Impact of delisting high‐strength opioid formulations from a public drug benefit formulary on opioid utilization in Ontario, Canada

Introduction Ontario delisted high-strength fentanyl, hydromorphone and morphine from the public drug formulary for non-palliative care prescribers on 31 January, 2017. Our aim is to assess the early impact of this policy on prescribing patterns and to examine whether this impact varied by prescriber type, opioid type and opioid strength. Methods We conducted a population-based, cross-sectional study on palliative and non-palliative care patients dispensed fentanyl, hydromorphone or morphine through the Ontario public drug program between 1 January, 2014, and 31 July, 2017. For each month during the study period, we reported the total number of high-strength opioid recipients stratified by prescriber type, and the total volume of each drug dispensed, stratified by strength. We used interventional autoregressive integrated moving average (ARIMA) models to assess the policy’s impact on prescribing patterns. Results We observed a 98% decrease in the total number of publicly funded recipients of high-strength opioids between December 2016 and July 2017 (5930 to 133 recipients) for all prescribers. The policy led to a significant decline in the total volume of all three opioids dispensed: hydromorphone from 20 374 621 to 16 952 097 mg (p $lt; .01); morphine from 40 644 190 to 33 555 480 mg (p $lt; .03); and fentanyl from 9 604 913 to 5 842 405 mcg/h (p $lt; .01). For both fentanyl and hydromorphone, this reduction generally corresponded to an increase in the number of low-strength opioids dispensed. Conclusion Delisting high-strength opioids substantially reduced the number of highstrength opioid recipients and reduced the overall volume of long-acting opioids dispensed in Ontario through the public drug program. Future studies should examine its impact on patient outcomes.

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Decomposition of the metastable beta titanium alloy Ti-15-3

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100075117 ◽

1983 ◽

Vol 41 ◽

pp. 264-265

Author(s):

Y. L. Chen ◽

S. Fujlshiro

Keyword(s):

Low Cost ◽

High Strength ◽

Alpha Phase ◽

Thick Sheet ◽

Omega Phase ◽

Beta Titanium Alloy ◽

Beta Titanium ◽

Beta Matrix ◽

Metastable Beta ◽

Very High

Metastable beta titanium alloys have been known to have numerous advantages such as cold formability, high strength, good fracture resistance, deep hardenability, and cost effectiveness. Very high strength is obtainable by precipitation of the hexagonal alpha phase in a bcc beta matrix in these alloys. Precipitation hardening in the metastable beta alloys may also result from the formation of transition phases such as omega phase. Ti-15-3 (Ti-15V- 3Cr-3Al-3Sn) has been developed recently by TIMET and USAF for low cost sheet metal applications. The purpose of the present study was to examine the aging characteristics in this alloy.The composition of the as-received material is: 14.7 V, 3.14 Cr, 3.05 Al, 2.26 Sn, and 0.145 Fe. The beta transus temperature as determined by optical metallographic method was about 770°C. Specimen coupons were prepared from a mill-annealed 1.2 mm thick sheet, and solution treated at 827°C for 2 hr in argon, then water quenched. Aging was also done in argon at temperatures ranging from 316 to 616°C for various times.

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Effects of cooling rate on the mechanical properties of dual phase treated vanadium steels

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100074896 ◽

1983 ◽

Vol 41 ◽

pp. 220-221

Author(s):

L.J. Chen ◽

H.C. Cheng ◽

J.R. Gong ◽

J.G. Yang

Keyword(s):

Mechanical Properties ◽

Cooling Rate ◽

Automobile Industry ◽

High Strength ◽

Weight Percent ◽

Low Alloy Steels ◽

Dual Phase ◽

Resource Requirement ◽

Alloy Steels ◽

Potential Weight

For fuel savings as well as energy and resource requirement, high strength low alloy steels (HSLA) are of particular interest to automobile industry because of the potential weight reduction which can be achieved by using thinner section of these steels to carry the same load and thus to improve the fuel mileage. Dual phase treatment has been utilized to obtain superior strength and ductility combinations compared to the HSLA of identical composition. Recently, cooling rate following heat treatment was found to be important to the tensile properties of the dual phase steels. In this paper, we report the results of the investigation of cooling rate on the microstructures and mechanical properties of several vanadium HSLA steels.The steels with composition (in weight percent) listed below were supplied by China Steel Corporation: 1. low V steel (0.11C, 0.65Si, 1.63Mn, 0.015P, 0.008S, 0.084Aℓ, 0.004V), 2. 0.059V steel (0.13C, 0.62S1, 1.59Mn, 0.012P, 0.008S, 0.065Aℓ, 0.059V), 3. 0.10V steel (0.11C, 0.58Si, 1.58Mn, 0.017P, 0.008S, 0.068Aℓ, 0.10V).

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The Nature of Delta Phase Precipitation in Inconel 718

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100055916 ◽

1982 ◽

Vol 40 ◽

pp. 724-725

Author(s):

L. S. Lin ◽

C. C. Law

Keyword(s):

Inconel 718 ◽

Base Alloy ◽

High Strength ◽

Physical Metallurgy ◽

Nickel Base Alloy ◽

Phase Precipitation ◽

Weight Percentage ◽

Delta Phase ◽

The Subject ◽

Nickel Base

Inconel 718, a precipitation hardenable nickel-base alloy, is a versatile high strength, weldable wrought alloy that is used in the gas turbine industry for components operated at temperatures up to about 1300°F. The nominal chemical composition is 0.6A1-0.9Ti-19.OCr-18.0Fe-3Mo-5.2(Cb + Ta)- 0.1C with the balance Ni (in weight percentage). The physical metallurgy of IN 718 has been the subject of a number of investigations and it is now established that hardening is due, primarily, to the formation of metastable, disc-shaped γ" an ordered body-centered tetragonal structure (DO2 2 type superlattice).

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Physical, Chemical, and Crystallographic Characterization of Anodic Coatings on High Strength Aluminum Base Alloys

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100093146 ◽

1976 ◽

Vol 34 ◽

pp. 636-637

Author(s):

R. E. Herfert ◽

N. T. McDevitt

Keyword(s):

Sulfuric Acid ◽

Salt Spray ◽

High Strength ◽

Environmental Stability ◽

Anodic Films ◽

Sodium Dichromate ◽

Corrosion Resistant ◽

Aerospace Applications ◽

Bond Strengths ◽

Adhesive Bonded Joints

Durability of adhesive bonded joints in moisture and salt spray environments is essential to USAF aircraft. Structural bonding technology for aerospace applications has depended for many years on the preparation of aluminum surfaces by a sulfuric acid/sodium dichromate (FPL etch) treatment. Recently, specific thin film anodizing techniques, phosphoric acid, and chromic acid anodizing have been developed which not only provide good initial bond strengths but vastly improved environmental durability. These thin anodic films are in contrast to the commonly used thick anodic films such as the sulfuric acid or "hard" sulfuric acid anodic films which are highly corrosion resistant in themselves, but which do not provide good initial bond strengths, particularly in low temperature peel.The objective of this study was to determine the characteristics of anodic films on aluminum alloys that make them corrosion resistant. The chemical composition, physical morphology and structure, and mechanical properties of the thin oxide films were to be defined and correlated with the environmental stability of these surfaces in humidity and salt spray. It is anticipated that anodic film characteristics and corrosion resistance will vary with the anodizing processing conditions.

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HREM interface studies in SiC-whisker-reinforced Al2O3 and Si3N4 ceramics

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100105734 ◽

1988 ◽

Vol 46 ◽

pp. 734-735

Author(s):

W. Braue ◽

R.W. Carpenter ◽

D.J. Smith

Keyword(s):

Analytical Data ◽

Base Material ◽

High Strength ◽

Ceramic Composites ◽

Good Thermal Stability ◽

All Ceramic ◽

Sic Whiskers ◽

Base Composite ◽

C 30 ◽

Si3n4 Ceramics

Whisker and fiber reinforcement has been established as an effective toughening concept for monolithic structural ceramics to overcome limited fracture toughness and brittleness. SiC whiskers in particular combine both high strength and elastic moduli with good thermal stability and are compatible with most oxide and nonoxide matrices. As the major toughening mechanisms - crack branching, deflection and bridging - in SiC whiskenreinforced Al2O3 and Si3N41 are critically dependent on interface properties, a detailed TEM investigation was conducted on whisker/matrix interfaces in these all-ceramic- composites.In this study we present HREM images obtained at 400 kV from β-SiC/α-Al2O3 and β-SiC/β-Si3N4 interfaces, as well as preliminary analytical data. The Al2O3- base composite was hotpressed at 1830 °C/60 MPa in vacuum and the Si3N4-base material at 1725 °C/30 MPa in argon atmosphere, respectively, adding a total of 6 vt.% (Y2O3 + Al2O3) to the latter to promote densification.

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Precipitation in Al-Li-Zr alloys

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100121338 ◽

1992 ◽

Vol 50 (1) ◽

pp. 186-187

Author(s):

D.M. Vanderwalker

Keyword(s):

Fracture Toughness ◽

Precipitation Hardening ◽

Weight Ratio ◽

High Strength ◽

Transmission Electron ◽

Water Quench ◽

Aluminum Lithium ◽

Aluminum Lithium Alloys ◽

Lithium Alloys ◽

Zr Alloys

Aluminum-lithium alloys have a low density and high strength to weight ratio. They are being developed for the aerospace industry.The high strength of Al-Li can be attributed to precipitation hardening. Unfortunately when aged, Al-Li aquires a low ductility and fracture toughness. The precipitate in Al-Li is part of a sequence SSSS → Al3Li → AlLi A description of the phases may be found in reference 1 . This paper is primarily concerned with the Al3Li phase. The addition of Zr to Al-Li is being explored to find the optimum in properties. Zirconium improves fracture toughness and inhibits recrystallization. This study is a comparision between two Al-Li-Zr alloys differing in Zr concentration.Al-2.99Li-0.17Zr(alloy A) and Al-2.99Li-0.67Zr (alloy B) were solutionized for one hour at 500oc followed by a water quench. The specimens were then aged at 150°C for 16 or 40 hours. The foils were punched into 3mm discs. The specimens were electropolished with a 1/3 nitric acid 2/3 methanol solution. The transmission electron microscopy was conducted on the JEM 200CX microscope.

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Microstructure of an extruded rapidly solidified Al-8Fe-2Mo alloy

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100144218 ◽

1986 ◽

Vol 44 ◽

pp. 548-549

Author(s):

W. T. Donlon ◽

J. E. Allison ◽

S. Shinozaki

Keyword(s):

Electron Microscopy ◽

Automotive Industry ◽

Fuel Economy ◽

High Strength ◽

Al Alloys ◽

Light Weight ◽

Thin Sections ◽

Strength And Durability ◽

Rapidly Solidified ◽

Whitney Aircraft

Light weight materials which possess high strength and durability are being utilized by the automotive industry to increase fuel economy. Rapidly solidified (RS) Al alloys are currently being extensively studied for this purpose. In this investigation the microstructure of an extruded Al-8Fe-2Mo alloy, produced by Pratt & Whitney Aircraft, Goverment Products Div. was examined in a JE0L 2000FX AEM. Both electropolished thin sections, and extraction replicas were examined to characterize this material. The consolidation procedure for producing this material included a 9:1 extrusion at 340°C followed by a 16:1 extrusion at 400°C, utilizing RS powders which have also been characterized utilizing electron microscopy.

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