To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Traditional decision rules have limitations when a new technology is less effective and less costly than a comparator. We propose a new probabilistic decision framework to examine non-inferiority in effectiveness and net monetary benefit (NMB) simultaneously. We illustrate this framework using the example of repetitive transcranial magnetic stimulation (rTMS) and electroconvulsive therapy (ECT) for treatment-resistant depression.
We modeled the quality-adjusted life-years (QALYs) associated with the new intervention (rTMS), an active control (ECT), and a placebo control, and we estimated the fraction of effectiveness preserved by the new intervention through probabilistic sensitivity analysis (PSA). We then assessed the probability of cost-effectiveness using a traditional cost-effectiveness acceptability curve (CEAC) and our new decision-making framework. In our new framework, we considered the new intervention cost-effective in each simulation of the PSA if it preserved at least 75 percent of the effectiveness of the active control (thus demonstrating non-inferiority) and had a positive NMB at a given willingness-to-pay threshold (WTP).
rTMS was less effective (i.e., associated with fewer QALYs) and less costly than ECT. The traditional CEAC approach showed that the probabilities of rTMS being cost-effective were 100 percent, 39 percent, and 14 percent at WTPs of $0, $50,000, and $100,000 per QALY gained, respectively. In the new decision framework, the probabilities of rTMS being cost-effective were reduced to 23 percent, 21 percent, and 13 percent at WTPs of $0, $50,000, and $100,000 per QALY, respectively.
This new framework provides a different perspective for decision making with considerations of both non-inferiority and WTP thresholds.
To investigate the feasibility of critical congenital heart disease (CCHD) screening test by pulse oximetry in four geographical regions of Turkey with different altitudes, before implementation of a nationwide screening program.
It was a prospective multi-centre study performed in four centres, between December, 2015 and May, 2017. Pre- and post-ductal oxygen saturations and perfusion indices (PI) were measured using Masimo Radical-7 at early postnatal days. The results were evaluated according to the algorithm recommended by the American Academy of Pediatrics. Additionally, a PI value <0.7 was accepted to be significant.
In 4888 newborns, the mean screening time was 31.5 ± 12.1 hours. At first attempt, the mean values of pre- and post-ductal measurements were: saturation 97.3 ± 1.8%, PI 2.8 ± 2.0, versus saturation 97.7 ± 1.8%, PI 2.3±1.3, respectively. Pre-ductal saturations and PI and post-ductal saturations were the lowest in Centre 4 with the highest altitude. Overall test positivity rate was 0.85% (n = 42). CCHD was detected in six babies (0.12%). Of them, right hand (91 ± 6.3) and foot saturations (92.1 ± 4.3%) were lower compared to ones with non-CCHD and normal variants (p <0.05, for all comparisons). Sensitivity, specificity, positive and negative predictive values, and likelihood ratio of the test were: 83.3%, 99.9%, 11.9%, 99.9%, and 99.2%, respectively.
This study concluded that pulse oximetry screening is an effective screening tool for congenital heart disease in newborns at different altitudes. We support the implementation of a national screening program with consideration of altitude differences for our country.
The citrus leafminer (CLM), Phyllocnistis citrella Stainton causes injury to citrus and related species in the Rutaceae family. The damage that the CLM larvae can cause is significant in citrus plantations. We tested two citrus cultivars — ‘Kinnow’ (Citrus reticulata Blanco) and ‘Fairchild’ (a hybrid of Citrus reticulata Clementine x Orlando Tangelo) — to quantify CLM larvae infestation and effect on the physiology of the citrus cultivars. We then compared the CLM larval weight with its associated damage. To calculate infestation level, mine area and total leaf area, we used the image analysis technique. The infestation level of CLM was higher in ‘Fairchild’ than in ‘Kinnow’ cultivar of citrus. For both cultivars, larval weight of CLM was directly proportional to the amount of mines generated. Taken together, the results of this study suggest that the mines that CLM larvae generate pose significant effect on the net photosynthetic rates and water use efficiency of citrus nursery plants. These results will help improve our understanding of the interaction between CLM and citrus nursery plants and effect of the pest on the yield potential of the crop.
One of the ways to obtain a detailed 3D ISM map is by gathering interstellar (IS) absorption data toward widely distributed background target stars at known distances (line-of-sight/LOS data). The radial and angular evolution of the LOS measurements allow the inference of the ISM spatial distribution. For a better spatial resolution, one needs a large number of the LOS data. It requires building fast tools to measure IS absorption. One of the tools is a global analysis that fit two different diffuse interstellar bands (DIBs) simultaneously. We derived the equivalent width (EW) ratio of the two DIBs recorded in each spectrum of target stars. The ratio variability can be used to study IS environmental conditions or to detect DIB family.
The State of Qatar experienced a sandstorm on the night of April 1, 2015, lasting approximately 12 hours, with winds of more than 100 km/h and average particulate matter of approximately 10 μm in diameter. The emergency department (ED) of the main tertiary hospital in Qatar managed 62% of the total emergency calls and those of higher triage order. The peak load of patients during the event manifested approximately 6 hours after the onset. The Major Emergency Command Centre of the hospital ensured the department was maximally organized in terms of disaster management, and established protocols were brought into action. Multiple timely meetings were convened in efforts to effectively execute plans that included rapid emergency medical services handover time, resourcing staff, maximizing bed space, preventing dust entry in the ED, bypassing certain administrative processes, canceling day-surgeries that did not affect inpatient morbidity, and procuring additional respiratory equipment. Patients arrived mainly with exacerbations of asthma and respiratory distress, ophthalmic emergencies, and vehicular trauma; surprisingly, the incidence of pedestrian injuries did not vary. (Disaster Med Public Health Preparedness. 2017;11:227–238)
Two-fluid quantum magnetohydrodynamic (QMHD) equations are employed to investigate linear and nonlinear properties of the magnetosonic waves in a semi-relativistic dense plasma accounting for degenerate relativistic electrons. In the linear analysis, a plane wave solution is used to derive the dispersion relation of magnetosonic waves, which is significantly modified due to relativistic degenerate electrons. However, for a nonlinear investigation of solitary and shock waves, we employ the reductive perturbation technique for the derivation of Korteweg–de Vries (KdV) and Korteweg–de Vries Burger (KdVB) equations, admitting nonlinear wave solutions. Numerically, it is shown that the wave frequency decreases to attain a lowest possible value at a certain critical number density
, and then increases beyond
as the plasma number density increases. Moreover, the relativistic electrons and associated pressure degeneracy lead to a reduction in the spatial extents of the magnetosonic waves and a strengthening of the shock amplitude. The results might be important for understanding the linear and nonlinear magnetosonic excitations in dense astrophysical plasmas, such as in white dwarfs, magnetars and neutron stars, etc., where relativistic degenerate electrons are present.
The formation and propagation characteristics of small-amplitude magnetoacoustic dark/grey solitons are investigated in a semi relativistic degenerate magnetoplasma whose constituents are electrons and singly ionized positive ions. For this purpose, the electrons are assumed to follow the degeneracy pressure law through the Chandrasekhar equation of state, while the inertial cold ions are taken as non-degenerate and magnetized. By solving the one-fluid quantum magnetohydrodynamic (QMHD) model with the aid of a reductive perturbation technique, a nonlinear Schrödinger (NLS) equation is derived for weakly nonlinear envelope magnetoacoustic solitons. The NLS equation admits the existence of stable excitations, e.g. dark and grey solitons for which the condition
holds. Numerical results reveal that the variation of plasma number density, magnetic field strength, relativistic parameter
and the quantum parameter
significantly modify the profiles of the envelope magnetoacoustic solitons. The present results are important to understanding of the nonlinear dynamics of magnetoacoustic solitons in astrophysical dense magnetoplasmas (viz., white dwarfs, magnetars, neutron stars, etc.), where the relativistic degeneracy effects play a vital role in collective interactions.
Remittances to developing countries sent through official channels were estimated at USD 406 billion in 2012 (World Bank, 2012). This represents a growth of 6.5 per cent over 2011 and is projected to rise by 8 per cent in 2013 and 10 per cent in 2014. Current remittance flows are over three times the amount of official development assistance (World Bank, 2012). In Pakistan, remittances through official channels have grown from just around USD 1.5 billion in 1997/98 to slightly over USD 13 billion in 2011/12 (State Bank of Pakistan, n.d.; see also Table 11.1). In the first six months (July– December 2012), they were slightly over USD 7 billion—an increase of 12 per cent over the corresponding period in the previous year (July–December 2011).
An earlier study (Amjad, Arif, & Irfan, 2012) analyzes the possible reasons for this manifold increase and in its preliminary findings suggests that the increase is primarily due to (i) a shift from unofficial (and unrecorded) channels (hawala) to official channels; (ii) an increase in the number of migrants abroad; and (iii) a rise in migrants' skill levels, resulting in higher wages and incomes abroad. The study also makes the important observation that the inflow of remittances is not just from Pakistani workers abroad but from the larger Pakistani diaspora, many of whom may have acquired nationality of their country of residence. The study also infers that official remittance flows also reflect shifts in the diaspora's savings and assets to their home country.
Amjad et al. (2012) also attempt a rough estimate of the volume of remittances coming through both official and unofficial channels. This is based on estimates of the size of the Pakistani diaspora, as reported by different sources, as well as the average volume of remittances sent, based on recent survey data. The range of these estimates suggests that total remittances could be as high as 180 per cent of official recorded remittances.
A low-resistance back contact for n-CdS/p-CdTe solar cells has been developed, which utilizes a thermally evaporated MoOx thin film as the buffer layer between the p-CdTe and the back electrode. The low-resistance behavior of back contact is attributed to the high work function of MoOx, which reportedly is as high as 6.8 eV, and thus adequately matches that of p-CdTe. With MoOx as the buffer, a variety of common metals, even those with a low work function such as Al, have been found to be useful as the electrode in forming the back contact. Other advantages of the MoOx buffer include dry application by vacuum deposition, and thus it is particularly suitable for the fabrication of ultra-thin CdTe solar cells without introducing additional shorting defects. Surface cleaning of CdTe films prior to MoOx deposition has also been studied. The cell stability has been evaluated through thermal annealing tests. Thermal degradation has been explained in terms of oxidation of the metal electrodes. CdTe cells with high efficiency and good stability have been demonstrated with MoOx as the back contact buffer and Ni as the electrode.
Chemical Mechanical Planarization (CMP) occurs at an atomic level at the slurry/wafer interface and hence slurries and polishing pads play a critical role in the successful implementation of this process. Surface roughness, visco-elastic properties, thickness and pore size also play an important role in this process. Unfortunately the mechanical properties of polyurethane polishing pads used in CMP are poorly understood. Here we have studied the mechanical and visco-elastic properties and surface morphology of CMP pads using nano-indentation and dynamic mechanical analysis along with high resolution scanning electron microscopy. A state-of-the-art Universal Micro-Tribometer was used to measure the pad deformation behavior under load. A novel non-destructive scanning ultrasonic transmission technique was also used to characterize inhomogeneity of the visco-elastic properties of full-size CMP pads. Results obtained by different techniques were analyzed to demonstrate methods for quick and reliable evaluation of pad quality for current CMP technology.
Discontinuously reinforced aluminum (DRA) composites with enhanced fracture toughness have recently been developed at ALCOA. The approach consists of producing a composite microstructure in which discrete ductile phases have been incorporated into the DRA through traditional powder processing routes. In the present paper, the high strain rate behavior of these toughened composites is investigated by obtaining (i) the dynamic flow characteristics at various levels of elevated strain rates using a split Hopkinson compression bar, and (ii) energy absorption during dynamic crack initiation and crack propagation using three-point bend specimens loaded on a modified Hopkinson bar configuration.
Mechanical properties of thin films differ significantly from those of bulk materials due to the effects of interfaces, microstructure and thick underlying substrates. In this study we will present the results of nanoindentation tests to evaluate mechanical properties of nitride (TiN, ZrN, CrN, TiCN and TiAlN) thin films. Films were coated on steel substrates using cathodic arc deposition technique. Surface morphology and roughness of the samples are investigated using atomic force microscopy (AFM). Films were also characterized by x-ray diffraction (XRD) technique. Nanoindentation technique along with AFM and XRD methods are very useful for characterizing hard thin coatings.
An agglomerate made of solid particles held together by
a viscous liquid phase when
sheared in an otherwise dry granular material is observed to deform by
This observation, based on experimental results, is confirmed in the present
means of a computer simulation model. Simulations as well as experimental
indicate that the degree of deformation by stretching, a critical factor
the stability of such agglomerates, is governed by a dimensionless parameter
system, called the deformation Stokes number, Stdef.
Two regimes, involving high and
low characteristic degrees of deformation, can be identified based upon
the value of
this number. Simulation results indicate that for the range of conditions
the value separating the two regimes, the critical deformation Stokes
is relatively insensitive to the agglomerate size and other parameters
of the system.
This critical number defines the conditions below which forces inducing
breakage are low and above which they are high and result in agglomerate
break-up. Calculation and/or measurement of this parameter is
essential for prediction of
equilibrium sizes of agglomerates in industrial granulation operations.
Email your librarian or administrator to recommend adding this to your organisation's collection.