Pattern of inappropriate antibiotic use among patients in the medical wards of a tertiary hospital in southwest Nigeria

Background: The inappropriate use of antibiotics results in the emergence of antimicrobial resistance and adverse clinical and economic outcomes in hospital in-patients. A lack of institutional and national antibiotic guidelines promotes inappropriate antibiotic use. The objectives of this study are to evaluate the appropriateness of antibiotic prescribing, and the quality of antibiotic use in medical wards of the Lagos University Teaching Hospital, Lagos, Nigeria. Methodology: This was a descriptive cross-sectional study of patients admitted and placed on antibiotics in the medical wards of Lagos University Teaching Hospital between July 2013 and August 2014. The appropriateness of antibiotic therapy was determined by compliance with the guidelines of the Infectious Diseases Society of America (IDSA). Results: A total of 350 hospitalized patients on antibiotic therapy during the period of the study were reviewed, including 197 (56.3%) males and 153 females (43.7%). The mean age of the patients was 48.7±17.6 years and a total of 539 initial antibiotics were empirically prescribed. Antibiotic therapy was considered inappropriate in 290 (82.9%) patients, of which 131 (37.4%) patients had no evidence of infection. Pneumonia (23.1%) was the most common indication for antibiotic use, out of which 59.3% had inappropriate antibiotic therapy. Overall, the most frequently prescribed initial empirical antibiotic classes were imidazole derivatives (32.4%) and cephalosporins (22.0%), while the most frequently prescribed inappropriate antibiotic classes were carbapenems (100.0%) and quinolones (89.3%). Conclusion: The study revealed a high rate of inappropriate antibiotic therapy. There is an imperative need to establish antimicrobial stewardship programmes to curb the inappropriate use of antibiotics in the hospital.

Establishment of Comprehensive Protection System for Intellectual Property of Single Herbs by Taking Callicarpa nudiflora of Jiuzhitang as An Example / 中国实验方剂学杂志

The development of single Chinese materia medica is an important direction of technological innovation in the field of Chinese materia medica at present， and the study of its comprehensive intellectual property protection system is of great significance to the intellectual property protection of the whole chain of innovative enterprises of single Chinese materia medica. Based on this， this paper takes the comprehensive protection system of intellectual property of Callicarpa nudiflora constructed by Jiuzhitang Pharmaceutical as a model to conduct empirical research， analyzes the protection forms applicable to intellectual property of Chinese materia medica， such as patents， administrative protection， trademarks， designs and intangible cultural heritages， and discusses the valuable and insufficient aspects of the protection system currently constructed by Jiuzhitang Pharmaceutical and puts forward the following suggestions：①paying attention to patent applications for planting/processing methods of raw medicinal materials， ②emphasizing the protection of geographical indications， authentic medicinal herbs， and new plant varieties， ③actively promoting product and technology upgrades， ④applying for data protection during product iteration， ⑤emphasizing the layout timing of patent and administrative protection， ⑥focusing on improving goodwill， ⑦enhancing awareness of intellectual property protection and promoting deep integration of industry， academia， and research. We hope that innovative enterprises engaged in the development of single Chinese materia medica can learn from the experience of the case， and optimize the strategy to better protect related products.

Cost-minimization analysis of drugs used for empirical treatment of urinary tract infection in a tertiary care hospital

Background: Urinary tract infections (UTIs) are one of the commonly encountered infections and a large number of drugs are indicated in UTI ranging from oral conventional drugs to most advanced injectable drugs. Cost-minimization analysis (CMA) is employed to project the least costly drug when two treatments are shown to be therapeutic equivalents. Aims and Objectives: This study aims to perform a CMA at a tertiary care center to determine the least expensive drug for UTI and to project a cheapest alternative from available options based on the results of CMA. Materials and Methods: This was a cross-sectional study conducted over duration of 3 months in the clinical departments on patients diagnosed to have UTI and prescribed empirical antimicrobial treatment. The approval of Institutional Ethics Committee was sought before beginning the study. Pattern of drug prescription and average cost incurred in the treatment of patients with empirical antimicrobial therapy was calculated. CMA included the projection of the least expensive drug based on average cost incurred per patient in outpatients and inpatients respectively. Results: A total of 59 patients of UTI given empirical treatment were included in the study. Fluoroquinolones and cephalosporins were commonly used drugs for empirical treatment of UTI. Nitrofurantoin (average cost of 11–14 Rs. per patient) can be projected as the cheapest drug for empirical treatment of UTI on outpatient basis as well as a drug to supplement injectables in indoor patients. Injectable ciprofloxacin can be projected as the most inexpensive alternative for empirical treatment of UTI in patients of the inpatient department. Conclusion: Nitrofurantoin for oral treatment and ciprofloxacin in injectable form are cheapest among available alternatives for empirical treatment of UTI. To prevent treatment failures and increase in cost of treatment, correlation of results of CMA with local antimicrobial sensitivity pattern is important.

A multiscale feature extraction algorithm for dysarthric speech recognition / 生物医学工程学杂志

In this paper, we propose a multi-scale mel domain feature map extraction algorithm to solve the problem that the speech recognition rate of dysarthria is difficult to improve. We used the empirical mode decomposition method to decompose speech signals and extracted Fbank features and their first-order differences for each of the three effective components to construct a new feature map, which could capture details in the frequency domain. Secondly, due to the problems of effective feature loss and high computational complexity in the training process of single channel neural network, we proposed a speech recognition network model in this paper. Finally, training and decoding were performed on the public UA-Speech dataset. The experimental results showed that the accuracy of the speech recognition model of this method reached 92.77%. Therefore, the algorithm proposed in this paper can effectively improve the speech recognition rate of dysarthria.

Exploring the Principles， Limitations， and Error-Correction Methods of Traditional Chinese Medicine's Empirical Thinking / 中医杂志

From the perspective of cybernetics， this study investigated the fundamental principles of empirical thinking in traditional Chinese medicine， encompassing six stages： experience input and storage， experience extraction and activation， experience combination and reconstruction， judgment and decision-making based on experience， and experience evaluation and feedback. The potential limitations of empirical thinking in clinical applications were analyzed， mainly manifested as “individuality”， “superficiality”， “conservatism”， “prioritizing commonality over individuality”， and “cognitive inertia”. To overcome these limitations， this paper also explored strategies and methods for clinical error-correction from four points： the integration of rational and empirical thinking， the reinforcement of feedback mechanisms and transcendent correction， the integration of individualization and quantity-quality balance， and the management and transference of tacit knowledge under empirical thinking.

The Empirical Research Path of Yin-Yang Thinking in Traditional Chinese Medicine / 中医杂志

The yin-yang theory is a thinking model used by ancient people to recognize the world， which is highly compatible with multimodal metaphors. By summarizing the current researches on traditional Chinese medicine （TCM） yin-yang theory and thinking， it is found that there are more clinical researches but few empirical studies， and more conceptual studies but few empirical researches. In view of this， we proposed to conduct researches on TCM yin-yang thinking with the methods such as behavioral experiments， event-related potentials， and functional magnetic resonance imaging techniques， based on the multimodal metaphor theory from the perspective of cognitive science. According to the characteristics of yin-yang， the process of TCM yin-yang thinking is divided into two stages which are yin-yang classification and yin-yang reasoning， and the main directions of empirical research on yin-yang thinking in TCM are outlined by combining with the paradigm of cognitive science， that is， the researches are carried out from the cognitive characteristics of TCM yin-yang thinking， as well as the differences in cognitive mechanisms between TCM yin-yang thinking and western logical thinking.

An empirical research on the enrollment quality of master of stomatology professional degree graduate students—Based on the statistical data of the comprehensive evaluation of professional degree graduate students by the guiding physicians / 中华医学教育探索杂志

Objective:Based on the statistical data of the comprehensive evaluation of professional degree graduate students by the guiding physicians, to conduct an empirical study on the quality of the enrollment of master of stomatology professional degree graduate students.Methods:A total of 67 master of stomatology professional degree graduate students from Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University were comprehensively evaluated by their guiding physicians when they went out the department. SPSS 25.0 software was used for t test and variance analysis. Results:The average score of 67 students was (91.39±3.55) points. There was good reliability and validity for the comprehensive evaluation index. Among the methods of promotion and exemption, unified examination, 7-year transfer to "5 + 3" of our school and enrollment of students from Hong Kong, Macao and Taiwan regions, the comprehensive evaluation total score of 7-year transfer to "5 + 3" of our school was the highest. The comprehensive evaluation results of the students with high initial scores were slightly higher than those students with low scores. The students who studied in the "Double First-class" universities and were with the fourth round of subject assessment grade A and grade B had better performances.Conclusion:We should attach importance to enrollment quality, through various channels to attract quality students and actively explore ways to improve the quality of graduate students. Meanwhile, we should make efforts to strengthen training quality and to build scientific comprehensive evaluation system for specialized degree graduate students. The connotation of "medicine-education collaboration" will be further deepened. And the training and development of oral medicine applied high-level medical talents will be promoted.

The current status and reflection of higher education research of independent medical universities: taking G University as an example / 中华医学教育探索杂志

Taking G University as an example, through empirical research, this study finds out that the motivation of teachers on medical education research is insufficient; the support and incentive for young and middle-aged teachers to participate in higher education research is insufficient; and universities lack of an efficient higher education research organization system; the social influence of medical research and education is not enough, etc. We call on independent medical universities to further improve the higher education research organization system, change the current situation and increase the support and incentives for young and middle-aged teachers to participate in higher education research, guide teachers to summarize the characteristics of medical education teaching, improve the quality of medical personnel training, and expand the influence of medical education research.

Intersectionality Theory, Challenges for Empirical Research and Contributions to Psychology / Teoria da Interseccionalidade, Desafios para Pesquisas Empíricas e Contribuições para a Psicologia / Teoría de la Interseccionalidad, Desafíos para la Investigación Empírica y Aportes a la Psicología

Abstract The Theory of Intersectionality is an important contribution from feminist epistemologies to the scientific field. This narrative literature review aims to discuss methodological possibilities and challenges in producing and analyzing empirical evidence based on the Theory of Intersectionality, as well as its contributions to Psychology. While this theory is increasingly being cited as the basis for empirical research, articulating its assumptions in knowledge production processes is still a difficulty. Qualitative approaches prevail in the field, but advancements in statistical analysis methods allow for an intersectional interpretation in quantitative studies. Intersectionality contributes to understanding psychological processes and challenging dominant and exclusionary assumptions in the field of Psychology. Embracing this theory requires a commitment to the imperative of social transformation and entails placing claims, values, practices, and power relations at the core of scientific knowledge production, regardless of the field under study.

Resumo A Teoria da Interseccionalidade é uma importante contribuição das epistemologias feministas para o campo científico. Este estudo de revisão narrativa da literatura teve como objetivo discutir possibilidades e desafios metodológicos na produção e análise de evidências empíricas embasadas na Teoria da Interseccionalidade e suas contribuições para a Psicologia. Embora essa teoria esteja crescentemente sendo citada como base de pesquisas empíricas, ainda se identifica a dificuldade de articular seus pressupostos nos processos de produção de conhecimento. As abordagens qualitativas são predominantes no campo e observa-se avanços em métodos de análises estatísticas que permitem uma leitura interseccional em estudos quantitativos. A interseccionalidade contribui para compreender processos psicológicos e desafiar suposições dominantes e excludentes no campo da Psicologia. Adotar essa teoria requer uma implicação com o imperativo de transformação social e implica tornar reivindicações, valores, práticas e relações de poder como cerne da produção de conhecimento científico, independentemente do campo estudado.

Resumen La Interseccionalidad es una importante contribución de las epistemologías feministas al campo científico. Este artículo de revisión narrativa tiene como objetivo discutir las posibilidades y desafíos metodológicos en la producción y análisis de evidencia empírica basada en la Interseccionalidad y sus contribuciones a la Psicología. Aunque esta teoría se cita cada vez más como base de investigaciones empíricas, aún se identifica la dificultad de articular sus supuestos en los procesos de producción de conocimiento. Los enfoques cualitativos predominan en el campo y se observan avances en métodos de análisis estadístico que permiten una lectura interseccional en estudios cuantitativos. La interseccionalidad contribuye a comprender los procesos psicológicos y desafiar suposiciones dominantes y excluyentes en el campo de la Psicología. Adoptar esta teoría requiere una implicación con el imperativo de transformación social e implica poner las demandas, valores, prácticas y relaciones de poder en el centro de la producción de conocimiento científico, independientemente del campo estudiado.

Bioética empírica y mejoramiento humano: una propuesta metodológica

Propósito/Contexto. La presente investigación se enfoca en el debate sobre el transhumanismo/bioconservadurismo desde la Bioética empírica, es decir, haciendo uso de evidencia empírica en el proceso del razonamiento moral. Su objetivo es proponer una guía metodológica para el planteamiento y la resolución de problemas morales concernientes al mejoramiento humano. Metodología/Enfoque. Se propone el método "mejoramiento humano ético paso a paso" (Mhepp), una guía que consta de 11 preguntas que son resultado de la adaptación de las pautas para identificar un procedimiento de mejoramiento humano como ético, desarrolladas por Julián Savulescu sobre el método de "contribuciones empíricas paso a paso", elaborado por Pascal Borry. Se brinda un ejemplo aplicativo sobre la moralidad de los implantes RFID del biohacking. Resultados/Hallazgos. El Mhepp propone que se aborden los procedimientos de mejoramiento humano como problemas específicos y que la norma moral planteada se reescriba como una proposición descriptiva que sirva como hipótesis a ser evaluada a la luz de la evidencia empírica. La evaluación de la proposición y, por lo tanto, del razonamiento moral, se realizará con ayuda de la información recabada por las 11 preguntas. Discusión/Conclusiones/Contribuciones. El Mhepp puede servir para brindar una primera respuesta sobre la moralidad de un procedimiento específico de mejoramiento humano, más no absoluto, pues el resultado puede variar en función de la información que se obtenga en el futuro y también evidencia vacíos en la investigación empírica relacionada al procedimiento que aborda. El método es una primera guía metodológica que podría ser revisada y mejorada.

Purpose/Background. The present research focuses on the debate on transhumanism/bioconservatism from the perspective of empirical bioethics, that is, making use of empirical evidence in the process of moral reasoning. Its objective is to propose a methodological guide for the approach and resolution of moral problems concerning human enhancement. Methodology/Approach. The method Step-wise Ethical Human Enhancemet (SWEH) is proposed. It is a guide consisting of 11 questions that are the result of the adaptation of the guidelines for identifying a human enhancement procedure as ethical developed by Julian Savulescu to the method of Step-wise Empirical Contributions elaborated by Pascal Borry. An applicative example on the morality of biohacking RFID implants is provided. Results/Findings. SWEH proposes that human enhancement procedures might be approached as specific problems and that the identified moral norm might be rewritten as a descriptive proposition that serves as a hypothesis that will be evaluated in the light of empirical evidence. The evaluation of the proposition, and thus of moral reasoning, will be done with the help of the information gathered by the 11 questions. Discussion/Conclusions/Contributions. SWEH can serve to provide a first answer on the morality of a specific human enhancement procedure, but not an absolute one, as the result may vary depending on the information obtained in the future. It also highlights gaps in empirical research related to the procedure it addresses. The method is a first methodological guide that could be revised and improved.

Objetivo/Contexto. Esta pesquisa se concentra no debate sobre o transhumanismo/bioconservadorismo a partir da perspectiva da bioética empírica, ou seja, fazendo uso de evidências empíricas no processo de raciocínio moral. Seu objetivo é propor um guia metodológico para a postagem e resolução de problemas morais relativos à valorização humana. Metodologia/Abordagem. O método Ethical Human Enhancement Step by Step (MHEPP) é proposto, um guia que consiste em 11 questões que são o resultado da adaptação das diretrizes para identificar um procedimento de melhoramento humano como ético desenvolvido por Julian Savulescu ao método de Contribuições Empíricas Passo a Passo elaborado por Pascal Borry. Um exemplo de aplicação é dado sobre a moralidade dos implantes RFID em biohacking. Resultados/Descobertas. O MHEPP propõe que os procedimentos de valorização humana sejam abordados como problemas específicos e que a norma moral colocada seja reescrita como uma proposta descritiva que serve como uma hipótese a ser avaliada à luz de evidências empíricas. A avaliação da proposta, e portanto do raciocínio moral, será realizada com a ajuda das informações coletadas pelas 11 perguntas. Discussão/Conclusões/Contribuições. O MHEPP pode ser usado para fornecer uma primeira resposta sobre a moralidade de um procedimento específico de aperfeiçoamento humano, mas não absoluta, pois o resultado pode variar de acordo com as informações obtidas no futuro. Ela também destaca lacunas na pesquisa empírica relacionada ao procedimento que ela aborda. O método é um primeiro guia metodológico que poderia ser revisado e melhorado.

Neuroética: comienza el reinado de las neurociencias en la fundamentación de la ética / Neuroethics: the reign of neuroscience begins in the foundation of the ethics / Neuroética: começa o reinado das neurociências na fundamentação da ética

Resumen: 1] La neurociencia de la ética constituye un progreso al aplicar la ciencia empírica en la investigación del fenómeno moral. 2] Resaltar la importancia de afectos y sentimientos representa una compensación a la excesiva importancia dada a la razón en la formación de los juicios morales. 3] Existen graves dificultades metodológicas al no precisar los conceptos de "intuición", "afectos", "deber" y especialmente qué se entiende por "ética". 4] Pero la investigación científica aprehende al hombre como una "entidad" en sí (presente) y no como una "existencia" (futuro), vale decir, ser-en-el-mundo. 5] En lugar de "tener" una moral el ser humano "es" moral y, como tal, es un proyecto lanzado hacia su más auténtica posibilidad que consiste en apropiarse de su ser-para-la-muerte.

Abstract: 1] The Neuroscience of Ethics constitutes a progress when applying empirical science in the investigation of the moral phenomenon. 2] Emphasizing the importance of affects and feelings represents a compensation for the excessive importance given to reason in the formation of moral judgments. 3] There are serious methodological difficulties by not specifying the concepts of intuition, affections, duty and especially what is understood by ethics. 4] But scientific research apprehends man as an "entity" in himself (present) and not as an "existence" (future), that is, being-in-the-world. 5] Instead of "having" a moral, the human being "is" moral and as such is a project thrown towards its most authentic possibility that consists of appropriating its being-for-death.

Resumo: 1] A neurociência da ética constitui um progresso ao aplicar a ciência empírica na investigação do fenômeno moral. 2] Ressaltar a importância de afetos e sentimentos representa uma compensação à excessiva importância dada à razão na formação dos juízos morais. 3] Existem graves dificuldades metodológicas ao não precisar os conceitos de "intuição", "afetos", "dever" e especialmente o que se entende por "ética". 4] Porém a investigação científica apreende o homem como uma "entidade" em si (presente) e não como una "existência" (futuro), vale dizer, ser-no-mundo. 5] Em lugar de "ter" uma moral o ser humano "é" moral e, como tal, é um projeto lançado à sua mais autêntica possibilidade, que consiste em apropriar-se de seu ser-para-a-morte.

Spectrum of bacterial keratitis in North India: A retrospective analysis of six years at a tertiary care eye center

Purpose: To analyze the pattern of bacterial pathogens causing infective keratitis and their resistance to the recommended antibiotics over six years. Methods: It was a retrospective study of 9,357 cases of bacterial keratitis from January 2015 to December 2020, at a tertiary care ophthalmic center. A total of 9,547 corneal specimens were obtained from the study subjects. Demographic details of the patients, pathogenic bacteria isolated, and their antimicrobial susceptibility were noted and analyzed. Results: Bacterial pathogens were identified in 23.52% of the specimens. The most common isolates were coagulase?negative Staphylococci (60.75%), followed by Pseudomonas aeruginosa (14.23%), Staphylococcus aureus (13.92%), gram negative bacilli of the family Enterobacterales (8.64%), Streptococcus spp. (1.72%), Acinetobacter spp. (0.13%), and other non?fermenting gram?negative bacilli (0.57%). In Staphylococci, 55–80% of isolates were resistant to erythromycin, and 40–70% to fluoroquinolones, while no resistance was observed against vancomycin. 40–60% of isolates of P. aeruginosa were resistant to cephalosporins, 40–55% to fluoroquinolones, and 30–60% to aminoglycosides. Also, 40–80% of isolates of Enterobacterales were resistant to cephalosporins, and 50–60% to fluoroquinolones. Most gram?negative isolates were susceptible to carbapenems and polymyxin B. Conclusion: To the best of our knowledge, our study is the largest compilation of microbiological profile of bacterial keratitis from North India. It highlights the current trend of the bacterial pathogens that cause infectious keratitis. Staphylococci and Pseudomonas were found to be the most common pathogens. Increased resistance was seen against some of the commonly prescribed empirical antibiotics. Such evidence is useful for restructuring the empirical prescription practices from time to time.

A hospital-based descriptive cross-sectional study in Eastern India to estimate the effect of nitrofurantoin, an age-old therapeutic option, in uncomplicated urinary tract infection

Background: Urinary pathogens develop lesser resistance against Nitrofurantoin than other antimicrobials such as Fluoroquinolones, Cotrimoxazole, and Carbapenems. Aim and Objective: The objective of this study was to estimate the sensitivity pattern of the urinary isolates against Nitrofurantoin in uncomplicated Urinary tract infection (UTI). Materials and Methods: The descriptive cross-sectional study was performed from January 1, 2020, to June 30, 2020, with 759 cases with signs and symptoms of uncomplicated UTI. Aseptically collected midstream urine was inoculated on Nutrient Agar Media, MacConkey’s Agar media, and Blood Agar media for bacterial isolation. Antimicrobial susceptibility testing was done by disk diffusion technique on Mueller Hinton Agar (Kirby Bauer technique) as per Clinical Laboratory Standards Institute guidelines. Results: Out of total of 759 urine samples, in 165 cases bacterial pathogens were isolated (21.73%). Only 17 were resistant to Nitrofurantoin (10.30%) whereas resistance to Fluoroquinolone (Ciprofloxacin) was in 58 isolates (35.15%) and Cotrimoxazole, in 37 isolates (22.42%). Resistance against Carbapenem antibiotics (Imipenem and Meropenem) was found in 29 isolates (17.57%). All the Nitrofurantoin resistant isolates were Gram-negative. Majority of the Nitrofurantoin resistant isolates were Klebsiella pneumonia (8 out of 17, i.e, 47.05%). All Nitrofurantoin resistant isolates were sensitive to Colistin and Tigecycline. Five out of 17 Nitrofurantoin resistant isolates were sensitive to Meropenem and Imipenem (29.41%). The Fischer exact test reveals that Nitrofurantoin is effective against the isolates resistant to Fluoroquinolones, Cotrimoxazole, and Carbapenems. Conclusion: Nitrofurantoin, even today, remains a good choice for empirical therapy for uncomplicated UTI.

Stoichiometric models for prediction of enteric methane production

This study aimed to empirically evaluate the adjustment quality of two stoichiometric models of methane production from diets that used different rumen fermentation modulators. We used the models proposed by Moss et al. (2000) and Blümmel et al. (1997). The data set consisted of 169 observations of in vitro methane production and volatile fatty acids (acetate, propionate, and butyrate) from dissertations, theses, and scientific articles. The model's adequacy evaluation was only possible through combination of several statistical analyzes. The models were unable to predict the enteric methane precisely and accurately. Despite this, the model proposed by Moss et al. (2000) showed a better fit based on the mean bias (% of observed, MB), MEF, RMSEP, Cb and CCC measures compared to the model proposed by Blümmel et al. (1997). However, both models presented strong evidence against the general hypothesis H0: a = 0 & b = 1. Thus, the model proposed by MOSS et al. (2000) was more efficient, whereas the model by Blümmel et al. (1997) showed a better fit for diets with high availability of H2.

Development and empirical research of the perioperative fine management evaluation scale for process control / 中华医院管理杂志

Objective:To design an evaluation scale of perioperative fine management, and test it in hospitals, for verifying its effectiveness and sorting out problems in such management.Methods:November 2020 to August 2021, the scale framework was designed by using the process management theories featuring process-oriented control; then the scale was built based on a risk measurement indicators pool created based on policies, literature, standards and expert interview results on perioperative management; an empirical study was made in the end.Results:The scale consists of 209 risk measurement indicators and Likert 5-level scoring method was adopted to measure the possibility of problems in each respect. A total of 99 experts from 31 hospitals participated in the trial of the scale in 2021, and Cronbach α coefficient was 0.997, indicating good consistency among risk measurement indicators. The median of the average scoring of respective risk measurement indicators was 1.69. The most common problems in the perioperative management process include: lack of analysis and countermeasure research on the perioperative fine management; insufficient medical staff; poor awareness of medical staff in standardized and fine management. Conclusions:This scale can quantitatively evaluate respective aspects of perioperative fine management.

An empirical study on the evaluation system of hospital scientific research based on principal component analysis / 中华医学科研管理杂志

Objective:To construct a scientific research evaluation model through principal component analysis, and to explore scientific research evaluation methods for hospitals.Methods:The professional title, educational background, positions and scientific research output information of the scientific research personnel in the First Hospital of Jilin University from 2019 to 2020 were collected. Delphi expert consultation was used to determine the assignment value of each variable, and use SPSS 21.0 software was used to build the principal component analysis model and conduct model verification.Results:The study collected a total of 1 882 researchers′ information. The KMO value of the validity test and the Bartlett sphere test meet the requirements of principal component analysis (KMO=0.731, P<0.05); the model obtained a total of 7 principal components. Among them, principal component 1 represents researchers who published SCI papers, applying for national, provincial and ministerial level scientific research projects, and their part-time positions in academic societies. The second principal component represents the status of applying for patents and publications, and the third principal component represents the status of the awards. The scores of scientific research output of researchers were summarized and sorted according to disciplines, according to which the neurology, endocrinology and metabolism, neurosurgery, general surgery and orthopedics ranked better. The model verification results found that researchers with senior professional titles and doctoral degrees had the highest median weighted comprehensive score( P<0.05), suggesting that scholars with higher professional title levels and higher education received higher comprehensive scientific research output scores. Conclusions:The scientific research evaluation model constructed by this study can provide scientific data reference for the hospital scientific research evaluation.

Study on the consistency and correlation of different methods for measuring energy consumption in patients with severe acute pancreatitis / 中华消化杂志

Objective:To analyze the consistency and correlation of indirect calorimetry (IC) and Harris-Benedict estimation method (H-B) in measuring energy consumption in patients with severe acute pancreatitis (SAP), as well as the characteristics of energy metabolism at resting state of SAP patients with different etiologies, and so as to guide the formulation of clinical energy nutrition support program.Methods:From February 1 to December 31, 2019, 61 SAP patients admitted into the intensive care unit of the First Affiliated Hospital of Nanchang University were enrolled. Collected relevant data of patients, such as the etiology of SAP, whether mechanical ventilation was needed, as well as the metabolic status. All SAP patients accepted IC test on the first day after admission to intensive care unit. According to the energy consumption measured by IC (hereinafter referred to as IC value) and the energy consumption measured by H-B (hereinafter referred to as H-B value), SAP patients were determined to be in high, normal or low metabolic state. Bland-Altman method and Pearson linear regression were used to analyze the consistency and correlation of the two methods in measuring energy consumption, and the linear equation was fitted. Paired t test was used for statistical analysis. Results:Among the 61 SAP patients, 13 cases were biliary SAP, 30 cases were hyperlipidemic SAP, 6 cases were alcoholic SAP, and 12 cases were SAP of other causes or unknown causes. Nineteen cases needed mechanical ventilation and 42 cases did not need mechanical ventilation. There were 70.5% (43/61) of SAP patients in high metabolic state, 13.1%(8/61) of SAP patients in normal metabolic state, and 16.4% (10/61) of SAP patients in low metabolic state. The IC value in 61 SAP patients was higher than H-B value((8 604.7±367.8) kJ/d vs. (6 491.2±133.7) kJ/d), and the difference was statistically significant ( t=5.95, P<0.001). The IC value in patients with hyperlipidemic, alcoholic and biliary SAP was (8 815.2±537.9), (7 631.2±890.5), and (8 108.0±933.1) kJ/d, respectively, and the H-B value was (6 869.6±204.5), (5 916.8±153.7), and (5 974.2±200.9) kJ/d, respectively. The IC value in patients with biliary or hyperlipidemic SAP were higher than H-B value, and the differences were statistically significant( t=2.29 and 3.38, both P<0.05). The IC value and H-B value in SAP patients with mechanical ventilation and without mechanical ventilation were (10 485.0±741.1) and (6 462.6±222.8) kJ/d, (6 595.1±364.7) and (6 503.2±166.7) kJ/d, respectively. The IC value in SAP patients with mechanical ventilation was higher than H-B value and the IC value in SAP patients without mechanical ventilation, and the differences were statistically significant ( t=4.71 and 5.20, both P<0.001). The consistency analyzed by Bland-Altman method showed that the two methods had obvious biases, and the average bias value was 92.2 kJ/d. The result of Pearson linear regression analysis indicated that there was a linear relationship between two methods ( r=0.44, P<0.001). The linear equation fitted by the univariate regression was Y=1.240 6 X+ 154.42, in which X was the H-B value and Y was the IC value. Conclusions:SAP patients are mostly in a hypermetabolic state in the early stages of the disease. The IC value is higher than H-B value, and it is recommended to use IC to measure energy consumption in SAP patients.

Comparison of different timing of empirical antifungal strategy in febrile neutropenic children with acute leukemia / 中国小儿急救医学

Objective:To compare the clinical value of early and deferred empirical antifungal strategies in febrile neutropenic children with acute leukemia.Methods:A total of 101 cases of febrile neutropenic children with acute leukemia hospitalized in Qilu Hospital of Shandong University from January 2019 to June 2021 were divided into two groups according to different empirical antifungal strategies.There were 41 cases in early group in which antifungal therapy was given within 4 days of fever, and 60 cases in deferred group in which antifungal therapy was not given within 4 days of fever.Outcomes such as time to stable defervescence, positive diagnosis rate of invasive fungal disease, incidence of severe pneumonia, rate of transference to PICU, exposure time and costs of antifungal agents, and infection-related hospitalization days were compared between two groups.Results:There were no significant differences in time to stable defervescence[5 (4, 7) days vs.5 (3, 7) days, P=0.986], positive diagnosis rate of invasive fungal disease[9.8%(4/41) vs.8.3%(5/60), P=1.000], incidence of severe pneumonia[19.5%(8/41) vs.10.0%(6/60), P=0.174], and rate of transference to PICU[2.4%(1/41)vs.0(0/60), P=0.406] between two groups.Exposure time of antifungal agents was longer in early group than that in deferred group[10 (6, 12)days vs.0 (0, 6)days, P<0.001]. Costs of antifungal agents were higher in early group than those in deferred group[0.78(0.51, 0.95)ten thousand yuan vs.0(0, 0.44)ten thousand yuan, P<0.001]. Infection-related hospitalization days were longer in early group than those in deferred group[16 (10, 21) days vs.9(6, 13)days, P<0.001]. Conclusion:For febrile neutropenic children with acute leukemia, clinical effect of early empirical antifungal strategy is not superior to that of deferred empirical antifungal strategy.Pediatricians should make reasonable antifungal decisions according to overall situation of patients.

Comprehensive Evaluation and Application of Experimental Sources of Variation in Gut Microbiome Sequencing Studies / 中国生物化学与分子生物学报

Gut microbiome sequencing studies have great potential to translate microbial analysis outcomes into human health research. Sequencing strategies of 16S amplicon and whole-metagenome shotgun (WMS) are two main methods in microbiome research with respective advantages. However, how sample heterogeneity, sequencers and library preparation protocols affect the sequencing reproducibility of gut microbiome needs further investigation. This study aims to provide a reference for the selection of sequencing technologies by comparing differences in microbial composition from different sampling sites. The results of three widely adopted sequencers showed that the technical repetition correlation (r= 0. 94) was high in WMS method, while the biological repetition correlation (r = 0. 69) was low. Bray-Curtis distance identified that dissimilarity from biological replicates was larger than that of technical replicates (P<0. 001). In addition, dissimilarity and specific taxonomic profiles were observed between 16S and WMS datasets. Our results imply that homogenization is a necessary step before sample DNA extraction. The sequencers contributed less to taxonomic variation than the library preparation protocols. We developed an empirical Bayes approach that " borrowed information" in calculations and analyzed batch effect parameters using standardized data and prior distributions of (non-) parameters, which may improve population comparability between 16S and WMS and provide a basis for further application to fusion analysis of published 16S and microbial datasets.