Barriers and opportunities to increase PD incidence and prevalence: Lessons from a European Survey

Introduction: Peritoneal dialysis (PD) remains underutilised and unplanned start of dialysis further diminishes the likelihood of patients starting on PD, although outcomes are equal to haemodialysis (HD). Methods: A survey was sent to members of EuroPD and regional societies presenting a case vignette of a 48-year-old woman not previously known to the nephrology department and who arrives at the emergency department with established end-stage kidney disease (unplanned start), asking which dialysis modality would most likely be chosen at their respective centre. We assessed associations between the modality choices for this case vignette and centre characteristics and PD-related practices. Results: Of 575 respondents, 32.8%, 32.2% and 35.0% indicated they would start unplanned PD, unplanned HD or unplanned HD with intention to educate patient on PD later, respectively. Likelihood for unplanned start of PD was only associated with quality of structure of the pre-dialysis program. Structure of pre-dialysis education program, PD program in general, likelihood to provide education on PD to unplanned starters, good collaboration with the PD access team and taking initiatives to enhance home-based therapies increased the likelihood unplanned patients would end up on PD. Conclusions: Well-structured pre-dialysis education on PD as a modality, good connections to dedicated PD catheter placement teams and additional initiatives to enhance home-based therapies are key to grow PD programs. Centres motivated to grow their PD programs seem to find solutions to do so.

Validation of the Chinese version of the Care Evaluation Scale for measuring the quality of structure and process of end-of-life care from the perspective of bereaved family

Background Assessing the quality of structure and process of end-of-life care can help improve outcomes. There was currently no valid tool for this purpose in Mainland China. The aim of this study is to validate the Chinese version of the Care Evaluation Scale (CES). Methods From January to December 2017, a cross-sectional online survey was conducted among bereaved family members of cancer patients from 10 medical institutes. The reliability of the CES was assessed with Cronbach’s α, and structural validity was evaluated by confirmatory factor analysis. Concurrent validity was tested by examining the correlation between the CES total score and overall satisfaction with end-of-life care, quality of dying and death, and quality of life. Results A total of 305 valid responses were analyzed. The average CES score was 70.7 ± 16.4, and the Cronbach’s α of the CES was 0.967 (range: 0.802–0.927 for the 10 domains). The fit indices for the 10-factor model of CES were good(root-mean-square error of approximation, 0.047; comparative fit index, 0.952; Tucker–Lewis index, 0.946; standardized root mean square residual, 0.053). The CES total score was highly correlated with overall satisfaction with medical care (r = 0.775, P < 0.01), and moderately correlated with patients’ quality of life (r = 0.579, P < 0.01) and quality of dying and death (r = 0.570, P < 0.01). In addition, few associations between CES total score and demographic characteristics, except for the family members’ age. Conclusions The Chinese version of the CES is a reliable and valid tool to evaluate the quality of structure and process of end-of-life care for patients with cancer from the perspective of bereaved family in Mainland China.

PyPLIF HIPPOS-Assisted Prediction of Molecular Determinants of Ligand Binding to Receptors

Identification of molecular determinants of receptor-ligand binding could significantly increase the quality of structure-based virtual screening protocols. In turn, drug design process, especially the fragment-based approaches, could benefit from the knowledge. Retrospective virtual screening campaigns by employing AutoDock Vina followed by protein-ligand interaction fingerprinting (PLIF) identification by using recently published PyPLIF HIPPOS were the main techniques used here. The ligands and decoys datasets from the enhanced version of the database of useful decoys (DUDE) targeting human G protein-coupled receptors (GPCRs) were employed in this research since the mutation data are available and could be used to retrospectively verify the prediction. The results show that the method presented in this article could pinpoint some retrospectively verified molecular determinants. The method is therefore suggested to be employed as a routine in drug design and discovery.

Validation of the Chinese Version of the Care Evaluation Scale for Measuring the Quality of Structure and Process of End-Of-Life Care From the Perspective of Bereaved Family

Background: Assessing the quality of structure and process of end-of-life care can help improve outcomes. There was currently no valid tool for this purpose in mainland China. The aim of this study is to validate the Chinese version of the Care Evaluation Scale (CES).Methods: From January to December 2017, a cross-sectional online survey was conducted among bereaved family members of cancer patients from 10 medical institutes. The reliability of the CES was assessed with Cronbach’s α, and structural validity was evaluated by confirmatory factor analysis. Concurrent validity was tested by examining the correlation between the CES total score and overall satisfaction with end-of-life care, quality of dying and death, and quality of life.Results: A total of 305 valid responses were analyzed. The average CES score was 70.67±16.42, and the Cronbach’s α of the CES was 0.967 (range: 0.802–0.927 for the 10 domains). The fit indices for the 10-factor model of CES were good (root-mean-square error of approximation, 0.047; comparative fit index, 0.952; Tucker–Lewis index, 0.946; standardized root mean square residual, 0.053). The CES total score was highly correlated with overall satisfaction with medical care (r=0.775, P<0.01), and moderately correlated with patients’ quality of life (r=0.579, P<0.01) and quality of dying and death (r=0.570, P<0.01). In addition, few associations between CES total score and demographic characteristics, except for the family members’ age.Conclusions: The Chinese version of the CES is a reliable and valid tool to evaluate the quality of structure and process of end-of-life care for patients with cancer from the perspective of bereaved family in mainland China.

Optimization of Botany Teaching Based on the Cultivation of Interest

Structure botany is a fundamental course in biotechnology. In order to improve the quality of structure botany teaching, this paper studies on the teaching management of structure botany in classrooms, the teacher's passion for work, and the standardization in teaching, so as to mobilize students' enthusiasm and initiative for learning, to develop their imagination and the ability to analyze and solve problems, and finally optimize the teaching patterns in classrooms. The paper aims to optimize teaching methods based on the existing problems of classroom botany teaching with developing students’ learning interest as its core, and as a result, to help students master effective methods of botany learning.

Structure of Government Support and Sustainability of SMEs in Uganda

This study was carried out to establish whether structure of government support has any association or influence onto sustainability of SMEs in Uganda. The focus was to ascertain whether there is a link between how government provides support to SMEs and sustainability of these SMEs. A maximum sample size of 384 SMEs was selected. Questionnaire approach was used to collect data from the owners and or managers of SMEs. Based on factor analysis, two components of structure of government support were established namely; quality of structure of government support and extent of policy implementation. To test the association of the variables, correlation analysis was carried out. The results from this analysis indicated that both components of structure of government support had significant association with SME sustainability in Uganda. Quality of structure however, had higher degree of association as compared to extent of policy implementation. Structural Equation Modeling (SEM) analysis was carried out to check the degree of influence of structure of government support onto SME sustainability. The results indicated that both components of structure of government support have influence onto SME sustainability. Based on this, it was concluded that structure of government support has a significant association with and influence onto SME sustainability in Uganda. It was therefore recommended that there was need for government support towards SMEs to be properly structured in order to realize SME sustainability. The structuring needs to take into consideration the quality of the structure as well as extent to which SME policy is implemented.

Evaluating DCA-based method performances for RNA contact prediction by a well-curated dataset

RNA molecules play many pivotal roles in the cellular functioning that are still not fully understood. Any detailed understanding of RNA function requires knowledge of its three-dimensional structure, yet experimental RNA structure resolution remains demanding. Recent advances in sequencing provide unprecedented amounts of sequence data that can be statistically analysed by methods such as Direct Coupling Analysis (DCA) to determine spatial proximity or contacts of specific nucleic acid pairs, which improve the quality of structure prediction. To quantify this structure prediction improvement, we here present a well curated dataset of about seventy RNA structures with high resolution and compare different nucleotide-nucleotide contact prediction methods available in the literature. We observe only minor difference between the performances of the different methods. Moreover, we discuss how these predictions are robust for different contact definitions and how strongly depend on procedures used to curate and align the families of homologous RNA sequences.

The development of criteria, indices and indicators and of medical care quality for patients with syndrome of diabetic foot in out-patient practice

The special techniques of evaluation of every single disease are required for assessing quality and effectiveness of treatment in out-patient practice. The purpose of study was development of criteria, indices and indicators of evaluation of quality of out-patient medical care of patients with syndrome of diabetic foot. The technique of literary searching and practice analysis were applied to develop criteria, indices and indicators for evaluating structure, processes and results of treatment. The evaluation of quality of result requires more complicated techniques of data collection as opposed to indices of quality of structure and processes. The developed indices can be also applied in evaluating effectiveness of treatment of other diseases with chronic course though curable in the main.