Chronic kidney disease (CKD) poses a major challenge to public health. China, a middle-income country, is the largest country globally with a current population of 1.4 billion. China accounts for... Show moreChronic kidney disease (CKD) poses a major challenge to public health. China, a middle-income country, is the largest country globally with a current population of 1.4 billion. China accounts for around one fifth of the global burden of CKD. Hence, eHealth self-management interventions are a great potential to Chinese populations. An extensively studied CKD self-management eHealth intervention is the Dutch ‘Medical Dashboard (MD)’. It has been demonstrated effective in decreasing the burden of CKD. To aim of this thesis is to inform the adaptation and evaluation of a tailored CKD self-management eHealth intervention in China based on the Dutch MD intervention. Specific characteristics and needs (e.g. facilitators and barriers) in Chinese settings need to be addressed to optimize the implementation of CKD self-management eHealth intervention. Emphasis should be placed on addressing the existing paternalistic patient-HCP relationship, stakeholder involvement in the development and implementation process, adjusting eHealth design features to fit the clinical workflows, and providing the needed support and training. This thesis is a vital step towards the design and implementation of a tailored eHealth solution to improve health outcomes of patients with CKD and address the high burden of CKD in China. Show less
Double-strand breaks (DSBs) are one of the most lethal forms of DNA damage. To prevent this, cells have evolved complex and highly conserved systems to detect these lesions, signal their presence,... Show moreDouble-strand breaks (DSBs) are one of the most lethal forms of DNA damage. To prevent this, cells have evolved complex and highly conserved systems to detect these lesions, signal their presence, trigger various downstream events and finally bring about repair. Two main pathways are used for DNA DSB repair: Homologous Recombination (HR) and Non-Homologous End-Joining (NHEJ). Both of them function together to maintain genome integrity. At least two NHEJ pathways have been identified: the classic NHEJ pathway (c-NHEJ) and the backup-NHEJ pathway (b-NHEJ) also called alternative-NHEJ (a-NHEJ) or microhomology-mediated end-joining (MMEJ). Agrobacterium tumefaciens is widely used as a vector to produce genetically modified plants. Agrobacterium-mediated genetic transformation involves the transfer of T-DNA from its tumor-inducing plasmid to the host cell nucleus, where it integrates into the plant genome. However, the molecular mechanism of T-DNA integration is still unclear. T-DNAs can integrate at artificially induced DSBs, which suggests that DSB repair mechanisms are probably involved in T-DNA integration in plants. Arabidopsis NHEJ mutants have subsequently been studied for T-DNA integration. However, the results obtained by different research groups were variable and revealed either no or limited negative effects. Show less
