The study regards the processing of data on urban land conversion along the Italian Adriatic coast in the last 50 years. The results obtained show different aspects of the phenomenon: values were obtained for the average annual speed of transformation of the coastal strip; clustering, dispersion and statistical concentration of the data obtained were studied, which has made it possible to show unparalleled threshold values in the present levels of urbanization; geostatistical surveys were conducted to determine the distribution changes of urban concentration over time; analyses were developed to point out what landscape and morphological elements have emerged, and are tendentially confirming greater sensitivity to land artificialization; a number of comparisons based on specific indicators were produced that show the typological and geographic variations of development taking place in the time period studied; important information has emerged on the different territorial policies implemented by the regions over the long-term. This research has made it possible to investigate one of the largest and most intense land transformation phenomena in Italy which has led to the construction of an urban organism extending along more than 1470 km of coast with very few breaks which, together with railroad and motorway infrastructural elements, forms the longest urban stretch in southern Europe and one of the most extensive in the entire continent. A further result of the work carried out concerned the extraction of data on the remaining coastal stretches, i.e. those not yet affected by urban transformation and thus of extreme importance for policies focused on the preservation of community habitats and the preservation of coastal landscape. In conclusion, it has been possible to draw a map of management responsibilities at the municipal and regional levels for the revision of future urban planning trends in terms of sustainable governance. 相似文献
A study to determine the effect of soaking soybeans (Glycine max) at different periods of time on trypsin inhibitor, crude protein and phosphorus contents was carried out. The results showed that the length of soaking period had significant effect (P < 0.05) on trypsin inhibitor and crude protein contents. The activities of the trypsin inhibitor were 10% in roasted soybeans, 27.5% in raw and a range of 26.6% for those soaked in water for 24 h to 17.7% for soybeans soaked for 96 h or more, with a standard error of 6.56 on each of the values. The crude protein contents were 41.58% in raw, 31.43% in roasted and a range of 40.05–30.64% for those soaked in water for 24–120 h. The standard error on each value was 5.09%. On the other hand, length of soaking period had no significant effect on phosphorus content. It can be concluded from this that soaking soybeans in water can effectively remove the anti‐nutritional factors. While roasting is better, the use of fire wood may not be encouraged as it has caused a lot of deforestation with consequent occurrence of floods and hence food shortages. Such a good animal husbandry practice can help to improve the health of animals, which can in turn help to improve the health of the population. 相似文献
Background: To assess the cost-effectiveness of ceritinib vs alternatives in patients who discontinue treatment with crizotinib in anaplastic lymphoma kinase-positive (ALK+) non-small cell lung cancer (NSCLC) from a Canadian public healthcare perspective.
Methods: A partitioned survival model with three health states (stable, progressive, and death) was developed. Comparators were chosen based on reported utilization from a retrospective Canadian chart study; comparators were pemetrexed, best supportive care (BSC), and historical control (HC). HC comprised of all treatment alternatives reported. Progression-free survival and overall survival for ceritinib were estimated using data reported from single-arm clinical trials (ASCEND-1 [NCT01283516] and ASCEND-2 [NCT01685060]). Survival data for comparators were obtained from published clinical trials in a NSCLC population and from a Canadian retrospective chart study. Parametric models were used to extrapolate outcomes beyond the trial period. Drug acquisition, administration, resource use, and adverse event (AE) costs were obtained from databases. Utilities for health states and disutilities for AEs based on EQ-5D were derived from literature. Incremental costs per quality-adjusted life year (QALY) gained were estimated. Univariate and probabilistic sensitivity analyses were performed.
Results: Over 4 years, ceritinib was associated with 0.86 QALYs and total direct costs of $89,740 for the post-ALK population. The incremental cost-effectiveness ratio (ICER) was $149,117 comparing ceritinib vs BSC, $80,100 vs pemetrexed, and $104,436 vs HC. Additional scenarios included comparison to docetaxel with an ICER of $149,780 and using utility scores reported from PROFILE 1007, with a reported ICER ranging from $67,311 vs pemetrexed to $119,926 vs BSC. Due to limitations in clinical efficacy input, extensive sensitivity analyses were carried out whereby results remained consistent with the base-case findings.
Conclusion: Based on the willingness-to-pay threshold for end-of-life cancer drugs, ceritinib may be considered as a cost-effective option compared with other alternatives in patients who have progressed or are intolerant to crizotinib in Canada. 相似文献
Objectives: Published reports have shown the prevalence and incidence of gastroesophageal reflux disease (GERD) is increasing in Japan. The objective of this study is to examine change in GERD incidence, and to understand current patient demographics, medical costs, treatment status, and the suitability of current treatment based on analysis of an insurance claims database.
Methods: An insurance claims database with data on ~1.9 million company employees from January 2005 to May 2015 was used. Prevalence, demographics, and medical costs were analyzed by cross-sectional analysis, and incidence and treatment status were analyzed by longitudinal analysis among newly-diagnosed GERD patients.
Results: GERD prevalence in 2014 was 3.3% among 20–59 year-olds, accounting for 40,134 people in the database, and GERD incidence increased from 0.63% in 2009 to 0.98% in 2014. In 2014, mean medical cost per patient per month for GERD patients aged 20–59 was JPY 31,900 (USD 266 as of January 2016), which was ~2.4-times the mean national healthcare cost. The most frequently prescribed drugs for newly-diagnosed GERD patients were proton pump inhibitors (PPIs). Although PPIs were prescribed more often in patients with more doctor visit months, over 20% of patients that made frequent doctor visits (19 or more visits during a 24 calendar months period) were prescribed PPIs during only 1 calendar month or not at all.
Limitations: The database included only reimbursable claims data and, therefore, did not cover over-the-counter drugs. The database also consisted of employee-based claims data, so included little data on people aged 60 years and older.
Conclusions: Given the increasing incidence of GERD in Japan there is a need for up-to-date information on GERD incidence. This study suggests that some GERD patients may not be receiving appropriate treatment according to Japanese guidelines, which is needed to improve symptom control. 相似文献