Authentic Learning Experience: Subtle but Useful Ways to Provide It in Practice

ERIC Educational Resources Information Center

Watagodakumbura, Chandana

2013-01-01

Authentic learning is conceptualised as an individualised experience learners undergo fulfilling their unique psychological as well as neurological needs. It provides a deep, more lasting experience and ideally assessed through generic attributes that are related to individual learners' intrinsic characteristics, spanning throughout the life.…

Evaluation of generic and branded herbicides : technical report.

DOT National Transportation Integrated Search

2015-03-01

As with other generic brand products in the marketplace, generic herbicides often have a lower initial product cost than : their brand-name counterparts. While the purchase price of herbicides is important to TxDOT, it is essential to look at : more ...

A method for validation of finite element forming simulation on basis of a pointwise comparison of distance and curvature

NASA Astrophysics Data System (ADS)

Dörr, Dominik; Joppich, Tobias; Schirmaier, Fabian; Mosthaf, Tobias; Kärger, Luise; Henning, Frank

2016-10-01

Thermoforming of continuously fiber reinforced thermoplastics (CFRTP) is ideally suited to thin walled and complex shaped products. By means of forming simulation, an initial validation of the producibility of a specific geometry, an optimization of the forming process and the prediction of fiber-reorientation due to forming is possible. Nevertheless, applied methods need to be validated. Therefor a method is presented, which enables the calculation of error measures for the mismatch between simulation results and experimental tests, based on measurements with a conventional coordinate measuring device. As a quantitative measure, describing the curvature is provided, the presented method is also suitable for numerical or experimental sensitivity studies on wrinkling behavior. The applied methods for forming simulation, implemented in Abaqus explicit, are presented and applied to a generic geometry. The same geometry is tested experimentally and simulation and test results are compared by the proposed validation method.

Querying Archetype-Based Electronic Health Records Using Hadoop and Dewey Encoding of openEHR Models.

PubMed

Sundvall, Erik; Wei-Kleiner, Fang; Freire, Sergio M; Lambrix, Patrick

2017-01-01

Archetype-based Electronic Health Record (EHR) systems using generic reference models from e.g. openEHR, ISO 13606 or CIMI should be easy to update and reconfigure with new types (or versions) of data models or entries, ideally with very limited programming or manual database tweaking. Exploratory research (e.g. epidemiology) leading to ad-hoc querying on a population-wide scale can be a challenge in such environments. This publication describes implementation and test of an archetype-aware Dewey encoding optimization that can be used to produce such systems in environments supporting relational operations, e.g. RDBMs and distributed map-reduce frameworks like Hadoop. Initial testing was done using a nine-node 2.2 GHz quad-core Hadoop cluster querying a dataset consisting of targeted extracts from 4+ million real patient EHRs, query results with sub-minute response time were obtained.

Generic phytosanitary irradiation treatments

USDA-ARS?s Scientific Manuscript database

The history of the development of generic phytosanitary irradiation (PI) treatments is discussed beginning with its initial proposal in 1986. Generic PI treatments in use today are 150 Gy for all hosts of Tephritidae, 250 Gy for all arthropods on mango and papaya shipped from Australia to New Zeala...

What Is the Future of Generics in Transplantation?

PubMed

van Gelder, Teun

2015-11-01

Generic immunosuppressive drugs are available in Europe, Canada, and the United States. Between countries, there are large differences in the market penetration of generic drugs in general, and for immunosuppressive drugs in particular. The registration criteria for generic immunosuppressive drugs are often criticized. However, it is unlikely that the criteria for registration of narrow therapeutic index drugs are going to change, and bioequivalence studies, performed in healthy volunteers, will remain the backbone of the registration process. It would be good if the registration authorities would demand that all generic variants of an innovator drug have the same pill appearance to reduce errors and promote drug adherence.To allow for safe substitution, a number of criteria need to be fulfilled. Generic substitution should not be taken out of the hands of the treating physicians. Generic substitution can only be done safely if initiated by the prescriber, and in well-informed and prepared patients. Payers should refrain from forcing pharmacists to dispense generic drugs in patients on maintenance treatment with innovator drug. Instead, together with transplant societies, they should design guidelines on how to implement generic immunosuppressive drugs into clinical practice. Substitutions must be followed by control visits to check if the patient is taking the medication correctly and if drug exposure remains stable. Inadvertent, uncontrolled substitutions from 1 generic to another, initiated outside the scope of the prescriber, must be avoided as they are unsafe. Repetitive subsequent generic substitutions result in minimal additional cost savings and have an inherent risk of medication errors.

A proof of the Biswas-Mitra-Bhattacharyya conjecture for the ideal quantum gas trapped under the generic power law potential U=\\sum\

NASA Astrophysics Data System (ADS)

Mehedi Faruk, Mir; Muktadir Rahman, Md

2016-03-01

The well known relation for ideal classical gas $\\Delta \\epsilon^2=kT^2 C_V$ which does not remain valid for quantum system is revisited. A new connection is established between energy fluctuation and specific heat for quantum gases, valid in the classical limit and the degenerate quantum regime as well. Most importantly the proposed Biswas-Mitra-Bhattacharyya (BMB) conjecture (Biswas $et.$ $al.$, J. Stat. Mech. P03013, 2015.) relating hump in energy fluctuation and discontinuity of specific heat is proved and precised in this manuscript.

Impact of generic antiretroviral therapy (ART) and free ART programs on time to initiation of ART at a tertiary HIV care center in Chennai, India.

PubMed

Solomon, Sunil S; Lucas, Gregory M; Kumarasamy, Nagalingeswaran; Yepthomi, Tokugha; Balakrishnan, Pachamuthu; Ganesh, Aylur K; Anand, Santhanam; Moore, Richard D; Solomon, Suniti; Mehta, Shruti H

2013-08-01

Antiretroviral therapy (ART) access in the developing world has improved, but whether increased access has translated to more rapid treatment initiation among those who need it is unknown. We characterize time to ART initiation across three eras of ART availability in Chennai, India (1996-1999: pregeneric; 2000-2003: generic; 2004-2007: free rollout). Between 1996 and 2007, 11,171 patients registered for care at the YR Gaitonde Centre for AIDS Research and Education (YRGCARE), a tertiary HIV referral center in southern India. Of these, 5726 patients became eligible for ART during this period as per Indian guidelines for initiation of ART. Generalized gamma survival models were used to estimate relative times (RT) to ART initiation by calendar periods of eligibility. Time to initiation of ART among patients in Chennai, India was also compared to an HIV clinical cohort in Baltimore, USA. Median age of the YRGCARE patients was 34 years; 77% were male. The median CD4 at presentation was 140 cells/µl. After adjustment for demographics, CD4 and WHO stage, persons in the pregeneric era took 3.25 times longer (95% confidence interval [CI]: 2.53-4.17) to initiate ART versus the generic era and persons in the free rollout era initiated ART more rapidly than the generic era (RT: 0.73; 95% CI: 0.63-0.83). Adjusting for differences across centers, patients at YRGCARE took longer than patients in the Johns Hopkins Clinical Cohort (JHCC) to initiate ART in the pregeneric era (RT: 4.90; 95% CI: 3.37-7.13) but in the free rollout era, YRGCARE patients took only about a quarter of the time (RT: 0.31; 95% CI: 0.22-0.44). These data demonstrate the benefits of generic ART and government rollouts on time to initiation of ART in one developing country setting and suggests that access to ART may be comparable to developed country settings.

The Fermi-Pasta-Ulam Problem and Its Underlying Integrable Dynamics

NASA Astrophysics Data System (ADS)

Benettin, G.; Christodoulidi, H.; Ponno, A.

2013-07-01

This paper is devoted to a numerical study of the familiar α+ β FPU model. Precisely, we here discuss, revisit and combine together two main ideas on the subject: (i) In the system, at small specific energy ɛ= E/ N, two well separated time-scales are present: in the former one a kind of metastable state is produced, while in the second much larger one, such an intermediate state evolves and reaches statistical equilibrium. (ii) FPU should be interpreted as a perturbed Toda model, rather than (as is typical) as a linear model perturbed by nonlinear terms. In the view we here present and support, the former time scale is the one in which FPU is essentially integrable, its dynamics being almost indistinguishable from the Toda dynamics: the Toda actions stay constant for FPU too (while the usual linear normal modes do not), the angles fill their almost invariant torus, and nothing else happens. The second time scale is instead the one in which the Toda actions significantly evolve, and statistical equilibrium is possible. We study both FPU-like initial states, in which only a few degrees of freedom are excited, and generic initial states extracted randomly from an (approximated) microcanonical distribution. The study is based on a close comparison between the behavior of FPU and Toda in various situations. The main technical novelty is the study of the correlation functions of the Toda constants of motion in the FPU dynamics; such a study allows us to provide a good definition of the equilibrium time τ, i.e. of the second time scale, for generic initial data. Our investigation shows that τ is stable in the thermodynamic limit, i.e. the limit of large N at fixed ɛ, and that by reducing ɛ (ideally, the temperature), τ approximately grows following a power law τ˜ ɛ - a , with a=5/2.

Quantum open system theory: bipartite aspects.

PubMed

Yu, T; Eberly, J H

2006-10-06

We demonstrate in straightforward calculations that even under ideally weak noise the relaxation of bipartite open quantum systems contains elements not previously encountered in quantum noise physics. While additivity of decay rates is known to be generic for decoherence of a single system, we demonstrate that it breaks down for bipartite coherence of even the simplest composite systems.

Karl Jaspers on the disease entity: Kantian ideas and Weberian ideal types.

PubMed

Walker, Chris

2014-09-01

Jaspers' nosology is indebted to Immanuel Kant's theory of knowledge. He drew the distinction of form and content from the Transcendental Analytic of Kant's Critique of Pure Reason. The distinction is universal to all knowledge, including psychopathology. Individual experience is constituted by a form or category of the Understanding to give a determinate or knowable object classified into the generic type of a real disease entity. The application of form and content is limited by the boundaries of experience. Beyond this boundary are wholes whose conception requires Ideas of reason drawn from the Transcendental Dialectic. Wholes are regulated by Ideas of reason to give an object or schema of the Idea collected into ideal types of an ideal typical disease entity. Jaspers drew ideal types from Max Weber's social theory. He anticipated that, as knowledge advanced, ideal typical disease entities would become real disease entities. By 1920, this had been the destiny of general paralysis as knowledge of its neuropathology, serology and microbiology emerged. As he presented the final edition of General Psychopathology in 1946, Jaspers was anticipating the transition of schizophrenia from ideal typical to real disease entity. Almost 70 years later, with knowledge of its aetiology still unclear, schizophrenia remains marooned as an ideal typical disease entity - still awaiting that crucial advance! © The Author(s) 2014.

Generic versus branded medicines: An observational study among patients with chronic diseases attending a public hospital outpatient department

PubMed Central

Das, Manisha; Choudhury, Supriyo; Maity, Somnath; Hazra, Avijit; Pradhan, Tirthankar; Pal, Aishee; Roy, Ranendra Kumar

2017-01-01

Background: The concept of generic prescription is widely accepted in various parts of the world. Nevertheless, it has failed to gain popularity in India due to factors such as nonavailability and distrust on the product quality. However, since 2012, the Government of West Bengal, India, has initiated exclusive generic drug outlets called “fair price medicine shop” (FPMS) inside the government hospital premises in a “public-private-partnership” model. This study was undertaken to evaluate the experience and attitude of patients who were consuming generic drugs purchased from these FPMS. Materials and Methods: It was a questionnaire-based cross-sectional study where we have interviewed 100 patients each consuming generic and branded drugs, respectively. The perceived effectiveness, reported safety, medication adherence, cost of therapy, and availability of drugs was compared between two mentioned groups. Medication adherence was estimated through Drug Attitude Inventory-10. Results: 93% of generic and 87% branded drug users believed that their drugs were effective (P = 0.238) in controlling their ailments. No significant difference (9% generic, 10% branded drug users, P = 1.000) was observed in reported adverse effects between generic and branded drug users. 82% and 77% of patients were adherent generic and branded drugs, respectively (P = 0.289). As expected, a significantly lower cost of generic drugs was observed compared to its branded counterpart. Conclusion: The policy of FPMS implemented by the Government of West Bengal, India appeared to be promising in terms of perceived effectiveness, safety, and adherence of generic drugs from FPMS compared to drugs purchased from open market retailers. Therefore, this study might act as an impetus for the policy-makers to initiate similar models across the country. PMID:28250671

Early Warning Signals for Regime Transition in the Stable Boundary Layer: A Model Study

NASA Astrophysics Data System (ADS)

van Hooijdonk, I. G. S.; Moene, A. F.; Scheffer, M.; Clercx, H. J. H.; van de Wiel, B. J. H.

2017-02-01

The evening transition is investigated in an idealized model for the nocturnal boundary layer. From earlier studies it is known that the nocturnal boundary layer may manifest itself in two distinct regimes, depending on the ambient synoptic conditions: strong-wind or overcast conditions typically lead to weakly stable, turbulent nights; clear-sky and weak-wind conditions, on the other hand, lead to very stable, weakly turbulent conditions. Previously, the dynamical behaviour near the transition between these regimes was investigated in an idealized setting, relying on Monin-Obukhov (MO) similarity to describe turbulent transport. Here, we investigate a similar set-up, using direct numerical simulation; in contrast to MO-based models, this type of simulation does not need to rely on turbulence closure assumptions. We show that previous predictions are verified, but now independent of turbulence parametrizations. Also, it appears that a regime shift to the very stable state is signaled in advance by specific changes in the dynamics of the turbulent boundary layer. Here, we show how these changes may be used to infer a quantitative estimate of the transition point from the weakly stable boundary layer to the very stable boundary layer. In addition, it is shown that the idealized, nocturnal boundary-layer system shares important similarities with generic non-linear dynamical systems that exhibit critical transitions. Therefore, the presence of other, generic early warning signals is tested as well. Indeed, indications are found that such signals are present in stably stratified turbulent flows.

Asymptotic Properties of Induced Maximum Likelihood Estimates of Nonlinear Models for Item Response Variables: The Finite-Generic-Item-Pool Case.

ERIC Educational Resources Information Center

Jones, Douglas H.

The progress of modern mental test theory depends very much on the techniques of maximum likelihood estimation, and many popular applications make use of likelihoods induced by logistic item response models. While, in reality, item responses are nonreplicate within a single examinee and the logistic models are only ideal, practitioners make…

The experiences of implementing generic medicine policy in eight countries: A review and recommendations for a successful promotion of generic medicine use

PubMed Central

Hassali, Mohamed Azmi; Alrasheedy, Alian A.; McLachlan, Andrew; Nguyen, Tuan Anh; AL-Tamimi, Saleh Karamah; Ibrahim, Mohamed Izham Mohamed; Aljadhey, Hisham

2013-01-01

Generic medicines are clinically interchangeable with original brand medicines and have the same quality, efficacy and safety profiles. They are, nevertheless, much cheaper in price. Thus, while providing the same therapeutic outcomes, generic medicines lead to substantial savings for healthcare systems. Therefore, the quality use of generic medicines is promoted in many countries. In this paper, we reviewed the role of generic medicines in healthcare systems and the experiences of promoting the use of generic medicines in eight selected countries, namely the United States (US), the United Kingdom (UK), Sweden, Finland, Australia, Japan, Malaysia and Thailand. The review showed that there are different main policies adopted to promote generic medicines such as generic substitution in the US, generic prescribing in the UK and mandatory generic substitution in Sweden and Finland. To effectively and successfully implement the main policy, different complementary policies and initiatives were necessarily introduced. Barriers to generic medicine use varied between countries from negative perceptions about generic medicines to lack of a coherent generic medicine policy, while facilitators included availability of information about generic medicines to both healthcare professionals and patients, brand interchangeability guidelines, regulations that support generic substitution by pharmacists, and incentives to both healthcare professionals and patients. PMID:25561861

A phylogenetically-based nomenclature for Cordycipitaceae (Hypocreales).

PubMed

Kepler, Ryan M; Luangsa-Ard, J Jennifer; Hywel-Jones, Nigel L; Quandt, C Alisha; Sung, Gi-Ho; Rehner, Stephen A; Aime, M Catherine; Henkel, Terry W; Sanjuan, Tatiana; Zare, Rasoul; Chen, Mingjun; Li, Zhengzhi; Rossman, Amy Y; Spatafora, Joseph W; Shrestha, Bhushan

2017-12-01

The ending of dual nomenclatural systems for pleomorphic fungi in 2011 requires the reconciliation of competing names, ideally linked through culture based or molecular methods. The phylogenetic systematics of Hypocreales and its many genera have received extensive study in the last two decades, however resolution of competing names in Cordycipitaceae has not yet been addressed. Here we present a molecular phylogenetic investigation of Cordycipitaceae that enables identification of competing names in this family, and provides the basis upon which these names can be maintained or suppressed. The taxonomy presented here seeks to harmonize competing names by principles of priority, recognition of monophyletic groups, and the practical usage of affected taxa. In total, we propose maintaining nine generic names, Akanthomyces, Ascopolyporus, Beauveria, Cordyceps, Engyodontium, Gibellula, Hyperdermium, Parengyodontium, and Simplicillium and the rejection of eight generic names, Evlachovaea , Granulomanus , Isaria , Lecanicillium, Microhilum, Phytocordyceps, Synsterigmatocystis, and Torrubiella . Two new generic names, Hevansia and Blackwellomyces , and a new species, Beauveria blattidicola , are described. New combinations are also proposed in the genera Akanthomyces, Beauveria, Blackwellomyces, and Hevansia.

0-6733 : evaluation of generic and branded herbicides.

DOT National Transportation Integrated Search

2012-08-01

As with other products in the marketplace, : generic herbicides often have a lower initial : product cost than their brand-name : counterparts.Herbicide formulations are : patented for 17 years with proprietary rights for : name, formula, and product...

Select Generic Dry-Storage Pilot Plant Design for Safeguards and Security by Design (SSBD) per Used Fuel Campaign

DOE Office of Scientific and Technical Information (OSTI.GOV)

Demuth, Scott Francis; Sprinkle, James K.

As preparation to the year-end deliverable (Provide SSBD Best Practices for Generic Dry-Storage Pilot Scale Plant) for the Work Package (FT-15LA040501–Safeguards and Security by Design for Extended Dry Storage), the initial step was to select a generic dry-storage pilot plant design for SSBD. To be consistent with other DOE-NE Fuel Cycle Research and Development (FCR&D) activities, the Used Fuel Campaign was engaged for the selection of a design for this deliverable. For the work Package FT-15LA040501–“Safeguards and Security by Design for Extended Dry Storage”, SSBD will be initiated for the Generic Dry-Storage Pilot Scale Plant described by the layout ofmore » Reference 2. SSBD will consider aspects of the design that are impacted by domestic material control and accounting (MC&A), domestic security, and international safeguards.« less

Fundamental limitation of a two-dimensional description of magnetic reconnection

NASA Astrophysics Data System (ADS)

Firpo, Marie-Christine

2014-10-01

For magnetic reconnection to be possible, the electrons have at some point to ``get free from magnetic slavery,'' according to von Steiger's formulation. Stochasticity may be considered as one possible ingredient through which this may be realized in the magnetic reconnection process. It will be argued that non-ideal effects may be considered as a ``hidden'' way to introduce stochasticity. Then it will be shown that there exists a generic intrinsic stochasticity of magnetic field lines that does not require the invocation of non-ideal effects but cannot show up in effective two-dimensional models of magnetic reconnection. Possible implications will be discussed in the frame of tokamak sawteeth that form a laboratory prototype of magnetic reconnection.

Thermodynamics of high temperature, Mie-Gruneisen solids

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lemons, Don S.; Lund, Carl M.

1999-12-01

We construct a set of equations of state for condensed matter at temperatures well above the Debye temperature. These equations incorporate the Mie-Gruneisen equation of state and generic properties of high temperature solids. They are simple enough to provide an alternative to the ideal gas and the van der Waals equations of state for illustrating thermodynamic concepts. (c) 1999 American Association of Physics Teachers.

Development of Generic Aircrew Measures of Performance for Distributed Mission Training

DTIC Science & Technology

2003-03-31

collecte de données utiles sur les performances humaines représente des défis considérables. De plus, on ne trouvera pas deux essais d’IMD exactement...weapons Countered bandits offensive Very sound energy management and aircraft manoeuvering Quickly capitalized on offensive position...Effectively countered bandits offensive to a neutral position Ideal Aircraft energy management and manoeuvering Expeditiously capitalized on

Similarity between generic and brand-name antihypertensive drugs for primary prevention of cardiovascular disease: evidence from a large population-based study.

PubMed

Corrao, Giovanni; Soranna, Davide; Merlino, Luca; Mancia, Giuseppe

2014-10-01

Although generic and earlier brand-name counterparts are bioequivalent, their equivalence in preventing relevant clinical outcomes is of concern. To compare effectiveness of generic and brand-name antihypertensive drugs for preventing the onset of cardiovascular (CV) outcomes. A population-based, nested case-control study was carried out by including the cohort of 78 520 patients from Lombardy (Italy) aged 18 years or older who were newly treated with antihypertensive drugs during 2005. Cases were the 2206 patients who experienced a hospitalization for CV disease from initial prescription until 2011. One control for each case was randomly selected from the same cohort that generated cases. Logistic regression was used to model the CV risk associated with starting on and/or continuing with generic or brand-name agents. There was no evidence that patients who started on generics experienced different CV risk than those on brand-name product (OR 0·86; 95% CI 0·63-1·17). Patients at whom generics were main dispensed had not significantly difference in CV outcomes than those mainly on brand-name agents (OR 1·19; 95% CI 0·86-1·63). Compared with patients who kept initial brand-name therapy, those who experienced brand-to-generic or generic-to-brand switches, and those always on generics, did not show differential CV risks, being the corresponding ORs (and 95% CIs), 1·18 (0·96-1·47), 0·87 (0·63-1·21) and 1·08 (0·80-1·46). Our findings do not support the notion that brand-name antihypertensive agents are superior to generics for preventing CV outcomes in the real-world clinical practice. © 2014 Stichting European Society for Clinical Investigation Journal Foundation.

Primary decomposition of zero-dimensional ideals over finite fields

NASA Astrophysics Data System (ADS)

Gao, Shuhong; Wan, Daqing; Wang, Mingsheng

2009-03-01

A new algorithm is presented for computing primary decomposition of zero-dimensional ideals over finite fields. Like Berlekamp's algorithm for univariate polynomials, the new method is based on the invariant subspace of the Frobenius map acting on the quotient algebra. The dimension of the invariant subspace equals the number of primary components, and a basis of the invariant subspace yields a complete decomposition. Unlike previous approaches for decomposing multivariate polynomial systems, the new method does not need primality testing nor any generic projection, instead it reduces the general decomposition problem directly to root finding of univariate polynomials over the ground field. Also, it is shown how Groebner basis structure can be used to get partial primary decomposition without any root finding.

White wines aroma recovery and enrichment: Sensory-led aroma selection and consumer perception.

PubMed

Lezaeta, Alvaro; Bordeu, Edmundo; Agosin, Eduardo; Pérez-Correa, J Ricardo; Varela, Paula

2018-06-01

We developed a sensory-based methodology to aromatically enrich wines using different aromatic fractions recovered during fermentations of Sauvignon Blanc must. By means of threshold determination and generic descriptive analysis using a trained sensory panel, the aromatic fractions were characterized, selected, and clustered. The selected fractions were grouped, re-assessed, and validated by the trained panel. A consumer panel assessed overall liking and answered a CATA question on some enriched wines and their ideal sample. Differences in elicitation rates between non-enriched and enriched wines with respect to the ideal product highlighted product optimization and the role of aromatic enrichment. Enrichment with aromatic fractions increased the aromatic quality of wines and enhanced consumer appreciation. Copyright © 2018. Published by Elsevier Ltd.

77 FR 12089 - Proposed Generic Communication; Regulatory Issue Summary 2012-XX: Developing Inservice Testing...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-28

... NUCLEAR REGULATORY COMMISSION [NRC-2012-0048] Proposed Generic Communication; Regulatory Issue... CFR) Part 52, ``Licenses, Certifications, and Approvals for Nuclear Power Plants,'' to satisfy the... inservice testing programs during the initial 120-month program interval following nuclear power plant...

Generic Principles for Resolving Intergroup Conflict.

ERIC Educational Resources Information Center

Fisher, Ronald J.

1994-01-01

Provides an initial statement of generic principles deemed effective for addressing protracted social conflicts between identity groups. These principles are compatible with certain values for societal organization and approaches to social change, raising questions of value differences between intervenors and the host culture(s). Three case…

Review of ongoing initiatives to improve prescribing efficiency in China; angiotensin receptor blockers as a case history.

PubMed

Zeng, Wenjie; Gustafsson, Lars L; Bennie, Marion; Finlayson, Alexander E; Godman, Brian

2015-02-01

Pharmaceutical expenditure is rising by 16% per annum in China and is now 46% of total expenditure. Initiatives to moderate growth include drug pricing regulations and encouraging international non-proprietary name prescribing. However, there is no monitoring of physician prescribing quality and perverse incentives. Assess changes in angiotensin receptor blocker (ARB) utilization and expenditure as more generics become available; compare findings to Europe. Observational retrospective study of ARB utilization and expenditure between 2006 and 2012 in the largest hospital in Chongqing district. Variable and low use of generics versus originators with a maximum of 31% among single ARBs. Similar for fixed dose combinations. Prices typically reduced over time, greatest for generic telmisartan (-54%), mirroring price reductions in some European countries. However, no preferential increase in prescribing of lower cost generics. Accumulated savings of 33 million CNY for this large provider if they adopted European practices. Considerable opportunities to improve prescribing efficiency in China.

A generic model of real-world non-ideal behaviour of FES-induced muscle contractions: simulation tool

NASA Astrophysics Data System (ADS)

Lynch, Cheryl L.; Graham, Geoff M.; Popovic, Milos R.

2011-08-01

Functional electrical stimulation (FES) applications are frequently evaluated in simulation prior to testing in human subjects. Such simulations are usually based on the typical muscle responses to electrical stimulation, which may result in an overly optimistic assessment of likely real-world performance. We propose a novel method for simulating FES applications that includes non-ideal muscle behaviour during electrical stimulation resulting from muscle fatigue, spasms and tremors. A 'non-idealities' block that can be incorporated into existing FES simulations and provides a realistic estimate of real-world performance is described. An implementation example is included, showing how the non-idealities block can be incorporated into a simulation of electrically stimulated knee extension against gravity for both a proportional-integral-derivative controller and a sliding mode controller. The results presented in this paper illustrate that the real-world performance of a FES system may be vastly different from the performance obtained in simulation using nominal muscle models. We believe that our non-idealities block should be included in future simulations that involve muscle response to FES, as this tool will provide neural engineers with a realistic simulation of the real-world performance of FES systems. This simulation strategy will help engineers and organizations save time and money by preventing premature human testing. The non-idealities block will become available free of charge at www.toronto-fes.ca in late 2011.

Different initiatives across Europe to enhance losartan utilization post generics: impact and implications.

PubMed

Moon, James C; Godman, Brian; Petzold, Max; Alvarez-Madrazo, Samantha; Bennett, Kathleen; Bishop, Iain; Bucsics, Anna; Hesse, Ulrik; Martin, Andrew; Simoens, Steven; Zara, Corinne; Malmström, Rickard E

2014-01-01

There is an urgent need for health authorities across Europe to fully realize potential savings from increased use of generics to sustain their healthcare systems. A variety of strategies were used across Europe following the availability of generic losartan, the first angiotensin receptor blocker (ARB) to be approved and marketed, to enhance its prescribing vs. single-sourced drugs in the class. Demand-side strategies ranged from 100% co-payment for single-sourced ARBs in Denmark to no specific measures. We hypothesized this heterogeneity of approaches would provide opportunities to explore prescribing in a class following patent expiry. Contrast the impact of the different approaches among European countries and regions to the availability of generic losartan to provide future guidance. Retrospective segmented regression analyses applying linear random coefficient models with country specific intercepts and slopes were used to assess the impact of the various initiatives across Europe following the availability of generic losartan. Utilization measured in defined daily doses (DDDs). Price reductions for generic losartan were also measured. Utilization of losartan was over 90% of all ARBs in Denmark by the study end. Multiple measures in Sweden and one English primary care group also appreciably enhanced losartan utilization. Losartan utilization actually fell in some countries with no specific demand-side measures. Considerable differences were seen in the prices of generic losartan. Delisting single-sourced ARBs produced the greatest increase in losartan utilization. Overall, multiple demand-side measures are needed to change physician prescribing habits to fully realize savings from generics. There is no apparent "spill over" effect from one class to another to influence future prescribing patterns even if these are closely related.

Different initiatives across Europe to enhance losartan utilization post generics: impact and implications

PubMed Central

Moon, James C.; Godman, Brian; Petzold, Max; Alvarez-Madrazo, Samantha; Bennett, Kathleen; Bishop, Iain; Bucsics, Anna; Hesse, Ulrik; Martin, Andrew; Simoens, Steven; Zara, Corinne; Malmström, Rickard E.

2014-01-01

Introduction: There is an urgent need for health authorities across Europe to fully realize potential savings from increased use of generics to sustain their healthcare systems. A variety of strategies were used across Europe following the availability of generic losartan, the first angiotensin receptor blocker (ARB) to be approved and marketed, to enhance its prescribing vs. single-sourced drugs in the class. Demand-side strategies ranged from 100% co-payment for single-sourced ARBs in Denmark to no specific measures. We hypothesized this heterogeneity of approaches would provide opportunities to explore prescribing in a class following patent expiry. Objective: Contrast the impact of the different approaches among European countries and regions to the availability of generic losartan to provide future guidance. Methodology: Retrospective segmented regression analyses applying linear random coefficient models with country specific intercepts and slopes were used to assess the impact of the various initiatives across Europe following the availability of generic losartan. Utilization measured in defined daily doses (DDDs). Price reductions for generic losartan were also measured. Results: Utilization of losartan was over 90% of all ARBs in Denmark by the study end. Multiple measures in Sweden and one English primary care group also appreciably enhanced losartan utilization. Losartan utilization actually fell in some countries with no specific demand-side measures. Considerable differences were seen in the prices of generic losartan. Conclusion: Delisting single-sourced ARBs produced the greatest increase in losartan utilization. Overall, multiple demand-side measures are needed to change physician prescribing habits to fully realize savings from generics. There is no apparent “spill over” effect from one class to another to influence future prescribing patterns even if these are closely related. PMID:25339902

Generic medicines policies in the Asia Pacific region: ways forward.

PubMed

Nguyen, Tuan A; Hassali, Mohamed A A; McLachlan, Andrew

2013-01-01

Generic medicines are a key strategy used by governments and third-party payers to contain medicines costs and improve the access to essential medicines. This strategy represents an important opportunity provided by the global intellectual property regimes to discover and develop copies of original products marketed by innovator companies once the patent protection term is over. While there is an extensive experience regarding generic medicines policies in developed countries, this evidence may not translate to developing countries. The generic medicines policies workshop at the Asia Pacific Conference on National Medicines Policies 2012 provided an important opportunity to discuss and document country-specific initiatives for improving access to and the rational of use of generic medicines in the Asia Pacific region. Based on the identified barriers and enablers to implementation of generic medicines policies in the region, a set of future action plans and recommendations has been made.

76 FR 60499 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

... supports initiatives designed to reduce the health and financial burden of tobacco use through prevention and cessation approaches. CDC requests OMB approval of a new, generic clearance mechanism to support...-needed basis, or in the context of a coordinated series of activities. A generic clearance is needed to...

The effect of generic competition on the price of brand-name drugs.

PubMed

Lexchin, Joel

2004-04-01

Literature from the US has shown that brand-name manufacturers do not compete on price once generic competitors become available. This study was undertaken to investigate if this is also true in Canada. Editions of the Ontario Drug Benefit Formulary were used to identify brand-name drugs that lacked generic competition in July 1990 but had acquired one or more generic competitors by December 1998. Prices of the brand-name drugs were compared before generic competition, at the point when generic competition started and subsequent to the initiation of competition. Price changes for 81 different products in 144 separate presentations were analysed. There was no statistically significant change in brand-name prices when generic competition started. The movement of brand-name prices was not influenced by whether the generic was made by the company producing the brand-name product or price freezes imposed by the Ontario government. When generics first became available having four or more generics was associated with a rise in the price of the brand-name drugs compared to having one, two or three generic competitor(s). The lack of price competition may lead to increased costs in the private market. Private insurance companies generally do not require generic substitution and some provinces do not require generic substitution for cash-paying customers. Maintaining higher prices on brand-name drugs impacts on the prices of new patented medications coming onto the Canadian market under the current pricing guidelines of the Patented Medicine Prices Review Board.

Extreme throat initial data set and horizon area-angular momentum inequality for axisymmetric black holes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dain, Sergio; Max Planck Institute for Gravitational Physics

2010-11-15

We present a formula that relates the variations of the area of extreme throat initial data with the variation of an appropriate defined mass functional. From this expression we deduce that the first variation, with fixed angular momentum, of the area is zero and the second variation is positive definite evaluated at the extreme Kerr throat initial data. This indicates that the area of the extreme Kerr throat initial data is a minimum among this class of data. And hence the area of generic throat initial data is bounded from below by the angular momentum. Also, this result strongly suggestsmore » that the inequality between area and angular momentum holds for generic asymptotically flat axially symmetric black holes. As an application, we prove this inequality in the nontrivial family of spinning Bowen-York initial data.« less

Generic screen representations for future-proof systems, is it possible? There is more to a GUI than meets the eye.

PubMed

van der Linden, Helma; Austin, Tony; Talmon, Jan

2009-09-01

Future-proof EHR systems must be capable of interpreting information structures for medical concepts that were not available at the build-time of the system. The two-model approach of CEN 13606/openEHR using archetypes achieves this by separating generic clinical knowledge from domain-related knowledge. The presentation of this information can either itself be generic, or require design time awareness of the domain knowledge being employed. To develop a Graphical User Interface (GUI) that would be capable of displaying previously unencountered clinical data structures in a meaningful way. Through "reasoning by analogy" we defined an approach for the representation and implementation of "presentational knowledge". A proof-of-concept implementation was built to validate its implementability and to test for unanticipated issues. A two-model approach to specifying and generating a screen representation for archetype-based information, inspired by the two-model approach of archetypes, was developed. There is a separation between software-related display knowledge and domain-related display knowledge and the toolkit is designed with the reuse of components in mind. The approach leads to a flexible GUI that can adapt not only to information structures that had not been predefined within the receiving system, but also to novel ways of displaying the information. We also found that, ideally, the openEHR Archetype Definition Language should receive minor adjustments to allow for generic binding.

An integrated aerodynamic/propulsion study for generic aero-space planes based on waverider concepts

NASA Technical Reports Server (NTRS)

Rasmussen, M. L.; Emanuel, George

1989-01-01

The design of a unified aero-space plane based on waverider technology is analyzed. The overall aerodynamic design and performance of an aero-space plane are discussed in terms of the forebody, scramjet, and afterbody. Other subjects considered in the study are combustion/nozzle optimization, the idealized tip-to-tail waverider model, and the two-dimensional minimum length nozzle. Charts and graphs are provided to show the results of the preliminary investigations.

Generic Evolution and Downward Coupling of Sudden Stratospheric Warmings in an Idealized GCM

NASA Astrophysics Data System (ADS)

Jucker, M.

2016-12-01

This work examines the life cycle of Sudden Stratospheric Warmings (SSWs) from composites of a large number of events. The events are sampled from idealized General Circulation Model (GCM) integrations, and form a database of several hundred major, displacement, splitting, and weak vortex events. It is shown that except for a few details, the generic zonal mean evolution does not depend on the definition used to detect SSWs. In all cases, the composites show the stratosphere in a positive annular mode phase prior to the events, and a barotropic response in the stratosphere at onset. There is a clear positive peak in upward Eliassen-Palm (EP) flux prior to the onset date in the stratosphere, and a much weaker peak in the troposphere, making the evolution more consistent with the picture of the stratosphere acting as a variable filter of tropospheric EP flux, rather than SSWs being forced by a strong `burst' in the troposphere. When comparing composites of SSWs from the database with apparent influence at the surface (downward `propagating') to those without such influence, the only significant differences are a somewhat more barotropic response at the onset date and longer persistence in the lower stratosphere after the onset for propagating SSWs. There is no significant difference in EP flux between propagating and non-propagating events, and none of the here considered definitions shows a particular skill in selecting propagating events.

Performance of active feedforward control systems in non-ideal, synthesized diffuse sound fields.

PubMed

Misol, Malte; Bloch, Christian; Monner, Hans Peter; Sinapius, Michael

2014-04-01

The acoustic performance of passive or active panel structures is usually tested in sound transmission loss facilities. A reverberant sending room, equipped with one or a number of independent sound sources, is used to generate a diffuse sound field excitation which acts as a disturbance source on the structure under investigation. The spatial correlation and coherence of such a synthesized non-ideal diffuse-sound-field excitation, however, might deviate significantly from the ideal case. This has consequences for the operation of an active feedforward control system which heavily relies on the acquisition of coherent disturbance source information. This work, therefore, evaluates the spatial correlation and coherence of ideal and non-ideal diffuse sound fields and considers the implications on the performance of a feedforward control system. The system under consideration is an aircraft-typical double panel system, equipped with an active sidewall panel (lining), which is realized in a transmission loss facility. Experimental results for different numbers of sound sources in the reverberation room are compared to simulation results of a comparable generic double panel system excited by an ideal diffuse sound field. It is shown that the number of statistically independent noise sources acting on the primary structure of the double panel system depends not only on the type of diffuse sound field but also on the sample lengths of the processed signals. The experimental results show that the number of reference sensors required for a defined control performance exhibits an inverse relationship to control filter length.

Optimizing stellarator coil winding surfaces with Regcoil

NASA Astrophysics Data System (ADS)

Bader, Aaron; Landreman, Matt; Anderson, David; Hegna, Chris

2017-10-01

We show initial attempts at optimizing a coil winding surface using the Regcoil code [1] for selected quasi helically symmetric equilibria. We implement a generic optimization scheme which allows for variation of the winding surface to allow for improved diagnostic access and allow for flexible divertor solutions. Regcoil and similar coil-solving algorithms require a user-input winding surface, on which the coils lie. Simple winding surfaces created by uniformly expanding the plasma boundary may not be ideal. Engineering constraints on reactor design require a coil-plasma separation sufficient for the introduction of neutron shielding and a tritium generating blanket. This distance can be the limiting factor in determining reactor size. Furthermore, expanding coils in other regions, where possible, can be useful for diagnostic and maintenance access along with providing sufficient room for a divertor. We minimize a target function that includes as constraints, the minimum coil-plasma distance, the winding surface volume, and the normal magnetic field on the plasma boundary. Results are presented for two quasi-symmetric equilibria at different aspect ratios. Work supported by the US DOE under Grant DE-FG02-93ER54222.

Cost sharing and branded antidepressant initiation among patients treated with generics.

PubMed

Buxbaum, Jason D; Chernew, Michael E; Bonafede, Machaon; Vlahiotis, Anna; Walter, Deborah; Mucha, Lisa; Fendrick, A Mark

2018-04-01

To determine the relationship between consumer cost sharing for branded antidepressants and the initiation of branded therapy among patients with major depressive disorder (MDD) filling a prescription for generic MDD medication.  Retrospective cross-sectional analyses. Patients aged 18 to 64 years with MDD who filled a generic antidepressant were identified in commercial claims data for 2012 to 2014. For each year-specific analysis, an average cost-sharing index for branded antidepressants at the level of the plan was computed. Multivariable models were used to estimate the relationship between plan-level cost sharing for branded antidepressant medications and the filling of branded prescriptions, with demographic and clinical variables as covariates. For patients with MDD filling a generic prescription, increases in branded cost sharing were associated with significant decreases in the likelihood of filling a branded antidepressant in each year (P <.001). Results in 2012 imply that a shift from the 0th to 90th percentile in the branded cost-sharing index corresponded with a 9.5% decrease in the relative likelihood of a branded fill among patients receiving a generic antidepressant. The corresponding figures for 2013 and 2014 were 9.3% and 3.5%, respectively. In MDD, patients and clinicians who dutifully adhere to guidelines requiring a trial of first-line medication may ultimately require therapy with alternate agents to achieve adequate disease control. A "reward the good soldier" benefit design would lower cost sharing for higher-tier evidence-based therapies when clinically indicated. Results suggest that narrowing the gap in cost sharing between branded and generic medications following a trial of a generic agent might improve access to second-line treatment in MDD.

Need for multicriteria evaluation of generic drug policies.

PubMed

Kaló, Zoltán; Holtorf, Anke-Peggy; Alfonso-Cristancho, Rafael; Shen, Jie; Ágh, Tamás; Inotai, András; Brixner, Diana

2015-03-01

Policymakers tend to focus on improving patented drug policies because they are under pressure from patients, physicians, and manufacturers to increase access to novel therapies. The success of pharmaceutical innovation over the last few decades has led to the availability of many off-patent drugs to treat disease areas with the greatest public health need. Therefore, the success of public health programs in improving the health status of the total population is highly dependent on the efficiency of generic drug policies. The objective of this article was to explore factors influencing the true efficiency of generic prescription drug policies in supporting public health initiatives in the developed world. Health care decision makers often assess the efficiency of generic drug policies by the level of price erosion and market share of generics. Drug quality, bioequivalence, in some cases drug formulations, supply reliability, medical adherence and persistence, health outcomes, and nondrug costs, however, are also attributes of success for generic drug policies. Further methodological research is needed to measure and improve the efficiency of generic drug policies. This also requires extension of the evidence base of the impact of generic drugs, partly based on real-world evidence. Multicriteria decision analysis may assist policymakers and researchers to evaluate the true value of generic drugs. Copyright © 2015. Published by Elsevier Inc.

Virial Coefficients from Unified Statistical Thermodynamics of Quantum Gases Trapped under Generic Power Law Potential in d Dimension and Equivalence of Quantum Gases

NASA Astrophysics Data System (ADS)

Bahauddin, Shah Mohammad; Mehedi Faruk, Mir

2016-09-01

From the unified statistical thermodynamics of quantum gases, the virial coefficients of ideal Bose and Fermi gases, trapped under generic power law potential are derived systematically. From the general result of virial coefficients, one can produce the known results in d = 3 and d = 2. But more importantly we found that, the virial coefficients of Bose and Fermi gases become identical (except the second virial coefficient, where the sign is different) when the gases are trapped under harmonic potential in d = 1. This result suggests the equivalence between Bose and Fermi gases established in d = 1 (J. Stat. Phys. DOI 10.1007/s10955-015-1344-4). Also, it is found that the virial coefficients of two-dimensional free Bose (Fermi) gas are equal to the virial coefficients of one-dimensional harmonically trapped Bose (Fermi) gas.

Influencers of generic drug utilization: A systematic review.

PubMed

Howard, Jennifer N; Harris, Ilene; Frank, Gavriella; Kiptanui, Zippora; Qian, Jingjing; Hansen, Richard

2017-08-04

With an increase in prescription drug spending and rising drug costs there is a need to encourage the use of generic prescription drugs. However, maximizing generic drug use is not possible without the public's positive perception and meeting their informational needs about generic drugs. Thus, improving the public's confidence in, and knowledge of generic drugs on the market is critical. The objective of this systematic review is to examine and evaluate the studies focusing on the nature and extent of key factors influencing generic drug use in the United States in order to help guide policy, education and practice interventions. Using multiple search engines and key word screening criteria, empirical studies published in English between January 1, 2005 and December 31, 2015 were identified. A qualitative synthesis of the evidence identified domains of key factors that influenced generic drug use across studies. Over 3000 citations met the key word screening criteria; 67 of these met inclusion criteria for the systematic review. Seven domains of factors that influence generic drug utilization were identified: 1) patient-related factors, 2) formulary management or cost containment, 3) healthcare policies, 4) promotional activities, 5) educational initiatives, 6) technology, and 7) physician-related factors. Patients, physicians, pharmacists, formulary managers, and policymakers play an important role in generic drug use. Understanding the factors influencing generic drug use can help guide future policy, education, and practice interventions to increase generic drug use. Copyright © 2017 Elsevier Inc. All rights reserved.

The lingering presence of the Nightingale legacy.

PubMed

Hegge, Margaret J

2011-04-01

The history of the nursing profession is still evolving. One-hundred years ago, Nightingale died, leaving a legacy of philosophical cornerstones that still infuses the profession. Her idealism flows through her writings, as fresh today as 150 years ago. The initiatives of nursing today had their roots in Nightingale ideals. The alignment of current trends in nursing with Nightingale constructs is striking. Contemporary nurses are challenged to propel these ideals forward. The author here tracks Nightingale quotes, events, and writings with current initiatives, linking philosophical ideals to practical realities of current nursing practice. Nightingale constructs influencing nursing theories and models are examined.

Comparative effectiveness and costs of generic and brand-name gabapentin and venlafaxine in patients with neuropathic pain or generalized anxiety disorder in Spain.

PubMed

Sicras-Mainar, Antoni; Rejas-Gutiérrez, Javier; Navarro-Artieda, Ruth

2015-01-01

To explore adherence/persistence with generic gabapentin/venlafaxine versus brand-name gabapentin/venlafaxine (Neurontin(®)/Vandral(®)) in peripheral neuropathic pain (pNP) or generalized anxiety disorder (GAD), respectively, and whether it is translated into different costs and patient outcomes in routine medical practice. A retrospective, new-user cohort study was designed. Electronic medical records (EMR) of patients included in the health plan of Badalona Serveis Assistencials SA, Barcelona, Spain were exhaustively extracted for analysis. Participants were beneficiaries aged 18+ years, followed between 2008 and 2012, with a pNP/GAD International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code, who initiated treatment with generic or brand-name gabapentin or venlafaxine. Assessments included 1-year treatment persistence and adherence (medication possession ratio), health care costs, and reduction in severity of pain and anxiety symptoms. A total of 2,210 EMR were analyzed; 1,369 on gabapentin (brand 400; generic 969) and 841 on venlafaxine (brand 370 and generic 471). Brand-name gabapentin and venlafaxine were both significantly associated with longer persistence than generic: 7.3 versus 6.3 months, P<0.001; and 8.8 versus 8.1 months, P<0.05, respectively. Brand-name was associated with higher adherence: 86.5% versus 81.3%, P<0.001; and 82.1% versus 79.0%, P<0.05, respectively. Adjusted average costs were higher with generic compared with brand: €1,277 versus €1,057 (difference of €220 per patient; P<0.001) for gabapentin; and €1,110 versus €928 (difference of €182 per patient; P=0.020) for venlafaxine, both because of more use of medical visits and concomitant medication. Compared with generic, brand-name was associated with higher reduction in pain (7.8%; P<0.001) and anxiety (13.2%; P<0.001). Patients initiating brand-name gabapentin or venlafaxine were more likely to adhere and persist on treatment of pNP or GAD, have lower health care costs, and show further reduction of pain and anxiety symptoms than with generic drugs in routine medical practice.

Generic antibiotic industries: Challenges and implied strategies with regulatory perspectives

PubMed Central

Venkatesh, M.; Bairavi, V. G.; Sasikumar, K. C.

2011-01-01

Ever since the discovery of antibiotics, the quality of human life greatly improved in the 20th century. The discovery of penicillin transformed the medicine industry and initiated a search for a better antibiotic every time resulting in several synthetic and semi-synthetic antibiotics. Beginning with the 1937 sulfa drug tragedy, the drug regulations had a parallel growth along with the antibiotics and the antibiotic-based generic Pharma industries. This review article is focused on the scenario depicting current global Pharma industries based on generic antibiotics. Several regulatory aspects involved with these industries have been discussed along with the complexity of the market, issues that could affect their growth, their struggle for quality, and their compliance with the tightened regulations. With the skyrocketing commercialization of antibiotics through generics and the leveraging technologic renaissance, generic industries are involved in providing maximum safer benefits for the welfare of the people, highlighting its need today.. PMID:21430959

Dynamic analysis of a system of hinge-connected rigid bodies with nonrigid appendages. [equations of motion

NASA Technical Reports Server (NTRS)

Likins, P. W.

1974-01-01

Equations of motion are derived for use in simulating a spacecraft or other complex electromechanical system amenable to idealization as a set of hinge-connected rigid bodies of tree topology, with rigid axisymmetric rotors and nonrigid appendages attached to each rigid body in the set. In conjunction with a previously published report on finite-element appendage vibration equations, this report provides a complete minimum-dimension formulation suitable for generic programming for digital computer numerical integration.

Equivalence and interchangeability of narrow therapeutic index drugs in organ transplantation

PubMed Central

Johnston, Atholl

2013-01-01

The calcineurin inhibitors (CNIs), ciclosporin and tacrolimus, are the mainstay of immunosuppression in solid organ transplantation. Generic formulations of these drugs are now available. With increasing pressure on healthcare budgets and the consequent need to match health expectations to available resources, substitution with a generic product appears an attractive option to reduce costs. Approval of generic products differs from innovator drugs, and narrow therapeutic index drugs (NTIs; including CNIs) bring their own particular considerations. With NTIs, small variations in drug exposure could result in reduced immunosuppression or drug toxicity with potentially adverse effects on patient outcomes. NTIs are subject to stricter regulatory approval versus many other generic drugs. However, different generic formulations may still not necessarily be therapeutically equivalent in individuals, raising the possibility of significant differences in exposure between products. Although regional recommendations vary, many guidelines emphasise the need for NTI drug substitution to be initiated by the transplant physician, thus ensuring careful therapeutic monitoring and reduced negative patient impact. The need for therapeutic monitoring during generic substitution has important implications for the overall costs of generic treatment as these costs have to be factored in to the potential savings made from using generic formulations. The reduced acquisition costs of generic products may not necessarily translate into lower overall healthcare costs. This article examines the issue of equivalence and interchangeability of NTI drugs used in organ transplantation, the implications of the approval process for generic drugs on treatment efficacy and safety, and the effective management of substitutions between products. PMID:24089632

Medication persistence and the use of generic and brand-name blood pressure-lowering agents.

PubMed

Corrao, Giovanni; Soranna, Davide; La Vecchia, Carlo; Catapano, Alberico; Agabiti-Rosei, Enrico; Gensini, Gianfranco; Merlino, Luca; Mancia, Giuseppe

2014-05-01

Because of their lower cost, healthcare systems recommend physicians to prefer generic products, rather than brand-name medicaments. There is then considerable interest and debate concerning safety and effectiveness of generic products. Few studies have compared patients treated with brand-name and generic drugs for adherence to treatment, with somewhat inconsistent results. The primary objective of this study was to compare the risk of discontinuing antihypertensive drug therapy in patients treated with generic or brand-name agents. The 101,618 beneficiaries of the Healthcare system of Lombardy, Italy, aged 18 years or older who were newly treated on monotherapy with antihypertensive generic or brand-name drugs during 2008, were followed until the earliest date among those of the occurrence of treatment discontinuation to whatever antihypertensive drug therapy (outcome), or censoring (death, emigration, 12 months after treatment initiation). Hazard ratios of discontinuation associated with starting on generic or brand-name products (intention-to-treat analysis), and incidence rate ratio of discontinuation during periods on generic and brand-name products (as-treated analysis) were respectively estimated from a cohort and self-controlled case series analyses. Patients who started on generics did not experience a different risk of discontinuation compared with those starting on brand-name agents (hazard ratio: 1.00; 95% confidence interval 0.98-1.02). Discontinuation did not occur with different rates during periods covered by generics or brand-name agents (incidence rate ratio: 1.01; 95% confidence interval 0.96-1.11) within the same individuals. A number of sensitivity and subgroup analyses confirmed the robustness of these findings. Generic products are not responsible for the high rate of discontinuation from antihypertensive drug therapy. Assuming therapeutic equivalence, clinical implication is of prescribing generic drug therapies.

A Systematic Review of Physicians' and Pharmacists' Perspectives on Generic Drug Use: What are the Global Challenges?

PubMed

Toverud, Else-Lydia; Hartmann, Katrin; Håkonsen, Helle

2015-08-01

Generic substitution has been introduced in most countries in order to reduce costs and improve access to drugs. However, regulations and the generic drugs available vary between countries. It is the prescriber or dispenser of the drug who is the final decision maker. Nevertheless, physicians' and pharmacists' perceptions of generic drug use are not well documented to date. This study presents a systematic review of physicians' and pharmacists' perspectives on generic drug use worldwide. A systematic literature search was performed to retrieve all articles published between 2002 and 2012 regarding physicians' and/or pharmacists' experiences with generic drugs and generic substitution. Of 1322 publications initially identified, 24 were eligible for inclusion. Overall, the studies revealed that physicians and pharmacists were aware of the cost-saving function of generic drugs and their role in improving global access to drugs. Nevertheless, marked differences were observed between countries when studying physicians' and pharmacists' perceptions of the available generic drugs. In less mature healthcare systems, large variations regarding, for example, control routines, bioequivalence requirements, and manufacturer standards were reported. A lack of reliable information and mistrust in the efficacy and quality were also mentioned by these participants. In the most developed healthcare systems, the participants trusted the quality of the generic drugs and did not hesitate to offer them to all patients regardless of socioeconomic status. In general, pharmacists seemed to have better knowledge of the concept of bioequivalence and generic drug aspects than physicians. The present study indicates that physicians and pharmacists are aware of the role of generic drugs in the improvement of global access to drugs. However, there are marked differences regarding how these health professionals view the quality of generic drugs depending on the maturity of their country's healthcare system. This can be attributed to the fact that developed healthcare systems have more reliable public control routines for drugs in general as well as better bioequivalence requirements concerning generics in particular.

A generic multibody simulation

NASA Technical Reports Server (NTRS)

Hopping, K. A.; Kohn, W.

1986-01-01

Described is a dynamic simulation package which can be configured for orbital test scenarios involving multiple bodies. The rotational and translational state integration methods are selectable for each individual body and may be changed during a run if necessary. Characteristics of the bodies are determined by assigning components consisting of mass properties, forces, and moments, which are the outputs of user-defined environmental models. Generic model implementation is facilitated by a transformation processor which performs coordinate frame inversions. Transformations are defined in the initialization file as part of the simulation configuration. The simulation package includes an initialization processor, which consists of a command line preprocessor, a general purpose grammar, and a syntax scanner. These permit specifications of the bodies, their interrelationships, and their initial states in a format that is not dependent on a particular test scenario.

Creating a Culture of Thinking in DCPS: A Generic Proposal for the District of Columbia Public Schools Board of Education

ERIC Educational Resources Information Center

Fluellen, Jerry E., Jr.

2006-01-01

Preparing students for college and work in the Knowledge Age. That is the mission of this generic proposal. A counterpoint to Industrial Age mindsets marking most initiatives in the District of Columbia Public schools and described in the "fifth discipline" works of Peter Senge, Creating a Culture of Thinking in DCPS proposes a project…

Technology to Enhance Mathematics and Science Instruction: Changes in Teacher Perceptions after Participating in a Yearlong Professional Development Program

ERIC Educational Resources Information Center

Kersaint, Gladis; Ritzhaupt, Albert D.; Liu, Feng

2014-01-01

The purpose of this study is to examine the extent to which teachers of mathematics or science who were engaged in a year-long initiative to help them integrate technological tools were (a) familiar with generic and mathematics- or science-specific technology, (b) comfortable integrating generic and content-specific technology, (c) believe that…

Evaluation of the clinical and economic impact of a brand name-to-generic warfarin sodium conversion program.

PubMed

Witt, Daniel M; Tillman, Donald J; Evans, Christy M; Plotkin, Tatyana V; Sadler, Melanie A

2003-03-01

Substitution of generic warfarin initially was discouraged because of concerns regarding therapeutic failure or toxicity. Although subsequent research with AB-rated (i.e., bioequivalent) warfarin did not confirm initial concerns, the issue is not settled for all clinicians. We sought to provide additional information regarding the clinical and economic impact of warfarin conversion by analyzing a real-life sample of patients receiving long-term anticoagulation therapy who were switched from brand name to generic warfarin. Patients who had been taking warfarin for at least 180 days and had received uninterrupted oral anticoagulation 90 days before and 90 days after switching to generic warfarin were included. The switch date was based on the first time generic warfarin was dispensed from our pharmacies. The primary end point was the calculated amount of time each patient's international normalized ratio (INR) values were within the patient-specific target INR range in the 90 days before and after the switch. Data regarding adverse events and medical resource utilization were also collected. Pharmacoeconomic analyses were performed. The analysis included 2299 patients. The overall difference in calculated time INR values were below (22.6% before vs 26.1% after switch, p<0.0001) and within (65.9% before vs 63.3% after switch, p=0.0002) the therapeutic INR range was statistically but not clinically significant. Only 28.0% of patients experienced a change in therapeutic INR control of 10% or less, 33.1% experienced INR control that improved by greater than 10%, and 38.9% experienced INR control that worsened by more than 10%. The difference in total treatment costs associated with brand name and generic warfarin was 3128 dollars/100 patient-years in favor of the generic product. Sensitivity analyses revealed that cost savings associated with warfarin conversion in this health care system were highly dependent on the difference between warfarin costs and cost of treating anticoagulation-related adverse events. Most of these patients were successfully switched from brand name to generic warfarin. However, supplemental INR monitoring is warranted when one warfarin product is substituted for another to allow timely detection of those patients who experience significant changes in anticoagulation response.

Spectral unmixing of urban land cover using a generic library approach

NASA Astrophysics Data System (ADS)

Degerickx, Jeroen; Lordache, Marian-Daniel; Okujeni, Akpona; Hermy, Martin; van der Linden, Sebastian; Somers, Ben

2016-10-01

Remote sensing based land cover classification in urban areas generally requires the use of subpixel classification algorithms to take into account the high spatial heterogeneity. These spectral unmixing techniques often rely on spectral libraries, i.e. collections of pure material spectra (endmembers, EM), which ideally cover the large EM variability typically present in urban scenes. Despite the advent of several (semi-) automated EM detection algorithms, the collection of such image-specific libraries remains a tedious and time-consuming task. As an alternative, we suggest the use of a generic urban EM library, containing material spectra under varying conditions, acquired from different locations and sensors. This approach requires an efficient EM selection technique, capable of only selecting those spectra relevant for a specific image. In this paper, we evaluate and compare the potential of different existing library pruning algorithms (Iterative Endmember Selection and MUSIC) using simulated hyperspectral (APEX) data of the Brussels metropolitan area. In addition, we develop a new hybrid EM selection method which is shown to be highly efficient in dealing with both imagespecific and generic libraries, subsequently yielding more robust land cover classification results compared to existing methods. Future research will include further optimization of the proposed algorithm and additional tests on both simulated and real hyperspectral data.

The Regular Education Initiative: A Deja Vu Remembered with Sadness and Concern.

ERIC Educational Resources Information Center

Silver, Larry B.

1991-01-01

This article compares the ideals of the regular education initiative to provide services for learning-disabled students within the regular classroom to the ideals and resulting negative effects (e.g., homelessness) of the deinstitutionalization of the mentally ill during the 1960s. Resistance to efforts to decrease or eliminate special education…

Two-rowed Hecke algebra representations at roots of unity

NASA Astrophysics Data System (ADS)

Welsh, Trevor Alan

1996-02-01

In this paper, we initiate a study into the explicit construction of irreducible representations of the Hecke algebraH n (q) of typeA n-1 in the non-generic case whereq is a root of unity. The approach is via the Specht modules ofH n (q) which are irreducible in the generic case, and possess a natural basis indexed by Young tableaux. The general framework in which the irreducible non-genericH n (q)-modules are to be constructed is set up and, in particular, the full set of modules corresponding to two-part partitions is described. Plentiful examples are given.

Real-Time Reed-Solomon Decoder

NASA Technical Reports Server (NTRS)

Maki, Gary K.; Cameron, Kelly B.; Owsley, Patrick A.

1994-01-01

Generic Reed-Solomon decoder fast enough to correct errors in real time in practical applications designed to be implemented in fewer and smaller very-large-scale integrated, VLSI, circuit chips. Configured to operate in pipelined manner. One outstanding aspect of decoder design is that Euclid multiplier and divider modules contain Galoisfield multipliers configured as combinational-logic cells. Operates at speeds greater than older multipliers. Cellular configuration highly regular and requires little interconnection area, making it ideal for implementation in extraordinarily dense VLSI circuitry. Flight electronics single chip version of this technology implemented and available.

Back from the Future: The Impact of Change on Airpower in the Decades Ahead

DTIC Science & Technology

2009-01-01

generic/story_generic.jsp?channel= awst &id=news/aw021108p2.xml&headline=Fate%20of%20F -22,%20C-17%20Lines%20Uncertain%20in%20Fiscal%202009; Pierre Sprey...second lot of low-rate initial production aircraft was announced on 22 May 2008 as $2.2 billion for 12 aircraft, and Maj Gen Charles R . Davis, USAF, the

Can authorities appreciably enhance the prescribing of oral generic risperidone to conserve resources? Findings from across Europe and their implications.

PubMed

Godman, Brian; Petzold, Max; Bennett, Kathleen; Bennie, Marion; Bucsics, Anna; Finlayson, Alexander E; Martin, Andrew; Persson, Marie; Piessnegger, Jutta; Raschi, Emanuel; Simoens, Steven; Zara, Corinne; Barbui, Corrado

2014-06-13

Generic atypical antipsychotic drugs offer health authorities opportunities for considerable savings. However, schizophrenia and bipolar disorders are complex diseases that require tailored treatments. Consequently, generally there have been limited demand-side measures by health authorities to encourage the preferential prescribing of generics. This is unlike the situation with hypertension, hypercholaesterolaemia or acid-related stomach disorders.The objectives of this study were to compare the effect of the limited demand-side measures in Western European countries and regions on the subsequent prescribing of risperidone following generics; to utilise the findings to provide future guidance to health authorities; and where possible, to investigate the utilisation of generic versus originator risperidone and the prices for generic risperidone. Principally, this was a segmented regression analysis of retrospective time-series data of the effect of the various initiatives in Belgium, Ireland, Scotland and Sweden following the introduction of generic risperidone. The study included patients prescribed at least one atypical antipsychotic drug up to 20 months before and up to 20 months after generic risperidone. In addition, retrospective observational studies were carried out in Austria and Spain (Catalonia) from 2005 to 2011 as well as one English primary care organisation (Bury Primary Care Trust (PCT)). There was a consistent steady reduction in risperidone as a percentage of total selected atypical antipsychotic utilisation following generics. A similar pattern was seen in Austria and Spain, with stable utilisation in one English PCT. However, there was considerable variation in the utilisation of generic risperidone, ranging from 98% of total risperidone in Scotland to only 14% in Ireland. Similarly, the price of generic risperidone varied considerably. In Scotland, generic risperidone was only 16% of pre-patent loss prices versus 72% in Ireland. Consistent findings of no increased prescribing of risperidone post generics with limited specific demand-side measures suggests no 'spillover' effect from one class to another encouraging the preferential prescribing of generic atypical antipsychotic drugs. This is exacerbated by the complexity of the disease area and differences in the side-effects between treatments. There appeared to be no clinical issues with generic risperidone, and prices inversely reflected measures to enhance their utilisation.

Evaluation of the cooperative multi-carrier delivery initiatives.

DOT National Transportation Integrated Search

2013-12-01

In the last several years there has been a surge of interest in fostering more sustainable logistical operations in : urban areas. Under the umbrella of the generic term City Logistics, these initiatives try to take advantage of : the coordinating po...

An Evaluation Tool for CONUS-Scale Estimates of Components of the Water Balance

NASA Astrophysics Data System (ADS)

Saxe, S.; Hay, L.; Farmer, W. H.; Markstrom, S. L.; Kiang, J. E.

2016-12-01

Numerous research groups are independently developing data products to represent various components of the water balance (e.g. runoff, evapotranspiration, recharge, snow water equivalent, soil moisture, and climate) at the scale of the conterminous United States. These data products are derived from a range of sources, including direct measurement, remotely-sensed measurement, and statistical and deterministic model simulations. An evaluation tool is needed to compare these data products and the components of the water balance they contain in order to identify the gaps in the understanding and representation of continental-scale hydrologic processes. An ideal tool will be an objective, universally agreed upon, framework to address questions related to closing the water balance. This type of generic, model agnostic evaluation tool would facilitate collaboration amongst different hydrologic research groups and improve modeling capabilities with respect to continental-scale water resources. By adopting a comprehensive framework to consider hydrologic modeling in the context of a complete water balance, it is possible to identify weaknesses in process modeling, data product representation and regional hydrologic variation. As part of its National Water Census initiative, the U.S. Geological survey is facilitating this dialogue to developing prototype evaluation tools.

Octupolar tensors for liquid crystals

NASA Astrophysics Data System (ADS)

Chen, Yannan; Qi, Liqun; Virga, Epifanio G.

2018-01-01

A third-rank three-dimensional symmetric traceless tensor, called the octupolar tensor, has been introduced to study tetrahedratic nematic phases in liquid crystals. The octupolar potential, a scalar-valued function generated on the unit sphere by that tensor, should ideally have four maxima (on the vertices of a tetrahedron), but it was recently found to possess an equally generic variant with three maxima instead of four. It was also shown that the irreducible admissible region for the octupolar tensor in a three-dimensional parameter space is bounded by a dome-shaped surface, beneath which is a separatrix surface connecting the two generic octupolar states. The latter surface, which was obtained through numerical continuation, may be physically interpreted as marking a possible intra-octupolar transition. In this paper, by using the resultant theory of algebraic geometry and the E-characteristic polynomial of spectral theory of tensors, we give a closed-form, algebraic expression for both the dome-shaped surface and the separatrix surface. This turns the envisaged intra-octupolar transition into a quantitative, possibly observable prediction.

A generic analysis of energy use and solvent selection for CO2 separation from post-combustion flue gases

USGS Publications Warehouse

Lu, Y.; Chen, S.; Rostam-Abadi, M.

2008-01-01

A thermodynamic calculation was performed to determine the theoretical minimum energy used to separate CO2 from a coal combustion flue gas in a typical adsorption-desorption system. Under ideal conditions, the minimum energy required to separate CO2 from post-combustion flue gas and produce pure CO2 at 1 atmospheric pressure was only about 1183 kJ/kg CO2. This amount could double with the addition of the driving forces of mass and heat transfer and the adverse impacts of absorption heat release on adsorption capacity. Thermodynamic analyses were also performed for the aqueous amine-based absorption process. Two CO2 reaction mechanisms, the carbamate formation reaction with primary/secondary amines and the CO2 hydration reaction with tertiary amines, were included in the absorption reaction. The reaction heat, sensible heat, and stripping heat were all important to the total heat requirement. The heat use of an ideal tertiary amine amounted to 2786 kJ/kg, compared to 3211 kJ/kg for an ideal primary amine. The heat usage of an ideal amine was about 20% lower than that of commercially available amines. Optimizing the absorption process configuration could further reduce energy use. This is an abstract of a paper presented at the 2008 AIChE Spring National Meeting (New Orleans, LA 4/6-10/2008).

Self-propulsion of free solid bodies with internal rotors via localized singular vortex shedding in planar ideal fluids

NASA Astrophysics Data System (ADS)

Tallapragada, P.; Kelly, S. D.

2015-11-01

Diverse mechanisms for animal locomotion in fluids rely on vortex shedding to generate propulsive forces. This is a complex phenomenon that depends essentially on fluid viscosity, but its influence can be modeled in an inviscid setting by introducing localized velocity constraints to systems comprising solid bodies interacting with ideal fluids. In the present paper, we invoke an unsteady version of the Kutta condition from inviscid airfoil theory and a more primitive stagnation condition to model vortex shedding from a geometrically contrasting pair of free planar bodies representing idealizations of swimming animals or robotic vehicles. We demonstrate with simulations that these constraints are sufficient to enable both bodies to propel themselves with very limited actuation. The solitary actuator in each case is a momentum wheel internal to the body, underscoring the symmetry-breaking role played by vortex shedding in converting periodic variations in a generic swimmer's angular momentum to forward locomotion. The velocity constraints are imposed discretely in time, resulting in the shedding of discrete vortices; we observe the roll-up of these vortices into distinctive wake structures observed in viscous models and physical experiments.

The development of a theoretically driven generic measure of quality of life for children aged 6-12 years: a preliminary report.

PubMed

Eiser, C; Vance, Y H; Seamark, D

2000-11-01

To report the development and psychometric properties of a generic computer-delivered measure of quality of life (QoL) suitable for children aged 6-12 years: the Exqol. The theoretical model adopted is based on an assumption that poorer QoL is the result of discrepancies between an individual's actual ('like me') and ideal self ('how I would like to be'). The Exqol consists of 12 pictures, each of which is rated twice; first in terms of 'like me' and second as 'I would like to be'. The Exqol is delivered using a Macintosh Powerbook and takes approximately 20 min to complete. Data are reported for 58 children with asthma (Mage = 8.95 years) and 69 healthy children (Mage = 749 years). In order to determine validity of the Exqol, children with asthma also completed the Childhood Asthma Questionnaire (CAQ) and their mothers completed a measure of child vulnerability and caregiver QoL. Higher discrepancies were found for children with asthma compared with healthy children (P < 0.05). For children with asthma, significant correlations were found between discrepancy scores and two of the four subscales of the CAQ. Children who rated their asthma to be more severe also had higher discrepancy scores (P < 0.05). The Exqol has acceptable internal reliability and validity and distinguishes between children with asthma and healthy children. These data provide preliminary support for the theoretical assumption that QoL reflects perceived discrepancies between an individual's actual and ideal self. Methodological refinements to the Exqol are suggested.

Comparing Generic Drug Markets in Europe and the United States: Prices, Volumes, and Spending.

PubMed

Wouters, Olivier J; Kanavos, Panos G; McKEE, Martin

2017-09-01

Policy Points: Our study indicates that there are opportunities for cost savings in generic drug markets in Europe and the United States. Regulators should make it easier for generic drugs to reach the market. Regulators and payers should apply measures to stimulate price competition among generic drugmakers and to increase generic drug use. To meaningfully evaluate policy options, it is important to analyze historical context and understand why similar initiatives failed previously. Rising drug prices are putting pressure on health care budgets. Policymakers are assessing how they can save money through generic drugs. We compared generic drug prices and market shares in 13 European countries, using data from 2013, to assess the amount of variation that exists between countries. To place these results in context, we reviewed evidence from recent studies on the prices and use of generics in Europe and the United States. We also surveyed peer-reviewed studies, gray literature, and books published since 2000 to (1) outline existing generic drug policies in European countries and the United States; (2) identify ways to increase generic drug use and to promote price competition among generic drug companies; and (3) explore barriers to implementing reform of generic drug policies, using a historical example from the United States as a case study. The prices and market shares of generics vary widely across Europe. For example, prices charged by manufacturers in Switzerland are, on average, more than 2.5 times those in Germany and more than 6 times those in the United Kingdom, based on the results of a commonly used price index. The proportion of prescriptions filled with generics ranges from 17% in Switzerland to 83% in the United Kingdom. By comparison, the United States has historically had low generic drug prices and high rates of generic drug use (84% in 2013), but has in recent years experienced sharp price increases for some off-patent products. There are policy solutions to address issues in Europe and the United States, such as streamlining the generic drug approval process and requiring generic prescribing and substitution where such policies are not yet in place. The history of substitution laws in the United States provides insights into the economic, political, and cultural issues influencing the adoption of generic drug policies. Governments should apply coherent supply- and demand-side policies in generic drug markets. An immediate priority is to convince more physicians, pharmacists, and patients that generic drugs are bioequivalent to branded products. Special-interest groups continue to obstruct reform in Europe and the United States. © 2017 The Authors The Milbank Quarterly published by Wiley Periodicals, Inc. on behalf of The Millbank Memorial Fund.

Cost-effectiveness of high-dose atorvastatin compared with regular dose simvastatin.

PubMed

Lindgren, Peter; Graff, Jennifer; Olsson, Anders G; Pedersen, Terje J; Jönsson, Bengt

2007-06-01

The aim of the study was to evaluate the long-term cost-effectiveness of high-dose atorvastatin when compared with generic simvastatin for secondary prevention in Denmark, Finland, Norway, and Sweden based on the recently completed IDEAL trial. The IDEAL trial showed that high-dose treatment with atorvastatin was associated with fewer non-fatal myocardial infarctions (MI) or coronary heart disease death (RR 0.89; 95% CI 0.78-1.01) and major cardiovascular events by (RR 0.87; 95% CI 0.77-0.98) or any coronary event (RR 0.84; 95% CI 0.76-0.91) than simvastatin with no significant difference in the number of serious adverse events. Costs during the trial period was estimated based on the trial data and a Markov model was constructed where the risk of MIs and revascularization procedures and the long-term costs, quality of life, and mortality associated with these events was simulated. Costs were based on resource consumptions recorded in the trial multiplied with recent unit costs from each country. Both direct health care costs and indirect costs (costs from lost production due to work absence) were included. Intervention lasted for the duration of the trial (4.8 years) while health-effects and costs are predicted for the lifespan of the patient. The main outcome was quality adjusted life-years (QALY) gained. High-dose treatment was predicted to lead to a mean increase in survival of 0.049 years per patient and 0.033 QALYs gained. The cost to gain one QALY was predicted to 47,197euro (Denmark), 62,639euro (Finland), 35,210euro (Norway), and 43,667euro (Sweden), with cost-effectiveness ratio decreasing with higher risk. In the prevention of cardiovascular events among patients with a previous MI, high-dose atorvastatin appears to be a cost-effective strategy when compared with generic simvastatin 20-40 mg in Denmark, Norway, and Sweden. In Finland, it is cost-effective in high-risk patients. The key driver of the cost-effectiveness is the price-difference between 80 mg atorvastatin and generic simvastatin.

Measurement of Quality of Life III. From the IQOL Theory to the Global, Generic SEQOL Questionnaire

PubMed Central

Ventegodt, Soren; Merrick, Joav; Andersen, Niels Jorgen

2003-01-01

The Danish Quality of Life Survey is based on the philosophy of life known as the integrative quality-of-life (IQOL) theory. It consists of eight different quality-of-life concepts, ranging from the superficially subjective via the deeply existential to the superficially objective (well being, satisfaction with life, happiness, meaning in life, biological order, realizing life potential, fulfillment of needs, and objective factors [ability of functioning and fulfilling societal norms]).This paper presents the work underlying the formulation of the theories of a good life and how these theories came to be expressed in a comprehensive, multidimensional, generic questionnaire for the evaluation of the global quality of life — SEQOL (self-evaluation of quality of life) — presented in full length in this paper. The instruments and theories on which the Quality of Life Survey was based are constantly being updated. It is an on-going process due to aspects such as human development, language, and culture. We arrived at eight rating scales for the quality of life that, guided by the IQOL theory, were combined into a global and generic quality-of-life rating scale. This was simplified to the validated QOL5 with only five questions, made for use in clinical databases. Unfortunately, the depth of human existence is to some extent lost in QOL5.We continue to aim towards greater simplicity, precision, and depth in the questions in order to explore the depths of human existence. We have not yet found a final form that enables us to fully rate the quality of life in practice. We hope that the several hundred questions we found necessary to adequately implement the theories of the Quality of Life Survey can be replaced by far fewer; ideally, only eight questions representing the eight component theories. These eight ideal questions have not yet been evaluated, and therefore they should not form the basis of a survey. However, the perspective is clear. If eight simple questions can accurately rate the quality of life as well as its depth, we have found an instrument of immense practical scope. PMID:14570988

Modelling Wireless Power Transfer Using an Array of Tesla Coils

NASA Astrophysics Data System (ADS)

Pierson, Casey Thomas

Wireless power transmission, or WPT, is a well-demonstrated property in electrical science and physics. Coil-and-wave transmission (CWT) consists of two Tesla coils, one powered by a controlled voltage source v src and one connected across a generic load Z 0 , at a mid- to long range distance apart with spherical capacitors at each of their top loads. The literature on the different methods of WPT varies widely, but research of CWT is sparse, lacking especially in the area of computer simulation. Recently, a physical experiment was conducted by Marzolf et al. in [1], and yielded surprising resonant frequencies in the high frequency range. The goal of this research is to answer the question of whether these reosnant frequencies originate in unexplained field effects or in non-ideal circuit behavior, and establish a formal model to indicate at what frequencies the resonant peaks occur as a first approximation. By carefully constructing a simulation of the most geometrically simple, power efficient design in the work of Marzolf et al. using the scientific software Octave, we investigate these frequencies computationally: first, an ideal scenario that has no flux leakage or exterior losses is modelled mathematically and simulated, and then, a non-ideal scenario that accounts for losses in the coils and surroundings is modelled mathematically and simulated. Both models utilize a simple formula for spherical capacitance for the top loads. After running these simulations through detailed sampling up to 4 MHz, the ideal model could not account for the resonant peaks, while the non-ideal model indicated the resonant peaks near the exact frequency ranges that were observed. An unexpected characteristic of these results was that coupling coefficients between the coils of the transmitter and receiver played a noticeable part in the indication of resonant peaks. This demonstrates that unknown field effects are not the primary driver of resonance in the ideal or non-ideal construction, and raises inriguing questions about the circuit design's relationship with resonance in the locality about the coils.

Generic particulate-monitoring system for retrofit to Hanford exhaust stacks

DOE Office of Scientific and Technical Information (OSTI.GOV)

Camman, J.W.; Carbaugh, E.H.

1982-11-01

Evaluations of 72 sampling and monitoring systems were performed at Hanford as the initial phase of a program to upgrade such systems. Each evaluation included determination of theoretical sampling efficiencies for particle sizes ranging from 0.5 to 10 micrometers aerodynamic equivalent diameter, addressing anisokinetic bias, sample transport line losses, and collector device efficiency. Upgrades needed to meet current Department of Energy guidance for effluent sampling and monitoring were identified, and a cost for each upgrade was estimated. A relative priority for each system's upgrade was then established based on evaluation results, current operational status, and future plans for the facilitymore » being exhausted. Common system upgrade requirements lead to the development of a generic design for common components of an exhaust stack sampling and monitoring system for airborne radioactive particulates. The generic design consists of commercially available off-the-shelf components to the extent practical and will simplify future stack sampling and monitoring system design, fabrication, and installation efforts. Evaluation results and their significance to system upgrades are empasized. A brief discussion of the analytical models used and experience to date with the upgrade program is included. Development of the generic stack sampling and monitoring system design is outlined. Generic system design features and limitations are presented. Requirements for generic system retrofitting to existing exhaust stacks are defined and benefits derived from generic system application are discussed.« less

Generic phytosanitary irradiation treatments

NASA Astrophysics Data System (ADS)

Hallman, Guy J.

2012-07-01

The history of the development of generic phytosanitary irradiation (PI) treatments is discussed beginning with its initial proposal in 1986. Generic PI treatments in use today are 150 Gy for all hosts of Tephritidae, 250 Gy for all arthropods on mango and papaya shipped from Australia to New Zealand, 300 Gy for all arthropods on mango shipped from Australia to Malaysia, 350 Gy for all arthropods on lychee shipped from Australia to New Zealand and 400 Gy for all hosts of insects other than pupae and adult Lepidoptera shipped to the United States. Efforts to develop additional generic PI treatments and reduce the dose for the 400 Gy treatment are ongoing with a broad based 5-year, 12-nation cooperative research project coordinated by the joint Food and Agricultural Organization/International Atomic Energy Agency Program on Nuclear Techniques in Food and Agriculture. Key groups identified for further development of generic PI treatments are Lepidoptera (eggs and larvae), mealybugs and scale insects. A dose of 250 Gy may suffice for these three groups plus others, such as thrips, weevils and whiteflies.

Impact of the introduction of generic latanoprost on glaucoma medication adherence.

PubMed

Stein, Joshua D; Shekhawat, Nakul; Talwar, Nidhi; Balkrishnan, Rajesh

2015-04-01

To assess possible changes in medication adherence to prostaglandin analog (PGA) regimens among patients with open-angle glaucoma (OAG) after the initial introduction of generic PGAs. Longitudinal cohort analysis. Patients older than 40 years with OAG continuously enrolled in a nationwide managed-care network during 2009-2012 who used PGAs. Mean adherence rates were calculated for topical PGA use during the 18 months before the introduction of generic latanoprost (September 2009-February 2011) and the 18 months after generic latanoprost became available (July 2011-December 2012). The rates were compared between persons who continued to use brand-name PGAs once generic latanoprost became available and others who switched to generic latanoprost. Multivariable logistic regression identified variables associated with an improvement or worsening of adherence of ≥25%. Mean adherence rates and odds of 25% or more improved or worsened adherence (with 95% confidence intervals [CIs]). A total of 8427 patients met the study eligibility criteria. Compared with persons switching to generic latanoprost, patients who continued taking brand name PGAs were 28% less likely to have improved adherence (odds ratio [OR], 0.72; 95% CI, 0.55-0.94) and 39% more likely to have reduced adherence (OR, 1.39; 1.04-1.86) of ≥25%. Improved adherence after the generic drug's introduction was also associated with higher monthly medication copay in the pregeneric period (P = 0.02), lower copay after introduction of the generic drug (P < 0.0001), and black race (OR, 1.25; 95% CI, 1.04-1.50). Six-hundred twelve patients (7.3%) discontinued all antiglaucoma interventions when generic latanoprost became available. Given that cost can significantly deter adherence, switching patients to generic medications may help improve patients' drug-regimen adherence. A considerable number of patients discontinued glaucoma drug use altogether when generic latanoprost became available. Ophthalmologists should work with insurers and pharmacists to prevent such discontinuation of use as generic forms of other PGA agents become available. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Generic Information Can Retrieve Known Biological Associations: Implications for Biomedical Knowledge Discovery

PubMed Central

van Haagen, Herman H. H. B. M.; 't Hoen, Peter A. C.; Mons, Barend; Schultes, Erik A.

2013-01-01

Motivation Weighted semantic networks built from text-mined literature can be used to retrieve known protein-protein or gene-disease associations, and have been shown to anticipate associations years before they are explicitly stated in the literature. Our text-mining system recognizes over 640,000 biomedical concepts: some are specific (i.e., names of genes or proteins) others generic (e.g., ‘Homo sapiens’). Generic concepts may play important roles in automated information retrieval, extraction, and inference but may also result in concept overload and confound retrieval and reasoning with low-relevance or even spurious links. Here, we attempted to optimize the retrieval performance for protein-protein interactions (PPI) by filtering generic concepts (node filtering) or links to generic concepts (edge filtering) from a weighted semantic network. First, we defined metrics based on network properties that quantify the specificity of concepts. Then using these metrics, we systematically filtered generic information from the network while monitoring retrieval performance of known protein-protein interactions. We also systematically filtered specific information from the network (inverse filtering), and assessed the retrieval performance of networks composed of generic information alone. Results Filtering generic or specific information induced a two-phase response in retrieval performance: initially the effects of filtering were minimal but beyond a critical threshold network performance suddenly drops. Contrary to expectations, networks composed exclusively of generic information demonstrated retrieval performance comparable to unfiltered networks that also contain specific concepts. Furthermore, an analysis using individual generic concepts demonstrated that they can effectively support the retrieval of known protein-protein interactions. For instance the concept “binding” is indicative for PPI retrieval and the concept “mutation abnormality” is indicative for gene-disease associations. Conclusion Generic concepts are important for information retrieval and cannot be removed from semantic networks without negative impact on retrieval performance. PMID:24260124

A possibility for standoff bomb detection

NASA Astrophysics Data System (ADS)

Akar Tarim, U.; Ozmutlu, E. N.; Gurler, O.; Yalcin, S.

2015-01-01

The response functions of backscattered photons, which are initially collimated with an energy of 662 keV, were obtained by a Monte Carlo method in an NaI(Tl) scintillation detector using a suitcase or briefcase full of paper, clothing, ammonium nitrate or other generic explosives, as these can be used for terrorism. The results show that characteristic response functions for ammonium nitrate and generic explosives may be found, and using this information, standoff detection of these materials may be possible.

Generic substitution of antihypertensive drugs: does it affect adherence?

PubMed

Van Wijk, Boris L G; Klungel, Olaf H; Heerdink, Eibert R; de Boer, Anthonius

2006-01-01

Generic substitution is an important opportunity to reduce the costs of pharmaceutical care. However, pharmacists and physicians often find that patients and brand-name manufacturers have doubt about the equivalence of the substituted drug. This may be reflected by decreased adherence to therapy. To assess the association between generic substitution and nonadherence to antihypertensive drugs. We conducted a matched cohort study between January 1, 1999, and December 31, 2002. Data were obtained from PHARMO, a record linkage system containing drug-dispensing records from community pharmacies and linked hospital discharge records of approximately 950,000 people in The Netherlands. Residents of 30 medium-sized cities who initiated antihypertensive drug therapy were potential subjects. Refill adherence with antihypertensive drugs after substitution was determined; those with refill adherence below 80% were considered nonadherent. Four hundred sixty-three patients with a substitution in therapy and 565 controls, matched on age, gender, therapy start date, duration of use, and generic product code, were identified. Of the patients who switched from brand-name to generic formulations ("substituted"), 13.6% were nonadherent, and of the non-substituted patients (those who did not switch to generic), 18.7% were nonadherent (OR 0.68; 95% CI 0.48 to 0.96). The association was absent in males. None of the patients discontinued the medication. No differences in hospitalizations for cardiovascular disease in the 6 months after the substitution were observed. Generic substitution of antihypertensive drugs does not lead to lower adherence or more discontinuation and cardiovascular disease-related hospitalizations compared with brand-name therapy. When a less-expensive antihypertensive generic equivalent becomes available, generic substitution should be considered to achieve economic benefits.

Pilot-in-the-Loop CFD Method Development

DTIC Science & Technology

2014-06-16

CFD analysis. Coupled simulations will be run at PSU on the COCOA -4 cluster, a high performance computing cluster. The CRUNCH CFD software has...been installed on the COCOA -4 servers and initial software tests are being conducted. Initial efforts will use the Generic Frigate Shape SFS-2 to

Addition of generic medication vouchers to a pharmacist academic detailing program: effects on the generic dispensing ratio in a physician-hospital organization.

PubMed

Bhargava, Vinay; Greg, Mark E; Shields, Mark C

2010-01-01

Generic dispensing ratio (GDR) is an important measure of efficiency in pharmacy benefit management. A few studies have examined the effects of academic detailing or generic drug samples on GDR. On July 1, 2007, a physician-hospital organization (PHO) with a pay-for-performance incentive for generic utilization initiated a pilot generic medication voucher program that augmented its existing pharmacist-led academic detailing efforts. No published studies have examined the role of generic medication vouchers in promoting generic drug utilization. To determine if supplementing an existing academic detailing initiative in a PHO with a generic medication voucher program would be more effective in increasing the GDR compared with academic detailing alone. The intervention took place over the 9-month period from July 1, 2007, through March 31, 2008. Vouchers provided patients with the first fill of a 30-day supply of a generic drug at no cost to the patient for 8 specific generic medications obtained through a national community pharmacy chain. The study was conducted in a PHO composed of 7 hospitals and approximately 2,900 physicians (900 primary care providers [PCPs] and 2,000 specialists). Of the approximately 300 PCP practices, 21 practices with at least 2 physicians each were selected on the basis of high prescription volume (more than 500 pharmacy claims for the practice over a 12-month pre-baseline period) and low GDR (practice GDR less than 55% in the 12-month pre-baseline period). These 21 practices were then randomized to a control group of academic detailing alone or the intervention group that received academic detailing plus generic medication vouchers. One of 10 intervention groups declined to participate, and 2 of 11 control groups dropped out of the PHO. GDR was calculated monthly for all pharmacy claims including the 8 voucher medications. GDR was defined as the ratio of the total number of paid generic pharmacy claims divided by the total number of paid pharmacy claims for 108 prescriber identification numbers (Drug Enforcement Administration [DEA] or National Provider Identifier [NPI]) for 9 intervention groups [n = 53 PCPs] and 9 control groups [n = 55 PCPs]). For both intervention and control arms, the GDR for each month from July 2007 (start of 2007 Q3, intervention start date) through September 2008 (end of 2008 Q3, 6 months after intervention end date) was compared with the same month in the previous year. A descriptive analysis compared a 9-month baseline period from 2006 Q3 through 2007 Q1 with a 9-month voucher period from 2007 Q3 to 2008 Q1. A panel data regression analysis assessed GDR for 18 practices over 27 months (12 months pre-intervention and 15 months post-intervention). A total of 656 vouchers were redeemed over the 9-month voucher period from July 1, 2007, through March 31, 2008, for an average of about 12 vouchers per participating physician; approximately one-third of the redeemed vouchers were for generic simvastatin. The GDR increase for all drugs, including the 8 voucher drugs, was 7.4 points for the 9 PCP group practices with access to generic medication vouchers, from 53.4% in the 9-month baseline period to 60.8% in the 9-month voucher period, compared with a 6.2 point increase for the control group from 55.9% during baseline to 62.1% during the voucher period. The panel data regression model estimated that the medication voucher program was associated with a 1.77-point increase in overall GDR compared with academic detailing alone (P = 0.047). Compared with academic detailing alone, a generic medication voucher program providing a 30-day supply of 8 specific medications in addition to academic detailing in PCP groups with low GDR and high prescribing volume in an outpatient setting was associated with a small but statistically significant increase in adjusted overall GDR.

Separability and Entanglement in the Hilbert Space Reference Frames Related Through the Generic Unitary Transform for Four Level System

NASA Astrophysics Data System (ADS)

Man'ko, V. I.; Markovich, L. A.

2018-02-01

Quantum correlations in the state of four-level atom are investigated by using generic unitary transforms of the classical (diagonal) density matrix. Partial cases of pure state, X-state, Werner state are studied in details. The geometrical meaning of unitary Hilbert reference-frame rotations generating entanglement in the initially separable state is discussed. Characteristics of the entanglement in terms of concurrence, entropy and negativity are obtained as functions of the unitary matrix rotating the reference frame.

GMODWeb: a web framework for the generic model organism database

PubMed Central

O'Connor, Brian D; Day, Allen; Cain, Scott; Arnaiz, Olivier; Sperling, Linda; Stein, Lincoln D

2008-01-01

The Generic Model Organism Database (GMOD) initiative provides species-agnostic data models and software tools for representing curated model organism data. Here we describe GMODWeb, a GMOD project designed to speed the development of model organism database (MOD) websites. Sites created with GMODWeb provide integration with other GMOD tools and allow users to browse and search through a variety of data types. GMODWeb was built using the open source Turnkey web framework and is available from . PMID:18570664

Scattering transform for nonstationary Schroedinger equation with bidimensionally perturbed N-soliton potential

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boiti, M.; Pempinelli, F.; Pogrebkov, A. K.

2006-12-15

In the framework of the extended resolvent approach the direct and inverse scattering problems for the nonstationary Schroedinger equation with a potential being a perturbation of the N-soliton potential by means of a generic bidimensional smooth function decaying at large spaces are introduced and investigated. The initial value problem of the Kadomtsev-Petviashvili I equation for a solution describing N wave solitons on a generic smooth decaying background is then linearized, giving the time evolution of the spectral data.

Human life support during interplanetary travel and domicile. VI - Generic modular flow schematic for hybrid physical/chemical-biological life support systems

NASA Technical Reports Server (NTRS)

Ganapathi, Gani B.; Seshan, P. K.; Ferrall, Joseph; Rohatgi, Naresh

1992-01-01

An extension is proposed for the NASA Space Exploration Initiative's Generic Modular Flow Schematics for physical/chemical life support systems which involves the addition of biological processes. The new system architecture includes plant, microbial, and animal habitat, as well as the human habitat subsystem. Major Feedstock Production and Food Preparation and Packaging components have also been incorporated. Inedible plant, aquaculture, microbial, and animal solids are processed for recycling.

Neuro-estimator based GMC control of a batch reactive distillation.

PubMed

Prakash, K J Jithin; Patle, Dipesh S; Jana, Amiya K

2011-07-01

In this paper, an artificial neural network (ANN)-based nonlinear control algorithm is proposed for a simulated batch reactive distillation (RD) column. In the homogeneously catalyzed reactive process, an esterification reaction takes place for the production of ethyl acetate. The fundamental model has been derived incorporating the reaction term in the model structure of the nonreactive distillation process. The process operation is simulated at the startup phase under total reflux conditions. The open-loop process dynamics is also addressed running the batch process at the production phase under partial reflux conditions. In this study, a neuro-estimator based generic model controller (GMC), which consists of an ANN-based state predictor and the GMC law, has been synthesized. Finally, this proposed control law has been tested on the representative batch reactive distillation comparing with a gain-scheduled proportional integral (GSPI) controller and with its ideal performance (ideal GMC). Copyright © 2011 ISA. Published by Elsevier Ltd. All rights reserved.

A new Lagrangian method for real gases at supersonic speed

NASA Technical Reports Server (NTRS)

Loh, C. Y.; Liou, Meng-Sing

1992-01-01

With the renewed interest in high speed flights, the real gas effect is of theoretical as well as practical importance. In the past decade, upwind splittings or Godunov-type Riemann solutions have received tremendous attention and as a result significant progress has been made both in the ideal and non-ideal gas. In this paper, we propose a new approach that is formulated using the Lagrangian description, for the calculation of supersonic/hypersonic real gas inviscid flows. This new formulation avoids the grid generation step which is automatically obtained as the solution procedure marches in the 'time-like' direction. As a result, no remapping is required and the accuracy is faithfully maintained in the Lagrangian level. In this paper, we give numerical results for a variety of real gas problems consisting of essential elements in high speed flows, such as shock waves, expansion waves, slip surfaces and their interactions. Finally, calculations for flows in a generic inlet and nozzle are presented.

Directing gaze: the effect of disclaimer labels on women's visual attention to fashion magazine advertisements.

PubMed

Bury, Belinda; Tiggemann, Marika; Slater, Amy

2014-09-01

In an effort to combat the known negative effects of exposure to unrealistic thin ideal images, there is increasing worldwide pressure on fashion, media and advertising industries to disclose when images have been digitally altered. The current study used eye tracking technology to investigate experimentally how digital alteration disclaimer labels impact women's visual attention to fashion magazine advertisements. Participants were 60 female undergraduate students who viewed four thin ideal advertisements with either no disclaimer, a generic disclaimer, or a specific more detailed disclaimer. It was established that women did attend to the disclaimers. The nature of the disclaimer had no effect on time spent looking at particular body parts, but did affect the direction of gaze following reading of the disclaimer. This latter effect was found to be greater for women high on trait appearance comparison. Further research is paramount in guiding effective policy around the use of disclaimer labels. Copyright © 2014 Elsevier Ltd. All rights reserved.

Disclaimer labels on fashion magazine advertisements: Impact on visual attention and relationship with body dissatisfaction.

PubMed

Bury, Belinda; Tiggemann, Marika; Slater, Amy

2016-03-01

Globally there is increasing advocacy for the implementation of laws requiring disclaimer labels to be attached to media images that have been digitally altered, with the goal of reducing the known negative effects of exposure to unrealistic thin ideal imagery for women. The current study used eye tracking technology to establish how digital alteration disclaimer labels affect women's visual attention to fashion magazine advertisements, and the interrelationship with body dissatisfaction and state appearance comparison. Participants were 120 female undergraduate students who viewed four thin ideal advertisements with either no disclaimer, a generic disclaimer, or a more detailed specific disclaimer. It was found that women did attend to the disclaimers. Specifically worded disclaimers directed visual attention towards target body areas, which resulted in increased body dissatisfaction, while state appearance comparison predicted increased body dissatisfaction. Further research is imperative to provide guidance on the most effective use of disclaimer labels. Copyright © 2015 Elsevier Ltd. All rights reserved.

Imperative to consider multiple initiatives to maximize prescribing efficiency from generic availability: case history from Abu Dhabi.

PubMed

Abuelkhair, Mohammed; Abdu, Shajahan; Godman, Brian; Fahmy, Sahar; Malmström, Rickard E; Gustafsson, Lars L

2012-02-01

Pharmaceutical expenditure has risen rapidly in Abu Dhabi, resulting in policies surrounding generics. However, various circumstances will reduce potential savings, including pharmacists still being free to dispense either originator or branded generics and be fully reimbursed. To research the changes in utilization patterns of proton pump inhibitors (PPIs) and lipid-lowering drugs before and after combined reforms on generics; and subsequently, calculate potential savings based on 'best practices' among Western European countries. An uncontrolled before-and-after observational study of utilization and expenditure of PPIs, statins and ezetimibe between 2004 and 2010, as well as up to 12 months before the first generic policy, to 1 year after the second generic policy, was carried out. Utilization was converted to defined daily doses (DDDs; 2011 DDDs) and DDDs/1000 inhabitants per day. Expenditure/DDD was calculated for omeprazole and simvastatin. PPI utilization rose by 6.5-fold from 2004 to 2010, principally driven by increased utilization of patent-protected PPIs, although more recently stabilization in esomperazole utilization has occurred. Similar changes were seen for statins. Introduction of best practices would reduce PPI expenditure in 2010 by 32.8 million United Arab Emirates dirham (AED; €6.26 million) and statins by over 27 million AED (€5.15 million). Limited demand-side measures led to increased utilization of patent-protected products in Abu Dhabi following the generic reforms. Successful measures will release considerable resources.

Global strategies to reduce the price of antiretroviral medicines: evidence from transactional databases.

PubMed

Waning, Brenda; Kaplan, Warren; King, Alexis C; Lawrence, Danielle A; Leufkens, Hubert G; Fox, Matthew P

2009-07-01

To estimate the impact of global strategies, such as pooled procurement arrangements, third-party price negotiation and differential pricing, on reducing the price of antiretrovirals (ARVs), which currently hinders universal access to HIV/AIDS treatment. We estimated the impact of global strategies to reduce ARV prices using data on 7253 procurement transactions (July 2002-October 2007) from databases hosted by WHO and the Global Fund to Fight AIDS, Tuberculosis and Malaria. For 19 of 24 ARV dosage forms, we detected no association between price and volume purchased. For the other five ARVs, high-volume purchases were 4-21% less expensive than medium- or low-volume purchases. Nine of 13 generic ARVs were priced 6-36% lower when purchased under the Clinton Foundation HIV/AIDS Initiative (CHAI). Fifteen of 18 branded ARVs were priced 23-498% higher for differentially priced purchases compared with non-CHAI generic purchases. However, two branded, differentially priced ARVs were priced 63% and 73% lower, respectively, than generic non-CHAI equivalents. Large purchase volumes did not necessarily result in lower ARV prices. Although current plans for pooled procurement will further increase purchase volumes, savings are uncertain and should be balanced against programmatic costs. Third-party negotiation by CHAI resulted in lower generic ARV prices. Generics were less expensive than differentially priced branded ARVs, except where little generic competition exists. Alternative strategies for reducing ARV prices, such as streamlining financial management systems, improving demand forecasting and removing barriers to generics, should be explored.

[Measures to reduce costs for prescriptions in Vienna--preliminary analysis].

PubMed

Tönies, Hans

2009-01-01

To increase the rate of prescriptions for generic drugs in Vienna an information campaign was started in 2004 and quality circles for prescribing doctors were organized. Since the result of this initiative is not yet known publicly this report aims to present a preliminary analysis. The prescription statements kindly provided by the health insurance fund of Vienna could be analysed. Data from the Chamber of Viennese Physicians were used for compiling a report about the quality circles. A total of 17 quality circles with an average of 15 participants were formed; they met four times yearly. Participants were paid for their attendance. The rate of prescribed generic drugs in Vienna has continuously improved, with the major increase in the first year of the activities. In the year 2006 a rate of over 40% generic prescriptions was reached by 80% of general practitioners. This cooperation between the health insurance fund and doctors apparently resulted in both an increase in the rate of generic drugs prescribed and in a good acceptance among physicians.

Developing and Validating a Competence Framework for Secondary Mathematics Student Teachers through a Delphi Method

ERIC Educational Resources Information Center

Muñiz-Rodríguez, Laura; Alonso, Pedro; Rodríguez-Muñiz, Luis J.; Valcke, Martin

2017-01-01

Initial teacher education programmes provide student teachers with the desired competences to develop themselves as teachers. Although a generic framework for teaching competences is available covering all school subjects in Spain, the initial teacher education programmes curriculum does not specify which competences secondary mathematics student…

DNA condensation and size effects of DNA condensation agent

NASA Astrophysics Data System (ADS)

Liu, Yan-Hui; Jiang, Chong-Ming; Guo, Xin-Miao; Tang, Yan-Lin; Hu, Lin

2013-08-01

Based on the model of the strong correlation of counterions condensed on DNA molecule, by tailoring interaction potential, interduplex spacing and correlation spacing between condensed counterions on DNA molecule and interduplex spacing fluctuation strength, toroidal configuration, rod-like configuration and two-hole configurations are possible. The size effects of counterion structure on the toroidal structure can be detected by this model. The autocorrelation function of the tangent vectors is found as an effective way to detect the structure of toroidal conformations and the generic pathway of the process of DNA condensation. The generic pathway of all of the configurations involves an initial nucleation loop, and the next part of the DNA chain is folded on the top of the initial nucleation loop with different manners, in agreement with the recent experimental results.

Statistics of initial density perturbations in heavy ion collisions and their fluid dynamic response

NASA Astrophysics Data System (ADS)

Floerchinger, Stefan; Wiedemann, Urs Achim

2014-08-01

An interesting opportunity to determine thermodynamic and transport properties in more detail is to identify generic statistical properties of initial density perturbations. Here we study event-by-event fluctuations in terms of correlation functions for two models that can be solved analytically. The first assumes Gaussian fluctuations around a distribution that is fixed by the collision geometry but leads to non-Gaussian features after averaging over the reaction plane orientation at non-zero impact parameter. In this context, we derive a three-parameter extension of the commonly used Bessel-Gaussian event-by-event distribution of harmonic flow coefficients. Secondly, we study a model of N independent point sources for which connected n-point correlation functions of initial perturbations scale like 1 /N n-1. This scaling is violated for non-central collisions in a way that can be characterized by its impact parameter dependence. We discuss to what extent these are generic properties that can be expected to hold for any model of initial conditions, and how this can improve the fluid dynamical analysis of heavy ion collisions.

The changing patterns of dispensing branded and generic drugs for the treatment of gastroesophageal reflux disease between 2006 and 2011 in Japan: a retrospective cohort study.

PubMed

Murata, Kyoko; Hinotsu, Shiro; Hamada, Shota; Ezoe, Yasumasa; Muto, Manabu; Kawakami, Koji

2015-02-27

Despite rising healthcare costs, generic drugs are less frequently dispensed in Japan compared with other developed countries. This study aimed to describe changes in dispensing of branded and generic drugs and to explore possible factors that promote the use of generic drugs. We conducted a retrospective cohort study using a Japanese medical and pharmacy claims database. All proton pump inhibitors (PPIs) and histamine H2-receptor antagonists (H2RAs) with indications for gastroesophageal reflux disease (GERD) described on Japanese labels were included. Patterns of dispensing branded and generic drugs for the treatment of GERD between 2006 and 2011 were analyzed. Multivariate logistic regression was applied to investigate factors associated with receiving generic drugs. The study cohort included 14,590 patients (male: 50.2%, mean age: 43.1 years). Branded drugs for GERD were still frequently dispensed despite an increase in the share of generic drugs. Only 4.3% of patients who initially received branded drugs switched to generic drugs. The percentage of patients who received only generic drugs increased over time (6.5% to 22.1%). The frequency of generic drug dispensing was the highest in the setting where both prescription and dispensing were implemented in clinics (43.3%), while the lowest in the setting where both prescription and dispensing were implemented in hospitals (11.5%). Factors associated with receiving generic drugs included year of dispensing (adjusted OR 2.22, 95% CI 1.94 to 2.55 for 2009-11 v 2006-8), prescription and dispensing setting (OR 1.81, 95% CI 1.44 to 2.26 for prescription in hospitals and dispensing in community pharmacies; OR 2.21, 95% CI 1.80 to 2.72 for prescription in clinics and dispensing in community pharmacies; and OR 4.55, 95% CI 3.68 to 5.62 for prescription and dispensing in clinics v prescription and dispensing in hospitals) and H2RAs (OR 1.64, 95% CI 1.49 to 1.81 compared to PPIs). The share of generic drugs for the treatment of GERD increased over time although branded drugs for GERD were still dispensed frequently. The use of generic drugs for GERD was influenced not only by government policies but also by changes in treatment approach and the setting of prescription and dispensing.

The doctor(s) in house: an analysis of the evolution of the television doctor-hero.

PubMed

Strauman, Elena C; Goodier, Bethany C

2011-03-01

The medical drama and its central character, the doctor-hero have been a mainstay of popular television. House M.D. offers a new (and problematic) iteration of the doctor-hero. House eschews the generic conventions of the "television doctor" by being neither the idealized television doctor of the past, nor the more recent competent but often fallible physicians in entertainment texts. Instead, his character is a fragmented text which privileges the biomedical over the personal or emotional with the ultimate goal of scientifically uncovering and resolving instances of disease. This article examines the implicit and explicit messages in House M.D. and critically analyzes both the show and its lead character in relation to the traditional medical drama genre that highlights the "doctor-hero" as the central character. While at first House seems to completely violate narrative and generic norms, ultimately the program provides a new form that reinforces the presence of the doctor-hero, but highlights House's character as the central figure who is personally and interpersonally problematic but biomedically effective.

Firm- and drug-specific patterns of generic drug payments by US medicaid programs: 1991-2008.

PubMed

Kelton, Christina M L; Chang, Lenisa V; Guo, Jeff J; Yu, Yan; Berry, Edmund A; Bian, Boyang; Heaton, Pamela C

2014-04-01

The entry of generic drugs into markets previously monopolized by patented, branded drugs often represents large potential savings for healthcare payers in the USA. Our objectives were to describe and explain the trends in drug reimbursement by public Medicaid programmes post-generic entry for as many drug markets and for as long a time period as possible. The data were the Medicaid State Drug Utilization Data maintained by the Centers for Medicare and Medicaid Services. Quarterly utilization and expenditure data from 1991 to 2008 were extracted for 83 drugs, produced by 229 firms, that experienced initial generic entry between 1992 and 2004. A relative 'price' for a specific drug, firm and quarter was constructed as Medicaid reimbursement per unit (e.g. tablet, capsule or vial) divided by average reimbursement per unit for the branded drug the year before entry. Fixed-effects models controlling for time-, firm- and drug-specific differences were estimated to explain reimbursement. Twelve quarters after generic entry, 18 % of drugs had average per-unit reimbursement less than 50 % of the original branded-drug reimbursement. For each additional firm manufacturing the drug, reimbursement per unit, relative to the pre-generic-entry branded-drug reimbursement, was estimated to fall by 17 (p < 0.01) and 3 (p < 0.01) percentage points for generic and branded-drug companies, respectively. Each additional quarter post-generic entry brought a 2 (p < 0.01) percentage point drop in relative reimbursement. State Medicaid programmes generally have been able to obtain relief from high drug prices following patent expirations for many branded-drug medications by adjusting reimbursement following the expanded competition in the pharmaceutical market.

Visuospatial and psychomotor aptitude predicts endovascular performance of inexperienced individuals on a virtual reality simulator.

PubMed

Van Herzeele, Isabelle; O'Donoghue, Kevin G L; Aggarwal, Rajesh; Vermassen, Frank; Darzi, Ara; Cheshire, Nicholas J W

2010-04-01

This study evaluated virtual reality (VR) simulation for endovascular training of medical students to determine whether innate perceptual, visuospatial, and psychomotor aptitude (VSA) can predict initial and plateau phase of technical endovascular skills acquisition. Twenty medical students received didactic and endovascular training on a commercially available VR simulator. Each student treated a series of 10 identical noncomplex renal artery stenoses endovascularly. The simulator recorded performance data instantly and objectively. An experienced interventionalist rated the performance at the initial and final sessions using generic (out of 40) and procedure-specific (out of 30) rating scales. VSA were tested with fine motor dexterity (FMD, Perdue Pegboard), psychomotor ability (minimally invasive virtual reality surgical trainer [MIST-VR]), image recall (Rey-Osterrieth), and organizational aptitude (map-planning). VSA performance scores were correlated with the assessment parameters of endovascular skills at commencement and completion of training. Medical students exhibited statistically significant learning curves from the initial to the plateau performance for contrast usage (medians, 28 vs 17 mL, P < .001), total procedure time (2120 vs 867 seconds, P < .001), and fluoroscopy time (993 vs. 507 seconds, P < .001). Scores on generic and procedure-specific rating scales improved significantly (10 vs 25, P < .001; 8 vs 17 P < .001). Significant correlations were noted for FMD with initial and plateau sessions for fluoroscopy time (r(s) = -0.564, P = .010; r(s) = -.449, P = .047). FMD correlated with procedure-specific scores at the initial session (r(s) = .607, P = .006). Image recall correlated with generic skills at the end of training (r(s) = .587, P = .006). Simulator-based training in endovascular skills improved performance in medical students. There were significant correlations between initial endovascular skill and fine motor dexterity as well as with image recall at end of the training period. In addition to current recruitment strategies, VSA may be a useful tool for predictive validity studies.

Ash deposits - Initiating the change from empiricism to generic engineering. Part 1: The generic approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wagoner, C.L.; Wessel, R.A.

1986-01-01

Empiricism has traditionally been used to relate laboratory and pilot-scale measurements of fuel characteristics with the design, performance, and the slagging and fouling behavior of steam generators. Currently, a new engineering approach is being evaluated. The goal is to develop and use calculations and measurements from several engineering disciplines that exceed the demonstrated limitations of present empirical techniques for predicting slagging/fouling behavior. In Part I of this paper, the generic approach to deposits and boiler performance is defined and a matrix of engineering concepts is described. General relationships are presented for assessing the effects of deposits and sootblowing on themore » real-time performance of heat transfer surfaces in pilot- and commercial-scale steam generators.« less

A Generic Ground Framework for Image Expertise Centres and Small-Sized Production Centres

NASA Astrophysics Data System (ADS)

Sellé, A.

2009-05-01

Initiated by the Pleiadas Earth Observation Program, the CNES (French Space Agency) has developed a generic collaborative framework for its image quality centre, highly customisable for any upcoming expertise centre. This collaborative framework has been design to be used by a group of experts or scientists that want to share data and processings and manage interfaces with external entities. Its flexible and scalable architecture complies with the core requirements: defining a user data model with no impact on the software (generic access data), integrating user processings with a GUI builder and built-in APIs, and offering a scalable architecture to fit any preformance requirement and accompany growing projects. The CNES jas given licensing grants for two software companies that will be able to redistribute this framework to any customer.

Tempting Fate or Inviting Happiness? Unrealistic idealization prevents the decline of marital satisfaction

PubMed Central

Murray, Sandra L.; Griffin, Dale W.; Derrick, Jaye L.; Harris, Brianna; Aloni, Maya; Leder, Sadie

2014-01-01

The authors examine whether unrealistically viewing a romantic partner as the image of one’s ideal partner accelerates or slows declines in marital satisfaction among newlyweds. A longitudinal study linked unrealistic idealization at the point of marriage to changes in satisfaction over the first three years of marriage. Overall, satisfaction declined markedly, consistent with past research. However, seeing a less-than-ideal partner as a reflection of one’s ideals predicted a certain level of immunity to the corrosive effects of time: People who initially idealized their partner highly experienced no declines in satisfaction. The obtained benefits of idealization remained in analyses that separately controlled for the positivity of partner perceptions and the possibility that better adjusted people might be in better relationships. PMID:21467549

Creating flexible work arrangements through idiosyncratic deals.

PubMed

Hornung, Severin; Rousseau, Denise M; Glaser, Jürgen

2008-05-01

A survey of 887 employees in a German government agency assessed the antecedents and consequences of idiosyncratic arrangements individual workers negotiated with their supervisors. Work arrangements promoting the individualization of employment conditions, such as part-time work and telecommuting, were positively related to the negotiation of idiosyncratic deals ("i-deals"). Worker personal initiative also had a positive effect on i-deal negotiation. Two types of i-deals were studied: flexibility in hours of work and developmental opportunities. Flexibility i-deals were negatively related and developmental i-deals positively related to work-family conflict and working unpaid overtime. Developmental i-deals were also positively related to increased performance expectations and affective organizational commitment, while flexibility i-deals were unrelated to either. PsycINFO Database Record (c) 2008 APA, all rights reserved.

Dynamics and stability of light-like tachyon condensation

NASA Astrophysics Data System (ADS)

Barnaby, Neil; Mulryne, David J.; Nunes, Nelson J.; Robinson, Patrick

2009-03-01

Recently, Hellerman and Schnabl considered the dynamics of unstable D-branes in the background of a linear dilaton. Remarkably, they were able to construct light-like tachyon solutions which interpolate smoothly between the perturbative and nonperturbative vacua, without undergoing the wild oscillations that plague time-like solutions. In their analysis, however, the full structure of the initial value problem for the nonlocal dynamical equations was not considered. In this paper, therefore, we reexamine the nonlinear dynamics of light-like tachyon condensation using a combination of numerical and analytical techniques. We find that for the p-adic string the monotonic behaviour obtained previously relied on a special choice of initial conditions near the unstable maximum. For generic initial conditions the wild oscillations come back to haunt us. Interestingly, we find an ``island of stability'' in initial condition space that leads to sensible evolution at late times. For the string field theory case, on the other hand, we find that the evolution is completely stable for generic choices of initial data. This provides an explicit example of a string theoretic system that admits infinitely many initial data but is nevertheless nonperturbatively stable. Qualitatively similar dynamics are obtained in nonlocal cosmologies where the Hubble damping plays a role very analogous to the dilaton gradient.

a Generic Probabilistic Model and a Hierarchical Solution for Sensor Localization in Noisy and Restricted Conditions

NASA Astrophysics Data System (ADS)

Ji, S.; Yuan, X.

2016-06-01

A generic probabilistic model, under fundamental Bayes' rule and Markov assumption, is introduced to integrate the process of mobile platform localization with optical sensors. And based on it, three relative independent solutions, bundle adjustment, Kalman filtering and particle filtering are deduced under different and additional restrictions. We want to prove that first, Kalman filtering, may be a better initial-value supplier for bundle adjustment than traditional relative orientation in irregular strips and networks or failed tie-point extraction. Second, in high noisy conditions, particle filtering can act as a bridge for gap binding when a large number of gross errors fail a Kalman filtering or a bundle adjustment. Third, both filtering methods, which help reduce the error propagation and eliminate gross errors, guarantee a global and static bundle adjustment, who requires the strictest initial values and control conditions. The main innovation is about the integrated processing of stochastic errors and gross errors in sensor observations, and the integration of the three most used solutions, bundle adjustment, Kalman filtering and particle filtering into a generic probabilistic localization model. The tests in noisy and restricted situations are designed and examined to prove them.

When and why do ideal partner preferences affect the process of initiating and maintaining romantic relationships?

PubMed

Eastwick, Paul W; Finkel, Eli J; Eagly, Alice H

2011-11-01

Three studies explored how the traits that people ideally desire in a romantic partner, or ideal partner preferences, intersect with the process of romantic relationship initiation and maintenance. Two attraction experiments in the laboratory found that, when participants evaluated a potential romantic partner's written profile, they expressed more romantic interest in a partner whose traits were manipulated to match (vs. mismatch) their idiosyncratic ideals. However, after a live interaction with the partner, the match vs. mismatch manipulation was no longer associated with romantic interest. This pattern appeared to have emerged because participants reinterpreted the meaning of the traits as they applied to the partner, a context effect predicted by classic models of person perception (S. E. Asch, 1946). Finally, a longitudinal study of middle-aged adults demonstrated that participants evaluated a current romantic partner (but not a partner who was merely desired) more positively to the extent that the partner matched their overall pattern of ideals across several traits; the match in level of ideals (i.e., high vs. low ratings) was not relevant to participants' evaluations. In general, the match between ideals and a partner's traits may predict relational outcomes when participants are learning about a partner in the abstract and when they are actually in a relationship with the partner, but not when considering potential dating partners they have met in person.

Global strategies to reduce the price of antiretroviral medicines: evidence from transactional databases

PubMed Central

Kaplan, Warren; King, Alexis C; Lawrence, Danielle A; Leufkens, Hubert G; Fox, Matthew P

2009-01-01

Abstract Objective To estimate the impact of global strategies, such as pooled procurement arrangements, third-party price negotiation and differential pricing, on reducing the price of antiretrovirals (ARVs), which currently hinders universal access to HIV/AIDS treatment. Methods We estimated the impact of global strategies to reduce ARV prices using data on 7253 procurement transactions (July 2002–October 2007) from databases hosted by WHO and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Findings For 19 of 24 ARV dosage forms, we detected no association between price and volume purchased. For the other five ARVs, high-volume purchases were 4–21% less expensive than medium- or low-volume purchases. Nine of 13 generic ARVs were priced 6–36% lower when purchased under the Clinton Foundation HIV/AIDS Initiative (CHAI). Fifteen of 18 branded ARVs were priced 23–498% higher for differentially priced purchases compared with non-CHAI generic purchases. However, two branded, differentially priced ARVs were priced 63% and 73% lower, respectively, than generic non-CHAI equivalents. Conclusion Large purchase volumes did not necessarily result in lower ARV prices. Although current plans for pooled procurement will further increase purchase volumes, savings are uncertain and should be balanced against programmatic costs. Third-party negotiation by CHAI resulted in lower generic ARV prices. Generics were less expensive than differentially priced branded ARVs, except where little generic competition exists. Alternative strategies for reducing ARV prices, such as streamlining financial management systems, improving demand forecasting and removing barriers to generics, should be explored. PMID:19649366

Generic health/safety/environment cases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kelland, A.N.; Primrose, M.; Pickles, J.C.

1996-12-31

A desire to implement HSE Management Systems including HSE Cases in all Shell companies operations prompted the development of a relational data base software package (THESIS) to provide a structured way of preparing an HSE Case. The software includes features which facilitate the management of {open_quotes}Keeping the Case Alive{close_quotes}, enabling the dissemination of tasks and hazard information to the workplace. During the software development it was recognized that a significant reduction could be made in the resources which would be required to prepare an HSE Case for each and every operation by the building of {open_quotes}Generic HSE Cases{close_quotes} addressing specificmore » activities which were repeated across the Company`s operations. This was recognized to be particularly valid for the smaller Single String Venture type of operations. The activities selected for the initial Generic HSE Case development include Land Drilling Operations, Land Seismic Acquisition, and Land Transport. To establish the Generic HSE Case, the THESIS data base is populated with data for a generic operation, identifying all the hazards and activities associated with that operation including all the associated controls, with established formats for the textual sections. In effect, the Generic Case defines the standards required for that type of operation. To generate an operation specific HSE Case, the Generic Case thereafter requires to be modified/adapted so that it represents the actual situation in the operation which it defines. This process includes itemization of all the operation specific details, and may involve the inclusion/deletion of any additional/existing activities or hazards together with their associated controls.« less

Initial Training for VET Teachers: A Portrait within a Larger Canvas

ERIC Educational Resources Information Center

Guthrie, Hugh; McNaughton, Alicen; Gamlin, Tracy

2011-01-01

This study focuses on a critical aspect of the vocational education and training (VET) workforce: initial VET teacher training. It has identified the generic teacher education courses offered both by the VET and higher education sectors, ranging from the Certificate IV in Training and Assessment (now the Certificate IV in Training and Education)…

Insensitive fuze train for high explosives

DOEpatents

Cutting, Jack L.; Lee, Ronald S.; Von Holle, William G.

1994-01-01

A generic insensitive fuze train to initiate insensitive high explosives, such as PBXW-124. The insensitive fuze train uses a slapper foil to initiate sub-gram quantities of an explosive, such as HNS-IV or PETN. This small amount of explosive drives a larger metal slapper onto a booster charge of an insensitive explosive, such as UF-TATB. The booster charge initiates a larger charge of an explosive, such as LX-17, which in turn, initiates the insensitive high explosive, such as PBXW-124.

Insensitive fuze train for high explosives

DOEpatents

Cutting, J.L.; Lee, R.S.; Von Holle, W.G.

1994-01-04

A generic insensitive fuze train to initiate insensitive high explosives, such as PBXW-124 is described. The insensitive fuze train uses a slapper foil to initiate sub-gram quantities of an explosive, such as HNS-IV or PETN. This small amount of explosive drives a larger metal slapper onto a booster charge of an insensitive explosive, such as UF-TATB. The booster charge initiates a larger charge of an explosive, such as LX-17, which in turn, initiates the insensitive high explosive, such as PBXW-124. 3 figures.

Chaos and noise.

PubMed

He, Temple; Habib, Salman

2013-09-01

Simple dynamical systems--with a small number of degrees of freedom--can behave in a complex manner due to the presence of chaos. Such systems are most often (idealized) limiting cases of more realistic situations. Isolating a small number of dynamical degrees of freedom in a realistically coupled system generically yields reduced equations with terms that can have a stochastic interpretation. In situations where both noise and chaos can potentially exist, it is not immediately obvious how Lyapunov exponents, key to characterizing chaos, should be properly defined. In this paper, we show how to do this in a class of well-defined noise-driven dynamical systems, derived from an underlying Hamiltonian model.

Look-normal: the colonized child of developmental science.

PubMed

Varga, Donna

2011-05-01

This article provides an analysis of the techniques, methods, materials, and discourses of child study observation to illuminate its role in the sociohistorical colonization of childhood. Through analysis of key texts it explains how early 20th-century child study provided for the transcendence of historical, racial, and social contexts for understanding human development. The colonizing project of child study promoted the advancement of Eurocentric culture through a generic "White" development. What a child is and can be, and the meaning of childhood has been disembodied through observation, record keeping, and analytical processes in which time and space are abstracted from behavior, and development symbolized as a universal ideal.

Collective attacks and unconditional security in continuous variable quantum key distribution.

PubMed

Grosshans, Frédéric

2005-01-21

We present here an information theoretic study of Gaussian collective attacks on the continuous variable key distribution protocols based on Gaussian modulation of coherent states. These attacks, overlooked in previous security studies, give a finite advantage to the eavesdropper in the experimentally relevant lossy channel, but are not powerful enough to reduce the range of the reverse reconciliation protocols. Secret key rates are given for the ideal case where Bob performs optimal collective measurements, as well as for the realistic cases where he performs homodyne or heterodyne measurements. We also apply the generic security proof of Christiandl et al. to obtain unconditionally secure rates for these protocols.

SP-100 initial startup and restart control strategy

NASA Astrophysics Data System (ADS)

Halfen, Frank J.; Wong, Kwok K.; Switick, Dennis M.; Shukla, Jaikaran N.

Startup control strategies for SP-100 are described. Revised control and operating strategies are discussed which have been developed and tested using the SP-100 dynamic simulation model Aries-GFS (Generic Flight System).

Cost-effectiveness of Tyrosine Kinase Inhibitor Treatment Strategies for Chronic Myeloid Leukemia in Chronic Phase After Generic Entry of Imatinib in the United States.

PubMed

Padula, William V; Larson, Richard A; Dusetzina, Stacie B; Apperley, Jane F; Hehlmann, Rudiger; Baccarani, Michele; Eigendorff, Ekkehard; Guilhot, Joelle; Guilhot, Francois; Hehlmann, Rudiger; Mahon, Francois-Xavier; Martinelli, Giovanni; Mayer, Jiri; Müller, Martin C; Niederwieser, Dietger; Saussele, Susanne; Schiffer, Charles A; Silver, Richard T; Simonsson, Bengt; Conti, Rena M

2016-07-01

We analyzed the cost-effectiveness of treating incident chronic myeloid leukemia in chronic phase (CML-CP) with generic imatinib when it becomes available in United States in 2016. In the year following generic entry, imatinib's price is expected to drop 70% to 90%. We hypothesized that initiating treatment with generic imatinib in these patients and then switching to the other tyrosine-kinase inhibitors (TKIs), dasatinib or nilotinib, because of intolerance or lack of effectiveness ("imatinib-first") would be cost-effective compared with the current standard of care: "physicians' choice" of initiating treatment with any one of the three TKIs. We constructed Markov models to compare the five-year cost-effectiveness of imatinib-first vs physician's choice from a US commercial payer perspective, assuming 3% annual discounting ($US 2013). The models' clinical endpoint was five-year overall survival taken from a systematic review of clinical trial results. Per-person spending on incident CML-CP treatment overall care components was estimated using Truven's MarketScan claims data. The main outcome of the models was cost per quality-adjusted life-year (QALY). We interpreted outcomes based on a willingness-to-pay threshold of $100 000/QALY. A panel of European LeukemiaNet experts oversaw the study's conduct. Both strategies met the threshold. Imatinib-first ($277 401, 3.87 QALYs) offered patients a 0.10 decrement in QALYs at a savings of $88 343 over five years to payers compared with physician's choice ($365 744, 3.97 QALYs). The imatinib-first incremental cost-effectiveness ratio was approximately $883 730/QALY. The results were robust to multiple sensitivity analyses. When imatinib loses patent protection and its price declines, its use will be the cost-effective initial treatment strategy for CML-CP. © The Author 2016. Published by Oxford University Press.

Cost-effectiveness of Tyrosine Kinase Inhibitor Treatment Strategies for Chronic Myeloid Leukemia in Chronic Phase After Generic Entry of Imatinib in the United States

PubMed Central

Padula, William V.; Larson, Richard A.; Dusetzina, Stacie B.; Apperley, Jane F.; Hehlmann, Rudiger; Baccarani, Michele; Eigendorff, Ekkehard; Guilhot, Joelle; Guilhot, Francois; Hehlmann, Rudiger; Mahon, Francois-Xavier; Martinelli, Giovanni; Mayer, Jiri; Müller, Martin C.; Niederwieser, Dietger; Saussele, Susanne; Schiffer, Charles A.; Silver, Richard T.; Simonsson, Bengt

2016-01-01

Background: We analyzed the cost-effectiveness of treating incident chronic myeloid leukemia in chronic phase (CML-CP) with generic imatinib when it becomes available in United States in 2016. In the year following generic entry, imatinib’s price is expected to drop 70% to 90%. We hypothesized that initiating treatment with generic imatinib in these patients and then switching to the other tyrosine-kinase inhibitors (TKIs), dasatinib or nilotinib, because of intolerance or lack of effectiveness (“imatinib-first”) would be cost-effective compared with the current standard of care: “physicians’ choice” of initiating treatment with any one of the three TKIs. Methods: We constructed Markov models to compare the five-year cost-effectiveness of imatinib-first vs physician’s choice from a US commercial payer perspective, assuming 3% annual discounting ($US 2013). The models’ clinical endpoint was five-year overall survival taken from a systematic review of clinical trial results. Per-person spending on incident CML-CP treatment overall care components was estimated using Truven’s MarketScan claims data. The main outcome of the models was cost per quality-adjusted life-year (QALY). We interpreted outcomes based on a willingness-to-pay threshold of $100 000/QALY. A panel of European LeukemiaNet experts oversaw the study’s conduct. Results: Both strategies met the threshold. Imatinib-first ($277 401, 3.87 QALYs) offered patients a 0.10 decrement in QALYs at a savings of $88 343 over five years to payers compared with physician’s choice ($365 744, 3.97 QALYs). The imatinib-first incremental cost-effectiveness ratio was approximately $883 730/QALY. The results were robust to multiple sensitivity analyses. Conclusion: When imatinib loses patent protection and its price declines, its use will be the cost-effective initial treatment strategy for CML-CP. PMID:26944912

Multiple policies to enhance prescribing efficiency for established medicines in Europe with a particular focus on demand-side measures: findings and future implications.

PubMed

Godman, Brian; Wettermark, Bjorn; van Woerkom, Menno; Fraeyman, Jessica; Alvarez-Madrazo, Samantha; Berg, Christian; Bishop, Iain; Bucsics, Anna; Campbell, Stephen; Finlayson, Alexander E; Fürst, Jurij; Garuoliene, Kristina; Herholz, Harald; Kalaba, Marija; Laius, Ott; Piessnegger, Jutta; Sermet, Catherine; Schwabe, Ulrich; Vlahović-Palčevski, Vera V; Markovic-Pekovic, Vanda; Vončina, Luka; Malinowska, Kamila; Zara, Corinne; Gustafsson, Lars L

2014-01-01

The appreciable growth in pharmaceutical expenditure has resulted in multiple initiatives across Europe to lower generic prices and enhance their utilization. However, considerable variation in their use and prices. Assess the influence of multiple supply and demand-side initiatives across Europe for established medicines to enhance prescribing efficiency before a decision to prescribe a particular medicine. Subsequently utilize the findings to suggest potential future initiatives that countries could consider. An analysis of different methodologies involving cross national and single country retrospective observational studies on reimbursed use and expenditure of PPIs, statins, and renin-angiotensin inhibitor drugs among European countries. Nature and intensity of the various initiatives appreciably influenced prescribing behavior and expenditure, e.g., multiple measures resulted in reimbursed expenditure for PPIs in Scotland in 2010 56% below 2001 levels despite a 3-fold increase in utilization and in the Netherlands, PPI expenditure fell by 58% in 2010 vs. 2000 despite a 3-fold increase in utilization. A similar picture was seen with prescribing restrictions, i.e., (i) more aggressive follow-up of prescribing restrictions for patented statins and ARBs resulted in a greater reduction in the utilization of patented statins in Austria vs. Norway and lower utilization of patented ARBs vs. generic ACEIs in Croatia than Austria. However, limited impact of restrictions on esomeprazole in Norway with the first prescription or recommendation in hospital where restrictions do not apply. Similar findings when generic losartan became available in Western Europe. Multiple demand-side measures are needed to influence prescribing patterns. When combined with supply-side measures, activities can realize appreciable savings. Health authorities cannot rely on a "spill over" effect between classes to affect changes in prescribing.

Multiple policies to enhance prescribing efficiency for established medicines in Europe with a particular focus on demand-side measures: findings and future implications

PubMed Central

Godman, Brian; Wettermark, Bjorn; van Woerkom, Menno; Fraeyman, Jessica; Alvarez-Madrazo, Samantha; Berg, Christian; Bishop, Iain; Bucsics, Anna; Campbell, Stephen; Finlayson, Alexander E.; Fürst, Jurij; Garuoliene, Kristina; Herholz, Harald; Kalaba, Marija; Laius, Ott; Piessnegger, Jutta; Sermet, Catherine; Schwabe, Ulrich; Vlahović-Palčevski, Vera V.; Markovic-Pekovic, Vanda; Vončina, Luka; Malinowska, Kamila; Zara, Corinne; Gustafsson, Lars L.

2014-01-01

Introduction: The appreciable growth in pharmaceutical expenditure has resulted in multiple initiatives across Europe to lower generic prices and enhance their utilization. However, considerable variation in their use and prices. Objective: Assess the influence of multiple supply and demand-side initiatives across Europe for established medicines to enhance prescribing efficiency before a decision to prescribe a particular medicine. Subsequently utilize the findings to suggest potential future initiatives that countries could consider. Method: An analysis of different methodologies involving cross national and single country retrospective observational studies on reimbursed use and expenditure of PPIs, statins, and renin-angiotensin inhibitor drugs among European countries. Results: Nature and intensity of the various initiatives appreciably influenced prescribing behavior and expenditure, e.g., multiple measures resulted in reimbursed expenditure for PPIs in Scotland in 2010 56% below 2001 levels despite a 3-fold increase in utilization and in the Netherlands, PPI expenditure fell by 58% in 2010 vs. 2000 despite a 3-fold increase in utilization. A similar picture was seen with prescribing restrictions, i.e., (i) more aggressive follow-up of prescribing restrictions for patented statins and ARBs resulted in a greater reduction in the utilization of patented statins in Austria vs. Norway and lower utilization of patented ARBs vs. generic ACEIs in Croatia than Austria. However, limited impact of restrictions on esomeprazole in Norway with the first prescription or recommendation in hospital where restrictions do not apply. Similar findings when generic losartan became available in Western Europe. Conclusions: Multiple demand-side measures are needed to influence prescribing patterns. When combined with supply-side measures, activities can realize appreciable savings. Health authorities cannot rely on a “spill over” effect between classes to affect changes in prescribing. PMID:24987370

Assessing the quality of life of children with sickle cell anaemia using self-, parent-proxy, and health care professional-proxy reports.

PubMed

Constantinou, Christina; Payne, Nicola; Inusa, Baba

2015-05-01

The quality of life (QoL) of children with sickle cell anaemia (SCA) in the United Kingdom has not been examined, and a discrepancy measure based on Gap theory has rarely been used. This study investigated whether (1) child self-reports of QoL using a discrepancy measure (the Generic Children's QoL Measure; GCQ) are lower than those from healthy children, (2) proxy reports from parents and health care professionals are lower than child self-reports, and (3) demographic and disease severity indicators are related to QoL. An interdependent groups, cross-sectional design was implemented. Seventy-four children with SCA, their parent, and members of their health care team completed the GCQ. Demographic and disease severity indicators were recorded. GCQ data from healthy children were obtained from the UK Data Archive. Contrary to past research, when examining generic discrepancy QoL, children with SCA did not report a lower QoL than healthy children, and parent- and health care professional-proxy reports were not lower than child self-reports. Few of the demographic and disease severity indicators were related to QoL. Proxy reports may be used to gain a more complete picture of QoL, but should not be a substitute for self-reports. The explanation for the relatively high levels of QoL reported is not clear, but children with SCA may have realistic expectations about their ideal-self, place greater emphasis on aspects other than health in shaping their QoL, and define achievements within the limits of their illness. Future research should focus on psychological factors in explaining QoL. Statement of contribution What is already known on this subject? Children with sickle cell disease (SCD) generally have a reduced QoL compared with healthy children, but there appears to be no research measuring QoL in paediatric SCD in the United Kingdom. Proxy QoL reports from parents are often lower than child self-reports, but there is less research examining proxy reports from health care professionals. Previous research has measured paediatric QoL using measures of current health-related QoL, but this is not in line with the WHO's definition of QoL as the discrepancy between current state and expectations. What does this study add? Children with Sickle cell anaemia do not have an impaired discrepancy QoL; they may have realistic expectations about their ideal-self and define achievements within the limits of their illness. Health care professionals are able to gauge a SCA child's discrepancy QoL better than parents. The GCQ (a generic discrepancy measure of QoL) takes into account expectations about ideal QoL and does not emphasize health; it may be of use to Psychologists working with SCA children. © 2014 The British Psychological Society.

The generic drug user fee amendments: an economic perspective

PubMed Central

Berndt, Ernst R; Murphy, Stephen J

2018-01-01

Abstract Since the vast majority of prescription drugs consumed by Americans are off patent (‘generic’), their regulation and supply is of wide interest. We describe events leading up to the US Congress's 2012 passage of the Generic Drug User Fee Amendments (GDUFA I) as part of the Food and Drug Administration Safety and Innovation Act (FDASIA). Under GDUFA I, generic manufacturers agreed to pay approximately $300 million in fees each year of the five-year program. In exchange, the US Food and Drug Administration (FDA) committed to performance goals. We describe GDUFA I’s FDA commitments, provisions, goals, and annual fee structure and compare it to that entailed in the authorization and implementation of GDUFA II on October 1, 2017. We explain how user fees required under GDUFA I erected barriers to entry and created scale and scope economies for incumbent manufacturers. Congress changed user fees under GDUFA II in part to lessen these incentives. In order to initiate and sustain user fees under GDUFA legislation, FDA requires the submission of self-reported data on generic manufacturers including domestic and foreign facilities. These data are public and our examination of them provides an unprecedented window into the recent organization of generic drug manufacturers supplying the US market. Our results suggest that generic drug manufacturing is increasingly concentrated and foreign. We discuss the implications of this observed market structure for GDUFA II’s implementation among other outcomes. PMID:29707218

Generic Ada code in the NASA space station command, control and communications environment

NASA Technical Reports Server (NTRS)

Mcdougall, D. P.; Vollman, T. E.

1986-01-01

The results of efforts to apply powerful Ada constructs to the formatted message handling process are described. The goal of these efforts was to extend the state-of-technology in message handling while at the same time producing production-quality, reusable code. The first effort was initiated in September, 1984 and delivered in April, 1985. That product, the Generic Message Handling Facility, met initial goals, was reused, and is available in the Ada Repository on ARPANET. However, it became apparent during its development that the initial approach to building a message handler template was not optimal. As a result of this initial effort, several alternate approaches were identified, and research is now on-going to identify an improved product. The ultimate goal is to be able to instantly build a message handling system for any message format given a specification of that message format. The problem lies in how to specify the message format, and one that is done, how to use that information to build the message handler. Message handling systems and message types are described. The initial efforts, its results and its shortcomings are detailed. The approach now being taken to build a system which will be significantly easier to implement, and once implemented, easier to use, is described. Finally, conclusions are offered.

Ideal gas behavior of a strongly coupled complex (dusty) plasma.

PubMed

Oxtoby, Neil P; Griffith, Elias J; Durniak, Céline; Ralph, Jason F; Samsonov, Dmitry

2013-07-05

In a laboratory, a two-dimensional complex (dusty) plasma consists of a low-density ionized gas containing a confined suspension of Yukawa-coupled plastic microspheres. For an initial crystal-like form, we report ideal gas behavior in this strongly coupled system during shock-wave experiments. This evidence supports the use of the ideal gas law as the equation of state for soft crystals such as those formed by dusty plasmas.

Comparing recurrent antibiotic prescriptions in children treated with a brand name or a generic formulation.

PubMed

Piovani, Daniele; Clavenna, Antonio; Cartabia, Massimo; Bortolotti, Angela; Fortino, Ida; Merlino, Luca; Bonati, Maurizio

2015-02-01

The aim of this study was to investigate the rate of recurrent prescriptions and hospital admissions in children receiving a brand name or generic antibiotic prescription. The data source was a database of reimbursed prescriptions. Outpatient children/adolescents <18 years old (Lombardy Region, Italy) were included. The observational period was February-April 2010. A recurrence was defined as an antibiotic prescription occurring within 28 days after an index prescription. The rate of recurrent prescriptions and hospital admissions was calculated for generic/brand name formulations and for each age strata (0-5, 6-11, and 12-17 years old) for four antibiotics: amoxicillin, amoxicillin clavulanate, clarithromycin, and cefaclor. The percentage of therapy switches was calculated. Cochran-Mantel-Haenszel test was used to compare the age-adjusted outcomes. In all, 17.5% (57 346) of children received at least one recurrent prescription. The rate of recurrent prescriptions was slightly lower in children receiving any generic (OR 0.96; 95%CI 0.93-0.98), compared with any brand name, antibiotic. The percentage of hospital admissions occurring in children initially treated with a brand name (1.01%; 95%CI 0.98-1.08) or generic (1.03%; 0.96-1.06) antibiotic was not different (p = 0.43). For children receiving amoxicillin clavulanate, the hospital admission rate was slightly higher in the brand name group (p = 0.002), while no differences were found for the other active substances. Children treated with generic antibiotics had no worse safety and effectiveness outcomes when compared with those receiving brand name ones. These results provide additional evidence on the safety of generic antibiotics. Copyright © 2014 John Wiley & Sons, Ltd.

The Initiation of Solar Eruptions by Flux Emergence

NASA Astrophysics Data System (ADS)

Leake, J. E.; Linton, M.; Antiochos, S. K.

2013-12-01

Understanding the mechanism for the initiation of solar eruptions, or coronal mass ejections (CMEs), is a vital step in the prediction of space weather. There are a number of different theoretical and numerical magnetic models for the initiation of CMEs, and to some extent they all rely on idealized initial conditions or boundary conditions. These idealizations typically involve the presence of pre-formed sheared magnetic fields in the corona, which contain enough free energy to drive an eruption, or the generation of sheared magnetic fields by velocity/electric field boundary flows. The roots of coronal magnetic fields lie in the convection zone, and to understand the CME initiation mechanism, we must understand how these convection zone fields emerge from the high beta convection zone into the low beta corona. Using visco-resistive MHD numerical simulations, we show how simple convection zone magnetic fields that are consistent with our understanding of the solar dynamo can dynamically emerge through the photosphere/chromosphere and into the corona and form sheared magnetic structures which are capable of erupting and creating CMEs. These results extend current CME models by introducing increased realism and removing the idealized initial coronal field conditions and kinematic boundary conditions, which is an important step in relating space weather and the Sun's dynamo generation of magnetic field. This work was funded by NASA's 'Living With a Star' program.

Entropic (de)stabilization of surface-bound peptides conjugated with polymers

NASA Astrophysics Data System (ADS)

Carmichael, Scott P.; Shell, M. Scott

2015-12-01

In many emerging biotechnologies, functional proteins must maintain their native structures on or near interfaces (e.g., tethered peptide arrays, protein coated nanoparticles, and amphiphilic peptide micelles). Because the presence of a surface is known to dramatically alter the thermostability of tethered proteins, strategies to stabilize surface-bound proteins are highly sought. Here, we show that polymer conjugation allows for significant control over the secondary structure and thermostability of a model surface-tethered peptide. We use molecular dynamics simulations to examine the folding behavior of a coarse-grained helical peptide that is conjugated to polymers of various lengths and at various conjugation sites. These polymer variations reveal surprisingly diverse behavior, with some stabilizing and some destabilizing the native helical fold. We show that ideal-chain polymer entropies explain these varied effects and can quantitatively predict shifts in folding temperature. We then develop a generic theoretical model, based on ideal-chain entropies, that predicts critical lengths for conjugated polymers to effect changes in the folding of a surface-bound protein. These results may inform new design strategies for the stabilization of surface-associated proteins important for a range technological applications.

Entropic (de)stabilization of surface-bound peptides conjugated with polymers.

PubMed

Carmichael, Scott P; Shell, M Scott

2015-12-28

In many emerging biotechnologies, functional proteins must maintain their native structures on or near interfaces (e.g., tethered peptide arrays, protein coated nanoparticles, and amphiphilic peptide micelles). Because the presence of a surface is known to dramatically alter the thermostability of tethered proteins, strategies to stabilize surface-bound proteins are highly sought. Here, we show that polymer conjugation allows for significant control over the secondary structure and thermostability of a model surface-tethered peptide. We use molecular dynamics simulations to examine the folding behavior of a coarse-grained helical peptide that is conjugated to polymers of various lengths and at various conjugation sites. These polymer variations reveal surprisingly diverse behavior, with some stabilizing and some destabilizing the native helical fold. We show that ideal-chain polymer entropies explain these varied effects and can quantitatively predict shifts in folding temperature. We then develop a generic theoretical model, based on ideal-chain entropies, that predicts critical lengths for conjugated polymers to effect changes in the folding of a surface-bound protein. These results may inform new design strategies for the stabilization of surface-associated proteins important for a range technological applications.

Moderators of the Intervention Effects for a Dissonance-Based Eating Disorder Prevention Program; Results from an Amalgam of Three Randomized Trials

PubMed Central

Müller, Sina; Stice, Eric

2013-01-01

Objective To investigate factors hypothesized to moderate the effects of a dissonance-based eating disorder prevention program, including initial elevations in thin-ideal internalization, body dissatisfaction, eating disorder symptoms, and older participant age. Method Adolescent female high school and college students with body image concerns (N = 977; M age = 18.6) were randomized to a dissonance-based thin-ideal internalization reduction program or an assessment-only control condition in three prevention trials. Results The intervention produced (a) significantly stronger reductions in thin-ideal internalization for participants with initial elevations in thin-ideal internalization and a threshold/subthreshold DSM-5 eating disorder at baseline, (b) significantly greater reductions in eating disorder symptoms for participants with versus without a DSM-5 eating disorder at baseline, and (c) significantly stronger reductions in body dissatisfaction for late adolescence/young adulthood versus mid-adolescent participants. Baseline body dissatisfaction did not moderate the intervention effects. Conclusion Overall, intervention effects tended to be amplified for individuals with initial elevations in risk factors and a DSM-5 eating disorder at baseline. Results suggest that this prevention program is effective for a broad range of individuals, but is somewhat more beneficial for the subgroups identified in the moderation analyses. PMID:23337181

Early Impact Of The Affordable Care Act On Oral Contraceptive Cost Sharing, Discontinuation, And Nonadherence.

PubMed

Pace, Lydia E; Dusetzina, Stacie B; Keating, Nancy L

2016-09-01

The oral contraceptive pill is the contraceptive method most commonly used by US women, but inconsistent use of the pill is a contributor to high rates of unintended pregnancy. The relationship between consumer cost sharing and consistent use of the pill is not well understood, and the impact of the elimination of cost sharing for oral contraceptive pills in a mandate in the Affordable Care Act (ACA) is not yet known. We analyzed insurance claims for 635,075 women with employer-sponsored insurance who were initiating use of the pill, to examine rates of discontinuation and nonadherence, their relationship with cost sharing, and trends before and during the first year after implementation of the ACA mandate. We found that cost sharing for oral contraceptives decreased markedly following implementation, more significantly for generic than for brand-name versions. Higher copays were associated with greater discontinuation of and nonadherence to generic pills than was the case with zero copayments. Discontinuation of the use of generic or brand-name pills decreased slightly but significantly following ACA implementation, as did nonadherence to brand-name pills. Our findings suggest a modest early impact of the ACA on improving consistent use of oral contraceptives among women initiating their use. Project HOPE—The People-to-People Health Foundation, Inc.

A longitudinal examination of generic and occupational specific job demands, and work-related social support associated with burnout among nurses in Sweden.

PubMed

Sundin, L; Hochwälder, J; Lisspers, J

2011-01-01

Burnout is a familiar problem within nursing. This longitudinal study was designed to examine the roles that generic and occupational specific job demands (i.e. "pain and death", "patient and relative needs", "threats and violence", "professional worries"), and various work-related sources of support play in association with burnout in a sample of registered nurses in Sweden. A questionnaire was completed on two different occasions, by the same group of nurses from three hospitals and two primary health care centers. Nurses with initial low and moderate scores on emotional exhaustion (n=585) and depersonalization (n=631) were included in the logistic regression analyses. Initial scores, as well as four categories examining change over time in the predictors (unchanged low, improved, impaired, unchanged high), were associated with burnout approximately one year later. In the multivariate analyses, quantitative job demands and professional worries were associated with emotional exhaustion. Poor co-worker support was associated with depersonalization over time. This study suggests an association between generic as well as occupational specific job demands and emotional exhaustion. Furthermore, an association between poor co-worker support and depersonalization was suggested. Implications of these findings and recommended directions for future research are discussed.

Ideal regularization for learning kernels from labels.

PubMed

Pan, Binbin; Lai, Jianhuang; Shen, Lixin

2014-08-01

In this paper, we propose a new form of regularization that is able to utilize the label information of a data set for learning kernels. The proposed regularization, referred to as ideal regularization, is a linear function of the kernel matrix to be learned. The ideal regularization allows us to develop efficient algorithms to exploit labels. Three applications of the ideal regularization are considered. Firstly, we use the ideal regularization to incorporate the labels into a standard kernel, making the resulting kernel more appropriate for learning tasks. Next, we employ the ideal regularization to learn a data-dependent kernel matrix from an initial kernel matrix (which contains prior similarity information, geometric structures, and labels of the data). Finally, we incorporate the ideal regularization to some state-of-the-art kernel learning problems. With this regularization, these learning problems can be formulated as simpler ones which permit more efficient solvers. Empirical results show that the ideal regularization exploits the labels effectively and efficiently. Copyright © 2014 Elsevier Ltd. All rights reserved.

Patient adherence to generic versus brand statin therapy after acute myocardial infarction: Insights from the Can Rapid Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the American College of Cardiology/American Heart Association Guidelines Registry.

PubMed

O'Brien, Emily C; McCoy, Lisa A; Thomas, Laine; Peterson, Eric D; Wang, Tracy Y

2015-07-01

Statins reduce mortality after acute myocardial infarction, but up to half of patients discontinue statin use within 1 year of therapy initiation. Although cost may influence medication adherence, it is unknown whether use of generic versus brand statins influences adherence. We linked detailed inhospital clinical data for 1421 non-ST-segment elevation myocardial infarction patients discharged on a statin in 2006 to Medicare Part D medication claims records to examine postdischarge medication use. One-year statin adherence was defined using the proportion of days covered with optimal adherence ≥80%. We examined the association of brand versus generic statin prescription and 1-year adherence after adjusting for demographics, clinical factors, predischarge lipid values, prior statin use, and socioeconomic status. Overall, 65.5% of statin fills were for brand-name statins. There were few baseline differences in demographics and clinical factors among generic versus brand users. Patient copay amounts were higher for brand versus generic statins (median = $25 vs $5, P < .001), yet the mean proportion of days covered over 1 year was similar (71.5% vs 68.9%; P = .97; unadjusted odds ratio 1.15 [95% CI 0.96-1.37]). Proportion of days covered ≥80% was low for both generic (56.2%) and brand statins (55.9%; P = .93). Statin adherence rates remained similar between generic and brand users after adjusting for demographics, clinical risk factors, lipid value, prior statin use, and socioeconomic status. In a cohort of older non-ST-segment elevation myocardial infarction patients, we found no evidence that use of generic versus brand drug was associated with higher adherence to statins at 1 year after hospital discharge. Copyright © 2015 Elsevier Inc. All rights reserved.

Cost variability of suggested generic treatment alternatives under the Medicare Part D benefit.

PubMed

Patel, Rajul A; Walberg, Mark P; Tong, Emily; Tan, Florence; Rummel, Ashley E; Woelfel, Joseph A; Carr-Lopez, Sian M; Galal, Suzanne M

2014-03-01

The substitution of generic treatment alternatives for brand-name drugs is a strategy that can help lower Medicare beneficiary out-of-pocket costs. Beginning in 2011, Medicare beneficiaries reaching the coverage gap received a 50% discount on the full drug cost of brand-name medications and a 7% discount on generic medications filled during the gap. This discount will increase until 2020, when beneficiaries will be responsible for 25% of total drug costs during the coverage gap. To examine the cost variability of brand and generic drugs within 4 therapeutic classes before and during the coverage gap for each 2011 California stand-alone prescription drug plan (PDP) and prospective coverage gap costs in 2020 to determine the effects on beneficiary out-of-pocket drug costs. Equivalent doses of brand and generic drugs in the following 4 pharmacological classes were examined: angiotensin II receptor blockers (ARBs), bisphosphonates, HMG-CoA reductase inhibitors (statins), and proton pump inhibitors (PPIs). The full drug cost and patient copay/coinsurance amounts during initial coverage and the coverage gap of each drug was recorded based on information retrieved from the Medicare website. These drug cost data were recorded for 28 California PDPs. The highest cost difference between a brand medication and a Centers for Medicare Medicaid Services (CMS)-suggested generic treatment alternative varied between $110.53 and $195.49 at full cost and between $51.37 and $82.35 in the coverage gap. The lowest cost difference varied between $38.45 and $76.93 at full cost and between -$4.11 and $18.52 during the gap. Medicare beneficiaries can realize significant out-of-pocket cost savings for their drugs by taking CMS-suggested generic treatment alternatives. However, due to larger discounts on brand medications made available through recent changes reducing the coverage gap, the potential dollar savings by taking suggested generic treatment alternatives during the gap is less compelling and will decrease as subsidies increase.

Mathematical Analysis of a Coarsening Model with Local Interactions

NASA Astrophysics Data System (ADS)

Helmers, Michael; Niethammer, Barbara; Velázquez, Juan J. L.

2016-10-01

We consider particles on a one-dimensional lattice whose evolution is governed by nearest-neighbor interactions where particles that have reached size zero are removed from the system. Concentrating on configurations with infinitely many particles, we prove existence of solutions under a reasonable density assumption on the initial data and show that the vanishing of particles and the localized interactions can lead to non-uniqueness. Moreover, we provide a rigorous upper coarsening estimate and discuss generic statistical properties as well as some non-generic behavior of the evolution by means of heuristic arguments and numerical observations.

Experiments with metallic and ceramic porous media

NASA Technical Reports Server (NTRS)

Frederking, T. H. K.; Abbassi, P.; Khandhar, P. K.; Luna, Jack

1988-01-01

Work in the area of mechano-caloric phenomena was initiated during 1988 with startup in the Summer 1988 period. The ideal system utilizing He-II super-phenomena is modeled readily, within the frame of thermodynamics energetics, using the concept of an ideal superleak. The real system however uses porous media of non-ideal pore-grain ingredients. The early phase of experimental and related modeling studies is outlined for the time period from Summer 1988 to the end of 1988.

"Hi Mommy": Parental Preferences of Greetings by Medical Staff.

PubMed

Wilks-Gallo, Lisa; Aron, Chaim Zev; Messina, Catherine R

2018-04-01

The therapeutic alliance between pediatricians and parents begins at the initial encounter. The manner in which pediatricians greet family members influences this relationship. This study evaluated whether parents are addressed using generic titles and investigated perceptions of parents regarding how they are addressed by medical staff. Written surveys of 137 parents of pediatric inpatients collected opinions about greetings during medical encounters. Parents were asked if they have been addressed as Mom/Dad/Mommy/Daddy during past medical encounters and which generic titles they would prefer. Using a Likert-type scale, the parents' perceptions of various salutations were assessed and compared. In this sample, 86% of parents were previously called Mom/Dad/Mommy/Daddy. Parents preferred to be addressed as Mom or Dad over other generic titles. Many disliked being addressed as Mommy/Daddy, Ma'am/Sir, or without a name, suggesting that providers should avoid the use of these salutations.

Modeling of ultrasonic processes utilizing a generic software framework

NASA Astrophysics Data System (ADS)

Bruns, P.; Twiefel, J.; Wallaschek, J.

2017-06-01

Modeling of ultrasonic processes is typically characterized by a high degree of complexity. Different domains and size scales must be regarded, so that it is rather difficult to build up a single detailed overall model. Developing partial models is a common approach to overcome this difficulty. In this paper a generic but simple software framework is presented which allows to coupe arbitrary partial models by slave modules with well-defined interfaces and a master module for coordination. Two examples are given to present the developed framework. The first one is the parameterization of a load model for ultrasonically-induced cavitation. The piezoelectric oscillator, its mounting, and the process load are described individually by partial models. These partial models then are coupled using the framework. The load model is composed of spring-damper-elements which are parameterized by experimental results. In the second example, the ideal mounting position for an oscillator utilized in ultrasonic assisted machining of stone is determined. Partial models for the ultrasonic oscillator, its mounting, the simplified contact process, and the workpiece’s material characteristics are presented. For both applications input and output variables are defined to meet the requirements of the framework’s interface.

Modeling generic aspects of ideal fibril formation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Michel, D., E-mail: denis.michel@live.fr

Many different proteins self-aggregate into insoluble fibrils growing apically by reversible addition of elementary building blocks. But beyond this common principle, the modalities of fibril formation are very disparate, with various intermediate forms which can be reshuffled by minor modifications of physico-chemical conditions or amino-acid sequences. To bypass this complexity, the multifaceted phenomenon of fibril formation is reduced here to its most elementary principles defined for a linear prototype of fibril. Selected generic features, including nucleation, elongation, and conformational recruitment, are modeled using minimalist hypotheses and tools, by separating equilibrium from kinetic aspects and in vitro from in vivo conditions.more » These reductionist approaches allow to bring out known and new rudiments, including the kinetic and equilibrium effects of nucleation, the dual influence of elongation on nucleation, the kinetic limitations on nucleation and fibril numbers, and the accumulation of complexes in vivo by rescue from degradation. Overlooked aspects of these processes are also pointed: the exponential distribution of fibril lengths can be recovered using various models because it is attributable to randomness only. It is also suggested that the same term “critical concentration” is used for different things, involved in either nucleation or elongation.« less

Modeling generic aspects of ideal fibril formation

NASA Astrophysics Data System (ADS)

Michel, D.

2016-01-01

Many different proteins self-aggregate into insoluble fibrils growing apically by reversible addition of elementary building blocks. But beyond this common principle, the modalities of fibril formation are very disparate, with various intermediate forms which can be reshuffled by minor modifications of physico-chemical conditions or amino-acid sequences. To bypass this complexity, the multifaceted phenomenon of fibril formation is reduced here to its most elementary principles defined for a linear prototype of fibril. Selected generic features, including nucleation, elongation, and conformational recruitment, are modeled using minimalist hypotheses and tools, by separating equilibrium from kinetic aspects and in vitro from in vivo conditions. These reductionist approaches allow to bring out known and new rudiments, including the kinetic and equilibrium effects of nucleation, the dual influence of elongation on nucleation, the kinetic limitations on nucleation and fibril numbers, and the accumulation of complexes in vivo by rescue from degradation. Overlooked aspects of these processes are also pointed: the exponential distribution of fibril lengths can be recovered using various models because it is attributable to randomness only. It is also suggested that the same term "critical concentration" is used for different things, involved in either nucleation or elongation.

Soft translations and soft extensions of BCI/BCK-algebras.

PubMed

Sultana, Nazra; Rani, Nazia; Ali, Muhammad Irfan; Hussain, Azhar

2014-01-01

The concept of soft translations of soft subalgebras and soft ideals over BCI/BCK-algebras is introduced and some related properties are studied. Notions of Soft extensions of soft subalgebras and soft ideals over BCI/BCK-algebras are also initiated. Relationships between soft translations and soft extensions are explored.

Sequential Ideal-Observer Analysis of Visual Discriminations.

ERIC Educational Resources Information Center

Geisler, Wilson S.

1989-01-01

A new analysis, based on the concept of the ideal observer in signal detection theory, is described. It allows: tracing of the flow of discrimination information through the initial physiological stages of visual processing for arbitrary spatio-chromatic stimuli, and measurement of the information content of said visual stimuli. (TJH)

Determination of an Optimal Control Strategy for a Generic Surface Vehicle

DTIC Science & Technology

2014-06-18

paragraphs uses the numerical procedure in MATLAB’s BVP (bvp4c) algorithm using the continuation method. The goal is to find a solution to the set of...solution. Solving the BVP problem using bvp4c requires an initial guess for the solution. Note that the algorithm is very sensitive to the particular...form of the initial guess. The quality of the initial guess is paramount in convergence speed of the BVP algorithm and often determines if the

Initial data sets and the topology of closed three-manifolds in general relativity

NASA Astrophysics Data System (ADS)

Carfora, M.

1983-10-01

The interaction between the matter content of a closed physical space associated with a generic gravitational configuration and the topology of the underlying closed three-manifold is discussed. Within the context of the conformal approach to the initial value problem, it is shown that the presence of enough matter and radiation favors the three-sphere topology or the worm-hole topology. It is argued that such topologies leave more room for possible gravitational initial data sets for the field equations.

Accessing quadratic nonlinearities of metals through metallodielectric photonic-band-gap structures.

PubMed

D'Aguanno, Giuseppe; Mattiucci, Nadia; Bloemer, Mark J; Scalora, Michael

2006-09-01

We study second harmonic generation in a metallodielectric photonic-band-gap structure made of alternating layers of silver and a generic, dispersive, linear, dielectric material. We find that under ideal conditions the conversion efficiency can be more than two orders of magnitude greater than the maximum conversion efficiency achievable in a single layer of silver. We interpret this enhancement in terms of the simultaneous availability of phase matching conditions over the structure and good field penetration into the metal layers. We also give a realistic example of a nine-period, Si3/N4Ag stack, where the backward conversion efficiency is enhanced by a factor of 50 compared to a single layer of silver.

Engine Data Interpretation System (EDIS)

NASA Technical Reports Server (NTRS)

Cost, Thomas L.; Hofmann, Martin O.

1990-01-01

A prototype of an expert system was developed which applies qualitative or model-based reasoning to the task of post-test analysis and diagnosis of data resulting from a rocket engine firing. A combined component-based and process theory approach is adopted as the basis for system modeling. Such an approach provides a framework for explaining both normal and deviant system behavior in terms of individual component functionality. The diagnosis function is applied to digitized sensor time-histories generated during engine firings. The generic system is applicable to any liquid rocket engine but was adapted specifically in this work to the Space Shuttle Main Engine (SSME). The system is applied to idealized data resulting from turbomachinery malfunction in the SSME.

Stem geometry changes initial femoral fixation stability of a revised press-fit hip prosthesis: A finite element study.

PubMed

Russell, Robert D; Huo, Michael H; Rodrigues, Danieli C; Kosmopoulos, Victor

2016-11-14

Stable femoral fixation during uncemented total hip arthroplasty is critical to allow for subsequent osseointegration of the prosthesis. Varying stem designs provide surgeons with multiple options to gain femoral fixation. The purpose of this study was to compare the initial fixation stability of cylindrical and tapered stem implants using two different underreaming techniques (press-fit conditions) for revision total hip arthroplasty (THA). A finite element femur model was created from three-dimensional computed tomography images simulating a trabecular bone defect commonly observed in revision THA. Two 18-mm generic femoral hip implants were modeled using the same geometry, differing only in that one had a cylindrical stem and the other had a 2 degree tapered stem. Surgery was simulated using a 0.05-mm and 0.01-mm press-fit and tested with a physiologically relevant loading protocol. Mean contact pressure was influenced more by the surgical technique than by the stem geometry. The 0.05-mm press-fit condition resulted in the highest contact pressures for both the cylindrical (27.35 MPa) and tapered (20.99 MPa) stems. Changing the press-fit to 0.01-mm greatly decreased the contact pressure by 79.8% and 78.5% for the cylindrical (5.53 MPa) and tapered (4.52 MPa) models, respectively. The cylindrical stem geometry consistently showed less relative micromotion at all the cross-sections sampled as compared to the tapered stem regardless of press-fit condition. This finite element analysis study demonstrates that tapered stem results in lower average contact pressure and greater micromotion at the implant-bone interface than a cylindrical stem geometry. More studies are needed to establish how these different stem geometries perform in such non-ideal conditions encountered in revision THA cases where less bone stock is available.

How healthcare states matter: comparing the introduction of clinical standards in Britain and Germany.

PubMed

Burau, Viola; Fenton, Laura

2009-01-01

This paper aims to identify variation in the introduction of New Public Management reforms in healthcare and how this variation is related to country-specific healthcare states. The analysis uses the introduction of clinical standards in Britain and Germany as cases. The two countries are characterised by interesting differences in relation to the institutional set-up of healthcare states and as such present ideal cases to explore the specific ways of how healthcare states filter clinical standards as tools of a generic managerialism. Both countries have introduced clinical standards but, importantly, the substantive nature of clinical standards differs, reflecting differences in initial institutional conditions. More specifically, in Britain clinical standards have taken the form of two parallel policies, which strengthen hierarchy-based governing and redefine professional self-regulation. In Germany, by contrast, clinical standards come in one single policy, which strengthens the hybrid of network- and hierarchy-based governing and to some extent also pure hierarchy-based forms of governing. First, with its cross-country comparative focus, the analysis is able to identify systematic variations across healthcare states and the specific ways in which they impact on the introduction of New Public Management. Second, with its focus on clinical standards, the analysis deals with the governance of medical practice as one of the central areas of healthcare states.

Advanced techniques and technology for efficient data storage, access, and transfer

NASA Technical Reports Server (NTRS)

Rice, Robert F.; Miller, Warner

1991-01-01

Advanced techniques for efficiently representing most forms of data are being implemented in practical hardware and software form through the joint efforts of three NASA centers. These techniques adapt to local statistical variations to continually provide near optimum code efficiency when representing data without error. Demonstrated in several earlier space applications, these techniques are the basis of initial NASA data compression standards specifications. Since the techniques clearly apply to most NASA science data, NASA invested in the development of both hardware and software implementations for general use. This investment includes high-speed single-chip very large scale integration (VLSI) coding and decoding modules as well as machine-transferrable software routines. The hardware chips were tested in the laboratory at data rates as high as 700 Mbits/s. A coding module's definition includes a predictive preprocessing stage and a powerful adaptive coding stage. The function of the preprocessor is to optimally process incoming data into a standard form data source that the second stage can handle.The built-in preprocessor of the VLSI coder chips is ideal for high-speed sampled data applications such as imaging and high-quality audio, but additionally, the second stage adaptive coder can be used separately with any source that can be externally preprocessed into the 'standard form'. This generic functionality assures that the applicability of these techniques and their recent high-speed implementations should be equally broad outside of NASA.

Soft Translations and Soft Extensions of BCI/BCK-Algebras

PubMed Central

Sultana, Nazra; Rani, Nazia; Ali, Muhammad Irfan

2014-01-01

The concept of soft translations of soft subalgebras and soft ideals over BCI/BCK-algebras is introduced and some related properties are studied. Notions of Soft extensions of soft subalgebras and soft ideals over BCI/BCK-algebras are also initiated. Relationships between soft translations and soft extensions are explored. PMID:25298968

The European Ideal of a University: Portugal's Views from the 1950s and 1960s

ERIC Educational Resources Information Center

Brandão, Tiago

2015-01-01

This study stems from research on the "Standing Conferences of Rectors and Vice-Chancellors of the European Universities" (1948-), an experimental initiative for co-operation among European universities, emphasising the reformative ideal that appeared in international circles in the years following the Second World War. These conceptions…

A Generic Evaluation Model for Semantic Web Services

NASA Astrophysics Data System (ADS)

Shafiq, Omair

Semantic Web Services research has gained momentum over the last few Years and by now several realizations exist. They are being used in a number of industrial use-cases. Soon software developers will be expected to use this infrastructure to build their B2B applications requiring dynamic integration. However, there is still a lack of guidelines for the evaluation of tools developed to realize Semantic Web Services and applications built on top of them. In normal software engineering practice such guidelines can already be found for traditional component-based systems. Also some efforts are being made to build performance models for servicebased systems. Drawing on these related efforts in component-oriented and servicebased systems, we identified the need for a generic evaluation model for Semantic Web Services applicable to any realization. The generic evaluation model will help users and customers to orient their systems and solutions towards using Semantic Web Services. In this chapter, we have presented the requirements for the generic evaluation model for Semantic Web Services and further discussed the initial steps that we took to sketch such a model. Finally, we discuss related activities for evaluating semantic technologies.

Elements of a next generation time-series ASCII data file format for Earth Sciences

NASA Astrophysics Data System (ADS)

Webster, C. J.

2015-12-01

Data in ASCII comma separated value (CSV) format are recognized as the most simple, straightforward and readable type of data present in the geosciences. Many scientific workflows developed over the years rely on data using this simple format. However, there is a need for a lightweight ASCII header format standard that is easy to create and easy to work with. Current OGC grade XML standards are complex and difficult to implement for researchers with few resources. Ideally, such a format should provide the data in CSV for easy consumption by generic applications such as spreadsheets. The format should use an existing time standard. The header should be easily human readable as well as machine parsable. The metadata format should be extendable to allow vocabularies to be adopted as they are created by external standards bodies. The creation of such a format will increase the productivity of software engineers and scientists because fewer translators and checkers would be required. Data in ASCII comma separated value (CSV) format are recognized as the most simple, straightforward and readable type of data present in the geosciences. Many scientific workflows developed over the years rely on data using this simple format. However, there is a need for a lightweight ASCII header format standard that is easy to create and easy to work with. Current OGC grade XML standards are complex and difficult to implement for researchers with few resources. Ideally, such a format would provide the data in CSV for easy consumption by generic applications such as spreadsheets. The format would use existing time standard. The header would be easily human readable as well as machine parsable. The metadata format would be extendable to allow vocabularies to be adopted as they are created by external standards bodies. The creation of such a format would increase the productivity of software engineers and scientists because fewer translators would be required.

76 FR 68769 - Bridging the Idea Development Evaluation Assessment and Long-Term Initiative and Total Product...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-07

... complementary methodological frameworks of the IDEAL and TPLC initiatives, more comprehensive and applicable... devices, surgical operations, and invasive medical procedures; Unique study designs and reporting methods...

Health status of children alive 10 years after pediatric liver transplantation performed in the US and Canada: report of the studies of pediatric liver transplantation experience.

PubMed

Ng, Vicky L; Alonso, Estella M; Bucuvalas, John C; Cohen, Geoff; Limbers, Christine A; Varni, James W; Mazariegos, George; Magee, John; McDiarmid, Susan V; Anand, Ravinder

2012-05-01

To determine clinical and health-related quality of life outcomes, and to derive an "ideal" composite profile of children alive 10 years after pediatric liver transplantation (LT) performed in the US and Canada. This was a multicenter cross-sectional analysis characterizing patients enrolled in the Studies of Pediatric Liver Transplantation database registry who have survived >10 years from LT. A total of 167 10-year survivors were identified, all of whom received daily immunosuppression therapy. Comorbidities associated with the post-LT course included post-transplantation lymphoproliferative disease (in 5% of patients), renal dysfunction (9%), and impaired linear growth (23%). Health-related quality of life, as assessed by the PedsQL 4.0 Generic Core Scales, revealed lower patient self-reported total scale scores for 10-year survivors compared with matched healthy children (77.2±12.9 vs 84.9±11.7; P<.001). At 10 years post-LT, only 32% of patients achieved an ideal profile of a first allograft stable on immunosuppression monotherapy, normal growth, and absence of common immunosuppression-induced sequelae. Success after pediatric LT has moved beyond patient survival. Availability of an ideal composite profile at follow-up provides opportunities for patients, families, and healthcare providers to identify broader sets of outcomes at earlier stages, ultimately contributing to improved outcomes after pediatric LT. Copyright © 2012 Mosby, Inc. All rights reserved.

Kinetic Models for Adiabatic Reversible Expansion of a Monatomic Ideal Gas.

ERIC Educational Resources Information Center

Chang, On-Kok

1983-01-01

A fixed amount of an ideal gas is confined in an adiabatic cylinder and piston device. The relation between temperature and volume in initial/final phases can be derived from the first law of thermodynamics. However, the relation can also be derived based on kinetic models. Several of these models are discussed. (JN)

Medicine prices, availability and affordability in Sri Lanka

PubMed Central

Senarathna, S.M.D.K. Ganga; Mannapperuma, Uthpali; Fernandopulle, B.M. Rohini

2011-01-01

Background: No pricing formula has been implemented from November 2002 to date in Sri Lanka. Therefore, we initiated a study in 2003 to determine the prices, availability and affordability of medicines in the private sector of Sri Lanka in the absence of a price control. Materials and Methods: The World Health Organization/Health Action International methodology was used. The study was conducted in retail pharmacies (Rajya Osu Sala) of State Pharmaceuticals Corporation (semigovernment) and privately owned retail pharmacies (n = 15) in 2003, 2006 and 2009 in a geographical area. Essential medicines (n = 28) were studied and, for each medicine, innovator, most sold generic and cheapest generic were monitored. The medicine’s median price was compared with the international reference prices (IRP) to obtain the median price ratio. The daily wage of the lowest-paid government worker was used to calculate affordability. Results: Innovators were five to six-times the IRP at privately owned pharmacies and four to seven-times at the Rajya Osu Sala. The prices of generics were ≤1 the IRP during 6 years in privately owned and Rajya Osu Sala pharmacies. Cheapest generics were high in availability (>80%) throughout the study period. Innovators cost more than a day’s wage of the lowest-paid government worker; in contrast, generics were always less than one day’s wage. There seems to be no difference in affordability between privately owned or semigovernment pharmacies. Conclusion: In Sri Lanka, generic medicines have effective pricing and are available and affordable. No drastic changes in prices of medicine in the private sector were observed over the 6 years despite removal of price control. PMID:21455424

Longitudinal factorial invariance of the PedsQL 4.0 Generic Core Scales child self-report Version: one year prospective evidence from the California State Children's Health Insurance Program (SCHIP).

PubMed

Varni, James W; Limbers, Christine A; Newman, Daniel A; Seid, Michael

2008-11-01

The measurement of health-related quality of life (HRQOL) in pediatric medicine and health services research has grown significantly over the past decade. The paradigm shift toward patient-reported outcomes (PROs) has provided the opportunity to emphasize the value and critical need for pediatric patient self-report. In order for changes in HRQOL/PRO outcomes to be meaningful over time, it is essential to demonstrate longitudinal factorial invariance. This study examined the longitudinal factor structure of the PedsQL 4.0 Generic Core Scales over a one-year period for child self-report ages 5-17 in 2,887 children from a statewide evaluation of the California State Children's Health Insurance Program (SCHIP) utilizing a structural equation modeling framework. Specifying four- and five-factor measurement models, longitudinal structural equation modeling was used to compare factor structures over a one-year interval on the PedsQL 4.0 Generic Core Scales. While the four-factor conceptually-derived measurement model for the PedsQL 4.0 Generic Core Scales produced an acceptable fit, the five-factor empirically-derived measurement model from the initial field test of the PedsQL 4.0 Generic Core Scales produced a marginally superior fit in comparison to the four-factor model. For the five-factor measurement model, the best fitting model, strict factorial invariance of the PedsQL 4.0 Generic Core Scales across the two measurement occasions was supported by the stability of the comparative fit index between the unconstrained and constrained models, and several additional indices of practical fit including the root mean squared error of approximation, the non-normed fit index, and the parsimony normed fit index. The findings support an equivalent factor structure on the PedsQL 4.0 Generic Core Scales over time. Based on these data, it can be concluded that over a one-year period children in our study interpreted items on the PedsQL 4.0 Generic Core Scales in a similar manner.

Generic and therapeutic statin switches and disruptions in therapy.

PubMed

Chapman, Richard H; Benner, Joshua S; Girase, Prafulla; Benigno, Michael; Axelsen, Kirsten; Liu, Larry Z; Nichol, Michael B

2009-05-01

The study objective was to compare dose-equivalence, adherence and subsequent switch rates among patients recently switched from a branded to generic version of the same statin (generic substitution, GS) vs. those switched from branded statin to generic version of a different statin (therapeutic substitution, TS). In a retrospective cohort analysis among adult enrollees in over 90 US health plans, the authors identified adult patients who switched from a branded to generic statin from July-December 2006 (simvastatin became generic in June 2006). Patients were classified by type of statin switch: GS (e.g., branded simvastatin --> generic simvastatin), and TS (e.g., branded atorvastatin --> generic simvastatin). Demographic and clinical data were collected from claims before switch through 6 months follow-up. Separate outcomes of interest included proportion of patients that switched to a less potent daily dose, that switched back to previous branded statin after switch, and that were at least 80% adherent during the 6 months after initial switch. Significant predictors of each clinical outcome were identified using multivariable logistic regression models, adjusting for differences between groups in covariates and potential confounders. The 6-month TS (n = 3807) and GS (n = 40,165) groups were generally similar demographically. Compared to GS, TS patients were significantly more likely to be switched to a less potent dose (26.2% vs. 0.5%, adjusted odds ratio [AOR] in patients with high-potency index medication = 83.4, p < 0.0001); 33% less likely to be adherent in the 6 months after switch (67.7% vs. 75.9%, AOR in patients with no switch in first 6 months follow-up = 0.67, p < 0.0001); and four times more likely to switch back to previous branded statin (11.3% vs. 2.9%, AOR = 4.1, p < 0.0001). This study did not account for co-payment changes, lipid measurements, or changes in pill burden. While this study did not have data on why patients had TS (e.g., for cost or clinical reasons), TS was more likely to involve a subsequent disruption to statin therapy than GS. TS could potentially lead to adverse impacts on patients' outcomes, and should be studied further.

Generic quality of life in persons with hearing loss: a systematic literature review.

PubMed

Nordvik, Øyvind; Laugen Heggdal, Peder O; Brännström, Jonas; Vassbotn, Flemming; Aarstad, Anne Kari; Aarstad, Hans Jørgen

2018-01-01

To the best of our knowledge, no empirically based consensus has been reached as to if, and to what extent, persons with hearing loss (HL) have reduced generic Quality of life (QoL). There seems to be limited knowledge regarding to what extent a hearing aid (HA) would improve QoL. The main aim of the present study was to review studies about the relationship between HL and QoL. A supporting aim was to study the association between distress and HL. Literature databases (Cinahl, Pub Med and Web of Science) were searched to identify relevant journal articles published in the period from January 2000 to March 17, 2016. We performed a primary search pertaining to the relationship between HL, HA and QoL (search number one) followed by a supporting search pertaining to the relationship between distress/mood/anxiety and HL (search number two). After checking for duplications and screening the titles of the papers, we read the abstracts of the remaining papers. The most relevant papers were read thoroughly, leaving us with the journal articles that met the inclusion criteria. Twenty journal articles were included in the present review: 13 were found in the primary search (HL and QoL), and seven in the supporting search (HL and distress). The literature yields equivocal findings regarding the association between generic QoL and HL. A strong association between distress and HL was shown, where distressed persons tend to have a lowered generic QoL. It is suggested that QoL is lowered among HL patients. Some studies suggest an increased generic QoL following the use of HA, especially during the first few months after initiation of treatment. Other studies suggest that HA use is one of several possible factors that contribute to improve generic QoL. The majority of the studies suggest that HL is associated with reduced generic QoL. Using hearing aids seem to improve general QoL at follow-up within the first year. HL is a risk factor for distress. Further research is needed to explore the relationship between HL and generic QoL, in addition to the importance of influencing variables on this relationship.

The operations of quantum logic gates with pure and mixed initial states.

PubMed

Chen, Jun-Liang; Li, Che-Ming; Hwang, Chi-Chuan; Ho, Yi-Hui

2011-04-07

The implementations of quantum logic gates realized by the rovibrational states of a C(12)O(16) molecule in the X((1)Σ(+)) electronic ground state are investigated. Optimal laser fields are obtained by using the modified multitarget optimal theory (MTOCT) which combines the maxima of the cost functional and the fidelity for state and quantum process. The projection operator technique together with modified MTOCT is used to get optimal laser fields. If initial states of the quantum gate are pure states, states at target time approach well to ideal target states. However, if the initial states are mixed states, the target states do not approach well to ideal ones. The process fidelity is introduced to investigate the reliability of the quantum gate operation driven by the optimal laser field. We found that the quantum gates operate reliably whether the initial states are pure or mixed.

Conventional curing practices reduce generic Escherichia coli and Salmonella spp. on dry bulb onions produced with contaminated irrigation water.

PubMed

Emch, Alexander W; Waite-Cusic, Joy G

2016-02-01

Food Safety Modernization Act (FSMA) has emphasized microbial risks associated with irrigation water. Treasure Valley (eastern Oregon/western Idaho) has the highest yield of dry bulb onions in the country; however, their irrigation water is often non-compliant with current industry and proposed federal standards for fresh produce. Conventional curing practices may provide a mechanism to mitigate irrigation water quality to comply with FSMA regulations. Dry bulb onions were grown in Owyhee silt loam and Semiahmoo muck soils in greenhouses and irrigated with water containing a cocktail of rifampicin-resistant generic Escherichia coli and Salmonella spp. (4.80 log CFU/ml). To mimic conventional practices, mature onions remained undisturbed in soil without irrigation for 12 days prior to being lifted and cured for 16 additional days. Surviving generic E. coli and Salmonella spp. were selectively enumerated on using standard plating (Hektoen Enteric Agar with rifampicin; HE + rif) or most probable number (lactose broth with rifampicin; HE + rif) methods. Generic E. coli and Salmonella spp. on onions decreased 0.19-0.26 log CFU/g·d during the initial 12 days of finishing. At lifting, generic E. coli and Salmonella spp. had been reduced to <1 CFU/g and persisted through the end of curing. This study demonstrates conventional curing practices as an effective mitigation strategy for dry bulb onions produced with water of poor microbiological quality. Copyright © 2015 Elsevier Ltd. All rights reserved.

In vivo social comparison to a thin-ideal peer promotes body dissatisfaction: a randomized experiment.

PubMed

Krones, Pamela G; Stice, Eric; Batres, Carla; Orjada, Kendra

2005-09-01

Although social comparison with media-portrayed thin-ideal images has been found to increase body dissatisfaction and negative affect, research has not yet tested whether social comparison with attractive peers in the real world produces similar effects. We randomly assigned 119 young women to interact either with a confederate who conformed to the thin ideal or one who conformed to the average body dimensions of women, within the context of an ostensive dating study. Exposure to the thin-ideal confederate resulted in an increase in body dissatisfaction but not negative affect or heart rate. Initial thin-ideal internalization, perceived sociocultural pressure, self-esteem, and observer-rated attractiveness did not moderate these effects. Results suggest that social comparative pressure to be thin fosters body dissatisfaction but may not promote negative affect. 2005 by Wiley Periodicals, Inc.

Work–life initiatives and organizational change: Overcoming mixed messages to move from the margin to the mainstream

PubMed Central

Kossek, Ellen Ernst; Lewis, Suzan; Hammer, Leslie B

2011-01-01

This article examines perspectives on employer work–life initiatives as potential organizational change phenomena. Work–life initiatives address two main organizational challenges: structural (flexible job design, human resource policies) and cultural (supportive supervisors, climate) factors. While work–life initiatives serve a purpose in highlighting the need for organizational adaptation to changing relationships between work, family, and personal life, we argue they usually are marginalized rather than mainstreamed into organizational systems. We note mixed consequences of work–life initiatives for individuals and organizations.While they may enable employees to manage work and caregiving, they can increase work intensification and perpetuate stereotypes of ideal workers. In order to advance the field, organizations and scholars need to frame both structural and cultural work–life changes as part of the core employment systems to enhance organizational effectiveness and not just as strategies to support disadvantaged, non-ideal workers. We conclude with an overview of the articles in this special issue. PMID:22021934

The Generic Spacecraft Analyst Assistant (gensaa): a Tool for Developing Graphical Expert Systems

NASA Technical Reports Server (NTRS)

Hughes, Peter M.

1993-01-01

During numerous contacts with a satellite each day, spacecraft analysts must closely monitor real-time data. The analysts must watch for combinations of telemetry parameter values, trends, and other indications that may signify a problem or failure. As the satellites become more complex and the number of data items increases, this task is becoming increasingly difficult for humans to perform at acceptable performance levels. At NASA GSFC, fault-isolation expert systems are in operation supporting this data monitoring task. Based on the lessons learned during these initial efforts in expert system automation, a new domain-specific expert system development tool named the Generic Spacecraft Analyst Assistant (GenSAA) is being developed to facilitate the rapid development and reuse of real-time expert systems to serve as fault-isolation assistants for spacecraft analysts. Although initially domain-specific in nature, this powerful tool will readily support the development of highly graphical expert systems for data monitoring purposes throughout the space and commercial industry.

The generic danger and the idiosyncratic support

NASA Astrophysics Data System (ADS)

Temme, Arnaud; Nijp, Jelmer; van der Meij, Marijn; Samia, Jalal; Masselink, Rens

2016-04-01

This contribution argues two main points. First, that generic landscapes used in some modelling studies sometimes have properties or cause simulation results that are unrealistic. Such initially flat or straight-sloped landscapes, sometimes with minor random perturbations, e.g. form the backdrop for ecological simulations of vegetation growth and competition that predict catastrophic shifts. Exploratory results for semi-arid systems suggest that the results based on these generic landscapes are end-members from a distribution of results, rather than an unbiased, typical outcome. Apparently, the desire to avoid idiosyncrasy has unintended consequences. Second, we argue and illustrate that in fact new insights often come from close inspection of idiosyncratic case studies. Our examples from landslide systems, connectivity and soil formation show how a central role for the case study - either in empirical work or to provide model targets - has advanced our understanding. Both points contribute to the conclusion that it is dangerous to forget about annoying, small-scale, idiosyncratic and, indeed, perhaps bad-ass case studies in Earth Sciences.

SEL Ada reuse analysis and representations

NASA Technical Reports Server (NTRS)

Kester, Rush

1990-01-01

Overall, it was revealed that the pattern of Ada reuse has evolved from initial reuse of utility components into reuse of generalized application architectures. Utility components were both domain-independent utilities, such as queues and stacks, and domain-specific utilities, such as those that implement spacecraft orbit and attitude mathematical functions and physics or astronomical models. The level of reuse was significantly increased with the development of a generalized telemetry simulator architecture. The use of Ada generics significantly increased the level of verbatum reuse, which is due to the ability, using Ada generics, to parameterize the aspects of design that are configurable during reuse. A key factor in implementing generalized architectures was the ability to use generic subprogram parameters to tailor parts of the algorithm embedded within the architecture. The use of object oriented design (in which objects model real world entities) significantly improved the modularity for reuse. Encapsulating into packages the data and operations associated with common real world entities creates natural building blocks for reuse.

Operationally Efficient Propulsion System Study (OEPSS) data book. Volume 1: Generic ground operations data

NASA Technical Reports Server (NTRS)

Byrd, Raymond J.

1990-01-01

This study was initiated to identify operations problems and cost drivers for current propulsion systems and to identify technology and design approaches to increase the operational efficiency and reduce operations costs for future propulsion systems. To provide readily usable data for the Advance Launch System (ALS) program, the results of the Operationally Efficient Propulsion System Study (OEPSS) were organized into a series of OEPSS Data Books as follows: Volume 1, Generic Ground Operations Data; Volume 2, Ground Operations Problems; Volume 3, Operations Technology; Volume 4, OEPSS Design Concepts; and Volume 5, OEPSS Final Review Briefing, which summarizes the activities and results of the study. This volume presents ground processing data for a generic LOX/LH2 booster and core propulsion system based on current STS experience. The data presented includes: top logic diagram, process flow, activities bar-chart, loaded timelines, manpower requirements in terms of duration, headcount and skill mix per operations and maintenance instruction (OMI), and critical path tasks and durations.

Overview of NASA Lewis Research Center free-piston Stirling engine activities

NASA Technical Reports Server (NTRS)

Slaby, J. G.

1984-01-01

A generic free-piston Stirling technology project is being conducted to develop technologies generic to both space power and terrestrial heat pump applications in a cooperative, cost-shared effort. The generic technology effort includes extensive parametric testing of a 1 kW free-piston Stirling engine (RE-1000), development of a free-piston Stirling performance computer code, design and fabrication under contract of a hydraulic output modification for RE-1000 engine tests, and a 1000-hour endurance test, under contract, of a 3 kWe free-piston Stirling/alternator engine. A newly initiated space power technology feasibility demonstration effort addresses the capability of scaling a free-piston Stirling/alternator system to about 25 kWe; developing thermodynamic cycle efficiency or equal to 70 percent of Carnot at temperature ratios in the order of 1.5 to 2.0; achieving a power conversion unit specific weight of 6 kg/kWe; operating with noncontacting gas bearings; and dynamically balancing the system. Planned engine and component design and test efforts are described.

A systematic review of instruments for measuring outcomes in economic evaluation within aged care.

PubMed

Bulamu, Norma B; Kaambwa, Billingsley; Ratcliffe, Julie

2015-11-09

This paper describes the methods and results of a systematic review to identify instruments used to measure quality of life outcomes in older people. The primary focus of the review was to identify instruments suitable for application with older people within economic evaluations conducted in the aged care sector. Online databases searched were PubMed, Medline, Scopus, and Web of Science, PsycInfo, CINAHL, Embase and Informit. Studies that met the following criteria were included: 1) study population exclusively above 65 years of age 2) measured health status, health related quality of life or quality of life outcomes more broadly through use of an instrument developed for this purpose, 3) used a generic preference based instrument or an older person specific preference based or non-preference based instrument or both, and 4) published in journals in the English language after 2000. The most commonly applied generic preference based instrument in both the community and residential aged care context was the EuroQol - 5 Dimensions (EQ-5D), followed by the Adult Social Care Outcomes Toolkit (ASCOT) and the Health Utilities Index (HUI2/3). The most widely applied older person specific instrument was the ICEpop CAPability measure for Older people (ICECAP-O) in both community and residential aged care. In the absence of an ideal instrument for incorporating into economic evaluations in the aged care sector, this review recommends the use of a generic preference based measure of health related quality of life such as the EQ-5D to obtain quality adjusted life years, in combination with an instrument that has a broader quality of life focus like the ASCOT, which was designed specifically for evaluating interventions in social care or the ICECAP-O, a capability measure for older people.

A common mode of origin of power laws in models of market and earthquake

NASA Astrophysics Data System (ADS)

Bhattacharyya, Pratip; Chatterjee, Arnab; Chakrabarti, Bikas K.

2007-07-01

We show that there is a common mode of origin for the power laws observed in two different models: (i) the Pareto law for the distribution of money among the agents with random-saving propensities in an ideal gas-like market model and (ii) the Gutenberg-Richter law for the distribution of overlaps in a fractal-overlap model for earthquakes. We find that the power laws appear as the asymptotic forms of ever-widening log-normal distributions for the agents’ money and the overlap magnitude, respectively. The identification of the generic origin of the power laws helps in better understanding and in developing generalized views of phenomena in such diverse areas as economics and geophysics.

Changes in the cardiac rehabilitation workflow process needed for the implementation of a self-management system.

PubMed

Wiggers, Anne-Marieke; Vosbergen, Sandra; Kraaijenhagen, Roderik; Jaspers, Monique; Peek, Niels

2013-01-01

E-health interventions are of a growing importance for self-management of chronic conditions. This study aimed to describe the process adaptions that are needed in cardiac rehabilitation (CR) to implement a self-management system, called MyCARDSS. We created a generic workflow model based on interviews and observations at three CR clinics. Subsequently, a workflow model of the ideal situation after implementation of MyCARDSS was created. We found that the implementation will increase the complexity of existing working procedures because 1) not all patients will use MyCARDSS, 2) there is a transfer of tasks and responsibilities from professionals to patients, and 3) information in MyCARDSS needs to be synchronized with the EPR system for professionals.

Anomalous current in diffusive ferromagnetic Josephson junctions

NASA Astrophysics Data System (ADS)

Silaev, M. A.; Tokatly, I. V.; Bergeret, F. S.

2017-05-01

We demonstrate that in diffusive superconductor/ferromagnet/superconductor (S/F/S) junctions a finite, anomalous Josephson current can flow even at zero phase difference between the S electrodes. The conditions for the observation of this effect are noncoplanar magnetization distribution and a broken magnetization inversion symmetry of the superconducting current. The latter symmetry is intrinsic for the widely used quasiclassical approximation and prevented previous works based on this approximation from obtaining the Josephson anomalous current. We show that this symmetry can be removed by introducing spin-dependent boundary conditions for the quasiclassical equations at the superconducting/ferromagnet interfaces in diffusive systems. Using this recipe, we consider generic multilayer magnetic systems and determine the ideal experimental conditions in order to maximize the anomalous current.

Detecting Gravitational Wave Memory without Parent Signals

NASA Astrophysics Data System (ADS)

McNeill, Lucy O.; Thrane, Eric; Lasky, Paul D.

2017-05-01

Gravitational-wave memory manifests as a permanent distortion of an idealized gravitational-wave detector and arises generically from energetic astrophysical events. For example, binary black hole mergers are expected to emit memory bursts a little more than an order of magnitude smaller in strain than the oscillatory parent waves. We introduce the concept of "orphan memory": gravitational-wave memory for which there is no detectable parent signal. In particular, high-frequency gravitational-wave bursts (≳kHz ) produce orphan memory in the LIGO/Virgo band. We show that Advanced LIGO measurements can place stringent limits on the existence of high-frequency gravitational waves, effectively increasing the LIGO bandwidth by orders of magnitude. We investigate the prospects for and implications of future searches for orphan memory.

Moist Adiabats with Multiple Condensing Species: A New Theory with Application to Giant-Planet Atmospheres

NASA Astrophysics Data System (ADS)

Li, Cheng; Ingersoll, Andrew P.; Oyafuso, Fabiano

2018-04-01

We derived a new formula for calculating the moist adiabatic temperature profile of an atmosphere consisting of ideal gases with multiple condensing species. This expression unifies various formulas published in the literature and can be generalized to account for chemical reactions. Unlike previous methods, it converges to machine precision independent of mesh size. It accounts for any ratio of condensable vapors to dry gas, from zero to infinity, and for variable heat capacities as a function of temperature. Because the derivation is generic, the new formula is not only applicable to planetary atmosphere in the solar system, but also to hot Jupiters and brown dwarfs in which a variety of alkali metals, silicates and exotic materials condense. We demonstrate that even though the vapors are ideal gases, they interact in their effects on the moist adiabatic lapse rate. Finally, we apply the new thermodynamic model to study the effects of downdrafts on the distribution of minor constituents and thermal profile in the Galileo probe hotspot. We find that the Galileo Probe measurements can be interpreted as a strong downdraft that displaces an air parcel from 1 bar to the 4 bar level.

Superthermal photon bunching in terms of simple probability distributions

NASA Astrophysics Data System (ADS)

Lettau, T.; Leymann, H. A. M.; Melcher, B.; Wiersig, J.

2018-05-01

We analyze the second-order photon autocorrelation function g(2 ) with respect to the photon probability distribution and discuss the generic features of a distribution that results in superthermal photon bunching [g(2 )(0 ) >2 ]. Superthermal photon bunching has been reported for a number of optical microcavity systems that exhibit processes such as superradiance or mode competition. We show that a superthermal photon number distribution cannot be constructed from the principle of maximum entropy if only the intensity and the second-order autocorrelation are given. However, for bimodal systems, an unbiased superthermal distribution can be constructed from second-order correlations and the intensities alone. Our findings suggest modeling superthermal single-mode distributions by a mixture of a thermal and a lasinglike state and thus reveal a generic mechanism in the photon probability distribution responsible for creating superthermal photon bunching. We relate our general considerations to a physical system, i.e., a (single-emitter) bimodal laser, and show that its statistics can be approximated and understood within our proposed model. Furthermore, the excellent agreement of the statistics of the bimodal laser and our model reveals that the bimodal laser is an ideal source of bunched photons, in the sense that it can generate statistics that contain no other features but the superthermal bunching.

Ideals as Anchors for Relationship Experiences

PubMed Central

Frye, Margaret; Trinitapoli, Jenny

2016-01-01

Research on young-adult sexuality in sub-Saharan Africa typically conceptualizes sex as an individual-level risk behavior. We introduce a new approach that connects the conditions surrounding the initiation of sex with subsequent relationship well-being, examines relationships as sequences of interdependent events, and indexes relationship experiences to individually held ideals. New card-sort data from southern Malawi capture young women’s relationship experiences and their ideals in a sequential framework. Using optimal matching, we measure the distance between ideal and experienced relationship sequences to (1) assess the associations between ideological congruence and perceived relationship well-being, (2) compare this ideal-based approach to other experience-based alternatives, and (3) identify individual- and couple-level correlates of congruence between ideals and experiences in the romantic realm. We show that congruence between ideals and experiences conveys relationship well-being along four dimensions: expressions of love and support, robust communication habits, perceived biological safety, and perceived relationship stability. We further show that congruence is patterned by socioeconomic status and supported by shared ideals within romantic dyads. We argue that conceiving of ideals as anchors for how sexual experiences are manifest advances current understandings of romantic relationships, and we suggest that this approach has applications for other domains of life. PMID:27110031

Genericness of inflation in isotropic loop quantum cosmology.

PubMed

Date, Ghanashyam; Hossain, Golam Mortuza

2005-01-14

Nonperturbative corrections from loop quantum cosmology (LQC) to the scalar matter sector are already known to imply inflation. We prove that the LQC modified scalar field generates exponential inflation in the small scale factor regime, for all positive definite potentials, independent of initial conditions and independent of ambiguity parameters. For positive semidefinite potentials it is always possible to choose, without fine-tuning, a value of one of the ambiguity parameters such that exponential inflation results, provided zeros of the potential are approached at most as a power law in the scale factor. In conjunction with the generic occurrence of bounce at small volumes, particle horizon is absent, thus eliminating the horizon problem of the standard big bang model.

Development of utility generic functional requirements for electronic work packages and computer-based procedures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oxstrand, Johanna

The Nuclear Electronic Work Packages - Enterprise Requirements (NEWPER) initiative is a step toward a vision of implementing an eWP framework that includes many types of eWPs. This will enable immediate paper-related cost savings in work management and provide a path to future labor efficiency gains through enhanced integration and process improvement in support of the Nuclear Promise (Nuclear Energy Institute 2016). The NEWPER initiative was organized by the Nuclear Information Technology Strategic Leadership (NITSL) group, which is an organization that brings together leaders from the nuclear utility industry and regulatory agencies to address issues involved with information technology usedmore » in nuclear-power utilities. NITSL strives to maintain awareness of industry information technology-related initiatives and events and communicates those events to its membership. NITSL and LWRS Program researchers have been coordinating activities, including joint organization of NEWPER-related meetings and report development. The main goal of the NEWPER initiative was to develop a set of utility generic functional requirements for eWP systems. This set of requirements will support each utility in their process of identifying plant-specific functional and non-functional requirements. The NEWPER initiative has 140 members where the largest group of members consists of 19 commercial U.S. nuclear utilities and eleven of the most prominent vendors of eWP solutions. Through the NEWPER initiative two sets of functional requirements were developed; functional requirements for electronic work packages and functional requirements for computer-based procedures. This paper will describe the development process as well as a summary of the requirements.« less

Initial eccentricity and constituent quark number scaling of elliptic flow in ideal and viscous dynamics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chaudhuri, A. K.

2010-04-15

In the Israel-Stewart theory of dissipative hydrodynamics, the scaling properties of elliptic flow in Au+Au collisions are studied. The initial energy density of the fluid was fixed to reproduce STAR data on phi-meson multiplicity in 0-5% Au+Au collisions such that, irrespective of fluid viscosity, entropy at the freeze-out is similar in ideal or in viscous evolution. The initial eccentricity or constituent quark number scaling is only approximate in ideal or minimally viscous (eta/s=1/4pi) fluid. Eccentricity scaling becomes nearly exact in more viscous fluid (eta/s>=0.12). However, in more viscous fluid, constituent quark number scaled elliptic flow for mesons and baryons splitsmore » into separate scaling functions. Simulated flows also do not exhibit 'universal scaling'; that is, elliptic flow scaled by the constituent quark number and charged particles v{sub 2} is not a single function of transverse kinetic energy scaled by the quark number. From a study of the violation of universal scaling, we obtain an estimate of quark-gluon plasma viscosity, eta/s=0.12+-0.03. The error is statistical only. The systematic error in eta/s could be as large.« less

A Coordinated Initialization Process for the Distributed Space Exploration Simulation (DSES)

NASA Technical Reports Server (NTRS)

Phillips, Robert; Dexter, Dan; Hasan, David; Crues, Edwin Z.

2007-01-01

This document describes the federate initialization process that was developed at the NASA Johnson Space Center with the HIIA Transfer Vehicle Flight Controller Trainer (HTV FCT) simulations and refined in the Distributed Space Exploration Simulation (DSES). These simulations use the High Level Architecture (HLA) IEEE 1516 to provide the communication and coordination between the distributed parts of the simulation. The purpose of the paper is to describe a generic initialization sequence that can be used to create a federate that can: 1. Properly initialize all HLA objects, object instances, interactions, and time management 2. Check for the presence of all federates 3. Coordinate startup with other federates 4. Robustly initialize and share initial object instance data with other federates.

Exploring pharmacists' opinions regarding PHARMAC's interventions in promoting brand changes.

PubMed

Babar, Z U; Polwin, A; Kan, S W; Amerasinghe, N; McCarthy, S; Rasheed, F; Stewart, J; Lessing, C; Ragupathy, R; Scahill, S L

2015-01-01

In New Zealand, the use of generic medicines is advocated by the Pharmaceutical Management Agency of New Zealand (PHARMAC). Among other interventions, PHARMAC uses educational awareness campaigns to educate pharmacists to promote the uptake of generic medicines. However, the opinion of pharmacists regarding these interventions has not yet been evaluated. The objective of this study was to explore pharmacists' opinions regarding PHARMAC's interventions in promoting medicine brand changes. A cross-sectional study design was employed to explore pharmacists' opinions regarding brand changes. A questionnaire was sent to 500 randomly selected pharmacists in New Zealand. In second component of the study, five community pharmacies in the Auckland region were selected through convenience sampling, and a semi-structured interview was conducted with a pharmacist in each site. One-hundred and eighty seven questionnaires were returned and analyzed (response rate of 37.4%). Sixty-eight percent of pharmacists supported brand changes and 98.4% mentioned that PHARMAC is responsible for informing them of brand changes. Over half (51.3%) of pharmacists found the current interventions effective, and 39.6% were satisfied with the current brand change information provided by PHARMAC. The majority (94.7%) of pharmacists currently receive faxed information but many indicated (70.8%) that they prefer email notifications. Cilazapril was considered the least difficult medicine to substitute in the past 10 years and omeprazole the most difficult. Patient acceptance and claims about effectiveness were the main factors in determining the difficulty of brand substitution. Fewer than half of the respondents felt that interventions were implemented with enough preparation time for a brand change. The ideal lead-in time was in the range of three to six months. Pharmacists expressed a number of concerns about brand changes such as the frequency at which they occur and the lack of generic stock availability when a brand change occurs. Over one-third of respondents were satisfied with brand change information provided by PHARMAC. Cilazapril was the least difficult medicine to substitute, while omeprazole and salbutamol changes were the most difficult. Claims about effectiveness, quality and side effects were the main factors identified as barriers to generic substitution. Copyright © 2015 Elsevier Inc. All rights reserved.

Stable Isotope Profiling of Internet-Sourced Viagra® and 'generic- Viagra' Tablets

NASA Astrophysics Data System (ADS)

Kemp, Helen; Meier-Augenstein, Wolfram

2013-04-01

Viagra® manufactured by Pfizer was the first prescription drug for the treatment of erectile dysfunction (ED), a condition that is estimated to affect 1 in 10 men at some stage in their lives (1). Viagra® contains the active pharmaceutical ingredient (API) sildenafil, as the citrate salt. Sildenafil, along with Tadalafil and Vardenafil belong to a class of drugs known as phosphodiesterase type 5 (PDE5) inhibitors. Since its first production in 1998, Viagra® has generated well in excess of 10 billion US dollars in sales (2) and with Pfizers' patent extended to April 2020 (3) it still remains the only sildenafil-based treatment option for sufferers of ED in the US. There are no legal 'generic-Viagra' formulations available in the US. However, formulations containing sildenafil citrate as API are widely available over the internet and often sold as 'generic Viagra'. These cheaper alternatives are often manufactured under less than ideal conditions with little or no QA/QC procedures in place. The World Health Organisation recognised the scale of the problem in its 2010 bulletin "Growing threat from counterfeit medicines" (4) and quotes a Dutch study cited in the International Journal of Clinical Practice in which from a cohort of 370 seized Viagra® samples, only 10 were genuine. We sourced a variety of tablets sold for the treatment of ED which claimed to have sildenafil citrate as API. Viagra®, 'generic-Viagra', Kamagra, Silagra and Filagra tablets were ordered via the internet and supplied from both UK-based pharmacies as well as overseas suppliers (Hong Kong, India, Vanuata). In this small-scale pilot study, we present results from bulk 2H/18O and 13C/15N stable isotope analysis performed on crushed tablets from 23 samples of internet-sourced tablets sold for the treatment of ED and purported to contain sildenafil citrate as API. References 1. www.healthcare.org.uk 2. www.moneynews.com 3. US Patent & trademark office (www.uspto.gov) 4. WHO bulletin 2010; 88:247-248

Community-Based Prevention Specialist. Trainer Manual.

ERIC Educational Resources Information Center

University Research Corp., Bethesda, MD.

This trainer manual is designed to assist facilitators in the design of entry-level courses and programs for substance abuse prevention specialists. The manual initially concentrates on a basic, generic approach to community work, and introduces the knowledge and skills needed to implement substance abuse prevention programs by using the community…

Development and Validation of an Internet Use Attitude Scale

ERIC Educational Resources Information Center

Zhang, Yixin

2007-01-01

This paper describes the development and validation of a new 40-item Internet Attitude Scale (IAS), a one-dimensional inventory for measuring the Internet attitudes. The first experiment initiated a generic Internet attitude questionnaire, ensured construct validity, and examined factorial validity and reliability. The second experiment further…

Information Services at the Nuclear Safety Analysis Center.

ERIC Educational Resources Information Center

Simard, Ronald

This paper describes the operations of the Nuclear Safety Analysis Center. Established soon after an accident at the Three Mile Island nuclear power plant near Harrisburg, Pennsylvania, its efforts were initially directed towards a detailed analysis of the accident. Continuing functions include: (1) the analysis of generic nuclear safety issues,…

Budget impact analysis of 8 hormonal contraceptive options.

PubMed

Crespi, Simone; Kerrigan, Matthew; Sood, Vipan

2013-07-01

To develop a model comparing costs of 8 hormonal contraceptives and determine whether acquisition costs for implants and intrauterine devices (IUDs) were offset by decreased pregnancy-related costs over a 3-year time horizon from a managed care perspective. A model was developed to assess the budget impact of branded or generic oral contraceptives (OCs), quarterly intramuscular depot medroxyprogesterone, etonogestrel/ethinyl estradiol vaginal ring, etonogestrel implant, levonorgestrel IUD, norelgestromin/ethinyl estradiol transdermal contraceptive, and ethinyl estradiol/levonorgestrel extended-cycle OC. Major variables included drug costs, typical use failure rates, discontinuation rates, and pregnancy costs. The base case assessed costs for 1000 women initiating each of the hormonal contraceptives. The etonogestrel implant and levonorgestrel IUD resulted in the fewest pregnancies, 63 and 85, respectively, and the least cost, $1.75 million and $2.0 million, respectively. In comparison, generic OC users accounted for a total of 243 pregnancies and $3.4 million in costs. At the end of year 1, costs for the etonogestrel implant ($800,471) and levonorgestrel IUD ($949,721) were already lower than those for generic OCs ($1,146,890). Sensitivity analysis showed that the cost of pregnancies, not product acquisition cost, was the primary cost driver. Higher initial acquisition costs for the etonogestrel implant and levonorgestrel IUD were offset within 1 year by lower contraceptive failure rates and consequent pregnancy costs. Thus, after accounting for typical use failure rates of contraceptive products, the etonogestrel implant and levonorgestrel IUD emerged as the least expensive hormonal contraceptives.

A computer program for cyclic plasticity and structural fatigue analysis

NASA Technical Reports Server (NTRS)

Kalev, I.

1980-01-01

A computerized tool for the analysis of time independent cyclic plasticity structural response, life to crack initiation prediction, and crack growth rate prediction for metallic materials is described. Three analytical items are combined: the finite element method with its associated numerical techniques for idealization of the structural component, cyclic plasticity models for idealization of the material behavior, and damage accumulation criteria for the fatigue failure.

Long-term Stability of Vancomycin Hydrochloride in Glucose 5% Polyolefin Bags: The Brand Name Versus a Generic Product.

PubMed

Huvelle, Sophie; Godet, Marie; Hecq, Jean-Daniel; Gillet, Patricia; Jamart, Jacques; Galanti, Laurence M

2016-01-01

The objectives of this study were to determine if the preparation of vancomycin hydrochloride in advance of infusion could improve the quality of the drug, time management of drug delivery, cost savings of drug delivery, and to investigate the long-term stability of vancomycin hydrochloride (brand name Vancocin®) infusion in glucose 5% polyolefin bags versus the generic (Vancomycine®) at 5°C ± 3°C. Five bags of each infusion 1 g/100 mL vancomycin hydrochloride in 5% glucose (Vancocin ® and Vancomycine®) were stored up to 57 days at 5°C ± 3°C. A visual inspection and pH measurement were performed periodically during the storage, and the concentrations were measured by high-performance liquid chromatography-diode array detection. No color change or precipitation in the solution was observed throughout the study period. As recommended by the U.S. Food and Drug Administration, the lower confidence limit at 95% of the concentration for the solutions remained superior to 90% of the initial concentration up to 43 days for the brand vancomycin (Vancocin®) infusion (96% ± 2%) and up to 57 days for the generic (Vancomycine®) (95% ± 4%). The solutions prepared either from brand or generic vancomycin hydrochloride were chemically stable more than one month (43 days for the brand and 57 days for the generic solution) and could be prepared in advance in a centralized intravenous additive service facility. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

The role of mass media in adolescents' sexual behaviors: exploring the explanatory value of the three-step self-objectification process.

PubMed

Vandenbosch, Laura; Eggermont, Steven

2015-04-01

This longitudinal study (N = 730) explored whether the three-step process of self-objectification (internalization of appearance ideals, valuing appearance over competence, and body surveillance) could explain the influence of sexual media messages on adolescents' sexual behaviors. A structural equation model showed that reading sexualizing magazines (Time 1) was related to the internalization of appearance ideals and valuing appearance over competence (Time 2). In turn, the internalization of appearance ideals was positively associated with body surveillance and valuing appearance over competence (all at Time 2). Valuing appearance over competence was also positively associated with body surveillance (all at Time 2). Lastly, body surveillance (Time 2) positively related to the initiation of French kissing (Time 3) whereas valuing appearance over competence (Time 2) positively related to the initiation of sexual intercourse (Time 3). No significant relationship was observed for intimate touching. The discussion focused on the explanatory role of self-objectification in media effects on adolescents' sexual behaviors.

A high-throughput assay of membrane protein stability.

PubMed

Postis, Vincent L G; Deacon, Sarah E; Roach, Peter C J; Wright, Gareth S A; Xia, Xiaobing; Ingram, Jean C; Hadden, Jonathan M; Henderson, Peter J F; Phillips, Simon E V; McPherson, Michael J; Baldwin, Stephen A

2008-12-01

The preparation of purified, detergent-solubilized membrane proteins in a monodisperse and stable form is usually a prerequisite for investigation not only of their function but also for structural studies by X-ray crystallography and other approaches. Typically, it is necessary to explore a wide range of conditions, including detergent type, buffer pH, and the presence of additives such as glycerol, in order to identify those optimal for stability. Given the difficulty of expressing and purifying membrane proteins in large amounts, such explorations must ideally be performed on as small a scale as practicable. To achieve this objective in the UK Membrane Protein Structure Initiative, we have developed a rapid, economical, light-scattering assay of membrane protein aggregation that allows the testing of 48 buffer conditions in parallel on 6 protein targets, requiring less than 2 mg protein for each target. Testing of the assay on a number of unrelated membrane transporters has shown that it is of generic applicability. Proteins of sufficient purity for this plate-based assay are first rapidly prepared using simple affinity purification procedures performed in batch mode. Samples are then transferred by microdialysis into each of the conditions to be tested. Finally, attenuance at 340 nm is monitored in a 384-well plate using a plate reader. Optimal conditions for protein stability identified in the assay can then be exploited for the tailored purification of individual targets in as stable a form as possible.

Motion artifact removal in FNIR spectroscopy for real-world applications

NASA Astrophysics Data System (ADS)

Devaraj, Ajit; Izzetoglu, Meltem; Izzetoglu, Kurtulus; Bunce, Scott C.; Li, Connie Y.; Onaral, Banu

2004-12-01

Near infrared spectroscopy as a neuroimaging modality is a recent development. Near infrared neuroimagers are typically safe, portable, relatively affordable and non-invasive. The ease of sensor setup and non-intrusiveness make functional near infrared (fNIR) imaging an ideal candidate for monitoring human cortical function in a wide range of real world situations. However optical signals are susceptible to motion-artifacts, hindering the application of fNIR in studies where subject mobility cannot be controlled. In this paper, we present a filtering framework for motion-artifact cancellation to facilitate the deployment of fNIR imaging in real-world scenarios. We simulate a generic field environment by having subjects walk on a treadmill while performing a cognitive task and demonstrate that measurements can be effectively cleaned of motion-artifacts.

The development of a post-test diagnostic system for rocket engines

NASA Technical Reports Server (NTRS)

Zakrajsek, June F.

1991-01-01

An effort was undertaken by NASA to develop an automated post-test, post-flight diagnostic system for rocket engines. The automated system is designed to be generic and to automate the rocket engine data review process. A modular, distributed architecture with a generic software core was chosen to meet the design requirements. The diagnostic system is initially being applied to the Space Shuttle Main Engine data review process. The system modules currently under development are the session/message manager, and portions of the applications section, the component analysis section, and the intelligent knowledge server. An overview is presented of a rocket engine data review process, the design requirements and guidelines, the architecture and modules, and the projected benefits of the automated diagnostic system.

Initiation of rotors by fast propagation regions in excitable media: A theoretical study

NASA Astrophysics Data System (ADS)

Gao, Xiang; Krekhov, Alexei; Zykov, Vladimir; Bodenschatz, Eberhard

2018-02-01

We study the effect of geometry of a fast propagation region (FPR) in an excitable medium on the rotor initiation using a generic two-dimensional reaction-diffusion model. We find that, while the flat boundary of a rectangularly shaped FPR may block the propagation of the excitation wave, a large local curvature at the rounded corners of the FPR would prevent the blockage and thus initiate a rotor. Our simulations demonstrate that the prerequisites for the rotor initiation are the degree of the heterogeneity, its shape and size. These results may explain the incidence of arrhythmias by local heterogeneities induced, for example, by a cardiac tissue remodeling.

Assigning Robust Default Values in Building Performance Simulation Software for Improved Decision-Making in the Initial Stages of Building Design.

PubMed

Hiyama, Kyosuke

2015-01-01

Applying data mining techniques on a database of BIM models could provide valuable insights in key design patterns implicitly present in these BIM models. The architectural designer would then be able to use previous data from existing building projects as default values in building performance simulation software for the early phases of building design. The author has proposed the method to minimize the magnitude of the variation in these default values in subsequent design stages. This approach maintains the accuracy of the simulation results in the initial stages of building design. In this study, a more convincing argument is presented to demonstrate the significance of the new method. The variation in the ideal default values for different building design conditions is assessed first. Next, the influence of each condition on these variations is investigated. The space depth is found to have a large impact on the ideal default value of the window to wall ratio. In addition, the presence or absence of lighting control and natural ventilation has a significant influence on the ideal default value. These effects can be used to identify the types of building conditions that should be considered to determine the ideal default values.

Assigning Robust Default Values in Building Performance Simulation Software for Improved Decision-Making in the Initial Stages of Building Design

PubMed Central

2015-01-01

Applying data mining techniques on a database of BIM models could provide valuable insights in key design patterns implicitly present in these BIM models. The architectural designer would then be able to use previous data from existing building projects as default values in building performance simulation software for the early phases of building design. The author has proposed the method to minimize the magnitude of the variation in these default values in subsequent design stages. This approach maintains the accuracy of the simulation results in the initial stages of building design. In this study, a more convincing argument is presented to demonstrate the significance of the new method. The variation in the ideal default values for different building design conditions is assessed first. Next, the influence of each condition on these variations is investigated. The space depth is found to have a large impact on the ideal default value of the window to wall ratio. In addition, the presence or absence of lighting control and natural ventilation has a significant influence on the ideal default value. These effects can be used to identify the types of building conditions that should be considered to determine the ideal default values. PMID:26090512

Vacancy-induced initial decomposition of condensed phase NTO via bimolecular hydrogen transfer mechanisms at high pressure: a DFT-D study.

PubMed

Liu, Zhichao; Wu, Qiong; Zhu, Weihua; Xiao, Heming

2015-04-28

Density functional theory with dispersion-correction (DFT-D) was employed to study the effects of vacancy and pressure on the structure and initial decomposition of crystalline 5-nitro-2,4-dihydro-3H-1,2,4-triazol-3-one (β-NTO), a high-energy insensitive explosive. A comparative analysis of the chemical behaviors of NTO in the ideal bulk crystal and vacancy-containing crystals under applied hydrostatic compression was considered. Our calculated formation energy, vacancy interaction energy, electron density difference, and frontier orbitals reveal that the stability of NTO can be effectively manipulated by changing the molecular environment. Bimolecular hydrogen transfer is suggested to be a potential initial chemical reaction in the vacancy-containing NTO solid at 50 GPa, which is prior to the C-NO2 bond dissociation as its initiation decomposition in the gas phase. The vacancy defects introduced into the ideal bulk NTO crystal can produce a localized site, where the initiation decomposition is preferentially accelerated and then promotes further decompositions. Our results may shed some light on the influence of the molecular environments on the initial pathways in molecular explosives.

Generic and Brand-Name l-Thyroxine Are Not Bioequivalent for Children With Severe Congenital Hypothyroidism

PubMed Central

Carswell, Jeremi M.; Gordon, Joshua H.; Popovsky, Erica; Hale, Andrea

2013-01-01

Context: In the United States, generic substitution of levothyroxine (l-T4) by pharmacists is permitted if the formulations are deemed to be bioequivalent by the Federal Drug Administration, but there is widespread concern that the pharmacokinetic standard used is too insensitive. Objective: We aimed to evaluate the bioequivalence of a brand-name l-T4 (Synthroid) and an AB-rated generic formulation (Sandoz, Princeton, NJ) in children with severe hypothyroidism. Design: This was a prospective randomized crossover study in which patients received 8 weeks of one l-T4 formulation followed by 8 weeks of the other. Setting: The setting was an academic medical center. Patients: Of 31 children with an initial serum TSH concentration >100 mU/L, 20 had congenital hypothyroidism (CH), and 11 had autoimmune thyroiditis. Main Outcome Measures: The primary endpoint was the serum TSH concentration. Secondary endpoints were the free T4 and total T3 concentrations. Results: The serum TSH concentration was significantly lower after 8 weeks of Synthroid than after generic drug (P = .002), but thyroid hormone levels did not differ significantly. Subgroup analysis revealed that the difference in TSH was restricted to patients with CH (P = .0005). Patients with CH required a higher l-T4 dose (P < .0004) and were younger (P = .003) but were not resistant to thyroid hormone; 15 of 16 CH patients had severe thyroid dysgenesis or agenesis on imaging. The response to generic vs brand-name preparation remained significant when adjusted for age. Conclusions: Synthroid and an AB-rated generic l-T4 are not bioequivalent for patients with severe hypothyroidism due to CH, probably because of diminished thyroid reserve. It would therefore seem prudent not to substitute l-T4 formulations in patients with severe CH, particularly in those <3 yr of age. Our results may have important implications for other severely hypothyroid patients in whom precise titration of l-T4 is necessary. PMID:23264396

A portable MPI-based parallel vector template library

NASA Technical Reports Server (NTRS)

Sheffler, Thomas J.

1995-01-01

This paper discusses the design and implementation of a polymorphic collection library for distributed address-space parallel computers. The library provides a data-parallel programming model for C++ by providing three main components: a single generic collection class, generic algorithms over collections, and generic algebraic combining functions. Collection elements are the fourth component of a program written using the library and may be either of the built-in types of C or of user-defined types. Many ideas are borrowed from the Standard Template Library (STL) of C++, although a restricted programming model is proposed because of the distributed address-space memory model assumed. Whereas the STL provides standard collections and implementations of algorithms for uniprocessors, this paper advocates standardizing interfaces that may be customized for different parallel computers. Just as the STL attempts to increase programmer productivity through code reuse, a similar standard for parallel computers could provide programmers with a standard set of algorithms portable across many different architectures. The efficacy of this approach is verified by examining performance data collected from an initial implementation of the library running on an IBM SP-2 and an Intel Paragon.

A Portable MPI-Based Parallel Vector Template Library

NASA Technical Reports Server (NTRS)

Sheffler, Thomas J.

1995-01-01

This paper discusses the design and implementation of a polymorphic collection library for distributed address-space parallel computers. The library provides a data-parallel programming model for C + + by providing three main components: a single generic collection class, generic algorithms over collections, and generic algebraic combining functions. Collection elements are the fourth component of a program written using the library and may be either of the built-in types of c or of user-defined types. Many ideas are borrowed from the Standard Template Library (STL) of C++, although a restricted programming model is proposed because of the distributed address-space memory model assumed. Whereas the STL provides standard collections and implementations of algorithms for uniprocessors, this paper advocates standardizing interfaces that may be customized for different parallel computers. Just as the STL attempts to increase programmer productivity through code reuse, a similar standard for parallel computers could provide programmers with a standard set of algorithms portable across many different architectures. The efficacy of this approach is verified by examining performance data collected from an initial implementation of the library running on an IBM SP-2 and an Intel Paragon.

Defining interdisciplinary competencies for audiological rehabilitation: findings from a modified Delphi study.

PubMed

Xue, Lina; Le Bot, Gaëlle; Van Petegem, Wim; van Wieringen, Astrid

2018-02-01

The aim of this study is to derive a consensus on an interdisciplinary competency framework regarding a holistic approach for audiological rehabilitation (AR), which includes disciplines from medicine, engineering, social sciences and humanities. We employed a modified Delphi method. In the first round survey, experts were asked to rate an initial list of 28 generic interdisciplinary competencies and to propose specific knowledge areas for AR. In the second round, experts were asked to reconsider their answers in light of the group answers of the first round. An international panel of 27 experts from different disciplines in AR completed the first round. Twenty-two of them completed the second round. We developed a competency framework consisting of 21 generic interdisciplinary competencies grouped in five domains and nine specific competencies (knowledge areas) in three clusters. Suggestions for the implementation of the generic competencies in interdisciplinary programmes were identified. This study reveals insights into the interdisciplinary competencies that are unique for AR. The framework will be useful for educators in developing interdisciplinary programmes as well as for professionals in considering their lifelong training needs in AR.

GeoSegmenter: A statistically learned Chinese word segmenter for the geoscience domain

NASA Astrophysics Data System (ADS)

Huang, Lan; Du, Youfu; Chen, Gongyang

2015-03-01

Unlike English, the Chinese language has no space between words. Segmenting texts into words, known as the Chinese word segmentation (CWS) problem, thus becomes a fundamental issue for processing Chinese documents and the first step in many text mining applications, including information retrieval, machine translation and knowledge acquisition. However, for the geoscience subject domain, the CWS problem remains unsolved. Although a generic segmenter can be applied to process geoscience documents, they lack the domain specific knowledge and consequently their segmentation accuracy drops dramatically. This motivated us to develop a segmenter specifically for the geoscience subject domain: the GeoSegmenter. We first proposed a generic two-step framework for domain specific CWS. Following this framework, we built GeoSegmenter using conditional random fields, a principled statistical framework for sequence learning. Specifically, GeoSegmenter first identifies general terms by using a generic baseline segmenter. Then it recognises geoscience terms by learning and applying a model that can transform the initial segmentation into the goal segmentation. Empirical experimental results on geoscience documents and benchmark datasets showed that GeoSegmenter could effectively recognise both geoscience terms and general terms.

78 FR 37783 - Proposed Information Collection; Comment Request; Generic Clearance for Internet Nonprobability...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-24

... design of a survey or a release of a Census Bureau data dissemination product with a feedback mechanism... encompass both methodological and subject matter research questions that can be tested on a medium-scale... comments to determine optimal interface designs and to obtain feedback from respondents. For the initial...

The Potential of Teaching Schools in Enabling Student Teacher Learning for the Teaching Profession

ERIC Educational Resources Information Center

Ramsaroop, Sarita; Gravett, Sarah

2017-01-01

In 2011 the Integrated Strategic Planning Framework for Teacher Education and Development in South Africa was promulgated. This framework proposes the establishment of teaching schools to strengthen pre-service teacher education. This study arises from this initiative. A generic qualitative study was undertaken to explore the views of research…

Health Promotion Using Life Skills Education Approach for Adolescents in Schools--Development of a Model

ERIC Educational Resources Information Center

Bharath, Srikala; Kumar, K. V. Kishore

2008-01-01

Life Skills Education (LSE) is a novel promotional program that teaches generic life skills through participatory learning methods of games, debates, role-plays, and group discussion. Conceptual understanding and practicing of the skills occurs through experiential learning in a non-threatening setting. Such initiatives provide the adolescent with…

The Unique Roles of Intrapersonal and Social Factors in Adolescent Smoking Development

ERIC Educational Resources Information Center

Defoe, Ivy N.; Semon Dubas, Judith; Somerville, Leah H.; Lugtig, Peter; van Aken, Marcel A. G.

2016-01-01

Adolescence is a vulnerable period for the initiation and peak of many harmful risk-taking behaviors such as smoking, which is among the most addictive and deadliest behaviors. Generic metatheories like the theory of triadic influence (TTI) suggest that interrelated risk factors across multiple domains (i.e., intrapersonal and…

Cognitive-Operative Model of Intelligent Learning Systems Behavior

ERIC Educational Resources Information Center

Laureano-Cruces, Ana Lilia; Ramirez-Rodriguez, Javier; Mora-Torres, Martha; de Arriaga, Fernando; Escarela-Perez, Rafael

2010-01-01

In this paper behavior during the teaching-learning process is modeled by means of a fuzzy cognitive map. The elements used to model such behavior are part of a generic didactic model, which emphasizes the use of cognitive and operative strategies as part of the student-tutor interaction. Examples of possible initial scenarios for the…

PelePhysics

DOE Office of Scientific and Technical Information (OSTI.GOV)

2017-05-17

PelePhysics is a suite of physics packages that provides functionality of use to reacting hydrodynamics CFD codes. The initial release includes an interface to reaction rate mechanism evaluation, transport coefficient evaluation, and a generalized equation of state (EOS) facility. Both generic evaluators and interfaces to code from externally available tools (Fuego for chemical rates, EGLib for transport coefficients) are provided.

78 FR 64413 - Proposed Waste Confidence Rule and Draft Generic Environmental Impact Statement

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-29

... rescheduled the Waste Confidence public meetings it initially planned to hold in San Luis Obispo and Carlsbad... Confidence public meeting in San Luis Obispo will now be held on November 20, 2013. The rescheduled meetings... rescheduled Waste Confidence public meeting in San Luis Obispo, California, on November 20, 2013. This...

Reconstruction of genome-scale human metabolic models using omics data.

PubMed

Ryu, Jae Yong; Kim, Hyun Uk; Lee, Sang Yup

2015-08-01

The impact of genome-scale human metabolic models on human systems biology and medical sciences is becoming greater, thanks to increasing volumes of model building platforms and publicly available omics data. The genome-scale human metabolic models started with Recon 1 in 2007, and have since been used to describe metabolic phenotypes of healthy and diseased human tissues and cells, and to predict therapeutic targets. Here we review recent trends in genome-scale human metabolic modeling, including various generic and tissue/cell type-specific human metabolic models developed to date, and methods, databases and platforms used to construct them. For generic human metabolic models, we pay attention to Recon 2 and HMR 2.0 with emphasis on data sources used to construct them. Draft and high-quality tissue/cell type-specific human metabolic models have been generated using these generic human metabolic models. Integration of tissue/cell type-specific omics data with the generic human metabolic models is the key step, and we discuss omics data and their integration methods to achieve this task. The initial version of the tissue/cell type-specific human metabolic models can further be computationally refined through gap filling, reaction directionality assignment and the subcellular localization of metabolic reactions. We review relevant tools for this model refinement procedure as well. Finally, we suggest the direction of further studies on reconstructing an improved human metabolic model.

GENDERED CHALLENGE, GENDERED RESPONSE

PubMed Central

KELLY, ERIN L.; AMMONS, SAMANTHA K.; CHERMACK, KELLY; MOEN, PHYLLIS

2010-01-01

This article integrates research on gendered organizations and the work-family interface to investigate an innovative workplace initiative, the Results-Only Work Environment (ROWE), implemented in the corporate headquarters of Best Buy, Inc. While flexible work policies common in other organizations “accommodate” individuals, this initiative attempts a broader and deeper critique of the organizational culture. We address two research questions: How does this initiative attempt to change the masculinized ideal worker norm? And what do women's and men's responses reveal about the persistent ways that gender structures work and family life? Data demonstrate the ideal worker norm is pervasive and powerful, even as employees begin critically examining expectations regarding work time that have historically privileged men. Employees' responses to ROWE are also gendered. Women (especially mothers) are more enthusiastic, while men are more cautious. Ambivalence about and resistance to change is expressed in different ways depending on gender and occupational status. PMID:20625518

Ballistically Initiated Fire Ball Generation Using M&S: Innovation Grant (Briefing Charts)

DTIC Science & Technology

2012-01-26

isotropic in nature Phenomenological models for explosives initiation. – HVRB, forest fire etc. Equation of state – Ideal gas, Mie-Gruneisen, JWL ...perfectly plastic description • EOS • Mie Gruneisen • JWL for explosive • Phenomenological Model for EFP • High Explosive input for programmed burn

The effects of thiopental and generic and nongeneric propofol on respiratory resistance during anesthetic induction in patients with reactive airways.

PubMed

Arain, Shahbaz R; Navani, Annu; Ebert, Thomas J

2002-06-01

To demonstrate a favorable effect of propofol on respiratory system resistance during anesthetic induction, and to determine if generic propofol causes adverse effects on respiratory resistance. Randomized pilot study. Anesthetic induction for elective surgery. 27 consenting ASA physical status II and III patients with reactive airways (positive smoking history or chronic obstructive pulmonary disease), but not receiving bronchodilator therapy. Patients were randomized equally to one of three anesthetic induction (and maintenance) drugs: sodium thiopental, 5 mg/kg (25 microg/kg/min), generic or nongeneric propofol, 1.25 mg/kg (50 microg/kg/min). They received preinduction midazolam and fentanyl (2 mg and 150 microg) and intravenous lidocaine (0.5 mg/kg). After anesthetic induction, tracheal intubation was established, and predetermined settings for mechanical ventilation were initiated. Immediately after intubation, a sensor was placed on the 8-mm endotracheal tube to detect baseline airway pressure and flow. During maintenance, repeat measurements of pressure and flow were obtained at 2.5-minute intervals for 10 minutes. Respiratory system resistance was derived off-line using the isovolumetric technique. Patients were similar across groups. The respiratory resistance measured after anesthetic induction did not differ among groups. During the maintenance infusion of thiopental or propofol, respiratory resistance increased gradually across all groups. There was no difference in the response of respiratory resistance either at induction or during the 10-minute maintenance between the generic and the nongeneric propofol groups. In contrast to earlier reports, this pilot study was unable to document a difference in the respiratory resistance in patients induced with thiopental or propofol. In addition, we were unable to demonstrate any different respiratory responses between generic propofol, containing sodium metabisulfite preservative, and nongeneric propofol.

Forecasting the (un)productivity of the 2014 M 6.0 South Napa aftershock sequence

USGS Publications Warehouse

Llenos, Andrea L.; Michael, Andrew J.

2017-01-01

The 24 August 2014 Mw 6.0 South Napa mainshock produced fewer aftershocks than expected for a California earthquake of its magnitude. In the first 4.5 days, only 59 M≥1.8 aftershocks occurred, the largest of which was an M 3.9 that happened a little over two days after the mainshock. We investigate the aftershock productivity of the South Napa sequence and compare it with other M≥5.5 California strike‐slip mainshock–aftershock sequences. While the productivity of the South Napa sequence is among the lowest, northern California mainshocks generally have fewer aftershocks than mainshocks further south, although the productivities vary widely in both regions. An epidemic‐type aftershock sequence (ETAS) model (Ogata, 1988) fit to Napa seismicity from 1980 to 23 August 2014 fits the sequence well and suggests that low‐productivity sequences are typical of this area. Utilizing regional variations in productivity could improve operational earthquake forecasting (OEF) by improving the model used immediately after the mainshock. We show this by comparing the daily rate of M≥2 aftershocks to forecasts made with the generic California model (Reasenberg and Jones, 1989; hereafter, RJ89), RJ89 models with productivity updated daily, a generic California ETAS model, an ETAS model based on premainshock seismicity, and ETAS models updated daily following the mainshock. RJ89 models for which only the productivity is updated provide better forecasts than the generic RJ89 California model, and the Napa‐specific ETAS models forecast the aftershock rates more accurately than either generic model. Therefore, forecasts that use localized initial parameters and that rapidly update the productivity may be better for OEF than using a generic model and/or updating all parameters.

Cross-cultural adaptation, reliability and validity of the Spanish version of the Quality of Life in Adult Cancer Survivors (QLACS) questionnaire: application in a sample of short-term survivors.

PubMed

Escobar, Antonio; Trujillo-Martín, Maria del Mar; Rueda, Antonio; Pérez-Ruiz, Elisabeth; Avis, Nancy E; Bilbao, Amaia

2015-11-16

The aim of this study was to validate the Quality of Life in Adult Cancer Survivors (QLACS) in short-term Spanish cancer survivor's patients. Patients with breast, colorectal or prostate cancer that had finished their initial cancer treatment 3 years before the beginning of this study completed QLACS, WHOQOL, Short Form-36, Hospital Anxiety and Depression Scale, EORTC-QLQ-BR23 and EQ-5D. Cultural adaptation was made based on established guidelines. Reliability was evaluated using internal consistency and test-retest. Convergent validity was studied by mean of Pearson's correlation coefficient. Structural validity was determined by a second-order confirmatory factor analysis (CFA) and Rasch analysis was used to assess the unidimensionality of the Generic and Cancer-specific scales. Cronbach's alpha were above 0.7 in all domains and summary scales. Test-retest coefficients were 0.88 for Generic and 0.82 for Cancer-specific summary scales. QLACS generic summary scale was correlated with other generic criterion measures, SF-36 MCS (r = - 0.74) and EQ-VAS (r = - 0.63). QLACS cancer-specific scale had lower values with the same constructs. CFA provided satisfactory fit indices in all cases. The RMSEA value was 0.061 and CFI and TLI values were 0.929 and 0.925, respectively. All factor loadings were higher than 0.40 and statistically significant (P < 0.001). Generic summary scale had eight misfitting items. In the remaining 20 items, the unidimensionality was supported. Cancer Specific summary scale showed four misfitting items, the remaining showed unidimensionality. The findings support the validity and reliability of QLACS questionnaire to be used in short-term cancer survivors.

Validity and reliability of the Iranian version of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™) Generic Core Scales in children

PubMed Central

2012-01-01

Background This study aimed to investigate the reliability and validity of the Iranian version of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™ 4.0) Generic Core Scales in children. Methods A standard forward and backward translation procedure was used to translate the US English version of the PedsQL™ 4.0 Generic Core Scales for children into the Iranian language (Persian). The Iranian version of the PedsQL™ 4.0 Generic Core Scales was completed by 503 healthy and 22 chronically ill children aged 8-12 years and their parents. The reliability was evaluated using internal consistency. Known-groups discriminant comparisons were made, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted. Results The internal consistency, as measured by Cronbach's alpha coefficients, exceeded the minimum reliability standard of 0.70. All monotrait-multimethod correlations were higher than multitrait-multimethod correlations. The intraclass correlation coefficients (ICC) between the children self-report and parent proxy-reports showed moderate to high agreement. Exploratory factor analysis extracted six factors from the PedsQL™ 4.0 for both self and proxy reports, accounting for 47.9% and 54.8% of total variance, respectively. The results of the confirmatory factor analysis for 6-factor models for both self-report and proxy-report indicated acceptable fit for the proposed models. Regarding health status, as hypothesized from previous studies, healthy children reported significantly higher health-related quality of life than those with chronic illnesses. Conclusions The findings support the initial reliability and validity of the Iranian version of the PedsQL™ 4.0 as a generic instrument to measure health-related quality of life of children in Iran. PMID:22221765

Validity and reliability of the Iranian version of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™) Generic Core Scales in children.

PubMed

Amiri, Parisa; Eslamian, Ghazaleh; Mirmiran, Parvin; Shiva, Niloofar; Jafarabadi, Mohammad Asghari; Azizi, Fereidoun

2012-01-05

This study aimed to investigate the reliability and validity of the Iranian version of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™ 4.0) Generic Core Scales in children. A standard forward and backward translation procedure was used to translate the US English version of the PedsQL™ 4.0 Generic Core Scales for children into the Iranian language (Persian). The Iranian version of the PedsQL™ 4.0 Generic Core Scales was completed by 503 healthy and 22 chronically ill children aged 8-12 years and their parents. The reliability was evaluated using internal consistency. Known-groups discriminant comparisons were made, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted. The internal consistency, as measured by Cronbach's alpha coefficients, exceeded the minimum reliability standard of 0.70. All monotrait-multimethod correlations were higher than multitrait-multimethod correlations. The intraclass correlation coefficients (ICC) between the children self-report and parent proxy-reports showed moderate to high agreement. Exploratory factor analysis extracted six factors from the PedsQL™ 4.0 for both self and proxy reports, accounting for 47.9% and 54.8% of total variance, respectively. The results of the confirmatory factor analysis for 6-factor models for both self-report and proxy-report indicated acceptable fit for the proposed models. Regarding health status, as hypothesized from previous studies, healthy children reported significantly higher health-related quality of life than those with chronic illnesses. The findings support the initial reliability and validity of the Iranian version of the PedsQL™ 4.0 as a generic instrument to measure health-related quality of life of children in Iran.

Direct-Write Fabrication of Cellulose Nano-Structures via Focused Electron Beam Induced Nanosynthesis

PubMed Central

Ganner, Thomas; Sattelkow, Jürgen; Rumpf, Bernhard; Eibinger, Manuel; Reishofer, David; Winkler, Robert; Nidetzky, Bernd; Spirk, Stefan; Plank, Harald

2016-01-01

In many areas of science and technology, patterned films and surfaces play a key role in engineering and development of advanced materials. Here, we introduce a new generic technique for the fabrication of polysaccharide nano-structures via focused electron beam induced conversion (FEBIC). For the proof of principle, organosoluble trimethylsilyl-cellulose (TMSC) thin films have been deposited by spin coating on SiO2 / Si and exposed to a nano-sized electron beam. It turns out that in the exposed areas an electron induced desilylation reaction takes place converting soluble TMSC to rather insoluble cellulose. After removal of the unexposed TMSC areas, structured cellulose patterns remain on the surface with FWHM line widths down to 70 nm. Systematic FEBIC parameter sweeps reveal a generally electron dose dependent behavior with three working regimes: incomplete conversion, ideal doses and over exposure. Direct (FT-IR) and indirect chemical analyses (enzymatic degradation) confirmed the cellulosic character of ideally converted areas. These investigations are complemented by a theoretical model which suggests a two-step reaction process by means of TMSC → cellulose and cellulose → non-cellulose material conversion in excellent agreement with experimental data. The extracted, individual reaction rates allowed the derivation of design rules for FEBIC parameters towards highest conversion efficiencies and highest lateral resolution. PMID:27585861

A standardized way to select, evaluate, and test an analog-to-digital converter for ultrawide bandwidth radiofrequency signals based on user's needs, ideal, published,and actual specifications

NASA Astrophysics Data System (ADS)

Chang, Daniel Y.; Rowe, Neil C.

2012-06-01

The most important adverse impact on the Electronic Warfare (EW) simulation is that the number of signal sources that can be tested simultaneously is relatively small. When the number of signal sources increases, the analog hardware, complexity and costs grow by the order of N2, since the number of connections among N components is O(N*N) and the signal communication is bi-directional. To solve this problem, digitization of the signal is suggested. In digitizing a radiofrequency signal, an Analog-to-Digital Converter (ADC) is widely used. Most research studies on ADCs are conducted from designer/test engineers' perspective. Some research studies are conducted from market's perspective. This paper presents a generic way to select, evaluate and test ultra high bandwidth COTS ADCs and generate requirements for digitizing continuous time signals from the perspective of user's needs. Based on user's needs, as well as vendor's published, ideal and actual specifications, a decision can be made in selecting a proper ADC for an application. To support our arguments and illustrate the methodology, we evaluate a Tektronix TADC-1000, an 8-bit and 12 gigasamples per second ADC. This project is funded by JEWEL lab, NAWCWD at Point Mugu, CA.

The desirable qualities of future doctors--a study of medical student perceptions.

PubMed

Hurwitz, Steven; Kelly, Brian; Powis, David; Smyth, Robyn; Lewin, Terry

2013-07-01

There is a lack of consensus regarding the qualities possessed by the ideal doctor, and very limited research regarding the views of medical students on these qualities. To investigate the views of commencing medical students regarding the desirable qualities of doctors. A survey containing a set of proposed desirable qualities of doctors identified from the existing literature was completed by 158 first-year medical students. The survey had a 75% response rate. Students rated the individual qualities of empathy, motivation to be a doctor, good verbal communication, ethically sound, integrity and honesty as the most important. A factor analysis identified six categories of qualities: methodical processing, cognitive capacity, people skills, generic work ethic, role certainty and warmth. Significant differences in factor scores were found across subgroups of students (international and domestic students, with and without prior tertiary studies) on the following factors: methodical processing, which was scored highest by domestic students with prior tertiary studies, cognitive capacity, which was scored highest by domestic students without prior tertiary studies and generic work ethic, which was scored highest by international students. Medical students identified a range of desirable personal qualities of a doctor which varied according to student characteristics, including their prior educational experience. Future research aiming to define such desirable qualities should include a broader range of stakeholders, including students at different training levels and institutions.

Characteristics of good supervision: a multi-perspective qualitative exploration of the Masters in Public Health dissertation.

PubMed

Katikireddi, Srinivasa Vittal; Reilly, Jacqueline

2017-09-01

A dissertation is often a core component of the Masters in Public Health (MPH) qualification. This study aims to explore its purpose, from the perspective of both students and supervisors, and identify practices viewed as constituting good supervision. A multi-perspective qualitative study drawing on in-depth one-to-one interviews with MPH supervisors (n = 8) and students (n = 10), with data thematically analysed. The MPH dissertation was viewed as providing generic as well as discipline-specific knowledge and skills. It provided an opportunity for in-depth study on a chosen topic but different perspectives were evident as to whether the project should be grounded in public health practice rather than academia. Good supervision practice was thought to require topic knowledge, generic supervision skills (including clear communication of expectations and timely feedback) and adaptation of supervision to meet student needs. Two ideal types of the MPH dissertation process were identified. Supervisor-led projects focus on achieving a clearly defined output based on a supervisor-identified research question and aspire to harmonize research and teaching practice, but often have a narrower focus. Student-led projects may facilitate greater learning opportunities and better develop skills for public health practice but could be at greater risk of course failure. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health.

Molecular Dynamics Simulations of an Idealized Shock Tube: N2 in Ar Bath Driven by He

NASA Astrophysics Data System (ADS)

Piskulich, Ezekiel Ashe; Sewell, Thomas D.; Thompson, Donald L.

2015-06-01

The dynamics of 10% N2 in Ar initially at 298 K in an idealized shock tube driven by He was studied using molecular dynamics. The simulations were performed using the Large-Scale Atomic/Molecular Massively Parallel Simulator (LAMMPS) code. Nitrogen was modeled as a Morse oscillator and non-covalent interactions were approximated by the Buckingham exponential-6 pair potential. The initial pressures in the He driver gas and the driven N2/Ar gas were 1000 atm and 20 atm, respectively. Microcanonical trajectories were followed for 2 ns following release of the driver gas. Results for excitation and subsequent relaxation of the N2, as well as properties of the gas during the simulations, will be reported.

78 FR 25418 - Initiation of Antidumping and Countervailing Duty Administrative Reviews and Request for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-01

... Create-Bio Engineering Co. Ltd. Ningbo Generic Chemical Co. Qingdao Samin Chemical Co., Ltd. Paras... CHINA: Certain Tissue Paper 3/1/12-2/28/13 Products,\\8\\ A-570-894 AR Printing & Packaging (India) Pvt... does not qualify for a separate rate, all other exporters of Tissue Paper Products from the PRC who...

Transforming Space Missions into Service Oriented Architectures

NASA Technical Reports Server (NTRS)

Mandl, Dan; Frye, Stuart; Cappelaere, Pat

2006-01-01

This viewgraph presentation reviews the vision of the sensor web enablement via a Service Oriented Architecture (SOA). An generic example is given of a user finding a service through the Web, and initiating a request for the desired observation. The parts that comprise this system and how they interact are reviewed. The advantages of the use of SOA are reviewed.

Adopting a Strategy for Enhancing Generic Skills in Engineering Education

ERIC Educational Resources Information Center

Krassadaki, Evangelia; Lakiotaki, Kleanthi; Matsatsinis, Nilolaos F.

2014-01-01

It is remarkable how often academic staff discover students' weaknesses in expressing their thoughts in written and oral contexts, and in team working. To examine these weaknesses, a study was conducted in 2009-2010 and 2010-2011 of students taking an engineering course. Students self-reported an initial high level of weakness in both…

Building a Dangerous Outpost in the Green Mountain State: A Case Study of Educator Preparation Policymaking

ERIC Educational Resources Information Center

McGough, David J.; Bedell, Claudine; Tinkler, Barri

2018-01-01

Poised at a bifurcation, the educator preparation community in Vermont faced either the adoption of a generic product for the assessment of initial educator licensure candidates or the comprehensive revision of a longstanding state-based assessment portfolio. Using a case study approach and narrative methods, specifically the Narrative Policy…

Toddler Autism Screening Questionnaire: Development and Potential Clinical Validity

ERIC Educational Resources Information Center

Tsai, Wen-Che; Soong, Wei-Tsuen; Shyu, Yea-Ing Lotus

2012-01-01

No feasible screening instrument is available for early detection of children with autism in Taiwan. The existing instruments may not be appropriate for use in Taiwan due to different health care systems and child-rearing cultures. The purpose of this study was to develop and test a screening questionnaire for generic autism. The initial 18-item…

Automated subsystems control development. [for life support systems of space station

NASA Technical Reports Server (NTRS)

Block, R. F.; Heppner, D. B.; Samonski, F. H., Jr.; Lance, N., Jr.

1985-01-01

NASA has the objective to launch a Space Station in the 1990s. It has been found that the success of the Space Station engineering development, the achievement of initial operational capability (IOC), and the operation of a productive Space Station will depend heavily on the implementation of an effective automation and control approach. For the development of technology needed to implement the required automation and control function, a contract entitled 'Automated Subsystems Control for Life Support Systems' (ASCLSS) was awarded to two American companies. The present paper provides a description of the ASCLSS program. Attention is given to an automation and control architecture study, a generic automation and control approach for hardware demonstration, a standard software approach, application of Air Revitalization Group (ARG) process simulators, and a generic man-machine interface.

Linear Transformation Method for Multinuclide Decay Calculation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ding Yuan

2010-12-29

A linear transformation method for generic multinuclide decay calculations is presented together with its properties and implications. The method takes advantage of the linear form of the decay solution N(t) = F(t)N{sub 0}, where N(t) is a column vector that represents the numbers of atoms of the radioactive nuclides in the decay chain, N{sub 0} is the initial value vector of N(t), and F(t) is a lower triangular matrix whose time-dependent elements are independent of the initial values of the system.

Master Logic Diagram: method for hazard and initiating event identification in process plants.

PubMed

Papazoglou, I A; Aneziris, O N

2003-02-28

Master Logic Diagram (MLD), a method for identifying events initiating accidents in chemical installations, is presented. MLD is a logic diagram that resembles a fault tree but without the formal mathematical properties of the latter. MLD starts with a Top Event "Loss of Containment" and decomposes it into simpler contributing events. A generic MLD has been developed which may be applied to all chemical installations storing toxic and/or flammable substances. The method is exemplified through its application to an ammonia storage facility.

Differences in Adverse Event Reporting Rates of Therapeutic Failure Between Two Once-daily Extended-release Methylphenidate Medications in Canada: Analysis of Spontaneous Adverse Event Reporting Databases.

PubMed

Park-Wyllie, Laura; van Stralen, Judy; Castillon, Genaro; Sherman, Stephen E; Almagor, Doron

2017-10-01

Our study evaluated adverse events of therapeutic failure (and specifically reduced duration of action) with the use of a branded product, Osmotic Release Oral System (OROS) methylphenidate, which is approved for the treatment of attention deficit/hyperactivity disorder, and a generic product (methylphenidate, methylphenidate ER-C), which was approved for marketing in Canada based on bioequivalence to OROS methylphenidate. This study was initiated following reports that some US-marketed generic methylphenidate ER products had substantially higher reporting rates of therapeutic failure than did the referenced brands. Through methodology similar to that used by the US Food and Drug Administration to investigate the issue with the US-marketed generic, reporting rates were calculated from cases of therapeutic failure identified in the Canadian Vigilance Adverse Reaction Online database for a 1-year period beginning 8 months after each product launch. Corresponding population exposure was estimated from the number of tablets dispensed. An in-depth analysis of narratives of individual case safety reports (ICSRs) with the use of the generic product was conducted in duplicate by 2 physicians to assess causality and to characterize the potential safety risk and clinical pattern of therapeutic failure. Similar secondary analyses were conducted on the US-marketed products. Reporting rates of therapeutic failure with the use of methylphenidate ER-C (generic) and OROS methylphenidate (brand name) were 411.5 and 37.5 cases per 100,000 patient-years, respectively (reporting rate ratio, 10.99; 95% CI, 5.93-22.21). In-depth analysis of narratives of 230 ICSRs of therapeutic failure with the Canadian-marketed generic determined that all ICSRs were either probably (60 [26%]) or possibly (170 [74%]) causally related to methylphenidate ER-C. Clinical symptoms suggestive of overdose were present in 31 reports of loss of efficacy (13.5%) and occurred primarily in the morning, and premature loss of efficacy (shorter duration of action) was described in 98 cases (42.6%) and occurred primarily in the afternoon. Impacts on social functioning, such as disruption in work or school performance or adverse social behaviors, were found in 51 cases (22.2%). The ~10-fold higher reporting rate of therapeutic failure with the generic product relative to its reference product in the present Canadian study resembles findings with US-marketed generic products. While these results should be interpreted with caution due to the limitations of spontaneous adverse event reporting, which may confound comparisons across products, similar findings nonetheless led the US Food and Drug Administration to declare in 2014 that 2 methylphenidate ER generic products in the United States were neither bioequivalent nor interchangeable with OROS methylphenidate-their reference product. Our results indicate a potential safety issue with the Canadian-marketed generic and suggest a need for further investigation by Health Canada. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Integrating Experiential and Academic Learning in Teacher Preparation for Development Education

ERIC Educational Resources Information Center

Ryan, Anne

2012-01-01

With a view to linking ideals with action in development education, the preparation of teachers for practice in this area merits consideration. Given the theory/practice disconnect associated with initial teacher education, it is appropriate to explore means of effectively initiating beginning teachers into development education. To that end, a…

New Teachers' Identity Shifts at the Boundary of Teacher Education and Initial Practice

ERIC Educational Resources Information Center

Beauchamp, Catherine; Thomas, Lynn

2011-01-01

As teachers enter the school communities of their initial practice, they experience identity shifts that reflect their learning. Throughout teacher education they have constructed an identity informed by their previous school experiences, the ideas and approaches promoted by their teacher education programs, and an ideal of the teachers they hope…

Conjugating binary systems for spacecraft thermal control

NASA Technical Reports Server (NTRS)

Grodzka, Philomena G.; Dean, William G.; Sisk, Lori A.; Karu, Zain S.

1989-01-01

The materials search was directed to liquid pairs which can form hydrogen bonds of just the right strength, i.e., strong enough to give a high heat of mixing, but weak enough to enable phase change to occur. The cursory studies performed in the area of additive effects indicate that Conjugating Binary (CB) performance can probably be fine-tuned by this means. The Fluid Loop Test Systems (FLTS) tests of candidate CBs indicate that the systems Triethylamine (TEA)/water and propionaldehyde/water show close to the ideal, reversible behavior, at least initially. The Quick Screening Tests QSTs and FLTS tests, however, both suffer from rather severe static due either to inadequate stirring or temperature control. Thus it is not possible to adequately evaluate less than ideal CB performers. Less than ideal performers, it should be noted, may have features that make them better practical CBs than ideal performers. Improvement of the evaluation instrumentation is thus indicated.

Effect of initial densities in the lattice Boltzmann model for non-ideal fluid with curved interface

NASA Astrophysics Data System (ADS)

Gong, Jiaming; Oshima, Nobuyuki

2017-06-01

The effect of initial densities in a free energy based two-phase-flow lattice Boltzmann method for non-ideal fluids with a curved interface was investigated in the present work. To investigate this effect, the initial densities in the liquid and gas phases coming from the saturation points and the equilibrium state were adopted in the simulation of a static droplet in an open and a closed system. For the purpose of simplicity and easier comparison, the closed system is fabricated by the implementation of the periodic boundary condition at the inlet and outlet of a gas channel, and the open system is fabricated by the implementation of a constant flux boundary condition at the inlet and a free-out boundary condition at the outlet of the same gas channel. By comparing the simulation results from the two types of initial densities in the open and closed systems, it is proven that the commonly used saturation initial densities setting is the reason for droplet mass and volume variation which occurred in the simulation, particularly in the open system with a constant flux boundary condition. Such problems are believed to come from the curvature effect of the surface tension and can be greatly reduced by adopting the initial densities in the two phases from equilibrium state.

Relational databases: a transparent framework for encouraging biology students to think informatically.

PubMed

Rice, Michael; Gladstone, William; Weir, Michael

2004-01-01

We discuss how relational databases constitute an ideal framework for representing and analyzing large-scale genomic data sets in biology. As a case study, we describe a Drosophila splice-site database that we recently developed at Wesleyan University for use in research and teaching. The database stores data about splice sites computed by a custom algorithm using Drosophila cDNA transcripts and genomic DNA and supports a set of procedures for analyzing splice-site sequence space. A generic Web interface permits the execution of the procedures with a variety of parameter settings and also supports custom structured query language queries. Moreover, new analytical procedures can be added by updating special metatables in the database without altering the Web interface. The database provides a powerful setting for students to develop informatic thinking skills.

Tidal Response to Sea-Level Rise in Different Types of Estuaries: The Importance of Length, Bathymetry, and Geometry

NASA Astrophysics Data System (ADS)

Du, Jiabi; Shen, Jian; Zhang, Yinglong J.; Ye, Fei; Liu, Zhuo; Wang, Zhengui; Wang, Ya Ping; Yu, Xin; Sisson, Mac; Wang, Harry V.

2018-01-01

Tidal response to sea-level rise (SLR) varies in different coastal systems. To provide a generic pattern of tidal response to SLR, a systematic investigation was conducted using numerical techniques applied to idealized and realistic estuaries, with model results cross-checked by analytical solutions. Our results reveal that the response of tidal range to SLR is nonlinear, spatially heterogeneous, and highly affected by the length and bathymetry of an estuary and weakly affected by the estuary convergence with an exception of strong convergence. Contrary to the common assumption that SLR leads to a weakened bottom friction, resulting in increased tidal amplitude, we demonstrate that tidal range is likely to decrease in short estuaries and in estuaries with a narrow channel and large low-lying shallow areas.

Relational Databases: A Transparent Framework for Encouraging Biology Students To Think Informatically

PubMed Central

2004-01-01

We discuss how relational databases constitute an ideal framework for representing and analyzing large-scale genomic data sets in biology. As a case study, we describe a Drosophila splice-site database that we recently developed at Wesleyan University for use in research and teaching. The database stores data about splice sites computed by a custom algorithm using Drosophila cDNA transcripts and genomic DNA and supports a set of procedures for analyzing splice-site sequence space. A generic Web interface permits the execution of the procedures with a variety of parameter settings and also supports custom structured query language queries. Moreover, new analytical procedures can be added by updating special metatables in the database without altering the Web interface. The database provides a powerful setting for students to develop informatic thinking skills. PMID:15592597

On equations of motion of a nonlinear hydroelastic structure

NASA Astrophysics Data System (ADS)

Plotnikov, P. I.; Kuznetsov, I. V.

2008-07-01

Formal derivation of equations of a nonlinear hydroelastic structure, which is a volume of an ideal incompressible fluid covered by a shell, is proposed. The study is based on two assumptions. The first assumption implies that the energy stored in the shell is completely determined by the mean curvature and by the elementary area. In a three-dimensional case, the energy stored in the shell is chosen in the form of the Willmore functional. In a two-dimensional case, a more generic form of the functional can be considered. The second assumption implies that the equations of motionhave a Hamiltonian structure and can be obtained from the Lagrangian variational principle. In a two-dimensional case, a condition for the hydroelastic structure is derived, which relates the external pressure and the curvature of the elastic shell.

Domain walls in the extensions of the Standard Model

NASA Astrophysics Data System (ADS)

Krajewski, Tomasz; Lalak, Zygmunt; Lewicki, Marek; Olszewski, Paweł

2018-05-01

Our main interest is the evolution of domain walls of the Higgs field in the early Universe. The aim of this paper is to understand how dynamics of Higgs domain walls could be influenced by yet unknown interactions from beyond the Standard Model. We assume that the Standard Model is valid up to certain, high, energy scale Λ and use the framework of the effective field theory to describe physics below that scale. Performing numerical simulations with different values of the scale Λ we are able to extend our previous analysis [1]. Our recent numerical simulations show that evolution of Higgs domain walls is rather insensitive to interactions beyond the Standard Model as long as masses of new particles are grater than 1012 GeV. For lower values of Λ the RG improved effective potential is strongly modified at field strengths crucial to the evolution of domain walls. However, we find that even for low values of Λ, Higgs domain walls decayed shortly after their formation for generic initial conditions. On the other hand, in simulations with specifically chosen initial conditions Higgs domain walls can live longer and enter the scaling regime. We also determine the energy spectrum of gravitational waves produced by decaying domain walls of the Higgs field. For generic initial field configurations the amplitude of the signal is too small to be observed in planned detectors.

Turbulence in Supercritical O2/H2 and C7H16/N2 Mixing Layers

NASA Technical Reports Server (NTRS)

Bellan, Josette; Harstad, Kenneth; Okong'o, Nora

2003-01-01

This report presents a study of numerical simulations of mixing layers developing between opposing flows of paired fluids under supercritical conditions, the purpose of the study being to elucidate chemical-species-specific aspects of turbulence. The simulations were performed for two different fluid pairs O2/H2 and C7H16/N2 at similar reduced initial pressures (reduced pressure is defined as pressure divided by critical pressure). Thermodynamically, O2/H2 behaves more nearly like an ideal mixture and has greater solubility, relative to C7H16/N2, which departs strongly from ideality. Because of a specified smaller initial density stratification, the C7H16/N2 layers exhibited greater levels of growth, global molecular mixing, and turbulence. However, smaller density gradients at the transitional state for the O2/H2 system were interpreted as indicating that locally, this system exhibits enhanced mixing as a consequence of its greater solubility and closer approach to ideality. These thermodynamic features were shown to affect entropy dissipation, which was found to be larger for O2/H2 and concentrated in high-density-gradient-magnitude regions that are distortions of the initial density-stratification boundary. In C7H16/N2, the regions of largest dissipation were found to lie in high-density-gradient-magnitude regions that result from mixing of the two fluids.

Comparison of response rates and cost-effectiveness for a community-based survey: postal, internet and telephone modes with generic or personalised recruitment approaches

PubMed Central

2012-01-01

Background Epidemiological research often requires collection of data from a representative sample of the community or recruitment of specific groups through broad community approaches. The population coverage of traditional survey methods such as mail-outs to residential addresses, and telephone contact via public directories or random-digit-dialing is declining and survey response rates are falling. There is a need to explore new sampling frames and consider multiple response modes including those offered by changes in telecommunications and internet technology. Methods We evaluated response rates and cost-effectiveness for three modes of survey administration (postal invitation/postal survey, postal invitation/internet survey and postal invitation/telephone survey) and two styles of contact approach (personalised and generic) in a community survey of greywater use. Potential respondents were contacted only once, with no follow up of non-responders. Results The telephone survey produced the highest adjusted response rate (30.2%), followed by the personalised postal survey (10.5%), generic postal survey (7.5%) and then the internet survey (4.7% for the personalised approach and 2.2% for the generic approach). There were some differences in household characteristics and greywater use rates between respondents to different survey modes, and between respondents to personalised and generic approaches. These may be attributable to the differing levels of motivations needed for a response, and varying levels of interest in the survey topic among greywater users and non-users. The generic postal survey had the lowest costs per valid survey received (Australian $22.93), followed by the personalised postal survey ($24.75). Conclusions Our findings suggest that postal surveys currently remain the most economic option for population-based studies, with similar costs for personalised and generic approaches. Internet surveys may be effective for specialised groups where email lists are available for initial contact, but barriers other than household internet access still exist for community-based surveys. Given the increasing recruitment challenges facing community-based studies, there is an imperative to gather contemporary comparative data on different survey modes and recruitment approaches in order to determine their strengths, limitations and costs. Researchers also need to document and report on the potential biases in the target and respondent populations and how this may affect the data collected. PMID:22938205

Comparison of Outcomes Following a Switch From a Brand to an Authorized Versus Independent Generic Drug.

PubMed

Hansen, R A; Qian, J; Berg, R L; Linneman, J G; Seoane-Vazquez, E; Dutcher, S; Raofi, S; Page, C D; Peissig, P L

2018-02-01

Authorized generics are identical in formulation to brand drugs, manufactured by the brand company but marketed as a generic. Generics, marketed by generic manufacturers, are required to demonstrate pharmaceutical and bioequivalence to the brand drug, but repetition of clinical trials is not required. This retrospective cohort study compared outcomes for generics and authorized generics, which serves as a generic vs. brand proxy that minimizes bias against generics. For the seven drugs studied between 1999 and 2014, 5,234 unique patients were on brand drugs prior to generic entry and 4,900 (93.6%) switched to a generic. During the 12 months following the brand-to-generic switch, patients using generics vs. authorized generics were similar in terms of outpatient visits, urgent care visits, hospitalizations, and medication discontinuation. The likelihood of emergency department (ED) visits was slightly higher for authorized generics compared with generics. These data suggest that generics were clinically no worse than their proxy brand comparators. © 2017 American Society for Clinical Pharmacology and Therapeutics.

The effect of extreme ionization rates during the initial collapse of a molecular cloud core

NASA Astrophysics Data System (ADS)

Wurster, James; Bate, Matthew R.; Price, Daniel J.

2018-05-01

What cosmic ray ionization rate is required such that a non-ideal magnetohydrodynamics (MHD) simulation of a collapsing molecular cloud will follow the same evolutionary path as an ideal MHD simulation or as a purely hydrodynamics simulation? To investigate this question, we perform three-dimensional smoothed particle non-ideal MHD simulations of the gravitational collapse of rotating, one solar mass, magnetized molecular cloud cores, which include Ohmic resistivity, ambipolar diffusion, and the Hall effect. We assume a uniform grain size of ag = 0.1 μm, and our free parameter is the cosmic ray ionization rate, ζcr. We evolve our models, where possible, until they have produced a first hydrostatic core. Models with ζcr ≳ 10-13 s-1 are indistinguishable from ideal MHD models, and the evolution of the model with ζcr = 10-14 s-1 matches the evolution of the ideal MHD model within 1 per cent when considering maximum density, magnetic energy, and maximum magnetic field strength as a function of time; these results are independent of ag. Models with very low ionization rates (ζcr ≲ 10-24 s-1) are required to approach hydrodynamical collapse, and even lower ionization rates may be required for larger ag. Thus, it is possible to reproduce ideal MHD and purely hydrodynamical collapses using non-ideal MHD given an appropriate cosmic ray ionization rate. However, realistic cosmic ray ionization rates approach neither limit; thus, non-ideal MHD cannot be neglected in star formation simulations.

Pre-Big-Bang bubbles from the gravitational instability of generic string vacua

NASA Astrophysics Data System (ADS)

Buonanno, A.; Damour, T.; Veneziano, G.

1999-03-01

We formulate the basic postulate of pre-Big-Bang cosmology as one of ``asymptotic past triviality", by which we mean that the initial state is a generic perturbative solution of the tree-level low-energy effective action. Such a past-trivial ``string vacuum'' is made of an arbitrary ensemble of incoming gravitational and dilatonic waves, and is generically prone to gravitational instability, leading to the possible formation of many black holes hiding singular space-like hypersurfaces. Each such singular space-like hypersurface of gravitational collapse becomes, in the string-frame metric, the usual Big-Bang t=0 hypersurface, i.e. the place of birth of a baby Friedmann universe after a period of dilaton-driven inflation. Specializing to the spherically symmetric case, we review and reinterpret previous work on the subject, and propose a simple, scale-invariant criterion for collapse/inflation in terms of asymptotic data at past null infinity. Those data should determine whether, when, and where collapse/inflation occurs, and, when it does, fix its characteristics, including anisotropies on the Big-Bang hypersurface whose imprint could have survived till now. Using Bayesian probability concepts, we finally attempt to answer some fine-tuning objections recently moved to the pre-Big-Bang scenario.

Greek Physicians' Perceptions on Generic Drugs in the Era of Austerity

PubMed Central

Labiris, Georgios; Fanariotis, Michael; Kastanioti, Catherine; Alexias, Georgios; Protopapas, Adonis; Karampitsakos, Theodoros; Niakas, Dimitris

2015-01-01

Purpose. To assess the beliefs and preferences of Greek physicians, regarding generic drugs, in the years of financial crisis. Setting. Multicentered, nationwide survey. Material and Methods. A custom questionnaire based on former similar studies was developed and administered to Greek physicians. The variable “perception on generics” was constructed after an exploratory study and the instrument was validated by conventional and Rasch analysis methods. 22 items formed 5 subscales that constructed the variable in question. Results. 908 physicians successfully participated in the study (response rate: 80%). Mean total scores to the instrument were 60.63 ± 12.12 for men and significantly less (58.24 ± 11.73) for women (p = 0.04). Greek physicians were not persuaded on the potential economic gain (45.79 ± 10.53); moreover they identified that Greek authorities cannot address the increased pharmacovigilance mandates. Physicians working in Athens and those working in surgical units demonstrated significantly worse scores than their colleagues from the rest of Greece and those working in Internal Medicine wards (p = 0.03).  Conclusion. Our results suggest an overall poor acceptance of the national initiative on generic drugs by Greek physicians. This trial is registered with Clinicaltrials.gov identifier: NCT01855802. PMID:26457225

Extracting recurrent scenarios from narrative texts using a Bayesian network: application to serious occupational accidents with movement disturbance.

PubMed

Abdat, F; Leclercq, S; Cuny, X; Tissot, C

2014-09-01

A probabilistic approach has been developed to extract recurrent serious Occupational Accident with Movement Disturbance (OAMD) scenarios from narrative texts within a prevention framework. Relevant data extracted from 143 accounts was initially coded as logical combinations of generic accident factors. A Bayesian Network (BN)-based model was then built for OAMDs using these data and expert knowledge. A data clustering process was subsequently performed to group the OAMDs into similar classes from generic factor occurrence and pattern standpoints. Finally, the Most Probable Explanation (MPE) was evaluated and identified as the associated recurrent scenario for each class. Using this approach, 8 scenarios were extracted to describe 143 OAMDs in the construction and metallurgy sectors. Their recurrent nature is discussed. Probable generic factor combinations provide a fair representation of particularly serious OAMDs, as described in narrative texts. This work represents a real contribution to raising company awareness of the variety of circumstances, in which these accidents occur, to progressing in the prevention of such accidents and to developing an analysis framework dedicated to this kind of accident. Copyright © 2014 Elsevier Ltd. All rights reserved.

Towards maximizing the haze effect of electrodes for high efficiency hybrid tandem solar cell

NASA Astrophysics Data System (ADS)

Vincent, Premkumar; Song, Dong-Seok; Kwon, Hyeok Bin; Kim, Do-Kyung; Jung, Ji-Hoon; Kwon, Jin-Hyuk; Choe, Eunji; Kim, Young-Rae; Kim, Hyeok; Bae, Jin-Hyuk

2018-02-01

In this study, we executed optical simulations to compute the optimum power conversion efficiency (PCE) of a-Si:H/organic photovoltaic (OPV) hybrid tandem solar cell. The maximum ideal short circuit current density (Jsc,max) of the tandem solar cell is initially obtained by optimizing the thickness of the active layer of the OPV subcell for varying thickness of the a-Si:H bottom subcell. To investigate the effect of Haze parameter on the ideal short-circuit current density (Jsc,ideal) of the solar cells, we have varied the haze ratio for the TCO electrode of the a-Si:H subcell in the tandem structure. The haze ratio was obtained for various root mean square (RMS) roughness of the TCO of the front cell. The effect of haze ratio on the Jsc,ideal on the tandem structured solar cell was studied, and the highest Jsc,ideal was obtained at a haze of 55.5% when the thickness of the OPV subcell was 150 nm and that of the a-Si:H subcell was 500 nm.

Cost effectiveness of letrozole versus anastrozole in postmenopausal women with HR+ early-stage breast cancer.

PubMed

Lipsitz, Michael; Delea, Thomas E; Guo, Amy

2010-10-01

The Breast International Group (BIG) 1-98 and Arimidex, Tamoxifen Alone or in Combination (ATAC) trials demonstrated that, in postmenopausal women with hormone receptor positive (HR+) early-stage breast cancer, 5 years of initial adjuvant endocrine therapy with letrozole or anastrozole is superior to tamoxifen. With expected generic availability of anastrozole in July 2010 and letrozole in June 2011, there may be financial pressures prior to letrozole's generic availability to start treatment-naïve patients on anastrozole vs. letrozole or to switch patients already receiving letrozole to anastrozole. A Markov model was used to estimate cost per quality-adjusted life-year (QALY) gained with letrozole vs. anastrozole from the US healthcare system perspective. Cost effectiveness was examined separately in treatment-naïve patients and in patients already receiving letrozole. For the latter, cost effectiveness of continued letrozole vs. therapeutic substitution (TS) to generic anastrozole was evaluated separately in cohorts defined on years of endocrine therapy remaining. TS to generic anastrozole was assumed to result in an additional 5% of patients discontinuing endocrine therapy. Probabilities of distant recurrence and death were taken from reports of BIG 1-98, ATAC, the Early Breast Cancer Trialists' Collaborative Group meta-analysis of tamoxifen, and other published sources. Carry-over effects of aromatase inhibitors were assumed to be proportional to treatment duration. Costs of aromatase inhibitors were assumed to decline by 75% with generic availability. In treatment-naïve patients, total expected lifetime costs are $3916 greater with letrozole vs. anastrozole. However, initiation of treatment with letrozole results in a gain of 0.15 QALYs. Cost per QALY gained with letrozole vs. anastrozole is $25,846. In patients already receiving letrozole, the increase in total expected lifetime costs with continued letrozole vs. TS to anastrozole is between $4200 and $4500 in all cohorts. QALYs gained with letrozole range from 0.21 in those with 4 years of endocrine therapy remaining to 0.13 in those with 1 year of therapy remaining. Cost per QALY gained ranges from $20,276 to $34,356. For postmenopausal women with HR+ early-stage breast cancer, letrozole is more likely to be cost effective vs. anastrozole in treatment-naïve patients and in patients already receiving letrozole. Limitations of the study include a lack of direct evidence comparing letrozole and anastrozole and lack of data on rates of discontinuation due to therapeutic substitution with aromatase inhibitors.

Exponential Sensitivity and its Cost in Quantum Physics

PubMed Central

Gilyén, András; Kiss, Tamás; Jex, Igor

2016-01-01

State selective protocols, like entanglement purification, lead to an essentially non-linear quantum evolution, unusual in naturally occurring quantum processes. Sensitivity to initial states in quantum systems, stemming from such non-linear dynamics, is a promising perspective for applications. Here we demonstrate that chaotic behaviour is a rather generic feature in state selective protocols: exponential sensitivity can exist for all initial states in an experimentally realisable optical scheme. Moreover, any complex rational polynomial map, including the example of the Mandelbrot set, can be directly realised. In state selective protocols, one needs an ensemble of initial states, the size of which decreases with each iteration. We prove that exponential sensitivity to initial states in any quantum system has to be related to downsizing the initial ensemble also exponentially. Our results show that magnifying initial differences of quantum states (a Schrödinger microscope) is possible; however, there is a strict bound on the number of copies needed. PMID:26861076

Exponential Sensitivity and its Cost in Quantum Physics.

PubMed

Gilyén, András; Kiss, Tamás; Jex, Igor

2016-02-10

State selective protocols, like entanglement purification, lead to an essentially non-linear quantum evolution, unusual in naturally occurring quantum processes. Sensitivity to initial states in quantum systems, stemming from such non-linear dynamics, is a promising perspective for applications. Here we demonstrate that chaotic behaviour is a rather generic feature in state selective protocols: exponential sensitivity can exist for all initial states in an experimentally realisable optical scheme. Moreover, any complex rational polynomial map, including the example of the Mandelbrot set, can be directly realised. In state selective protocols, one needs an ensemble of initial states, the size of which decreases with each iteration. We prove that exponential sensitivity to initial states in any quantum system has to be related to downsizing the initial ensemble also exponentially. Our results show that magnifying initial differences of quantum states (a Schrödinger microscope) is possible; however, there is a strict bound on the number of copies needed.

Policies to Enhance Prescribing Efficiency in Europe: Findings and Future Implications

PubMed Central

Godman, Brian; Shrank, William; Andersen, Morten; Berg, Christian; Bishop, Iain; Burkhardt, Thomas; Garuoliene, Kristina; Herholz, Harald; Joppi, Roberta; Kalaba, Marija; Laius, Ott; Lonsdale, Julie; Malmström, Rickard E.; Martikainen, Jaana E.; Samaluk, Vita; Sermet, Catherine; Schwabe, Ulrich; Teixeira, Inês; Tilson, Lesley; Tulunay, F. Cankat; Vlahović-Palčevski, Vera; Wendykowska, Kamila; Wettermark, Bjorn; Zara, Corinne; Gustafsson, Lars L.

2010-01-01

Introduction: European countries need to learn from each other to address unsustainable increases in pharmaceutical expenditures. Objective: To assess the influence of the many supply and demand-side initiatives introduced across Europe to enhance prescribing efficiency in ambulatory care. As a result provide future guidance to countries. Methods: Cross national retrospective observational study of utilization (DDDs – defined daily doses) and expenditure (Euros and local currency) of proton pump inhibitors (PPIs) and statins among 19 European countries and regions principally from 2001 to 2007. Demand-side measures categorized under the “4Es” – education engineering, economics, and enforcement. Results: Instigating supply side initiatives to lower the price of generics combined with demand-side measures to enhance their prescribing is important to maximize prescribing efficiency. Just addressing one component will limit potential efficiency gains. The influence of demand-side reforms appears additive, with multiple initiatives typically having a greater influence on increasing prescribing efficiency than single measures apart from potentially “enforcement.” There are also appreciable differences in expenditure (€/1000 inhabitants/year) between countries. Countries that have not introduced multiple demand side measures to counteract commercial pressures to enhance the prescribing of generics have seen considerably higher expenditures than those that have instigated a range of measures. Conclusions: There are considerable opportunities for European countries to enhance their prescribing efficiency, with countries already learning from each other. The 4E methodology allows European countries to concisely capture the range of current demand-side measures and plan for the future knowing that initiatives can be additive to further enhance their prescribing efficiency. PMID:21833180

Large-eddy simulations of mechanical and thermal processes within boundary layer of the Graciosa Island

NASA Astrophysics Data System (ADS)

Sever, G.; Collis, S. M.; Ghate, V. P.

2017-12-01

Three-dimensional numerical experiments are performed to explore the mechanical and thermal impacts of Graciosa Island on the sampling of oceanic airflow and cloud evolution. Ideal and real configurations of flow and terrain are planned using high-resolution, large-eddy resolving (e.g., Δ < 100 meter) simulations. Ideal configurations include model initializations with ideal dry and moist temperature and wind profiles to capture flow features over an island-like topography. Real configurations will use observations from different climatological background states over the Eastern Northern Atlantic, Atmospheric Radiation Measurement (ENA-ARM) site on Graciosa Island. Initial small-domain large-eddy simulations (LES) of dry airflow produce cold-pool formation upstream of an ideal two-kilometer island, with von Kármán like vortices propagation downstream. Although the peak height of Graciosa is less than half kilometer, the Azores island chain has a mountain over 2 km, which may be leading to more complex flow patterns when simulations are extended to a larger domain. Preliminary idealized low-resolution moist simulations indicate that the cloud field is impacted due to the presence of the island. Longer simulations that are performed to capture diurnal evolution of island boundary layer show distinct land/sea breeze formations under quiescent flow conditions. Further numerical experiments are planned to extend moist simulations to include realistic atmospheric profiles and observations of surface fluxes coupled with radiative effects. This work is intended to produce a useful simulation framework coupled with instruments to guide airborne and ground sampling strategies during the ACE-ENA field campaign which is aimed to better characterize marine boundary layer clouds.

Cost of non-persistence with oral bisphosphonates in post-menopausal osteoporosis treatment in France

PubMed Central

2011-01-01

Background During the last decade, oral bisphosphonates (BP) became the most widely prescribed pharmacologic class for post-menopausal osteoporosis. However, many surveys revealed the important issue of poor persistence with those drugs resulting in a failure of treatment to reduce fracture risk sufficiently. Using a published Markov model, this study analyses the economic impact of non-persistence with bisphosphonates in the context of the introduction of generics in France. Methods Direct costs of vertebral, hip and wrist fracture were assessed and included in an existing 10-year Markov model developed to analyse consequences of non-persistence. Three alternatives of comparison were set: no treatment, real-world persistence, and ideal persistence. Simulated patients' characteristics matched those from a French observational study and the real-world adherence alternative employed persistence data from published database analysis. The risk of fracture of menopausal women and the risk reduction associated with the drugs were based on results reported in clinical trials. Incremental cost-effectiveness ratios (ICERs) were calculated first between real-world adherence and no treatment alternatives, and second between ideal and real-world persistence alternatives. The cost of non-persistence was defined as the difference between total cost of ideal and real-world persistence alternatives. Results Within fractured women population, mean costs of 10-year management of fracture were significantly different between the three alternatives with €7,239 (± €4,783), €6,711 (± €4,410) and €6,134 (± €3,945) in the no-treatment, the real-world and ideal persistence alternatives, respectively (p < 0.0001). Cost-effectiveness ratio for real-world treatment persistence compared with no-treatment alternative was found dominant and as well, alternative of ideal persistence dominated the former. Each ten percentage point of persistence gain amounted to €58 per patient, and extrapolation resulted in a global annual cost of non-persistence of over €30 million to the French health care system, with a substantial transfer from hospital to pharmacy budgets. Conclusion Within term, improving persistence with oral bisphosphonates should be economically dominant on levels currently known in real-world. Given this potential savings, ambitious adherence-enhancing interventions should be considered in osteoporotic patients. PMID:21702989

Decay Rates and Probability Estimatesfor Massive Dirac Particlesin the Kerr-Newman Black Hole Geometry

NASA Astrophysics Data System (ADS)

Finster, F.; Kamran, N.; Smoller, J.; Yau, S.-T.

The Cauchy problem is considered for the massive Dirac equation in the non-extreme Kerr-Newman geometry, for smooth initial data with compact support outside the event horizon and bounded angular momentum. We prove that the Dirac wave function decays in L∞ {loc} at least at the rate t-5/6. For generic initial data, this rate of decay is sharp. We derive a formula for the probability p that the Dirac particle escapes to infinity. For various conditions on the initial data, we show that p = 0, 1 or 0 < p < 1. The proofs are based on a refined analysis of the Dirac propagator constructed in [4].

Design and Economic Potential of an Integrated High-Temperature Fuel Cell and Absorption Chiller Combined Cooling, Heat, and Power System

NASA Astrophysics Data System (ADS)

Hosford, Kyle S.

Clean distributed generation power plants can provide a much needed balance to our energy infrastructure in the future. A high-temperature fuel cell and an absorption chiller can be integrated to create an ideal combined cooling, heat, and power system that is efficient, quiet, fuel flexible, scalable, and environmentally friendly. With few real-world installations of this type, research remains to identify the best integration and operating strategy and to evaluate the economic viability and market potential of this system. This thesis informs and documents the design of a high-temperature fuel cell and absorption chiller demonstration system at a generic office building on the University of California, Irvine (UCI) campus. This work details the extension of prior theoretical work to a financially-viable power purchase agreement (PPA) with regard to system design, equipment sizing, and operating strategy. This work also addresses the metering and monitoring for the system showcase and research and details the development of a MATLAB code to evaluate the economics associated with different equipment selections, building loads, and economic parameters. The series configuration of a high-temperature fuel cell, heat recovery unit, and absorption chiller with chiller exhaust recirculation was identified as the optimal system design for the installation in terms of efficiency, controls, ducting, and cost. The initial economic results show that high-temperature fuel cell and absorption chiller systems are already economically competitive with utility-purchased generation, and a brief case study of a southern California hospital shows that the systems are scalable and viable for larger stationary power applications.

Effective-one-body model for black-hole binaries with generic mass ratios and spins

NASA Astrophysics Data System (ADS)

Taracchini, Andrea; Buonanno, Alessandra; Pan, Yi; Hinderer, Tanja; Boyle, Michael; Hemberger, Daniel A.; Kidder, Lawrence E.; Lovelace, Geoffrey; Mroué, Abdul H.; Pfeiffer, Harald P.; Scheel, Mark A.; Szilágyi, Béla; Taylor, Nicholas W.; Zenginoglu, Anil

2014-03-01

Gravitational waves emitted by black-hole binary systems have the highest signal-to-noise ratio in LIGO and Virgo detectors when black-hole spins are aligned with the orbital angular momentum and extremal. For such systems, we extend the effective-one-body inspiral-merger-ringdown waveforms to generic mass ratios and spins calibrating them to 38 numerical-relativity nonprecessing waveforms produced by the SXS Collaboration. The numerical-relativity simulations span mass ratios from 1 to 8, spin magnitudes up to 98% of extremality, and last for 40 to 60 gravitational-wave cycles. When the total mass of the binary is between 20 and 200M⊙, the effective-one-body nonprecessing (dominant mode) waveforms have overlap above 99% (using the advanced-LIGO design noise spectral density) with all of the 38 nonprecessing numerical waveforms, when maximizing only on initial phase and time. This implies a negligible loss in event rate due to modeling. We also show that—without further calibration— the precessing effective-one-body (dominant mode) waveforms have overlap above 97% with two very long, strongly precessing numerical-relativity waveforms, when maximizing only on the initial phase and time.

Evidence-Based Evaluation of Practice and Innovation in Physical Therapy Using the IDEAL-Physio Framework.

PubMed

Beard, David; Hamilton, David; Davies, Loretta; Cook, Jonathan; Hirst, Allison; McCulloch, Peter; Paez, Arsenio

2018-02-01

The IDEAL framework is an established method for initial and ongoing evaluations of innovation and practice for complex health care interventions. First derived for surgical sciences and embedded at a global level for evaluating surgery/surgical devices, the IDEAL framework is based on the principle that innovation and evaluation in clinical practice can, and should, evolve together in an ordered manner: from conception to development and then to validation by appropriate clinical studies and, finally, longer-term follow-up. This framework is highly suited to other complex, nonpharmacological interventions, such as physical therapist interventions. This perspective outlines the application of IDEAL to physical therapy in the new IDEAL-Physio framework. The IDEAL-Physio framework comprises 5 stages. In stage 1, the idea phase, formal data collection should begin. Stage 2a is the phase for iterative improvement and adjustment with thorough data recording. Stage 2b involves the onset of formal evaluation using systematically collected group or cohort data. Stage 3 is the phase for formal comparative assessment of treatment, usually involving randomized studies. Stage 4 involves long-term follow-up. The IDEAL-Physio framework is recommended as a method for guiding and evaluating both innovation and practice in physical therapy, with the overall goal of providing better evidence-based care. © 2017 American Physical Therapy Association.

Preparing Adolescents With Chronic Disease for Transition to Adult Care: A Technology Program

PubMed Central

Terrones, Laura; Tompane, Trevor; Dillon, Lindsay; Pian, Mark; Gottschalk, Michael; Norman, Gregory J.; Bartholomew, L. Kay

2014-01-01

BACKGROUND: Adolescents with chronic disease (ACD) must develop independent disease self-management and learn to communicate effectively with their health care team to transition from pediatric to adult-oriented health care systems. Disease-specific interventions have been implemented to aid specific ACD groups through transition. A generic approach might be effective and cost-saving. METHODS: Eighty-one ACD, aged 12 to 20 years, were recruited for a randomized clinical trial evaluating an 8-month transition intervention (MD2Me). MD2Me recipients received a 2-month intensive Web-based and text-delivered disease management and skill-based intervention followed by a 6-month review period. MD2Me recipients also had access to a texting algorithm for disease assessment and health care team contact. The intervention was applicable to adolescents with diverse chronic illnesses. Controls received mailed materials on general health topics. Disease management, health-related self-efficacy, and health assessments were performed at baseline and at 2 and 8 months. Frequency of patient-initiated communications was recorded over the study period. Outcomes were analyzed according to assigned treatment group over time. RESULTS: MD2Me recipients demonstrated significant improvements in performance of disease management tasks, health-related self-efficacy, and patient-initiated communications compared with controls. CONCLUSIONS: Outcomes in ACD improved significantly among recipients of a generic, technology-based intervention. Technology can deliver transition interventions to adolescents with diverse chronic illnesses, and a generic approach offers a cost-effective means of positively influencing transition outcomes. Further research is needed to determine whether improved short-term outcomes translate into an improved transition for ACD. PMID:24843066

Adherence to thyroid hormone replacement therapy: a retrospective, claims database analysis.

PubMed

Hepp, Zsolt; Wyne, Kathleen; Manthena, Shivaji R; Wang, Siting; Gossain, Ved

2018-06-25

The objective of this analysis was to compare adherence at 6 months and 12 months across levothyroxine formulations for patients with hypothyroidism. This retrospective analysis utilized insurance claims data from a commercially insured population from January 1, 2000 through March 31, 2016. Patients were included if they were diagnosed with hypothyroidism and initiated treatment with generic levothyroxine, Levoxyl, Synthroid, Unithroid, or Tirosint. Patients were excluded if they were younger than age 18, were diagnosed with thyroid cancer, received a prescription for liothyronine, or did not have continuous insurance coverage over the study period. Adherence, defined by the proportion of days covered (PDC) ≥ 80%, was examined using multivariable analyses for both 6 and 12 months post-initiation on therapy Results: The study identified 580,331 patients who fit the study criteria. At 6 months, 40.3% of patients were found to be non-adherent, while 51.9% were non-adherent at 12 months. Synthroid was associated with significantly higher adherence compared to all other levothyroxine formulations at both 6 and 12 months. Compared to generic levothyroxine, the likelihood of being adherent at 12 months was highest for Synthroid (OR = 1.44; 95% CI = 1.43-1.46), followed by Levoxyl (OR = 1.20 95% CI = 1.17-1.23). Tirosint and Unithroid were associated with significantly lower adherence at 12 months compared to generic levothyroxine (OR = 0.65; 95% CI = 0.57-0.75 and OR = 0.79; 95% CI = 0.71-0.89, respectively). This large, retrospective real-world study demonstrated that adherence to levothyroxine remains a concern among patients with hypothyroidism, and that differences in adherence may exist across levothyroxine formulations.

Preparing adolescents with chronic disease for transition to adult care: a technology program.

PubMed

Huang, Jeannie S; Terrones, Laura; Tompane, Trevor; Dillon, Lindsay; Pian, Mark; Gottschalk, Michael; Norman, Gregory J; Bartholomew, L Kay

2014-06-01

Adolescents with chronic disease (ACD) must develop independent disease self-management and learn to communicate effectively with their health care team to transition from pediatric to adult-oriented health care systems. Disease-specific interventions have been implemented to aid specific ACD groups through transition. A generic approach might be effective and cost-saving. Eighty-one ACD, aged 12 to 20 years, were recruited for a randomized clinical trial evaluating an 8-month transition intervention (MD2Me). MD2Me recipients received a 2-month intensive Web-based and text-delivered disease management and skill-based intervention followed by a 6-month review period. MD2Me recipients also had access to a texting algorithm for disease assessment and health care team contact. The intervention was applicable to adolescents with diverse chronic illnesses. Controls received mailed materials on general health topics. Disease management, health-related self-efficacy, and health assessments were performed at baseline and at 2 and 8 months. Frequency of patient-initiated communications was recorded over the study period. Outcomes were analyzed according to assigned treatment group over time. MD2Me recipients demonstrated significant improvements in performance of disease management tasks, health-related self-efficacy, and patient-initiated communications compared with controls. Outcomes in ACD improved significantly among recipients of a generic, technology-based intervention. Technology can deliver transition interventions to adolescents with diverse chronic illnesses, and a generic approach offers a cost-effective means of positively influencing transition outcomes. Further research is needed to determine whether improved short-term outcomes translate into an improved transition for ACD. Copyright © 2014 by the American Academy of Pediatrics.

Restructurable VLSI Program

DTIC Science & Technology

1981-03-31

logic testing element and a concomitant testability criterion ideally suited to dynamic circuit applications and appro- priate for automatic computer...making connections automatically . PF is an experimental feature which provides users with only four different chip sizes (full, half, quarter, and eighth...initial solution is found constructively which is improved by pair-wise swapping. Results show, however, that the constructive initial sorter , which

Molecular Simulations of Shear-Induced Dynamics in Nitromethane

DTIC Science & Technology

2016-09-01

initially staggered along the y axis, and then after the crystal is sheared b), the NM molecules are rotated to orient themselves in the same... rotation of the grain. ...............................................................................8 List of Tables Table 1 Summary of the maximum...it an ideal candidate to study chemical reaction mechanisms associated with conventional explosive initiation and subsequent detonation .3,6,7

Comparison of generic-to-brand switchback patterns for generic and authorized generic drugs

PubMed Central

Hansen, Richard A.; Qian, Jingjing; Berg, Richard; Linneman, James; Seoane-Vazquez, Enrique; Dutcher, Sarah K.; Raofi, Saeid; Page, C. David; Peissig, Peggy

2018-01-01

Background While generic drugs are therapeutically equivalent to brand drugs, some patients and healthcare providers remain uncertain about whether they produce identical outcomes. Authorized generics, which are identical in formulation to corresponding brand drugs but marketed as a generic, provide a unique post-marketing opportunity to study whether utilization patterns are influenced by perceptions of generic drugs. Objectives To compare generic-to-brand switchback rates between generics and authorized generics. Methods A retrospective cohort study was conducted using claims and electronic health records data from a regional U.S. healthcare system. Ten drugs with authorized generics and generics marketed between 1999 and 2014 were evaluated. Eligible adult patients received a brand drug during the 6 months preceding generic entry, and then switched to a generic or authorized generic. Patients in this cohort were followed for up to 30 months from the index switch date to evaluate occurrence of generic-to-brand switchbacks. Switchback rates were compared between patients on authorized generics versus generics using Kaplan-Meier curves and Cox proportional hazards models, controlling for individual drug effects, age, sex, Charlson comorbidity score, pre-index drug use characteristics, and pre-index healthcare utilization. Results Among 5,542 unique patients that switched from brand-to-generic or brand-to-authorized generic, 264 (4.8%) switched back to the brand drug. Overall switchback rates were similar for authorized generics compared with generics (HR=0.86; 95% CI 0.65-1.15). The likelihood of switchback was higher for alendronate (HR=1.64; 95% CI 1.20-2.23) and simvastatin (HR=1.81; 95% CI 1.30-2.54) and lower for amlodipine (HR=0.27; 95% CI 0.17-0.42) compared with other drugs in the cohort. Conclusions Overall switchback rates were similar between authorized generic and generic drug users, indirectly supporting similar efficacy and tolerability profiles for brand and generic drugs. Reasons for differences in switchback rates among specific products need to be further explored. PMID:28152215

Analysis of generic reentry vehicle flight dynamics

NASA Astrophysics Data System (ADS)

Metsker, Yu.; Weinand, K.; Geulen, G.; Haidn, O. J.

2018-06-01

The knowledge of reentry vehicles (RV) flight characteristics regarding geometrical shape, dimensions, and mechanical properties is essential for precise prediction of their flight trajectory, impact point, and possible deviations according to simulation uncertainties. The flight characteristic estimations of existing RV require both body dimensions and mechanical properties of the objects. Due to comparatively simple and reliable methods of specifying the vehicle outer dimensions, e. g., photos and videomaterials, the estimation of mechanical properties is a subject of higher uncertainties. Within this study, a generic medium range ballistic missile (MRBM) RV was examined for several modifications such as center of gravity (CoG) position, weight moment of inertia, and initial reentry flight states. Combinations of these variables with constant aerodynamic properties for maximal lateral accelerations will be determined. Basing on these, potential evasion maneuver capabilities of the RV will be described.

Model Development for VDE Computations in NIMROD

NASA Astrophysics Data System (ADS)

Bunkers, K. J.; Sovinec, C. R.

2017-10-01

Vertical displacement events (VDEs) and the disruptions associated with them have potential for causing considerable physical damage to ITER and other tokamak experiments. We report on simulations of generic axisymmetric VDEs and a vertically unstable case from Alcator C-MOD using the NIMROD code. Previous calculations have been done with closures for heat flux and viscous stress. Initial calculations show that halo current width is dependent on temperature boundary conditions, and so transport together with plasma-surface interaction may play a role in determining halo currents in experiments. The behavior of VDEs with Braginskii thermal conductivity and viscosity closures and Spitzer-like resistivity are investigated for both the generic axisymmetric VDE case and the C-MOD case. This effort is supported by the U.S. Dept. of Energy, Award Numbers DE-FG02-06ER54850 and DE-FC02-08ER54975.

Broken Ergodicity in Two-Dimensional Homogeneous Magnetohydrodynamic Turbulence

NASA Technical Reports Server (NTRS)

Shebalin, John V.

2010-01-01

Two-dimensional (2-D) homogeneous magnetohydrodynamic (MHD) turbulence has many of the same qualitative features as three-dimensional (3-D) homogeneous MHD turbulence.The se features include several ideal invariants, along with the phenomenon of broken ergodicity. Broken ergodicity appears when certain modes act like random variables with mean values that are large compared to their standard deviations, indicating a coherent structure or dynamo.Recently, the origin of broken ergodicity in 3-D MHD turbulence that is manifest in the lowest wavenumbers was explained. Here, a detailed description of the origins of broken ergodicity in 2-D MHD turbulence is presented. It will be seen that broken ergodicity in ideal 2-D MHD turbulence can be manifest in the lowest wavenumbers of a finite numerical model for certain initial conditions or in the highest wavenumbers for another set of initial conditions.T he origins of broken ergodicity in ideal 2-D homogeneous MHD turbulence are found through an eigen analysis of the covariance matrices of the modal probability density functions.It will also be shown that when the lowest wavenumber magnetic field becomes quasi-stationary, the higher wavenumber modes can propagate as Alfven waves on these almost static large-scale magnetic structures

Anomalous scaling of Δ C versus T c in the Fe-based superconductors: the $${S}_{\\pm }$$-wave pairing state model

DOE PAGES

Bang, Yunkyu; Stewart, G. R.

2016-02-01

The strong power law behavior of the specific heat jumpmore » $${\\rm{\\Delta }}C\\;$$ versus T c $$({\\rm{\\Delta }}C/{T}_{{\\rm{c}}}\\sim {T}_{{\\rm{c}}}^{\\alpha },\\alpha \\approx 2)$$, first observed by Bud'ko et al (2009 Phys. Rev. B 79 220516), has been confirmed with several families of the Fe-based superconducting compounds with various dopings. We tested a minimal two band BCS model to understand this anomalous behavior and showed that this non-BCS relation between $${\\rm{\\Delta }}C\\;$$ versus T c is a generic property of the multiband superconducting state paired by a dominant interband interaction ($${V}_{\\mathrm{inter}}\\gt {V}_{\\mathrm{intra}}$$) reflecting the relation $$\\frac{{{\\rm{\\Delta }}}_{{\\rm{h}}}}{{{\\rm{\\Delta }}}_{{\\rm{e}}}}\\sim \\sqrt{\\frac{{N}_{{\\rm{e}}}}{{N}_{{\\rm{h}}}}}$$ near T c, as in the $${S}_{\\pm }$$-wave pairing state. We also found that this $${\\rm{\\Delta }}C\\;$$ versus T c power law can continuously change from the ideal BNC scaling to a considerable deviation by a moderate variation of the impurity scattering rate $${{\\rm{\\Gamma }}}_{0}$$ (non-pair-breaking). Finally, as a result, our model provides a consistent explanation why the electron-doped Fe-based superconductors follow the ideal BNC scaling very well while the hole-doped systems often show varying degree of deviations.« less

Ideal hydrodynamics and elliptic flow at CERN Super Proton Synchrotron (SPS) energies: Importance of the initial conditions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Petersen, Hannah; Institut fuer Theoretische Physik, Johann Wolfgang Goethe-Universitaet, Max-von-Laue-Str. 1, D-60438 Frankfurt am Main; Bleicher, Marcus

2009-05-15

The elliptic flow excitation function calculated in a full (3+1) dimensional hybrid Boltzmann approach with an intermediate hydrodynamic stage for heavy ion reactions from GSI Schwerionen Synchrotron to the highest CERN Super Proton Synchrotron (SPS) energies is discussed in the context of the experimental data. In this study, we employ a hadron gas equation of state to investigate the differences in the dynamics and viscosity effects. The specific event-by-event setup with initial conditions and freeze-out from a nonequilibrium transport model allows for a direct comparison between ideal fluid dynamics and transport simulations. At higher SPS energies, where the pure transportmore » calculation cannot account for the high elliptic flow values, the smaller mean free path in the hydrodynamic evolution leads to higher elliptic flow values. In contrast to previous studies within pure hydrodynamics, the more realistic initial conditions employed here and the inclusion of a sequential final state hadronic decoupling provides results that are in line with the experimental data almost over the whole energy range from E{sub lab}=2-160A GeV. Thus, this new approach leads to a substantially different shape of the v{sub 2}/{epsilon} scaling curve as a function of (1/SdN{sub ch}/dy) in line with the experimental data compared to previous ideal hydrodynamic calculations. This hints at a strong influence of the initial conditions for the hydrodynamic evolution on the finally observed v{sub 2} values, thus questioning the standard interpretation that the hydrodynamic limit is only reached at BNL Relativistic Heavy Ion Collider energies.« less

Authorized generic drugs, price competition, and consumers' welfare.

PubMed

Berndt, Ernst R; Mortimer, Richard; Bhattacharjya, Ashoke; Parece, Andrew; Tuttle, Edward

2007-01-01

The growing frequency of authorized generics has important implications for the welfare of prescription drug consumers. Authorized generic entry could affect the timing of generic entry, brand-name and generic prices, and generic penetration. We reviewed 1999-2003 data and found that generic entry in the absence of short-run exclusivity restrictions benefits consumers through lower short-run prices. We suggest that these benefits likely also result from authorized generics. We posit that long-run prices and shares are likely essentially unaffected by authorized generics and that potential costs to consumers from any delayed generic entry are likely small.

The impact of social cognitive variables on the initial level of depression and recovery.

PubMed

Lam, D H; Green, B; Power, M J; Checkley, S

1994-10-01

Thirty-seven patients who fulfilled DSM-III-R criteria for Major Depressive Disorder were recruited for a double-blind controlled trial of Desipramine and placebo for 6 weeks. Data about social cognitive variables, including social adversities, investment in roles and goals, general social support and crisis support were collected. Crisis support had a moderating effect on the initial level of depression: the more crisis support the subjects had, the less depressed they were on recruitment. Initial level of depression, the experience of adversity and drugs all contributed significantly to recovery defined as Hamilton Rating for Depression less than 10 at week 6. When recovery was defined as Hamilton score halved or more than halved between week 2 and week 6, subjects' level of ideal emotional support, and whether they had experienced adversity in their most invested domains, contributed significantly to recovery, independent of any drug effects or the initial level of depression. The higher their level of ideal emotional support, the less was the chance of these subjects recovering. The findings of this study pointed to the importance of controlling for psycho-social variables in studies of response to treatment.

Cost-effectiveness of hepatitis C treatment using generic direct-acting antivirals available in India

PubMed Central

Aggarwal, Rakesh; Chen, Qiushi; Goel, Amit; Seguy, Nicole; Pendse, Razia; Ayer, Turgay

2017-01-01

Background & aims Availability of directly-acting antivirals (DAAs) has changed the treatment landscape of hepatitis C virus (HCV) infection. The high price of DAAs has restricted their use in several countries. However, in some countries such as India, generic DAAs are available at much cheaper price. This study examined whether generic DAAs could be cost-saving and how long it would take for the treatment to become cost-saving/effective. Methods A previously-validated, mathematical model was adapted to the HCV-infected population in India to compare the outcomes of no treatment versus treatment with DAAs. Model parameters were estimated from published studies. Cost-effectiveness of HCV treatment using available DAAs was calculated, using a payer’s perspective. We estimated quality-adjusted life years (QALYs), disability-adjusted life years (DALYs), total costs, and incremental cost-effectiveness ratio of DAAs versus no treatment. One-way and probabilistic sensitivity analyses were conducted. Results Compared with no treatment, the use of generic DAAs in Indian HCV patients would increase the life expectancy by 8.02 years, increase QALYs by 3.89, avert 19.07 DALYs, and reduce the lifetime healthcare costs by $1,309 per-person treated. Treatment became cost-effective within 2 years, and cost-saving within 10 years of its initiation overall and within 5 years in persons with cirrhosis. Treating 10,000 HCV-infected persons could prevent 3400–3850 decompensated cirrhosis, 1800–2500 HCC, and 4000–4550 liver-related deaths. The results were sensitive to the costs of DAAs, pre- and post-treatment diagnostic tests and management of cirrhosis, and quality of life after sustained virologic response. Conclusions Treatment with generic DAAs available in India will improve patient outcomes, provide a good value for money within 2 years, and be ultimately cost-saving. Therefore, in this and similar settings, HCV treatment should be a priority from a public health as well an economic perspective. PMID:28520728

Cost-effectiveness of hepatitis C treatment using generic direct-acting antivirals available in India.

PubMed

Aggarwal, Rakesh; Chen, Qiushi; Goel, Amit; Seguy, Nicole; Pendse, Razia; Ayer, Turgay; Chhatwal, Jagpreet

2017-01-01

Availability of directly-acting antivirals (DAAs) has changed the treatment landscape of hepatitis C virus (HCV) infection. The high price of DAAs has restricted their use in several countries. However, in some countries such as India, generic DAAs are available at much cheaper price. This study examined whether generic DAAs could be cost-saving and how long it would take for the treatment to become cost-saving/effective. A previously-validated, mathematical model was adapted to the HCV-infected population in India to compare the outcomes of no treatment versus treatment with DAAs. Model parameters were estimated from published studies. Cost-effectiveness of HCV treatment using available DAAs was calculated, using a payer's perspective. We estimated quality-adjusted life years (QALYs), disability-adjusted life years (DALYs), total costs, and incremental cost-effectiveness ratio of DAAs versus no treatment. One-way and probabilistic sensitivity analyses were conducted. Compared with no treatment, the use of generic DAAs in Indian HCV patients would increase the life expectancy by 8.02 years, increase QALYs by 3.89, avert 19.07 DALYs, and reduce the lifetime healthcare costs by $1,309 per-person treated. Treatment became cost-effective within 2 years, and cost-saving within 10 years of its initiation overall and within 5 years in persons with cirrhosis. Treating 10,000 HCV-infected persons could prevent 3400-3850 decompensated cirrhosis, 1800-2500 HCC, and 4000-4550 liver-related deaths. The results were sensitive to the costs of DAAs, pre- and post-treatment diagnostic tests and management of cirrhosis, and quality of life after sustained virologic response. Treatment with generic DAAs available in India will improve patient outcomes, provide a good value for money within 2 years, and be ultimately cost-saving. Therefore, in this and similar settings, HCV treatment should be a priority from a public health as well an economic perspective.

Application of Gene Expression Trajectories Initiated from ErbB Receptor Activation Highlights the Dynamics of Divergent Promoter Usage.

PubMed

Carbajo, Daniel; Magi, Shigeyuki; Itoh, Masayoshi; Kawaji, Hideya; Lassmann, Timo; Arner, Erik; Forrest, Alistair R R; Carninci, Piero; Hayashizaki, Yoshihide; Daub, Carsten O; Okada-Hatakeyama, Mariko; Mar, Jessica C

2015-01-01

Understanding how cells use complex transcriptional programs to alter their fate in response to specific stimuli is an important question in biology. For the MCF-7 human breast cancer cell line, we applied gene expression trajectory models to identify the genes involved in driving cell fate transitions. We modified trajectory models to account for the scenario where cells were exposed to different stimuli, in this case epidermal growth factor and heregulin, to arrive at different cell fates, i.e. proliferation and differentiation respectively. Using genome-wide CAGE time series data collected from the FANTOM5 consortium, we identified the sets of promoters that were involved in the transition of MCF-7 cells to their specific fates versus those with expression changes that were generic to both stimuli. Of the 1,552 promoters identified, 1,091 had stimulus-specific expression while 461 promoters had generic expression profiles over the time course surveyed. Many of these stimulus-specific promoters mapped to key regulators of the ERK (extracellular signal-regulated kinases) signaling pathway such as FHL2 (four and a half LIM domains 2). We observed that in general, generic promoters peaked in their expression early on in the time course, while stimulus-specific promoters tended to show activation of their expression at a later stage. The genes that mapped to stimulus-specific promoters were enriched for pathways that control focal adhesion, p53 signaling and MAPK signaling while generic promoters were enriched for cell death, transcription and the cell cycle. We identified 162 genes that were controlled by an alternative promoter during the time course where a subset of 37 genes had separate promoters that were classified as stimulus-specific and generic. The results of our study highlighted the degree of complexity involved in regulating a cell fate transition where multiple promoters mapping to the same gene can demonstrate quite divergent expression profiles.

Might generic OCs create contraceptive price war?

PubMed

1987-02-01

Genora 1/35 and 1/50, the 1st generic oral contraceptives (OCs) in the world, are now being marketed in the US. Clinicians interviewed by "Contraceptive Technology Update" (CTU) offer differing opinions as to what this new OC may mean in the marketplace. Products of Rugby Laboratories, the pills are copy products of Ortho Pharmaceutical's ON 1/35 and ON 1/50 formulations. Most clinicians believe that Genora's success or failure in the OC market depends on its eventual retail price. The price difference of $3-$4 may be sufficiently substantial for retailers to charge less for the generic OCs. If that is the case, many doctors may prescribe a pill which will save their patients $4/month. Dr. Mildred Hanson, a Minneapolis gynecologist/obstetrician, feels any cost savings from Genora will have a significant impact on the OC market. She suggests that the less expensive OCs will catch the attention of health maintenance organizations (HMOs) and the business of women who participate in such health plans. Yet James Burns, director of family planning services for the Hartford City Health Department, thinks that even a full-scale retail price war won't have much effect from a clinic standpoint. He reports that clinics are able to obtain contraceptive supplies rather inexpensively through the contracting system. Hanson also expressed doubt over the potential popularity of Genora 1/50 as clinical concerns about the effects of combined OCs on serum lipid levels and carbohydrate metabolism have resulted in a nationwide push toward OCs containing less than 50 micrograms of estrogen. He indicated concern that declines in pharmaceutical house products from pricing competition with generic pills might have a negative impact on contraceptive research and development. Dick Haskitt, director of business planning for Syntex Laboratories, Inc., who will produce the OCs for Rugby, reports that their market research shows that people are very interested in having a generic OC available. Initially, Genora will be marketed only to retail pharmacies, wholesalers, and drug chains.

Application of process mapping to understand integration of high risk medicine care bundles within community pharmacy practice.

PubMed

Weir, Natalie M; Newham, Rosemary; Corcoran, Emma D; Ali Atallah Al-Gethami, Ashwag; Mohammed Abd Alridha, Ali; Bowie, Paul; Watson, Anne; Bennie, Marion

2017-11-21

The Scottish Patient Safety Programme - Pharmacy in Primary Care collaborative is a quality improvement initiative adopting the Institute of Healthcare Improvement Breakthrough Series collaborative approach. The programme developed and piloted High Risk Medicine (HRM) Care Bundles (CB), focused on warfarin and non-steroidal anti-inflammatories (NSAIDs), within 27 community pharmacies over 4 NHS Regions. Each CB involves clinical assessment and patient education, although the CB content varies between regions. To support national implementation, this study aims to understand how the pilot pharmacies integrated the HRM CBs into routine practice to inform the development of a generic HRM CB process map. Regional process maps were developed in 4 pharmacies through simulation of the CB process, staff interviews and documentation of resources. Commonalities were collated to develop a process map for each HRM, which were used to explore variation at a national event. A single, generic process map was developed which underwent validation by case study testing. The findings allowed development of a generic process map applicable to warfarin and NSAID CB implementation. Five steps were identified as required for successful CB delivery: patient identification; clinical assessment; pharmacy CB prompt; CB delivery; and documentation. The generic HRM CB process map encompasses the staff and patients' journey and the CB's integration into routine community pharmacy practice. Pharmacist involvement was required only for clinical assessment, indicating suitability for whole-team involvement. Understanding CB integration into routine practice has positive implications for successful implementation. The generic process map can be used to develop targeted resources, and/or be disseminated to facilitate CB delivery and foster whole team involvement. Similar methods could be utilised within other settings, to allow those developing novel services to distil the key processes and consider their integration within routine workflows to effect maximal, efficient implementation and benefit to patient care. Copyright © 2017 Elsevier Inc. All rights reserved.

Scalable synthesis and post-modification of a mesoporous metal-organic framework called NU-1000

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Timothy C.; Vermeulen, Nicolaas A.; Kim, In Soo

The synthesis of NU-1000, a mesoporous metal-organic framework (MOF), can be conducted efficiently on a multigram scale from inexpensive starting materials. NU-1000 has been reported as an excellent candidate for gas separation and catalysis. In particular, it is ideal for the catalytic deactivation of nerve agents and shows great promise as a new generic platform for a wide range of applications. Multiple post-synthetic modification protocols have been developed using NU-1000 as the parent material, making it a potentially useful scaffold for several catalytic applications. The procedure for the preparation of NU-1000 can be scaled up reliably, and it is suitablemore » for the production of 50 g of the tetracarboxylic acid containing organic linker and 200 mg–2.5 g of NU-1000. Lastly, the entire synthesis is performed without purification by column chromatography and can be completed within 10 d.« less

Drivers for renewal and reform of contemporary nursing curricula: a blueprint for change.

PubMed

Waters, Cheryl Denise; Rochester, Suzanne Freda; McMillan, Margaret Anna

2012-06-01

The creation of a curriculum blueprint appropriate to the development of a professional nurse who is practice-ready for the current and future context of health service delivery must take account of the extant context as well as an unpredictable and sometimes ambiguous future. The curriculum renewal process itself ought to challenge existing long held ideals, practices, and sacred cows within the health and higher education sectors. There is much to consider and importantly curriculum developers need to be mindful of reform within the health sector and health workforce education, as well as the concomitant vision and requirements of the nursing profession. Curriculum must develop more than discipline knowledge and skills: it must provide an infrastructure for generic abilities both social and intellectual in order to better prepare students for the registered nurse role. This paper discusses a number of forces that are essential to consider in curriculum development in undergraduate nursing education.

Scalable synthesis and post-modification of a mesoporous metal-organic framework called NU-1000

DOE PAGES

Wang, Timothy C.; Vermeulen, Nicolaas A.; Kim, In Soo; ...

2015-12-17

The synthesis of NU-1000, a mesoporous metal-organic framework (MOF), can be conducted efficiently on a multigram scale from inexpensive starting materials. NU-1000 has been reported as an excellent candidate for gas separation and catalysis. In particular, it is ideal for the catalytic deactivation of nerve agents and shows great promise as a new generic platform for a wide range of applications. Multiple post-synthetic modification protocols have been developed using NU-1000 as the parent material, making it a potentially useful scaffold for several catalytic applications. The procedure for the preparation of NU-1000 can be scaled up reliably, and it is suitablemore » for the production of 50 g of the tetracarboxylic acid containing organic linker and 200 mg–2.5 g of NU-1000. Lastly, the entire synthesis is performed without purification by column chromatography and can be completed within 10 d.« less

The elusive Heisenberg limit in quantum-enhanced metrology

PubMed Central

Demkowicz-Dobrzański, Rafał; Kołodyński, Jan; Guţă, Mădălin

2012-01-01

Quantum precision enhancement is of fundamental importance for the development of advanced metrological optical experiments, such as gravitational wave detection and frequency calibration with atomic clocks. Precision in these experiments is strongly limited by the 1/√N shot noise factor with N being the number of probes (photons, atoms) employed in the experiment. Quantum theory provides tools to overcome the bound by using entangled probes. In an idealized scenario this gives rise to the Heisenberg scaling of precision 1/N. Here we show that when decoherence is taken into account, the maximal possible quantum enhancement in the asymptotic limit of infinite N amounts generically to a constant factor rather than quadratic improvement. We provide efficient and intuitive tools for deriving the bounds based on the geometry of quantum channels and semi-definite programming. We apply these tools to derive bounds for models of decoherence relevant for metrological applications including: depolarization, dephasing, spontaneous emission and photon loss. PMID:22990859

Comparison and Characterisation of Regenerated Chitosan from 1-Butyl-3-methylimidazolium Chloride and Chitosan from Crab Shells

PubMed Central

Arnold, Lyndon

2015-01-01

Chitosan is a biopolymer derived from chitin which is naturally occurring in the exoskeleton of crustaceans. This paper reports dissolution and regeneration of chitosan by directly dissolving in an ionic liquid solvent, 1-butyl-3-methylimidazolium chloride (BMIMCl). This will provide an ideal platform to solubilise these kinds of polymers to achieve the dissolution. The current study dissolved chitosan from crab shell utilising BMIMCl as a solvent and characterised the resultant regenerated polymer. The regenerated chitosan showed increased hydrogen bonding when characterised by Fourier transform infrared (FTIR) spectral analysis. In addition, the study also compared the characteristics of regenerated and generic chitosan. The regenerated chitosan was also evaluated for antimicrobial properties and showed to possess antibacterial features similar to the commercial grade. This method can be utilised in future for blending of polymers with chitosan in a dissolved phase. PMID:26090452

Observations of the structure and vertical transport of the polar upper ionosphere with the EISCAT VHF radar. I - Is EISCAT able to determine O(+) and H(+) polar wind characteristic? A simulation study

NASA Technical Reports Server (NTRS)

Blelly, Pierre-Louis; Barakat, Abdullah R.; Fontanari, Jean; Alcayde, Denis; Blanc, Michel; Wu, Jian; Lathuillere, C.

1992-01-01

A method presented by Wu et al. (1992) for computing the H(+) vertical velocity from the main ionospheric parameters measured by the EISCAT VHF radar is tested in a fully controlled sequence which consists of generating an ideal ionospheric model by solving the coupled continuity and momentum equations for a two-ion plasma (O(+) and H(+)). Synthetic autocorrelation functions are generated from this model with the radar characteristics and used as actual measurements to compute the H(+) vertical velocities. Results of these simulations are shown and discussed for three cases of typical and low SNR and for low and increased mixing ratios. In most cases general agreement is found between computed H(+) velocities and generic ones with the altitude range considered, i.e., 200-1000 km. The method is shown to be reliable.

Physical limits to biomechanical sensing in disordered fibre networks

NASA Astrophysics Data System (ADS)

Beroz, Farzan; Jawerth, Louise M.; Münster, Stefan; Weitz, David A.; Broedersz, Chase P.; Wingreen, Ned S.

2017-07-01

Cells actively probe and respond to the stiffness of their surroundings. Since mechanosensory cells in connective tissue are surrounded by a disordered network of biopolymers, their in vivo mechanical environment can be extremely heterogeneous. Here we investigate how this heterogeneity impacts mechanosensing by modelling the cell as an idealized local stiffness sensor inside a disordered fibre network. For all types of networks we study, including experimentally-imaged collagen and fibrin architectures, we find that measurements applied at different points yield a strikingly broad range of local stiffnesses, spanning roughly two decades. We verify via simulations and scaling arguments that this broad range of local stiffnesses is a generic property of disordered fibre networks. Finally, we show that to obtain optimal, reliable estimates of global tissue stiffness, a cell must adjust its size, shape, and position to integrate multiple stiffness measurements over extended regions of space.

Smoothed Particle Hydrodynamics Simulations of Ultrarelativistic Shocks with Artificial Viscosity

NASA Astrophysics Data System (ADS)

Siegler, S.; Riffert, H.

2000-03-01

We present a fully Lagrangian conservation form of the general relativistic hydrodynamic equations for perfect fluids with artificial viscosity in a given arbitrary background spacetime. This conservation formulation is achieved by choosing suitable Lagrangian time evolution variables, from which the generic fluid variables of rest-mass density, 3-velocity, and thermodynamic pressure have to be determined. We present the corresponding equations for an ideal gas and show the existence and uniqueness of the solution. On the basis of the Lagrangian formulation we have developed a three-dimensional general relativistic smoothed particle hydrodynamics (SPH) code using the standard SPH formalism as known from nonrelativistic fluid dynamics. One-dimensional simulations of a shock tube and a wall shock are presented together with a two-dimensional test calculation of an inclined shock tube. With our method we can model ultrarelativistic fluid flows including shocks with Lorentz factors of even 1000.

The Thermodynamics of General and Local Anesthesia

PubMed Central

Græsbøll, Kaare; Sasse-Middelhoff, Henrike; Heimburg, Thomas

2014-01-01

General anesthetics are known to cause depression of the freezing point of transitions in biomembranes. This is a consequence of ideal mixing of the anesthetic drugs in the membrane fluid phase and exclusion from the solid phase. Such a generic law provides physical justification of the famous Meyer-Overton rule. We show here that general anesthetics, barbiturates, and local anesthetics all display the same effect on melting transitions. Their effect is reversed by hydrostatic pressure. Thus, the thermodynamic behavior of local anesthetics is very similar to that of general anesthetics. We present a detailed thermodynamic analysis of heat capacity profiles of membranes in the presence of anesthetics. Using this analysis, we are able to describe experimentally observed calorimetric profiles and predict the anesthetic features of arbitrary molecules. In addition, we discuss the thermodynamic origin of the cutoff effect of long-chain alcohols and the additivity of the effect of general and local anesthetics. PMID:24853743

The nature and perception of fluctuations in human musical rhythms

NASA Astrophysics Data System (ADS)

Hennig, Holger; Fleischmann, Ragnar; Fredebohm, Anneke; Hagmayer, York; Nagler, Jan; Witt, Annette; Theis, Fabian; Geisel, Theo

2012-02-01

Although human musical performances represent one of the most valuable achievements of mankind, the best musicians perform imperfectly. Musical rhythms are not entirely accurate and thus inevitably deviate from the ideal beat pattern. Nevertheless, computer generated perfect beat patterns are frequently devalued by listeners due to a perceived lack of human touch. Professional audio editing software therefore offers a humanizing feature which artificially generates rhythmic fluctuations. However, the built-in humanizing units are essentially random number generators producing only simple uncorrelated fluctuations. Here, for the first time, we establish long-range fluctuations as an inevitable natural companion of both simple and complex human rhythmic performances [1]. Moreover, we demonstrate that listeners strongly prefer long-range correlated fluctuations in musical rhythms. Thus, the favorable fluctuation type for humanizing interbeat intervals coincides with the one generically inherent in human musical performances. [1] HH et al., PLoS ONE,6,e26457 (2011)

Geothermal Resource/Reservoir Investigations Based on Heat Flow and Thermal Gradient Data for the United States

DOE Office of Scientific and Technical Information (OSTI.GOV)

D. D. Blackwell; K. W. Wisian; M. C. Richards

2000-04-01

Several activities related to geothermal resources in the western United States are described in this report. A database of geothermal site-specific thermal gradient and heat flow results from individual exploration wells in the western US has been assembled. Extensive temperature gradient and heat flow exploration data from the active exploration of the 1970's and 1980's were collected, compiled, and synthesized, emphasizing previously unavailable company data. Examples of the use and applications of the database are described. The database and results are available on the world wide web. In this report numerical models are used to establish basic qualitative relationships betweenmore » structure, heat input, and permeability distribution, and the resulting geothermal system. A series of steady state, two-dimensional numerical models evaluate the effect of permeability and structural variations on an idealized, generic Basin and Range geothermal system and the results are described.« less

The Thermodynamics of General and Local Anesthesia

NASA Astrophysics Data System (ADS)

Græsbøll, Kaare; Sasse-Middelhoff, Henrike; Heimburg, Thomas

2014-05-01

General anesthetics are known to cause depression of the freezing point of transitions in biomembranes. This is a consequence of ideal mixing of the anesthetic drugs in the membrane fluid phase and exclusion from the solid phase. Such a generic law provides physical justification of the famous Meyer-Overton rule. We show here that general anesthetics, barbiturates and local anesthetics all display the same effect on melting transitions. Their effect is reversed by hydrostatic pressure. Thus, the thermodynamic behavior of local anesthetics is very similar to that of general anesthetics. We present a detailed thermodynamic analysis of heat capacity profiles of membranes in the presence of anesthetics. This analysis is able to describe experimentally observed calorimetric profiles and permits prediction of the anesthetic features of arbitrary molecules. In addition, we discuss the thermodynamic origin of the cutoff-effect of long-chain alcohols and the additivity of the effect of general and local anesthetics.

How should we build a generic open-source water management simulator?

NASA Astrophysics Data System (ADS)

Khadem, M.; Meier, P.; Rheinheimer, D. E.; Padula, S.; Matrosov, E.; Selby, P. D.; Knox, S.; Harou, J. J.

2014-12-01

Increasing water needs for agriculture, industry and cities mean effective and flexible water resource system management tools will remain in high demand. Currently many regions or countries use simulators that have been adapted over time to their unique system properties and water management rules and realities. Most regions operate with a preferred short-list of water management and planning decision support systems. Is there scope for a simulator, shared within the water management community, that could be adapted to different contexts, integrate community contributions, and connect to generic data and model management software? What role could open-source play in such a project? How could a genericuser-interface and data/model management software sustainably be attached to this model or suite of models? Finally, how could such a system effectively leverage existing model formulations, modeling technologies and software? These questions are addressed by the initial work presented here. We introduce a generic water resource simulation formulation that enables and integrates both rule-based and optimization driven technologies. We suggest how it could be linked to other sub-models allowing for detailed agent-based simulation of water management behaviours. An early formulation is applied as an example to the Thames water resource system in the UK. The model uses centralised optimisation to calculate allocations but allows for rule-based operations as well in an effort to represent observed behaviours and rules with fidelity. The model is linked through import/export commands to a generic network model platform named Hydra. Benefits and limitations of the approach are discussed and planned work and potential use cases are outlined.

A randomized comparison of platelet reactivity in patients after treatment with various commercial clopidogrel preparations: the CLO-CLO trial.

PubMed

Oberhänsli, Markus; Lehner, Cédric; Puricel, Serban; Lehmann, Sonja; Togni, Mario; Stauffer, Jean-Christophe; Baeriswyl, Gérard; Goy, Jean-Jacques; Cook, Stéphane

2012-11-01

The salt linked to the clopidogrel molecule in generic preparations is suspected to affect its clinical efficacy. There is a lack of information about inhibition of platelet reactivity by generic preparations. To compare the effect of original clopidogrel (clopidogrel bisulphate [Plavix(®)]), generic clopidogrel preparations (clopidogrel hydrochloride [Clopidogrel-Mepha(®)]; clopidogrel besylate [Clopidogrel Sandoz(®)]) and prasugrel (Efient(®)) on platelet reactivity in patients with coronary artery disease. Patients with coronary artery disease treated with stents received, in a random sequence, original clopidogrel bisulphate, clopidogrel hydrochloride and clopidogrel besylate. Platelet function was assessed with the Multiplate analyser after an initial loading dose (600 mg) and at day 10 after each treatment period. Prasugrel was given for another 10 days. An adenosine diphosphate (ADP) test value<46 antiaggregation units (U) was defined as therapeutic platelet inhibition. Sixty patients (mean age 69 ± 10 years; 50 men) were randomized. Original clopidogrel bisulphate, clopidogrel hydrochloride and clopidogrel besylate provided similar inhibition of platelet reactivity with values of 31 ± 25, 33 ± 28 and 28 ± 23 U, respectively (P not significant). Prasugrel provided better inhibition of platelet function (10 ± 11 vs. 31 ± 25 U for clopidogrel bisulphate; P<0.001). An ADP test value>46 U was measured in 11 patients (18%) with clopidogrel bisulphate, 13 (22%) with clopidogrel besylate and 13 (22%) with clopidogrel hydrochloride compared with only one (2%) with prasugrel. Generic clopidogrel preparations provided similar inhibition of platelet reactivity to original clopidogrel bisulphate, although prasugrel was more efficient. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Distributed sensor for water and pH measurements using fiber optics and swellable polymeric systems

NASA Astrophysics Data System (ADS)

Michie, W. C.; Culshaw, B.; McKenzie, I.; Konstantakis, M.; Graham, N. B.; Moran, C.; Santos, F.; Bergqvist, E.; Carlstrom, B.

1995-01-01

We report on the design, construction and test of a generic form of sensor for making distributed measurements of a range of chemical parameters. The technique combines optical time-domain reflectometry with chemically sensitive water-swellable polymers (hydrogels). Initial experiments have concentrated on demonstrating a distributed water detector; however, gels have been developed that enable this sensor to be

Unmanned Ground Vehicle

DTIC Science & Technology

2001-11-01

Systems ( JAUGS ). JAUGS is a JRP technology initiative under the cognizance of the Aviation and Missile Command Research, Development and Engineering Center...AMRDEC). The JAUGS focus is on developing a high-level command and control architecture for UGVs. As defined in the JRP Glossary, “ JAUGS is an upper...vehicle platforms and missions. JAUGS uses the Society of Automotive Engineers Generic Open Architecture framework to classify UGV interfaces and

Exploring Strategic Thinking: Insights to Assess, Develop, and Retain Strategic Thinkers

DTIC Science & Technology

2013-02-01

rise even as goal difficulty increases (Nisan, 1972). Individual time perspective is associated with the ability to perform professional... initial association with things military, strategy has assumed other more generic meanings that people use broadly and commonly. To mention just a...quantitative methods. Even within the holistic or systemic approach to design there are times when such methods are useful , particularly when

Evolution of the magnetorotational instability on initially tangled magnetic fields

NASA Astrophysics Data System (ADS)

Bhat, Pallavi; Ebrahimi, Fatima; Blackman, Eric G.; Subramanian, Kandaswamy

2017-12-01

The initial magnetic field of previous magnetorotational instability (MRI) simulations has always included a significant system-scale component, even if stochastic. However, it is of conceptual and practical interest to assess whether the MRI can grow when the initial field is turbulent. The ubiquitous presence of turbulent or random flows in astrophysical plasmas generically leads to a small-scale dynamo (SSD), which would provide initial seed turbulent velocity and magnetic fields in the plasma that becomes an accretion disc. Can the MRI grow from these more realistic initial conditions? To address this, we supply a standard shearing box with isotropically forced SSD generated magnetic and velocity fields as initial conditions and remove the forcing. We find that if the initially supplied fields are too weak or too incoherent, they decay from the initial turbulent cascade faster than they can grow via the MRI. When the initially supplied fields are sufficient to allow MRI growth and sustenance, the saturated stresses, large-scale fields and power spectra match those of the standard zero net flux MRI simulation with an initial large-scale vertical field.

One-impulse targeting strategy for longitudinal drift control of geosynchronous spacecraft subject to tesseral harmonics and luni-solar gravity perturbations

NASA Technical Reports Server (NTRS)

Kechichian, J. A.

1984-01-01

Kamel's (1973) East-West Stationkeeping Analysis is extended and an algorithm is presented that targets the geosynchronous spacecraft to the ideal initial conditions starting from any given relative longitude deviation within a given tolerance deadband in order to repeat the ideal longitudinal drift cycle that results in the longest possible period of time between maneuvers. The motion description takes into account the perturbations introduced by earth's tesseral harmonics and by the luni-solar gravity, assuming a near-circular orbit that requires only the control of orbital energy to repeat the ideal drift cycle via a single impulsive velocity change. The location of the maneuver along the orbit is such that the post-Delta-V eccentricity is always minimized.

The "booty call": a compromise between men's and women's ideal mating strategies.

PubMed

Jonason, Peter K; Li, Norman P; Cason, Margaret J

2009-01-01

Traditionally, research on romantic and sexual relationships has focused on one-night stands and monogamous pairs. However, as the result of men and women pursuing their ideal relationship types, various compromise relationships may emerge. One such compromise is explored here: the "booty call." The results of an act-nomination and frequency study of college students provided an initial definition and exploration of this type of relationship. Booty calls tend to utilize various communication mediums to facilitate sexual contact among friends who, for men, may represent low-investment, attractive sexual partners and, for women, may represent attractive test-mates. The relationship is discussed as a compromise between men's and women's ideal mating strategies that allows men greater sexual access and women an ongoing opportunity to evaluate potential long-term mates.

Modification of porous silicon rugate filters through thiol-yne photochemistry

DOE Office of Scientific and Technical Information (OSTI.GOV)

Soeriyadi, Alexander H., E-mail: alexander.soeriyadi@unsw.edu.au; Zhu, Ying, E-mail: alexander.soeriyadi@unsw.edu.au; Gooding, J. Justin, E-mail: justin.gooding@unsw.edu.au

2014-02-24

Porous silicon (PSi) has a considerable potential as biosensor platform. In particular, the ability to modify the surface chemistry of porous silicon is of interest. Here we present a generic method to modify the surface of porous silicon through thiol-yne photochemistry initiated by a radical initiator. Firstly, a freshly etched porous silicon substrate is modified through thermal hydrosilylation with 1,8-nonadiyne to passivate the surface and introduce alkyne functionalities. The alkyne functional surface could then be further reacted with thiol species in the presence of a radical initiator and UV light. Functionalization of the PSi rugate filter is followed with opticalmore » reflectivity measurements as well as high resolution X-ray photoelectron spectroscopy (XPS)« less

A Yang-Mills field on the extremal Reissner-Nordström black hole

NASA Astrophysics Data System (ADS)

Bizoń, Piotr; Kahl, Michał

2016-09-01

We consider a spherically symmetric (magnetic) SU(2) Yang-Mills field propagating on the exterior of the extremal Reissner-Nordström black hole. Taking advantage of the conformal symmetry, we reduce the problem to the study of the Yang-Mills equation in a geodesically complete spacetime with two asymptotically flat ends. We prove the existence of infinitely many static solutions (two of which are found in closed form) and determine the spectrum of their linear perturbations and quasinormal modes. Finally, using the hyperboloidal approach to the initial value problem, we describe the process of relaxation to the static endstates of evolution, both stable (for generic initial data) and unstable (for codimension-one initial data).

Generic medicines and generic substitution: contrasting perspectives of stakeholders in Ireland.

PubMed

O'Leary, A; Usher, C; Lynch, M; Hall, M; Hemeryk, L; Spillane, S; Gallagher, P; Barry, M

2015-12-15

The Health (Pricing and Supply of Medical Goods) Act 2013 passed into law in July 2013 and legislated for generic substitution in Ireland. The aim of the study was to ascertain the knowledge and perceptions of stakeholders i.e. patients, pharmacists and prescribers, of generic medicines and to generic substitution with the passing of legislation. Three stakeholder specific questionnaires were developed to assess knowledge of and perceptions to generic medicines and generic substitution. Purposive samples of patients, prescribers and pharmacists were analysed. Descriptive quantitative and qualitative analyses were undertaken. A total of 762 healthcare professionals and 353 patients were recruited. The study highlighted that over 84% of patients were familiar with generic medicines and are supportive of the concept of generic substitution. Approximately 74% of prescribers and 84% of pharmacists were supportive of generic substitution in most cases. The main areas of concern highlighted by the healthcare professionals that might impact on the successful implementation of the policy, were the issue of bioequivalence with generic medicines, the computer software systems used at present in general practitioner (GP) surgeries and the availability of branded generics. The findings from this study identify a high baseline rate of acceptance to generic medicines and generic substitution among patients, prescribers and pharmacists in the Irish setting. The concerns of the main stakeholders provide a valuable insight into the potential difficulties that may arise in its implementation, and the need for on-going reassurance and proactive dissemination of the impact of the generic substitution policy. The existing positive attitude to generic medicines and generic substitution among key stakeholders in Ireland to generic substitution, combined with appropriate support and collaboration should result in the desired increase in rates of prescribing, dispensing and use of generic medicines.

Is there a relationship between patient beliefs or communication about generic drugs and medication utilization?

PubMed

Shrank, William H; Cadarette, Suzanne M; Cox, Emily; Fischer, Michael A; Mehta, Jyotsna; Brookhart, Alan M; Avorn, Jerry; Choudhry, Niteesh K

2009-03-01

Insurers and policymakers strive to stimulate more cost-effective prescribing and, increasingly, are educating beneficiaries about generics. To evaluate the relationship between patient beliefs and communication about generic drugs and actual drug use. We performed a national mailed survey of a random sample of 2500 commercially-insured adults. Patient responses were linked to pharmacy claims data to assess actual generic medication use. We used factor analysis to develop 5 multi-item scales from patient survey responses that measured: (1) general preferences for generics, (2) generic safety/effectiveness, (3) generic cost/value, (4) comfort with generic substitution, and (5) communication with providers about generics. The relationship between each scale and the proportion of prescriptions filled for generics was assessed using linear regression, controlling for demographic, health, and insurance characteristics. Separate models were created for each scale and then all 5 scales were included simultaneously in a fully-adjusted model. The usable response rate was 48%. When evaluated independently, a 1 SD increase in each of the 5 scales was associated with a 3.1% to 6.3% increase in generic drug use (P < 0.05 for each). In the fully adjusted model, only 2 scales were significantly associated with generic drug use: comfort with generic substitution (P = 0.021) and communication with providers about generic drugs (P = 0.012). Generic drug use is most closely associated with the 2 actionable items we evaluated: communication with providers about generics and comfort with generic substitution. Educational campaigns that focus on these 2 domains may be most effective at influencing generic drug use.

Evaluation of the Utility of Static and Adaptive Mesh Refinement for Idealized Tropical Cyclone Problems in a Spectral Element Shallow Water Model

DTIC Science & Technology

2015-04-09

where u is the zonal momentum per unit mass, v is the meridional momentum per unit mass, h is the fluid depth, and f is the Coriolis parameter. An...from each cyclone advects the other116 creating a net cyclonic motion (the Fujiwhara effect ; Fujiwhara 1921) (case 2 idealization).117 In Fig. 2c, the...the interaction of the two136 vortices cause a net cyclonic motion (the Fujiwhara effect ).137 The initial condition for the binary vortex interaction

Region grouping in natural foliage scenes: image statistics and human performance.

PubMed

Ing, Almon D; Wilson, J Anthony; Geisler, Wilson S

2010-04-27

This study investigated the mechanisms of grouping and segregation in natural scenes of close-up foliage, an important class of scenes for human and non-human primates. Close-up foliage images were collected with a digital camera calibrated to match the responses of human L, M, and S cones at each pixel. The images were used to construct a database of hand-segmented leaves and branches that correctly localizes the image region subtended by each object. We considered a task where a visual system is presented with two image patches and is asked to assign a category label (either same or different) depending on whether the patches appear to lie on the same surface or different surfaces. We estimated several approximately ideal classifiers for the task, each of which used a unique set of image properties. Of the image properties considered, we found that ideal classifiers rely primarily on the difference in average intensity and color between patches, and secondarily on the differences in the contrasts between patches. In psychophysical experiments, human performance mirrored the trends predicted by the ideal classifiers. In an initial phase without corrective feedback, human accuracy was slightly below ideal. After practice with feedback, human accuracy was approximately ideal.

Ontological approach for safe and effective polypharmacy prescription

PubMed Central

Grando, Adela; Farrish, Susan; Boyd, Cynthia; Boxwala, Aziz

2012-01-01

The intake of multiple medications in patients with various medical conditions challenges the delivery of medical care. Initial empirical studies and pilot implementations seem to indicate that generic safe and effective multi-drug prescription principles could be defined and reused to reduce adverse drug events and to support compliance with medical guidelines and drug formularies. Given that ontologies are known to provide well-principled, sharable, setting-independent and machine-interpretable declarative specification frameworks for modeling and reasoning on biomedical problems, we explore here their use in the context of multi-drug prescription. We propose an ontology for modeling drug-related knowledge and a repository of safe and effective generic prescription principles. To test the usability and the level of granularity of the developed ontology-based specification models and heuristic we implemented a tool that computes the complexity of multi-drug treatments, and a decision aid to check the safeness and effectiveness of prescribed multi-drug treatments. PMID:23304299

Concerns about the safety of obesity agents from a manufacturing perspective.

PubMed

Kanfer, Isadore

2008-07-01

Salt derivatives of active pharmaceutical ingredients (API), such as hydrochloride and mesylate salts, are frequently used during drug product development. Compared with the underivatized API, salt derivatives are often associated with beneficial properties, including improved solubility and better absorption. Although the obesity agent sibutramine was initially approved as the hydrochloride salt, it has also been formulated as a mesylate salt (sibutramine mesylate). In order to qualify as interchangeable, generic products generally must be both pharmaceutically equivalent and bioequivalent to an approved reference product. Because generic versions of hydrochloride salt formulations that have been reformulated as mesylate salts are not pharmaceutically equivalent to the approved reference products, they would not be interchangeable, even if bioequivalent. The safety of APIs and drug products manufactured outside the United States in non-Food and Drug Administration-regulated facilities are of concern, particularly agents that may contain harmful impurities, such as obesity products formulated as mesylate salts.

Telerobotic system performance measurement - Motivation and methods

NASA Technical Reports Server (NTRS)

Kondraske, George V.; Khoury, George J.

1992-01-01

A systems performance-based strategy for modeling and conducting experiments relevant to the design and performance characterization of telerobotic systems is described. A developmental testbed consisting of a distributed telerobotics network and initial efforts to implement the strategy described is presented. Consideration is given to the general systems performance theory (GSPT) to tackle human performance problems as a basis for: measurement of overall telerobotic system (TRS) performance; task decomposition; development of a generic TRS model; and the characterization of performance of subsystems comprising the generic model. GSPT employs a resource construct to model performance and resource economic principles to govern the interface of systems to tasks. It provides a comprehensive modeling/measurement strategy applicable to complex systems including both human and artificial components. Application is presented within the framework of a distributed telerobotics network as a testbed. Insight into the design of test protocols which elicit application-independent data is described.

Association of authorized generic marketing with prescription drug spending on antidepressants from 2000 to 2011.

PubMed

Cheng, Ning; Banerjee, Tannista; Qian, Jingjing; Hansen, Richard A

Prior research suggests that authorized generic drugs increase competition and decrease prices, but little empirical evidence supports this conclusion. This study evaluated the impact of authorized generic marketing on brand and generic prices. Longitudinal analysis of the household component of the Medical Expenditure Panel Survey. Interview panels over 12 years, with a new panel each year. For each panel, 5 rounds of household interviews were conducted over 30 months. Nationally representative sample of the U.S. civilian noninstitutionalized population, focusing on people using 1 of 5 antidepressant drugs that became generically available between 2000 to 2011. Drugs and dose/formulations with versus without an authorized generic drug marketed. Multiple linear regression models with lagged variables evaluated the effect of an authorized generic on average inflation-adjusted brand and generic price, adjusting for payment sources, generic entry time, competitor price, and year. During 2000-2011, annual brand antidepressant utilization decreased from 51.47 to 7.52 million prescriptions, and generic antidepressant utilization increased from 0 to 88.83 million prescriptions. Over time, payment per prescription for brand prescriptions increased 25% overall, and generic payments decreased 70% for all payer types. With unadjusted data, after generic entry the average brand price decreased $0.59 per year with and $3.62 per year without an authorized generic in the market. Average generic prices decreased $10.30 per year with and $8.47 per year without an authorized generic in the market. In multiple regression models with lagged variables adjusted for heteroscedasticity, payer source, time since generic entry, competitor price, and year, authorized generics significantly reduced average payment for generic (-$3.03) and brand (-$60.64) prescriptions, and over time this price change slowly diminished. Availability of an authorized generic was associated with reduced average generic and brand price in the antidepressant market, supporting prior evidences. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

The Communicative Participation Item Bank (CPIB): Item bank calibration and development of a disorder-generic short form

PubMed Central

Baylor, Carolyn; Yorkston, Kathryn; Eadie, Tanya; Kim, Jiseon; Chung, Hyewon; Amtmann, Dagmar

2015-01-01

Purpose The purpose of this study was to calibrate the items for the Communicative Participation Item Bank (CPIB) using Item Response Theory (IRT). One overriding objective was to examine if the IRT item parameters would be consistent across different diagnostic groups, thereby allowing creation of a disorder-generic instrument. The intended outcomes were the final item bank and a short form ready for clinical and research applications. Methods Self-report data were collected from 701 individuals representing four diagnoses: multiple sclerosis, Parkinson’s disease, amyotrophic lateral sclerosis and head and neck cancer. Participants completed the CPIB and additional self-report questionnaires. CPIB data were analyzed using the IRT Graded Response Model (GRM). Results The initial set of 94 candidate CPIB items were reduced to an item bank of 46 items demonstrating unidimensionality, local independence, good item fit, and good measurement precision. Differential item function (DIF) analyses detected no meaningful differences across diagnostic groups. A 10-item, disorder-generic short form was generated. Conclusions The CPIB provides speech-language pathologists with a unidimensional, self-report outcomes measurement instrument dedicated to the construct of communicative participation. This instrument may be useful to clinicians and researchers wanting to implement measures of communicative participation in their work. PMID:23816661

Scaling Limits and Generic Bounds for Exploration Processes

NASA Astrophysics Data System (ADS)

Bermolen, Paola; Jonckheere, Matthieu; Sanders, Jaron

2017-12-01

We consider exploration algorithms of the random sequential adsorption type both for homogeneous random graphs and random geometric graphs based on spatial Poisson processes. At each step, a vertex of the graph becomes active and its neighboring nodes become blocked. Given an initial number of vertices N growing to infinity, we study statistical properties of the proportion of explored (active or blocked) nodes in time using scaling limits. We obtain exact limits for homogeneous graphs and prove an explicit central limit theorem for the final proportion of active nodes, known as the jamming constant, through a diffusion approximation for the exploration process which can be described as a unidimensional process. We then focus on bounding the trajectories of such exploration processes on random geometric graphs, i.e., random sequential adsorption. As opposed to exploration processes on homogeneous random graphs, these do not allow for such a dimensional reduction. Instead we derive a fundamental relationship between the number of explored nodes and the discovered volume in the spatial process, and we obtain generic bounds for the fluid limit and jamming constant: bounds that are independent of the dimension of space and the detailed shape of the volume associated to the discovered node. Lastly, using coupling techinques, we give trajectorial interpretations of the generic bounds.

Refinement and evaluation of helicopter real-time self-adaptive active vibration controller algorithms

NASA Technical Reports Server (NTRS)

Davis, M. W.

1984-01-01

A Real-Time Self-Adaptive (RTSA) active vibration controller was used as the framework in developing a computer program for a generic controller that can be used to alleviate helicopter vibration. Based upon on-line identification of system parameters, the generic controller minimizes vibration in the fuselage by closed-loop implementation of higher harmonic control in the main rotor system. The new generic controller incorporates a set of improved algorithms that gives the capability to readily define many different configurations by selecting one of three different controller types (deterministic, cautious, and dual), one of two linear system models (local and global), and one or more of several methods of applying limits on control inputs (external and/or internal limits on higher harmonic pitch amplitude and rate). A helicopter rotor simulation analysis was used to evaluate the algorithms associated with the alternative controller types as applied to the four-bladed H-34 rotor mounted on the NASA Ames Rotor Test Apparatus (RTA) which represents the fuselage. After proper tuning all three controllers provide more effective vibration reduction and converge more quickly and smoothly with smaller control inputs than the initial RTSA controller (deterministic with external pitch-rate limiting). It is demonstrated that internal limiting of the control inputs a significantly improves the overall performance of the deterministic controller.

Is There a Relationship Between Patient Beliefs or Communication About Generic Drugs and Medication Utilization?

PubMed Central

Shrank, William H.; Cadarette, Suzanne M.; Cox, Emily; Fischer, Michael A.; Mehta, Jyotsna; Brookhart, Alan M.; Avorn, Jerry; Choudhry, Niteesh K.

2009-01-01

Background Insurers and policymakers strive to stimulate more cost-effective prescribing and, increasingly, are educating beneficiaries about generics. Objectives To evaluate the relationship between patient beliefs and communication about generic drugs and actual drug use. Research Design and Subjects We performed a national mailed survey of a random sample of 2500 commercially-insured adults. Patient responses were linked to pharmacy claims data to assess actual generic medication use. Measures We used factor analysis to develop 5 multi-item scales from patient survey responses that measured: (1) general preferences for generics, (2) generic safety/effectiveness, (3) generic cost/value, (4) comfort with generic substitution, and (5) communication with providers about generics. The relationship between each scale and the proportion of prescriptions filled for generics was assessed using linear regression, controlling for demographic, health, and insurance characteristics. Separate models were created for each scale and then all 5 scales were included simultaneously in a fully-adjusted model. Results The usable response rate was 48%. When evaluated independently, a 1 SD increase in each of the 5 scales was associated with a 3.1% to 6.3% increase in generic drug use (P < 0.05 for each). In the fully adjusted model, only 2 scales were significantly associated with generic drug use: comfort with generic substitution (P = 0.021) and communication with providers about generic drugs (P = 0.012). Conclusions Generic drug use is most closely associated with the 2 actionable items we evaluated: communication with providers about generics and comfort with generic substitution. Educational campaigns that focus on these 2 domains may be most effective at influencing generic drug use. PMID:19194329

The Market Dynamics of Generic Medicines in the Private Sector of 19 Low and Middle Income Countries between 2001 and 2011: A Descriptive Time Series Analysis

PubMed Central

Kaplan, Warren A.; Wirtz, Veronika J.; Stephens, Peter

2013-01-01

This observational study investigates the private sector, retail pharmaceutical market of 19 low and middle income countries (LMICs) in Latin America, Asia and the Middle East/South Africa analyzing the relationships between volume market share of generic and originator medicines over a time series from 2001 to 2011. Over 5000 individual pharmaceutical substances were divided into generic (unbranded generic, branded generic medicines) and originator categories for each country, including the United States as a comparator. In 9 selected LMICs, the market share of those originator substances with the largest decrease over time was compared to the market share of their counterpart generic versions. Generic medicines (branded generic plus unbranded generic) represent between 70 and 80% of market share in the private sector of these LMICs which exceeds that of most European countries. Branded generic medicine market share is higher than that of unbranded generics in all three regions and this is in contrast to the U.S. Although switching from an originator to its generic counterpart can save money, this narrative in reality is complex at the level of individual medicines. In some countries, the market behavior of some originator medicines that showed the most temporal decrease, showed switching to their generic counterpart. In other countries such as in the Middle East/South Africa and Asia, the loss of these originators was not accompanied by any change at all in market share of the equivalent generic version. For those countries with a significant increase in generic medicines market share and/or with evidence of comprehensive “switching” to generic versions, notably in Latin America, it would be worthwhile to establish cause-effect relationships between pharmaceutical policies and uptake of generic medicines. The absence of change in the generic medicines market share in other countries suggests that, at a minimum, generic medicines have not been strongly promoted. PMID:24098644

The market dynamics of generic medicines in the private sector of 19 low and middle income countries between 2001 and 2011: a descriptive time series analysis.

PubMed

Kaplan, Warren A; Wirtz, Veronika J; Stephens, Peter

2013-01-01

This observational study investigates the private sector, retail pharmaceutical market of 19 low and middle income countries (LMICs) in Latin America, Asia and the Middle East/South Africa analyzing the relationships between volume market share of generic and originator medicines over a time series from 2001 to 2011. Over 5000 individual pharmaceutical substances were divided into generic (unbranded generic, branded generic medicines) and originator categories for each country, including the United States as a comparator. In 9 selected LMICs, the market share of those originator substances with the largest decrease over time was compared to the market share of their counterpart generic versions. Generic medicines (branded generic plus unbranded generic) represent between 70 and 80% of market share in the private sector of these LMICs which exceeds that of most European countries. Branded generic medicine market share is higher than that of unbranded generics in all three regions and this is in contrast to the U.S. Although switching from an originator to its generic counterpart can save money, this narrative in reality is complex at the level of individual medicines. In some countries, the market behavior of some originator medicines that showed the most temporal decrease, showed switching to their generic counterpart. In other countries such as in the Middle East/South Africa and Asia, the loss of these originators was not accompanied by any change at all in market share of the equivalent generic version. For those countries with a significant increase in generic medicines market share and/or with evidence of comprehensive "switching" to generic versions, notably in Latin America, it would be worthwhile to establish cause-effect relationships between pharmaceutical policies and uptake of generic medicines. The absence of change in the generic medicines market share in other countries suggests that, at a minimum, generic medicines have not been strongly promoted.

Passive Sun seeker/tracker and a thermally activated power module

NASA Technical Reports Server (NTRS)

Siebert, C. J.; Morris, F. A.

1984-01-01

Development and testing of two mechanisms using a shape memory alloy metal (NITINOL) as the power source are described. The two mechanisms developed are a passive Sun Seeker/Tracker and a generic type power module. These mechanisms use NITINOL wire initially strained in pure torsion which provides the greatest mechanical work capacity upon recovery, as compared to other deformation modes (i.e., tension, helical springs, and bending).

Health-Related Quality of Life and Cognitive Functioning from the Perspective of Parents of School-Aged Children with Asperger's Syndrome Utilizing the PedsQL[TM

ERIC Educational Resources Information Center

Limbers, Christine A.; Heffer, Robert W.; Varni, James W.

2009-01-01

HRQOL as a multidimensional construct has not been previously investigated in children with Asperger's Syndrome. The objective of the present study was to examine the initial feasibility, reliability, and validity of the PedsQL[TM] 4.0 Generic Core Scales and PedsQL[TM] Cognitive Functioning Scale parent proxy-report versions in school-aged…

A simple mathematical model of gradual Darwinian evolution: emergence of a Gaussian trait distribution in adaptation along a fitness gradient.

PubMed

Biktashev, Vadim N

2014-04-01

We consider a simple mathematical model of gradual Darwinian evolution in continuous time and continuous trait space, due to intraspecific competition for common resource in an asexually reproducing population in constant environment, while far from evolutionary stable equilibrium. The model admits exact analytical solution. In particular, Gaussian distribution of the trait emerges from generic initial conditions.

Generics, Supergenerics and Patent Strategies--SMi's 13th Annual Meeting.

PubMed

Edwards, Catherine

2010-07-01

SMi's 13th Annual Meeting on Generics, Supergenerics and Patent Strategies, held in London, included topics covering new trends in the generics field, the difficulties faced by companies in entering the generics market and recent developments in IP. This conference report highlights selected presentations on generics in India, protecting pharmaceutical products in China, changes in generics law and litigation in the US and Europe, challenges for market selection and entry for generics companies, the influence of changes in the healthcare market on the generics industry, supergenerics, and biosimilars.

THE FINAL SPIN FROM BINARY BLACK HOLES IN QUASI-CIRCULAR ORBITS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hofmann, Fabian; Rezzolla, Luciano; Barausse, Enrico

2016-07-10

We revisit the problem of predicting the spin magnitude and direction of the black hole (BH) resulting from the merger of two BHs with arbitrary masses and spins inspiraling in quasi-circular orbits. We do this by analyzing a catalog of 619 recent numerical-relativity simulations collected from the literature and spanning a large variety of initial conditions. By combining information from the post-Newtonian approximation, the extreme mass-ratio limit, and perturbative calculations, we improve our previously proposed phenomenological formulae for the final remnant spin. In contrast with alternative suggestions in the literature, and in analogy with our previous expressions, the new formulamore » is a simple algebraic function of the initial system parameters and is not restricted to binaries with spins aligned/anti-aligned with the orbital angular momentum but can be employed for fully generic binaries. The accuracy of the new expression is significantly improved, especially for almost extremal progenitor spins and for small mass ratios, yielding an rms error σ ≈ 0.002 for aligned/anti-aligned binaries and σ ≈ 0.006 for generic binaries. Our new formula is suitable for cosmological applications and can be employed robustly in the analysis of the gravitational waveforms from advanced interferometric detectors.« less

On the local well-posedness of Lovelock and Horndeski theories

NASA Astrophysics Data System (ADS)

Papallo, Giuseppe; Reall, Harvey S.

2017-08-01

We investigate local well-posedness of the initial value problem for Lovelock and Horndeski theories of gravity. A necessary condition for local well-posedness is strong hyperbolicity of the equations of motion. Even weak hyperbolicity can fail for strong fields so we restrict to weak fields. The Einstein equation is known to be strongly hyperbolic in harmonic gauge so we study Lovelock theories in harmonic gauge. We show that the equation of motion is always weakly hyperbolic for weak fields but, in a generic weak-field background, it is not strongly hyperbolic. For Horndeski theories, we prove that, for weak fields, the equation of motion is always weakly hyperbolic in any generalized harmonic gauge. For some Horndeski theories there exists a generalized harmonic gauge for which the equation of motion is strongly hyperbolic in a weak-field background. This includes "k-essence" like theories. However, for more general Horndeski theories, there is no generalized harmonic gauge for which the equation of motion is strongly hyperbolic in a generic weak-field background. Our results show that the standard method used to establish local well-posedness of the Einstein equation does not extend to Lovelock or general Horndeski theories. This raises the possibility that these theories may not admit a well-posed initial value problem even for weak fields.

Application of digital computer APU modeling techniques to control system design.

NASA Technical Reports Server (NTRS)

Bailey, D. A.; Burriss, W. L.

1973-01-01

Study of the required controls for a H2-O2 auxiliary power unit (APU) technology program for the Space Shuttle. A steady-state system digital computer program was prepared and used to optimize initial system design. Analytical models of each system component were included. The program was used to solve a nineteen-dimensional problem, and then time-dependent differential equations were added to the computer program to simulate transient APU system and control. Some system parameters were considered quasi-steady-state, and others were treated as differential variables. The dynamic control analysis proceeded from initial ideal control modeling (which considered one control function and assumed the others to be ideal), stepwise through the system (adding control functions), until all of the control functions and their interactions were considered. In this way, the adequacy of the final control design over the required wide range of APU operating conditions was established.

General and program-specific moderators of two eating disorder prevention programs.

PubMed

Stice, Eric; Marti, Nathan; Shaw, Heather; O'Neil, Kelly

2008-11-01

To investigate general and program-specific factors hypothesized to moderate the effects of two eating disorder prevention programs. High-risk adolescent girls (N = 481; M age = 17) were randomized to a dissonance-based thin-ideal internalization reduction program, a healthy weight management program, an expressive-writing control condition, or an assessment-only control condition. Participants completed diagnostic interviews and surveys at pretest, post-test, 6-month follow-up, and 12-month follow-up. Dissonance program effects on bulimic symptoms were stronger for participants with initial elevations in body image distress, bulimic symptoms, and thin-ideal internalization. Healthy weight program effects on bulimic symptoms were stronger for adolescents with initial elevations in body image distress, bulimic symptoms, readiness to change, body mass, and emotional eating. Overall, intervention effects tended to be amplified for high-risk versus low-risk adolescents. However, certain moderator effects appeared to be specific to the two different prevention programs.

Evaluation of retrieval methods of daytime convective boundary layer height based on lidar data

NASA Astrophysics Data System (ADS)

Li, Hong; Yang, Yi; Hu, Xiao-Ming; Huang, Zhongwei; Wang, Guoyin; Zhang, Beidou; Zhang, Tiejun

2017-04-01

The atmospheric boundary layer height is a basic parameter in describing the structure of the lower atmosphere. Because of their high temporal resolution, ground-based lidar data are widely used to determine the daytime convective boundary layer height (CBLH), but the currently available retrieval methods have their advantages and drawbacks. In this paper, four methods of retrieving the CBLH (i.e., the gradient method, the idealized backscatter method, and two forms of the wavelet covariance transform method) from lidar normalized relative backscatter are evaluated, using two artificial cases (an idealized profile and a case similar to real profile), to test their stability and accuracy. The results show that the gradient method is suitable for high signal-to-noise ratio conditions. The idealized backscatter method is less sensitive to the first estimate of the CBLH; however, it is computationally expensive. The results obtained from the two forms of the wavelet covariance transform method are influenced by the selection of the initial input value of the wavelet amplitude. Further sensitivity analysis using real profiles under different orders of magnitude of background counts show that when different initial input values are set, the idealized backscatter method always obtains consistent CBLH. For two wavelet methods, the different CBLH are always obtained with the increase in the wavelet amplitude when noise is significant. Finally, the CBLHs as measured by three lidar-based methods are evaluated by as measured from L-band soundings. The boundary layer heights from two instruments coincide with ±200 m in most situations.

Brand vs generic adverse event reporting patterns: An authorized generic-controlled evaluation of cardiovascular medications.

PubMed

Alatawi, Y; Rahman, Md M; Cheng, N; Qian, J; Peissig, P L; Berg, R L; Page, C D; Hansen, R A

2018-06-01

Some public scepticism exists about generics in terms of whether brand and generic drugs produce identical outcomes. This study explores whether adverse event (AE) reporting patterns are similar between brand and generic drugs, using authorized generics (AGs) as a control for possible generic drug perception biases. Events reported to the FDA Adverse Event Reporting System from the years 2004-2015 were analysed. Drugs were classified as brand, AG or generic based on drug and manufacturer names. Reports were included if amlodipine, losartan, metoprolol extended release (ER) or simvastatin were listed as primary or secondary suspect drugs. Disproportionality analyses using the reporting odds ratio (ROR) assessed the relative rate of reporting labelled AEs compared to reporting these AEs with all other drugs. The Breslow-Day test compared RORs across brand, AG and generic. Interrupted time series analysis evaluated the impact of generic entry on reporting trends. Generics accounted for significant percentages of total U.S. reports, but AGs accounted for smaller percentages of reports, including for amlodipine (14.26%), losartan (1.48%), metoprolol ER (0.35%) and simvastatin (0.70%). Whereas the RORs were significantly different for multiple brand vs generic comparisons, the AG vs generic comparisons yielded fewer statistically significant findings. Namely, only the ROR for AG differed from generic for amlodipine with peripheral oedema (P < .01). Inconsistent reporting patterns were observed more between brand and generic compared with AG and generic. Use of AGs as a control for perception biases against generics is useful, but this approach can be limited by small AG report numbers. Requiring the manufacturer name to be printed on the prescription bottle or packaging could improve the accuracy of assignment for products being reported. © 2017 John Wiley & Sons Ltd.

Intervening in global markets to improve access to HIV/AIDS treatment: an analysis of international policies and the dynamics of global antiretroviral medicines markets

PubMed Central

2010-01-01

Background Universal access to antiretroviral therapy (ART) in low- and middle-income countries faces numerous challenges: increasing numbers of people needing ART, new guidelines recommending more expensive antiretroviral (ARV) medicines, limited financing, and few fixed-dose combination (FDC) products. Global initiatives aim to promote efficient global ARV markets, yet little is known about market dynamics and the impact of global policy interventions. Methods We utilize several data sources, including 12,958 donor-funded, adult first-line ARV purchase transactions, to describe the market from 2002-2008. We examine relationships between market trends and: World Health Organization (WHO) HIV/AIDS treatment guidelines; WHO Prequalification Programme (WHO Prequal) and United States (US) Food and Drug Administration (FDA) approvals; and procurement policies of the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM), US President's Emergency Plan for AIDS Relief (PEPFAR) and UNITAID. Results WHO recommended 7, 4, 24, and 6 first-line regimens in 2002, 2003, 2006 and 2009 guidelines, respectively. 2009 guidelines replaced a stavudine-based regimen ($88/person/year) with more expensive zidovudine- ($154-260/person/year) or tenofovir-based ($244-465/person/year) regimens. Purchase volumes for ARVs newly-recommended in 2006 (emtricitabine, tenofovir) increased >15-fold from 2006 to 2008. Twenty-four generic FDCs were quality-approved for older regimens but only four for newer regimens. Generic FDCs were available to GFATM recipients in 2004 but to PEPFAR recipients only after FDA approval in 2006. Price trends for single-component generic medicines mirrored generic FDC prices. Two large-scale purchasers, PEPFAR and UNITAID, together accounted for 53%, 84%, and 77% of market volume for abacavir, emtricitabine, and tenofovir, respectively, in 2008. PEPFAR and UNITAID purchases were often split across two manufacturers. Conclusions Global initiatives facilitated the creation of fairly efficient markets for older ARVs, but markets for newer ARVs are less competitive and slower to evolve. WHO guidelines shape demand, and their complexity may help or hinder achievement of economies of scale in pharmaceutical manufacturing. Certification programs assure ARV quality but can delay uptake of new formulations. Large-scale procurement policies may decrease the numbers of buyers and sellers, rendering the market less competitive in the longer-term. Global policies must be developed with consideration for their short- and long-term impact on market dynamics. PMID:20500827

Comparison of Generic-to-Brand Switchback Rates Between Generic and Authorized Generic Drugs.

PubMed

Hansen, Richard A; Qian, Jingjing; Berg, Richard; Linneman, James; Seoane-Vazquez, Enrique; Dutcher, Sarah K; Raofi, Saeid; Page, C David; Peissig, Peggy

2017-04-01

Generic drugs contain identical active ingredients as their corresponding brand drugs and are pharmaceutically equivalent and bioequivalent, whereas authorized generic drugs (AGs) contain both identical active and inactive ingredients as their corresponding brand drugs but are marketed as generics. This study compares generic-to-brand switchback rates between generic and AGs. Retrospective cohort study. Claims and electronic health record data from a regional U.S. health care system. The full cohort consisted of 5542 unique patients who received select branded drugs during the 6 months prior to their generic drug market availability (between 1999 and 2014) and then were switched to an AG or generic drug within 30 months of generic drug entry. For these patients, 5929 unique patient-drug combinations (867 with AGs and 5062 with generic drugs) were evaluated. Ten drugs with AGs and generics marketed between 1999 and 2014 were evaluated. The date of the first generic prescription was considered the index date for each drug, and it marked the beginning of follow-up to evaluate the occurrence of generic-to-brand switchback patterns over the subsequent 30 months. Switchback rates were compared between patients receiving AGs versus those receiving generics using multivariable Cox proportional hazards models, controlling for individual drug effects, age, sex, Charlson Comorbidity Score, pre-index drug use characteristics, and pre-index health care utilization. Among the 5542 unique patients who switched from brand to generic or brand to AG, 264 (4.8%) switched back to the brand drug. Overall switchback rates were similar for AGs compared with generics (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.65-1.15). The likelihood of switchback was higher for alendronate (HR 1.64, 95% CI 1.20-2.23) and simvastatin (HR 1.81, 95% CI 1.30-2.54) and lower for amlodipine (HR 0.27, 95% CI 0.17-0.42) compared with the other drugs evaluated. Overall switchback rates were similar between AG and generic drug users, indirectly supporting similar efficacy and tolerability profiles for brand and generic drugs. Reasons for differences in switchback rates among specific products need to be explored further. © 2017 Pharmacotherapy Publications, Inc.

Encouraging generic use can yield significant savings.

PubMed

Zimmerman, Christina

2012-11-01

Key findings. (1) Zero copayment for generic drugs is the greatest influencer of generic statin utilization. (2) Both higher copayments for generic drugs and lower copayments for competing brands are associated with a decreased probability of using generic statins. (3) Prior authorization and step therapy requirements for brand-name statins are associated with an increased use of generic drugs. (4) Greater use of generic statins should reduce costs for patients, plans, and Medicare.

Medicaid prescription limits: policy trends and comparative impact on utilization.

PubMed

Lieberman, Daniel A; Polinski, Jennifer M; Choudhry, Niteesh K; Avorn, Jerry; Fischer, Michael A

2016-01-15

Medicaid programs face growing pressure to control spending. Despite evidence of clinical harms, states continue to impose policies limiting the number of reimbursable prescriptions (caps). We examined the recent use of prescription caps by Medicaid programs and the impact of policy implementation on prescription utilization. We identified Medicaid cap policies from 2001-2010. We classified caps as applying to all prescriptions (overall caps) or only branded prescriptions (brand caps). Using state-level, aggregate prescription data, we developed interrupted time-series analyses to evaluate the impact of implementing overall caps and brand caps in a subset of states with data available before and after cap initiation. For overall caps, we examined the use of essential medications, which were classified as preventive or as providing symptomatic benefit. For brand caps, we examined the use of all branded drugs as well as branded and generic medications among classes with available generic replacements. The number of states with caps increased from 12 in 2001 to 20 in 2010. Overall cap implementation (n = 3) led to a 0.52% (p < 0.001) annual decrease in the proportion of essential prescriptions but no change in cost. For preventive essential medications, overall caps led to a 1.12% (p = 0.001) annual decrease in prescriptions (246,000 prescriptions annually) and a 1.20% (p < 0.001) decrease in spending (-$12.2 million annually), but no decrease in symptomatic essential medication use. Brand cap implementation (n = 6) led to an immediate 2.29% (p = 0.16) decrease in branded prescriptions and 1.26% (p = 0.025) decrease in spending. For medication classes with generic replacements, the decrease in branded prescriptions (0.74%, p = 0.003) approximately equaled the increase in generics (0.79%, p = 0.009), with estimated savings of $17.4 million. An increasing number of states are using prescription caps, with mixed results. Overall caps decreased the use of preventive but not symptomatic essential medications, suggesting that patients assign higher priority to agents providing symptomatic benefit when faced with reimbursement limits. Among medications with generic replacements, brand caps shifted usage from branded drugs to generics, with considerable savings. Future research should analyze the patient-level impact of these policies to measure clinical outcomes associated with these changes.

An analysis of volumes, prices and pricing trends of the pediatric antiretroviral market in developing countries from 2004 to 2012.

PubMed

Lee, Janice Soo Fern; Sagaon Teyssier, Luis; Dongmo Nguimfack, Boniface; Collins, Intira Jeannie; Lallemant, Marc; Perriens, Joseph; Moatti, Jean-Paul

2016-03-15

The pediatric antiretroviral (ARV) market is poorly described in the literature, resulting in gaps in understanding treatment access. We analyzed the pediatric ARV market from 2004 to 2012 and assessed pricing trends and associated factors. Data on donor funded procurements of pediatric ARV formulations reported to the Global Price Reporting Mechanism database from 2004 to 2012 were analyzed. Outcomes of interest were the volume and mean price per patient-year ARV formulation based on WHO ARV dosing recommendations for a 10 kg child. Factors associated with the price of formulations were assessed using linear regression; potential predictors included: country income classification, geographical region, market segment (originator versus generic ARVs), and number of manufacturers per formulation. All analyses were adjusted for type of formulations (single, dual or triple fixed-dose combinations (FDCs)) Data from 111 countries from 2004 to 2012 were included, with procurement of 33 formulations at a total value of USD 204 million. Use of dual and triple FDC formulations increased substantially over time, but with limited changes in price. Upon multivariate analysis, prices of originator formulations were found to be on average 72 % higher than generics (p < 0.001). A 10 % increase in procurement volume was associated with a 1 % decrease (p < 0.001) in both originator and generic prices. The entry of one additional manufacturer producing a formulation was associated with a decrease in prices of 2 % (p < 0.001) and 8 % (p < 0.001) for originator and generic formulations, respectively. The mean generic ARV price did not differ by country income level. Prices of originator ARVs were 48 % (p < 0.001) and 14 % (p < 0.001) higher in upper-middle income and lower-middle income countries compared to low income countries respectively, with the exception of South Africa, which had lower prices despite being an upper-middle income country. The donor funded pediatric ARV market as represented by the GPRM database is small, and lacks price competition. It is dominated by generic drugs due to the lower prices offered and the practicality of FDC formulations. This market requires continued donor support and the current initiatives to protect it are important to ensure market viability, especially if new formulations are to be introduced in the future.

High rates of regimen change due to drug toxicity among a cohort of South Indian adults with HIV infection initiated on generic, first-line antiretroviral treatment.

PubMed

Sivadasan, Ajith; Abraham, O C; Rupali, Priscilla; Pulimood, Susanne A; Rajan, Joyce; Rajkumar, S; Zachariah, Anand; Kannangai, Rajesh; Kandathil, Abraham Joseph; Sridharan, G; Mathai, Dilip

2009-05-01

To determine the rates, reasons and predictors of treatment change of the initial antiretroviral treatment (ART) regimen in HIV-infected south Indian adults. In this prospective cohort study, ART-naive adults initiated on generic, fixed dose combination ART as per the National AIDS Control Organization guidelines were followed up at an academic medical center. Treatment change was defined as any event which necessitated a change in or discontinuation of the initial ART regimen. Two hundred and thirty persons with HIV infection (males 74.8% and median age 37 years) were followed up for median duration of 48 weeks. The majority (98.7%) had acquired HIV infection through the heterosexual route. Most (70.4%) had advanced IV infection (WHO clinical stage 3 or 4) and 78% had CD4+ T-lymphocyte counts below 200 cells/microL. The initial ART regimens used were: Lamivudine (3TC) with Stavudine (d4T) (in 76%) or Azidothymidine (AZT) and Nevirapine (NVP) (in 86%) or Efavirenz (EFV). The cumulative incidence of treatment change was 39.6% (91 patients). Drug toxicity (WHO grade 3 or 4) was the reason for treatment change among 62 (27%) (incidence rate 35.9/100 person-years). The most common toxicities were attributable to the thymidine analogue nucleoside reverse transcriptase inhibitors (NRTIs), d4T and AZT [lactic acidosis (8.7%), anemia (7%) and peripheral neuropathy (5.2%)]. The other toxicities were rash (3.9%) and hepatitis (1.3%) due to NVP. The mortality (4.6/100 person-years) and disease progression rates (4.1/100 person-years) were low. The ART regimens used in this study were effective in decreasing disease progression and death. However, they were associated with high rates of drug toxicities, particularly those attributable to thymidine analogue NRTI. As efforts are made to improve access to ART, treatment regimens chosen should not only be potent, but also safe.

27 CFR 4.24 - Generic, semi-generic, and non-generic designations of geographic significance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Generic, semi-generic, and non-generic designations of geographic significance. 4.24 Section 4.24 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS LABELING AND...

Generic drugs in Brazil: known by many, used by few.

PubMed

Bertoldi, Andréa D; Barros, Aluísio J D; Hallal, Pedro C

2005-01-01

This study evaluated knowledge and use of generic drugs in a population-based sample of adults from a southern Brazilian city. The outcomes were: the proportion of generics in total medicines used; theoretical and practical knowledge about generics; and strategies used to buy medicines on medical prescriptions. The recall period for drug utilization was 15 days. The proportion of generics in total medicines was 3.9%. While 86.0% knew that generics cost less and 70.0% that the quality is similar to brand name medicines, only 57.0% knew any packaging characteristics that distinguish generics from other medicines. The highest proportion of generic drug utilization was in the antimicrobial pharmacological group. A brand name medicine (with a brand similar to the generic name) was mistakenly classified as a generic through photos by 48.0% of the interviewees. Among subjects who bought medicines in the 15-day period, 18.9% reported buying a generic, but this result should be interpreted with caution, because the population frequently fails to differentiate between generics and other medicines.

Dynamics and stability of a 2D ideal vortex under external strain

NASA Astrophysics Data System (ADS)

Hurst, N. C.; Danielson, J. R.; Dubin, D. H. E.; Surko, C. M.

2017-11-01

The behavior of an initially axisymmetric 2D ideal vortex under an externally imposed strain flow is studied experimentally. The experiments are carried out using electron plasmas confined in a Penning-Malmberg trap; here, the dynamics of the plasma density transverse to the field are directly analogous to the dynamics of vorticity in a 2D ideal fluid. An external strain flow is applied using boundary conditions in a way that is consistent with 2D fluid dynamics. Data are compared to predictions from a theory assuming a piecewise constant elliptical vorticity distribution. Excellent agreement is found for quasi-flat profiles, whereas the dynamics of smooth profiles feature modified stability limits and inviscid damping of periodic elliptical distortions. This work supported by U.S. DOE Grants DE-SC0002451 and DE-SC0016532, and NSF Grant PHY-1414570.

Towards a typology of business process management professionals: identifying patterns of competences through latent semantic analysis

NASA Astrophysics Data System (ADS)

Müller, Oliver; Schmiedel, Theresa; Gorbacheva, Elena; vom Brocke, Jan

2016-01-01

While researchers have analysed the organisational competences that are required for successful Business Process Management (BPM) initiatives, individual BPM competences have not yet been studied in detail. In this study, latent semantic analysis is used to examine a collection of 1507 BPM-related job advertisements in order to develop a typology of BPM professionals. This empirical analysis reveals distinct ideal types and profiles of BPM professionals on several levels of abstraction. A closer look at these ideal types and profiles confirms that BPM is a boundary-spanning field that requires interdisciplinary sets of competence that range from technical competences to business and systems competences. Based on the study's findings, it is posited that individual and organisational alignment with the identified ideal types and profiles is likely to result in high employability and organisational BPM success.

Comparison of brand versus generic antiepileptic drug adverse event reporting rates in the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS).

PubMed

Rahman, Md Motiur; Alatawi, Yasser; Cheng, Ning; Qian, Jingjing; Plotkina, Annya V; Peissig, Peggy L; Berg, Richard L; Page, David; Hansen, Richard A

2017-09-01

Despite the cost saving role of generic anti-epileptic drugs (AEDs), debate exists as to whether generic substitution of branded AEDs may lead to therapeutic failure and increased toxicity. This study compared adverse event (AE) reporting rates for brand vs. authorized generic (AG) vs. generic AEDs. Since AGs are pharmaceutically identical to brand but perceived as generics, the generic vs. AG comparison minimized potential bias against generics. Events reported to the U.S. Food and Drug Administration Adverse Event Reporting System between January 2004 to March 2015 with lamotrigine, carbamazepine, and oxcarbazepine listed as primary or secondary suspect were classified as brand, generic, or AG based on the manufacturer. Disproportionality analyses using the reporting odds ratio (ROR) assessed the relative rate of reporting of labeled AEs compared to reporting these events with all other drugs. The Breslow-Day statistic compared RORs across brand, AG, and other generics using a Bonferroni-corrected P<0.01. A total of 27,150 events with lamotrigine, 13,950 events with carbamazepine, and 5077 events with oxcarbazepine were reported, with generics accounting for 27%, 41%, and 32% of reports, respectively. Although RORs for the majority of known AEs were different between brand and generics for all three drugs of interest (Breslow-Day P<0.001), RORs generally were similar for AG and generic comparisons. Generic lamotrigine and carbamazepine were more commonly involved in reports of suicide or suicidal ideation compared with the respective AGs based on a multiple comparison-adjusted P<0.01. Similar AED reporting rates were observed for the AG and generic comparisons for most outcomes and drugs, suggesting that brands and generics have similar reporting rates after accounting for generic perception biases. Disproportional suicide reporting was observed for generics compared with AGs and brand, although this finding needs further study. Copyright © 2017 Elsevier B.V. All rights reserved.

Knowledge, perceptions and use of generic drugs: a cross sectional study

PubMed Central

de Lira, Claudio Andre Barbosa; Oliveira, Jéssica Nathalia Soares; Andrade, Marília dos Santos; Vancini-Campanharo, Cássia Regina; Vancini, Rodrigo Luiz

2014-01-01

Objective To assess the level of knowledge, perceptions and usage profile for generic drugs among laypersons. Methods A cross-sectional study was conducted with 278 volunteers (180 women and 98 men, aged 37.1±15.8 years). A questionnaire was drawn up with questions on their use, perceptions and knowledge of generic drugs. Results Most respondents (99.6%) knew that generic drugs exist, but only 48.6% were able to define them correctly, while 78.8% of the respondents had some information about generics. This information was obtained mainly through television (49.3%). In terms of generic drug characteristics, 79.1% stated that they were confident about their efficacy, 74.8% believed that generic drugs have the same effect as branded medications, 88.8% said that generics were priced lower than branded medications, and 80.2% stated that they bought generic drugs because of price. With regard to drugs prescribed by medical practitioners, 17.6% of the participants said that their doctors never prescribed generics and only 7.5% confirmed that their doctors always prescribed generics. Conclusion For the lay public, the sample in this study has sufficient knowledge of generic drugs in terms of definition, efficacy and cost. Consequently, the volunteers interviewed are very likely to use generics. Furthermore, the results of this study indicate that programs should be implemented in order to boost generic drug prescriptions by medical practitioners. PMID:25295444

Multimodal analysis of pretreated biomass species highlights generic markers of lignocellulose recalcitrance.

PubMed

Herbaut, Mickaël; Zoghlami, Aya; Habrant, Anouck; Falourd, Xavier; Foucat, Loïc; Chabbert, Brigitte; Paës, Gabriel

2018-01-01

Biomass recalcitrance to enzymatic hydrolysis has been assigned to several structural and chemical factors. However, their relative importance remains challenging to evaluate. Three representative biomass species (wheat straw, poplar and miscanthus) were submitted to four standard pretreatments (dilute acid, hot water, ionic liquid and sodium chlorite) in order to generate a set of contrasted samples. A large array of techniques, including wet chemistry analysis, porosity measurements using NMR spectroscopy, electron and fluorescence microscopy, were used in order to determine possible generic factors of biomass recalcitrance. The pretreatment conditions selected allowed obtaining samples displaying different susceptibility to enzymatic hydrolysis (from 3 up to 98% of the initial glucose content released after 96 h of saccharification). Generic correlation coefficients were calculated between the measured chemical and structural features and the final saccharification rates. Increases in porosity displayed overall strong positive correlations with saccharification efficiency, but different porosity ranges were concerned depending on the considered biomass. Lignin-related factors displayed highly negative coefficients for all biomasses. Lignin content, which is likely involved in the correlations observed for porosity, was less detrimental to enzymatic hydrolysis than lignin composition. Lignin influence was highlighted by the strong negative correlation with fluorescence intensity which mainly originates from monolignols in mature tissues. Our results provide a better understanding of the factors responsible for biomass recalcitrance that can reasonably be considered as generic. The correlations with specific porosity ranges are biomass species-dependent, meaning that enzymes cocktails with fitted enzyme size are likely to be needed to optimise saccharification depending on the biomass origin. Lignin composition, which probably influences its structure, is the most important parameter to overcome to enhance enzymes access to the polysaccharides. Accordingly, fluorescence intensity was found to be a rapid and simple method to assess recalcitrance after pretreatment.

The PedsQL Multidimensional Fatigue Scale in pediatric rheumatology: reliability and validity.

PubMed

Varni, James W; Burwinkle, Tasha M; Szer, Ilona S

2004-12-01

. The PedsQL (Pediatric Quality of Life Inventory) is a modular instrument designed to measure health related quality of life (HRQOL) in children and adolescents ages 2-18 years. The recently developed 18-item PedsQL Multidimensional Fatigue Scale was designed to measure fatigue in pediatric patients and comprises the General Fatigue Scale (6 items), Sleep/Rest Fatigue Scale (6 items), and Cognitive Fatigue Scale (6 items). The PedsQL 4.0 Generic Core Scales were developed as the generic core measure to be integrated with the PedsQL Disease-Specific Modules. The PedsQL 3.0 Rheumatology Module was designed to measure pediatric rheumatology-specific HRQOL. Methods. The PedsQL Multidimensional Fatigue Scale, Generic Core Scales, and Rheumatology Module were administered to 163 children and 154 parents (183 families accrued overall) recruited from a pediatric rheumatology clinic. Results. Internal consistency reliability for the PedsQL Multidimensional Fatigue Scale Total Score (a = 0.95 child, 0.95 parent report), General Fatigue Scale (a = 0.93 child, 0.92 parent), Sleep/Rest Fatigue Scale (a = 0.88 child, 0.90 parent), and Cognitive Fatigue Scale (a = 0.93 child, 0.96 parent) were excellent for group and individual comparisons. The validity of the PedsQL Multidimensional Fatigue Scale was confirmed through hypothesized intercorrelations with dimensions of generic and rheumatology-specific HRQOL. The PedsQL Multidimensional Fatigue Scale distinguished between healthy children and children with rheumatic diseases as a group, and was associated with greater disease severity. Children with fibromyalgia manifested greater fatigue than children with other rheumatic diseases. The results confirm the initial reliability and validity of the PedsQL Multidimensional Fatigue Scale in pediatric rheumatology.

A systematic investigation of sample diluents in modern supercritical fluid chromatography.

PubMed

Desfontaine, Vincent; Tarafder, Abhijit; Hill, Jason; Fairchild, Jacob; Grand-Guillaume Perrenoud, Alexandre; Veuthey, Jean-Luc; Guillarme, Davy

2017-08-18

This paper focuses on the possibility to inject large volumes (up to 10μL) in ultra-high performance supercritical fluid chromatography (UHPSFC) under generic gradient conditions. Several injection and method parameters have been individually evaluated (i.e. analyte concentration, injection volume, initial percentage of co-solvent in the gradient, nature of the weak needle wash solvent, nature of the sample diluent, nature of the column and of the analyte). The most critical parameters were further investigated using in a multivariate approach. The overall results suggested that several aprotic solvents including methyl tert-butyl ether (MTBE), dichloromethane, acetonitrile or cyclopentyl methyl ether (CPME) were well adapted for the injection of large volume in UHPSFC, while MeOH was generally the worst alternative. However, the nature of the stationary phase also had a strong impact and some of these diluents did not perform equally on each column. This was due to the existence of a competition in the adsorption of the analyte and the diluent on the stationary phase. This observation introduced the idea that the sample diluent should not only be chosen according to the analyte but also to the column chemistry to limit the interactions between the diluent and the ligands. Other important characteristics of the "ideal" SFC sample diluent were finally highlighted. Aprotic solvents with low viscosity are preferable to avoid strong solvent effects and viscous fingering, respectively. In the end, the authors suggest that the choice of the sample diluent should be part of the method development, as a function of the analyte and the selected stationary phase. Copyright © 2017 Elsevier B.V. All rights reserved.

An Efficient, Recyclable, and Stable Immobilized Biocatalyst Based on Bioinspired Microcapsules-in-Hydrogel Scaffolds.

PubMed

Zhang, Shaohua; Jiang, Zhongyi; Shi, Jiafu; Wang, Xueyan; Han, Pingping; Qian, Weilun

2016-09-28

Design and preparation of high-performance immobilized biocatalysts with exquisite structures and elucidation of their profound structure-performance relationship are highly desired for green and sustainable biotransformation processes. Learning from nature has been recognized as a shortcut to achieve such an impressive goal. Loose connective tissue, which is composed of hierarchically organized cells by extracellular matrix (ECM) and is recognized as an efficient catalytic system to ensure the ordered proceeding of metabolism, may offer an ideal prototype for preparing immobilized biocatalysts with high catalytic activity, recyclability, and stability. Inspired by the hierarchical structure of loose connective tissue, we prepared an immobilized biocatalyst enabled by microcapsules-in-hydrogel (MCH) scaffolds via biomimetic mineralization in agarose hydrogel. In brief, the in situ synthesized hybrid microcapsules encapsulated with glucose oxidase (GOD) are hierarchically organized by the fibrous framework of agarose hydrogel, where the fibers are intercalated into the capsule wall. The as-prepared immobilized biocatalyst shows structure-dependent catalytic performance. The porous hydrogel permits free diffusion of glucose molecules (diffusion coefficient: ∼6 × 10(-6) cm(2) s(-1), close to that in water) and retains the enzyme activity as much as possible after immobilization (initial reaction rate: 1.5 × 10(-2) mM min(-1)). The monolithic macroscale of agarose hydrogel facilitates the easy recycling of the immobilized biocatalyst (only by using tweezers), which contributes to the nonactivity decline during the recycling test. The fiber-intercalating structure elevates the mechanical stability of the in situ synthesized hybrid microcapsules, which inhibits the leaching and enhances the stability of the encapsulated GOD, achieving immobilization efficiency of ∼95%. This study will, therefore, provide a generic method for the hierarchical organization of (bio)active materials and the rational design of novel (bio)catalysts.

What use is generic prescribing?

PubMed Central

Archer, Michael

1985-01-01

The dispensing of generic preparations at four dispensing chemist shops was investigated by means of a questionnaire. Certain generic prescriptions result in the dispensing of proprietary products despite the existence of generic preparations, and the pharmacist may be reimbursed for the cost of the proprietary drug which has been dispensed. Not all generic prescriptions result in the dispensing of cheaper drugs because of the methods of payment to chemists. If doctors write more generic prescriptions there will ultimately be more dispensing of generic products. Even in the case of drugs still under patent, prescribing by generic name should be encouraged. The savings achieved by generic prescribing are to some extent at the cost of the dispensing chemists. The method and scale of payments for dispensing requires urgent review. PMID:4032358

Generic lamotrigine versus brand-name Lamictal bioequivalence in patients with epilepsy: A field test of the FDA bioequivalence standard.

PubMed

Ting, Tricia Y; Jiang, Wenlei; Lionberger, Robert; Wong, Jessica; Jones, Jace W; Kane, Maureen A; Krumholz, Allan; Temple, Robert; Polli, James E

2015-09-01

To test the current U.S. Food and Drug Administration (FDA) bioequivalence standard in a comparison of generic and brand-name drug pharmacokinetic (PK) performance in "generic-brittle" patients with epilepsy under clinical use conditions. This randomized, double-blind, multiple-dose, steady-state, fully replicated bioequivalence study compared generic lamotrigine to brand-name Lamictal in "generic-brittle" patients with epilepsy (n = 34) who were already taking lamotrigine. Patients were repeatedly switched between masked Lamictal and generic lamotrigine. Intensive PK blood sampling at the end of each 2-week treatment period yielded two 12-h PK profiles for brand-name and generic forms for each patient. Steady-state area under the curve (AUC), peak plasma concentration (Cmax ), and minimum plasma concentration (Cmin ) data were subjected to conventional average bioequivalence (ABE) analysis, reference-scaled ABE analysis, and within-subject variability (WSV) comparisons. In addition, generic-versus-brand comparisons in individual patients were performed. Secondary clinical outcomes included seizure frequency and adverse events. Generic demonstrated bioequivalence to brand. The 90% confidence intervals of the mean for steady-state AUC, Cmax , and Cmin for generic-versus-brand were 97.2-101.6%, 98.8-104.5%, and 93.4-101.0%, respectively. The WSV of generic and brand were also similar. Individual patient PK ratios for generic-versus-brand were similar but not identical, in part because brand-versus-brand profiles were not identical, even though subjects were rechallenged with the same product. Few subjects had seizure exacerbations or tolerability issues with product switching. One subject, however, reported 267 focal motor seizures, primarily on generic, although his brand and generic PK profiles were practically identical. Some neurologists question whether bioequivalence in healthy volunteers ensures therapeutic equivalence of brand and generic antiepileptic drugs in patients with epilepsy, who may be at increased risk for problems with brand-to-generic switching. Bioequivalence results in "generic-brittle" patients with epilepsy under clinical conditions support the soundness of the FDA bioequivalence standards. Adverse events on generic were not related to the small, allowable PK differences between generic and brand. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

Plant Tissue Culture in a Bag.

ERIC Educational Resources Information Center

Beck, Mike

2000-01-01

Describes the use of an oven bag as a sterile chamber for culture initiation and tissue transfer. Plant tissue culture is an ideal tool for introducing students to plants, cloning, and experimental design. Includes materials, methods, discussion, and conclusion sections. (SAH)

Impact of medicare part D plan features on use of generic drugs.

PubMed

Tang, Yan; Gellad, Walid F; Men, Aiju; Donohue, Julie M

2014-06-01

Little is known about how Medicare Part D plan features influence choice of generic versus brand drugs. To examine the association between Part D plan features and generic medication use. Data from a 2009 random sample of 1.6 million fee-for-service, Part D enrollees aged 65 years and above, who were not dually eligible or receiving low-income subsidies, were used to examine the association between plan features (generic cost-sharing, difference in brand and generic copay, prior authorization, step therapy) and choice of generic antidepressants, antidiabetics, and statins. Logistic regression models accounting for plan-level clustering were adjusted for sociodemographic and health status. Generic cost-sharing ranged from $0 to $9 for antidepressants and statins, and from $0 to $8 for antidiabetics (across 5th-95th percentiles). Brand-generic cost-sharing differences were smallest for statins (5th-95th percentiles: $16-$37) and largest for antidepressants ($16-$64) across plans. Beneficiaries with higher generic cost-sharing had lower generic use [adjusted odds ratio (OR)=0.97, 95% confidence interval (CI), 0.95-0.98 for antidepressants; OR=0.97, 95% CI, 0.96-0.98 for antidiabetics; OR=0.94, 95% CI, 0.92-0.95 for statins]. Larger brand-generic cost-sharing differences and prior authorization were significantly associated with greater generic use in all categories. Plans could increase generic use by 5-12 percentage points by reducing generic cost-sharing from the 75th ($7) to 25th percentiles ($4-$5), increasing brand-generic cost-sharing differences from the 25th ($25-$26) to 75th ($32-$33) percentiles, and using prior authorization and step therapy. Cost-sharing features and utilization management tools were significantly associated with generic use in 3 commonly used medication categories.

Do higher-priced generic medicines enjoy a competitive advantage under reference pricing?

PubMed

Puig-Junoy, Jaume

2012-11-01

In many countries with generic reference pricing, generic producers and distributors compete by means of undisclosed discounts offered to pharmacies in order to reduce acquisition costs and to induce them to dispense their generic to patients in preference over others. The objective of this article is to test the hypothesis that under prevailing reference pricing systems for generic medicines, those medicines sold at a higher consumer price may enjoy a competitive advantage. Real transaction prices for 179 generic medicines acquired by pharmacies in Spain have been used to calculate the discount rate on acquisition versus reimbursed costs to pharmacies. Two empirical hypotheses are tested: the discount rate at which pharmacies acquire generic medicines is higher for those pharmaceutical presentations for which there are more generic competitors; and, the discount rate at which pharmacies acquire generic medicines is higher for those pharmaceutical forms for which the consumer price has declined less in relation to the consumer price of the brand drug before generic entry (higher-priced generic medicines). An average discount rate of 39.3% on acquisition versus reimbursed costs to pharmacies has been observed. The magnitude of the discount positively depends on the number of competitors in the market. The higher the ratio of the consumer price of the generic to that of the brand drug prior to generic entry (i.e. the smaller the price reduction of the generic in relation to the brand drug), the larger the discount rate. Under reference pricing there is intense price competition among generic firms in the form of unusually high discounts to pharmacies on official ex-factory prices reimbursed to pharmacies. However, this effect is highly distorting because it favours those medicines with a higher relative price in relation to the brand price before generic entry.

Questionnaire on the awareness of generic drugs among outpatients and medical staff.

PubMed

Hoshi, S; Kimura, H

2008-06-01

Generic drugs are not as widely used in Japan as they are in the West. The objective of this study was to survey the awareness of generic drugs among outpatients and medical staff and propose methods of promoting the use of generic drugs. Our survey showed that 86.7% of respondents were aware of generic drugs. This is a higher awareness rate than that in a survey of other groups conducted last year. One reason to explain this higher awareness is the recent increase in generic drug advertisements both in newspapers and on television. However, a point of note is that generic drug usage has not increased. Our survey also showed that generic drug awareness was differed widely among age groups, as younger respondents were much more aware of generic drugs than older respondents. Still, about 40% of respondents who were aware of generic drugs did not realize that they were less expensive than name-brand drugs ? including 30% of medical staff. In addition to continuing advertisement of generic drugs in the media, medical doctors and pharmacists should also be encouraged to endorse the use of generic drugs. Furthermore a new system allowing for substitution prescriptions started in April 2008 and consequently pharmacists can now play an important role in promoting the use of generic drugs.

Analysis of French generic medicines retail market: why the use of generic medicines is limited.

PubMed

Dylst, Pieter; Vulto, Arnold; Simoens, Steven

2014-12-01

The market share of generic medicines in France is low compared to other European countries. This perspective paper provides an overview of the generic medicines retail market in France and how the current policy environment may affect the long-term sustainability. Looking at the French generic medicines retail market and the surrounding regulatory framework, all conditions seem to be in place to create a healthy generic medicines market: the country has well-respected regulatory authorities, generic medicines enter the market in a timely manner and prices of generic medicines are competitive compared with other European countries. Despite the success of the demand-side policies targeted at pharmacists and patients, those targeted at physicians were less successful due to a lack of enforcement and a lack of trust in generic medicines by French physicians. Recommendations to increase the use of generic medicines in France round off this perspective paper.

Holographic thermalization with initial long range correlation

DOE PAGES

Lin, Shu

2016-01-19

Here, we studied the evolution of the Wightman correlator in a thermalizing state modeled by AdS 3-Vaidya background. A prescription was given for calculating the Wightman correlator in coordinate space without using any approximation. For equal-time correlator , we obtained an enhancement factor v 2 due to long range correlation present in the initial state. This was missed by previous studies based on geodesic approximation. Moreover, we found that the long range correlation in initial state does not lead to significant modification to thermalization time as compared to known results with generic initial state. We also studied the spatially integratedmore » Wightman correlator and showed evidence on the distinction between long distance and small momentum physics for an out-of-equilibrium state. We also calculated the radiation spectrum of particles weakly coupled to O and found that lower frequency mode approaches thermal spectrum faster than high frequency mode.« less

Perception of Generic Prescription Drugs and Utilization of Generic Drug Discount Programs

PubMed Central

Omojasola, Anthony; Hernandez, Mike; Sansgiry, Sujit; Jones, Lovell

2012-01-01

Objective Our study aimed to assess patient’s perceptions of generic drugs and utilization of generic drug discount programs. Design, Setting and Participants A survey was administered to adult participants at community health centers and community-based organizations in Houston, Texas, USA (n=525). Main Outcome Measures Multivariate logistic regression was used to quantify the strength of association between generic drug perception and utilization of generic drug discount programs. Results Respondents who agreed that “Generic prescription drugs are as effective as brand name prescription drugs,” were 3 times as likely to utilize generic drug discount programs (AOR: 3.0, 95% CI: 1.8–4.8, P<.001). Compared to non-Hispanic Whites, African Americans (OR: 10.2; 95% CI: 1.4–76.4) and Hispanics (OR: 10.3; 95% CI: 1.3–79.4) were 10 times as likely to agree that generic drugs have more side effects than brand name drugs. Conclusion Race/ethnicity had no impact in utilization of generic drug discount programs, despite racial disparities in perception toward generic drugs’ side effects and generic drugs being inferior to brand name drugs. PMID:23140080

Process of establishing a plane-wave system on ice cover over a dipole moving uniformly in an ideal fluid column

NASA Astrophysics Data System (ADS)

Il'ichev, A. T.; Savin, A. S.

2017-12-01

We consider a planar evolution problem for perturbations of the ice cover by a dipole starting its uniform rectilinear horizontal motion in a column of an initially stationary fluid. Using asymptotic Fourier analysis, we show that at supercritical velocities, waves of two types form on the water-ice interface. We describe the process of establishing these waves during the dipole motion. We assume that the fluid is ideal and incompressible and its motion is potential. The ice cover is modeled by the Kirchhoff-Love plate.

Soft Congruence Relations over Rings

PubMed Central

Xin, Xiaolong; Li, Wenting

2014-01-01

Molodtsov introduced the concept of soft sets, which can be seen as a new mathematical tool for dealing with uncertainty. In this paper, we initiate the study of soft congruence relations by using the soft set theory. The notions of soft quotient rings, generalized soft ideals and generalized soft quotient rings, are introduced, and several related properties are investigated. Also, we obtain a one-to-one correspondence between soft congruence relations and idealistic soft rings and a one-to-one correspondence between soft congruence relations and soft ideals. In particular, the first, second, and third soft isomorphism theorems are established, respectively. PMID:24949493

Semi-idealized modeling of lightning initiation related to vertical air motion and cloud microphysics

NASA Astrophysics Data System (ADS)

Wang, Fei; Zhang, Yijun; Zheng, Dong; Xu, Liangtao; Zhang, Wenjuan; Meng, Qing

2017-10-01

A three-dimensional charge-discharge numerical model is used, in a semi-idealized mode, to simulate a thunder-storm cell. Characteristics of the graupel microphysics and vertical air motion associated with the lightning initiation are revealed, which could be useful in retrieving charge strength during lightning when no charge-discharge model is available. The results show that the vertical air motion at the lightning initiation sites ( W ini) has a cubic polynomial correlation with the maximum updraft of the storm cell ( W cell-max), with the adjusted regression coefficient R 2 of approximately 0.97. Meanwhile, the graupel mixing ratio at the lightning initiation sites ( q g-ini) has a linear correlation with the maximum graupel mixing ratio of the storm cell ( q g-cell-max) and the initiation height ( z ini), with the coefficients being 0.86 and 0.85, respectively. These linear correlations are more significant during the middle and late stages of lightning activity. A zero-charge zone, namely, the area with very low net charge density between the main positive and negative charge layers, appears above the area of q g-cell-max and below the upper edge of the graupel region, and is found to be an important area for lightning initiation. Inside the zero-charge zone, large electric intensity forms, and the ratio of q ice (ice crystal mixing ratio) to q g (graupel mixing ratio) illustrates an exponential relationship to q g-ini. These relationships provide valuable clues to more accurately locating the high-risk area of lightning initiation in thunderstorms when only dual-polarization radar data or outputs from numerical models without charging/discharging schemes are available. The results can also help understand the environmental conditions at lightning initiation sites.

The Portuguese generic medicines market: a policy analysis

PubMed Central

Simoens, Steven

2008-01-01

Objectives: This study aims to conduct a descriptive analysis of the policy environment surrounding the generic medicines retail market in Portugal. The policy analysis focuses on supply-side measures (i.e. market access, pricing, reference-pricing and reimbursement of generic medicines) and demand-side measures (i.e. incentives for physicians to prescribe, for pharmacists to dispense and for patients to use generic medicines). Methods: The policy analysis was based on an international literature review. Also, a simulation exercise was carried out to compute potential savings from substituting generic for originator medicines in Portugal using IMS Health data. Results: Portugal has developed a successful generic medicines market by increasing reimbursement of generic medicines (until October 2005), by introducing a reference-pricing system, by encouraging physicians to prescribe by international non-proprietary name (INN), and by allowing generic substitution by pharmacists. However, the development of the generic medicines market has been hindered by the existence of copies, pricing regulation, certain features of the reference-pricing system, weak incentives for physicians to prescribe generic medicines and a financial disincentive for pharmacists to dispense generic medicines. Increased generic substitution would be expected to reduce public expenditure on originator medicines by 45%. Conclusions: The development of the Portuguese generic medicines market has mainly been fuelled by supply-side measures. To support the further expansion of the market, policy makers need to strengthen demand-side measures inciting physicians to prescribe, pharmacists to dispense and patients to use generic medicines. PMID:25152781

Simulations of supersonic highly under-expanded hydrogen jets

NASA Astrophysics Data System (ADS)

Miarnau Marin, Ana; Xiao, Cheng-Nian; Denner, Fabian; van Wachem, Berend

2017-11-01

The pressure drop across choke valves required to transport natural gas can be in the order of several hundred bars, leading to the development of supersonic under-expanded jets. When considering a real gas, the gas can cool upon expansion, a phenomenon which can be explained by the Joule-Thomson effect. This study compares the effects of using ideal and real gas equations of state, using a computational model in which hydrogen is released from a high-pressure tank, through a converging nozzle, into a chamber containing hydrogen at near-atmospheric conditions. The initial studies were carried out using an ideal gas assumption and nozzle pressure ratios of 10, 30 and 70 and the results were validated against existing literature. To account for the Joule-Thomson effect, ideal and real gas simulations were then carried out with a pressure ratio of 70. For the real gas model, the Peng-Robinson equation of state was chosen. At the nozzle exit, the ideal gas model underestimates the velocity and overestimates the temperature and density; as the flow expands, the flow properties are the same up to the Mach disk, at which point the ideal gas underestimates the Mach number and predicts a higher temperature and density than the Peng-Robinson model due to the absence of cooling.

The theory-practice relationship: reflective skills and theoretical knowledge as key factors in bridging the gap between theory and practice in initial nursing education.

PubMed

Hatlevik, Ida Katrine Riksaasen

2012-04-01

This paper is a report of a correlational study of the relations of nursing students' acquired reflective skills, practical skills and theoretical knowledge on their perception of coherence between theory and practice. Reflection is considered a key factor in bridging the gap between theory and practice. However, it is not evident whether reflective skills are primarily generic in nature or whether they develop from a theoretical knowledge base or the acquisition of practical skills. This study is a secondary analysis of existing data. The data are part of a student survey that was conducted among third-year nursing students in Norway during the spring of 2007. A total of 446 nursing students participated in this study and the response rate was 71%. Structural equation modelling analyses were performed. The results indicate that students' perception of coherence between theory and practice during initial nursing education is directly influenced by reflective skills and theoretical knowledge. The results also reveal that reflective skills have mediating effects and that practical skills have a fully mediated and theoretical knowledge a partially mediated influence on students' perception of coherence. The findings imply that helping students perceive coherence between theory and practice in nursing education, developing students' reflective skills and strengthening the theoretical components of the initial nursing education programme might be beneficial. The results suggest that reflective thinking is not merely a generic skill but rather a skill that depends on the acquisition of relevant professional knowledge and experience. © 2011 Blackwell Publishing Ltd.

Do English healthcare settings use 'Choice Architecture' principles in promoting healthy lifestyles for people with psoriasis? An observational study.

PubMed

Keyworth, Chris; Nelson, Pauline A; Griffiths, Christopher E M; Cordingley, Lis; Bundy, Chris

2015-06-02

The influence of environmental factors in shaping behaviour is becoming increasingly prominent in public health policy, but whether health promotion strategies use this knowledge is unknown. Health promotion is important in the management of psoriasis, a long-term inflammatory skin condition, and health centre waiting areas are ideal places to promote health information to such patients. We systematically examined patient information materials containing either general, or specific, health messages for patients with psoriasis. An observation schedule was used to record the frequency and quality of leaflets and posters addressing lifestyle behaviour change in health centre waiting areas. Content analysis was used to analyse: frequency, characteristics and standard of the materials. Across 24 health centres 262 sources of lifestyle information were recorded (median per site = 10; range = 0-40). These were mainly: generic posters/displays of lifestyle support (n = 113); and generic materials in waiting areas (n = 98). Information quality was poor and poorly displayed, with no high quality psoriasis-specific patient materials evident. There is little attempt to promote healthy lifestyle as an important aspect of psoriasis management in the clinic environment. Evidence about using environmental cues/techniques to prompt behaviour change in people with psoriasis does not currently inform the design and display of such information in standard health centre settings, which are prime locations for communicating messages about healthy lifestyle. Future research should test the efficacy and impact of theory-informed, high quality health promotion messages on health outcomes for patients with psoriasis.

Visual programming for next-generation sequencing data analytics.

PubMed

Milicchio, Franco; Rose, Rebecca; Bian, Jiang; Min, Jae; Prosperi, Mattia

2016-01-01

High-throughput or next-generation sequencing (NGS) technologies have become an established and affordable experimental framework in biological and medical sciences for all basic and translational research. Processing and analyzing NGS data is challenging. NGS data are big, heterogeneous, sparse, and error prone. Although a plethora of tools for NGS data analysis has emerged in the past decade, (i) software development is still lagging behind data generation capabilities, and (ii) there is a 'cultural' gap between the end user and the developer. Generic software template libraries specifically developed for NGS can help in dealing with the former problem, whilst coupling template libraries with visual programming may help with the latter. Here we scrutinize the state-of-the-art low-level software libraries implemented specifically for NGS and graphical tools for NGS analytics. An ideal developing environment for NGS should be modular (with a native library interface), scalable in computational methods (i.e. serial, multithread, distributed), transparent (platform-independent), interoperable (with external software interface), and usable (via an intuitive graphical user interface). These characteristics should facilitate both the run of standardized NGS pipelines and the development of new workflows based on technological advancements or users' needs. We discuss in detail the potential of a computational framework blending generic template programming and visual programming that addresses all of the current limitations. In the long term, a proper, well-developed (although not necessarily unique) software framework will bridge the current gap between data generation and hypothesis testing. This will eventually facilitate the development of novel diagnostic tools embedded in routine healthcare.

Serial nominations for the AWH initiative: The paradigm of seven-stone antas and beyond

NASA Astrophysics Data System (ADS)

Belmonte, Juan Antonio; González García, César; Hoskin, Michael

2016-10-01

In this short report we examine the ideal status of the seven-stone antas (a type of very ancient megalithic monument in the southwest of the Iberian Peninsula) as an excellent candidate for a serial nomination within the Astronomy and World Heritage Initiative. This case will be compared with an extraordinary set of dolmens at the other side of the Mediterranean, within the Transjordan Plateau, worthy of being protected under the umbrella of the same initiative but which are in serious danger of `extinction'.

Explicit solutions for exit-only radioactive decay chains

NASA Astrophysics Data System (ADS)

Yuan, Ding; Kernan, Warnick

2007-05-01

In this study, we extended Bateman's [Proc. Cambridge Philos. Soc. 15, 423 (1910)] original work for solving radioactive decay chains and explicitly derived analytic solutions for generic exit-only radioactive decay problems under given initial conditions. Instead of using the conventional Laplace transform for solving Bateman's equations, we used a much simpler algebraic approach. Finally, we discuss methods of breaking down certain classes of large decay chains into collections of simpler chains for easy handling.

Hierarchical Architectural Considerations in Econometric Modeling of Manufacturing Systems

DTIC Science & Technology

1981-06-01

behavioral factors must also be considered. A proposed economic model, to be aligned with ICAM program intentions, should be generic and have the... relevant to the effort and to identify contractors, if any, involved in economic model development. Due to the nature of involvement of other con...tractors with the ICAM program office, information which was thought relevant to the initiation of the current effort was in a lag-time and was

Measuring performance in off-patent drug markets: a methodological framework and empirical evidence from twelve EU Member States.

PubMed

Kanavos, Panos

2014-11-01

This paper develops a methodological framework to help evaluate the performance of generic pharmaceutical policies post-patent expiry or after loss of exclusivity in non-tendering settings, comprising five indicators (generic availability, time delay to and speed of generic entry, number of generic competitors, price developments, and generic volume share evolution) and proposes a series of metrics to evaluate performance. The paper subsequently tests this framework across twelve EU Member States (MS) by using IMS data on 101 patent expired molecules over the 1998-2010 period. Results indicate that significant variation exists in generic market entry, price competition and generic penetration across the study countries. Size of a geographical market is not a predictor of generic market entry intensity or price decline. Regardless of geographic or product market size, many off patent molecules lack generic competitors two years after loss of exclusivity. The ranges in each of the five proposed indicators suggest, first, that there are numerous factors--including institutional ones--contributing to the success of generic entry, price decline and market penetration and, second, MS should seek a combination of supply and demand-side policies in order to maximise cost-savings from generics. Overall, there seems to be considerable potential for faster generic entry, uptake and greater generic competition, particularly for molecules at the lower end of the market. Copyright © 2014. Published by Elsevier Ireland Ltd.

Predictors of generic substitution: The role of psychological, sociodemographic, and contextual factors.

PubMed

Drozdowska, Aleksandra; Hermanowski, Tomasz

2016-01-01

Escalating pharmaceutical costs have become a global challenge for both governments and patients. Generic substitution is one way of decreasing these costs. The aim of this study was to investigate factors associated with patients' choice between generic drugs and innovator drugs. The survey was conducted in June 2013, 1000 people from across Poland were chosen as a representative population sample. The outcome (a preference for generics/a preference for innovator pharmaceuticals/no preference) was modeled by multinomial logistic regression, adjusted for several variables describing patients' sensitivity to selected generic features (price, brand, and country of origin), to third-party opinions about generics (information on generics in the mass media, opinions of health professionals (i.e. physicians, pharmacists), relatives/friends), as well as patients' personal experiences and income per household. The results supported the predictive capacity of most independent variables (except for patient sensitivity to the country of origin and to the information on generics in the mass media), denoting patients' preferences toward generic substitution. Patient sensitivity to recommendations by physicians, generic brand, and household income were the strongest predictors of the choice between generic and innovator pharmaceuticals (P < 0.001). The probability of choosing generics over innovator drugs was significantly higher among respondents with the lowest income levels, in those who were indifferent to generic brand or their physician's opinion, as well as in respondents who were sensitive to recommendations by pharmacists or attached a greater value to a past experience with generics (their own experience or that of relatives/friends). In consideration of the foregoing, awareness-raising campaigns may be recommended, supported by a variety of systemic solutions and tools to encourage generic substitution. Copyright © 2016 Elsevier Inc. All rights reserved.

The Third Phase of AQMEII: Evaluation Strategy and Multi-Model Performance Analysis

EPA Science Inventory

AQMEII (Air Quality Model Evaluation International Initiative) is an extraordinary effort promoting policy-relevant research on regional air quality model evaluation across the European and North American atmospheric modelling communities, providing the ideal platform for advanci...

Scalable geocomputation: evolving an environmental model building platform from single-core to supercomputers

NASA Astrophysics Data System (ADS)

Schmitz, Oliver; de Jong, Kor; Karssenberg, Derek

2017-04-01

There is an increasing demand to run environmental models on a big scale: simulations over large areas at high resolution. The heterogeneity of available computing hardware such as multi-core CPUs, GPUs or supercomputer potentially provides significant computing power to fulfil this demand. However, this requires detailed knowledge of the underlying hardware, parallel algorithm design and the implementation thereof in an efficient system programming language. Domain scientists such as hydrologists or ecologists often lack this specific software engineering knowledge, their emphasis is (and should be) on exploratory building and analysis of simulation models. As a result, models constructed by domain specialists mostly do not take full advantage of the available hardware. A promising solution is to separate the model building activity from software engineering by offering domain specialists a model building framework with pre-programmed building blocks that they combine to construct a model. The model building framework, consequently, needs to have built-in capabilities to make full usage of the available hardware. Developing such a framework providing understandable code for domain scientists and being runtime efficient at the same time poses several challenges on developers of such a framework. For example, optimisations can be performed on individual operations or the whole model, or tasks need to be generated for a well-balanced execution without explicitly knowing the complexity of the domain problem provided by the modeller. Ideally, a modelling framework supports the optimal use of available hardware whichsoever combination of model building blocks scientists use. We demonstrate our ongoing work on developing parallel algorithms for spatio-temporal modelling and demonstrate 1) PCRaster, an environmental software framework (http://www.pcraster.eu) providing spatio-temporal model building blocks and 2) parallelisation of about 50 of these building blocks using the new Fern library (https://github.com/geoneric/fern/), an independent generic raster processing library. Fern is a highly generic software library and its algorithms can be configured according to the configuration of a modelling framework. With manageable programming effort (e.g. matching data types between programming and domain language) we created a binding between Fern and PCRaster. The resulting PCRaster Python multicore module can be used to execute existing PCRaster models without having to make any changes to the model code. We show initial results on synthetic and geoscientific models indicating significant runtime improvements provided by parallel local and focal operations. We further outline challenges in improving remaining algorithms such as flow operations over digital elevation maps and further potential improvements like enhancing disk I/O.

[Generic drugs: good or bad? Physician's knowledge of generic drugs and prescribing habits].

PubMed

García, A J; Martos, F; Leiva, F; Sánchez de la Cuesta, F

2003-01-01

In this article we analyze the responses of 1220 Spanish physicians who participated in a survery about generic drugs. A previously validated questionnaire was sent to physicians through the Spanish Medical Councils of the different provinces. Four items were analyzed: what doctors know about generic drugs (knowledge); physicians' prescribing habits concerning these drugs (attitude and professional competence); how prescription of generic drugs effects pharmaceutical costs amd, finally, what doctors believe a generic drug should be. The influence of physician-related variables (age, type of contract, specialty, workload, etc.) on prescribing of generic drugs was also analyzed. In view of the results, we believe that to rationalize expenditure through and appropriate policy on generic drugs Spanish health authorities should offer more and better training and information (clear and independent) about what generic drugs are.

76 FR 17182 - Agency Information Collection Activities: Proposed Collection; Comment Request; Generic Clearance...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-28

... Activities: Proposed Collection; Comment Request; Generic Clearance for the Collection of Qualitative... Request (Generic ICR): ``Generic Clearance for the Collection of Qualitative Feedback on Agency Service...: Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery. Abstract...

Generic Example Proving Criteria for All

ERIC Educational Resources Information Center

Yopp, David; Ely, Rob; Johnson­-Leung, Jennifer

2015-01-01

We review literature that discusses generic example proving and highlight ambiguities that pervade our research community's discourse about generic example arguments. We distinguish between pedagogical advice for choosing good examples that can serve as generic examples when teaching and advice for developing generic example arguments. We provide…

Dynamics of living matter: can we ``see'' collective motions in proteins?

NASA Astrophysics Data System (ADS)

Hekstra, Doeke

2015-03-01

Proteins are ideal model systems for quantitative study of the interplay of physical and evolutionary forces. Collective, anharmonic motions of amino acid residues within proteins are thought to be central to their function, and to explain, in large part, the complex dependence of protein function on its constituent parts. Currently, the experimental characterization of such motions poses a major stumbling block on the way to a physical understanding of protein function and evolution. We are addressing this problem in two ways. First, alternate conformations of protein residues can often be distinguished in the electron density estimated from room-temperature X-ray crystallography. The dense packing of residues in the folded protein requires that such conformational variations must propagate through networks of amino acids to preclude local steric clashes. Fraser and colleagues showed that such steric conflicts can be used to extract contact networks of residues collectively switching conformation. We ask if these networks are conserved over homologous sequences and connected to the functional reaction coordinate, both of which would demonstrate their fundamental importance. I will describe initial results for the family of PDZ domains: small ligand-binding proteins for which a network of energetically and conformationally coupled residues controlling ligand affinity has been demonstrated previously by a range of methods. Second, the analysis of collective motions in proteins, by nearly any means, is indirect: nothing is seen moving. To directly induce and ``see'' motions on a range of time scales, we developed a new approach based on (a) electric field pulses to induce motions within a protein crystal and (b) time-resolved crystallography to observe these motions. Since proteins generically have a heterogeneous, modifiable charge distribution, this method could provide a powerful, general way of probing the collective motions, and excited states, of proteins in kinetic and atomic detail. I will present initial experiments showing the method is feasible. Taken together, these experiments begin to provide a basis for the development of a physical theory of proteins consistent with their function and adaptation - the source of their survival throughout the evolutionary process.

Estimating the gravitational-wave content of initial-data sets for numerical relativity using the Beetle--Burko scalar

NASA Astrophysics Data System (ADS)

Burko, Lior M.

2006-04-01

The Beetle--Burko radiation scalar is a gauge independent, tetrad independent, and background independent quantity that depends only on the radiative degrees of freedom where the notion of radiation is incontrovertible, and can be computed from spatial data as is typical in numerical relativity simulations even for strongly dynamical spacetimes. We show that the Beetle--Burko radiation scalar can be used for estimating the graviational-wave content of initial-data sets in numerical relativity, and can thus be useful for the construction of physically meaningful ones, and the identification of ``junk'' data on the intial value surface. We apply this method for the case of a momentarily stationary black hole binary, and demonstrate how the Beetle-- Burko scalar distinguishes between Misner and Brill--Lindquist initial data. The method, however, is robust, and is applicable to generic initial data sets. In addition to initial data sets, the Beetle--Burko radiation scalar is equally applicable also for evolution data.

Perspectives of physicians practicing in low and middle income countries towards generic medicines: a narrative review.

PubMed

Hassali, Mohamed Azmi; Wong, Zhi Yen; Alrasheedy, Alian A; Saleem, Fahad; Mohamad Yahaya, Abdul Haniff; Aljadhey, Hisham

2014-09-01

This review was conducted to document published literature related to physicians' knowledge, attitudes, and perceptions of generic medicines in low- and middle-income countries (LMICs) and to compare the findings with high-income countries. A systematic search of articles published in peer-reviewed journals from January 2001 to February 2013 was performed. The search comprised nine electronic databases. The search strategy involved using Boolean operators for combinations of the following terms: generic medicines, generic medications, generic drugs, generic, generic substitution, generic prescribing, international non-proprietary, prescribers, doctors, general practitioners, physicians, and specialists. Sixteen articles were included in this review. The majority (n=11) were from high income countries and five from LMICs. The main difference between high income countries and LMICs is that physicians from high income countries generally have positive views whereas those from LMICs tend to have mixed views regarding generic medicines. Few similarities were identified among different country income groups namely low level of physicians' knowledge of the basis of bioequivalence testing, cost of generic medicines as an encouraging factor for generic medicine prescribing, physicians' concerns towards safety and quality of generic medicines and effect of pharmaceutical sales representative on generic medicine prescribing. The present literature review revealed that physicians from LMICs tend to have mixed views regarding generic medicines. This may be due to differences in the health care system and pharmaceutical funding system, medicine policies, the level of educational interventions, and drug information sources in countries of different income levels. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Assessing bioequivalence of generic antiepilepsy drugs.

PubMed

Krauss, Gregory L; Caffo, Brian; Chang, Yi-Ting; Hendrix, Craig W; Chuang, Kelly

2011-08-01

Patients with epilepsy are often concerned that switching between brand-name and generic formulations of antiepilepsy drugs (AEDs) may cause clinically significant changes in plasma drug concentrations. We assessed bioequivalence (BE) studies for approved generic AEDs to evaluate US Food and Drug Administration claims that: (1) generic AEDs are accurate copies of reference formulations; (2) delivery of reference formulations may be as variable as generic AEDs and so provide no increased benefit; and (3) switches between generic AED formulations are safe and effective. We determined differences in 90% confidence interval limits for total drug exposure (AUC(0-t) ) and peak concentration (Cmax) ratios of generic and reference formulations during fasting and fed BE studies. We simulated BE between generic formulations after adjusting for reference values. AUC(0-t) values of approved reference and generic formulations differed by <15% in 99% of BE studies; Cmax differed by <15% in 89% of studies. Food affected variability of Cmax but not AUC(0-t) . Intersubject variability in Cmax and AUC(0-t) was small and similar for reference and generic products. In simulated switches between 595 pairs of generic AED formulations, estimated AUC(0-t) differed by >15% for 17% of pairs; estimated Cmax differed by >15% for 39%. AEDs with low bioavailability and solubility (eg, oxcarbazepine) had the greatest variability in BE. Most generic AED products provide total drug delivery (AUC) similar to reference products; differences in peak concentrations between formulations are more common. Switches between generic AED products may cause greater changes in plasma drug concentrations than generic substitutions of reference products. Copyright © 2011 American Neurological Association.

The risks and costs of multiple-generic substitution of topiramate.

PubMed

Duh, M S; Paradis, P E; Latrémouille-Viau, D; Greenberg, P E; Lee, S P; Durkin, M B; Wan, G J; Rupnow, M F T; LeLorier, J

2009-06-16

To investigate clinical and economic consequences following generic substitution of one vs multiple generics of topiramate (Topamax; Ortho-McNeil Neurologics, Titusville, NJ). Medical and pharmacy claims data of Régie de l'Assurance-Maladie du Québec from January 2006 to October 2007 were used. Patients with epilepsy treated with topiramate were selected. An open-cohort design was used to classify the observation period into periods of brand, single-generic, and multiple-generic use. One-year generic-switch and switchback-to-brand rates were estimated using Kaplan-Meier methodology. Medical resource utilization and costs were compared among the three periods using multivariate regression analysis. In total, 948 patients were observed during 1,105 person-years of brand use, 233 person-years of single-generic use, and 92 person-years of multiple-generic use. A total of 23% of generic users received at least two different generic versions. Compared to brand use, multiple-generic use was associated with higher utilization of other prescription drugs (incidence rate ratio [IRR] = 1.27, 95% confidence interval [CI] = 1.24-1.31), higher hospitalization rates (0.48 vs 0.83 visit/person-year, IRR = 1.65, 95% CI = 1.28-2.13), and longer hospital stays (2.6 vs 3.9 days/person-year, IRR = 1.43, 95% CI = 1.27-1.60), but the effect was less pronounced in single-generic use (hospitalization: IRR = 1.08, 95% CI = 0.88-1.34, length of stay: IRR = 1.12, 95% CI = 1.03-1.23). The risk of head injury or fracture was nearly three times higher (hazard ratio = 2.84, 95% CI = 1.24-6.48) following a generic-to-generic switch compared to brand use. The total annualized health care cost per patient was higher in the multiple-generic than brand periods by C$1,716 (cost ratio = 1.21, p = 0.0420). Multiple-generic substitution of topiramate was significantly associated with negative outcomes, such as hospitalizations and injuries, and increased health care costs.

76 FR 39893 - Agency Information Collection Activities: Proposed Collection; Comment Request; Generic Clearance...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-07

...; Comment Request; Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery... (Generic ICR): ``Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery.... SUPPLEMENTARY INFORMATION: Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service...

76 FR 19359 - Agency Information Collection Activities: Proposed Collection; Comment Request; Generic Clearance...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-07

... Request; Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery AGENCY... Information Collection Request (Generic ICR): ``Generic Clearance for the Collection of Qualitative Feedback...: Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery. Abstract...

High-resolution proton density weighted three-dimensional fast spin echo (3D-FSE) of the knee with IDEAL at 1.5 Tesla: comparison with 3D-FSE and 2D-FSE--initial experience.

PubMed

McMahon, Colm J; Madhuranthakam, Ananth J; Wu, Jim S; Yablon, Corrie M; Wei, Jesse L; Rofsky, Neil M; Hochman, Mary G

2012-02-01

To assess the feasibility of combining three-dimensional fast spin echo (3D-FSE) and Iterative-decomposition-of water-and-fat-with-echo asymmetry-and-least-squares-estimation (IDEAL) at 1.5 Tesla (T), generating a high-resolution 3D isotropic proton density-weighted image set with and without "fat-suppression" (FS) in a single acquisition, and to compare with 2D-FSE and 3D-FSE (without IDEAL). Ten asymptomatic volunteers prospectively underwent sagittal 3D-FSE-IDEAL, 3D-FSE, and 2D-FSE sequences at 1.5T (slice thickness [ST]: 0.8 mm, 0.8 mm, and 3.5 mm, respectively). 3D-FSE and 2D-FSE were repeated with frequency-selective FS. Fluid, cartilage, and muscle signal-to-noise ratio (SNR) and fluid-cartilage contrast-to-noise ratio (CNR) were compared among sequences. Three blinded reviewers independently scored quality of menisci/cartilage depiction for all sequences. "Fat-suppression" was qualitatively scored and compared among sequences. 3D-FSE-IDEAL fluid-cartilage CNR was higher than in 2D-FSE (P < 0.05), not different from 3D-FSE (P = 0.31). There was no significant difference in fluid SNR among sequences. 2D-FSE cartilage SNR was higher than in 3D FSE-IDEAL (P < 0.05), not different to 3D-FSE (P = 0.059). 2D-FSE muscle SNR was higher than in 3D-FSE-IDEAL (P < 0.05) and 3D-FSE (P < 0.05). Good or excellent depiction of menisci/cartilage was achieved using 3D-FSE-IDEAL in the acquired sagittal and reformatted planes. Excellent, homogeneous "fat-suppression" was achieved using 3D-FSE-IDEAL, superior to FS-3D-FSE and FS-2D-FSE (P < 0.05). 3D FSE-IDEAL is a feasible approach to acquire multiplanar images of diagnostic quality, both with and without homogeneous "fat-suppression" from a single acquisition. Copyright © 2011 Wiley Periodicals, Inc.

Tactical lighting in special operations medicine: survey of current preferences.

PubMed

Calvano, Christopher J; Enzenauer, Robert W; Eisnor, Derek L; Laporta, Anthony J

2013-01-01

Success in Special Operations Forces medicine (SOFMED) is dependent on maximizing visual capability without compromising the provider or casualty position when under fire. There is no single ideal light source suitable for varied SOFMED environments. We present the results of an online survey of Special Operations Medical Operators in an attempt to determine strengths and weaknesses of current systems. There was no consensus ideal hue for tactical illumination. Most Operators own three or more lights, and most lights were not night vision compatible. Most importantly, nearly 25% of respondents reported that lighting issues contributed to a poor casualty outcome; conversely, a majority (50 of 74) stated their system helped prevent a poor outcome. Based on the results of this initial survey, we can affirm that the design and choice of lighting is critical to SOFMED success. We are conducting ongoing studies to further define ideal systems for tactical applications including field, aviation, and marine settings. 2013.

Routes to the past: neural substrates of direct and generative autobiographical memory retrieval.

PubMed

Addis, Donna Rose; Knapp, Katie; Roberts, Reece P; Schacter, Daniel L

2012-02-01

Models of autobiographical memory propose two routes to retrieval depending on cue specificity. When available cues are specific and personally-relevant, a memory can be directly accessed. However, when available cues are generic, one must engage a generative retrieval process to produce more specific cues to successfully access a relevant memory. The current study sought to characterize the neural bases of these retrieval processes. During functional magnetic resonance imaging (fMRI), participants were shown personally-relevant cues to elicit direct retrieval, or generic cues (nouns) to elicit generative retrieval. We used spatiotemporal partial least squares to characterize the spatial and temporal characteristics of the networks associated with direct and generative retrieval. Both retrieval tasks engaged regions comprising the autobiographical retrieval network, including hippocampus, and medial prefrontal and parietal cortices. However, some key neural differences emerged. Generative retrieval differentially recruited lateral prefrontal and temporal regions early on during the retrieval process, likely supporting the strategic search operations and initial recovery of generic autobiographical information. However, many regions were activated more strongly during direct versus generative retrieval, even when we time-locked the analysis to the successful recovery of events in both conditions. This result suggests that there may be fundamental differences between memories that are accessed directly and those that are recovered via the iterative search and retrieval process that characterizes generative retrieval. Copyright © 2011 Elsevier Inc. All rights reserved.

Routes to the past: Neural substrates of direct and generative autobiographical memory retrieval

PubMed Central

Addis, Donna Rose; Knapp, Katie; Roberts, Reece P.; Schacter, Daniel L.

2011-01-01

Models of autobiographical memory propose two routes to retrieval depending on cue specificity. When available cues are specific and personally-relevant, a memory can be directly accessed. However, when available cues are generic, one must engage a generative retrieval process to produce more specific cues to successfully access a relevant memory. The current study sought to characterize the neural bases of these retrieval processes. During functional magnetic resonance imaging (fMRI), participants were shown personally-relevant cues to elicit direct retrieval, or generic cues (nouns) to elicit generative retrieval. We used spatiotemporal partial least squares to characterize the spatial and temporal characteristics of the networks associated with direct and generative retrieval. Both retrieval tasks engaged regions comprising the autobiographical retrieval network, including hippocampus, and medial prefrontal and parietal cortices. However, some key neural differences emerged. Generative retrieval differentially recruited lateral prefrontal and temporal regions early on during the retrieval process, likely supporting the strategic search operations and initial recovery of generic autobiographical information. However, many regions were activated more strongly during direct versus generative retrieval, even when we time-locked the analysis to the successful recovery of events in both conditions. This result suggests that there may be fundamental differences between memories that are accessed directly and those that are recovered via the iterative search and retrieval process that characterizes generative retrieval. PMID:22001264

The Full Kostant-Toda Hierarchy on the Positive Flag Variety

NASA Astrophysics Data System (ADS)

Kodama, Yuji; Williams, Lauren

2015-04-01

We study some geometric and combinatorial aspects of the solution to the full Kostant-Toda (f-KT) hierarchy, when the initial data is given by an arbitrary point on the totally non-negative (tnn) flag variety of . The f-KT flows on the tnn flag variety are complete, and we show that their asymptotics are completely determined by the cell decomposition of the tnn flag variety given by Rietsch (Total positivity and real flag varieties. Ph.D. Thesis, Massachusetts Institute of Technology, Cambridge, 1998). Our results represent the first results on the asymptotics of the f-KT hierarchy (and even the f-KT lattice); moreover, our results are not confined to the generic flow, but cover non-generic flows as well. We define the f-KT flow on the weight space via the moment map, and show that the closure of each f-KT flow forms an interesting convex polytope which we call a Bruhat interval polytope. In particular, the Bruhat interval polytope for the generic flow is the permutohedron of the symmetric group . We also prove analogous results for the full symmetric Toda hierarchy, by mapping our f-KT solutions to those of the full symmetric Toda hierarchy. In the appendix we show that Bruhat interval polytopes are generalized permutohedra, in the sense of Postnikov (Int. Math. Res. Not. IMRN (6):1026-1106, 2009).

Computational study of generic hypersonic vehicle flow fields

NASA Technical Reports Server (NTRS)

Narayan, Johnny R.

1994-01-01

The geometric data of the generic hypersonic vehicle configuration included body definitions and preliminary grids for the forebody (nose cone excluded), midsection (propulsion system excluded), and afterbody sections. This data was to be augmented by the nose section geometry (blunt conical section mated with the noncircular cross section of the forebody initial plane) along with a grid and a detailed supersonic combustion ramjet (scramjet) geometry (inlet and combustor) which should be merged with the nozzle portion of the afterbody geometry. The solutions were to be obtained by using a Navier-Stokes (NS) code such as TUFF for the nose portion, a parabolized Navier-Stokes (PNS) solver such as the UPS and STUFF codes for the forebody, a NS solver with finite rate hydrogen-air chemistry capability such as TUFF and SPARK for the scramjet and a suitable solver (NS or PNS) for the afterbody and external nozzle flows. The numerical simulation of the hypersonic propulsion system for the generic hypersonic vehicle is the major focus of this entire work. Supersonic combustion ramjet is such a propulsion system, hence the main thrust of the present task has been to establish a solution procedure for the scramjet flow. The scramjet flow is compressible, turbulent, and reacting. The fuel used is hydrogen and the combustion process proceeds at a finite rate. As a result, the solution procedure must be capable of addressing such flows.

Leininger's model for discoveries at The Farm and midwifery services to the Amish.

PubMed

Finn, J

1995-01-01

This paper is a descriptive report and analysis of a transcultural nurse's experiences immersed in a hippie subculture at The Farm near Summertown, Tennessee. This subcultural group initially was established over 20 years ago as a community with a unique worldview which included pacifistic, vegetarian, and collective values and beliefs. This community prefers health care provided by their own community members who serve as generic care providers and also as folk midwives for home births. Leininger's (1991) Theory of Culture Care Diversity and Universality and her Sunrise Model provided the framework for discovering and understanding this unique subcultural group. The major components of Leininger's Sunrise Model including worldview, cultural values, and lifeways were used in the analysis. The important social structure factors discovered included environmental context, technological factors, religious and philosophical factors, political and legal factors, economic factors, and educational factors. The Farm community's culture care expressions, patterns and practices for health and well being were discovered including generic and folk systems of care. The farm midwives provide primary care and home birthing care to a nearby Old Order Amish community. The Amish culture and health care seeking patterns are discussed including their selective use of generic, folk, and professional care systems. The discoveries that resulted from the application of Leininger's Sunrise Model are presented including implications for transcultural nurse caregiving.

76 FR 57767 - Proposed Generic Communication; Draft NRC Generic Letter 2011-XX: Seismic Risk Evaluations for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-16

... NUCLEAR REGULATORY COMMISSION [NRC-2011-0204] Proposed Generic Communication; Draft NRC Generic Letter 2011-XX: Seismic Risk Evaluations for Operating Reactors AGENCY: Nuclear Regulatory Commission... FR 54507), that requested public comment on Draft NRC Generic Letter 2011- XX: Seismic Risk...

42 CFR 447.506 - Authorized generic drugs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Authorized generic drugs. 447.506 Section 447.506... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payment for Drugs § 447.506 Authorized generic drugs. (a) Authorized generic drug defined. For the purposes of this subpart, an authorized generic drug...

42 CFR 447.506 - Authorized generic drugs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Authorized generic drugs. 447.506 Section 447.506... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payment for Drugs § 447.506 Authorized generic drugs. (a) Authorized generic drug defined. For the purposes of this subpart, an authorized generic drug...

42 CFR 447.506 - Authorized generic drugs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Authorized generic drugs. 447.506 Section 447.506... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payment for Drugs § 447.506 Authorized generic drugs. (a) Authorized generic drug defined. For the purposes of this subpart, an authorized generic drug...

42 CFR 447.506 - Authorized generic drugs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Authorized generic drugs. 447.506 Section 447.506... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payment for Drugs § 447.506 Authorized generic drugs. (a) Authorized generic drug defined. For the purposes of this subpart, an authorized generic drug...

42 CFR 447.506 - Authorized generic drugs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Authorized generic drugs. 447.506 Section 447.506... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PAYMENTS FOR SERVICES Payment for Drugs § 447.506 Authorized generic drugs. (a) Authorized generic drug defined. For the purposes of this subpart, an authorized generic drug...

Cognitive and affective determinants of generic drug acceptance and use: cross-sectional and experimental findings

PubMed Central

Dohle, Simone; Siegrist, Michael

2013-01-01

An increase in generic substitution could be a viable approach to reduce global healthcare expenditures. In many countries, however, generic drug use is rather low. This study examines cognitive predictors (knowledge and beliefs) and affective predictors (general affect and sacred values) to explain generic drug acceptance and use. Data for the study come from a random postal survey conducted in Switzerland (N = 668). A detailed knowledge scale about generic drugs was developed. In addition, an experimental choice task was constructed in which respondents chose between branded and generic drugs. Generic drug acceptance as well as drug choices were influenced by knowledge, beliefs, and affect. It was also found that generic substitution is chosen less frequently for a more severe illness. Key insights could be used for developing information material or interventions aimed at increasing the substitution of generic drugs in order to make health care more affordable. PMID:25632372

Two-year-olds use the generic/non-generic distinction to guide their inferences about novel kinds

PubMed Central

Graham, Susan A.; Nayer, Samantha L.; Gelman, Susan A.

2011-01-01

These studies investigated 24- and 30-month-olds’ sensitivity to generic versus nongeneric language when acquiring knowledge about novel kinds. Toddlers were administered an inductive inference task, during which they heard a generic noun-phrase (e.g., “Blicks drink milk”) or a non-generic noun-phrase (e.g., “This blick drinks milk”) paired with an action (e.g., drinking) modeled on an object. They were then provided with the model and a non-model exemplar and asked to imitate the action. After hearing non-generic phrases, 30-month-olds, but not 24-month-olds, imitated more often with the model than with the non-model exemplar. In contrast, after hearing generic phrases, 30-month-olds imitated equally often with both exemplars. These results suggest that 30-month-olds use the generic/non-generic distinction to guide their inferences about novel kinds. PMID:21410928

Methodological Considerations for Comparison of Brand Versus Generic Versus Authorized Generic Adverse Event Reports in the US Food and Drug Administration Adverse Event Reporting System (FAERS).

PubMed

Rahman, Md Motiur; Alatawi, Yasser; Cheng, Ning; Qian, Jingjing; Peissig, Peggy L; Berg, Richard L; Page, David C; Hansen, Richard A

2017-12-01

The US Food and Drug Administration Adverse Event Reporting System (FAERS), a post-marketing safety database, can be used to differentiate brand versus generic safety signals. To explore the methods for identifying and analyzing brand versus generic adverse event (AE) reports. Public release FAERS data from January 2004 to March 2015 were analyzed using alendronate and carbamazepine as examples. Reports were classified as brand, generic, and authorized generic (AG). Disproportionality analyses compared reporting odds ratios (RORs) of selected known labeled serious adverse events stratifying by brand, generic, and AG. The homogeneity of these RORs was compared using the Breslow-Day test. The AG versus generic was the primary focus since the AG is identical to brand but marketed as a generic, therefore minimizing generic perception bias. Sensitivity analyses explored how methodological approach influenced results. Based on 17,521 US event reports involving alendronate and 3733 US event reports involving carbamazepine (immediate and extended release), no consistently significant differences were observed across RORs for the AGs versus generics. Similar results were obtained when comparing reporting patterns over all time and just after generic entry. The most restrictive approach for classifying AE reports yielded smaller report counts but similar results. Differentiation of FAERS reports as brand versus generic requires careful attention to risk of product misclassification, but the relative stability of findings across varying assumptions supports the utility of these approaches for potential signal detection.

Improving the assessment of prescribing: use of a 'substitution index'.

PubMed

Kunisawa, Susumu; Otsubo, Tetsuya; Lee, Jason; Imanaka, Yuichi

2013-07-01

To analyse the current and potential utilization of generic drugs in Japan, to examine the maximum possible cost savings from generic drug use and to develop a fairer measure to assess the level of generic drug substitution. We conducted a cross-sectional retrospective analysis of nine million dispensing records during January to March 2010 in Kyoto Prefecture. Maximum potential quantity-based shares were defined as the quantity of generic drugs used plus the quantity of branded drugs that could have been replaced by generic drugs divided by the quantity of all drugs dispensed. We developed a 'substitution index', defined as the proportion of generic drugs out of the total drugs substitutable with generic drugs (based on quantity rather than cost). Generic drugs had a quantity-based share of 17.9%, a cost-based share of 8.9% and a maximum potential quantity-based share of 50.1%, which is lower than the actual generic drug shares of some other countries. The maximum possible cost savings as a result of generic drug substitution was 16.5%. We also observed wide variations in maximum potential quantity-based shares between health care sectors and health care institutions. Simple comparisons based on quantity-based shares may misrepresent the actual generic drug use. A substitution index that takes into account the maximum potential quantity-based share of generic drugs as a fairer measure may promote more realistic goals and encourage generic drug usage.

A developmental analysis of generic nouns in Southern Peruvian Quechua.

PubMed

Mannheim, Bruce; Gelman, Susan A; Escalante, Carmen; Huayhua, Margarita; Puma, Rosalía

2010-01-01

Generic noun phrases (e.g., "Cats like to drink milk") are a primary means by which adults express generalizations to children, yet they pose a challenging induction puzzle for learners. Although prior research has established that English speakers understand and produce generic noun phrases by preschool age, little is known regarding the cross-cultural generality of generic acquisition. Southern Peruvian Quechua provides a valuable comparison because, unlike English, it is a highly inflected language in which generics are marked by the absence rather than the presence of any linguistic markers. Moreover, Quechua is spoken in a cultural context that differs markedly from the highly educated, middle-class contexts within which earlier research on generics was conducted. We presented participants from 5 age groups (3-6, 7-9, 10-12, 14-35, and 36-90 years of age) with two tasks that examined the ability to distinguish generic from non-generic utterances. In Study 1, even the youngest children understood generics as applying broadly to a category (like "all") and distinct from indefinite reference ("some"). However, there was a developmental lag before children understood that generics, unlike "all", can include exceptions. Study 2 revealed that generic interpretations are more frequent for utterances that (a) lack specifying markers and (b) are animate. Altogether, generic interpretations are found among the youngest participants, and may be a default mode of quantification. These data demonstrate the cross-cultural importance of generic information in linguistic expression.

A developmental analysis of generic nouns in Southern Peruvian Quechua

PubMed Central

Mannheim, Bruce; Gelman, Susan A.; Escalante, Carmen; Huayhua, Margarita; Puma, Rosalía

2010-01-01

Generic noun phrases (e.g., “Cats like to drink milk”) are a primary means by which adults express generalizations to children, yet they pose a challenging induction puzzle for learners. Although prior research has established that English speakers understand and produce generic noun phrases by preschool age, little is known regarding the cross-cultural generality of generic acquisition. Southern Peruvian Quechua provides a valuable comparison because, unlike English, it is a highly inflected language in which generics are marked by the absence rather than the presence of any linguistic markers. Moreover, Quechua is spoken in a cultural context that differs markedly from the highly educated, middle-class contexts within which earlier research on generics was conducted. We presented participants from 5 age groups (3-6, 7-9, 10-12, 14-35, and 36-90 years of age) with two tasks that examined the ability to distinguish generic from non-generic utterances. In Study 1, even the youngest children understood generics as applying broadly to a category (like “all”) and distinct from indefinite reference (“some”). However, there was a developmental lag before children understood that generics, unlike “all”, can include exceptions. Study 2 revealed that generic interpretations are more frequent for utterances that (a) lack specifying markers and (b) are animate. Altogether, generic interpretations are found among the youngest participants, and may be a default mode of quantification. These data demonstrate the cross-cultural importance of generic information in linguistic expression. PMID:21779154

Effective policy initiatives to constrain lipid-lowering drug expenditure growth in South Korea.

PubMed

Bae, Green; Park, Chanmi; Lee, Hyejin; Han, Euna; Kim, Dong-Sook; Jang, Sunmee

2014-03-03

The rapid growth of prescription drug expenditures is a major problem in South Korea. Accordingly, the South Korean government introduced a positive listing system in 2006. They also adopted various price reduction policies. Nevertheless, the total expenditure for lipid-lowering drugs have steadily increased throughout South Korea. The present study explores the factors that have influenced the increased expenditures of lipid-lowering drugs with a particular focus on the effects of statins in this process. This paper investigates the National Health Insurance claims data for prescribed lipid-lowering drugs collected between January 1, 2005 and December 31, 2009. We specifically focused on statins and assessed the yearly variation of statin expenditure by calculating the increased rate of paired pharmaceutical expenditures over a 2 year period. Our study classified statins into three categories: new entrants, core medicines and exiting medicines. For core medicines, we further examined influencing factors such as price, amount of drugs consumed by volume, and prescription changes (substitutes for other drug). Statin expenditure showed an average annual increase of 25.7% between 2005 and 2009. Among the different statins, the expenditure of atorvastatin showed a 36.6% annual increase rate, which was the most dramatic among all statins. Also we divided expenditure for core medicines by the price factor, volume factor, and prescription change. The result showed that annual weighted average prices of individual drug decreased each year, which clearly showed that price influenced statin expenditure in a negative direction. The use of generic drugs containing the same active ingredient as name-brand drugs increased and negatively affected statin expenditure (Generic Mix effect). However, the use of relatively expensive ingredients within statin increase, Ingredient Mix effect contributed to increased statin expenditure (Ingredient Mix effect). In particular, the volume effect was found to be critical for increasing statin expenditure as the amount of statin consumed increased steadily throughout the study period. The recent rapid increase in statin expenditure can largely be attributed to an increase in consumption volume. In order to check drug expenditures effectively in our current situation, in which chronic diseases remain steadily on the rise, it is necessary to not only have supply-side initiatives such as price reduction, but also demand-side initiatives that could control drug consumption volume, for example: educational programs for rational prescription, generic drug promotional policies, and policies providing prescription targets.

An evaluation of consumers' knowledge, perceptions and attitudes regarding generic medicines in Auckland.

PubMed

Babar, Zaheer-Ud-Din; Stewart, Joanna; Reddy, Shiwangni; Alzaher, Woroud; Vareed, Prateeka; Yacoub, Nineweh; Dhroptee, Bandhana; Rew, Anne

2010-08-01

The aim of this project was to evaluate the perceptions, knowledge and attitudes regarding generic medicines. A cross-sectional study, with self administered questionnaires, was conducted to survey consumers visiting pharmacies in four regions of Auckland (North Shore, Waitakere, Central Auckland and South Auckland). Through stratified random sampling, approximately 10% of pharmacies from each region were selected, which turn out to be 30 pharmacies. Every alternate customer coming to the pharmacy, who was eligible to participate in the study, was asked by the researchers to complete the questionnaire. A total of 441 questionnaires were included in the analysis. Different response rates were obtained in different regions of Auckland. Of all respondents, 51.6% had previous knowledge of generic medicines. Pharmacists were the main source of information regarding generic medicines followed by doctors and media. A higher level of education had a direct relationship with having correct knowledge of generics (P = .002). Attitude of participants toward the use of generic medicines was determined by their knowledge of generics, whether it was recommended by a pharmacist and their type of illness. Participants were more prepared to change to a generic for a minor illness (79%) than for a major illness (58.7%). Those who had better knowledge were more likely than those with poor knowledge to say they would to use a generic in major illness (P = .001) as well as minor illness (P < .0001). Previous positive experiences with generics also determined consumers' willingness to use generics. Many consumers have misconceptions regarding generic medicines. Having knowledge about generics and the advice by doctors and pharmacists are key indicators to improve the quality use of generic medicines.

Societal value of generic medicines beyond cost-saving through reduced prices.

PubMed

Dylst, Pieter; Vulto, Arnold; Simoens, Steven

2015-01-01

This paper aims to provide an overview of the added societal value of generic medicines beyond their cost-saving potential through reduced prices. In addition, an observational case study will document the impact of generic entry on access to pharmacotherapy in The Netherlands and an illustrative exercise was carried out to highlight the budget impact of generic entry. A narrative literature review was carried out to explore the impact of generic medicines on access to pharmacotherapy, innovation and medication adherence. Data from the Medicines and Medical Devices Information Project database in The Netherlands were used for the case study in which the impact of generic medicine entrance on the budget and the number of users was calculated as an illustrative exercise. Generic medicines have an additional societal value beyond their cost-saving potential through reduced prices. Generic medicines increase access to pharmacotherapy, provide a stimulus for innovation by both originator companies and generic companies and, under the right circumstances, have a positive impact on medication adherence. Generic medicines offer more to society than just their cost-saving potential through reduced prices. As such, governments must not focus only on the prices of generic medicines as this will threaten their long-term sustainability. Governments must therefore act appropriately and implement a coherent set of policies to increase the use of generic medicines.

A survey to determine the views of renal transplant patients on generic substitution in the UK.

PubMed

Al Ameri, Mubarak N; Whittaker, Clare; Tucker, Arthur; Yaqoob, Magdi; Johnston, Atholl

2011-08-01

Rising healthcare costs promote the generic substitution among patients because it is identifiable costs. A key concern is that patients should be involved in the decision of switching. The aim of this study was to examine renal transplant patients' views on generic substitution in the UK. A total of 163 renal patients were surveyed using 36 multiple-choice questions at Barts and The London Renal Transplant Clinic, in the UK. Transplant recipients over 18 years, able to read and write English and willing to fill in the questionnaire were targeted; 84% of patients were conscious of the availability of generic medicines, 70% understood the terms "generic" and "branded" in relation to medicines and 54% were aware of generic substitution practice. However, 75% did not know if they were taking generics and 84% felt that generics are not equivalent or only equivalent sometimes and they were uncertain that generics had the same quality as branded medicines. Moreover, many patients admitted that they would not accept the generic substitution of ciclosporin when become available in the UK. A number of factors such as patients' education, knowledge, severity of the disease, efficacy of generic medicines and patients' involvement in decisions regarding their health appear to drive patients' attitudes towards generic substitution. © 2011 The Authors. Transplant International © 2011 European Society for Organ Transplantation.

A heuristic approach to incremental and reactive scheduling

NASA Technical Reports Server (NTRS)

Odubiyi, Jide B.; Zoch, David R.

1989-01-01

An heuristic approach to incremental and reactive scheduling is described. Incremental scheduling is the process of modifying an existing schedule if the initial schedule does not meet its stated initial goals. Reactive scheduling occurs in near real-time in response to changes in available resources or the occurrence of targets of opportunity. Only minor changes are made during both incremental and reactive scheduling because a goal of re-scheduling procedures is to minimally impact the schedule. The described heuristic search techniques, which are employed by the Request Oriented Scheduling Engine (ROSE), a prototype generic scheduler, efficiently approximate the cost of reaching a goal from a given state and effective mechanisms for controlling search.

Quench dynamics of the interacting Bose gas in one dimension.

PubMed

Iyer, Deepak; Andrei, Natan

2012-09-14

We obtain an exact expression for the time evolution of the interacting Bose gas following a quench from a generic initial state using the Yudson representation for integrable systems. We study the time evolution of the density and noise correlation for a small number of bosons and their asymptotic behavior for any number. We show that for any value of the coupling, as long as it is repulsive, the system asymptotes towards a strongly repulsive gas, while for any value of an attractive coupling the long time behavior is dominated by the maximal bound state. This occurs independently of the initial state and can be viewed as an emerging "dynamic universality."

Generic drug prices and policy in Australia: room for improvement? a comparative analysis with England.

PubMed

Mansfield, Sarah J

2014-02-01

To assess the degree to which reimbursement prices in Australia and England differ for a range of generic drugs, and to analyse the supply- and demand-side factors that may contribute to these differences. Australian and English reimbursement prices were compared for a range of generic drugs using pricing information obtained from government websites. Next, a literature review was conducted to identify supply- and demand-side factors that could affect generic prices in Australia and England. Various search topics were identified addressing potential supply-side (e.g. market approval, intellectual property protection of patented drugs, generic pricing policy, market size, generic supply chain and discounting practices) and demand-side (consumers, prescribers and pharmacists) factors. Related terms were searched in academic databases, official government websites, national statistical databases and internet search engines. Analysis of drug reimbursement prices for 15 generic molecules (representing 45 different drug presentations) demonstrated that Australian prices were on average over 7-fold higher than in England. Significant supply-side differences included aspects of pricing policy, the relative size of the generics markets and the use of clawback policies. Major differences in demand-side policies related to generic prescribing, pharmacist substitution and consumer incentives. Despite recent reforms, the Australian Government continues to pay higher prices than its English counterpart for many generic medications. The results suggest that particular policy areas may benefit from review in Australia, including the length of the price-setting process, the frequency of subsequent price adjustments, the extent of price competition between originators and generics, medical professionals' knowledge about generic medicines and incentives for generic prescribing. WHAT IS KNOWN ABOUT THE TOPIC? Prices of generic drugs have been the subject of much scrutiny over recent years. From 2005 to 2010 the Australian Government responded to observations that Pharmaceutical Benefits Scheme prices for many generics were higher than in numerous comparable countries by instituting several reforms aimed at reducing the prices of generics. Despite this, several studies have demonstrated that prices for generic statins (one class of cholesterol-lowering drug) are higher in Australia compared with England and many other developed countries, and prices of numerous other generics remain higher than in the USA and New Zealand. Recently there has been increasing interest in why these differences exist. WHAT DOES THIS PAPER ADD? By including a much larger range of commonly used and costly generic drugs, this paper builds significantly on the limited previous investigations of generic drug prices in Australia and England. Additionally, this is the first comprehensive investigation of multiple supply- and, in particular, demand-side factors that may explain any price differences between these countries. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Practitioners may contribute to the higher prices of generic medications in Australia compared with England through relatively low rates of generic prescribing. There are also significant implications for health policy makers, as this paper demonstrates that if Australia achieved the same prices as England for many generic drugs there could be substantial savings for the Pharmaceutical Benefits Scheme.

Idealized Experiments for Optimizing Model Parameters Using a 4D-Variational Method in an Intermediate Coupled Model of ENSO

NASA Astrophysics Data System (ADS)

Gao, Chuan; Zhang, Rong-Hua; Wu, Xinrong; Sun, Jichang

2018-04-01

Large biases exist in real-time ENSO prediction, which can be attributed to uncertainties in initial conditions and model parameters. Previously, a 4D variational (4D-Var) data assimilation system was developed for an intermediate coupled model (ICM) and used to improve ENSO modeling through optimized initial conditions. In this paper, this system is further applied to optimize model parameters. In the ICM used, one important process for ENSO is related to the anomalous temperature of subsurface water entrained into the mixed layer ( T e), which is empirically and explicitly related to sea level (SL) variation. The strength of the thermocline effect on SST (referred to simply as "the thermocline effect") is represented by an introduced parameter, α Te. A numerical procedure is developed to optimize this model parameter through the 4D-Var assimilation of SST data in a twin experiment context with an idealized setting. Experiments having their initial condition optimized only, and having their initial condition plus this additional model parameter optimized, are compared. It is shown that ENSO evolution can be more effectively recovered by including the additional optimization of this parameter in ENSO modeling. The demonstrated feasibility of optimizing model parameters and initial conditions together through the 4D-Var method provides a modeling platform for ENSO studies. Further applications of the 4D-Var data assimilation system implemented in the ICM are also discussed.

A Cross-Linguistic Comparison of Generic Noun Phrases in English and Mandarin.

ERIC Educational Resources Information Center

Gelman, Susan A.; Tardif, Twila

1998-01-01

Three studies examined adults' generic noun phrases in English and Mandarin Chinese from child-directed speech of caregivers interacting with their toddlers. Found that generic noun phrases were reliably identified in both languages. Generic noun phrases most frequently referred to animals. Non-generic noun phrases were used most frequently for…

Generic Language and Judgements about Category Membership: Can Generics Highlight Properties as Central?

ERIC Educational Resources Information Center

Hollander, Michelle A.; Gelman, Susan A.; Raman, Lakshmi

2009-01-01

Many languages distinguish generic utterances (e.g., "Tigers are ferocious") from non-generic utterances (e.g., "Those tigers are ferocious"). Two studies examined how generic language specially links properties and categories. We used a novel-word extension task to ask if 4- to 5-year-old children and adults distinguish…

On assessing bioequivalence and interchangeability between generics based on indirect comparisons.

PubMed

Zheng, Jiayin; Chow, Shein-Chung; Yuan, Mengdie

2017-08-30

As more and more generics become available in the market place, the safety/efficacy concerns may arise as the result of interchangeably use of approved generics. However, bioequivalence assessment for regulatory approval among generics of the innovative drug product is not required. In practice, approved generics are often used interchangeably without any mechanism of safety monitoring. In this article, based on indirect comparisons, we proposed several methods to assessing bioequivalence and interchangeability between generics. The applicability of the methods and the similarity assumptions were discussed, as well as the inappropriateness of directly adopting adjusted indirect comparison to the field of generics' comparison. Besides, some extensions were given to take into consideration the important topics in clinical trials for bioequivalence assessments, for example, multiple comparisons and simultaneously testing bioequivalence among three generics. Extensive simulation studies were conducted to investigate the performances of the proposed methods. The studies of malaria generics and HIV/AIDS generics prequalified by the WHO were used as real examples to demonstrate the use of the methods. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Acquisition of Generic Noun Phrases in Chinese: Learning about lions without an ‘-s’

PubMed Central

Tardif, Twila; Gelman, Susan A.; Fu, Xiaolan; Zhu, Liqi

2013-01-01

English-speaking children understand and produce generic expressions in the preschool years, but there are cross-linguistic differences in how generics are expressed. Three studies examined interpretation of generic noun phrases in 3- to 7-year-old child (N = 192) and adult speakers (N = 163) of Mandarin Chinese. Contrary to suggestions by A. Bloom (1981), Chinese-speaking adults honor a clear distinction between generics (expressed as bare NPs) and other quantified expressions (‘all’/suo3you3 and ‘some’/you3de). Furthermore, Mandarin-speaking children begin to distinguish generics from ‘all’ or ‘some’ as early as 5 years, as shown in both confirmation (Study 2) and property-generation (Study 3) tasks. Nonetheless, the developmental trajectory for Chinese appears prolonged relative to English and this seems to reflect difficulty with ‘all’ and ‘some’ rather than difficulty with generics. Altogether these results suggest that generics are primary, and that the consistency of markings affects the rate at which non-generic NPs are distinguished from generics. PMID:21849102

Transport of Passive Tracers in Baroclinic Wave Life Cycles

NASA Technical Reports Server (NTRS)

Stone, Elizabeth M.; Randel, William J.; Stanford, John L.

1999-01-01

The transport of passive tracers in idealized baroclinic wave life cycles is studied using output from the National Center for Atmospheric Research Community Climate Model (CCM2). Two life cycles, LCn and LCs, are simulated, starting with baroclinically unstable initial conditions similar to those used by Thorncroft et al. in their study of two life cycle paradigms. The two life cycles LCn and LCs have different initial horizontal wind shear structures that result in distinctive nonlinear development. In terms of potential vorticity-potential temperature (PV-theta) diagnostics, the LCn case is characterized by thinning troughs that are advected anti-cyclonically and equatorward, while the LCs case has broadening troughs that wrap up cyclonically and poleward. Four idealized passive tracers are included in the model to be advected by the semi-Lagrangian transport scheme of the CCM2, and their evolutions are investigated throughout the life cycles. Tracer budgets are analyzed in terms of the transformed Eulerian mean constituent transport formalism in pressure coordinates and also in isentropic coordinates. Results for both LCn and LCs show transport that is downgradient with respect to the background structure of the tracer field, but with a characteristic spatial structure that maximizes in the middle to high latitudes. For the idealized tropospheric tracers in this study, this represents a net upward and poleward transport that enhances concentrations at high latitudes. These results vary little with the initial distribution of the constituent field. The time tendency of the tracer is influenced most strongly by the eddy flux term. with the largest transport occurring during the nonlinear growth stage of the life cycle. The authors also study the transport of a lower-stratospheric tracer, to examine stratosphere-troposphere exchange for baroclinic waves.

Generation of higher-order rogue waves from multibreathers by double degeneracy in an optical fiber.

PubMed

Wang, Lihong; He, Jingsong; Xu, Hui; Wang, Ji; Porsezian, Kuppuswamy

2017-04-01

In this paper, we construct a special kind of breather solution of the nonlinear Schrödinger (NLS) equation, the so-called breather-positon (b-positon for short), which can be obtained by taking the limit λ_{j}→λ_{1} of the Lax pair eigenvalues in the order-n periodic solution, which is generated by the n-fold Darboux transformation from a special "seed" solution-plane wave. Further, an order-n b-positon gives an order-n rogue wave under a limit λ_{1}→λ_{0}. Here, λ_{0} is a special eigenvalue in a breather of the NLS equation such that its period goes to infinity. Several analytical plots of order-2 breather confirm visually this double degeneration. The last limit in this double degeneration can be realized approximately in an optical fiber governed by the NLS equation, in which an injected initial ideal pulse is created by a frequency comb system and a programable optical filter (wave shaper) according to the profile of an analytical form of the b-positon at a certain position z_{0}. We also suggest a new way to observe higher-order rogue waves generation in an optical fiber, namely, measure the patterns at the central region of the higher-order b-positon generated by above ideal initial pulses when λ_{1} is very close to the λ_{0}. The excellent agreement between the numerical solutions generated from initial ideal inputs with a low signal-to-noise ratio and analytical solutions of order-2 b-positon supports strongly this way in a realistic optical fiber system. Our results also show the validity of the generating mechanism of a higher-order rogue waves from a multibreathers through the double degeneration.

Does the market share of generic medicines influence the price level?: a European analysis.

PubMed

Dylst, Pieter; Simoens, Steven

2011-10-01

After the expiry of patents for originator medicines, generic medicines can enter the market, and price competition may occur. This process generates savings to the healthcare payer and to patients, but knowledge about the factors affecting price competition in the pharmaceutical market following patent expiry is still limited. This study aimed to investigate the relationship between the market share of generic medicines and the change of the medicine price level in European off-patent markets. Data on medicine volumes and values for 35 active substances were purchased from IMS Health. Ex-manufacturer prices were used, and the analysis was limited to medicines in immediate-release, oral, solid dosage forms. Countries included were Austria, Belgium, Denmark, Germany, France, Italy, the Netherlands, Spain, Sweden and the UK, which constitute a mix of countries with low and high generic medicines market shares. Data were available from June 2002 until March 2007. Market volume has risen in both high and low generic market share countries (+29.27% and +27.40%, respectively), but the cause of the rise is different for the two markets. In low generic market share countries, the rise was caused by the increased use of generic medicines, while in high market share countries, the rise was driven by the increased use of generic medicines and a shift of use from originator to generic medicines. Market value was substantially decreased in high generic market share countries (-26.6%), while the decrease in low generic market share countries was limited (-0.06%). In high generic market share countries, medicine prices dropped by -43.18% versus -21.56% in low market share countries. The extent to which price competition from generic medicines leads to price reductions appears to vary according to the market share of generic medicines. High generic market share countries have seen a larger decrease in medicine prices than low market share countries.

Economic savings versus health losses: The cost-effectiveness of generic antiretroviral therapy in the United States

PubMed Central

Walensky, Rochelle P.; Sax, Paul E.; Nakamura, Yoriko M.; Weinstein, Milton C.; Pei, Pamela P.; Freedberg, Kenneth A.; Paltiel, A. David; Schackman, Bruce R.

2013-01-01

Background US HIV treatment guidelines recommend branded once-daily, one-pill efavirenz/emtricitabine/tenofovir as preferred first-line antiretroviral treatment (ART). With the anticipated approval of generic efavirenz in 2012 in the US, the cost of a once-daily, three-pill alternative (generic efavirenz, generic lamivudine, tenofovir) will decrease, but adherence and virologic suppression may be reduced. Objectives To assess the clinical impact, costs, and cost-effectiveness of the generic-based three-pill regimen compared to the branded, co-formulated regimen. To project the potential national savings in the first year of a switch to generic-based ART. Design Mathematical simulation of HIV disease. Data Sources Published data from US clinical trials and observational cohorts. Target Population HIV-infected patients eligible to start on or switch to an efavirenz-based generic ART regimen. Time Horizon Lifetime, One-year Perspective US health system Interventions No ART (for comparison), Three-pill Generic ART, and Branded ART Outcome Measures Quality-adjusted life expectancy, costs, and incremental cost-effectiveness ratios (ICER, $/quality-adjusted life expectancy [QALY]). Results of Base-Case Analysis Compared to No ART, Generic ART has an ICER of $21,100/QALY. Compared to Generic ART, Branded ART increases lifetime costs by $42,500, and per-person survival gains by 0.37 QALYs, for an ICER of $114,800/QALY. Estimated first-year savings, if all eligible US patients start on or switch to Generic ART, are $920 million. Results of Sensitivity Analysis Most plausible assumptions about Generic ART efficacy and costs lead to Branded ART ICERs >$100,000/QALY. Limitations The efficacy and price reduction associated with generics are unknown; estimates are intended to be conservative. Conclusions Compared to a slightly less effective generic-based regimen, the cost-effectiveness of first-line Branded ART exceeds $100,000/QALY. Generic-based ART in the US could yield substantial budgetary savings to HIV programs. PMID:23318310

Physicians' Trust in the FDA's Use of Product-Specific Pathways for Generic Drug Approval.

PubMed

Kesselheim, Aaron S; Eddings, Wesley; Raj, Tara; Campbell, Eric G; Franklin, Jessica M; Ross, Kathryn M; Fulchino, Lisa A; Avorn, Jerry; Gagne, Joshua J

2016-01-01

Generic drugs are cost-effective versions of brand-name drugs approved by the Food and Drug Administration (FDA) following proof of pharmaceutical equivalence and bioequivalence. Generic drugs are widely prescribed by physicians, although there is disagreement over the clinical comparability of generic drugs to brand-name drugs within the physician community. The objective of this survey was to assess physicians' perceptions of generic drugs and the generic drug approval process. A survey was administered to a national sample of primary care internists and specialists between August 2014 and January 2015. In total, 1,152 physicians comprising of internists with no reported specialty certification and those with specialty certification in hematology, infectious diseases, and endocrinology were surveyed. The survey assessed physicians' perceptions of the FDA's generic drug approval process, as well as their experiences prescribing six generic drugs approved between 2008 and 2012 using product-specific approval pathways and selected comparator drugs. Among 718 respondents (62% response rate), a majority were comfortable with the FDA's process in ensuring the safety and effectiveness of generic drugs overall (91%) and with letting the FDA determine which tests were necessary to determine bioequivalence in a particular drug (92%). A minority (13-26%) still reported being uncomfortable prescribing generic drugs approved using product-specific pathways. Overall, few physicians heard reports of concerns about generic versions of the study drugs or their comparators, with no differences between the two groups. Physicians tended to hear about concerns about the safety or effectiveness of generic drugs from patients, pharmacists, and physician colleagues. Physicians hold largely positive views of the FDA's generic drug approval process even when some questioned the performance of certain generic drugs in comparison to brand-name drugs. Better education about the generic drug approval process and standards may alleviate concerns among the physician community and support the delivery of cost-effective health care.

[It is not only about cost ... when it comes to generic medication].

PubMed

Piguet, Valérie; D'Incau, Stéphanie; Besson, Marie; Desmeules, Jules; Cedraschi, Christine

2016-06-22

The aim of this qualitative study was to explore patients' representations regarding generics in patients suffering from non-specific disabling chronic musculoskeletal pain, as these patients are confronted with the issue of the prescription and/or substitution of original formulations with generics. Patients' representations suggest that they might be confident in taking a generic medication: when the generic medication is prescribed by the physician and each prescription is discussed, i.e., the patient is prescribed the generic version of a given medication and not a generic medication. Economic arguments are not sufficient to accept substitution. Negative representations require attention and need be considered.

Initial value formulation of dynamical Chern-Simons gravity

NASA Astrophysics Data System (ADS)

Delsate, Térence; Hilditch, David; Witek, Helvi

2015-01-01

We derive an initial value formulation for dynamical Chern-Simons gravity, a modification of general relativity involving parity-violating higher derivative terms. We investigate the structure of the resulting system of partial differential equations thinking about linearization around arbitrary backgrounds. This type of consideration is necessary if we are to establish well-posedness of the Cauchy problem. Treating the field equations as an effective field theory we find that weak necessary conditions for hyperbolicity are satisfied. For the full field equations we find that there are states from which subsequent evolution is not determined. Generically the evolution system closes, but is not hyperbolic in any sense that requires a first order pseudodifferential reduction. In a cursory mode analysis we find that the equations of motion contain terms that may cause ill-posedness of the initial value problem.

Generic medications for you, but brand-name medications for me.

PubMed

Keenum, Amy J; Devoe, Jennifer E; Chisolm, Deena J; Wallace, Lorraine S

2012-01-01

Because generic medications are less expensive than brand-name medications, government and private insurers have encouraged and/or mandated the use of generics. This study aimed at evaluating perceptions about generic medications among English-speaking women of childbearing age currently enrolled in U.S. TennCare (Medicaid). We recruited a convenience sample of patients from the waiting room of a primary care/gynecology health clinic, with 80% recruitment rate among those approached. We orally administered a 25-item questionnaire to gather sociodemographic information and to assess beliefs regarding the efficacy, safety, cost, and preferences for personal use of generic medications. The average age of the women (n=172) was 28.8 ± 6.4 years, and most were white (82.0%) and currently married (58.1%). Nearly one-fifth (19.2%) had not completed high school. Most women believed that generic medications were less expensive (97.6%) and better value (60.5%) than brand-name medications, but only 45.3% preferred to take generics themselves. About a quarter (23.3%) believed that brand-name medications were more effective than generics, whereas 13.4% believed that generics caused more side effects. Few women reported that their doctor (29.7%) and/or pharmacist (35.5%) had ever talked to them about taking generics. Awareness of the benefits of generics did not equal preferences for personal use of generics among this sample of women enrolled in U.S. TennCare. Furthermore, women reported that providers-both physicians and pharmacists-infrequently discussed generic substitution with them. Copyright © 2012 Elsevier Inc. All rights reserved.

Factors influencing the preference for purchasing generic drugs in a Southern Brazilian city.

PubMed

Guttier, Marília Cruz; Silveira, Marysabel Pinto Telis; Luiza, Vera Lucia; Bertoldi, Andréa Dâmaso

2017-06-26

The objective of this study is to identify factors associated with the preference for purchasing generic drugs in a medium-sized municipality in Southern Brazil. We have analyzed data from a population-based cross-sectional study conducted in 2012 with a sample of 2,856 adults (≥ 20 years old). The preference for purchasing generic drugs was the main outcome. The explanatory variables were the demographic and socioeconomic variables. Statistical analyses included Poisson regressions. The preference for purchasing generic drugs was 63.2% (95%CI 61.4-64.9). The variables correlated with this preference in the fully adjusted models were: male (prevalence ratio [PR] = 1.08; 95%CI 1.03-1.14), age of 20-39 years (PR = 1.10; 95%CI 1.02-1.20), low socioeconomic status (PR = 1.15; 95%CI 1.03-1.28), and good knowledge about generic drugs (PR= 4.66; 95%CI 2.89-7.52). Among those who preferred to purchase generic drugs, 55.1% have reported accepting to replace the prescribed drug (if not a generic) with the equivalent generic drug. Another correlate of the preference for purchasing generic drugs was because individuals consider their quality equivalent to reference medicines (PR = 2.15; 95%CI 1.93-2.41). Knowledge about generic drugs was the main correlate of the preference for purchasing generic drugs. The greater the knowledge or positive perception about generic drugs, the greater is the preference to purchase them. Therefore, educational campaigns for healthcare professionals and consumers appear to be the best strategy for expanding the use of generic drugs in Brazil.

Orbital Spacecraft Consumables Resupply System (OSCRS). Volume 2: Study results

NASA Technical Reports Server (NTRS)

1987-01-01

The objective was to establish an earth storable fluids tanker concept which satisfies the initial resupply requirements for the Gamma Ray Observatory (GRO) for reasonable front end (design, development, verification) cost while providing growth potential for foreseeable future earth storable resupply mission requirements. The achievement of these objectives becomes possible with the development of a modularized tanker concept which is a hybrid of a dedicated GRO tanker and a generic earth storable propellant tanker.

High-Frequency Axial Fatigue Test Procedures for Spectrum Loading

DTIC Science & Technology

2016-07-20

histories can be performed at frequencies much higher than standard servo-hydraulic test frames by using a test frame that is optimized to run at higher...by using a test frame that is optimized to run at higher frequencies. AIR 4.3 has conducted a research program to develop a test capability for...Applied Research (BAR) program (219BAR-10-008) was initiated in 2010. The program investigated the influence of a generic rotorcraft main rotor blade root

Integrable mappings with transcendental invariants

NASA Astrophysics Data System (ADS)

Grammaticos, B.; Ramani, A.

2007-06-01

We examine a family of integrable mappings which possess rational invariants involving polynomials of arbitrarily high degree. Next we extend these mappings to the case where their parameters are functions of the independent variable. The resulting mappings do not preserve any invariant but are solvable by linearisation. Using this result we then proceed to construct the solution of the initial autonomous mappings and use it to explicitly construct the invariant, which turns out to be transcendental in the generic case.

ORAC-DR: A generic data reduction pipeline infrastructure

NASA Astrophysics Data System (ADS)

Jenness, Tim; Economou, Frossie

2015-03-01

ORAC-DR is a general purpose data reduction pipeline system designed to be instrument and observatory agnostic. The pipeline works with instruments as varied as infrared integral field units, imaging arrays and spectrographs, and sub-millimeter heterodyne arrays and continuum cameras. This paper describes the architecture of the pipeline system and the implementation of the core infrastructure. We finish by discussing the lessons learned since the initial deployment of the pipeline system in the late 1990s.

Overview of free-piston Stirling technology at the NASA Lewis Research Center

NASA Technical Reports Server (NTRS)

Slaby, J. G.

1985-01-01

An overview of the National Aeronautics and Space Administration (NASA) Lewis Research Center (Lewis) free-piston Stirling engine activities is presented. These activities include: (1) a generic free-piston Stirling technology project being conducted to develop technologies synergistic to both space power and terrestrial heat pump applications in a cooperative, cost-shared effort with the Department of Energy (DOE/Oak Ridge National Laboratory (ONRL)), and (2) a free-piston Stirling space-power technology demonstration project as part of the SP-100 program being conducted in support of the Department of Defense (DOD), DOE, and NASA/Lewis. The generic technology effort includes extensive parametric testing of a 1 kw free-piston Stirling engine (RE-1000), development and validation of a free-piston Stirling performance computer code, and fabrication and initial testing of an hydraulic output modification for the RE-1000 engine. The space power technology effort, under SP-100, addresses the status of the 25 kWe Space Power Demonstrator Engine (SPDE) including early test results.

Pre-Big Bang Bubbles from the Gravitational Instability of Generic String Vacua

NASA Astrophysics Data System (ADS)

Buonanno, A.; Damour, T.; Veneziano, G.

1998-06-01

We formulate the basic postulate of pre-big bang cosmology as one of 'asymptotic past triviality', by which we mean that the initial state is a generic perturbative solution of the tree-level low-energy effective action. Each such singular space-like hypersurface of gravitational collapse becomes, in the string-frame metric, the usual big-bang t = 0 hypersurface, i.e. the place of birth of a baby Friedmann universe after a period of dilaton-driven inflation. Specializing to the spherically-symmetric case, we review and reinterpret previous work on the subject, and propose a simple, scale-invariant criterion for collapse/inflation in terms of asymptotic data at past null infinity. Those data should determine whether, when, and where collapse/inflation occurs, and, when it does, fix its characteristics, including anisotropies on the big bang hypersurface whose imprint could have survived till now. Using Bayesian probability concepts, we finally attempt to answer some fine-tuning objections recently moved to the pre-gib bang scenario.

A Simulation and Modeling Framework for Space Situational Awareness

DOE Office of Scientific and Technical Information (OSTI.GOV)

Olivier, S S

This paper describes the development and initial demonstration of a new, integrated modeling and simulation framework, encompassing the space situational awareness enterprise, for quantitatively assessing the benefit of specific sensor systems, technologies and data analysis techniques. The framework is based on a flexible, scalable architecture to enable efficient, physics-based simulation of the current SSA enterprise, and to accommodate future advancements in SSA systems. In particular, the code is designed to take advantage of massively parallel computer systems available, for example, at Lawrence Livermore National Laboratory. The details of the modeling and simulation framework are described, including hydrodynamic models of satellitemore » intercept and debris generation, orbital propagation algorithms, radar cross section calculations, optical brightness calculations, generic radar system models, generic optical system models, specific Space Surveillance Network models, object detection algorithms, orbit determination algorithms, and visualization tools. The use of this integrated simulation and modeling framework on a specific scenario involving space debris is demonstrated.« less

Reconstruction of the optical system of personalized eye models by using magnetic resonance imaging.

PubMed

Sun, Han-Yin; Lee, Chi-Hung; Chuang, Chun-Chao

2016-11-10

This study presents a practical method for reconstructing the optical system of personalized eye models by using magnetic resonance imaging (MRI). Monocular images were obtained from a young (20-year-old) healthy subject viewing at a near point (10 cm). Each magnetic resonance image was first analyzed using several commercial software to capture the profile of each optical element of the human eye except for the anterior lens surface, which could not be determined because it overlapped the ciliary muscle. The missing profile was substituted with a modified profile from a generic eye model. After the data-including the refractive indices from a generic model-were input in ZEMAX, we obtained a reasonable initial layout. By further considering the resolution of the MRI, the model was optimized to match the optical performance of a healthy eye. The main benefit of having a personalized eye model is the ability to quantitatively identify wide-angle ocular aberrations, which were corrected by the designed free-form spectacle lens.

Thermalization and its mechanism for generic quantum isolated systems

NASA Astrophysics Data System (ADS)

Olshanii, Maxim; Dunjko, Vanja; Rigol, Marcos

2008-05-01

Time dynamics of isolated many-body quantum systems has long been an elusive subject, perhaps most urgently needed in the foundations of quantum statistical mechanics. In generic systems, one expects the nonequilibrium dynamics to lead to thermalization: a relaxation to states where the values of macroscopic quantities are stationary, universal with respect to widely differing initial conditions, and predictable through the time-tested recipe of statistical mechanics. The relaxation mechanism is not obvious, however; dynamical chaos cannot play the key role as it does in classical systems since quantum evolution is linear. Here we demonstrateootnotetextM. Rigol, V. Dunjko, and M. Olshanii, to appear in Nature (2008), using the results of an ab initio numerical experiment with 5 hard-core bosons moving in a 5x5 lattice, that in quantum systems thermalization happens not in course of time evolution but instead at the level of individual eigenstates, as first proposed by DeutschootnotetextJ. M. Deutsch, Phys.Rev. A 43, 2046 (1991) and SrednickiootnotetextM. Srednicki, Phys. Rev. E 50, 888 (1994).

A generic model of contagious disease and its application to human-to-human transmission of avian influenza.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hirsch, Gary B.

2007-03-01

Modeling contagious diseases has taken on greater importance over the past several years as diseases such as SARS and avian influenza have raised concern about worldwide pandemics. Most models developed to consider projected outbreaks have been specific to a single disease. This paper describes a generic System Dynamics contagious disease model and its application to human-to-human transmission of a mutant version of avian influenza. The model offers the option of calculating rates of new infections over time based either on a fixed ''reproductive number'' that is traditional in contagious disease models or on contact rates for different sub-populations and likelihoodmore » of transmission per contact. The paper reports on results with various types of interventions. These results suggest the potential importance of contact tracing, limited quarantine, and targeted vaccination strategies as methods for controlling outbreaks, especially when vaccine supplies may initially be limited and the efficacy of anti-viral drugs uncertain.« less

Asymptotic dynamics of the exceptional Bianchi cosmologies

NASA Astrophysics Data System (ADS)

Hewitt, C. G.; Horwood, J. T.; Wainwright, J.

2003-05-01

In this paper we give, for the first time, a qualitative description of the asymptotic dynamics of a class of non-tilted spatially homogeneous (SH) cosmologies, the so-called exceptional Bianchi cosmologies, which are of Bianchi type VI$_{-1/9}$. This class is of interest for two reasons. Firstly, it is generic within the class of non-tilted SH cosmologies, being of the same generality as the models of Bianchi types VIII and IX. Secondly, it is the SH limit of a generic class of spatially inhomogeneous $G_{2}$ cosmologies. Using the orthonormal frame formalism and Hubble-normalized variables, we show that the exceptional Bianchi cosmologies differ from the non-exceptional Bianchi cosmologies of type VI$_{h}$ in two significant ways. Firstly, the models exhibit an oscillatory approach to the initial singularity and hence are not asymptotically self-similar. Secondly, at late times, although the models are asymptotically self-similar, the future attractor for the vacuum-dominated models is the so-called Robinson-Trautman SH model instead of the vacuum SH plane wave models.

Motion of discrete solitons assisted by nonlinearity management.

PubMed

Cuevas, Jesús; Malomed, Boris A; Kevrekidis, P G

2005-06-01

We demonstrate that time-periodic modulation of the nonlinearity coefficient in the discrete nonlinear Schrödinger equation strongly facilitates creation of traveling solitons in the lattice. We predict this possibility in a semi-qualitative form analytically, and test it in direct numerical simulations. Systematic computations reveal several generic dynamical regimes, depending on the amplitude and frequency of the time modulation, and on the initial thrust which sets the soliton in motion. These regimes include irregular motion of the soliton, regular motion of a decaying one, and regular motion of a stable soliton. The motion may occur in both the straight and reverse directions, relative to the initial thrust. In the case of stable motion, extremely long simulations in a lattice with periodic boundary conditions demonstrate that the soliton keeps moving indefinitely long without any visible loss. Velocities of moving stable solitons are in good agreement with the analytical prediction, which is based on requiring a resonance between the ac drive and motion of the soliton through the periodic lattice. The generic dynamical regimes are mapped in the model's parameter space. Collisions between moving stable solitons are briefly investigated too, with a conclusion that two different outcomes are possible: elastic bounce, or bounce with mass transfer from one soliton to the other. The model can be realized experimentally in a Bose-Einstein condensate trapped in a deep optical lattice.

Files in /noaa/dhs

Science.gov Websites

noaa_20110510_wbg.gif 10-May-2011 20:58 31K generic file noaa_20110510_wbg.pdf 10-May-2011 20:58 128K generic file noaa_20110513_wbg.gif 13-May-2011 20:10 27K generic file noaa_20110513_wbg.pdf 13-May-2011 20:10 122K generic file noaa_20110518_wbg.gif 18-May-2011 21:10 33K generic file noaa_20110518_wbg.pdf 18-May-2011 21:10 128K generic file

DOE Office of Scientific and Technical Information (OSTI.GOV)

Field, Scott E.; Hesthaven, Jan S.; Lau, Stephen R.

In the context of metric perturbation theory for nonspinning black holes, extreme mass ratio binary systems are described by distributionally forced master wave equations. Numerical solution of a master wave equation as an initial boundary value problem requires initial data. However, because the correct initial data for generic-orbit systems is unknown, specification of trivial initial data is a common choice, despite being inconsistent and resulting in a solution which is initially discontinuous in time. As is well known, this choice leads to a burst of junk radiation which eventually propagates off the computational domain. We observe another potential consequence ofmore » trivial initial data: development of a persistent spurious solution, here referred to as the Jost junk solution, which contaminates the physical solution for long times. This work studies the influence of both types of junk on metric perturbations, waveforms, and self-force measurements, and it demonstrates that smooth modified source terms mollify the Jost solution and reduce junk radiation. Our concluding section discusses the applicability of these observations to other numerical schemes and techniques used to solve distributionally forced master wave equations.« less

The differences between the branded and generic medicines using solid dosage forms: In-vitro dissolution testing

PubMed Central

Al Ameri, Mubarak Nasser; Nayuni, Nanda; Anil Kumar, K.G.; Perrett, David; Tucker, Arthur; Johnston, Atholl

2011-01-01

Introduction Dissolution is the amount of substance that goes into solution per unit time under standardised conditions of liquid/solid interface, solvent composition and temperature. Dissolution is one of the most important tools to predict the in-vivo bioavailability and in some cases to determine bioequivalence and assure interchangeability. Aim To compare the differences in dissolution behaviour of solid dosage forms between innovators (reference products) and their generic counterparts (tested products). Methods Four replicates for each batch of 37 tested medicines was carried out using A PT-DT70 dissolution tester from Pharma Test. A total of 13 branded medicines and 24 generic counterparts were obtained locally and internationally to detect any differences in their dissolution behaviour. They were tested according to the British Pharmacopeia, European Pharmacopeia and the US Pharmacopeia with the rate of dissolution determined by ultra-violet Spectrophotometery. Results Most tested medicines complied with the pharmacopoeial specifications and achieved 85% dissolution in 60 min. However, some generic medicines showed significant differences in dissolution rate at 60 and 120 min. Many generic medicines showed a slower dissolution rate than their branded counterparts such as the generic forms of omeprazole 20 mg. Some showed an incomplete dissolution such as the generic form of nifedipine 10 mg. Other generics showed faster dissolution rate than their branded counterpart such as the generic forms of meloxicam 15 mg. Moreover, some generics from different batches of the same manufacturer showed significant differences in their dissolution rate such as the generic forms of meloxicam 7.5 mg. Nevertheless, some generic medicines violated the EMA and the FDA guidelines for industry when they failed to achieve 85% dissolution at 60 min, such as the generic form of diclofenac sodium 50 mg. Conclusion Most medicines in this study complied with the pharmacopeial limits. However, some generics dissolved differently than their branded counterparts. This can clearly question the interchangeability between the branded and its generic counterpart or even among generics. PMID:25755988

Ideal strength of bcc molybdenum and niobium

NASA Astrophysics Data System (ADS)

Luo, Weidong; Roundy, D.; Cohen, Marvin L.; Morris, J. W.

2002-09-01

The behavior of bcc Mo and Nb under large strain was investigated using the ab initio pseudopotential density-functional method. We calculated the ideal shear strength for the {211}<111> and {011}<111> slip systems and the ideal tensile strength in the <100> direction, which are believed to provide the minimum shear and tensile strengths. As either material is sheared in either of the two systems, it evolves toward a stress-free tetragonal structure that defines a saddle point in the strain-energy surface. The inflection point on the path to this tetragonal ``saddle-point'' structure sets the ideal shear strength. When either material is strained in tension along <100>, it initially follows the tetragonal, ``Bain,'' path toward a stress-free fcc structure. However, before the strained crystal reaches fcc, its symmetry changes from tetragonal to orthorhombic; on continued strain it evolves toward the same tetragonal saddle point that is reached in shear. In Mo, the symmetry break occurs after the point of maximum tensile stress has been passed, so the ideal strength is associated with the fcc extremum as in W. However, a Nb crystal strained in <100> becomes orthorhombic at tensile stress below the ideal strength. The ideal tensile strength of Nb is associated with the tetragonal saddle point and is caused by failure in shear rather than tension. In dimensionless form, the ideal shear and tensile strengths of Mo (τ*=τm/G111=0.12, σ*=σm/E100=0.078) are essentially identical to those previously calculated for W. Nb is anomalous. Its dimensionless shear strength is unusually high, τ*=0.15, even though the saddle-point structure that causes it is similar to that in Mo and W, while its dimensionless tensile strength, σ*=0.079, is almost the same as that of Mo and W, even though the saddle-point structure is quite different.

Models of initial training and pathways to registration: a selective review of policy in professional regulation.

PubMed

Fealy, Gerard M; Carney, Marie; Drennan, Jonathan; Treacy, Margaret; Burke, Jacqueline; O'Connell, Dympna; Howley, Breeda; Clancy, Alison; McHugh, Aine; Patton, Declan; Sheerin, Fintan

2009-09-01

To provide a synthesis of literature on international policy concerning professional regulation in nursing and midwifery, with reference to routes of entry into training and pathways to licensure. Internationally, there is evidence of multiple points of entry into initial training, multiple divisions of the professional register and multiple pathways to licensure. Policy documents and commentary articles concerned with models of initial training and pathways to licensure were reviewed. Item selection, quality appraisal and data extraction were undertaken and documentary analysis was performed on all retrieved texts. Case studies of five Western countries indicate no single uniform system of routes of entry into initial training and no overall consensus regarding the optimal model of initial training. Multiple regulatory systems, with multiple routes of entry into initial training and multiple pathways to licensure pose challenges, in terms of achieving commonly-agreed understandings of practice competence. The variety of models of initial training present nursing managers with challenges in the recruitment and deployment of personnel trained in many different jurisdictions. Nursing managers need to consider the potential for considerable variation in competency repertoires among nurses trained in generic and specialist initial training models.

Is bioavailability altered in generic versus brand anticonvulsants?

PubMed

Jankovic, Slobodan M; Ignjatovic Ristic, Dragana

2015-03-01

Therapeutic window of anticonvulsants is not a wide one, with phenytoin being one extreme, which can be classified as a narrow therapeutic index drug, since its ratio between the least toxic and the least effective concentration is less than twofold. In order to obtain marketing authorization, a generic anticonvulsant should demonstrate relative bioequivalence with its brand-name counterpart. However, although bioequivalent, generic anticonvulsants still do not have the same bioavailability as brand-name drugs, which may lead to larger fluctuations of steady-state plasma concentrations, and sometimes to loss of seizure control if a patient is switched from brand-name to generic or from generic to generic anticonvulsant. Generic anticonvulsants are effective, safe and affordable drugs for treatment of epilepsy, and patients could be successfully treated with them from the very beginning. It is switching from brand-name to generic anticonvulsant or from one generic anticonvulsant to another that should be avoided in clinical practice, since subtle differences in bioavailability may disturb optimal degree of seizure control to which the patient was previously successfully titrated.

Generic medicines: solutions for a sustainable drug market?

PubMed

Dylst, Pieter; Vulto, Arnold; Godman, Brian; Simoens, Steven

2013-10-01

Generic medicines offer equally high-quality treatment as originator medicines do at much lower prices. As such, they represent a considerable opportunity for authorities to obtain substantial savings. At the moment, the pharmaceutical landscape is changing and many pharmaceutical companies have altered their development and commercial strategies, combining both originator and generic divisions. In spite of this, the generic medicines industry is currently facing a number of challenges: delayed market access; the limited price differential with originator medicines; the continuous downwards pressure on prices; and the negative perception regarding generic medicines held by some key stakeholder groups. This could jeopardize the long-term sustainability of the generic manufacturing industry. Therefore, governments must focus on demand-side policies, alongside policies to accelerate market access, as the generic medicines industry will only be able to deliver competitive and sustainable prices if they are ensured a high volume. In the future, the generic medicines industry will increasingly look to biosimilars and generic versions of orphan drugs to expand their business.

Analysis of the Italian generic medicines retail market: recommendations to enhance long-term sustainability.

PubMed

Dylst, Pieter; Vulto, Arnold; Simoens, Steven

2015-02-01

Italy is among the European countries with the lowest uptake of generic medicines. This paper provides a perspective on the Italian generic medicines retail market. Fast market entrance of generic medicines in Italy is hindered by several factors: the existence of Complementary Protection Certificates in the past, the large market for copies and multiple cases of patent linkage. Prices of generic medicines in Italy are low compared to other European countries. To contain pharmaceutical expenditure, pharmaceutical companies are currently forced to pay back in case of overspending, which disproportionally penalizes small and fast growing companies, to which most generic companies belong to. Current demand-side policies do not successfully stimulate the use of generic medicines. The current market environment surrounding the Italian generic medicines retail market (i.e., low prices, low volumes) threatens its long-term sustainability. Recommendations to enhance the long-term sustainability of the Italian generic medicines retail market round off this perspective paper.

Building Bridges through Science.

PubMed

Lissek, Thomas; Adams, Michelle; Adelman, John; Ahissar, Ehud; Akaaboune, Mohammed; Akil, Huda; al'Absi, Mustafa; Arain, Fazal; Arango-Lasprilla, Juan Carlos; Atasoy, Deniz; Avila, Jesus; Badawi, Ashraf; Bading, Hilmar; Baig, Abdul Mannan; Baleriola, Jimena; Belmonte, Carlos; Bertocchi, Ilaria; Betz, Heinrich; Blakemore, Colin; Blanke, Olaf; Boehm-Sturm, Philipp; Bonhoeffer, Tobias; Bonifazi, Paolo; Brose, Nils; Campolongo, Patrizia; Celikel, Tansu; Chang, Cathy C; Chang, Ta-Yuan; Citri, Ami; Cline, Hollis T; Cortes, Jesus M; Cullen, Kathleen; Dean, Kellie; Delgado-Garcia, José M; Desroches, Mathieu; Disterhoft, John F; Dowling, John E; Draguhn, Andreas; El-Khamisy, Sherif F; El Manira, Abdeljabbar; Enam, S Ather; Encinas, Juan M; Erramuzpe, Asier; Esteban, José A; Fariñas, Isabel; Fischer, Edmond; Fukunaga, Izumi; Gabilondo, Iñigo; Ganten, Detlev; Gidon, Albert; Gomez-Esteban, Juan Carlos; Greengard, Paul; Grinevich, Valery; Gruart, Agnés; Guillemin, Roger; Hariri, Ahmad R; Hassan, Bassem; Häusser, Michael; Hayashi, Yasunori; Hussain, Natasha K; Jabbar, Adnan Abdul; Jaber, Mohamed; Jahn, Reinhardt; Janahi, Essam Mohammed; Kabbaj, Mohamed; Kettenmann, Helmut; Kindt, Merel; Knafo, Shira; Köhr, Georg; Komai, Shoji; Krugers, Harm; Kuhn, Bernd; Ghazal, Nouria Lakhdar; Larkum, Matthew E; London, Mickey; Lutz, Beat; Matute, Carlos; Martinez-Millan, Luis; Maroun, Mouna; McGaugh, James; Moustafa, Ahmed A; Nasim, Anwar; Nave, Klaus-Armin; Neher, Erwin; Nikolich, Karoly; Outeiro, Tiago; Palmer, Lucy M; Penagarikano, Olga; Perez-Otano, Isabel; Pfaff, Donald W; Poucet, Bruno; Rahman, Atta-Ur; Ramos-Cabrer, Pedro; Rashidy-Pour, Ali; Roberts, Richard J; Rodrigues, Serafim; Sanes, Joshua R; Schaefer, Andreas T; Segal, Menahem; Segev, Idan; Shafqat, Saad; Siddiqui, Nikhat Ahmed; Soreq, Hermona; Soriano-García, Eduardo; Spanagel, Rainer; Sprengel, Rolf; Stuart, Greg; Südhof, Thomas C; Tønnesen, Jan; Treviño, Mario; Uthman, Basim M; Venter, J Craig; Verkhratsky, Alexei; Weiss, Craig; Wiesel, Torsten N; Yaksi, Emre; Yizhar, Ofer; Young, Larry J; Young, Paul; Zawia, Nasser H; Zugaza, José L; Hasan, Mazahir T

2017-11-15

Science is ideally suited to connect people from different cultures and thereby foster mutual understanding. To promote international life science collaboration, we have launched "The Science Bridge" initiative. Our current project focuses on partnership between Western and Middle Eastern neuroscience communities. Copyright © 2017 Elsevier Inc. All rights reserved.

Children with HIV-Related Developmental Difficulties.

ERIC Educational Resources Information Center

Seidel, John F.

1992-01-01

Children with HIV infection, although they remain healthy and exhibit age-appropriate development, can be mainstreamed without program modifications or specialized treatment. Such children should be included in definitions of eligibility for at-risk services. Ideally, general developmental stimulation should be initiated before symptoms emerge.…

Loan Stars: ILL Comes of Age.

ERIC Educational Resources Information Center

Jackson, Mary E.

1998-01-01

Assesses the changes in interlibrary loan (ILL) practices, and points the way to an ideal future. Discusses patron-initiated document request systems; library-mediated ordering systems; document delivery suppliers; accessing electronic resources; ILL management software; paying ILL invoices; new electronic delivery options; and results of a…

Using Adverse Outcome Pathways to Build Chemical Groups: A Case Study for Hepatic Steatosis

EPA Science Inventory

The Adverse Outcome Pathway (AOP) framework systematically documents the mechanisms underlying effects of chemicals. Ideally, the AOP traces the mechanism to the initial interaction of chemicals with the biological system. Thus, AOPs should help inform chemical grouping by identi...

Can Multiculturalism Be Exported? Dilemmas of Diversity on Nigeria's "Sesame Square"

ERIC Educational Resources Information Center

Moland, Naomi A.

2015-01-01

While scholars argue that "multicultural education" initiatives are rooted in liberal Western ideals, such projects are increasingly being exported to non-Western countries with significantly different sociohistorical contexts. This article examines the adaptation of multicultural education on the Nigerian version of "Sesame…

Towards the Construction of Life-Long Education System.

ERIC Educational Resources Information Center

Moro-Oka, Kazufusa

Since the ideal of lifelong education is closely related to the reorganization of the entire educational system, it is necessary to recognize the distinction between education and its administration. Democratization, continuity, flexibility and freedom are principles related to planning and administration; active participation, initiative and…

Linear dependence of surface expansion speed on initial plasma temperature in warm dense matter

DOE PAGES

Bang, Woosuk; Albright, Brian James; Bradley, Paul Andrew; ...

2016-07-12

Recent progress in laser-driven quasi-monoenergetic ion beams enabled the production of uniformly heated warm dense matter. Matter heated rapidly with this technique is under extreme temperatures and pressures, and promptly expands outward. While the expansion speed of an ideal plasma is known to have a square-root dependence on temperature, computer simulations presented here show a linear dependence of expansion speed on initial plasma temperature in the warm dense matter regime. The expansion of uniformly heated 1–100 eV solid density gold foils was modeled with the RAGE radiation-hydrodynamics code, and the average surface expansion speed was found to increase linearly withmore » temperature. The origin of this linear dependence is explained by comparing predictions from the SESAME equation-of-state tables with those from the ideal gas equation-of-state. In conclusion, these simulations offer useful insight into the expansion of warm dense matter and motivate the application of optical shadowgraphy for temperature measurement.« less

Modeling of the Bosphorus exchange flow dynamics

NASA Astrophysics Data System (ADS)

Sözer, Adil; Özsoy, Emin

2017-04-01

The fundamental hydrodynamic behavior of the Bosphorus Strait is investigated through a numerical modeling study using alternative configurations of idealized or realistic geometry. Strait geometry and basin stratification conditions allow for hydraulic controls and are ideally suited to support the maximal-exchange regime, which determines the rate of exchange of waters originating from the adjacent Black and Mediterranean Seas for a given net transport. Steady-state hydraulic controls are demonstrated by densimetric Froude number calculations under layered flow approximations when corrections are applied to account for high velocity shears typically observed in the Bosphorus. Analyses of the model results reveal many observed features of the strait, including critical transitions at hydraulic controls and dissipation by turbulence and hydraulic jumps. It is found that the solution depends on initialization, especially with respect to the basin initial conditions. Significant differences between the controlled maximal-exchange and drowned solutions suggest that a detailed modeling implementation involving coupling with adjacent basins needs to take full account of the Bosphorus Strait in terms of the physical processes to be resolved.

Concentration Fluctuations and Capacitive Response in Dense Ionic Solutions.

PubMed

Uralcan, Betul; Aksay, Ilhan A; Debenedetti, Pablo G; Limmer, David T

2016-07-07

We use molecular dynamics simulations in a constant potential ensemble to study the effects of solution composition on the electrochemical response of a double layer capacitor. We find that the capacitance first increases with ion concentration following its expected ideal solution behavior but decreases upon approaching a pure ionic liquid in agreement with recent experimental observations. The nonmonotonic behavior of the capacitance as a function of ion concentration results from the competition between the independent motion of solvated ions in the dilute regime and solvation fluctuations in the concentrated regime. Mirroring the capacitance, we find that the characteristic decay length of charge density correlations away from the electrode is also nonmonotonic. The correlation length first decreases with ion concentration as a result of better electrostatic screening but increases with ion concentration as a result of enhanced steric interactions. When charge fluctuations induced by correlated ion-solvent fluctuations are large relative to those induced by the pure ionic liquid, such capacitive behavior is expected to be generic.

The effect of digital alteration disclaimer labels on social comparison and body image: Instructions and individual differences.

PubMed

Bury, Belinda; Tiggemann, Marika; Slater, Amy

2016-06-01

The current study aimed to investigate the effect of digital alteration disclaimer labels appended to fashion magazine advertisements, as well as instructional condition, on women's social comparison and body dissatisfaction. Participants were 378 female undergraduate students who viewed 11 thin ideal advertisements with either no disclaimer, a generic disclaimer, or a more detailed specific disclaimer. There were three instructional conditions: neutral, distractor, and social comparison. Disclaimer labels did not affect appearance comparison or body dissatisfaction, but instructional condition did, with the social comparison instructions producing the highest appearance comparison and body dissatisfaction. In addition, there was a three-way interaction with trait appearance comparison, such that women high on trait appearance comparison who saw specifically worded disclaimers in the distractor instructional condition experienced increased body dissatisfaction, whereas women low on this trait experienced decreased body dissatisfaction. It seems that both instructions and individual differences may influence responses to disclaimer labels. Copyright © 2016 Elsevier Ltd. All rights reserved.

Black-hole kicks from numerical-relativity surrogate models

NASA Astrophysics Data System (ADS)

Gerosa, Davide; Hébert, François; Stein, Leo C.

2018-05-01

Binary black holes radiate linear momentum in gravitational waves as they merge. Recoils imparted to the black-hole remnant can reach thousands of km /s , thus ejecting black holes from their host galaxies. We exploit recent advances in gravitational waveform modeling to quickly and reliably extract recoils imparted to generic, precessing, black-hole binaries. Our procedure uses a numerical-relativity surrogate model to obtain the gravitational waveform given a set of binary parameters; then, from this waveform we directly integrate the gravitational-wave linear momentum flux. This entirely bypasses the need for fitting formulas which are typically used to model black-hole recoils in astrophysical contexts. We provide a thorough exploration of the black-hole kick phenomenology in the parameter space, summarizing and extending previous numerical results on the topic. Our extraction procedure is made publicly available as a module for the Python programming language named surrkick. Kick evaluations take ˜0.1 s on a standard off-the-shelf machine, thus making our code ideal to be ported to large-scale astrophysical studies.

Conformational thermostabilization of the β1-adrenergic receptor in a detergent-resistant form

PubMed Central

Serrano-Vega, Maria J.; Magnani, Francesca; Shibata, Yoko; Tate, Christopher G.

2008-01-01

There are ≈350 non-odorant G protein-coupled receptors (GPCRs) encoded by the human genome, many of which are predicted to be potential therapeutic targets, but there are only two structures available to represent the whole of the family. We hypothesized that improving the detergent stability of these receptors and simultaneously locking them into one preferred conformation will greatly improve the chances of crystallization. We developed a generic strategy for the isolation of detergent-solubilized thermostable mutants of a GPCR, the β1-adrenergic receptor. The most stable mutant receptor, βAR-m23, contained six point mutations that led to an apparent Tm 21°C higher than the native protein, and, in the presence of bound antagonist, βAR-m23 was as stable as bovine rhodopsin. In addition, βAR-m23 was significantly more stable in a wide range of detergents ideal for crystallization and was preferentially in an antagonist conformation in the absence of ligand. PMID:18192400

An overview of state-of-the-art image restoration in electron microscopy.

PubMed

Roels, J; Aelterman, J; Luong, H Q; Lippens, S; Pižurica, A; Saeys, Y; Philips, W

2018-06-08

In Life Science research, electron microscopy (EM) is an essential tool for morphological analysis at the subcellular level as it allows for visualization at nanometer resolution. However, electron micrographs contain image degradations such as noise and blur caused by electromagnetic interference, electron counting errors, magnetic lens imperfections, electron diffraction, etc. These imperfections in raw image quality are inevitable and hamper subsequent image analysis and visualization. In an effort to mitigate these artefacts, many electron microscopy image restoration algorithms have been proposed in the last years. Most of these methods rely on generic assumptions on the image or degradations and are therefore outperformed by advanced methods that are based on more accurate models. Ideally, a method will accurately model the specific degradations that fit the physical acquisition settings. In this overview paper, we discuss different electron microscopy image degradation solutions and demonstrate that dedicated artefact regularisation results in higher quality restoration and is applicable through recently developed probabilistic methods. © 2018 The Authors Journal of Microscopy © 2018 Royal Microscopical Society.

The mechanics of decompressive craniectomy: Bulging in idealized geometries

NASA Astrophysics Data System (ADS)

Weickenmeier, Johannes; Kuhl, Ellen; Goriely, Alain

2016-11-01

In extreme cases of traumatic brain injury or a stroke, the resulting uncontrollable swelling of the brain may lead to a harmful increase of the intracranial pressure. As a common measure for immediate release of pressure on the brain, part of the skull is surgically removed allowing for the brain to bulge outwards, a procedure known as a decompressive craniectomy. During this excessive brain swelling, the affected tissue typically undergoes large deformations resulting in a complex three-dimensional mechanical loading state with several important implications on optimal treatment strategies and outcome. Here, as a first step towards a better understanding of the mechanics of a decompressive craniectomy, we consider simple models for the bulging of elastic solids under geometric constraints representative of the surgical intervention. In small deformations and simple geometries, the exact solution of this problem is derived from the theory of contact mechanics. The analysis of these solutions reveals a number of interesting generic features relevant for the mechanics of craniectomy.

Patients' perceptions of generic drugs in Greece.

PubMed

Skaltsas, Leonora N; Vasileiou, Konstantinos Z

2015-11-01

The use of generic drugs is growing increasingly around the world and in Greece, in particular, in order to reduce pharmaceutical expenditure. However, patients' perceptions and attitudes about generics have only partially been studied so far in Greece. This study aimed to examine the factors that influence the attitude of patients and consumers regarding generic drugs. A questionnaire survey of 364 patients visiting a pharmacy was conducted. The questionnaire consisted of 29 questions, including questions regarding their knowledge about generics, the reasons for using them, their previous experience, their willingness for generic substitution, and the factors behind these choices. Nearly half of the participants in the survey know the term 'generic' and that it has a lower price compared to the brand name drug. Their views on safety and efficacy vary significantly and the main source of information on generics is the media and the internet. The lack of knowledge is the main barrier for attitudes of doctors. Health professionals play the most influential role for the substitution of a branded drug by a generic, followed by the cost of the generic. Almost half of the patients know about generic drugs, with their lower price being the most popular feature which most patients are familiar with. It seems that primarily the doctor and, subsequently the pharmacist play the most important role in a patient's decision to replace his/her medicine with a generic. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Nonuniform dependence on initial data for compressible gas dynamics: The periodic Cauchy problem

NASA Astrophysics Data System (ADS)

Keyfitz, B. L.; Tığlay, F.

2017-11-01

We start with the classic result that the Cauchy problem for ideal compressible gas dynamics is locally well posed in time in the sense of Hadamard; there is a unique solution that depends continuously on initial data in Sobolev space Hs for s > d / 2 + 1 where d is the space dimension. We prove that the data to solution map for periodic data in two dimensions although continuous is not uniformly continuous.

The importance of being first: evidence from Canadian generic pharmaceuticals.

PubMed

Hollis, Aidan

2002-12-01

This paper uses pooled cross-section data on Canadian ethical drug sales to examine the effect of entry timing on sales of generic drugs. The data is for all drugs for which the first generic competitor entered during the years 1994-1997. It is found that the first generic entrant has a lasting competitive advantage: being first into the market appears to lead to an increase of around 30% in market share (among generics) over a period of at least 4 years. This finding has considerable implications for the current policy of allowing brandname drug companies to issue pseudo-generic equivalents as a preemptive strike against true generic competitors. Copyright 2002 John Wiley & Sons, Ltd.

Generic penetration in the retail antidepressant market.

PubMed

Ventimiglia, Jeffrey; Kalali, Amir H

2010-06-01

In this article, we explore the accelerated penetration of generic antidepressants in the United States market following the availability of generic citalopram and sertraline. Analysis suggests that overall, generic penetration into the antidepressant market has grown from approximately 41 percent in January 2004 to over 73 percent in January 2010. Similar trends are uncovered when branded and generic prescriptions are analyzed by specialty.

A review of the differences and similarities between generic drugs and their originator counterparts, including economic benefits associated with usage of generic medicines, using Ireland as a case study.

PubMed

Dunne, Suzanne; Shannon, Bill; Dunne, Colum; Cullen, Walter

2013-01-05

Generic medicines are those where patent protection has expired, and which may be produced by manufacturers other than the innovator company. Use of generic medicines has been increasing in recent years, primarily as a cost saving measure in healthcare provision. Generic medicines are typically 20 to 90% cheaper than originator equivalents. Our objective is to provide a high-level description of what generic medicines are and how they differ, at a regulatory and legislative level, from originator medicines. We describe the current and historical regulation of medicines in the world's two main pharmaceutical markets, in addition to the similarities, as well as the differences, between generics and their originator equivalents including the reasons for the cost differences seen between originator and generic medicines. Ireland is currently poised to introduce generic substitution and reference pricing. This article refers to this situation as an exemplar of a national system on the cusp of significant health policy change, and specifically details Ireland's history with usage of generic medicines and how the proposed changes could affect healthcare provision.

Effects of generic versus non-generic feedback on motor learning in children.

PubMed

Chiviacowsky, Suzete; Drews, Ricardo

2014-01-01

Non-generic feedback refers to a specific event and implies that performance is malleable, while generic feedback implies that task performance reflects an inherent ability. The present study examined the influences of generic versus non-generic feedback on motor performance and learning in 10-year-old children. In the first experiment, using soccer ball kicking at a target as a task, providing participants with generic feedback resulted in worse performance than providing non-generic feedback, after both groups received negative feedback. The second experiment measured more permanent effects. Results of a retention test, performed one day after practicing a throwing task, showed that participants who received non-generic feedback during practice outperformed the generic feedback group, after receiving a negative feedback statement. The findings demonstrate the importance of the wording of feedback. Even though different positive feedback statements may not have an immediate influence on performance, they can affect performance, and presumably individuals' motivation, when performance is (purportedly) poor. Feedback implying that performance is malleable, rather than due to an inherent ability, seems to have the potential to inoculate learners against setbacks--a situation frequently encountered in the context of motor performance and learning.

Generic medicine pricing in Europe: current issues and future perspective.

PubMed

Simoens, Steven

2008-01-01

This editorial discusses a number of trends affecting the pricing of generic medicines in Europe. With respect to pricing, recent evidence has emerged that European generic medicine manufacturers face competition from Indian manufacturers; that the price level of generic medicines varies substantially between European countries; and that generic medicine manufacturers engage in competition by discount rather than price competition in France, The Netherlands and the UK. These trends suggest that there may be scope for further reducing the prices of generic medicines in several countries. In relation to reference pricing, most European countries have incorporated market incentives within reference pricing systems with a view to promoting price competition. The European experience indicates that the generic medicines industry delivers competitive prices under a reference pricing system if demand-side policies are in place that stimulate physicians, pharmacists and patients to use generic medicines. Finally, caution needs to be exercised when focusing on the drivers of generic medicine pricing as these drivers not only vary between countries, but may also vary within a country. Manufacturers of originator and generic medicines do not take a single pricing approach following patent expiry, but vary their pricing strategy from molecule to molecule.

Effects of Generic versus Non-Generic Feedback on Motor Learning in Children

PubMed Central

Chiviacowsky, Suzete; Drews, Ricardo

2014-01-01

Non-generic feedback refers to a specific event and implies that performance is malleable, while generic feedback implies that task performance reflects an inherent ability. The present study examined the influences of generic versus non-generic feedback on motor performance and learning in 10-year-old children. In the first experiment, using soccer ball kicking at a target as a task, providing participants with generic feedback resulted in worse performance than providing non-generic feedback, after both groups received negative feedback. The second experiment measured more permanent effects. Results of a retention test, performed one day after practicing a throwing task, showed that participants who received non-generic feedback during practice outperformed the generic feedback group, after receiving a negative feedback statement. The findings demonstrate the importance of the wording of feedback. Even though different positive feedback statements may not have an immediate influence on performance, they can affect performance, and presumably individuals' motivation, when performance is (purportedly) poor. Feedback implying that performance is malleable, rather than due to an inherent ability, seems to have the potential to inoculate learners against setbacks – a situation frequently encountered in the context of motor performance and learning. PMID:24523947

A review of the differences and similarities between generic drugs and their originator counterparts, including economic benefits associated with usage of generic medicines, using Ireland as a case study

PubMed Central

2013-01-01

Generic medicines are those where patent protection has expired, and which may be produced by manufacturers other than the innovator company. Use of generic medicines has been increasing in recent years, primarily as a cost saving measure in healthcare provision. Generic medicines are typically 20 to 90% cheaper than originator equivalents. Our objective is to provide a high-level description of what generic medicines are and how they differ, at a regulatory and legislative level, from originator medicines. We describe the current and historical regulation of medicines in the world’s two main pharmaceutical markets, in addition to the similarities, as well as the differences, between generics and their originator equivalents including the reasons for the cost differences seen between originator and generic medicines. Ireland is currently poised to introduce generic substitution and reference pricing. This article refers to this situation as an exemplar of a national system on the cusp of significant health policy change, and specifically details Ireland’s history with usage of generic medicines and how the proposed changes could affect healthcare provision. PMID:23289757

Patterns of use for brand-name versus generic oral bisphosphonate drugs in Ontario over a 13-year period: a descriptive study.

PubMed

Fraser, Lisa-Ann; Albaum, Jordan M; Tadrous, Mina; Burden, Andrea M; Shariff, Salimah Z; Cadarette, Suzanne M

2015-01-01

Bisphosphonates are the first-line therapy for the treatment of osteoporosis. In the province of Ontario, the Ontario Drug Benefit Program funds medications for patients aged 65 years and older. The Ontario Drug Benefit Program has a generic substitution policy that requires lower-cost generic drugs to be dispensed when they are available. However, there is controversy surrounding the efficacy and tolerability of generic bisphosphonates. The objective of this study was to describe patterns in the use of brand-name versus generic formulations when dispensing oral bisphosphonate over a 13-year period. We identified all osteoporotic preparations for alendronate and risedronate that were dispensed through the Ontario Drug Benefit Program from 2001 to 2014. We stratified our sample into community-dwelling residents and residents in long-term care facilities. The number of prescriptions dispensed per month were plotted to illustrate trends over time. We found a rapid switch from brand-name to generic bisphosphonate equivalents immediately after the generic became available on the Ontario Drug Benefit formulary, with generics accounting for > 88% of dispensed drug within 2 months. We also observed a reduction in the number of generic drugs dispensed each time a new brand-name alternative (e.g., monthly risedronate, weekly alendronate plus vitamin D) was introduced to the formulary. The dispensing trends were similar in the community and long-term care settings. The Ontario Drug Benefit Program generic substitution policy resulted in rapid uptake of generic oral bisphosphonates among seniors in Ontario. However, there was a switch away from generic medications to new brand-name alternatives whenever they were introduced to the formulary. Therefore, some patients continued to use brand-name bisphosphonate despite the availability of generic options.

Impact of generic substitution decision support on electronic prescribing behavior.

PubMed

Stenner, Shane P; Chen, Qingxia; Johnson, Kevin B

2010-01-01

To evaluate the impact of generic substitution decision support on electronic (e-) prescribing of generic medications. The authors analyzed retrospective outpatient e-prescribing data from an academic medical center and affiliated network for July 1, 2005-September 30, 2008 using an interrupted time-series design to assess the rate of generic prescribing before and after implementing generic substitution decision support. To assess background secular trends, e-prescribing was compared with a concurrent random sample of hand-generated prescriptions. Proportion of generic medications prescribed before and after the intervention, evaluated over time, and compared with a sample of prescriptions generated without e-prescribing. The proportion of generic medication prescriptions increased from 32.1% to 54.2% after the intervention (22.1% increase, 95% CI 21.9% to 22.3%), with no diminution in magnitude of improvement post-intervention. In the concurrent control group, increases in proportion of generic prescriptions (29.3% to 31.4% to 37.4% in the pre-intervention, post-intervention, and end-of-study periods, respectively) were not commensurate with the intervention. There was a larger change in generic prescribing rates among authorized prescribers (24.6%) than nurses (18.5%; adjusted OR 1.38, 95% CI 1.17 to 1.63). Two years after the intervention, the proportion of generic prescribing remained significantly higher for e-prescriptions (58.1%; 95% CI 57.5% to 58.7%) than for hand-generated prescriptions ordered at the same time (37.4%; 95% CI 34.9% to 39.9%) (p<0.0001). Generic prescribing increased significantly in every specialty. Implementation of generic substitution decision support was associated with dramatic and sustained improvements in the rate of outpatient generic e-prescribing across all specialties.

Impact of generic substitution decision support on electronic prescribing behavior

PubMed Central

Chen, Qingxia; Johnson, Kevin B

2010-01-01

Objective To evaluate the impact of generic substitution decision support on electronic (e-) prescribing of generic medications. Design The authors analyzed retrospective outpatient e-prescribing data from an academic medical center and affiliated network for July 1, 2005–September 30, 2008 using an interrupted time-series design to assess the rate of generic prescribing before and after implementing generic substitution decision support. To assess background secular trends, e-prescribing was compared with a concurrent random sample of hand-generated prescriptions. Measurements Proportion of generic medications prescribed before and after the intervention, evaluated over time, and compared with a sample of prescriptions generated without e-prescribing. Results The proportion of generic medication prescriptions increased from 32.1% to 54.2% after the intervention (22.1% increase, 95% CI 21.9% to 22.3%), with no diminution in magnitude of improvement post-intervention. In the concurrent control group, increases in proportion of generic prescriptions (29.3% to 31.4% to 37.4% in the pre-intervention, post-intervention, and end-of-study periods, respectively) were not commensurate with the intervention. There was a larger change in generic prescribing rates among authorized prescribers (24.6%) than nurses (18.5%; adjusted OR 1.38, 95% CI 1.17 to 1.63). Two years after the intervention, the proportion of generic prescribing remained significantly higher for e-prescriptions (58.1%; 95% CI 57.5% to 58.7%) than for hand-generated prescriptions ordered at the same time (37.4%; 95% CI 34.9% to 39.9%) (p<0.0001). Generic prescribing increased significantly in every specialty. Conclusion Implementation of generic substitution decision support was associated with dramatic and sustained improvements in the rate of outpatient generic e-prescribing across all specialties. PMID:20962131

Factors influencing the preference for purchasing generic drugs in a Southern Brazilian city

PubMed Central

Guttier, Marília Cruz; Silveira, Marysabel Pinto Telis; Luiza, Vera Lucia; Bertoldi, Andréa Dâmaso

2017-01-01

ABSTRACT OBJECTIVE The objective of this study is to identify factors associated with the preference for purchasing generic drugs in a medium-sized municipality in Southern Brazil. METHODS We have analyzed data from a population-based cross-sectional study conducted in 2012 with a sample of 2,856 adults (≥ 20 years old). The preference for purchasing generic drugs was the main outcome. The explanatory variables were the demographic and socioeconomic variables. Statistical analyses included Poisson regressions. RESULTS The preference for purchasing generic drugs was 63.2% (95%CI 61.4–64.9). The variables correlated with this preference in the fully adjusted models were: male (prevalence ratio [PR] = 1.08; 95%CI 1.03–1.14), age of 20–39 years (PR = 1.10; 95%CI 1.02–1.20), low socioeconomic status (PR = 1.15; 95%CI 1.03–1.28), and good knowledge about generic drugs (PR= 4.66; 95%CI 2.89–7.52). Among those who preferred to purchase generic drugs, 55.1% have reported accepting to replace the prescribed drug (if not a generic) with the equivalent generic drug. Another correlate of the preference for purchasing generic drugs was because individuals consider their quality equivalent to reference medicines (PR = 2.15; 95%CI 1.93–2.41). CONCLUSIONS Knowledge about generic drugs was the main correlate of the preference for purchasing generic drugs. The greater the knowledge or positive perception about generic drugs, the greater is the preference to purchase them. Therefore, educational campaigns for healthcare professionals and consumers appear to be the best strategy for expanding the use of generic drugs in Brazil. PMID:28678909

Determinants of generic drug substitution in Switzerland.

PubMed

Decollogny, Anne; Eggli, Yves; Halfon, Patricia; Lufkin, Thomas M

2011-01-26

Since generic drugs have the same therapeutic effect as the original formulation but at generally lower costs, their use should be more heavily promoted. However, a considerable number of barriers to their wider use have been observed in many countries. The present study examines the influence of patients, physicians and certain characteristics of the generics' market on generic substitution in Switzerland. We used reimbursement claims' data submitted to a large health insurer by insured individuals living in one of Switzerland's three linguistic regions during 2003. All dispensed drugs studied here were substitutable. The outcome (use of a generic or not) was modelled by logistic regression, adjusted for patients' characteristics (gender, age, treatment complexity, substitution groups) and with several variables describing reimbursement incentives (deductible, co-payments) and the generics' market (prices, packaging, co-branded original, number of available generics, etc.). The overall generics' substitution rate for 173,212 dispensed prescriptions was 31%, though this varied considerably across cantons. Poor health status (older patients, complex treatments) was associated with lower generic use. Higher rates were associated with higher out-of-pocket costs, greater price differences between the original and the generic, and with the number of generics on the market, while reformulation and repackaging were associated with lower rates. The substitution rate was 13% lower among hospital physicians. The adoption of the prescribing practices of the canton with the highest substitution rate would increase substitution in other cantons to as much as 26%. Patient health status explained a part of the reluctance to substitute an original formulation by a generic. Economic incentives were efficient, but with a moderate global effect. The huge interregional differences indicated that prescribing behaviours and beliefs are probably the main determinant of generic substitution.

Patients’ beliefs about generic medicines in Malaysia

PubMed Central

Wong, Zhi Y.; Hassali, Mohamed A.; Alrasheedy, Alian A.; Saleem, Fahad; Yahaya, Abdul H.; Aljadhey, Hisham

2014-01-01

Background: Acceptance of generic medicines by patients is an essential factor given that they are the end users of these medicines. In fact, adequate knowledge and positive perceptions are prerequisite to patients’ acceptance and use of generic medicines. Objective: To assess the current belief and views of patients about generic medicines in Malaysia. Method: This was a self-administered questionnaire-based study. The study was conducted with patients visiting outpatient pharmacy department at a tertiary care hospital in Malaysia. The Malaysian version of Generic Medicines Scale (GMS) was used. The GMS consists of two subscales: efficacy and similarity of generic medicines to original brand medicines. The efficacy subscale consists of 10 items while the similarity subscale consists of 6 items. The responses to the items were framed as a five-point Likert scale (1=strongly disagree to 5=strongly agree). Results: A total of 202 out of 300 patients participated in the study, giving a response rate of 67.3%. In this study, only 49% of them (n=99) knew the term ‘generic medicine’. Moreover, only 53.5% of the respondents (n=108) believed that the efficacy of generic medicines was the same as original brand medicines. In terms of quality, only 44% of the respondents (n=89) disagreed that generic medicines were of a lower quality. About one third (n=65, 32.2%) believed that generic medicines were cheaper because they were less efficacious. In terms of side effects, 44.5% of the respondents (n=90) believed that generic medicines had the same side effect profile as original brand medicines. Conclusions: The study finding showed that almost half of the respondents had negative belief in generic medicines. Similarly, many patients were not aware of the similarities and differences between generic and original brand medicines. Therefore, there is a need to provide patients with adequate information about generic medicines. PMID:25580171

The cost of antiretroviral therapy in Haiti

PubMed Central

Koenig, Serena P; Riviere, Cynthia; Leger, Paul; Severe, Patrice; Atwood, Sidney; Fitzgerald, Daniel W; Pape, Jean W; Schackman, Bruce R

2008-01-01

Background We determined direct medical costs, overhead costs, societal costs, and personnel requirements for the provision of antiretroviral therapy (ART) to patients with AIDS in Haiti. Methods We examined data from 218 treatment-naïve adults who were consecutively initiated on ART at the GHESKIO Center in Port-au-Prince, Haiti between December 23, 2003 and May 20, 2004 and calculated costs and personnel requirements for the first year of ART. Results The mean total cost of treatment per patient was $US 982 including $US 846 in direct costs, $US 114 for overhead, and $US 22 for societal costs. The direct cost per patient included generic ART medications $US 355, lab tests $US 130, nutrition $US 117, hospitalizations $US 62, pre-ART evaluation $US 58, labor $US 51, non-ART medications $US 39, outside referrals $US 31, and telephone cards for patient retention $US 3. Higher treatment costs were associated with hospitalization, change in ART regimen, TB treatment, and survival for one year. We estimate that 1.5 doctors and 2.5 nurses are required to treat 1000 patients in the first year after initiating ART. Conclusion Initial ART treatment in Haiti costs approximately $US 1,000 per patient per year. With generic first-line antiretroviral drugs, only 36% of the cost is for medications. Patients who change regimens are significantly more expensive to treat, highlighting the need for less-expensive second-line drugs. There may be sufficient health care personnel to treat all HIV-infected patients in urban areas of Haiti, but not in rural areas. New models of HIV care are needed for rural areas using assistant medical officers and community health workers. PMID:18275615

Exploring community pharmacists' views on generic medicines: a nationwide study from Malaysia.

PubMed

Chong, Chee Ping; Hassali, Mohamed Azmi; Bahari, Mohd Baidi; Shafie, Asrul Akmal

2011-02-01

To evaluate the Malaysian community pharmacists' views on generic medicines. A sample of 1419 Malaysian community pharmacies with resident pharmacists. A cross-sectional nationwide survey using a self-completed mailing questionnaire. Pharmacists' views on generic medicines including issues surrounding efficacy, safety, quality and bioequivalence. Responses were received from 219 pharmacies (response rate 15.4%). Only 50.2% of the surveyed pharmacists agreed that all products that are approved as generic equivalents can be considered therapeutically equivalent with the innovator medicines. Around 76% of respondents indicated that generic substitution of narrow therapeutic index medicines is inappropriate. The majority of the pharmacists understood that a generic medicine must contain the same amount of active ingredient (84.5%) and must be in the same dosage form as the innovator brand (71.7%). About 21% of respondents though that generic medicines are of inferior quality compared to innovator medicines. Most of the pharmacists (61.6%) disagreed that generic medicines produce more side-effects than innovator brand. Pharmacists graduated from Malaysian universities, twinning program and overseas universities were not differed significantly in their views on generic medicines. Additionally, the respondents appeared to have difficulty in ascertaining the bioequivalent status of the marketed generic products in Malaysia. The Malaysian pharmacists' have lack of information and/or trust in the generic manufacturing and/or approval system in Malaysia. This issue should be addressed by pharmacy educators and relevant government agencies.

A price and use comparison of generic versus originator cardiovascular medicines: a hospital study in Chongqing, China

PubMed Central

2013-01-01

Background Developed countries use generic competition to contain pharmaceutical expenditure. China, as a developing and transitional country, has not yet deemed an increase in the use of generic products as important; otherwise, much effort has been made to decrease the drug prices. This paper aims to explore dynamically the price and use comparison of generic and originator drugs in China, and estimate the potential savings of patients from switching originator drugs to generics. Methods A typical hospital in Chongqing, China, was selected to examine the price and use comparisons of 12 cardiovascular drugs from 2006 to 2011. Results The market share of the 12 generic medicines studied in this paper was 34.37% for volume and 31.33% for value in the second half of 2011. The price ratio of generic to originator drugs was between 0.34 and 0.98, and the volume price index of originators to generics was 1.63. The potential savings of patients from switching originator drugs to generics is 65%. Conclusion The market share of the generics was lowering and the weighted mean price kept increasing in face of the strict price control. Under the background of hospitals both prescribing and dispensing medicines, China’s comprehensive healthcare policy makers should take measures from supply and demand sides to promote the consumption of generic medicines. PMID:24093493

76 FR 69294 - Proposed Generic Communication Draft Generic Letter on Seismic Risk Evaluations for Operating...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-08

.... Nuclear Regulatory Commission (NRC) published for public comment Draft Generic Letter 2011-XX: Seismic... comment Draft Generic Letter 2011-XX: Seismic Risk Evaluations for Operating Reactors to inform addressees...

Analysis of Spanish generic medicines retail market: recommendations to enhance long-term sustainability.

PubMed

Dylst, Pieter; Vulto, Arnold G; Simoens, Steven

2014-06-01

The use of generic medicines in Spain is traditionally low compared to other European countries, despite efforts of the Spanish government in the past. This paper provides a perspective on the Spanish generic medicines retail market and how the current policy environment may affect the long-term sustainability. The Spanish government's focus on prices of generic medicines (e.g., mandatory price cuts, reference price set at the lowest level) have made them amongst the lowest in Europe. In our opinion, this combination of continuous pressure on prices and limited diffusion of generic medicines may undermine the long-term sustainability of the Spanish generic medicines retail market. The unique experience in Spain shows the impact of demand-side policies on the use of generic medicines. Because a sustainable generic medicines retail market is important to maintain future competition in the off-patent medicines market, this perspective paper rounds off with recommendations to increase its sustainability.

Generic Penetration in the Retail Antidepressant Market

PubMed Central

Kalali, Amir H.

2010-01-01

In this article, we explore the accelerated penetration of generic antidepressants in the United States market following the availability of generic citalopram and sertraline. Analysis suggests that overall, generic penetration into the antidepressant market has grown from approximately 41 percent in January 2004 to over 73 percent in January 2010. Similar trends are uncovered when branded and generic prescriptions are analyzed by specialty. PMID:20622940

L1 Transfer in Article Selection for Generic Reference by Spanish, Turkish and Japanese L2 Learners

ERIC Educational Resources Information Center

Snape, Neal; García-Mayo, Maria Del Pilar; Gurel, Ayse

2013-01-01

This study examines second language (L2) acquisition of English generic noun phrases (NPs) by Spanish, Turkish and Japanese learners. The aim is to identify the role of the first language (L1) in the L2 acquisition of definite NP-level generics and indefinite sentence-level generics with singular, bare plural, and mass generic nouns. The four…

Exploring factors underlying the attitude of community pharmacists to generic substitution: a nationwide study from Poland.

PubMed

Drozdowska, Aleksandra; Hermanowski, Tomasz

2016-02-01

Generic uptake will increasingly be promoted by governments in the face of increasing healthcare costs and global economic uncertainties. The purpose of this study was to investigate attitudes towards generic substitution among community pharmacists, with a focus on the perception of the efficacy, knowledge of the generics characteristics, as well as the willingness to recommend generic substitution. Community pharmacies in Poland. The survey was conducted in 2013 by telephone interviews with 802 holders of an MSc degree in pharmacy working as community pharmacists. Stratified sampling was implemented to make the study representative in geographic terms. Pharmacists' attitudes towards generics drugs. The study showed that only 40 % of pharmacists always inform patients about their right to choose a generic substitute. It was also shown that the less time a pharmacist has been practising, the less likely they are to invite consumers to choose between generic and innovator products. The likelihood of informing was not affected by pharmacist's sex or age, or by pharmacy location or status (chain vs. independent pharmacy) (p > 0.05). Pharmacists varied in their approach to their statutory obligation to inform about a generic; a more or less equal share of respondents were either in favour or against it. Approximately 60 % pharmacists were shown to be familiar with the definition of a generic medicine. Pharmacists with shorter time of practice proved to know more about generics. However, more than 30 % respondents failed to choose the correct statement on generic versus reference medicine dosage. The majority of respondents (67 %) believed there are no differences in efficacy between generics and innovator drugs, whereas 31 % claimed that original brands could be more effective. A significant correlation was demonstrated between the views of pharmacists on the therapeutic efficacy and their willingness to substitute for generics whenever permitted by a physician. It is important to address all concerns pharmacists may have over generics, for example by implementing comprehensive awareness-raising campaigns. Also, pharmacotherapy monitoring systems (i.e. provided in a framework of pharmaceutical care) could be considered to identify any safety or quality concerns that may arise.

Compulsory generic switching of antiepileptic drugs: high switchback rates to branded compounds compared with other drug classes.

PubMed

Andermann, Frederick; Duh, Mei Sheng; Gosselin, Antoine; Paradis, Pierre Emmanuel

2007-03-01

Compulsory generic substitution of antiepileptic drugs (AEDs) may lead to adverse effects in epilepsy patients because of seizure recurrence or increased toxicity. The study objectives were (a) to quantify and compare the switchback rates from generic to brand-name AEDs versus non-AEDs, and (b) to assess clinical implications of switching from branded Lamictal to generic lamotrigine (LTG) and whether signals exist suggesting outcome worsening. By using a public-payer pharmacy-claims database from Ontario, Canada, switchback rates from generic to branded AEDs [Lamictal, Frisium (clobazam; CLB), and Depakene (VPA; divalproex)] were calculated and compared with non-AED long-term therapies, antihyperlipidemics and antidepressants, in January 2002 through March 2006. We then assessed pharmacy utilization and AED dosage among LTG patients switching back to branded Lamictal compared with those staying on generic formulation. The 1,354 patients (403 monotherapy, 951 polytherapy) were prescribed generic LTG, of whom 12.9% switched back to Lamictal (11.7% monotherapy, 13.4% polytherapy). Switchback rates of other AEDs were approximately 20% for CLB and VPA. The switchback rates for AEDs were substantially higher than for non-AEDs (1.5-2.9%). Significant increases in LTG doses were observed after generic substitution for those who did not switch back (6.2%; p<0.0001). The average number of codispensed AEDs and non-AED drugs significantly increased (p<0.0001) after LTG generic entry, especially in the generic group. These results reflect poor acceptance of switching AEDs to generic compounds. They may also indicate increased toxicity and/or loss of seizure control associated with generic AED use.

Understanding and perceptions of final-year Doctor of Pharmacy students about generic medicines in Karachi, Pakistan: a quantitative insight

PubMed Central

Jamshed, Shazia Qasim; Ibrahim, Mohamad Izham Mohamad; Hassali, Mohamad Azmi; Sharrad, Adheed Khalid; Shafie, Asrul Akmal; Babar, Zaheer-Ud-Din

2015-01-01

General objective To evaluate the understanding and perceptions of generic medicines among final-year Doctor of Pharmacy students in Karachi, Pakistan. Methods A 23-item survey instrument that included a question on the bioequivalence limits and Likert-type scale questions regarding the understanding and perceptions of generic medicines among the students was executed. Cronbach’s alpha was found to be 0.62. Results Responses were obtained from 236 final-year Doctor of Pharmacy students (n=85 from a publicly funded institute; n=151 from a privately funded institute). When comparing a brand-name medicine to a generic medicine, pharmacy students scored poorly on bioequivalence limits. More than 80% of the students incorrectly answered that all the products that are rated as generic equivalents are therapeutically equivalent to each other (P<0.04). Half of the students agreed that a generic medicine is bioequivalent to the brand-name medicine (P<0.001). With regard to quality, effectiveness, and safety, more than 75% of the students disagreed that generic medicines are of inferior quality and are less effective than brand-name medicines (P<0.001). More than 50% of the students disagreed that generic medicines produce more side effects than brand-name medicines (P<0.001). Conclusion The current study identified a positive perception toward generic medicines but also gaps in the understanding of generic medicines. Pharmacy students lacked a thorough understanding of the concepts of bioequivalence. Pharmacy academia should address these issues, which will help build confidence in generic medicines and increase the generic medicine use in Pakistan. PMID:26028981

Individual differences in children's and parents' generic language

PubMed Central

Gelman, Susan A.; Ware, Elizabeth A.; Kleinberg, Felicia; Manczak, Erika M.; Stilwell, Sarah M.

2014-01-01

Generics (“Dogs bark”) convey important information about categories and facilitate children’s learning. Two studies with parents and their 2- or 4-year-old children (N=104 dyads) examined whether individual differences in generic language use are: (a) stable over time, contexts, and domains, and (b) linked to conceptual factors. For both children and parents, individual differences in rate of generic production were stable across time, contexts, and domains, and parents' generic usage significantly correlated with that of their own children. Furthermore, parents’ essentialist beliefs correlated with their own and their children’s rates of generic frequency. These results indicate that generic language use exhibits substantial stability and may reflect individual differences in speakers’ conceptual attitudes toward categories. PMID:24266531

40 CFR 721.2083 - Polysubstituted carbomonocyclic hydroxylamine (generic).

Code of Federal Regulations, 2010 CFR

2010-07-01

... hydroxylamine (generic). 721.2083 Section 721.2083 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Specific Chemical Substances § 721.2083 Polysubstituted carbomonocyclic hydroxylamine (generic). (a... generically as a polysubstituted carbomonocyclic hydroxylamine (PMN P-97-878) is subject to reporting under...

Orthopaedic Surgery Residents and Program Directors Agree on How Time Is Currently Spent in Training and Targets for Improvement.

PubMed

Camp, Christopher L; Martin, John R; Karam, Matthew D; Ryssman, Daniel B; Turner, Norman S

2016-04-01

Although much attention has been paid to the role of deliberate practice as a means of achieving expert levels of performance in other medical specialties, little has been published regarding its role in maximizing orthopaedic surgery resident potential. As an initial step in this process, this study seeks to determine how residents and program directors (PDs) feel current time spent in training is allocated compared with a theoretical ideal distribution of time. According to residents and PDs, (1) how do resident responsibilities change by level of training as perceived and idealized by residents and PDs? (2) How do resident and PD perceptions of current and ideal time distributions compare with one another? (3) Do the current training structures described by residents and PDs differ from what they feel represents an ideal time allocation construct that maximizes the educational value of residency training? A survey was sent to orthopaedic surgery resident and PD members of the Midwest Orthopedic Surgical Skills Consortium asking how they felt residents' time spent in training was distributed across 10 domains and four operating room (OR) roles and what they felt would be an ideal distribution of that time. Responses were compared between residents and PDs and between current schedules and ideal schedules. Both residents and PDs agreed that time currently spent in training differs by postgraduate year with senior-level residents spending more time in the OR (33.7% ± 8.3% versus 17.9% ± 6.2% [interns] and 27.4% ± 10.2% [juniors] according to residents, p < 0.001; and 38.6% ± 8.1% versus 11.8% ± 6.4% [interns] and 26.1% ± 5.7% [juniors] according to PD, p < 0.001). The same holds true for their theoretical ideals. Residents and PDs agree on current resident time allocation across the 10 domains; however, they disagree on multiple components of the ideal program with residents desiring more time spent in the OR than what PDs prefer (residents 40.3% ± 10.3% versus PD 32.6% ± 14.6% [mean difference {MD}, 7.7; 95% confidence interval {CI}, 4.4, 11.0], p < 0.001). Residents would also prefer to have more time spent deliberately practicing surgical skills outside of the OR (current 1.8% ± 2.1% versus ideal 3.7% ± 3.2% [MD, -1.9; 95% CI, -.2.4 to -1.4], p < 0.001). Both residents and PDs want residents to spend less time completing paperwork (current 4.4% ± 4.1% versus ideal 0.8% ± 1.6% [MD, 3.6; 95% CI, 3.0-4.2], p < 0.001 for residents; and current 3.6% ± 4.1% versus ideal 1.5% ± 1.9% [MD, 2.1; 95% CI, 0.9-3.3], p < 0.001 for PDs). Residents and PDs seem to agree on how time is currently spent in residency training. Some differences of opinions continue to exist regarding how an ideal program should be structured; however, this work identifies a few potential targets for improvement that are agreed on by both residents and PDs. These areas include increasing OR time, finding opportunities for deliberate practice of surgical skills outside of the OR, and decreased clerical burden. This study may serve as a template to allow programs to continue to refine their educational models in an effort to achieve curricula that meet the desired goals of both learners and educators. Additionally, it is an initial step toward more objective identification of the optimal educational structure of an orthopaedic residency program.

Color Memory: A Yang-Mills Analog of Gravitational Wave Memory.

PubMed

Pate, Monica; Raclariu, Ana-Maria; Strominger, Andrew

2017-12-29

A transient color flux across null infinity in classical Yang-Mills theory is considered. It is shown that a pair of test "quarks" initially in a color singlet generically acquire net color as a result of the flux. A nonlinear formula is derived for the relative color rotation of the quarks. For a weak color flux, the formula linearizes to the Fourier transform of the soft gluon theorem. This color memory effect is the Yang-Mills analog of the gravitational memory effect.

Color Memory: A Yang-Mills Analog of Gravitational Wave Memory

NASA Astrophysics Data System (ADS)

Pate, Monica; Raclariu, Ana-Maria; Strominger, Andrew

2017-12-01

A transient color flux across null infinity in classical Yang-Mills theory is considered. It is shown that a pair of test "quarks" initially in a color singlet generically acquire net color as a result of the flux. A nonlinear formula is derived for the relative color rotation of the quarks. For a weak color flux, the formula linearizes to the Fourier transform of the soft gluon theorem. This color memory effect is the Yang-Mills analog of the gravitational memory effect.

Schwarzschild black holes can wear scalar wigs.

PubMed

Barranco, Juan; Bernal, Argelia; Degollado, Juan Carlos; Diez-Tejedor, Alberto; Megevand, Miguel; Alcubierre, Miguel; Núñez, Darío; Sarbach, Olivier

2012-08-24

We study the evolution of a massive scalar field surrounding a Schwarzschild black hole and find configurations that can survive for arbitrarily long times, provided the black hole or the scalar field mass is small enough. In particular, both ultralight scalar field dark matter around supermassive black holes and axionlike scalar fields around primordial black holes can survive for cosmological times. Moreover, these results are quite generic in the sense that fairly arbitrary initial data evolve, at late times, as a combination of those long-lived configurations.

Higher-Order Containers

NASA Astrophysics Data System (ADS)

Altenkirch, Thorsten; Levy, Paul; Staton, Sam

Containers are a semantic way to talk about strictly positive types. In previous work it was shown that containers are closed under various constructions including products, coproducts, initial algebras and terminal coalgebras. In the present paper we show that, surprisingly, the category of containers is cartesian closed, giving rise to a full cartesian closed subcategory of endofunctors. The result has interesting applications in generic programming and representation of higher order abstract syntax. We also show that the category of containers has finite limits, but it is not locally cartesian closed.

78 FR 59911 - Generic Information Collection for Land Management Planning

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-30

... DEPARTMENT OF AGRICULTURE Forest Service Generic Information Collection for Land Management... organizations on the proposed information collection, Generic Information Collection for Land Management... related to forest management. The intent of this generic information collection request (ICR) is to...

40 CFR 721.10524 - Fluorinated alkylsulfonamidol urethane polymer (generic).

Code of Federal Regulations, 2013 CFR

2013-07-01

... polymer (generic). 721.10524 Section 721.10524 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Specific Chemical Substances § 721.10524 Fluorinated alkylsulfonamidol urethane polymer (generic). (a... generically as fluorinated alkylsulfonamidol urethane polymer (PMN P-11-384) is subject to reporting under...

40 CFR 721.10524 - Fluorinated alkylsulfonamidol urethane polymer (generic).

Code of Federal Regulations, 2014 CFR

2014-07-01

... polymer (generic). 721.10524 Section 721.10524 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Specific Chemical Substances § 721.10524 Fluorinated alkylsulfonamidol urethane polymer (generic). (a... generically as fluorinated alkylsulfonamidol urethane polymer (PMN P-11-384) is subject to reporting under...

40 CFR 721.1655 - Alkylbenzenesulfonic acid (generic).

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Alkylbenzenesulfonic acid (generic... Substances § 721.1655 Alkylbenzenesulfonic acid (generic). (a) Chemical substance and significant new uses subject to reporting. (1) The chemical substance identified generically as alkylbenzenesulfonic acid (PMN...

Generic penetration in the retail atypical antipsychotic market.

PubMed

Lenderts, Susan; Kalali, Amir H; Buckley, Peter

2010-03-01

In this article, we explore the penetration of generic atypical antipsychotics in the United States market before and after the availability of generic risperidone in July 2008. Analysis suggests that, overall, generic penetration into the atypical antipsychotic market has grown from approximately three percent in January 2008 to more than 25 percent in December 2009. Similar trends are uncovered when branded and generic prescriptions are analyzed by specialty.

Generic Penetration in the Retail Atypical Antipsychotic Market

PubMed Central

Kalali, Amir H; Buckley, Peter

2010-01-01

In this article, we explore the penetration of generic atypical antipsychotics in the United States market before and after the availability of generic risperidone in July 2008. Analysis suggests that, overall, generic penetration into the atypical antipsychotic market has grown from approximately three percent in January 2008 to more than 25 percent in December 2009. Similar trends are uncovered when branded and generic prescriptions are analyzed by specialty. PMID:20436769