The influence of marketing factors and substance characteristics on pharmaceutical sales in a state-controlled prescriptions pharmaceuticals market

The present dissertation investigates the influence of brand as well as substance-related marketing attributes on prescription pharmaceutical sales within a state-controlled market. For this purpose, a systematic literature review was conducted in the first instance, during which knowledge about the most relevant research within this field was gathered. Consequently, over 538 publications were reviewed and indicated as being potentially relevant, leading to an eventual count of 98 core publications. However, most of these studies had been conducted in the mainly unrestricted US market. These findings were then summarised and statistically evaluated. In a second step, based on the literature review, a qualitative study, containing focus and Delphi groups, was then performed. The participants in these studies were involved in pharmaceutical marketing within a state-controlled prescriptions pharmaceuticals market. Consequently, the findings were slightly different to those derived by the systematic literature review. Based on this second step, seven hypotheses were proposed. In the third step, these hypotheses were tested, using collected data and a secondary market dataset provided by a market research institute. A statistical analysis was then performed, applying descriptive as well as multiple regression analytical methods. The evaluation of the results resulted in a conceptual model of physician targeting, leading to several theoretical, methodological and managerial implications.

Experimental investigation of performance, emission and combustion characteristics of an indirect injection multi-cylinder CI engine fuelled by blends of de-inking sludge pyrolysis oil with biodiesel

De-inking sludge can be converted into useful forms of energy to provide economic and environmental benefits. In this study, pyrolysis oil produced from de-inking sludge through an intermediate pyrolysis technique was blended with biodiesel derived from waste cooking oil, and tested in a multi-cylinder indirect injection type CI engine. The physical and chemical properties of pyrolysis oil and its blends (20 and 30 vol.%) were measured and compared with those of fossil diesel and pure biodiesel (B100). Full engine power was achieved with both blends, and very little difference in engine performance and emission results were observed between 20% and 30% blends. At full engine load, the brake specific fuel consumption on a volume basis was around 6% higher for the blends when compared to fossil diesel. The brake thermal efficiencies were about 3-6% lower than biodiesel and were similar to fossil diesel. Exhaust gas emissions of the blends contained 4% higher CO2 and 6-12% lower NOx, as compared to fossil diesel. At full load, CO emissions of the blends were decreased by 5-10 times. The cylinder gas pressure diagram showed stable engine operation with the 20% blend, but indicated minor knocking with 30% blend. Peak cylinder pressure of the 30% blend was about 5-6% higher compared to fossil diesel. At full load, the peak burn rate of combustion from the 30% blend was about 26% and 12% higher than fossil diesel and biodiesel respectively. In comparison to fossil diesel the combustion duration was decreased for both blends; for 30% blend at full load, the duration was almost 12% lower. The study concludes that up to 20% blend of de-inking sludge pyrolysis oil with biodiesel can be used in an indirect injection CI engine without adding any ignition additives or surfactants.

Correlations between optimal temporal width and spectral characteristics of an optical signal in a wavelength-paired CS-RZ transmission with high spectral efficiency

We examine the correlations between the parameters of ultra-narrow off-centred filtering and pulse width on the performance of a wavelength paired Nx40Gbit/s DWDM transmission, consisting of carrier suppressed return-to-zero signal with 0.64 bit/s/Hz (without polarization-division multiplexing) spectral efficiency.

Analysis of secretory, immunostaining and clinical characteristics of human "functionless" pituitary adenomas:transdifferentiation or gonadotropinomas?

In this study, the central technique of in vitro culture has been used to further investigate whether LH/FSH-expressing, but clinically "functionless" pituitary adenomas are gonadotropinomas or whether their hormone secretion is due to transdifferentiation events. 664 "functionless" pituitary adenomas were examined for hormone secretion by in vitro culture and for hormone content by immunostaining. The results were correlated with the clinical findings. 40% of the tumours (n = 263) secreted at least one of the gonadotropins alone, 8% (n = 53) exhibited various patterns of anterior pituitary hormones, whilst the remaining 52% of tumours were not associated with any hormone. In the secretory tumours, immunostaining revealed only a few scattered hormone-containing cells (5 to 15%). Mild hyperprolactinaemia was observed in some cases, presumably because of pressure effects of the tumours. The majority of the patients suffered clear cut hypopituitarism (p < 0.05). Pre-operatively, gonadotropin hypersecretion was observed in 3 cases, but only one of these secreted hormones in culture. Interestingly, a higher proportion of tumours removed from patients with hypopituitarism showed secretory activity in vitro than those tumours removed from patients showing no hormonal dysfunction or hyperprolactinaemia. We conclude that the term "gonadotropinoma" to describe functionless pituitary tumours associated with LH and/or FSH secretion is a misnomer, because the presence of LH and/or FSH confirmed by in vitro methods in the present series is a result of only a few scattered cells. We suggest that primary pituitary tumour cells differentiate into a secretory type (transdifferentiation), possibly in response to altered serum hormone levels such as decreased steroids. Further work is required to identify the factors which trigger the altered cells' characteristics. © J. A. Barth Verlag in Georg Thieme Verlag KG.

Contracts for the sale of land and personal property:the equitable interests of the purchaser

As property lawyers, we are all familiar with the general principle that a contract for the sale of land, which is capable of specific performance, operates in equity so as to confer a trust on the purchaser pending completion of the sale. Although some controversy exists as to the exact nature of the trust, it is well established that, upon exchange of contracts, equity will ‘‘treat that as done which ought to be done’’1 with the consequence that the purchaser acquires equitable ownership even though full (legal) title to the land will not pass until completion (and registration). As land is unique, specific performance is readily available in the context of sales of land where damages would, clearly, not be an adequate remedy. The same cannot be said for contracts for the purchase of personal property where invariably the subject matter is not unique and where a substitute can easily be acquired in the open market. In circumstances, however, where the property is unique or scarce (for example, a rare painting or vintage car), the maxim that ‘‘equity treats as done that which ought to be done’’ may be invoked so as to confer on the seller an equitable obligation to transfer the property to the purchaser in fulfilment of the contract. Where, therefore, the contract is specifically enforceable in this way, the seller, it is submitted, will again hold the property on trust for the purchaser where, as in a contract for the sale of land, there is an interval between the date of the contract and completion of the sale. The notion that a seller holds personal property upon trust for the purchaser pending completion of the sale is admittedly controversial, but this article seeks to argue that the same principles governing equity’s intervention in sales of land should apply in the context of sales of personalty. It is submitted that equity’s role in imposing a trust on the vendor both in relation to sales of land and personalty may be important in safeguarding the interests of the purchaser prior to, as well as after, completion of the transaction.

Annealing and spectral characteristics of femtosecond laser inscribed long period gratings written into a photonic crystal fibre

A series of LPGs with the same period was inscribed by femtosecond laser into photonic crystal fibre with various powers. All suffered post-fabrication spectral evolution at low temperatures, apparently related to inscription power.

Correlations between optimal temporal width and spectral characteristics of an optical signal in a wavelength-paired CS-RZ transmission with high spectral efficiency

We examine the correlations between the parameters of ultra-narrow off-centred filtering and pulse width on the performance of a wavelength paired Nx40Gbit/s DWDM transmission, consisting of carrier suppressed return-to-zero signal with 0.64 bit/s/Hz (without polarization-division multiplexing) spectral efficiency. © 2004 Optical Society of America.

Combustion and emission characteristics of a typical biodiesel engine operated on waste cooking oil derived biodiesel

Waste cooking oils can be converted into fuels to provide economical and environmental benefits. One option is to use such fuels in stationary engines for electricity generation, co-generation or tri-generation application. In this study, biodiesel derived from waste cooking oil was tested in an indirect injection type 3-cylinder Lister Petter biodiesel engine. We compared the combustion and emission characteristics with that of fossil diesel operation. The physical and chemical properties of pure biodiesel (B100) and its blends (20% and 60% vol.) were measured and compared with those of diesel. With pure biodiesel fuel, full engine power was achieved and the cylinder gas pressure diagram showed stable operation. At full load, peak cylinder pressure of B100 operation was almost similar to diesel and peak burn rate of combustion was about 13% higher than diesel. For biodiesel operation, occurrences of peak burn rates were delayed compared to diesel. Fuel line injection pressure was increased by 8.5-14.5% at all loads. In comparison to diesel, the start of combustion was delayed and 90% combustion occurred earlier. At full load, the total combustion duration of B100 operation was almost 16% lower than diesel. Biodiesel exhaust gas emissions contained 3% higher CO2 and 4% lower NOx, as compared to diesel. CO emissions were similar at low load condition, but were decreased by 15 times at full load. Oxygen emission decreased by around 1.5%. Exhaust gas temperatures were almost similar for both biodiesel and diesel operation. At full engine load, the brake specific fuel consumption (on a volume basis) and brake thermal efficiency were respectively about 2.5% and 5% higher compared to diesel. Full engine power was achieved with both blends, and little difference in engine performance and emission results were observed between 20% and 60% blends. The study concludes that biodiesel derived from waste cooking oil gave better efficiency and lower NOx emissions than standard diesel. Copyright © 2012 SAE International.

Methicillin-resistant Staphylococcus aureus bacteremia:epidemiology, outcome, and laboratory characteristics in a tertiary referral center in the UK

Objective: To analyze the recent epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia in a UK tertiary referral center. Methods: We collected epidemiological and laboratory data on all cases of MRSA bacteremia from September 1, 2005 to December 31, 2007. Results: There were 195 clinically significant episodes. Most were hospital-acquired. Only one episode occurred in patients without a history of hospital admission in the previous 12 months. An intravascular device was the most common focus of infection (37%), with no identifiable source found in 35% of episodes. Twenty-eight percent of patients died within 30 days of bacteremia. Mortality was significantly higher in the absence of an identifiable focus. Failure to include an antibiotic active against MRSA in the empirical treatment was only significantly associated with death in patients showing signs of hemodynamic instability (p < 0.001). No isolates had a minimum inhibitory concentration to vancomycin above 1.5. mg/l and no heteroresistance to glycopeptide antibiotics (heteroresistant vancomycin-intermediate Staphylococcus aureus; hVISA) was detected. All isolates were sensitive to daptomycin, tigecycline, and linezolid. Conclusions: Despite improvement in infection control measures, medical devices remain the most common source of infection. Inappropriate empirical antibiotic usage is associated with a poor outcome in patients with signs of severe sepsis. Susceptibility to glycopeptides and newer antibiotics remains good. © 2010 International Society for Infectious Diseases.

Discovering biomarkers for antidepressant response:protocol from the Canadian biomarker integration network in depression (CAN-BIND) and clinical characteristics of the first patient cohort

Background: Major Depressive Disorder (MDD) is among the most prevalent and disabling medical conditions worldwide. Identification of clinical and biological markers ("biomarkers") of treatment response could personalize clinical decisions and lead to better outcomes. This paper describes the aims, design, and methods of a discovery study of biomarkers in antidepressant treatment response, conducted by the Canadian Biomarker Integration Network in Depression (CAN-BIND). The CAN-BIND research program investigates and identifies biomarkers that help to predict outcomes in patients with MDD treated with antidepressant medication. The primary objective of this initial study (known as CAN-BIND-1) is to identify individual and integrated neuroimaging, electrophysiological, molecular, and clinical predictors of response to sequential antidepressant monotherapy and adjunctive therapy in MDD. Methods: CAN-BIND-1 is a multisite initiative involving 6 academic health centres working collaboratively with other universities and research centres. In the 16-week protocol, patients with MDD are treated with a first-line antidepressant (escitalopram 10-20 mg/d) that, if clinically warranted after eight weeks, is augmented with an evidence-based, add-on medication (aripiprazole 2-10 mg/d). Comprehensive datasets are obtained using clinical rating scales; behavioural, dimensional, and functioning/quality of life measures; neurocognitive testing; genomic, genetic, and proteomic profiling from blood samples; combined structural and functional magnetic resonance imaging; and electroencephalography. De-identified data from all sites are aggregated within a secure neuroinformatics platform for data integration, management, storage, and analyses. Statistical analyses will include multivariate and machine-learning techniques to identify predictors, moderators, and mediators of treatment response. Discussion: From June 2013 to February 2015, a cohort of 134 participants (85 outpatients with MDD and 49 healthy participants) has been evaluated at baseline. The clinical characteristics of this cohort are similar to other studies of MDD. Recruitment at all sites is ongoing to a target sample of 290 participants. CAN-BIND will identify biomarkers of treatment response in MDD through extensive clinical, molecular, and imaging assessments, in order to improve treatment practice and clinical outcomes. It will also create an innovative, robust platform and database for future research. Trial registration: ClinicalTrials.gov identifier NCT01655706. Registered July 27, 2012.

Investigating the role of parent and child characteristics in healthy eating intervention outcomes

While numerous studies have investigated the efficacy of interventions at increasing children's vegetable consumption, little research has examined the effect of individual characteristics on intervention outcomes. In previous research, interventions consisting of modelling and rewards have been shown to increase children's vegetable intake, but differences were identified in terms of how much children respond to such interventions. With this in mind, the current study investigated the role of parental feeding practices, child temperament, and child eating behaviours as predictors of intervention success. Parents (N = 90) of children aged 2-4 years were recruited from toddler groups across Leicestershire, UK. Parents completed measures of feeding practices, child eating behaviours and child temperament, before participating in one of four conditions of a home-based, parent led 14 day intervention aimed at increasing their child's consumption of a disliked vegetable. Correlations and logistic regressions were performed to investigate the role of these factors in predicting intervention success. Parental feeding practices were not significantly associated with intervention success. However, child sociability and food fussiness significantly predicted intervention success, producing a regression model which could predict intervention success in 61% of cases. These findings suggest that future interventions could benefit from being tailored according to child temperament. Furthermore, interventions for children high in food fussiness may be better targeted at reducing fussiness in addition to increasing vegetable consumption.

Inventory investment and sectoral characteristics in some OECD countries

This paper discusses the effects of sectoral structure on the long run macroeconomic inventory behaviour of national economies. Data on 15 OECD countries are included in the analysis, which is based on correlation and cluster analysis methodologies. The study is part of a long-term research project exploring factors influencing the inventory behaviour of national economies. First, we introduce some basic characteristics of macroeconomic inventory formation in the 15 OECD countries. We argue that our previous results on the existence of specific characteristic features of macroeconomic inventory investment are justified, hence it makes sense to study the factors influencing these features. We then examine the contribution of various sectors to the production of in the countries involved and the relationship between sectoral structure and inventory intensity (annual inventory change/Gross Value Added). We find that the high share of agriculture and manufacturing increases inventory intensity, that the increasing share of services has a negative effect and that the role of construction and trade is not obvious. The relatively low stability of the statistical results warns us to be cautious with our judgements. Further, case-by-case analysis would be required to obtain more solid results.

Inventory investment and GDP characteristics in OECD countries

There are very few research studies on macroeconomic inventory behaviour of various countries. It is clear that macro inventories are the results of a large number of individual microdecisions. However, we believe that it is worth analysing how inventories develop in the individual countries and why we can see different tendencies. This paper is the newest piece in a series of studies on the above subject. We use the OECD database to analyse inventory trends between 1987 and 2004 in nine of the most developed economies of the world. Annual inventory investment data are used and their connections with other components of GDP expenditure (governmental and private consumption, investment in fixed assets and foreign trade balance as well as the annual growth rate of GDP) are examined by multi-variable statistical analysis. Conclusions include the steadily decreasing tendency of inventory fluctuations, the varying periods of higher and lower rates of inventory investments and the differences of main influencing factors by country.

Tőkeallokációs módszerek és tulajdonságaik a gyakorlatban (Methods of capital allocation and their characteristics in practice)

A pénzügyekben mind elméletileg, mind az alkalmazások szempontjából fontos kérdés a tőkeallokáció. Hogyan osszuk szét egy adott portfólió kockázatát annak alportfóliói között? Miként tartalékoljunk tőkét a fennálló kockázatok fedezetére, és a tartalékokat hogyan rendeljük az üzleti egységekhez? A tőkeallokáció vizsgálatára axiomatikus megközelítést alkalmazunk, tehát alapvető tulajdonságok megkövetelésével dolgozunk. Cikkünk kiindulópontja Csóka-Pintér [2010] azon eredménye, hogy a koherens kockázati mértékek axiómái, valamint a tőkeallokációra vonatkozó méltányossági, ösztönzési és stabilitási követelmények nincsenek összhangban egymással. Ebben a cikkben analitikus és szimulációs eszközökkel vizsgáljuk ezeket a követelményeket. A gyakorlati alkalmazások során használt, illetve az elméleti szempontból érdekes tőkeallokációs módszereket is elemezzük. A cikk fő következtetése, hogy a Csóka-Pintér [2010] által felvetett probléma gyakorlati szempontból is releváns, tehát az nemcsak az elméleti vizsgálatok során merül fel, hanem igen sokszor előforduló és gyakorlati probléma. A cikk további eredménye, hogy a vizsgált tőkeallokációs módszerek jellemzésével segítséget nyújt az alkalmazóknak a különböző módszerek közötti választáshoz. / === / Risk capital allocation in finance is important theoretically and also in practical applications. How can the risk of a portfolio be shared among its sub-portfolios? How should the capital reserves be set to cover risks, and how should the reserves be assigned to the business units? The study uses an axiomatic approach to analyse risk capital allocation, by working with requiring basic properties. The starting point is a 2010 study by Csoka and Pinter (2010), who showed that the axioms of coherent measures of risk are not compatible with some fairness, incentive compatibility and stability requirements of risk allocation. This paper discusses these requirements using analytical and simulation tools. It analyses methods used in practical applications that have theoretically interesting properties. The main conclusion is that the problems identified in Csoka and Pinter (2010) remain relevant in practical applications, so that it is not just a theoretical issue, it is a common practical problem. A further contribution is made because analysis of risk allocation methods helps practitioners choose among the different methods available.

Determinants of pharmaceutical innovation diffusion: social contagion and prescribing characteristics

This article studies the determinants of pharmaceutical innovation diffusion among specialists. To this end, it investigates the influences of six categories of factors—social embeddedness, socio-demography, scientific orientation, prescribing patterns, practice characteristics, and patient panel composition—on the use of new drugs for the treatment of type 2 diabetes mellitus in Hungary. Here, in line with international trends, 11 brands were introduced between April 2008 and April 2010, outperforming all other therapeutic classes. The Cox proportional hazards model identifies three determinants—social contagion (in the social embeddedness category) and prescribing portfolio and insulin prescribing ratio (in the prescribing pattern category). First, social contagion has a positive effect among geographically close colleagues—the higher the adoption ratio, the higher the likelihood of early adoption—but no influence among former classmates and scientific collaborators. Second, the wider the prescribing portfolio, the earlier the new drug uptake. Third, the lower the insulin prescribing ratio, the earlier the new drug uptake—physicians’ therapeutic convictions and patients’ socioeconomic statuses act as underlying influencers. However, this finding does not extend to opinion-leading physicians such as scientific leaders and hospital department and outpatient center managers. This article concludes by arguing that healthcare policy strategists and pharmaceutical companies may rely exclusively on practice location and prescription data to perfect interventions and optimize budgets.