Cost-effective Use Research Articles

GINGIVAL MARGIN, CORRECTION IN ORTHOPEDIC DENTISTRY

A big problem for obtaining aesthetic and functional results of dental treatment is the condition of the gingival papillae. The effectiveness of orthopedic interventions without high-quality correction of the marginal edge of the gums can lead to an unsatisfactory result and the occurrence of numerous complications Materials and methods. A literature search was conducted in the PubMed and Medline databases for the period 2000-2024, for which the following keywords were used: correction of soft gingival tissues, fixed dentures, effectiveness, front group of teeth. A general search revealed 112 sources regarding gingival margin correction in fixed dentures. The primary exclusion referred to literary sources in which the correction of the gingival margin applied to all types of prosthetics. Literary sources that contained only reference information were included in the secondary exclusion. As a result, only relevant full-text articles in professional journals remained (n=25). The purpose of the research is to analyze the methods of gingival margin correction in orthopedic dentistry at the current stage, to formulate relevant tasks for further research. Research results. Methods of restoration of the aesthetics of the marginal part of the gums during orthopedic treatment are divided into the following groups: plastic of soft and bone tissues; laboratory and technical procedures; use of materials for artificial gums. It has been established that the plastic-surgical method is used for the loss of the gingival papilla, defects of the ridge of the alveolar process, asymmetric contour of the gums, and their unaesthetic shape. Correction of the gums allows to achieve satisfactory aesthetic results both at the final stage of orthopedic treatment (prosthetics with fixed orthopedic prostheses) and at the intermediate stage of temporary prosthetics with plastic fixed prostheses. It was found that the most common methods of gingival margin correction are flap operations on the gums using the technique of lateral movement of the muco-osseous flap. These include the following types of interventions: endothelial modification from the tooth-alveolar ridge; oblique displaced flap; periosteally stimulated flap; partial or complete split flap. The positive effect of hyaluronic acid on the healing of the gingival margin and tissue regeneration has been proven. Several researches have shown the positive effects of hyaluronic acid on gingival margin healing and tissue regeneration due to its properties to stimulate cell adhesion, migration and proliferation, mediate cell signaling. The authors indicate a better effectiveness of hyaluronic acid in relation to periodontal parameters during the correction of the marginal gingival margin. The use of a laser scalpel is characterized by less pronounced traumatization of tissues, lower temporary costs for intervention, reduced blood loss, less pronounced signs of inflammation in the postoperative period, relative simplicity and cost-effectiveness of use. Conclusions. To date, only a combination of various orthopedic and surgical manipulations allows to achieve an optimal aesthetic result during prosthetics with fixed dentures of the front group of teeth.

THERMAL ADAPTIVE ARCHITECTURE: INTERPLAY BETWEEN ARCHITECTURE AND CLIMATE

The concept of architecture as a form of shelter, integral to both classical and contemporary discourse emphasizes the interplay between building structures and their climatic contexts. Vitruvius early observations underscore the importance of understanding how buildings act as barriers and responsive filters to their environments thereby shaping human activities. This paper explores the multi-faceted roles of buildings-functional, social, symbolic, artistic and their interconnections with thermal performance. While the adaptability of buildings to thermal conditions is well recognized, the impact of fluctuating economic factors such as energy prices, and the unpredictability of space usage add layers of complexity to thermal performance assessments. The research highlights the gap between theoretical knowledge and practical application in achieving optimal thermal conditions. By examining the integration of precise thermal techniques into building design this study aims to bridge these gaps and propose strategies for designing climate-sensitive architecture. The focus is on achieving comfortable and healthy living environments while ensuring cost-effective resource use. This approach advocates for a refined understanding of thermal response and its application in the design-build-occupy process ultimately contributing to more efficient and adaptive building practices.

Exploring the potential cost-effectiveness of a new computerised decision support tool for identifying fetal compromise during monitored term labours: an early health economic model

BackgroundAround 60% of term labours in the UK are continuously monitored using cardiotocography (CTG) to guide clinical labour management. Interpreting the CTG trace is challenging, leading to some babies suffering adverse outcomes and others unnecessary expedited deliveries. A new data driven computerised tool combining multiple clinical risk factors with CTG data (attentive CTG) was developed to help identify term babies at risk of severe compromise during labour. This paper presents an early health economic model exploring its potential cost-effectiveness.MethodsThe model compared attentive CTG and usual care with usual care alone and simulated clinical events, healthcare costs, and infant quality-adjusted life years over 18 years. It was populated using data from a cohort of term pregnancies, the literature, and administrative datasets. Attentive CTG effectiveness was projected through improved monitoring sensitivity/specificity and potential reductions in numbers of severely compromised infants. Scenario analyses explored the impact of including litigation costs.ResultsNationally, attentive CTG could potentially avoid 10,000 unnecessary alerts in labour and 2400 emergency C-section deliveries through improved specificity. A reduction of 21 intrapartum stillbirths amongst severely compromised infants was also predicted with improved sensitivity. Attentive CTG could potentially lead to cost savings and health gains with a probability of being cost-effective at £25,000 per QALY ranging from 70 to 95%. Potential exists for further cost savings if litigation costs are included.ConclusionsAttentive CTG could offer a cost-effective use of healthcare resources. Prospective patient-level studies are needed to formally evaluate its effectiveness and economic impact in routine clinical practice.

A systematic review of cost-effectiveness analyses of gene therapy for hemophilia type A and B.

In 2022-2023, the US Food and Drug Administration approved 2 novel gene therapies, valoctocogene roxaparvovec and etranacogene dezaparavovec, for hemophilia A and B, respectively. These one-time-administered gene therapies have been marketed at prices that create financial challenges for payers and patients. Understanding the magnitude and uncertainties around the long-term value of these therapies and how they can potentially relate to managed care practices is of high interest to the payer and patient community. To conduct a systematic review of cost-effectiveness analysis (CEA) studies to assess (1) the long-term value of valoctocogene roxaparvovec and etranacogene dezaparavovec and (2) the relevance and validity of the underlying data and assumptions used in the CEA models and discuss how they relate to the challenges identified for CEAs of gene therapies. A systematic review of cost-effectiveness studies of novel hemophilia A and B gene therapy was conducted. PubMed and Embase were searched for published studies from inception to January 12, 2024. Original research articles published in English that conducted a CEA on gene therapy treatments for hemophilia A and B, with a comparison of incremental costs and health effects, were considered. Critical appraisal of the quality of reporting and the underlying modeling assumptions were conducted to assess the relevance and validity of the results. Two hundred thirty-eight studies were identified, of which 4 met the inclusion criteria. Three studies were conducted from a US health care perspective and 1 from a Dutch societal perspective. Despite the high upfront costs of the gene therapies, all included studies' (3 hemophilia A and 1 hemophilia B) modeled results showed that gene therapies had lower overall costs and better health outcomes compared with factor concentrate replacement therapies and emicizumab. The results were driven by the assumption that gene therapies will have a durable effect of at least 10 years and offset the high cost of the current standard of care. The modeled health improvements varied substantially across studies, showing that the long-term value is sensitive to varying clinical and economic assumptions. The novel hemophilia gene therapy treatments can potentially be a cost-effective use of treatment resources if the treatment effects are durable over time. To reduce the risk for payers while still facilitating patient access, outcomes-based agreements similar to what has recently been proposed by the Centers for Medicare & Medicaid Services for sickle-cell therapies are well supported.

A Cost-Effectiveness Analysis of Axicabtagene Ciloleucel versus Tisagenlecleucel in the Treatment of Diffuse Large B-cell Lymphoma Based on a Real-World French Registry.

Axicabtagene ciloleucel (axi-cel) and tisagenlecleucel (tisa-cel) are chimeric antigen receptor T-cell therapies that were evaluated in third and later line (3L+) relapsed or refractory (r/r) diffuse large B-cell lymphoma (DLBCL) in the ZUMA-1 and JULIET trials, respectively. As of October 2021, the DESCAR-T registry included 729 French patients with 3L+r/r DLBCL who received axi-cel or tisa-cel. Using these data, propensity score matching was used to conduct an adjusted comparison between axi-cel and tisa-cel. Axi-cel was associated with statistically significant improvements in overall survival (OS) and progression-free survival (PFS), and significantly more frequent Grade≥3 immune effector cell-associated neurotoxicity syndrome (ICANS), compared with tisa-cel. There was no significant difference in Grade≥3 cytokine release syndrome (CRS). The current analysis assessed the cost-effectiveness of axi-cel versus tisa-cel in the treatment of 3L+r/r DLBCL using propensity score-matched data from the DESCAR-T registry. A partitioned survival model was used to extrapolate costs and quality-adjusted life years (QALYs) over a lifetime. Survival curves for PFS and OS were based on independent mixture cure models fitted to digitized Kaplan-Meier data for the propensity score-matched DESCAR-T populations. Average duration of intensive care unit stays for each of axi-cel and tisa-cel in DESCAR-T were used to inform adverse event costs. Selected parametric survival distributions were based on clinical expert validation. Utility values were derived from ZUMA-1, and costs were obtained from French registries and published sources. List prices were used for both axi-cel and tisa-cel. Costs and outcomes were discounted at an annual rate of 2.5%. Axi-cel is associated with an incremental cost-effectiveness ratio of €15,520 per QALY compared with tisa-cel. Based on explicit willingness-to-pay thresholds applied in Europe, axi-cel is expected to be a cost-effective use of healthcare resources in real-world clinical settings compared with tisa-cel in 3L+r/r DLBCL.

Harnessing wood bottom ash for efficient arsenic removal from wastewater: Adsorption mechanisms and process optimisation

This study explored the innovative application of wood bottom ash (WBA) as an adsorbent for arsenic (As) removal from wastewater, focusing on the adsorption mechanism and optimisation of the operational conditions. Comprehensive spectroscopic analyses, including FE-SEM/EDS, BET, XRF, XRD, FT-IR, and XPS, were performed to examine the elemental and mineralogical changes in WBA before and after As adsorption. The study assessed the adsorption kinetics and isotherms, revealing that As adsorption reached equilibrium within 48 h, with a maximum capacity of 121.13 mg/g. The adsorption process followed a pseudo-second-order kinetic model and aligned well with the Langmuir isotherm, indicating that the process is governed by chemisorption and occurs as monolayer adsorption. The primary removal mechanism was the surface precipitation of amorphous calcium arsenate. Response surface methodology was employed to analyse and optimise the factors influencing As removal, including solution pH, ionic strength, adsorbent dose and reaction time. The optimal conditions for maximum As removal were pH 7.11, 8.37 mM ionic strength, 9.08 g/L WBA dose, and 2.58 h reaction time. This study offers novel insights into the efficient and cost-effective use of WBA for As removal, highlighting its potential as a sustainable solution for wastewater treatment in developing countries.

CO2 Sorption on Ti-, Zr-, and [Ti,Zr]-Pillared Montmorillonites.

Montmorillonite is a layered clay mineral whose modification by pillaring, i.e., insertion of oxide nanoclusters between the layers, yields porous materials of great potential in sorption and catalysis. In the present study, an unrefined industrial bentonite from Kopernica (Slovakia), containing ca. 70% of montmorillonite, was used for the preparation of Ti-, Zr-, and mixed [Ti,Zr]-pillared clay sorbents. The pillared samples were characterized with X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), and N2 adsorption at -196 °C and tested for the capacity of CO2 sorption at 0 °C and 1 bar pressure. The experiments revealed that pillared samples sorbed at least four times more CO2 than the parent bentonite. Of the materials tested, the sample pillared with mixed [Ti,Zr] oxide props showed the best performance, which was attributed to its superior microporosity. The results of CO2 adsorption demonstrated that the cost-effective use of crude industrial bentonite as the sorbent precursor is a viable synthesis option. In another experiment, all pillared montmorillonites were subjected to 24 h exposure at room temperature to a flow of dry CO2 and then tested using simultaneous thermal analysis (STA) and the mass spectrometry (MS) analysis of the evolving gases (STA/QMS). It was found that interaction with dry CO2 reduces the amount of bound carbon dioxide and affects the processes of dehydration, dehydroxylation, and the mode of CO2 binding in the pillared structure.

The IMS Library: from IN-Stock to Virtual.

A chemical library is a key element in the early stages of pharmaceutical research. Its design encompasses various factors, such as diversity, size, ease of synthesis, aimed at increasing the likelihood of success in drug discovery. This article explores the collaborative efforts of computational and synthetic chemists in tailoring chemical libraries for cost-effective and resource-efficient use, particularly in the context of academic research projects. It proposes chemoinformatics methodologies that address two pivotal questions: first, crafting a diverse panel of under 1000 compounds from an existing pool through synthetic efforts, leveraging the expertise of organic chemists; and second, expanding pharmacophoric diversity within this panel by creating a highly accessible virtual chemical library. Chemoinformatics tools were developed to analyse initial panel of about 10,000 compounds into two tailored libraries: eIMS and vIMS. The eIMS Library comprises 578 diverse in-stock compounds ready for screening. Its virtual counterpart, vIMS, features novel compounds guided by chemists, ensuring synthetic accessibility. vIMS offers a broader array of binding motifs and improved drug-like characteristics achieved through the addition of diverse functional groups to eIMS scaffolds followed by filtering of reactive or unusual structures. The uniqueness of vIMS is emphasized through a comparison with commercial suppliers' virtual chemical space.

506 The Potential for Cost effective use of mobile devices and MCQ banks for international assessment, or recognition of mastery, based on the Australian Experience

506 The Potential for Cost effective use of mobile devices and MCQ banks for international assessment, or recognition of mastery, based on the Australian Experience

Promising porous spherical PbI2/poly-2-aminobenzenethiol nanocomposite as a photocathode for hydrogen generation from Red Sea water

A highly efficient porous spherical nanocomposite photocathode, known as PbI2/poly-2-amino benzene thiol (PbI2/P2ABT), is created through a two-step reaction process involving the oxidation of 2-amino benzene thiol with iodine, followed by a double displacement reaction. The resulting nanocomposite displays outstanding morphology, comprising spherical particles with a diameter of 500 nm and featuring nanoscale porosity with pore sizes around 5 nm. Notably, the hydrogen production estimate reaches 9.6 μmole/h·10 cm2, a promising outcome attributed to the environmentally friendly and cost-effective use of natural Red Sea water. The quantification of hydrogen gas is accomplished by assessing the photogenerated carriers using the current density relationship. The calculated Jph value experiences a substantial increase to −0.122 mA.cm−2 compared to a minimal 0.07 mA.cm−2 in the absence of light. Furthermore, the optical assessment reveals exceptional Jph values under 340 nm, reaching 0.121 mA.cm−2, which extends to the visible spectrum with a value of 0.112 mA.cm−2. The remarkable features of this nanocomposite include its cost-effectiveness, ease of fabrication, and scalability for mass production. These qualities collectively enable the conversion of Red Sea water into hydrogen gas, offering a practical and efficient solution aligned with eco-friendly and economically viable practices. This nanocomposite shows significant potential for advancing clean energy technologies and contributing to sustainable hydrogen production from natural water sources.

Investigation of adsorption potential of waste jewelry meerschaum powder for Cu(II) and cationic dye

The presence of heavy metals and pollutant dyes can have detrimental effects on aquatic ecosystems and compromise aquatic aesthetics. This study investigates the use of unprocessed waste gem meerschaum powder as a new adsorbent in the removal of both Cu(II) and methylene blue (MB) from aqueous solutions to reduce water pollution. The structure of the waste powder was characterized by FT-IR, XRD, SEM and BET methods. Optimization of Cu(II) and MB dye removal was carried out using design of experiment technique. Under optimum conditions, remarkable removal efficiencies of 95.5% (± 3.7) for Cu(II) and 97.8% (± 0.4) for MB were achieved. The removal of Cu(II) followed the Freundlich isotherm model, while the removal of MB dye adhered to the Langmuir isotherm model. Both adsorption processes obeyed the pseudo-second-order kinetic model and occurred spontaneously. This innovative approach offers a promising solution to water pollution by highlighting the importance of sustainable and cost-effective waste use.

Real-world biomarker variability and effects of biologics on severe asthma in Alberta

Rationale: Guidelines recommend biomarker testing to phenotype patients with severe asthma (SA), to guide treatment. However, biomarker levels fluctuate, and individual responses to biologics are not fully understood. Objectives: This study estimated the proportion of patients experiencing biomarker variability and the real-world effectiveness of biologics in SA. Methods: A population-based retrospective cohort study was conducted using administrative data from Alberta, Canada (April 1, 2010 to March 31, 2020) for patients with SA. Year-to-year variability in biomarker levels was assessed using clinical thresholds (blood eosinophil count [EOS] ≥ 300 cells/µL; immunoglobin E [IgE] ≥ 30 IU/mL) to explore category switching. Incidence rate ratios of exacerbations were estimated by biomarker level. Associations between follow-up time with biologics exposure (bio-experience), biomarker levels and exacerbation rates were modeled. Results: Up to 28% of SA patients displayed year-over-year biomarker threshold switching for EOS and up to 12% for IgE. Severe exacerbation rates were higher with blood EOS count ≥300cells/µL or IgE ≥30 IU/mL. Bio-experience was associated with lower blood EOS versus pre-bio-experience (relative mean EOS: 0.53 [0.42-0.68]), persisting >1 year following discontinuation. Bio-experience was associated with a nearly 50% reduction in exacerbation risk after initiating biologics (IRR = 0.54 [0.48, 0.62]), regardless of comorbid status. Conclusions: Higher biomarker levels were associated with higher exacerbation rates, but a proportion of patients demonstrated variability, crossing clinical thresholds. Treatments with upstream agents targeting multiple pathways of inflammation may circumvent this issue. Biologics had real-world effectiveness in reducing SA biomarkers. Their persistent temporal effect provides a groundwork for exploring cost-effective biologics use.

Biomass Pellet Processing from Sugar Industry Byproducts: A Study on Pelletizing Behavior and Energy Usage

As global energy demand has increased, bioenergy has emerged as a viable option for reducing greenhouse gas emissions. This study focuses on using waste materials from the sugar industry, such as sugarcane straw, bagasse, and filter cake, to compress into pellets to investigate pelletizing behavior and energy usage. Raw material preparation was a critical phase influencing pelletizing efficiency. Biomass pellet quality depended on a uniform particle size distribution and adequate moisture content. A moisture content of 20% (wb) was found to be suitable for biomass pelletization from the sugar sector. Specific energy in the pelletizing process ranged from 144.28 to 197.85 Wh/kg. The suggested mixing ingredients (sugarcane leaves: bagasse: filter cake) of 0% sugarcane leaves, 90% bagasse, 10% filter cake, and 5% sugarcane leaves, 93.5% bagasse, and 1.5% filter cake resulted in pellets with a bulk density of over 600 kg/m3 and a durability of at least 97.5%. All aspects were assessed according to standardized criteria for developing biomass pellet processing technology from sugar industry byproducts. This method could improve efficiency, boost production volume, lower production costs, and promote the efficient and cost-effective use of renewable energy.

REVIEW: AN EXPERIMENTAL STUDY ON EFFECT OF NANO MATERIALS ON STRENGTH OF CONCRETE AND PLANE STRESS ANALYSIS USING ANSYS SOFTWARE

These days, making efficient and cost-effective use of resources has taken precedence. The main ingredient in concrete, cement has been under criticism in recent years for the quantity of CO2 released during production. Although cement has better mechanical properties, it hasn't been able to live up to the expectations in terms of durability. Owing to cement's shortcomings, scientists started looking into additives that would enhance concrete's qualities while also making it stronger and lighter. Fly ash, silica fume, and other micro particles were added to cementitious materials to improve their compactness, strength, and durability. These additives were also selected because they are eco-friendly by products of industrial waste that may be handled ethically. Fly ash has significant disadvantages because it is not good for initial strength increase and setting time. Because silica fume affects cementitious material performance, researchers have recently become interested in combining it with ceramic waste and rice husk ash. A more effective way to utilize rice husk ash, a by-product of rice cultivation, would be to replace 10% to 15% of cement. Studies have shown improvements in the durability performance of recycled ceramic waste concrete and rice husk ash concrete. There are issues since the RHA production process is quite time-consuming. With the discovery of nano-particles (NP) smaller than 100 nm, researchers have advanced the field of nanotechnology to new levels. The mechanical properties of many materials, including polymers and cementitious materials, can be enhanced by NP. NP is also helpful in the fields of food, engineering, and medicine. This led researchers to investigate the effects of nano-silica (NS) on concrete in further detail. Nano materials can improve the compressive strength and ductility of concrete. In this project an effort will be made to increase the compressive strength of concrete using Nano materials and waste product like GGBS. Also plane stress analysis of concrete cubes and cylinders is to be done using Ansys Software to find deformation, principal stresses and shear stresses. Keywords: Nano –Silica, Nano Titanium dioxide, Ansys, GGBS, Compressive strength

Exploring the Cost-Effectiveness of Newborn Screening for Metachromatic Leukodystrophy (MLD) in the UK.

Metachromatic leukodystrophy (MLD) is a fatal inherited lysosomal storage disease that can be detected through newborn bloodspot screening. The feasibility of the screening assay and the clinical rationale for screening for MLD have been previously demonstrated, so the aim of this study is to determine whether the addition of screening for MLD to the routine newborn screening program in the UK is a cost-effective use of National Health Service (NHS) resources. A health economic analysis from the perspective of the NHS and Personal Social Services was developed based on a decision-tree framework for each MLD subtype using long-term outcomes derived from a previously presented partitioned survival and Markov economic model. Modelling inputs for parameters related to epidemiology, test characteristics, screening and treatment costs were based on data from three major UK specialist MLD hospitals, structured expert opinion and published literature. Lifetime costs and quality-adjusted life years (QALYs) were discounted at 1.5% to account for time preference. Uncertainty associated with the parameter inputs was explored using sensitivity analyses. This health economic analysis demonstrates that newborn screening for MLD is a cost-effective use of NHS resources using a willingness-to-pay threshold appropriate to the severity of the disease; and supports the inclusion of MLD into the routine newborn screening programme in the UK.

Enhanced peroxymonosulfate activation by δ-MnO2 nanocatalyst enriched with oxygen vacancies for phenolic pollutants polymerization

Heterogeneous advanced oxidation processes technology holds great potential for the removal of toxic phenolic molecules in water, but is currently challenged by overuse of oxidation agents and undesirable carbon emissions during the mineralization process. The present work demonstrates that with an oxygen-vacancy-rich Fe doped δ-phase MnO2 (δ-MnO2) as the nanocatalyst, the phenol (PhOH) could be removed with high selectivity as well as effective conversion into non-toxic phenolic polymers via a non-radical electron transfer route, instead of complete mineralization by common radical attacking route. Oxygen vacancies in δ-MnO2 were enriched by Fe doping, which greatly improved the activation of peroxymonosulfate (PMS) by extending the length of the O-O bond in PMS. A 6.68-fold enhancement of the removal rate of PhOH was achieved by Fe doping δ-MnO2, compared to the pristine δ-MnO2. Moreover, the consumption of PMS could be reduced by up to 95.08 %, and the carbon emissions were also reduced by up 99.13 % during the polymerization process. The present study manifests that rationally designing a non-radical route offers significant potential for the cost-effective use of oxidation agents as well as reducing carbon emissions, presenting a superior approach for the target of achieving carbon neutrality in environmental remediation.

Michael Scriven and “The Missing Half of Quantitative Evaluation”

Although Michael Scriven is one of the most recognized parents of program evaluation in general, it may be surprising to learn that he also was a founder of cost-inclusive evaluation (CIE) in particular. CIE incorporates into evaluations information on the amounts, types, and monetary values of resources used by programs to achieve outcomes, and, increasingly, the monetary value of those outcomes (Herman et al., 2009; Persaud & Yates, 2023; Yates, 1996). Michael Scriven blazed a trail toward routine use of cost, cost-effectiveness, and cost-benefit analyses by emphasizing that evaluations should measure costs as well as nonmonetary and monetary outcomes, and should compare costs and outcomes for alternative programs in cost-effectiveness and cost-benefit analyses. Scriven also was emphatic that CIE be recognized as a core evaluator competency. Noting that “cost analysis” in evaluation was “the missing half of quantitative evaluation” (Scriven, 2008a, p. iii), he did not immediately succeed in convincing most evaluators that program costs, and monetary program outcomes, were essential to assess. However, his publications, his supervision, and his encouragement of junior colleagues legitimized and recognized CIE as nothing else could.

A master-slave adaptive linear neuron-based approach for cost-effective use of battery energy storage systems in wind farms

Nowadays, clean and sustainable energy development is of essential concern, which justifies use of renewable energy sources. Wind energy is an important resource to provide such a demand. Due to the high costs of wind power generation compared to other renewable sources, the wind turbines should be designed in such a way that they usually operate at the highest point of their power. In this case, because of the random and alternating wind speed, the output power of the wind turbine generators and thus the windfarms fluctuate. When the capacity of windfarms is increased, the power injected from the windfarm into the grid can have significant negative effects on the power grid stability. In order to prevent these effects, it is necessary to use BESSs in windfarms. To this end, a waveform with acceptable fluctuations is considered for the windfarm output power. This waveform is compared with the output power waveform and then the difference between the two waveforms is compensated by a BESS. Proper tracking with the minimum delay reduces the required BESS capacity and thus initial investment cost for the windfarms is significantly reduced. In this paper, using real windfarm data, the conventional tracking methods for the windfarm output power waveform are analyzed and compared, first. Then, a novel tracking scheme, namely the MSA, is proposed, which is based on a two-fold master-slave adaptive linear neuron. Acquired results show that compared with the conventional methods, using the MSA scheme can reduce the costs of a 99 MW windfarm by 4.8 million dollars.

Integrating Renewable Energy Solutions in Small-Scale Industrial Facilities

The purpose of this study was to analyze the economical suitability of numerous on-site renewable electricity generation technologies which were intended to be used in a recently built industrial facility designed and utilized as a warehouse. The facility was located in the vicinity of Riga, Latvia. Data were collected and calculations were performed within the scope of the project “Mitigating Energy Poverty through Innovative Solutions” as part of several planned activities to address the broad spectrum of energy poverty and self-reliance issues in both the residential sector and small-scale industrial facilities. During the project, evaluations of various renewable energy technologies, including PV installations, wind energy installations, battery storage solutions, and hybrid technologies, were carried out. The aim of these evaluations was to develop an electricity production–consumption model for efficient and cost-effective energy use and to reduce greenhouse gas emissions from the test facility. A model was created and subsequent research scenarios were developed based on a payback period instead of the net present value criterion. The project was carried out over several steps to develop a calculation methodology. The open access databases of energy resource providers were used to evaluate statistical data and make forecasts for the analysis of the electricity consumption of companies. MATLAB/Simulink 23/2 was used for the data analysis, and the H-TEC method was employed. This made it possible to modulate the required production capacity as the model allowed for the addition of new modules to modules already installed. The project results proved that despite high initial investment costs, renewable energy sources and efficient storage systems can provide cost-effective solutions and reduce dependence on fossil fuels in the long term.

Laparoscopic cholecystectomy versus conservative management for adults with uncomplicated symptomatic gallstones: the C-GALL RCT.

Gallstone disease is a common gastrointestinal disorder in industrialised societies. The prevalence of gallstones in the adult population is estimated to be approximately 10-15%, and around 80% remain asymptomatic. At present, cholecystectomy is the default option for people with symptomatic gallstone disease. To assess the clinical and cost-effectiveness of observation/conservative management compared with laparoscopic cholecystectomy for preventing recurrent symptoms and complications in adults presenting with uncomplicated symptomatic gallstones in secondary care. Parallel group, multicentre patient randomised superiority pragmatic trial with up to 24 months follow-up and embedded qualitative research. Within-trial cost-utility and 10-year Markov model analyses. Development of a core outcome set for uncomplicated symptomatic gallstone disease. Secondary care elective settings. Adults with symptomatic uncomplicated gallstone disease referred to a secondary care setting were considered for inclusion. Participants were randomised 1: 1 at clinic to receive either laparoscopic cholecystectomy or observation/conservative management. The primary outcome was quality of life measured by area under the curve over 18 months using the Short Form-36 bodily pain domain. Secondary outcomes included the Otago gallstones' condition-specific questionnaire, Short Form-36 domains (excluding bodily pain), area under the curve over 24 months for Short Form-36 bodily pain domain, persistent symptoms, complications and need for further treatment. No outcomes were blinded to allocation. Between August 2016 and November 2019, 434 participants were randomised (217 in each group) from 20 United Kingdom centres. By 24 months, 64 (29.5%) in the observation/conservative management group and 153 (70.5%) in the laparoscopic cholecystectomy group had received surgery, median time to surgery of 9.0 months (interquartile range, 5.6-15.0) and 4.7 months (interquartile range 2.6-7.9), respectively. At 18 months, the mean Short Form-36 norm-based bodily pain score was 49.4 (standard deviation 11.7) in the observation/conservative management group and 50.4 (standard deviation 11.6) in the laparoscopic cholecystectomy group. The mean area under the curve over 18 months was 46.8 for both groups with no difference: mean difference -0.0, 95% confidence interval (-1.7 to 1.7); p-value 0.996; n = 203 observation/conservative, n = 205 cholecystectomy. There was no evidence of differences in quality of life, complications or need for further treatment at up to 24 months follow-up. Condition-specific quality of life at 24 months favoured cholecystectomy: mean difference 9.0, 95% confidence interval (4.1 to 14.0), p < 0.001 with a similar pattern for the persistent symptoms score. Within-trial cost-utility analysis found observation/conservative management over 24 months was less costly than cholecystectomy (mean difference -£1033). A non-significant quality-adjusted life-year difference of -0.019 favouring cholecystectomy resulted in an incremental cost-effectiveness ratio of £55,235. The Markov model continued to favour observation/conservative management, but some scenarios reversed the findings due to uncertainties in longer-term quality of life. The core outcome set included 11 critically important outcomes from both patients and healthcare professionals. The results suggested that in the short term (up to 24 months) observation/conservative management may be a cost-effective use of National Health Service resources in selected patients, but subsequent surgeries in the randomised groups and differences in quality of life beyond 24 months could reverse this finding. Future research should focus on longer-term follow-up data and identification of the cohort of patients that should be routinely offered surgery. This trial is registered as ISRCTN55215960. This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 14/192/71) and is published in full in Health Technology Assessment; Vol. 28, No. 26. See the NIHR Funding and Awards website for further award information.