AimsTo estimate the healthcare costs attributable to diabetes in Ontario, Canada using a propensity‐matched control design and health administrative data from the perspective of a single‐payer healthcare system.MethodsIncident diabetes cases among adults in Ontario were identified from the Ontario Diabetes Database between 2004 and 2012 and matched 1:3 to control subjects without diabetes identified in health administrative databases on the basis of sociodemographics and propensity score. Using a comprehensive source of administrative databases, direct per‐person costs (Canadian dollars 2012) were calculated. A cost analysis was performed to calculate the attributable costs of diabetes; i.e. the difference of costs between patients with diabetes and control subjects without diabetes.ResultsThe study sample included 699 042 incident diabetes cases. The costs attributable to diabetes were greatest in the year after diagnosis [C$3,785 (95% CI 3708, 3862) per person for women and C$3,826 (95% CI 3751, 3901) for men], increasing substantially for older age groups and patients who died during follow‐up. After accounting for baseline comorbidities, attributable costs were primarily incurred through inpatient acute hospitalizations, physician visits and prescription medications and assistive devices.ConclusionsThe excess healthcare costs attributable to diabetes are substantial and pose a significant clinical and public health challenge. This burden is an important consideration for decision‐makers, particularly given increasing concern over the sustainability of the healthcare system, aging population structure and increasing prevalence of diabetic risk factors, such as obesity.
Particle morphological features at different scale levels hold the key to understanding the geological origin and mechanical behaviour of natural sands. In this context, it is necessary to characterise and quantify these morphological features by defining a series of reasonable descriptors. In this study, based on X-ray micro-computed tomographic (μCT) images collected from a series of image-processing techniques, the authors first introduced spherical harmonic analysis to reconstruct a three-dimensional (3D) realistic surface of the sand particles. Then 3D sphericity, roundness and fractal dimension were introduced to define the global form, local features and surface textures of the particle morphology. Based on the spherical harmonic-reconstructed surface, a novel framework was established to measure the descriptors of 3D sphericity, roundness and fractal dimension of sand particles. The 3D fractal dimension was an original descriptor used to characterise the fractal nature of the surface textures of real sand particle morphology. By using the proposed methods, these morphological descriptors were measured for two types of natural sand particle. The statistical results show clear correlations between different descriptors at different characteristic scales. The correlation relies heavily upon the distance between the characteristic scales of the morphological descriptors.
Boiling and fouling are taken as typical examples of new phase formation process to be analyzed and discussed in this paper. The process dynamics of nucleate boiling is analyzed and its mechanism is discussed from the view point of self-organization. Fouling, which is a more complicated phenomenon of new phase formation, involves series of underlying processes. The morphology and fractal analysis of fouling on low-energy surface and that with fouling inhibitors are studied and discussed. It is suggested that considering the process dynamics, fractal analysis and self-organization, a new avenue of research should be found.
Compressive fracture is one of the most common failure patterns in geotechnical engineering. For better understanding of the local failure mechanism of compressive fractures of brittle geomaterials, three compressive fracture tests were conducted on sandstone. Edge cracked semicircular bend specimens were used and, consequently, fresh and unfilled compressive fracture surfaces were obtained. A laser profilometer was employed to measure the topography of each rough fracture surface, followed by fractal analysis of the irregularities of the obtained compression-induced fracture surfaces using the cubic cover method. To carry out a contrastive analysis with the results of compressive fracture tests, three tension mode fracture tests were also conducted and the fractal features of the obtained fracture surfaces were determined. The obtained average result of the fractal dimensions of the compression-induced surfaces was 2.070, whereas the average result was 2.067 for the tension-induced fracture surfaces. No remarkable differences between the fractal dimensions of the compression-induced and tension-induced fracture surfaces may indicate that compressive fracture may occur, at least on the investigative scale of this work, in a similar manner to tension fracture.
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