Cyclosporine versus tacrolimus: cost-effectiveness analysis for renal transplantation in Brazil

OBJECTIVE To analyze the cost-effectiveness of treatment regimens with cyclosporine or tacrolimus, five years after renal transplantation.METHODS This cost-effectiveness analysis was based on historical cohort data obtained between 2000 and 2004 and involved 2,022 patients treated with cyclosporine or tacrolimus, matched 1:1 for gender, age, and type and year of transplantation. Graft survival and the direct costs of medical care obtained from the National Health System (SUS) databases were used as outcome results.RESULTS Most of the patients were women, with a mean age of 36.6 years. The most frequent diagnosis of chronic renal failure was glomerulonephritis/nephritis (27.7%). In five years, the tacrolimus group had an average life expectancy gain of 3.96 years at an annual cost of R$78,360.57 compared with the cyclosporine group with a gain of 4.05 years and an annual cost of R$61,350.44.CONCLUSIONS After matching, the study indicated better survival of patients treated with regimens using tacrolimus. However, regimens containing cyclosporine were more cost-effective.

Intra-hospital organ and tissue donation coordination project: cost-effectiveness and social benefits

OBJECTIVE To evaluate the viability of a professional specialist in intra-hospital committees of organ and tissue donation for transplantation. METHODS Epidemiological, retrospective and cross-sectional study (2003-2011 and 2008-2012), which was performed using organ donation for transplants data in the state of Sao Paulo, Southeastern Brazil. Nine hospitals were evaluated (hospitals 1 to 9). Logistic regression was used to evaluate the differences in the number of brain death referrals and actual donors (dependent variables) after the professional specialist started work (independent variable) at the intra-hospital committee of organ and tissue donation for transplantation. To evaluate the hospital invoicing, the hourly wage of the doctor and registered nurse, according to the legislation of the Consolidation of Labor Laws, were calculated, as were the investment return and the time elapsed to do so. RESULTS Following the nursing specialist commencement on the committee, brain death referrals and the number of actual donors increased at hospital 2 (4.17 and 1.52, respectively). At hospital 7, the number of actual donors also increased from 0.005 to 1.54. In addition, after the nurse started working, hospital revenues increased by 190.0% (ranging 40.0% to 1.955%). The monthly cost for the nurse working 20 hours was US$397.97 while the doctor would cost US$3,526.67. The return on investment was 275% over the short term (0.36 years). CONCLUSIONS This paper showed that including a professional specialist in intra-hospital committees for organ and tissue donation for transplantation proved to be cost-effective. Further economic research in the area could contribute to the efficient public policy implementation of this organ and tissue harvesting model.

On international cost-sharing of pharmaceutical R&D

Ramsey pricing has been proposed in the pharmaceutical industry as a principle to price discriminate among markets while allowing to recover the (fixed) R&D cost. However, such analyses neglect the presence of insurance or the fund raising costs for most of drug reimbursement. By incorporating these new elements, we aim at providing some building blocks towards an economic theory incorporating Ramsey pricing and insurance coverage. We show how coinsurance affects the optimal prices to pay for the R&D investment. We also show that under certain conditions, there is no strategic incentive by governments to set coinsurance rates in order to shift the financial burden of R&D. This will have important implications to the application of Ramsey pricing principles to pharmaceutical products across countries.

Low-cost vibration sensors: tendencies and applications in condition monitoring of machines and structures

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Mecânica

Experimental study on polyester based concretes filled with glass fibre reinforced plastic recyclates – a contribution to composite materials sustainability

The development and applications of thermoset polymeric composites, namely fibre reinforced plastics (FRP), have shifted in the last decades more and more into the mass market [1]. Despite of all advantages associated to FRP based products, the increasing production and consume also lead to an increasing amount of FRP wastes, either end-of-lifecycle products, or scrap and by-products generated by the manufacturing process itself. Whereas thermoplastic FRPs can be easily recycled, by remelting and remoulding, recyclability of thermosetting FRPs constitutes a more difficult task due to cross-linked nature of resin matrix. To date, most of the thermoset based FRP waste is being incinerated or landfilled, leading to negative environmental impacts and supplementary added costs to FRP producers and suppliers. This actual framework is putting increasing pressure on the industry to address the options available for FRP waste management, being an important driver for applied research undertaken cost efficient recycling methods. [1-2]. In spite of this, research on recycling solutions for thermoset composites is still at an elementary stage. Thermal and/or chemical recycling processes, with partial fibre recovering, have been investigated mostly for carbon fibre reinforced plastics (CFRP) due to inherent value of carbon fibre reinforcement; whereas for glass fibre reinforced plastics (GFRP), mechanical recycling, by means of milling and grinding processes, has been considered a more viable recycling method [1-2]. Though, at the moment, few solutions in the reuse of mechanically-recycled GFRP composites into valueadded products are being explored. Aiming filling this gap, in this study, a new waste management solution for thermoset GFRP based products was assessed. The mechanical recycling approach, with reduction of GFRP waste to powdered and fibrous materials was applied, and the potential added value of obtained recyclates was experimentally investigated as raw material for polyester based mortars. The use of a cementless concrete as host material for GFRP recyclates, instead of a conventional Portland cement based concrete, presents an important asset in avoiding the eventual incompatibility problems arisen from alkalis silica reaction between glass fibres and cementious binder matrix. Additionally, due to hermetic nature of resin binder, polymer based concretes present greater ability for incorporating recycled waste products [3]. Under this scope, different GFRP waste admixed polymer mortar (PM) formulations were analyzed varying the size grading and content of GFRP powder and fibre mix waste. Added value of potential recycling solution was assessed by means of flexural and compressive loading capacities of modified mortars with regard to waste-free polymer mortars.

A low cost method to produce a gaseous environment for the isolation of Helicobacter pylori

A low cost method (LCM) to produce a gaseous environment for the isolation of Helicobacter pylori, was compared with the standard Gas Park system. The LCM uses a carbonated antacid tablet, a plastic bag with tap water, a candle, and a wide-mouthed glass jar provided with a tight-fitting metalic screw cap and a rubber gasket. Antral gastric biopsies from 153 cases were incubated by duplicate on blood agar plates and treated with the two methods. In 95 cases the agent was isolated from both, and only from the standard method in 10 cases; the opposite condition was found in five cases, and 43 were negative. That difference is not significant (Pearson's X²= 93.25 p > 0,05)

Integrated Management of Cloud Computing Resources

Lunacloud is a cloud service provider with offices in Portugal, Spain, France and UK that focus on delivering reliable, elastic and low cost cloud Infrastructure as a Service (IaaS) solutions. The company currently relies on a proprietary IaaS platform - the Parallels Automation for Cloud Infrastructure (PACI) - and wishes to expand and integrate other IaaS solutions seamlessly, namely open source solutions. This is the challenge addressed in this thesis. This proposal, which was fostered by Eurocloud Portugal Association, contributes to the promotion of interoperability and standardisation in Cloud Computing. The goal is to investigate, propose and develop an interoperable open source solution with standard interfaces for the integrated management of IaaS Cloud Computing resources based on new as well as existing abstraction libraries or frameworks. The solution should provide bothWeb and application programming interfaces. The research conducted consisted of two surveys covering existing open source IaaS platforms and PACI (features and API) and open source IaaS abstraction solutions. The first study was focussed on the characteristics of most popular open source IaaS platforms, namely OpenNebula, OpenStack, CloudStack and Eucalyptus, as well as PACI and included a thorough inventory of the provided Application Programming Interfaces (API), i.e., offered operations, followed by a comparison of these platforms in order to establish their similarities and dissimilarities. The second study on existing open source interoperability solutions included the analysis of existing abstraction libraries and frameworks and their comparison. The approach proposed and adopted, which was supported on the conclusions of the carried surveys, reuses an existing open source abstraction solution – the Apache Deltacloud framework. Deltacloud relies on the development of software driver modules to interface with different IaaS platforms, officially provides and supports drivers to sixteen IaaS platform, including OpenNebula and OpenStack, and allows the development of new provider drivers. The latter functionality was used to develop a new Deltacloud driver for PACI. Furthermore, Deltacloud provides a Web dashboard and REpresentational State Transfer (REST) API interfaces. To evaluate the adopted solution, a test bed integrating OpenNebula, Open- Stack and PACI nodes was assembled and deployed. The tests conducted involved time elapsed and data payload measurements via the Deltacloud framework as well as via the pre-existing IaaS platform API. The Deltacloud framework behaved as expected, i.e., introduced additional delays, but no substantial overheads. Both the Web and the REST interfaces were tested and showed identical measurements. The developed interoperable solution for the seamless integration and provision of IaaS resources from PACI, OpenNebula and OpenStack IaaS platforms fulfils the specified requirements, i.e., provides Lunacloud with the ability to expand the range of adopted IaaS platforms and offers a Web dashboard and REST API for the integrated management. The contributions of this work include the surveys and comparisons made, the selection of the abstraction framework and, last, but not the least, the PACI driver developed.

Cost Allocation Model for Distribution Networks Considering High Penetration of Distributed Energy Resources

The high penetration of distributed energy resources (DER) in distribution networks and the competitiveenvironment of electricity markets impose the use of new approaches in several domains. The networkcost allocation, traditionally used in transmission networks, should be adapted and used in the distribu-tion networks considering the specifications of the connected resources. The main goal is to develop afairer methodology trying to distribute the distribution network use costs to all players which are usingthe network in each period. In this paper, a model considering different type of costs (fixed, losses, andcongestion costs) is proposed comprising the use of a large set of DER, namely distributed generation(DG), demand response (DR) of direct load control type, energy storage systems (ESS), and electric vehi-cles with capability of discharging energy to the network, which is known as vehicle-to-grid (V2G). Theproposed model includes three distinct phases of operation. The first phase of the model consists in aneconomic dispatch based on an AC optimal power flow (AC-OPF); in the second phase Kirschen’s andBialek’s tracing algorithms are used and compared to evaluate the impact of each resource in the net-work. Finally, the MW-mile method is used in the third phase of the proposed model. A distributionnetwork of 33 buses with large penetration of DER is used to illustrate the application of the proposedmodel.

Low cost inertial-based localization system for a service robot

Dissertation presented at Faculty of Sciences and Technology of the New University of Lisbon to attain the Master degree in Electrical and Computer Science Engineering

New and low cost plastic membrane electrode with low detection limits for sulfadimethoxine determination in aquaculture waters

Sulfadimethoxine (SDM) is one of the drugs, often used in the aquaculture sector to prevent the spread of disease in freshwater fish aquaculture. Its spread through the soil and surface water can contribute to an increase in bacterial resistance. It is therefore important to control this product in the environment. This work proposes a simple and low-cost potentiometric device to monitor the levels of SDM in aquaculture waters, thus avoiding its unnecessary release throughout the environment. The device combines a micropipette tip with a PVC membrane selective to SDM, prepared from an appropriate cocktail, and an inner reference solution. The membrane includes 1% of a porphyrin derivative acting as ionophore and a small amount of a lipophilic cationic additive (corresponding to 0.2% in molar ratio). The composition of the inner solution was optimized with regard to the kind and/or concentration of primary ion, chelating agent and/or a specific interfering charged species, in different concentration ranges. Electrodes constructed with inner reference solutions of 1 × 10−8 mol/L SDM and 1 × 10−4 mol/L chromate ion showed the best analytical features. Near-Nernstian response was obtained with slopes of −54.1 mV/decade, an extraordinary detection limit of 7.5 ng/mL (2.4 × 10−8 mol/L) when compared with other electrodes of the same type. The reproducibility, stability and response time are good and even better than those obtained by liquid contact ISEs. Recovery values of 98.9% were obtained from the analysis of aquaculture water samples.

A framework for using real data with distributed low cost sensors

Currently, due to the widespread use of computers and the internet, students are trading libraries for the World Wide Web and laboratories with simulation programs. In most courses, simulators are made available to students and can be used to proof theoretical results or to test a developing hardware/product. Although this is an interesting solution: low cost, easy and fast way to perform some courses work, it has indeed major disadvantages. As everything is currently being done with/in a computer, the students are loosing the “feel” of the real values of the magnitudes. For instance in engineering studies, and mainly in the first years, students need to learn electronics, algorithmic, mathematics and physics. All of these areas can use numerical analysis software, simulation software or spreadsheets and in the majority of the cases data used is either simulated or random numbers, but real data could be used instead. For example, if a course uses numerical analysis software and needs a dataset, the students can learn to manipulate arrays. Also, when using the spreadsheets to build graphics, instead of using a random table, students could use a real dataset based, for instance, in the room temperature and its variation across the day. In this work we present a framework which uses a simple interface allowing it to be used by different courses where the computers are the teaching/learning process in order to give a more realistic feeling to students by using real data. A framework is proposed based on a set of low cost sensors for different physical magnitudes, e.g. temperature, light, wind speed, which are connected to a central server, that the students have access with an Ethernet protocol or are connected directly to the student computer/laptop. These sensors use the communication ports available such as: serial ports, parallel ports, Ethernet or Universal Serial Bus (USB). Since a central server is used, the students are encouraged to use sensor values results in their different courses and consequently in different types of software such as: numerical analysis tools, spreadsheets or simply inside any programming language when a dataset is needed. In order to do this, small pieces of hardware were developed containing at least one sensor using different types of computer communication. As long as the sensors are attached in a server connected to the internet, these tools can also be shared between different schools. This allows sensors that aren't available in a determined school to be used by getting the values from other places that are sharing them. Another remark is that students in the more advanced years and (theoretically) more know how, can use the courses that have some affinities with electronic development to build new sensor pieces and expand the framework further. The final solution provided is very interesting, low cost, simple to develop, allowing flexibility of resources by using the same materials in several courses bringing real world data into the students computer works.

A low-cost method to test cytotoxic effects of Crotalus vegrandis (Serpentes: Viperidae) venom on kidney cell cultures

The pathogenesis of the renal lesion upon envenomation by snakebite has been related to myolysis, hemolysis, hypotension and/or direct venom nephrotoxicity caused by the venom. Both primary and continuous cell culture systems provide an in vitro alternative for quantitative evaluation of the toxicity of snake venoms. Crude Crotalus vegrandis venom was fractionated by molecular exclusion chromatography. The toxicity of C. vegrandis crude venom, hemorrhagic, and neurotoxic fractions were evaluated on mouse primary renal cells and a continuous cell line of Vero cells maintained in vitro. Cells were isolated from murine renal cortex and were grown in 96 well plates with Dulbecco's Modified Essential Medium (DMEM) and challenged with crude and venom fractions. The murine renal cortex cells exhibited epithelial morphology and the majority showed smooth muscle actin determined by immune-staining. The cytotoxicity was evaluated by the tetrazolium colorimetric method. Cell viability was less for crude venom, followed by the hemorrhagic and neurotoxic fractions with a CT50 of 4.93, 18.41 and 50.22 µg/mL, respectively. The Vero cell cultures seemed to be more sensitive with a CT50 of 2.9 and 1.4 µg/mL for crude venom and the hemorrhagic peak, respectively. The results of this study show the potential of using cell culture system to evaluate venom toxicity.

High-Accuracy Low-Cost RTK-GPS for an Unmanned Surface Vehicle

This work presents a low cost RTK-GPS system for localization of unmanned surface vehicles. The system is based on the use of standard low cost L1 band receivers and in the RTKlib open source software library. Mission scenarios with multiple robotic vehicles are addressed as the ones envisioned in the ICARUS search and rescue case where the possibility of having a moving RTK base on a large USV and multiple smaller vehicles acting as rovers in a local communication network allows for local relative localization with high quality. The approach is validated in operational conditions with results presented for moving base scenario. The system was implemented in the SWIFT USV with the ROAZ autonomous surface vehicle acting as a moving base. This setup allows for the performing of a missions in a wider range of environments and applications such as precise 3D environment modeling in contained areas and multiple robot operations.