注重细节建立人性化质控体系提高医疗质量

通过对89家综合性医院医疗质量控制情况的调查，发现当前医疗机构医疗质控中存在诸多问题。针对问题提出了建立人性化质控体系的目标、方法、步骤，以及时质控进行细化和量化等，在医院应用并取得了较好的效果。     

Behavior and neuroimaging at baseline predict individual response to combined mathematical and working memory training in children

Mathematical performance is highly correlated with several general cognitive abilities, including working memory (WM) capacity. Here we investigated the effect of numerical training using a number-line (NLT), WM training (WMT), or the combination of the two on a composite score of mathematical ability. The aim was to investigate if the combination contributed to the outcome, and determine if baseline performance or neuroimaging predict the magnitude of improvement.We randomly assigned 308, 6-year-old children to WMT, NLT, WMT + NLT or a control intervention. Overall, there was a significant effect of NLT but not WMT. The WMT + NLT was the only group that improved significantly more than the controls, although the interaction NLTxWM was non-significant. Higher WM and maths performance predicted larger benefits for WMT and NLT, respectively. Neuroimaging at baseline also contributed significant information about training gain. Different individuals showed as much as a three-fold difference in their responses to the same intervention.These results show that the impact of an intervention is highly dependent on individual characteristics of the child. If differences in responses could be used to optimize the intervention for each child, future interventions could be substantially more effective.     

Active assistance technology for health-related behavior change: an interdisciplinary review

Background

Information technology can help individuals to change their health behaviors. This is due to its potential for dynamic and unbiased information processing enabling users to monitor their own progress and be informed about risks and opportunities specific to evolving contexts and motivations. However, in many behavior change interventions, information technology is underused by treating it as a passive medium focused on efficient transmission of information and a positive user experience.

Objective

To conduct an interdisciplinary literature review to determine the extent to which the active technological capabilities of dynamic and adaptive information processing are being applied in behavior change interventions and to identify their role in these interventions.

Methods

We defined key categories of active technology such as semantic information processing, pattern recognition, and adaptation. We conducted the literature search using keywords derived from the categories and included studies that indicated a significant role for an active technology in health-related behavior change. In the data extraction, we looked specifically for the following technology roles: (1) dynamic adaptive tailoring of messages depending on context, (2) interactive education, (3) support for client self-monitoring of behavior change progress, and (4) novel ways in which interventions are grounded in behavior change theories using active technology.

Results

The search returned 228 potentially relevant articles, of which 41 satisfied the inclusion criteria. We found that significant research was focused on dialog systems, embodied conversational agents, and activity recognition. The most covered health topic was physical activity. The majority of the studies were early-stage research. Only 6 were randomized controlled trials, of which 4 were positive for behavior change and 5 were positive for acceptability. Empathy and relational behavior were significant research themes in dialog systems for behavior change, with many pilot studies showing a preference for those features. We found few studies that focused on interactive education (3 studies) and self-monitoring (2 studies). Some recent research is emerging in dynamic tailoring (15 studies) and theoretically grounded ontologies for automated semantic processing (4 studies).

Conclusions

The potential capabilities and risks of active assistance technologies are not being fully explored in most current behavior change research. Designers of health behavior interventions need to consider the relevant informatics methods and algorithms more fully. There is also a need to analyze the possibilities that can result from interaction between different technology components. This requires deep interdisciplinary collaboration, for example, between health psychology, computer science, health informatics, cognitive science, and educational methodology.     

药学图书馆资源建设策略

本文结合药学院校图书馆的专业特色，对网络环境下如何开展资源建设进行了探讨，并从电子资源建设、虚拟资源建设、读者个性化服务建设、人才资源建设四个途径进行了比较系统的论述，     

计算机辅助设计股骨远端个性化解剖型接骨板

背景：现有解剖型接骨板在个性化方面存在缺点及不足。 目的：用CT原始数据建立股骨远端骨折模拟复位后的三维实体模型,并设计个性化解剖型接骨板的三维实体模型。 方法：选取1例左股骨远端骨折患者的CT扫描原始数据。导入Mimics软件,得到股骨远端骨折模拟复位的三维实体模型;用Geomagic软件转换为符合要求的NURBS封闭曲面模型;接着用UG软件设计出接骨板的内外表面,得到模型数据,确定螺钉孔的位置并设计螺钉孔,并对设计好的接骨板进行数控编程。将生成的NC代码输入数控机床,加工出股骨远端个性化解剖型接骨板。 结果与结论：①建立了股骨远端复杂骨折模拟复位后的三维实体模型。②建立了股骨远端个性化解剖型接骨板的三维实体模型及股骨远端个性化解剖型接骨板螺钉系统装配的三维实体模型。③加工出了股骨远端个性化解剖型接骨板模型及股骨远端骨骼模型。模型外形逼真,接近真实情况,具有良好的骨面贴合性和特殊的螺钉孔设计。     

Drug-drug interactions in breast cancer patients treated with CDK4/6 inhibitors

CDK4/6 inhibitors are a new class of anticancer drugs used for the treatment of women with hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced or metastatic breast cancer with disease progression following endocrine therapy. Polypharmacy is a well-known problem in advanced cancer causing potential drug-drug interactions (DDIs), which, in turn, may limit the therapeutic value of CDK4/6 inhibitors. Therefore, understanding the mechanisms underlying potential DDIs in patients taking CDK4/6 inhibitors may be useful in decision-making processes and represent an important step towards treatment personalization. The present review is aimed at describing the potential DDIs that might occur in breast cancer patients receiving CDK4/6 inhibitors based on direct evidence from the literature and mechanistic considerations tailored on specific class of drugs used in combination.     

儿童药物制剂存在的问题及其创新开发策略

儿童药物制剂广受关注，但目前儿童药物制剂还存在制剂种类少、辅料安全性低、规格不适宜、服药依从性差等问题。本研究针对儿童药物制剂存在的问题，概述了一些儿童药物制剂的创新开发策略，尤其分析指出3D打印技术在创新儿童药物制剂开发中的优势及应用前景，以期为新型儿童药物制剂开发提供思路。     

Viscoelastic Polyurethane Foams for Use in Seals of Respiratory Protective Devices

A key factor in effective protection against airborne hazards, i.e., biological and nonbiological aerosols, vapors, and gases, is a good face fit of respiratory protective devices (RPDs). Equally important is the comfort of use, which may encourage or discourage users from donning RPDs. The objective of the work was to develop viscoelastic polyurethane foams for use in RPD seals. The obtained foams were characterized using scanning electron microscopy, infrared spectroscopy, thermogravimetry, and differential scanning calorimetry. Measurements also involved gel fraction, apparent density, air permeability, elastic recovery time, compression set, rebound resilience, and sweat uptake. The results were discussed in the context of modifications to the foam formulation: the isocyanate index (I_NCO) in the range of 0.6–0.9 and the blowing agent content in the range of 1.2–3.0 php. FTIR analysis revealed a higher level of urea groups with increasing water content in the formulation. Higher I_NCO and water content levels also led to lower onset temperatures of thermal degradation and higher glass-transition temperatures of the soft phase. A decrease in apparent density and an increase in mean pore sizes of the foams with increasing I_NCO and water content levels was observed. Functional parameters (air permeability, elastic recovery time, compression set, rebound resilience, and sweat uptake) were also found to be satisfactory at lower I_NCO and water content levels.     

Access在开发医院个性化药学信息管理软件中的应用

目的 通过较为简单的操作程序开发出适合笔者所在医院特点的药学信息管理软件,实现程序个性化。方法收集药学信息,组织整理成数据库文件后,用Access的窗体功能制作药学信息管理软件。结果Access设计的药学信息管理软件操作简便,维护方便,实用性较强。结论医院结合自身的特点开发出个性化药学信息管理软件更为经济实用,数据更新方便,能较好地满足信息化的需求。     

New biological perspectives for the improvement of the efficacy of sorafenib in hepatocellular carcinoma

Sorafenib, an orally-available kinase inhibitor, is the only medical treatment with a proven efficacy against Hepatocellular Carcinoma (HCC). Although the overall clinical efficacy of sorafenib is modest, recent experimental results have uncovered new potential strategies that may increase its clinical benefits. The potential implication of Receptor Tyrosine Kinases (RTKs), such as the Epidermal Growth Factor Receptor (EGFR), in the development of resistance to sorafenib highlights the importance of the RAF kinase pathway. Various strategies aiming to optimize the control exerted over this pathway by combining sorafenib with other targeted molecules (such as anti-EGFR, anti-MEK) are under investigation. Increasing the cytotoxicity of sorafenib in HCC, either through apoptosis or through new forms of non-apoptotic cell death, such as ferroptosis, may also promote more sustained tumour regression. Finally, the heterogeneity of individual responses to sorafenib is increasingly recognised, even though clinically-applicable biomarkers remain to be identified. Here, we discuss how molecular genetics and complementary approaches such as short term culture of tumour samples could help to personalize the use of sorafenib.