Understanding the Impact of Indirect System Use in the hospital: A Control Perspective

In the hospital, designated system users (i.e., principal physicians) are usually found to delegate system-related tasks to other people (i.e., agent physicians). This behavior is termed as indirect use. Despite the prevalence of indirect use, the understanding of its clinical impacts is limited. In this research, we first propose different effects of indirect use on clinical care quality and physician–patient interaction care quality. We then draw on the agency theory and organization control literature to identify the moderating effects of three control mechanisms: input control, process control, and outcome control. A total of 242 physicians from a general public hospital were surveyed to verify the proposed hypotheses. The results show that three control mechanisms moderate the impacts of indirect use in different manners. Implications and plan for future research are then discussed

Catchment scale spatial variability of soil salt content in agricultural oasis, Northwest China

Soil salinization is a serious environmental problem in the world, especially in arid and semi-arid regions. Therefore, estimating spatial variability of soil salinity plays an important role in environmental sciences. Aiming at the problem of soil salinization inside an oasis, a case study was carried out at the Sangong River catchment in Xinjiang province, northwest China. Methods of classical statistics, geostatistics, remote sensing (RS) and geographic information system (GIS) were applied to estimate the spatial variability of soil salt content in the topsoil (0-20 cm) and its relationship with landscape structure at catchment scale. The objective of this study was to provide a scientific basis to understand the heterogeneous of spatial distribution of soil salt content at a large scale. The results revealed that (1) elevation of landform was a key factor for soil salt content's spatial variability, and soil salt content had a strong spatial autocorrelation, which was mainly induced by structural factors. (2) Mapping of soil salt content by Kriging and comparing it with landscape maps showed that area of soil salinization in old oasis was smaller than that in new oasis, and degree of soil salinization in old oasis was also lower than that in the new one. Among all landscapes, cropland was mostly affected by salinity, with 38.8% of the cropland in new oasis moderately affected by soil salinity, and 8.54% in old oasis

Domain fluctuations in a ferroelectric low-strain BaTiO3 thin film

A ferroelectric BaTiO3 thin film grown on a NdScO3 substrate was studied using x-ray photon correlation spectroscopy (XPCS) to characterize thermal fluctuations near the a/b to a/c domain structure transformation present in this low-strain material, which is absent in the bulk. XPCS studies provide a direct comparison of the role of domain fluctuations in first- and second-order phase transformations. The a/b to a/c domain transformation is accompanied by a decrease in fluctuation timescales, and an increase in intensity and correlation length. Surprisingly, domain fluctuations are observed up to 25 degrees C above the transformation, concomitant with the growth of a/c domains and coexistence of both domain types. After a small window of stability, as the Curie temperature is approached, a/c domain fluctuations are observed, albeit slower, potentially due to the structural transformation associated with the ferroelectric to paraelectric transformation. The observed time evolution and reconfiguration of domain patterns highlight the role played by phase coexistence and elastic boundary conditions in altering fluctuation timescales in ferroelectric thin films

Rapid, ultra low coverage copy number profiling of cell-free DNA as a precision oncology screening strategy.

Current cell-free DNA (cfDNA) next generation sequencing (NGS) precision oncology workflows are typically limited to targeted and/or disease-specific applications. In advanced cancer, disease burden and cfDNA tumor content are often elevated, yielding unique precision oncology opportunities. We sought to demonstrate the utility of a pan-cancer, rapid, inexpensive, whole genome NGS of cfDNA approach (PRINCe) as a precision oncology screening strategy via ultra-low coverage (~0.01x) tumor content determination through genome-wide copy number alteration (CNA) profiling. We applied PRINCe to a retrospective cohort of 124 cfDNA samples from 100 patients with advanced cancers, including 76 men with metastatic castration-resistant prostate cancer (mCRPC), enabling cfDNA tumor content approximation and actionable focal CNA detection, while facilitating concordance analyses between cfDNA and tissue-based NGS profiles and assessment of cfDNA alteration associations with mCRPC treatment outcomes. Therapeutically relevant focal CNAs were present in 42 (34%) cfDNA samples, including 36 of 93 (39%) mCRPC patient samples harboring AR amplification. PRINCe identified pre-treatment cfDNA CNA profiles facilitating disease monitoring. Combining PRINCe with routine targeted NGS of cfDNA enabled mutation and CNA assessment with coverages tuned to cfDNA tumor content. In mCRPC, genome-wide PRINCe cfDNA and matched tissue CNA profiles showed high concordance (median Pearson correlation = 0.87), and PRINCe detectable AR amplifications predicted reduced time on therapy, independent of therapy type (Kaplan-Meier log-rank test, chi-square = 24.9, p < 0.0001). Our screening approach enables robust, broadly applicable cfDNA-based precision oncology for patients with advanced cancer through scalable identification of therapeutically relevant CNAs and pre-/post-treatment genomic profiles, enabling cfDNA- or tissue-based precision oncology workflow optimization

The role of N-terminal pro-B-type natriuretic peptide in prognostic evaluation of heart failure

Heart failure (HF) is a growing challenge in the Asia Pacific region. N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a well-established tool for diagnosis of HF; however, it is relatively underutilized in predicting adverse outcomes in HF. Multiple studies have demonstrated the prognostic role of NT-proBNP in HF. A single value of NT-proBNP >5000 pg/mL predicts a worse outcome in hospitalized patients with HF with reduced ejection fraction (HFrEF). In stable outpatients with HFrEF, NT-proBNP > 1000 pg/mL predicts a poorer prognosis. NT-proBNP provides the same prognostic information in patients with HF with preserved ejection fraction (HFpEF) as in those with HFrEF. An expert panel composed of cardiologists mainly from Asia Pacific region was convened to discuss the utility of NT-proBNP in HF prognostication. This article summarizes available scientific evidence and consensus recommendations from the meeting

Profile storage of organic/inorganic carbon in soil: From forest to desert

Understanding the distribution of organic/inorganic carbon storage in soil profile is crucial for assessing regional, continental and global soil C stores and predicting the consequences of global change. However, little is known about the organic/inorganic carbon storages in deep soil layers at various landscapes. This study was conducted to determine the soil organic/inorganic carbon storage in soil profile of 0-3 m at 5 sites of natural landscape from forest to desert. Landscapes are temperate forest, temperate grassland, temperate shrub-grassland, temperate shrub desert, and temperate desert. Root mass density and carbon contents at the profile were determined for each site. The results showed that considerable decrease in root biomass and soil organic carbon content at the soil profile of 0-3 m when landscape varied from forest to desert along a precipitation gradient, while soil inorganic carbon content increased significantly along the precipitation gradient. Namely, for density of soil organic carbon: forest > grassland > shrub-grassland > shrub desert > desert; for density of soil inorganic carbon: forest, grassland < shrub-grassland < shrub desert < desert (P<0.05 in all cases). In landscapes other than forest, more than 50% soil carbon storage was found in 1-3 m depth. For grassland and shrub-grassland, the contribution from 1-3 m was mainly in the form of organic carbon, while for shrub desert and desert the contribution from this depth was mainly in the form of inorganic carbon. The comparison of soil C storage between top 0-1 m and 1-3 m showed that the using top 1 m of soil profile to estimate soil carbon storages would considerably underestimate soil carbon storage. This is especially true for organic soil carbon at grassland region, and for soil inorganic carbon at desert region. (C) 2010 Elsevier B.V. All rights reserved

Detection and isolation of disseminated tumor cells in bone marrow of patients with clinically localized prostate cancer

BackgroundDisseminated tumor cells (DTCs) have been reported in the bone marrow (BM) of patients with localized prostate cancer (PCa). However, the existence of these cells continues to be questioned, and few methods exist for viable DTC isolation. Therefore, we sought to develop novel approaches to identify and, if detected, analyze localized PCa patient DTCs.MethodsWe used fluorescence‐activated cell sorting (FACS) to isolate a putative DTC population, which was negative for CD45, CD235a, alkaline phosphatase, and CD34, and strongly expressed EPCAM. We examined tumor cell content by bulk cell RNA sequencing (RNA‐Seq) and whole‐exome sequencing after whole genome amplification. We also enriched for BM DTCs with α‐EPCAM immunomagnetic beads and performed quantitative reverse trancriptase polymerase chain reaction (qRT‐PCR) for PCa markers.ResultsAt a threshold of 4 cells per million BM cells, the putative DTC population was present in 10 of 58 patients (17%) with localized PCa, 4 of 8 patients with metastatic PCa of varying disease control, and 1 of 8 patients with no known cancer, and was positively correlated with patients’ plasma PSA values. RNA‐Seq analysis of the putative DTC population collected from samples above (3 patients) and below (5 patients) the threshold of 4 putative DTCs per million showed increased expression of PCa marker genes in 4 of 8 patients with localized PCa, but not the one normal donor who had the putative DTC population present. Whole‐exome sequencing also showed the presence of single nucleotide polymorphisms and structural variants in the gene characteristics of PCa in 2 of 3 localized PCa patients. To examine the likely contaminating cell types, we used a myeloid colony formation assay, differential counts of cell smears, and analysis of the RNA‐Seq data using the CIBERSORT algorithm, which most strongly suggested the presence of B‐cell lineages as a contaminant. Finally, we used EPCAM enrichment and qRT‐PCR for PCa markers to estimate DTC prevalence and found evidence of DTCs in 21 of 44 samples (47%).ConclusionThese data support the presence of DTCs in the BM of a subset of patients with localized PCa and describe a novel FACS method for isolation and analysis of viable DTCs.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151343/1/pros23896.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151343/2/pros23896_am.pd

Comprehensive Study in the Inhibitory Effect of Berberine on Gene Transcription, Including TATA Box

Berberine (BBR) is an established natural DNA intercalator with numerous pharmacological functions. However, currently there are neither detailed reports concerning the distribution of this alkaloid in living cells nor reports concerning the relationship between BBR's association with DNA and the function of DNA. Here we report that the distribution of BBR within the nucleus can be observed 30 minutes after drug administration, and that the content of berberine in the nucleus peaks at around 4 µmol, which is twelve hours after drug administration. The spatial conformation of DNA and chromatin was altered immediately after their association with BBR. Moreover, this association can effectively suppress the transcription of DNA in living cell systems and cell-free systems. Electrophoretic mobility shift assays (EMSA) demonstrated further that BBR can inhibit the association between the TATA binding protein (TBP) and the TATA box in the promoter, and this finding was also attained in living cells by chromatin immunoprecipitation (ChIP). Based on results from this study, we hypothesize that berberine can suppress the transcription of DNA in living cell systems, especially suppressing the association between TBP and the TATA box by binding with DNA and, thus, inhibiting TATA box-dependent gene expression in a non-specific way. This novel study has significantly expanded the sphere of knowledge concerning berberine's pharmacological effects, beginning at its paramount initial interaction with the TATA box