Design Characteristics Influence Performance of Clinical Prediction Rules in Validation: A Meta-Epidemiological Study

Background

Many new clinical prediction rules are derived and validated. But the design and reporting quality of clinical prediction research has been less than optimal. We aimed to assess whether design characteristics of validation studies were associated with the overestimation of clinical prediction rules’ performance. We also aimed to evaluate whether validation studies clearly reported important methodological characteristics.

Methods

Electronic databases were searched for systematic reviews of clinical prediction rule studies published between 2006 and 2010. Data were extracted from the eligible validation studies included in the systematic reviews. A meta-analytic meta-epidemiological approach was used to assess the influence of design characteristics on predictive performance. From each validation study, it was assessed whether 7 design and 7 reporting characteristics were properly described.

Results

A total of 287 validation studies of clinical prediction rule were collected from 15 systematic reviews (31 meta-analyses). Validation studies using case-control design produced a summary diagnostic odds ratio (DOR) 2.2 times (95% CI: 1.2–4.3) larger than validation studies using cohort design and unclear design. When differential verification was used, the summary DOR was overestimated by twofold (95% CI: 1.2 -3.1) compared to complete, partial and unclear verification. The summary RDOR of validation studies with inadequate sample size was 1.9 (95% CI: 1.2 -3.1) compared to studies with adequate sample size. Study site, reliability, and clinical prediction rule was adequately described in 10.1%, 9.4%, and 7.0% of validation studies respectively.

Conclusion

Validation studies with design shortcomings may overestimate the performance of clinical prediction rules. The quality of reporting among studies validating clinical prediction rules needs to be improved.     

Tim-3 Is Upregulated in NK Cells during Early Pregnancy and Inhibits NK Cytotoxicity toward Trophoblast in Galectin-9 Dependent Pathway

NK cells accumulate at the maternal-fetal interface (MFI) and play essential roles in maintaining immune tolerance during pregnancy. The mechanisms that facilitate NK cells tolerance to fetal tissue are largely unknown. T cell Ig and mucin domain-containing protein 3 (Tim-3) is a newly defined molecule with essential immunological function in many physiological and pathological processes. Recent study showed that Tim-3 was involved in the regulation of immune tolerance at MFI. However, whether Tim-3 regulates NK cells cytotoxicity toward trophoblasts is unclear. Here, we showed Tim-3 was mainly expressed by decidual NK cells (dNK) and Tim-3 level in dNK was higher than peripheral NK cells (pNK). Tim-3⁺ dNK expressed more levels of mature markers CD94 and CD69 than Tim-3^- dNK cells and blocking Tim-3 significantly inhibited dNK IFN-γ and TNF-α secretion. Furthermore, we found TGF-β1 may contribute to such up-regulation of Tim-3 in NK cells. Interestingly, blocking Tim-3 enhanced NK cytotoxicity toward trophoblast cell line HTR-8 but not K562. We found HTR-8 expressed Tim-3 ligand Galectin-9, in contrast K562 did not. Small interfering RNA-mediated silencing of Galectin-9 expression enhanced NK cytotoxicity toward HTR-8. We further showed Tim-3/Galecin-9 inhibited NK cytotoxicity toward trophoblast partially via impairing the degranulation process. In addition, clinical data showed that abnormal Tim-3 level on pNK might be associated with recurrent spontaneous abortion (RSA). Thus, our data demonstrate Tim-3/Galectin-9 pathway maintains local tolerance by suppressing NK cytotoxicity toward trophoblasts which may represent a new immunologic tolerance mechanism at MFI.     

构建重组枯草芽孢杆菌催化制备D-对羟基苯甘氨酸

目的: 在Bacillus subtilis中表达异源D-海因酶基因(hyd)和D-氨甲酰水解酶基因(adc),构建重组细胞作为催化剂,用于生产D-对羟基苯甘氨酸(D-HPG)。方法: 构建hyd表达质粒,考察培养基中二价金属离子对D-海因酶活性的影响。过表达acoR基因,考察AcoR蛋白胞内水平与P_acoA-hyd基因拷贝数的关系。筛选表达adc基因的启动子,构建hyd和adc基因共表达质粒,考察双酶活性菌株的催化特性。结果: 成功构建了海因酶表达质粒pHPS和pUBS,培养基中添加0.8mmol/L的MnCl₂·4H₂O,使168N/pUBS菌株的D-海因酶活性达到956U/gDCW。整合表达P_cdd-acoR基因,使LSL02/pUBS菌株的D-海因酶活性达到1 470U/gDCW。单拷贝P_AE-adc基因的表达水平相对最高。双酶共表达质粒pUBSC被成功构建,菌株LSL02/pUBSC的最适催化温度为40℃45℃,催化活性能够持续12h,当底物起始浓度为20g/L时,反应12h生成的D-HPG达到14.32g/L,转化率达到95%,收率超过80%。结论: 构建具有D-海因酶和D-氨甲酰水解酶双酶活性的重组Bacillus subtilis作为全细胞催化剂,用于海因酶法生产D-HPG,具有技术上的可行性和优势。     

Polymorphic Microsatellite Markers for Solen grandis and Their Cross-Species Amplification in Three Other Species

The grand jackknife clam Solen grandis is a commercially important mollusk species, but has been suffering from severe population decline due to over-exploitation and habitat destruction in China. To promote a conservation program for this species, it is necessary to evaluate its genetic diversity and population genetics. In this study, 10 novel polymorphic microsatellite makers were developed and characterized from the S. grandis through high throughput sequencing. The number of alleles at each locus ranged from 10 to 34 with an average of 20.8 alleles per locus. The observed and expected heterozygosities varied from 0.433 to 1.000 and from 0.696 to 0.976, with an average of 0.793 and 0.884, respectively. The polymorphism information content (PIC) value ranged from 0.633 (Sg43838) to 0.958 (Sg3754), with an average of 0.858. The cross-species amplification transferability of 10 loci to three closely related species ranged from 4.17 to 62.5%. These microsatellite loci will be useful for further investigation of population structure and conversation genetics of this species.     

Discrimination of higher plant calluses based on embryogenic capacity and taxonomic classification by pyrolysis mass spectrometry

Pyrolysis mass spectrometry (PyMS) is a rapid, simple, high-resolution analytical method based on thermal degradation of complex material in a vacuum, and has been widely applied to the discrimination of closely related microbial strains. Minimally prepared samples of embryogenic and non-embryogenic calluses derived from various higher plants (sweet potato, morning glory, Korean ginseng, Siberian ginseng, and balloon flower) were subjected to PyMS for spectral fingerprinting. A dendrogram based on the unweighted pair group method, with arithmetic mean of pyrolysis mass spectra, divided the calluses into Siberian ginseng embryogenic callus and the others, which were subsequently divided into embryogenic and non-embryogenic callus groups, regardless of plant species from which the calluses were derived. In the non-embryogenic callus group, the dendrogram was in agreement with the known taxonomy of the plants. These results indicate that PyMS analysis could be applied for discriminating plant calluses based on embryogenic capacity and taxonomic classification.     

Protein-protein interfaces: properties, preferences, and projections

Herein, we study the interfaces of a set of 146 transient protein-protein interfaces in order to better understand the principles of their interactions. We define and generate the protein interface using tools from computational geometry and topology and then apply statistical analysis to its residue composition. In addition to counting individual occurrences, we evaluate pairing preferences, both across and as neighbors on one side of an interface. Likelihood correction emphasizes novel and unexpected pairs, such as the His-Cys pair found in most complexes of serine proteases with their diverse inhibitors and the Met-Met neighbor pair found in unrelated protein interfaces. We also present a visualization of the protein interface that allows for facile identification of residue-residue contacts and other biochemical properties.