IntroductionThe purpose of this study was to describe healthcare resource utilization and costs resulting from early (within 30 days of diagnosis) versus late (>30 days after diagnosis) treatment with prescriptions for H.P. Acthar® Gel (repository corticotropin injection; Acthar; Mallinckrodt) to manage infantile spasms (IS).MethodsWe included all patients in the Truven Health MarketScan® Commercial Claims and Encounters Database and the Truven Health MarketScan Multi-State Medicaid Database who were diagnosed with IS from 2007 to 2012. We performed unadjusted and adjusted regressions examining the relationship between healthcare resource utilization variables and their associated costs to compare outcomes in the early and late Acthar users.ResultsA total of 252 patients with IS who received Acthar fit our study criteria; 191 (76%) were early Acthar users. In adjusted analyses, we found that early Acthar use was associated with, on average, 3.8 fewer outpatient services (99% CI 0.7–6.7 fewer services). We did not find significant associations between early prescriptions for Acthar and number of hospitalizations, emergency room visits, prescription medications filled, or total costs of health services.ConclusionPatients prescribed Acthar within 30 days of their IS diagnoses tended to have fewer outpatient services performed compared to patients prescribed Acthar later in the disease process. Although additional research is needed to confirm these exploratory findings, physicians may consider early treatment with Acthar to manage IS.FundingThis study was funded by a grant to the University of Washington from Mallinckrodt Pharmaceuticals.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-016-0361-2) contains supplementary material, which is available to authorized users.
Engineers must consider performance, power consumption, and cost when designing embedded digital systems; furthermore, memory is a key factor in such systems. Code compression is a technique used in embedded systems to reduce the memory usage. BitMask-based code compression is a modified version of dictionary-based code compression. The basic purpose of BitMask is to record mismatched values and their positions to compress a greater number of instructions; it can be used exclusively or incorporated with the reference instructions to decode the codewords. In this paper, we applied a small separated dictionary, and variable mask numbers were used with the BitMask algorithm to reduce the codeword length of highfrequency instructions. In addition, a novel dictionary selection algorithm was proposed to increase the instruction match rates. The fully separated dictionary method was used to improve the performance of the decompression engine without affecting the compression ratio (CR) (the compressed code size divided by original code size). Based on the experimental results, the proposed method can achieve a 7.5% improvement in the CR with nearly no hardware overhead.Index Terms-Computer architecture, dictionary-based code compression (DCC), embedded systems, separated dictionaries.
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