Lung transplant waitlist outcomes in the United States and patient travel distance

There is a broad range of patient travel distances to reach a lung transplant hospital in the United States. Whether patient travel distance is associated with waitlist outcomes is unknown. We present a cohort study of patients listed between January 1, 2006 and May 31, 2017 using the Scientific Registry of Transplant Recipients. Travel distance was measured from the patient's permanent zip code to the transplant hospital using shared access signature URL access to Google Maps, and assessed using multivariable competing risk regression models. There were 22 958 patients who met inclusion criteria. Median travel distance was 69.7 miles. Among patients who traveled > 60 miles, 41.2% bypassed a closer hospital and sought listing at a more distant hospital. In the adjusted models, when compared to patients who traveled ≤60 miles, patients who traveled >360 miles had a 27% lower subhazard ratio (SHR) for waitlist removal (SHR 0.73, 95% confidence interval [CI]: 0.60, 0.89, P = .002), 16% lower subhazard for waitlist death (SHR 0.84; 95% CI 0.73-0.95, P = .07), and 13% increased likelihood for transplant (SHR 1.13, 95% CI: 1.07, 1.20, P < .001). Many patients bypassed the nearest transplant hospital, and longer patient travel distance was associated with favorable waitlist outcomes.     

Early steroid withdrawal in HIV-infected kidney transplant recipients: Utilization and outcomes

Kidney transplant (KT) outcomes for HIV-infected (HIV+) persons are excellent, yet acute rejection (AR) is common and optimal immunosuppressive regimens remain unclear. Early steroid withdrawal (ESW) is associated with AR in other populations, but its utilization and impact are unknown in HIV+ KT. Using SRTR, we identified 1225 HIV+ KT recipients between January 1, 2000, and December 31, 2017, without AR, graft failure, or mortality during KT admission, and compared those with ESW with those with steroid continuation (SC). We quantified associations between ESW and AR using multivariable logistic regression and interval-censored survival analysis, as well as with graft failure and mortality using Cox regression, adjusting for donor, recipient, and immunologic factors. ESW utilization was 20.4%, with more zero HLA mismatch (8% vs 4%), living donors (26% vs 20%), and lymphodepleting induction (64% vs 46%) compared to the SC group. ESW utilization varied widely across 129 centers, with less use at high- versus moderate-volume centers (6% vs 21%, P < .001). AR was more common with ESW by 1 year (18.4% vs 12.3%; aOR: _1.081.61_2.41, P = .04) and over the study period (aHR: _1.021.39_1.90, P = .03), without difference in death-censored graft failure (aHR _0.600.91_1.36, P = .33) or mortality (aHR: _0.751.15_1.77, P = .45). To reduce AR after HIV+ KT, tailoring of ESW utilization is reasonable.     

Kidney transplant program waitlisting rate as a metric to assess transplant access

Kidney transplant program performance in the United States is commonly measured by posttransplant outcomes. Inclusion of pretransplant measures could provide a more comprehensive assessment of transplant program performance and necessary information for patient decision-making. In this study, we propose a new metric, the waitlisting rate, defined as the ratio of patients who are waitlisted in a center relative to the person-years referred for evaluation to a program. Furthermore, we standardize the waitlisting rate relative to the state average in Georgia, North Carolina, and South Carolina. The new metric was used as a proof-of-concept to assess transplant-program access compared to the existing transplant rate metric. The study cohorts were defined by linking 2017 United States Renal Data System (USRDS) data with transplant-program referral data from the Southeastern United States between January 1, 2012 and December 31, 2016. Waitlisting rate varied across the 9 Southeastern transplant programs, ranging from 10 to 22 events per 100 patient-years, whereas the program-specific waitlisting rate ratio ranged between 0.76 and 1.33. Program-specific waitlisting rate ratio was uncorrelated with the transplant rate ratio (r = −.15, 95% CI, −0.83 to 0.57). Findings warrant collection of national data on early transplant steps, such as referral, for a more comprehensive assessment of transplant program performance and pretransplant access.     

Conflicts of interest among scientific foundations and societies in the field of childhood nutrition

ObjectiveTo describe food-industry sponsorships of associations active in the field of childhood nutrition and obesity prevention in Spain in 2017-2018.MethodThe associations were located at https://www.google.es/ using the words “society”, “foundation” or “federation” in combination with the terms “nutrition”, “obesity”, “childhood”, “paediatrics” and “diabetes”. Sponsorship was defined as the declaration of funding received or the appearance of a food company logo on an association's website or in the programmes of its congresses or courses. The percentage of sponsored societies and its association with the existence of ethical codes was calculated using MS Excel.Results64% of the associations displayed some type of sponsorship, with this being most frequent among paediatric and nutrition societies, 83% and 80% respectively, and non-existent among public health societies. No association was found between the existence of an ethical code and sponsorship (odds ratio: 0.75; 95% confidence interval: 0.14-3.94). The leading corporate sponsors were Nestlé, Coca-Cola and Danone. Whereas the initiatives of sponsored societies were targeted at changing eating individual behaviours, those of unsponsored societies sought to promote changes in the food system and eating environments.ConclusionsFood industry sponsorship of foundations and scientific societies is very widespread in Spain, except among public health associations. Unlike sponsored associations, those unsponsored propose policies opposed by the food industry, which are aimed at improving the system and food and eating environments.     

医药卫生科技查新咨询工作的质量与规范化管理

科学地组织科技查新流程，其目的是在于规范流程中每一阶段的工作内容，建立合理的工作程序，提高工作效率，确保查新质量。     

Bright Futures Ahead

Bright Futures will be an essential component in assuring quality in the implementation of Title XXI of the Social Security Act, the new State Child Health Insurance Program (SCHIP). With this federal announcement and with nationwide acceptance of Bright Futures: Guidelines for Health Supervision of Infants, Children and Adolescents, the Maternal and Child Health Bureau is supporting the National Center for Education in Maternal and Child Health (NCEMCH) in a multiyear implementation phase: Building Bright Futures. The publication Bright Futures in Practice: Oral Health is the first volume in the second generation of Bright Future's publications. Utilizing its successful methodology of collaborating with many partners, NCEMCH has formed multidisciplinary panels of experts to prepare population-specific publications and provide implementation tools and training to broaden the movement for a series of guidelines and materials that respond to current and emerging needs of children and adolescents.     

白求恩医科大学十年科研项目概况分析

对白求恩医科大学１９８８－１９９７年间各顷主管部门批准的科研项目及经费情况进行了分析,并与国内其它９所部属院校１９８８－１９９７年间获准国家自然科学基金情况进行了比较。     

重视医院知识产权保护

简述了医院知识产权保护的范围及其重要性,提出医院知识产权保护现状不容乐观,强调必须尽快加强医院知识产权管理,重点一是要强化知识产权意识,建立相应的机构与制度;二是要对科研项目和商业技术秘密等实行全程知识产权跟踪管理;三是要专设科研项目知识产权协调管理员;四是要为知识产权保护提供相应的配套服务,并制定激励政策.     

ISO9000族国际标准与医学科研管理

科研是医科大学研究所生存的根本。在新形势下如何加强科研管理、提高科研水平是现代化研究所发展的关键。本文将ISO9000族国际标准的一般原理应用于科研管理。提出了以全新的质量理念、科学的管理方法、先进的管理模式做好医学科研工作的对策。     

2001-2004年《中国胸心血管外科临床杂志》引文分析

目的 了解《中国胸心血管外科临床杂志》引文引用规律及情报吸收能力，找出我国胸心血管外科研究领域科研及临床人员的文献需求特征，为该学科研究人员利用文献提出建议。方法 采用引文计量分析法按文章发表的时序逐篇统计该刊2001-2004年刊载的639篇文章所引用的参考文献。结果 引文率为78．72％，篇均引文量为7．88条，主要引文类型为期刊（94．90％）和图书（5．10％），普赖斯指数52．33％，作者自引率2．36％，期刊自引率3．61％。被引用频次前20位的中外文期刊的引文量占引文总量的48．17％。结论 中国胸心血管外科杂志是该领域高水平的专业学术期刊。引文类型以期刊为主，引文语种以英、中文为主．引文内容新颖性好．质量水平高。