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Validation of third molar maturity index (I 3M ) for discrimination of juvenile/adult status in South Indian population
Get PDFDeliberate falsification of age was considered to be one of the main reasons for forensic age estimation of the living individuals. This posed to be a challenging task during criminal and legal proceedings, and ultimate care must be taken not to classify juveniles as adults. Third molars are the only developing teeth during late adolescence and early adulthood. Our study was designed to analyze the usefulness of the third molar maturity index (I3M) specific cut-off value (I3M < 0.08) to discriminate adults (≥18 years) and juveniles (<18 years) in South Indian children.
216 panoramic radiographs (114 females and 102 males) of living subjects aged between 14 and 21 years were analyzed. Our results demonstrated high sensitivity (83.3% and 90.2%) and specificity (98.3% and 95.1%) for females and males respectively. The positive likelihood ratios of being adult were 50.00 and 18.35 while the negative likelihood ratios were 0.17 and 0.10 in females and males respectively. The estimated posttest probability was 98.0% in females and 94.8% in males. The obtained results showed that the specific cut-off value of I3M < 0.08 may be a useful additional tool in discrimination of individuals who are around 18 years of age
System influences on work disability due to low back pain: an international evidence synthesis
Get PDFWork disability due to low back pain is a significant global health concern. Current policy and practice aimed at tackling this problem is largely informed by the biopsychosocial model. Resultant interventions have demonstrated some small-scale success, but they have not created a widespread decrease in work disability. This may be explained by the under-representation of the less measurable aspects in the biopsychosocial evidence base; namely the influence of relevant systems. Thus, a ‘best-evidence’ synthesis was conducted to collate the evidence on how compensatory (worker’s compensation and disability benefits), healthcare and family systems (spouse/partner/close others) can act as obstacles to work participation for those with low back pain. Systematic searches of several scientific and grey literature sources were conducted, resulting in 1,762 records. Following a systematic exclusion process, 57 articles were selected and the evidence was assessed using a system adapted from previous large-scale policy reviews conducted in this field. Results indicated how specific features of relevant systems could act as obstacles to individual efforts/interventions aimed at tackling work disability due to LBP. These findings reinforce the need for a ‘whole-systems’ approach, with all key players onside and have implications for the revision of current biopsychosocial-informed policy and practice
A review of DTCA techniques: Appraising their success and potential impact on medication users
No full textBackground
Direct-to-consumer advertising (DTCA) has been present in some countries for nearly two decades. Its success and ramifications have been examined but not yet cataloged recently in a comprehensive manner.
Objective
To review existing literature studies on the topic of DTCA techniques to provide an analysis of the current methods considered by drug marketers to enhance the effect of pharmaceutical product promotion and its success, as well as examine ramifications on the drug use process.
Methods
A search of 7 electronic databases including MEDLINE and SCOPUS was conducted in December 2015, and updated until February 2016. A scientific review of literature (2008–2015) was performed to identify and collate information from relevant, peer reviewed original study articles investigating various DTCA techniques commonly employed in pharmaceutical promotion. A thematic analysis was undertaken to categorize categories of drug promotion, or techniques, and the saliency and impact of these.
Results
Nineteen original study articles were included in this review. All articles were based in the U.S. and New Zealand, where DTCA is legal. After reviewing all the articles, 4 themes with 11 subcategories were generated. These themes included disease mongering and medicalization, drug references, advertisement strategies and eDTCA. The themes describe different categories of techniques used to augment DTC advertisements to increase their impact and overall success in promoting a pharmaceutical product.
Many DTCA techniques utilized by pharmaceutical marketers are beneficial to the success of DTC promotion of a drug. These techniques include the use of drug efficacy information, comparative claims, non-branded help seeking advertisements, formatted risks information, celebrity or expert endorsers and website trust factors. Through their use, public perception of the drug is made more favorable, increased attention is drawn to the advertisement, and the pharmaceutical product gains greater credibility and subsequent success in sales. However some techniques, although beneficial to pharmaceutical promotion, need to be monitored by policymakers and regulatory advisors, as they have the potential to negatively impact consumer health knowledge.
Conclusion
Overall, through this review it is evident that there are a number if techniques that employed by pharmaceutical marketers to augment the success of pharmaceutical promotion. While these techniques may be beneficial to pharmaceutical companies and might increase awareness amongst consumers, it is important to be critical of them, as they have the potential to be exploited by pharmaceutical marketers. This review indicated that although some techniques are successful and appear to be satisfactory in providing information to consumers, other techniques need to be appraised more closely
Development of Novel Vehicle Design Modelling Functions for Quantifying Vehicles’ Shapes
No full textThe inland goods transportation sector has become dominant by high fuel consuming heavy goods vehicles, which are more commonly known as truck-trailer units. Manufacturers have been trying to design aerodynamically efficient truck-trailer units to reduceever increasing fuel costs. The scope for streamlining the shape of the truck-trailer unit is severely limited due to legally imposed dimensional restrictions. The development of truck-trailer prototypes is both time consuming and costly. Hence, in the present study, a novel mathematical model has been developed to generate the shape of a truck-trailer units.Furthermore, Computational Fluid Dynamics (CFD) based techniques have been employed to analyse the aerodynamic performance of the truck–trailer unit. It has been noticed that the developed vehicle modelling functions are accurate, inexpensive, user-friendly and robust. These vehicle modelling functions are expected to aid the truck-trailer manufacturers for optimising vehicle shapes
Analysis of a tilted turbine housing volute design under pulsating inlet conditions
No full textRadial inflow turbines are widely used in the automotive turbocharger industry due to the greater amount of work that can be extracted per stage and their ease of manufacture compared with equivalent axial designs [1]. The current industry trend towards downsized engines for lower emissions has driven research to focus on improving turbine technologies for greater aero-thermal efficiency. Consequently, mixed flow turbines have recently received significant interest due to a number of potential performance benefits over their radial counterparts, including reduced inertia and improved performance at low velocity ratios.
This paper investigates the performance of a tilted volute design compared with that of a radial design, under steady state and pulsating flow conditions. The tilted volute design was introduced in an attempt to improve inlet flow conditions of a mixed flow turbine wheel and hence improve performance. The investigation is entirely computational and the approach used was carefully validated against gas stand test results.
The results of the study show that under steady state conditions the tilted volute design resulted in stage efficiency improvements of up to 1.64%. Under pulsating flow conditions, the tilted housing design resulted in a reduction in incidence angle and a maximum cycle averaged rotor efficiency improvement of 1.49% while the stage efficiencies resulted in a 1.23% increase. To assess the loss mechanisms within the rotor, the entropy flux generation through the blade passage was calculated. The tilted housing design resulted in reductions in leading edge suction and shroud surface separation resulting in the improved efficiency as observed
How can pricing and reimbursement policies improve affordable access to medicines? Lessons learned from European countries
No full textThis article discusses pharmaceutical pricing and reimbursement policies in European countries with regard to their ability to ensure affordable access to medicines. A frequently applied pricing policy is external price referencing. While it provides some benchmark for policy-makers and has been shown to be able to generate savings, it may also contribute to delay in product launch in countries where medicine prices are low. Value-based pricing has been proposed as a policy that promotes access while rewarding useful innovation; however, implementing it has proven quite challenging. For high-priced medicines, managed-entry agreements are increasingly used. These agreements allow policy-makers to manage uncertainty and obtain lower prices. They can also facilitate earlier market access in case of limited evidence about added therapeutic value of the medicine. However, these agreements raise transparency concerns due to the confidentiality clause. Tendering as used in the hospital and offpatent outpatient sectors has been proven to reduce medicine prices but it requires a robust framework and appropriate design with clear strategic goals in order to prevent shortages. These pricing and reimbursement policies are supplemented by the widespread use of Health Technology Assessment to inform decision-making, and by strategies to improve the uptake of generics, and also biosimilars. While European countries have been implementing a set of policy options, there is a lack of thorough impact assessments of several pricing and reimbursement policies on affordable access. Increased cooperation between authorities, experience sharing and improving transparency on price information, including the disclosure of confidential discounts, are opportunities to address current challenges
Automated planning for urban traffic management
No full textThe global growth in urbanisation increases the demand for services including road transport infrastructure, presenting challenges in terms of mobility. Optimising the exploitation of urban road network, while attempting to minimise the effects of traffic emissions, is a great challenge. SimplyfAI was a UK research council grant funded project which was aimed towards solving air quality problems caused by road traffic emissions. Large cities such as Manchester struggle to meet air quality limits as the range of available traffic management devices is limited. In the study, we investigated the application of linked data to enrich environmental and traffic data feeds, and we used this with automated planning tools to enable traffic to be managed at a region level. The management will have the aim of
avoiding air pollution problems before they occur. This demo focuses on the planning component, and in particular the engineering and validation aspects, that were pivotal for the success of the projec
How child protection’s ‘investigative turn’ impacts on poor and deprived communities
Get PDFIn recent years there have been major changes in responses to children in need with an ‘investigative turn’ because of widening suspicion of abuse and neglect. This turn is located within an increasingly harsh policy context where support services are being hollowed out at the same time as more families are experiencing poverty and its attendant pressures. This article examines these changes in response to need and outlines the ‘investigative turn’ which it is argued results from a broadening of what is considered reasonable cause to suspect significant harm. It combines research data to show that deprived families experience significant levels of child protection investigations questioning the efficacy of this particularly when these families already suffer high levels of need and shame
Structural insights into the function of ZRANB3 in replication stress response
No full textStrategies to resolve replication blocks are critical for the maintenance of genome stability. Among the factors implicated in the replication stress response is the ATP-dependent endonuclease ZRANB3. Here, we present the structure of the ZRANB3 HNH (His-Asn-His) endonuclease domain and provide a detailed analysis of its activity. We further define PCNA as a key regulator of ZRANB3 function, which recruits ZRANB3 to stalled replication forks and stimulates its endonuclease activity. Finally, we present the co-crystal structures of PCNA with two specific motifs in ZRANB3: the PIP box and the APIM motif. Our data provide important structural insights into the PCNA-APIM interaction, and reveal unexpected similarities between the PIP box and the APIM motif. We propose that PCNA and ATP-dependency serve as a multi-layered regulatory mechanism that modulates ZRANB3 activity at replication forks. Importantly, our findings allow us to interpret the functional significance of cancer associated ZRANB3 mutations
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