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Chinese Journal of Cancer 2011年第3期30卷 197-203页

作者： John Bian1 Michael T. Halpern Atlanta Veterans Affairs Medical Center rti international

The practice of outpatient breast cancer surgery has been controversial in the United States. This study aimed to update time trends and geographic variation in outpatient breast cancer surgery among elderly Medicare fee-for-service women in the United States. Using the 1993-2002 linked Surveillance, Epidemiology and End Results (SEER)-Medicare claims data and the Area Resource Files, we identified 2 study samples, including the women whose breast cancers were the first-ever-diagnosed cancer at age 65 years or older from 9 regions continuously covered by the SEER registries since 1993. The first sample included the women receiving unilateral mastectomy for stage 0-IV cancer; the second included the women receiving the breast-conserving surgery with lymph node dissection (BCS/LND) for stage 0-II cancer. The proportions of patients receiving outpatient surgery increased from 3.2% to 19.4% for mastectomy and from 48.9% to 77.8% for BCS/LND from 1993 to 2002. We observed substantial geographic variation in the average proportion of the patients receiving outpatient surgery in the studied areas across the 10-year period, ranging from 3.9% in Connecticut to 27.2% in Utah for mastectomy and from 54.7% in Hawaii to 78.1% in Seattle, Washington, for BCS/LND. As the popularity of outpatient breast cancer surgery continues to grow, more evidence-based analyses related to quality and outcomes of outpatient breast cancer surgery among various populations are needed in order to facilitate the public debates about state and federal mandated health benefit legislations.

关键词：医疗费用有偿服务乳腺癌手术门诊患者美国 SEER

Maximizing Sampling Efficiency

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Applied Mathematics 2013年第11期4卷 1547-1557页

作者： Harmon S. Jordan Health Care Quality Program RTI International Waltham Massachusetts USA

Background and Goals: Although health care quality improvement has traditionally involved extensive work with paper records, the adoption of health information technology has increased the use of electronic record and administrative systems. Despite these advances, quality improvement practitioners now and for the foreseeable future need guidance in defining populations of individuals for study and in selecting and analyzing sample data from such populations. Statistical data analysis in health care research often involves using samples to make inferences about populations. The investigator needs to consider the goals of the study, whether sampling is to be used, and the type of population being studied. While there are numerous sampling strategies designed to conserve resources and yield accurate results, one of these techniques—use of the finite population correction (FPC)—has received relatively little attention in health care sampling contexts. It is important for health care quality practitioners to be aware of sampling options that may increase accuracy and conserve resources. This article describes common sampling situations in which the issue of the finite population correction decision often arises. Methods: This article describes 3 relevant sampling situations that influence the design and analysis phases of a study and offers guidance for choosing the most effective and efficient design. Situation 1: The study or activity involves taking a sample from a large finite target population for which enumerative inferences are needed. Situation 2: The population is finite and the study is enumerative. A complete enumerative count of “defects” in the process is needed so that remediation can occur. Here, statistical inference is unnecessary. Situation 3: The target population is viewed as infinite;such populations are “conceptual populations” [1] or “processes”. Results: The article shows how savings in resources can be achieved by choosing the correct analytic f

关键词： Sampling Finite Population Correction FPC Finite Population Infinite Population

Modeling Climate Change Impacts on the US Agricultural Exports

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Journal of Integrative Agriculture 2014年第4期13卷 666-676页

作者： ZHANG Yu-quan CAI Yong-xia Beach Robert H McCARL Bruce A Agricultural Resource & Energy Economics and Policy ProgramRTI InternationalResearch Triangle Park Department of Agricultural Economics Texas A&M UniversityCollege Station

Climate change is expected to have substantial effects on agricultural productivity worldwide. However, these impacts will differ across commodities, locations and time periods. As a result, landowners will see changes in relative returns that are likely to induce modifications in production practices and land allocation. In addition, regional variations in impacts can alter relative competitiveness across countries and lead to adjustments in international trade patterns. Thus in climate change impact studies it is likely useful to account for worldwide productivity effects. In this study, we investigate the implications of considering rest of world climate impacts on projections of the US agricultural exports. We chose to focus on the US because it is one of the largest agricultural exporters. To conduct our analyses, we consider four alternative climate scenarios, both with and without rest of world climate change impacts. Our results show that considering/ignoring rest of world climate impacts causes significant changes in the US production and exports projections. Thus we feel climate change impact studies should account not only for climate impacts in the country of focus but also on productivity in the rest of the world in order to capture effects on commodity markets and trade potential.

关键词： climate change relative competitiveness trade agricultural sector model (ASM)

The Shifting Landscape of Latent Print Testimony:An American Perspective

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Journal of Forensic Science and Medicine 2017年第2期3卷 72-81页

作者： Heidi Eldridge rti international Research Triangle ParkNCUSA School of Criminal Justice University of LausanneLausanneSwitzeriand

Friction ridge comparison testimony in the United States has long been characterized by speaking in absolutes:fingerprints are unique,the Analysis,Comparison,Evaluation,and Verification methodology has a zero-error rate,and the testimony presented by the expert should be regarded as an incontrovertible *** the National Research Council released their watershed report in 2009,questioning and criticizing these clear overstatements of the strength of the evidence,many commentators and professional organizations recommended that the friction ridge community rethink the way their evidence was presented in reports and in ***,change has been slow to *** some agencies have begun a shift in the way they present their findings,many others still testify the same way they always *** paper presents the historical context of where American friction ridge testimony has been,lays out the arguments for why it needs to change,describes some recent efforts to improve,and highlights some likely directions for the future of friction ridge reporting and testimony in the United States.

关键词： Friction ridge latent prints testimony

Impacts of timing,length,and intensity of behavioral interventions to COVID-19 dynamics:North Carolina countylevel examples

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Infectious Disease Modelling 2022年第3期7卷 535-544页

作者： Claire Quiner Kasey Jones Georgiy Bobashev rti international 3040 E.Cornwallis RoadPO Box 12194Research Triangle ParkNC27709USA

We sought to examine how the impact of revocable behavioral interventions,e.g.,shelterin-place,varies throughout an epidemic,as well as the role that the proportion of susceptible individuals had on an intervention's *** estimated the theoretical impacts of start day,length,and intensity of interventions on disease transmission and illustrated them on COVID-19 dynamics inWake County,North Carolina,to inform how interventions can be most *** used a Susceptible,Exposed,Infectious,and Recovered(SEIR)model to estimate epidemic curves with modifications to the disease transmission parameter(β).We designed modifications to simulate events likely to increase transmission(e.g.,long weekends,holiday seasons)or behavioral interventions likely to decrease it(e.g.,shelter-in-place,masking).We compared the resultant curves'shape,timing,and cumulative case count to baseline and across other modified *** led to changes in COVID-19 dynamics,including moving the peak's location,height,and *** proportion susceptible,at the start day,strongly influenced their *** interventions shifted the curve,while interventions near the peak modified shape and case *** some scenarios,in which the transmission parameter was decreased,the final cumulative count increased over *** showed that the timing of revocable interventions has a strong impact on their *** same intervention applied at different time points,corresponding to different proportions of susceptibility,resulted in qualitatively differential *** estimation of the proportion susceptible is critical for understanding an intervention's *** findings presented here provide evidence of the importance of estimating the proportion of the population that is susceptible when predicting the impact of behavioral infection control *** emphasis should be placed on the estimation of this epidemic component in intervention design and decision-makin

关键词： Sars-cov-2 Public health decision-making Infection control policies

Exploring hemp seed hull biomass for an integrated C-5 biorefinery:Xylose and activated carbon

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Journal of Bioresources and Bioproducts 2024年第3期9卷 310-321页

作者： Sreesha Malayil Luke Loughran Frederik Mendoza Ulken Jagannadh Satyavolu Conn Center for Renewable Energy Research University of LouisvilleKentucky 40292United States Bioproducts LLC LouisvilleKentucky 40206United States rti international Research Triangle ParkNC 27709United States

Large quantities of hemp hulls can be completely utilized for creation of value-added products (cost effective biofuels and biochemicals) through a biorefinery approach. A sustainable approach in making xylose, a low calorie sweetener and high surface area activated carbons (AC) for super capacitors, attracts interest. The AC when leveraged as a co-product from biorefinery process makes it more cost effective and, in this paper, we discuss the production of xylose and AC from hemp seed hull with methane sulphonic acid (MSA) hydrolysis. Xylose recovery with MSA hydrolysis was 25.15 g/L when compared to the traditional sulphuric acid (SA) hydrolysis of 19.96 g/L at the same acid loading of 1.8 %. The scanning electron microscope (SEM) images and Fourier transform infrared (FT-IR) spectra indicate partial delignification along with hemicellulose hydrolysis responsible for high xylose recovery. Post hydrolysis fibers were KOH activated and carbonized to make AC. The MSA hydrolyzed and KOH activated fiber produced pure, fluffier and finer particle AC with a drastic increase in surface area 1 452 m2/g when compared to SA hydrolyzed of 977 m2/g. These results indicate the potential of MSA in dilute acid hydrolysis of biomass for xylose recovery and production of high surface area activated carbon. From a production standpoint this can lead to increased use of sustainable low-cost agricultural biomass for making high surface area AC as components in supercapacitors.

关键词： Xylose C-5 biorefinery Methane sulphonic acid Delignification Activated carbon Dilute acid hydrolysis

The natural analgesic conolidine targets the newly identified opioid scavenger ACKR3/CXCR7

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Signal Transduction and Targeted Therapy 2021年第7期6卷 1966-1968页

作者： Martyna Szpakowska Ann M.Decker Max Meyrath Christie B.Palmer Bruce E.Blough Ojas A.Namjoshi Andy Chevigne Immuno-Pharmacology and Interactomics Department of Infection and ImmunityLuxembourg Institute of Health(LIH)Esch-sur-AlzetteLuxembourg Center for Drug Discovery RTI InternationalDurhamNCUSA Faculty of Science Technology and MedicineUniversity of LuxembourgEsch-sur-AlzetteLuxembourg

Dear Editor,The atypical chemokine receptor ACKR3 has recently been reported to act as an opioid scavenger with unique negative regulatory properties towards different families of opioid ***,we show that conolidine,a natural analgesic alkaloid used in traditional Chinese medicine,targets ACKR3,thereby providing additional proof of a correlation between ACKR3 and pain modulation and opening alternative therapeutic avenues for the treatment of chronic pain.

关键词： CXCR7 opioid analgesic

Burden and outcomes for complex perianal fistulas in Crohn's disease:Systematic review

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World Journal of Gastroenterology 2018年第42期24卷 4821-4834页

作者： Julian Panes Walter Reinisch Ewa Rupniewska Shahnaz Khan Joan Forns Javaria Mona Khalid Daniela Bojic Haridarshan Patel Department of Gastroenterology Hospital Clínic de BarcelonaIDIBAPSCIBERehdBarcelona 08036Spain Medical University of Vienna Vienna 1090Austria rti Health Solutions Manchester M20 2LSUnited Kingdom rti Health Solutions Research Triangle ParkNC 27709United States rti Health Solutions Barcelona 08028Spain Takeda DeerfieldIL 60015United States

AIM To systematically review the literature on epidemiology,disease burden, and treatment outcomes for Crohn's disease(CD) patients with complex perianal *** PubMed, Embase, and Cochrane were searched for relevant articles(published 2000-November 2016) and congress abstracts(published 2011-November 2016).RESULTS Of 535 records reviewed, 62 relevant sources were identified(mostly small observational studies). The cumulative incidence of complex perianal fistulas in CD from two referral-centre studies was 12%-14%(follow-up time, 12 years in one study; not reported in the second study). Complex perianal fistulas result in greatly diminished quality of life; up to 59% of patients are at risk of faecal incontinence. Treatments include combinations of medical and surgical interventions and expanded allogeneic adipose-derived stem cells. High proportions of patients experience lack of or inadequate response to treatment(failure and relapse rates,respectively: medical, 12%-73% and 0%-41%; surgical:0%-100% and 11%.20%; combined medical/surgical:0%-80% and 0%-50%; stem cells: 29%-47% and not reported). Few studies(1 of infliximab; 3 of surgical interventions)have been conducted in treatment-refractory patients, a population with high unmet needs. Limited data exist on the clinical value of anti-tumour necrosis factor-α dose escalation in patients with complex perianal fistulas in *** Complex perianal fistulas in CD pose substantial clinical and humanistic burden. There is a need for effective treatments, especially for patients refractory to antitumour necrosis factor-α agents, as evidenced by high failure and relapse rates.

关键词： Burden Complex perianal fistulas Crohn’s disease Epidemiology Outcomes Systematic literature review Treatment

Incorporation of near-real-time hospital occupancy data to improve hospitalization forecast accuracy during the COVID19 pandemic

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Infectious Disease Modelling 2022年第1期7卷 277-285页

作者： Alexander Preiss Emily Hadley Kasey Jones Marie C.D.Stoner Caroline Kery Peter Baumgartner Georgiy Bobashev Jessica Tenenbaum Charles Carter Kimberly Clement Sarah Rhea rti international Research Triangle ParkNCUSA Explosion BerlinGermany North Carolina Department of Health and Human Services RaleighNCUSA North Carolina State University Department of Population Health and PathobiologyRaleighNCUSA

Public health decision makers rely on hospitalization forecasts to inform COVID-19 pandemic planning and resource *** forecasts are most relevant when they are accurate,made available quickly,and updated *** rapidly adapted an agent-based model(ABM)to provide weekly 30-day hospitalization forecasts(i.e.,demand for intensive care unit[ICU]beds and non-ICU beds)by state and region in North Carolina for public health decision *** ABM was based on a synthetic population of North Carolina residents and included movement of agents(i.e.,patients)among North Carolina hospitals,nursing homes,and the *** assigned SARSCoV-2 infection to agents using county-level compartmental models and determined agents’COVID-19 severity and probability of hospitalization using synthetic population characteristics(e.g.,age,comorbidities).We generated weekly 30-day hospitalization forecasts during MayeDecember 2020 and evaluated the impact of major model updates on statewide forecast accuracy under a SARS-CoV-2 effective reproduction number range of *** the 21 forecasts included in the assessment,the average mean absolute percentage error(MAPE)was 7.8%for non-ICU beds and 23.6%for ICU *** the major model updates,integration of near-real-time hospital occupancy data into the model had the largest impact on improving forecast accuracy,reducing the average MAPE for non-ICU beds from 6.6%to 3.9%and for ICU beds from 33.4%to 6.5%.Our results suggest that future pandemic hospitalization forecasting efforts should prioritize early inclusion of hospital occupancy data to maximize accuracy.

关键词： forecast hospital adapted

Systematic literature review of the antitumor effect of octreotide in neuroendocrine tumors

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World Journal of Meta-Analysis 2018年第2期6卷 9-20页

作者： Stephanie M Barrows Beilei Cai Catherine Copley-Merriman Kelly R Wright Colleen V Castro Raoudha Soufi-Mahjoubi rti Health Solutions Novartis Pharmaceuticals rti Health Solutions Research Triangle Park

AIM To provide a comprehensive examination of the existing evidence of the antitumor effect of long-acting octreotide in neuroendocrine tumors(NETs).METHODS A systematic literature review of clinical trials and observational studies was conducted in PubM ed, EMBASE, and Cochrane through January 18, 2017. Conference abstracts for 2015 and 2016 from 5 scientific meetings were also *** Of 41 articles/abstracts identified, 13 unique studies compared octreotide with active or no treatment. Two of the 13 studies were clinical trials; the remaining were observational studies. The phase 3 Placebo-Controlled, Double-Blind, Prospective, Randomized Study of the Effect of Octreotide long-acting repeatable(LAR) in the Control of Tumor Growth in Patients with MetastaticNeuroendocrine Midgut Tumors clinical trial showed that long-acting octreotide significantly prolonged time to tumor progression compared with placebo in patients with functionally active and inactive metastatic midgut NETs; no statistically significant difference in overall survival(OS) was observed, possibly due to the crossover of placebo patients to octreotide. Retrospective observational studies found that long-acting octreotide use was associated with significantly longer OS than no octreotide use for patients with distant metastases although not for those with local/regional disease. CONCLUSION The clinical trial and observational studies with informative evidence support long-acting octreotide's antitumor effect on time to tumor progression and OS. This review showed the rarity of existing studies assessing octreotide's antitumor effect and recommends that future research is warranted.

关键词： Neuroendocrine tumors Antitumor effect Octreotide Overall survival Progression-free survival