Bayes shrinkage estimator for consistency assessment of treatment effects in multi-regional clinical trials

The primary objective of a multi-regional clinical trial is to investigate the overall efficacy of the drug across regions and evaluate the possibility of applying the overall trial result to some specific region. A challenge arises when there is not enough regional sample size. We focus on the problem of evaluating applicability of a drug to a specific region of interest under the criterion of preserving a certain proportion of the overall treatment effect in the region. We propose a variant of James-Stein shrinkage estimator in the empirical Bayes context for the region-specific treatment effect. The estimator has the features of accommodating the between-region variation and finiteness correction of bias. We also propose a truncated version of the proposed shrinkage estimator to further protect risk in the presence of extreme value of regional treatment effect. Based on the proposed estimator, we provide the consistency assessment criterion and sample size calculation for the region of interest. Simulations are conducted to demonstrate the performance of the proposed estimators in comparison with some existing methods. A hypothetical example is presented to illustrate the application of the proposed method.     

词语的交集现象和汉字的词式书写——兼论汉字词式书写的发展前景

汉语中的词语交集现象容易造成误读,影响阅读速度。汉字的词式书写能够有效地解决词语交集现象所造成的误读。词式书写能够分化部分歧义句式,有利于提高阅读速度,有利于中文信息处理,能适应现代信息社会发展的需要,因此,有着广阔的发展前景。     

信息技术与集团资金管理

随着科学技术尤其是信息技术的飞速发展,信息技术给企业生产、管理活动的方式带来了根本性的变革。信息技术对企业管理提出了重大的挑战,促使其考虑如何利用信息技术改进企业管理模式,适应信息社会,在日益激烈的竞争中保持不败的地位。本文将讨论如何利用信息技术改进集团资金管理,实现企业管理信息化的第一步。     

壮族的民间信仰与民俗医疗

壮族的传统医药文化非常丰富,民间至今依然盛行与宗教信仰密切相关的“神药两解”的民俗医疗方法。笔者在田野调查中发现,壮族乡村的病人在积极寻求药物治疗的同时,还借助麽公、囊妹、道士等神职人员施行各种仪式来治病,且往往能取得意想不到的效果。本文拟从田野资料出发,借鉴医学人类学的相关理论,以目前壮族农村盛行的巫术与祝由疗法为例,来探讨壮族的民间信仰与民俗医疗的关系。     

先秦至魏普时期民俗中的桃

先秦至魏晋是桃文化的滥觞和形成期。古人对灵魂不死的信仰以及在生活中对桃的崇拜,奠定了桃为仙品的文化内涵的基础。而汉、魏、晋出现的大量的有关桃的神话、仙话小说推动了这一内涵的发展,而此时兴起并不断发展的道教更是强化了这一民俗信仰,使桃成为民俗生活中的仙桃。     

对一个撒拉族移民乡村的民族学调查

世居于青海省循化县的少部分撒拉族从20世纪30年代开始陆续迁居该省乌兰县希里沟地区,逐步形成柴达木盆地第一个撒拉族移民村落。文章在民族学田野工作的基础上,反映了该村人口迁移、婚姻家庭、教育、宗教及经济文化类型的变化等基本情况。     

Inference in Targeted Group‐Sequential Covariate‐Adjusted Randomized Clinical Trials

This article is devoted to the construction and asymptotic study of adaptive, group‐sequential, covariate‐adjusted randomized clinical trials analysed through the prism of the semiparametric methodology of targeted maximum likelihood estimation. We show how to build, as the data accrue group‐sequentially, a sampling design that targets a user‐supplied optimal covariate‐adjusted design. We also show how to carry out sound statistical inference based on such an adaptive sampling scheme (therefore extending some results known in the independent and identically distributed setting only so far), and how group‐sequential testing applies on top of it. The procedure is robust (i.e. consistent even if the working model is mis‐specified). A simulation study confirms the theoretical results and validates the conjecture that the procedure may also be efficient.     

血栓弹力图在PCI术后患者抗血小板治疗中的应用研究

目的:研究血栓弹力图在经皮冠状动脉介入治疗(PCI)患者中,使用血栓弹力图所测定的血小板抑制率的波动及临床疗效作用。方法:选取我院2012年1月份至2013年12月份收治的200例冠心病PCI治疗患者,应用血栓弹力图分析仪测定其二磷酸腺苷(ADP)途径诱导的血小板抑制率数据,根据抑制率差异分为3组,抑制率70%的为合格组,抑制率30%的为不合格组,入选不合格组再次分为2组,1组保持常规剂量治疗不变,另一组为大剂量治疗组。结果:随访半年的记录,记录一般情况及严重心脏不良事件发生情况。结果:随访的6个月中,共发生不良事件28例,其中合格组10例(9.6%),常规治疗组11例(22.4%),大剂量治疗组7例(14.9%),3组中不良事件发生率比常规治疗组大于大剂量治疗组,大剂量治疗组大于合格组,统计学上有明显差异(P0.05)。结论:血栓弹力图在PCI患者抗血小板治疗中应用具有一定的指导意义。     

Confidence Corridors for Multivariate Generalized Quantile Regression

We focus on the construction of confidence corridors for multivariate nonparametric generalized quantile regression functions. This construction is based on asymptotic results for the maximal deviation between a suitable nonparametric estimator and the true function of interest, which follow after a series of approximation steps including a Bahadur representation, a new strong approximation theorem, and exponential tail inequalities for Gaussian random fields. As a byproduct we also obtain multivariate confidence corridors for the regression function in the classical mean regression. To deal with the problem of slowly decreasing error in coverage probability of the asymptotic confidence corridors, which results in meager coverage for small sample sizes, a simple bootstrap procedure is designed based on the leading term of the Bahadur representation. The finite-sample properties of both procedures are investigated by means of a simulation study and it is demonstrated that the bootstrap procedure considerably outperforms the asymptotic bands in terms of coverage accuracy. Finally, the bootstrap confidence corridors are used to study the efficacy of the National Supported Work Demonstration, which is a randomized employment enhancement program launched in the 1970s. This article has supplementary materials online.     

Care without coercion – mental health rights,personal recovery and trauma‐informed care

Australian mental health services continue to use involuntary measures in response to consumers' mental distress. Regardless of the intent behind these practices, the experience of being forced to receive treatment, be secluded or restrained is traumatic and can cause further distress and harm. Other parts of the health or social service system have shifted to approaches that emphasise agency, social context, prevention, and rights. Three frameworks currently used in mental health services – human rights, personal recovery, and trauma‐informed – are consistent with a shift away from the use of force. We applied these frameworks to the text of the National Standards for Mental Health Services 2010 to analyse the degree to which it reflects a shift. We also analysed the public text of speakers' notes from the Care Without Coercion Conference 2012 concerning lived experiences of force in mental health services. The analysis highlights force in many aspects of policy. The findings have implications for directions of change, including freedom from violence; support for decision making; access and choice about community and inpatient options; safety and risk management; and greater understanding of current policy frameworks through engagement with people with lived experience about the options and impact of support processes that exclude the use of force.