Renal function changes and NHS resource use in breast cancer patients with metastatic bone disease treated with IV zoledronic acid or oral ibandronic acid: a four-centre non-interventional study

Abstract

Aims: To describe renal function monitoring practice in patients with metastatic bone disease (MBD) treated with IV zoledronic acid (ZA) and oral ibandronic acid (IA), the management pathways and NHS hospital resources used.

Methods: Medical records of 189 patients; IA (91), ZA (98) with primary breast cancer and MBD were reviewed, and data collected on renal monitoring and hospital visits during bisphosphonate therapy. Time and motion review of resources to administer the bisphosphonates was also conducted.

Results: Only 30% of patients given ZA and no patient given IA had baseline creatinine clearance (CrCl) recorded. Calculated baseline CrCl suggested impaired renal function in 33% ZA and 29% IA patients. Dose reductions were not made correctly in 29 ZA and 2 IA patients whose monitoring suggested it. ZA patients made more clinic and day care attendances than IA-treated patients, at twice the cost. Staff activity and patient time per visit was higher with ZA than IA.

Conclusion: Although limited by retrospective design, these results demonstrate that in many patients, CrCl is not calculated before or during treatment with bisphosphonates. Renal function deteriorated in many patients during therapy. In view of these effects, practice should be reviewed to ensure appropriate dosing.     

湖南省国省干线公路路面改造中反射裂缝的处治研究

旧水泥砼路面加铺沥青砼面层非常容易形成反射裂缝。文章介绍了常用的反射裂缝防治措施。结合湖南省国省干线公路路面改造中对原有水泥砼路面处治方案,分析了原旧水泥砼路面处治方案对消除反射裂缝的效果,结合工程实例,提出了尽量少采用整体利用原有水泥砼路和尽量多采用共振机械碎石化原有水泥砼路面。     

山区输电线路塔位边坡治理方法及技术经济分析

针对目前山区输电线路铁塔塔位边坡的特点，总结输电线路工程中常见的塔位边坡主要处理措施，包括工程治理、生物治理，对相应方法的适用范围和优缺点进行了比较分析，提出了合理的环保设计建议。     

工程建设中的混凝土裂缝控制与处理

建设工程中的混凝土裂缝控制是一项复杂的工作,需要材料、设计、施工等方面的相互协调、共同配合。在各个环节采取严密的措施,混凝土裂缝是可以得到有效控制的。文章结合工程实践,分析了混凝土工程中常见裂缝的产生原因,提出了混凝土施工中应注意的事项,以完善混凝土施工工艺,避免混凝土产生裂缝,从而保证建筑工程的质量,延长建筑物的使用寿命。     

Party Discipline and Environmental Policy: The Role of “Smoke‐filled Back Rooms”*

We adopt the view that greater party discipline induces legislators to commit to promised policies after being elected. We then develop the hypothesis that the effect of party discipline on the stringency of environmental policy is conditional on the degree of government corruption. Our empirical work suggests that greater party discipline results in more stringent environmental policies when the level of corruption is relatively low, but in weaker policies when the level of corruption is comparatively high.     

谈公路工程施工中软土地基处理

软土是指以水下沉积的软弱粘性土或淤泥为主的地层,有时也夹有少量的腐泥或泥炭层。处理的目的是要提高软弱地基的强度,保证地基的稳定,降低软弱土的压缩性,减少基础的沉降和不均匀沉降。文中主要对公路施工中的软土地基处理的方式方法进行了分析探讨。     

财务困境、政府干预与管理者自利

文章运用处理效应(treatment effect)模型,从财务困境视角研究了政府干预对管理者自利行为的影响。研究发现,当政府干预程度较低时,相对于未发生财务困境的公司,困境公司管理者的自利行为会有所减弱;但当政府干预程度增强时,困境公司管理者自利行为减弱的程度将趋缓。对于政府控制的公司,当金融机构信贷决策受到政府干预的影响较弱时,财务困境期间管理者自利行为会有所减弱;随着政府对金融机构信贷决策干预程度的加强,困境公司管理者自利行为趋于严重。对于非政府控制的公司,困境期间管理者自利行为对金融机构信贷决策的自主性并不敏感。     

试论高校图书馆馆员素质

在图书馆工作的构成要素中,馆员的素质是关键要素,它直接决定着图书馆服务工作的质量高低,是图书馆事业的关键。本文通过分析高校图书馆馆员素质要求和现状,提出提高馆员素质的方法。     

浅谈河南电力通信综合网管系统的实用化建设

随着电力通信综合网管系统的广泛建设,实用化水平的高低已成为其能否发挥效益的关键因素。本文主要阐述了河南电力通信综合网管系统在资源入库、数据存储、方式管理、检修处理、系统互联等方面所做的实用化探索和尝试,并对未来的实用化道路提出了新的要求。     

基于机器学习的凋亡蛋白的亚细胞位点预测

准确预测凋亡蛋白的亚细胞位点有利于理解细胞死亡的机理和其生物学功能。本文利用裂解位点的蛋白质序列信息提出了一种新的凋亡蛋白的预测算法PSSP.对三个凋亡蛋白数据集进行Jackknife验证表明我们的方法得到了令人满意的结果。