Current Scenario of Prevalence of Vitamin D Deficiency in Ostensibly Healthy Indian Population: A Hospital Based Retrospective Study

25-hydroxy vitamin D [25(OH) vit D] deficiency is a serious public health problem, particularly in the Indian sub-continent. The objective of the present study was to study the prevalence of 25(OH) vit D in different age groups. The data of 25(OH) vit D assay of 26,346 ostensibly healthy individuals, enrolled under executive health checkup at Medanta The Medicity, Gurgaon, over a period of 3 years, were extracted from the hospital information system and reviewed extensively. 25(OH) vit D deficiency (VDD) was defined as 25(OH) vit D < 20 ng/ml, insufficiency (VDI) as 25(OH) vit D between 20 and 40 ng/ml and 25(OH) vit D sufficiency (VDS) as 25(OH) D > 40 ng/mL. 25(OH) vit D deficiency (VDD + VDI) was observed in 93 % of the subject population. Maximum number of the subjects belonged to the age group of 41–60 years. 59 % had frank 25(OH) vit D deficiency when cut off level was <20 ng/mL. Mean value of 25(OH) vit D in our subjects was 21.4 ± 14.4 ng/mL. Significant difference in 25(OH) vit D level was observed in between male and female subjects. Simultaneously 25(OH) vit D levels were significantly lower in the patient visited hospital in winter-spring season than the summer-autumn season (p > 0.001). Our study demonstrates a high prevalence of 25(OH) vit D deficiency in an ostensibly healthy Indian population. There is a need for redefining our reference ranges according to our population and extensively improving the status of vitamin D.     

数据挖掘在E-Learning中的应用研究

当前,E-Learning发展极为迅速,一个重要的原因是应用了各种信息通信技术和大数据处理技术,使E-Learning更加便捷、高效和满足个性化的需求。文章阐述数据挖掘在E-learning中的应用,并指出这一研究领域所面临的挑战及对未来的研究进行展望。     

学习者知识建构中的e-Learning资源开发

数字环境中,e-Learning资源开发是e-Learning建设中的重要环节.文章从学习者知识建构中的知识需求和学习过程出发,分析了学习设计对数字信息资源的要求,并在当前数字信息资源开发的实际中制定了e-Leaming资源开发框架,并在此基础上制定了相应的开发策略.     

Errors in the Extra-Analytical Phases of Clinical Chemistry Laboratory Testing

The total testing process consists of various phases from the pre-preanalytical to the post-postanalytical phase, the so-called brain-to-brain loop. With improvements in analytical techniques and efficient quality control programmes, most laboratory errors now occur in the extra-analytical phases. There has been recent interest in these errors with numerous publications highlighting their effect on service delivery, patient care and cost. This interest has led to the formation of various working groups whose mission is to develop standardized quality indicators which can be used to measure the performance of service of these phases. This will eventually lead to the development of external quality assessment schemes to monitor these phases in agreement with ISO15189:2012 recommendations. This review focuses on potential errors in the extra-analytical phases of clinical chemistry laboratory testing, some of the studies performed to assess the severity and impact of these errors and processes that are in place to address these errors. The aim of this review is to highlight the importance of these errors for the requesting clinician.     

不确定环境下解读未来的方法:情景分析法

通过壳牌公司的案例,分别介绍了情景分析法的定义、产生背景和发展,以及情景分析法的基本理论、情景分析法的基本步骤。以澳门为例对情景分析法的实际操作进行了演示。     

Implementation of External Quality Assessment Scheme in Clinical Chemistry for District Laboratories in Bhutan

External Quality Assessment Scheme (EQAS) involves evaluation of a number of laboratories by an outside agency on the performance of a number of laboratories based on their analytical performance of tests on samples supplied by the external agency. In developing countries, establishment of national EQAS by preparing homemade quality control material is a useful scheme in terms of resources and time to monitor the laboratory performance. The objective of this study is to implement an EQAS to monitor the analytical performance of the district laboratories in Bhutan. Baseline information was collected through questionnaires. Lyophilized human serum including normal and abnormal levels were prepared and distributed to 19 participating laboratories. Nine routine analytes were included for the study. Their results were evaluated using Variance index scores (VIS) and Coefficient of variations (CV) was compared with Clinical Laboratory Improvement Act (CLIA) Proficiency Testing Criteria (PT) for each analyte. There was significant decrease in CV at the end of the study. The percentages of results in acceptable VIS as ‘A’ were 63, 60, 66, 69, 73 and 74, 75, 76 and 79 % in November 2009–July 2010 respectively. From our results, we concluded that, establishment of EQAS through distribution of home-made quality control material could be the useful scheme to monitor the laboratory performance in clinical chemistry in Bhutan.     

情景模拟在行政法实践教学中的应用

现代法学本科教育应当以培养掌握法律专业知识并具备法律专门技能的实践性人才为目标。鉴于行政法学具有理论性与应用性的统一、规范性与程序性的统一等特点,我们展开在行政法实践教学中引入情景模拟教学方法的尝试。在具体操作中,建构以＂学生为主体,教师为主导＂的教学模式,综合应用情景模拟等多元化教学方法,建立立体互动式的考核评估体系。     

危机情境中的决策信息流分析

动态变化的危机情境,使危机决策面临诸多不确定性,对决策信息流的认知与控制是有效决策的前提.本文在界定危机情境基础上,对危机决策信息流模型、特点和控制机制等问题进行了探讨.     

区域生态足迹情景预测——以吉林省为例

生态足迹模型偏重于生态可持续性的评估,缺乏针对社会经济发展动态性特征的预测功能。为探索生态足迹变化的驱动因子,建立了吉林省生态足迹时间序列,结果表明:居民消费水平的上升和能源消费的增加是该省生态足迹上升的主要原因。以居民消费水平和能源强度为策略变量,构建区域生态足迹预测模型;检验结果显示,该模型的拟合优度较好,相对误差均低于4.3%。最后,结合情景分析法,对吉林省生态足迹进行了预测,并分析了策略变量对生态足迹变化的影响。维持现行发展趋势,2010年吉林省生态足迹将增至2.99 hm2/人,年均增长率为4.35%;按照“十一五”规划发展,2010年该省生态足迹升至3.53 hm2/人,年均增长率为6.84%;情景三下,生态足迹增长最慢,2010年该省生态足迹达到2.98 hm2/人;情景四下,生态足迹增长最快,2010年该省生态足迹为3.55 hm2/人;居民消费水平对生态足迹变化的影响远大于能源强度的影响,降低能源强度对于缓解生态足迹增长的作用是有限的。     

Evaluation of Imprecision,Bias and Total Error of Clinical Chemistry Analysers

Context Two Biosystems analysers are used in our laboratory, a fully automated A25 and a semi-automated BTS-350. Internal quality control is done for both but external quality control only for A25. As BTS-350 is used for backup, it is important that the results of both analysers are not just comparable but also within predefined limits of systematic, random and total error (TE). Aim To evaluate the imprecision, bias and TE of the two Biosystem analysers. Materials and Methods Biosystems level-1 quality control sera lot number 70A was run in duplicate for 32 days on both the analysers. Between day imprecision (measured by the coefficient of variation), bias and TE were calculated for ten analytes and were checked to see whether they are within the acceptable minimum limits, desirable limits and optimum limits of allowable error based on specifications on Westgard’s website updated in 2014. Results On both the analysers, all the analytes except alkaline phosphatase were within the acceptable minimum limits of TE and most analytes were within the desirable limits of TE. Only TG on A25 was within the optimum limit of TE. Conclusion The two Biosystem analysers performed comparably with errors within acceptable limits for most analytes. BTS-350 was found to be a suitable and ready backup analyser for A25.     

优化中西医临床医学专业医用化学课程教学的探讨

医用化学是中西医临床医学专业的一门重要的基础课,做好该门课的教学工作,应围绕人才培养目标,以实用为原则,突出医学特色,从教学内容、教学方法、实验教学、评价体系四个方面进行优化,为培养优秀中西医临床医学专业人才奠定坚实的基础。     

动态战略规划的情景分析法及其给中国企业的思考

在介绍动态战略规划、情景分析法的概念及特征的基础上,讨论了情景分析法在企业战略规划中的作用、步骤及适用范围,并分析了中国企业所面临的高度不确定性情形和运用情景分析法的关键所在.     

Scenario模型在供应链合同管理中的应用

合同管理是供应链管理中新的研究领域。文章针对最近几年来国内外学者在这一领域的研究工作，总结了10种基本的供应链合同模型，为供应链合同管理研究提供研究方向。文章尝试性应用Scenario模型处理未来价格变化的不确定信息，结合供应链中时间柔性合同模型，分析在风险共享的供应链环境下时间柔性合同的决策方案。     

情景分析方法在突发事件应急决策中的应用

突发事件一旦出现,事前规划难以应对不断衍变的突发事件。依靠良好的分析工具可以帮助决策者把握时机,基于当前信息对危机趋势进行分析。本文通过对应急决策和情景分析方法的论述,从不确定性分析、动态分析和阶段性决策角度进行结合,设计一套基于情景分析的应急决策机制,从而为突发事件应急管理提供一种基于"情景——应对"模式的方法和思路。     

吉林省2020年CO2排放情景预测

使用中国吉林省1978～2009年人口、GDP和单位GDP能耗数据,采用BP神经网络模型分2种情景预测了吉林省2020年CO2排放量.结果表明,如果以吉林省2005年单位GDP的CO2排放为参照,2种情景下,吉林省2020年单位GDP的CO2排放分别降低55.17％和58.79％;如果以中国2005年平均水平为参照,吉林省2020年单位GDP的CO2排放分别降低35.40％和40.62％.     

Acute Renal Failure in Liver Transplant Patients: Indian Study

The acute renal failure is the frequent medical complication observed in liver transplant patients. The objective of this study was to determine the cause of acute renal failure in post liver transplant patients. A total of 70 patients who underwent (cadaveric 52, live 18) liver transplantation were categorized based on clinical presentation into two groups, namely hepatorenal failure (HRF, n = 29), and Hepatic failure (HF, n = 41). All the patients after the liver transplant had received tacrolimus, mycophenolate and steroids. We analyzed the modification of diet in renal disease, (MDRD) serum urea, creatinine and albumin before and after 5th and 30th day of liver transplant and data was categorized into survivors and non-survivors group. In HRF survivor group, serum creatinine, and urea levels were high and, albumin, MDRD were low in pre- transplant and reached to normal levels on 30th day of post transplant, and 79.3 % of patients in this group showed resumption of normal kidney function. On the contrary in HRF nonsurvivor group, we did not observed any significant difference and 20.7 % of patients showed irreversible changes after the liver transplant. In HF survivor group, 82.9 % of liver failure patients did not show any deviation in serum creatinine, urea, albumin and MDRD, whereas in HF non survivor group, 17.1 % of liver failure patients who had HCV positive before the transplant developed acute renal failure. The levels of creatinine, urea, albumin and MDRD were normal before the transplant and on day 30th, the levels of albumin and MDRD were significantly low whereas serum urea, creatinine levels were high. In conclusion, based on these observations, an diagnosis and treatment of Acute renal failure is important among the liver transplantation cases in the early postoperative period.     

Market structure and technology: Their interdependence in Indian industry

A survey of 37 Indian industries shows that their market structures are competitive; they range from oligopolistic industries to industries with a large number of firms. The number of firms has been increasing in almost all industries. The paper classifies the market structures into four classes based on the degree of concentration and the coefficient of variation of market shares. A large number of small firms emerge in industries with two characteristics: namely, where technology is easily transferred within the country, and where buyers are sensitive to price and insensitive to quality. Industries with the opposite characteristics tend to be oligopolistic. The paper proposes a classification of the technological behaviour of firms on the basis of whether a firm produces more innovations than it uses or less, and whether its stimulus to innovation is scientific or economic.