Simulated patient methodology as a“gold standard”in community pharmacy practice:Response to criticism

The simulated patient methodology(SPM)is considered the“gold standard”as covert participatory observation.SPM is attracting increasing interest for the investigation of community pharmacy practice;however,there is criticism that SPM can only show a small picture of everyday pharmacy practice and therefore has limited external validity.On the one hand,a certain design and application of the SPM goes hand in hand with an increase in external validity.Even if,on the other hand,this occurs at the expense of internal validity due to the trade-off situation,the justified criticism of the SPM for investigating community pharmacy practice can be countered.

Deciding the Gold Standard for Oral Anticoagulation Therapy

Healthcare practitioners have many anticoagulant options for treating various disease states pertaining to blood clots and blood clot formation. Each anticoagulant has pros and cons and the decision of which pharmacological agent to use can be confusing and difficult. In years past, Vitamin K antagonists have been the standard of care when treating specific disease states such as atrial fibrillation and venous thromboembolism based on habit and cost of care. The emergence of newer anticoagulants should be considered the new standard of care based on the evidence presented over the last several years.

Diagnosis of Helicobacter pylori : What should be the gold standard?

Since the discovery of Helicobacter pylori (H. pylori) in 1983, numerous detection methods for the presence of the bacterium have been developed. Each one of them has been associated with advantages and disadvantages. Noninvasive tests such as serology, 13C urea breath test (UBT) and stool antigen tests are usually preferred by the clinicians. Serology has its own limitation especially in endemic areas while 13C UBT is technically very demanding. The stool antigen detection method, although specific, is usually associated with poor sensitivity. The 13C UBT is believed to be specific, but with present revelation of the fact that stomach is colonized by many other urease producing bacteria makes it questionable. Histology, culture, rapid urease test and polymerase chain reaction (PCR) are the tests which are carried out on antral biopsies collected by invasive means. Histology has been proposed to be very sensitive and specific but the question is how by simply looking the morphology of the bacteria in the microscope, one can claim that the curved bacterium is exclusively H. pylori. Rapid urease test (RUT), the doctor’s test, is also challenged because the presence of other urease producing bacteria in the stomach cannot be denied. Moreover, RUT has been reported with poor sensitivity specially, when density of the bacterium is low. Isolation of H. pylori is essential to investigate its growth requirements, antibiotic susceptibility testing, studying virulence factor to develop vaccine and many more explorations. It has also got several disadvantages i.e., special condition for transporting, media, incubation and few days waiting for the colonies to appear, apart from the speed essentially needed to process the specimens. Till date, majority of the microbiological laboratories in the world are not equipped and trained to isolate such fastidious bacterium. The option left is PCR methods to detect H. pylori’s DNA in gastric mucosa, gastric juice, saliva, dental plaques and environmental specimens. There are speculations for false positivity due to detection of non-pylori Helicobacters due to genetic sharing; and false negativity due to low bacterial counts and presence of PCR inhibitors. However, specimen collection, transportation and processing do not require speed and special conditions. PCR based diagnosis may be considered as gold standard by designing primers extremely specific to H. pylori and targeting at least more than one conserved genes. Similarly specificity of PCR may be improved by use of internal Primers. Further, nested PCR will take care of false negatives by countering the effect of PCR inhibitors and low bacterial counts. Therefore, nested PCR based methods if performed properly, may be proposed as gold standard test.

‘Outbreak Gold Standard’Selection to Provide Optimized Threshold for Infectious Diseases Early-alert Based on China Infectious Disease Automated-alert and Response System

The China Infectious Disease Automated-alert and Response System（CIDARS） was successfully implemented and became operational nationwide in 2008. The CIDARS plays an important role in and has been integrated into the routine outbreak monitoring efforts of the Center for Disease Control（CDC） at all levels in China. In the CIDARS, thresholds are determined using the ？Mean＋2SD？ in the early stage which have limitations. This study compared the performance of optimized thresholds defined using the ？Mean ＋2SD？ method to the performance of 5 novel algorithms to select optimal ？Outbreak Gold Standard（OGS）？ and corresponding thresholds for outbreak detection. Data for infectious disease were organized by calendar week and year. The ？Mean＋2 SD？, C1, C2, moving average（MA）, seasonal model（SM）, and cumulative sum（CUSUM） algorithms were applied. Outbreak signals for the predicted value（Px） were calculated using a percentile-based moving window. When the outbreak signals generated by an algorithm were in line with a Px generated outbreak signal for each week, this Px was then defined as the optimized threshold for that algorithm. In this study, six infectious diseases were selected and classified into TYPE A（chickenpox and mumps）, TYPE B（influenza and rubella） and TYPE C [hand foot and mouth disease（HFMD） and scarlet fever]. Optimized thresholds for chickenpox（P_（55））, mumps（P_（50））, influenza（P_（40）, P_（55）, and P_（75））, rubella（P_（45） and P_（75））, HFMD（P_（65） and P_（70））, and scarlet fever（P_（75） and P_（80）） were identified. The C1, C2, CUSUM, SM, and MA algorithms were appropriate for TYPE A. All 6 algorithms were appropriate for TYPE B. C1 and CUSUM algorithms were appropriate for TYPE C. It is critical to incorporate more flexible algorithms as OGS into the CIDRAS and to identify the proper OGS and corresponding recommended optimized threshold by different infectious disease types.

Reaching for the Gold Standard: Metaphors and Good University Teachers

This article considers "good" teachers in the context of current developments in universities in China to reach a "gold standard" of considerably higher and more challenging levels of teaching and learning. We outline this context and consider concepts of good teachers in classical Chinese traditions and more recent Western thinking as a possible dialogue within and between cultures of learning. Using cognitive and cultural linguistic perspectives, we analyze metaphorical concepts of "gold" in "the gold standard" as related to teachers. We report our applied metaphor research which analyzes Chinese students’ expectations, values and beliefs about good university language teachers;this presents a rich picture beyond developing knowledge, skills and understanding to include strong social and moral characteristics. Other aspects which recognize the complexity of "good" teachers show a student appreciation of teachers’ tireless effort, devotion and selfless sacrifice: these aspects are absent in many discussions of good teachers. The participant-centered picture from elicited metaphor analysis is part of students’ "cultures of learning," but this should be developed culturally for the gold standard through further teacher development and student engagement. In line with interaction in cultures of learning, we indicate some classroom ways to extend students’ thinking through scaffolding teacher-student interaction based on textbook activities.

Lewis acid-driven reaction pathways in synergistic cooperative catalysis over gold/palladium bimetallic nanoparticles for hydrogen autotransfer reaction between amide and alcohol

Metal nanoparticle catalysts, especially gold and its bimetallic nanoparticle catalysts, have been widely used in organic transformations as powerful and green catalysts. The concept of employing two distinct catalysts in one reaction system, such as in cooperative and synergistic catalysis, is a powerful strategy in homogeneous catalysis. However, the adaption of such a strategy to metal nanoparticle catalysis is still under development. Recently, we have found that cooperative catalytic systems of gold/palladium bimetallic nanoparticles and Lewis acid can be used for the N‐alkylation of primary amides through hydrogen autotransfer reaction between amide and alcohol. Herein, the results of a detailed investigation into the effects of Lewis acids on this hydrogen autotransfer reac‐tion are reported. It was found that the choice of Lewis acid affected not only the reaction pathway leading to the desired product, but also other reaction pathways that produced several intermedi‐ates and by‐products. Weak Lewis acids, such as alkaline‐earth metal triflates, were found to be optimal for the desired N‐alkylation of amides.

Synthesis and Characterization of Bimetallic Gold-Silver Core-Shell Nanoparticles: A Green Approach

Bimetallic gold-silver core-shell nanoparticles were prepared by chemical reduction in aqueous solution, following a method that was friendly to the environment, allowing us to use this for medicinal purposes. Gold nanoparticles were synthesized, and silver cations were then reduced on the nanoparticles. Using the optical properties of metallic nanoparticles, surface plasmon resonance was determined by UV-Vis spectroscopy, and the values obtained for gold and silver were approximately 520 nm and 400 nm in wavelength, respectively. The absorption peaks of the surface plasmon band show a clear red-shift due to size effect in the case of the silver surface, and a plasmon coupling effect, in the case of gold. To obtain a better understanding of the coating conditions, high resolution transmission electron microscopy was used. The average hydrodynamic size and the size distribution of the synthesized nanoparticles were obtained by dynamic light scattering. The development of this process, which is benign for the environment, opens the possibility for many applications in the areas of renewable energy, medicine and biology.

Density functional study on structural and electronic properties of bimetallic gold-yttrium clusters: comparison with pure gold and yttrium clusters

Employing first-principles methods, based on the density functional theory, this paper investigates the ground state geometric and electronic properties of pure gold clusters, pure yttrium clusters and gold clusters doped each with one yttrium atom. It is shown that the average bond lengths in the Aun-1Y（n≤9） bimetallic clusters are shorter than those in the corresponding pure gold and yttrium clusters. The most stable isomers of the yttrium-doped gold clusters tend to equally delocalize valence s, p and d electrons of the constituent atoms over the entire structure. The Y atom has maximum number of neighbouring Au atom, which tends to be energetically favourable in the lowest-energy equilibrium structures, because the Au-Y bond is stronger than the Au-Au bond. The three-dimensional isomers of Aun-1Y structures are found in an early appearance starting at n=5 （Au4Y）. Calculated vertical ionization potential and electron affinities as a function of the cluster size show odd-even oscillatory behaviour, and resemble pure gold clusters. However, one of the most striking feature of pure yttrium clusters is the absence of odd-even alternation, in agreement with mass spectrometric observations. The HOMO LUMO gap of Au3Y is the biggest in all the doped Aun-1Y（n≤9） bimetallic clusters.

罗德亚洲董事寿玉滢女士荣获The Gold Standard Awards 2018年度卓越领袖大奖

2018年12月6日,由亚太地区首屈一指的公共政策和企业事务网络平台Public Affairs Asia主办的The Gold Standard Awards于2018年12月6日晚在香港揭晓了2018年度评选的最终赢家。此次,罗德亚洲共有三个项目获得荣誉提名.

福建吉花金银矿床地质特征及含矿蚀变带元素迁移对区域成矿的启示

吉花金银矿床为中型浅成中低温热液型矿床,共圈定36个金银矿体,均赋存于北东向断裂蚀变带中。银物相分析表明,银以硫化物银、自然银为主,银、金总体上同体共生,且二者品位具有正相关性。主成矿阶段矿物组合以石英-黄铁矿-黄铜矿-金-辉银矿为特征。沿矿体横向(侧向)划分为4个蚀变分带。为了厘定热液蚀变过程中的物质迁移,对蚀变碎裂岩采用标准化Isocon图解法计算物质迁移特征,结果表明,蚀变过程中Fe、Si、Mg、Ti、Cu、As、Mo、Co、Cr、La、Li、Ni、V呈迁入特征;Na、Ca、Ba、Sr、Nb呈迁出特征,其中Ca、Ba、Sr的迁出表明成矿热液具有富硅、去钙化的特征。通过类比区域内邱村金矿床、东洋金矿床、大冬坑金矿床,四者均为闽中金银成矿系统形成的矿床系列,可能是在古太平洋板块俯冲、后撤动力背景下,含矿流体沿火山机构及酸性岩脉通道运移至到浅部断裂中沉淀成矿的区域成矿模式。该成果可为区域内寻找金银矿提供思路。

双金属有机框架/纳米金适配传感检测恩诺沙星

利用钴镍基双金属有机框架和纳米金构建一种用于检测肉品中恩诺沙星的电化学适配体传感器。采用溶剂热法合成钴镍基双金属有机框架,通过滴涂法将其与沉积的纳米金修饰于玻碳电极表面,适配体通过金硫共价键结合在纳米金表面而制成工作电极。采用扫描电子显微镜、傅里叶红外光谱和X射线光电子能谱等技术对材料进行形貌和结构表征,同时利用循环伏安法、电化学阻抗法评估该传感器的性能。恩诺沙星浓度的对数与传感器的电子转移电阻为10^(-3)~10^(2) pg/mL和10^(2)~105 pg/mL内时呈现良好的线性关系,线性回归方程分别为ΔRct=0.233 logCon_(ENR)+1.548和ΔRct=0.637 logCon_(ENR)+0.720,检测限(S/N=3)为3.3×10^(-4) pg/mL。同时,该传感器还兼备良好的灵敏度、选择性、稳定性和重现性,能够成功用于实际样品的检测。该分析方法准确、可靠,可用于恩诺沙星的快速定量分析。

经阴道三维超声在宫腔病变中的临床应用

目的探讨经阴道三维超声(3D-TVS)在宫腔病变诊断中的临床应用价值。方法选取2022年1月至2023年12月宁夏医科大学总医院收治的154例宫腔病变患者作为研究对象。患者入院后常规进行3D-TVS检查,宫腔粘连者以宫腔镜检查为“金标准”,宫腔其他病变者以术后病理结果为“金标准”。以3D-TVS诊断结果与“金标准”进行比较,得出结论。结果154例宫腔病变患者,包含以下4种:子宫内膜息肉、宫腔粘连、子宫黏膜下肌瘤、子宫内膜癌,其所占例数及比例分别为70例(45.4%)、56例(36.4%)、18例(11.7%)、10例(6.5%)。3D-TVS诊断宫腔病变的总体诊断准确性为92.9%。3D-TVS在诊断下述病例中的灵敏度、特异度、阳性预测值、阴性预测值、准确度分别为:子宫内膜息肉(94.3%、94.0%、92.9%、95.2%、94.2%);宫腔粘连(92.9%、96.9%、94.5%、96.0%、95.5%);子宫黏膜下肌瘤(88.9%、98.5%、88.9%、98.5%、97.4%);子宫内膜癌(90%、99.3%、90%、99.3%、98.7%)。结论3D-TVS对诊断宫腔病变具有较高的诊断效能,且具有无创、安全、经济、可重复性强等优势,建议筛查宫腔病变时首选。

黄金检测技术发展历程与展望

随着科学技术的不断发展,中国黄金检测技术得到了大幅提升。从黄金检测的历史、标准化道路、质量保证、自动化智能化发展4个方面阐述了黄金检测技术的发展历程,并对黄金检测的未来发展方向进行了展望,以期为黄金检测技术的高质量发展提供参考。

诊断试验设计要点和规范

疾病诊断是临床治疗和干预的基础和前提,因此诊断试验是临床研究的一个重要内容。正确了解诊断试验的设计要点、评价原则和注意事项不仅可以加强对诊断试验内涵的认识,同时也可以避免将其错误应用。此外,应用临床流行病学方法对诊断试验进行评价研究,有助于正确认识诊断试验的价值,科学解读诊断试验的结果,从而提高临床医师的诊断水平。本文从诊断试验的概念入手,讲解诊断试验的设计要点和规范,评价的基本原则,真实性、可靠性和临床应用价值的评价指标,提高诊断试验效果的方法等内容,以期为研究者们应用诊断试验提供参考。

我国金矿床的成矿规律及找矿标志

黄金一直是各国的关键资源之一,对于国家的发展有着至关重要的作用。目前我国在多个行业中都需要应用黄金资源,黄金价格的波动对于国际经济形势的发展也有着一定的影响。黄金的开采工作十分重要,金矿的开采有助于推动我国经济的发展,但是在现实金矿开采过程中受到多种因素的影响,开展工作较为艰难,为了有效进行金矿的开采,工作人员必须具备丰富的理论知识和实践经验,在开采过程中要了解金矿的成矿规律以及相应的黄金矿点标志,本文将对金矿床的成矿规律及相应的找矿标志进行简单的分析,结合实际情况进行讲解。

面向岗位任职需求的军校专业课程“金课”建设研究——以军事卫星通信课程教学为例

军事卫星通信课程是军校学员面向部队任职岗位的专业课程。随着信息化战争对军事通信人才的技术水平要求越来越高,以“金课”标准进行高水平课程建设迫在眉睫。首先分析课程建设中“金课”建设标准与部队岗位任职需求衔接方面存在的“五重五轻”问题,然后提出面向岗位任职需求的军事卫星通信专业课程“金课”建设方案,基于成果导向教育(outcome-based education, OBE)理念,从课程目标制定、课程内容优化、教学模式创新和考核机制完善等方面提出了具体措施,实现岗位任职需求和“金课”标准的有机统一,可为面向岗位任职需求的专业课程建设提供思路。

桂西北某卡林型金矿区地下水重金属污染特征研究

为摸清桂北某卡林型金矿区地下水环境重金属污染特征,分别在丰水期和枯水期对矿区的地下水进行取样监测,并采用标准指数法对监测结果进行评价。结果显示,研究区中的地下水受到重金属污染,主要的重金属污染因子为砷、铅、锑,污染程度从高到低依次为砷、铅、锑;地下水的pH值、铜、锌、镉、铬(六价)、汞的含量均满足《地下水质量标准》(GB/T 14848—2017)Ⅲ类标准的要求;污染范围主要在矿区内,没有对外环境地下水造成污染。

新工科背景下高校数学金课建设标准研究

基于现阶段科技革命,新经济体系建设和新的产业革命的持续性推进,在此背景下提出了“新工科”战略体系,主要的目的是顺应当前时代发展的需求,培养更多具备时代因素、符合时代需求的优秀人才。高等数学作为高校工科专业中的必修科目之一,对现阶段我国高等教育改革具有十分重要的作用。因此要充分结合时代背景,进一步探究高等数学金课的建设标准,通过该方式提升学生的应用与实践能力,使其具备更强的创新意识,在时代浪潮之下勇于拼搏与探索。本文基于此,将从不同的角度简单探究有关新工科背景下高校数学金课建设标准。

基于HBM及金的达标理论护理干预对产后压力性尿失禁患者症状及自我效能影响的研究

目的研究基于健康信念模式(HBM)及金的达标理论护理干预对产后压力性尿失禁患者症状及自我效能的影响。方法选取140例产后压力性尿失禁患者,采用随机数字表法将其分为观察组与对照组,每组70例。对照组采用常规盆底康复护理,观察组在对照组基础上增加基于HBM及金的达标理论的康复护理。比较两组护理干预有效性、生活质量、满意率及自我效能。结果干预8周后,观察组总有效率为92.86%,高于对照组的81.43%,差异有统计学意义(P<0.05)。干预前,两组尿失禁生活质量问卷(I-QOL)中的行为限制、社会障碍、心理影响评分及总分比较,差异均无统计学意义(P>0.05);干预4周、8周后,两组均较干预前明显提高,且观察组高于对照组,差异有统计学意义(P<0.05)。干预前,两组自我效能评分比较,差异无统计学意义(P>0.05);干预4周、8周后,观察组自我效能评分均高于对照组,差异有统计学意义(P<0.05)。观察组满意率高于对照组,差异有统计学意义(P<0.05)。干预前,两组自我效能评分比较,差异无统计学意义(P>0.05);干预4周、8周后,观察组自我效能评分均高于对照组,差异有统计学意义(P<0.05)。结论将基于HBM及金的达标理论的护理干预应用于产后压力性尿失禁患者护理中,可有效减轻患者症状,提高患者生活质量及满意率,增强其自我效能,可在临床上借鉴应用。

冰冻切片对甲状腺微小乳头状癌术中病理诊断的准确性及价值

目的分析冰冻切片在甲状腺微小乳头状癌术中病理诊断中的准确性及应用价值。方法选取2021年1月—2022年10月在东莞东华医院接受治疗的甲状腺微小乳头状癌患者50例,所有研究对象均予以术中冰冻切片和术后石蜡切片病理检查,并以术后石蜡切片结果为诊断金标准,分析术中冰冻切片对该疾病的诊断准确率。结果肉眼可见大多数甲状腺微小乳头状癌组织为灰红色,其中见大小不等的灰白色结节,边界欠清。部分患者可见多个结节状肿物,切面灰白者质硬,紧邻表面被膜;切面半透明者边界均尚清,质中-硬,部分半透明者呈胶冻样。以术后石蜡病理学检查结果为金标准,术中冰冻切片检查准确48例,误诊1例,漏诊1例,诊断准确率为95.00%。结论冰冻切片在甲状腺微小乳头状癌术中病理诊断中的准确性较高,具有临床参考价值。