To describe the costs of the Diabetes Prevention Program (DPP) interventions to prevent or delay type 2 diabetes.
We describe the direct medical costs, direct nonmedical costs, and indirect costs of ...the placebo, metformin, and intensive lifestyle interventions over the 3-year study period of the DPP. Resource use and cost are summarized from the perspective of a large health system and society. Research costs are excluded.
The direct medical cost of laboratory tests to identify one subject with impaired glucose tolerance (IGT) was $139. Over 3 years, the direct medical costs of the interventions were $79 per participant in the placebo group, $2,542 in the metformin group, and $2,780 in the lifestyle group. The direct medical costs of care outside the DPP were $272 less per participant in the metformin group and $432 less in the lifestyle group compared with the placebo group. Direct nonmedical costs were $9 less per participant in the metformin group and $1,445 greater in the lifestyle group compared with the placebo group. Indirect costs were $230 greater per participant in the metformin group and $174 less in the lifestyle group compared with the placebo group. From the perspective of a health system, the cost of the metformin intervention relative to the placebo intervention was $2,191 per participant and the cost of the lifestyle intervention was $2,269 per participant over 3 years. From the perspective of society, the cost of the metformin intervention relative to the placebo intervention was $2,412 per participant and the cost of the lifestyle intervention was $3,540 per participant over 3 years.
The metformin and lifestyle interventions are associated with modest incremental costs compared with the placebo intervention. The evaluation of costs relative to health benefits will determine the value of these interventions to health systems and society.
The layer 0 inner silicon detector of the D0 experiment Angstadt, R.; Bagby, L.; Bean, A. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
10/2010, Letnik:
622, Številka:
1
Journal Article
Recenzirano
Odprti dostop
This paper describes the design, fabrication, installation and performance of the new inner layer called Layer 0 (L0) that was inserted in the existing Run IIa silicon micro-strip tracker (SMT) of ...the D0 experiment at the Fermilab Tevatron p¯p collider. L0 provides tracking information from two layers of sensors, which are mounted with center lines at a radial distance of 16.1 and 17.6mm from the beam axis. The sensors and read-out electronics are mounted on a specially designed and fabricated carbon fiber structure that includes cooling for sensor and read-out electronics. The structure has a thin polyimide circuit bonded to it so that the circuit couples electrically to the carbon fiber allowing the support structure to be used both for detector grounding and a low impedance connection between the remotely mounted hybrids and the sensors.
Electrical properties of carbon fiber support systems Cooper, W.; Daly, C.; Demarteau, M. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
09/2005, Letnik:
550, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Carbon fiber support structures have become common elements of detector designs for high energy physics experiments. Carbon fiber has many mechanical advantages but it is also characterized by high ...conductivity, particularly at high frequency, with associated design issues. This paper discusses the elements required for sound electrical performance of silicon detectors employing carbon fiber support elements. Tests on carbon fiber structures are presented indicating that carbon fiber must be regarded as a conductor for the frequency region of 10–100
MHz. The general principles of grounding configurations involving carbon fiber structures will be discussed. To illustrate the design requirements, measurements performed with a silicon detector on a carbon fiber support structure at small radius are presented. A grounding scheme employing copper–kapton mesh circuits is described and shown to provide adequate and robust detector performance.
The D0 Silicon Microstrip Tracker Ahmed, S.N.; Aoki, M.; Åsman, B. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
04/2011, Letnik:
634, Številka:
1
Journal Article
Recenzirano
Odprti dostop
This paper describes the mechanical design, the readout chain, the production, testing and the installation of the Silicon Microstrip Tracker of the D0 experiment at the Fermilab Tevatron collider. ...In addition, we describe the performance and operational experience of the detector during the experiment data collection between 2001 and 2010.
The Silicon Micro-strip Tracker (SMT) at the DØ experiment in the Fermilab Tevatron collider has been operating since 2001. In 2006, an additional layer, referred to as ‘Layer 0’, was installed to ...improve impact parameter resolution and compensate for detector degradation due to radiation damage to the original innermost SMT layer. The SMT detector provides valuable tracking and vertexing information for the experiment. This contribution will highlight aspects of the long term operation of the SMT, including the impact of the silicon readout test-stand. Due to the full integration of the test-stand into the DØ trigger framework, this test-stand provides an advantageous tool for training of new experts and studying subtle effects in the SMT while minimizing impact on the global data acquisition.
Testing a system as large as the D Zero data acquisition system is difficult. The use of IBM compatible personal computers in a hardware test system that can run on any size system from an engineer’s ...test bench to the entire subsystem in the D Zero Detector is described. The test system uses a PC to W E bus interface for the local testing and the Token Ring network for more global testing. This system has been implemented for several different hardware systems in D Zero.
Strategies to Identify Adults at High Risk for Type 2 Diabetes
The Diabetes Prevention Program
The Diabetes Prevention Program Research Group *
George Washington University Biostatistics Center, ...Diabetes Prevention Program Coordinating Center, Rockville, Maryland
Address correspondence and reprint requests to DPP Coordinating Center, George Washington University, 6110 Executive Blvd.,
Suite 750, Rockville, MD 20852. E-mail: dppmail{at}biostat.bsc.gwu.edu
Abstract
OBJECTIVE —The Diabetes Prevention Program (DPP) was a large, multicenter, randomized clinical trial testing interventions to prevent
or delay type 2 diabetes. A major challenge was to identify eligible high-risk adults, defined by DPP as having both impaired
glucose tolerance (IGT) (2-h glucose 140–199 mg/dl) and elevated fasting plasma glucose (EFG) (95–125 mg/dl).
RESEARCH DESIGN AND METHODS —We analyzed how screening yields would be affected by the presence of established risk factors such as age, sex, ethnicity,
BMI, and family history of diabetes, and how much yields would be enhanced by preselecting individuals with elevated capillary
blood glucose levels. Of 158,177 contacted adults, 79,190 were potentially eligible (no history of diabetes, age 25 years
and older, BMI ≥24 kg/m 2 ). We focus on the 30,383 participants who completed an oral glucose tolerance test (OGTT).
RESULTS —Based on OGTT, 27% had IGT with EFG, meeting DPP eligibility criteria for being at high risk of diabetes, and 13% had previously
undiagnosed diabetes based on OGTT. Older age and higher BMI increased yield of high-risk individuals and those with newly
discovered diabetes in most ethnic groups (whites, African Americans, Hispanics, and American Indians). In Asian Americans,
age but not BMI predicted high risk and diabetes. Independent of age and BMI, the preliminary fasting capillary glucose predicted
screening yield in all ethnic groups, with an inverted-U pattern defining DPP eligibility alone (IGT-EFG) and a steep curvilinear
pattern defining either IGT-EFG or newly discovered diabetes. Fasting capillary glucose did not attenuate the affects of other
participant characteristics in predicting IGT-EFG or the combination of IGT-EFG and newly discovered diabetes.
CONCLUSIONS —The DPP screening approach identified adults with or at high risk for type 2 diabetes across various ethnic groups and provided
guidance to more efficient use of OGTTs. Fasting capillary glucose is a useful adjunct in screening programs combined with
data on age and adiposity.
ADA, American Diabetes Association
CBL, Central Biochemistry Laboratory
DPP, Diabetes Prevention Program
EFG, elevated fasting glucose
IGT, impaired glucose tolerance
OGTT, oral glucose tolerance test
Footnotes
*
↵ * Prepared by Sharon L. Edelstein, ScM; Fred L. Brancati, MD, MPH; Elizabeth Barrett-Connor, MD; Michael M. Engelgau, MD; Richard
F. Hamman, MD, DrPH; William C. Knowler, MD, DrPH; Margaret J. Matulik, RN, BSN, CDE; and Boyd E. Metzger, MD.
A complete list of members of the Diabetes Prevention Program Research Group appears in New Engl J Med 346:393–403, 2002.
Additional information for this article can be found in an online appendix available at http://care.diabetesjournals.org .
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
Accepted September 13, 2004.
Received June 1, 2004.
DIABETES CARE
The SiliconMicro-strip Tracker (SMT) at the D{\O} experiment in the Fermilab
Tevatron collider has been operating since 2001. In 2006, an additional layer,
referred to as 'Layer 0', was installed to ...improve impact parameter resolution
and compensate for detector degradation due to radiation damage to the original
innermost SMT layer. The SMT detector provides valuable tracking and vertexing
information for the experiment. This contribution will highlight aspects of the
long term operation of the SMT, including the impact of the silicon readout
test-stand. Due to the full integration of the test-stand into the D{\O}
trigger framework, this test-stand provides an advantageous tool for training
of new experts and studying subtle effects in the SMT while minimizing impact
on the global data acquisition.
The drift chambers making up the Central Tracking region of the DO detector are being replaced by an 830,000 channel silicon vertex detector and a 90,000 channel scintillating fiber detector. Readout ...electronics is being designed to be common to both detectors. A custom high-density mixed-technology integrated circuit, mounted in the interaction region, is being used to digitize charge deposited on each silicon strip. Data from the detectors is routed to custom VME Modules via commercially available high speed optical links. Events are stored in up to 12 memory buffers, waiting for intermediate trigger processing and transport to higher level event processing systems. Overall detector read out systems are described. Individual module and system designs are described.< >
The SiliconMicro-strip Tracker (SMT) at the DØ experiment in the Fermilab Tevatron collider has been operating since 2001. In 2006, an additional layer, referred to as 'Layer 0', was installed to ...improve impact parameter resolution and compensate for detector degradation due to radiation damage to the original innermost SMT layer. The SMT detector provides valuable tracking and vertexing information for the experiment. This contribution will highlight aspects of the long term operation of the SMT, including the impact of the silicon readout test-stand. Due to the full integration of the test-stand into the DØ trigger framework, this test-stand provides an advantageous tool for training of new experts and studying subtle effects in the SMT while minimizing impact on the global data acquisition.
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