Compliance Data Research Articles

Enhanced recovery after surgery programs versus traditional perioperative care in laparoscopic and open cholecystectomy

Target: In this research, the Multimodal Pathway designed for Elective Laparoscopic Docystectomy through collaboration between the Departments of General Surgery and Anesthesiology and the patient was investigated for functional healing, duration and protection. Patients and procedures The research included 80 patients who were candidates for abdominal or laparoscopic cholecystectomy, with a gallbladder infection, and Randomly, patients were divided into four equivalent categories according to the allocated management method utilising sealed envelopes: two laparoscopic and open-scopic ERAS categories, and two normal, laparoscopic and openness categories. The patients were evaluated by a multidisciplinary team and observed throughout the peri-operative phase. The data collected contained demographic and general clinical data, compliance data, surgical data, post-operative injuries, rehabilitation, ICU and hospital stays. When we have a strong adherence rate to the ERAS protocol, the rates vary greatly across various parameters. We find that ERAS has been correlated with a substantial decrease of the average overall patient residence. This was 1.2 days for laparscopic and 2.65 days for open group compared to 1.55 days for traditional laparoscopic and 3.8 days for conventional open group. Our ERAS portion leads to less discomfort and no danger of excessive narcotic problems and further reduces tension and postoperative nausea and vomiting (PONV) as well as other complications. Conclusion: In addition to optimising patient's functional rehabilitation and his quality of life, ERAS route for elective patients with open or laparoscopic cholecystectomy is secure. AS is correlated with an important decrease in average postoperative hospitalisation and overall hospitalisation with lower complications and little chance of readmission.

"If the glove fits": Hospital-wide universal gloving is associated with improved hand hygiene and may reduce Clostridioides difficile infection.

To determine whether a hospital-wide universal gloving program resulted in increased hand hygiene compliance and reduced inpatient Clostridioides difficile infection (CDI) rates. We carried out a multiple-year before-and-after quasi-experimental quality improvement study. Gloving and hand hygiene compliance data as well as hospital-acquired infection rates were prospectively collected from January 1, 2015, to December 31, 2017, by secret monitors. The University of Rochester Strong Memorial Hospital, an 849-bed quaternary-care teaching hospital. All adult inpatients with the exception of patients in the obstetrics unit. A hospital-wide universal gloving protocol was initiated on January 1, 2016. Hand hygiene compliance increased from 68% in 2015 reaching an average of 88% by 2017 (P < .0002). A 10% increase in gloving per unit was associated with a 1.13-fold increase in the odds of hand hygiene (95% credible interval, 1.12-1.14). The rates of CDI decreased from 1.05 infections per 1,000 patient days in 2015 to 0.74 in 2017 (P < .04). A universal gloving initiative was associated with a statistically significant increase in both gloving and hand hygiene compliance. CDI rates decreased during this intervention.

Severity of Sleep Apnea and COVID-19 Illness.

ObjectiveTo characterize the relationship between severity of sleep apnea and coronavirus disease 2019 (COVID-19) hospitalization and severe illness.Study DesignRetrospective cohort study.SettingMontefiore Health System in the Bronx, New York.MethodsThe data set consisted of adult patients with an active diagnosis of obstructive sleep apnea in the past 2 years and a positive severe acute respiratory syndrome coronavirus 2 quantitative polymerase chain reaction test at our institution between March 16, 2020, and May 26, 2020. Sleep apnea severity and continuous positive airway pressure compliance data were abstracted from the electronic medical record. The International Classification of Diseases, 10th Revision was used to classify comorbidities.ResultsA total of 461 patients with sleep apnea tested positive for COVID-19, of whom 149 were excluded for missing data in the electronic medical record. Patients with moderate and severe sleep apnea had higher rates of COVID-19 hospitalization compared to those with mild sleep apnea (P = .003). This association was reduced when accounting for confounders, most notably the Charlson Comorbidity Index, a measure of comorbid illness burden. Moderate and severe sleep apnea were associated with increased Charlson Comorbidity Indices, compared to mild sleep apnea (P = .01). Sleep apnea severity was not associated with a composite outcome of mechanical ventilation, intensive care unit admission, and death.ConclusionSleep apnea severity was associated with the Charlson Comorbidity Index and may be a risk factor for COVID-19 hospitalization. We found no evidence that sleep apnea severity among hospitalized patients was associated with a composite outcome of mechanical ventilation, intensive care unit admission, and death.

Residual stresses near cold-expanded hole at different stages of high-cycle fatigue by crack compliance data

Experimental method for a characterization of high-cycle fatigue evolution of residual stress near cold-expanded hole is developed and implemented. The technique is based on simultaneous measurements of deformation response to narrow notch, inserted in residual stress field, on opposite specimen’s faces by electronic speckle-pattern interferometry (ESPI). Two-side measurements of notch opening displacements are performed when a single notch, emanating from cold-expanded hole edge, is inserted. The transition from in-plane displacement component to residual stress intensity factor (SIF) values follows from the relationships of modified version of the crack compliance method. The approach provides a difference in residual stress values referred to mandrel entrance and exit surface. Notches are inserted at different stages of low-cycle fatigue without applying external load. The results obtained describe fine nuances of residual stress evolution, which cannot be considered as monotonic relaxation.

The impact of vinyl chloride exposure on the health of Italian workers: an evaluation from SIREP compliance data

The aim of the study is to investigate exposures to vinyl chloride monomer (VCM) at workplace in Italy and the related burden of diseases. Measurements data was collected from a nation-wide occupational exposure registry (SIREP, 1996–2016). Potentially exposed workers were estimated for some industrial sectors. Concurrent exposures were investigated using cluster analysis. Proportionate mortality ratios were calculated linking data to national mortality statistics (2005–2015). Overall 8,460 measurements were analyzed. Most exposures occurred in the manufacture of chemicals and plastic products. A total of 12,148 workers potentially exposed was estimated (64% male). Concurrent exposures were detected frequently (83%). An elevated proportion of deaths for liver cancer was found in male exposed workers. Although VCM is a known carcinogen for humans, there are still many exposure situations, albeit at low doses, in the chemical and plastic industries.

China’s Global Leadership Through G20 Compliance

What kind of leadership role is China playing in the G20? How has this leadership role evolved over time, particularly with the recent global crises created by the COVID-19 pandemic? In addition, will China’s rising role in providing badly needed global public goods reinforce its rivalry with a declining US, present the opportunity of co-leading with its BRICS counterparts, or mediate and foster co-operative solutions among all? This study seeks to address these critical questions using quantitative analysis based on G20 compliance data since its start in 2008, and especially at the recent Osaka Summit in June 2019 and the emergency virtual summit on March 26, 2020. Specifically, this study analyses China’s changing compliance levels over time and across issue areas, in comparison with its key G20 partners (or rivals): the US, India and Russia. Observing China’s compliance trends alongside those of other major G20 powers provides important insights into the characteristics, evolution and interactions of China’s leadership. This analysis finds that China’s leadership role has increased over time but that China remains largely a flexible and co-operative leader. From 2008 to 2018, China’s compliance rose while that of the US declined. Overall, China leads more with its BRICS partners than with the US. China’s leadership model has been characterized by flexibility and cooperativeness, as China has never led alone, and China’s closest compliance companions vary across different issue areas. China and other G20 members’ compliance in 2020 largely confirms these trends and the causal strength of the shock activated vulnerability of COVID-19 and members’ relevant specialized capabilities in response.

COVID-19 outbreak and healthcare worker behavioural change toward hand hygiene practices

BackgroundThe coronavirus disease (COVID-19) pandemic has affected healthcare workers (HCWs) in their clinical practice. HCWs were challenged with new guidelines and practices to protect themselves from occupational risks.AimTo determine whether hand hygiene behaviour by real-time measurement was related to the dynamic of the epidemic, and the type of patient being cared for in France.MethodsThis study used an automated hand hygiene recording system to measure HCW hand hygiene on entry to and exit from patient rooms throughout the COVID-19 pandemic. The correlation between hand hygiene compliance and COVID-19 epidemiological data was analysed. Analysis of variance was performed to compare compliance rate during the different periods of the epidemic.FindingsHCW hand hygiene rate on room entry decreased over time; on room exit, it increased by 13.73% during the first wave of COVID-19, decreased by 9.87% during the post-lockdown period, then rebounded by 2.82% during the second wave of the epidemic. Hand hygiene during patient care and hand hygiene on room exit had a positive relationship with the local COVID-19 epidemic; conversely, hand hygiene on room entry did not depend on the trend of the epidemic, nor on nursing of COVID-19 patients, and it decreased over time.ConclusionHCWs modified their behaviours to face the risk propensity of the pandemic. However, to improve the poor compliance at room entry, reducing confusion between the hand hygiene recommendation and glove recommendation may be necessary; disinfection of gloving hands might solve this issue.

Central monitoring in a randomized, open-label, controlled phase 3 clinical trial for a treatment-shortening regimen for pulmonary tuberculosis

IntroductionWith the growing use of online study management systems and rapid availability of data, timely data review and quality assessments are necessary to ensure proper clinical trial implementation. In this report we describe central monitoring used to ensure protocol compliance and accurate data reporting, implemented during a large phase 3 clinical trial. Material and methodsThe Tuberculosis Trials Consortium (TBTC) Study 31/AIDS Clinical Trials Group (ACTG) study A5349 (S31) is an international, multi-site, randomized, open-label, controlled, non-inferiority phase 3 clinical trial comparing two 4-month regimens to a standard 6 month regimen for treatment of drug-susceptible tuberculosis (TB) among adolescents and adults with a sample size of 2500 participants. ResultsCentral monitoring utilized primary study data in a five-tiered approach, including (1) real-time data checks & topic-specific intervention reports, (2) missing forms reports, (3) quality assurance metrics, (4) critical data reports and (5) protocol deviation identification, aimed to detect and resolve quality challenges. Over the course of the study, 240 data checks and reports were programed across the five tiers used. DiscussionThis use of primary study data to identify issues rapidly allowed the study sponsor to focus quality assurance and data cleaning activities on prioritized data, related to protocol compliance and accurate reporting of study results. Our approach enabled us to become more efficient and effective as we informed sites about deviations, resolved missing or inconsistent data, provided targeted guidance, and gained a deeper understanding of challenges experienced at clinical trial sites.Trial registration: This trial was registered with ClinicalTrials.gov (Identifier: NCT02410772) on April 8, 2015.

Impact of bariatric surgery on obstructive sleep apnea severity and continuous positive airway pressure therapy compliance\u2014prospective observational study

To evaluate association between bariatric surgery and changes in obstructive sleep apnea (OSA) severity and sleep architecture was as well as to asses continuous positive airway pressure (CPAP) effectiveness and compliance. We enrolled patients undergoing bariatric surgery. Polysomnography was performed in each patient preoperatively and 12 months after the procedure in a subgroup of patients diagnosed with OSA. STOP-BANG, Epworth Sleepiness Scale (ESS) and Berlin questionnaire scores were obtained pre- and postoperatively. CPAP compliance data was recorded during follow-up hospitalization. Among 44 patients with median age of 49.5 years, predominantly women (68.2%) pre- and postoperative polysomnography was performed. We observed significant improvement in STOP-BANG (6.0 vs. 3.0, p < 0.001) and ESS (12.0 vs. 5.0, p < 0.001) scores, apnea–hypopnea index (44.9 vs. 29.2, p < 0.001), oxygen desaturation index (43.6 vs. 18.3, p < 0.001) and sleep architecture parameters. CPAP compliance was poor with a median percentage of days with CPAP use accounting to 49.3%. Bariatric surgery is associated with a significant decrease in the number of sleep-related respiratory disturbances, as well as improvement of sleep efficiency. Postoperative CPAP therapy compliance was poor despite low rate of OSA resolution. This study suggests that patients with OSA undergoing bariatric surgery require postoperative reassessment.

Impact of Obesity on Quality of Life, Psychological Distress, and Coping on Patients with Colon Cancer

Despite the causal relationship between obesity and colon cancer being firmly established, the effect of obesity on the course of cancer calls for further elucidation. The objective of this study was to assess differences in clinical-pathological and psychosocial variables between obese and nonobese individuals with colon cancer. This was a prospective, multicentric, observational study conducted from 2015-2018. The sample comprised patients with stage II-III, resected colon cancer about to initiate adjuvant chemotherapy with fluoropyrimidine in monotherapy or associated with oxaliplatin and grouped into nonobese (body mass index <30 kg/m2 ) or obese (≥30 kg/m2 ). Subjects completed questionnaires appraising quality of life (European Organization for Research and Treatment of Cancer Quality of Life Core questionnaire), coping (Mini-Mental Adjustment to Cancer), psychological distress (Brief Symptom Inventory 18), perceived social support (Multidimensional Scale of Perceived Social Support), personality (Big Five Inventory 10), and pain (Brief Pain Inventory). Toxicity, chemotherapy compliance, 12-month recurrence, and mortality rate data were recorded. Seventy-nine of the 402 individuals recruited (19.7%) were obese. Obese subjects exhibited more comorbidities (≥2 comorbidities, 46.8% vs. 30.3%, p = .001) and expressed feeling slightly more postoperative pain (small size-effect). There was more depression, greater helplessness, less perceived social support from friends, and greater extraversion among the obese versus nonobese subjects (all p < .04). The nonobese group treated with fluoropyrimidine and oxaliplatin suffered more grade 3-4 hematological toxicity (p = .035), whereas the obese had higher rates of treatment withdrawal (17.7% vs. 7.7%, p = .033) and more recurrences (10.1% vs. 3.7%, p = .025). No differences in sociodemographic, quality of life, or 12-month survival variables were detected. Obesity appears to affect how people confront cancer, as well as their tolerance to oncological treatment and relapse. Obesity is a causal factor and affects prognosis in colorectal cancer. Obese patients displayed more comorbidities, more pain after cancer surgery, worse coping, and more depression and perceived less social support than nonobese patients. Severe hematological toxicity was more frequent among nonobese patients, whereas rates of withdrawal from adjuvant chemotherapy were higher in the obese cohort, and during follow-up, obese patients presented greater 12-month recurrence rates. With the growing and maintained increase of obesity and the cancers associated with it, including colorectal cancer, the approach to these more fragile cases that have a worse prognosis must be adapted to improve outcomes.

Processing of viscoelastic data via a generalized fractional model

Data fitting and interconversion remain to be a difficult task in linear viscoelasticity. On the basis of transfer function, a generalized fractional model is proposed to fit linear viscoelastic data. The new model is modified from the fractional Maxwell model, and it is abbreviated as the MFM model in this paper. Common fractional viscoelastic models, including the fractional Kelvin and fractional Maxwell models, can be considered as special cases of the MFM model. Apart from inheriting the properties of the fractional Maxwell model, the MFM model is capable of adjusting the transient region between the power-law and plateau regions. Case studies are provided to apply the MFM model in data fitting of various kinds of viscoelastic data, and the results generally demonstrate improved fitting quality with fewer fitting modes compared with the generalized Maxwell model. In addition, the MFM model is used as a venue to convert time-domain data (including creep compliance data, creep data with ringing, and realistic relaxation data) to dynamic moduli data. Compared with classical numerical methods for data interconversion, this method appears to be more direct and convenient.

A compliance real-time monitoring system for the management of the brace usage in adolescent idiopathic scoliosis patients: a pilot study

BackgroundPatient compliance is essential to the effectiveness of brace treatment for adolescent idiopathic scoliosis (AIS) patients. Subjective measurements like questionnaires and inquiries proved to be arguably inaccurate. Although some scholars have applied temperature/force monitors to measuring patient compliance objectively, few studies to date could monitor patient compliance in real time. The objective of this study is to describe and evaluate a compliance real-time monitoring system of the brace usage in AIS patients.MethodsA compliance real-time monitoring system (specifically consisting of a compliance monitor, a WeChat Mini Program, a cloud-based storage system and a website backstage management system) was designed to manage the brace treatment. Thirty patients receiving brace treatment were enrolled. They were told to upload the data at least once a day. Clinicians downloaded the compliance data and communicated with the patients online based on their analysis of data at least once every 3 months. The measured force, quality compliance (measured force / baseline force), measured time, and quantity compliance (measured time/ prescribed time) were used to evaluate patient compliance. Patients were also asked to rate their satisfaction at the final follow-up.ResultsTwenty-eight patients were included in the final analysis. The mean baseline force was 1.23 ± 0.28 N. The mean measured force was 0.79 ± 0.29 N. The mean quality compliance was 64.8 ± 22.2%. The prescribed time of all patients was 23 h. The mean measured time was 14.1 ± 2.9 h. The mean quantity compliance was 61.3 ± 12.6%. Both the quality and quantity compliance during the first 3 months of treatment was significantly lower than the latter 3 months. In this study, 96.4% (27/28) patients were satisfied with the use of the monitoring system, among whom 21.4% (6/28) are very satisfied and 75.0% (21/28) are somewhat satisfied.ConclusionsThe compliance real-time monitoring system, without evaluating the clinical and radiographic outcomes for now, has already shown some feasibility and effectiveness for the management of the brace usage in AIS patients. This system, as a useful tool for online patient management and patient-clinician communication, would be potentially employed on a large scale in future for clinicians to improve the compliance and satisfaction of AIS patients who have received brace treatment.

Perioperative treatment compliance, anxiety and depression of elderly patients with ophthalmic surgery and the influential factors.

Ophthalmic surgery is invasive, and treatment efficacy is affected by a variety of factors. We aimed to analyze perioperative treatment compliance, anxiety and depression of elderly patients undergoing ophthalmic surgery and the influential factors. The study group comprised 119 elderly patients undergoing ophthalmic surgery between March 2018 and March 2020. Clinical and treatment compliance data of all patients were collected. The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were administered to all patients, and logistic regression analysis was used for multivariate analysis. During the perioperative period the 119 elderly patients had a mean SAS score of 65.13±14.36, and SDS score of 61.94±17.39. Treatment compliance was as follows: 76 cases of complete compliance, 25 of incomplete compliance, and 18 of complete non-compliance. Economic status, complications, treatment options and levels of TNF-α, IL-6, and IL-8 are independent risk factors that affected the compliance of elderly patients undergoing ophthalmology surgery (P<0.05). Education level, marital status, economic status, complications, treatment options and levels of TNF-α, IL-6, and IL-8 were independent risk factors affecting perioperative anxiety and depression. There are many factors affecting the perioperative treatment compliance, anxiety and depression of elderly patients undergoing ophthalmic surgery. Effective intervention measures should be taken to improve patients' compliance, reduce their negative emotions, and improve the surgical efficacy.

Assessment on the effectiveness of vessel-approach regulations to protect cetaceans in Australia: A review on behavioral impacts with case study on the threatened Burrunan dolphin (Tursiops australis).

Vessels cause considerable disturbance to cetaceans world-wide, with potential long-term impacts to population viability. Here we present a comprehensive review of vessel impacts to cetacean behavior in Australian waters (2003–2015), finding inadequate protections to be in place. The majority of these studies found trends of decreased animal travel and resting behavioral states as well as low compliance to regulations, and they recommended further regulatory action such as greater enforcement or monitoring, or passive management strategies. As a case study, we conducted the first field assessment of vessel compliance with the Wildlife (Marine Mammal) Regulations 2009 in Gippsland Lakes, Australia, and provide the first assessment of the endangered Gippsland Lakes Burrunan dolphin (Tursiops australis) population’s behavioral ecology. Dolphin behavior and vessel regulation compliance data were collected during boat-based surveys of Gippsland Lakes from July 2017 to January 2018, with a total of 22 dolphin group sightings resulting in 477 five-minute point samples. 77% of dolphin sightings involved vessel interactions (within 400 m), and 56 regulation breaches were observed. These breaches were most severe in summer (mean = 4.54 breaches/hour). Vessels were found to alter dolphin behavior before, during, and after interactions and regulation breaches, including increased mating (mate guarding) and milling behavioral states, and increased ‘fish catch’, ‘high leap’ and ‘tail slap’ behavioral events. These behavioral changes may indicate masking of the dolphins' acoustic communication, disturbance of prey, increased dolphin transition behaviors, and/or induced stress and changes to group structure (including increased mate guarding). While our results provide evidence of short-term altered behavior, the potential for long-term effects on population dynamics for this threatened species is high. In the context of reported inadequate cetacean protection Australia-wide, our management recommendations include greater monitoring and enforcement, and the utilisation of adaptive management.

Influence of COVID-19 Pandemic on Health-care Workers’ Hand Hygiene Practice at a Private Academic Hospital in Johannesburg, South Africa: A Quantitative and Qualitative Longitudinal Study

ABSTRACT Background: Hand hygiene (HH) is a cornerstone infection prevention measure and is crucial in the fight against the COVID-19 pandemic. Improving and monitoring of HH compliance in a hospital setting is a complex challenge given the behavioural component associated with it. We aimed to assess the impact of the COVID-19 pandemic on HH compliance using both quantifiable hand product usage and observational data. Methods: Using the hospital's HH usage monitoring system, the quantity of different HH products per nursing unit, expressed as millilitres (mL) per patient bed day (PBD), was analysed longitudinally during the course of the pandemic. Observational HH compliance data was drawn from the hospital audit system for comparison. Results: Across all units, there was a significant increase in HH product usage coinciding with the onset of the pandemic (53 mL/PBD to 111 mL/PBD, in non-critical care units (non-CCU's); 127 mL/PBD to 217 mL/PBD, in CCU's). This increase was largely attributable to an increase in alcohol-based hand rub usage. Discordance with observed compliance rates was noted. Conclusion: An unprecedented increase in HH product usage in a hospital setting was seen to coincide with the onset of the COVID-19 pandemic. No specific HH campaign was introduced, and the improved usage compliance appears to be driven primarily by health-care workers’ own behavioural change.

Fatigue Damage Monitoring of CFRP Elements by Thermographic Procedure under Bending Loads

For structural health of mechanical structures, non-destructive detection and material defect characterization represent the main useful tools for mechanical decay prediction caused by local composite damage phenomena. In this work, internal delamination due to alternate bending were characterized in flat specimens, performing fatigue and static tests, coupled with thermographic, optical, and ultrasonic analysis for damage detection and evolution purposes. Damage to rupture behavior of CFRP material through mechanical tensile tests is performed on several samples and non-destructive inspection procedures are optimized during successive HCF tests to detect in real time local compliance variations and damage initiation. Thermographic continuous monitoring and occasional ultrasonic analysis are implemented to analyze composite anomalies during fatigue life and to elaborate a procedure for identification of delamination induced damage before failure. IRT and UT results are computed with MATLAB analysis for damage evaluation with strain and compliance data acquired during tests.

599. Dalbavancin Utilization in Rural Healthcare Setting: A Single Center Three Years’ Experience

BackgroundDalbavancin is a second generation lipoglycopeptide, approved by the Food and Drug Administration (FDA) for treatment of acute bacterial skin and skin structure infections (ABSSSI). The weekly dosing of Dalbavancin has encouraged its off-label use to treat other severe infections, especially in patients deemed to be poor candidates for intravenous antimicrobial therapy through a long-term intravenous catheter.MethodsSingle center retrospective chart review of 33 patients who were planned to receive Dalbavancin between March 2015 and March 2019 at a rural medical center in New Hampshire.We reviewed demographics, indications, microbiological, intravenous drug use status and compliance data.ResultsDalbavancin therapy was planned for 25/33 patients (75.75%) specifically due to safety concerns around use of a peripherally inserted central catheter (PICC) in Persons Who Inject Drugs (PWID). All 25 patients (75.75%) were actively injecting at the time of the infection with 16/33 patients (48.48%) receiving or newly enrolled in medication assisted treatment. The planned duration of therapy was not completed in 15/33 patients (45.45%) and all were PWID. 11/33 patients (33.3%) were lost to follow up. Additionally, 6 patients experienced insurance coverage issues or difficulty having peripheral access placed. The average driving distance between home and infusion suite was 47 miles.Methicillin Resistant Staphylococcus aureus (19/33) and Methicillin Susceptible Staphylococcus aureus (8/33) were the most commonly treated organisms and the average pathogen-directed therapy duration prior to starting Dalbavancin was 15 days.ConclusionDespite recent data suggesting that Dalbavancin therapy for PWID has good compliance rates in urban settings, our experience suggests that the same principle might not be true in rural settings as the non-compliance and loss to follow up rates were very high.Disclosures All Authors: No reported disclosures

Influence of stress ratio on residual stress evolution near cold-expanded hole due to low-cycle fatigue by crack compliance data

Modified version of the crack compliance method is used for determination of stress intensity factor (SIF) related to narrow notches emanating from cold-expanded holes. These notches are inserted at different stages of low-cycle fatigue under constant external load. It is shown how residual SIF values, generated by residual stress field influence, can be separated from total experimental SIF values. Residual SIF values, obtained at different stage of low-cycle fatigue with the same stress range Δσ = 350 MPa but different stress R = –0.4 and R = –1.0, provide quantitative description of residual stress evolution near cold-expanded hole. It shown that maximal residual stress relaxation of order 20 per cent occurs at 95 lifetime per cent for both loading programs.

The Breast Cancer Cohort Study in Chinese Women: research design and preliminary results of clinical multi-center cohort

Objective: The incidence of breast cancer in Chinese women continues to rise. The large breast cancer cohort studies in China are relatively scarce. There are many bottlenecks in the construction of large clinical cohort for breast cancer diagnosis, treatment, and prognoses, such as inconsistent standards, high rates of lost follow-up, repeated construction, and inability to share. To better solving the difficulties and problems faced by large-scale clinical cohort research in China, this project will cooperate with several tertiary A hospitals to establish a breast cancer cohort in Chinese women. It also provides a data platform and technical support for breast cancer multi-center clinical cohort research. Methods: Based on the evidence-based medicine and expert opinion and consensus, we established a breast cancer cohort standardized indicator set-recording baseline information, diagnosis and treatment-related information of the enrolled patients, and collecting biological specimens. According to the technical specification of long-term follow-up for the endpoint, data management, and data security and in the large population-based cohort study, a standardized follow-up system for the diagnosis, treatment, and prognosis of breast cancer prospective cohorts is formed. Results: Based on standardized data sets and the computer discipline's advantage from the University of Science and Technology Beijing, we integrate the new information technology methods, including dynamic information collection terminals and social networks. Thus, the quality of control programs on compliance and intelligence data was improved, and a Chinese women breast cancer cohort database was developed. By February 2020, 12 147 patients were included in the clinical cohort database. Biological specimens'resources in cohort construction were collected and cooperated with Shandong University to research the multi-center quality control system and shared evaluation system of biobanks. Building an open and shared biobank network and forming a full chain of breast cancer research platform. Conclusion: With the implementation of the "13(th) Five-Year Plan" precision medicine research, this study provides a research foundation for precision diagnosis and treatment of breast cancer and provides data support for the country to formulate relevant medical policies.

Acceptability and effectiveness of Ujiplus®- a school meal fortified with a natural anthelminthic agent for control of Schistosoma mansoni

Background: Mass chemotherapy is currently the recommended approach for control of schistosomiasis. However, there is concern that this might not be financially sustainable over extended periods and the increasing drug pressure is likely to favor resistant parasite genotypes. We formulated a local and easier to implement alternative; porridge flour fortified with papaya seeds extracts (UjiPlus®) as a potential antischistosoma compound and evaluated it's acceptability and efficacy. Methods and materials: A total of 346 children aged 3–6 yrs. [x̃ = 4.5; IQR = 4–5] were enrolled. UjiPlus® was provided daily through a school feeding program for 4 consecutive weeks. Stool samples were collected from each child at baseline (week zero) and follow-up (week 4) and subjected to Kato-Katz microscopic examination for Schistosoma mansoni egg/s presence and infection intensity by two independent microscopists. Results: At baseline 294 participants provided a stool sample. At follow-up (FU) 247 participants provided a stool sample, of these 52 had not provided a sample at baseline. Compliance data to UjiPlus® was available for 237 children; 105(44.3%), 107(45.2%), 18(7.6%), 5(2.1%), and 2(0.8%) missed taking UjiPlus® for 0 days (100% compliance), 1–3 days, 4–6 days, 7–9 days and 10 or more days respectively. Reasons for non-compliance included absenteeism due to minor illnesses not related to UjiPlus® (n = 77), truancy (n = 31), family related issues (n = 16); some participants had been sent home to collect UjiPlus® cooking fuel fee (n = 9) while some refused to take UjiPlus® due to stomach-ache (n = 3) or diarrhoea (n = 1) caused by drinking the porridge. Side effects were observed in 16 children, with 2 reporting 3 and 1 reporting 2 side effects. These included Stomach-ache (n = 5), vomit (n = 4), cough (n = 4), running nose (n = 3), diarrhea (n = 2), nausea (n = 2) and body rush (n = 1). The overall prevalence of Schistosoma mansoni infections at baseline and follow-up was 39.8% vs. 30.4% [P = 0.022; RR = 1.31; 95% CI (1.04–1.66)]. Among the infected mean egg counts were 183.2 epg vs. 161.3 epg. Conclusion: In these preliminary results, UjiPlus® was well accepted and tolerated in the children population. UjiPlus® also yielded a reduction in Schistosoma mansoni prevalence and infection intensity.