Costs associated with adverse events in patients with metastatic renal cell carcinoma

Objective:

To estimate adverse event (AE) costs in patients receiving targeted therapies for the first line treatment of metastatic renal cell carcinoma (mRCC).

Methods:

Retrospective study based on healthcare claims data for patients with mRCC, aged ≥18 years, receiving first-line treatment with targeted therapies. AEs of interest comprised of abdominal pain, back pain, diarrhea, dyspnea, extremity pain, fatigue/asthenia, hand-foot syndrome, hypertension, lymphopenia, nausea/vomiting, neutropenia, proteinuria, and thrombocytopenia. Healthcare encounters for AEs were based on ICD-9-CM diagnosis/procedure codes on healthcare claims. AE costs were examined over a 30-day period, beginning with the date of first mention of AE, and were estimated based on the difference in total costs between patients with and without events. Drug costs of targeted agents were excluded from the analysis. Multivariate generalized linear models with a log-link function and gamma response probability distribution were utilized to control for differences in baseline characteristics between patients with and without evidence of AEs.

Results:

A total of 533 patients were included in this analysis: 418 patients with AE and 115 patients without AE. Baseline characteristics were generally similar between patients in the two groups. The GLM-based estimate of incremental 30-day post-event costs among patients with evidence of any adverse events was $9807 (95% CI?=?$4386–$22,947). For all types of adverse events examined, the estimated difference in costs between evented and non-evented patients was positive; the 95% CI did not include zero for all of the adverse events considered, except hypertension and proteinurea. Study limitations include errors of commission/omission, especially as they may affect case-finding methods that rely on ICD-9-CM diagnosis and procedure codes, as was the case in the current study.

Conclusion:

Costs associated with AEs of first-line targeted therapies are substantial in patients with mRCC. Efforts to prevent and/or better manage these events may reduce overall healthcare costs.     

中国居民劳动报酬占初次分配比重演变轨迹研究

本文结合我国计划经济时期、文革至改革前期、改革开放至今三个特定社会经济背景,对建国以来我国劳动报酬在初次分配中所占比重的演变进行分析,研究得出该比重的演变在改革开放之前主要受到政府管理体制的影响,改革开放之后则受到政府、企业与劳动者三方面因素的影响。主张政府应建立健全市场规则以保障劳动力供需双方在市场上的公平竞争,企业则应积极转变利润至上观念、提高劳动者地位,劳动者应注意提升自身素质与技能。     

浅析社会主义初级阶段是中国特色社会主义理论体系的基石

中国共产党第十七次全国代表大会提出了中国特色社会主义理论体系的科学命题,这一体系的根基是社会主义初级阶段,原因在于处于并将长期处于社会主义初级阶段是我国的基本国情。     

氯碱工业中防腐蚀新技术的应用

氯碱工业中防腐蚀新技术的应用:玻璃鳞片涂层和衬里、耐腐蚀玻璃钢、耐酸耐温砖(空心)/法奥里特复合衬里、不停车带压堵漏等。     

基于蚁群算法的多单元物料路径协同布置

为保证车间多单元系统布置的物料流路径总成本最小,考虑单元系统物料输入输出I/O点和多单元物料路径布置对总成本的影响,在对I/O点进行定位的基础上,着重对多个单元物料流路径布置进行协同研究,并根据不同情况建立了上下迂回布置的具体优化数学模型--模型A和模型B。设计了一种基于蚁群优化算法(Ant Colony Optimization,ACO)的车间多单元物料流路径优化布置方法,该算法首先通过蚂蚁构建可行解,然后采用局部与全局信息素更新相结合的信息素更新策略,并通过最优改进2-选择局部搜索方法对构建的可行解进行优化,提高了全局最优解的质量。最后通过求解车间多单元系统布置实例,验证模型和算法的有效性。     

酪氨酸激酶抑制剂治疗非小细胞肺癌的临床应用

吉非替尼为一种选择性的EGFR一蛋白酪氨酸激酶抑制剂,能阻断酪氨酸蛋白激酶信号传导通路,从而促进肿瘤细胞凋亡。它是作为第一个用于肺癌治疗的分子靶向药物,在治疗非小细胞肺癌中拥有其自身的优越性在临床中取得了一定成效,但仍存在很多问题。本文针对吉非替尼靶向治疗非肺癌小细胞肺癌中的优点和所面临的问题进行阐述。     

Using patent data to analyze trends and the technological strategies of the amorphous silicon thin-film solar cell industry

With the shortage of raw materials for the production of crystalline silicon solar cells, the next generation of solar cells has reached the perfect stage for development. While in the past, researchers have emphasized the development of crystalline silicon solar cells, the application of the next generation of crystalline silicon solar cells is different. Of the thin-film solar cells (TFSCs), the most widely recognized is the amorphous silicon (a-Si) TFSC. It has the greatest potential to be developed, and many manufacturers have already invested in its research and development (R&D). In this study, we employed a set of indicators to analyze the technological development of the a-Si TFSC, and found that the major technology field has reached the mature stage in the technology life cycle of this product; moreover, four patent strategic clusters were identified. The results regarding the company and technology levels of the clusters were integrated with profile data and developmental progress information to understand the patent performance, technologic capacity, and R&D background of the a-Si TFSC.     

Converting EORTC QLQ-C30 scores to utility scores in the brigatinib ALTA study

Abstract

Aims: Health utilities summarize a patient’s overall health status. This study estimated utilities based on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (QLQ-C30), a widely used measure of health-related quality-of-life (HRQoL) in oncology, using published mapping algorithms.

Materials and methods: Data were from the Anaplastic Lymphoma Kinase (ALK) in Lung Cancer Trial of brigatinib (ALTA; NCT02094573), an open-label, international, phase 2 study. ALTA evaluated the efficacy and safety of two randomized dosing regimens of brigatinib in patients with locally advanced or metastatic ALK?+?non-small cell lung cancer (NSCLC) that had progressed on prior therapy with crizotinib. QLQ-C30 scores were mapped to European Quality-of-Life-5 Dimensions (EQ-5D) utility scores using two published algorithms (Khan et al. for EQ-5D-5L; Longworth et al. for EQ-5D-3L). The impact of brigatinib treatment on health utilities over time was assessed.

Results: The analysis included 208 subjects. Mean baseline utility scores for both algorithms ranged between 0.60???0.71 and increased to 0.78 by cycle 5. Utility improvements were sustained during most of the treatment, before disease progression. Minor variations were observed between utility scores; Khan et al. estimates were approximately 0.01 or 0.02 points lower than Longworth et al. estimates.

Limitations: Algorithms considered were limited to those available in the published literature at the time of the study. This utility analysis was exploratory, and the ALTA trial did not include an internal control group (i.e. standard of care) and was not powered to detect differences in QoL/utility outcomes between treatment arms.

Conclusions: Converting QLQ-C30 scores into utilities in trials using established mapping algorithms can improve evaluation of medicines from the patient perspective. Both algorithms suggested that brigatinib improved health utility in crizotinib-refractory ALK?+?NSCLC patients, and improvements were maintained during most of the treatment.

Clinicaltrials.gov identifier: NCT02094573     

村卫生室医疗服务水平现状及提升研究——以宁波为例

在基层医疗服务水平中,农村影响面最大.村卫生室作为农村三级卫生服务网络的最底层,存在着基础设施较差、服务能力较弱、补助机制未完全建立、管理不规范等问题.随着医改的深入,乡村医生以药品为利润的主要收入格局被打破,如何建好符合村民百姓期待的村卫生室是摆在目前非常紧迫的问题.或许可以从提高认识、强化激励制度、重视人员配备、加大投入保障和加大村卫生室信息化建设等几方面入手解决问题.     

燃料电池电动汽车用大功率Buck DC/DC变换器研究

针对燃料电池电动汽车用大功率DC/DC变换器的要求,文章提出了一种新型的柔性换流BuckDC/DC变换器拓扑,并重点分析了该拓扑结构的特点和工作过程。通过在常规的Buck电路中增加少量L、C、D器件,使主功率开关管和功率二极管可以平缓地切换工作电流,该方法提高了变换器可靠性和电磁兼容性。用Pspice对该电路拓扑进行了仿真,并给出了基于该电路拓扑研制的90kWDC/DC变换器的开关波形和效率曲线。该变换器已经成功地应用在国内自主研发的燃料电池城市客车中,各项技术指标均满足使用要求。