Correlates of quality of life in South Korean patients undergoing hematopoietic stem cell transplantation based on the symptom management model.

While hematopoietic stem cell transplantation (HSCT) has led to higher survival rates, the number of patients experiencing adverse reactions is also increasing. Based on the symptom management model, we aimed to analyze the relationships between symptom experience, symptom management strategies, self-management behavior, and quality of life among patients undergoing HSCT in South Korea and to identify the factors affecting their quality of life. The data of 67 conveniently sampled patients undergoing HSCT at a university-affiliated hospital, for the period from March 23 to June 7, 2016, were collected using a self-reported structured questionnaire. Data were analyzed using Pearson's correlations and multiple regression analysis. Quality of life showed a significant negative correlation with symptom experience and significant positive correlations with symptom management strategies. Factors influencing quality of life included symptom distress, symptom management strategies, and self-management behavior; these explained 39.4% of the variance. To improve quality of life in patients undergoing HSCT, the efficient management of multiple co-existing symptoms is important. There is a need for tailored nursing interventions based on a patient-focused and person-centered approach for patients undergoing HSCT.

Synergistic effects of 2A-mediated polyproteins on the production of lignocellulose degradation enzymes in tobacco plants.

Cost-effective bioethanol production requires a supply of various low-cost enzymes that can hydrolyse lignocellulosic materials consisting of multiple polymers. Because plant-based enzyme expression systems offer low-cost and large-scale production, this study simultaneously expressed ß-glucosidase (BglB), xylanase (XylII), exoglucanase (E3), and endoglucanase (Cel5A) in tobacco plants, which were individually fused with chloroplast-targeting transit peptides and linked via the 2A self-cleaving oligopeptideex from foot-and-mouth disease virus (FMDV) as follows: [RsBglB-2A-RaCel5A], [RsXylII-2A-RaCel5A], and [RsE3-2A-RaCel5A]. The enzymes were targeted to chloroplasts in tobacco cells and their activities were confirmed. Similarly to the results of a transient assay using Arabidopsis thaliana protoplasts, when XylII was placed upstream of the 2A sequence, the [RsXylII-2A-RaCel5A] transgenic tobacco plant had a more positive influence on expression of the protein placed downstream. The [RsBglB-2A-RaCel5A] and [RsE3-2A-RaCel5A] transgenic lines displayed higher activities towards carboxylmethylcellulose (CMC) compared to those in the [RsXylII-2A-RaCel5A] transgenic line. This higher activity was attributable to the synergistic effects of the different cellulases used. The [RsBglB-2A-RaCel5A] lines exhibited greater efficiency (35-74% increase) of CMC hydrolysis when the exoglucanase CBHII was added. Among the various exoglucanases, E3 showed higher activity with the crude extract of the [RsBglB-2A-RaCel5A] transgenic line. Transgenic expression of 2A-mediated multiple enzymes induced synergistic effects and led to more efficient hydrolysis of lignocellulosic materials for bioethanol production.