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This paper investigates the effect of scientific information from randomized controlled clinical trials (RCTs) on the demand for off-label uses of cancer drugs. This is a unique setting where demand for a drug for a specific use is observable both before and after the first RCT results are released. Using variation in the timing of RCTs across off-label uses of drugs, I find that demand responds asymmetrically to the trial results based on the statistical significance of the clinically relevant endpoint. When this endpoint is statistically significant, there is a large and immediate increase in demand. When this end point is not statistically significant, physicians are relatively slow to abandon use of the drug. 相似文献
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《Bulletin du cancer》2019,106(4):389-394
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《中国现代医生》2020,58(17):37-40
目的研究miR-1与miR-499在心肌细胞增殖与凋亡中的调控作用及其机制。方法通过脂质体2000转染试剂将miR-1 mimics、miR-499 inhibitor转染至H9C2心肌细胞。设置空白对照组、H_2O_2组(未进行转染的H9C2心肌细胞)、干预组A(miR-1 mimics转染的H9C2心肌细胞)、干预组B(miR-499 inhibitor转染的H9C2心肌细胞)、干预组C(miR-1 mimics+miR-499 inhibitor转染的H9C2心肌细胞)。通过H_2O_2诱导建立H9C2心肌细胞氧化应激模型。采用CCK-8法检测细胞增殖情况,流式细胞仪检测细胞凋亡情况,Western Blot检测Bim、Mcl-1蛋白表达水平。结果与空白对照组比较,H_2O_2组细胞增殖显著降低而细胞凋亡率显著升高,差异有统计学意义(P0.05)。与H_2O_2组相比,干预组A、干预组B细胞增殖进一步降低而细胞凋亡率进一步升高,这种改变在干预组C中更加显著,差异有统计学意义(P0.05)。与空白对照组比较,H_2O_2组Bim蛋白表达水平明显升高,Mcl-1蛋白表达水平明显降低,差异有统计学意义(P0.05)。与H_2O_2组相比,干预组A、干预组B的Bim蛋白表达水平进一步升高,Mcl-1蛋白表达水平进一步降低,这种改变在干预组C中更加显著,差异有统计学意义(P0.05)。结论 miR-1与miR-499在心肌细胞增殖与凋亡中发挥重要调控作用,miR-1可能通过上调Bim、下调Mcl-1蛋白表达促进心肌细胞凋亡,miR-499则通过下调Bim、上调Mcl-1蛋白表达抑制心肌细胞凋亡。 相似文献
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《Vaccine》2022,40(6):924-933
The European Clinical Trial Regulation No 536/2014 is the first mandate for a non-technical, publicly disclosed, plain language summary (PLS) of clinical trial results. This easy-to-understand summary has the potential to inform the public about clinical trial results and thereby improve health literacy in vaccines.To investigate the utility of the PLS, we undertook 2 online surveys (July/October 2020) in the United Kingdom, the United States and India. Participants were selected by quota sampling to ensure representation of gender, age and parental status. Those lacking interest in vaccine clinical research were excluded. In survey 1, participants were questioned about their interest in and expectations of vaccine trial results. In survey 2, the perceptions of participants to a range of written communication styles used in publicly available PLSs were evaluated.A total of 66 (13%) and 122 (29%) individuals were excluded solely due to lack of interest in vaccine clinical research in surveys 1 and 2, respectively; 450 respondents (150/country) completed survey 1 and 300 (100/country) completed survey 2. In survey 1, there was a correlation (p < 0.01) between claimed knowledge of and trust in vaccines. Healthcare professionals were the most trusted source for vaccine information, while vaccine companies were ranked relatively low. In survey 2, infographic PLS formats were considered easiest to understand, most engaging and the strongest communicators. Emphasizing the main points of the infographics in the text did not improve comprehension or recall. Most respondents (86%) indicated that they would like to see this type of communication in the future.Overall, this research suggests that the PLS, by optimizing content and format, has a potential to increase health literacy, and thereby, as part of a wider integrated communication strategy, build vaccine knowledge and confidence. 相似文献
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ObjectivesThis review explores the literature about the status and influence of statutory regulation in healthcare with a focus on medical imaging. It summarises the status of regulation in Australia for radiographers and sonographers, with brief reference to the global situation. The role of regulation is explored in terms of its evolution, function and effect on professional behaviours.Key findingsReports of medical errors, sentinel events and professional misconduct in healthcare have raised concern about how health care professionals are regulated. Patient-centric healthcare delivery has changed how people interact with healthcare, contributing to the development of statutory regulation for many healthcare professions.In Australia, the Health Practitioner Regulation National Law (The National Law) 2009, established the National Registration and Accreditation Scheme (NRAS) in order to practice. Not all health care professions are included in the scheme. In medical imaging, radiographers are included but sonographers are a notable exception.Regulation is designed to positively influence practitioners' professional behaviours. The available evidence however is limited, but suggests that under certain circumstances, it can negatively impact practitioners’ professional behaviours.ConclusionStatutory regulation has been implemented to address serious issues highlighted in reports of medical errors and professional misconduct, but it may have unintended consequences on the professional behaviours of practitioners. Limited research means the relationship between statutory regulation of healthcare practitioners and its impact upon professional behaviours remains unclear.Implications for practiceIf statutory regulation of healthcare professionals is to achieve its aim of protecting the public, it is imperative that we understand the impact that it has on professional behaviours. This review highlights that it can negatively impact professional behaviours which may be detrimental to patient's safety. 相似文献