Brain metastases in non-small cell lung cancer patients on epidermal growth factor receptor tyrosine kinase inhibitors: symptom and economic burden

Objective: This study describes the symptom and economic burden associated with brain metastases (BM) in patients with non-small cell lung cancer (NSCLC) receiving epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (EGFR-TKIs).

Methods: This retrospective study included adults with ≥2 medical claims, within 90 days, for lung cancer and ≥1 administration of EGFR-TKIs. Based on ICD-9 codes, patients were stratified into cohorts by type of metastases (BM, other metastases [OM], or no metastases [NM]), and by when the metastasis diagnosis occurred (synchronous or asynchronous).

Results: The population (synchronous BM [SBM]?=?24, synchronous OM [SOM]?=?23, asynchronous BM [ASBM]?=?15, asynchronous OM [ASOM]?=?49, NM?=?85) was mostly female (57%), average age 69 years (SD?=?11). SBM patients experienced more fatigue and nausea/vomiting compared with SOM and NM patients and more headaches and loss of appetite than NM patients. ASBM was associated with more fatigue, nausea/vomiting, headaches, pain/numbness, altered mental status, and seizures than NM, and more headaches and pain/numbness than ASOM. SBM patients experienced a greater increase in per-member-per-month all-cause total healthcare costs after diagnosis ($20,301) vs SOM ($9,131, p?=?.001) and NM ($2,493, p?=?.001). ASBM’s cost increase between baseline and follow-up ($7,867) did not differ from ASOM’s ($4,947, p?=?.195); both were larger than NM ($2,493, p?=?.001 and p?=?.009, respectively).

Limitations: EGFR mutation status was inferred based on EGFR-TKI treatment, not by molecular testing. Patients were from US commercial insurance plans; results may not be generalizable to other populations.

Conclusions: Among patients with EGFR-TKI-treated NSCLC, patients with BM experienced more symptoms and, when diagnosed synchronously, had significant increases in total medical costs vs patients with OM and NM. Therapeutic options with central nervous system activity may offer advantages in symptomatology and costs in EGFR-mutated patients with BM.     

Understanding re-expatriation intentions among overseas returnees – an emerging economy perspective

This study investigates the reasons why returnees in an emerging economy, Vietnam, who have studied and/or worked abroad, and who have returned to their home country, intend to re-expatriate on their own initiative. We combine pull–push theory with the theory of planned behaviour (TPB) to explain the re-expatriation intentions of returnees. Using path analysis on a sample of 290 Vietnamese returnees, we find three pull–push factors associated with home and host countries that have a significant impact on returnees’ intention to re-expatriate: (1) dissatisfaction with career and life in their home country, (2) reverse culture shock and (3) expected career, family and quality-of-life outcomes from re-expatriation. For the TPB, we find that attitudes toward re-expatriation and subjective norms affect returnees’ intention to re-expatriate. Further, these factors either fully or partially mediate the role of pull–push factors on intention to re-expatriate. The study adds to the limited number of empirical studies on self-initiated re-expatriation and brain circulation of returnees in emerging economies.     

损失厌恶与偏好异质性——来自神经经济学的证据

损失厌恶是行为经济学家发现的人类进行风险决策时的一种重要行为模式。我们通过近年来兴起的功能性近红外脑成像（fNIRS）技术,对被试风险决策时的大脑前额叶皮层进行了测量和成像。结果表明,人们在处理收益和损失时,大脑皮层的激活状态存在着明显的差异。由此可以证实,损失厌恶是一种人类在长期进化过程中所获得的适应性心理本能。     

中小企业人才流失的影响及对策研究

随着社会经济的发展,中小企业的竞争已成为人才的竞争,谁拥有了人才,谁就确立了竞争的优势,就能抓住发展机遇,可见,人才对中小企业来说非常重要。然而,目前的现状是,中小企业人才流失率较高,给企业造成了巨大的损失,而如何破解中小企业人才流失的难题,成为许多中小企业亟待解决的问题。     

中小企业人才流失的影响及对策研究

随着社会经济的发展,中小企业的竞争已成为人才的竞争,谁拥有了人才,谁就确立了竞争的优势,就能抓住发展机遇,可见,人才对中小企业来说非常重要。然而,目前的现状是,中小企业人才流失率较高,给企业造成了巨大的损失,而如何破解中小企业人才流失的难题,成为许多中小企业亟待解决的问题。     

喷墨打印系统中墨滴在涂布纸上成像机理的研究

在深入研究纸张涂层结构的基础上,根据多相流离散相的流体动力学方程,研究和分析喷墨成像系统中墨滴喷射飞行的物理现象,进而准确计算和预测墨滴与承印物接触前的能量分布;然后从墨滴成像过程能量转换的角度,结合其流体动力学条件,研究了墨滴与纸张涂层表面碰撞、渗透、扩散和铺展的作用机理,为解决喷墨印刷成像体系中的网点增大问题及提高喷墨印刷成像质量提供一定的科学理论依据。     

浅谈发热现象及应对方法

高压设备接头发热对设备的正常运行非常重要,同时也是供电可靠率的一项重要指标。现在红外测温能及时发现运行设备的发热缺陷,并将信息反馈到检修班组及时进行处理。本文对发现的发热现象的分析、如何应对也是现在设备检修的首要问题。设备检修时检修人员要严格按照检修工艺工作,对检修后设备检测接触电阻,人员的技术培训,以及对各类型发热的案例、应对方法进行了介绍。     

环周声波扫描测井仪（CAST）原理及应用

人们正在努力使地层的描述像井眼特征那样更全面、更容易理解,作为成像装置,声成像测井仪主要应用于确定地层的构造特征、沉积环境,描述确定井眼的几何形态和井壁垮塌情况。此外,它还能在套管中确定套管厚度,了解套管的变形和腐蚀情况。文章描述了声成像测井仪器的工作原理,基本模型和测井过程中不同衰减因素的影响以及具体应用,使人们认识到声成像测井仪的重要性。     

乡镇企业人才流失危机管理

乡镇企业在我国国民经济中占据重要的战略地位,尤其对解决“三农”问题有着重要的意义。然而,乡镇企业的人才大量流失,已成为一种严重的企业危机,威胁到乡镇企业的生存与发展。因此,对乡镇企业人才流失危机应引起高度重视,积极进行管理创新,本文试探索构建科学有效的应对机制———双轨制动态人才流失危机管理系统。