Cost-effectiveness Of Techniques Research Articles

Exploring FSO link performance in varied atmospheric conditions to optimize 5G communication with a polarized quasi-diffuse transmitter

Abstract Free space optical (FSO) communication is an innovative technology that holds immense promise for numerous applications thanks to its high data transmission rates, rapid scalability, cost-effectiveness, superior security, and comprehensive capacity access techniques for Gbps data transmission. FSO communication relies on the Earth’s atmosphere as the medium, which introduces atmospheric disturbances that have driven the development of spatial diversity techniques aimed at enhancing the technology’s performance. Our proposed system employs a polarized quasi-diffused system with a fork as a spatial diversity scheme, which eliminates the need for multiple transmitters. We have developed a model that integrates both simulation designs to achieve optimal results. The proposed model has demonstrated excellent performance under various atmospheric turbulences, including rain, fog, and haze, exhibiting a very high maximum quality factor, improved received power, and better bit error rate (BER). Finally, we have obtained, analyzed, and extensively discussed the simulation results to provide a comprehensive understanding of the proposed model’s potential benefits. Our simulations show a maximum quality factor of 23 compared to existing models in much better, a 34 % increase in received power, and a 31 % decrease in BER compared to existing models. These results highlight the potential benefits of the proposed model for FSO communication systems.

Cost–benefit analysis of the COVID-19 vaccination model incorporating different infectivity reductions

The spread and control of coronavirus disease 2019 (COVID-19) present a worldwide economic and medical burden to public health. It is imperative to probe the effect of vaccination and infectivity reductions in minimizing the impact of COVID-19. Therefore, we analyze a mathematical model incorporating different infectivity reductions. This work provides the most economical and effective control methods for reducing the impact of COVID-19. Using data from Ghana as a sample size, we study the sensitivity of the parameters to estimate the contributions of the transmission routes to the effective reproduction number Re. We also devise optimal interventions with cost–benefit analysis that aim to maximize outcomes while minimizing COVID-19 incidences by deploying cost-effectiveness and optimization techniques. The outcomes of this work contribute to a better understanding of COVID-19 epidemiology and provide insights into implementing interventions needed to minimize the COVID-19 burden in similar settings worldwide.

Eye-Readable and Wearable Colorimetric Sensor Arrays for In Situ Monitoring of Volatile Organic Compounds.

Wearable sensors utilize changes in color as a response to physiological stimuli, making them easily recognizable by the naked eye. These colorimetric wearable sensors offer benefits such as easy readability, rapid responsiveness, cost-effectiveness, and straightforward manufacturing techniques. However, their applications in detecting volatile organic compounds (VOCs) in situ have been limited due to the low concentration of complex VOCs and complicated external interferences. Aiming to address these challenges, we introduced readable and wearable colorimetric sensing arrays with a microchannel structure and highly gas-sensitive materials for in situ detection of complex VOCs. The highly gas-sensitive materials were designed by loading gas-sensitive dyes into the porous metal-organic frameworks and further depositing the composites on the electrospun nanofiber membrane. The colorimetric sensor arrays were fabricated using various gas-sensitive composites, including eight dye/MOF composites that respond to various VOCs and two Pd2+/dye/MOF composites that respond to ethylene. This enables the specific recognition of multiple characteristic VOCs. A microfluidic channel made of polydimethylsiloxane (PDMS) was integrated with different colorimetric elements to create a wearable sensor array. It was attached to the surface of fruits to collect and monitor VOCs using the DenseNet classification method. As a proof of concept, we demonstrated the feasibility of the wearable sensing system in monitoring the ripening process of fruits by continuously measuring the VOC emissions from the skin of the fruit.

Tuning the physical properties of inorganic novel perovskite materials Ca3PX3 (X=I, Br and Cl): Density function theory

In photovoltaic technology, inorganic perovskite solar cells formed from halide have developed into a noteworthy prospect, primarily attributable to their exceptional efficiency, cost-effectiveness, and straightforward manufacturing techniques. Lead-free A3BX3 inorganic perovskites have generated significant attention within the environmentally friendly solar industry thanks to their extraordinary characteristics encompassing thermoelectricity, optoelectronics, and elasticity. This research focuses on the attributes of the structural, electrical, and optical inorganic halide perovskites Ca3PX3 (X = I, Br, and Cl) using the first-principles density-functional theory (FP-DFT). According to the electronic band structures, Ca3PI3, Ca3PBr3, and Ca3PCl3 show semiconductor characteristics with a straight bandgap of 1.4909 eV, 1.9502 eV, and 2.2058 eV, respectively, at the Γ(gamma)-point. Whenever one takes consideration into account the spin-orbital coupling (SOC) effect, the bandgap of the Ca3PI3, Ca3PBr3, and Ca3PCl3 perovskites is minimized to 1.2382 eV, 1.6456 eV, and 1.9056 eV. All these structures' bandgaps are compressed under compressive strain while they expand with tensile strain. The optical properties indicate that these materials have outstanding visible light consumption capabilities due to their distinct band features, comprising functions of dielectric, consumption coefficient, and function of electron collapse. Observations indicate that the dielectric constant peaks of Ca3PX3 (where X represents I, Br, or Cl) exhibit a redshift, moving towards lower photon energy levels as compressive strain increases. Conversely, they show a blueshift behavior, shifting to a greater amount of photon energy levels by applying tensile strain. Therefore, these characteristics render Ca3PX3 perovskites highly suitable for optimizing light guidance for solar power and energy retention tools.

Prospective bioencapsulation to improve the quality of phosphate-solubilizing biofertilizers for crop production: A review

Farmers commonly use chemical phosphorus fertilizer to increase crop yields, but long-term use may harm the environment. Biofertilizers specifically phosphate solubilizing microbes (PSMs), are used for restoring soil fertility in crop production. PSMs contribute to plant phosphorus supply by increasing phosphorus availability in the soil through organic acid and phosphatase enzyme secretion. However, the conventional biofertilizer formulation is often limited by a short shelf-life followed by a decreased microbial effectiveness. In recent years, bioencapsulation formulation have received more attention because they offer products that have a longer shelf-life, protect microbes in harsh environments, and maintain the effectiveness of biofertilizers. This literature review focuses on the latest bioencapsulation technology, the impact of bioencapsulation on phosphate-solubilizing biofertilizers, and the potential for developing bioencapsulation-based biofertilizers for sustainable agriculture. Precise formulation is crucial in bioencapsulation, influencing the quality and performance of biofertilizer inoculants. Bioencapsulated biofertilizers offer advantages such as improved nutrient management, enhanced plant stress tolerance, disease suppression, and innovative agricultural waste management. Despite longer shelf life and adaptability to various crops, further research is needed to address scalability, cost-effectiveness, and standardized encapsulation techniques. In conclusion, bioencapsulation innovations have the potential to promote sustainable and productive crop production.

Quality-by-Design-Assisted Optimization of Carvacrol Oil-Loaded Niosomal Gel for Anti-Inflammatory Efficacy by Topical Route.

Niosomes are multilamellar vesicles that effectively transfer active ingredients into the skin's layers. To improve the active substance's penetration across the skin, these carriers are frequently utilized as topical drug delivery systems. Essential oils (EOs) have garnered significant interest in the field of research and development owing to their various pharmacological activities, cost-effectiveness, and simple manufacturing techniques. However, these ingredients undergo degradation and oxidation over time, leading to a loss of functionality. Niosome formulations have been developed to deal with these challenges. The main goal of this work was to create a niosomal gel of carvacrol oil (CVC) to improve its penetration into the skin for anti-inflammatory actions and stability. By changing the ratio of drug, cholesterol and surfactant, various formulations of CVC niosomes were formulated using Box Behnken Design (BBD). A thin-film hydration technique using a rotary evaporator was employed for the development of niosomes. Following optimization, the CVC-loaded niosomes had shown: 180.23 nm, 0.265, -31.70 mV, and 90.61% of vesicle size, PDI, zeta potential, and EE%. An in vitro study on drug release discovered the rates of drug release for CVC-Ns and CVC suspension, which were found to be 70.24 ± 1.21 and 32.87 ± 1.03, respectively. The release of CVC from niosomes best fit the Higuchi model, and the Korsmeyer-Peppas model suggests that the release of the drug followed the non-Fickian diffusion. In a dermatokinetic investigation, niosome gel significantly increased CVC transport in the skin layers when compared to CVC-conventional formulation gel (CVC-CFG). Confocal laser scanning microscopy (CLSM) of rat skin exposed to the rhodamine B-loaded niosome formulation showed a deeper penetration of 25.0 µm compared to the hydroalcoholic rhodamine B solution (5.0 µm). Additionally, the CVC-N gel antioxidant activity was higher than that of free CVC. The formulation coded F4 was selected as the optimized formulation and then gelled with carbopol to improve its topical application. Niosomal gel underwent tests for pH determination, spreadability, texture analysis, and CLSM. Our findings imply that the niosomal gel formulations could represent a potential strategy for the topical delivery of CVC in the treatment of inflammatory disease.

Broad-band-enhanced and minimal hysteresis perovskite solar cells with interfacial coating of biogenic plasmonic light trapping silver nanoparticles

ABSTRACT Perovskite solar cells (PSCs) have evolved into a viable potential alternative energy source due to their cost-effectiveness and simple fabrication techniques. Despite the immense research interest attracted by PSCs, their rooftop application remains constrained by their low efficiency and hysteretic nature. To address these issues, in this paper, the introduction of silver metallic nanoparticles (AgNPs) with plasmonic effect was achieved by an experimental approach to stimulate the generation and transport of charge carriers, which subsequently results to minimal hysteresis and broadband-enhanced plasmonic devices. Due to the far-field light scattering effect, AgNPs improve the light-trapping of the devices. As a result, electrical characteristics and light absorption are significantly enhanced, leading to broadband increase in photovoltaic performance. With the introduction of one coating cycle of AgNPs, the highest power conversion efficiency (PCE) of the perovskite solar cells increases from a reference value of 4.543 to 10.856%. The fill factor (FF) of such a device was 0.650, the current density (J sc) was 18.998 mA/cm2, and voltage (V oc) was 0.879 V. This device shows an improvement of ~139.0% in PCE, ~61.7% in FF, ~43.7% in J sc and ~2.8% in V oc over the pristine device that lacks AgNPs. The findings of this study contribute to further insight and understanding of plasmonic PSCs by offering useful references and recommendations for PSCs with noble metal NPs incorporation.

Designing Hybrid Lanthanum Stannate/Functionalized Halloysite Nanotubes as Electrode Material for Electrochemical Detection of 4-(Methylamino)phenol (Metol) in Environmental Samples

Electrochemical applications such as electrical conductivity, sensitivity, selectivity, cost-effectiveness, and sampling techniques of different forms of pyrochlore oxide have been a field of current interest. In this regard, pyrochlore structured lanthanum stannate nanoparticles (LSO) decorated with functionalized halloysite nanotubes (f-HNT) were prepared via hydrothermal followed by sonochemical synthesis. The obtained samples were characterized through various spectroscopic and microscopic methods to investigate the LSO@f-HNT structure and morphology. Electrocatalytic studies of LSO@f-HNT were performed by cyclic voltammetry (CV) and differential pulse voltammetry (DPV) techniques. The beneficial response of LSO interacting with the hollow structured f-HNT groups of aluminol (Al–OH) and siloxane (Si–O–Si) enhances the electron transmission channel and active site size, both of which contribute to improved electrocatalytic performance. The fabricated sustainable LSO@f-HNT electrocatalyst exhibits outstanding selectivity and linear range (0.01–480 μM) with a detection limit of 2.1 nM and produces good recovery results (97.8–99.68%) under the optimized measurement conditions. This study discusses the design of the LSO@f-HNT composite and its application as an electrode material for the sensitive and focused electrochemical detection of hazardous Metol. This research demonstrates that LSO and f-HNT (LSO@f-HNT) is an excellent electrode material for electrochemical detection of Metol in real-world samples.

P867 Cost-effectiveness and cost-only studies for Inflammatory Bowel Disease surgery: a scoping review

Abstract Background Studies examining the relative cost-effectiveness of surgical procedures and surgery-related interventions for patients with inflammatory bowel disease (IBD) remain limited. This dearth of studies hampers decision-makers’ assessment of surgery-related interventions for IBD patients. The purpose of this study was to conduct a scoping review of available literature for cost-effectiveness analyses of IBD-related surgery. Methods We performed a comprehensive search of English-language articles in MEDLINE, EMBASE, Cochrane Reviews, and Scopus from each database's inception to May 1, 2022. Preplanned controlled vocabulary related to IBD and its subtypes, surgery, and measures of costs were used. We defined study selection criteria to include all IBD-related surgical interventions (including preoperative, intraoperative, and postoperative) in all age groups that also reported a measure of costs of care. Studies comparing medical versus surgical interventions for refractory IBD were excluded. All search findings were screened by two reviewers using titles, abstracts, and ultimately full-length manuscripts. Full screened studies were then extracted for study characteristics and findings to facilitate a qualitative synthesis of results. Results We identified 1,804 citations for screening and ultimately found 10 formal cost-effectiveness studies and 56 cost-only studies. Cost-effectiveness studies assessed intraoperative (50%) and postoperative interventions (50%) mostly in patients with Crohn's disease (60%). Topics included comparisons of surgical approach (50%), venous thromboembolism prophylaxis (30%), and surveillance for postoperative recurrence (2%). Of the cost-only studies, the majority focused on intraoperative interventions (89%), particularly in ulcerative colitis patients (60%). Areas of interest included costs associated with healthcare resource utilization during a surgery-related admission (89%), venous thromboembolism prophylaxis (4%), and others (7%). Pre-defined areas of interest with no reported interventions included IBD-specific roles of Enhanced Recovery After Surgery interventions such as alvimopan, robotic surgery, timing to surgery, surgical therapies for perianal disease, pediatric Crohn's Disease, and genetic testing. Conclusion A scoping review found minimal literature using cost-effectiveness techniques to inform IBD-related surgical care. There are many more cost-only than cost-effectiveness studies related to these clinical topics. This asymmetry highlights immediately available opportunities for broadening the use of cost-effectiveness analysis of IBD-related surgical interventions.

Zinc oxide based gas sensors and their derivatives: a critical review

The most extensively explored gas sensors are metal oxide semiconductor (MOS) materials owing to their high selectivity, stability, cost-effectiveness, and simple synthesis techniques.

Systematic Review of Cost-Effectiveness Analyses Comparing Open and Minimally Invasive Lumbar Spinal Surgery.

Minimally invasive surgery (MIS) has benefits over open surgery for lumbar decompression and/or fusion. Published literature on its cost-effectiveness vs open techniques is mixed. Systematically review the cost-effectiveness of minimally invasive vs open lumbar spinal surgical decompression, fusion, or discectomy using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic electronic search of databases (MEDLINE, Embase, and Cochrane Library) and a manual search from the cost-effectiveness analysis (CEA) database and National Health Service economic evaluation database was conducted. Studies that included adult populations undergoing surgery for degenerative changes in the lumbar spine (stenosis, radiculopathy, and spondylolisthesis) and reported outcomes of costing analysis, CEA, or incremental cost-effectiveness ratio were included. A total of 17 studies were included. Three studies assessed outcomes of MIS vs open discectomy. All 3 reported statistically significant lower total costs in the MIS, compared with the open group, with similar reported gains in quality-adjusted life years (QALYs). Two studies reported cost differences in MIS vs open laminectomy, with significantly lower total costs attributed to the MIS group. Twelve studies reported findings on the relative direct costs of MIS vs open lumbar fusion. Among those, 3 of the 4 studies comparing single-level MIS-transforaminal lumbar interbody fusion (TLIF) and open TLIF reported lower total costs associated with MIS procedures. Six studies reported cost evaluation of single- and 2-level TLIF procedures. Lower total costs were found in the MIS group compared with the open fusion group in all studies except for the subgroup analysis of 2-level fusions in a single study. Three of these 6 studies reported cost-effectiveness (cost/QALY). MIS fusion was found to be more cost-effective than open fusion in all 3 studies. The studies reviewed were of poor to moderate methodological quality. Generally, studies reported a reduced cost associated with MIS vs open surgery and suggested better cost-effectiveness, particularly in MIS vs open single- and 2-level TLIF procedure. Most studies had a high risk of bias. Therefore, this review was unable to conclusively recommend MIS over open surgery from a cost-effectiveness perspective. The incidence of spinal decompressive and fusion surgey and financial constraints on healthcare services continue to increase. This study aims to identify the cost and clinical effectiveness of common approaches to spinal surgery. 3a.

Cu2O-Based Electrochemical Biosensor for Non-Invasive and Portable Glucose Detection.

Electrochemical voltammetric sensors are some of the most promising types of sensors for monitoring various physiological analytes due to their implementation as non-invasive and portable devices. Advantages in reduced analysis time, cost-effectiveness, selective sensing, and simple techniques with low-powered circuits distinguish voltammetric sensors from other methods. In this work, we developed a Cu2O-based non-enzymatic portable glucose sensor on a graphene paste printed on cellulose cloth. The electron transfer of Cu2O in a NaOH alkaline medium and sweat equivalent solution at very low potential (+0.35 V) enable its implementation as a low-powered portable glucose sensor. The redox mechanism of the electrodes with the analyte solution was confirmed through cyclic voltammetry, differential pulse voltammetry, and electrochemical impedance spectroscopy studies. The developed biocompatible, disposable, and reproducible sensors showed sensing performance in the range of 0.1 to 1 mM glucose, with a sensitivity of 1082.5 ± 4.7% µA mM−1 cm−2 on Cu2O coated glassy carbon electrode and 182.9 ± 8.83% µA mM−1 cm−2 on Cu2O coated graphene printed electrodes, making them a strong candidate for future portable, non-invasive glucose monitoring devices on biodegradable substrates. For portable applications we demonstrated the sensor on artificial sweat in 0.1 M NaOH solution, indicating the Cu2O nanocluster is selective to glucose from 0.0 to +0.6 V even in the presence of common interference such as urea and NaCl.

A Scoping Review of Different Methods of Assessing the Impact of New Medical Technologies at Early Stages of Development.

Background: Investing in the R & D sector of new medical technologies is associated with the risk of being rejected by paying organizations because of the lack of value-for-money. The purpose of this study is to investigate the different methods of evaluating the impacts of emerging medical technologies. Methods: Using scoping review method, we analyzed studies that investigated methods for assessing the impacts of emerging medical technologies on development. To find these studies, the Cochran Library, ISI Web of Knowledge, Embase, Ebsco and Pubmed databases from 2000 to 2018 were searched. The methodological quality of the studies was assessed using the STROBE Checklist. Two reviewers independently selected the qualified studies. Charting and collating the data were used based on the method proposed by Arksey and O'Malley. Results: Overall, 38 studies met the inclusion criteria. Sixteen methods were identified and put in five distinct categories: forecasting, Pro-HTA, Early-HTA, priority setting, and HHS were found to measure the impact of emerging technologies. The quality of these studies was acceptable. Few studies were conducted on emerging pharmaceutical technologies, and they were mostly on emerging medical devices. The Early HTA methods were often used to measure the effects of pharmaceutical technologies and medical devices technologies. The Pro-HTA method used dynamic modeling to examine the impact of medical technologies on a broad range of dimensions, while the HTA and Early-HTA methods used cost-effectiveness techniques throughout the development process. The HHS method used a multivariate decision-making technique. Conclusion: Different methods were used to investigate the impacts of emerging medical technologies. Chronologically Pro-HTA methods are new ways for investigating emerging medical technologies beyond clinical and economic impacts. Assessing the feasibility of implementing Pro-HTA in real environments deserves further research.

Preventing the primary debulking: An educational initiative to increase rates of salpingectomy at cesarean delivery

<h3>Objectives:</h3> Opportunistic salpingectomy is being performed at higher rates at benign hysterectomy and interval sterilization than at cesarean delivery (CD). The aim of the study was to assess physician practices in offering and performing bilateral salpingectomy (BS) at time of CD after an educational initiative. <h3>Methods:</h3> We conducted a prospective cohort study of OBGYN physicians who perform cesarean deliveries. We compared outcomes before and after an educational initiative, which comprised of a Grand Rounds presentation on the latest data on BS at CD reviewing feasibility, safety, cost effectiveness and surgical techniques. Chart abstraction assessed patient demographics and rates of BS at CD before and after the intervention. Anonymous physician surveys were also administered before and six months after the intervention. Chi-square or Fisher's exact test were used for categorical variables and T-test or ANOVA for continuous variables. The study was powered to detect a difference of 10% between rates of BS at CD (β=0.20). <h3>Results:</h3> There were 370 (14% of all CD) sterilization procedures completed at time of CD during the year prior to our intervention, and 168 (12% of all CD) in the subsequent 6 months. Rates of BS at CD increased from 5.1% to 17% (p<0.0001). Tubal ligation and BS had similar mean estimated blood loss (684 vs 718cc, p=0.45) and total operative time (51 vs 53min, p=0.59). Patients who underwent BS tended to be married (79% vs 59%, p=0.008), white (79% vs 60%, p=0.26), and non-Hispanic (78% vs 59%, p=0.02). When completing a BS, suture ligation and sealing bipolar electrocautery were utilized at similar rates (50% and 50% after the intervention, p=0.53). A total of 51 surveys were completed before the intervention and 43 completed 6 months afterwards (68% and 57% response rates of OBGYN providers who perform CD). Half of the providers who completed the post-intervention survey had attended the Grand Rounds. Provider characteristics were similar between the 2 groups. In the pre-intervention survey, 88% of providers reported offering their patients a salpingectomy at the time of hysterectomy, 86% at time of interval sterilization and only 37% at time of cesarean delivery. After the intervention, more physicians offered BS at CD to their patients considering permanent sterilization (37% vs 56%, p=0.09). Similarly, more providers reported having ever completed a BS at CD (71% vs. 88%, p=0.04). The most common reasons providers listed for not offering BS at CD included increased bleeding, increased operative time, and inexperience. Over 90% of providers reported that they would feel comfortable completing a BS with an electrocautery bipolar device and only 67% by using suture ligation. <h3>Conclusions:</h3> Educational initiatives can increase provider willingness to offer and to complete bilateral salpingectomy at cesarean delivery. Ongoing educational efforts to encourage bilateral salpingectomy may potentially prevent future cases of ovarian cancer.

A review of minimally invasive techniques for correction of adult spine deformity

This paper highlights the current status of minimally invasive surgery (MIS), with special attention to learning curve, cost-effectiveness, and different techniques, for the correction of adult spine deformity (ASD). A literature review was performed through the PubMed database. Studies that fit the inclusion criteria (n = 27) were analyzed by the authors through the MINORS criteria and their results were then presented. The abundance of data on the learning curve of the procedure shows that it takes at least 22–39 surgeries for a surgeon to reach optimal operative time. The literature search showed that there is a paucity of data available on the cost-effectiveness of the procedure in developing countries; however, if the results from the developed countries were to be considered, MIS is cost-effective for ASD correction. There are certain limitations to the procedure including inadequate sagittal balance as well as chances of proximal junctional kyphosis and adjacent segment disease; however, the overall benefits of MIS including decreased operative time, blood loss, and hospital stay could tilt the balance in its favor.

A Review of the Theoretical Basis, Effects, and Cost Effectiveness of Online Smoking Cessation Interventions in the Netherlands: A Mixed-Methods Approach.

BackgroundTobacco smoking is a worldwide public health problem. In 2015, 26.3% of the Dutch population aged 18 years and older smoked, 74.4% of them daily. More and more people have access to the Internet worldwide; approximately 94% of the Dutch population have online access. Internet-based smoking cessation interventions (online cessation interventions) provide an opportunity to tackle the scourge of tobacco.ObjectiveThe goal of this paper was to provide an overview of online cessation interventions in the Netherlands, while exploring their effectivity, cost effectiveness, and theoretical basis.MethodsA mixed-methods approach was used to identify Dutch online cessation interventions, using (1) a scientific literature search, (2) a grey literature search, and (3) expert input. For the scientific literature, the Cochrane review was used and updated by two independent researchers (n=651 identified studies), screening titles, abstracts, and then full-text studies between 2013 and 2016 (CENTRAL, MEDLINE, and EMBASE). For the grey literature, the researchers conducted a Google search (n=100 websites), screening for titles and first pages. Including expert input, this resulted in six interventions identified in the scientific literature and 39 interventions via the grey literature. Extracted data included effectiveness, cost effectiveness, theoretical factors, and behavior change techniques used.ResultsOverall, many interventions (45 identified) were offered. Of the 45 that we identified, only six that were included in trials provided data on effectiveness. Four of these were shown to be effective and cost effective. In the scientific literature, 83% (5/6) of these interventions included changing attitudes, providing social support, increasing self-efficacy, motivating smokers to make concrete action plans to prepare their attempts to quit and to cope with challenges, supporting identity change and advising on changing routines, coping, and medication use. In all, 50% (3/6) of the interventions included a reward for abstinence. Interventions identified in the grey literature were less consistent, with inclusion of each theoretical factor ranging from 31% to 67% and of each behavior change technique ranging from 28% to 54%.ConclusionsAlthough the Internet may provide the opportunity to offer various smoking cessation programs, the user is left bewildered as far as efficacy is concerned, as most of these data are not available nor offered to the smokers. Clear regulations about the effectiveness of these interventions need to be devised to avoid disappointment and failed quitting attempts. Thus, there is a need for policy regulations to regulate the proliferation of these interventions and to foster their quality in the Netherlands.

Development of a Population-Based Cost-Effectiveness Model of Chronic Graft-Versus-Host Disease in Spain

BackgroundChronic graft-versus-host disease (cGvHD) is the leading cause of late nonrelapse mortality (transplant-related mortality) after hematopoietic stem cell transplant. Given that there are a wide range of treatment options for cGvHD, assessment of the associated costs and efficacy can help clinicians and health care providers allocate health care resources more efficiently. ObjectiveThe purpose of this study was to assess the cost-effectiveness of extracorporeal photopheresis (ECP) compared with rituximab (Rmb) and with imatinib (Imt) in patients with cGvHD at 5 years from the perspective of the Spanish National Health System. MethodsThe model assessed the incremental cost-effectiveness/utility ratio of ECP versus Rmb or Imt for 1000 hypothetical patients by using microsimulation cost-effectiveness techniques. Model probabilities were obtained from the literature. Treatment pathways and adverse events were evaluated taking clinical opinion and published reports into consideration. Local data on costs (2010 Euros) and health care resources utilization were validated by the clinical authors. Probabilistic sensitivity analyses were used to assess the robustness of the model. ResultsThe greater efficacy of ECP resulted in a gain of 0.011 to 0.024 quality-adjusted life-year in the first year and 0.062 to 0.094 at year 5 compared with Rmb or Imt. The results showed that the higher acquisition cost of ECP versus Imt was compensated for at 9 months by greater efficacy; this higher cost was partially compensated for (€517) by year 5 versus Rmb. After 9 months, ECP was dominant (cheaper and more effective) compared with Imt. The incremental cost-effectiveness ratio of ECP versus Rmb was €29,646 per life-year gained and €24,442 per quality-adjusted life-year gained at year 2.5. Probabilistic sensitivity analysis confirmed the results. The main study limitation was that to assess relative treatment effects, only small studies were available for indirect comparison. ConclusionECP as a third-line therapy for cGvHD is a more cost-effective strategy than Rmb or Imt.

Concerns around the human papilloma virus (HPV) vaccine

This debate piece focuses on the concerns of the human papilloma virus (HPV) vaccine specifically in India. It discusses the efficacy of the vaccine side effects cost effectiveness and marketing techniques. It provides strong recommendations and demands to the Indian Government as to how the HPV vaccine should be handled in terms of other reproductive health services the trials and studies that are currently under way and financing and prioritization.

Understanding the effects of changes on the cost‐effectiveness of regression testing techniques

AbstractRegression testing is an expensive testing process used to validate modified software. Regression test selection and test‐case prioritization can reduce the costs of regression testing by selecting a subset of test cases for execution, or scheduling test cases to meet testing objectives better. The cost‐effectiveness of these techniques can vary widely, however, and one cause of this variance is the type and magnitude of changes made in producing a new software version. Engineers unaware of the causes and effects of this variance can make poor choices in designing change integration processes, selecting inappropriate regression testing techniques, designing excessively expensive regression test suites and making unnecessarily costly changes. Engineers aware of causal factors can perform regression testing more cost‐effectively. This article reports the results of an embedded multiple case study investigating the modifications made in the evolution of four software systems and their impact on regression testing techniques. The results of this study expose tradeoffs and constraints that affect the success of techniques and provide guidelines for designing and managing regression testing processes. Copyright © 2003 John Wiley &amp; Sons, Ltd.

Fitting nutrition into the medical model: the role of decision analytic cost-effectiveness techniques

Physicians are accustomed to making decisions based on information regarding the prevalence of disease, symptoms, physical signs, laboratory test results, and the risks and benefits of alternative treatments. If nutritional assessment and therapeutics are to become more common components of medical practice, significant barriers in each of these areas must be overcome. Even rudimentary dietary assessment is often missing from physician education. Dietary assessment tools that are readily available and that have demonstrated usefulness are largely unknown. In addition, many nutritional interventions have not been formally investigated in randomized, controlled trials, and thus their cost-effectiveness remains unknown. We present one approach to these issues by discussing the construction of a decision model examining strategies for vitamin D and calcium screening. The application of medical decision making techniques to problems in clinical nutrition illustrates how findings from research studies may be used to determine the risks, benefits and costs of alternative population based health related nutrition policies which can then be applied by physicians in their daily interactions with patients.