目的假针刺对照是针刺临床试验中常用的评价针刺特异性效应的对照方式。然而由于缺乏相应的报告规范,目前针刺临床试验中假针刺对照的报告质量较差。为规范假针刺对照的报告,提高其报告质量,项目组制订了针刺临床试验中假针刺对照报告指南与清单(sham acupuncture reporting guidelines and a checklist in clinical trials,SHARE)。方法研制过程包括四个部分:通过文献研究形成假针刺对照报告初始条目;开展两轮德尔菲调查评价假针刺对照报告初始条目的报告必要性;召开两次专家共识会议进一步讨论、共识德尔菲调查的结果,确定假针刺对照报告清单;最后,进行清单预测试以评价假针刺对照报告清单的可操作性与实用性,形成假针刺对照报告清单。结果SHARE清单包括10个方面,19个报告条目,主要从假针刺对照细节要素和相关背景因素等方面对假针刺对照提出了规范化报告要求。结论SHARE指南是专门针对假针刺对照的报告指南,为全面、清晰地报告假针刺对照提供了明确的指导。
While density functional theory(DFT)serves as a prevalent computational approach in electronic structure calculations,its computational demands and scalability limitations persist.Recently,leveraging neural networks to parameterize the Kohn-Sham DFT Hamiltonian has emerged as a promising avenue for accelerating electronic structure computations.Despite advancements,challenges such as the necessity for computing extensive DFT training data to explore each new system and the complexity of establishing accurate machine learning models for multi-elemental materials still exist.Addressing these hurdles,this study introduces a universal electronic Hamiltonian model trained on Hamiltonian matrices obtained from first-principles DFT calculations of nearly all crystal structures on the Materials Project.We demonstrate its generality in predicting electronic structures across the whole periodic table,including complex multi-elemental systems,solid-state electrolytes,Moir´e twisted bilayer heterostructure,and metal-organic frameworks.Moreover,we utilize the universal model to conduct high-throughput calculations of electronic structures for crystals in GNoME datasets,identifying 3940 crystals with direct band gaps and 5109 crystals with flat bands.By offering a reliable efficient framework for computing electronic properties,this universal Hamiltonian model lays the groundwork for advancements in diverse fields,such as easily providing a huge data set of electronic structures and also making the materials design across the whole periodic table possible.
北京中医药大学刘存志教授团队于2021年11月10日在Arthritis&Rheumatology杂志发表Efficacy of intensive acupuncture versus sham acupuncture in knee osteoarthritis:a randomized controlled trial(强化针刺对比假针治疗膝骨关节炎随机对照试验)一文,对每周3次针刺治疗膝骨关节炎有效性、安全性给予了肯定。海内外专家对这一试验报告的研究设计、针刺方案、结果解读等方面进行了深入讨论,强调了预试验实施、针刺剂量、合理设置对照组及判断针刺疗效的重要性,并指出针刺治疗膝骨关节炎的潜在机制仍需进一步研究,如何在确保针刺疗效的前提下根据国外临床实际推广针刺治疗膝骨关节炎是值得探索的问题。
目的:评估针对膝骨性关节炎治疗中安慰针刺的随机对照试验(RCT)文献的质量,探讨安慰针刺临床试验设计的思路。方法:计算机检索中国期刊全文数据库(CNKI)、维普中文期刊全文数据数据库(VIP)、万方数据知识服务平台(WF)、中国生物医学文献数据库(SinoMed)、PubMed、Web of Science(WOS)及Embase数据库,收集使用单纯针刺与安慰针刺进行对比的针灸治疗膝骨性关节炎RCT研究,检索时限从建库至2022年12月31日。使用CONSORT与TIDieR-Placebo标准评估文献报告质量,并对结果进行分析讨论。结果:共纳入20篇文献。CONSORT评价结果显示报告率不高于10%的条目为条目3b、6b、11b、12b、14b、17b、18。TIDieR-Placebo评价结果显示报告率不高于10%的条目为条目6、9、10、11、13。安慰针刺的方式主要为“假穴假刺”“假穴真刺”“假穴浅刺”“非治疗穴真刺”“治疗穴假刺”5种。结论:有关安慰针刺的临床试验尚不严谨,质量有待提高。为推动针灸领域临床研究的标准化,建议未来的研究应更加重视依据这些标准来规范化研究报告。
Background The effect of transdermal glyceryl trinitrate(GTN,a nitrovasodilator)on clinical outcome when administered before hospital admission in suspected stroke patients is unclear.Here,we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2(RIGHT-2).Methods RIGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4hours of onset.The primary outcome was a shift in scores on the modified Rankin scale(mRS)at day 90.Secondary outcomes included death;a global analysis(Wei-Lachin test)containing Barthel Index,EuroQol-5D,mRS,telephone interview for cognitive status-modified and Zung depression scale;and neuroimaging-determined‘brain frailty’markers.Data were reported as n(%),mean(SD),median[IQR],adjusted common OR(acOR),mean difference or Mann-Whitney difference(MWD)with 95%CI.Results 597 of 1149(52%)patients had a final diagnosis of ischaemic stroke;age 75(12)years,premorbid mRS>2107(18%),Glasgow Coma Scale 14(2)and time from onset to randomisation 67[45,108]min.Neuroimaging‘brain frailty’was common:median score 2[2,3](range 0–3).At day 90,GTN did not influence the primary outcome(acOR for increased disability 1.15,95%CI 0.85 to 1.54),death or global analysis(MWD 0.00,95%CI-0.10 to 0.09).In subgroup analyses,there were non-significant interactions suggesting GTN may be associated with more death and dependency in participants randomised within 1hour of symptom onset and in those with more severe stroke.Conclusions In patients who had an ischaemic stroke,ultra-acute administration of transdermal GTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital trials.WHAT IS ALREADY KNOWN ON THIS TOPIC⇒Transdermal glyceryl trinitrate(GTN)was associat-ed with less death and dependency in those with acute stroke treated within 6hou
Jason Philip AppletonLisa J WoodhouseCraig S AndersonSandeep AnkolekarLesley CalaMark DixonTimothy J EnglandKailash KrishnanGrant MairKeith W MuirJohn PotterChristopher I PriceMarc RandallThompson G RobinsonChristine RoffeElse C SandsetJeffrey L SaverAngela ShoneAloysius Niroshan SiriwardenaJoanna M WardlawNikola SpriggPhilip M Bath
随着网络直播带货模式的兴起,伴随而来的伪劣商品销售问题日益严重,对市场和消费者权益造成了显著影响。本文通过系统的分析揭示了网络直播销售伪劣商品的特点和成因,探讨了法律责任的界定复杂性和监管的不足,并提出了一系列针对性的治理对策,例如完善相关法律法规、强化平台责任、提高消费者自我保护意识,以及加强科技在监管中的应用等,旨在为治理网络直播带货中的伪劣商品问题提供有力的策略和建议。With the rise of the live commerce, the accompanying problem of the sale of sham and shoddy commodities has become increasingly serious, which has significantly affected the market and the rights and interests of consumers. This paper reveals the characteristics and causes of the sale of sham and shoddy commodities on live commerce through systematic analysis, explores the complexity of defining legal responsibility and the inadequacy of regulation, and proposes a series of targeted governance countermeasures. By improving relevant laws and regulations, strengthening the responsibility of platforms, raising consumers’ awareness of self-protection, and enhancing the application of science and technology in supervision, this paper aims to provide powerful strategies and suggestions for the governance of the problem of sale of sham and shoddy commodities in live commerce.
Objective: To determine the feasibility of conducting a full-scale randomized controlled trial(RCT)and investigate the basic information and safety of acupuncture for patients with chronic spontaneous urticaria(CSU). Methods: A total of 80 participants with CSU from July 2018 to July 2019 were randomly assigned to receive active acupuncture(n=41) on a fixed prescription of acupoints or sham acupuncture(n=39) with superficial acupuncture on non-acupuncture points through the completely randomized design. Patients in both groups received 5 sessions per week for 2 weeks, and participants were followed for a further 2 weeks.Feasibility was assessed by recruitment and randomization rates, retention of participants, treatment protocol adherence, and the incidence of adverse events(AEs). The clinical primary outcome was the changes from baseline weekly urticaria activity scores(UAS7) after treatment at 2 weeks. Secondary outcomes included the Visual Analogue Scale(VAS) score of itching intensity, Dermatology Life Quality Index(DLQI), Hamilton Depression Scale(HAMD), and Hamilton Anxiety Scale(HAMA). Results: A total of 80 participants were enrolled. The recruitment rate of 24.02%, randomization rate of 100%, a loss rate of 6.25%, and no obvious AEs were observed in either group. The decrease from baseline in the mean UAS7 total score at week 2 in the active acupuncture group was –8.63(95%CI, –11.78 to –5.49) and –6.21(95%CI, –9.43 to –2.98) in the sham acupuncture group for a between-group difference of –2.42(95% CI, –6.93 to 2.07). The change in the DLQI,VAS of itching intensity, HAMA, and HAMD were a slightly better improvement trend in the active acupuncture group than the sham acupuncture group, but the between-group difference was not significant. Conclusion:Active acupuncture had a better improvement trend in alleviating symptoms, improving quality of life and regulating the mood of anxiety and depression in patients with CSU than sham acupuncture.(Registration Nos.AMCTR-ICR-18000190 and ChiCTR2100
In[Dai et al.,Multi.Model.Simul.18(4)(2020)],a structure-preserving gradient flow method was proposed for the ground state calculation in Kohn-Sham density functional theory,based on which a linearized method was developed in[Hu et al.,EAJAM.13(2)(2023)]for further improving the numerical efficiency.In this paper,a complete convergence analysis is delivered for such a linearized method for the all-electron Kohn-Sham model.Temporally,the convergence,the asymptotic stability,as well as the structure-preserving property of the linearized numerical scheme in the method is discussed following previous works,while spatially,the convergence of the h-adaptive mesh method is demonstrated following[Chen et al.,Multi.Model.Simul.12(2014)],with a key study on the boundedness of the Kohn-Sham potential for the all-electron Kohn-Sham model.Numerical examples confirm the theoretical results very well.
