Custo-efetividade da Terapia Tripla para pacientes adultos portadores do genótipo 1 da hepatite C crônica.

As ações de prevenção, diagnóstico e tratamento da hepatite C crônica integram as agendas das políticas de saúde do Brasil e do mundo, pois se trata de uma doença com grande número de acometidos, com alto custo tratamento e que ocasiona graves desfechos e incapacidade, o que acaba por onerar seu custo social. Os protocolos clínicos e diretrizes terapêuticas demonstram os esforços de inúmeras entidades no combate da hepatite C, pois informam aos profissionais de saúde, pacientes e familiares e cidadãos em geral, qual seria a melhor forma, comprovada cientificamente, de se proceder frente a uma infecção desta natureza. Realizouse uma análise de custoefetividade, sob a perspectiva do SUS, das estratégias: tratamento e retratamento com a terapia dupla, tratamento com a terapia dupla e retratamento com a terapia tripla e tratamento com a terapia tripla. Através de modelo de simulação baseado em cadeias Markov foi criada uma coorte hipotética de 1000 indivíduos adultos, acima de 40 anos, de ambos os sexos, sem distinção declasse socioeconômica, com diagnóstico confirmado para hepatite C crônica, monoinfectados pelo genótipo 1 do VHC e com ausência de comorbidades. A simulação foi iniciada com todos os indivíduos portando a forma mais branda da doença, tida como a classificação histológica F0 ou F1 segundo a escala Metavir. Os resultados demonstram que as duas opções, ou seja, a terapia dupla/tripla e a terapia tripla estão abaixo do limiar de aceitabilidade para incorporação de tecnologia proposto pela OMS (2012) que é de 72.195 (R$/QALY) (IBGE, 2013; WHO, 2012). Ambas são custoefetivas, visto que o ICER da terapia dupla/tripla em relação alinha de base foi de 7.186,3 (R$/QALY) e o da terapia tripla foi de 59.053,8 (R$/QALY). Entretanto o custo incremental de terapia tripla em relação à dupla/tripla foi de 31.029 e a efetividade incremental foi de 0,52. Em geral, quando as intervenções analisadas encontramse abaixo do limiar, sugerese a adoção do esquema de maior efetividade. A terapia tripla, apesar de ter apresentado uma efetividade um pouco acima da terapia dupla/tripla, apresentou custo muito superior. Assim, como seria coerente a adoção de uma ou da outra para utilização no SUS, visto que este sistema apresenta recursos limitados, indicase a realização de um estudo de impacto orçamentário para obterse mais um dado de embasamento da decisão e assim poder apoiar o protocolo brasileiro existente ou sugerir a confecção de novo documento.

Topic 1. Some steric-height features of the water off the Pacific coast of Canada; Topic 2. Possible warming of the water at station P in the northeast Pacific during 1956-1984 [abstract]

TOPIC 1: In terms of seasonal scale, temperature effect dominates the annual change of steric height in the open ocean whereas salinity effect controls it along the continental shelf. Large portion of the annual change of height relative to the 1000-db surface is contained in the upper 100m layer. However, in interannual scale large anomalies of steric height in the open ocean, are more often than not, caused by halosteric rather than thermosteric effect. At least in the open ocean the heights are almost totally determined by the behavior of deep water. Their interannual variability appears to be related to the cumulative effect of Eckman pumping. TOPIC 2: There is a "trend" that over the past 28 years the water at Station P has warmed. Least-square analysis indicates that this warming may be significant but shortening of the time-series data by approximately 10 years fails to show that this is the case. These "trends" have to be interpreted with care. The warming may be "apparent" in that it is not indicated clearly in the deep isopynal surfaces which, during the above period, have deepened. Thus warming at the isobaric surfaces may be the effect of the downward migration of the isopynal surfaces.

An overview of 1000 years of tropical climatic variability from ice cores from the Andes of southern Peru [abstract]

EXTRACT (SEE PDF FOR FULL ABSTRACT): Each summer between 1976 and 1984 research was conducted on the Quelccaya Ice Cap with one central objective, to recover an ice core to bedrock from which an approximate 1000 year climatic history for tropical South America could be reconstructed. In 1983 that central objective was accomplished by recovering one core 155 meters in length containing 1350 years and a second core of 163.6 meters containing more than 1500 years of climatic history. ... The most significant climatic event in tropical South America over the last 1500 years was the "Little Ice Age" which is recorded between 1490 to 1880 A.D. in these ice core records. Records from the summit of the Quelccaya Ice Cap show that during the "Little Ice Age" period there was (1) a general increase in particulates (both insoluble and soluble, starting around 1490 A.D. and ending abruptly in 1880 A.D.; (2) an initial increase in net accumulation (1500-1720 A.D.) followed by a period of decreased net accumulation (1720-1860 A.D.); (3) more negative delta-O-18 values beginning in the 1520's and ending around 1880 A.D. The "Little Ice Age" event is evident as a perturbation in all five ice core parameters.

Fish farm technology. 1 - Brackishwater fish culture based on "aquafeed"

A method has been evolved to enhance the production of natural feed in brackish water fish farms by providing substrates for bio-growth ('aquafeed' production) which is a biomass complex consisting of sedentary and associated organisms of plant and animal species. The seasonal fluctuations of the aquafeed production over different substrates ranged as: 787-1830g/coconut leaf (6m²)/45 days, 16.0-072.9g/glass panel (2x10x10cm²)/30 days, 52-230g/nylon mat (2x25x25cm²)/30 days and 18.6-123.1g/wooden block (6x10x10cm²)/30 days. The average dry weight composition of the major components of aquafeed obtained in the present study was sand-silt-clay 40%, protein 22%, carbohydrate (water soluble) 1.8% and fat 3.35% (water content 85%). Mugil cephalus of 1.85 cm reared in a 0.01ha pond and fed on aquafeed attained a size of 23 cm length and 146.73g weight during one year. Survival rate was 54% at a density of 1000/ha. Salinity and temperature of the pond during the culture period ranged between 1.4 and 32.8‰ and 28.1 and 36.5°C respectively.

Role of Bi3+ ions for Er3+ ions efficient 1.54 mu m light emission in Er/Bi codoped SiO2 thin film prepared by sol-gel method

Er/Bi codoped SiO2 thin films were prepared by sol-gel method and spin-on technology with subsequent annealing process. The bismuth silicate crystal phase appeared at low annealing temperature while vanished as annealing temperature exceeded 1000 degrees C, characterized by X-ray diffraction, and Rutherford backscattering measurements well explained the structure change of the films, which was due to the decrease of bismuth concentration. Fine structures of the Er3+-related 1.54 mu m light emission (line width less than 7 nm) at room temperature was observed by photoluminescence (PL) measurement. The PL intensity at 1.54 gm reached maximum at 800 degrees C and decreased dramatically at 1000 degrees C. The PL dependent annealing temperature was studied and suggested a clear link with bismuth silicate phase. Excitation spectrum measurements further reveal the role of Bi3+ ions for Er3+ ions near infrared light emission. Through sol-gel method and thermal treatment, Bi3+ ions can provide a perfect environment for Er3+ ion light emission by forming Er-Bi-Si-O complex. Furthermore, energy transfer from Bi3+ ions to Er3+ ions is evidenced and found to be a more efficient way for Er3+ ions near infrared emission. This makes the Bi3+ ions doped material a promising application for future erbium-doped waveguide amplifier and infrared LED

Low threshold current density 1.5 mu m strained-MQW laser by n-type modulation-doping

1.5 mu m. n-type modulation-doping InGaAsP/InGaAsP strained multiple quantum wells grown by low pressure metalorganic chemistry vapor decomposition technology is reported for the first time in the world. N-type modulation-doped lasers exhibit much lower threshold current densities than conventional lasers with undoped barrier layers. The lowest threshold current density we obtained was 1052.5 A/cm(2) for 1000 mu m long lasers with seven quantum wells. The estimated threshold current density for an infinite cavity length was 94.72A/cm(2)/well, reduced by 23.3% compared with undoped barrier lasers. The n-type modulation doping effects on the lasing characteristics in 1.5 mu m devices have been demonstrated.

Pockels effect in GaN/Al-x,Gal(1-x)N superlattice with different quantum structures - art. no. 69841G

The linear electro-optic (Pockels) effect of wurtzite gallium nitride (GaN) films and six-period GaN/AlxGa1-xN superlattices with different quantum structures were demonstrated by a polarization-maintaining fiber-optical Mach-Zehnder interferometer system with an incident light wavelength of 1.55 mu m. The samples were prepared on (0001) sapphire substrate by low-temperature metalorganic chemical vapor deposition (MOCVD). The measured coefficients of the GaN/AlxGa1-xN superlattices are much larger than those of bulk material. Taking advantage of the strong field localization due to resonances, GaN/AlxGa1-xN SL can be proposed to engineer the nonlinear responses.

1.55 mu m Ge islands resonant-cavity-enhanced narrowband detector

The high quality Ge islands material with 1.55 mu m photo-response grown on Sol substrate is reported. Due to the modulation of the cavity formed by the mirrors at the surface and the buried SiO2 interface, seven sharp and strong peaks with narrow linewidth are found. And a 1.55 mu m Ge islands resonant-cavity-enhanced (RCE) detector with narrowband was fabricated by a simple method. The bottom mirror was deposited in the hole formed by anisotropically etching, in a basic solution from the backside of the sample with the buried SiO2 layer in silicon-on-insulator substrate as the etch-stop layer. Reflectivity spectrum indicates that the mirror deposited in the hole has a reflectivity as high as 99% in the range of 1.2-1.65 mu m. The peak responsivity of the RCE detector at 1543.8 nm is 0.028 mA/W and a full width at half maximum of 5 nm is obtained. Compared with the conventional p-i-n photodetector, the responsivity of RCE detector has a nearly threefold enhancement.

C离子注入Si中Si_(1-x)C_x合金的形成及其稳定性

利用离子注入和高温退火的方法在Si中生长了C含量为0.6%～1.0%的Si_(1-x)C_x合金，研究了不同注入剂量下Si_(1-x)C_x合金的形成及其在退火过程中的稳定性。如果注入剂量小于引起Si非晶化的剂量，850℃退火后，注入产生的损伤缺陷容易与C原子结合形成缺陷团簇，难于形成Si_(1-x)C_x合金。随着注入C离子剂量的增大，注入产生的损伤增强，容易形成Si_(1-x)C_x合金，但注入的剂量增大到一定程度，Si_(1-x)C_x合金的应变将趋于饱和，即只有部分C原子进入晶格位置形成合金相。Si_(1-x)C_X合金一旦形成，在950℃仍比较稳定，而温度高于1000℃，合金的应力将部分释放。随着合金中C原子浓度的升高，合金的稳定性变差。

Fabrication of 1.3 mu m Si-based MEMS tunable optical filter

In this paper we report the fabrication of 1.3 mum Si-based MEMS tunable optical filter, by surface micromaching. Through wet etching of polyimide sacrificial layer, a tunable Fabry-Perot filter was successfully fabricated. We make the capacitance measurement of the prototype device, compare the experimental curve with the theoretical one, and explain the difference between them.

1.3 mu m GaInNAs/GaAs quantum well lasers and photodetectors

The growth of GalnNAs/GaAs quantum well (QW) has been investigated by solid-source molecular beam epitaxy (MBE). N was introduced by a dc-active plasma source. Highest N concentration of 2.6% in GaInNAs/GaAs QW was obtained, corresponding to the photoluminescence peak wavelength of 1.57 mum at 10K. The nitrogen incorporation behavior in MBE growth and the quality improvement of the QW have been studied in detail. 1.3 mum GaInNAs/GaAs SQW laser and MQW resonant-cavity enhanced photodetector have been achieved.

1.3 mu m GaInNAs/GaAs multiple-quantum-wells resonant-cavity-enhanced photodetectors

A GaInNAs/GaAs multiple quantum well (MQW) resonant-cavity enhanced (RCE) photodetector operating at 1.3 mum with the full-width at half-maximum of 5.5 nm was demonstrated. The GaInNAs RCE photodetector was grown by molecular-beam epitaxy using an ion-removed dc-plasma cell as nitrogen source. GaInNAs/GaAs MQW shows a strong exciton peak at room temperature that is very beneficial for applications in long-wavelength absorption devices. For a 100-mum diameter RCE photodetector, the dark current is 20 and 32 pA at biases of 0 and 6 V, respectively, and the breakdown voltage is -18 V. The measured 3-dB bandwidth is 308 MHz. The reasons resulting in the poor high speed property were analyzed. The tunable wavelength of 18 nm with the angle of incident light was observed.

1.5 mu m DFB integrated with vertical tapered spotsize converter fabricated by selective MOVPE

1.5 mu m DFB LD butt-joint integrated with vertical tapered spotsize converter was fabricated by LP-MOVPE. The vertical far field angle (FWHM) was decreased from 34degrees to 10degrees the threshold currents was as low as 19.8mA, the output power was 9.6mw at 100mA without HR coating and the SMSR was 35.8dB. The 1-dBm misalignment tolerance was 3.2 mu m, while the counterpart of the device without SSC was 2.2 mu m.

Normal-incident SiGe/Si MQWs photodetectors operating at 1.3 mu m

A normal-incident SiGe/Si multiple quantum wells (MQWs) photodetector was reported. The structure and fabrication process of the photodetector were introduced. The photocurrent spectra measurement showed that the response spectra was expanded to 1.3 mu m wavelength. The quantum efficiency of the photodetector was 0.1% at 1.3 mu m and 20% at 0.95 mu m.

High performance 1.55 mu m InGaAsP/InP strained layer quantum well laser diodes fabricated by MOCVD overgrowth method

High performance uncooled 1.55 mu m InGaAsP/InP strained layer quantum well (SL-QW) lasers grown by low pressure metal organic chemical vapor deposition (LP-MOCVD) were reported in this paper. Whole MOCVD over growth method were applied in this work. The threshold currents of 5mA and the highest lasing temperature of 122 degrees C were obtained.