Experimental Evaluation of Kolmogorov’s -5/3 and 2/3 Power Laws in the Developing Turbulent Round Jet

The current work investigates the validity of two cornerstone results of the Kolmogorov K41 theory of turbulence in terms of the typical power law representations viz. the -5/3 law for turbulence spectra and the 2/3 law for second order structure functions. The developing region of the jet has been chosen since it is an equilibrium flow once fully developed (but not necessarily in the development phase), it becomes fully developed over lengths that are practical on a laboratory scale and it is a high-intensity flow with accessibly resolvable scales in time and space. The developing region of the jet is thus the perfect testbed for these investigations, which can herein be accurately mapped using our in-house laser Doppler anemometry (LDA) system. The high turbulence intensity and high shear flow is challenging from a measurement technical perspective, which is perhaps why this flow is so underexplored. This software-driven LDA system was developed specifically to optimize measurement of high shear and high turbulence intensities accurately in challenging flows such as the turbulent round jet in air. The jet was investigated experimentally both in the developing (non-equilibrium) and in the developed regions (equilibrium). Velocity static moments at each point are first presented to show the time averaged flow behavior while the spatial energy spectra and second order structure functions are computed to evaluate the power laws postulated by Kolmogorov. Measurements from both the developed and from the developing parts of the jet are presented to show validity of the measurement technique and unveil the actual spectral shapes in the developing non-equilibrium region, respectively

Impact of Attention-Deficit/Hyperactivity Disorder (ADHD) on prescription dug spending for children and adolescents: increasing relevance of health economic evidence

<p>Abstract</p> <p>Background</p> <p>During the last decade, pharmaceutical spending for patients with attention-deficit-hyperactivity disorder (ADHD) has been escalating internationally.</p> <p>Objectives</p> <p>First, to estimate future trends of ADHD-related drug expenditures from the perspectives of the statutory health insurance (SHI; Gesetzliche Krankenversicherung, GKV) in Germany and the National Health Service (NHS) in England, respectively, for children and adolescents age 6 to 18 years. Second, to evaluate the budgetary impact on individual prescribers (child and adolescent psychiatrists and pediatricians treating patients with ADHD) in Germany.</p> <p>Methods</p> <p>A model was developed to predict plausible scenarios of future pharmaceutical expenditures for treatment of ADHD. Model inputs were derived from demographic and epidemiological data, a literature review of past spending trends, and an analysis of new pharmaceutical products in development for ADHD. Only products in clinical development phase III or later were considered. Uncertainty was addressed by way of scenario analysis. For each jurisdiction, five scenarios used different assumptions of future diagnosis prevalence, treatment prevalence, rates of adoption and unit costs of novel drugs, and treatment intensity.</p> <p>Results</p> <p>Annual ADHD pharmacotherapy expenditures for children and adolescents will further increase and may exceed €310 m (D; E: ₤78 m) in 2012 (2002: ~€21.8 m; ~₤7.0 m). During this period, overall drug spending by individual physicians may increase 2.3- to 9.5-fold, resulting from the multiplicative effects of four variables: increased number of diagnosed cases, growing acceptance and intensity of pharmacotherapy, and higher unit costs of novel medications.</p> <p>Discussion</p> <p>Even for an extreme low case scenario, a more than six-fold increase of pharmaceutical spending for children and adolescents is predicted over the decade from 2002 to 2012, from the perspectives of both the NHS in England and the GKV in Germany. This budgetary impact projection represents a partial analysis only because other expenditures are likely to rise as well, for instance those associated with physician services, including diagnosis and psychosocial treatment. Further to this, by definition budgetary impact analyses have little to nothing to say about clinical appropriateness and about value of money.</p> <p>Conclusion</p> <p>Providers of care for children and adolescents with ADHD should anticipate serious challenges related to the cost-effectiveness of interventions.</p

On the Response of an OST to a Point-like Heat Source

A new technique of superconducting cavity diagnostics has been introduced by D. Hartrill at Cornell University, Ithaca, USA. Oscillating Superleak Transducers (OST) detect the heat transferred from a cavity's quench point via "Second Sound" through the superfluid He bath, needed to cool the superconducting cavity. The observed response of an OST is a complex, but reproducible pattern of oscillations. A small helium evaporation cryostat was built which allows the investigation of the response of an OST in greater detail. The distance between a point-like electrical heater and the OST can be varied. The OST can be mounted either parallel or perpendicular to the plate, housing the heat source. If the artificial quench-point releases an amount of energy compatible to a real quench spot on a cavity's surface, the OST signal starts with a negative pulse, which is usually strong enough to allow automatic detection. Furthermore, the reflection of the Second Sound on the wall is observed. A reflection coefficient R = 0.39 +- 0.05 of the glass wall is measured. This excludes a strong influence of multiple reflections in the complex OST response. Fourier analyses show three main frequencies, found in all OST spectra. They can be interpreted as modes of an oscillating circular membrane.Comment: 10 pages, 16 figure

Forecasting pharmaceutical expenditure in Europe : adjusting for the impact of rebates and discounts

European healthcare systems are under constant pressure to contain healthcare expenditure. Understanding future drug expenditure is an important consideration for payers when formulating policies. QuintileIMS publishes European forecasts that are underpinned by its audited volume data and publicly available list prices. With increasing price pressures, list to net price divergence is growing, although some of this information is commercially sensitive and thus not publicly available. The objective of this study was to further develop an established forecast to account for this divergence and explore its impact

Quality Appraisal in Systematic Literature Reviews of Studies Eliciting Health State Utility Values: Conceptual Considerations.

BACKGROUND: The increasing number of studies that generate health state utility values (HSUVs) and the impact of HSUVs on cost-utility analyses make a robust tailored quality appraisal (QA) tool for systematic reviews of these studies necessary. OBJECTIVE: This study aimed to address conceptual issues regarding QA in systematic reviews of studies eliciting HSUVs by establishing a consensus on the definitions, dimensions and scope of a QA tool specific to this context. METHODS: A modified Delphi method was used in this study. An international multidisciplinary panel of seven experts was purposively assembled. The experts engaged in two anonymous online survey rounds. After each round, the experts received structured and controlled feedback on the previous phase. Controlled feedback allowed the experts to re-evaluate and adjust their positions based on collective insights. Following these surveys, a virtual face-to-face meeting was held to resolve outstanding issues. Consensus was defined a priori at all stages of the modified Delphi process. RESULTS: The response rates to the first-round and second-round questionnaires and the virtual consensus meeting were 100%, 86% and 71%, respectively. The entire process culminated in a consensus on the definitions of scientific quality, QA, the three QA dimensions-reporting, relevance and  methodological quality-and the scope of a QA tool specific to studies that elicit HSUVs. CONCLUSIONS: Achieving this consensus marks a pivotal step towards developing a QA tool specific to systematic reviews of studies eliciting HSUVs. Future research will build on this foundation, identify QA items, signalling questions and response options, and develop a QA tool specific to studies eliciting HSUVs

Qualitative assessment of innovations in healthcare provision

<p>Abstract</p> <p>Background</p> <p>The triad of quality, innovation and economic restraint is as important in health care as it is in the business world. There are many proposals for the assessment of quality and of economic restraints in health care but only a few address assessment of innovations. We propose a strategy and new structures to standardize the description of health care innovations and to quantify them.</p> <p>Discussion</p> <p>Strategy and structure are based on the assumption that in the early phase of an innovation only data on the feasibility and possibly on the efficacy or effectiveness of an innovation can be expected. From the patient's perspective, benefit resulting from an innovation can be confirmed only in a later phase of development. Early indicators of patient's benefit will be surrogate parameters which correlate only weakly with the desired endpoints. After the innovation has been in use, there will be more evidence on correlations between surrogate parameters and the desired endpoints to provide evidence of the patient benefit. From an administrative perspective, this evidence can be considered in decisions about public financing. Different criteria are proposed for the assessment of innovations in prevention, diagnosis and therapy. For decisions on public financing a public fund for innovations may be helpful. Depending on the phase of innovation risk sharing models are proposed between manufacturers, private insurers and public funding.</p> <p>Summary</p> <p>Potential for patient benefit is always uncertain during early stages of innovations. This uncertainty decreases with increasing information on the effects of the innovation. Information about an innovation can be quantified, categorized and integrated into rational economic decisions.</p