1,879 research outputs found

    Book Review: The Innovation Crisis: Creating Disruptive Influence in the Ministry You Lead by Ted Esler

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    Development of advanced fuel cell system, phase 2

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    A multiple task research and development program was performed to improve the weight, life, and performance characteristics of hydrogen-oxygen alkaline fuel cells for advanced power systems. Development and characterization of a very stable gold alloy catalyst was continued from Phase I of the program. A polymer material for fabrication of cell structural components was identified and its long term compatibility with the fuel cell environment was demonstrated in cell tests. Full scale partial cell stacks, with advanced design closed cycle evaporative coolers, were tested. The characteristics demonstrated in these tests verified the feasibility of developing the engineering model system concept into an advanced lightweight long life powerplant

    Development of advanced fuel cell system, phase 3

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    A multiple task research and development program was performed to improve the weight, life, and performance characteristics of hydrogen-oxygen alkaline fuel cells for advanced power systems. Gradual wetting of the anode structure and subsequent long-term performance loss was determined to be caused by deposition of a silicon-containing material on the anode. This deposit was attributed to degradation of the asbestos matrix, and attention was therefore placed on development of a substitute matrix of potassium titanate. An 80 percent gold 20 percent platinum catalyst cathode was developed which has the same performance and stability as the standard 90 percent gold - 10 percent platinum cathode but at half the loading. A hybrid polysulfone/epoxy-glass fiber frame was developed which combines the resistance to the cell environment of pure polysulfone with the fabricating ease of epoxy-glass fiber laminate. These cell components were evaluated in various configurations of full-size cells. The ways in which the baseline engineering model system would be modified to accommodate the requirements of the space tug application are identified

    Impact of in-house specialty pharmacy on access to novel androgen axis inhibitors in men with advanced prostate cancer

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    Introduction: Novel androgen axis inhibitors are standard of care treatments in advanced prostate cancer. The billed amounts for these medications are often very high, which may create significant financial toxicity for patients and lead to delays in treatment. Our institution implemented an in-house specialty pharmacy in 2014, that provides these medications and evaluates copay assistance options for all patients. We evaluated the program’s impact on out of pocket cost (OOP) and turnaround time (TAT). Methods: We reviewed available internal specialty pharmacy records to identify prescriptions for abiraterone or enzalutamide filled between 1/1/17 and 12/31/18. Payments were stratified by primary payment (amount reimbursed by the patient’s prescription plan based on the benefit’s design) and copayment assistance. Turnaround times (TAT) in business days were stratified by prescriptions requiring intervention (prior authorization, copayment assistance, or insufficient inventory) and clean prescriptions (those requiring no intervention). Results: One thousand four hundred seventeen prescriptions for 175 unique patients requiring abiraterone (n=869, 61.3%) or enzalutamide (n=548, 38.7%) were filled through the institution’s specialty pharmacy. The average amount paid by primary payer was 9,492.96fora30daysupply(range:9,492.96 for a 30 day supply (range: 3,382.48-12,939.84).Averagequotedcopaywas12,939.84). Average quoted copay was 577.53 (range 3.08−3.08-10,560.39). 64% of patients received copayment assistance. Average OOP cost per prescription after co-pay assistance was 100.83(range100.83 (range 0-$8556.64). Three patients declined treatment due to cost (1.7% of overall). Average TAT was 2.98 days for clean prescriptions and 3.36 days for prescriptions needing intervention (p=0.055). Discussion: OOP cost varied significantly based on plan design and copayment assistance eligibility. The majority of patients received copayment assistance, which markedly reduced OOP cost. Cost rarely precluded access to treatment. TAT was not significantly prolonged for prescriptions requiring intervention. Further studies to determine impact of pharmacy type on access to specialty medications are indicated
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