METHODS: Published literature on multicriteria decision analysis (MCDA) were studied and five sessions of expert group discussions were conducted to build the MAST framework and to review the evidence. The attributes identified and selected for analysis were efficacy (clinical efficacy, clinical endpoints), safety (drug interactions, serious side effects and documentation), drug applicability (drug strength/formulation, indications, dose frequency, side effects, food-drug interactions, and dose adjustments), and cost. The average weights assigned by the members for efficacy, safety, drug applicability and cost were 32.6%, 26.2%, 24.1%, and 17.1%, respectively. The utility values of the attributes were scored based on the published evidence or/and agreements during the group discussions. The attribute scores were added up to provide the total utility score.
RESULTS: Using the MAST, the six statins under review were successfully scored and ranked. Atorvastatin scored the highest total utility score (TUS) of 84.48, followed by simvastatin (83.11). Atorvastatin and simvastatin scored consistently high, even before drug costs were included. The low scores on the side effects for atorvastatin were compensated for by the higher scores on the clinical endpoints resulting in a higher TUS for atorvastatin. Fluvastatin recorded the lowest TUS.
CONCLUSION: The multiattribute scoring tool was successfully applied to organize decision variables in reviewing statins for the formulary. Based on the TUS, atorvastatin is recommended to remain in the formulary and be considered as first-line in the treatment of hypercholesterolemia.
AIM AND OBJECTIVES: The aim of this study was to evaluate the clinical significance of serum CD26 in patients with acute lymphoblastic leukaemia patients in the post remission induction phase, as well as the relationship between CD26 activity and the oxidative stress status.
MATERIALS AND METHODS: CD26, total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI), in addition to activity of related enzymes myeloperoxidase, glutathione- s-transferase and xanthine oxidase, were analysed in sixty children with acute lymphoblastic leukaemia in the post remission induction phase.
RESULTS: The study showed significant elevation in CD26, TOS and OSI levels in patients with acute lymphoblastic leukaemia in the post remission induction phase in comparison to healthy control samples. In contrast, myeloperoxidase, glutathione-s-transferase and xanthine oxidase activities were decreased significantly. A significant correlation between CD26 concentration and some oxidative stress parameters was evident in ALL patients.
CONCLUSIONS: Serum levels of CD26 appear to be useful as a new biomarker of oxidative stress in children with acute lymphoblastic leukaemia in the post remission induction phase, and levels of antioxidants must be regularly estimated during the treatment of children with ALL.
METHODS: Data were collected from 437 medical postgraduates in China, to investigate their challenge-hindrance stressors, emotional exhaustion, learning, relaxation and academic engagement. Among these postgraduates, 40.3% were male and 59.7% were female, with the mean age of the participants being 25.71 years. Statistical procedures were conducted using Mplus 8.3, ensuring a robust analysis of the data collected.
RESULTS: Our study showed that both challenge and hindrance stressors are significantly positively correlated with emotional exhaustion among Chinese medical postgraduates, and emotional exhaustion is negatively associated with academic engagement. Emotional exhaustion mediates the relationship between challenge-hindrance stressors and academic engagement. Learning plays a protective role, moderating the challenge stressors and emotional exhaustion relationship and its indirect effect on academic engagement. However, relaxation was not identified as a significant moderating factor in this context.
CONCLUSION: Our findings not only revealed emotional exhaustion as a potential mechanism underlying the relationship between challenge-hindrance stressors and academic engagement but also validated the moderating role of learning in mitigating the adverse effects of challenge stressors on emotional exhaustion and academic engagement among Chinese medical postgraduates. This comprehensive insight into the complex dynamics between different stressors and academic engagement provides both theoretical and empirical evidence for medical universities. It underscores the importance of interventions to enhance academic engagement in stressful environments and serves as a valuable reference for the development of reasonable assessment systems. These contributions are crucial for fostering a supportive educational atmosphere and promoting the well-being of medical postgraduates.