BACKGROUND & AIMS: :A toxic sensory neuropathy associated with exposure to inexpensive nucleoside analogue reverse transcriptase inhibitors (NRTIs) [particularly stavudine (d4T)] causes dilemmas in the management of patients with HIV, especially in resource-poor settings. Here patients (n = 96) attending Pokdisus AIDS Clinic at the Cipto Mangunkusumo Hospital, Jakarta who had been treated with d4T were screened for symptomatic neuropathy. Clinical, demographic, and genetic factors were considered as possible neuropathy risk factors. DNA from saliva was used to examine alleles of TNFA-308, BAT1 (intron 10), TNFA-1031, IL1A+4845, and IL12B (3' UTR). The prevalence of neuropathy (symptoms and signs) was 34%. On multivariate analysis, neuropathy following d4T exposure was associated with increasing age, increasing height, and TNFA-1031*2 (model p = 0.0009). Isoniazid exposure (present in 56% of patients) was not associated with neuropathy in this cohort, where all patients had received pyridoxine coadministration. These data suggest that a simple algorithm based on patient age, height, and TNF genotype could be used to predict the individual's risk of symptomatic neuropathy prior to prescription of d4T.

背景与目标： ：与廉价的核苷类似物逆转录酶抑制剂（NRTIs）[特别是司他夫定（d4T）]暴露有关的毒性感觉神经病会导致艾滋病毒患者的管理陷入困境，尤其是在资源贫乏地区。在这里，对接受过d4T治疗的雅加达Cipto Mangunkusumo医院的Pokdisus艾滋病诊所的患者（n = 96）进行了筛查，以检查是否患有症状性神经病。临床，人口和遗传因素被认为是可能的神经病危险因素。来自唾液的DNA用于检查TNFA-308，BAT1（内含子10），TNFA-1031，IL1A 4845和IL12B（3'UTR）的等位基因。神经病（症状和体征）的患病率为34％。在多变量分析中，d4T暴露后的神经病变与年龄增加，身高增加和TNFA-1031 * 2相关（模型p = 0.0009）。在这个队列中，所有患者均接受吡ido醇联合给药，异烟肼暴露（占56％的患者）与神经病变无关。这些数据表明，基于患者年龄，身高和TNF基因型的简单算法可用于在开处方d4T之前预测个体出现症状性神经病的风险。

BACKGROUND & AIMS: :Mycobacterial interspersed repetitive units variable number tandem repeat (MIRU-VNTR) typing of Mycobacterium tuberculosis complex (MTBC) isolates, based on 24 loci, is still widely used as the standard for routine molecular surveillance of tuberculosis (TB). QIAxcel system is proposed as an affordable tool that could replace conventional gel electrophoresis and provide high concordance with the reference methods regarding MIRU-VNTR typing of MTBC. We aimed to evaluate the QIAxcel accuracy for allele calling of MIRU-VNTR loci in two regional reference laboratories. A total of 173 DNA were used for the study. Results obtained with QIAxcel were compared to the reference results obtained with an ABI 3730 DNA analyzer. In Albania, the overall agreement with the reference method was 97.92%. A complete agreement result was obtained for 17 loci. In Tunisia, the overall agreement with the reference method was 98.95%. A complete agreement result was obtained for 17 loci. Overall agreement in both centers was 98.43%. In our opinion, use of QIAxcel technology has the potential to be reliable, given an optimized algorithm. Inaccuracies in sizing of long fragments should be solved, especially regarding locus 4052.

背景与目标： 结核分枝杆菌复合物（MTBC）分离株的分枝杆菌重复单元可变数目串联重复序列（MIRU-VNTR）分型，基于24个基因座，仍广泛用作常规的结核病分子监测（TB）标准。 QIAxcel系统被认为是一种经济实惠的工具，可以代替传统的凝胶电泳，并与有关MTBC的MIRU-VNTR分型的参考方法高度一致。我们旨在评估两个区域参考实验室中MIRU-VNTR基因座等位基因调用的QIAxcel准确性。该研究总共使用了173个DNA。将使用QIAxcel获得的结果与使用ABI 3730 DNA分析仪获得的参考结果进行比较。在阿尔巴尼亚，与参考方法的总体一致性为97.92％。获得了17个基因座的完整一致性结果。在突尼斯，与参考方法的总体一致性为98.95％。获得了17个基因座的完整一致性结果。两个中心的总体协议率为98.43％。我们认为，在优化算法的情况下，使用QIAxcel技术具有可靠的潜力。应该解决长片段大小不正确的问题，尤其是在4052位点上。

BACKGROUND & AIMS: BACKGROUND:Oral anticoagulants present multiple practical problems for patients undergoing chemotherapy. To assess the practice implications of anticoagulation therapy, a review was carried out. METHODS:A review of all patients with cancer treated with warfarin for venous thromboembolism (VTE) over a 1-year-period was carried out. Adverse events and therapeutic efficacy were assessed and the extra volume of work involved in monitoring was quantified. RESULTS:Fifty-five patients with cancer and VTE were treated with warfarin from 07/04 to 06/05. Twenty-one invasive interventions required disruption of anticoagulation. There were eight admissions for haemorrhage. Nine patients died while on warfarin. A total of 1,379 coagulation tests were performed. There were 382 extra dayward visits attributable to warfarin monitoring. On treatment, 13 patients (24%) were changed from warfarin therapy to low molecular weight heparin (LMWH). CONCLUSIONS:This study identifies and quantifies the extra resource utilization with warfarin therapy in patients undergoing chemotherapy.

背景与目标： 背景：口服抗凝剂给化疗患者带来了许多实际问题。为了评估抗凝治疗的实践意义，进行了回顾。
方法：对所有使用华法令治疗1年以上静脉血栓栓塞（VTE）的癌症患者进行了回顾。评估不良事件和治疗效果，并对监测所涉及的额外工作量进行量化。
结果：55例癌症和VTE患者在07/04至06/05期间接受了华法林治疗。 21项侵入性干预措施需要中断抗凝治疗。有八次因大出血入院。服用华法林时有9名患者死亡。总共进行了1379次凝血试验。由于对华法林的监测，每天有382次额外的日间访问。治疗后，有13例患者（24％）从华法林治疗改为低分子量肝素（LMWH）。
结论：本研究确定并量化了华法林治疗化疗患者额外的资源利用。

BACKGROUND & AIMS: BACKGROUND:Clinical research sites conduct trials with diverse complexities, timelines, and ever-changing workloads. Though the principal investigator (PI) is ultimately responsible for the content and conduct of trials, they rely heavily on site staff to successfully enroll and complete studies following good clinical practice (GCP) Guidelines. The mainstays of the site workforce are the clinical research coordinators (CRCs) to whom the trials are assigned. These CRCs work on many studies concurrently. Managing study assignments and workload is a difficult task that requires knowledge of the trial complexity, expected enrollment, and many other factors affecting performance. METHODS:Traditional methods for allocating workload to site staff quantitate trial complexity and estimate work hours by factoring in the number of trial participants. However, this does not account for the effects of associated workload or variability in staff attributes. It also neglects other factors that affect performance and assumes maximum enrollment and completion of the trial by all participants. This article introduces a novel approach that determines the effects of protocol complexity on CRC productivity without effort tracking. These metrics permit an assessment of how the CRC's performance is affected by the number of studies assigned. RESULTS:By understanding the effects of workload allocation on CRC productivity and capacity, the site manager can use an algorithmic approach toward improving performance. The process takes into account factors that are both within and outside the control of the site manager. CONCLUSION:Sites may benefit from analytics that measures how CRCs adapt to the effects of study complexity on cumulative workloads over time. Optimizing productivity also means conforming to GCP Guidelines and avoiding staff burnout. As studies become increasingly difficult, site managers need tools to manage complexity and balance workloads among staff.

背景与目标： 背景：临床研究站点以各种复杂性，时间表和不断变化的工作量进行试验。尽管首席研究人员（PI）最终负责试验的内容和进行，但他们仍然严重依赖现场人员按照良好临床实践（GCP）准则成功注册并完成研究。现场工作人员的主要力量是分配了试验的临床研究协调员（CRC）。这些CRC同时进行许多研究。管理研究任务和工作量是一项艰巨的任务，需要了解试验的复杂性，预期的入学率以及许多其他影响绩效的因素。
方法：传统的分配工作量给现场人员的方法是通过考虑试验参与者的数量来量化试验的复杂性并估算工作时间。但是，这并未考虑相关工作量或人员属性变化的影响。它还忽略了影响性能的其他因素，并假定所有参与者的注册人数和试验完成人数都达到了上限。本文介绍了一种新颖的方法，该方法无需费力即可确定协议复杂度对CRC生产率的影响。这些指标可以评估CRC的表现如何受到分配的研究数量的影响。
结果：通过了解工作负载分配对CRC生产率和容量的影响，站点管理员可以使用算法方法来提高性能。该过程考虑了站点管理员控制范围之内和之外的因素。
结论：站点可从分析中受益，该分析可测量CRC如何适应研究复杂性随时间推移对累积工作量的影响。优化生产力还意味着要符合GCP准则并避免员工精疲力尽。随着研究变得越来越困难，站点管理员需要工具来管理复杂性并平衡员工之间的工作量。

BACKGROUND & AIMS: :A current, widespread example of vegetation change is the invasion of grassland by woody plants. This is associated with an increase in soil heterogeneity, and it has been argued that woody plants both cause and benefit from high heterogeneity. We know of no experimental demonstrations of differences between grasses and woody plants in their effects on heterogeneity. Here we compare heterogeneity between mixed-grass prairie and aspen forest, and we report the results of a soil transplant experiment that tested for differences between these vegetation types in their effects on soil resource heterogeneity. We measured the heterogeneity of resources and plant mass along 10 transects in both prairie and aspen forest in spring and summer. Light and available nitrogen (N; sum of ammonium and nitrate) were significantly more variable in forest than prairie, as were root and understory shoot mass. The variability of soil moisture and topography did not differ between prairie and forest. In our experiment, N and water in cores of prairie soil moved to forest attained the relatively high variability of forest soils. Further, forest soils moved to prairie attained the relatively low variability of prairie soils. In summary, both the biomass heterogeneity measurements and the soil transplant experiment suggested that plant uptake contributed to greater heterogeneity in forests.

背景与目标： ：目前，植被变化的一个广泛例子是木本植物入侵草原。这与土壤异质性的增加有关，有人认为木本植物既引起高异质性又从中受益。我们还没有实验证明草和木本植物对异质性的影响之间存在差异。在这里，我们比较了混合草草原和白杨林之间的异质性，并报告了一项土壤移植试验的结果，该试验测试了这些植被类型对土壤资源异质性的影响之间的差异。我们在春季和夏季测量了草原和白杨林中10个样带的资源和植物群的异质性。森林中的轻质氮和有效氮（N；铵态氮和硝酸盐之和）比大草原的根系和林下枝条的质量具有更大的可变性。草原和森林之间土壤水分和地形的变化没有差异。在我们的实验中，草原土壤核心中的氮和水分迁移到森林中获得了相对较高的森林土壤变异性。此外，迁移到草原的森林土壤的变异性相对较低。总而言之，生物量异质性测量和土壤移植实验均表明，植物吸收促进了森林中更大的异质性。

BACKGROUND & AIMS: :The Mental Health (Care and Treatment) (Scotland) Act 2003 was developed with the participation of patients and carers. This Act is fundamentally different from all previous versions of the Mental Health Acts in the UK because it is based on Millan's 10 principles. Its objective is to ensure that people with mental disorder receive effective care and treatment. It is crucial that all staff who deal with persons with mental disorder are familiar with the Act and incorporate it into practice. This depends on the effectiveness of educational resources in supporting staff to develop their practice. The project presented here was commissioned by the National Health Service Education for Scotland (NES) to evaluate the accessibility and use of the educational resources produced for all frontline staff in Scotland. The aim was to evaluate the educational resources produced by NES to prepare the frontline staff in relation to the Mental Health (Care and Treatment) (Scotland) Act 2003. Evaluation was conducted through a questionnaire survey, focus groups and individual interviews. The NES educational resource was effective in assisting professionals in implementing the complex and progressive requirements of the new Mental Health Act. The three formats reached a wide audience, and are an effective model for future initiatives.

背景与目标： ：2003年《精神健康（护理和治疗）（苏格兰）法》在患者和护理人员的参与下制定。该法案与英国以前的所有《精神卫生法案》根本不同，因为它基于Millan的10项原则。其目的是确保精神障碍患者得到有效的护理和治疗。所有与精神障碍患者打交道的工作人员都必须熟悉该法令并将其付诸实践，这一点至关重要。这取决于教育资源在支持员工发展实践方面的有效性。此处介绍的项目是受苏格兰国家卫生服务教育（NES）委托进行的，旨在评估为苏格兰所有一线工作人员提供的教育资源的可访问性和使用情况。目的是评估NES所提供的教育资源，以使其与2003年《精神卫生（护理和治疗）（苏格兰）法》相关，以准备一线员工。评估是通过问卷调查，焦点小组和个人访谈进行的。 NES的教育资源有效地协助了专业人员实施新的《精神卫生法》的复杂和渐进要求。这三种格式吸引了广泛的受众，并且是未来计划的有效模型。

BACKGROUND & AIMS: OBJECTIVE:Bedside chest ultrasonography, when integrated with clinical data, is an accurate tool for improving the diagnostic process of many respiratory diseases. This study aims to evaluate the feasibility of a chest ultrasonographic screening program in nursing homes for detecting coronavirus disease-19 (COVID-19)-related pneumonia and improving the appropriateness of hospital referral of residents. DESIGN:Pragmatic, descriptive, feasibility study from April 2 to April 9, 2020. SETTING AND PARTICIPANTS:A total of 83 older residents (age 85 ± 8) presenting mild to moderate respiratory symptoms and not previously tested for COVID-19, residing in 5 nursing homes in Northern Italy. METHODS:Chest ultrasonography was performed at the bedside by a team of hospital specialists with certified expertise in thoracic ultrasonography, following a systematic approach exploring 4 different areas for each hemithorax, from the anterior and posterior side. Presence of ultrasonographic signs of interstitial pneumonia, including comet-tail artifacts (B-lines) with focal or diffuse distribution, subpleural consolidations, and pleural line indentation, was detected. The specialist team integrated ultrasonography data with clinical and anamnestic information, and gave personalized therapeutic advice for each patient, including hospital referral when needed. RESULTS:The most frequent reasons for ultrasonographic evaluation were fever (63% of participants) and mild dyspnea (40%). Fifty-six patients (67%) had abnormal ultrasonographic findings. The most common patterns were presence of multiple subpleural consolidations (32 patients) and diffuse B-lines (24 patients), with bilateral involvement. A diagnosis of suspect COVID-19 pneumonia was made in 44 patients, and 6 of them required hospitalization. Twelve patients had ultrasonographic patterns suggesting other respiratory diseases, and 2 patients with normal ultrasonographic findings were diagnosed with COPD exacerbation. CONCLUSIONS AND IMPLICATIONS:In nursing home residents, screening of COVID-19 pneumonia with bedside chest ultrasonography is feasible and may represent a valid diagnostic aid for an early detection of COVID-19 outbreaks and adequate patient management.

背景与目标： 目的：床旁胸部超声检查与临床数据相结合，是改善许多呼吸系统疾病诊断过程的准确工具。这项研究的目的是评估在护理院中进行胸部超声检查程序以检测冠状病毒病19（COVID-19）相关性肺炎并提高住院病人转诊的适宜性的可行性。
设计：2020年4月2日至4月9日的实用，描述性，可行性研究。
地点和参加者：居住在意大利北部的5家疗养院中，共有83名年龄稍大的居民（年龄85±8），表现出轻度至中度的呼吸道症状，以前没有接受过COVID-19的测试。
方法：由一组经胸腔超声检查合格的专业医生在床旁进行胸部超声检查，采用系统的方法，从前侧和后侧针对每个半胸腔探查4个不同区域。检测到间质性肺炎的超声征象，包括具有局灶性或弥散性分布的彗尾伪影（B线），胸膜下巩固和胸膜线压痕。专家团队将超声检查数据与临床和记忆检查信息集成在一起，并为每位患者提供个性化的治疗建议，包括在需要时转诊医院。
结果：超声检查最常见的原因是发烧（占参与者的63％）和轻度呼吸困难（占40％）。五十六例患者（67％）超声检查结果异常。最常见的模式是多发性胸膜下巩固（32例）和弥漫性B线（24例），双侧受累。诊断为疑似COVID-19肺炎的44例患者，其中6例需要住院治疗。 12例患者的超声检查提示有其他呼吸系统疾病，其中2例超声检查结果正常的患者被诊断为COPD恶化。
结论和意义：在疗养院居民中，通过床旁胸部超声检查筛查COVID-19肺炎是可行的，并且可能是早期发现COVID-19暴发和适当患者管理的有效诊断手段。

BACKGROUND & AIMS: BACKGROUND:Many agricultural species and their pathogens have sequenced genomes and more are in progress. Agricultural species provide food, fiber, xenotransplant tissues, biopharmaceuticals and biomedical models. Moreover, many agricultural microorganisms are human zoonoses. However, systems biology from functional genomics data is hindered in agricultural species because agricultural genome sequences have relatively poor structural and functional annotation and agricultural research communities are smaller with limited funding compared to many model organism communities. DESCRIPTION:To facilitate systems biology in these traditionally agricultural species we have established "AgBase", a curated, web-accessible, public resource http://www.agbase.msstate.edu for structural and functional annotation of agricultural genomes. The AgBase database includes a suite of computational tools to use GO annotations. We use standardized nomenclature following the Human Genome Organization Gene Nomenclature guidelines and are currently functionally annotating chicken, cow and sheep gene products using the Gene Ontology (GO). The computational tools we have developed accept and batch process data derived from different public databases (with different accession codes), return all existing GO annotations, provide a list of products without GO annotation, identify potential orthologs, model functional genomics data using GO and assist proteomics analysis of ESTs and EST assemblies. Our journal database helps prevent redundant manual GO curation. We encourage and publicly acknowledge GO annotations from researchers and provide a service for researchers interested in GO and analysis of functional genomics data. CONCLUSION:The AgBase database is the first database dedicated to functional genomics and systems biology analysis for agriculturally important species and their pathogens. We use experimental data to improve structural annotation of genomes and to functionally characterize gene products. AgBase is also directly relevant for researchers in fields as diverse as agricultural production, cancer biology, biopharmaceuticals, human health and evolutionary biology. Moreover, the experimental methods and bioinformatics tools we provide are widely applicable to many other species including model organisms.

背景与目标： 背景：许多农业物种及其病原体均已测序基因组，并且仍在进行中。农业物种提供食物，纤维，异种移植组织，生物药物和生物医学模型。此外，许多农业微生物是人畜共患病。但是，由于功能基因组学数据的系统生物学在农业物种中受到了阻碍，因为与许多模型生物群落相比，农业基因组序列的结构和功能注释相对较差，并且农业研究界的规模较小，资金有限。
描述：为了促进这些传统农业物种中的系统生物学，我们建立了“ AgBase”，这是一个经过整理的，可通过网络访问的公共资源，网址为http://www.agbase.msstate.edu，用于农业基因组的结构和功能注释。 AgBase数据库包括一套使用GO批注的计算工具。我们遵循人类基因组组织基因命名准则使用标准化的命名法，目前正在使用基因本体论（GO）在功能上注释鸡，牛和绵羊的基因产品。我们开发的计算工具可以接受和批处理来自不同公共数据库（具有不同的登录代码）的数据，返回所有现有的GO批注，提供没有GO批注的产品列表，识别潜在的直系同源物，使用GO建模功能基因组学数据并提供帮助EST和EST组装的蛋白质组学分析。我们的日志数据库有助于防止多余的手动GO管理。我们鼓励并公开认可研究人员的GO注释，并为对GO和功能基因组数据分析感兴趣的研究人员提供服务。
结论：AgBase数据库是第一个专门用于对农业重要物种及其病原体进行功能基因组学和系统生物学分析的数据库。我们使用实验数据来改善基因组的结构注释并在功能上表征基因产物。 AgBase还与农业生产，癌症生物学，生物制药，人类健康和进化生物学等领域的研究人员直接相关。此外，我们提供的实验方法和生物信息学工具可广泛应用于包括模型生物在内的许多其他物种。

BACKGROUND & AIMS: INTRODUCTION:Klebsiella pneumoniae with OXA-48-like enzymes were introduced into Tshwane Tertiary Hospital (TTH) (Pretoria, South Africa) during September 2015, causing nosocomial outbreaks. METHODS:PCR methodologies and WGS were used to characterize K. pneumoniae with carbapenemases (n = 124) from TTH (July 2015-December 2016). RESULTS:PCR was used to track K. pneumoniae ST307 with OXA-181 among 60% of carbapenemase-positive isolates in different wards/units over time and showed the transmission of IncX3 plasmids to other K. pneumoniae clones. WGS identified different ST307 clades: 307_OXA181 (consisting of two lineages, A and B) with OXA-181 on IncX3 plasmids (named p72_X3_OXA181) and clade 307_VIM with VIM-1 on IncFII plasmids. Clade 307_OXA181 lineage B was responsible for the rapid increase and transmission of OXA-181 K. pneumoniae in various wards/units throughout TTH, while the numbers of clade 307_OXA181 lineage A and clade 307_VIM remained low. Separate outbreaks were due to K. pneumoniae ST17 and ST29 with p72_X3_OXA181 plasmids. CONCLUSIONS:The high-risk clone K. pneumoniae ST307 with OXA-181 rapidly spread to different wards/units despite infection and prevention measures. ST307 clades and lineages seemingly acted differently in outbreak situations. This study also highlighted the threat of promiscuous plasmids such as p72_X3_OXA181.

背景与目标： 简介：2015年9月，带有OXA-48样酶的肺炎克雷伯菌被引入茨瓦内第三医院（TTH）（南非比勒陀利亚），引起医院内暴发。
方法：使用PCR方法和WGS鉴定2015年7月至2016年12月来自TTH的碳青霉烯酶（n = 124）的肺炎克雷伯菌。
结果：PCR检测了不同病房/病房中60％碳青霉烯酶阳性分离物中随时间变化的OXA-181与肺炎克雷伯氏菌ST307的关系，并显示了IncX3质粒向其他肺炎克雷伯菌克隆的传播。 WGS鉴定了不同的ST307进化枝：在IncX3质粒（命名为p72_X3_OXA181）上具有OXA-181的307_OXA181（由两个谱系A和B组成），在IncFII质粒上鉴定了具有VIM-1的307_VIM进化枝。进化枝307_OXA181谱系B负责整个TTH中各个病房/单位中肺炎OXA-181肺炎克雷伯菌的快速增加和传播，而进化枝307_OXA181谱系A和进化枝307_VIM的数量保持较低。单独的暴发是由于带有p72_X3_OXA181质粒的肺炎克雷伯菌ST17和ST29引起的。
结论：尽管有感染和预防措施，但带有OXA-181的高危克隆肺炎克雷伯氏菌ST307仍可迅速传播到不同病房/病房。 ST307进化枝和血统在爆发情况下的表现似乎有所不同。这项研究还强调了混杂质粒（如p72_X3_OXA181）的威胁。

BACKGROUND & AIMS: OBJECTIVE:To evaluate the impact of child and adolescent mental health services (CAMHS) transformation in South East England on patient access, resource utilisation and health outcomes. DESIGN:In an observational study, we use difference-in-differences analysis with propensity score matching to analyse routinely collected patient level data. SETTING:Three CAMHS services in South East England. PARTICIPANTS:All patients attending CAMHS between April 2012 and December 2018, with more than 57 000 spells of care included. MAIN OUTCOME MEASURES:The rate and volume of people accessing CAMHS; waiting times to the first contact and waiting times between the first and second contact; and health outcomes, including the Strengths and Difficulties Questionnaire (SDQ) and the Revised Child Anxiety and Depression Scale (RCADS). RESULTS:The intervention led to 20% (incidence rate ratio: 1.20; 95% CI: 1.15 to 1.24) more new patients starting per month. There was mixed evidence on waiting times for the first contact. The intervention led to 10% (incidence rate ratio: 1.10; 95% CI: 1.02 to 1.18) higher waiting time for the second contact. The number of contacts per spell (OR: 1.08; 95% CI: 0.94 to 1.25) and the rereferral rate (OR: 1.06; 95% CI: 0.96 to 1.17) were not significantly different. During the post intervention period, patients in the intervention group scored on average 3.3 (95% CI: -5.0 to -1.6) points lower on the RCADS and 1.0 (95% CI: -1.8 to -0.3) points lower on the SDQ compared with the control group after adjusting for the baseline score. CONCLUSIONS:Overall, there are signs that transformation can help CAMHS achieve the objectives of greater access and improved health outcomes, but trade-offs exist among different performance metrics, particularly between access and waiting times. Commissioners and providers should be conscious of any trade-offs when undertaking service redesign and transformation.

背景与目标： 目的：评估英格兰东南部的儿童和青少年心理健康服务（CAMHS）转型对患者获取，资源利用和健康结果的影响。
设计：在一项观察性研究中，我们使用差异评分分析和倾向得分匹配来分析常规收集的患者水平数据。
地点：英格兰东南部的三项CAMHS服务。
参加者：2012年4月至2018年12月期间参加CAMHS的所有患者，包括57 000多种护理方式。
主要观察指标：访问CAMHS的人数和数量；第一联系人的等待时间以及第一联系人和第二联系人之间的等待时间；和健康结果，包括优势和困难问卷（SDQ）和修订后的儿童焦虑和抑郁量表（RCADS）。
结果：干预导致每月开始增加新患者20％（发生率：1.20； 95％CI：1.15至1.24）。关于首次联系的等待时间，有各种各样的证据。干预导致第二次接触的等待时间增加10％（发生率比率：1.10； 95％1.0CI：1.02至1.18）。每个咒语的接触次数（OR：1.08； 95％CI：0.94至1.25）和推荐率（OR：1.06； 95％CI：0.96至1.17）没有显着差异。在干预后期间，干预组患者在RCADS上平均得分低3.3分（95％CI：-5.0至-1.6），在SDQ上平均得分低1.0分（95％CI：-1.8至-0.3）。调整基线得分后，再与对照组进行比较。
结论：总的来说，有迹象表明，转型可以帮助CAMHS实现更多获取和改善健康结果的目标，但是在不同的绩效指标之间存在权衡，特别是在获取和等待时间之间。专员和提供者在进行服务重新设计和转换时应意识到任何权衡取舍。

BACKGROUND & AIMS: :Zebrafish is a common model organism in research and yet, despite its widespread use, anatomical resources for this species are incomplete or lacking in functionality. There remains a need for a single reference resource that integrates user-friendly tools to facilitate the identification of structures, display of reference images, provides data on gene expression, links to relevant literature, and covers the complete range of zebrafish developmental stages. To fulfill this need, we have designed the Zebrafish Anatomy Portal (www.zfap.org), containing annotated three-dimensional images of zebrafish at stages throughout development and adulthood, acquired by optical projection tomography. ZFAP combines functionalities to allow scanning through 3D data sets, searching of images by anatomical terms, predictions of gene expression from literature analysis, and facilitation of the identification of relevant literature through assisted searching of the NCBI PubMed resource. ZFAP provides a highly functional anatomical resource that will aid future education and research in the zebrafish model system.

背景与目标： 斑马鱼是研究中常见的模式生物，尽管用途广泛，但该物种的解剖资源不完整或缺乏功能。仍然需要一个单一的参考资源，该资源集成了易于使用的工具，以帮助识别结构，显示参考图像，提供有关基因表达的数据，链接到相关文献并涵盖斑马鱼发育阶段的整个范围。为满足此需求，我们设计了斑马鱼解剖门户网站（www.zfap.org），其中包含斑马鱼在整个发育和成年阶段的带注释的三维图像，这些图像是通过光学投影层析成像技术获得的。 ZFAP结合了各种功能，可以扫描3D数据集，通过解剖学术语搜索图像，通过文献分析预测基因表达，并通过辅助搜索NCBI PubMed资源来促进相关文献的鉴定。 ZFAP提供了功能强大的解剖资源，将有助于斑马鱼模型系统的未来教育和研究。

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: :This review covers the issue of kidney retransplantation. Patients waiting for a second transplant are increasing in number, and it is more and more difficult to find a suitable kidney. The main reasons are both clinical and immunological. Immunological problems are the most difficult to overcome. New techniques allow the identification of anti-HLA antibodies previously not easy to find. As a consequence, patients waiting for a new transplant are often hyperimmunized, and the cross-match is often positive. The authors discuss several immunosuppressive approaches for such patients and new allocation criteria to allow an easier retransplant. New allocation programs such as acceptable mismatch programs and paired kidney exchange programs are being implemented, and new drugs are now emerging allowing new desensitization criteria. Some of them are not yet on the market, but preliminary clinical studies show such drugs to be promising in a short time.

背景与目标： ：本文综述了肾脏移植的问题。等待第二次移植的患者数量在增加，找到合适的肾脏越来越困难。主要原因是临床和免疫学原因。免疫学问题是最难克服的。新技术可以鉴定以前不易发现的抗HLA抗体。结果，等待新移植的患者通常被超免疫，并且交叉匹配通常是阳性的。作者讨论了针对此类患者的几种免疫抑制方法，并提出了新的分配标准，以使重新移植更加容易。正在实施新的分配方案，例如可接受的失配方案和配对的肾脏交换方案，现在正在出现新的药物，允许使用新的脱敏标准。其中一些尚未上市，但初步临床研究表明此类药物在短期内很有希望。

BACKGROUND & AIMS: :A DNA microarray, comprising 70-mer oligonucleotides, representing 8,453 open reading frames (ORFs), was constructed based on the Bradyrhizobium japonicum strain USDA110 genomic sequence. New annotation predicted 199 additional genes, which were added to the microarray and were shown to be transcribed. These arrays were used to profile transcription in cells under a variety of conditions, including growth in minimal versus rich medium, osmotic stress, and free-living cells versus bacteroids. Increased expression was seen for genes involved in translation, motility, and cell envelope synthesis in rich medium whereas expression increased in minimal medium for genes involved in vitamin biosynthesis and stress responses. Treatment with 50 mM NaCl activated stress-inducible genes but repressed genes involved in chemotaxis and motility. Strikingly, no known transport systems for accumulation of compatible solutes or osmoprotectants were induced in response to osmotic stress. A number of nif, fix, and hup genes, but not all, were upregulated in bacteroids. The B. japonicum type III secretion system, known to be important in early nodulation, was downregulated in bacteroids. The availability of a reliable, low-cost B. japonicum microarray provides a useful tool for functional genomic studies of one of the most agriculturally important bacteria.

背景与目标： ：基于日本根瘤菌（Bradyrhizobium japonicum）菌株USDA110基因组序列，构建了一个DNA芯片，该芯片包含70个寡核苷酸，代表8453个开放阅读框（ORF）。新的注释预测了199个其他基因，这些基因已添加到微阵列中并显示为可转录的。这些阵列用于在各种条件下分析细胞中的转录情况，包括在最少量培养基与丰富培养基中的生长，渗透压以及在自由生活中的细胞与类细菌的生长。在丰富的培养基中，涉及翻译，运动和细胞包膜合成的基因表达增加，而在涉及维生素生物合成和应激反应的基因的基本培养基中，表达增加。用50 mM NaCl处理可激活应激诱导基因，但抑制了涉及趋化性和运动性的基因。令人惊讶的是，没有任何已知的响应于渗透压的积累相容性溶质或渗透保护剂的转运系统被诱导出来。许多nif，fix和hup基因（但不是全部）在类细菌中上调。已知在早期结瘤中很重要的日本血吸虫III型分泌系统在类细菌中被下调。可靠，低成本的日本根瘤菌微阵列的可用性为最重要的农业细菌之一的功能基因组研究提供了有用的工具。

BACKGROUND & AIMS: :Nitrogen (N) availability is a major factor determining plant growth and productivity. Plants acquire inorganic N from the soil, mainly in the form of nitrate and ammonium. To date, researchers have focused on these N sources, and demonstrated that plants exhibit elaborate responses at both physiological and morphological levels. Mixtures of nitrate and ammonium are beneficial in terms of plant growth, as compared to nitrate or ammonium alone, and therefore synergistic responses to both N sources are predicted at different steps ranging from acquisition to assimilation. In this review, we summarize interactions between nitrate and ammonium with respect to uptake, allocation, assimilation, and signaling. Given that cultivated land often contains both nitrate and ammonium, a better understanding of the synergism between these N sources should help to identify targets with the potential to improve crop productivity.

背景与目标： ：氮（N）的可用性是决定植物生长和生产力的主要因素。植物从土壤中获取无机氮，主要是以硝酸盐和铵的形式。迄今为止，研究人员已将重点放在这N种来源上，并证明植物在生理和形态学水平上均表现出精细的反应。与单独的硝酸盐或铵相比，硝酸盐和铵的混合物在植物生长方面是有益的，因此在从采集到同化的不同步骤中预测了对两种氮源的协同响应。在这篇综述中，我们总结了硝酸盐和铵盐之间在吸收，分配，同化和信号传导方面的相互作用。鉴于耕地通常同时含有硝酸盐和铵盐，因此更好地了解这些氮源之间的协同作用将有助于确定具有提高作物生产力潜力的目标。