A Diamond Shaped Multilevel Inverter With Dual Mode of Operation

This study presents a novel multilevel inverter structure that can operate in both switched capacitor and asymmetric DC source modes. In the first mode, it can produce seven-level output voltage employing two switched capacitors and one single DC supply. The five-level output voltage is produced while operating the second mode. The voltage ratio between the input and output voltage for the capacitor mode is 1:3 (triple voltage gain). During the first mode, the capacitor of the inverter is self -balanced whereas the inverter can produce higher voltage output in the DC source mode. The proposed inverter reduces the total standing voltage in both modes of operations as it can generate the output voltage without requiring any additional H-bridge circuit. The feasibility and predominate features of the proposed inverter have been established by comparing with existing topologies in terms of power components count. Results obtained from this study are validated using simulation employing sinusoidal pulse width modulation (SPWM). A hardware prototype has also been developed for further validation

Plasma alpha-2-macroglobulin level in moderate to severe psoriasis

Psoriasis is a T-cell mediated chronic inflammatory diseases where pro-inflammatory mediators are involved in its pathogenesis. Alpha-2-macroglobulin (α-2M) is a panproteinase inhibitor having unique clearing role of different cytokines. This study was conducted on 30 patients with moderate to severe psoriasis to see the plasma level of α-2M and was compared with the normal healthy controls. Patients who were already selected for systemic treatment (methotrexate) and consented for routine blood test for monitoring at baseline and 12 weeks after treatment were enrolled along with 10 healthy controls. The venous blood (5 mL) was collected and the plasma alfa-2 macroglobulin was estimated using the enzyme-linked immunosorbent assay. The mean  plasma α-2M level was 3.0 ± 0.4 g/L among the normal healthy persons, and 2.8 ± 0.7 g/L among the untreated patients of psoriasis (p>0.05). Its level among the patients with psoriasis after systemic antipsoriatic drugs was 2.8 ± 0.6 g/L which was not significantly different from the baseline level (p>0.05). The study shows that the plasma α-2M  level in psoriasis is not different comparing with normal healthy persons

Cost-effectiveness of the introduction of two-dose bi valent (Cervarix) and quadrivalent (Gardasil) HPV vaccination for adolescent girls in Bangladesh

Background: Cervical cancer is one of the most prevalent cancers in women caused by the human papillomavirus (HPV) that leads to a substantial disease burden for health systems. Prevention through vaccination can significantly reduce the prevalence of cervical cancer. The objective of this study is to evaluate the potential health and economic impacts of introducing two-dose bivalent (Cervarix) and quadrivalent (Gardasil) HPV vaccines in Bangladesh. Methods: The study uses the Papillomavirus Rapid Interface for Modelling and Economics (PRIME) model to assess the cost-effectiveness of introducing HPV vaccination. The incremental cost-effectiveness ratios (ICERs) were estimated per disability-adjusted life years (DALYs) averted using the cost-effectiveness threshold (CET). The analyses were done from a health system perspective in terms of vaccine delivery routes. Results: Introduction of bi-valent HPV vaccination was found highly cost-effective (ICER = US$488/DALY) at Gavi (The Vaccine Alliance for Vaccines and Immunizations) negotiated prices. The value of ICERs were US$710, US$356 and US$397 per DALY averted for school-based, health facility-based, and outreachbased programs, respectively, which is consistent with the CET range (US$67 to US$854). However, bivalent and quadrivalent vaccines at listed prices were not found cost-effective, with ICERs of US$1405 and US$3250 per DALY averted, respectively, that exceeds the CETs values. Conclusions: Introducing a two-dose bi-valent HPV vaccination program is cost-effective in Bangladesh at Gavi negotiated prices. Vaccine price is the dominating parameter for the cost-effectiveness of bivalent and quadrivalent vaccines. Both vaccines are not cost effective at listed prices in Bangladesh. The evaluation highlights that introducing the two-dose bivalent HPV vaccine at Gavi negotiated prices into a national immunization program in Bangladesh is economically viable to reduce the burden of cervical cancer

Relationship of Soluble RAGE with Insulin Resistance and Beta Cell Function during Development of Type 2 Diabetes Mellitus

This study examined whether circulating levels of soluble receptor for advanced glycation end products (sRAGE) alter in prediabetes and correlate with insulin resistance (IR) and beta cell function in prediabetes and newly diagnosed type 2 diabetes mellitus (T2DM). Subjects without previous history of diabetes were recruited and grouped as control, prediabetes, and newly diagnosed T2DM. The control subjects (n=40) and people with prediabetes (n=52) and diabetes (n=66) were similar in terms of age, sex, BMI, systolic and diastolic BP, and fasting insulin level. HOMA-IR was found significantly higher in people with diabetes than control subjects (p<0.001) and people with prediabetes (p=0.005); and HOMA-%B was found significantly deteriorated in people with diabetes (p<0.001) compared to control subjects and people with prediabetes. However, serum sRAGE levels did not show any significant alteration in people with prediabetes compared to control subjects. Moreover, univariate and multivariate analyses did not identify any significant correlation and statistical association of sRAGE with HOMA-IR and HOMA-%B in people with prediabetes and newly diagnosed T2DM. Our data suggest that serum sRAGE levels do not alter in people with prediabetes compared to control subjects and do not correlate or associate with IR and beta cell function during development of T2DM