How Does Triage by an Electronic Symptom Checker Match with Triage by a Nurse?

Publisher Copyright: © 2022 European Federation for Medical Informatics (EFMI) and IOS Press.Electronic symptom checkers (ESCs) have been developed to make triage for primary health care patients in Finland. Based on the analysis of the patient's responses to a set of questions, the ESC classifies him/her as emergent, urgent, not urgent, or advices on self-care. In this study the user answered the questions posed by the electronic symptom checker, after which a nurse assessed the urgency of the same user's symptom. The triage nurse was not allowed to know the result of the electronic symptom assessment until he or she had assessed the patient's condition. The level of triage was compared between ESC and nurse in each individual case. Findings from 825 individual cases were analyzed. The mean 'exactly matched' for all symptom estimates was 52.6%. The mean 'exactly matched' or 'overconservative but suitable' for all symptom assessments was 66.6%. Safe assessments of electronic symptom checkers accounted for 98.6% of all assessments. A case was defined as 'safe' if the recommendation for action given by the symptom assessment was at most one level less urgent than the nurse's triage assessment of the same case. The findings show that electronic symptom assessments are safe compared to the assessment of an experienced nurse Omaolo.Peer reviewe

Equity pledge of controlling shareholders, property right structure and enterprise innovation efficiency: evidence from Chinese firms

The innovation efficiency of an enterprise is subject to the behavior of the innovation subject, while the equity pledge behavior of the controlling shareholder not only brings convenience for innovation investment and financing, but also brings risks which has an impact on the innovation output of the enterprise. In this paper, we investigate how equity pledge of controlling shareholders affect the enterprise innovation efficiency using the data of China’s A-share listed companies from 2014 to 2020, and examine the effect of property right structure on the relationship between them from the two dimensions of equity nature and equity concentration. We find that equity pledge of controlling shareholders are signifcantly negatively related to innovation efficiency, meaning that equity pledge inhibits the innovation behavior of enterprises and reduces the innovation efficiency. We further provide evidence to show that the impediment effect of equity pledge of controlling shareholder on enterprise innovation efficiency is more pronounced in non-state-owned enterprises and decentralized equity enterprises. Moreover, our analysis shows that different equity concentration levels have different effects in the process of equity pledge affecting enterprise innovation efficiency and the effect of concentrated equity enterprises is lower than that of decentralized enterprises

Analysis of Transcriptome and Terpene Constituents of Scots Pine Genotypes Inherently Resistant or Susceptible to Heterobasidion annosum

Root and stem rot caused by Heterobasidion annosum is a severe problem in boreal Scots pine. Dissecting the features of disease resistance is generally an essential step in resistance breeding in plants and forest trees. In this study, we explored inherent resistance factors of Scots pine against H. annosum. A total of 236 families consisting of 85 full-sib (FS), 35 half-sib population mix (HSpm), and 116 half-sib (HS) families of Scots pine seedlings were inoculated with a H. annosum isolate. We sampled needle tissues before inoculation for terpene measurements and RNA sequencing. Based on the lesion area, the extremes of 12 resistant and 12 susceptible families were selected for further analyses. Necrotic lesions resulting from fungal infection were in a weak to moderate relationship with the plant height. Monoterpenes were the principal terpene compounds observed in Scots pine seedlings. Concentrations of 3-carene were significantly higher in pine genotypes inherently resistant compared with susceptible seedlings. By contrast, susceptible genotypes had significantly higher proportions of alpha-pinene. Gene ontology analysis of differential expressed transcripts (DETs) revealed that response to biotic factors was enriched in resistant seedlings. Functional characterization of individual DETs revealed that higher expression of transcripts involved in response to abiotic stress was common in susceptible genotypes. This observation was supported by the annotation of hub genes in a key module that was significantly correlated with the lesion trait through weighted gene co-expression network analysis (WGCNA) of 16 HS and HSpm samples. These findings contribute to our understanding of constitutive resistance factors of Scots pine against Heterobasidion root and stem rot diseases.Peer reviewe

Research Progress on Ferroptosis as a Therapeutic Strategy in Renal Cell Carcinoma

Renal cell carcinoma (RCC) is a common type of kidney cancer in adults and constitutes approximately 90% of all renal malignancies. Although advancements have been made in the treatment of RCC, the 5 -year survival rate is still low, and new treatment modalities are still required. Ferroptosis is an iron-dependent programmed cell death caused by the accumulation of lipid peroxide products. Recent studies revealed the involvement of ferroptosis metabolism, lipid peroxidation, and System XC-GSH-GPX4 shafts as major mechanisms closely related to RCC progression. Nanoparticles in combination with small molecular ferroptosis induction agents have the advantages of solubility, targeted enhancement, low systemic toxicity, controllable drug control, and synergy advantage in emerging combination therapies. In the future, it is possible to be used in nano treatment. The relationship between ferroptosis-related mechanisms and RCC progression and its role in the treatment could provide novel treatment strategies for patients with advance-stage RCC

Dual RNA-seq analysis provides new insights into interactions between Norway spruce and necrotrophic pathogen Heterobasidion annosum s.l.

BackgroundRoot and butt rot of conifer trees caused by fungi belonging to the Heterobasidion annosum species complex is one of the most economically important fungal diseases in commercial conifer plantations throughout the Northern hemisphere. We investigated the interactions between Heterobasidion fungi and their host by conducting dual RNA-seq and chemical analysis on Norway spruce trees naturally infected by Heterobasidion spp. We analyzed host and pathogen transcriptome and phenolic and terpenoid contents of the spruce trees.ResultsPresented results emphasize the role of the phenylpropanoid and flavonoid pathways in the chemical defense of Norway spruce trees. Accumulation of lignans was observed in trees displaying symptoms of wood decay. A number of candidate genes with a predicted role in the higher level regulation of spruce defense responses were identified. Our data indicate a possible role of abscisic acid (ABA) signaling in the spruce defense against Heterobasidion infection. Fungal transcripts corresponding to genes encoding carbohydrate- and lignin-degrading enzymes, secondary metabolism genes and effector-like genes were expressed during the host colonization.ConclusionsOur results provide additional insight into defense strategies employed by Norway spruce trees against Heterobasidion infection. The potential applications of the identified candidate genes as markers for higher resistance against root and butt rot deserve further evaluation.Peer reviewe

Polymorphisms, Mutations, and Amplification of the EGFR Gene in Non-Small Cell Lung Cancers

Masaharu Nomura and colleagues examine the distribution ofEGFR polymorphisms in different populations and find differences that might explain different responses to tyrosine kinase inhibitors in lung cancer patients

Livestock overgrazing disrupts the positive associations between soil biodiversity and nitrogen availability

8 páginas.- 4 figuras.- 1 tabla.- 64 referencias.- Additional supporting information may be found online in the Supporting Information sectionLivestock overgrazing influences both microbial communities and nutrient cycling in terrestrial ecosystems. However, the role of overgrazing in regulating the relationship between soil biodiversity and nitrogen availability remains largely unexplored.We performed long-term grazing exclusion experiments across eight sites along precipitation gradient covering three major types of grassland in northern China to compare the linkage between soil microbial diversity and N availability in overgrazed versus non-grazed conditions.We found a significantly positive association between fungal diversity and soil available N in non-grazed grasslands. However, the positive association was absent in overgrazed environments. Bacterial diversity is not related to soil available N in either non-grazed or overgrazed grasslands. Moreover, in bacterial community, we found a positive link between the relative abundance of Actinobacteria with soil available N in non-grazed, but not overgrazed, grasslands. Instead we found the links between relative abundance of Bacteroidetes and Acidobacteria with soil available N in overgrazed grasslands, but not non-grazed, grasslands.Synthesis. Our work provides evidence that the relationships between microbial diversity and ecosystem functions are context-dependent, and so microbial community diversity is likely not the major driver of soil N mineralization in overgrazed grasslands. Our study suggests that high intensity anthropogenic activities in grasslands restrains the capacity of diverse soil microbial communities to sustain ecosystem function, and more broadly the capacity of entire ecosystems to maintain important ecosystem processes such as plant production. Our study also indicates that the fundamental microbial communities associated with N availability change with differing land management strategies (e.g. livestock grazing).National Natural Science Foundation of China, Grant/Award Number: 31772652, U1603235, 31660679 and 31770500; National Key Research and Development Program of China, Grant/Award Number: 2016YFC0500602; Program for Introducing Talents to Universities, Grant/Award Number: B16011; Ministry of Education Innovation Team Development Plan, Grant/Award Number: 2013-373; Innovative Team of Grassland Resources from the Ministry of Education of China, Grant/Award Number: IRT_17R59; Horizon 2020 Framework Program, Grant/Award Number: H2020-MSCA-IF-2016Peer reviewe