Adherence with tobramycin inhaled solution and health care utilization

<p>Abstract</p> <p>Background</p> <p>Adherence with tobramycin inhalation solution (TIS) during routine cystic fibrosis (CF) care may differ from recommended guidelines and affect health care utilization.</p> <p>Methods</p> <p>We analyzed 2001-2006 healthcare claims data from 45 large employers. Study subjects had diagnoses of CF and at least 1 prescription for TIS. We measured adherence as the number of TIS therapy cycles completed during the year and categorized overall adherence as: low ≤ 2 cycles, medium >2 to <4 cycles, and high ≥ 4 cycles per year. Interquartile ranges (IQR) were created for health care utilization and logistic regression analysis of hospitalization risk was conducted by TIS adherence categories.</p> <p>Results</p> <p>Among 804 individuals identified with CF and a prescription for TIS, only 7% (n = 54) received ≥ 4 cycles of TIS per year. High adherence with TIS was associated with a decreased risk of hospitalization when compared to individuals receiving ≤ 2 cycles (adjusted odds ratio 0.40; 95% confidence interval 0.19-0.84). High adherence with TIS was also associated with lower outpatient service costs (IQR: $2,159-$8444 vs. $2,410-$14,423) and higher outpatient prescription drug costs (IQR: $35,125-$60,969 vs. $10,353-$46,768).</p> <p>Conclusions</p> <p>Use of TIS did not reflect recommended guidelines and may impact other health care utilization.</p

Additive Manufacturing Technologies From an Optimization Perspective

In this technology-driven era, conventional manufacturing is increasingly at risk of reaching its limit, and a more design-driven manufacturing process, additive manufacturing, might just hold the key to innovation. Offering a higher degree of design freedom, the optimization and integration of functional features, and the manufacturing of small batch sizes, additive manufacturing is changing industry as we know it.Additive Manufacturing Technologies From an Optimization Perspective is a critical reference source that provides a unified platform for the dissemination of basic and applied knowledge about additive manufacturing. It carefully examines how additive manufacturing is increasingly being used in series production, giving those in the most varied sectors of industry the opportunity to create a distinctive profile for themselves based on new customer benefits, cost-saving potential, and the ability to meet sustainability goals. Highlighting topics such as bio-printing, tensile strength, and cell printИспользуемые программы Adobe AcrobatВ эту технологичную эпоху традиционное производство все чаще рискует достичь предела своих возможностей и производственный процесс, ориентированный на дизайн, аддитивное производство, может оказаться ключом к инновациям. Предлагая более высокую степень свободы проектирования, оптимизацию и интеграцию функциональных возможностей, а также производство небольших партий, аддитивное производство меняет отрасль, какой мы ее знаем. Технологии аддитивного производства с точки зрения оптимизации является важнейшим справочным источником, который обеспечивает единую платформу для распространения базовых и прикладных знаний об аддитивном производстве. В книге тщательно исследуется, как аддитивное производство все чаще используется в серийном производстве, предоставляя работникам самых разных отраслей промышленности возможность создать для себя особый профиль, основанный на новых преимуществах для клиентов, потенциале экономии средств и способности достигать целей устойчивого развития. Освещая такие темы, как биопечать,