Current status and solutions for gender equity in anaesthesia research

Despite increasing numbers of women entering anaesthesia, they remain persistently under-represented within academic anaesthesia and research. Gender discordance is seen across multiple aspects of research, including authorship, editorship, peer review, grant receipt, speaking and leading. Women are also under-represented at higher faculty ranks and in department chair positions. These inequities are further magnified for women with intersectional identities, such as those who identify as Black, indigenous and women of colour. Several barriers to participation in research have been identified to date, including a disproportionate amount of family responsibilities, a disproportionate burden of clinical service, gender bias, sexual harassment and the gender pay gap. Several strategies to improve gender equity have been proposed. Increasing access to formal mentorship of women in academic medicine is frequently cited and has been used by healthcare institutions and medical societies. Senior faculty and leaders must also be conscious of including women in sponsorship and networking opportunities. Institutions should provide support for parents of all genders, including supportive parental leave policies and flexible work models. Women should also be materially supported to attend formal educational conferences targeted for women, aimed at improving networking, peer support and professional development. Finally, leaders must display a clear intolerance for sexual harassment and discrimination to drive culture change. Peers and leaders alike, of all genders, can act as upstanders and speak up on behalf of targets of discrimination, both in the moment or after the fact. Gender inequities have persisted for far too long and can no longer be ignored. Diversifying the anaesthesia research community is essential to the future of the field.     

单味药药性成因假说下的范式方法研究淫羊藿药性

科学合理的中药药性研究方法是中医药药性科学内涵研究的基础和客观要求。在既往创建的“单味药药性成因假说”理论指导下,在国内外首次创建“单味药药性形成演变分类范式模块”研究方法。运用此方法,在利用现代药效物质基础研究成果解析淫羊藿四气药性合理性的基础上,在中医学理论语境下,分析单味药淫羊藿四气药性历史形成、演变过程及影响因素,并将研究结果纳入模块类别单元分类。为建立系统、科学合理的中药药性研究方法与手段,提供了新思路。     

中药材及饮片质量等级标准研究思路和方法

中药质量评价作为保障中药材及饮片质量安全有效的有力手段,对维护人民群众身心健康、促进中药产业高质量发展具有重要意义。长久以来,中药质量多以法定检验标准为准入门槛进行低限控制,质量等级标准缺乏,致使中药质量仅能满足基本要求,而“优质优价”未能得到充分体现,导致“劣币驱逐良币”,市场公平严重受损,这很大程度影响了中药产业高质量发展。因此,开展中药质量优劣评价研究,构建中药质量等级标准体系对于全面落实“四个最严”要求、促进中医药传承创新发展、规范市场秩序、引导产业健康发展具有深远而重大的意义。对中药材质量评价现状进行概述,针对目前中药材质量评价的瓶颈问题,提出符合中医药特点的质量等级标准研究思路,包括关键质量控制指标确立、综合质量评价方法建立、质量等级标准验证等内容,以期为建立中药质量等级评价体系提供参考,助力中药产业高质量发展。     

基于CiteSpace的近5年国内外男性骨质疏松症研究热点可视化分析

目的 对比近5年男性骨质疏松症国内外研究现状、热点。方法 以中国知网（CNKI）、Web of Science（WOS）核心合集数据库为数据来源,利用CtieSpace,v.5.6.R1对近5年男性骨质疏松症文献进行可视化分析。结果 共纳入中文文献552篇、英文文献3632篇,针对男性骨质疏松症领域的研究主要国家为美国、英国、法国、澳大利亚,主要期刊为Journal of Bone and Mineral Research、Osteoporosis International、Bone。与国外相比,国内机构之间、作者之间缺乏合作。国内外男性骨质疏松症的研究在骨质疏松症的病因、危险因素、实验室检查、影像学检查、治疗药物、骨折风险评估等基础上,以药物治疗、疾病筛查、骨折风险评估等方面为研究热点,就骨质疏松症预防与骨折风险评估而言,国内外研究方向大致相同。在药物治疗方面,国外对新型抗骨质疏松药物的研究较国内更深入。结论 在我国未来男性骨质疏松症的相关研究中,多中心、机构、作者之间的合作有助于研究领域的发展,同时也需更进一步开展骨质疏松性骨折评估、预防、新型抗骨质疏松药物等研究。     

Predictors of Hand Function Following Digit Replantation: Quantitative Review and Meta-Analysis

Background: Digit replantation affords the opportunity to restore hand function following amputation. To date, however, few studies have evaluated functional outcomes following replantation. Therefore, it was the objective of this study to perform a meta-analysis to better characterize the predictors of hand function. Methods: A literature search was performed using the PubMed database to identify studies that focused on digit amputation/replantation and functional outcomes. Studies were evaluated for patient- and injury-related factors and their respective effects on clinical outcomes of sensation, grip strength, and Disabilities of the Arm, Shoulder, and Hand (DASH) scores. Statistical analysis was conducted across the pooled data set to identify significant trends. Results: Twenty-eight studies representing 618 replanted digits were included in this study. We found the average grip strength was 78.7% (relative to contralateral), the average 2-point discrimination (2PD) was 7.8 mm, and the average DASH score was 12.81. After conducting statistical analysis, we found patients with more proximal injuries had lower grip strength scores (P < .05). We found 2PD scores were influenced by age, mechanism of injury, and amputation level (P < .05). Finally, we found DASH scores after replantation were predicted by mechanism of injury and level of amputation (P < .05). The following variables did not influence outcomes: gender, tobacco use, ischemia time, and digit number. Conclusions: Digit replant does not restore premorbid hand function but does result in adequate hand function. Expected functional outcomes following replant should be considered in the decision-making process. These data can help risk-stratify patients, guide postreplant expectations, and influence the decision for replantation.