Cost-minimization analysis of three decision strategies for cardiac revascularization : results of the "suspected CAD"cohort of the european cardiovascular magnetic resonance registry.

BACKGROUND: Coronary artery disease (CAD) continues to be one of the top public health burden. Perfusion cardiovascular magnetic resonance (CMR) is generally accepted to detect CAD, while data on its cost effectiveness are scarce. Therefore, the goal of the study was to compare the costs of a CMR-guided strategy vs two invasive strategies in a large CMR registry. METHODS: In 3'647 patients with suspected CAD of the EuroCMR-registry (59 centers/18 countries) costs were calculated for diagnostic examinations (CMR, X-ray coronary angiography (CXA) with/without FFR), revascularizations, and complications during a 1-year follow-up. Patients with ischemia-positive CMR underwent an invasive CXA and revascularization at the discretion of the treating physician (=CMR + CXA-strategy). In the hypothetical invasive arm, costs were calculated for an initial CXA and a FFR in vessels with ≥50 % stenoses (=CXA + FFR-strategy) and the same proportion of revascularizations and complications were applied as in the CMR + CXA-strategy. In the CXA-only strategy, costs included those for CXA and for revascularizations of all ≥50 % stenoses. To calculate the proportion of patients with ≥50 % stenoses, the stenosis-FFR relationship from the literature was used. Costs of the three strategies were determined based on a third payer perspective in 4 healthcare systems. RESULTS: Revascularizations were performed in 6.2 %, 4.5 %, and 12.9 % of all patients, patients with atypical chest pain (n = 1'786), and typical angina (n = 582), respectively; whereas complications (=all-cause death and non-fatal infarction) occurred in 1.3 %, 1.1 %, and 1.5 %, respectively. The CMR + CXA-strategy reduced costs by 14 %, 34 %, 27 %, and 24 % in the German, UK, Swiss, and US context, respectively, when compared to the CXA + FFR-strategy; and by 59 %, 52 %, 61 % and 71 %, respectively, versus the CXA-only strategy. In patients with typical angina, cost savings by CMR + CXA vs CXA + FFR were minimal in the German (2.3 %), intermediate in the US and Swiss (11.6 % and 12.8 %, respectively), and remained substantial in the UK (18.9 %) systems. Sensitivity analyses proved the robustness of results. CONCLUSIONS: A CMR + CXA-strategy for patients with suspected CAD provides substantial cost reduction compared to a hypothetical CXA + FFR-strategy in patients with low to intermediate disease prevalence. However, in the subgroup of patients with typical angina, cost savings were only minimal to moderate.

Stability of Citrus tristeza virus protective isolate 'Pêra IAC' according to SSCP analysis of old and new lines of three sweet orange varieties

Clonal cleaning, followed by pre-immunization with protective complexes of Citrus tristeza virus(CTV), allowed the commercial cultivation of Pêra sweet orange, a variety that has great importance for Brazilian citriculture but is sensitive to the virus. The use of mild protective isolates in other citrus varieties, even those more tolerant to CTV, can also be of interest to prevent the spread of severe isolates. The aim of this study was to characterize, by means of SSCP (Single Strand Conformational Polymorphism) analysis of the coat protein gene, CTV isolates present in plants of the sweet orange cultivars Pêra, Hamlin and Valencia propagated from four budwood sources: 1) old lines, 2) nucellar lines, 3) shoot-tip-grafted lines, and 4) shoot-tip-grafted lines pre-immunized with the mild CTV protective isolate 'PIAC'. We also evaluated the correlation of the obtained SSCP patterns to stem pitting intensity, tree vigor and fruit yield. SSCP results showed low genetic diversity among the isolates present in different trees of the same variety and same budwood source and, in some cases, in different budwood sources and varieties. Considering tristeza symptoms, lower intensity was noted for plants of new, shoot-tip-grafted and pre-immunized shoot-tip-grafted lines, compared to old lines of the three varieties. The observed SSCP patterns and symptomatology suggested that more severe CTV complexes infect the plants of old lines of all three varieties. The protective complex stability was observed in the SSCP patterns of CTV isolates of some shoot-tip-grafted and pre-immunized clones. It was concluded that the changes detected in other electrophoretic profiles of this treatment did not cause loss of the protective capacity of CTV isolate 'PIAC' inoculated in the pre-immunization.

Molecular detection of Neorickettsia risticii in Brazilian free-tailed bats (Tadarida brasiliensis) from Buenos Aires , Argentina

Neorickettsia risticii is the causative agent of Potomac Horse Fever, a severe febrile disease affecting horses, transmitted by trematodes species with a complex life cycle. A total of 30 insectivorous bats (Brazilian free-tailed bat Tadarida brasiliensis) were analyzed by PCR for presence of genus Anaplasma, Ehrlichia, Neorickettsia and Rickettsia. Three samples showed positive reactions for genus Anaplasma, Ehrlichia and Neorickettsia, and the sequences were 99.67% identical to Neorickettsia risticii. The role of bats in the life cycle of N. risticii has yet to be elucidated; however bats may be reservoirs for this bacterium. To our knowledge, this is the first evidence of N. risticii in Argentina.

Genus Bourrellyodesmus (Desmidiaceae, Zygnemaphyceae) in the state of São Paulo, Brazil

Floristic survey of genus Bourrellyodesmus (Desmidiaceae, Zygnemaphyceae) was based on 149 sample units, 76 of which were already deposited at the Herbário Científico do Estado "Maria Eneyda P. Kauffmann Fidalgo" (SP) of the Instituto de Botânica, Secretaria do Meio Ambiente do Estado de São Paulo, and 73 of which were collected during 2000-2001. Two species of Bourrellyodesmus were identified: B. jolyanus (C. Bicudo & Azevedo) C. Bicudo & Compère e B. guarrerae sp. nov.

Morphological cladistic analysis of Pseudobombax Dugand (Malvaceae, Bombacoideae) and allied genera

(Morphological cladistic analysis of Pseudobombax Dugand (Malvaceae, Bombacoideae) and allied genera). Pseudobombax Dugand belongs to the family Malvaceae subfamily Bombacoideae and aggregates 29 species restricted to the Neotropics. A morphological cladistic analysis of Pseudobombax and allied genera was carried out to test the monophyly of the genus and to provide hypotheses on its phylogeny. Parsimony analyses were based on 40 morphological characters and 28 species, 14 belonging to Pseudobombax and 14 to other species of Bombacoideae, Matisieae (Malvoideae) and Ochromeae. Nine most parsimonious trees (144 steps, ci 0.40, ri 0.67) were produced when 10 multistate characters were taken as ordered while only two most parsimonious trees (139 steps, ci 0.41, ri 0.67) were obtained when all characters were considered as unordered. Pseudobombax monophyly had moderate bootstrap support, appearing as sister to a clade composed of the genera Bombacopsis Pittier and Pachira Aubl., or to the genus Bombax L. according to the analysis. The petiole widened at the apex and the leaflets not jointed to the petiole are probably synapomorphies of Pseudobombax. Three main clades were found in the genus: one characterised by petiolulated leaflets and 5-angular fruits, the other by pubescent leaves and calyx, and the other by reduction of the number of leaflets. The latter includes species endemic to the Brazilian semi-arid region also characterised by the absence of phalanges in the androecium. Interspecific affinities in Pseudobombax as well as the morphological evolution in Bombacoideae are discussed.

The genera Eriochrysis P. Beauv., Imperata Cirillo and Saccharum L. (Poaceae - Andropogoneae - Saccharinae) in the state of Rio Grande do Sul, Brazil

The subtribe Saccharinae belongs to the tribe Andropogoneae and comprises ca. 140 species in 13 genera, including Eriochrysis, Imperata and Saccharum. This work presents a survey of the species of these three genera in the state of Rio Grande do Sul. Intensive field collections were made in different physiographic regions of the state, as well as studies in several herbaria. The occurrence of three native species of each genus was confirmed in Rio Grande do Sul, in addition to sugar cane (Saccharum officinarum) that is cultivated in the region. Based on the material examined, Eriochrysis villosa is reported for the first time in the state of Paraná, Brazil. Identification keys for the species, descriptions, data on their geographical distributions, habitats and flowering and fruiting periods, as well as illustrations of important taxonomic characters are provided.

Analytic evaluation of three-phase short circuit demagnetization and hysteresis loss risk in rotor-surface-magnet Permanent-Magnet Synchronous Machines

Permanent magnet synchronous machines (PMSM) have become widely used in applications because of high efficiency compared to synchronous machines with exciting winding or to induction motors. This feature of PMSM is achieved through the using the permanent magnets (PM) as the main excitation source. The magnetic properties of the PM have significant influence on all the PMSM characteristics. Recent observations of the PM material properties when used in rotating machines revealed that in all PMSMs the magnets do not necessarily operate in the second quadrant of the demagnetization curve which makes the magnets prone to hysteresis losses. Moreover, still no good analytical approach has not been derived for the magnetic flux density distribution along the PM during the different short circuits faults. The main task of this thesis is to derive simple analytical tool which can predict magnetic flux density distribution along the rotor-surface mounted PM in two cases: during normal operating mode and in the worst moment of time from the PM’s point of view of the three phase symmetrical short circuit. The surface mounted PMSMs were selected because of their prevalence and relatively simple construction. The proposed model is based on the combination of two theories: the theory of the magnetic circuit and space vector theory. The comparison of the results in case of the normal operating mode obtained from finite element software with the results calculated with the proposed model shows good accuracy of model in the parts of the PM which are most of all prone to hysteresis losses. The comparison of the results for three phase symmetrical short circuit revealed significant inaccuracy of the proposed model compared with results from finite element software. The analysis of the inaccuracy reasons was provided. The impact on the model of the Carter factor theory and assumption that air have permeability of the PM were analyzed. The propositions for the further model development are presented.

Use of real-time PCR to evaluate two DNA extraction methods from food

The DNA extraction is a critical step in Genetically Modified Organisms analysis based on real-time PCR. In this study, the CTAB and DNeasy methods provided good quality and quantity of DNA from the texturized soy protein, infant formula, and soy milk samples. Concerning the Certified Reference Material consisting of 5% Roundup Ready® soybean, neither method yielded DNA of good quality. However, the dilution test applied in the CTAB extracts showed no interference of inhibitory substances. The PCR efficiencies of lectin target amplification were not statistically different, and the coefficients of correlation (R²) demonstrated high degree of correlation between the copy numbers and the threshold cycle (Ct) values. ANOVA showed suitable adjustment of the regression and absence of significant linear deviations. The efficiencies of the p35S amplification were not statistically different, and all R² values using DNeasy extracts were above 0.98 with no significant linear deviations. Two out of three R² values using CTAB extracts were lower than 0.98, corresponding to lower degree of correlation, and the lack-of-fit test showed significant linear deviation in one run. The comparative analysis of the Ct values for the p35S and lectin targets demonstrated no statistical significant differences between the analytical curves of each target.

Development and optimization of a HPLC-RI method for the determination of major sugars in apple juice and evaluation of the effect of the ripening stage

The sugars in apple juice prove its authenticity and its sensory and nutritional properties. The aim of this study was to develop and validate a simple analytical method using high performance liquid chromatography with refractive index detection (HPLC-RI) to determinate and quantify the sugars sucrose, D-glucose, D-fructose, and D-sorbitol polyol in apple juices, as well as to analyze the juices from the Fuji suprema and Lis Gala cultivars at three ripening stages. The analytical performance parameters evaluated indicated that the method was specific for the compounds analyzed, and the linearity of the calibration curves of sugars showed high correlation coefficients (close to 1.0). The limits of detection and quantification are consistent with recommendations available in the literature for this type of matrix. Sample preparation is simple and generates small amount of residues. Over 70% of the sugars were determined in the juices of apples at the pre-ripe stage, with an increase during senescence. This method is applicable for the determination of sugars in juices and evaluation of apple ripening.

The micromorphology of Paleoseismic soft sediment deformation structures in glacial deposits from three sample sites in Scotland /

The nature of this research is to investigate paleoseismic deformation of glacial soft sediments from three sampling sites throughout the Scottish Highlands; Arrat's Mills, Meikleour and Glen Roy. The paleoseismic evidence investigated in this research will provide a basis for applying criteria to soft sediment deformation structures, and the trigger mechanisms that create these structures. Micromorphology is the tool used in this to investigate paleoseismic deformation structures in thin section. Thin section analysis, (micromorphology) of glacial sediments from the three sampling sites is used to determine microscale evidence of past earthquakes that can be correlated to modem-day events and possibly lead to a better understanding of the impact of earthquakes throughout a range of sediment types. The significance of the three sampling locations is their proximity to two major active fault zones that cross Scotland. The fault zones are the Highland Boundary Fault and the Great Glen Fault, these two major faults that parallel each other and divide the country in half Sims (1975) used a set of seven criteria that identified soft sediment deformation structures created by a magnitude six earthquake in Cahfomia. Using criteria set forth by Sims (1975), the paleoseismic evidence can be correlated to the magnitude of the deformation structures found in the glacial sediments. This research determined that the microstructures at Arrat's Mill, Meikleour and Glen Roy are consistent with a seismically induced origin. It has also been demonstrated that, even without the presence of macrostructures, the use of micromorphology techniques in detecting such activity within sediments is of immense value.

The nesting biology of Ceratina (Hymenoptera: Apidae) in the Niagara Region : new species, nest site selection and parasitism

One of the most common bee genera in the Niagara Region, the genus Ceratina (Hymenoptera: Apidae) is composed of four species, C. dupla, C. calcarata, the very rare C. strenua, and a previously unknown species provisionally named C. near dupla. The primary goal of this thesis was to investigate how these closely related species coexist with one another in the Niagara ~ee community. The first necessary step was to describe and compare the nesting biologies and life histories of the three most common species, C. dupla, C. calcarata and the new C. near dupla, which was conducted in 2008 via nest collections and pan trapping. Ceratina dupla and C. calcarata were common, each comprising 49% of the population, while C. near dupla was rare, comprising only 2% of the population. Ceratina dupla and C. near dupla both nested more commonly in teasel (Dipsacus sp.) in the sun, occasionally in raspberry (Rubus sp.) in the shade, and never in shady sumac (Rhus sp.), while C. calcarata nested most commonly in raspberry and sumac (shaded) and occasionally in teasel (sunny). Ceratina near dupla differed from both C. dupla and C. calcarata in that it appeared to be partially bivoltine, with some females founding nests very early and then again very late in the season. To examine the interactions and possible competition for nests that may be taking place between C. dupla and C. calcarata, a nest choice experiment was conducted in 2009. This experiment allowed both species to choose among twigs from all three substrates in the sun and in the shade. I then compared the results from 2008 (where bees chose from what was available), to where they nested when given all options (2009 experiment). Both C. dupla and C. calcarata had the same preferences for microhabitat and nest substrate in 2009, that being raspberry and sumac twigs in the sun. As that microhabitat and nest substrate combination is extremely rare in nature, both species must make a choice. In nature Ceratina dupla nests more often in the preferred microhabitat (sun), while C. calcarata nests in the preferred substrate (raspberry). Nesting in the shade also leads to smaller clutch sizes, higher parasitism and lower numbers of live brood in C. calcarata, suggesting that C. dupla may be outcompeting C. calcarata for the sunny nesting sites. The development and host preferences of Ceratina parasitoids were also examined. Ceratina species in Niagara were parasitized by no less than eight species of arthropod. Six of these were wasps from the superfamily Chalcidoidea (Hymenoptera), one was a wasp from the family Ichneumonidae (Hymenoptera) and one was a physogastric mite from the family Pyemotidae (Acari). Parasites shared a wide range of developmental strategies, from ichneumonid larvae that needed to consume multiple Ceratina immatures to complete development, to the species from the Eulophidae (Baryscapus) and Encyrtidae (Coelopencyrtus), in which multiple individuals completed development inside a single Ceratina host. Biological data on parasitoids is scarce in the scientific literature, and this Chapter documents these interactions for future research.

Evolutionary Origin and Maintenance of Sociality in the Small Carpenter Bees

Many arthropods exhibit behaviours precursory to social life, including adult longevity, parental care, nest loyalty and mutual tolerance, yet there are few examples of social behaviour in this phylum. The small carpenter bees, genus Ceratina, provide important insights into the early stages of sociality. I described the biology and social behaviour of five facultatively social species which exhibit all of the preadaptations for successful group living, yet present ecological and behavioural characteristics that seemingly disfavour frequent colony formation. These species are socially polymorphic with both / solitary and social nests collected in sympatry. Social colonies consist of two adult females, one contributing both foraging and reproductive effort and the second which remains at the nest as a passive guard. Cooperative nesting provides no overt reproductive benefits over solitary nesting, although brood survival tends to be greater in social colonies. Three main theories explain cooperation among conspecifics: mutual benefit, kin selection and manipulation. Lifetime reproductive success calculations revealed that mutual benefit does not explain social behaviour in this group as social colonies have lower per capita life time reproductive success than solitary nests. Genetic pedigrees constructed from allozyme data indicate that kin selection might contribute to the maintenance of social nesting -, as social colonies consist of full sisters and thus some indirect fitness benefits are inherently bestowed on subordinate females as a result of remaining to help their dominant sister. These data suggest that the origin of sociality in ceratinines has principal costs and the great ecological success of highly eusociallineages occurred well after social origins. Ecological constraints such as resource limitation, unfavourable weather conditions and parasite pressure have long been considered some of the most important selective pressures for the evolution of sociality. I assessed the fitness consequences of these three ecological factors for reproductive success of solitary and social colonies and found that nest sites were not limiting, and the frequency of social nesting was consistent across brood rearing seasons. Local weather varied between seasons but was not correlated with reproductive success. Severe parasitism resulted in low reproductive success and total nest failure in solitary nests. Social colonies had higher reproductive success and were never extirpated by parasites. I suggest that social nesting represents a form of bet-hedging. The high frequency of solitary nests suggests that this is the optimal strategy when parasite pressure is low. However, social colonies have a selective advantage over solitary nesting females during periods of extreme parasite pressure. Finally, the small carpenter bees are recorded from all continents except Antarctica. I constructed the first molecular phylogeny of ceratinine bees based on four gene regions of selected species covering representatives from all continents and ecological regions. Maximum parsimony and Bayesian Inference tree topology and fossil dating support an African origin followed by an Old World invasion and New World radiation. All known Old World ceratinines form social colonies while New World species are largely solitary; thus geography and phylogenetic inertia are likely predictors of social evolution in this genus. This integrative approach not only describes the behaviour of several previously unknown or little-known Ceratina species, bu~ highlights the fact that this is an important, though previously unrecognized, model for studying evolutionary transitions from solitary to social behaviour.

Three works on religious themes : psalmus 150, string quartet on the life of Saint John Paul II and symphony “The Redemption”

Dans cette dissertation, je présente trois pièces sur des thèmes religieux composées au cours de ma maîtrise, ainsi que leur analyse : Psalmus 150 pour chœur de jeunes à trois voix, chœur d'adultes à huit voix et orgue ou piano ; Quatuor à Cordes sur la vie de Saint Jean-Paul II ; et la Symphonie « La Rédemption » pour orchestre et chœur. Malgré les particularités de chacune, elles présentent des aspects communs. L'idée principale des compositions fut d'éviter la rupture avec la tradition tout en apportant des nouvelles idées aux pièces, et de souligner l'importance de ma recherche sur la beauté. À cet égard, certaines techniques contemporaines, ainsi que les sonorités médiévales des quintes et octaves parallèles, furent utilisées en accord avec un langage tonal / modal qui demeure la base des trois compositions. Le chant Grégorien fut aussi une importante caractéristique de ces compositions. Pour mieux comprendre les analyses des œuvres, deux techniques seront expliquées, la douce toile de dissonances linéaires et l'harmonie d'accords parfaits majeurs. L'analyse de chaque pièce est divisée en deux parties. La première est une vision générale et la deuxième est plus détaillée. À la fin, les connaissances acquises par la composition des ces œuvres seront résumées et l'importance intemporelle de la beauté sera réaffirmée.

Finite Element Analysis of Warship Structures

Warships are generally sleek, slender with V shaped sections and block coefficient below 0.5, compared to fuller forms and higher values for commercial ships. They normally operate in the higher Froude number regime, and the hydrodynamic design is primarily aimed at achieving higher speeds with the minimum power. Therefore the structural design and analysis methods are different from those for commercial ships. Certain design guidelines have been given in documents like Naval Engineering Standards and one of the new developments in this regard is the introduction of classification society rules for the design of warships.The marine environment imposes subjective and objective uncertainties on ship structure. The uncertainties in loads, material properties etc.,. make reliable predictions of ship structural response a difficult task. Strength, stiffness and durability criteria for warship structures can be established by investigations on elastic analysis, ultimate strength analysis and reliability analysis. For analysis of complicated warship structures, special means and valid approximations are required.Preliminary structural design of a frigate size ship has been carried out . A finite element model of the hold model, representative of the complexities in the geometric configuration has been created using the finite element software NISA. Two other models representing the geometry to a limited extent also have been created —- one with two transverse frames and the attached plating alongwith the longitudinal members and the other representing the plating and longitudinal stiffeners between two transverse frames. Linear static analysis of the three models have been carried out and each one with three different boundary conditions. The structural responses have been checked for deflections and stresses against the permissible values. The structure has been found adequate in all the cases. The stresses and deflections predicted by the frame model are comparable with those of the hold model. But no such comparison has been realized for the interstiffener plating model with the other two models.Progressive collapse analyses of the models have been conducted for the three boundary conditions, considering geometric nonlinearity and then combined geometric and material nonlinearity for the hold and the frame models. von Mises — lllyushin yield criteria with elastic-perfectly plastic stress-strain curve has been chosen. ln each case, P-Delta curves have been generated and the ultimate load causing failure (ultimate load factor) has been identified as a multiple of the design load specified by NES.Reliability analysis of the hull module under combined geometric and material nonlinearities have been conducted. The Young's Modulus and the shell thickness have been chosen as the variables. Randomly generated values have been used in the analysis. First Order Second Moment has been used to predict the reliability index and thereafter, the probability of failure. The values have been compared against standard values published in literature.

Economics of Hybrid Photovoltaic Power Plants

The global power supply stability is faced to several severe and fundamental threats, in particular steadily increasing power demand, diminishing and degrading fossil and nuclear energy resources, very harmful greenhouse gas emissions, significant energy injustice and a structurally misbalanced ecological footprint. Photovoltaic (PV) power systems are analysed in various aspects focusing on economic and technical considerations of supplemental and substitutional power supply to the constraint conventional power system. To infer the most relevant system approach for PV power plants several solar resources available for PV systems are compared. By combining the different solar resources and respective economics, two major PV systems are identified to be very competitive in almost all regions in the world. The experience curve concept is used as a key technique for the development of scenario assumptions on economic projections for the decade of the 2010s. Main drivers for cost reductions in PV systems are learning and production growth rate, thus several relevant aspects are discussed such as research and development investments, technical PV market potential, different PV technologies and the energetic sustainability of PV. Three major market segments for PV systems are identified: off-grid PV solutions, decentralised small scale on-grid PV systems (several kWp) and large scale PV power plants (tens of MWp). Mainly by application of ‘grid-parity’ and ‘fuel-parity’ concepts per country, local market and conventional power plant basis, the global economic market potential for all major PV system segments is derived. PV power plant hybridization potential of all relevant power technologies and the global power plant structure are analyzed regarding technical, economical and geographical feasibility. Key success criteria for hybrid PV power plants are discussed and comprehensively analysed for all adequate power plant technologies, i.e. oil, gas and coal fired power plants, wind power, solar thermal power (STEG) and hydro power plants. For the 2010s, detailed global demand curves are derived for hybrid PV-Fossil power plants on a per power plant, per country and per fuel type basis. The fundamental technical and economic potentials for hybrid PV-STEG, hybrid PV-Wind and hybrid PV-Hydro power plants are considered. The global resource availability for PV and wind power plants is excellent, thus knowing the competitive or complementary characteristic of hybrid PV-Wind power plants on a local basis is identified as being of utmost relevance. The complementarity of hybrid PV-Wind power plants is confirmed. As a result of that almost no reduction of the global economic PV market potential need to be expected and more complex power system designs on basis of hybrid PV-Wind power plants are feasible. The final target of implementing renewable power technologies into the global power system is a nearly 100% renewable power supply. Besides balancing facilities, storage options are needed, in particular for seasonal power storage. Renewable power methane (RPM) offers respective options. A comprehensive global and local analysis is performed for analysing a hybrid PV-Wind-RPM combined cycle gas turbine power system. Such a power system design might be competitive and could offer solutions for nearly all current energy system constraints including the heating and transportation sector and even the chemical industry. Summing up, hybrid PV power plants become very attractive and PV power systems will very likely evolve together with wind power to the major and final source of energy for mankind.