BACKGROUND Steroids remain the primary treatment for severe alcohol-associated hepatitis(AAH),though there is little available tools to predict patient response to steroids.It was hypothesized that phosphatidylethanol...BACKGROUND Steroids remain the primary treatment for severe alcohol-associated hepatitis(AAH),though there is little available tools to predict patient response to steroids.It was hypothesized that phosphatidylethanol(PEth)value will inversely corre-late with response to steroid therapy based on Lille score in AAH.AIM To assess the relationship of patient factors,focusing on pre-steroid therapy PEth value,to steroid therapy response in AAH.METHODS A retrospective case control study was performed on patients who received≥4 days of steroid therapy for AAH at our hospital between July 1,2019 and June 30,2022.A total of 2087 patients were screened for AAH and those treated with steroids were included for statistical analysis utilizing independent sample t-test and for categorical variables using the χ^(2) test.RESULTS No correlation was found between PEth value,pre-steroids abstinence length,or number of drinks per week pre-steroids and response to steroids.Non-responder status significantly correlated with older age(P=0.024),lower albumin(P=0.003),and higher bilirubin(P=0.010)pre-steroids.Our study suggests that age,pre-steroid albumin,and pre-steroid bilirubin levels may predict nonresponse to steroid therapy.Non-responders have increased incidence of death and higher medical costs.CONCLUSION Identifying non-responders through these identified factors should prompt early referral for liver transplantation.Future prospective studies with larger population size are needed to assess the efficacy of combined pre-steroid age,albumin,bilirubin and other biochemical markers as predictors of steroid response.展开更多
The Federal Highway Administration (FHWA) sponsored a large,multi-year project conducted by the Multidisciplinary Center for Earthquake Engineering Research (MCEER) titled'Seismic Vulnerability of New Highway Cons...The Federal Highway Administration (FHWA) sponsored a large,multi-year project conducted by the Multidisciplinary Center for Earthquake Engineering Research (MCEER) titled'Seismic Vulnerability of New Highway Construction'(MCEER Project 112),which was completed in 1998.MCEER coordinated the work of many researchers,who performed studies on the seismic design and vulnerability analysis of highway bridges,tunnels,and retaining structures. Extensive research was conducted to provide revisions and improvements to current design and detailing approaches and national design specifications for highway bridges.The program included both analytical and experimental studies,and addressed seismic hazard exposure and ground motion input for the U.S.highway system;foundation design and soil behavior: structural importance,analysis,and response:structural design issues and details;and structural design criteria.展开更多
Major chemical properties of tea-growing soils are of paramount importance for better management in a sustainable fashion.Therefore,this study was carried out to understand the major soil chemical properties of major ...Major chemical properties of tea-growing soils are of paramount importance for better management in a sustainable fashion.Therefore,this study was carried out to understand the major soil chemical properties of major tea(Camellia sinensis L.)-growing areas,Dibrugarh and Tinsukia districts,in the state of Assam,India.A total of 991 surface soil samples were collected from 15 large tea estates(TEs) for analysis of their major chemical properties.Soil pH ranged from 3.61 to 6.81.Total organic carbon and total nitrogen ranged from 2.4 to 47.3 and 0.24 to 3.60 g kg^(-1),respectively.All soils were sufficiently rich in plant-available potassium(as K_2O),which ranged from 127.71 to 252.33 mg kg^(-1),exceeding the amount prescribed for optimum tea yield of > 100 mg kg^(-1).Plant-available sulfur among soil samples widely varied from 4 to 129 mg kg^(-1).Results of hierarchical clustering analysis for homogenous grouping of the 15 TEs based on soil chemical properties showed that the 15 TEs could be classified into three distinct groups which consisted of6,8 and 1 TEs,respectively.Based on the Kolmogorov-Smirnov(K-S) test,the best fitted theoretical probability distributions were found out for different soil chemical properties.It could be concluded that a balanced fertilizer application would be needed as a part of tea improvement program using soil chemical test.展开更多
Austenitic stainless steel(ASS) and High nickel steel(HNS) welding consumables are being used for welding Q&T steels, as they have higher solubility for hydrogen in austenitic phase, to avoid hydrogen induced crac...Austenitic stainless steel(ASS) and High nickel steel(HNS) welding consumables are being used for welding Q&T steels, as they have higher solubility for hydrogen in austenitic phase, to avoid hydrogen induced cracking(HIC) but they are very expensive. In recent years, the developments of low hydrogen ferritic steel(LHF) consumables that contain no hygroscopic compounds are utilized for welding Q&T steels. Heat affected zone(HAZ) softening is another critical issue during welding of armour grade Q&T steels and it depends on the welding process employed and the weld thermal cycle. In this investigation an attempt has been made to study the influence of welding consumables and welding processes on metallurgical characteristics of armour grade Q&T steel joints by various metallurgical characterization procedures. Shielded metal arc welding(SMAW) and flux cored arc welding(FCAW) processes were used for making welds using ASS, LHF and HNS welding consumables. The joints fabricated by using LHF consumables offered lower degree of HAZ softening and there is no evidence of HIC in the joints fabricated using LHF consumables.展开更多
Utilization of gene therapy approaches for cancertreatment requires either that the transferred genegains access to the great majority of the tumor cells orthat gene transfer results in a cytotoxic effect that willkil...Utilization of gene therapy approaches for cancertreatment requires either that the transferred genegains access to the great majority of the tumor cells orthat gene transfer results in a cytotoxic effect that willkill a large number of tumor cells that do not directlyreceive the gene of interest. The latter effect can beachieved by the transfer into tumors of展开更多
In the US Federal government, an analysis of alternatives (AoA) is required for a significant investment of resources. The AoA yields the recommended alternative from a set of viable alternatives for the investment de...In the US Federal government, an analysis of alternatives (AoA) is required for a significant investment of resources. The AoA yields the recommended alternative from a set of viable alternatives for the investment decision. This paper presents an integrated AoA and project management framework for analyzing new or emerging alternatives (e.g., Cloud computing), as may be driven by an information system strategy that incorporates a methodology for analyzing the costs, benefits, and risks of each viable alternative. The case study in this paper, about a business improvement project to provide public health and safety services to citizens in a US Federal agency, is a practical application of this integrated framework and reveals the benefits of this integrated approach for an investment decision. The decision making process in the framework—as an integrated, organized, and adaptable set of management and control practices—offers a defensible recommendation and provides accountability to stakeholders.展开更多
Cancer trials often start investigational therapy at diagnosis or after a selected number of relapses.These are the usual core inclusion criteria in clinical trials.Hence it is helpful when planning a trial to know th...Cancer trials often start investigational therapy at diagnosis or after a selected number of relapses.These are the usual core inclusion criteria in clinical trials.Hence it is helpful when planning a trial to know the likely percentages of patients receiving standard therapy at clinics and hospitals who meet this key inclusion criteria of being newly diagnosed during a period or having just had their first,second or third relapse during an anticipated enrollment time frame.Often regulatory agencies will have approvals tied to the use of a therapy in a relapsed context or in a newly diagnosed context.We provide details on calculations to help those in clinical trial operations make realistic assessments on the number of sites and likely enrollment at clinical trial sites,and the enrollment time frames that might be needed to complete planned total patient enrollment.The estimates complement site feasibility questionnaires which are often sent to gauge patient availability and site interest.展开更多
The biomass and distribution of black clam (Villorita cyprinoides) in Vembanad, a tropical estuary located along the southwest coast of India varied significantly. Sampling was done in freshwater-dominated zone in the...The biomass and distribution of black clam (Villorita cyprinoides) in Vembanad, a tropical estuary located along the southwest coast of India varied significantly. Sampling was done in freshwater-dominated zone in the south (distal) and brackish water zone in the north (proximal), during pre and post monsoon seasons. Clam biomass was estimated from samples, collected from different stations during the study period. Water transparency and temperature were measured at the sample sites. Water samples were collected and analysed for salinity, dissolved oxygen (DO), pH and hardness. There was a significant difference in the clam biomass during the two seasons in the distal zone, and those collected from the distal and proximal zones during pre-monsoon season. The data were further analysed to determine the factors affecting the clam biomass distribution in the two zones and seasons. Factor analyses, comparing the distal zone during two seasons and zonal variations were similar to earlier observations. Step wise regression analyses found that dissolved oxygen (adjusted R2 = 0.3) is the only variable affecting clam survival during pre-monsoon period in the distal and proximal zones. A geographic map of the region obtained from the Indian satellite sensor LISS (Linear Image Self Scanner) was used along with in situ data to map the results using inverse distance weightage model.展开更多
Objective:Paid sick leave(PSL)laws mandate employers give workers paid time off when they are sick or injured.This current study aims to examine whether access to PSL is associated with healthcare utilization and heal...Objective:Paid sick leave(PSL)laws mandate employers give workers paid time off when they are sick or injured.This current study aims to examine whether access to PSL is associated with healthcare utilization and health outcomes and to summarize the types of utilization and outcomes which have been reported to be associated with PSL.Methods:We conducted a rapid evidence review.Our search of seven databases,including Medline,Embase,PsycINFO,Cochrane Library,CINAHL,Scopus,and JSTOR,on September 21,2020,identified 757 studies,30 of which were retained.Results:Previous evidence is mostly provided by cross-sectional studies with survey data.In this study,evidence suggests that PSL is significantly associated with some types of healthcare utilization and health outcomes.In terms of healthcare utilization,findings indicate PSL is associated with an increase in the use of some preventive sendees and a decrease in the use of emergency care;while findings are mixed regarding associations of PSL with health provider visits and the use of mammograms and pap smears.As for health outcomes,findings suggest PSL is associated with improved mental and self-rated health,decreased incidence of influenza-like illness,and lower occupational injuries and mortality rates.Conclusion:PSL may be an effective tool in improving some healthcare utilization and health outcomes.Future research could help identify mechanisms through which PSL access works and identify what policy components lead to better outcomes.展开更多
In 2015,the U.S National Institute of Standards and Technology(NIST)funded the Center of Excellence for Risk-Based Community Resilience Planning(CoE),a fourteen university-based consortium of almost 100 col-laborators...In 2015,the U.S National Institute of Standards and Technology(NIST)funded the Center of Excellence for Risk-Based Community Resilience Planning(CoE),a fourteen university-based consortium of almost 100 col-laborators,including faculty,students,post-doctoral scholars,and NIST researchers.This paper highlights the scientific theory behind the state-of-the-art cloud platform being developed by the CoE-the Interdisciplinary Networked Community Resilience Modeling Environment(IN-CORE).IN-CORE enables communities,consul-tants,and researchers to set up complex interdependent models of an entire community consisting of people,businesses,social institutions,buildings,transportation networks,water networks,and electric power networks and to predict their performance and recovery to hazard scenario events,including uncertainty propagation through the chained models.The modeling environment includes a detailed building inventory,hazard scenario models,building and infrastructure damage(fragility)and recovery functions,social science data-driven house-hold and business models,and computable general equilibrium(CGE)models of local economies.An important aspect of IN-CORE is the characterization of uncertainty and its propagation throughout the chained models of the platform.Three illustrative examples of community testbeds are presented that look at hazard impacts and recovery on population,economics,physical services,and social services.An overview of the IN-CORE technology and scientific implementation is described with a focus on four key community stability areas(CSA)that encompass an array of community resilience metrics(CRM)and support community resilience informed decision-making.Each testbed within IN-CORE has been developed by a team of engineers,social scientists,urban planners,and economists.Community models,begin with a community description,i.e.,people,businesses,buildings,infras-tructure,and progresses to the damage and loss of functions caused by a hazard scenario,i.e.,a flood,tornado,hurricane,or earthquake.This process is accomplished through chaining of modular algorithms,as described.The baseline community characteristics and the hazard-induced damage sets are the initial conditions for the recovery models,which have been the least studied area of community resilience but arguably one of the most important.Communities can then test the effect of mitigation and/or policies and compare the effects of“what if”scenarios on physical,social,and economic metrics with the only requirement being that the change much be able to be numerically modeled in IN-CORE.展开更多
Heart transplantation is without doubt a very effective treatment for patients’ whose lives and well-being are threatened by their failing heart. We previously categorized our concerns into four areas or Ds: Donor av...Heart transplantation is without doubt a very effective treatment for patients’ whose lives and well-being are threatened by their failing heart. We previously categorized our concerns into four areas or Ds: Donor availability, Disorganization, Disillusionment (of clinicians) and Disaffection (of tomorrow’s clinicians). After a decade, this is a timely reflection on this crisis of cardiac transplantation. It is also appropriate to set this in the context of a fifth D, the Demand for heart transplantation. In this reflective analysis, we use the 5 Ds to explore the current climate in heart transplantation, with particular reference to the situation in the UK.展开更多
The primary objective of the study was to evaluate baseline patient perception on single versus multiple community pharmacy systems. The secondary objective was to determine effects of a pharmacist provided educationa...The primary objective of the study was to evaluate baseline patient perception on single versus multiple community pharmacy systems. The secondary objective was to determine effects of a pharmacist provided educational intervention on perception of using a single community pharmacy system. This was a prospective survey based study implemented in a single grocery store chain pharmacy and one location of a large retail pharmacy. An anonymous pre-survey was administered to eligible patients. The primary investigator then delivered a brief educational intervention followed by an anonymous post survey. This aimed to determine if there was a change in perception of components assessed in the pre-survey. Data analysis was performed using descriptive statistics. Subjects reported using approximately 1.5 pharmacies. Major reasons included cost, location, and immunizations. 63% of subjects answered that their pharmacist will not have an accurate medication list when using multiple pharmacies, however, 92% of subjects responded that the pharmacist should be aware of all medications they take. Education on multiple pharmacy use may help protect against its risks. Cognizance of medications filled at other pharmacies and close communication between patients and pharmacists may help foster pharmacist-patient relationships while reducing the risk of multiple pharmacy use.展开更多
Using 1987-2006panel data for China, we explore the dynamics of the skill premium. The present paper focuses on the skill premium as an explanation for why income differences are so large in China. Our empirics show t...Using 1987-2006panel data for China, we explore the dynamics of the skill premium. The present paper focuses on the skill premium as an explanation for why income differences are so large in China. Our empirics show that： the rise in the relative supply of skilled labor results in an increase, instead of a decrease, in the skill premium; domestic investment is not complementary with skill formation; the skill premium is higher in more developed provinces; economic openness facilitates an increase in the skill premium; whether foreign direct investment induces skill-based technology change or not, it drives up the skill premium. An array of policy prescriptions for reducing income differences and ensuring sustained economic growth are provided.展开更多
文摘BACKGROUND Steroids remain the primary treatment for severe alcohol-associated hepatitis(AAH),though there is little available tools to predict patient response to steroids.It was hypothesized that phosphatidylethanol(PEth)value will inversely corre-late with response to steroid therapy based on Lille score in AAH.AIM To assess the relationship of patient factors,focusing on pre-steroid therapy PEth value,to steroid therapy response in AAH.METHODS A retrospective case control study was performed on patients who received≥4 days of steroid therapy for AAH at our hospital between July 1,2019 and June 30,2022.A total of 2087 patients were screened for AAH and those treated with steroids were included for statistical analysis utilizing independent sample t-test and for categorical variables using the χ^(2) test.RESULTS No correlation was found between PEth value,pre-steroids abstinence length,or number of drinks per week pre-steroids and response to steroids.Non-responder status significantly correlated with older age(P=0.024),lower albumin(P=0.003),and higher bilirubin(P=0.010)pre-steroids.Our study suggests that age,pre-steroid albumin,and pre-steroid bilirubin levels may predict nonresponse to steroid therapy.Non-responders have increased incidence of death and higher medical costs.CONCLUSION Identifying non-responders through these identified factors should prompt early referral for liver transplantation.Future prospective studies with larger population size are needed to assess the efficacy of combined pre-steroid age,albumin,bilirubin and other biochemical markers as predictors of steroid response.
基金the Federal Highway Administration under contract number DTFH61-92-C-00112.
文摘The Federal Highway Administration (FHWA) sponsored a large,multi-year project conducted by the Multidisciplinary Center for Earthquake Engineering Research (MCEER) titled'Seismic Vulnerability of New Highway Construction'(MCEER Project 112),which was completed in 1998.MCEER coordinated the work of many researchers,who performed studies on the seismic design and vulnerability analysis of highway bridges,tunnels,and retaining structures. Extensive research was conducted to provide revisions and improvements to current design and detailing approaches and national design specifications for highway bridges.The program included both analytical and experimental studies,and addressed seismic hazard exposure and ground motion input for the U.S.highway system;foundation design and soil behavior: structural importance,analysis,and response:structural design issues and details;and structural design criteria.
文摘Major chemical properties of tea-growing soils are of paramount importance for better management in a sustainable fashion.Therefore,this study was carried out to understand the major soil chemical properties of major tea(Camellia sinensis L.)-growing areas,Dibrugarh and Tinsukia districts,in the state of Assam,India.A total of 991 surface soil samples were collected from 15 large tea estates(TEs) for analysis of their major chemical properties.Soil pH ranged from 3.61 to 6.81.Total organic carbon and total nitrogen ranged from 2.4 to 47.3 and 0.24 to 3.60 g kg^(-1),respectively.All soils were sufficiently rich in plant-available potassium(as K_2O),which ranged from 127.71 to 252.33 mg kg^(-1),exceeding the amount prescribed for optimum tea yield of > 100 mg kg^(-1).Plant-available sulfur among soil samples widely varied from 4 to 129 mg kg^(-1).Results of hierarchical clustering analysis for homogenous grouping of the 15 TEs based on soil chemical properties showed that the 15 TEs could be classified into three distinct groups which consisted of6,8 and 1 TEs,respectively.Based on the Kolmogorov-Smirnov(K-S) test,the best fitted theoretical probability distributions were found out for different soil chemical properties.It could be concluded that a balanced fertilizer application would be needed as a part of tea improvement program using soil chemical test.
基金Armament Research Board (ARMREB), New Delhi for funding this project work (Project no. MAA/03/ 41)
文摘Austenitic stainless steel(ASS) and High nickel steel(HNS) welding consumables are being used for welding Q&T steels, as they have higher solubility for hydrogen in austenitic phase, to avoid hydrogen induced cracking(HIC) but they are very expensive. In recent years, the developments of low hydrogen ferritic steel(LHF) consumables that contain no hygroscopic compounds are utilized for welding Q&T steels. Heat affected zone(HAZ) softening is another critical issue during welding of armour grade Q&T steels and it depends on the welding process employed and the weld thermal cycle. In this investigation an attempt has been made to study the influence of welding consumables and welding processes on metallurgical characteristics of armour grade Q&T steel joints by various metallurgical characterization procedures. Shielded metal arc welding(SMAW) and flux cored arc welding(FCAW) processes were used for making welds using ASS, LHF and HNS welding consumables. The joints fabricated by using LHF consumables offered lower degree of HAZ softening and there is no evidence of HIC in the joints fabricated using LHF consumables.
文摘Utilization of gene therapy approaches for cancertreatment requires either that the transferred genegains access to the great majority of the tumor cells orthat gene transfer results in a cytotoxic effect that willkill a large number of tumor cells that do not directlyreceive the gene of interest. The latter effect can beachieved by the transfer into tumors of
文摘In the US Federal government, an analysis of alternatives (AoA) is required for a significant investment of resources. The AoA yields the recommended alternative from a set of viable alternatives for the investment decision. This paper presents an integrated AoA and project management framework for analyzing new or emerging alternatives (e.g., Cloud computing), as may be driven by an information system strategy that incorporates a methodology for analyzing the costs, benefits, and risks of each viable alternative. The case study in this paper, about a business improvement project to provide public health and safety services to citizens in a US Federal agency, is a practical application of this integrated framework and reveals the benefits of this integrated approach for an investment decision. The decision making process in the framework—as an integrated, organized, and adaptable set of management and control practices—offers a defensible recommendation and provides accountability to stakeholders.
文摘Cancer trials often start investigational therapy at diagnosis or after a selected number of relapses.These are the usual core inclusion criteria in clinical trials.Hence it is helpful when planning a trial to know the likely percentages of patients receiving standard therapy at clinics and hospitals who meet this key inclusion criteria of being newly diagnosed during a period or having just had their first,second or third relapse during an anticipated enrollment time frame.Often regulatory agencies will have approvals tied to the use of a therapy in a relapsed context or in a newly diagnosed context.We provide details on calculations to help those in clinical trial operations make realistic assessments on the number of sites and likely enrollment at clinical trial sites,and the enrollment time frames that might be needed to complete planned total patient enrollment.The estimates complement site feasibility questionnaires which are often sent to gauge patient availability and site interest.
文摘The biomass and distribution of black clam (Villorita cyprinoides) in Vembanad, a tropical estuary located along the southwest coast of India varied significantly. Sampling was done in freshwater-dominated zone in the south (distal) and brackish water zone in the north (proximal), during pre and post monsoon seasons. Clam biomass was estimated from samples, collected from different stations during the study period. Water transparency and temperature were measured at the sample sites. Water samples were collected and analysed for salinity, dissolved oxygen (DO), pH and hardness. There was a significant difference in the clam biomass during the two seasons in the distal zone, and those collected from the distal and proximal zones during pre-monsoon season. The data were further analysed to determine the factors affecting the clam biomass distribution in the two zones and seasons. Factor analyses, comparing the distal zone during two seasons and zonal variations were similar to earlier observations. Step wise regression analyses found that dissolved oxygen (adjusted R2 = 0.3) is the only variable affecting clam survival during pre-monsoon period in the distal and proximal zones. A geographic map of the region obtained from the Indian satellite sensor LISS (Linear Image Self Scanner) was used along with in situ data to map the results using inverse distance weightage model.
文摘Objective:Paid sick leave(PSL)laws mandate employers give workers paid time off when they are sick or injured.This current study aims to examine whether access to PSL is associated with healthcare utilization and health outcomes and to summarize the types of utilization and outcomes which have been reported to be associated with PSL.Methods:We conducted a rapid evidence review.Our search of seven databases,including Medline,Embase,PsycINFO,Cochrane Library,CINAHL,Scopus,and JSTOR,on September 21,2020,identified 757 studies,30 of which were retained.Results:Previous evidence is mostly provided by cross-sectional studies with survey data.In this study,evidence suggests that PSL is significantly associated with some types of healthcare utilization and health outcomes.In terms of healthcare utilization,findings indicate PSL is associated with an increase in the use of some preventive sendees and a decrease in the use of emergency care;while findings are mixed regarding associations of PSL with health provider visits and the use of mammograms and pap smears.As for health outcomes,findings suggest PSL is associated with improved mental and self-rated health,decreased incidence of influenza-like illness,and lower occupational injuries and mortality rates.Conclusion:PSL may be an effective tool in improving some healthcare utilization and health outcomes.Future research could help identify mechanisms through which PSL access works and identify what policy components lead to better outcomes.
基金The Center for Risk-Based Community Resilience Planning is a NIST-funded Center of Excellencethe Center is funded through a cooperative agreement between the U.S.National Institute of Standards and Tech-nology and Colorado State University(NIST Financial Assistance Award Numbers:70NANB15H044 and 70NANB20H008)。
文摘In 2015,the U.S National Institute of Standards and Technology(NIST)funded the Center of Excellence for Risk-Based Community Resilience Planning(CoE),a fourteen university-based consortium of almost 100 col-laborators,including faculty,students,post-doctoral scholars,and NIST researchers.This paper highlights the scientific theory behind the state-of-the-art cloud platform being developed by the CoE-the Interdisciplinary Networked Community Resilience Modeling Environment(IN-CORE).IN-CORE enables communities,consul-tants,and researchers to set up complex interdependent models of an entire community consisting of people,businesses,social institutions,buildings,transportation networks,water networks,and electric power networks and to predict their performance and recovery to hazard scenario events,including uncertainty propagation through the chained models.The modeling environment includes a detailed building inventory,hazard scenario models,building and infrastructure damage(fragility)and recovery functions,social science data-driven house-hold and business models,and computable general equilibrium(CGE)models of local economies.An important aspect of IN-CORE is the characterization of uncertainty and its propagation throughout the chained models of the platform.Three illustrative examples of community testbeds are presented that look at hazard impacts and recovery on population,economics,physical services,and social services.An overview of the IN-CORE technology and scientific implementation is described with a focus on four key community stability areas(CSA)that encompass an array of community resilience metrics(CRM)and support community resilience informed decision-making.Each testbed within IN-CORE has been developed by a team of engineers,social scientists,urban planners,and economists.Community models,begin with a community description,i.e.,people,businesses,buildings,infras-tructure,and progresses to the damage and loss of functions caused by a hazard scenario,i.e.,a flood,tornado,hurricane,or earthquake.This process is accomplished through chaining of modular algorithms,as described.The baseline community characteristics and the hazard-induced damage sets are the initial conditions for the recovery models,which have been the least studied area of community resilience but arguably one of the most important.Communities can then test the effect of mitigation and/or policies and compare the effects of“what if”scenarios on physical,social,and economic metrics with the only requirement being that the change much be able to be numerically modeled in IN-CORE.
文摘Heart transplantation is without doubt a very effective treatment for patients’ whose lives and well-being are threatened by their failing heart. We previously categorized our concerns into four areas or Ds: Donor availability, Disorganization, Disillusionment (of clinicians) and Disaffection (of tomorrow’s clinicians). After a decade, this is a timely reflection on this crisis of cardiac transplantation. It is also appropriate to set this in the context of a fifth D, the Demand for heart transplantation. In this reflective analysis, we use the 5 Ds to explore the current climate in heart transplantation, with particular reference to the situation in the UK.
文摘The primary objective of the study was to evaluate baseline patient perception on single versus multiple community pharmacy systems. The secondary objective was to determine effects of a pharmacist provided educational intervention on perception of using a single community pharmacy system. This was a prospective survey based study implemented in a single grocery store chain pharmacy and one location of a large retail pharmacy. An anonymous pre-survey was administered to eligible patients. The primary investigator then delivered a brief educational intervention followed by an anonymous post survey. This aimed to determine if there was a change in perception of components assessed in the pre-survey. Data analysis was performed using descriptive statistics. Subjects reported using approximately 1.5 pharmacies. Major reasons included cost, location, and immunizations. 63% of subjects answered that their pharmacist will not have an accurate medication list when using multiple pharmacies, however, 92% of subjects responded that the pharmacist should be aware of all medications they take. Education on multiple pharmacy use may help protect against its risks. Cognizance of medications filled at other pharmacies and close communication between patients and pharmacists may help foster pharmacist-patient relationships while reducing the risk of multiple pharmacy use.
基金the National Science Foundation of China (No.70673072 and 70203008)the National Social Science Foundation (No.06 BJL 039) for financial support.
文摘Using 1987-2006panel data for China, we explore the dynamics of the skill premium. The present paper focuses on the skill premium as an explanation for why income differences are so large in China. Our empirics show that： the rise in the relative supply of skilled labor results in an increase, instead of a decrease, in the skill premium; domestic investment is not complementary with skill formation; the skill premium is higher in more developed provinces; economic openness facilitates an increase in the skill premium; whether foreign direct investment induces skill-based technology change or not, it drives up the skill premium. An array of policy prescriptions for reducing income differences and ensuring sustained economic growth are provided.
