The cost of moderate and severe COPD exacerbations to the Canadian healthcare system

SummaryBackgroundThe cost of exacerbations in chronic obstructive pulmonary disease (COPD) has not been well studied. The aim of this study was to identify and quantify the (average) cost of moderate and severe exacerbations (ME and SE, respectively) from a Canadian perspective.MethodsResources used during ME and SE were identified in a year long prospective, observational study (Resource Utilization Study In COPD (RUSIC)). The units of analysis were ME and SE. Unit costs (2006$CAN), based on provincial, hospital and published sources, were applied to resources. The overall cost per ME and SE were calculated. The population burden of exacerbations was also calculated.ResultsAmong study participants (N=609, aged 68.6±9.4 years, 58.3$126 (N=574) and $515 (N=105), respectively. The average overall cost of a ME was$641. For SEs, the average hospital stay was 10.0 days. The overall mean costs of outpatient, ED and hospitalization services for SE were $114 (N=44),$774 (N=140) and $8669 (N=151), respectively. The average overall cost of a SE was$9557.ConclusionThe economic burden associated with MEs and especially SEs, in Canada, is considerable and likely has a substantial impact on healthcare costs. The overall burden of exacerbations has been estimated in the range of $646 million to$736 million per annum

A cohort study of the associations between udder conformation, milk somatic cell count, and lamb weight in suckler ewes

A cohort study of 67 suckler ewes from 1 farm was carried out from January to May 2010 to investigate associations between udder conformation, udder half milk somatic cell count (SCC), and lamb weight. Ewes and lambs were observed at lambing. Ewe health and teat condition and lamb health and weight were recorded on 4 to 5 further occasions at 14-d intervals. At each observation, a milk sample was collected from each udder half for somatic cell counting. Two weeks after lambing, ewe udder conformation and teat placement were scored. Low lamb weight was associated with ewe SCC >400,000 cells/mL (−0.73kg), a new teat lesion 14 d previously (−0.91kg), suboptimal teat position (−1.38kg), rearing in a multiple litter (−1.45kg), presence of diarrhea at the examination (−1.19kg), and rearing by a 9-yr-old ewe compared with a 6-yr-old ewe (−2.36kg). High lamb weight was associated with increasing lamb age (0.21kg/d), increasing birth weight (1.65kg/kg at birth), and increasing number of days the ewe was given supplementary feed before lambing (0.06kg/d). High udder half SCC was associated with pendulous udders (9.6% increase in SCC/cm of drop) and greater total cross-sectional area of the teats (7.2% increase of SCC/cm2). Low SCC were associated with a heavier mean litter weight (6.7% decrease in SCC/kg). Linear, quadratic, and cubic terms for days in lactation were also significant. We conclude that poor udder and teat conformation are associated with high levels of intramammary infection, as indicated by increased SCC and that both physical attributes of the udder and SCC are linked to lamb growth, suggesting that selection of suckler ewes with better udder and teat conformation would reduce intramammary infection and increase lamb growth rate

Design and performance of the ADMX SQUID-based microwave receiver

The Axion Dark Matter eXperiment (ADMX) was designed to detect ultra-weakly interacting relic axion particles by searching for their conversion to microwave photons in a resonant cavity positioned in a strong magnetic field. Given the extremely low expected axion-photon conversion power we have designed, built and operated a microwave receiver based on a Superconducting QUantum Interference Device (SQUID). We describe the ADMX receiver in detail as well as the analysis of narrow band microwave signals. We demonstrate the sustained use of a SQUID amplifier operating between 812 and 860 MHz with a noise temperature of 1 K. The receiver has a noise equivalent power of 1.1x10^-24 W/sqrt(Hz) in the band of operation for an integration time of 1.8x10^3 s.Comment: 8 pages, 12 figures, Submitted to Nuclear Inst. and Methods in Physics Research,

Anti-IL5 therapies for chronic obstructive pulmonary disease

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the efficacy and safety of monoclonal antibody therapies targeting IL‐5 signalling (anti‐IL‐5 or anti‐IL‐5Rα) compared with placebo in the treatment of adults with COPD

ICER is requisite for Th17 differentiation.

Inducible cAMP early repressor (ICER) has been described as a transcriptional repressor isoform of the cAMP response element modulator (CREM). Here we report that ICER is predominantly expressed in Th17 cells through the IL-6-STAT3 pathway and binds to the Il17a promoter, where it facilitates the accumulation of the canonical enhancer RORγt. In vitro differentiation from naive ICER/CREM-deficient CD4(+) T cells to Th17 cells is impaired but can be rescued by forced overexpression of ICER. Consistent with a role of Th17 cells in autoimmune and inflammatory diseases, ICER/CREM-deficient B6.lpr mice are protected from developing autoimmunity. Similarly, both anti-glomerular basement membrane-induced glomerulonephritis and experimental encephalomyelitis are attenuated in ICER/CREM-deficient mice compared with their ICER/CREM-sufficient littermates. Importantly, we find ICER overexpressed in CD4(+) T cells from patients with systemic lupus erythematosus. Collectively, our findings identify a unique role for ICER, which affects both organ-specific and systemic autoimmunity in a Th17-dependent manner

Optimized loading of an optical dipole trap for the production of Chromium BECs

We report on a strategy to maximize the number of chromium atoms transferred from a magneto-optical trap into an optical trap through accumulation in metastable states via strong optical pumping. We analyse how the number of atoms in a chromium Bose Einstein condensate can be raised by a proper handling of the metastable state populations. Four laser diodes have been implemented to address the four levels that are populated during the MOT phase. The individual importance of each state is specified. To stabilize two of our laser diode, we have developed a simple ultrastable passive reference cavity whose long term stability is better than 1 MHz

On the two-dimensional solution of both adhesive and non-adhesive contact problems involving functionally graded materials

This paper presents a semi-analytical algorithm for the determination of the contact half width and surface pressure which results from both adhesive and non-adhesive contact problems involving functionally graded materials (FGM). The inhomogeneously elastic solid comprises a graded elastic coating whose shear modulus depends exponentially on the vertical coordinate and a homogeneously elastic substrate. The solid is assumed to be in a state of plane strain and thus a two-dimensional analysis is performed within this work. Using the work of Chidlow et al. (2011a) as a starting point, we derive a pair of integral equations which may be used to determine approximations to the contact pressure when either the surface deflection or the deflection gradient is known over the contact region. As these integral equations are non-singular, we use Galerkin's method to approximate the contact pressure and it is found that relatively small trial spaces allow accurate computation of the pressure. Information about the prescribed load is then used to formulate an iterative algorithm to determine the contact half width. A selection of numerical results are presented using this method and it is found that the solutions computed here compare favourably with those of other authors. A further investigation is then conducted into the solution of adhesive contact problems using the assumptions of Maugis (1992) and Johnson and Greenwood (2008) to inform the nature of the adhesive stresses outside of the contact. It is found that both JKR-like and DMT-like behaviour can be observed in contact problems involving FGMs

Automatic Structure Detection in Constraints of Tabular Data

Abstract. Methods for the protection of statistical tabular data—as controlled tabular adjustment, cell suppression, or controlled rounding— need to solve several linear programming subproblems. For large multi-dimensional linked and hierarchical tables, such subproblems turn out to be computationally challenging. One of the techniques used to reduce the solution time of mathematical programming problems is to exploit the constraints structure using some specialized algorithm. Two of the most usual structures are block-angular matrices with either linking rows (primal block-angular structure) or linking columns (dual block-angular structure). Although constraints associated to tabular data have intrin-sically a lot of structure, current software for tabular data protection neither detail nor exploit it, and simply provide a single matrix, or at most a set of smallest submatrices. We provide in this work an efficient tool for the automatic detection of primal or dual block-angular struc-ture in constraints matrices. We test it on some of the complex CSPLIB instances, showing that when the number of linking rows or columns is small, the computational savings are significant