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61.
Voorn VM de Mheen PJ So-Osman C Vlieland TP Gemert AW Nelissen RG van Bodegom-Vos L;for the LISBOA study group 《Implementation science : IS》2012,7(1):58-6
ABSTRACT: BACKGROUND: Total hip and knee arthroplasties are two of the most commonly performed procedures in orthopedic surgery. Different blood-saving measures (BSMs) are used to reduce the often-needed allogenic blood transfusions in these procedures. A recent large randomized controlled trial showed it is not cost effective to use the BSMs of erythropoietin and perioperative autologous blood salvage in elective primary hip and knee arthroplasties. Despite dissemination of these study results, medical professionals keep using these BSMs. To actually change practice, an implementation strategy is needed that is based on a good understanding of target groups and settings and the psychological constructs that predict behavior of medical professionals. However, detailed insight into these issuses is lacking. Therefore, this study aims to explore which groups of professionals should be targeted at which settings, as well as relevant barriers and facilitators that should be taken into acount in the strategy to implement evidence-based, cost-effective blood transfusion management and to de-implement BSMs. METHODS: The study consists of three phases. First, a questionnaire survey among all Dutch orthopedic hospital departments and independent treatment centers (n?=?99) will be conducted to analyze current blood management practice. Second, semistructured interviews will be held among 10 orthopedic surgeons and 10 anesthesiologists to identify barriers and facilitators that are relevant for the uptake of cost-effective blood transfusion management. Interview questions will be based on the Theoretical Domains Interview framework. The interviews will be followed by a questionnaire survey among 800 medical professionals in orthopedics and anesthesiology (400 professionals per discipline) in which the identified barriers and facilitators will be ranked by frequency and importance. Finally, an implementation strategy will be developed based on the results from the previous phases, using principles of intervention mapping and an expert panel. DISCUSSION: The developed strategy for cost-effective blood transfusion management by de-implementing BSMs is likely to reduce costs for elective hip and knee arthroplasties. In addition, this study will lead to generalized knowledge regarding relevant factors for the de-implementation of non-cost-effective interventions and insight in the differences between implementation and de-implementation strategies. 相似文献
62.
The patterns of synonymous codon usage in 91 Drosophila melanogaster genes
have been examined. Codon usage varies strikingly among genes. This
variation is associated with differences in G+C content at silent sites,
but (unlike the situation in mammalian genes) these differences are not
correlated with variation in intron base composition and so are not easily
explicable in terms of mutational biases. Instead, those genes with high
G+C content at silent sites, resulting from a strong "preference" for a
particular subset of the codons that are mostly C- ending, appear to be the
more highly expressed genes. This suggests that G+C content is reduced in
sequences where selective constraints are weaker, as indeed seen in a
pseudogene. These and other data discussed are consistent with the effects
of translational selection among synonymous codons, as seen in unicellular
organisms. The existence of selective constraints on silent substitutions,
which may vary in strength among genes, has implications for the use of
silent molecular clocks.
相似文献
63.
NICO PM. SMIT WIETE WESTERHOF WILMA J. MENKO NETTY M. VERBEEK STAN PAVEL 《Pigment cell & melanoma research》1995,8(1):19-27
Melanocyte cultures were established and maintained routinely in Ham's F-10 medium containing 12-O-tetradecanoyl-phorbol-13-acetate (TPA), isobutylmethylxanthine (IBMX), cholera toxin (CT) and fetal calf serum (FCS). Three serum substitutes (Ultroser-G, Nutridoma-Hu and Nutricyte-H) were tested in order to obtain a medium without FCS having a more constant composition. Melanocyte proliferation was examined in long-term culture experiments by in situ cell counts at different periods of time. Only with Ultroser-G (1-2%) was the proliferation of melanocytes maintained without both FCS and CT, whereas the addition of the other two serum substitutes resulted in stabilization of melanocyte densities in the cultures up to 28 days. In the medium containing 1% Ultroser-G and IBMX without TPA minimal or no increases in melanocyte density were found. Addition of basic fibroblast growth factor (bFGF, 1 ng/ml) to the medium without TPA resulted in a partial restimulation of growth in different experiments. In this system with 1% Ultroser-G and 1 ng/ml bFGF, IBMX could also be replaced by other factors (dbcAMP LTC4 and a purified form of α-melanocyte stimulating hormone). The culture medium with 1% Ultroser-G containing TPA and IBMX is now used for routine melanocyte culture. In this medium TPN/IBMX can easily be replaced by bFGF/dbcAMP with optimal growth stimulation. The combination bFGF/α-MSH and other more physiological stimulators offers an alternative to study responses of melanocytes in culture with respect to proliferation, metabolism, and phenotype. 相似文献
64.
Molecular evolution of mammalian aquaporin-2: further evidence that elephant shrew and aardvark join the paenungulate clade 总被引:1,自引:1,他引:0
Madsen O; Deen PM; Pesole G; Saccone C; de Jong WW 《Molecular biology and evolution》1997,14(4):363-371
A 328-bp sequence from exon 1 of the gene for aquaporin-2 (AQP2) was
compared in 12 mammalian species, representing as many eutherian orders.
This sequence encodes the N-terminal half of this kidney- specific water
channel protein. Most amino acid replacements, as well as an insertion,
have occurred in extracellular loops connecting the transmembrane helices,
in agreement with a lower functional importance of these loops.
Phylogenetic analyses were performed with parsimony, distance, and
maximum-likelihood methods. The AQP2 data set, alone as well as in
combination with previously published alpha A-crystallin protein sequences,
strongly supports a clade consisting of elephant, hyrax, aardvark, and
elephant shrew, reaching bootstrap values of 99%. This finding fully agrees
with the only other presently available sequence data sets that include
these taxa, those of von Willebrand factor and interphotoreceptor
retinoid-binding protein, and suggests that this extended paenungulate
clade is one of the most conspicuous superordinal groupings in eutherian
phylogeny. Some support was obtained for an artiodactyl/perissodactyl
clade, while the grouping of pholidotes with edentates was contradicted.
相似文献
65.
Chevonne D Eversley Tavia Clark Yuying Xie Jill Steigerwalt Timothy A Bell Fernando PM de Villena David W Threadgill 《BMC genetics》2010,11(1):1-6
Background
Sheep carcasses with yellow fat are sporadically observed at Norwegian slaughter houses. This phenomenon is known to be inherited as a recessive trait, and is caused by accumulation of carotenoids in adipose tissue. Two enzymes are known to be important in carotenoid degradation in mammals, and are therefore potential candidate genes for this trait. These are beta-carotene 15,15'-monooxygenase 1 (BCMO1) and the beta-carotene oxygenase 2 (BCO2).Results
In the present study the coding region of the BCMO1 and the BCO2 gene were sequenced in yellow fat individuals and compared to the corresponding sequences from control animals with white fat. In the yellow fat individuals a nonsense mutation was found in BCO2 nucleotide position 196 (c.196C>T), introducing a stop codon in amino acid position 66. The full length protein consists of 575 amino acids. In spite of a very low frequency of this mutation in the Norwegian AI-ram population, 16 out of 18 yellow fat lambs were found to be homozygous for this mutation.Conclusion
In the present study a nonsense mutation (c.196C>T) in the beta-carotene oxygenase 2 (BCO2) gene is found to strongly associate with the yellow fat phenotype in sheep. The existence of individuals lacking this mutation, but still demonstrating yellow fat, suggests that additional mutations may cause a similar phenotype in this population. The results demonstrate a quantitatively important role for BCO2 in carotenoid degradation, which might indicate a broad enzyme specificity for carotenoids. Animals homozygous for the mutation are not reported to suffer from any negative health or development traits, pointing towards a minor role of BCO2 in vitamin A formation. Genotyping AI rams for c.196C>T can now be actively used in selection against the yellow fat trait. 相似文献66.
Alien fishes are considered a major threat to aquatic biodiversity in South Africa, yet relatively little regional information on their biology and ecology is available for many of these species. Seasonal changes in the diet of the bluegill Lepomis macrochirus in Howieson’s Poort Dam, Grahamstown, were assessed during summer and winter in 2014–2015, using stomach content analysis. In winter, juvenile and adult fish diets were dominated by crustacean zooplankton and insects, respectively. In summer, juvenile fish fed on crustaceans and insects, whereas adults consumed mostly fish eggs, indicating a potential impact by these invasive fish on native fish through oophagy. 相似文献
67.
Jennifer H Humphreys Jessica AB van Nies Jackie Chipping Tarnya Marshall Annette HM van der Helm-van Mil Deborah PM Symmons Suzanne MM Verstappen 《Arthritis research & therapy》2014,16(6)
Introduction
This study aimed to investigate rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA) status and levels as predictors of mortality in two large cohorts of patients with early inflammatory arthritis (EIA).Methods
Data from the Norfolk Arthritis Register (NOAR) and Leiden Early Arthritis Clinic (EAC) cohorts were used. At baseline, patients had demographic data and smoking status recorded; RF, ACPA and inflammatory markers were measured in the local laboratories. Patients were flagged with national death registers until death or censor date. Antibody status was stratified as negative, low or high positive by RF and ACPA levels individually. In addition, patients were grouped as seronegative, RF positive, ACPA positive or double antibody (RF and ACPA) positive. Cox regression models explored associations between antibody status and mortality adjusting for age, sex, smoking status, inflammatory markers and year of enrolment.Results
A total of 4962 patients were included, 64% were female. Median age at onset was 56 (NOAR) and 54 (EAC) years. In NOAR and EAC respectively, 35% and 42% of patients were ACPA/RF positive. When antibody status was stratified as negative, low or high positive, there were no consistent findings between the two cohorts. Double antibody positivity was associated with excess mortality in both cohorts compared to seronegative patients: NOAR and EAC respective adjusted HR (95% confidence interval) 1.35 (1.09 to 1.68) and 1.58 (1.16 to 2.15).Conclusions
Patients with EIA who are seropositive for both RF and ACPA have increased mortality compared to those who are single positive or seronegative. Antibody level in seropositive patients was not consistently associated with excess mortality.Electronic supplementary material
The online version of this article (doi:10.1186/s13075-014-0483-3) contains supplementary material, which is available to authorized users. 相似文献68.
The rate of synonymous substitution in enterobacterial genes is inversely related to codon usage bias 总被引:31,自引:14,他引:31
Genes sequences from Escherichia coli, Salmonella typhimurium, and other
members of the Enterobacteriaceae show a negative correlation between the
degree of synonymous-codon usage bias and the rate of nucleotide
substitution at synonymous sites. In particular, very highly expressed
genes have very biased codon usage and accumulate synonymous substitutions
very slowly. In contrast, there is little correlation between the degree of
codon bias and the rate of protein evolution. It is concluded that both the
rate of synonymous substitution and the degree of codon usage bias largely
reflect the intensity of selection at the translational level. Because of
the high variability among genes in rates of synonymous substitution,
separate molecular clocks of synonymous substitution might be required for
different genes.
相似文献
69.
Molecular evolution of bacteriophages: evidence of selection against the recognition sites of host restriction enzymes 总被引:12,自引:0,他引:12
Restriction enzymes produced by bacteria serve as a defense against
invading bacteriophages, and so phages without other protection would be
expected to undergo selection to eliminate recognition sites for these
enzymes from their genomes. The observed frequencies of all restriction
sites in the genomes of all completely sequenced DNA phages (T7, lambda,
phi X174, G4, M13, f1, fd, and IKe) have been compared to expected
frequencies derived from trinucleotide frequencies. Attention was focused
on 6-base palindromes since they comprise the typical recognition sites for
type II restriction enzymes. All of these coliphages, with the exception of
lambda and G4, exhibit significant avoidance of the particular sequences
that are enterobacterial restriction sites. As expected, the sequenced
fraction of the genome of phi 29, a Bacillus subtilis phage, lacks Bacillus
restriction sites. By contrast, the RNA phage MS2, several viruses that
infect eukaryotes (EBV, adenovirus, papilloma, and SV40), and three
mitochondrial genomes (human, mouse, and cow) were found not to lack
restriction sites. Because the particular palindromes avoided correspond
closely with the recognition sites for host enzymes and because other
viruses and small genomes do not show this avoidance, it is concluded that
the effect indeed results from natural selection.
相似文献
70.