Ce Planes Research Articles

Meta-analysis of economic evaluation studies: data harmonisation and methodological issues

BackgroundIn the context of ever-growing health expenditure and limited resources, economic evaluations aid in making evidence-informed policy decisions. Cost-utility analysis (CUA) is often used, and CUA data synthesis is also desirable, but methodological issues are challenged. Hence, we aim to provide a step-by-step process to prepare the CUA data for meta-analysis.MethodsData harmonisation methods were constructed specifically considering CUA methodology, including inconsistent reports, economic parameters, heterogeneity (i.e., country’s income, time horizon, perspective, modelling approaches, currency, willingness to pay). An incremental net benefit (INB) and its variance were estimated and pooled across studies using a basic meta-analysis by COMER.ResultsFive scenarios show how to obtain INB and variance with various reported data: Study reports the mean and variance (Scenario 1) or 95% confidence interval (Scenario 2) of ΔC, ΔE, and ICER for INB/variance calculations. Scenario 3: ΔC, ΔE, and variances are available, but not for the ICER; a Monte Carlo was used to simulate ΔC and ΔE data, variance and covariance can be then estimated leading INB calculation. Scenario-4: Only the CE plane was available, ΔC and ΔE data can be extracted; means of ΔC, ΔE, and variance/covariance can be estimated accordingly, leading to INB/variance estimates. Scenario-5: Only mean cost/outcomes and ICER are available but not for variance and the CE-plane. A variance INB can be borrowed from other studies which are similar characteristics, including country income, ICERs, intervention-comparator, time period, country region, and model type and inputs (i.e., discounting, time horizon).ConclusionOut data harmonisation and meta-analytic methods should be useful for researchers for the synthesis of economic evidence to aid policymakers in decision making.

Synthesis and characterization of the heavy-fermion compound CePtAl4Ge2

We report the synthesis of the Ce-based quaternary compound CePtAl4Ge2 that crystallizes in the trigonal structure (space group R3¯m, 166) with unit cell parameters, a = 4.1995(5) Å, c = 31.851(7) Å, and γ = 120°. Powder X-ray diffraction and energy dispersive X-ray spectroscopy show that CePtAl4Ge2 (LaPtAl4Ge2) is in a single, homogeneous phase. Magnetic susceptibility, electrical resistivity, and heat capacity measurements of CePtAl4Ge2 show that it exhibits antiferromagnetic behavior below 2.3 K. The magnetic susceptibility for the magnetic field applied perpendicular (χab) and parallel (χc) to the crystalline c-axis is very anisotropic, and the susceptibility ratio (χab/χc) reaches a maximum value of 10, indicating that the spin easy axis is within the Ce plane. The entropy recovered at TN is consistent with the doublet ground state of the crystal field split J = 5/2 multiplet of Ce3+ ions.

Preventing recurrent ankle sprains: Is the use of an App more cost-effective than a printed Booklet? Results of a RCT.

Recurrent ankle sprains can be reduced by following a neuromuscular training (NMT) program via a printed Booklet or a mobile application. Regarding the high incidence of ankle sprains, cost-effectiveness regarding implementation can have a large effect on total societal costs. In this economic analysis, we evaluated whether the method of implementing a proven effective NMT program using an App or a Booklet resulted in differences in injury incidence rates leading to costs and hence to differences in cost-effectiveness. In total, 220 athletes with a previous ankle sprain were recruited for this randomized controlled trial with a follow-up of 12months. Half of the athletes used the freely available "Strengthen your ankle" App and the other half received a printed Booklet. After the 8-week program, athletes were questioned monthly on their recurrent injuries. Primary outcome measures were incidence density of ankle injury and incremental cost-effectiveness ratio (ICER). During follow-up, 31 athletes suffered from a recurrent ankle sprain that led to costs resulting in a hazard ratio of 1.13 (95% CI: 0.56-2.27). The incremental cost-effectiveness ratio of the App group in comparison with the Booklet group was €361.52. The CE plane shows that there was neither a difference in effects nor in costs between both intervention methods. This study showed that the method of implementing the NMT program using an App or a Booklet led to similar cost-effectiveness ratios and the same occurrence of recurrent injuries leading to costs. Both the App and the Booklet can be used to prevent recurrent ankle injuries, showing no differences in (cost-) effectiveness at 12-month follow-up.

The cost-effectiveness of interventions targeting lifestyle change for the prevention of diabetes in a Swedish primary care and community based prevention program

BackgroundPolicymakers need to know the cost-effectiveness of interventions to prevent type 2 diabetes (T2D). The objective of this study was to estimate the cost-effectiveness of a T2D prevention initiative targeting weight reduction, increased physical activity and healthier diet in persons in pre-diabetic states by comparing a hypothetical intervention versus no intervention in a Swedish setting.MethodsA Markov model was used to study the cost-effectiveness of a T2D prevention program based on lifestyle change versus a control group where no prevention was applied. Analyses were done deterministically and probabilistically based on Monte Carlo simulation for six different scenarios defined by sex and age groups (30, 50, 70 years). Cost and quality adjusted life year (QALY) differences between no intervention and intervention and incremental cost-effectiveness ratios (ICERs) were estimated and visualized in cost-effectiveness planes (CE planes) and cost-effectiveness acceptability curves (CEA curves).ResultsAll ICERs were cost-effective and ranged from 3833 €/QALY gained (women, 30 years) to 9215 €/QALY gained (men, 70 years). The CEA curves showed that the probability of the intervention being cost-effective at the threshold value of 50,000 € per QALY gained was very high for all scenarios ranging from 85.0 to 91.1%.Discussion/conclusionThe prevention or the delay of the onset of T2D is feasible and cost-effective. A small investment in healthy lifestyle with change in physical activity and diet together with weight loss are very likely to be cost-effective.

Studies of unusual magnetic and electronic properties of the low-carrier system CeP by synchrotron X-rays

We have observed superlattice reflections from the low-carrier system CeP under high pressures up to 2 GPa and also under magnetic field up to 12.5 T by means of synchrotron X-ray diffraction. The observed intensities of superlattice reflections are well explained by a model that takes into account both the lattice and charge modulation due to the periodic arrangement of ferromagnetic double layers of Γ 8-like Ce ions in the lattice of Γ 7 Ce ions. A new magnetic phase with the period of nine Ce planes was found in the experiment at the magnetic field of 12.5 T.

Crystallographic Structure of the Retinal and the Protein after Deprotonation of the Schiff Base: The Switch in the Bacteriorhodopsin Photocycle

We illuminated bacteriorhodopsin crystals at 210 K to produce, in a photostationary state with 60% occupancy, the earliest M intermediate (M 1) of the photocycle. The crystal structure of this state was then determined from X-ray diffraction to 1.43 Å resolution. When the refined model is placed after the recently determined structure for the K intermediate but before the reported structures for two later M states, a sequence of structural changes becomes evident in which movements of protein atoms and bound water are coordinated with relaxation of the initially strained photoisomerized 13- cis,15- anti retinal. In the K state only retinal atoms are displaced, but in M 1 water 402 moves also, nearly 1 Å away from the unprotonated retinal Schiff base nitrogen. This breaks the hydrogen bond that bridges them, and initiates rearrangements of the hydrogen-bonded network of the extracellular region that develop more fully in the intermediates that follow. In the M 1 to M 2 transition, relaxation of the C 14–C 15 and C 15NZ torsion angles to near 180° reorients the retinylidene nitrogen atom from the extracellular to the cytoplasmic direction, water 402 becomes undetectable, and the side-chain of Arg82 is displaced strongly toward Glu194 and Glu204. Finally, in the M 2 to M 2′ transition, correlated with release of a proton to the extracellular surface, the retinal assumes a virtually fully relaxed bent shape, and the 13-methyl group thrusts against the indole ring of Trp182 which tilts in the cytoplasmic direction. Comparison of the structures of M 1 and M 2 reveals the principal switch in the photocycle: the change of the angle of the C 15NZ–CE plane breaks the connection of the unprotonated Schiff base to the extracellular side and establishes its connection to the cytoplasmic side.

A Kondo lattice model for the phase diagram of CeSb at zero field

In this work we present a model to describe the different magnetic phases of CeSb as a function of temperature at zero magnetic field. A Kondo–Heisenberg–ANNNI model with Kondo and ferromagnetic interactions within the Ce planes together with first and second neighbor interplane spin interactions is proposed and solved using a mean-field approach inside the planes and an exact transfer matrix method along the easy direction of the magnetic planes. The total free energy of this effective one-dimensional model is computed and the lowest configurations are obtained by means of a Monte Carlo calculation. We find, within numerical resolution, most of the antiferro-non-magnetic phases below the Néel temperature at zero field, thereby reproducing the data obtained by neutron diffraction.

Magnetic structure of CeAs under high pressure

Neutron diffraction experiments on CeAs revealed that the pressure versus temperature phase diagram and magnetic structures in the phase diagram are very similar to those of CeP. The difference is critical pressure values P c, which are about 0.3 GPa in CeP and about 1.2 GPa in CeAs, and above which the long period magnetic structures composed of Γ 7 and Γ 8 Ce (0 0 1) planes appear. This is discussed in connection with the difference of their carrier numbers and the Γ 8 p-f mixing effect.

Physics of low-carrier system detected by neutron and X-ray scattering: Ce-monopnictides case

The origin of the unusual magnetic properties of Ce-monopnictide, CeX (X=P,As,Sb,Bi), whose carrier density is very low, is discussed on the basis of the physical picture obtained from recent neutron and X-ray scattering experiments. It is revealed that the unusual properties of the compounds originate from the appearance of Γ 8-like Ce ions, the moment value of which is about 2 μ B, among Ce ions with Γ 7 crystal field ground state. The 2 μ B Ce ions appear in the form of ferromagnetic sheets of (0 0 1) planes, which form stacking magnetic structures of various sequences with sandwiching Γ 7 Ce planes depending on the carrier density. The formation of the ferromagnetic sheets of 2 μ B Ce in the Γ 7 Ce lattice is ascribed to the combined effects of strong p–f mixing and carrier localization due to the low-carrier density.

Mixing of Jet Air with a Fuel-Rich, Reacting Crossflow

The mixing of jet air into hot, fuel-rich products of a gas-turbine primary zone is a critical step in staged combustion.Often referred to as quick quench, themixingoccurs instead with chemical conversion and substantial heat release. An experiment has been designed to simulate and study this process. The geometry is a cross ow conŽ ned in a cylindrical duct with a sidewall injection of jets issuing from round holes. A specially designed reactor, operating on propane, presents a uniformmixture to a module containing jet-air-injection oriŽ ces that can be varied in geometry. Temperature and species concentrations of O2 , CO2, CO, and HC are obtained upstream, downstream, and within oriŽ ce planes. From this information,penetration of the jet, the spatial extent of chemical reaction, and mixing can be deduced. Results are presented for a mixing module containing 10 round holes that is operated at a momentum- ux ratio of 57 and a jet-to-mainstreammass- ow ratio of 2.5.

Novel magnetic structures of the low-carrier system CeP under high pressure

The results of neutron scattering experiments on the low-carrier system CeP under high pressure up to 1.7 GPa are presented. The magnetic structures derived from the scattering patterns at various pressures at low temperatures are similar to those of CeP under magnetic field, forming the periodic stacking of the double Γ 8 Ce (0 0 1) planes with sandwiching the Γ 7 Ce (0 0 1) planes. The difference is a wide and systematic change of the period of the stacking of Γ 8 Ce (0 0 1) planes with changing pressure. These results support strongly the magnetic polaron model for the unusual properties of CeP.

Submonolayer structures of Ce adsorbed on Mo(110) surface

The surface structure of Ce adsorbed on a Mo(110) surface was studied by reflection high energy electron diffraction. Five kinds of surface structures were found with different deposition coverages in the submonolayer region. These structures have a common feature that Ce atoms possess a periodicity with double spacing at the atomic rows in the Mo[1̄10] direction. Observed at 1 ML of Ce coverage was a surface structure related to a deformed fcc Ce(111) plane.

Frustration effects in a Kondo lattice: a model for the coexistence of magnetic and non-magnetic Ce planes in CeSb

The coexistence of magnetic and non-magnetic planes, observed by neutron diffraction in CeSb, is described assuming that each Ce plane is a two-dimensional Kondo lattice, interacting with the neighbouring planes through RKKY interaction. We show that, when the Ce planes are close to the Kondo-ferromagnetic instability, such magnetic structures are stabilized if the interplane interactions are frustrated.

Cost - Effectiveness Concepts and the CE Plane

Cost - Effectiveness Concepts and the CE Plane

The CE Plane

The concept of cost-effectiveness is illustrated graphically on the CE plane. Strategies are represented according to their effectiveness (e) and cost (c) relative to those of some reference standard. A straight line with slope K passes through the origin, where K is the maximum acceptable cost-effectiveness ratio. Strategies plotted to the right of line K are cost-effective, while those plotted to the left are not. Furthermore, the most cost-effective of two or more mutually exclusive alternatives is that plotted the greatest distance to the right of K. The CE plane can be used to resolve ambiguities about the meaning of cost-effectiveness and to illustrate its relevance to medical decision making.