The economic burden of asthma and chronic obstructive pulmonary disease and the impact of poor inhalation technique with commonly prescribed dry powder inhalers in three European countries

Contains fulltext : 171713.pdf (publisher's version ) (Open Access)BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) are common chronic inflammatory respiratory diseases, which impose a substantial burden on healthcare systems and society. Fixed-dose combinations (FDCs) of inhaled corticosteroids (ICS) and long-acting beta2 agonists (LABA), often administered using dry powder inhalers (DPIs), are frequently prescribed to control persistent asthma and COPD. Use of DPIs has been associated with poor inhalation technique, which can lead to increased healthcare resource use and costs. METHODS: A model was developed to estimate the healthcare resource use and costs associated with asthma and COPD management in people using commonly prescribed DPIs (budesonide + formoterol Turbuhaler((R)) or fluticasone + salmeterol Accuhaler((R))) over 1 year in Spain, Sweden and the United Kingdom (UK). The model considered direct costs (inhaler acquisition costs and scheduled and unscheduled healthcare costs), indirect costs (productive days lost), and estimated the contribution of poor inhalation technique to the burden of illness. RESULTS: The direct cost burden of managing asthma and COPD for people using budesonide + formoterol Turbuhaler((R)) or fluticasone + salmeterol Accuhaler((R)) in 2015 was estimated at euro813 million, euro560 million, and euro774 million for Spain, Sweden and the UK, respectively. Poor inhalation technique comprised 2.2-7.7 % of direct costs, totalling euro105 million across the three countries. When lost productivity costs were included, total expenditure increased to euro1.4 billion, euro1.7 billion and euro3.3 billion in Spain, Sweden and the UK, respectively, with euro782 million attributable to poor inhalation technique across the three countries. Sensitivity analyses showed that the model results were most sensitive to changes in the proportion of patients prescribed ICS and LABA FDCs, and least sensitive to differences in the number of antimicrobials and oral corticosteroids prescribed. CONCLUSIONS: The cost of managing asthma and COPD using commonly prescribed DPIs is considerable. A substantial, and avoidable, contributor to this burden is poor inhalation technique. Measures that can improve inhalation technique with current DPIs, such as easier-to-use inhalers or better patient training, could offer benefits to patients and healthcare providers through improving disease outcomes and lowering costs

Jet energy measurement with the ATLAS detector in proton-proton collisions at root s=7 TeV

The jet energy scale and its systematic uncertainty are determined for jets measured with the ATLAS detector at the LHC in proton-proton collision data at a centre-of-mass energy of √s = 7TeV corresponding to an integrated luminosity of 38 pb-1. Jets are reconstructed with the anti-kt algorithm with distance parameters R=0. 4 or R=0. 6. Jet energy and angle corrections are determined from Monte Carlo simulations to calibrate jets with transverse momenta pT≥20 GeV and pseudorapidities {pipe}η{pipe}<4. 5. The jet energy systematic uncertainty is estimated using the single isolated hadron response measured in situ and in test-beams, exploiting the transverse momentum balance between central and forward jets in events with dijet topologies and studying systematic variations in Monte Carlo simulations. The jet energy uncertainty is less than 2. 5 % in the central calorimeter region ({pipe}η{pipe}<0. 8) for jets with 60≤pT<800 GeV, and is maximally 14 % for pT<30 GeV in the most forward region 3. 2≤{pipe}η{pipe}<4. 5. The jet energy is validated for jet transverse momenta up to 1 TeV to the level of a few percent using several in situ techniques by comparing a well-known reference such as the recoiling photon pT, the sum of the transverse momenta of tracks associated to the jet, or a system of low-pT jets recoiling against a high-pT jet. More sophisticated jet calibration schemes are presented based on calorimeter cell energy density weighting or hadronic properties of jets, aiming for an improved jet energy resolution and a reduced flavour dependence of the jet response. The systematic uncertainty of the jet energy determined from a combination of in situ techniques is consistent with the one derived from single hadron response measurements over a wide kinematic range. The nominal corrections and uncertainties are derived for isolated jets in an inclusive sample of high-pT jets. Special cases such as event topologies with close-by jets, or selections of samples with an enhanced content of jets originating from light quarks, heavy quarks or gluons are also discussed and the corresponding uncertainties are determined. © 2013 CERN for the benefit of the ATLAS collaboration

The evaluation of the technical state of exploited motional batteries

W artykule przedstawiono metodę oceny stanu technicznego eksploatowanych akumulatorów rozruchowych. Zilustrowano procedurę diagnozowania pod kątem uściślenia kryteriów dotyczących stanu częściowej zdatności wybranej grupy badanych obiektów. Podano przykład monitorowania przebiegu charakterystyk wyładowania akumulatorów zasiarczonych.In the article the method of estimation of the technical state of motional batteries has been presented. The procedure of diagnosis has been discussed with focus on précising the criteria concerning the state of partial usefulness of a selected group of examined objects. One has provided an example of monitoring of steps of characterising the exploitation of batteries

Selected issues in the field of electric vehicle equipment concerning the extension of the teaching and training programs

W artykule przedstawiono rozszerzenie możliwości pomiarowych dwóch wybranych stanowisk przeznaczonych do demonstracji systemu klimatyzacji pojazdu oraz samochodowych układów zapłonowych. Modułowa budowa stanowisk umożliwia rozszerzenie ich funkcji pomiarowych i badawczych o diagnostykę termowizyjną. Takie rozszerzenie zakresu badań wyposażania elektrycznego umożliwia jednocześnie wzbogacenie programu dydaktycznego prowadzonych ćwiczeń laboratoryjnych. Zaprezentowano tu również przykładowe termogramy wykonane na w/w stanowiskach.The article presents the extension of the measurement capabilities of two selected lab stands intended for the demonstration of a vehicle air conditioning system and automotive ignition systems. The modular structure of the stands allows to extend their measuring and research functionality of thermal imaging diagnostics. Such an extension of the scope of electrical equipment in stands also allows enrichment of the didactic program by expand of laboratory exercises. In the article was presented and discussed additional samples of thermograms taken at the stands

Researches on power transmission systems of traction vehicles with a hybrid drive

The structures of modern traction vehicles are based on new generation devices. Technical progress within the field of power transmission concerns such elements as sources of power supply, electric devices and energy electronic solutions in power transmission systems. The prototypes of traction vehicles being currently drawn up are hybrid vehicles using different kinds of sources of power supply ofpower transmission systems, the most important of which are combustion engines, contact systems, supercapacitors (ultracapacitors), accumulators and fuel cells. Main engines are usually electric machines. In energy electronic starting systems it is permissible to use all kinds of main electric engines, for example, direct-current motors (inline engines, commutator motors with permanent magnets or non-commutator motors) or three-phase motors of alternating current (induction and synchronous). This means a complete change of rules in energy managing in a vehicle. Sources of energy can have the function of basic power supply (contact system, combustion engine or combustion cell) or the function of power supply support (supercapacitors, accumulators or fuel cell). New functions of drive operation will be available, namely, leveling of basic power supply load, recuperation of braking energy of the whole train set, driving at the temporary disconnection of basic power supply (short-term application of accumulator as basic power supply). Each of the above functions can contribute to the improvement of watt-hour efficiency of the system or to prolonging the range of driving. Therefore, it is necessary to undertake research on new generation power transmission systems. Research tasks focus on measurement of state variables of a drive, analyses of traction signals, modeling of drive operation in the conditions of driving cycle realization, verification of a model, drawing up a strategy of energy management in order to achieve the best watt-hour efficiency and the range of driving. In the article presented, sample results of researches on applications of hybrid power transmission systems conducted in various national research centers will be demonstrated. They concern both theoretical research (model simulation) and prototype research. The conception will be presented of a laboratory station for conducting research on modern sources of power supply and drives, which is currently being built at the Faculty of Transport of Warsaw Polytechnic at the Division of Exploitation of Tracking Systems and Electric Equipment in Transport

Extending the scope of research of thermal imaging diagnostics of an alternator on a laboratory stand

W artykule przedstawiono aktualne możliwości pomiarowe istniejącego stanowiska laboratoryjnego do badań charakterystyk alternatorów wraz z symulacją usterek w obwodzie zasilania. Modułowa budowa tego stanowiska umożliwia rozszerzenie jego funkcji pomiarowych i badawczych o diagnostykę termowizyjną. Takie rozszerzenie zakresu badań alternatora umożliwia również wzbogacenie programu dydaktycznego prowadzonych ćwiczeń laboratoryjnych. Zaprezentowano również przykładowe termogramy wykonane na tym stanowisku.The paper presents current ability of measurement of the existing laboratory stand using for testing the characteristics of alternators and for simulating faults in a power supply circuit. The modular design of the stand allows to extend its measurement functionality and research of thermal imaging diagnostics. This extension of the scope of research an alternator also allows to enrich of the teaching program conducted in the laboratory. The examples of thermal images were taken on presented laboratory stand

Selected issues in the field of electric vehicle equipment concerning the extension of the teaching and training programs

W artykule przedstawiono rozszerzenie możliwości pomiarowych dwóch wybranych stanowisk przeznaczonych do demonstracji systemu klimatyzacji pojazdu oraz samochodowych układów zapłonowych. Modułowa budowa stanowisk umożliwia rozszerzenie ich funkcji pomiarowych i badawczych o diagnostykę termowizyjną. Takie rozszerzenie zakresu badań wyposażania elektrycznego umożliwia jednocześnie wzbogacenie programu dydaktycznego prowadzonych ćwiczeń laboratoryjnych. Zaprezentowano tu również przykładowe termogramy wykonane na w/w stanowiskach.The article presents the extension of the measurement capabilities of two selected lab stands intended for the demonstration of a vehicle air conditioning system and automotive ignition systems. The modular structure of the stands allows to extend their measuring and research functionality of thermal imaging diagnostics. Such an extension of the scope of electrical equipment in stands also allows enrichment of the didactic program by expand of laboratory exercises. In the article was presented and discussed additional samples of thermograms taken at the stands