Generic detection of coronaviruses and differentiation at the prototype strain level by reverse transcription-PCR and nonfluorescent low-density microarray

A nonfluorescent low-cost, low-density oligonucleotide array was designed for detecting the whole coronavirus genus after reverse transcription (RT)-PCR. The limit of detection was 15.7 copies/reaction. The clinical detection limit in patients with severe acute respiratory syndrome was 100 copies/sample. In 39 children suffering from coronavirus 229E, NL63, OC43, or HKU1, the sensitivity was equal to that of individual real-time RT-PCRs.

The Cost-Effectiveness of Monitoring Strategies for Antiretroviral Therapy of HIV Infected Patients in Resource-Limited Settings: Software Tool.

BACKGROUND The cost-effectiveness of routine viral load (VL) monitoring of HIV-infected patients on antiretroviral therapy (ART) depends on various factors that differ between settings and across time. Low-cost point-of-care (POC) tests for VL are in development and may make routine VL monitoring affordable in resource-limited settings. We developed a software tool to study the cost-effectiveness of switching to second-line ART with different monitoring strategies, and focused on POC-VL monitoring. METHODS We used a mathematical model to simulate cohorts of patients from start of ART until death. We modeled 13 strategies (no 2nd-line, clinical, CD4 (with or without targeted VL), POC-VL, and laboratory-based VL monitoring, with different frequencies). We included a scenario with identical failure rates across strategies, and one in which routine VL monitoring reduces the risk of failure. We compared lifetime costs and averted disability-adjusted life-years (DALYs). We calculated incremental cost-effectiveness ratios (ICER). We developed an Excel tool to update the results of the model for varying unit costs and cohort characteristics, and conducted several sensitivity analyses varying the input costs. RESULTS Introducing 2nd-line ART had an ICER of US$1651-1766/DALY averted. Compared with clinical monitoring, the ICER of CD4 monitoring was US$1896-US$5488/DALY averted and VL monitoring US$951-US$5813/DALY averted. We found no difference between POC- and laboratory-based VL monitoring, except for the highest measurement frequency (every 6 months), where laboratory-based testing was more effective. Targeted VL monitoring was on the cost-effectiveness frontier only if the difference between 1st- and 2nd-line costs remained large, and if we assumed that routine VL monitoring does not prevent failure. CONCLUSION Compared with the less expensive strategies, the cost-effectiveness of routine VL monitoring essentially depends on the cost of 2nd-line ART. Our Excel tool is useful for determining optimal monitoring strategies for specific settings, with specific sex-and age-distributions and unit costs.

A cost-effective surgical navigation solution for periacetabular osteotomy (PAO) surgery

In this chapter a low-cost surgical navigation solution for periacetabular osteotomy (PAO) surgery is described. Two commercial inertial measurement units (IMU, Xsens Technologies, The Netherlands), are attached to a patient’s pelvis and to the acetabular fragment, respectively. Registration of the patient with a pre-operatively acquired computer model is done by recording the orientation of the patient’s anterior pelvic plane (APP) using one IMU. A custom-designed device is used to record the orientation of the APP in the reference coordinate system of the IMU. After registration, the two sensors are mounted to the patient’s pelvis and acetabular fragment, respectively. Once the initial position is recorded, the orientation is measured and displayed on a computer screen. A patient-specific computer model generated from a pre-operatively acquired computed tomography (CT) scan is used to visualize the updated orientation of the acetabular fragment. Experiments with plastic bones (7 hip joints) performed in an operating room comparing a previously developed optical navigation system with our inertial-based navigation system showed no statistical difference on the measurement of acetabular component reorientation (anteversion and inclination). In six out of seven hip joints the mean absolute difference was below five degrees for both anteversion and inclination.

A cost-effective surgical navigation solution for periacetabular osteotomy (PAO) surgery.

PURPOSE To evaluate a low-cost, inertial sensor-based surgical navigation solution for periacetabular osteotomy (PAO) surgery without the line-of-sight impediment. METHODS Two commercial inertial measurement units (IMU, Xsens Technologies, The Netherlands), are attached to a patient's pelvis and to the acetabular fragment, respectively. Registration of the patient with a pre-operatively acquired computer model is done by recording the orientation of the patient's anterior pelvic plane (APP) using one IMU. A custom-designed device is used to record the orientation of the APP in the reference coordinate system of the IMU. After registration, the two sensors are mounted to the patient's pelvis and acetabular fragment, respectively. Once the initial position is recorded, the orientation is measured and displayed on a computer screen. A patient-specific computer model generated from a pre-operatively acquired computed tomography scan is used to visualize the updated orientation of the acetabular fragment. RESULTS Experiments with plastic bones (eight hip joints) performed in an operating room comparing a previously developed optical navigation system with our inertial-based navigation system showed no statistically significant difference on the measurement of acetabular component reorientation. In all eight hip joints the mean absolute difference was below four degrees. CONCLUSION Using two commercially available inertial measurement units we show that it is possible to accurately measure the orientation (inclination and anteversion) of the acetabular fragment during PAO surgery and therefore to successfully eliminate the line-of-sight impediment that optical navigation systems have.

A comparative review of water disinfection methods appropriate for developing countries and their efficacy, cost-efficiency, and usability

Developing countries are heavily burdened by limited access to safe drinking water and subsequent water-related diseases. Numerous water treatment interventions combat this public health crisis, encompassing both traditional and less-common methods. Of these, water disinfection serves as an important means to provide safe drinking water. Existing literature discusses a wide range of traditional treatment options and encourages the use of multi-barrier approaches including coagulation-flocculation, filtration, and disinfection. Most sources do not delve into approaches specifically appropriate for developing countries, nor do they exclusively examine water disinfection methods.^ The objective of this review is to focus on an extensive range of chemical, physio-chemical, and physical water disinfection techniques to provide a compilation, description and evaluation of options available. Such an objective provides further understanding and knowledge to better inform water treatment interventions and explores alternate means of water disinfection appropriate for developing countries. Appropriateness for developing countries corresponds to the effectiveness of an available, easy to use disinfection technique at providing safe drinking water at a low cost.^ Among chemical disinfectants, SWS sodium hypochlorite solution is preferred over sodium hypochlorite bleach due to consistent concentrations. Tablet forms are highly recommended chemical disinfectants because they are effective and very easy to use, but also because they are stable. Examples include sodium dichloroisocyanurate, calcium hypochlorite, and chlorine dioxide, which vary in cost depending on location and availability. Among physio-chemical disinfection options, electrolysis which produces mixed oxidants (MIOX) provides a highly effective disinfection option with a higher upfront cost but very low cost over the long term. Among physical disinfection options, solar disinfection (SODIS) applications are effective, but they treat only a fixed volume of water at a time. They come with higher initial costs but very low on-going costs. Additional effective disinfection techniques may be suitable depending on the location, availability and cost.^

The determinants of improvements in health outcomes and of cost reduction in hospital inpatient care

This study aims to address two research questions. First, ‘Can we identify factors that are determinants both of improved health outcomes and of reduced costs for hospitalized patients with one of six common diagnoses?’ Second, ‘Can we identify other factors that are determinants of improved health outcomes for such hospitalized patients but which are not associated with costs?’ The Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) database from 2003 to 2006 was employed in this study. The total study sample consisted of hospitals which had at least 30 patients each year for the given diagnosis: 954 hospitals for acute myocardial infarction (AMI), 1552 hospitals for congestive heart failure (CHF), 1120 hospitals for stroke (STR), 1283 hospitals for gastrointestinal hemorrhage (GIH), 979 hospitals for hip fracture (HIP), and 1716 hospitals for pneumonia (PNE). This study used simultaneous equations models to investigate the determinants of improvement in health outcomes and of cost reduction in hospital inpatient care for these six common diagnoses. In addition, the study used instrumental variables and two-stage least squares random effect model for unbalanced panel data estimation. The study concluded that a few factors were determinants of high quality and low cost. Specifically, high specialty was the determinant of high quality and low costs for CHF patients; small hospital size was the determinant of high quality and low costs for AMI patients. Furthermore, CHF patients who were treated in Midwest, South, and West region hospitals had better health outcomes and lower hospital costs than patients who were treated in Northeast region hospitals. Gastrointestinal hemorrhage and pneumonia patients who were treated in South region hospitals also had better health outcomes and lower hospital costs than patients who were treated in Northeast region hospitals. This study found that six non-cost factors were related to health outcomes for a few diagnoses: hospital volume, percentage emergency room admissions for a given diagnosis, hospital competition, specialty, bed size, and hospital region.^

Cost and energy efficient reconfigurable embedded platform using Spartan-6 FPGAs

Modern FPGAs with run-time reconfiguration allow the implementation of complex systems offering both the flexibility of software-based solutions combined with the performance of hardware. This combination of characteristics, together with the development of new specific methodologies, make feasible to reach new points of the system design space, and make embedded systems built on these platforms acquire more and more importance. However, the practical exploitation of this technique in fields that traditionally have relied on resource restricted embedded systems, is mainly limited by strict power consumption requirements, the cost and the high dependence of DPR techniques with the specific features of the device technology underneath. In this work, we tackle the previously reported problems, designing a reconfigurable platform based on the low-cost and low-power consuming Spartan-6 FPGA family. The full process to develop the platform will be detailed in the paper from scratch. In addition, the implementation of the reconfiguration mechanism, including two profiles, is reported. The first profile is a low-area and low-speed reconfiguration engine based mainly on software functions running on the embedded processor, while the other one is a hardware version of the same engine, implemented in the FPGA logic. This reconfiguration hardware block has been originally designed to the Virtex-5 family, and its porting process will be also described in this work, facing the interoperability problem among different families.

Digital Control Implementation to Reduce the Cost and Improve the Performance of the Control Stage of an Industrial Switched-Mode Power Supply

The main objective of this work is the design and implementation of the digital control stage of a 280W AC/DC industrial power supply in a single low-cost microcontroller to replace the analog control stage. The switch-mode power supply (SMPS) consists of a PFC boost converter with fixed frequency operation and a variable frequency LLC series resonant DC/DC converter. Input voltage range is 85VRMS-550VRMS and the output voltage range is 24V-28V. A digital controller is especially suitable for this kind of SMPS to implement its multiple functionalities and to keep the efficiency and the performance high over the wide range of input voltages. Additional advantages of the digital control are reliability and size. The optimized design and implementation of the digital control stage it is presented. Experimental results show the stable operation of the controlled system and an estimation of the cost reduction achieved with the digital control stage.

Synthesis of glycerol-based carbon materials as environmental application

Crude glycerol, obtained from the biodiesel production, is actually an abundant and low-cost feedstock, making the preparation of carbonaceous materials by partial carbonization and sulfonation of this by-product an interesting research focus. Bearing this in mind, the aim of this study is to explore several types of glycerol-based carbon materials synthesized by partial carbonization of glycerol in concentrated sulphuric acid solution for the removal of flumequine and tetracycline from aqueous solutions. This study is focused on the synthesis and application of glycerol-based carbon materials as adsorbents for the removal of the antibiotic compounds flumequine and tetracycline from aqueous solution. The different synthesized materials were labelled as GBCM followed by a subscript number corresponding to the activation temperature in oC (i.e., GBCM200, GBCM300, and GBCM350)

A cost-effectiveness analysis of two rehabilitation support services for women with breast cancer

The purpose of this research was to estimate the cost-effectiveness of two rehabilitation interventions for breast cancer survivors, each compared to a population-based, non-intervention group (n = 208). The two services included an early home-based physiotherapy intervention (DAART, n = 36) and a group-based exercise and psychosocial intervention (STRETCH, n = 31). A societal perspective was taken and costs were included as those incurred by the health care system, the survivors and community. Health outcomes included: (a) 'rehabilitated cases' based on changes in health-related quality of life between 6 and 12 months post-diagnosis, using the Functional Assessment of Cancer Therapy - Breast Cancer plus Arm Morbidity (FACT-B+4) questionnaire, and (b) quality-adjusted life years (QALYs) using utility scores from the Subjective Health Estimation (SHE) scale. Data were collected using self-reported questionnaires, medical records and program budgets. A Monte-Carlo modelling approach was used to test for uncertainty in cost and outcome estimates. The proportion of rehabilitated cases was similar across the three groups. From a societal perspective compared with the non-intervention group, the DAART intervention appeared to be the most efficient option with an incremental cost of $1344 per QALY gained, whereas the incremental cost per QALY gained from the STRETCH program was $14,478. Both DAART and STRETCH are low-cost, low-technological health promoting programs representing excellent public health investments.

Fibre optic sensors for high speed hypervelocity impact studies and low velocity drop tests

The initial aim of this project was to develop a non-contact fibre optic based displacement sensor to operate in the harsh environment of a 'Light Gas Gun' (LGG), which can 'fire' small particles at velocities ranging from 1-8.4 km/s. The LGG is used extensively for research in aerospace to analyze the effects of high speed impacts on materials. Ideally the measurement should be made close to the centre of the impact to minimise corruption of the data from edge effects and survive the impact. A further requirement is that it should operate at a stand-off distance of ~ 8cm. For these reasons we chose to develop a pseudo con-focal intensity sensor, which demonstrated resolution comparable with conventional PVDF sensors combined with high survivability and low cost. A second sensor was developed based on 'Fibre Bragg Gratings' (FBG) which although requiring contact with the target the low weight and very small contact area had minimal effect on the dynamics of the target. The FBG was mounted either on the surface of the target or tangentially between a fixed location. The output signals from the FBG were interrogated in time by a new method. Measurements were made on composite and aluminium plates in the LGG and on low speed drop tests. The particle momentum for the drop tests was chosen to be similar to that of the particles used in the LGG.

Fibre optic sensors for high speed hypervelocity impact studies and low velocity drop tests

The initial aim of this project was to develop a non-contact fibre optic based displacement sensor to operate in the harsh environment of a 'Light Gas Gun' (LGG), which can 'fire' small particles at velocities ranging from 1-8.4 km/s. The LGG is used extensively for research in aerospace to analyze the effects of high speed impacts on materials. Ideally the measurement should be made close to the centre of the impact to minimise corruption of the data from edge effects and survive the impact. A further requirement is that it should operate at a stand-off distance of ~ 8cm. For these reasons we chose to develop a pseudo con-focal intensity sensor, which demonstrated resolution comparable with conventional PVDF sensors combined with high survivability and low cost. A second sensor was developed based on 'Fibre Bragg Gratings' (FBG) which although requiring contact with the target the low weight and very small contact area had minimal effect on the dynamics of the target. The FBG was mounted either on the surface of the target or tangentially between a fixed location. The output signals from the FBG were interrogated in time by a new method. Measurements were made on composite and aluminium plates in the LGG and on low speed drop tests. The particle momentum for the drop tests was chosen to be similar to that of the particles used in the LGG.

Novel cost-effective PON-to-mm-wave RoF photonic bridge for multigigabit access networks

A novel low-cost photonic PON-to-RoF bridge is presented, allowing simultaneous wireline and wireless multi-Gbps data transmission with minor impact on deployed PON networks. Simulation results show that the proposed scheme does not require narrow-linewidth lasers when envelope detector mobile terminals are used, since the transmission performance is not limited by the phase noise but by the RIN and the frequency difference between the two beating lasers. © 2013 IEEE.

Cost-efficient OFDM generation at 60-GHz by heterodyne technique with direct modulation and envelope detector

A cost-effective radio over fiber system to up-convert and transmit multigigabit signals at 60 GHz is presented. A low intermediate frequency OFDM signal is used to directly modulate a laser, which is combined with an independent unmodulated laser. The generated millimeter wave frequency can be adjusted by tuning the frequency separation between the lasers. Since no external modulator is required, this technique is low-cost and it is easily integrable in a single chip. In this paper, we present numerical results showing the feasibility of generating an IEEE 802.15.3c compliant 3.5-Gbps 60-GHz OFDM. We show that received signal quality is not limited by the lasers' linewidth but by the relative intensity noise. © 2013 IEEE.

A cost-effective steam-driven RO plant for brackish groundwater

Desalination is a costly means of providing freshwater. Most desalination plants use either reverse osmosis (RO) or thermal distillation. Both processes have drawbacks: RO is efficient but uses expensive electrical energy; thermal distillation is inefficient but uses less expensive thermal energy. This work aims to provide an efficient RO plant that uses thermal energy. A steam-Rankine cycle has been designed to drive mechanically a batch-RO system that achieves high recovery, without the high energy penalty typically incurred in a continuous-RO system. The steam may be generated by solar panels, biomass boilers, or as an industrial by-product. A novel mechanical arrangement has been designed for low cost, and a steam-jacketed arrangement has been designed for isothermal expansion and improved thermodynamic efficiency. Based on detailed heat transfer and cost calculations, a gain output ratio of 69-162 is predicted, enabling water to be treated at a cost of 71 Indian Rupees/m3 at small scale. Costs will reduce with scale-up. Plants may be designed for a wide range of outputs, from 5 m3/day, up to commercial versions producing 300 m3/day of clean water from brackish groundwater.