Direct medical costs of COPD diagnosis and treatment, Eastern vs. Western European country : examples of Serbia and Belgium

OBJECTIVE: Comparison of COPD financial burden and underlying factors, between Eastern upper middle income and a Western European high income, healthcare settings. METHODS: The patient sample was 433 in Belgium and 322 in Serbia, age ≥ 40, with spirometry and clinically confirmed COPD diagnosis. Belgian trial followed patients prospectively during 2006, using structured survey of clinicians in charge. Serbian trial conducted in 2008, retrieved data from clinical invoice database. Time horizon was one year and perspective of third party payers was taken into account for both studies. Clinical outcomes of interest were disease exacerbation, hospital admission and death. Economic inputs referred to COPD-attributable medical services consumption value during observed period of time. RESULTS: Average annual cost was 1,812.84 € for the Serbian patients and 1,738.13 €/year for the Belgian patients (not including the value of laboratory diagnostics or imaging techniques). Severity grade and duration of hospital admissions significantly directly correlated with overall cost in both populations. Pattern of diagnostic procedures requested and ATC classes of drug consumed to treat COPD remains similar and comparable in both countries. GDP per capita ratio in respective years (10.4: 37.4), exhibits the paradox of patient being much less affordable to treat in a less developed society. CONCLUSIONS: Burden of COPD in Europe is huge and, due to contemporary life style expected to grow further. We compared cost of illness structures between two societies with different macroeconomic past in healthcare financing and management. According to our findings, direct medical costs were driven by exacerbations and hospital admissions. Significantly cheaper human labor caused higher relative relevance of drug acquisition expenses in the East and higher portion of hospital admission costs in the West. More in-depth research of indirect COPD attributable costs (e.g. lost productivity, absenteeism, premature death etc) will be needed in future. It implies serious health policy necessities to provide accessibility of care

Vectorially Imprinted Hybrid Nanofilm for Acetylcholinesterase Recognition

Effective recognition of enzymatically active tetrameric acetylcholinesterase (AChE) is accomplished by a hybrid nanofilm composed of a propidium-terminated self-assembled monolayer (Prop-SAM) which binds AChE via its peripheral anionic site (PAS) and an ultrathin electrosynthesized molecularly imprinted polymer (MIP) cover layer of a novel carboxylate-modified derivative of 3,4-propylenedioxythiophene. The rebinding of the AChE to the MIP/Prop-SAM nanofilm covered electrode is detected by measuring in situ the enzymatic activity. The oxidative current of the released thiocholine is dependent on the AChE concentration from ≈0.04 × 10−6 to 0.4 × 10−6m. An imprinting factor of 9.9 is obtained for the hybrid MIP, which is among the best values reported for protein imprinting. The dissociation constant characterizing the strength of the MIP-AChE binding is 4.2 × 10−7m indicating the dominant role of the PAS-Prop-SAM interaction, while the benefit of the MIP nanofilm covering the Prop-SAM layer is the effective suppression of the cross-reactivity toward competing proteins as compared with the Prop-SAM. The threefold selectivity gain provided by i) the “shape-specific” MIP filter, ii) the propidium-SAM, iii) signal generation only by the AChE bound to the nanofilm shows promise for assessing AChE activity levels in cerebrospinal fluid

New high-pressure phase of HfTiO4 and ZrTiO4 ceramics

We studied the high-pressure effects on the crystalline structure of monoclinic HfTiO4 and ZrTiO4. We found that the compressibility of these ceramics is highly non-isotropic, being the b-axis the most compressible one. In addition, the a-axis is found to have a small and negative compressibility. At 2.7 GPa (10.7 GPa) we discovered the onset of an structural phase transition in HfTiO4 (ZrTiO4), coexisting the low- and high-pressure phases in a broad pressure range. The new high-pressure phase has a monoclinic structure which involves an increase in the Ti-O coordination and a collapse of the cell volume. The equation of state for the low-pressure phase is also determined.Comment: 16 pages, 5 figures, 26 references, Article in Pres

Computing p-adic heights on hyperelliptic curves

We describe an algorithm to compute the local Coleman-Gross p-adic height at p on a hyperelliptic curve. Previously, this was only possible using an algorithm due to Balakrishnan and Besser, which was limited to odd degree. While we follow their general strategy, our algorithm is significantly faster and simpler and works for both odd and even degree. We discuss a precision analysis and an implementation in SageMath. Our work has several applications, also discussed in this article. These include various versions of the quadratic Chabauty method, and numerical evidence for a p-adic version of the conjecture of Birch and Swinnerton-Dyer in cases where this was not previously possible

Linear quadratic Chabauty

We present a new quadratic Chabauty method to compute the integral points on certain even degree hyperelliptic curves. Our approach relies on a nontrivial degree zero divisor supported at the two points at infinity to restrict the p-adic height to a linear function; we can then express this restriction in terms of holomorphic Coleman integrals under the standard quadratic Chabauty assumption. Then we use this linear relation to extract the integral points on the curve. We also generalize our method to integral points over number fields. Our method is significantly simpler and faster than all other existing versions of the quadratic Chabauty method. We give examples over \Q and \Q(\sqrt{7})