Functional testosterone: Biochemical assessment of hypogonadism in men – Report from a multidisciplinary workshop hosted by the Ontario Society of Clinical Chemists

Objectives. In 2004, the Ontario Society of Clinical Chemists (OSCC) held an invitational multidisciplinary workshop to establish the most reliable, cost-effective approach to the biochemical assessment of hypogonadism in men.

Methods. Specialists across Canada in clinical biochemistry, endocrinology, family medicine and urology were invited to participate in this workshop which included individual presentations and a consensus component addressing two challenge statements: 1) ‘Determinations for total testosterone (TT) are equivalent to those for bioavailable testosterone (BAT) or calculated BAT (cBAT) or free testosterone (FT) (by analogue radioimmunoassay or equilibrium dialysis) or calculated FT (cFT)’; 2) ‘There is no good evidence that borderline low testosterone concentrations in men should be treated’. The main outcomes were to identify what agreement exists in Canada, what issues were still controversial, and what research remains to be addressed.

Results. Six recommendations based on expert opinion addressed these main themes: investigate with morning total testosterone (TT) followed by repetition and reflexive testing of sex hormone binding globulin (SHBG) if testosterone is 8–15 nmol/L with automatic calculation of cBAT; discontinue the use of analogue free testosterone assays; and definitive methods and standards must be available to ensure standardized results.

Conclusions. Total testosterone is a reliable marker for the initial investigation of men presenting with symptoms of hypogonadism; cBAT is a reasonable follow-up test in patients with equivocal biochemical or consistent symptomatic findings.     

北宋文坛对“元和、长庆风格”之接受及其意义

“贞元、元和风格”亦可表述为“贞元、长庆风格”、“元和、长庆风格”或径称为“元和之风”,是宋代文坛极为流行的文学批评话语.它滥觞于五代,盛行于北宋前期,演变于北宋中叶.大宗淳化、至道间特指以元白为代表的翰苑文章,真宗景德、祥符间兼指馆阁翰苑的诗歌赋颂,仁宗庆历、嘉祐间则转为推重韩柳古文a这一话语集中体现了宋人对唐代文章...     

“事实”投射的句构与功能语义阐释

功能语言学理论的构建是以功能语义为出发点的,“事实”作为一种介于现象与元现象之间的语义抽象,对研究功能语义具有重要意义。本文对“事实”投射的各种句构类型进行梳理,重点聚集“事实”投射的功能语义。首先。区分了“事实”投射与其他投射类型的差异;然后,从及物性过程、言语功能和元功能三个方面描述“事实”的句构特征,并结合语法隐喻,阐释了“事实”投射的功能语义;最后,本文尝试构建一个归类清晰,语义明确的“事实”投射系统,以期对“事实”投射的句构和功能语义有一个更全面深入的认识。     

专业中介服务机构虚假陈述民事责任研究

为了更好地保护投资者的权益 ,遏制违法违规行为 ,加强证券市场的监管 ,有必要进一步完善专业中介服务机构虚假陈述民事责任制度。专业中介机构虚假陈述的民事责任应认定为侵权责任 ,其因果关系、归则原则以及损害赔偿数额的确定等都需要通过立法予以明确     

Properties of simultaneous confidence intervals for multinomial proportions

Inversion of Pearson's chi-square statistic yields a confidence ellipsoid that can be used for simultaneous inference concerning multinomial proportions. Because the ellipsoid is difficult to interpret, methods of simultaneous confidence interval construction have been proposed by Quesenberry and hurst,goodman,fitzpatrick and scott and sison and glaz . Based on simulation results, we discuss the performance of these methods in terms of empirical coverage probabilities and enclosed volume. None of the methods is uniformly better than all others, but the Goodman intervals control the empirical coverage probability with smaller volume than other methods when the sample size supports the large sample theory. If the expected cell counts are small and nearly equal across cells, we recommend the sison and glaz intervals.     

隐喻表达与经济性原则

人们为什么频繁地使用隐喻,这是认知科学关注的一个重要问题.人类行为的内在逻辑总是遵循"省力原则",这一原则在具体的语言实践中就表现为表达的经济性.隐喻表达可分为隐喻式命名和隐喻式陈述:隐喻式命名虽然花费了命名者更多的精力,但由于其形象、生动、易记的特点而减少了使用者的投入,从而实现了命名活动的经济性;隐喻式陈述借助预设、衍推等表达形式,可以使特定话语的信息量激增.隐喻式命名和隐喻式陈述均体现了思维和表达的经济性原则.     

合并会计报表理论问题探讨

合并会计报表理论问题一直是合并问题中探讨的热点。文中首先介绍了合并会计报表3种主要理论———所有权理论、主体理论、母公司理论,从各自的理论依据、报表的使用者、母公司编制报表的立场、对科目的处理方法、目前的使用情况进行了简单的说明;再从合并范围、报表需求者、国际发展趋势这些对合并会计报表理论选择的影响因素进行了分析,并提出了我国应该选择主体理论;最后对我国企业合并会计准则的制定提出了建议。     

热力学第二定律的表述和绝对熵的定义

给出了热力学第二律的一种新表述．并在此基础上．定义了封闭热力学系统的绝对熵；证明了在绝热过程中Δs≥0，在准静态过程中存在ds≥δQ／T定义了温度；给出了熵的物理意义；讨论了新表述与经典热力学的关系，得出了新表述与经典力学一样可靠的结论．     

财务报表的常见问题及对策研究

本文通过理论探讨与实例分析相结合的方式,对财务报表操纵的具体手段进行分析与探讨,并且根据财务报表操纵的动机与常见手段,提出审计企业时应采取的一些审计对策。     

International consensus definition of critical thinking in midwifery practice: A Delphi study

ProblemCurrently there is no discipline-specific definition of critical thinking in midwifery practice.BackgroundCritical thinking in midwifery practice is the cornerstone for safe, evidence based, and woman centred clinical decision-making. Available definitions of critical thinking in other disciplines do not align with midwifery practice which is distinctive, multidimensional and complex.AimTo develop an international consensus definition of critical thinking in midwifery practice.MethodsA two round Delphi study was used. Thirty-two international midwifery experts contributed to the first round which was qualitative in nature. Twenty one of these experts then ranked the relevance and clarity of concepts from round one.FindingsA consensus definition of critical thinking in midwifery practice was achieved. The expert panel identified and defined 14 ‘Habits of Mind’ and 12 Skills that are the core of critical thinking in midwifery practice. Skills included; analysis, constructive application and contextualisation of best available evidence, problem solving, discriminating, predicting, evaluation of care, collect and interpret clinical cues, collaboration/ negotiation, reflexivity, facilitates shared decision-making, communication, and transforming knowledge. Habits of Mind included; intellectual curiosity, reflective, holistic view, intellectual integrity, flexibility, questioning/challenging, participatory, open mindedness, listening with understanding and empathy, cultural humility, woman centred, being brave, confidence, and creativity.Discussion/conclusionThis study is an international first and delineates characteristics of critical thinking in midwifery. Development of a consensus definition provides a common and shared understanding of the skills and attributes required for critical thinking in midwifery practice and can also be applied in education and research.