Water allocation based on multiple criteria has the potential to maximize the total benefits to be gained from the use of a single unit of water. However most of the multi-criteria methods inherently include a conside...Water allocation based on multiple criteria has the potential to maximize the total benefits to be gained from the use of a single unit of water. However most of the multi-criteria methods inherently include a considerable degree of subjectivity. In this study, we have attempted to reduce the subjectivity factor from water allocation decision-making process by introducing a conjoint analysis method. Opinions on the importance of a number of water allocation criteria were sought from a large number of irrigation farmers. The opinion survey data were then analyzed using the traditional conjoint analysis method which is widely used to analyze marketing surveys. The analysis allowed objective determination of the relative importance of five water allocation criteria (i.e. net farm income, percent of family working on the farm, amount paid to irrigation agency for canal water share). Each water allocation criteria was divided into three levels and utility values for each criteria level were estimated from the farmers’ preferences on five water allocation criteria (attributes). The conjoint survey results revealed that the respondents prefer that “annual net farm income” be the most important attribute in water allocation decisions. As would be expected the vast majority of the respondents overwhelmingly placed the “water price” in the last position.展开更多
Background: Pre-exposure prophylaxis(PrEP) prevents human immunodeficiency virus(HIV) infection, but its use remains low among U.S. military men who have sex with men(MSM), likely due to mis-matching with personal pre...Background: Pre-exposure prophylaxis(PrEP) prevents human immunodeficiency virus(HIV) infection, but its use remains low among U.S. military men who have sex with men(MSM), likely due to mis-matching with personal preferences. We conducted a study to characterize preferences to PrEP measures within this population.Methods: HIV-negative military MSM were recruited through a closed, Lesbian, Gay, Bisexual, and Transgendered(LGBT) military social media group. The survey was anonymous, and consisted of five experimentally varied attributes in service delivery: dosing method, provider type, visit location, lab work evaluation location, and dispensing venue.Relative importance and part-worth utility scores were generated using hierarchical bayes(HB) estimation, and the randomized first choice model was used to examine participation interest across eight possible PrEP program scenarios.Results: A total of 429 participants completed the survey. Among the eight scenarios with varying attributes, the most preferred scenario featured a daily tablet, PrEP injection or implant, along with a military provider, smartphone/telehealth visit, and on-base locations for lab evaluation and medication pick-up. The results also emphasized the importance for providers to be familiar with PrEP prescription knowledge, and to provide interactions sensitive to sexual identity and mental health.Conclusions: A PrEP program consisting of daily tablet is preferred in military healthcare settings is preferred. Longacting implants and injections are also desired.展开更多
The long head of the biceps tendon （LHBT） pathology has been implicated as a common source of shoulder pain. The patients may be more resistant to conservative treatment than those with isolated subacromial impingem...The long head of the biceps tendon （LHBT） pathology has been implicated as a common source of shoulder pain. The patients may be more resistant to conservative treatment than those with isolated subacromial impingement. Even though, the surgical options of this disease remain controversial. It has been reported that tenotomy and tenodesis of the biceps tendon were usually utilized. However, persistent pain, deformity, and muscle cramping were frequently observed. Transfer of the LHBT to the conjoint tendon was originally described by Post and Benca in 1982.4 Verma et all has performed the transfer under arthroscopy since 2004. Eighty percent of their patients reported good results with a minimum 2 years of follow-up. However, there was a steep learning curve to become proficient in their technique. We devised a more convenient transfer compared with O＇Brien＇s technique. Six patients received our modified arthroscopic transfers from May 2006 to May 2007. All of them obtained good results.展开更多
This article presents the potential integration of psychotherapy and massage when considering the essence of their beneficial effects.The essence of this model of practice is multifaceted,combining principles from ana...This article presents the potential integration of psychotherapy and massage when considering the essence of their beneficial effects.The essence of this model of practice is multifaceted,combining principles from anatomy,physiology and neuroscience with psychotherapy to benefit patient care.It has been advocated that possessing multidisciplinary knowledge from these areas of science enhances psychotherapists＇ holistic care of their depressive patients.A narrative review of the literatures and a qualitative,conceptual synthesis has been performed to create a new theoretical-pragmatic construct.This article introduces the concept of massage practice as a part of psychotherapy practice and presents the potential integration of psychotherapeutic knowledge with clinical decision-making and the management of depressive symptoms.The authors emphasize the usefulness of multi- and interdisciplinary knowledge in the psychotherapeutic process and explain how this knowledge might be extrapolated and incorporated into theoretical and practical settings to benefit depressive patients.The justification for this concept is also presented.The principles set out in this article may be a useful source of information for psychotherapists concerned about their patients＇ holistic well-being in addition to the psychopathology for which they have sought treatment.Researchers and psychotherapists can obtain valuable and additional knowledge through cross-fertilization of ideas across the arguments presented here.展开更多
背景与目的:胶质瘤是中枢神经系统常见且预后较差的恶性肿瘤,手术后联合替莫唑胺(temozolomide,TMZ)同步放化疗是胶质瘤的主要治疗方案。O6-甲基鸟嘌呤DNA甲基转移酶(O6-methylguanine DNA methyltranferase,MGMT)基因启动子甲基化(MGMT...背景与目的:胶质瘤是中枢神经系统常见且预后较差的恶性肿瘤,手术后联合替莫唑胺(temozolomide,TMZ)同步放化疗是胶质瘤的主要治疗方案。O6-甲基鸟嘌呤DNA甲基转移酶(O6-methylguanine DNA methyltranferase,MGMT)基因启动子甲基化(MGMT promoter methylation,MGMTmet)状态可预测胶质瘤患者对TMZ治疗的敏感性,但其与临床病理学特征的关系及如何更好地预测治疗效果及患者预后尚需深入研究。本研究旨在分析胶质瘤中MGMTmet状态及其与临床病理学特征和其他常见分子异常的相关性,探讨MGMTmet与其他分子异常联合分析对胶质瘤患者预后和TMZ治疗效果判断的价值。方法:回顾性收集复旦大学附属肿瘤医院病理科2019年7月—2022年9月诊断的205例胶质瘤患者的临床病理学资料,采用实时荧光定量聚合酶链反应(real-time fluorescence quantitative polymerase chain reaction,RTFQPCR)法检测MGMTmet状态;采用Sanger测序法检测异柠檬酸脱氢酶(isocitrate dehydrogenase,IDH)1和IDH2端粒酶反转录酶(telomerase reverse transcriptase,TERT)基因突变情况;采用荧光原位杂交(fluorescence in situ hybridization,FISH)检测1号染色体短臂和19号染色体长臂(the short arm of chromosome 1 and the long arm of chromosome 19,1p19q)缺失情况。结果:205例患者中,女性患者的MGMTmet发生率高于男性。相比于胶质母细胞瘤(47.3%),星形细胞瘤(74.1%)和少突胶质细胞瘤(100.0%)中MGMT基因启动子更易发生甲基化(P<0.05)。在MGMTmet组中,IDH1突变(mutant,mut)率和1p19q共缺失(co-deletion,co-del)率明显提高,且MGMTmet与IDH1mut和1p19qco-del具有相关性(P<0.05)。MGMTmet、年龄小于55岁、少突胶质细胞瘤及世界卫生组织(World Health Organization,WHO)1~3级的患者均表现出较长的总生存期(overall survival,OS),差异有统计学意义(P<0.05)。相比于单个影响因素,双/三基因联合分析[MGMTmet/IDH1mut、MGMTmet/1p19q co-del或MGMTmet/IDH1mut/1p19q co-del]预测患者预后的效果更好(P<0.05),后两者是独立预后因素。在TMZ治疗患者中,MGMTmet(MGMTmet/TMZ+)患者比其他组预后好,如果患者联合存在IDH1mut,患者预后得到进一步提高(P<0.05)。结论:MGMTmet好发于女性和少突胶质细胞瘤患者中;其与IDH1mut及1p19 qco-del呈正相关。MGMTmet的患者与TMZ治疗效果及预后较好有关,且MGMTmet联合IDH突变和1p19q co-del分析可能具有更好的TMZ治疗效果和预后提示价值。展开更多
文摘Water allocation based on multiple criteria has the potential to maximize the total benefits to be gained from the use of a single unit of water. However most of the multi-criteria methods inherently include a considerable degree of subjectivity. In this study, we have attempted to reduce the subjectivity factor from water allocation decision-making process by introducing a conjoint analysis method. Opinions on the importance of a number of water allocation criteria were sought from a large number of irrigation farmers. The opinion survey data were then analyzed using the traditional conjoint analysis method which is widely used to analyze marketing surveys. The analysis allowed objective determination of the relative importance of five water allocation criteria (i.e. net farm income, percent of family working on the farm, amount paid to irrigation agency for canal water share). Each water allocation criteria was divided into three levels and utility values for each criteria level were estimated from the farmers’ preferences on five water allocation criteria (attributes). The conjoint survey results revealed that the respondents prefer that “annual net farm income” be the most important attribute in water allocation decisions. As would be expected the vast majority of the respondents overwhelmingly placed the “water price” in the last position.
基金supported by the National Institute of Nursing Research (NINR),under award number 1F31NR018620-01A1supported by the National Institute of Mental Health (NIMH),Center for HIV Identification,Prevention,and Treatment Services (CHIPTS) under award number P30MH059107。
文摘Background: Pre-exposure prophylaxis(PrEP) prevents human immunodeficiency virus(HIV) infection, but its use remains low among U.S. military men who have sex with men(MSM), likely due to mis-matching with personal preferences. We conducted a study to characterize preferences to PrEP measures within this population.Methods: HIV-negative military MSM were recruited through a closed, Lesbian, Gay, Bisexual, and Transgendered(LGBT) military social media group. The survey was anonymous, and consisted of five experimentally varied attributes in service delivery: dosing method, provider type, visit location, lab work evaluation location, and dispensing venue.Relative importance and part-worth utility scores were generated using hierarchical bayes(HB) estimation, and the randomized first choice model was used to examine participation interest across eight possible PrEP program scenarios.Results: A total of 429 participants completed the survey. Among the eight scenarios with varying attributes, the most preferred scenario featured a daily tablet, PrEP injection or implant, along with a military provider, smartphone/telehealth visit, and on-base locations for lab evaluation and medication pick-up. The results also emphasized the importance for providers to be familiar with PrEP prescription knowledge, and to provide interactions sensitive to sexual identity and mental health.Conclusions: A PrEP program consisting of daily tablet is preferred in military healthcare settings is preferred. Longacting implants and injections are also desired.
文摘The long head of the biceps tendon （LHBT） pathology has been implicated as a common source of shoulder pain. The patients may be more resistant to conservative treatment than those with isolated subacromial impingement. Even though, the surgical options of this disease remain controversial. It has been reported that tenotomy and tenodesis of the biceps tendon were usually utilized. However, persistent pain, deformity, and muscle cramping were frequently observed. Transfer of the LHBT to the conjoint tendon was originally described by Post and Benca in 1982.4 Verma et all has performed the transfer under arthroscopy since 2004. Eighty percent of their patients reported good results with a minimum 2 years of follow-up. However, there was a steep learning curve to become proficient in their technique. We devised a more convenient transfer compared with O＇Brien＇s technique. Six patients received our modified arthroscopic transfers from May 2006 to May 2007. All of them obtained good results.
文摘This article presents the potential integration of psychotherapy and massage when considering the essence of their beneficial effects.The essence of this model of practice is multifaceted,combining principles from anatomy,physiology and neuroscience with psychotherapy to benefit patient care.It has been advocated that possessing multidisciplinary knowledge from these areas of science enhances psychotherapists＇ holistic care of their depressive patients.A narrative review of the literatures and a qualitative,conceptual synthesis has been performed to create a new theoretical-pragmatic construct.This article introduces the concept of massage practice as a part of psychotherapy practice and presents the potential integration of psychotherapeutic knowledge with clinical decision-making and the management of depressive symptoms.The authors emphasize the usefulness of multi- and interdisciplinary knowledge in the psychotherapeutic process and explain how this knowledge might be extrapolated and incorporated into theoretical and practical settings to benefit depressive patients.The justification for this concept is also presented.The principles set out in this article may be a useful source of information for psychotherapists concerned about their patients＇ holistic well-being in addition to the psychopathology for which they have sought treatment.Researchers and psychotherapists can obtain valuable and additional knowledge through cross-fertilization of ideas across the arguments presented here.
文摘背景与目的:胶质瘤是中枢神经系统常见且预后较差的恶性肿瘤,手术后联合替莫唑胺(temozolomide,TMZ)同步放化疗是胶质瘤的主要治疗方案。O6-甲基鸟嘌呤DNA甲基转移酶(O6-methylguanine DNA methyltranferase,MGMT)基因启动子甲基化(MGMT promoter methylation,MGMTmet)状态可预测胶质瘤患者对TMZ治疗的敏感性,但其与临床病理学特征的关系及如何更好地预测治疗效果及患者预后尚需深入研究。本研究旨在分析胶质瘤中MGMTmet状态及其与临床病理学特征和其他常见分子异常的相关性,探讨MGMTmet与其他分子异常联合分析对胶质瘤患者预后和TMZ治疗效果判断的价值。方法:回顾性收集复旦大学附属肿瘤医院病理科2019年7月—2022年9月诊断的205例胶质瘤患者的临床病理学资料,采用实时荧光定量聚合酶链反应(real-time fluorescence quantitative polymerase chain reaction,RTFQPCR)法检测MGMTmet状态;采用Sanger测序法检测异柠檬酸脱氢酶(isocitrate dehydrogenase,IDH)1和IDH2端粒酶反转录酶(telomerase reverse transcriptase,TERT)基因突变情况;采用荧光原位杂交(fluorescence in situ hybridization,FISH)检测1号染色体短臂和19号染色体长臂(the short arm of chromosome 1 and the long arm of chromosome 19,1p19q)缺失情况。结果:205例患者中,女性患者的MGMTmet发生率高于男性。相比于胶质母细胞瘤(47.3%),星形细胞瘤(74.1%)和少突胶质细胞瘤(100.0%)中MGMT基因启动子更易发生甲基化(P<0.05)。在MGMTmet组中,IDH1突变(mutant,mut)率和1p19q共缺失(co-deletion,co-del)率明显提高,且MGMTmet与IDH1mut和1p19qco-del具有相关性(P<0.05)。MGMTmet、年龄小于55岁、少突胶质细胞瘤及世界卫生组织(World Health Organization,WHO)1~3级的患者均表现出较长的总生存期(overall survival,OS),差异有统计学意义(P<0.05)。相比于单个影响因素,双/三基因联合分析[MGMTmet/IDH1mut、MGMTmet/1p19q co-del或MGMTmet/IDH1mut/1p19q co-del]预测患者预后的效果更好(P<0.05),后两者是独立预后因素。在TMZ治疗患者中,MGMTmet(MGMTmet/TMZ+)患者比其他组预后好,如果患者联合存在IDH1mut,患者预后得到进一步提高(P<0.05)。结论:MGMTmet好发于女性和少突胶质细胞瘤患者中;其与IDH1mut及1p19 qco-del呈正相关。MGMTmet的患者与TMZ治疗效果及预后较好有关,且MGMTmet联合IDH突变和1p19q co-del分析可能具有更好的TMZ治疗效果和预后提示价值。
