United States-based practice patterns and resource utilization in advanced neuroendocrine tumor treatment

AIM: To assess advanced neuroendocrine tumor (NET) treatment patterns and resource utilization by tumor progression stage and tumor site in the United States. METHODS: United States Physicians meeting eligibility criteria were provided with online data extraction forms to collect patient chart data on recent NET patients. Resource utilization and treatment pattern data were collected over a baseline period (after diagnosis and before tumor progression), as well as initial and secondary progression periods, with progression defined according to measureable radiographic evidence of tumor progression. Resource categories used in the analysis include: Treatments (e.g. , surgery, chemotherapy, radiotherapy, targeted therapies), hospitalizations and physician visits, diagnostic tests (biomarkers, imaging, laboratory tests). Comparisons between categories of resource utilization and tumor progression status were examined using univariate (by tumor site) and multivariate analyses (across all tumor sites). RESULTS: Fifty-five physicians were included in the study and completed online data extraction forms using the charts of 110 patients. The physician sample showed a relatively even distribution for those affiliated with academic versus community hospitals (46% vs 55%). Forty (36.3%) patients were reported to have pancreatic NET (pNET), while 70 (63.6%) patients had gastrointestinal tract (GI)/Lung as the primary NET site. Univariate analysis showed the proportion of patients hospitalized increased from 32.7% during baseline to 42.1% in the progression stages. While surgeries were performed at similar proportions overall at baseline and progression, pNET patients, were more likely than GI/Lung NET patients to have undergone surgery during the baseline (33.3% vs 25.0%) and any progression periods (26.7% vs 23.4%). While peptide-receptor radionuclide and targeted therapy utilization was low across NET types and tumor stages, GI/Lung types exhibited greater utilization of these technologies compared to pNET. Chemotherapy utilization was also greater among GI/Lung types. Multivariate analysis results demonstrated that patients in first progression period were over 3 times more likely to receive chemotherapy when compared to baseline (odds ratio: 3.31; 95%CI: 1.46-7.48, P=0.0041). Further, progression was associated with a greater likelihood of having a study physician visit [relative risk (RR): 1.54; 95%CI: 1.10-2.17, P=0.0117], and an increased frequency of other physician visits (RR: 1.84; 95%CI: 1.10-3.10, P=0.0211). CONCLUSION: Resource utilization in advanced NET in the United States is significant overall and data suggests progression has an impact on resource utilization regardless of NET tumor site.

Management Practices, Utilization and Challenges of Donkey in Godey Town, Somali Regional State, Ethiopia

The study was conducted in Godey town of Shebelle zone, Somali Regional State, Ethiopia. The objective of the study was to assess management practices, utilization, and challenges of donkey. A total of 200 households who own working donkeys were selected purposely for this study. Data were collected using semi-structured questionnaires, key informants interviews, focus group discussions with communities who own donkeys and personal observations. The study revealed that the majority of the respondents were illiterate which might be associated with poor education access in the area. The study further revealed that 92% of working donkeys were involved in drought work, whereas 18% were used for pack work. The common feed resources for donkeys were feeds obtained from natural pasture, green maize leaves, hay, household wastes and grain supplements. Pipe water, river water, and pond water were the main water sources for working donkeys in the study area. About 91% of households kept their donkeys in an open backyard, while 9% of them kept them in a separate shed built adjacent to or a short distance away from the family home. Donkeys provide cart services in the study area, transporting various items weighing more than 300 kg in order to obtain a high benefit in a short period of time and are more than six days per week. Working donkeys in the current study area had a life span of fewer than 6 years, 7 - 10 years, and more than 10 years, with 18.5%, 75.5%, and 6%, respectively. The most important constraints that affect donkey production and utilization in the study area were a lack of feed, health problems (sickness, wounds, etc.), overloading and overworking, poor road and harnessing problems, and poor attitude/lack of awareness. As a result, in order to enhance working donkey management concerns, area-based development interventions that can overcome current constraints should be employed.

数字遗产开发利用的多元策略——英国迈向国家宝藏项目的启示

文章剖析英国迈向国家宝藏项目案例,分析以跨边界为内核的奠基性项目、以知识服务为关键的探索性项目、以线上利用为重点的新冠肺炎紧急项目三大类子项目,从行动理念、主体、技术和保障机制等方面予以分析。在此基础上,从明确数字遗产开发利用国家模式、构建产学研用导向的协作机制、建设数智化引领的技术体系、健全多重举措并行的保障机制等方面提出我国数字遗产开发利用的优化策略。

水资源节约集约利用理论体系与应用实践

水资源节约集约利用是促进全社会节约用水、保障国家水安全、促进生态文明建设、助力高质量发展的重要举措。通过梳理水资源节约集约利用的提出背景及历程,深入剖析水资源节约集约利用的概念内涵,提出了水资源节约集约利用理论体系框架,包括基础理论、符合原则与研究内容。重点分析了水资源节约集约利用理论在节水型社会建设、水利高质量发展、人与自然和谐共生以及水资源刚性约束制度建设中的应用实践,旨在为我国现代水资源利用提供理论支撑和实践指导。

The Importance of Practice in English Learning

With the break down of this thesis,I intend to elaborate the significance of English atmosphere in English studying; in addition,the agenda for utilization in practice should hardly be ignored. Should the proposed assertion succeed in fulfilling,the authority and the whole society have responsibility for assistance to maintain English surrounding properly. Qualified teachers play an essential role in organizing mini English environment ideally concerning the same issue in terms of ability in language aspect and capacity in communication.

农业生物质资源化工程课程交互混合式教学模式探索

农业生物质资源化工程是以化学、微生物学、能源工程和机械设计等学科知识交织融合与渗透的综合应用型课程,课程围绕生物质高值化利用作展开。针对课程呈现出知识结构复杂、体量大、跨度广和理论知识晦涩难懂等特点,通过对课程及教学过程存在的问题进行分析,基于OBE-CDIO理念提出构建交互混合式教学模式对课程的教学内容及教学过程进行改进,满足当今社会快速发展的农业工程专业的人才需求。

“双碳”目标下新能源利用概论课程思政教学实践

普及国家“双碳”目标需要面向学生开展新能源教育,优化设计新能源教学与思政元素的深度融合是开展新能源课程教育的关键点。该文以新能源利用概论课程为例,加载“能源动力”与“思想动力”的双核驱动,深入挖掘新能源利用的课程思政元素,规划和设计授课内容、教学案例与课程思政内涵,建立章节具体内容与课程思政点的衔接融合,在课程教学中潜移默化地开展多维度课程思政教育,让学生收获专业知识和思想价值,从而推动工科专业课程教学质量的提升。

南昌局集团公司新能源项目开发应用场景设计与实践探索

随着国家制定交通运输领域“碳达峰、碳中和”重要任务目标,实现铁路资产能源化、用能绿色化成为国铁企业积极探索的重要方向。国铁集团积极推动各铁路局集团公司实施新能源项目开发,南昌局集团公司利用沿线铁路土地和房屋资源优势,加快推进铁路新能源项目开发应用场景设计和实践探索。从新能源经营市场需求、利用形式和利用方向等方面,分析南昌局集团公司铁路新能源项目开发市场,探讨铁路新能源融合项目的主要途径,建立新能源项目开发机制。在此基础上,研究南昌局集团公司新能源项目开发应用场景设计,加强铁路新能源项目开发规划分析,形成政策、资源和专业的融合发展。

Prescription practice of antihistamines for acute upper respiratory tract infections in pediatric patients in a local emergency department in Hong Kong

BACKGROUND: Currently there is very limited data in the literature assessing the prevalence of antihistamine prescription, and there is no local prevalence data about the prescription of antihistamine agents among primary practitioner and emergency physicians. The objectives are 1) to report the prevalence of antihistamine prescription for children less than 6 years old with acute upper respiratory infection and 2) to explore the associated factors for the prescription practice.METHODS: This is a cross-sectional study. All consecutive cases of paediatric patients aged 6 or below who presented to the emergency department during a study period of one week from April 1 to July 4, 2009 with diagnosis of acute upper respiratory infection were included. Totally 162 patients were included.RESULTS: Among the 162 cases, 141(87%) patients were prescribed one antihistamine of any group. Sixty(37%) patients were prescribed two or more antihistamines. In multivariate logistic regression model, age was found to be signi? cantly(P<0.001) associated with multiple antihistamine prescription(OR=1.042, 95%CI=1.02 to 1.06). Years of graduation of attending physician for more than 5 years was also a strong predictor of multiple antihistamine prescription(OR=4.654, 95%CI=2.20 to 9.84, P<0.001).CONCLUSION: In the local emergency department, patients' age and the years of graduation from medical school of the attending physician were predictors of multiple antihistamine prescription for acute upper respiratory infections for children aged less than 6.

Nurses’ perspective of the research-practice gap in nursing

This work aims to explore the views of Nigerian nurses on research-practice gap in the clinical practice and the challenges in the utilization of nursing research. The results from in-depth interview and focus group discussion demonstrated that a research-practice gap existed in the clinical setting. The nurses generally did not utilize research findings in their practice. Some useful suggestions were recommended to solve the problem.

Knowledge about Sexual and Reproductive Health Services and Practice of What Is Known among Ghanaian Youth, a Mixed Method Approach

Most young person will become sexually active before their 20th birthday having to battle with early and unplanned pregnancies, unsafe abortions, maternal deaths and injuries. This study examined young person’s sexual knowledge, attitudes and practices and their levels of utilization of sexual reproductive health. Our study progresses beyond current research of reporting only sexual behaviour among youth to have insight into sexual and reproductive health update drivers yielding new empirically robust results for the Ghanaian case for sexual and reproductive health service uptake. The descriptively cross sectional design was employed in sampling 170 youth (150 surveyed and 20 Interviewed) using the stratified sampling technique together with a purposive selection of one key informant. Test of significance and associations were performed with the Chisquare test. In all 45.2% (77/170) of youth (10 - 24) had had sexual experience in life time. In respect of in-school youth, 42% (63/150) had had sexual experience whiles 70% (14/20) out-of-school youth had had sexual intercourse in life time. A total of 28.8% (49/170) of all the youth had sexual intercourse in the last six months with only 40.1 (20/49) using condom for protection. Parental discussion of contraceptive methods (29.3%) and sexual and romantic relationship (28.0%) was the least sexual and reproductive health area discussed among in-school youth. Youth knowledge of the available sexual reproductive health service was statistically associated with reproductive health service utilization (X2 = 0.00, P ≤ 0.05). A concerted effort is required from government, NGO, Civil society organizations and religious bodies to help translate youth knowledge about sexual health into responsible sexual life and protective sex.

Effect of a region-wide incorporation of an algorithm based on the 2012 international consensus guideline on the practice pattern for the management of pancreatic cystic neoplasms in an integrated health system

AIM To examine the practice pattern in Kaiser Permanente Southern California(KPSC), i.e., gastroenterology(GI)/surgery referrals and endoscopic ultrasound(EUS), for pancreatic cystic neoplasms(PCNs) after the regionwide dissemination of the PCN management algorithm.METHODS Retrospective review was performed; patients with PCN diagnosis given between April 2012 and April 2015(18 mo before and after the publication of the algorithm) in KPSC(integrated health system with 15 hospitals and 202 medical offices in Southern California) were identified.RESULTS2558(1157 pre-and 1401 post-algorithm) received a new diagnosis of PCN in the study period. There was no difference in the mean cyst size(pre-19.1 mm vs post-18.5 mm, P = 0.119). A smaller percentage of PCNs resulted in EUS after the implementation of the algorithm(pre-45.5% vs post-34.8%, P < 0.001). A smaller proportion of patients were referred for GI(pre-65.2% vs post-53.3%, P < 0.001) and surgery consultations(pre-24.8% vs post-16%, P < 0.001) for PCN after the implementation. There was no significant change in operations for PCNs. Cost of diagnostic care was reduced after the implementation by 24%, 18%, and 36% for EUS, GI, and surgery consultations, respectively, with total cost saving of 24%.CONCLUSION In the current healthcare climate, there is increased need to optimize resource utilization. Dissemination of an algorithm for PCN management in an integrated health system resulted in fewer EUS and GI/surgery referrals, likely by aiding the physicians ordering imaging studies in the decision making for the management of PCNs. This translated to cost saving of 24%, 18%, and 36% for EUS, GI, and surgical consultations, respectively, with total diagnostic cost saving of 24%.

农民对闲置宅基地和农房盘活利用的认知调研与对策探讨——以苏南桃源村为例

针对农村闲置宅基地和农房盘活利用问题,通过问卷调查和深度访谈,调研农民个体特征、利用意愿、评价建议等,对各因素进行相关性分析,挖掘农民对相关问题的认知机理,探究各个观察变量对潜变量的影响程度。结果表明:农民年龄、房屋建造年代、政策认知程度是影响农民利用意愿的显著因素,其中农民年龄、房屋建造年代对农民利用意愿有显著负向影响,政策认知程度有显著正向影响;农民的其他相关顾虑主要在安全、管理、投入、政策等方面。建议相关部门完善配套政策并强化宣传,树立典型并强化其示范作用,提供适当资金扶持,积极引入社会资本,完善乡村发展规划,规范宅基地流转市场,以此提升农民的积极性,促进农村人居环境改善和乡村振兴。

农业硕士研究生开展耕读教育的思考——以资源利用与植物保护专业为例

耕读文化是中国传统乡村社会形成的独特文化形态,组成中华优秀传统文化的重要部分。《中共中央国务院关于全面推进乡村振兴加快农业农村现代化的意见》中,在提升农村基本公共服务水平方面提出“开展耕读教育”的要求。耕读教育对于高校研究生教育尤为重要,特别是涉农高校在专业学位硕士研究生培养中进行耕读教育的实践,不仅可以引导学生健康成长和提升学生道德素养,还可以激励专业学位研究渗入农村实践,激励学生献身乡村振兴,为乡村社会可持续发展作出贡献。该文结合资源利用与植物保护专业学位硕士研究生培养的特点,提出在专业学位硕士研究生培养全过程应开展耕读教育的思考,可为耕读教育的实施提供指导。

安钢冶炼除尘灰资源化利用实践与探索

安钢集团安阳基地钢铁冶炼过程中除尘灰产生量为钢产量的10%左右,这些粉尘不仅含有铁元素,部分还含有钾、钠、锌等元素,无法直接在高炉冶炼工序利用。为适应发改环资【2021】381号文《关于“十四五”大宗固体废弃物综合利用的指导意见》中明确提出的创新大宗固废综合利用模式,在钢铁冶金行业推广“固废不出厂”的要求,安阳基地通过建设除尘灰资源化处置和利用生产线,加强除尘灰固废资源全量化利用,并取得了较好效果。

我国农村生活垃圾分类和资源化利用的地方实践——以浙江省德清县为例

本研究以浙江省德清县为研究对象,选取了4个实地调研点,分别为舞阳街道长春村、阜溪街道郭肇村、阜溪街道龙山村、德清县餐厨垃圾集中收运处置项目。通过深度调研与座谈,汇总并梳理德清县在农村生活垃圾治理方面的优秀做法,从创新做法、政策制度、治理模式、监管体系等方面进行分析和梳理,总结可复制推广的经验,以期为各地治理工作提供一定的启发与借鉴。

黄金行业尾矿处置政策与综合利用实践

从黄金尾矿综合利用与处置政策形势及现状入手,梳理了我国尾矿产量及综合利用的基本情况、黄金行业尾矿产生情况以及国家在黄金行业尾矿综合利用方面的相关政策法规。汇总整理了国内外黄金尾矿综合回收、生产建筑材料、井下充填、生态修复及氰渣综合利用与无害化处置等方面的相关技术研究与应用进展情况,并基于此综合预判了“无废”矿山建设、尾矿综合利用产业化、规模化发展以及新技术、新工艺的发展趋势,提出了在当前政策背景下,推动尾矿实现减量化、资源化和无害化,推进矿业绿色低碳高质量转型的路径。研究结果可为黄金尾矿、氰渣等综合利用和处置工作提供有益借鉴。

酒糟综合利用研究进展及茅台实践

酒糟是酿酒过程中产生的量大且集中的主要废弃物,营养物质丰富、含水率高、极易腐败变质,使其丢弃或不科学利用不仅造成环境污染,而且导致资源巨大浪费,因此开展酒糟高值化利用研究迫在眉睫。为掌握国内外酒糟综合利用情况,该文综述了近年来酒糟的资源化利用情况,并根据利用方式将其划分为微生物高附加值转化、功能性材料加工、有机物提取三大类,具体包含生物质能源转化、有机肥开发、菌种培育、生物炭材料制备、食品及其包装材料生产、阻燃材料研制、粘合剂提取等。此外,介绍了茅台集团在酒糟综合利用方面的实践与经验,并提出通过闭环循环利用酿酒废弃物的组合方式节约资源、发展循环经济,还对酒糟资源化开发中的短板和未来利用方向进行了分析和展望。

数字乡村建设评价指标体系构建及其实践效用

数字乡村建设成效事关乡村振兴的有序推进、共同富裕目标的有效达成、中国式现代化的有力推进以及中华民族伟大复兴中国梦的最终实现。构建科学、合理的数字乡村建设评价指标体系,实现对全国数字乡村建设情况的定量评估和动态监测,对于数字乡村建设的高质量推进至关重要。因此,研究立足于数字乡村建设的国家政策及任务目标,综合全面地考虑了数字乡村评价的各方影响因素,构建了一套包含信息基础设施、数字产业发展、乡村数字生活、乡村数字治理以及城乡融合发展5项一级指标,13项二级指标与40项三级指标的数字乡村建设评价指标体系。该指标体系可系统评估数字乡村建设成效、有效发挥数字乡村试点优势及推进数字乡村建设政策高质量执行。

义乌市再生水利用配置现状与启示

加强再生水利用对优化供水结构、增加水资源供给、缓解水资源供需矛盾、减少水污染、保障水生态安全具有重要意义。以浙江省金华市义乌市为典型,分析了该市再生水利用配置的发展历程与现状,从规划布局、管理体系、标准建设、市场激励、设施建设运行投入等方面,深入剖析了义乌市再生水利用配置主要做法,总结经验启示,以期为其他地区再生水利用配置提供借鉴参考。