诊疗最优化原则的伦理学探析

讨论了诊疗最优化原则的伦理学意义:它充分体现了医学的宗旨、医学职业道德理想和对患者的无私关爱,有利于纠正医疗卫生行业的时弊,昭示着医疗卫生改革发展的方向.针对实践中遇到的阻力和困惑,作者提出了促进最优化原则实施的五点建议.     

适宜技术与诊疗最优化的可行性研究

在案例分析的基础上,作出了医生是临床诊疗中适宜技术的主要选择者的判断;论证了运用适宜技术实现诊疗最优化的可行性;认为适宜技术难以选择和实施的主要原因是利益关系、责任心不强和管理措施不到位;提出了必须着力培育适合于适宜技术生长的土壤的对策,即:实行政策引导与资金支持、进一步加大监管力度、营造良好的氛围、高度重视并加强医生道德素质的培养.     

食管癌内镜技术最优化原则的思考

随着消化内镜及其配件的不断更新和内镜医师操作技术的进步,消化内镜在食管癌的应用从诊断为主发展到诊断与治疗并重.回顾历史,医疗需求是医学科学进步的强大动力,科学技术进步推动医学的发展,内镜技术的发展促进了食管癌诊断与治疗水平的最优化.     

限制性饮食者对食物线索的认知偏向：行为和脑机制的证据

限制饮食是为了控制体重, 长期严格地控制进食的倾向。大量研究表明相对于非限制性饮食者, 限制性饮食者对食物线索尤其是高能量或高美味食物线索存在认知偏向。这种偏向是基于一定的脑神经基础的如前额叶背内侧, 小脑等区域。未来研究应设置严格的筛选标准, 运用视觉odd-one-out和学习-再认实验范式, 重视认知神经机制的探讨, 开展中国限制性饮食者对食物线索加工的认知机制和主要影响因素模型的系统研究。     

Optimal Partitioning of Testing Time: Theoretical Properties and Practical Implications

This paper deals with optimal partitioning of limited testing time in order to achieve maximum total test score. Nonlinear optimization theory was used to analyze this problem. A general case using a generic item response model is first presented. A special case that applies a response time model proposed by Wang and Hanson (2005) is also presented. Theoretical properties of the optimal solution are derived. Their practical implications to optimal test-taking strategies are also discussed. The theoretical properties are in general agreement with the conventional advice to the examinees on pacing strategy.     

下腰痛综合征的诊治与人文思想

下腰痛是一种常见的骨科病症,轻者可影响患者生活,重者可使患者丧失劳动力。它的发病原因有很多,治疗方法各有不同。在下腰痛的诊断中要按照适度医疗的原则选择合适的检查;在下腰痛的治疗中须按照最优化医疗的原则选择最佳的治疗方案。在治疗中要注意结合人文思想来提高下腰痛的治疗效果。     

基于性能反馈的PSO算法速度上限调整策略

速度上限是影响微粒群算法性能的一个主要参数。针对现有调节策略存在参数统一设置、与微粒性能无关等缺点,本文提出一种基于性能反馈的调整策略,使得速度上限能随着个体性能的改变而动态调整,从而更加真实有效的模拟了鸟类觅食的群体行为特征。仿真结果表明该算法能较好地提高微粒群算法的计算效率。     

The Problem of local optimality with OSMOD

The possibility of obtaining locally optimal solutions with categorical data is pointed out for the original version of OSMOD development by Saito and Otsu. A revision of the initialization strategy in OSMOD is suggested, and its effectiveness in diminishing this possibility is demonstrated.     

Information on response requirements compared with information on food density as a reinforcer of observing in pigeons

On a variable-interval schedule, pecking the key to the pigeon's right (observing response) produced red or green displays relating to the delivery of grain and its dependence on pecking the key to the left (food key). During various blocks of sessions, mixed (no stimulus change) schedules including the following pairs of components were temporarily converted by the observing response to their corresponding multiple (correlated stimuli) schedules: variable-interval 60-s, extinction; variable-interval 60-s, variable-time (response-independent) 60-s; extinction, variable-time 60-s. Differences in food delivery maintained substantial rates of responding on the observing key, without regard to pecking requirements on the food key. Although stimuli correlated with differences in the response requirement on the food key maintained higher observing rates than those maintained by uncorrelated stimuli, they were much lower than those based on food. The value of predictive stimuli as reinforcers is determined by the value of the events predicted. In particular, the cost of pecking appears to be low, and this may place limitations on the applicability of energy-based and economic models of behavior.     

Latent class models for nonmonotone dichotomous items

Starting from perfectly discriminating nonmonotone dichotomous items, a class of probabilistic models with or without response errors and with or without intrinsically unscalable respondents is described. All these models can be understood as simply restricted latent class analysis. Thus, the estimation and identifiability of the parameters (class sizes and item latent probabilities) as well as the chi-squared goodness-of-fit tests (Pearson and likelihood-ratio) are free of the problems. The applicability of the proposed variants of latent class models is demonstrated on real attitudinal data.This research was supported by the Kulturamt der Stadt Wien, Magistratsabteilung 7.The author wishes to thank the editor, Ivo W. Molenaar, as well as Clifford C. Clogg and the anonymous reviewers for their valuable comments on the earlier drafts of this paper.