Allocation Status Research Articles

Human Resource Allocation Status and Countermeasure Analysis of a National Children's Regional Medical Center

Objective: This study aims to conduct a longitudinal and cross-sectional comparative analysis of the human resource allocation at a national children's regional medical center in Chongqing. The goal is to optimize the human resource allocation at national regional pediatric hospitals and enhance overall hospital efficiency. Methods: Data was collected from the annual reports of the center, national children's medical centers, and national children's regional medical centers, as well as the "Health Statistics Yearbook" of the regions where these centers are located. The longitudinal analysis covers changes in absolute numbers, composition ratios, average annual growth, and annual growth rates of human resources at the center over the past ten years. The cross-sectional analysis compares human resource allocation and personnel structure differences between the center and other national children's medical centers, national children's regional medical centers, and pediatric hospitals in China. The workload differences of physicians between the center and pediatric hospitals in China were also compared. Results: Over the past ten years, the total amount of human resources at the center has shown an annual growth trend with reasonable overall allocation. However, there are still certain gaps in personnel structure and allocation compared to other national children's medical centers and national children's regional medical centers. The physician workload at the center is higher than that of pediatric hospitals in China. Conclusion: It is necessary to adjust the personnel structure reasonably, increase the training and introduction of high-level talents, accurately position the functions of the national children's regional medical center, and promote high-quality development of the national children's regional medical center.

Pediatric priority in kidney allocation after the age of 18 years

Children registered for kidney transplants prior to the age of 18 years retain “pediatric” allocation status after their 18th birthday. There are no data on the impact of this policy. We performed a retrospective cohort study of 7097 candidates listed for kidney transplant prior to 18 years of age who remained on the waitlist after their 18th birthday between January 1, 2015, and April 1, 2022, using United Network for Organ Sharing data. A total of 1193 candidates remained on the waitlist after their 18th birthday. The median age at listing was 17 years (IQR: 17-17 years). A total of 588 candidates (8% of 7097 pediatric candidates) received a kidney transplant with pediatric status at the age of 18 years or older; 465 (79%) were deceased-donor transplants. The median age at deceased-donor transplants was 18 years (IQR: 18-19 years); 97% were performed before the age of 21 years. In the 7.25 years of the study, 12 adults aged 21 years and older received a deceased-donor kidney transplant with pediatric allocation priority. Deceased-donor transplants with pediatric priority after the age of 18 years are rare, comprising an estimated 0.4% of all adult deceased-donor transplants. Candidates with pediatric priority after 18 years of age typically progress to transplant within 3 years. Ongoing monitoring of this population is important to fully understand the allocation policy.

Study on the Role of Public Sector Human Resource Management in Educational Management Reforms

Abstract The principles and methods of human resource management have been introduced into the field of education for some time, but the analysis of the current state of research, specifically on educational management, is still insufficient. The first part of this paper analyzes the measures that are related to human resource management in education management reform in each sector and further investigates the factor analysis method in the public sector human resource management system. By constructing the factor analysis model and factor calculation method, we can provide an algorithmic basis for studying the role of public sector human resource management in education management reform. The article utilizes the factor analysis method to conduct an empirical study by using the educational resources of different schools in 11 cities of Province A as test objects. According to the study, the first principal component has seven-factor loadings that are higher than 0.72, which indicates that all seven factors have a positive impact on the allocation efficiency of higher vocational education. The second principal component has four-factor loadings greater than 0.80, suggesting that all four factors have a positive effect on the allocation efficiency output of higher vocational education. From the sample data of the school education resource allocation status of each city, it can be obtained that the school education resource allocation status of city A is the most favorable, with the highest overall score of 43,153.1, followed by city B and city D, with 25,431.9 and 12,136.4, respectively. This indicates that the education resource allocation effect of these three cities is better and belongs to the upstream level in province Z.

Human resource allocation status and equity research of Centers for Disease Control and Prevention in China from 2016 to 2020.

In recent years, the development of global public health has become a matter of great concern and importance for governments worldwide. China, as the largest developing country, plays a crucial role in shaping the development of the public health and its ability to respond to sudden public health emergencies through the fairness of its human resource allocation in center for disease control and prevention (CDC). This study aims to analyze the situation of health human resource allocation in the China Centers for Disease Control and Prevention (China CDCs), assess the fairness of the allocation, and provide reference for the rational allocation of human resources. We selected data from the China Health Statistics Yearbook on healthcare technical personnel, other technical personnel, managerial personnel, and workforce technical personnel of China CDCs for the period of 2016-2020. We utilized the Health Resource Density Index to evaluate the level of human resource allocation in China CDCs. Additionally, we used the Gini coefficient and Theil index to assess the fairness of human resource allocation in China CDCs from both a population and geographical perspective. Firstly, the educational qualifications and professional titles of CDC staff have improved, but the workforce is aging. Secondly, HRDI development trends vary among different personnel types and regions with varying levels of economic development. Finally, the results of the Gini coefficient and Theil index indicate that population distribution fairness is better than geographical distribution fairness. Overall, the unfair population distribution is primarily due to regional disparities. The China CDCs should tailor different standards for the allocation of health human resources based on regional characteristics, aiming to enhance the accessibility of health human resources in various regions and achieve equitable allocation.

Blinding Induced Risk of Bias in Randomized Controlled Trials of Physiotherapy Interventions — A Retrospective Study

Introduction: In randomized clinical trials, the methodological idea of preventing bias by withholding knowledge of the allocation status is known as blinding. Blinding refers back to the concealment of group allocation from one or extra individuals concerned in scientific studies, most commonly a randomized controlled trial (RCT). Even though randomization minimizes variations among treatment groups on the outset of the trial, it does nothing to prevent differential treatment of the groups later within the trial or the differential assessment of outcomes, either of which may also bring about biased estimates of treatment outcomes. The most beneficial strategy to limit the chance of differential remedy or assessments of results is to blind as many individuals as viable in a trial. Objective: To study the extent of blinding induced bias in RCT of physiotherapy interventions and to evaluate the extent of interpretative consideration it the trials are not blinded in the sample of RCT included. Methodology : We conducted a retrospective analysis to estimate the blinding bias in the randomized controlled trials published in physiotherapy interventions from 2016 to 2022. Results & Conclusion : We included 50 RCTs for blinding assessment. About 88% of included articles were not having participants blinding 90% has not done therapist blinding and nearly 50% of studies were conducted without assessors blinding. Based on the results of this study blinding of important participants were infrequently reported in the included studies. Keywords: Blinding, Risk of bias, Physiotherapy, Randomized controlled trials

Preoperative dexamethasone administration in hepatectomy of 25-min intermittent Pringle’s maneuver for hepatocellular carcinoma: protocol for a randomized controlled trial

BackgroundOur previous randomized controlled trial (RCT) have demonstrated that intermittent Pringle’s maneuver (IPM) with a 25-min ischemic interval can be applied safely and efficiently in open or laparoscopic hepatectomy in patients with hepatocellular carcinoma (HCC) patients. But prolonging the hepatic inflow blocking time will inevitably aggravate the ischemia-reperfusion injury (IRI) caused by systemic response. This RCT aims to evaluate the effect of administration of dexamethasone versus placebo before clamping the hilar pedicle on postoperative liver function, inflammatory response, and perioperative outcomes among HCC patients undergoing liver resection with 25-min hepatic inflow occlusion.Methods and analysisThis will be a randomized, dual-arm, parallel-group, double-blinded trial. All eligible and consecutive patients are coming from a regional medical center who are diagnosed with HCC and underwent radical R0/R1 resection. All participates are randomly allocated in dexamethasone group or placebo group. All surgeons, anesthesiologists, and outcome assessors will be blinded to allocation status. Primary endpoints are transaminase-based postoperative hepatic injury on seven consecutive days after surgery and assessed by their peak values as well as area under the curve (AUC) of the postoperative course of aminotransferases. Secondary endpoints are postoperative total bilirubin (TBil), coagulation function, inflammatory cytokines and their respective peaks, intraoperative blood loss, postoperative hospital stay, morbidity, and mortality. The above parameters will be compared using the corresponding statistical approach. Subgroup analysis will be performed according to the liver cirrhosis and major hepatectomy.DiscussionBased on our previous study, we will explore further the effect of glucocorticoid administration on attenuating the surgical stress response in order to follow securely 25-min hepatic inflow occlusion. Therefore, the trial protocol is reasonable and the results of the trial may be clinically significant.Trial registrationThis trial was registered on 3 December 2022, in the Chinese Clinical Trial Registry (http://www.chictr.org.cn), ChiCTR2200066381. The protocol version is V1.0 (20221104).

Investigation and analysis of oral health resources allocation status in Yunnan Province

Objective: To investigate and analyze the allocation status of oral health resources in Yunnan Province at the end of the 13th Five-Year Plan, providing a scientific basis for the rational resource allocation and formulation regional oral health plan for government health administrative departments. Methods: With the method of general survey, a cross-sectional study was conducted to investigate the allocation of material and human resources of all kinds of stomatological medical institutions registered in the health administrative departments in Yunnan before January 1, 2020. The general situation of oral health resources was analyzed by descriptive statistical analysis. Results: There were 2 712 stomatological medical institutions in Yunnan, 634 public and 2 078 non-public included. The largest number was in Kunming (1 167) and the least in Diqing (19). There were 9 018 dental chairs in total, among which 2 584 in public and 6 434 in non-public. Kunming had the largest number of chairs (3 612) and Nujiang had the least (57). There were 702 oral and maxillofacial surgical beds, all of which were distributed in public. There were 15 148 stomatological personnel, including 3 667 in public and 11 481 in non-public. The average ratio of stomatologist to population was 1∶6 615. Dehong (1∶6 620) was close to this average level, while Kunming (1∶2 283) and Yuxi (1∶4 936) were lower than the average and the other 13 states (cities) were higher. The population ratio of licensed stomatologist was only 1∶9 110. The average ratio of stomatologist to nurses was 1∶0.94. Honghe (1∶1.05), Kunming (1∶1.00), Yuxi (1∶1.18) and Qujing (1∶0.94) was better than or reached the average level, while the other 13 states (cities) were lower than this average. And this ratio in public comprehensive medical institutions was only 1∶0.38. Conclusions: The distribution of oral health resources in Yunnan was unbalanced between public and non-public institutions and among states (cities), mainly distributed in economically developed states (cities) and non-public institutions. For the oral health in Yunnan Province, the workforce was insufficient and the structure was unreasonable, and the proportion of nurses was seriously insufficient in public comprehensive medical institutions.

Fixed-time adaptive tracking control of two moving targets for a class of non-linear multi-agent systems

In this research paper, the fixed-time adaptive tracking of two moving targets for a class of unknown non-linear multi-agent systems based on a distributed competition approach is studied. Each agent simultaneously participates in two competitions based on the k-Winner Take All (k-WTA) approach to obtain its allocation status. Using a mean value estimator, the agent can calculate its allocation status only by its neighbor's information. Since an agent can only track one target, an extended tracking error is introduced, where if the agent wins one of the competitions, it will track the assigned target, and if the agent wins both competitions, by selecting one of the targets, track the selected target. Also, the agent which is not win any competitions, return to a specified point. Then, using neural networks and adaptive techniques, an adaptive fixed-time controller is introduced for the agents to track the target based on the allocation status or to return to the specified point. Analysis of the stability of the closed-loop system through the Lyapunov theorem is investigated. Finally, a simulation study to show the efficiency of the theoretical results is presented.

Do tumor infiltrating lymphocytes (TILs) predict benefits from trastuzumab therapy for HER2 positive breast cancer? Meta-analysis of individual patient data from 4097 women in 5 trials.

508 Background: High TIL counts are associated with a lower risk of breast cancer recurrence, especially in women with ER negative, HER2 negative tumors and, possibly, greater benefit from trastuzumab in women with HER2 positive cancer: the FinHER trial reported a differential effect of trastuzumab based upon TIL status. We performed a meta-analysis of randomized trials of trastuzumab in early breast cancer to attempt to validate this finding. Methods: TILs were quantified in 4097 women in 5 randomized controlled trials (NSABP B-31, FinHER, HERA, Intergroup N9831, PACS-04). All trials contributed to the Early Breast Cancer Trialists' Collaborative Group individual patient data meta-analysis of trastuzumab for women with HER2 positive tumors which found a significant benefit for trastuzumab therapy. TILs were assessed using established International Guidelines, with HERA using digital TIL-scores. The primary outcome was time to first recurrence. Cox regression analyses, adjusted for trial, treatment allocation, and nodal status, were used to quantify the prognostic value of TILs; and standard stratified logrank tests were used to assess the differential effect of trastuzumab therapy. Results: The median percentage TILs was 13% (Interquartile Range 5-30), with fewer than 10% of patients exhibiting TILs >50%. The prognostic value of TILs was confirmed, with patients with higher TILs being at lower risk for recurrence (adjusted hazard ratio per 10% increase in TILs 0.87 (95% CI 0.84-0.90), p<.0001) with similar effects in both treatment groups. Outcomes improved steadily with increasing TILs, and unadjusted 10-year recurrence rates fell from 30% in women with TILs <10% to 15% in those with TILs 70% or greater. Consequently, analyses of the predictive effect of TILs were stratified into 5 groups (0-9, 10-19, 20-39, 40-59, 60+). Overall, there was a highly significant benefit of trastuzumab on recurrence (HR 0.62 (0.54-0.70) p<.0001), but there was no evidence of any interaction between TILs and the proportional reduction in recurrence (p=0.8 for heterogeneity and trend). Conclusions: While higher TILs are associated with lower recurrence rates, there was no indication that the proportional reduction in recurrence with trastuzumab varied by TILs, although the number of patients with high levels was limited. Owing to a lower underlying recurrence rate, absolute benefits from trastuzumab were lower, but still substantial, in women with high TIL tumors. Clinical trial information: NCT00045032 , ISRCTN76560285 , NCT00005970 , NCT00004067 , NCT00054587 . [Table: see text]

Blinding Induced Risk of Bias in Randomized Controlled Trials of Physiotherapy Interventions — A Retrospective Study

Introduction: In randomized clinical trials, the methodological idea of preventing bias by withholding knowledge of the allocation status is known as blinding. Blinding refers back to the concealment of group allocation from one or extra individuals concerned in scientific studies, most commonly a randomized controlled trial (RCT). Even though randomization minimizes variations among treatment groups on the outset of the trial, it does nothing to prevent differential treatment of the groups later within the trial or the differential assessment of outcomes, either of which may also bring about biased estimates of treatment outcomes. The most beneficial strategy to limit the chance of differential remedy or assessments of results is to blind as many individuals as viable in a trial. Objective: To study the extent of blinding induced bias in RCT of physiotherapy interventions and to evaluate the extent of interpretative consideration it the trials are not blinded in the sample of RCT included. Methodology : We conducted a retrospective analysis to estimate the blinding bias in the randomized controlled trials published in physiotherapy interventions from 2016 to 2022. Results & Conclusion : We included 50 RCTs for blinding assessment. About 88% of included articles were not having participants blinding 90% has not done therapist blinding and nearly 50% of studies were conducted without assessors blinding. Based on the results of this study blinding of important participants were infrequently reported in the included studies. Keywords: Blinding, Risk of bias, Physiotherapy, Randomized controlled trials

The impact of weather on time allocation to physical activity and sleep of child-parent dyads

PurposePrevious studies showed that unfavourable weather conditions discourage physical activity. However, it remains unclear whether unfavourable weather conditions have a differential impact on physical activity in children compared with adults. We aim to explore the differential impact of weather on time allocation to physical activity and sleep by children and their parents. MethodWe use nationally representative data with time use indicators objectively measured on multiple occasions for >1100 Australian pairs of 12–13-year-old children and their middle-aged parents, coupled with daily meteorological data. We employ an individual fixed effects regression model to estimate the causal impact of weather. ResultsWe find that unfavourable weather conditions, as measured by cold or hot temperatures or rain, cause children to reduce moderate- and vigorous-intensity physical activity time and increase sedentary time. However, such weather conditions have little impact on children's sleep time or the time allocation of their parents. We also find substantial differential weather impact, especially on children's time allocation, by weekdays/weekends and parental employment status, suggesting that these factors may contribute to explaining the differential weather impact that we observed. Our results additionally provide evidence of adaptation, as temperature appears to have a more pronounced impact on time allocation in colder months and colder regions. ConclusionOur finding of a negative impact of unfavourable weather conditions on the time allocated to physical activity by children indicates a need to design policies to encourage them to be more physically active on days with unfavourable weather conditions and hence improve child health and wellbeing. Evidence of a more pronounced and negative impact on the time allocated to physical activity by children than their parents suggests that extreme weather conditions, including those associated with climate change, could make children vulnerable to reduced physical activity.

Outcomes of heart transplant recipients bridged with percutaneous versus durable left ventricular assist devices.

The new United Network for Organ Sharing (UNOS) heart allocation policy prioritizes temporary percutaneous over durable left ventricular assist devices (LVAD) as bridge to transplant. We sought to examine 1-year outcomes of heart transplant recipients bridged with Impella versus durable LVADs. All primary adult orthotopic heart transplant recipients registered in UNOS between January 2016 and June 2021 were analyzed. Recipients were identified as being bridged with isolated durable or percutaneous LVAD at the time of transplant. Baseline characteristics were compared and 1-year survival was examined using the Kaplan Meier method and multivariable Cox proportional hazards regression. During our study period, heart transplant recipients bridged with LVADs were divided between 5422(94%) durable and 324(6%) percutaneous options. Impella-bridged recipients were more likely to be status 1A under the old allocation system (98% vs. 70%, p<.01) and status 2 or higher under the new allocation system (99% vs. 24%, p<.01). Impella-bridged recipients were less likely to be obese (27% vs. 42%, p<.01), have ischemic cardiomyopathy (27% vs. 34%, p<.01), and were more likely to be on inotropic agents at the time of transplant (68% vs. 6%, p<.01). One-year post-transplant survival was not significantly different between the two groups on univariable (HR .87, 95% CI .56-1.37) or multivariable analysis (aHR .63, 95% CI .37-1.07). Following the UNOS allocation policy change, Impella utilization has increased with no significant difference in 1-year survival compared to bridge with durable LVADs. Impella may be a reasonable alternative to durable LVADs in select patients.

The role of baseline insomnia in moderating the hypnotic properties of quetiapine

IntroductionThe primary aim of this study was to investigate the effect of quetiapine on insomnia and alcohol craving (craving) in subjects with co-occurring insomnia and AUD. MethodsInsomnia was assessed with the Insomnia Severity Index (ISI) and craving with the Penn Alcohol Craving Scale (PACS, primary) and Obsessive-Compulsive Drinking Scale (OCDS, secondary). A multivariable model adjusted for covariates (N = 123) evaluated the relationship between craving (PACS and OCDS total scores) and insomnia (ISI total score). To simultaneously assess the effects of treatment arm allocation and insomnia status, subjects (N = 115) were stratified into 4 groups, quetiapine-insomnia(N = 38), quetiapine-No insomnia(N = 19), placebo-insomnia(N = 38), and placebo-No insomnia(N = 20). Linear mixed-effects regression models adjusted for covariates compared the trajectories of ISI, PACS, and OCDS total scores across 12 weeks of treatment and at post-treatment follow-up at week 24, between the four groups. ResultsThe ISI total score was positively associated with the PACS (p = 0.006) and OCDS (p = 0.001) total scores in the multivariable models. In the longitudinal analysis, when compared to the three other groups, subjects with insomnia treated with quetiapine showed a marked reduction in their insomnia scores with a return of insomnia after stopping treatment. There was no significant difference between the groups for the PACS and OCDS total score trajectories. DiscussionAlthough craving is associated with insomnia, treatment with quetiapine may improve insomnia but not craving in patients with co-occurring AUD and insomnia.

Analysis on the Allocation Status and Fairness of TCM Resources in Guizhou Province

<i>Background: </i>TCM plays an important role in ensuring people's health and developing TCM undertakings. However, some studies have shown that the current allocation of TCM and health resources in China is relatively poor, and there are few regional research literature. <i>Objective</i>: To analyze the status and fairness of TCM (Traditional Chinese medicine) resources in Guizhou Province and provide evidence-based basis for health administrative departments. <i>Methods</i>: The status of TCM resources in Guizhou and the fairness of Lorentz curve, gini coefficient and health density index. <i>Results</i>: From 2010 to 2019, The TCM and health resources in Guizhou province have increased year by year, The average annual growth rate of TCM doctors per 1,000 people and their ownership per 100 square kilometer was 13.88% and 14.43%, respectively; Regarding the Gini coefficient, By population distribution is mainly located at 0.2-0.4, By area, the distribution is mostly below 0.3, The Gini coefficient of the economic distribution showed an overall downward trend, In 2019, Chinese pharmacists had the lowest economic distribution (0.093), The highest distribution by population distribution of practicing (assistant) physicians in 2015 (0.523); In terms of density-based exponential growth, In 2019, The highest bed density in Guizhou Province (0.3506), The lowest density of mechanism number (0.0016). <i>Conclusion</i>: The resources grow overall, but the total amount is relatively small; the region is unbalanced; the fairness by economic allocation is better than allocation by population than allocation by area. Therefore, the health administrative departments perform their functions, optimize the resource structure, strengthen the layout of TCM industry, give full play to the local characteristics, and stimulate the potential of TCM and health services.

Nonlinear fault-accommodation thrust allocation for over-activated vessels using artificial neural network and multivariate analysis

This study seeks to develop a better understanding of the thrust allocation process of over-actuated marine vessels. A two-stage analysis framework is proposed for thrust allocation when thrusters experience faults. In Stage-I, sequential quadratic programming with a multi-start mechanism (SQP-MultiStart) is used to find the optimal solution to the nonlinear fault-accommodation thrust allocation problem. According to the solution feasibility, another two different optimization models are considered in Stage-II. A newly developed meta-heuristic optimization approach, neural network algorithm (NNA), and SQP-MultiStart method are employed to find optimal solutions. Histories of decision variables and thrust allocation status are obtained. Self-organization mapping (SOM) and principal component analysis (PCA) are utilized to mine the hidden information in the thrust allocation. A deepwater pipe-laying crane vessel with 7 azimuth thrusters is selected to illustrate the analysis procedure. The features of thrust allocation are investigated and the effectiveness of the proposed framework is verified. Simulation results extend the understanding of the thrust allocation process and assist in choosing the thrust allocation model in different cases. The framework is suitable for fault-free and faulty cases. Neural network technique and multivariate analysis help to mine the knowledge about the thrust allocation performances.

Impacts of the hearing aid intervention on healthcare utilization and costs among middle-aged and older adults: results from a randomized controlled trial in rural China

Hearing impairment has become a major global health issue. To reduce the burden of hearing impairment, we explored impacts of the hearing aid intervention on healthcare utilization and costs. In this randomized controlled trial, participants aged 45+ were allocated with a ratio of 1:1.5 (intervention: control). Neither the investigators nor the assessors were blinded to the allocation status. Those in the intervention group were fitted with hearing aids, and those in the control group received no care. We applied the difference-in-difference (DID) approach to examine the impacts on healthcare utilization and costs. Given that social network and age can be significant variables affecting effectiveness of the intervention, subgroup analyses by social network and age were used to explore the heterogeneity. 395 subjects were successfully recruited and randomized. 10 subjects did not meet the inclusion criteria and therefore, 385 eligible subjects (150 in the treatment group and 235 in the control group) were analyzed. The intervention significantly reduced their total healthcare costs (average treatment effect (ATE)=-1.26, 95% CI=-2.39, -0.14, p=0.028) and total out-of-pocket (OOP) healthcare costs (ATE=-1.29, 95% CI=-2.37, -0.20, p=0.021) in the 20-month follow-up. To be exact, it reduced self-medication costs (ATE=-0.82, 95% CI=-1.49, -0.15, p=0.016) and OOP self-medication costs (ATE=-0.84, 95% CI=-1.46, -0.21, p=0.009). Subgroup analysis showed that the impacts on self-medication costs and OOP self-medication costs varied by social network (ATE for self-medication costs=-0.26, 95% CI=-0.50, -0.01, p=0.041; ATE for OOP self-medication costs=-0.27, 95% CI=-0.52, -0.01, p=0.038). The impacts also varied by age groups (ATE for self-medication costs=-0.22, 95% CI=-0.40, -0.04, p=0.019; ATE for OOP self-medication costs=-0.17, 95% CI=-0.29, -0.04, p=0.010). There were no adverse events or side effects during the trial. Hearing aid use significantly lowered self-medication costs and total healthcare costs, but had no impacts on inpatient or outpatient services utilization or costs. The impacts were manifested among people with active social network or younger age. It can be speculated that the intervention may be adapted to other similar settings in developing countries to reduce healthcare costs. P.H. reports grants from National Natural Science Foundation of China (No. 71874005) and Major Project of the National Social Science Fund of China (No. 21&ZD187). Chinese Clinical Trial Registry: ChiCTR1900024739.

Comprehensive Analysis Of Clinical Trials In Pakistan From September 1992 To February 2019.

Clinical trials are conducted to evaluate interventions (drugs, medical devices, surgical methods and radiation treatment) for treating diseases or conditions. They may also be done to prevent the development or prevent recurrence or determining risk factors. We wanted to review the current status of clinical trials in Pakistan. On searching ClinicalTrials.gov, registered clinical trials conducted in Pakistan from September 1992 to February 2019 were reviewed. The analysis evaluated the characteristics of the clinical studies including the type of intervention, geographic distribution of studies, anticipated enrolment and number of participants, blinding, allocation status, lead sponsors, age group, study type, recruitment status, gender, study results, study phase, primary purpose and subject distribution. The results were tabulated with frequencies and percentages provided by category. There were 508 registered clinical trials conducted in Pakistan from September 1992 to February 2019. Interventional clinical trials were conducted more often than observational trials (77.2% and 22.8% respectively), with drugs (41.4%) as the most common intervention. The majority of registered trials had participants ranging between 101-1000 (47.2%) with most having no blinding in their methodology (34.1%). Most of the trials conducted were randomized (66.5%) while few (5.3%) were non-randomized. Among the sponsor categories, 66.5% of the trials belong to the 'Other' (non-governmental, non-industry) category. Although 59.6% of the registered trials have been completed, most of them (91.3%) did not report their results. Treatment intervention trials in Internal Medicine were the most common primary purpose. An increasing trend in the frequency of clinical trials was also evident. The number of clinical trials in Pakistan showed an increasing trend over the time period studied, which may reflect on the general outlook of clinical research in the country. Most clinical trials were sponsored by universities, hospitals and non-profit organizations but less than 10% of studies reported results.

Soil Inoculation With Beneficial Microbes Buffers Negative Drought Effects on Biomass, Nutrients, and Water Relations of Common Myrtle.

Common myrtle (Myrtus communis L.) occurs in (semi-)arid areas of the Palearctic region where climate change, over-exploitation, and habitat destruction imperil its existence. The evergreen shrub is of great economic and ecological importance due to its pharmaceutical value, ornamental use, and its role in urban greening and habitat restoration initiatives. Under greenhouse conditions, we investigated the effect of soil inoculation with arbuscular mycorrhizal fungi (AMF) and plant growth-promoting rhizobacteria (PGPR) on biomass allocation, water relations, and nutritional status of drought-stressed myrtle seedlings. Single and dual AMF (Funneliformis mosseae and Rhizophagus irregularis) and PGPR (Pseudomonas fluorescens and P. putida) soil inoculations were applied to myrtle seedlings growing under different soil water regimes (100, 60, and 30% of field capacity) for 6 months using a full factorial, completely randomized design. AMF and PGPR treatments, especially dual inoculations, alleviated negative drought effects on biomass and morpho-physiological traits, except for water-use efficiency, which peaked under severe drought conditions. Under the greatest soil water deficit, dual inoculations promoted leaf biomass (104%–108%), root biomass (56%–73%), mesophyll conductance (58%), and relative water content (1.4-fold) compared to non-inoculated controls. Particularly, dual AMF and PGPR inoculations stimulated nutrient dynamics in roots (N: 138%–151%, P: 176%–181%, K: 112%–114%, Ca: 124%–136%, and Mg: 130%–140%) and leaves (N: 101%–107%, P: 143%–149%, K: 83%–84%, Ca: 98%–107%, and Mg: 102%–106%). Our findings highlight soil inoculations with beneficial microbes as a cost-effective way to produce highly drought resistant seedling stock which is vital for restoring natural myrtle habitats and for future-proofing myrtle crop systems.

Characteristics of clinical trials associated with early results reporting at ClinicalTrials.gov

Objective: We aimed to investigate the trial characteristics associated with earlier results reporting on ClinicalTrials.gov.Study Design and Setting: We sampled interventional trials registered with ClinicalTrials.gov and examined the time from trial completion to results reporting on ClinicalTrials.gov as the event of interest. A Cox proportional hazards model was used to examine associations between the time to results reporting on ClinicalTrials.gov with funding type, intervention type, number of enrolled participants, trial phase, trial allocation status, and the year of trial completion. The model accounts for multiple risk factors simultaneously.Results: Among 102,404 completed trials, the median follow-up for the result reporting event was 18.5 months (IQR 12.7–33.6), during which time 25% (26,608 of 102,404) had results available on ClinicalTrials.gov. Compared to industry funded trials (18.1 months), non-industry trials (median 18.8 months) had results reported slower (HR 0.35, 95% CI 0.34–0.36); compared to drug trials (18.4 months) non-drug trials (19.0 months) were reported slower (HR 0.61, 95% CI 0.59–0.64); compared to trials with more than 50 participants (18.0 months), smaller trials (19.3 months) were reported slower (HR 0.97, 95% CI 0.94–0.99).Conclusion: Non-industry, non-drug, and earlier phase trials reported results on ClinicalTrials.gov more slowly if at all. Much of the efforts aimed at improving trial reporting through structured reporting on ClinicalTrials.gov have been focused on industry funded drug trials, but these results suggest that incentives and tools targeting non-industry and non-drug trials are also needed.

Does Environmental Regulation Help Mitigate Factor Misallocation?-Theoretical Simulations Based on a Dynamic General Equilibrium Model and the Perspective of TFP.

How environmental regulation affects factor allocation is becoming an emerging hot topic in academia. In this paper, we construct a dynamic general equilibrium model accommodating environmental regulatory shock based on the H-K framework to explain the impact of environmental regulation on factor misallocation from the perspective of aggregate total factor productivity loss changes, and numerical simulation results are provided for several representative scenarios. The results show that environmental regulation has a significant effect on factor market misallocation, but this effect is not simply positive or negative, and it mainly depends on the firms’ initial factor allocation status and the intensity of the shock. Reducing the intensity of environmental regulation for firms that face stronger distortion helps mitigate factor misallocation and, on the contrary, the same policy could exacerbate factor market misallocation. Under the environmental regulatory shock condition, firms’ overhead labor input has a moderating effect on the factor allocation mitigation of environmental regulation. Distorted firms’ higher overhead labor share inhibits the correction of factor misallocation by environmental regulation. And reducing firms’ overhead labor share amplifies the correcting effect of environmental regulation on factor misallocation.