Development and pilot testing of a clinic implementation program delivering physical activity electronic referrals to cancer survivors.

Provider physical activity referrals are recommended for cancer survivors, though barriers exist to clinical system integration. To develop and test ActivityChoice, an electronic referral (eReferral) clinic implementation program referring cancer survivors to physical activity programs of their choice. In Phase 1, we conducted semi-structured interviews with Cancer Center clinicians (n = 4) and cancer-focused physical activity program leaders (n = 3) assessing adaptations needed to implement an eReferral previously designed for another context. In Phase 2, we pilot-tested clinician-delivered referrals to survivors in two 12-week Plan, Do, Study, Act (PDSA) cycles. We examined feasibility using descriptive statistics (clinicians' adoption and engagement, patient referrals, and physical activity program enrollment) and acceptability through semi-structured interviews with enrolled clinicians (n = 4) and referred patients (n = 9). ActivityChoice included a secure referral webform, text message/email referral confirmations, clinician training/booster sessions, visual reminders, and referrals to in-person or virtual group physical activity programs. Results for each PDSA cycle respectively included: 41% (n = 7) and 53% (n = 8) of clinicians adopted ActivityChoice; 18 and 36 patients were referred; 39% (n = 7) and 33% (n = 12) of patients enrolled in programs, and 30% (n = 4) and 14% (n = 5) of patients deferred enrollment. Patients and clinicians appreciated the referrals and choices. A printed handout describing both programs was added to the clinic workflow for Cycle 2, which yielded more referrals, but lower program enrollment rates. Clinic-based eReferrals to choices of physical activity programs were feasible and acceptable by clinicians and patients. Added clinic workflow support may facilitate referrals.

Physical activity can improve the health, quality of life, and longevity among cancer survivors. Patients want to receive physical activity referrals and guidance from their cancer care team, but clinicians lack the knowledge, resources, time, and methods to counsel and refer their patients to community-based physical activity programs. One solution is to create a comprehensive electronic referral (eReferral) system giving cancer care clinicians the tools to support and refer their patients. We developed a simple eReferral that allows clinicians to refer patients to existing, evidence-based physical activity programs led by qualified exercise professions, LIVESTRONG at the YMCA (in-person) and Fit Cancer (virtual). We pilot tested the system with clinicians in two 12-week cycles. Clinicians were excited about the program and like the options they had to offer patients while providing suggestions on how we could better integrate it into their work environment. Patients appreciated the referral from their trusted cancer care clinician and appreciated choices of an in-person and virtual program to accommodate their preferences. To improve patient referrals and enrollment in physical activity programs, a more detailed printed handout that explains the benefits of physical activity in survivorship and describes each of the programs in detail may be helpful.

Effect of pH on biomass production and carbohydrate accumulation of Chlorella vulgaris JSC-6 under autotrophic, mixotrophic, and photoheterotrophic cultivation.

Microalgal biomass, known as the third generation feedstock for biofuels production, is currently being explored mainly for lipids and functional components. However, the potential of microalgal carbohydrates has not been evaluated. In this investigation, Chlorella vulgaris JSC-6 was used for carbohydrates production from CO2 and fatty acids under different cultivation strategies to meet the requirements of a CO2-neutral and clean fermentation system for biofuel production. Autotrophic cultivation resulted in better carbon assimilation and carbohydrate accumulation; about 1.4 g CO2 could be converted to 1 g biomass, of which 50% are carbohydrates. Assimilation of fatty acids in photoheterotrophic and mixotrophic modes was influenced by pH, and pH 7-7.5 supported butyrate and acetate assimilation. The maximum carbohydrate content (49.86%) was attained in mixotrophic mode, and the ratio of the simple sugars glucose-xylose-arabinose was 1:0.11:0.02. The higher glucose content makes the microalgal biomass a suitable feedstock for sugar-based fermentations.

Benign Hand Tumors (Part I): Cartilaginous and Bone Tumors.

Background: Benign tumors of the hand present in a wide array of histological subtypes and compose most of the bony tissue tumors in the hand. This study evaluates the characteristics and treatment of benign bone tumors in light of one institution's experience. Methods: Histologically confirmed benign tumors of the hand were retrospectively identified using International Classification of Diseases codes from 1992 to 2015. A medical chart review was conducted to collect patient characteristics and tumor epidemiology and treatment. Results: A total of 155 benign bone tumors were identified. The median age of patients at the time of surgery was 39.9 ± 12.8 years. All bone tumors were located in the digits, and most were treated by intralesional curettage (n = 118, 76%). Pathologic fractures occurred in 79 bone tumors (51%). Conclusion: Enchondromas (n = 118, 76%) were the most common bone tumor in this series, whereas giant cell tumors were the most destructive and also had the highest recurrence rate (40%). Awareness of tumor features may help physicians with diagnosis, and awareness of recurrence rates is important when counseling patients.

Benign Hand Tumors (Part II): Soft Tissue Tumors.

Background: Benign soft-tissue tumors of the hand are more common than both their benign bone and malignant soft-tissue counterparts. This study evaluates the characteristics and treatment of benign soft tissue tumors in light of 1 institution's experience. Methods: Histologically confirmed benign soft-tissue tumors of the hand were retrospectively identified using International Classification of Disease codes from 1992 to 2015. A medical chart review was conducted to collect patient demographics, tumor epidemiology, and treatment. Results: A total of 199 soft-tissue tumors were identified. The median patient age at time of treatment was 47.4 ± 14.7 years in age. The majority of tumors were located in the digits (n = 168, 84%) and treated by excision (n = 191, 96%). Localized type tenosynovial giant cell tumors (n = 71, 36%) were the most common and had the highest rates of recurrence (8.5%) in this series. Other frequent histologies included hemangioma, schwannoma, and glomus tumors. Conclusion: Awareness and understanding of tumor characteristics may help physicians with diagnosis and treatment. There is an extensive variety of tumors, but the principles of clinical and imaging diagnosis are common to all of them. Marginal excision for the treatment pain, improvement of function, and cosmetic correction applies to all these tumors independent of the histology.

Microbial keystone taxa drive crop productivity through shifting aboveground-belowground mineral element flows.

Unbalanced fertilization of nutritional elements is a potential threat to environmental quality and agricultural productivity in acid soil. Harnessing keystone taxa in soil microbiome represents a promising strategy to enhance crop productivity as well as reducing the adverse environmental effects of fertilizers, with the goal of agricultural sustainability. However, there is a lack of information on which and how soil microbial keystone taxa contribute to sustainable crop productivity in acid soil. Here, we examined soil microbial communities (including bacteria, fungi, and archaea) and soil nutrients, and the mineral nutrition and yield of maize subjected to different inorganic and organic fertilization treatments over 35 years in acid soil. The application of organic fertilizer alone or in combination with inorganic fertilizers sustained high maize yield when compared with the other fertilization treatments. Microbial abundances and community structures rather than their alpha diversities explained the main variation in maize yield among different treatments. Sixteen soil keystone taxa (a fungal operational taxonomic unit and 15 bacterial operational taxonomic units) were identified from the microbial co-occurrence network. Among them, five keystone taxa (in Hypocreales, Bryobacter, Solirubrobacterales, Thermomicrobiales, and Roseiflexaceae) contributed to high maize yield through increasing phosphorus flow and inhibiting toxic aluminum and manganese flow from soils to plants. However, the remaining eleven keystone taxa (in Conexibacter, Acidothermus, Ktedonobacteraceae, Deltaproteobacteria, Actinobacteria, Elsterales, Ktedonobacterales, and WPS-2) exerted the opposite effects. As a result, maize productivity varied among different fertilization treatments because of the altered maize mineral element flows by microbial keystone taxa. We conclude that microbial keystone taxa drive crop productivity through shifting aboveground-belowground mineral element flows in acid soil. This study highlights the importance of microbial keystone taxa for sustainable crop productivity in acid soil and provides deep insights into the relationships between soil microbial keystone taxa, crop mineral nutrition, and productivity.

Wearable device use and technology preferences in cancer survivors with or at risk for atrial fibrillation.

Background: Cancer survivors face increased risk of heart disease, including atrial fibrillation (AF). Certain types of technology, such as consumer wearable devices, can be useful to monitor for AF, but little is known about wearables and AF monitoring in cancer survivor populations. Objective: The purpose of this study was to understand technology usage and preferences in cancer survivors with or at risk for AF, and to describe demographic factors associated with wearable device ownership in this population. Methods: Eligible patients completed a remote survey assessment regarding use of commercial wearable devices. The survey contained questions designed to assess commercial wearable device use, electronic health communications, and perceptions regarding the participant's cardiac health. Results: A total of 424 cancer survivors (mean age 74.2 years; 53.1% female; 98.8% white) were studied. Although most participants owned a smartphone (85.9%), only 31.8% owned a wearable device. Over half (53.5%) of cancer survivors were worried about their heart health. Overall, patients believed arrhythmias (79.7%) were the most important heart condition for a wearable to detect. Survivors reported being most willing to share blood pressure (95.6%) and heart rate (95.3%) data with their providers and were least willing to share information about their diet, weight, and physical activity using these devices. Conclusion: Understanding factors such as device ownership, usage, and heart health concerns in cancer survivors can play an important role in improving cardiovascular monitoring and its accessibility. Long-term patient outcomes may be improved by incorporating wearable devices into routine care of cancer survivors.

Balanced fertilization over four decades has sustained soil microbial communities and improved soil fertility and rice productivity in red paddy soil.

The influence of long-term fertilization on soil microbial communities is critical for revealing the association between belowground microbial flora and aboveground crop productivity-a relationship of great importance to food security, environmental protection, and ecosystem functions. Here, we examined shifts in soil chemical properties, microbial communities, and the nutrient uptake and yield of rice subjected to different chemical and organic fertilization treatments over a 40-year period in red paddy soil. Ten different treatments were used: a control without fertilizer, and applications of nitrogen (N), phosphorus (P), potassium (K), NP, NK, PK, NPK, double NPK, or NPK plus manure. Compared with the effects of withholding one or two nutrients (N, P, or K), the balanced application of chemical NPK and organic fertilizers markedly improved soil nutrient status and rice yield. This improvement of soil fertility and rice yield was not associated with bacterial, archaeal, or fungal alpha diversities. The bacterial abundance and community structure and archaeal abundance effectively explained the variation in rice yield, whereas those of fungi did not. The community structure of bacteria and archaea, but not that of fungi, was correlated with soil properties. Among various soil properties, P was the key factor influencing rice yield and soil microbial communities because of the extremely low content of soil available P. Seven keystones at the operational taxonomic unit level were identified: four archaea (belonging to Thermoplasmata, Methanosaeta, Bathyarchaeia, and Nitrososphaeraceae) and three bacteria (in Desulfobacteraceae and Acidobacteriales). These keystones, which were mainly related to soil C and N transformation and pH, may work cooperatively to influence rice yield by regulating soil fertility. Our results collectively suggest that four decades of balanced fertilization has sustained the bacterial and archaeal abundances, bacterial community structure, and keystones, which potentially contribute to soil fertility and rice yield in red paddy soil.

Soft-tissue Sarcoma of the Hand: Patient Characteristics, Treatment, and Oncologic Outcomes.

INTRODUCTION: The aim of this study was to describe patient characteristics, treatment, and oncologic outcomes of soft-tissue sarcomas (STSs) of the hand. METHODS: Sixty-nine STSs of the hand in adult patients treated at a tertiary referral center were retrospectively included. We describe patient and tumor characteristics along with oncologic outcomes. RESULTS: Epithelioid sarcoma (23%) was the most common histologic subtype, followed by synovial sarcoma (15%). Of all tumors, 17 (25%) were grade I, 22 (32%) were grade II, and 30 (44%) were grade III. The 5-year disease-free survival for epithelioid sarcomas was 75% with a disease survival of 100%, along with a metastatic rate of 15%. Of the patients with a synovial sarcoma, 40% developed metastases, and the 5-year disease-free survival was 68% and the 5-year disease survival was 73%. CONCLUSION: Hand STSs are aggressive tumors with a high metastatic potential. Even with adequate oncologic treatment, long-term clinical follow-up (10 years) in these tumors is advised. The treating surgical oncologist should not be deceived by their smaller size.

Trophic upgrading and mobilization of wax esters in microzooplankton.

Heterotrophic protists play pivotal roles in aquatic ecosystems by transferring matter and energy, including lipids, from primary producers to higher trophic predators. Using Oxyrrhis marina as a model organism, changes to the non-saponifiable protist lipids were investigated under satiation and starvation conditions. During active feeding on the alga Cryptomonas sp., the O. marina hexane soluble non-saponifiable fraction lipid profile reflected its food source with the observed presence of long chain mono-unsaturated fatty alcohols up to C25:1. Evidence of trophic upgrading in O. marina was observed with long chain mono-unsaturated fatty alcohol accumulation of up to C35:1. To the best of our knowledge, this is the first evidence that heterotrophic dinoflagellates are capable of producing ester derived alcohols and that dinoflagellates like O. marina are capable of synthesizing fatty alcohols up to C35. Additionally, we show evidence of trophic upgrading of lipids. During a 20-day resource deprivation, the lipid profile remained constant. During starvation, the mobilization of wax esters as energy stores was observed with long chain fatty alcohols mobilized first. Changes in lipid class profile and utilization of wax esters in O. marina provides insight into the types of lipids available for energy demand, the transfer of lipids through the base of marine food webs, and the catabolic response induced by resource deprivation.

Soft tissue sarcoma of the hand: Is unplanned excision a problem?

BACKGROUND: Soft tissue sarcoma (STS) of the hand are prone to unplanned excisions, altering oncologic outcomes. The aim of this study is to compare STS of the hand with initial treatment at an oncology center versus those initially treated at a non-oncology center. Additionally, we evaluated what factors were associated with oncologic outcomes. METHODS: We retrospectively identified patients with a STS of the hand using ICD-9 codes along with an institutional oncologic database. We included all adult patients with a non-metastatic STS of the hand (n = 64) with a median follow up of 4.0 years (IQR:1.7-10.0). RESULTS: Eight-three percent (n = 53) of tumors had an unplanned excision, of which one was treated at the oncology center. Patients treated primarily at an oncology center were older (57.6 vs. 43.6 years), had fewer operations and tended to have a larger tumors (median 4.7 cm vs. 3.0 cm) compared to those initially treated at a non-oncology center. The 5-year survival for patients treated at an oncology center was 60% compared to 89% in those initially treated at a non-oncology center. Worse disease-free survival was associated with positive final margins and subfascial tumors. CONCLUSION: Tumors with primary treatment at an oncology center were larger and presented in older patients, having worse overall survival compared to those initially treated at a non-oncology center. Initial treatment at a non-oncology center did not influence the oncologic outcomes, but lead to more re-excisions and amputations. Final tumor margins and tumor depth determined oncologic outcomes.

[Basic soil productivity in the double rice cropping system under long-term fertilization regimes in the Poyang Lake region, China]. / 鄱阳湖流域长期施肥下双季稻田的土壤基础地力.

We aimed to explore changes in basic soil productivity (BSP) under different fertilization regimes in the Poyang Lake region, Jiangxi Province, China. Soil samples were collected from a long-term fertilization experiment (since 1981) that included treatments of no fertilization (CK), chemical fertilization (NPK), and combined chemical and organic fertilization (NPKM). Then, a three-year pot experiment (from 2012 to 2014) with double rice cropping was conducted with two different fertilization regimes (no fertilization, F0; fertilization, F1) using CK, NPK and NPKM soils. Grain yield and BSP were analyzed among soils with different fertilization regimes to identify the key factors driving changes in BSP. Results showed that grain yields in NPKM soil were higher than in NPK and CK soils regardless of fertilization in the pot experiment. Under the F0 condition, annual grain yields of NPKM soil were 37.7%-143.9% and 20.8%-66.7% higher than CK and NPK soils, respectively. The BSP values of CK, NPK and NPKM soils in three years were 41.8%-53.1%, 45.2%-62.6% and 59.1%-88.1%, respectively. NPKM soil had significantly higher BSP than NPK and CK soils. Furthermore, there were significant positive correlations between soil organic matter and BSP as well as between organic carbon balance and BSP. These results suggested that long-term application of chemical and organic fertilizers could improve BSP in the double rice cropping system of the Poyang Lake region. In addition, soil organic matter and organic carbon balance are important factors for improving BSP in this region.

Effect of Tangshenkang Granule containing serum on renal mesangial cells' proliferation and TGF-β1/Smad2/3 pathway in the high glucose condition / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the effect of Tangshenkang Granule (TG) containing serum on renal mesangial cells' (RMCs) proliferation and TGF-β1/Smad2/3 pathway in the high glucose condition.</p><p><b>METHODS</b>Twelve SD rats were randomly divided into four groups, i.e., the low dose TG group, the middle dose TG group, the high dose TG group, and the blank control group, 3 in each group. After 7-day gastrogavage via portal vein blood, rats were sacrificed and their serum samples were collected. RMCs were cultured in common rat serum and TG containing serum respectively. The proliferation of mesangial cells was determined by methly thiazolyl tetrazolium (MTT) assay to determine the optimal TG containing serum concentration. Expression levels of TGF-β1 mRNA and protein were determined by real time quantitative PCR and ELISA. Smad2/3 protein expression and phosphorylation were determined by Western blot and immunofluorescence.</p><p><b>RESULTS</b>TG containing serum at different doses could inhibit high glucose induced RMC cells' proliferation, TGF-β1 over-expression and Smad2/3 phosphorylation.</p><p><b>CONCLUSION</b>TG containing serum could inhibit high glucose induced RMC cells' proliferation, and its mechanism might be possibly associated with inhibiting TGF-β1/Smad2/3 signaling pathway.</p>

Effect of Chinese herbal compounds for blood activating stasis removing, qi benefiting Shen invigorating on high glucose stimulated proliferation of renal mesangial cells and expressions of fibronectin / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study effects of Chinese Herbal Compounds (CHC) for blood activating stasis removing (BASR), qi benefiting Shen invigorating (QBSI) on high glucose stimulated proliferation of renal mesangial cells (RMCs) and expressions of fibronectin (FN).</p><p><b>METHODS</b>Rats' RMCs were dealt with high glucose and different concentrations of Chinese medicine for 24 and 48 h respectively. The proliferation of RMCs was detected with 4-A thiazolyl blue. mRNA expressions of FN was detected by real time quantitative PCR. The protein expression of FN was detected by ELISA.</p><p><b>RESULTS</b>Compared with the control group, the proliferation obviously increased (P < 0.05, P < 0.01) after 24 and 48 h of treatment in the high glucose group, mRNA and protein expressions of FN also increased (P < 0.01). There was no statistical difference in the proliferation of RMCs or expressions of FN at 24 h between each CHC group and the high glucose group (P > 0.05). Compared with the high glucose group, the proliferation of RMCs and expressions of FN at 24 h each obviously decreased in the CHC group (P < 0.05, P < 0.01).</p><p><b>CONCLUSIONS</b>High glucose could promote the proliferation of RMCs and induce expressions of FN. No obvious effect could be stimulated by CHC treatment for 24 h. The proliferation of RMCs, protein and mRNA expressions of FN could be reversed by CHC treatment for 48 h.</p>

[Determination of trace bismuth in traditional Chinese medicines by hydride generation atomic fluorescence spectrometry].

A method is reported for the determination of trace bismuth in traditional chinese medicine by hydride generation atomic fluorescence spectrometry. The effect of different means of digestion, the medium amounts of acid and reducing agent on the determination of Bi is investigated. In the given conditions, the linear range of determination is 0.1-200 microg x L(-1), and the detection limit is 0.0946 microg x L(-1). The instrumental relative standard deviation is about 0.55% and the recovery is about 94%-107%. The method is accurate, rapid and convenient with satisfactory results.

Identification of Antagonistic Strain P-13 and the Preliminary Studies on Its Antimicrobial Substances Against Bacterial Spot Diseases of Muskmelon / 微生物学通报

An actinomycete strain P-13, with antimicrobial activity against muskmelon bacterial spot pathogens, was isolated from the muskmelon rhizosphere soil samples in Xinjiang. The strain P-13 was identified as Streptomyces rochei based on morphological, physiological characteristics and 16S rRNA sequence analysis. The agar diffusion bioassay showed that the diameter of inhibition zone against Acidovorax avenae subsp. citrull BFB and Pseudomonas syringae pv. Lachrymans P4 was above 19 mm and 17 mm, respectively. The antimicrobial substances obtained from strain P-13 were demonstrated to be alkaline and water-soluble compounds according to paper chromatogram analysis and exocellular metabolites. Furthermore, it was stable to be treated by 100?C for 10 min, pH 6 for 6 h, or ultraviolet treatment for 7 h. Moreover, it was insoluble in organic solvents, such as petroleum benzine, diethyl ether, and acetic ether.