3,003 research outputs found
Humanistic and economic burden of fibromyalgia in Japan [Corrigendum]
No full textLee LK, Ebata N, Hlavacek P, DiBonaventura M, Cappelleri JC, Sadosky A. Humanistic and economic burden of fibromyalgia in Japan. Journal of Pain Research. 2016;9:967–978.Figures 3, 4, 5, and 6 contain errors in the key. Fibromyalgia should be dark gray and matched controls should be light gray.Read the original article
Perancangan Sistem Informasi Pengelola Barang/Inventaris Di Jc Komp
No full textInventory information system is a system used to enter inventory data into the database, so that there are no errors in input, output data, and reporting based on the desired data. based on surveys and interviews with jc comp personnel, information was obtained that the existing system in the jc comp warehouse section is still manual. therefore, the system that will be created by the author is the result of a replication of the existing system in the jc comp warehouse section. in addition to the process of input and output of goods, this information system is also equipped with features for creating data reports, input and output of goods, and searching for goods data by item name. with the inventory information system is expected to be useful for the warehouse parts jc comp. By implementing this system in the jc comp warehouse, it is hoped that it can reduce errors that may occur. this system is also expected to further speed up the process of input, output, and report generation, which in turn will help the jc comp warehouseSistem Informasi Persediaan Barang adalah sebuah sistem yang digunakan untuk memasukkan data-data persediaan barang ke dalam database, sehinggga tidak terjadi kesalahan dalam input, output data, dan pembuatan laporan berdasarkan data yang diinginkan. Berdasarkan survey dan wawancara dengan bagian personalia Jc Komp, didapatkan informasi bahwa sistem yang ada dibagian gudang Jc Komp masih manual. Oleh karena itu, sistem yang akan dibuat oleh penulis adalah hasil replikasi dari sistem yang telah ada dibagian gudang Jc Comp. Selain proses input dan output barang, pada sistem informasi ini juga dilengkapi fitur pembuatan laporan data, input, dan output barang, dan pencarian data barang berdasarkan nama barang. Dengan adanya Sistem Informasi persediaan barang ini diharapkan dapat bermanfaat bagi bagian gudang Jc Komp. Dengan diterapkannya sistem ini pada bagian gudang Jc Comp, maka diharapkan dapat mengurangi kesalahan-kesalahan yang mungkin terjadi. Sistem ini juga diharapkan dapat lebih mempercepat proses input, output, dan pembuatan laporan yang pada akhirnya dapat membantu bagian gudang Jc Komp
Amenable L-2-Theoretic Methods and Knot Concordance
No full textWe reveal new structures in the topological knot concordance group. As a key ingredient, we develop obstructions using L-2-theoretic methods for amenable groups in Strebel's class recently introduced by Orr and the author. Concerning (h)-solvable knots, which are defined in terms of certain Whitney towers of height h in bounding 4-manifolds, we show the following: for any n>1, there are (n)-solvable but non-(n. 5)-solvable (and therefore nonslice) knots, which are not detected by prior methods using Cochran-Orr-Teichner L-2-signature obstructions as well as Levine algebraic obstructions and Casson-Gordon invariants.X1197sciescopu
Dynamics of Network Formation Processes in the Co-Author Model
No full textThis article studies the dynamics in the formation processes of a mutual consent network in game theory setting: the Co-Author Model. In this article, a limited observation is applied and analytical results are derived. Then, 2 parameters are varied: the number of individuals in the network and the initial probability of the links in the network in its initial state. A simulation result shows a finding that is consistent with an analytical result for a state of equilibrium while it also shows different possible equilibria.Dynamics, Network, Game Theory, Model,Simulation, Equilibrium, Complexity
Evaluating increased resource use in fibromyalgia using electronic health records
No full textJay M Margolis,1 Elizabeth T Masters,2 Joseph C Cappelleri,3 David M Smith,1 Steven Faulkner4 1Truven Health Analytics, Life Sciences, Outcomes Research, Bethesda, MD, 2Pfizer Inc, Outcomes & Evidence, New York, NY, 3Pfizer Inc, Statistics, Groton, CT, 4Pfizer Inc, North American Medical Affairs, Medical Outcomes Specialists, St Louis, MO, USA Objective: The management of fibromyalgia (FM), a chronic musculoskeletal disease, remains challenging, and patients with FM are often characterized by high health care resource utilization. This study sought to explore potential drivers of all-cause health care resource utilization and other factors associated with high resource use, using a large electronic health records (EHR) database to explore data from patients diagnosed with FM. Methods: This was a retrospective analysis of de-identified EHR data from the Humedica database. Adults (≥18 years) with FM were identified based on ≥2 International Classification of Diseases, Ninth Revision codes for FM (729.1) ≥30 days apart between January 1, 2008 and December 31, 2012 and were required to have evidence of ≥12 months continuous care pre- and post-index; first FM diagnosis was the index event; 12-month pre- and post-index reporting periods. Multivariable analysis evaluated relationships between variables and resource utilization. Results: Patients were predominantly female (81.4%), Caucasian (87.7%), with a mean (standard deviation) age of 54.4 (14.8) years. The highest health care resource utilization was observed for the categories of “medication orders” and “physician office visits,” with 12-month post-index means of 21.2 (21.5) drug orders/patient and 15.1 (18.1) office visits/patient; the latter accounted for 73.3% of all health care visits. Opioids were the most common prescription medication, 44.3% of all patients. The chance of high resource use was significantly increased (P<0.001) 26% among African-Americans vs Caucasians and for patients with specific comorbid conditions ranging from 6% (musculoskeletal pain or depression/bipolar disorder) to 21% (congestive heart failure). Factors significantly associated with increased medications ordered included being female (P<0.001) and specific comorbid conditions (P<0.05). Conclusion: Physician office visits and pharmacotherapy orders were key drivers of all-cause health care utilization, with demographic factors, opioid use, and specific comorbidities associated with resource intensity. Health systems and providers may find their EHRs to be a useful tool for identifying and managing resource-intensive FM patients. Keywords: fibromyalgia, electronic health records, health care resource utilizatio
High-level polyomavirus JC viruria following long-term steroid therapy
No full textCASE REPORT JC virus is a highly seroprevalent ubiquitous polyomavirus which is acquired at an early age through respiratory or oral route, Thereafter JCV establishes persistent, but mainly asymptomatic, infections in various tissues, including the genitourinary tract and brain Corresponding author Cristina Costa, MD S.C.D.U. Virologia Azienda Ospedaliero-Universitaria San Giovanni Battista di Torino Via Santena, 9 -10126 Torino E-mail: [email protected] increasing with age, with adult prevalence rate often between 15% and 60
Engineering Framework to Utilize Miniaturized Charpy Type SE(B) Specimens to Predict Jc of Full Sized Specimens
No full textAbstractThis paper introduces our experience of using miniature Charpy type SE(B) specimen in obtaining fracture toughness Jc of a material in the ductile to brittle transition temperature (DBTT) region. Width W x thickness B of 2 x 2 mm, 3 x 3 mm and 10 x 10 mm were chosen as miniature specimens and 25 x 25 mm were chosen as full sized specimen. 0.55% carbon steel JIS S55C, whose tensile to yield stress ratio σTS/σYS was equal to 1.8 was chosen as a material to simulate a degraded (embrittled) material in the DBTT region. Focus was placed on whether cleavage fracture could be predicted for these miniaturized specimens. Another focus was placed on whether the Jc of full sized specimen is predictable from the test results of the miniature sized specimens, in case cleavage fracture were observed. The results showed that the modified Ritch-Knott-Rice (RKR) failure criterion (which predicts the onset of cleavage fracture when the crack opening stress measured at 4 times the crack-tip opening displacement exceeds this σ22c) could predict whether cleavage fracture would occur or not. Another finding was that, in case cleavage fracture was observed though, the critical value σ22c in the modified RKR failure criterion was independent of specimen size, and thus, Jc of the full sized specimen is predictable from the miniature specimen test results, though M = (W-a)σYS/Jc was smaller than ASTM E1921 requirement of 30. Here, a and σYS are crack length and yield strength, respectively
A cross-sectional study examining the psychometric properties of the painDETECT measure in neuropathic pain
No full textJoseph C Cappelleri,1 Vijaya Koduru,2 E Jay Bienen,3 Alesia Sadosky41Pfizer Inc, Groton, CT, USA; 2Eliassen Group, New London, CT, USA; 3Outcomes Research Consultant, New York, NY, USA; 4Pfizer Inc, New York, NY, USABackground: Similarities and differences on the nine-item and seven-item versions of painDETECT, a patient-reported screener to identify neuropathic pain (NeP), have not been psychometrically explored across NeP conditions.Methods: Scores on the nine-item painDETECT (seven pain symptom items, one pain course pattern item, one pain radiation item) range from -1 to 38; scores ≥19 indicate NeP is likely (>90% probability). The seven-item version (only pain symptoms) score range is 0 to 35. painDETECT was administered to subjects with confirmed diagnoses of human immunodeficiency virus-related peripheral NeP (HIVP) (n=103), spinal cord injury-related NeP (SCI) (n=103), small fiber neuropathy (n=100), painful diabetic peripheral neuropathy (n=112), posttrauma/postsurgical NeP (n=100), and NeP in chronic low back pain (n=106) identified during office visits to US community-based physicians. Analysis of covariance compared mean scores (adjusted for age, sex, race, ethnicity, time since NeP diagnosis, and number of comorbidities) on the nine-item and seven-item versions of painDETECT. Cronbach's alpha assessed internal consistency reliability, and corrected item-to-total correlations assessed item-level discrimination.Results: The adjusted mean nine-item scores ranged from 21.0 (SCI) to 24.3 (small fiber neuropathy). Differences between conditions were either trivial or small-to-medium in magnitude. Cronbach's alpha gave overall internal consistency reliability of 0.76, with a range of 0.63 (SCI) to 0.82 (HIVP). Mean scores and Cronbach's alphas for the seven-item version were generally similar to the nine-item version. Corrected item-to-total correlations adequately discriminated all pain symptom items on both painDETECT versions for each condition (0.3–0.7), but the two nonsensory items on the nine-item version showed lackluster discrimination (<0.3).Conclusion: painDETECT scores were within the range indicating high probability of NeP. Differences between conditions were generally modest or not large. Both versions showed evidence of internal consistency reliability and item-level discrimination, suggesting that painDETECT is a useful screening measure for identifying NeP across NeP conditions.Keywords: painful diabetic neuropathy, spinal cord injury, back pain, small fiber neuropathy, HIV-related peripheral neuropathy, posttrauma neuropath
The association between lower back pain and health status, work productivity, and health care resource use in Japan
No full textAlesia B Sadosky,1 Marco DiBonaventura,2 Joseph C Cappelleri,3 Nozomi Ebata,4 Koichi Fujii4 1Pfizer Inc, New York, NY, USA; 2Kantar Health, New York, NY, USA; 3Pfizer Inc, Groton, CT, USA; 4Pfizer Japan Inc, Tokyo, Japan Introduction: This study investigated the effect of pain severity on health status, work productivity, health care resource use, and costs among respondents with lower back pain (LBP), in Japan. Materials and methods: Data from the 2013 Japan National Health and Wellness Survey, a survey of Japanese adults, were analyzed (N=30,000). All respondents provided informed consent, and the protocol was institutional review board-approved. Respondents who reported experiencing LBP were propensity score–matched to those without LBP, based on demographics and health history. Using regression modeling, patients with mild, moderate, and severe pain were compared against matched controls, with respect to health status (Mental and Physical Component Summary scores, and health utilities from the Short Form®-36 Health Survey version 2), work productivity (Work Productivity and Activity Impairment – General Health version), health care resource use, and annual per-patient costs (estimated using published annual wages and resource use event costs). Results: A total 1,897 patients reported experiencing LBP in the past month (6.32%); 52.45% reported their pain as mild, 32.79% as moderate, and 14.76% as severe. Increasing pain severity was associated with significantly lower levels of mental component scores (46.99 [mild], 42.93 [moderate], and 40.58 [severe] vs 48.10 [matched controls]), physical component scores (50.29 [mild], 46.74 [moderate], and 43.94 [severe] vs 52.93 [matched controls]), and health utilities (0.72 [mild], 0.66 [moderate], and 0.62 [severe] vs 0.76 [matched controls]) (all P<0.05). Indirect costs were significantly higher (P<0.05) among those with moderate (¥1.69 million [MM] [equivalent to 17,000, based on United States dollar exchange rates on September 1, 2014]) and severe (¥1.88 MM [19,000]) pain, relative to matched controls (¥0.95 MM [9,500]). Direct costs were only marginally different (P=0.05) between those with severe pain and matched controls (¥1.33 MM [13,000] vs ¥0.54 MM [$5,000]). Conclusion: Increasing pain severity among respondents with LBP was associated with significantly worse health status, to a clinically-relevant degree, along with greater indirect and direct costs, in Japan. Keywords: low back pain, pain severity, quality of life, cos
Characterizing neuropathic pain profiles: enriching interpretation of painDETECT
No full textJoseph C Cappelleri,1 Vijaya Koduru,2 E Jay Bienen,3 Alesia Sadosky4 1Pfizer Inc, Groton, CT, USA; 2Eliassen Group, New London, CT, USA; 3Outcomes Research Consultant, New York, NY, USA; 4Pfizer Inc, New York, NY, USA Purpose: To psychometrically evaluate painDETECT, a patient-reported screening questionnaire for neuropathic pain (NeP), for discriminating among sensory pain symptoms (burning, tingling/prickling, light touching, sudden pain attacks/electric shock-type pain, cold/heat, numbness, and slight pressure). Methods: The seven-item version of painDETECT provides an overall score that targets only sensory symptoms, while the nine-item version adds responses on two items to the overall score, covering pain course pattern and pain radiation. Both versions have relevance in terms of characterizing broad NeP. The nine- and seven-item versions of painDETECT were administered to subjects with confirmed NeP across six conditions identified during office visits to US community-based physicians. Responses on the sensory symptom items were dichotomized into “at least moderate” (ie, moderate, strongly, very strongly) relative to the combined other responses (never, hardly noticed, slightly). Logistic regression of dichotomized variables on the total painDETECT score provided probabilities of experiencing each symptom across the range of painDETECT scores. Results: Both painDETECT versions discriminated among the symptoms with similar probabilities across the score ranges. Using these data, the probability of moderately experiencing each pain sensory item was estimated for a particular score, providing a pain profile. Additionally, the likelihood of experiencing each sensation was determined for a discrete increase in score, ie, the odds of at least a moderate sensation of burning (versus less than a moderate sensation) was 1.29 for a 1-point increase, 3.52 for a 5-point increase, and 12.42 for every 10-point increase in the nine-item painDETECT score. Conclusion: painDETECT differentiates pain profiles across the range of scores such that, for a particular score, the probability of experiencing at least a moderate sensation of each symptom was determined and compared. These results can help characterize NeP symptomatology, enrich interpretation of painDETECT scores, and provide a basis for individualizing NeP management. Keywords: neuropathic pain, painDETECT, sensory symptoms, pain profile, interpretation, patient-reported outcome
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