Hospitalization budget impact during the COVID-19 pandemic in Spain

To Mrs. Anne Murray for her support to translate the manuscript. This article is part of the doctoral thesis of Laura Álvarez as part of the Doctoral Program in Pharmacy, Granada University (Spain).Objectives: The aim was to determine the direct impact of the COVID-19 pandemic on Spain’s health budget. Methods: Budget impact analyses based on retrospective data from patients with suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) admitted to a Spanish hospital between February 26 and May 21, 2020. Direct medical costs from the perspective of the hospital were calculated. We analyzed diagnostic tests, drugs, medical and nursing care, and isolation ward and ICU stays for three cohorts: patients seen in the emergency room only, hospitalized patients who tested positive for SARS-CoV-2, and patients who tested negative. Results: The impact on the hospital’s budget for the 3 months was calculated at €15,633,180, 97.4% of which was related to health care and hospitalization. ICU stays accounted for 5.3% of the total costs. The mean cost per patient was €10,744. The main costs were staffing costs (10,131 to 11,357 €/patient for physicians and 10,274 to 11,215 €/patient for nurses). Scenario analysis showed that the range of hospital expenditure was between €14,693,256 and €16,524,924. The median impact of the pandemic on the Spanish health budget in the sensitivity analysis using bootstrapped individual data was €9357 million (interquartile range [IQR], 9071 to 9689) for the conservative scenario (113,588 hospital admissions and 11,664 ICU admissions) and €10,385 million (IQR, 110,030 to 10,758) for the worst-case scenario (including suspected cases). Conclusion: The impact of COVID-19 on the Spanish public health budget (12.3% of total public health expenditure) is greater than multiple sclerosis, cancer and diabetes cost

Efficient interrogation method of forward Brillouin scattering in optical fibers using a narrow bandwidth long-period grating

A new technique for the characterization of the effective refractive index modulation in optical fibers due to transverse acoustic mode resonances excited by electrostriction is reported. Resonances excited by an optical pulse are probed by a narrow bandwidth longperiod grating (LPG) inscribed in the fiber, which is interrogated by a CW beam. The LPG used in this experiment has a narrow bandwidth and high sensitivity to small mode index perturbations, allowing the measurement of index variations from below 10-9 to 10-6. Radial and torsional-radial acoustic modes were characterized up to 1.1 GHz. The linewidth of resonances was found to be much shorter than in previous reports in which long fiber lengths are typically required, obtaining Q factors as high as 5000

Instantaneous frequency measurement by in-fiber 0.5th order fractional differentiation

We experimentally demonstrate the possibility to retrieve the instantaneous frequency profile of a given temporal light pulse by in-fiber fractional order differentiation of 0.5th-order. The signal's temporal instantaneous frequency profile is obtained by simple dividing two temporal intensity profiles, namely the intensities of the input and output pulses of a spectrally-shifted fractional order differentiation. The results are supported by the experimental measurement of the instantaneous frequency profile of a mode-locked laser.Fil: Poveda-Wong, L.. Universidad de Valencia; EspañaFil: Carrascosa, A.. Universidad de Valencia; EspañaFil: Cuadrado Laborde, Christian Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Física de Rosario. Universidad Nacional de Rosario. Instituto de Física de Rosario; Argentina. Universidad Catolica Argentina; ArgentinaFil: Cruz, J. L.. Universidad de Valencia; EspañaFil: Díez, A.. Universidad de Valencia; EspañaFil: Andrés, M. V.. Universidad de Valencia; Españ

Analog Photonic Fractional Signal Processing

In this work, we provide an up to date overview on the subject of photonic fractional signal processing, including both, in-fiber and waveguide on-chip technology. Thus, we discuss in detail fractional differentiation, fractional integration, fractional Hilbert transforms, and finally, fractional Fourier transforms. In each case, the underlying mathematical principles are explained for each operation, together with a short historical discussion in the context of classical optics. After that, the different proposals to perform these operations photonically on the complex field envelope of a given light pulse are presented, divided according to its working principle. Finally, current applications for these operators are also discussed, as well as some of its future possibilities are envisaged

Long-period grating assisted fractional differentiation of highly chirped light pulses

We experimentally demonstrate the possibility to perform a fractional differentiation of arbitrary order on a given light pulse by propagation through a single long-period grating. A simple analytical expression is obtained also, relating the fractional order of differentiation with the parameters of the long-period grating. A secant hyperbolic like pulse of 23 ps time width with a chirp parameter of -30 was successfully fractionally differentiated to the 0.5th order. The proposal was corroborated experimentally and numerically. The device may find applications in real time phase recovery.Fil: Poveda Wong, L.. Universidad de Valencia; EspañaFil: Carrascosa, A.. Universidad de Valencia; EspañaFil: Cuadrado Laborde, Christian Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Física de Rosario. Universidad Nacional de Rosario. Instituto de Física de Rosario; Argentina. Universidad Catolica de Rosario; ArgentinaFil: Cruz, J. L.. Universidad de Valencia; EspañaFil: Díez, A.. Universidad de Valencia; EspañaFil: Andrés, M. V.. Universidad de Valencia; Españ

Fabrication of long period fiber gratings of subnanometric bandwidth

This paper reports on the fabrication of long period fiber gratings having subnanometric bandwidth in the 1500 nm spectral region. Large gratings have been photo-inscribed in a high NA fiber, the grating pitch and the order of the HE cladding mode are optimized to produce gratings with a large number of periods and preventing the coupling to TE, TM or EH modes. Resonances with a FWHM of 0.83 nm and 0.68 nm have been achieved for gratings 15 and 20 cm long respectively, the free spectral range between transmission notches is 125 nm. The polarization effects and the sensitivity of the gratings to temperature and to strain variations are presented as well. © 2015 Optical Society of AmericaThis paper reports on the fabrication of long period fiber gratings having subnanometric bandwidth in the 1500 nm spectral region. Large gratings have been photo-inscribed in a high NA fiber, the grating pitch and the order of the HE cladding mode are optimized to produce gratings with a large number of periods and preventing the coupling to TE, TM or EH modes. Resonances with a FWHM of 0.83 nm and 0.68 nm have been achieved for gratings 15 and 20 cm long respectively, the free spectral range between transmission notches is 125 nm. The polarization effects and the sensitivity of the gratings to temperature and to strain variations are presented as well. © 2015 Optical Society of Americ

A multi-criteria decision analysis on the value of nintedanib for interstitial lung diseases

Objectives Our aim was to assess the value of nintedanib for non-idiopathic progressive fibrosing interstitial lung disease (non-IPF PF-ILD) and systemic sclerosis-associated ILD (SSc-ILD) in the Spanish context, using a multi-criteria decision analysis (MCDA). Methods Following an adaptation of the Evidence and Value: Impact on DEcision Making (EVIDEM) MCDA methodology, the estimated value of nintedanib was obtained by means of an additive linear model that combined individual weights (100-points distribution) of criteria with the individual scoring of nintedanib in each criterion for every indication, assigned by a multidisciplinary committee of twelve clinicians, patients, pharmacists, and decision-makers. To assess the reproducibility, an alternative weighting method was applied, as well as a re-test of weights and scores at a different moment of time. Results The experts committee recognized nintedanib as an intervention with a positive value contribution in comparison to placebo for the treatment of non-IPF PF-ILD (0.50 ± 0.16, on a scale from -1 to 1) and SSc-ILD (0.40 ± 0.12), diseases which were considered as very severe and with high unmet needs. The drug was perceived as a treatment that provides an added therapeutic benefit for patients (0.06-0.07), given its proven clinical efficacy (0.05-0.06), slight improvements in patient-reported outcomes (0.01-0.02), and similar safety profile than placebo (-0.04-0.00), which will likely be positioned as a recommended therapy in the next clinical practice guidelines updates. Conclusions Under this increasingly used methodology, nintedanib has shown to provide a positive value estimate for non-IPF PF-ILD and SSc-ILD when compared to placebo in Spain