The REV2 gene of Saccharomyces cerevisiae: cloning and DNA sequence

Summary The REV2 gene of Saccharomyces cerevisiae was cloned and sequenced; it contains an open reading frame of 1985 bp with a coding potential of 662 amino acids. Interruption of the chromosomal REV2 gene by integrating the URA3 gene coupled with partial deletion of the 3 terminal region produced viable haploid rev2 mutants. This indicates that the REV2 gene is non-essential for growth. The rev2 mutant is slightly more UV-sensitive than strains carrying various rev2 alleles (rev2-1, rev2x, rad5-1, rad5-8). The putative Rev2 protein is probably a globular protein containing a highly conserved nucleotide-binding site and two zinc-finger domains.     

慢性肾脏病继发甲状旁腺功能亢进外科临床实践中国专家共识（2021版）

正慢性肾脏病(chronic kidney disease,CKD)已成为影响公共卫生健康的全球性问题。据统计,我国CKD的患病率估计为10.8%(11.7%～15.1%)[1-2]。继发性甲状旁腺功能亢进(secondary hyperparathyroidism,SHPT)是CKD病人常见的并发症之一,临床表现为甲状旁腺激素(parathyroid hor-mone,PTH)升高,持续性高磷、高钙或低钙血症,可导致皮肤、骨骼及心脑血管等多系统疾病,严重影响病人的生活质量和长期生存。     

儿童肝移植围手术期管理专家共识

肝移植是治疗儿童各种急慢性终末期肝病和遗传代谢性疾病的有效手段,已在全国多家移植中心开展,并取得满意效果。然而,各移植中心的发展不均衡,缺乏行业内统一的共识及标准。为减少术后并发症、加快患儿术后康复、改善患儿短期及长期生活质量,中国研究型医院学会加速康复外科专业委员会组织多个学科的专家,总结国内外儿童肝移植的研究进展,依据循证医学原则深入论证并制定了本共识。本共识从围手术期肝移植患儿的术前评估和准备、术中管理、术后管理三个方面提出了推荐意见,以期为正在开展或准备开展儿童肝移植的中心提供参考。     

医学专家决策支持系统的发展与现状综述

本文简要介绍了医学专家系统的发展过程、现状及趋势,综述了目前国内外医学专家系统的大致种类和取得的成果,并对未来医学专家系统的发展趋势做了探讨。     

针灸专家系统的研制

皮温、皮电、脉相是机体状况的综合敏感反映，本课题研究的是皮温、皮阻、脉相对针刺的响应，进而发展成为诊断２治疗系统。该系统由三大部分组成；（１）检测系统；（２）分析系统；（３）治疗输出系统。本的专家系统知识在知识表示上采用模糊产生式 ，在推理方法上采用加权模糊逻辑模型，在推理策略上提出了混合推理模式，在数字信号自理方面采用汇编语言与０混合编程，有效地降低了系统运行费用，实现了诊断、治疗一体化。     

Patient-Centered Care for Women: Delphi Consensus on Evidence-Derived Recommendations

ObjectivePatient-centered care (PCC) could reduce gender inequities in quality of care. Little is known about how to implement patient-centered care for women (PCCW). We aimed to generate consensus recommendations for achieving PCCW.MethodsWe used a 2-round Delphi technique. Panelists included 21 women of varied age, ethnicity, education, and urban/rural residence; and 21 health professionals with PCC or women’s health expertise. Panelists rated recommendations, derived from prior research and organized by a 6-domain PCC framework, on a 7-point Likert scale in an online survey. We used summary statistics to report response frequencies and defined consensus as when ≥85% panelists chose 5 to 7.ResultsThe response rate was 100%. In round 1, women and professionals retained 46 (97.9%) and 42 (89.4%) of 47 initial recommendations, respectively. The round 2 survey included 6 recommendations for women and 5 recommendations for professionals (did not achieve consensus in round 1 or were newly suggested). In round 2, women retained 2 of 6 recommendations and professionals retained 3 of 5 recommendations. Overall, 49 recommendations were generated. Both groups agreed on 44 (94.0%) recommendations (13 retained by 100% of both women and clinicians): fostering patient-physician relationship (n = 11), exchanging information (n = 10), responding to emotions (n = 4), managing uncertainty (n = 5), making decisions (n = 8), and enabling patient self-management (n = 6).ConclusionThe recommendations represent the range of PCC domains, are based on evidence from primary research, and reflect high concordance between women and professional panelists. They can inform the development of policies, guidelines, programs, and performance measures that foster PCCW.     

Nature and Predictors of Response Changes in Modified-Delphi Panels

ObjectivesTo describe the extent and nature of changes in participants’ responses after exposure to group feedback and discussion in modified-Delphi panels and to identify factors affecting those changes.MethodsWe analyzed data from 2 online modified-Delphi panels, each consisting of 2 rating rounds and an online discussion round. We included responses from 55 participants who answered 38 questions in both rating rounds. Because not all participants answered each question twice, our sample consisted of 1846 cases (response changes). We used mixed-effect logistic and multinomial logistic regression to identify factors predicting response changes and their direction relative to group median—our consensus measure.ResultsParticipants changed, on average, 49% of their responses. A response was changed in 47% of the 1846 cases: 28% of responses were changed toward consensus and 19% away from it. Although some measures of subjective participation experiences had a marginally significant impact on the propensity and direction of response changes, several objective measures of discussion engagement were statistically significant predictors of both the presence and direction of response changes.ConclusionOur results illustrate the nature of response changes and highlight the importance of exposing participants to alternative perspectives and encouraging them to explain their perspectives.