In the United States(US),the Surveillance,Epidemiology,and End Results(SEER)program is the only comprehensive source of population-based information that includes stage of cancer at the time of diagnosis and patient s...In the United States(US),the Surveillance,Epidemiology,and End Results(SEER)program is the only comprehensive source of population-based information that includes stage of cancer at the time of diagnosis and patient survival data.This program aims to provide a database about cancer incidence and survival for studies of surveillance and the development of analytical and methodological tools in the cancer field.Currently,the SEER program covers approximately half of the total cancer patients in the US.A growing number of clinical studies have applied the SEER database in various aspects.However,the intrinsic features of the SEER database,such as the huge data volume and complexity of data types,have hindered its application.In this review,we provided a systematic overview of the commonly used methodologies and study designs for retrospective epidemiological research in order to illustrate the application of the SEER database.Therefore,the goal of this review is to assist researchers in the selection of appropriate methods and study designs for enhancing the robustness and reliability of clinical studies by mining the SEER database.展开更多
Curriculum ideology and politics are critical for colleges and universities to fulfill theirfundamental mission of fostering moral and intellectual development. Within this framework, professionalcourses serve as the ...Curriculum ideology and politics are critical for colleges and universities to fulfill theirfundamental mission of fostering moral and intellectual development. Within this framework, professionalcourses serve as the primary vehicles for integrating ideological and political education. Specifically, inthe field of study tours, the Study Tour Course Design emerges as a pivotal component for actualizingthe educational objectives of such programs. To construct a robust ideological and political curriculum,it is essential to devise a comprehensive system that aligns with professional teaching standards, industrybenchmarks, and vocational skill requirements. This involves a thorough exploration of ideologicaland political elements within the curriculum, ensuring their seamless integration throughout the coursedevelopment process.展开更多
In this feasibility study, we investigate the viability of using Liquefied Natural Gas （LNG） fuel in an open type Ro-Ro passenger ferry and the associated potential challenges with regard to the vessel safety system...In this feasibility study, we investigate the viability of using Liquefied Natural Gas （LNG） fuel in an open type Ro-Ro passenger ferry and the associated potential challenges with regard to the vessel safety systems. We recommend an appropriate methodology for converting existing ships to run on LNG fuel, discuss all the necessary modifications to the ship’s safety systems, and also evaluate the relevant ship evacuation procedures. We outline the basic requirements with which the ship already complies for each safety system and analyze the additional restrictions that must be taken into consideration for the use of LNG fuel. Appropriate actions are recommended. Furthermore, we carry out a hazard identification study. Overall, we clearly demonstrate the technical feasibility of the investigated scenario. Minimal modifications to the ship’s safety systems are required to comply with existing safety rules for this specific type of ship.展开更多
Background:Degradable magnesium implants are promising for clinical fracture treatment,providing less stress-shielding mechanical support and superior bone-strengthening benefits to traditional materials.The quality o...Background:Degradable magnesium implants are promising for clinical fracture treatment,providing less stress-shielding mechanical support and superior bone-strengthening benefits to traditional materials.The quality of preclinical research is essential for developing Mg implants;however,there are considerable variations in the model selection and study design in published studies,posing challenges for safe and effective clinical translation of lab discoveries.Objective:The purpose of this systematic review is to investigate the current progress on in vivo research of Mg implants for fracture treatment,focusing on model selection,Mg materials,implant design,methodological and analyzing techniques,aiming to provide comprehensive guidance for future preclinical research.Materials and methods:Pub Med and Embase online databases were searched to identify researches investigating Mg implants in animal models of fracture from 1960 to December 2019,using a combination of keywords:magnesium and fracture.Eligible studies were included without language restriction.Data extraction was conducted for qualitative analysis.Meta-analysis was not performed due to extensive heterogeneities among studies.Results:Twenty studies published from 2014 to 2019 were included.Publication information,animal model,methodological quality,implants preparation,and evaluation techniques were extracted.The methodological assessment revealed low to high risk of bias among studies.Both rodent and non-rodent species were selected,and the anatomical sites for inducing fractures included both cranial-facial and limb bones.Pure Mg and alloys with or without surface modification were evaluated,covering implant designs of both intra-medullary and extra-medullary fixation.Radiological and histological evaluations were commonly conducted.Conclusions:Published in vivo evidence confirmed the role of Mg-based implants in promoting fracture healing.However,considering heterogeneity in animal selection,implant preparation,and evaluation methods,there still lacks a standardized reference model.By analyzing the information extracted from included studies,the systematic review may facilitate planning and conducting preclinical research with translational perspective.展开更多
Shaoyang acupoints are the most frequently used in migraine treatment. However, the central anal- gesic mechanism remains poorly understood. Studies have demonstrated that single stimulus of the verum acupuncture in h...Shaoyang acupoints are the most frequently used in migraine treatment. However, the central anal- gesic mechanism remains poorly understood. Studies have demonstrated that single stimulus of the verum acupuncture in healthy subjects can induce significant connectivity or activity changes in pain- related central networks compared with sham acupuncture. However, these findings are not indicative of the central analgesic mechanism of acupuncture at Shaoyang acupoints. Thus, we recruited 100 migraine sufferers and randomly assigned them into five groups： Shaoyang uncommon acupoint, Shaoyang common acupoint, Yangming uncommon acupoint, non-acupoint control, and blank control groups. Subjects were subjected to evaluation of curative effects and functional MRI prior to and after 10 and 20 acupuncture treatments. All subjects were diagnosed by physicians and enrolled following clinical physical examination. Subjects were observed during 1-4 weeks after inclusion. At the fifth week, the first clinical evaluation and resting functional MRI were conducted. The Shaoyang uncom- mon acupoint, Shaoyang common acupoint, Yangming uncommon acupoint, and non-acupoint control grousp then were treated with acupuncture, five times per week, 20 times in total over 4 weeks. The second and third clinical evaluations and resting functional MRI screenings were conducted following 10 and 20 acupuncture treatments. The blank control group was observed during the 5 to 8 week pe- riod, followed by clinical evaluation and resting functional MRI. The aim of this study was to examine changes in brain functional activity and central networks in subjects with migraine undergoing acu- puncture at Shaoyang uncommon acupoints. This study provides a further explanation of the central analgesic mechanism by which acupuncture at Shaoyang acupoints treats migraine,展开更多
Following a few preliminary remarks on the tunneling methods at the beginning of the 20th century, thesuccessful applications of the full-face method also in difficult conditions are underlined. The attention isposed ...Following a few preliminary remarks on the tunneling methods at the beginning of the 20th century, thesuccessful applications of the full-face method also in difficult conditions are underlined. The attention isposed on the use of a systematic reinforcement of the face and of the ground, by means of fiber-glasselements. A selection of tunnels where this method was used successfully is reported with the purposeof illustrating the wide spectrum of ground conditions where it has been applied. Then, following adescription of the main concepts behind the method, the attention moves from the so-called “heavymethod”, where deformations are restrained, to the “light method”, where deformations are allowedwith the intention to decrease the stresses acting on the primary and final linings. The progress in theapplication of the “light method” is underlined, up to the development of a novel technique, which relieson the use of a yielding support composed of top head steel sets with sliding joints and specialdeformable elements inserted in the primary lining. The well-known case study of the Saint Martin LaPorte access adit, along the Lyon-Turin Base Tunnel, is described. In this tunnel, a yield-control supportsystem combined with full-face excavation has been adopted successfully in order to cope with the largedeformations experienced during face advance through the Carboniferous formation. The monitoringresults obtained during excavation are illustrated, together with the modeling studies performed whenpaying attention to the rock mass time-dependent behavior.展开更多
The implementation of molecular profiling technologies in oncology deepens our knowledge for the molecular landscapes of cancer diagnoses, identifying aberrations that could be linked with specific therapeutic vulnera...The implementation of molecular profiling technologies in oncology deepens our knowledge for the molecular landscapes of cancer diagnoses, identifying aberrations that could be linked with specific therapeutic vulnerabilities. In particular, there is an increasing list of molecularly targeted anticancer agents undergoing clinical development that aim to block specific molecular aberrations. This leads to a paradigm shift, with an increasing list of specific aberrations dictating the treatment of patients with cancer. This paradigm shift impacts the field of clinical trials, since the classical approach of having clinico-pathological disease characteristics dictating the patients' enrolment in oncology trials shifts towards the implementation of molecular profiling as prescreening step. In order to facilitate the successful clinical development of these new anticancer drugs within specific molecular niches of cancer diagnoses, there have been developed new, innovative trial designs that could be classified as follows: i)longitudinal cohort studies that implement(or not) "nested" downstream trials, 2) studies that assess the clinical utility of molecular profiling, 3) "master" protocol trials, iv) "basket" trials, v) trials following an adaptive design. In the present article, we review these innovative study designs, providing representative examples from each category and we discuss the challenges that still need to be addressed in this era of new generation oncology trials implementing molecular profiling. Emphasis is put on the field of breast cancer clinical trials.展开更多
Intermittent androgen deprivation therapy(IADT)is now being increasingly opted by the treating physicians and patients with prostate cancer.The most common reason driving this is the availability of an off-treatment p...Intermittent androgen deprivation therapy(IADT)is now being increasingly opted by the treating physicians and patients with prostate cancer.The most common reason driving this is the availability of an off-treatment period to the patients that provides some relief from treatment-related side-effects,and reduced treatment costs.IADT may also delay the progression to castration-resistant prostate cancer.However,the use of IADT in the setting of prostate cancer has not been strongly substantiated by data from clinical trials.Multiple factors seem to contribute towards this inadequacy of supportive data for the use of IADT in patients with prostate cancer,e.g.,population characteristics(both demographic and clinical),study design,treatment regimen,on-and off-treatment criteria,duration of active treatment,endpoints,and analysis.The present review article focuses on seven clinical trials that evaluated the efficacy of IADT vs.continuous androgen deprivation therapy for the treatment of prostate cancer.The results from these clinical trials have been discussed in light of the factors that may impact the treatment outcomes,especially the disease(tumor)burden.Based on evidence,potential candidate population for IADT has been suggested along with recommendations for the use of IADT in patients with prostate cancer.展开更多
Recently we read the article entitled“Outcomes of different minimally invasive surgical treatments for vertebral compression fractures:An observational study”.This was an observational study that reviewed the safety...Recently we read the article entitled“Outcomes of different minimally invasive surgical treatments for vertebral compression fractures:An observational study”.This was an observational study that reviewed the safety and efficacy of different cement augmentation modalities for vertebral compression fractures under osteoporotic condition.Overall,this is a valuable study that can provide a reference for clinical practice.On the other hand,we also noticed some points in the article and are willing to share our views.Further studies with a higher level of evidence can add more knowledge regarding relevant concerns.展开更多
From the perspectives of physiology and psychology, this article not only analyzes the interrelation between landscape and sight, but also classifies and studies the courtyard landscape sight. According to the studies...From the perspectives of physiology and psychology, this article not only analyzes the interrelation between landscape and sight, but also classifies and studies the courtyard landscape sight. According to the studies of courtyard sight, courtyard space and courtyard construction, how to optimize the courtyard landscape construction is to be discussed to provide references for further researches and field applications.展开更多
Scientific research is challenged to translate findingsfrom multiple, often conflicting, clinical trials into a simple answer of whether a treatment works or not. The public and healthcare providers alike frequently ...Scientific research is challenged to translate findingsfrom multiple, often conflicting, clinical trials into a simple answer of whether a treatment works or not. The public and healthcare providers alike frequently voice their frustrations when the media reports a treatment working on one day, but seemingly the next day reports a study refuting the previous one. Meta-analyses are being used more commonly by researchers to convey an understandable summary of scientific studies to the general public and healthcare providers. As time goes by, we have learned how to improve meta-analytic techniques to reflect more valid results and when it is appropriate to pool or not to pool results from different studies. Retrospective reviews often don’t acknowledge this learning curve and may fail to recommend the most current valid guidelines. This editorial presents an example of how the current use of meta-analysis has shifted in one feld （the therapeutic effects of probiotics） and recommendations on how to correctly interpret the results of such an analysis.展开更多
HIV （Human Immuno-deficiency Virus） prevalence in Malawi is one of the highest in the world, with 10.3% of population living with HIV. Kenya has a prevalence rate of 6% and with 1.6 million people living with HIV in...HIV （Human Immuno-deficiency Virus） prevalence in Malawi is one of the highest in the world, with 10.3% of population living with HIV. Kenya has a prevalence rate of 6% and with 1.6 million people living with HIV infection. The broad objective of the study was to assess the proportion of youth aged 15-24 years affected by HIV in Malawi and Kenya. This was a descriptive study design. Data were mainly collected from reports from government, World Bank, World Health Organization and UN agencies. Graphs, tables and charts have been used to present statistics. Data for specific age cohort were hard to find and hence, data were used for general HIV and AIDS with special attention to the youth where possible. In Kenya, HIV prevalence among young women jumps three folds from 2.8% of 15-17 year olds to 8.3% among 23-24 year olds. In Malawi, around 2,100 young people and adolescents are infected with HIV every day. In 2013, four million young people aged 15-24 were living with HIV, with 29% aged under 19 years. This age group includes school going youths, newly employed, economically productive and sexually active group. HIV prevalence in Malawi has been declining over time among persons aged 15-19 years from 16.4% in 1999 to 11.8 % in 2004 to 10.6% in 2010 and 10.3% in 2016. However, in Kenya, the trend of HIV prevalence reached its peak of 10.55% in 1995-1996 after which it declined to 6.7% in 2003 and has been stable since then.展开更多
The purpose of this review is to provide medical researchers,especially those without a bioinformatics background,with an easy-to-understand summary of the concepts and technologies used in microbiome research.First,w...The purpose of this review is to provide medical researchers,especially those without a bioinformatics background,with an easy-to-understand summary of the concepts and technologies used in microbiome research.First,we define primary concepts such as microbiota,microbiome,and metagenome.Then,we discuss study design schemes,the methods of sample size calculation,and the methods for improving the reliability of research.We emphasize the importance of negative and positive controls in this section.Next,we discuss statistical analysis methods used in microbiome research,focusing on problems with multiple comparisons and ways to compare β-diversity between groups.Finally,we provide step-by-step pipelines for bioinformatics analysis.In summary,the meticulous study design is a key step to obtaining meaningful results,and appropriate statistical methods are important for accurate interpretation of microbiome data.The step-by-step pipelines provide researchers with insights into newly developed bioinformatics analysis methods.展开更多
Two randomized controlled trials of acupuncture concerning polycystic ovary syndrome（PCOS） and stress urinary incontinence（SUI） were published simultaneously in the 24 th issue, 2017 of The Journal of the American...Two randomized controlled trials of acupuncture concerning polycystic ovary syndrome（PCOS） and stress urinary incontinence（SUI） were published simultaneously in the 24 th issue, 2017 of The Journal of the American Medical Association（JAMA）. A trial involving PCOS indicated that active acupuncture did not increase live birth compared with sham acupuncture; meanwhile, another trial referring to SUI showed that electroacupuncture resulted in less urine leakage compared with sham electroacupuncture. With an eye to the negative and positive results of acupuncture, three pivotal factors should be contemplated：（1） proper illness for acupuncture, that is, a problem need to be solved in current medical science, and acupuncture may really work for it;（2） proper pre-studied primary outcome, which is better be objective and repeatedly measurable to reveal the therapeutic effect of acupuncture truly and objectively;（3） proper sham control, which can blind the patients to the upmost extent with minimal biological effects. Through the publication of clinical trials of acupuncture in high-impact journals in recent years, researchers should have confidence in their clinical trials by pondering over these three pivotal factors.展开更多
Class III medical devices are those devices that support or sustain human life or prevent impairment of human health but,when used,pose high risks to the patients.There were 15 class III medical devices that were appr...Class III medical devices are those devices that support or sustain human life or prevent impairment of human health but,when used,pose high risks to the patients.There were 15 class III medical devices that were approved by the US Food and Drug Administration from September 1,2005 to December 31,2018 for glucose monitoring and diabetes treatment.In this article,we reviewed the study design and statistical analysis in clinical trials that were conducted to provide evidences for safety and effectiveness of these medical devices.Two exemplars of clinical trials for"Eversense continuous glucose monitoring system"and"t:slim X2 Insulin Pump with Basal-IQ Technology"are discussed in details.展开更多
Ambient air pollution in China has worsened following dramatic increases in industrialization, automobile use and energy consumption. Particularly bothersome is the increase in the PM2.5 fraction of pollutants. This f...Ambient air pollution in China has worsened following dramatic increases in industrialization, automobile use and energy consumption. Particularly bothersome is the increase in the PM2.5 fraction of pollutants. This fraction has been associated with increasing rates of cardio-respiratory disease in China and elsewhere. Ambient pollutant levels have been described in many of China＇s cities and are comparable to previous levels in southern California. Lung cancer mortality in China has increased since the 1970s and has been higher in men and in urban areas, the exact explanation for which has not been determined. The estimation of individual risk for Chinese citizens living in areas of air pollution will require further research. Occupational cohort and casecontrol designs each have unique attributes that could make them helpful to use in this setting. Other important future research considerations include detailed exposure assessment and the possible use of biomarkers as a means to better understand and manage the threat posed by air pollution in China.展开更多
In recent years,with the development of artificial intelligence,especially deep learning technology,researches on automatic detection of cerebrovascular diseases on medical images have made tremendous progress and the...In recent years,with the development of artificial intelligence,especially deep learning technology,researches on automatic detection of cerebrovascular diseases on medical images have made tremendous progress and these models are gradually entering into clinical practice.However,because of the complexity and flexibility of the deep learning algorithms,these researches have great variability on model building,validation process,performance description and results interpretation.The lack of a reliable,consistent,standardized design protocol has,to a certain extent,affected the progress of clinical translation and technology development of computer aided detection systems.After reviewing a large number of literatures and extensive discussion with domestic experts,this position paper put forward recommendations of standardized design on the key steps of deep learning-based automatic image detection models for cerebrovascular diseases.With further research and application expansion,this position paper would continue to be updated and gradually extended to evaluate the generalizability and clinical application efficacy of such tools.展开更多
People with diabetes are 30 times more likely to undergo amputation than the general population.A total of 3.2million people in the UK have been diagnosed with diabetes and by 2025 this number is estimated to be 5mill...People with diabetes are 30 times more likely to undergo amputation than the general population.A total of 3.2million people in the UK have been diagnosed with diabetes and by 2025 this number is estimated to be 5million.One potential complication post amputation is phantom limb pain(PLP),a prevalent and often chronic condition which is difficult to treat.To inform a展开更多
Ⅰ Why do we need to conduct a study?·To fill in knowledge gap·To identify the good and the bad management·To find out new diagnostic methods·To prevent adverse outcome·To improve patient care...Ⅰ Why do we need to conduct a study?·To fill in knowledge gap·To identify the good and the bad management·To find out new diagnostic methods·To prevent adverse outcome·To improve patient care FINER is the key concept when we start to think about to conduct a study.展开更多
Diet plays a substantial role in the etiology, progression, and treatment of chronic disease and is best considered as a multifacetedset of modifiable input variables with pleiotropic effects on a variety of biologica...Diet plays a substantial role in the etiology, progression, and treatment of chronic disease and is best considered as a multifacetedset of modifiable input variables with pleiotropic effects on a variety of biological pathways spanning multiple organ systems. Thisbrief review discusses key issues related to the design and conduct of diet interventions in rodent models of metabolic disease andtheir implications for interpreting experiments. We also make specific recommendations to improve rodent diet studies to help betterunderstand the role of diet on metabolic physiology and thereby improve our understanding of metabolic disease.展开更多
基金Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization(2021B1212040007)Clinical Frontier Technology Program of the First Affiliated Hospital of Jinan University,China(JNU1AF-CFTP-2022-a01235)Science and Technology Projects in Guangzhou,China(202201020054,2023A03J1032).
文摘In the United States(US),the Surveillance,Epidemiology,and End Results(SEER)program is the only comprehensive source of population-based information that includes stage of cancer at the time of diagnosis and patient survival data.This program aims to provide a database about cancer incidence and survival for studies of surveillance and the development of analytical and methodological tools in the cancer field.Currently,the SEER program covers approximately half of the total cancer patients in the US.A growing number of clinical studies have applied the SEER database in various aspects.However,the intrinsic features of the SEER database,such as the huge data volume and complexity of data types,have hindered its application.In this review,we provided a systematic overview of the commonly used methodologies and study designs for retrospective epidemiological research in order to illustrate the application of the SEER database.Therefore,the goal of this review is to assist researchers in the selection of appropriate methods and study designs for enhancing the robustness and reliability of clinical studies by mining the SEER database.
基金Vocational Education Teaching Reform Research Project of Shandong Province(2022273)2023 General Project of Shandong Higher Education AssociationSchool-level Key Research Project of Qingdao Preschool Education College(kyzd2023-01).
文摘Curriculum ideology and politics are critical for colleges and universities to fulfill theirfundamental mission of fostering moral and intellectual development. Within this framework, professionalcourses serve as the primary vehicles for integrating ideological and political education. Specifically, inthe field of study tours, the Study Tour Course Design emerges as a pivotal component for actualizingthe educational objectives of such programs. To construct a robust ideological and political curriculum,it is essential to devise a comprehensive system that aligns with professional teaching standards, industrybenchmarks, and vocational skill requirements. This involves a thorough exploration of ideologicaland political elements within the curriculum, ensuring their seamless integration throughout the coursedevelopment process.
基金conducted within the framework of the project LNG-COMSHIP,Greek General Secretariat of Research and Technology Code:12CHN400,and was funded by the European Regional Development Fund(ERDF) and National Resources
文摘In this feasibility study, we investigate the viability of using Liquefied Natural Gas （LNG） fuel in an open type Ro-Ro passenger ferry and the associated potential challenges with regard to the vessel safety systems. We recommend an appropriate methodology for converting existing ships to run on LNG fuel, discuss all the necessary modifications to the ship’s safety systems, and also evaluate the relevant ship evacuation procedures. We outline the basic requirements with which the ship already complies for each safety system and analyze the additional restrictions that must be taken into consideration for the use of LNG fuel. Appropriate actions are recommended. Furthermore, we carry out a hazard identification study. Overall, we clearly demonstrate the technical feasibility of the investigated scenario. Minimal modifications to the ship’s safety systems are required to comply with existing safety rules for this specific type of ship.
文摘Background:Degradable magnesium implants are promising for clinical fracture treatment,providing less stress-shielding mechanical support and superior bone-strengthening benefits to traditional materials.The quality of preclinical research is essential for developing Mg implants;however,there are considerable variations in the model selection and study design in published studies,posing challenges for safe and effective clinical translation of lab discoveries.Objective:The purpose of this systematic review is to investigate the current progress on in vivo research of Mg implants for fracture treatment,focusing on model selection,Mg materials,implant design,methodological and analyzing techniques,aiming to provide comprehensive guidance for future preclinical research.Materials and methods:Pub Med and Embase online databases were searched to identify researches investigating Mg implants in animal models of fracture from 1960 to December 2019,using a combination of keywords:magnesium and fracture.Eligible studies were included without language restriction.Data extraction was conducted for qualitative analysis.Meta-analysis was not performed due to extensive heterogeneities among studies.Results:Twenty studies published from 2014 to 2019 were included.Publication information,animal model,methodological quality,implants preparation,and evaluation techniques were extracted.The methodological assessment revealed low to high risk of bias among studies.Both rodent and non-rodent species were selected,and the anatomical sites for inducing fractures included both cranial-facial and limb bones.Pure Mg and alloys with or without surface modification were evaluated,covering implant designs of both intra-medullary and extra-medullary fixation.Radiological and histological evaluations were commonly conducted.Conclusions:Published in vivo evidence confirmed the role of Mg-based implants in promoting fracture healing.However,considering heterogeneity in animal selection,implant preparation,and evaluation methods,there still lacks a standardized reference model.By analyzing the information extracted from included studies,the systematic review may facilitate planning and conducting preclinical research with translational perspective.
基金supported by the National Basic Research Program of China(973 Program),No.2012CB518501the Key Project of the National Natural Science Foundation of China,No.30930112/C190301
文摘Shaoyang acupoints are the most frequently used in migraine treatment. However, the central anal- gesic mechanism remains poorly understood. Studies have demonstrated that single stimulus of the verum acupuncture in healthy subjects can induce significant connectivity or activity changes in pain- related central networks compared with sham acupuncture. However, these findings are not indicative of the central analgesic mechanism of acupuncture at Shaoyang acupoints. Thus, we recruited 100 migraine sufferers and randomly assigned them into five groups： Shaoyang uncommon acupoint, Shaoyang common acupoint, Yangming uncommon acupoint, non-acupoint control, and blank control groups. Subjects were subjected to evaluation of curative effects and functional MRI prior to and after 10 and 20 acupuncture treatments. All subjects were diagnosed by physicians and enrolled following clinical physical examination. Subjects were observed during 1-4 weeks after inclusion. At the fifth week, the first clinical evaluation and resting functional MRI were conducted. The Shaoyang uncom- mon acupoint, Shaoyang common acupoint, Yangming uncommon acupoint, and non-acupoint control grousp then were treated with acupuncture, five times per week, 20 times in total over 4 weeks. The second and third clinical evaluations and resting functional MRI screenings were conducted following 10 and 20 acupuncture treatments. The blank control group was observed during the 5 to 8 week pe- riod, followed by clinical evaluation and resting functional MRI. The aim of this study was to examine changes in brain functional activity and central networks in subjects with migraine undergoing acu- puncture at Shaoyang uncommon acupoints. This study provides a further explanation of the central analgesic mechanism by which acupuncture at Shaoyang acupoints treats migraine,
文摘Following a few preliminary remarks on the tunneling methods at the beginning of the 20th century, thesuccessful applications of the full-face method also in difficult conditions are underlined. The attention isposed on the use of a systematic reinforcement of the face and of the ground, by means of fiber-glasselements. A selection of tunnels where this method was used successfully is reported with the purposeof illustrating the wide spectrum of ground conditions where it has been applied. Then, following adescription of the main concepts behind the method, the attention moves from the so-called “heavymethod”, where deformations are restrained, to the “light method”, where deformations are allowedwith the intention to decrease the stresses acting on the primary and final linings. The progress in theapplication of the “light method” is underlined, up to the development of a novel technique, which relieson the use of a yielding support composed of top head steel sets with sliding joints and specialdeformable elements inserted in the primary lining. The well-known case study of the Saint Martin LaPorte access adit, along the Lyon-Turin Base Tunnel, is described. In this tunnel, a yield-control supportsystem combined with full-face excavation has been adopted successfully in order to cope with the largedeformations experienced during face advance through the Carboniferous formation. The monitoringresults obtained during excavation are illustrated, together with the modeling studies performed whenpaying attention to the rock mass time-dependent behavior.
文摘The implementation of molecular profiling technologies in oncology deepens our knowledge for the molecular landscapes of cancer diagnoses, identifying aberrations that could be linked with specific therapeutic vulnerabilities. In particular, there is an increasing list of molecularly targeted anticancer agents undergoing clinical development that aim to block specific molecular aberrations. This leads to a paradigm shift, with an increasing list of specific aberrations dictating the treatment of patients with cancer. This paradigm shift impacts the field of clinical trials, since the classical approach of having clinico-pathological disease characteristics dictating the patients' enrolment in oncology trials shifts towards the implementation of molecular profiling as prescreening step. In order to facilitate the successful clinical development of these new anticancer drugs within specific molecular niches of cancer diagnoses, there have been developed new, innovative trial designs that could be classified as follows: i)longitudinal cohort studies that implement(or not) "nested" downstream trials, 2) studies that assess the clinical utility of molecular profiling, 3) "master" protocol trials, iv) "basket" trials, v) trials following an adaptive design. In the present article, we review these innovative study designs, providing representative examples from each category and we discuss the challenges that still need to be addressed in this era of new generation oncology trials implementing molecular profiling. Emphasis is put on the field of breast cancer clinical trials.
基金Ferring Pharmaceuticals provided funding for editorial assistance.The author acknowledges Dr.Payal Bhardwaj of Tata Consultancy Services,who provided editorial assistance.
文摘Intermittent androgen deprivation therapy(IADT)is now being increasingly opted by the treating physicians and patients with prostate cancer.The most common reason driving this is the availability of an off-treatment period to the patients that provides some relief from treatment-related side-effects,and reduced treatment costs.IADT may also delay the progression to castration-resistant prostate cancer.However,the use of IADT in the setting of prostate cancer has not been strongly substantiated by data from clinical trials.Multiple factors seem to contribute towards this inadequacy of supportive data for the use of IADT in patients with prostate cancer,e.g.,population characteristics(both demographic and clinical),study design,treatment regimen,on-and off-treatment criteria,duration of active treatment,endpoints,and analysis.The present review article focuses on seven clinical trials that evaluated the efficacy of IADT vs.continuous androgen deprivation therapy for the treatment of prostate cancer.The results from these clinical trials have been discussed in light of the factors that may impact the treatment outcomes,especially the disease(tumor)burden.Based on evidence,potential candidate population for IADT has been suggested along with recommendations for the use of IADT in patients with prostate cancer.
文摘Recently we read the article entitled“Outcomes of different minimally invasive surgical treatments for vertebral compression fractures:An observational study”.This was an observational study that reviewed the safety and efficacy of different cement augmentation modalities for vertebral compression fractures under osteoporotic condition.Overall,this is a valuable study that can provide a reference for clinical practice.On the other hand,we also noticed some points in the article and are willing to share our views.Further studies with a higher level of evidence can add more knowledge regarding relevant concerns.
基金Sponsored by 2016 Guangxi Higher Education Undergraduate Teaching Reform Project
文摘From the perspectives of physiology and psychology, this article not only analyzes the interrelation between landscape and sight, but also classifies and studies the courtyard landscape sight. According to the studies of courtyard sight, courtyard space and courtyard construction, how to optimize the courtyard landscape construction is to be discussed to provide references for further researches and field applications.
文摘Scientific research is challenged to translate findingsfrom multiple, often conflicting, clinical trials into a simple answer of whether a treatment works or not. The public and healthcare providers alike frequently voice their frustrations when the media reports a treatment working on one day, but seemingly the next day reports a study refuting the previous one. Meta-analyses are being used more commonly by researchers to convey an understandable summary of scientific studies to the general public and healthcare providers. As time goes by, we have learned how to improve meta-analytic techniques to reflect more valid results and when it is appropriate to pool or not to pool results from different studies. Retrospective reviews often don’t acknowledge this learning curve and may fail to recommend the most current valid guidelines. This editorial presents an example of how the current use of meta-analysis has shifted in one feld （the therapeutic effects of probiotics） and recommendations on how to correctly interpret the results of such an analysis.
文摘HIV （Human Immuno-deficiency Virus） prevalence in Malawi is one of the highest in the world, with 10.3% of population living with HIV. Kenya has a prevalence rate of 6% and with 1.6 million people living with HIV infection. The broad objective of the study was to assess the proportion of youth aged 15-24 years affected by HIV in Malawi and Kenya. This was a descriptive study design. Data were mainly collected from reports from government, World Bank, World Health Organization and UN agencies. Graphs, tables and charts have been used to present statistics. Data for specific age cohort were hard to find and hence, data were used for general HIV and AIDS with special attention to the youth where possible. In Kenya, HIV prevalence among young women jumps three folds from 2.8% of 15-17 year olds to 8.3% among 23-24 year olds. In Malawi, around 2,100 young people and adolescents are infected with HIV every day. In 2013, four million young people aged 15-24 were living with HIV, with 29% aged under 19 years. This age group includes school going youths, newly employed, economically productive and sexually active group. HIV prevalence in Malawi has been declining over time among persons aged 15-19 years from 16.4% in 1999 to 11.8 % in 2004 to 10.6% in 2010 and 10.3% in 2016. However, in Kenya, the trend of HIV prevalence reached its peak of 10.55% in 1995-1996 after which it declined to 6.7% in 2003 and has been stable since then.
基金grants from the Project of Young Talent in Medical Field in Zhejiang Province(201570)from the Health Commission of Zhejiang Province,and the National Natural Science Foundation of China(No.31500992).
文摘The purpose of this review is to provide medical researchers,especially those without a bioinformatics background,with an easy-to-understand summary of the concepts and technologies used in microbiome research.First,we define primary concepts such as microbiota,microbiome,and metagenome.Then,we discuss study design schemes,the methods of sample size calculation,and the methods for improving the reliability of research.We emphasize the importance of negative and positive controls in this section.Next,we discuss statistical analysis methods used in microbiome research,focusing on problems with multiple comparisons and ways to compare β-diversity between groups.Finally,we provide step-by-step pipelines for bioinformatics analysis.In summary,the meticulous study design is a key step to obtaining meaningful results,and appropriate statistical methods are important for accurate interpretation of microbiome data.The step-by-step pipelines provide researchers with insights into newly developed bioinformatics analysis methods.
文摘Two randomized controlled trials of acupuncture concerning polycystic ovary syndrome（PCOS） and stress urinary incontinence（SUI） were published simultaneously in the 24 th issue, 2017 of The Journal of the American Medical Association（JAMA）. A trial involving PCOS indicated that active acupuncture did not increase live birth compared with sham acupuncture; meanwhile, another trial referring to SUI showed that electroacupuncture resulted in less urine leakage compared with sham electroacupuncture. With an eye to the negative and positive results of acupuncture, three pivotal factors should be contemplated：（1） proper illness for acupuncture, that is, a problem need to be solved in current medical science, and acupuncture may really work for it;（2） proper pre-studied primary outcome, which is better be objective and repeatedly measurable to reveal the therapeutic effect of acupuncture truly and objectively;（3） proper sham control, which can blind the patients to the upmost extent with minimal biological effects. Through the publication of clinical trials of acupuncture in high-impact journals in recent years, researchers should have confidence in their clinical trials by pondering over these three pivotal factors.
基金HZ would thank the Robert H.Lurie Comprehensive Cancer Center of Northwestern University in Chicago,IL for the use of the Quantitative Data Sciences Core.The Lurie Cancer Center is supported in part by an NCI Cancer Center Support Grant#P30CA060553.
文摘Class III medical devices are those devices that support or sustain human life or prevent impairment of human health but,when used,pose high risks to the patients.There were 15 class III medical devices that were approved by the US Food and Drug Administration from September 1,2005 to December 31,2018 for glucose monitoring and diabetes treatment.In this article,we reviewed the study design and statistical analysis in clinical trials that were conducted to provide evidences for safety and effectiveness of these medical devices.Two exemplars of clinical trials for"Eversense continuous glucose monitoring system"and"t:slim X2 Insulin Pump with Basal-IQ Technology"are discussed in details.
文摘Ambient air pollution in China has worsened following dramatic increases in industrialization, automobile use and energy consumption. Particularly bothersome is the increase in the PM2.5 fraction of pollutants. This fraction has been associated with increasing rates of cardio-respiratory disease in China and elsewhere. Ambient pollutant levels have been described in many of China＇s cities and are comparable to previous levels in southern California. Lung cancer mortality in China has increased since the 1970s and has been higher in men and in urban areas, the exact explanation for which has not been determined. The estimation of individual risk for Chinese citizens living in areas of air pollution will require further research. Occupational cohort and casecontrol designs each have unique attributes that could make them helpful to use in this setting. Other important future research considerations include detailed exposure assessment and the possible use of biomarkers as a means to better understand and manage the threat posed by air pollution in China.
基金Project supported by the Key Program of the National Natural Sci-ence Foundation of China(Grant Nos.81830057 and 82230068)the Young Scientists Fund of the National Natural Science Foundation of China(Grant No.82102155).
文摘In recent years,with the development of artificial intelligence,especially deep learning technology,researches on automatic detection of cerebrovascular diseases on medical images have made tremendous progress and these models are gradually entering into clinical practice.However,because of the complexity and flexibility of the deep learning algorithms,these researches have great variability on model building,validation process,performance description and results interpretation.The lack of a reliable,consistent,standardized design protocol has,to a certain extent,affected the progress of clinical translation and technology development of computer aided detection systems.After reviewing a large number of literatures and extensive discussion with domestic experts,this position paper put forward recommendations of standardized design on the key steps of deep learning-based automatic image detection models for cerebrovascular diseases.With further research and application expansion,this position paper would continue to be updated and gradually extended to evaluate the generalizability and clinical application efficacy of such tools.
文摘People with diabetes are 30 times more likely to undergo amputation than the general population.A total of 3.2million people in the UK have been diagnosed with diabetes and by 2025 this number is estimated to be 5million.One potential complication post amputation is phantom limb pain(PLP),a prevalent and often chronic condition which is difficult to treat.To inform a
文摘Ⅰ Why do we need to conduct a study?·To fill in knowledge gap·To identify the good and the bad management·To find out new diagnostic methods·To prevent adverse outcome·To improve patient care FINER is the key concept when we start to think about to conduct a study.
基金an NIH Training Grant during the drafting of this manuscript(T32ES027801)K.D.H.is supported by the Intramural Research Program of the NIH,National Institute of Diabetes&Digestive&Kidney Diseases(1ZIADK013038).
文摘Diet plays a substantial role in the etiology, progression, and treatment of chronic disease and is best considered as a multifacetedset of modifiable input variables with pleiotropic effects on a variety of biological pathways spanning multiple organ systems. Thisbrief review discusses key issues related to the design and conduct of diet interventions in rodent models of metabolic disease andtheir implications for interpreting experiments. We also make specific recommendations to improve rodent diet studies to help betterunderstand the role of diet on metabolic physiology and thereby improve our understanding of metabolic disease.
