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Developing applications for the by-products obtained from waste processing is vital for resource recovery. The synthesis of ZnCl2-activated biochar with high electrocatalytic activity was carried out by the microwave-assisted pyrolysis of pineapple peel and subsequent chemical activation process. Activated biochar is employed in the electrochemical sensing of nitrite by drop casting in a glassy carbon electrode (GCE). The activated biochar exhibited a stacked carbon sheet, 254 m2 g−1 Brunauer, Emmett and Teller (BET) surface area, 0.076 cm3 g−1 pore volume, 189.53 m2 g−1 micropore area and oxygen-containing functional groups. The electrochemical impedance spectroscopy of the modified GCE showed a reduced charge transfer resistance of 61%. This is crucial to determine the electrochemical properties of biochar. The sensor showed a significant current response and an excellent limit of detection of 0.97 µmol L−1. The modified-activated biochar electrochemical sensor demonstrated high selectivity, reproducibility (RSD=2.4%), and stability (RSD=2.6%). Graphical abstract

Background Uremic pruritus has an impact on the quality of life and sleep of hemodialysis patients, but the majority of cases go unreported and untreated unless severe, due to a lack of awareness. The purpose of this study is to determine the prevalence, associated factors, and impact on health-related quality of life (HR-QOL) and sleep in hemodialysis patients. Methodology A single-center observational study of 3 months wherein 120 adults on maintenance hemodialysis were included. Baseline characteristics, dialysis-related factors, and lab parameters influencing uremic pruritus were recorded. Those with uremic pruritus completed “12-item pruritus severity scale (12-PSS)”, “SKINDEX10”, and “Itch-MOS” questionnaires to evaluate severity, impact on HR-QOL, and sleep respectively. Results Sixty seven over one hundred twenty (55.83%) patients had pruritus and majority were mild (40.83%) as per 12-PSS. Those with pruritus (n=67) had a mean age of 56.5±11.3 years, most were males (82%), chronic glomerulonephritis (29.1%) was the commonest cause of end-stage kidney disease, 3 active smokers, and 4 seropositive. 65(97%) patients were on twice-weekly dialysis, 36/67 had Conclusion The majority of patients on maintenance hemodialysis experience uremic pruritus. None of the clinical characteristics, dialysis-related factors, and laboratory parameters affected uremic pruritus. Uremic pruritus patients had the worst HR-QOL & their sleep quality significantly declined as pruritus severity escalated. Trial registration number and date of registration Study approval was obtained from Institutional Research Committee and Institutional Ethical Committee (IEC 642/2021). Clinical Trial Registry of India (CTRI) registration (CTRI/2022/01/039143) was also obtained.

Graphene is a highly sought-after material for a wide range of applications, particularly in areas such as energy harvesting and storage, electronics, electrochemical sensors, biomedical, composites, and coatings. The synthesis of high-quality graphene is a precondition for its real-time application. However, conventional synthesis methods have certain drawbacks including laborious procedures and structural defects in graphene nanosheets. Plasma-based synthesis techniques such as plasma-enhanced chemical vapor deposition and atmospheric pressure microwave plasma are high-tech synthesis practices that can produce graphene without any solvents in a few seconds. This article reviews these state-of-the-art techniques emphasizing mainly their process parameters for the synthesis of high-grade graphene, which is defect-free, and comprises mono to few layers, great carrier mobility, and high purity. The applications of as-synthesized graphene in various fields are also provided. Moreover, the potential breakthroughs and the prospect of these techniques are also discussed in this work.

The purpose of this study was to evaluate the peri-operative outcomes of patients with Prader–Willi Syndrome (PWS) undergoing spinal deformity correction and compare the outcomes to patients with adolescent idiopathic scoliosis (AIS). A retrospective review of the Kid’s Inpatient Database was performed from 2000 to 2012 to identify all pediatric patients with scoliosis undergoing spinal fusion. Cohorts were created on the basis of PWS diagnosis and adolescent idiopathic scoliosis. Statistical analysis was performed for differences in post-operative outcomes between these two patient cohorts. Between 2000 and 2012, the number of spinal fusions performed increased by 24.6 and 32.2% in the PWS and adolescent idiopathic scoliosis populations, respectively. There was no difference between the incidence of major complications in PWS patients when compared to AIS (1.7% vs. 1.0% in idiopathic scoliosis; p = 0.362). Although there was no significant difference in the rate of overall minor complications, PWS patients were demonstrated to be more likely to experience post-operative pneumonia (p

Antifouling/antibacterial coating derived from a sustainable natural resource for biomedical devices have shown promising outcomes, especially in the prevention of bacterial growth. Herein, pulse-plasma chemical vapour deposition is used to fabricate antimicrobial coatings from Terpinen-4-ol, a tea tree oil-based precursor. In this manuscript, during RF plasma polymerisation, pulsed plasma is used to retain the pristine monomer structure in the developed stable coating and thereby enhance its antibacterial activity. The developed films have tunable physical and chemical properties. Diverse film surface properties were obtained by varying the plasma deposition parameters, mainly the deposition mode (pulse and continuous wave) and duty cycle. The role of film wettability on degree of bacterial attachment has been elucidated. Overall, the number of viable bacteria on all the deposited coatings (25–30%) were reduced to half with respect to the control (56%).

This work reports analog implementation of $$\hbox {PI}^\lambda \hbox {D}^\mu $$ controller realized by solid-state fractional capacitor. The fractional integrator is implemented with a solid-state fractional capacitor fabricated by the authors, and the fractional differentiator circuit is implemented using optimal pole–zero interlacing algorithm. The paper proposes a tuning algorithm for finding the parameters of the fractional $$\hbox {PI}^{\lambda }\hbox {D}^{\mu }$$ controller to get the desired time domain performance. Using the tuning algorithm, the combinations of $$\lambda $$, $$\mu $$ and gain values of the controller are evaluated on a DC motor emulator to limit % overshoot $$\le $$ 12% and settling time < 13 ms. The performance of the controller (with $$\lambda = \mu = 0.4$$) on speed regulation of DC motor emulator has also been discussed in detail both in simulation and in hardware.

Integrated battery chargers (IBCs) provide the flexibility of reusing the electric drive-train components of the electric vehicle (EV) for the charging operation. The purpose of the paper is to reuse its traction inverter and motor windings as rectifier and grid interfacing filter, respectively for charging and keeping rotor standstill without using any external brake. Various winding configurations are developed by splitting the three-phase induction motor (IM) winding into two parts at zero electrical degree to keep the rotor standstill. The different stator winding connections are proposed for IM which restricts the formation of rotating magnetic field (RMF). Cases are categorized into two parts, in the first part, RMF is cancelled to zero and in the other part, RMF is converted into pulsating magnetic field (PMF). Mathematical investigation for torque production in both cases is provided to prove that the proposed winding connections are incapable of developing electromagnetic torque in machine. Mathematical findings are validated by experimentation on split three-phase IM (STP-IM). This analysis is useful in identifying the nature of torque developed in motor during charging operation of EV.

Study Design Retrospective, chart review. Objectives The identification and management of pelvic obliquity in neuromuscular scoliosis can be difficult; therefore, appropriate evaluation of this pathology is important. Variations in presentation have resulted in various methods of measurement, without a consensus or gold standard measurement. This study is the evaluation of reliability of five methods commonly used to determine pelvic obliquity in the frontal plane. Summary of Background Data Previous studies have used five different methods (ie, the Maloney method, the O'Brien method, the Osebold method, the Allen and Ferguson method, and the Lindseth method) to determine pelvic obliquity in the frontal plane. Methods Radiographic images of 50 patients with neuromuscular scoliosis involving the pelvic girdle were identified and evaluated by a team of 5 raters. Each rater was instructed to apply five commonly used methods of measuring pelvic obliquity. The same raters were asked to rate the same radiographs again after a minimum of one month. The interobserver reliability was assessed using the intraclass correlation coefficient (ICC) and the intraobserver analysis was assessed using the Pearson correlation. A rating greater than 0.8 was considered excellent reliability. Results The Maloney method showing the highest interobserver reliability of ICC of 0.965 and 0.964. The Lindseth method had the lowest ICC, but all the methods were considered highly reliable by the rating classification system. The Maloney method also showed the highest intraobserver reliability, ranging from 0.845 to 0.962. The Allen and Ferguson method had the lowest intraobserver reliability. Conclusions Many of the methods tested had excellent reliability in this study, but our data suggest the Maloney method is the most reliable method of measuring pelvic obliquity on a frontal view radiograph. Level of Evidence Level III, retrospective, comparative study.

The present study describes an environmentally friendly approach to fabricate hydrocarbon-rich polymer thin films from a bio-renewable precursor, orange oil, cold extracted from orange peels using radio frequency plasma polymerization. The polymer thin films fabricated at different RF power level (10–75 W) were characterized with variable angle spectroscopic ellipsometry, UV–visible spectroscopy, Fourier transform infrared spectroscopy and atomic force microscopy. Optical characterization showed that independent of deposition power films exhibited good transparency (~ 90%) in the visible region and a refractive index of 1.55 at 500 nm. The optical band gap measured around 3.60 eV and falls within the insulating region. The atomic force microscopic images revealed that the surface is pinhole-free in nature and smooth at nanoscale, with average surface roughness dependent on the deposition power. Film hardness increased from 0.50 to 0.78 GPa as applied power increased from 10 to 75 W.

Plasma polymers such as polyterpenol have been investigated for use as biofunctional coatings, insulating/dielectric layers in electronics, and adhesion promoting interlayers in organic electronics. The commercialisation of plasma polymers in these and other biomaterial-related applications is contingent upon their ability to resist degradation in response to sterilising and potentially damaging ionising radiation, such as gamma rays. Hence, this study focusses on the stability of plasma polymerised polyterpenol thin films following exposure to gamma radiation doses ranging from 0 to 100 kGy. Irradiated films were subjected to ellipsometry, current–voltage, dielectric, Fourier transform infrared, and atomic force microscopy characterisation. Stability of polyterpenol was evidenced by the observed lack of radiation-induced variation in its complex refractive index, optical band gap, relative permittivity, dc conductivity, surface chemical functionalities, and surface morphology.

This paper presents the implementation of fractional order PID (FO-PID) controller using hardwired modules of constant phase element (CPE). A new approach of phase shaping by slope cancellation of asymptotic phase plots for zeros and poles within the given bandwidth is realized. Analog circuits, which exhibit analog fractional-order integrator and fractional-order differentiator, are used for building the FO-PID controller. The design procedure is developed to obtain the optimal pole---zero pairs and respective "Fractance" components to realize for any value of fractional differ-integrator. These CPE elements give minimum error tolerance over the set phase value by using commercially available (R---C) components and Op-Amps. The pole---zero location in the root locus plot with constant asymptotic angle under various feed-forward gains is achieved with these analog integrodifferential circuits of the FO-PID. The iso-damping feature of the controller is practically demonstrated. A comparative performance is demonstrated under various settings of feed forward gains, which indicate the constant overshoot with FO-PID against the conventional PID. These circuits are developed and implemented with a DC motor emulator to confirm the designed performance of the controller.

The aim of paper is to employ digital fractional order proportional integral derivative (FO-PID) controller for speed control of buck converter fed DC motor. Optimal pole-zero approximation method in discrete form is proposed for realization of digital fractional order controller. The stand-alone controller is implemented on embedded platform using digital signal processor TMS320F28027. The five tuning parameters of controller enhance the performance of control scheme. For tuning of the controller parameters, dynamic particle swarm optimization technique is employed. The proposed control scheme is simulated on MATLAB and verified by experimental results. Performance comparison shows better speed control of separately excited DC motor with the realized digital FO-PID controller than that of the integer order PID controller.

The five-phase induction motor inherently has the minimal torque ripple. However, when it is controlled by direct torque control (DTC) technique, the torque ripple increases due to the presence of a hysteresis torque comparator. The classical five-level torque comparator is presented in the previous literatures to control the torque ripple. However, this comparator has the drawback of wrong selection of zero voltage vectors inside the inner band on the positive side of the comparator, which enables the torque ripple to increase and dc-link utilization to decrease. In this paper, in order to reduce the torque ripple and to increase the dc-link utilization, a modified five-level torque comparator is proposed, which selects either medium or small voltage vectors instead of zero voltage vectors inside the inner band on the positive side of the comparator. In addition to torque ripple reduction and improvement in dc-link utilization, the proposed comparator significantly improves the quality of phase current. All the available 32 voltage vectors are selected through the proposed five-level torque comparator based on the location of x–y stator flux in order to eliminate the x–y stator flux so as to obtain reduced distortion in the phase current. By employing all the available voltage vectors, the freedom of utilization of all voltage vectors in the five-phase induction motor DTC drive is availed. The proposed five-level torque comparator is compared to its classical five-level counterpart through simulation and experimental results in order to validate the proposed DTC strategy.

To succeed, business organisations need comprehensive competency development to continuously churn out talent. However, existing approaches are inadequate because they focus on specific technicalities, people and internal firm matters, rather than tackling the issues in a comprehensive manner. We address this deficiency by testing a framework that integrates three concepts—core competencies, dynamic competencies and learning organisation—in an under-researched context: banks’ risk management functions. Our survey of 135 risk management professionals yielded a five-factor framework. The proposed framework guides competency development more comprehensively in that it integrates the three concepts hitherto studied in isolation. It is also systematic and practical given its overarching and expandable dimensions.

This paper presents a new open-loop speed estimation method for a three-phase induction motor drive. The open-loop speed estimators available in literature have the advantage of reduced computational stress over the observers but they share a common limitation of being largely dependent on flux and machine parameters. They involve integrations and differentiation in the algorithm that leads to serious error in estimation when subject to different operating conditions. The proposed estimator is based on synchronous speed tracking and is cost-effective. It is immune to any variation in machine parameters and noise. The synchronous speed is computed from stator frequency which is estimated on-line using the stator current signals. A unique, non-adaptive method for estimation of stator frequency within one-sixteenth of time period is also proposed to enhance the speed of estimation. Computer simulation and experimentation on a 2.2 kW Field oriented controlled induction motor drive is carried out to verify the performance of proposed speed estimator. The results show excellent response over a wide range of rotor speed in both directions including low speed and under different operating conditions. This confirms the effectiveness of the proposed method.

The voltage fluctuations caused by rapid industrial load change have been a major concern for supply utilities, regulatory agencies and customers. This paper gives a general review about how to examine/assess voltage flicker and methods followed in measuring the flickers due to rapid changing loads and means for its mitigation. It discusses the effects on utilities conditions, compensators response time and compensator capacity of flicker mitigation. A comparison between conventional mitigation techniques and the state-of-art mitigation techniques are carried out. It is shown in many cases that the state-of-art solution provides higher performance compared with conventional mitigation techniques. However, the choice of most suitable solution depends on characteristics of the supply at the point of connection, the requirement of the load and economics.

This article presents low-temperature, one-step dry synthesis of optically transparent thermally-stable, biocompatible cis−β−ocimene-based thin films for applications as interlayer dielectric and encapsulating layer for flexible electronic devices, e.g. OLEDs. Morphological analysis of thin films shows uniform, very smooth (Rq

Contact angle and temperature-dependent variable angle spectroscopic ellipsometry measurements have been performed on plasma-deposited linalyl acetate thin films in order to provide insight into the compatibility of the material with current organic electronic fabrication techniques. XPS data on several substrates confirmed that the chemical properties of the thin films were substrate independent. The plasma-deposited layers were found to be insoluble in many solvents commonly used in the deposition of organic semiconducting layers, including chloroform and dichlorobenzene, and the wetting envelope for the surfaces presented. Thermal degradation was found to begin at ~200 °C, and up until this temperature the material’s thickness, refractive index and transparency in the visible region were constant. The exhibited properties show plasma-deposited linalyl acetate thin films to be compatible with state of the art organic electronic processing techniques.

Biomaterials play a fundamental role in disease management and the improvement of health care. In recent years, there has been a significant growth in the diversity, function, and number of biomaterials used worldwide. Yet, attachment of pathogenic microorganisms onto biomaterial surfaces remains a significant challenge that substantially undermines their clinical applicability, limiting the advancement of these systems. The emergence and escalating pervasiveness of antibiotic-resistant bacterial strains makes the management of biomaterial-associated nosocomial infections increasingly difficult. The conventional post-operative treatment of implant-caused infections using systemic antibiotics is often marginally effective, further accelerating the extent of antimicrobial resistance. Methods by which the initial stages of bacterial attachment and biofilm formation can be restricted or prevented are therefore sought. The surface modification of biomaterials has the potential to alleviate pathogenic biofouling, therefore preventing the need for conventional antibiotics to be applied.

Organic plasma polymers are currently attracting significant interest for their potential in the areas of flexible optoelectronics and biotechnology. Thin films of plasma-polymerized polyterpenol fabricated under varied deposition conditions were studied using nanoindentation and nanoscratch analyses. Coatings fabricated at higher deposition power were characterized by improved hardness, from 0.33 GPa for 10 W to 0.51 GPa for 100 W at 500-μN load, and enhanced wear resistance. The elastic recovery was estimated to be between 0.1 and 0.14. Coatings deposited at higher RF powers also showed less mechanical deformation and improved quality of adhesion. The average (Ra) and root mean square (Rq) surface roughness parameters decreased, from 0.44 nm and 0.56 nm for 10 W to 0.33 nm and 0.42 nm for 100 W, respectively.

Thin films of the n-type, organic semiconductor PDI-8CN2 were thermally evaporated on two different dielectric surfaces and their optical and morphological properties investigated using Variable Angle Spectroscopic Ellipsometry (VASE) and Atomic Force Microscopy (AFM), respectively. The two dielectric surfaces used were SiO2 and a plasma polymer derived from the non-synthetic monomer linalyl acetate. The characterisations were performed in order to assess the viability of plasma polymerised linalyl acetate (PLA) thin films as dielectric layers in future Organic Field-Effect Transistor (OFET) devices. These studies resulted in determination of the optical profiles (refractive index and extinction coefficient) in the UV-Vis band of PDI-8CN2 grown on SiO2 and an observation of uniaxial anisotropy in the organic semiconductor. This information is useful for the design of opto-electronic devices using PDI-8CN2 layers. Variations in morphological properties and small variations optical properties were found when the PDI-8CN2 films were grown on PLA layers, and attributed to the change in surface chemistry between dielectrics.

The development of novel organic polymer thin films is essential for the advancement of many emerging fields including organic electronics and biomedical coatings. In this study, the effect of synthesis conditions, namely radio frequency (rf) deposition power, on the material properties of polyterpenol thin films derived from nonsynthetic environmentally friendly monomer was investigated. At lower deposition powers, the polyterpenol films preserved more of the original monomer constituents, such as hydroxy functional groups; however, they were also softer and more hydrophilic compared to polymers fabricated at higher power. Enhanced monomer fragmentation and consequent reduction in the presence of the polar groups in the structure of the high-power samples reduced their optical band gap value from 2.95 eV for 10 W to 2.64 eV for 100 W. Regardless of deposition power, all samples were found to be optically transparent with smooth, defect-free, and homogenous surfaces.

MgTe2O5 ceramics were prepared by solid-state route. These materials were sintered in the temperature range of 640–720 °C. The structure and microstructure of the compound was investigated using x-ray diffraction (XRD), Fourier transform infrared (FTIR), Raman spectroscopy, and scanning electron microscopy (SEM) techniques. The dielectric properties of the ceramics were studied in the frequency range 4–6 GHz. The MgTe2O5 ceramics have a dielectric constant (ϵr) of 10.5, quality factors (Qu × f) of 61000 at 5.3 GHz, and temperature coefficient of resonant frequency (τf) of −45 ppm/°C at the optimized sintering temperature of 700 °C. The microwave dielectric properties of these materials at cryogenic temperatures were also investigated.

Pine litter flame is a weakly ionised medium. Electron-neutral collisions are a dominant form of particle interaction in the flame. Assuming flame electrons to be in thermal equilibrium with neutrals and average electron-neutral collision frequency to be much higher than the plasma frequency, the propagation of microwaves through the flame is predicted to suffer signal intensity loss. A controlled fire burner was constructed where various natural vegetation species could be used as fuel. The burner was equipped with thermocouples and used as a cavity for microwaves with a laboratory quality network analyzer to measure wave attenuation. Electron density and collision frequency were then calculated from the measured attenuation. The parameters are important for numerical prediction of electromagnetic wave propagation in wildfire environments. A controlled pine litter fire with a maximum flame temperature of 1080 K was set in the burner and microwaves (8–10.5 GHz) were caused to propagate through the flame. A microwave signal loss of 1.6–5.8 dB was measured within the frequency range. Based on the measured attenuation, electron density and electron-neutral collision frequency in pine fire were calculated to range from 0.51–1.35 × 1016 m−3 and 3.43–5.97 × 1010 s−1 respectively.

It has been shown in the past that a random uncertainty in surface resistance measurements of HTS films as low as 1.1% can be achieved. However for comparative studies between differing samples and different laboratories the absolute uncertainty should be used instead. In this paper we discuss random and absolute uncertainties of R S measurements for three types of superconducting thin films, namely YBa2Cu3O7−δ, Tl(Ba,Sr)2Ca2Cu3Oy, and MgB2 when using an optimized Hakki–Coleman dielectric resonator.

Assessing the cost effectiveness of a new health intervention often requires modelling to estimate the impact of the intervention on cost, survival and quality of life over the lifetime of a cohort of patients. Markov modelling is a methodology that is commonly employed to estimate these long-term costs and benefits. As commonly used, these models assume that the patients continue to get the treatments assigned regardless of the change in health states. In this paper, we describe an extension to the Markov modelling approach, called Markov decision modelling. Such a model starts with a set of health states and treatments and optimally assigns treatments to each of the health states. A Markov decision model can be used to identify the optimal treatment strategy not just for the initial disease state, but also as the disease state changes over time. We present a dynamic programming approach to identifying the optimal assignment of treatments, and illustrate this methodology using an example. The Markov decision modelling approach provides an efficient way of identifying optimal assignment of treatments to health states, but, like the standard Markov model, may be of limited use when probabilities of future events depend on past history in a complex fashion. Even with its limitations, Markov decision models offer an opportunity for health economists to inform healthcare decision-makers on how to modify current treatment pathways to incorporate new treatments as they become available.

Yttrium Vanadate (YVO4) is a birefringent crystal, which has similar dielectric constant as that of Sapphire. In this paper we have reported the measurement of the real part of permittivity and loss tangent of YVO4 crystal in the temperature range 15–295 K at a frequency of 16.3 GHz. We have used the dielectric post resonator technique for the microwave characterisation of the YVO4 dielectric rod. The multifrequency Transmission Mode Q-Factor (TMQF) technique has been used for data processing and hence precise values of permittivity and loss tangent are achieved. Easily machineable YVO4 is characterized by low losses at microwave frequencies. At temperature of 15 K and frequency of 16.3 GHz the permittivity was 9.23 and loss tangent was 2 × 10− 5. YVO4 is identified as a potential candidate to replace expensive Sapphire in many microwave applications.

We have precisely measured the surface resistance (R S )of high quality YBCO thin films, deposited on Lanthanum Aluminate and Silver doped YBCO thin films on Cesium buffered Sapphire substrates using the Hakki-Coleman dielectric resonator at frequency of 10 GHz as a function of temperature from 25 K to 85 K. We have also studied the microwave power dependence of YBCO films on both substrates and the frequency dependence of films on LAO. Precise microwave characterisation of HTS films is needed for selection of best films for mobile phone base station receivers.

This paper summarizes the different methods used to estimate confidence intervals for cost-effectiveness ratios, along with their main strengths and weaknesses. We then examine the cost-effectiveness panel’s recommendation on how to use these confidence intervals in decision making. We conclude that the guidelines on the use of confidence intervals need to be based in decision theory, and that further work is needed to guide the use of confidence intervals in health care decision making. We propose Bayesian analysis as a promising theoretical framework for integrating uncertainty into health economic analysis.

We have modeled surface impedance of YBa2Cu3O7−δ thin films, using an exponential dependence on an applied rf magnetic field. For verification of the model we compared simulation results with experimental data of Nguyen et al. [2] and of Hein [14] at differing temperatures, frequencies and rf power levels. Obtained temperature dependence of the model fitting coefficients exhibited the same character in both cases.

Pramipexole was recently approved in the US for treatment of the symptoms of idiopathic Parkinson's disease (PD). Although pramipexole has been found to be safe and efficacious when compared with placebo, little data are yet available on its cost effectiveness when compared with baseline treatment. The aim of this study was to estimate the costs and cost effectiveness (cost utility) of pramipexole compared with baseline treatment in patients with early and advanced PD.We developed a cost-effectiveness (CE) model in the US setting that linked Unified Parkinson's Disease Rating Scale (UPDRS) Part II (activities of daily life) and III (motor) scores to disease progression, costs and patient utility. Data for the model were obtained from clinical trials, a literature review and a survey of 193 patients' health resource use and utility. We used cost and quality-adjusted life-year (QALY) estimates from the model to estimate the incremental cost effectiveness of pramipexole relative to baseline treatment patterns. We performed separate analyses for patients with early and advanced PD. We also performed extensive sensitivity analyses by adding other dopamine agonists to the no-pramipexole treatment regimen and varying disease progression parameters. The study was conducted from the societal perspective, although data presentation allows interpretation of cost effectiveness from either the societal or payer perspective.For patients with both early and advanced PD, treatment with pramipexole had higher costs but was more effective than baseline treatment. For patients with early onset of PD, the incremental total CE ratio for pramipexole was $US8837/QALY. For patients with advanced PD, the incremental CE ratio was $US12 294/QALY (1997 costs). These ratios were lower than the CE ratios of many widely used medical treatments.Subject to the inherent limitations of modelling chronic disease progression and subsequent healthcare costs and patient utility, the results suggested that pramipexole was a cost effective treatment for patients with early and advanced PD in the US.

Pneumocystis carinii pneumonia (PCP) is the most common severe opportunistic infection, and one of the most costly, among people with AIDS. Over 50% of patients experience toxic effects of the major anti-PCP medications- cotrimoxazole (trimethoprim-sulfamethoxazole) and pentamidine. Recently, the US Food and Drug Administration approved a new oral drug therapy, atovaquone, as an alternative to pentamidine for the treatment of people with mild-to-moderate PCP who are intolerant of cotrimoxazole. We developed a decision tree model to estimate the costs and cost effectiveness of atovaquone therapy compared with intravenous pentamidine therapy for cotrimoxazole-intolerant patients with mild-to-moderate PCP. Clinical outcomes were based on data from a phase III trial comparing the 2 medications. Our economic outcomes were based on treatment algorithms derived from discharge data, published reports and the clinical judgement of the co-authors. We estimate the total expected cost of treating a patient for an episode of PCP with atovaquone to be $US3990 compared with $US6545 for pentamidine under our baseline scenario (1995 dollars). Our decision model also provides insight into the large cost-savings benefits of treating mild-to-moderate PCP on an outpatient basis.

This paper contributes a novel methodology for operations analysis of computer integrated manufacturing systems. The methodology employs an integrated set of personal computer-based manufacturing systems modelling software, and is conducted in three stages. The methodology is illustrated in detail for analysis of materials flow and staffing for a flexible manufacturing system (FMS) installed at a medical instruments manufacturing plant. First, a rough-cut capacity and materials flow analysis was performed using a queueing model. Second, a detailed analysis of FMS system characteristics was conducted by creating and analysing a discrete-event simulation model. Finally, a graphical animation package was used to verify previous results and provide visual feedback on FMS system performance. Analysis results were obtained rapidly and conveniently, and were used to advise manufacturing managers regarding FMS operating policy. This analysis methodology can be applied to a wide range of computer integrated manufacturing systems and manufacturing cells.

Background Two nuclear localization sequences (NLS) in influenza A virus nucleoprotein (NP) have been demonstrated to be critical for nuclear import of NP and viral ribonucleoprotein complexes. However, a deletion mutant lacking these two signals was still able to localize to the nucleus suggesting the presence of yet another (a third) potential NLS in the NP protein. In order to identify the nature of this potential NLS signal in the NP of a WS/33L influenza virus A strain, we utilized the tools of bioinformatics coupled with functional experimental analyses in the present study. Results Comparison of the deduced aa sequence of NP of WS/33L strain with the published WS/33 NP sequences revealed that a single amino acid (aa) change (Met to Arg) at position 105 results in converting the flanking regions (between aa position 90–121, a 32-residue stretch) into two classical overlapping bipartite NLS (obpNLS). GenBank search revealed that 9 out of 500 published NP sequences contain a similar Arg at position 105 (instead of Met) with a 100% homology to the obpNLS region. Various NP-green fluorescent protein (GFP) fusion constructs with and without the signal (obpNLS-Arg105) were utilized to understand the functional nature of this signal. We analyzed the transport competency of the expressed chimeric proteins in terms of their cellular localization by confocal immunofluorescence assay. Our analysis revealed that all NP-GFP constructs containing the wild-type (R105) sequence localized predominantly to the nucleus. Constructs lacking the obpNLS or constructs with reverse mutation (R105 to M105) on the other hand exhibited predominant cytoplasmic localization pattern. Interestingly, when the 32 aa obpNLS was fused with an unrelated viral protein (rotavirus NSP6) that has been known to be cytoplasmic protein, the chimeric protein (obpNLS-NSP6) was efficiently transported into the nucleus, indicating an efficient nuclear transport function of the 32-residue obpNLS in the NP of WS/33L strain of influenza A virus. Conclusion This report while not only establishing a new NLS in the influenza A virus strain, it also reinforces the idea that proper application of bioinformatics-coupled experimental analysis serves as a powerful tool in identifying new functional signals in proteins of interest.