Preliminary Analysis of Competency Assessment of Organ Donation Coordinators in Hunan Province, China

BACKGROUND

The organ donation coordinator is indispensable in the process of organ donation and transplantation. The competency of coordinators is closely related to the organ donation rate.

OBJECTIVE

1) To construct a competency assessment system for organ donation coordinators; and 2) to evaluate the competency level of coordinators in Hunan province.

METHODS

We constructed the competency model framework for coordinators based on the McClelland competency model and then extracted and screened the competency indicators by interview and Delphi methods. Next, we determined the weight of the indicators by an analytic hierarchy process method. Finally, we evaluated the competency level of 42 coordinators in Hunan province with the use of our assessment system.

RESULTS

1) We constructed the competency evaluation system for organ donation coordinators, which included 6 dimensions and 21 competency indicators. 2) The average competency score of 42 coordinators was 79.43 ± 8.51. Five coordinators were at qualified level (11.9%), 18 at moderate level (42.9%), 12 at good level (25.6%), and 7 at excellent level (16.7%).

CONCLUSIONS

1) This competency evaluation system for organ donation coordinators will provide scientific evidence for human resource management in health institutions. 2) The organ donation coordinators in Hunan were qualified, but their number was insufficient.

Duality in Power-Law Localization in Disordered One-Dimensional Systems

The transport of excitations between pinned particles in many physical systems may be mapped to single-particle models with power-law hopping, 1/r^{a}. For randomly spaced particles, these models present an effective peculiar disorder that leads to surprising localization properties. We show that in one-dimensional systems almost all eigenstates (except for a few states close to the ground state) are power-law localized for any value of a>0. Moreover, we show that our model is an example of a new universality class of models with power-law hopping, characterized by a duality between systems with long-range hops (a<1) and short-range hops (a>1), in which the wave function amplitude falls off algebraically with the same power γ from the localization center.

Characteristics, management, and outcome of primary hyperparathyroidism at a single clinical center from 2005 to 2016

This study presents the clinical and biochemical profiles of patients with PHPT between 2005 and 2016 at our center. Most PHPT patients in China show symptomatic features. The number of symptomatic and asymptomatic patients increased during that time, and the number of individuals with parathyroid carcinoma is now increasing.

INTRODUCTION

Over the last decade, the prevalence of primary hyperparathyroidism (PHPT) has increased sharply, and the number of individuals with parathyroid cancer is still trending upward. Little is known about the clinical outlook of the disease over the last decade in China. The aim of this study was to describe the clinical characteristics of PHPT patients at our center from January 2005 to December 2016.

METHODS

Two hundred sixty patients with PHPT visiting Shanghai Jiao Tong University Affiliated Sixth People's Hospital were enrolled retrospectively. The clinical manifestations and biochemical abnormalities of these patients were analyzed.

RESULTS

Among all patients, 73.1% had symptomatic PHPT, while the number of symptomatic and asymptomatic patients increased 1 to 2.5 times and 1.5 to 3 times, respectively, from 2005 to 2016. Bone pain and single adenoma were the most frequent signs and pathological results. The patients with parathyroid carcinoma over the last 5 years accounted for 90% (9/10) of all parathyroid carcinoma patients from 2005 to 2016, and parathyroid carcinoma patients had higher levels of serum calcium, parathyroid hormone (PTH), and serum creatinine (P < 0.05) than parathyroid hyperplasia and parathyroid adenoma patients.

CONCLUSIONS

Most patients with PHPT in China still exhibit classic clinical and biochemical features. Both symptomatic and asymptomatic patients have increased over the last 12 years. Although the proportion of parathyroid carcinoma was small, a noticeable upward tendency was observed at our center.

[Disease burden caused by violence in the Chinese population, in 1990 and 2013]

Objective: To analyze the disease burden of violence in the Chinese population, in 1990 and 2013. Methods: Indicators including mortality rate, years of life lost due to premature mortality (YLL), years lived with disability (YLD), and disability-adjusted of life years (DALY) related to violence, were extracted from the Global Burden of Disease 2013 and used to describe the burden of disease caused by violence in the Chinese population. Data related to corresponding parameters on disease burden of violence in 1990 and 2013 were described. Results: In 2013, a total of 20 500 people died of violent events, with the death rate as 1.44 per 100 000, in China. DALY caused by violence was 1.08 million person years in 2013. DALY caused by sharp violence was 0.47 million person years, with 0.09 million person years lost due to firearm violence. Disease burden caused by violence appeared higher in males than in females. When comparing with data from the 1990s, reductions were seen by 67.35% on the standardized death rate of violence, by 68.07% on the DALY attributable to violence, and by 70.47% on the standardized DALY rate attributable to violence, respectively, in 2013. Disease burden of violence among young adults and elderly was among the highest. When comparing with data from the 1990, DALY in 2013 decreased among all the age groups except for the 70-year-old showed an increase of 9.36%. The standardized DALY rate in 2013 showed a declining trend in all the age groups, mostly in the 0-4-year-old group. The standardized DALY rates caused by sharp violence or firearm decreased by75.11% and 83.20% in the 0-4-year-old group. Conclusion: In recent years, the disease burden caused by violence showed a decreasing trend but appeared higher in males however with the increase of DALY in the elder population.

[Disease burden on falls among elderly aged 70 and over in the Chinese population, in 1990 and 2013]

Objective: To analyze the disease burden of falls in Chinese population aged 70 and over, in 1990 and 2013 and to provide evidence for the development of prevention strategies on falls in the elderly. Methods: Indicators including mortality rate, years of life lost due to premature mortality (YLL), years lived with disability (YLD) and disability-adjusted of life years (DALY) on falls, were gathered from the results of Global Burden of Disease 2013 and used to describe the disease burden of falls in China by calculating the changing rates on corresponding parameters in 1990 and 2013. Results: In 2013, the number of deaths, YLLs, YLDs, DALYs caused by falls among Chinese population aged 70 and over were 48 800, 0.44 million person years, 0.30 millions person years, and 0.74 million person years, respectively. The standardized mortality rate, rates on YLLs, YLDs and DALYs of falls were 561.71 per 100 000, 55.87 per 100 000, 373.98 per 100 000 and 929.85 per 100 000, respectively. The burden of falls increased along with the increase of age. Compared with 1990, the number of deaths, YLLs, YLDs and DALYs caused by falls increased by 308.80%, 161.01%, 54.67% and 104.47%, respectively, in 2013, more seen in males than in females. The standardized mortality rate, YLLs and DALYs caused by falls increased by 63.67%, 38.54% and 73.08%, respectively, during 1990 and 2013. However, the standardized YLDs rate fell by 17.90% during the same period. Conclusion: Falls caused heavy disease burden which increased in 1990 and 2013 among the Chinese population aged 70 and over.

[Disease burden caused by suicide in the Chinese population, in 1990 and 2013]

Objective: To provide basic suicide prevention strategy through analyzing the disease burden of suicide in the Chinese population, in 1990 and 2013. Methods: Indicators including mortality rate, years of life lost due to premature mortality (YLL), years lived with disability (YLD), and disability-adjusted of life years (DALY) on suicide, were from the results of Global Burden of Disease 2013 and used to describe the burden of disease caused by suicide in Chinese population. Data described the disease burden of suicide in China by comparing the corresponding parameters in 1990 and 2013. Results: In 2013, the standard mortality on suicide was 9.08 per 100 000, and 73.39 per 100 000 in the 80 and above year-old, with the highest rates on DALY and YLL seen in the 75-79-year-old. Each parameter related to suicide burden in males appeared higher than that in females. Compare to data in the 1990s, these parameters declined in 2013, especially seen in females. The rate of YLLs/YLDs on suicide was 90.03 in 2013, 89.83 in males and 89.00 in females. Conclusion: The disease burden of suicide decreased sharply between 1990 and 2013 but was still a serious issue in the elderly that called for more attention.

Abstract P5-07-03: Withdrawn

This abstract was withdrawn by the authors.

[Antibody persistence following on different vaccination strategies of domestic measles, mumps and rubella combined attenuated live vaccine: a 3-year follow-up study]

Objective: To assess the 3-year antibody persistence after vaccination of domestic measles, mumps and rubella combined attenuated live vaccine (MMR) with different program. Methods: Children from three different vaccination strategies (Group 8 m MR: 8 months and 18 months vaccinated with measles-rubella combined attenuated live vaccine and domestic MMR,respectively; Group 8 m MMR: 8 months and 18 months both vaccinated with domestic MMR; Group 12 m MMR: 12 months and 22 months both vaccinated with domestic MMR ) were followed up in Zhejiang province in July 2015. There were 170 participants in Group 8 m MR, 171 participants in Group 8 m MMR and 173 participants in Group 12 m MMR selected by simple random sampling method .Blood samples (venous blood 2-3 ml) were collected 1 month after the first dose vaccination of MMR (only in Group 8 m MMR and Group 12 m MMR) and 3 years (36-38 months) after the last dose vaccination of MMR and tested for antibody IgG against Measles, Mumps and Rubella using ELISA. Seropostive rate and Geometric mean concentration (GMC) were calculated and compared among different groups by Chi-square test or Fisher exact test and Kruskal-Wallis H test. Results: A total of 514 participants (8 m MR: 170; 8 m MMR:171; 12 m MMR:173) were enrolled. The overall seropositivity rate of measles, mumps and rubella was 98.1% (504), 93.4% (480) and 88.1% (453), respectively, with corresponding GMC was 1 012.33 mU/ml, 502.87 U/ml and 50.53 U/ml respectively. There was no significant difference of seropositivity rate for measles among three groups (all groups were>97%). The highest seropositivity rate for mumps was found in the Group 12 m MMR with the rate of 98.8% (171/173), followed by Group 8 m MMR and Group 8 m MR with 93.0% (159/171) and 88.2%(150/170) respectively (Fisher exact test, P<0.001). The highest seropositivity rate for rubella was also found in the Group 12 m MMR with the rate of 94.8% (164/173), followed by Group 8 m MMR and Group 8 m MR with 86.6%(148/171) and 82.9%(141/170) respectively (Fisher exact test, P=0.002). The highest GMC of antibody against measles, mumps and rubella were all found in Group 12 m MMR, with 1 217.30 (1 119.35-1 323.82) mU/ml, 717.07 (643.83-798.65) U/ml and 62.54(56.21-69.58) U/ml respectively. The lowest GMC of antibody against measles and mumps were both in Group 12 m MR with 812.01 (734.52-897.67) mU/ml and 363.28 (305.42-432.11) U/ml respectively. The lowest GMC of antibody against rubella was in Group 8 m MMR with 44.10 (39.08-49.76) U/ml. These differences of GMCs among three groups were all reach significant means (P<0.05). Conclusion: High level seropostive rates and GMCs were exist against measles and rubella after 3-year vaccination of domestic MMR among different program. Higher antibody level against mumps were found in those children with two doses vaccination of MMR.

Coalescence of Macroscopic Flux Ropes at the Subsolar Magnetopause: Magnetospheric Multiscale Observations

We report unambiguous in situ observation of the coalescence of macroscopic flux ropes by the magnetospheric multiscale (MMS) mission. Two coalescing flux ropes with sizes of ∼1  R_{E} were identified at the subsolar magnetopause by the occurrence of an asymmetric quadrupolar signature in the normal component of the magnetic field measured by the MMS spacecraft. An electron diffusion region (EDR) with a width of four local electron inertial lengths was embedded within the merging current sheet. The EDR was characterized by an intense parallel electric field, significant energy dissipation, and suprathermal electrons. Although the electrons were organized by a large guide field, the small observed electron pressure nongyrotropy may be sufficient to support a significant fraction of the parallel electric field within the EDR. Since the flux ropes are observed in the exhaust region, we suggest that secondary EDRs are formed further downstream of the primary reconnection line between the magnetosheath and magnetospheric fields.

Two 'Candidatus Liberibacter asiaticus' Strains Recently Found in California Harbor Different Prophages

'Candidatus Liberibacter asiaticus' (CLas), an α-proteobacterium, is associated with citrus Huanglongbing (HLB; yellow shoot disease). In California, two cases of CLas have been detected in Los Angeles County, one in Hacienda Heights in 2012 and the other in San Gabriel in 2015. Although all infected trees were destroyed in compliance with a state mandate, citrus industry stakeholder concerns about HLB in California are high. Little is known about the biology of CLas, particularly the California strains, hindering effective HLB management efforts. In this study, next-generation sequencing technology (Illumina MiSeq) was employed to characterize the California CLas strains. Data sets containing >4 billion (Giga) bp of sequence were generated from each CLas sample. Two prophages (P-HHCA1-2 and P-SGCA5-1) were identified by the MiSeq read mapping technique referenced to two known Florida CLas prophage sequences, SC1 and SC2. P-HHCA1-2 was an SC2-like or Type 2 prophage of 38,989 bp in size. P-SGCA5-1 was an SC1-like or Type 1 prophage of 37,487 bp in size. Phylogenetic analysis revealed that P-HHCA1-2 was part of an Asiatic lineage within the Type 2 prophage group. Similarly, P-SGCA5-1 was part of an Asiatic lineage within Type 1 prophage group. The Asiatic relatedness of both P-HHCA1-2 and P-SGCA5-1 was further presented by single nucleotide polymorphism analysis at terL (encoding prophage terminase) that has been established for CLas strain differentiation. The presence of different prophages suggests that the two California CLas strains could have been introduced from different sources. An alternative explanation is that there was a mixed CLas population containing the two types of prophages, and limited sampling in a geographic region may not accurately depict the true CLas diversity. More accurate pathway analysis may be achieved by including more strains collected from the regions.

Magnitude of and gender differences in cardiovascular risk profiles among community residents in Shenzhen, China

OBJECTIVES

Understanding the prevalence of cardiovascular disease (CVD) risk factors has an impact on the public policy for initiating CVD prevention. This study aimed to examine the prevalence of current smoking, overweight/obesity, hypertension, diabetes mellitus (DM), and dyslipidemia among Shenzhen residents and to investigate gender differences in CVD risk profiles to identify the subgroups at higher risk.

STUDY DESIGN

A large cross-sectional study was conducted between April and May 2015.

METHODS

Using multistage cluster random sampling methods, a total of 1784 residents finished the face-toface interview survey. Physical examinations and blood tests were performed by qualified professionals.

RESULTS

The prevalence of current smoking, overweight/obesity, hypertension, DM, and dyslipidemia were 21.8%, 40.6%, 17.6%, 4.8%, and 35.7%, respectively. Clustering of two or more or three or more of CVD risk factors was noted in 35.7% and 14.1% of participants. The prevalence of current smoking (45.0% vs 1.1%, P < 0.001), overweight/obesity (48.5% vs 33.4%, P < 0.001), hypertension (19.7% vs 15.7%, P < 0.05), and dyslipidemia (46.5% vs 20.5%, P < 0.001) was found higher among male than among female participants.

CONCLUSIONS

This study adds to the evidence suggesting high prevalence rates of CVD risk factors and composite measures among Shenzhen residents. The higher level of CVD risk factors in male than in female residents is suggested. Effective population-based intervention programs such as smoking cessation, early detection, management, and treatment of hypertension, DM, and dyslipidemia should be initiated and enhanced especially among the males.

Protein arginine methyltransferase 5 functions as an epigenetic activator of the androgen receptor to promote prostate cancer cell growth

Protein arginine methyltransferase 5 (PRMT5) is an emerging epigenetic enzyme that mainly represses transcription of target genes via symmetric dimethylation of arginine residues on histones H4R3, H3R8 and H2AR3. Accumulating evidence suggests that PRMT5 may function as an oncogene to drive cancer cell growth by epigenetic inactivation of several tumor suppressors. Here, we provide evidence that PRMT5 promotes prostate cancer cell growth by epigenetically activating transcription of the androgen receptor (AR) in prostate cancer cells. Knockdown of PRMT5 or inhibition of PRMT5 by a specific inhibitor reduces the expression of AR and suppresses the growth of multiple AR-positive, but not AR-negative, prostate cancer cells. Significantly, knockdown of PRMT5 in AR-positive LNCaP cells completely suppresses the growth of xenograft tumors in mice. Molecular analysis reveals that PRMT5 binds to the proximal promoter region of the AR gene and contributes mainly to the enriched symmetric dimethylation of H4R3 in the same region. Mechanistically, PRMT5 is recruited to the AR promoter by its interaction with Sp1, the major transcription factor responsible for AR transcription, and forms a complex with Brg1, an ATP-dependent chromatin remodeler, on the proximal promoter region of the AR gene. Furthermore, PRMT5 expression in prostate cancer tissues is significantly higher than that in benign prostatic hyperplasia tissues, and PRMT5 expression correlates positively with AR expression at both the protein and mRNA levels. Taken together, our results identify PRMT5 as a novel epigenetic activator of AR in prostate cancer. Given that inhibiting AR transcriptional activity or androgen synthesis remains the major mechanism of action for most existing anti-androgen agents, our findings also raise an interesting possibility that targeting PRMT5 may represent a novel approach for prostate cancer treatment by eliminating AR expression.