block used as biological shielding. The quality of the model is verified first by code/code comparison of MCS against MCNP6 for criticality and power distributions (pin-by-pin and axial power). The validation of MCS results is then performed against six critical cases, 260 measured pin powers and benchmark calculations of the axial power profile. Finally, a comparison of calculated and measured neutron spectra inside the mock-up core is presented as a preliminary study for upcoming works on the deep-penetration shielding capability of MCS.
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Lazecký, Milan, Emma Hatton, Pablo J. González, Ivana Hlaváčová, Eva Jiránková, František Dvořák, Zdeněk Šustr, and Jan Martinovič. "Displacements Monitoring over Czechia by IT4S1 System for Automatised Interferometric Measurements Using Sentinel-1 Data." Remote Sensing 12, no. 18 (September 11, 2020): 2960. http://dx.doi.org/10.3390/rs12182960.
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The Sentinel-1 satellite system continuously observes European countries at a relatively high revisit frequency of six days per orbital track. Given the Sentinel-1 configuration, most areas in Czechia are observed every 1–2 days by different tracks in a moderate resolution. This is attractive for various types of analyses by various research groups. The starting point for interferometric (InSAR) processing is an original data provided in a Single Look Complex (SLC) level. This work represents advantages of storing data augmented to a specifically corrected level of data, SLC-C. The presented database contains Czech nationwide Sentinel-1 data stored in burst units that have been pre-processed to the state of a consistent well-coregistered dataset of SLC-C. These are resampled SLC data with their phase values reduced by a topographic phase signature, ready for fast interferometric analyses (an interferogram is generated by a complex conjugate between two stored SLC-C files). The data can be used directly into multitemporal interferometry techniques, e.g., Persistent Scatterers (PS) or Small Baseline (SB) techniques applied here. A further development of the nationwide system utilising SLC-C data would lead into a dynamic state where every new pre-processed burst triggers a processing update to detect unexpected changes from InSAR time series and therefore provides a signal for early warning against a potential dangerous displacement, e.g., a landslide, instability of an engineering structure or a formation of a sinkhole. An update of the processing chain would also allow use of cross-polarised Sentinel-1 data, needed for polarimetric analyses. The current system is running at a national supercomputing centre IT4Innovations in interconnection to the Czech Copernicus Collaborative Ground Segment (CESNET), providing fast on-demand InSAR results over Czech territories. A full nationwide PS processing using data over Czechia was performed in 2017, discovering several areas of land deformation. Its downsampled version and basic findings are demonstrated within the article.
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Hsu, Yi-Min, Hsin-Yu Fang, Cheng-Li Lin, and Shwn-Huey Shieh. "The Risk of Depression in Patients with Pemphigus: A Nationwide Cohort Study in Taiwan." International Journal of Environmental Research and Public Health 17, no. 6 (March 17, 2020): 1983. http://dx.doi.org/10.3390/ijerph17061983.
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Pemphigus is a chronic dermatological disorder caused by an autoimmune response and is associated with a high proportion of comorbidities and fatalities. The aim of this study was to investigate the risk of depression in patients with pemphigus. Data were derived from the National Health Insurance Research Database recorded during the period 2000–2010 in Taiwan. Multivariate Cox proportional hazards regression models were used to analyze the data and assess the effects of pemphigus on the risk of depression after adjusting for demographic characteristics and comorbidities. Patients with pemphigus were 1.98 times more likely to suffer from depression than the control group (pemphigus, adjusted HR: 1.99, 95% CI = 1.37–2.86). People aged ≥65 years were 1.69 times more likely to suffer from depression than those aged 20–49 years (≥65 years, adjusted HR: 1.42, 95% CI = 0.92–2.21). Female and male patients with pemphigus were respectively 2.02 and 1.91 times more likely to suffer from depression than the control group (female, adjusted HR: 2.09, 95% CI = 1.24–3.54; male, adjusted HR: 1.87, 95% CI = 0.97–3.60). People with HTN, hyperlipidemia, asthma/COPD, and chronic liver disease were respectively 1.73, 2.3, 2.2, and 1.69 times more likely to suffer from depression than those without these comorbidities (HTN, adjusted HR: 0.75, 95% CI = 0.41–1.42; hyperlipidemia, adjusted HR: 1.48, 95% CI = 0.78–2.82; asthma/COPD, adjusted HR: 1.4, 95% CI = 0.72–2.69; and chronic liver disease, adjusted HR: 1.61, 95% CI = 1.07–2.43). There was a significant association between pemphigus and increased risk of depression. Female patients had a higher incidence of depression.
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Hesselink, Gijs, Julie Johnson, Paul Batalden, Michelle Carlson, Wytske Geense, Stef Groenewoud, Sylvester Jones, et al. "‘Reframing Healthcare Services through the Lens of Co-Production’ (RheLaunCh): a study protocol for a mixed methods evaluation of mechanisms by which healthcare and social services impact the health and well-being of patients with COPD and CHF in the USA and The Netherlands." BMJ Open 7, no. 9 (September 2017): e017292. http://dx.doi.org/10.1136/bmjopen-2017-017292.
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IntroductionThe USA lags behind other high-income countries in many health indicators. Outcome differences are associated with differences in the relative spending between healthcare and social services at the national level. The impact of the ratio and delivery of social and healthcare services on the individual patient’s health is however unknown. ‘Reframing Healthcare Services through the Lens of Co-Production’ (RheLaunCh) will be a cross-Atlantic comparative study of the mechanisms by which healthcare and social service delivery may impact patient health with chronic conditions. Insight into these mechanisms is needed to better and cost-effectively organise healthcare and social services.MethodsWe designed a mixed methods study to compare the socioeconomic background, needs of and service delivery to patients with congestive heart failure and chronic obstructive pulmonary disease in the USA and the Netherlands. We will conduct: (1) a literature scan to compare national and regional healthcare and social service systems; (2) a retrospective database study to compare patient’s socioeconomic and clinical characteristics and the service use and spending at the national, regional and hospital level; (3) a survey to compare patient perceived quality of life, receipt and experience of service delivery and ability of these services to meet patient needs; and (4) multiple case studies to understand what patients need to better govern their quality of life and how needs are met by services.Ethics and disseminationEthics approval was granted by the ethics committee of the Radboud University Medical Center (2016–2423) in the Netherlands and by the Human Subjects Research Committee of the Hennepin Health Care System, Inc. (HSR #16–4230) in the USA. Multiple approaches will be used for dissemination of results, including (inter)national research presentations and peer-reviewed publications. A website will be established to support the development of a community of practice.
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Konda, Manojna, Arya Mariam Roy, Anusha Jillella, Akshay Goel, and Appalanaidu Sasapu. "Potentially Modifiable Risk Factors for 30‐Day Readmission in Adults with Sickle Cell Disease: A National Database Study." Blood 134, Supplement_1 (November 13, 2019): 4857. http://dx.doi.org/10.1182/blood-2019-132215.
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Introduction The overall impact of morbidity related to sickle cell disease (SCD) is enormous due to decreased quality of life, high health care utilization and immense financial strain on the patients and health care system. Patients with SCD have also been found have high hospital readmission rates compared to other medical conditions, further leading to increased health care burden. The objective of this study was to explore the common reasons, healthcare utilization and identify modifiable factors associated with 30-day readmission in patients with SCD using the most recently available national data in the United States. Methods Cohort selection. 2016 Nationwide Readmission Database (NRD) from the Healthcare Cost and Utilization Project (HCUP) by the Agency for Healthcare Research and Quality (AHRQ) was queried for analysis. NRD captures discharge data from 22 states, representing about 50% of all hospitalizations in the United States. National estimates can be produced by using sampling weights provided by the NRD. Patients with SCD were identified by using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis code D57. Patients younger than 18 years were excluded. Readmission was defined as any admission within 30 days of index hospitalization discharge. Statistical Analysis. Sampling weights were used throughout all calculations, facilitating appropriate national projections. Percentages in all figures reflect national estimates. Chi-square test and Student's t-test were used for univariate analysis. Multivariable logistic regression analysis was done to determine independent predictors of 30-day readmission in patients with SCD. Data analyses was performed using SAS v9.4 (SAS Institute, Cary, NC). Results In a total of 83,692 hospitalizations for SCD in 2016, 15,880 (18.9%) had at least one 30-day readmission and 40% of the readmissions occurred within the first two weeks of discharge. The most common reason for 30-day readmission was due to complications of SCD (29.8%) with sickle-cell pain crisis (18.4%) being the most frequent one. The other common causes for readmission were sepsis (10.3%), cardiac related (9.7%), respiratory failure (6.2%), renal failure (4.3%) and mood related (4.04%). Female sex (P<0.001), younger age (p<0.01) and patients with public insurance (P <.001) were more likely to be readmitted. Multivariable logistic regression analysis showed age 31-45 years (OR 1.28, 95% CI 1.16 - 1.40, P<0.01), alcohol abuse (OR 1.39, 95% CI 1.17 - 1.66, P<0.001), opioid abuse (OR 2.66, 95% CI 2.34 - 3.02, P<0.0001), depression (OR: 1.59, 95% CI 1.45 - 1.73, P<0.01), substance abuse (OR: 1.35, 95% CI 1.21 -1.50, P<0.001), tobacco use (OR: 1.35, 95% CI 1.24 - 1.46, P<0.01), heart failure (OR: 1.81, 95% CI 1.66 - 1.97, P<0.002), COPD (OR: 1.74, 95% CI 1.55 - 1.96, P<0.03) were significantly associated with 30-day readmission while adjusting other co-morbidities. The mean cost of readmission was an additional $39,259 (±182). Conclusion This study showed that the 30-day readmission rate in patients with SCD in 2016 has decreased to less than 20% compared to previously published rates (31.9%, Elixhauser A, 2013). While this decrease in readmission rate is encouraging, further studies are needed to investigate the reasons for this trend. Several modifiable risk factors were identified in this study such as alcohol, tobacco, opioid, substance abuse and depression which can be addressed to potentially bring down the readmission rate further and improve patient care. Disclosures No relevant conflicts of interest to declare.
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Jakubinsky, J., R. Bacova, E. Svobodova, P. Kubicek, and V. Herber. "Small watershed management as a tool of flood risk prevention." Proceedings of the International Association of Hydrological Sciences 364 (September 16, 2014): 243–48. http://dx.doi.org/10.5194/piahs-364-243-2014.
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Abstract. According to the International Disaster Database (CRED 2009) frequency of extreme hydrological situations on a global scale is constantly increasing. The most typical example of a natural risk in Europe is flood – there is a decrease in the number of victims, but a significant increase in economic damage. A decrease in the number of victims is caused by the application of current hydrological management that focuses its attention primarily on large rivers and elimination of the damages caused by major flood situations. The growing economic losses, however, are a manifestation of the increasing intensity of floods on small watercourses, which are usually not sufficiently taken into account by the management approaches. The research of small streams should focus both on the study of the watercourse itself, especially its ecomorphological properties, and in particular on the possibility of flood control measures and their effectiveness. An important part of society’s access to sustainable development is also the evolution of knowledge about the river landscape area, which is perceived as a significant component of global environmental security and resilience, thanks to its high compensatory potential for mitigation of environmental change. The findings discussed under this contribution are based on data obtained during implementation of the project "GeoRISK" (Geo-analysis of landscape level degradation and natural risks formation), which takes into account the above approaches applied in different case studies – catchments of small streams in different parts of the Czech Republic. Our findings offer an opportunity for practical application of field research knowledge in decision making processes within the national level of current water management.
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Senan, Suresh, Naomi E. Verstegen, David Palma, George Rodrigues, Frank J. Lagerwaard, A. van der Elst, R. Mollema, et al. "Stages I-II non-small cell lung cancer treated using either lobectomy by video-assisted thoracoscopic surgery (VATS) or stereotactic ablative radiotherapy (SABR): Outcomes of a propensity score-matched analysis." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): 7009. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.7009.
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7009 Background: VATS procedures are increasingly used in early-stage NSCLC. As high local control rates are also seen with stereotactic ablative radiotherapy (SABR), we performed a propensity score-matched analysistocompare loco-regional control (LRC) after both treatments. Methods: Patients with stage I-II NSCLC treated at 6 hospitals (1 university and 5 regional hospitals) with VATS lobectomy were eligible. Details of SABR patients were obtained from a single-institutional database. All VATS-lobectomies were performed in accordance with ESTS guidelines. Patients were matched using propensity scores based on cTNM, age, gender, Charlson comorbidity score, lung function and performance score. Matching was performed blinded to all outcomes. Excluded were: synchronous lung tumors, COPD GOLD class 4 or history of prior lung cancer. A total of 86 VATS- and 527 SABR patients were eligible for matching (1:1 ratio, caliper distance of 0.025 without replacement). Loco-regional failure was defined as recurrence in/adjacent to the radiation planning target volume or surgical margins, the ipsilateral hilum or mediastinum. Recurrences were either biopsy-confirmed or PET-positive and reviewed by a tumor board. Patients upstaged during VATS and those developing recurrence were treated in accordance with national guidelines. Results: The matched cohort consisted of 128 patients with cT1-3N0 NSCLC following SABR (n=64) or VATS-lobectomy (n=64). Median follow-up was 30 and 16 months, respectively. The groups were well matched on baseline variables. SABR patients had better LRC rates at 1- and 3-years (96.8% and 93.3% vs. 86.9% and 82.6%, respectively, p= .03). Three-year progression-free survival (PFS) did not significantly differ after SABR (79.3% versus 63.2%, p = .09). Distant recurrence rates and overall survival (OS) did not significantly differ. Conclusions: Although loco-regional control was superior after SABR compared to VATS-lobectomy, PFS and OS did not differ at this time-point. Our findings support the current randomized controlled trial evaluating both treatments (ACOSOG Z4099).
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Abbasi, Saqib, Bassel Nazha, Elias Moussaly, Monika Manchanda, and Jean Paul Atallah. "Febrile neutropenia in the nationwide inpatient sample: In-hospital outcomes and impact of cormobidities in 2007-2012." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e18103-e18103. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e18103.
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e18103 Background: Febrile Neutropenia (FN) is associated with significant in-patient morbidity and mortality. The goal of this study is to describe the in-patient outcomes of febrile neutropenia as well as the impact of comorbid conditions through a large national dataset. Methods: Using the Nationwide Inpatient Sample (NIS) for years 2007-2012, FN was defined as ICD-9 codes 288.0x for a primary discharge diagnosis of neutropenia in conjunction with 780.61 and 780.6 for fever in cancer patients. Linear regression analysis assessed for annual trends in in-hospital mortality, length of stay (LOS), and cost of stay (COS). Seasonal variations in admission rates were evaluated using ANOVA. We employed univariate and multivariate logistic regression analysis to elucidate the relationship between common comorbid conditions and mortality. Results: Among 55,253 cancer patients (weighted N = 264,384) admitted with FN between 2007 and 2012, there is a mean decrease in LOS from 5.78 to 5.47 days (p < 0.0001), an increase in COS from $33,939 to $41,395 (p < 0.0001), and a 12-15% drop in hospital admissions in winter months. Mortality rate is unchanged annually (1.06-1.28%). Univariate analysis identified an increased risk of mortality associated with atrial fibrillation (OR = 4.06), coronary artery disease (OR = 2.09), congestive heart failure (OR 4.39), hypertension (1.20), COPD (OR 2.33) pancytopenia (OR 1.81), and adrenal insufficiency (OR 5.32). All remained significant on multivariate analysis, except hypertension and diabetes mellitus. Conclusions: Between 2007-2012, FN had a slight decrease in length of stay, unchanged in-patient mortality and a 22% increase in hospitalization costs. Our results are in line with recently presented analyses of the same database (Blood 2016 128:4762, Blood 2016 128:5904). Comorbid conditions are associated with higher in-patient mortality, with up to 5-fold increase for those with atrial fibrillation, congestive heart failure and adrenal insufficiency. Clinicians should consider the significant impact of such comorbidities. Additional vigilance and potentially prophylactic antibiotics following treatment should be considered in affected patients.
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Cullen, Jennifer, Huai-Ching Kuo, Lauren Hurwitz, Inger L. Rosner, Timothy Rebbeck, Anthony Victor D'Amico, and Grace L. Lu-Yao. "Predictors of post-surgical race-specific prostate cancer progression." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 5048. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.5048.
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5048 Background: Disparity in prostate cancer (CaP) incidence and mortality for African American (AA) versus Caucasian American (CA) men may reflect tumor biology, comorbidity, treatment, follow-up care, and/or health care access. In a racially diverse cohort of patients undergoing radical prostatectomy (RP), this study examined how race, comorbidity, and PSA doubling time (PSADT) impact CaP progression. Methods: Enrollees in the Center for Prostate Disease Research (CPDR) Multi-Center National Database from 1989-2014 who underwent RP within 12 months of CaP diagnosis were eligible. Biochemical recurrence (BCR) was defined as PSA ≥0.2 ng/mL post-RP. Comorbid conditions included coronary artery disease (CAD), cerebral vascular incident (CVI), Type II diabetes (DB), hypertension (HT), elevated cholesterol (EC), lung disease (COPD), prostatitis (PS), renal insufficiency (RI) and other cancer (OC). Multivariable Cox proportional hazards (PH) analysis was used to examine comorbid conditions (yes vs. no) and PSADT ( < 3, 3-8.9, 9-14.9, and ≥15 mos) to predict BCR, controlling for age at RP, D’Amico risk stratum, pathology features, and adjuvant treatment. Results: A total of 6,785 patients were eligible; 22% AA and 78% CA. Median age and follow-up was 62 and 6.1 years, respectively. Across race, comparable median follow-up time, distributions of pathologic features and adjuvant treatments were observed. However, AA vs. CA patients had greater HT (53 vs. 39% p < 0.0001), DB (17 vs. 7%, p < 0.0001), and RI (3 vs. 1%, p = 0.002). Alternatively, CA vs. AA patients had greater CVD (10 vs. 7%, p = 0.0008) and OC (3 vs. 0.5%, p < 0.0001). Cox PH analysis showed poorer BCR-free survival for AA vs. CA men (HR = 1.28, CI = 1.11, 1.48, p = 0.0009) adjusting for D’Amico risk stratum, pathology, and treatment. PSADT, not comorbidity, was a critical predictor of BCR, with poorest outcome at extremes: HR PSADT < 3 vs. > = 15 months = 41.5, CI = 33.6, 51.3, p < 0.0001). Conclusions: Despite comparable health care access and distribution in clinical risk stratum and pathology features, race persisted in predicting poor CaP outcome. Disparate comorbidity for AA and CA men did not eliminate this difference. PSADT remained the most striking determinant of poor BCR-free survival.
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Sidhu, Jasdeep Singh, Jeevanjot Kaur Virk, Shivani Handa, Amrendra Mandal, and Sridevi Rajeeve. "Risk Factors and Trends for Incidence of Acute Coronary Syndrome after Hematopoietic Stem Cell Transplant - a 15-Year Experience with National Inpatient Sample." Blood 134, Supplement_1 (November 13, 2019): 4564. http://dx.doi.org/10.1182/blood-2019-127487.
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Background:Significant improvement has been noted in the outcome of patients with advanced hematologic malignancies with the advances in hematopoietic cell transplantation (HCT) techniques. However, it has been observed that patients receiving HCT have increased risk of cardiovascular disease (CVD) over time with increased risk of cardiovascular mortality. Materials and Methods:This was a retrospective observational analysis. We queried the National Inpatient Sample database from 1998 to 2012 for patients aged ≥18 years who had received HCTin the past and were admitted for non-ST-elevation acute coronary syndrome (NSTE-ACS) or ST-elevation myocardial infarction (STEMI). We performed univariate logistic regression followed by multivariate logistic regression analysis to study various demographic factors and comorbiditiesand temporal trends of ACS in these patients. Results:A total of 150,072 patients with prior history of HCT were identified, out of which 952 hospitalizations were for ACS.47.16% of these patients underwent Percutaneous CoronaryIntervention.Mean age for ACS patients was 56.98 years and 71.75% patients were male. The demographic factors found to significantly affect the incidence of ACS were increasing Age (OR 1.02, p=0.01) and Insurance(Medicare as reference)[Medicaid(OR 0.3, p=0.04), private(OR 1.66, p=0.01). Charlson Comorbidity Index (CCI) had significant correlation with incidence of ACS (CCI=1 as reference) [CCI=2(OR 0.12, p=0.00), CCI³3(OR 0.60, p=0.01)]. The Medical comorbidities found to significantly affect the outcome were Congestive Heart Failure (OR 1.53, p=0.04), COPD(OR 0.54, p=0.02), smoking(OR 2.96, p=0.00), underlying CAD (OR 39.65, p=0.00) and Pulmonary Hypertension (OR 4.01, p=0.00). A trend analysis for Incidence of ACS in patients with History of HCT showed overall decline in ACS incidence which was found to be statistically significant. (Trend p-Value 0.003). Conclusion:Our study identifiedvarious factors affecting incidence of ACS in HCT patients. We also discoveredan overall downward trend in incidence of ACSin HCT patients.Further studies need to be conducted to confirm these findings. Disclosures Rajeeve: ASH-HONORS Grant: Research Funding.
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Haba, Julia, Clara Haba, and Julia Osca-Lluch. "Co-authorship networks and institutional collaboration in works about Learning, Teaching and Education Leadership." Contemporary Educational Researches Journal 6, no. 4 (February 8, 2017): 175–88. http://dx.doi.org/10.18844/cerj.v6i4.931.
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Bibliometric indicators, based on the statistical analysis of quantitative data from scientific literature, constitute currently in an essential tool for the study of research activity. In the last years, the use of bibliometric indicators as a complement to other scientific indicators to analyse the research situation of a country, its evolution in its time and their position in the international context, has been extended. Collaboration is a characteristic feature of modern science and it is very difficult to measure this aspect. Nevertheless, it is widely accepted to count the combined signatures done by two or more authors, with the analysis of the institutional affiliation mentions and geographical provenance of these authors, constitute a very reasonable and coherent way to estimate this collaboration. To know roughly the peculiarities of patterns of institutional collaboration of researchers working on issues of Learning, Teaching and Education Leadership, we have analysed the institutions where these researchers have worked. Two types of collaboration have been distinguished: national collaboration (between institutions from the same country) and international (between institutions from different countries), using as source of information the communications submitted at the World Conference on Learning, Teaching and Education Leadership (WCLTA) included in the database Web of Science (WoS). The programs used to build collaborative networks were Pajek and Ucinet.A remarkable characteristic is that even if 73% of the works done by co-authorship (done by 2 or more authors), only in 6.19% there was an institutional collaboration. Works done by institutional collaboration move from a range of 52 papers done by institutions in two different countries up to 4 works done by institutions from four countries. The countries with a higher rate of national collaboration are Turkey, Spain, Romania, Czech Republic and People’s R. China. Only 0.80% of the works were made in international institutional collaboration by researchers working in 14 different countries. Of all these country, Turkey, Spain, Italy and Portugal standout being the countries that have participated in a larger number of works carried out with researchers and institutions from other countries.
Key works: institutional collaboration, Learning, Teaching and Education Leadership, Collaboration networks, scientific production
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Huang, Shih-Ting, Chen-Li Lin, Tung-Min Yu, Chia-Hung Kao, Wen-Miin Liang, and Tzu-Chieh Chou. "Risk, Severity, and Predictors of Obstructive Sleep Apnea in Hemodialysis and Peritoneal Dialysis Patients." International Journal of Environmental Research and Public Health 15, no. 11 (October 26, 2018): 2377. http://dx.doi.org/10.3390/ijerph15112377.
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Our study aimed to determine the incidence and severity of obstructive sleep apnea (OSA) in patients with end-stage renal disease (ESRD) and also whether different dialysis modalities confer different risk and treatment response for OSA. We used Taiwan’s National Health Insurance Research Database for analysis and identified 29,561 incident dialysis patients as the study cohort between 2000 and 2011. Each dialysis patient was matched with four non-dialysis control cases by age, sex, and index date. Cox regression hazard models were used to identify the risk of OSA. The incidence rate of OSA was higher in the peritoneal dialysis (PD) cohort than the hemodialysis (HD) and control cohort (18.9, 7.03 vs. 5.5 per 10,000 person-years, respectively). The risk of OSA was significantly higher in the PD (crude subhazard ratio (cSHR) 3.50 [95% CI 2.71–4.50], p < 0.001) and HD cohort (cSHR 1.31 [95% CI 1.00–1.72], p < 0.05) compared with the control cohort. Independent risk factors for OSA in this population were age, sex, having coronary artery disease (CAD), hyperlipidemia, chronic obstructive pulmonary disease (COPD), and hypertension. Major OSA (MOSA) occurred in 68.6% in PD and 50.0% in HD patients with OSA. In the PD subgroup, the incidence of mortality was significantly higher in OSA patients without continuous positive airway pressure (CPAP) treatment compared with OSA patients undergoing CPAP treatment. The results of this study indicate that ESRD patients were at higher risk for OSA, especially PD patients, compared with control. The severity of OSA was higher in PD patients than HD patients. Treatment of MOSA with CPAP was associated with reduced mortality in PD patients.
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Yang, Shang-Feng, Chia-Jen Liu, Wu-Chang Yang, Chao-Fu Chang, Chih-Yu Yang, Szu-Yuan Li, and Chih-Ching Lin. "The Risk Factors and the Impact of Hernia Development on Technique Survival in Peritoneal Dialysis Patients: A Population-Based Cohort Study." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 35, no. 3 (May 2015): 351–59. http://dx.doi.org/10.3747/pdi.2013.00139.
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ObjectivesThere is a lack of consensus on the risk factors for hernia formation, and the impact on peritoneal dialysis (PD) survival has seldom been studied.MethodsThis was a population-based study and all collected data were retrieved from the National Health Insurance Research Database of Taiwan. Patients who commenced PD between January 1998 and December 2006 were screened for inclusion. Multiple logistic regression and Cox proportional hazards models were applied to estimate the predictors for hernia formation and determine the predictors of PD withdrawal.ResultsA total of 6,928 PD patients were enrolled and followed until December 2009, with 631 hernia events and 391 hernioplasties being registered in 530 patients (7.7%). The incidence rate was 0.04 hernias/patient/year. Longer PD duration (per 1 month increase, hazard ratio (HR) 1.019) and history of mitral valve prolapse (MVP) (HR 1.584) were independent risk factors for hernia formation during PD, and female gender (HR 0.617) was a protective factor. On the other hand, there were 4,468 PD withdrawals, with cumulative incidence rates of 41% at 1 year, 66% at 3 years, and 82% at 5 years. Independent determinants for cumulative PD withdrawal included hernia formation during PD (HR 1.154), age (per 1 year increase, HR 1.014), larger dialysate volume (per 1 liter increase, HR 0.496), female gender (HR 0.763), heart failure (HR 1.092), hypertension (HR 1.207), myocardial infarction (HR 1.292), chronic obstructive pulmonary disease (COPD) (HR 1.227), cerebrovascular accident (CVA) (HR 1.364), and history of MVP (HR 0.712)ConclusionsProlonged PD duration was a risk factor for hernia formation, and female gender was protective. Hernia formation during PD therapy may increase the risk of PD withdrawal.
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Decarriere, G., J. Pastor, D. Demoulin, G. Mouterde, C. Lukas, B. Combe, G. Mercier, J. Morel, and C. Daien. "OP0214 IMPACT OF A MULTI-MORBIDITY SCREENING AND PREVENTION PROGRAM IN CHRONIC INFLAMMATORY RHEUMATIC DISEASES ON THE ONE-YEAR HOSPITALIZATION RATE BASED ON AN ANALYSIS OF THE FRENCH NATIONAL HEALTH DATABASE." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 128.2–129. http://dx.doi.org/10.1136/annrheumdis-2021-eular.3454.
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Background:A screening program for multimorbidities started in 2014 at the Montpellier University Hospital for primary prevention in patients with chronic inflammatory rheumatic diseases (IRD).Objectives:The objective of this work was to assess the impact of this program on morbidity by comparing the hospitalization rate of those patients in the year following the screening to the one of patients with IRD who did not benefit from this program.Methods:Patients with IRD who benefit from the screening program in 2015, 2016 and 2017 were identified in the French national health database PMSI and matched to 3 controls living in the same area on age, sex, type of IRD, use of intravenous (IV) biologic (b) DMARDs and index date. The exclusion criteria were subjects in secondary prevention identified as history of myocardial infarction in the previous 5 years or use of antiplatelet therapy. The primary outcome was the rate of all-cause hospitalization in the following year. The secondary endpoints were hospitalizations for another reason than IRD (“non-IRD”) including those for cardiovascular [CV] events and major fractures. Hospitalization rates were compared between the two groups in the year after screening (or index date) and also between the year preceding screening and the year after for each group. Univariate and multivariate odds ratios (CI95%) were calculated, taking into account the medical history (hypertension, diabetes, heart failure, CV disease, COPD, major fractures in the 5 years preceding the index date) and hospitalizations in the previous year.Results:486 patients were identified and matched with 1458 controls. 67.08% had rheumatoid arthritis and 21.81% spondyloarthritis; 7% of them had IV bDMARDs. Unscreened patients had more hypertension (19% vs 10.1%), diabetes (9% vs 4.9%), heart failure (2.3% vs 0.4%) and “non-IRD” hospitalizations (78.5% vs 72.2%) in the 5 years preceding the index date. In the year following the index date, the percentages of “all causes” and “non-IRD” hospitalizations were significantly higher in non-screened than in screened patients (n = 1944, 64.8% versus 51%, Chi2 test, p <0.001; and 47.1% versus 37.9%, p <0.001 respectively). 17 (1.17%) cardiovascular events occurred in non-screened versus 2 (0.41%) in screened patients (n = 1944, Chi2 test, p = 0.14). There was no difference in the occurrence of CV events or major fractures between the 2 groups. In multivariate analysis, screening was associated with a 49% (0.51 [0.41-0.64]) reduction in “all causes” hospitalization and a 27% (0, 73 [0.58-0.91]) decrease in “non-IRD” hospitalization, with no difference for CV or fracture cardiological events. The risk factors associated with “non-IRD” hospitalization were: history of “non-IRD” hospitalization in the previous year (2.26 [1.63-3.13]), IV bDMARDs (1.69 [1, 14-2.53]) and age> 70 years (1.44 [1.02-2.03] vs <50 years). Hospitalization in the previous year for “all causes” or “non-IRD” was associated with rehospitalization in the following year in the non-screened group (p <0.001), but not in the screened group (p = 0.750 and p = 0.066 respectively).Conclusion:Our screening and prevention program was associated with a reduction in hospitalizations in the following year and a decrease in the risk of re-hospitalization compared to unscreened patients with IRD. This suggests a positive impact of performing systematic screening for multi-morbidities in IRD patients.Acknowledgements:We thank Pfizer for their financial supportDisclosure of Interests:guillaume decarriere: None declared, Jenica PASTOR: None declared, David DEMOULIN: None declared, Gael Mouterde Speakers bureau: Bristol-Myers Squibb; Gilead; Janssen; Lilly; Merck; Novartis; Pfizer; Roche-Chugai; and Sanofi, Grant/research support from: Pfizer, Cédric Lukas Speakers bureau: Abbvie, Amgen, Janssen, Lilly, MSD, Novartis, Pfizer, Roche-Chugai, UCB, Consultant of: Abbvie, Amgen, Janssen, Lilly, MSD, Novartis, Pfizer, Roche-Chugai, UCB, Grant/research support from: Pfizer, Novartis and Roche-Chugai, Bernard Combe Speakers bureau: AbbVie; Bristol-Myers Squibb; Gilead; Janssen; Lilly; Merck; Novartis; Pfizer; Roche-Chugai; and Sanofi, Consultant of: AbbVie; Bristol-Myers Squibb; Gilead; Janssen; Lilly; Merck; Novartis; Pfizer; Roche-Chugai; and Sanofi, Grant/research support from: Novartis, Pfizer, and Roche-Chugai, Grégoire Mercier: None declared, Jacques Morel Speakers bureau: AbbVie; Bristol-Myers Squibb; Gilead; Janssen; Lilly; Merck; Novartis; Pfizer; Roche-Chugai; and Sanofi, Consultant of: AbbVie; Bristol-Myers Squibb; Gilead; Janssen; Lilly; Merck; Novartis; Pfizer; Roche-Chugai; and Sanofi, Grant/research support from: Novartis, Pfizer, and Roche-Chugai, Claire Daien Speakers bureau: Pfizer, Roche-Chugai, Fresenius, BMS, MSD, Lilly, Novartis, Galapagos, Consultant of: Abivax, Abbbvie, BMS, Roche-Chugai, Grant/research support from: Pfizer, roche-chugai, fresenius, MSD
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Smith, T. Alexander, Sumit Verma, Yi Liu, Slaven Sikirica, and Nora Anita Janjan. "Retrospective real-world comparison of clinical and economic burden between first-generation and second-generation tyrosine kinase inhibitors (TKIs) in chronic myeloid leukemia (CML)." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e19030-e19030. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e19030.
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e19030 Background: TKIs are the standard of care for the treatment of chronic phase CML under National Comprehensive Cancer Network (NCCN) guidelines. Imatinib is recommended as a first-generation TKI (1GTKI), and bosutinib, dasatinib, nilotinib, and ponatinib are recommended as second-generation TKIs (2GTKIs). TKIs are associated with high healthcare resource utilization (HRU) and costs, although literature is limited comparing 1GTKI and 2GTKIs in a U.S. population. Methods: Using the Veteran’s Health Administration (VHA) database between April 1, 2013 and March 31, 2018, the study included patients aged ≥18 years with ≥1 medical claim for CML and ≥1 prescription claim for a TKI on or after the initial CML diagnosis date during the identification period (October 1, 2014 to September 30, 2017); the first TKI prescription claim was defined as the index date. Inverse probability of treatment weighting (IPTW) minimized potential confounding; included variables were age, race, Quan-Charlson Comorbidity Index (CCI) score, and CHA2DS2-VASc Score. Medication possession ratio (MPR) assessed adherence to index TKI; optimal adherence was defined as MPR ≥80%. Results: 944 patients were included: 78.9% on 1GTKI and 21.1% on 2GTKI. Mean age was 62.21 years (SD:18.8); 77.2% were white. At baselinetients on 1GTKI had a higher comorbidity burden than 2GTKIs: COPD (19.7% vs. 8%; p < 0.01), anemia (17.7% vs. 11.1%; p = 0.02), GI symptoms (28.5% vs. 18.6%; p < 0.01), cardiac dysrhythmias (15.6% vs. 7.5%; p < 0.01), coronary artery disease (26.3% vs. 13.6%; p < 0.01), hypertension (55.7% vs. 43.2%; p < 0.01) and CHA2DS2-VASc Score (2.2 vs 1.6; p < 0.01). Optimal adherence was higher with 1GTKI (69.6% vs. 62.2%; p = 0.04), although this was not statistically significant when mean MPR was compared. During follow-up, no difference between 1GTKI and 2GTKIs patients occurred with cardiac-related risk factors or CHA2DS2-VASc Score. Compared to 1GTKI, 2GTKIs had lower medical (inpatient and outpatient) costs ($3,162 vs. $3,906; p = 0.04) but higher all-cause pharmacy cost ($7,214 vs. $3,895; p < 0.01) due to imatinib becoming a generic drug during the study period. CML-related ($2,260 vs. $1,640, p < 0.01) and cardiac-related medical costs ($1,365 vs. $665, p < 0.01) were significantly higher in 1GTKI vs. 2GTKIs patients. Conclusions: Adherence to TKI therapy was suboptimal for both 1GTKI and 2GTKIs. 2GTKIs incurred lower medical cost in comparison to 1GTKI. Differences in total all-cause cost was primarily driven by pharmacy cost of TKIs. These results show that, beyond the cost of the TKI, using a 2GTKIs in the first-line can lead to cost offsets when compared to imatinib.
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Lin, Shih-Yi, Meng-Hsuen Hsieh, Cheng-Li Lin, Meng-Ju Hsieh, Wu-Huei Hsu, Cheng-Chieh Lin, Chung Y. Hsu, and Chia-Hung Kao. "Artificial Intelligence Prediction Model for the Cost and Mortality of Renal Replacement Therapy in Aged and Super-Aged Populations in Taiwan." Journal of Clinical Medicine 8, no. 7 (July 9, 2019): 995. http://dx.doi.org/10.3390/jcm8070995.
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Background: Prognosis of the aged population requiring maintenance dialysis has been reportedly poor. We aimed to develop prediction models for one-year cost and one-year mortality in aged individuals requiring dialysis to assist decision-making for deciding whether aged people should receive dialysis or not. Methods: We used data from the National Health Insurance Research Database (NHIRD). We identified patients first enrolled in the NHIRD from 2000–2011 for end-stage renal disease (ESRD) who underwent regular dialysis. A total of 48,153 Patients with ESRD aged ≥65 years with complete age and sex information were included in the ESRD cohort. The total medical cost per patient (measured in US dollars) within one year after ESRD diagnosis was our study’s main outcome variable. We were also concerned with mortality as another outcome. In this study, we compared the performance of the random forest prediction model and of the artificial neural network prediction model for predicting patient cost and mortality. Results: In the cost regression model, the random forest model outperforms the artificial neural network according to the mean squared error and mean absolute error. In the mortality classification model, the receiver operating characteristic (ROC) curves of both models were significantly better than the null hypothesis area of 0.5, and random forest model outperformed the artificial neural network. Random forest model outperforms the artificial neural network models achieved similar performance in the test set across all data. Conclusions: Applying artificial intelligence modeling could help to provide reliable information about one-year outcomes following dialysis in the aged and super-aged populations; those with cancer, alcohol-related disease, stroke, chronic obstructive pulmonary disease (COPD), previous hip fracture, osteoporosis, dementia, and previous respiratory failure had higher medical costs and a high mortality rate.
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Jordan, Rachel E., Saimma Majothi, Nicola R. Heneghan, Deirdre B. Blissett, Richard D. Riley, Alice J. Sitch, Malcolm J. Price, et al. "Supported self-management for patients with moderate to severe chronic obstructive pulmonary disease (COPD): an evidence synthesis and economic analysis." Health Technology Assessment 19, no. 36 (May 2015): 1–516. http://dx.doi.org/10.3310/hta19360.
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BackgroundSelf-management (SM) support for patients with chronic obstructive pulmonary disease (COPD) is variable in its coverage, content, method and timing of delivery. There is insufficient evidence for which SM interventions are the most effective and cost-effective.ObjectivesTo undertake (1) a systematic review of the evidence for the effectiveness of SM interventions commencing within 6 weeks of hospital discharge for an exacerbation for COPD (review 1); (2) a systematic review of the qualitative evidence about patient satisfaction, acceptance and barriers to SM interventions (review 2); (3) a systematic review of the cost-effectiveness of SM support interventions within 6 weeks of hospital discharge for an exacerbation of COPD (review 3); (4) a cost-effectiveness analysis and economic model of post-exacerbation SM support compared with usual care (UC) (economic model); and (5) a wider systematic review of the evidence of the effectiveness of SM support, including interventions (such as pulmonary rehabilitation) in which there are significant components of SM, to identify which components are the most important in reducing exacerbations, hospital admissions/readmissions and improving quality of life (review 4).MethodsThe following electronic databases were searched from inception to May 2012: MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Science Citation Index [Institute of Scientific Information (ISI)]. Subject-specific databases were also searched: PEDro physiotherapy evidence database, PsycINFO and the Cochrane Airways Group Register of Trials. Ongoing studies were sourced through themetaRegister of Current Controlled Trials, International Standard Randomised Controlled Trial Number database, World Health Organization International Clinical Trials Registry Platform Portal and ClinicalTrials.gov. Specialist abstract and conference proceedings were sourced through ISI’s Conference Proceedings Citation Index and British Library’s Electronic Table of Contents (Zetoc). Hand-searching through European Respiratory Society, the American Thoracic Society and British Thoracic Society conference proceedings from 2010 to 2012 was also undertaken, and selected websites were also examined. Title, abstracts and full texts of potentially relevant studies were scanned by two independent reviewers. Primary studies were included if ≈90% of the population had COPD, the majority were of at least moderate severity and reported on any intervention that included a SM component or package. Accepted study designs and outcomes differed between the reviews. Risk of bias for randomised controlled trials (RCTs) was assessed using the Cochrane tool. Random-effects meta-analysis was used to combine studies where appropriate. A Markov model, taking a 30-year time horizon, compared a SM intervention immediately following a hospital admission for an acute exacerbation with UC. Incremental costs and quality-adjusted life-years were calculated, with sensitivity analyses.ResultsFrom 13,355 abstracts, 10 RCTs were included for review 1, one study each for reviews 2 and 3, and 174 RCTs for review 4. Available studies were heterogeneous and many were of poor quality. Meta-analysis identified no evidence of benefit of post-discharge SM support on admissions [hazard ratio (HR) 0.78, 95% confidence interval (CI) 0.52 to 1.17], mortality (HR 1.07, 95% CI 0.74 to 1.54) and most other health outcomes. A modest improvement in health-related quality of life (HRQoL) was identified but this was possibly biased due to high loss to follow-up. The economic model was speculative due to uncertainty in impact on readmissions. Compared with UC, post-discharge SM support (delivered within 6 weeks of discharge) was more costly and resulted in better outcomes (£683 cost difference and 0.0831 QALY gain). Studies assessing the effect of individual components were few but only exercise significantly improved HRQoL (3-month St George’s Respiratory Questionnaire 4.87, 95% CI 3.96 to 5.79). Multicomponent interventions produced an improved HRQoL compared with UC (mean difference 6.50, 95% CI 3.62 to 9.39, at 3 months). Results were consistent with a potential reduction in admissions. Interventions with more enhanced care from health-care professionals improved HRQoL and reduced admissions at 1-year follow-up. Interventions that included supervised or unsupervised structured exercise resulted in significant and clinically important improvements in HRQoL up to 6 months.LimitationsThis review was based on a comprehensive search strategy that should have identified most of the relevant studies. The main limitations result from the heterogeneity of studies available and widespread problems with their design and reporting.ConclusionsThere was little evidence of benefit of providing SM support to patients shortly after discharge from hospital, although effects observed were consistent with possible improvement in HRQoL and reduction in hospital admissions. It was not easy to tease out the most effective components of SM support packages, although interventions containing exercise seemed the most effective. Future work should include qualitative studies to explore barriers and facilitators to SM post exacerbation and novel approaches to affect behaviour change, tailored to the individual and their circumstances. Any new trials should be properly designed and conducted, with special attention to reducing loss to follow-up. Individual participant data meta-analysis may help to identify the most effective components of SM interventions.Study registrationThis study is registered as PROSPERO CRD42011001588.FundingThe National Institute for Health Research Health Technology Assessment programme.
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Burn, E., L. Kearsley-Fleet, K. Hyrich, M. Schaefer, D. Huschek, A. Strangfeld, J. Zavada, et al. "OP0285 TOWARDS IMPLEMENTING THE OMOP CDM ACROSS FIVE EUROPEAN BIOLOGIC REGISTRIES." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 177.2–178. http://dx.doi.org/10.1136/annrheumdis-2020-eular.3303.
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Background:The Observational and Medical Outcomes Partnerships (OMOP) common data model (CDM) provides a framework for standardising health data.Objectives:To map national biologic registry data collected from different European countries to the OMOP CDM.Methods:Five biologic registries are currently being mapped to the OMOP CDM: 1) the Czech biologics register (ATTRA), 2) Registro Español de Acontecimientos Adversos de Terapias Biológicas en Enfermedades Reumáticas (BIOBADASER), 3) British Society for Rheumatology Biologics Register for Rheumatoid Arthritis (BSRBR-RA), 4) German biologics register ‘Rheumatoid arthritis observation of biologic therapy’ (RABBIT), and 5) Swiss register ’Swiss Clinical Quality Management in Rheumatic Diseases’ (SCQM).Data collected at baseline are being mapped first. Details that uniquely identify individuals are mapped to the person table, with the observation_period table defining the time a person may have had clinical events recorded. Baseline comorbidities are mapped to the condition_occurrence CDM table, while baseline medications are mapped to the drug_exposure CDM table. This mapping is summarised in Figure 1.Figure 1.Overview of initial mappingResults:A total of 64,901 individuals are included in the 5 registries being mapped to the OMOP CDM, see table 1. The number of unique baseline conditions being mapped range from 17 in BSRBR-RA to 108 in RABBIT, while the number of baseline medications range from 26 in ATTRA to 802 in BSRBR-RA. Those registries which captured more comorbidities or medications generally allowed for these to be inputted as free text.Table 1.Summary of initial code mappingRegistryNumber of individualsNumber of mapped baseline conditionsNumber of mapped baseline medicationsATTRA5,3262626BIOBADASER6,4963051BSRBR-RA21,69517802RABBIT13,06210878SCQM18,3222633Conclusion:Due to differences in study design and data capture, the baseline information captured on comorbidities and drugs across registries varies greatly. However, these data have been mapped and mapping biologic registry data to the OMOP CDM is feasible. The adoption of the OMOP CDM will facilitate collaboration across registries and allow for multi-database studies which include data from both biologic registries and other sources of health data which have been mapped to the CDM.Disclosure of Interests:Edward Burn: None declared, Lianne Kearsley-Fleet: None declared, Kimme Hyrich Grant/research support from: Pfizer, UCB, BMS, Speakers bureau: Abbvie, Martin Schaefer: None declared, Doreen Huschek: None declared, Anja Strangfeld Speakers bureau: AbbVie, BMS, Pfizer, Roche, Sanofi-Aventis, Jakub Zavada Speakers bureau: Abbvie, UCB, Sanofi, Elli-Lilly, Novartis, Zentiva, Accord, Markéta Lagová: None declared, Delphine Courvoisier: None declared, Christoph Tellenbach: None declared, Kim Lauper: None declared, Carlos Sánchez-Piedra: None declared, Nuria Montero: None declared, Jesús-Tomás Sanchez-Costa: None declared, Daniel Prieto-Alhambra Grant/research support from: Professor Prieto-Alhambra has received research Grants from AMGEN, UCB Biopharma and Les Laboratoires Servier, Consultant of: DPA’s department has received fees for consultancy services from UCB Biopharma, Speakers bureau: DPA’s department has received fees for speaker and advisory board membership services from Amgen
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Hlavackova, Alzbeta, Jana Stikarova, Jiri Suttnar, Roman Kotlin, Pavel Majek, Leona Chrastinova, Ondrej Pastva, Jaroslav Cermak, and Jan E. Dyr. "Oxidatively Modified Serotransferrin in Refractory Anemia with Ring Sideroblasts." Blood 128, no. 22 (December 2, 2016): 5502. http://dx.doi.org/10.1182/blood.v128.22.5502.5502.
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Abstract Introduction Refractory anemia with ring sideroblasts (RARS), as a form of acquired primary sideroblastic anemia, represents about 11% of myelodysplastic syndromes (MDS) and is classified as a low risk MDS. It´s defined by the WHO as a pure dyserythropoietic disorder with presence of >15% ringed sideroblasts in the bone marrow. Abnormal expression of several genes of heme synthesis in this MDS subgroup and excessive accumulation of iron especially in mitochondria, the main place of reactive oxygen species (ROS) formation, contributes to the elevated oxidative stress. Oxidative stress is also known as one of the factors involved in the pathogenesis of MDS. High iron concentrations catalyse a Fenton reaction, where a hydroxyl radical is produced from hydrogen peroxide and causes an increase in ROS which may lead to the oxidation of DNA, lipids, and proteins, thereby causing cell damage. The aim of this study was to find a useful method for detection and identification of oxidatively modified proteins in plasma unique for RARS patients. Methods Carbonylated protein levels were determined spectrophotometrically using dinitrophenylhydrazine (DNPH) derivatization. Oxidatively modified proteins of plasma samples were derivatized with biotin hydrazide. The dialyzed biotin hydrazide labeled samples and negative controls were mixed with monomeric avidin resin. Captured carbonylated proteins were digested by trypsin and then identified by MS/MS mass spectrometry coupled to a nano-LC system. Mascot (Matrix Science, London, UK) was used for database searching (Swiss-Prot). Two unique peptides (with a higher Mascot score than the minimum for identification, P<0.05) were necessary to successfully identify a protein. Serum iron (Fe), serum ferritin, transferrin, total iron binding capacity (TIBC), and iron saturation were estimated in MDS patients in the Central National Biochemical Laboratory at the Institute of Hematology and Blood Transfusion. Results We have compared plasma of RARS patients with healthy controls or with RCMD patients. We have found significant differences in the measured carbonyl levels between all three groups (***P=0.00036). Furthermore, carbonylated protein levels were significantly elevated in RARS patients (n=10; 2.63±0.58 nmol/mg protein) compared to healthy donors (n=20; 1.80±0.42 nmol/mg protein) (***P<0.001) and to RCMD patients (n=10; 1.83±0.58 nmol/mg protein) (**P=0.00298). We have identified a total number of 27 carbonylated proteins unique for RARS patients which were generated by the effect of ROS. Serotransferrin was found as one of the oxidatively modified proteins. We have also found a significant decrease in TIBC in RARS patients compared to RCMD patients (*P=0.03078). TIBC moderately negatively correlated with carbonyl levels (r=-0.56, P=0.04864) in two investigated subgroups of MDS. Conclusions We have shown that there is a clear difference in the effect of oxidative stress between RARS, RCMD patients and healthy controls. Moreover, RARS patients, as a low risk MDS, are characterized by significantly higher protein carbonyl levels in comparison to healthy controls and to RCMD patients. The various sensibility of proteins to oxidation (carbonylation) depends both on their plasma concentration and on their susceptibility to oxidative stress as metal-binding sites or structural characteristics of the proteins. Modification in molecular structure of transferrin could be associated with decreased TIBC. This is in agreement with our data of oxidative modification of serotransferrin in RARS patients and could explain the decreased TIBC levels. Our results suggest that measurement of plasma carbonyl levels and the isolation and identification of carbonylated plasma proteins could serve as a potential diagnostic and prognostic tool in MDS. Acknowledgment This work was supported by the project of the Ministry of Health of the Czech Republic for conceptual development of the research organization 00023736, by Grant from the Academy of Sciences, Czech Republic (P205/12/G118), and by ERDF OPPK CZ.2.16/3.1.00/28007. Disclosures No relevant conflicts of interest to declare.
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Krejci, Jiri, and Jiri Cajthaml. "Transformation of the Vltava Historical Riverine Landscape within the Modern Times." Abstracts of the ICA 1 (July 15, 2019): 1–2. http://dx.doi.org/10.5194/ica-abs-1-189-2019.
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<p><strong>Abstract.</strong> The Vltava River and its surroundings had many different faces and functions in the past centuries. The Vltava is the longest river running through the heart of Bohemia, probably the most famous and popular river in the Czech Republic, one of the national symbols, important trade and transport route in the past, river with beautiful landscape favourite by poets, travellers, and tourists, place where the biggest dam reservoir system in the Czech Republic was built, popular recreational area in the present and many more. Therefore, many different documents are dealing with the Vltava River and its riverine landscape.</p><p> The main objective of the project supported by the Ministry of Culture of the Czech Republic is to create comprehensive information system about the Vltava River aggregating and incorporating various historical and modern documents and data. This system will allow maintaining and documenting a wealth of information about the history of the Vltava River, including immovable and movable cultural heritage using new technologies. The project is focused on the upper three quarters of the Vltava River from its springs to confluence with the Berounka River close to Prague in the period from mid 18th century up to the present day. Riverine landscape along the Vltava underwent an intensive transformation in many aspects. Firstly, the cultural landscape with mostly minor settlement combined with appreciated but even feared wild natural narrow valleys has changed intensively along with a construction of the dam cascade especially in the middle part of the river in the second half of the 20th century. Small but widespread settlements, transport function of the river and wild nature were replaced by dams producing electric energy and retaining extensive water reservoirs providing water supply and protection from frequent inundations and last but not least being very popular for recreation. Unfortunately, many houses, water mills, chapels, churches, picturesque natural places, etc. have been flooded. The former face of the Vltava riverine landscape is preserved only in various archival documents and their online presentation is the main project goal.</p><p> There are large volumes of miscellaneous historical and modern data sources dealing with the Vltava river which are being used in the project. Extensive research of various public and institutional archives is currently still being carried out. Some resources such as old photographs and postcards are found also in private collections. First of all, there are various works from old cadastral maps, old river maps with cross sections, longitudinal profiles of the river, old site plans and interesting building plans, State Derived Map and aerial photographs from 1950s, site and constructional plans of dams to the up to date cadastral map, orthophotos and DTM. The Imperial Imprints of the Stable Cadastre (scale 1&thinsp;:&thinsp;2&thinsp;880) from the years 1826–1843 rank among the most valuable and very useful. Due to their geometric precision and visual attractiveness, these maps are suitable for vectorization, and form an excellent base layer for the web mapping application and 3D visualization. Another very important map is the State Derived Map (scale 1&thinsp;:&thinsp;5&thinsp;000; its first issue) from the early 1950s containing planimetry as well as altimetry. It shows situation of area just before the dam reservoirs cascade construction was started hence it allows reconstruction of former Vltava valley. Maps and plans are complemented by old photographs, postcards, iconography and also text sources.</p><p> All data sources described above have to be carefully processed before their incorporation into the information system and subsequent 2D- or 3D- applications could be designed. Speaking in particular about maps and plans, they have to be digitised, georeferenced and selected map content is vectorised. The majority of data sources are obtained in the analogue paper form, thereby a high resolution scanning has to be done to acquire digital copies of requested maps and plans. Then the scanned data is georeferenced employing suitable global or local transformations depending on the type of map. Carefully selected map content is vectorised and the database of significant features (buildings or objects of cultural, social, production and water management importance) with important attributes is being filled up. Every feature has its location, at least approximately if precise position is unknown. Also the old photographs and postcards are geolocated to be incorporated into the information system.</p><p> 2D web mapping application (Figure 1) has been created based on processed data and it is being updated. It presents and compares various layers (georeferenced maps and plans, vectorised data model, objects of interest, etc.). The application allows overlaying of various raster and vector layers from different times using the swipe tool. Objects of interest and photographs are represented by points, where each point leads to a popup with more information.</p><p> Online 3D visualisation is effective and popular way of geographical data presentation thus besides the 2D also 3D application may bring a new perspective to former Vltava landscape. The Vltava River valley, often narrow and deep, is perfect for the 3D presentation, especially if it is completed by other objects or phenomena (e.g. extinct settlements, important buildings, historical or potential floods). Precise 3D modelling of important structures in CAD software is a common but time-consuming process. Therefore, it is not possible to model the whole extinct settlements in 3D and thus procedural modelling is applied instead. It allows to visualise a simplified reconstructive model of flooded villages in the entire area of interest even in various periods of time.</p><p> The mission of the project is, in particular, to document information on the changes of the Vltava riverine landscape within the last three centuries in the context of various events, as well as to make it subsequently available to the general public. Thus, it might act as a transfer of historical science into education through modern cartographic methods. The project itself is actually in its first phase and the activities proceed continuously.</p>
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Khelifi, Rania S., Steven J. T. Huang, Kerry J. Savage, Diego Villa, David W. Scott, Khaled Ramadan, Joseph M. Connors, Laurie H. Sehn, Cynthia L. Toze, and Alina S. Gerrie. "Real-World Characterization of Ibrutinib Therapy for Chronic Lymphocytic Leukemia (CLL) and Small Lymphocytic Lymphoma (SLL) Patients in British Columbia (BC)." Blood 136, Supplement 1 (November 5, 2020): 33–34. http://dx.doi.org/10.1182/blood-2020-138887.
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Background: Ibrutinib has dramatically changed the treatment landscape for relapsed/refractory (R/R) and newly diagnosed CLL/SLL patients (pts), leading to durable remissions in the majority of pts; however, this comes at a high cost to the healthcare system particularly since treatment is continued until progression. Ibrutinib has been available in BC on compassionate access basis since 2014, publicly funded for R/R CLL/SLL or upfront for pts with deletion 17p (del17p) since 2016, and as upfront therapy in fludarabine-ineligible pts since 2018. In view of Ibrutinib's widespread use and rapid uptake among BC physicians, we sought to investigate discontinuation rates, dose modifications, and overall survival (OS) with introduction of ibrutinib within the publicly funded BC healthcare system. Methods: CLL/SLL pts ≥ 18 years (y) who initiated single-agent ibrutinib in routine practice in BC from Nov. 2014-Jun. 2018, with minimum of 6 months follow-up (f/u), were included. Pts were identified retrospectively using provincial databases. Patient level information on dates of ibrutinib and dose modifications were obtained from the BC Cancer Pharmacy Database. Results: 350 CLL/SLL pts were identified who received ibrutinib for first line (1L, n=31) or R/R disease (2L, n=175; 3L+, n=144) at a median 7.3 y (range, 0.17 - 30) from CLL diagnosis. Most pts were male (69%) with Rai stage 0-II (287/319, 90%) at CLL diagnosis. FISH abnormalities prior to any therapy, among 205 pts tested, were: 16% del17p, 22% del11q, 23% trisomy 12, 51% del13q and 19% no abnormalities. Median age at ibrutinib treatment was 71 y (range, 42-92) and pts with R/R disease had a median of 2 prior treatment lines (range, 1-13). At ibrutinib initiation, most pts had low-intermediate Rai stage (209/332, 63%). Median f/u from ibrutinib initiation for living pts was 27.2 months (mos) (range, 6.1-49.4). Median starting dose was 420 mg daily (range, 140-560) and median duration of ibrutinib was 22.3 mos (range, 0-49.4), with 261 pts (75%) alive and remaining on ibrutinib at last f/u. Dose reductions occurred in 32% (104/322) of pts, most commonly for toxicity (86/104, 83%). Other reasons for dose reductions included new comorbidities, n=2; medication interactions, n=3; incorrect starting dose, n=1; other causes, n=10; and unknown, n=2. Temporary dose interruptions recorded by physicians were observed in 114/305 pts (37%). A total of 89 pts (25%) discontinued ibrutinib for reasons other than death: toxicity, including infections and/or cardiac events, n=45 (51%); progression, n=28 (31%); and other reasons, n=16 (18%) (6 patient/physician choice, 4 SCT, 4 new comorbidity/drug interaction, 2 change in goals of care). Pts who discontinued treatment for toxicity and progression had median exposure times of 10.4 mos (range, 0.8-31.4) and 11.9 mos (range, 1.0-32.8), respectively. An additional 21 pts (6%) died while on ibrutinib: 9 from CLL progression; 5 cardiac causes (2 ischemic heart disease; 1 myocardial infarction; 1 cardiac arrest; 1 ventricular tachycardia); 4 infection; and secondary malignancy, COPD and unknown in 1 pt each. From time of ibrutinib initiation, 2 y OS for the whole cohort was 87.4% (95% CI: 83-91%) with median not reached (Fig. 1A). By line of therapy, 2 y OS from ibrutinib was 95.7% for 1L, 88.0% 2L, and 84.9% 3L+, with no significant difference between groups (P=.4) (Fig. 1B). Pts who discontinued ibrutinib, excluding those who died on ibrutinib, had a median OS from time of discontinuation of 32.5 mos (95% CI: 23.4-41.6) (Fig. 2A), with no significant difference based on reason for discontinuation (2 y OS from discontinuation for toxicity, progression or other was 72.4 %, 56.1%, and 78%, respectively, P=.14; P=.06 for toxicity vs progression) (Fig. 2B). Conclusion: This real-world analysis of CLL/SLL pts on ibrutinib confirms excellent survival in both the front-line and R/R settings; however, after 2 years on ibrutinib therapy, 25% of pts discontinued treatment and had poor outcomes regardless of the reason for discontinuation. This data serves as a benchmark to assess healthcare utilization with the introduction of ibrutinib at a population-level, in order to assess its cost-effectiveness and sustainability. Disclosures Savage: Merck, BMS, Seattle Genetics, Gilead, AstraZeneca, AbbVie: Honoraria; Roche (institutional): Research Funding; BeiGene: Other: Steering Committee; Merck, BMS, Seattle Genetics, Gilead, AstraZeneca, AbbVie, Servier: Consultancy. Villa:Celgene: Consultancy, Honoraria; Janssen: Consultancy, Honoraria; Roche: Consultancy, Honoraria, Research Funding; AZ: Consultancy, Honoraria, Research Funding; Kite/Gilead: Consultancy, Honoraria; Nano String: Consultancy, Honoraria; Seattle Genetics: Consultancy, Honoraria; Sandoz Canada: Consultancy, Honoraria; Immunovaccine: Consultancy, Honoraria; Purdue Pharma: Consultancy, Honoraria. Scott:NanoString: Patents & Royalties: Named inventor on a patent licensed to NanoString, Research Funding; Celgene: Consultancy; Abbvie: Consultancy; AstraZeneca: Consultancy; Janssen: Consultancy, Research Funding; NIH: Consultancy, Other: Co-inventor on a patent related to the MCL35 assay filed at the National Institutes of Health, United States of America.; Roche/Genentech: Research Funding. Sehn:Chugai: Consultancy, Honoraria; Servier: Consultancy, Honoraria; Takeda: Consultancy, Honoraria; Teva: Consultancy, Honoraria, Research Funding; Seattle Genetics: Consultancy, Honoraria; F. Hoffmann-La Roche Ltd: Consultancy, Honoraria, Research Funding; MorphoSys: Consultancy, Honoraria; Merck: Consultancy, Honoraria; Lundbeck: Consultancy, Honoraria; Karyopharm: Consultancy, Honoraria; Gilead: Consultancy, Honoraria; Kite: Consultancy, Honoraria; Janssen: Consultancy, Honoraria; Celgene: Consultancy, Honoraria; Acerta: Consultancy, Honoraria; Genentech, Inc.: Consultancy, Honoraria, Research Funding; AstraZeneca: Consultancy, Honoraria; Apobiologix: Consultancy, Honoraria; AbbVie: Consultancy, Honoraria; Amgen: Consultancy, Honoraria; Verastem Oncology: Consultancy, Honoraria; TG therapeutics: Consultancy, Honoraria. Toze:Janssen: Consultancy, Other: advisory board. Gerrie:Astrazeneca: Consultancy, Research Funding; AbbVie: Consultancy, Honoraria, Research Funding; Janssen: Consultancy, Honoraria, Research Funding; Roche: Research Funding; Sandoz: Consultancy.