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In this short paper we recall the (Garfield) Impact Factor of a journal, we improve and extend it, and eventually present the Total Impact Factor that reflects the most accurate impact factor.
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Introduction Extended half-life factor products have reduced annualized bleeding rates in hemophilia patients. The impact of extended half-life versus conventional factor products on hemophilia caregiver burden has not been invest...
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Introduction Extended half-life factor products have reduced annualized bleeding rates in hemophilia patients. The impact of extended half-life versus conventional factor products on hemophilia caregiver burden has not been investigated. This study aimed to evaluate caregiver burden in extended half-life versus conventional factor products for hemophilia A and B. Methods This cross-sectional web-based study of caregivers of people with hemophilia A or B was recruited from a panel research company and by word of mouth. Participants completed the Hemophilia Caregiver Impact measure, the PedsQL Family Impact Module (PedsQL), and the Work Productivity and Activity Impairment Questionnaire (WPAI). We also collected demographic, insurance coverage, and medical information related to the hemophilia patient(s). Burden differences were assessed using linear regression and matched cohort analyses. Results The sample ( n ?=?448) included 49 people who were caring for people on extended half-life factor products. Worse caregiver burden was associated with more infusions per week and more bleeds in the past 6?months. Regression analyses suggested that caring for someone who is on a extended half-life factor product is associated with lower emotional impact ( β ?=???0.11, p ?收起
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An accurate estimation of the structural flexibility is crucial in applications such as deflection prediction, damage detection, and finite element model updating. By introducing a unit impulsive response function (UIRF) matrix es...
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An accurate estimation of the structural flexibility is crucial in applications such as deflection prediction, damage detection, and finite element model updating. By introducing a unit impulsive response function (UIRF) matrix estimated from noisy input and output signals collected through impact testing, this paper proposes a new method for estimating the structural flexibility matrix from a noisy UIRF. The advantages lie in the way the noise and decoupling modes of the impulse response signal are handled in the time domain. The proposed method consists of three steps: (1) Constructing an enhanced unit impulse response function (EUIRF) from the UIRF by utilizing the orthogonality of the displacement mode shapes for mode decoupling, (2) Noise removal from the constructed EUIRF to obtain a filtered one by implementing the improved Cadzow's algorithm for the structured target rank approximation (STRA) of the Hankel matrix constructed from the EUIRF, and (3) Structural flexibility identification from the EUIRF using the extended Prony's method to identify the basic modal parameters and modal scaling factors for a single-mode impulse response function with one degree of freedom. To validate the applicability of the proposed method, numerical and laboratory case studies were performed. A noisy impact test was simulated for a three-span continuous beam bridge, and the identified modal parameters and structural flexibility matrix were found to be accurate. Moreover, an impact test was conducted on a simply supported beam in a laboratory, and the results showed that the deformation predicted from the identified flexibility matrix and the one measured from the static load test are in good agreement.
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Objective To evaluate real-world annualized bleeding rates (ABRs), dosing frequency, and factor consumption of four recombinant FVIII (rFVIII) products using pooled data from centers in the US, Germany, and Italy. Methods De-ident...
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Objective To evaluate real-world annualized bleeding rates (ABRs), dosing frequency, and factor consumption of four recombinant FVIII (rFVIII) products using pooled data from centers in the US, Germany, and Italy. Methods De-identified patient medical chart data were collected from 48 hemophilia treatment centers in the US, Germany, and Italy. Patients included in this analysis had hemophilia A and were treated with rVIII-SingleChain, rFVIIIFc, octocog alfa, or BAY 81-8973 for >= 12 weeks. Where possible, patient selection considered age and disease severity in order to balance patient groups across products. Summary statistics were presented descriptively by product for dosing frequency, consumption, ABR/annualized spontaneous bleeding rate (AsBR), and corresponding percentage of patients with zero bleeds. Logistic regression was performed for patients with zero bleeds or zero spontaneous bleeds (vs. patients with any such bleeds). Generalized linear model regression was performed for ABR, AsBR, and consumption. All regression models included the product variable for comparison as well as additional independent variables for adjustment (age, weight, severity, and country for the consumption model, with the addition of consumption for the bleeding outcomes models). Results Overall, 616 patients were included (rVIII-SingleChain, n = 129; rFVIIIFc, n = 159; octocog alfa, n = 181; BAY 81-8973, n = 147). Dosing frequency was <= 2 times a week for 65.9%, 75.5%, 25.4%, and 40.1% of patients treated with rVIII-SingleChain, rFVIIIFc, octocog alfa, and BAY 81-8973, respectively. ABRs were not significantly different among products, with mean (median) values of 1.1 (0.0), 1.0 (0.0), 1.4 (1.0), and 1.9 (1.0) for rVIII-SingleChain, rFVIIIFc, octocog alfa, and BAY 81-8973, respectively. The percentage of patients with zero bleeds was comparable between rVIII-SingleChain and rFVIIIFc (59.7% vs. 62.3%; p =.916) and significantly higher for rVIII-SingleChain compared with octocog alfa (p <.001) and BAY 81-8973 (p =.003). Comparison of mean weekly consumption showed: rVIII-SingleChain (83.0 IU/kg/week) vs. rFVIIIFc (96.9; p =.055) and significantly lower for rVIII-SingleChain vs. octocog alfa (108.6; p <.001) and BAY 81-8973 (104.3; p =.001). The median values for weekly consumption were 85.7, 90.1, 100.1, and 98.5 IU/kg/week for rVIII-SingleChain, rFVIIIFc, octocog alfa, and BAY 91-8973, respectively. Similar trends were observed for all outcomes when analyzing the subgroups of patients aged >= 12 years and patients with severe disease (all age and >= 12 years). Conclusions rVIII-SingleChain prophylaxis may provide improved bleed protection, less frequent dosing, and lower consumption compared with standard-acting FVIII products, and comparable protection and consumption to the other long-acting FVIII product, in patients with hemophilia A.
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Introduction: This study compared costs of care among colorectal surgery patients who received liposomal bupivacaine versus those who did not (control) from a health institution perspective. Material and methods: This pharmacoecon...
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Introduction: This study compared costs of care among colorectal surgery patients who received liposomal bupivacaine versus those who did not (control) from a health institution perspective. Material and methods: This pharmacoeconomic evaluation was conducted among adults undergoing open or minimally invasive colorectal resection at an academic medical center from May 2016 to February 2018. Healthcare resource utilization was derived from the electronic health record. Total cost of care (2018 USD) was analyzed using a generalized linear model adjusted for American Society of Anesthesiologists score, enhanced recovery after surgery management, open surgery, opioid use before surgery, height, cancer, and age. The primary analysis used public costs. A sensitivity analysis used internal costs from the hospital to maximize internal validity. Results: Of 486 included patients, 286 (59%) received liposomal bupivacaine. Total cost of care using public costs included perioperative local anesthetics (mean +/- standard deviation [SD]: $392 +/- 74 liposomal bupivacaine versus $8 +/- 13 control), analgesics within 48 h after surgery (mean +/- SD: $132 +/- 99 liposomal bupivacaine versus $117 +/- 127 control), postoperative ileus management (mean +/- SD: $5 +/- 51 liposomal bupivacaine versus $65 +/- 284 control), and hospital length of stay (mean +/- SD: $4459 +/- 3576 liposomal bupivacaine versus $7769 +/- 7082 control). Liposomal bupivacaine was associated with an adjusted absolute difference in total cost of care of -$1435 (95% confidence interval -$2401 to -$470; P = 0.004) using public costs and -$1345 (95% confidence interval -$2215 to -$476; P = 0.002) using internal costs. Conclusions: Use of liposomal bupivacaine in colorectal surgery was associated with a significant reduction in total cost of care that was predominately driven by reduced costs for hospital stay and postoperative ileus management despite higher medication costs. (c) 2021 Elsevier Inc. All rights reserved.
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Background: Routine surveillance data revealed increasing rates of invasive extended spectrum cephalosporin-resistant Klebsiella pneumoniae (ESCR-KP) in Switzerland, from 1.3% in 2004 to 8.5% in 2019. Aim: The main aim of this stu...
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Background: Routine surveillance data revealed increasing rates of invasive extended spectrum cephalosporin-resistant Klebsiella pneumoniae (ESCR-KP) in Switzerland, from 1.3% in 2004 to 8.5% in 2019. Aim: The main aim of this study was to understand the causes of this recent trend, specifically to identify predictors affecting the incidence of invasive ESCR-KP infections in Switzerland. Methods: A retrospective observational multi-centre study was conducted in 21 Swiss hospitals over a period of 11 years (2009-2019). Potential predictor variables for the incidence of invasive ESCR-KP infections were studied with a multiple linear regression model. In an additional analysis, the overall ESCR-KP incidence (all sample sites) was investigated. Findings: An increasing incidence of invasive ESCR-KP infections from 0.01 to 0.04 patients per 1000 bed-days was observed between 2009 and 2019 and confirmed by multiple linear regression analysis (P < 0.01). ESCR-KP incidence was higher in university hospitals (P < 0.01) and in the French-speaking region than in the German-speaking region (P < 0.01). There was no association with antibiotic consumption. Analysing the overall ESCR-KP incidence (all sample sites) revealed high variability between university hospitals, mainly due to a high proportion of patients with screening isolates at Geneva University Hospital (50% of patients with ESCR-KP). Conclusion: The incidence of invasive ESCR-KP infections increased in Switzerland between 2009 and 2019 and was not associated with antibiotic consumption. Our findings indicate that, in this low-incidence setting, structural factors such as the hospital type and the linguistic region play a more important role in relation to ESCR-KP incidence than the hospital's antibiotic consumption. 2021 The Author(s). Published by Elsevier Ltd on behalf of The Healthcare Infection Society. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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The aim of this study is to investigate the use of different global sensitivity analysis techniques in conjunction with a mechanistic model in the numerical analysis of a permeable pavement installed at the University of Calabria....
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The aim of this study is to investigate the use of different global sensitivity analysis techniques in conjunction with a mechanistic model in the numerical analysis of a permeable pavement installed at the University of Calabria. The Morris method and the variance-based E-FAST procedure are applied to investigate the influence of soil hydraulic parameters on the pavement's behavior. The analysis reveals that the Morris method represents a reliable computationally cheap alternative to variance-based procedures for screening important factors and provides the first inspection of the model. The study is completed by a combined GSA-GLUE uncertainty analysis used to evaluate the model accuracy.
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