55,916 research outputs found
Update of the budget impact analysis of the simplification to atazanavir + ritonavir + lamivudine dual therapy of HIV-positive patients receiving atazanavir-based triple therapies in Italy starting from data of the Atlas-M trial
No full textUmberto Restelli,1,2 Massimiliano Fabbiani,3 Simona Di Giambenedetto,3 Carmela Nappi,4 Davide Croce,1,21Center for Health Economics, Social and Health Care Management, LIUC – Università Cattaneo, Castellanza, Italy; 2School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 3Institute of Clinical Infectious Diseases, Catholic University of Sacred Heart, 4Health Economics, Bristol Myers Squibb S.r.l., Rome, ItalyIn 2017, the authors published an article to assess the financial consequences for the Italian National Health Service, over a 5-year period, of the adoption of a simplification strategy to atazanavir (ATV) + ritonavir (r) + lamivudine (3TC) dual therapy of HIVpositive patients receiving ATV plus two nucleoside reverse transcriptase inhibitors (NRTIs) starting from data of the Atlas-M trial at 48 weeks.1Consequently to the publication of the clinical results of the Atlas-M trial at 96 weeks, we updated the model implemented for the analysis, considering the most recent evidence.2The model was adapted considering the transitions among antiretroviral therapies (ARTs) observed in the trial, as reported in Figure 1, for years 1 and 2, and maintaining for years 3, 4, and 5 the same differential effectiveness (percentage of patients without virologic failure) observed between 48 and 96 weeks. In detail, the percentage of virologic failures considered in year 1 were 4.51% for ATV+r+2 NRTI and 0.76% for ATV+r+3TC; and in each following year were 8.66% for ATV+r+2 NRTI and 3.05% for ATV+r+3TC
Economic burden of the management of metastatic castrate-resistant prostate cancer in Italy: a cost of illness study
No full textUmberto Restelli,1,2 Giovanni Luca Ceresoli,3 Davide Croce,1,2 Laura Evangelista,4 Lorenzo Stefano Maffioli,5 Letizia Gianoncelli,3 Emilio Bombardieri6 1Center for Health Economics, Social and Health Care Management, LIUC – Università Cattaneo, Castellanza, Italy; 2School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 3Medical Oncology Department, Thoracic and Urologic Oncology Unit, Cliniche Humanitas Gavazzeni, Bergamo, 4Nuclear Medicine and Molecular Imaging Unit, Veneto Institute of Oncology IOV – IRCCS, Padova, 5Nuclear Medicine Department, Cancer Centre – ASST Ovest Milanese, Legnano, 6Nuclear Medicine Department, Cliniche Humanitas Gavazzeni, Bergamo, Italy Background: Prostate cancer (PCa) accounts for 20% of all cancers in subjects over 50 years in Italy. The majority of patients with PCa present with localized disease at the time of diagnosis, but many patients develop recurrent metastatic disease after treatment with curative intent. Androgen deprivation therapy is the standard of care for metastatic PCa patients; unfortunately, most of them progress to castrate-resistant prostate cancer (CRPC) within 5 years. Metastatic CRPC (mCRPC) heavily affects patients in terms of quality of life, side effects, and survival, and greatly impacts economic costs. The approval of new effective agents in recent years, including cabazitaxel, abiraterone acetate, enzalutamide, and radium-223, has dramatically changed patient management.Materials and methods: Here, we aimed to estimate the current costs of illness of mCRPC in Italy. All patients affected by mCRPC and treated with a single agent in an annual time horizon were considered. Therefore, the analysis was not focused on the management pathway of single patients through different lines of treatment. Direct medical costs referred to therapy, adverse event management, and skeletal-related event management were analyzed. A bottom-up approach was used to estimate the resource consumption: through national guidelines and expert opinions, the mean cost per patient was estimated and then multiplied by the total number of patients diagnosed with mCRPC. Results: Direct medical costs ranged from €196.5 million to €228.0 million, representing ~0.2% of the financing of the Italian National Health Service in 2016. The main cost driver was the cost of treatment, which represented more than 77% of the overall economic burden.Conclusion: Our analysis, reflective of real clinical practice, shows for the first time the high economic cost of mCRPC in Italy. Keywords: metastatic castrate-resistant prostate cancer, cost analysis, resource consumption, Italy, skeletal related events, oncolog
Lenograstim and filgrastim in the febrile neutropenia prophylaxis of hospitalized patients: efficacy and cost of the prophylaxis in a retrospective survey [Corrigendum]
No full textInnocenti R, Rigacci L, Restelli U, et al J Blood Med. 2019;10:21–27. On page 24, Figure 2, the key for the figure was incorrect. Read the original articl
A Dynamic Subfilter-scale Stress Model for Large Eddy Simulations Based on Physical Flow Scales
No full textWe propose a new definition of the length scale in an eddy-viscosity model for large-eddy simulations (LES). This formulation extends and generalizes a previous proposal [Piomelli, Rouhi and Geurts, Proc. ETMM10, 2014], in which the LES length scale was expressed in terms of the integral length-scale of turbulence determined by the flow characteristics and explicitly decoupled from the simulation grid; this approach was named Integral Length-Scale Approximation (ILSA). As in the original ILSA, the model coefficient was determined by the user, and required to maintain a desired contribution of the unresolved, subfilter scales (SFS) to the global transport. We propose a local formulation (local ILSA) in which the model coefficient is local in space, allowing a precise control over SFS activity as a function of location. This new formulation preserves the properties of the global model; application to channel flow and backward-facing step verifies its features and accuracy
Large-eddy simulation of a separated flow with a sub-filter scale model based on the integral length-scale
No full textA new sub-filter scale model for large-eddy simulations, which uses a length-scale proportional to the integral scale of the turbulence instead of the grid resolution to parametrize the modelled stresses, will be assessed in the prediction of the flow of a boundary-layer over a rough surface, which includes separation and reattachment
Near Wall PIV-Measurements on the Windward Slope of a Hill
No full textThe turbulent flow over periodic hills was measured near to the wall, using planar Particle-Image-Velocimetry (PIV) at high spatial resolution. Our focus is on the near wall turbulence structure on the windward slope of the hill. For large-eddy simulation (LES) we suspect that, if this was not predicted accurately, it affects the prediction of the velocity profiles over the hill crest which in turn will affect the recirculation length downstream of the hill. Regarding the time averaged velocities, we were able to resolve the linear viscous region of the boundary layer. The velocity distribution and also the Reynolds stress does not comply with the law of the wall as it is valid for a turbulent boundary layer at equilibrium
Energy dissipation and flux laws for unsteady turbulence
No full textDirect Numerical Simulations of spatially periodic unsteady turbulence show that the high Reynolds number scalings of the instantaneous energy dissipation rate and interscale energy flux at intermediate wavenumbers are qualitatively different from the well-known cornerstone scalings of equilibrium turbulence where and are time-dependent rms velocity and integral length-scales. Instead, they both scale as where and are length and velocity scales characterizing initial/overall unsteady turbulence conditions
Direct numerical simulation of turbulent Couette-Poiseuille flow with zero skin friction
No full textThe near-wall scaling of mean velocity U(y) is addressed for the case of zero skin friction on one wall of a fully turbulent channel flow. The present DNS results can be added to the evidence in support of the conjecture that U is proportional to √yw in the region just above the wall at which the mean shear dU/dy = 0
Real-space Manifestations of Bottlenecks in Turbulence Spectra
No full textAn energy-spectrum bottleneck, a bump in the turbulence spectrum between the inertial and dissipation ranges, is shown to occur in the non-turbulent, one-dimensional, hyperviscous Burgers equation and found to be the Fourier-space signature of oscillations in the real-space velocity, which are explained by boundary-layer-expansion techniques. Pseudospectral simulations are used to show that such oscillations occur in velocity correlation functions in one- and three-dimensional hyperviscous hydrodynamical equations that display genuine turbulence
Braid Entropy of Faraday Waves driven 2D Turbulence
No full textWe report new experimental results that use tools from braid theory to characterize two-dimensional turbulent flows driven by Faraday waves. The average topological length of the material fluid lines is found to grow exponentially with time. It allows us to compute the braid’s topological entropy SBraid. We show that SBraid increases as the square root of the turbulence kinetic energy E ~ u^2, where u^2 is the horizontal velocity variance . At long times, the PDFs of Lbraid are positively skewed and present strong exponential tails
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