This paper takes the assessment and evaluation of computational mechanics course as the background,and constructs a diversified course evaluation system that is student-centered and integrates both quantitative and qu...This paper takes the assessment and evaluation of computational mechanics course as the background,and constructs a diversified course evaluation system that is student-centered and integrates both quantitative and qualitative evaluation methods.The system not only pays attention to students’practical operation and theoretical knowledge mastery but also puts special emphasis on the cultivation of students’innovative abilities.In order to realize a comprehensive and objective evaluation,the assessment and evaluation method of the entropy weight model combining TOPSIS(Technique for Order Preference by Similarity to Ideal Solution)multi-attribute decision analysis and entropy weight theory is adopted,and its validity and practicability are verified through example analysis.This method can not only comprehensively and objectively evaluate students’learning outcomes,but also provide a scientific decision-making basis for curriculum teaching reform.The implementation of this diversified course evaluation system can better reflect the comprehensive ability of students and promote the continuous improvement of teaching quality.展开更多
Green manufacturing is a mode to realize environmental friendliness by considering the environmental impact and energy consumption in manufacturing process.In order to make an environmental friendly assessment for man...Green manufacturing is a mode to realize environmental friendliness by considering the environmental impact and energy consumption in manufacturing process.In order to make an environmental friendly assessment for manufacturing process,a multi-criteria decision making( MCDM) model combined with fuzzy analytic hierarchy process( FAHP) and fuzzy technique for order preference by similarity to ideal solution( FTOPSIS) is proposed in this work.The environmental and resource criteria and manufacturing process objects are identified as the first step.Then,the weights of the criteria are calculated by FAHP.Finally,based on experts' evaluation using fuzzy words,the manufacturing process objects are ranked by FTOPSIS.The proposed methodology is applied to a gear shaft manufacturing.The sensitivity analysis and comparisons are implemented to prove its robustness and effectiveness for the ecofriendly assessment for process objects.展开更多
The paper reviews issues in language assessment, especially pertaining to the challenges faced in examining non-native speakers of English. The review revealed that low proficiency levels of well-established standard ...The paper reviews issues in language assessment, especially pertaining to the challenges faced in examining non-native speakers of English. The review revealed that low proficiency levels of well-established standard varieties of English affect the test achievement of non-native speakers across the world. Furthermore, the absence and improper evaluation of English tests, coupled with poor educational systems in Africa, Asia, and the Caribbean lead to very low achievement in English. Based on the review, the paper recommends the use of accommodation, culture-specific designed tests, and more research as remedy for the problems. Areas of future research for Africa and specifically, Ghana are recommended.展开更多
This work was aimed at assessing one of the examinations applied to the students enrolled in courses of Biochemistry and Molecular Biology at the School of Medicine, UNAM. We analyzed a f'mal examination in this subj...This work was aimed at assessing one of the examinations applied to the students enrolled in courses of Biochemistry and Molecular Biology at the School of Medicine, UNAM. We analyzed a f'mal examination in this subject. The test consisted of 80 multiple choice questions. The database was exported to Excel and then to the SPSS 16 statistical software for statistical analyses. The following techniques were used: (1) dificulty index (Pi), (2) discrimination index (Di), (3) discrimination coefficient (rpbis), and (4) Cronbach's alpha. Those questions that complied with 3 of the 4 mentioned techniques were considered acceptable; of the 80 questions, only 25 were accepted corresponding to 31%. The topic with the largest number of accepted questions was Water and pH (75%), and the topics without accepted questions were Bioenergetics and Hormones (0%). It is recommended that the faculty members that elaborate multiple choice examinations must know the subject, and should have a formation in didactics and educational methodology.展开更多
As an institution,Xi’an Jiaotong Liverpool University(XJTLU)is unique in China.It is the only Chinese institution that awards students both UK degree and Chinese degree,so it has two sets of control,one of which is t...As an institution,Xi’an Jiaotong Liverpool University(XJTLU)is unique in China.It is the only Chinese institution that awards students both UK degree and Chinese degree,so it has two sets of control,one of which is to meet all the requirements of the UK Higher Education(HE)standards and the other is to go through all the requirements of Chinese degree awarding powers.Due to its specific relationship with University of Liverpool(UoL),XJTLU is also under close scrutiny from UoL.All of these are reflected in the XJTLU internal and external Quality Assurance(QA)frameworks and procedures.This article focuses on describing and analysing how XJTLU monitors the teaching and assessment processes to meet the UK HE QA standards.Generally,the monitoring system is robust and multidimensional,involving students and peers as observers/reviewers.To understand students’perspectives on the teaching quality and their learning experience,the university provides official channels for students to provide ratings and/or qualitative comments on modules and instructors at the middle and the end of semester,while module instructors are expected to do reflection and revision of their teaching accordingly.In addition to that,each module instructor has to observe a peer’s class annually and engage in dialogues with the peer reviewer before and after the observation.To ensure the quality of assessment tasks and marking standards,module leaders have to actively communicate with internal moderators,UoL moderators and external moderators in the Assessment Preparation Review(APR)and Marking Moderation Review(MMR)processes.In general,the evaluation practice of teaching and assessment plays an important role in ensuring the educational quality is maintained and enhanced at XJTLU and is comparable with international best practice.So far,many disciplines at the university have been certified by international professional organizations,which strengthens the university’s global positioning,and directly improves the competitiveness of graduates in the global job market.The author hopes to provide some insights of the QA practice at XJTLU to help teachers and education administrators in different contexts to understand the benefits and progress to be made in terms of teaching and assessment evaluation to ensure the high quality of student training.展开更多
BACKGROUND The standard management of autoimmune hepatitis(AIH)is based on corticosteroids,alone or in combination with azathioprine.Second-line treatments are needed for patients who have refractory disease.However,h...BACKGROUND The standard management of autoimmune hepatitis(AIH)is based on corticosteroids,alone or in combination with azathioprine.Second-line treatments are needed for patients who have refractory disease.However,high-quality data on the alternative management of AIH are scarce.AIM To evaluate the efficacy and safety of tacrolimus and mycophenolate mofetil(MMF)and the quality of evidence by using the Grading of Recommendations Assessment,Development and Evaluation approach(GRADE).METHODS A systematic review and meta-analysis of the available data were performed.We calculated pooled event rates for three outcome measures:Biochemical remission,adverse events,and mortality,with their corresponding 95%confidence intervals(CI).RESULTS The pooled biochemical remission rate was 68.9%(95%CI:60.4-76.2)for tacrolimus,and 59.6%(95%CI:54.8-64.2)for MMF,and rates of adverse events were 25.5%(95%CI:12.4-45.3)for tacrolimus and 24.1%(95%CI:15.4-35.7)for MMF.The pooled mortality rate was estimated at 11.5%(95%CI:7.1-18.1)for tacrolimus and 9.01%(95%CI:6.2-12.8)for MMF.Pooled biochemical remission rates for tacrolimus and MMF in patients with intolerance to standard therapy were 56.6%(CI:43.4-56.6)vs 73.5%(CI:58.1-84.7),and among non-responders were 59.1%(CI:48.7-68.8)vs 40.8%(CI:32.3-50.0),respectively.Moreover,the overall quality assessments using GRADE proved to be very low for all our outcomes in both treatment groups.CONCLUSION Tacrolimus and MMF are in practice considered effective for patients with AIH who are non-responders or intolerant to first-line treatment,but we found no high-quality evidence to support this statement.展开更多
BACKGROUND Nonalcoholic fatty liver disease(NAFLD)affects more than one-quarter of the global population.Due to the lack of approved chemical agents,many patients seek treatment from traditional Chinese medicine(TCM)f...BACKGROUND Nonalcoholic fatty liver disease(NAFLD)affects more than one-quarter of the global population.Due to the lack of approved chemical agents,many patients seek treatment from traditional Chinese medicine(TCM)formulas.A variety of systematic reviews have been published regarding the effectiveness and safety of TCM formulas for NAFLD.AIM To critically appraise available systematic reviews and sort out the high-quality evidence on TCM formulas for the management of NAFLD.METHODS Seven databases were systematically searched from their inception to 28 February 2020.The search terms included“non-alcoholic fatty liver disease,”“Chinese medicines,”“systematic review,”and their synonyms.Systematic reviews involving TCM formulas alone or in combination with conventional medications were included.The methodological quality and risk of bias of eligible systematic reviews were evaluated by using A Measure Tool to Assess Systematic Reviews 2(AMSTAR 2)and Risk of Bias in Systematic Review(ROBIS).The quality of outcomes was assessed by the Grading of Recommendations Assessment,Development and Evaluation(GRADE)system.RESULTS Seven systematic reviews were ultimately included.All systematic reviews were conducted based on randomized controlled trials and published in the last decade.According to the AMSTAR 2 tool,one systematic review was judged as having a moderate confidence level,whereas the other studies were rated as having a low or extremely low level of confidence.The ROBIS tool showed that the included systematic reviews all had a high risk of bias due to insufficient consideration of identified concerns.According to the GRADE system,only two outcomes were determined as high quality;namely,TCM formulas with the HuoXueHuaYu principle were better than conventional medications in ultrasound improvement,and TCM formulas were superior to antioxidants in alanine aminotransferase normalization.Other outcomes were downgraded to lower levels,mainly because of heterogeneity among studies,not meeting optimal information sample size,and inclusion of excessive numbers of small sample studies.Nevertheless,the evidence quality of extracted outcomes should be further downgraded when applying to clinical practice due to indirectness.CONCLUSION The quality of available systematic reviews was not satisfactory.Researchers should avoid repeatedly conducting systematic reviews in this area and focus on designing rigorous randomized controlled trials to support TCM formula applications.展开更多
AIM: To evaluate the current state-of-the-art of gastric electrical stimulation to treat obesity. METHODS: Systematic reviews of all studies have been conducted to evaluate the effect of different types of gastric ele...AIM: To evaluate the current state-of-the-art of gastric electrical stimulation to treat obesity. METHODS: Systematic reviews of all studies have been conducted to evaluate the effect of different types of gastric electrical stimulation(GES) on obesity.RESULTS: Thirty-one studies consisting of a total of 33 different trials were included in the systematic review for data analysis. Weight loss was achieved in most studies, especially during the first 12 mo, but only very few studies had a follow-up period longer than 1 year. Among those that had a longer follow-up period, many were from the Transcend(Implantable Gastric Stimulation) device group and maintained significant weight loss. Other significant results included changes in appetite/satiety, gastric emptying rate, blood pressure and neurohormone levels or biochemical markers such as ghrelin or HbA1 c respectively. CONCLUSION: GES holds great promises to be an effective obesity treatment. However, stronger evidence is required through more studies with a standardized way of carrying out trials and reporting outcomes, to determine the long-term effect of GES on obesity.展开更多
This study aimed to develop a guideline for therapeutic drug monitoring(TDM) of vancomycin. We adopted the new guideline definition from the Institute of Medicine(IOM), adhered closely to the six domains of the Ap...This study aimed to develop a guideline for therapeutic drug monitoring(TDM) of vancomycin. We adopted the new guideline definition from the Institute of Medicine(IOM), adhered closely to the six domains of the Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREE Ⅱ), and made recommendations based on systematic reviews. We established a Guideline Steering Group and a Guideline Development Group, formulated 12 questions in the form of Population, Intervention, Comparison, Outcome(PICO) and completed a literature search. As far as we know, we will develop the first evidenced-based guideline for vancomycin TDM under the framework of the Grade of Recommendations Assessment, Development and Evaluation(GRADE).展开更多
The International Accounting Standards Board (IASB) and the Financial Accounting Standards Board (FASB) stress the importance of high-quality 'financial reports. From a scientific point of view, however, major me...The International Accounting Standards Board (IASB) and the Financial Accounting Standards Board (FASB) stress the importance of high-quality 'financial reports. From a scientific point of view, however, major methodological drawbacks can arise when trying to arrive at a comprehensive assessment and evaluation of the decision usefulness of financial reports. In this conceptually-based exploratory study, the authors construct a 33-item index aimed at operationalizing decision usefulness in terms of the fundamental and enhancing qualitative characteristics laid out in the conceptual framework (CF) of the IASB (2010). Using a matched-pairs sample design, which includes 70 UK annual reports and 70 US 10-K reports for 2010, the results of test-retest and inter-rater reliability tests show that these multiple items, which were based on items used in previous research, can be measured in a reliable manner. At the same time, the results of an exploratory factor analysis indicate that the IASB qualitative characteristics cannot be measured separately when the 33-item index is applied. At an aggregate level, the results of paired-sample t-tests reveal that UK reports score on average higher than US 10-K reports, which suggests that the overall quality of UK reports is better. The findings of this study add to the existing literature on the empirical evaluation of the effects of international accounting standards, showing that, as compared with 10-K reports, UK annual reports provide more information on topics such as corporate social responsibility (CSR), corporate governance, and annual bonus schemes. On the other hand, US reports outperform UK reports with respect to the content of fair value information, cash flow statements, off-balance financing, and audit reporting.展开更多
Project-based learning (PBL) as an instructional approach focuses on student-centeredness through contextualizing learning by presenting students with real world issues and practices that aim at achieving enduring l...Project-based learning (PBL) as an instructional approach focuses on student-centeredness through contextualizing learning by presenting students with real world issues and practices that aim at achieving enduring learning effects. As a challenge to traditional lecture-based instruction, PBL may generate positive backwash assessment effects via documenting the process of developing authentic language skills. These skills-oriented outcomes are achieved through proper curricula in appropriate learning situations via various dimensions. However, problems may occur such as management, pressure from administration, evaluation doing their selected projects. teacher/student attitude, class size and proper group process and criteria, and students' likely frustrations in展开更多
Objective: To assess the quality of integrative medicine clinical practice guidelines(CPGs) published before 2014. Methods: A systematic search of the scientific literature published before 2014 was conducted to s...Objective: To assess the quality of integrative medicine clinical practice guidelines(CPGs) published before 2014. Methods: A systematic search of the scientific literature published before 2014 was conducted to select integrative medicine CPGs. Four major Chinese integrated databases and one guideline database were searched: the Chinese Biomedical Literature Database(CBM), the China National Knowledge Infrastructure(CNKI), China Science and Technology Journal Database(VIP), Wanfang Data, and the China Guideline Clearinghouse(CGC). Four reviewers independently assessed the quality of the included guidelines using the Appraisal of Guidelines for Research and Evaluation(AGREE) Ⅱ Instrument. Overall consensus among the reviewers was assessed using the intra-class correlation coefficient(ICC). Results: A total of 41 guidelines published from 2003 to 2014 were included. The overall consensus among the reviewers was good [ICC: 0.928; 95% confidence interval(CI): 0.920 to 0.935]. The scores on the 6 AGREE domains were: 17% for scope and purpose(range: 6% to 32%), 11% for stakeholder involvement(range: 0 to 24%), 10% for rigor of development(range: 3% to 22%), 39% for clarity and presentation(range: 25% to 64%), 11% for applicability(range: 4% to 24%), and 1% for editorial independence(range: 0 to 15%). Conclusions: The quality of integrative medicine CPGs was low, the development of integrative medicine CPGs should be guided by systematic methodology. More emphasis should be placed on multi-disciplinary guideline development groups, quality of evidence, management of funding and conflicts of interest, and guideline updates in the process of developing integrative medicine CPGs in China.展开更多
Objective To evaluate the reliability and validity of the 4 myasthenia gravis(MG)scales widely used for assessing the grades of disease severity in Chinese MG patients.Methods Sixty MG patients were examined by a neur...Objective To evaluate the reliability and validity of the 4 myasthenia gravis(MG)scales widely used for assessing the grades of disease severity in Chinese MG patients.Methods Sixty MG patients were examined by a neurologist with the following four MG scales:Quantitative Myasthenia Gravis Score(QMGS),Myasthenia Gravis Composite(MGC),Myasthenic Muscle Scale(MMS),Absolute and Relative Score of MG(ARS-展开更多
The "WMO Typhoon Landfall Forecast Demonstration Project(TLFDP)" was started in May 2010 in conjunction with the start of the Shanghai World Expo 2010. The project was successful in terms of assisting the lo...The "WMO Typhoon Landfall Forecast Demonstration Project(TLFDP)" was started in May 2010 in conjunction with the start of the Shanghai World Expo 2010. The project was successful in terms of assisting the local forecasters in providing an efficient tropical cyclone(TC) forecast service for World Expo 2010, demonstrating the performance of the most up-to-date techniques in TC forecasting, and enhancing the ability of forecasters to effectively use products based on advanced TC forecasting techniques. The first phase was completed in December 2012 and the second phase was completed in December 2015. The third phase(TLFDP-III) started in 2016.During its first(2010-2012) and second(2013-2015) phases, TLFDP collected real-time TC forecast products from 15 Typhoon Forecast Product Providers(TFPPs). The products include deterministic track and intensity forecasts, ensemble track and intensity forecasts, deterministic wind radii forecasts, wind probability forecasts, and gridded model outputs. The products were disseminated through the project's website and the operational website of the Shanghai Typhoon Warning Center.TLFDP has made significant progress in TC forecast verification, including setting up the tools for both realtime and post-season TC forecast verification, developing and integrating several new verification techniques, carrying out a survey on the operational status of TC forecast verification in the western North Pacific region, and contributing to the WMO document "Verification of tropical cyclone forecasts". The post-season forecast verification was reported to the Session of the UNESCAP/WMO Typhoon Committee since 2013. New consensus methods for TC track and intensity forecasts were also proposed either based on Ensemble Prediction Systems(EPSs) products or multiple deterministic NWP model products. Two training workshops on TC forecasting were organized by the TLFDP and held in Shanghai, China, in May 2010 and June 2012, respectively, and seven research fellowship projects were implemented as jointly supported by the UNESCAP/WMO Typhoon Committee, Shanghai Typhoon Institute and Hong Kong Observatory.In its third phase(TLFDP-III, 2016-2018), the project will continue its effort on demonstration and evaluation of the newly developed forecasting techniques for TCs, and developing and documenting advanced guidance for the verification of TC forecasts, with special attention to TC intensity and precipitation.展开更多
The scientific literature presents a modest amount ot evidence m the use or complementary ana al[erna- tire medicine (CAM). On the other hand, in practice, relevant results are common. The debates among CAM practiti...The scientific literature presents a modest amount ot evidence m the use or complementary ana al[erna- tire medicine (CAM). On the other hand, in practice, relevant results are common. The debates among CAM practitioners about the quality and execution of scientific research are important, Therefore, the aim of this review is to gather, synthesize and describe the differentiated methodological models that encompass the complexity of therapeutic interventions. The process of bringing evidence-based medicine into clinical practice in CAM is essential for the growth and strengthening of complementary medicines worldwide.展开更多
基金2024 Key Project of Teaching Reform Research and Practice in Higher Education in Henan Province“Exploration and Practice of Training Model for Outstanding Students in Basic Mechanics Discipline”(2024SJGLX094)Henan Province“Mechanics+X”Basic Discipline Outstanding Student Training Base2024 Research and Practice Project of Higher Education Teaching Reform in Henan University of Science and Technology“Optimization and Practice of Ability-Oriented Teaching Mode for Computational Mechanics Course:A New Exploration in Cultivating Practical Simulation Engineers”(2024BK074)。
文摘This paper takes the assessment and evaluation of computational mechanics course as the background,and constructs a diversified course evaluation system that is student-centered and integrates both quantitative and qualitative evaluation methods.The system not only pays attention to students’practical operation and theoretical knowledge mastery but also puts special emphasis on the cultivation of students’innovative abilities.In order to realize a comprehensive and objective evaluation,the assessment and evaluation method of the entropy weight model combining TOPSIS(Technique for Order Preference by Similarity to Ideal Solution)multi-attribute decision analysis and entropy weight theory is adopted,and its validity and practicability are verified through example analysis.This method can not only comprehensively and objectively evaluate students’learning outcomes,but also provide a scientific decision-making basis for curriculum teaching reform.The implementation of this diversified course evaluation system can better reflect the comprehensive ability of students and promote the continuous improvement of teaching quality.
基金National Natural Science Foundation of China(No.51475459)the Priority Academic Program Development of Jiangsu Higher Education Institutions of China(No.PAPD)
文摘Green manufacturing is a mode to realize environmental friendliness by considering the environmental impact and energy consumption in manufacturing process.In order to make an environmental friendly assessment for manufacturing process,a multi-criteria decision making( MCDM) model combined with fuzzy analytic hierarchy process( FAHP) and fuzzy technique for order preference by similarity to ideal solution( FTOPSIS) is proposed in this work.The environmental and resource criteria and manufacturing process objects are identified as the first step.Then,the weights of the criteria are calculated by FAHP.Finally,based on experts' evaluation using fuzzy words,the manufacturing process objects are ranked by FTOPSIS.The proposed methodology is applied to a gear shaft manufacturing.The sensitivity analysis and comparisons are implemented to prove its robustness and effectiveness for the ecofriendly assessment for process objects.
文摘The paper reviews issues in language assessment, especially pertaining to the challenges faced in examining non-native speakers of English. The review revealed that low proficiency levels of well-established standard varieties of English affect the test achievement of non-native speakers across the world. Furthermore, the absence and improper evaluation of English tests, coupled with poor educational systems in Africa, Asia, and the Caribbean lead to very low achievement in English. Based on the review, the paper recommends the use of accommodation, culture-specific designed tests, and more research as remedy for the problems. Areas of future research for Africa and specifically, Ghana are recommended.
文摘This work was aimed at assessing one of the examinations applied to the students enrolled in courses of Biochemistry and Molecular Biology at the School of Medicine, UNAM. We analyzed a f'mal examination in this subject. The test consisted of 80 multiple choice questions. The database was exported to Excel and then to the SPSS 16 statistical software for statistical analyses. The following techniques were used: (1) dificulty index (Pi), (2) discrimination index (Di), (3) discrimination coefficient (rpbis), and (4) Cronbach's alpha. Those questions that complied with 3 of the 4 mentioned techniques were considered acceptable; of the 80 questions, only 25 were accepted corresponding to 31%. The topic with the largest number of accepted questions was Water and pH (75%), and the topics without accepted questions were Bioenergetics and Hormones (0%). It is recommended that the faculty members that elaborate multiple choice examinations must know the subject, and should have a formation in didactics and educational methodology.
文摘As an institution,Xi’an Jiaotong Liverpool University(XJTLU)is unique in China.It is the only Chinese institution that awards students both UK degree and Chinese degree,so it has two sets of control,one of which is to meet all the requirements of the UK Higher Education(HE)standards and the other is to go through all the requirements of Chinese degree awarding powers.Due to its specific relationship with University of Liverpool(UoL),XJTLU is also under close scrutiny from UoL.All of these are reflected in the XJTLU internal and external Quality Assurance(QA)frameworks and procedures.This article focuses on describing and analysing how XJTLU monitors the teaching and assessment processes to meet the UK HE QA standards.Generally,the monitoring system is robust and multidimensional,involving students and peers as observers/reviewers.To understand students’perspectives on the teaching quality and their learning experience,the university provides official channels for students to provide ratings and/or qualitative comments on modules and instructors at the middle and the end of semester,while module instructors are expected to do reflection and revision of their teaching accordingly.In addition to that,each module instructor has to observe a peer’s class annually and engage in dialogues with the peer reviewer before and after the observation.To ensure the quality of assessment tasks and marking standards,module leaders have to actively communicate with internal moderators,UoL moderators and external moderators in the Assessment Preparation Review(APR)and Marking Moderation Review(MMR)processes.In general,the evaluation practice of teaching and assessment plays an important role in ensuring the educational quality is maintained and enhanced at XJTLU and is comparable with international best practice.So far,many disciplines at the university have been certified by international professional organizations,which strengthens the university’s global positioning,and directly improves the competitiveness of graduates in the global job market.The author hopes to provide some insights of the QA practice at XJTLU to help teachers and education administrators in different contexts to understand the benefits and progress to be made in terms of teaching and assessment evaluation to ensure the high quality of student training.
文摘BACKGROUND The standard management of autoimmune hepatitis(AIH)is based on corticosteroids,alone or in combination with azathioprine.Second-line treatments are needed for patients who have refractory disease.However,high-quality data on the alternative management of AIH are scarce.AIM To evaluate the efficacy and safety of tacrolimus and mycophenolate mofetil(MMF)and the quality of evidence by using the Grading of Recommendations Assessment,Development and Evaluation approach(GRADE).METHODS A systematic review and meta-analysis of the available data were performed.We calculated pooled event rates for three outcome measures:Biochemical remission,adverse events,and mortality,with their corresponding 95%confidence intervals(CI).RESULTS The pooled biochemical remission rate was 68.9%(95%CI:60.4-76.2)for tacrolimus,and 59.6%(95%CI:54.8-64.2)for MMF,and rates of adverse events were 25.5%(95%CI:12.4-45.3)for tacrolimus and 24.1%(95%CI:15.4-35.7)for MMF.The pooled mortality rate was estimated at 11.5%(95%CI:7.1-18.1)for tacrolimus and 9.01%(95%CI:6.2-12.8)for MMF.Pooled biochemical remission rates for tacrolimus and MMF in patients with intolerance to standard therapy were 56.6%(CI:43.4-56.6)vs 73.5%(CI:58.1-84.7),and among non-responders were 59.1%(CI:48.7-68.8)vs 40.8%(CI:32.3-50.0),respectively.Moreover,the overall quality assessments using GRADE proved to be very low for all our outcomes in both treatment groups.CONCLUSION Tacrolimus and MMF are in practice considered effective for patients with AIH who are non-responders or intolerant to first-line treatment,but we found no high-quality evidence to support this statement.
基金Evidence-based Capacity Building Project for Basic Traditional Chinese Medicine-Specialized Diseases,No.2019XZZX-XH012Shanghai Three-year Action Plan for Accelerating the Development of Traditional Chinese Medicine,No.ZY(2018-2020)-CCCX-2002-01.
文摘BACKGROUND Nonalcoholic fatty liver disease(NAFLD)affects more than one-quarter of the global population.Due to the lack of approved chemical agents,many patients seek treatment from traditional Chinese medicine(TCM)formulas.A variety of systematic reviews have been published regarding the effectiveness and safety of TCM formulas for NAFLD.AIM To critically appraise available systematic reviews and sort out the high-quality evidence on TCM formulas for the management of NAFLD.METHODS Seven databases were systematically searched from their inception to 28 February 2020.The search terms included“non-alcoholic fatty liver disease,”“Chinese medicines,”“systematic review,”and their synonyms.Systematic reviews involving TCM formulas alone or in combination with conventional medications were included.The methodological quality and risk of bias of eligible systematic reviews were evaluated by using A Measure Tool to Assess Systematic Reviews 2(AMSTAR 2)and Risk of Bias in Systematic Review(ROBIS).The quality of outcomes was assessed by the Grading of Recommendations Assessment,Development and Evaluation(GRADE)system.RESULTS Seven systematic reviews were ultimately included.All systematic reviews were conducted based on randomized controlled trials and published in the last decade.According to the AMSTAR 2 tool,one systematic review was judged as having a moderate confidence level,whereas the other studies were rated as having a low or extremely low level of confidence.The ROBIS tool showed that the included systematic reviews all had a high risk of bias due to insufficient consideration of identified concerns.According to the GRADE system,only two outcomes were determined as high quality;namely,TCM formulas with the HuoXueHuaYu principle were better than conventional medications in ultrasound improvement,and TCM formulas were superior to antioxidants in alanine aminotransferase normalization.Other outcomes were downgraded to lower levels,mainly because of heterogeneity among studies,not meeting optimal information sample size,and inclusion of excessive numbers of small sample studies.Nevertheless,the evidence quality of extracted outcomes should be further downgraded when applying to clinical practice due to indirectness.CONCLUSION The quality of available systematic reviews was not satisfactory.Researchers should avoid repeatedly conducting systematic reviews in this area and focus on designing rigorous randomized controlled trials to support TCM formula applications.
文摘AIM: To evaluate the current state-of-the-art of gastric electrical stimulation to treat obesity. METHODS: Systematic reviews of all studies have been conducted to evaluate the effect of different types of gastric electrical stimulation(GES) on obesity.RESULTS: Thirty-one studies consisting of a total of 33 different trials were included in the systematic review for data analysis. Weight loss was achieved in most studies, especially during the first 12 mo, but only very few studies had a follow-up period longer than 1 year. Among those that had a longer follow-up period, many were from the Transcend(Implantable Gastric Stimulation) device group and maintained significant weight loss. Other significant results included changes in appetite/satiety, gastric emptying rate, blood pressure and neurohormone levels or biochemical markers such as ghrelin or HbA1 c respectively. CONCLUSION: GES holds great promises to be an effective obesity treatment. However, stronger evidence is required through more studies with a standardized way of carrying out trials and reporting outcomes, to determine the long-term effect of GES on obesity.
文摘This study aimed to develop a guideline for therapeutic drug monitoring(TDM) of vancomycin. We adopted the new guideline definition from the Institute of Medicine(IOM), adhered closely to the six domains of the Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREE Ⅱ), and made recommendations based on systematic reviews. We established a Guideline Steering Group and a Guideline Development Group, formulated 12 questions in the form of Population, Intervention, Comparison, Outcome(PICO) and completed a literature search. As far as we know, we will develop the first evidenced-based guideline for vancomycin TDM under the framework of the Grade of Recommendations Assessment, Development and Evaluation(GRADE).
文摘The International Accounting Standards Board (IASB) and the Financial Accounting Standards Board (FASB) stress the importance of high-quality 'financial reports. From a scientific point of view, however, major methodological drawbacks can arise when trying to arrive at a comprehensive assessment and evaluation of the decision usefulness of financial reports. In this conceptually-based exploratory study, the authors construct a 33-item index aimed at operationalizing decision usefulness in terms of the fundamental and enhancing qualitative characteristics laid out in the conceptual framework (CF) of the IASB (2010). Using a matched-pairs sample design, which includes 70 UK annual reports and 70 US 10-K reports for 2010, the results of test-retest and inter-rater reliability tests show that these multiple items, which were based on items used in previous research, can be measured in a reliable manner. At the same time, the results of an exploratory factor analysis indicate that the IASB qualitative characteristics cannot be measured separately when the 33-item index is applied. At an aggregate level, the results of paired-sample t-tests reveal that UK reports score on average higher than US 10-K reports, which suggests that the overall quality of UK reports is better. The findings of this study add to the existing literature on the empirical evaluation of the effects of international accounting standards, showing that, as compared with 10-K reports, UK annual reports provide more information on topics such as corporate social responsibility (CSR), corporate governance, and annual bonus schemes. On the other hand, US reports outperform UK reports with respect to the content of fair value information, cash flow statements, off-balance financing, and audit reporting.
文摘Project-based learning (PBL) as an instructional approach focuses on student-centeredness through contextualizing learning by presenting students with real world issues and practices that aim at achieving enduring learning effects. As a challenge to traditional lecture-based instruction, PBL may generate positive backwash assessment effects via documenting the process of developing authentic language skills. These skills-oriented outcomes are achieved through proper curricula in appropriate learning situations via various dimensions. However, problems may occur such as management, pressure from administration, evaluation doing their selected projects. teacher/student attitude, class size and proper group process and criteria, and students' likely frustrations in
基金Supported by the Special Program on Science and Technology of Traditional Chinese Medicine,Guangdong Provincial Hospital of Chinese Medicine and Guangdong Province Fund for Nature(No.S2013010015427)
文摘Objective: To assess the quality of integrative medicine clinical practice guidelines(CPGs) published before 2014. Methods: A systematic search of the scientific literature published before 2014 was conducted to select integrative medicine CPGs. Four major Chinese integrated databases and one guideline database were searched: the Chinese Biomedical Literature Database(CBM), the China National Knowledge Infrastructure(CNKI), China Science and Technology Journal Database(VIP), Wanfang Data, and the China Guideline Clearinghouse(CGC). Four reviewers independently assessed the quality of the included guidelines using the Appraisal of Guidelines for Research and Evaluation(AGREE) Ⅱ Instrument. Overall consensus among the reviewers was assessed using the intra-class correlation coefficient(ICC). Results: A total of 41 guidelines published from 2003 to 2014 were included. The overall consensus among the reviewers was good [ICC: 0.928; 95% confidence interval(CI): 0.920 to 0.935]. The scores on the 6 AGREE domains were: 17% for scope and purpose(range: 6% to 32%), 11% for stakeholder involvement(range: 0 to 24%), 10% for rigor of development(range: 3% to 22%), 39% for clarity and presentation(range: 25% to 64%), 11% for applicability(range: 4% to 24%), and 1% for editorial independence(range: 0 to 15%). Conclusions: The quality of integrative medicine CPGs was low, the development of integrative medicine CPGs should be guided by systematic methodology. More emphasis should be placed on multi-disciplinary guideline development groups, quality of evidence, management of funding and conflicts of interest, and guideline updates in the process of developing integrative medicine CPGs in China.
文摘Objective To evaluate the reliability and validity of the 4 myasthenia gravis(MG)scales widely used for assessing the grades of disease severity in Chinese MG patients.Methods Sixty MG patients were examined by a neurologist with the following four MG scales:Quantitative Myasthenia Gravis Score(QMGS),Myasthenia Gravis Composite(MGC),Myasthenic Muscle Scale(MMS),Absolute and Relative Score of MG(ARS-
基金supported by WMO, CMA, ECRMC/CMA, STI/CMA, NCAR, HKO, RSMC Tokyo Typhoon Center/WMO and all TFPPsProject activities are WMO, UNESCAP/WMO Typhoon Committee, STI/CMA, ECRMC/CMA, HKO+2 种基金National Basic Research Program of China 2015CB452806, 2009CB421500National Natural Science Foundation of China 40921160381Projects for Public Welfare (Meteorology) of China GYHY201506007, GYHY201406010, GYHY201006008
文摘The "WMO Typhoon Landfall Forecast Demonstration Project(TLFDP)" was started in May 2010 in conjunction with the start of the Shanghai World Expo 2010. The project was successful in terms of assisting the local forecasters in providing an efficient tropical cyclone(TC) forecast service for World Expo 2010, demonstrating the performance of the most up-to-date techniques in TC forecasting, and enhancing the ability of forecasters to effectively use products based on advanced TC forecasting techniques. The first phase was completed in December 2012 and the second phase was completed in December 2015. The third phase(TLFDP-III) started in 2016.During its first(2010-2012) and second(2013-2015) phases, TLFDP collected real-time TC forecast products from 15 Typhoon Forecast Product Providers(TFPPs). The products include deterministic track and intensity forecasts, ensemble track and intensity forecasts, deterministic wind radii forecasts, wind probability forecasts, and gridded model outputs. The products were disseminated through the project's website and the operational website of the Shanghai Typhoon Warning Center.TLFDP has made significant progress in TC forecast verification, including setting up the tools for both realtime and post-season TC forecast verification, developing and integrating several new verification techniques, carrying out a survey on the operational status of TC forecast verification in the western North Pacific region, and contributing to the WMO document "Verification of tropical cyclone forecasts". The post-season forecast verification was reported to the Session of the UNESCAP/WMO Typhoon Committee since 2013. New consensus methods for TC track and intensity forecasts were also proposed either based on Ensemble Prediction Systems(EPSs) products or multiple deterministic NWP model products. Two training workshops on TC forecasting were organized by the TLFDP and held in Shanghai, China, in May 2010 and June 2012, respectively, and seven research fellowship projects were implemented as jointly supported by the UNESCAP/WMO Typhoon Committee, Shanghai Typhoon Institute and Hong Kong Observatory.In its third phase(TLFDP-III, 2016-2018), the project will continue its effort on demonstration and evaluation of the newly developed forecasting techniques for TCs, and developing and documenting advanced guidance for the verification of TC forecasts, with special attention to TC intensity and precipitation.
文摘The scientific literature presents a modest amount ot evidence m the use or complementary ana al[erna- tire medicine (CAM). On the other hand, in practice, relevant results are common. The debates among CAM practitioners about the quality and execution of scientific research are important, Therefore, the aim of this review is to gather, synthesize and describe the differentiated methodological models that encompass the complexity of therapeutic interventions. The process of bringing evidence-based medicine into clinical practice in CAM is essential for the growth and strengthening of complementary medicines worldwide.