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关键词： Randomized controlled trials   RCTs   Randomization   Methods   Bias   Controlled trials   Research reporting   CLINICALTRIALS.GOV RESULTS DATABASE   CLINICAL-TRIAL   QUALITY   REGISTRATION  

摘要： Objectives: We evaluated whether sample sizes in different arms of two-arm parallel group randomized controlled trials of nonregulated interventions were systematically closer in size than would plausibly occur by chance if simple randomization had been applied. Study Design and Setting: We searched PubMed for trials of nonregulated health care interventions that did not report using restricted randomization from journals in behavioral sciences and psychology, nursing, nutrition and dietetics, rehabilitation, and surgery. We emailed trial authors to clarify randomization procedures. Results: We identified 148 nonregulated intervention trials that indicated they used simple randomization. Difference in trial arm sizes was smaller than would be predicted by chance if simple randomization had occurred in all trials (P < 0.001). Rather than approximately half of the trials being within a 50% prediction interval for the difference, 96% had differences within this interval. Results were similar and statistically significant (P < 0.001) for trials that were published in journals with impact factors >= 4 and when stratified by type of nonregulated intervention. Conclusion: There is a need for education and better understanding of clinical trial methods to ensure that randomization procedures are implemented as intended and reported fully and accurately. (C) 2019 Elsevier Inc. All rights reserved.

关键词： Wavenumber selection   Falsified medicines   SVD   KNN   ATR-FTIR   COUNTERFEIT MEDICINES   FTIR SPECTROSCOPY   TABLETS   IDENTIFICATION   VIAGRA(R)  

摘要： The dissemination of falsified medicines is a public health risk. Techniques such as attenuated total reflectance Fourier transform infrared (ATR -FTIR) spectroscopy are commonly adopted for fraudulent drug detection. However, the spectrum generated by the ATR-FTIR typically results in hundreds of wavenumbers, reducing the performance of classification methods aimed at discriminating between authentic and falsified medicines. This article proposes a novel method for selecting a reduced size subset of wavenumbers that improves the classifier performance. The singular value decomposition SVD is used to generate a wavenumber importance index. An iterative process creates k -nearest neighbor (KNN) models by adding the wavenumbers in a decreasing order according to the importance index. Wavenumbers that increase classification accuracy are selected. When applied to Cialis (R) ATR-FTIR data, the proposed approach retained average 0.51% of the original wavenumbers with 100% accurate classifications; as for the Viagra (R) data set, the method yielded perfect classifications retaining average 0.17% of the original wavenumbers. (c) 2020 Elsevier B.V. All rights reserved.

关键词： Problem-based learning   teamwork   interaction   conversation analysis   tutorless groups   SUSTAINABLE EDUCATION   CHALLENGES   TALK   WORK   OH  

摘要： With the increasing complexity of the engineering role, today's graduates must be capable of confronting both technical and societal problems; underpinned by effective teamwork at their core. Problem-based learning has been implemented in engineering to better prepare students for modern industry. However, limited research has examined the complex social processes involved in PBL. The present study, therefore, reports on how students working in tutorless PBL groups - owing to teaching limitations - must effectively self-manage their team efforts if they are to succeed. This PBL arrangement involved a 'floating facilitator' but the analysis focuses exclusively on the students' tutorless interactions. The data collected is from 22 chemical engineering undergraduates in four groups, and consists of naturalistic video-recordings of 32 PBL meetings (35 h). This corpus was examined empirically using conversation analysis to elucidate students' recurrent communicational practices. The microanalyses showed how students continuously established PBL as the collective responsibility of the group. Furthermore, students maintained 'average', equal social identities, and used humour/self-deprecation in constructing an informal learning environment. In the absence of the tutor who would normally maintain cohesion, these strategies offer a means through which students adapt to the unfamiliarity of the tutorless setting, where no member is positioned as the substitute tutor.

关键词： 糖尿病肾损伤   尿糖、尿微量白蛋白联合检验   尿糖单独检验   尿微量白蛋白单独检验  

摘要： 目的探究尿糖、尿微量白蛋白联合检验对糖尿病早期肾损伤的诊断价值。方法选取42例糖尿病早期肾损伤患者作为观察组, 42例糖尿病非肾损伤患者作为对照组, 42例健康体检患者作为健康组。检测对比三组尿糖、尿微量白蛋白水平,统计尿糖单独检验、尿微量白蛋白单独检验及尿糖、尿微量白蛋白联合检验的诊断结果。对比尿糖单独检验、尿微量白蛋白单独检验及尿糖、尿微量白蛋白联合检验的敏感性、特异性及准确率。结果观察组尿糖、尿微量白蛋白水平分别为(3.38±0.45)mmol/L、(36.53±6.15)mg/L;对照组尿糖、尿微量白蛋白水平分别为(2.91±0.36)mmol/L、(24.85±4.73)mg/L;健康组尿糖、尿微量白蛋白水平分别为(1.15±0.28)mmol/L、(14.13±2.84)mg/L;观察组尿糖、尿微量白蛋白水平均显著高于对照组和健康组,对照组显著高于健康组,差异有统计学意义(P<0.05)。尿糖单独检验检出阳性72例,阴性54例;尿微量白蛋白单独检验检出阳性34例,阴性92例;尿糖、尿微量白蛋白联合检验检出阳性40例,阴性86例;病理结果显示:阳性42例,阴性84例。尿微量白蛋白单独检验及尿糖、尿微量白蛋白联合检验的特异性、准确率显著高于尿糖单独检验,尿糖、尿微量白蛋白联合检验的敏感性、准确率显著高于尿微量白蛋白单独检验,差异有统计学意义(P<0.05)。结论尿糖、尿微量白蛋白是糖尿病早期肾损伤的重要指标,尿糖、尿微量白蛋白联合检验诊断糖尿病早期肾损伤效果良好,显著优于单独检验,宜于临床推广。

关键词： 金融发展   收入贫困   中介效应模型   Sobel检验  

摘要： 本文结合中国2010-2016年省际面板数据考察了金融发展对收入贫困的影响及作用机制。研究结论表明:总体而言,金融发展对收入贫困存在非线性的倒U型影响,即金融发展达到一定水平之后才会降低贫困发生率;分地区来看,在包含国家级贫困县的省份,金融发展对收入贫困影响的倒U型趋势更为明显。机制检验表明:金融发展通过经济增长渠道和人力资本积累渠道改善了收入贫困,而金融资源向研发投入水平较高的非贫困地区和非农部门的集聚可能"挤出"贫困人口的资金供给,不利于收入贫困的改善;此外,考察期内,金融体系并未通过影响收入分配而对收入贫困产生影响。本文进一步从金融视角探讨了改善收入贫困的政策启示。

关键词： 临床   血液标本   检验   护理质量控制   作用   分析  

摘要： 目的分析护理质量控制(质控)在临床血液标本检验中的作用。方法选择2018年7月-2019年7月湖南省肿瘤医院收治的住院患者312例,应用随机数字表法分为常规检验组和护理质控组,每组各156例。常规检验组进行常规临床血液标本检验,护理质控组在检验过程中进行护理质控。比较两组的标本合格率、标本错误率、医疗纠纷事件发生率以及患者的满意程度。结果护理质控组标本合格率〔98.7%(154/156)比86.5%(135/156)〕和患者满意程度〔98.7%(154/156)比85.3%(133/156)〕均明显高于常规检验组;标本错误率〔0.6%(1/156)比7.7%(12/156)〕和医疗纠纷事件发生率〔1.9%(31/156)比9.6%(15/156)〕均明显低于常规检验组,差异均有统计学意义(均P<0.05)。结论护理质控在临床血液标本检验中的效果值得肯定,可在临床推广应用。

关键词： 尿路感染   微生物检验   诊断价值   防治作用  

摘要： 目的探讨微生物检验在尿路感染中的临床诊断价值与防治作用。方法对医院收治的尿路感染患者分别进行血清学检验诊断及广谱抗生素治疗和微生物检验诊断及敏感抗生素治疗,观察并比较其诊断结果和临床疗效。结果微生物组患者的诊断正确率和临床治疗总有效率分别为95.00%和97.50%,均明显高于血清学组患者(P<0.05);临床治疗无效者的中重度感染率为0.00%,明显低于血清学组患者(P<0.05)。结论微生物检验能够有效提高尿路感染的诊断正确率及其临床疗效。

关键词： 授权签字人   检验检测报告   风险规避  

摘要： 授权签字人是由检验检测机构提名,经资质认定部门考核合格后,在其资质认定授权的能力范围内签发检验检测报告的人员[1]。授权签字人是检验检测机构关键岗位人员之一,与最高管理者、质量负责人和技术负责人同等重要[2]。检验检测报告是检验检测活动的最终产品,是履行对客户服务承诺出具公正性、科学性、准确性的一种具有法律效力的技术文件[3],也是检验检测机构技术能力和管理水平的体现。

关键词： 微生物检验   感染性疾病   预防   诊断治疗   作用  

摘要： 目的探讨在感染性疾病预防和诊断治疗中应用微生物检验的临床作用。方法本次纳入对象为2018年8月-2019年8月收治的尿路感染患者90例,按照数字随机法分成两组,各45例,其中对照组直接应用抗生素治疗,观察组开展微生物检验后再依据结果选择抗生素,比较两组感染控制效果。结果观察组轻度感染率为64.4%,明显高于对照组35.6%;观察组中度感染率为22.2%,重度感染率为13.3%,均明显低于对照组,比较有统计学差异(P<0.05)。结论在感染性疾病的预防和诊断治疗中微生物检验作用突出,值得推广。