Economic Studies Research Articles

Economic Evaluation of Expanding HPV Vaccination Programs for Boys: A Systematic Review

Background: Human papillomavirus is responsible for almost all cases of cervical and non-cervical cancers. Various treatments have been carried out, but they have not been effective enough in reducing the burden. The U.S. Food and Drug Administration has approved three HPV vaccines for use. Since its recommendation in 2006, HPV infections have significantly decreased by 88% among teen girls and 81% among young adult women. Additionally, research has indicated that HPV vaccine is cost-effective in preventing both cervical and non-cervical cancers. The primary target group of HPV vaccination is girls aged 9-14, but some countries are starting to expand their programs according to the WHO recommendation for secondary targets: boys and adult women. This study gave updated information regarding the expansion of HPV vaccination programs for boys. Objective: To systematically review the health economic studies to evaluate the cost-effectiveness of expanding HPV vaccination program for including boys to prevent HPV-related cancer. Method: An electronic literature search was performed on two databases (Pubmed and ScienceDirect) to identify studies published from 2013 to 2023 in English and Indonesian. Three search strategies were used, including the terms «economic evaluation», «HPV», and «boys». The screening and selection of the literature was performed according to the PRISMA statement. Results: A total of 306 articles were identified. Only 26 of them were deemed relevant. This research compiled studies from countries with varying economic levels on the expansion of vaccination programs in boys to prevent or reduce cervical, anogenital, and HNC cancers. All the studies used a modeling approach to estimate the number of cases averted and the health care costs. Sixteen studies found that it was cost-effective to expand HPV vaccination programs to include boys. The ICER values were found to be sensitive to the vaccine price, duration of protection, and vaccination coverage. Conclusion: Expanding HPV vaccination to boys is considered a cost-effective solution for preventing HPV-related cancers, based on studies conducted in many countries. It is recommended to conduct an economic evaluation to estimate the cost-effectiveness of HPV vaccination as a prevention method for HPV-related cancers in low and middle-income countries like Indonesia. To begin the study, it is suggested to expand the HPV vaccination target to boys with a lower-priced vaccine and increased vaccination coverage.

Techno-Economic Analysis of Beam-Down Solar Tower Secondary Reflectors

Beam-down solar towers are presented as an alternative to conventional solar towers that allow modular design, easily adaptable to industrial environments. Secondary reflectors are a key component in this type of configuration, due to the high concentration of radiation received from the solar field. The results of a technical and economic study of new secondary reflectors, based on a polished stainless-steel substrate with silver PVD coating and a system of protective layers, are presented and compared with aluminum reflectors, currently used in such configurations. For this, twelve different designs, grouped in three cases are simulated using ray tracing and finite elements. The results show that the steel reflectors reach lower temperatures compared to aluminum reflectors, allowing for greater durability. Additionally, the optical efficiency of the plant was determined, and it was estimated that steel reflectors can reduce the LCOH of the plant by approximately 3.5%.

A Microfinance Intervention With or Without Peer Support to Improve Mental Health Among Transgender and Nonbinary Adults (the Creating Access to Resources and Economic Support Study): Protocol for a Randomized Controlled Trial.

Transgender and nonbinary (TNB) people experience economic and psychosocial inequities that make them more likely to be subject to financial and mental health harms exacerbated by the COVID-19 pandemic. Sustainable, multilevel interventions are needed to address these harms. The onset of the COVID-19 pandemic galvanized many TNB-led organizations to provide emergency financial and peer support for TNB people negatively impacted by the pandemic. However, the efficacy of these interventions has not been evaluated. The Creating Access to Resources and Economic Support (CARES) study seeks to assess the efficacy of feasible, acceptable, and community-derived interventions to reduce economic and psychological harms experienced by transgender people in the wake of the COVID-19 pandemic. The study aims to (1) compare the efficacy of microgrants with peer mentoring with that of microgrants without peer mentoring in reducing psychological distress, (2) examine mechanisms by which microgrants with or without peer mentoring may impact psychological distress, and (3) explore participants' intervention experiences and perceived efficacy. We will enroll 360 TNB adults into an embedded, mixed methods, 3-arm, and 12-month randomized controlled trial. Participants will be randomized 1:1:1 to arm A (enhanced usual care), which will receive a single microgrant plus monthly financial literacy education, arm B (extended microgrants), which will receive enhanced usual care plus monthly microgrants, or arm C (peer mentoring), which will receive extended microgrants combined with peer mentoring. All intervention arms last for 6 months, and participants complete semiannual, web-based surveys at 0, 6, and 12 months as well as brief process measures at 3 and 6 months. A subset of 36 participants, 12 (33%) per arm, will complete longitudinal in-depth interviews at 3 and 9 months. Full recruitment began on January 8, 2024, and, as of July 26, 2024, a total of 138 participants have enrolled. Recruitment is expected to be completed no later than March 31, 2025, and the final study visit will take place in March 2026. This national, web-based study will demonstrate whether an intervention tailored to reduce material hardship and improve peer support among TNB adults will reduce psychological distress. Its equitable, community-academic partnership will ensure the rapid dissemination of study findings. ClinicalTrials.gov NCT05971160; https://clinicaltrials.gov/study/NCT05971160. DERR1-10.2196/63656.

Editorial for the Special Issue of Comparative Economic Studies: 50 Years After the End of Bretton Woods—The Experiences of Small Open Economies

AbstractThis special issue of Comparative Economic Studies, commemorating fifty years since the end of the Bretton Woods system, examines the adjustment of small open economies to floating exchange rates and new monetary policy frameworks. Based on a workshop held at the KOF Swiss Economic Institute in June 2023, six papers analyse dimensions such as the evolution of monetary policy regimes, the impact of economic crises and the use of unconventional monetary policies in Canada, Israel, Norway, Sweden and Switzerland. The findings highlight the benefits and limitations of inflation targeting, the challenges of global financial integration and the strategic responses of central banks to maintain stability and independence, providing policymakers with valuable insights into the complex dynamics of monetary policy in the post-Bretton Woods era.

Cost and Cost Effectiveness of Treatments for Psoriatic Arthritis: An Updated Systematic Literature Review.

Psoriatic arthritis (PsA) is an inflammatory disease characterised by a variety of clinical manifestations. Considering the economic burden posed by PsA and the increasing number of treatment options, economic evaluations are required to better allocate available resources. This work aims to update a previous published literature review on PsA cost-of-illness and cost-effectiveness analysis. A search was performed of English-language literature between January 2017 and March 20, 2024 in Medline/PubMed, Embase and Cochrane library using the terms 'psoriatic arthritis', 'cost of illness' and 'cost effectiveness'. Data on decision model, time horizon, population, treatment options, perspective, type of costs, relevant results and authors' conclusion were extracted from the reviewed articles. Finally, the quality of the included studies was evaluated. Twenty-seven studies met the inclusion criteria: 16 cost-of-illness and 11 cost-effectiveness/cost-utility analyses. PsA is characterised by high direct and indirect costs. Drug costs as well as hospitalisation and absenteeism were the major drivers of the observed costs. The cost-effectiveness analyses reported the dominance or the cost effectiveness of biologic therapies compared with non-biologic PsA treatment. Biological options like bimekizumab and ixekizumab have demonstrated a better cost-effectiveness profile in PsA patients compared with other treatments (i.e., other biological treatments). There was an increased number of economic evaluations compared with the previous review. PsA is still associated with significant economic burden worldwide. The main cost was represented by therapies, specifically biological therapies. Amongst the biological therapies, bimekizumab and ixekizumab appear to provide the most economic benefit. Finally, new economic studies are needed to enrich knowledge on the economic burden of subgroups of PsA patients as well as early treatment of PsA with new therapies.

A real-world survey on expensive drugs used as first-line chemotherapy in patients with HER2-negative unresectable advanced/recurrent gastric cancer in the stomach cancer study group of the Japan clinical oncology group.

Molecular-targeted drugs and immune checkpoint inhibitors have been developed for various malignant diseases, thereby improving clinical outcomes. However, these drugs are expensive, and few studies have assessed their actual use and costs in Japan. This study aimed to survey the use and costs of first-line chemotherapy for advanced/recurrent gastric cancer (AGC) in real-world settings. The survey included patients with human epidermal growth factor receptor type2 (HER2)-negative AGC who initiated first-line chemotherapy from January 2022 to December 2022 at the participating 92 institutions in the Japan Clinical Oncology Group. Data on the regimens were collected using Google Forms. A regimen that costs >500 000 Japanese yen (JPY) per month was defined as expensive. Data on chemotherapy regimens were collected from 2173 patients at all 92 institutions between March 2023 and May 2023. We analyzed 2113 patients who underwent the chemotherapy with recommended regimens and conditionally recommended regimens according to the Japanese Gastric Cancer Treatment Guidelines sixth edition. The expensive regimens were triplet chemotherapy with fluoropyrimidine (S-1 or capecitabine or 5-fluorouracil/levofolinate), oxaliplatin, and nivolumab. Their monthly costs ranged from 767 648 to 771 046 JPY. Nivolumab-containing regimens cost more than 20 times the price of conventional chemotherapy with fluoropyrimidine and oxaliplatin. These regimens were used in 1416 (67%) of 2113 patients: in 71% of patients aged ≤74years and in 59% of patients aged ≥75years. The regimens with >20-fold cost of conventional chemotherapy were used as first-line chemotherapy in two-thirds of patients and more than half even in the elderly population with HER2-negative AGC. This finding is important for future health economic studies on drug cost-efficacy.

Comparative economic analysis of urban sanitation interventions in low- and middle-income countries: a systematic review

ABSTRACT This review assesses evaluative criteria for least-cost economic analyses of citywide inclusive sanitation (CWIS) interventions, focusing on their alignment with the practical needs for decision support in low- and middle-income countries. We examined the literature from 2003 to 2022 that compares the costs and benefits of urban sanitation interventions to analyse their capacity to select cost-efficient and equitable urban sanitation options. The analysis revealed that finer disaggregation of cost perspectives could better articulate the diverse demands for services. Furthermore, options for comparison should be framed in addition to the diverse service provision models already existing within a context to ensure these perspectives are included. Developing the capacity to forecast a context-specific without-project scenario, using locally derived cost data as a basis of comparison, will be essential for adhering to CWIS planning principles. In addition, involving marginalised users more effectively in decision-making processes within economic analyses is essential for advancing equitable service provision. Future comparative economic analysis studies should embrace the complexities of CWIS contexts by supplementing broad-scale comparisons with detailed, context-sensitive evaluations to support more inclusive urban sanitation planning.

The artisanal octopus fishery in Mauritania: A lucrative fishery in decline

The octopus fishery is important for the socioeconomic development of Mauritania. However, in recent times the fishery has been declining. To enhance sustainable octopus management and tap maximum economic benefits, we analysed catches and flow of artisanal octopus fishery, fishing effort, employment, and income of octopus fishers. We used data provided by the Artisanal and Coastal Fisheries Monitoring System database collected along the coastline by the Mauritanian Institute of Oceanographic Research and Fisheries surveyors. The data on the operating costs of pirogues came from one-off surveys carried out by the Laboratory of Social and Economic Studies. Our findings show that octopus production increased from 14 thousand tonnes in 2006 to 33 thousand tonnes in 2018. In 2019, octopus landings reached a record level of 55 thousand tonnes before falling sharply to 29 thousand tonnes in 2020. Octopus production reached 27 thousand tonnes in 2021, 25 thousand tonnes in 2022 and 26 thousand tonnes in 2023. The total value of octopus production rose from MRU 411 million in 2006 to MRU 4.02 billion in 2019, before dropping dramatically to MRU 1.01 billion in 2020, MRU 952 million in 2021, MRU 892 million in 2022 and 920 million in 2023. The artisanal pirogues provide the bulk of octopus production, which is exported exclusively to Europe and Asia. Around 22,000 tonnes are frozen, 1,000 tonnes undergo industrial processing, and over 24,000 tonnes are exported, bringing in foreign currency for the Mauritanian economy. We recommend a reduction in fishing effort and improvement in policies to sustain the octopus fishery. Additionally, there should be professional training for artisanal fishermen in fishing techniques to reduce overcapacity in octopus fishing, which will enable fishermen to switch to other fishing techniques and target other fish species.

Economic Study of Wind and Solar Power Generation with Energy Storage Configuration

Economic Study of Wind and Solar Power Generation with Energy Storage Configuration

The burden of systemic therapy administration route in treating HER2-positive breast cancer (for patients, healthcare professionals, and healthcare system): a systematic literature review.

Breast cancer (BC) is one of the leading causes of cancer and is the first cause of death from malignant tumors among women worldwide. New cancer therapies receive regulatory approval yearly and to avoid health disparities in society, the health systems are challenged to adapt their infrastructure, methodologies, and reimbursement policies to allow broad access to these treatments. In addition, listening to patients' voices about their therapy preferences is essential. We aim to investigate the administration route preferences [subcutaneous (SC) or intravenous (IV)] among patients diagnosed with HER2 positive BC and healthcare professionals (HCPs) and to investigate healthcare resources utilization (quality and quantity) for each route of administration (SC or IV) for treating those patients. We conducted a systematic literature review focused on clinical trials and observational and economic studies, using PubMed (MEDLINE), Cochrane Library, Virtual Health Library (VHL), Scientific Electronic Library Online (SciELO), and Latin American and Caribbean Health Sciences Literature (LILACS) databases based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The literature review included 25 studies in the analysis. Studies have reported that patients and HCPs prefer the SC route of administration to IV because it saves time in terms of chair time, administration, and preparation and is less painful. In addition, SC administration might be a more cost-saving option when analyzing direct and indirect costs. As BC stands as a significant global health concern and the leading cause of cancer-related deaths in women worldwide, understanding and incorporating patient and HCPs preferences in the choice of administration route become paramount. The observed preference for SC administration not only aligns with the imperative of adapting health systems to facilitate broad access to new cancer therapies but also underscores the importance of considering patient experiences and economic implications in shaping treatment strategies. These insights are crucial for healthcare policymakers, clinicians, and stakeholders in optimizing healthcare resources and enhancing the overall quality of BC care.

Exposure and knowledge on peanut aflatoxin B1 among urban consumer in Jakarta, Indonesia

Groundnut (Arachis hypogaea L), an important food in the Indonesian diet, has been reported to be contaminated with the carcinogenic Aflatoxin B1. However, research on consumer knowledge and exposure to AfB1 from peanuts in Indonesia is still limited. This study aimed to assess the exposure to aflatoxin B1 (AfB1) from peanuts consumed by urban Jakarta and their knowledge of aflatoxin risk. This observational study was cross-sectional in design, involving 192 randomly selected respondents. Peanut intake frequency was measured using a semi-quantitative FFQ instrument. Questionnaires were used to collect data regarding knowledge and income. The AfB1 content was analyzed by HPLC. Pearson Chi-Square test was used for analysis. The results showed that AfB1 contaminants were present in all samples. Respondents who frequently consumed high amounts of peanuts and processed products were exposed to AfB1 with a median of 22.55 ppb bb/day. There was no significant relationship between knowledge and AfB1 exposure (p= 0.874), age (p= 0.884), or income (p= 0.355). In conclusion, aflatoxin B1 exposure was still high in urban areas. There was no relationship between knowledge and exposure to AfB1 peanuts. Inter-sectoral strengthening of the empowerment and control of aflatoxin exposure is needed, as are economic and health impact studies related to AfB1 exposure.

A global coastal permeability dataset (CoPerm 1.0)

The permeability of aquifers strongly influences groundwater flow characteristics. Worldwide, coastal groundwater is often the primary freshwater source for coastal communities and ecosystems but is also particularly vulnerable to abstraction since saltwater intrusion may threaten its quality. Thus, understanding coastal permeability is crucial to the sustainable use of coastal groundwater. Here, we present the first global dataset of coastal permeability (CoPerm 1.0), which provides data on coasts’ landward, shoreline, and seaward permeability. CoPerm accounts for shoreline characteristics such as cliffs and beaches and contains information on four million segments representing more than two million kilometers of global coastline. Rocky Shores are the most abundant shoreline class, followed by mangroves, beaches, and muddy coasts. Permeability differs between the immediate shoreline (median permeability: 10−12.3 m2), the seaward (median: 10−13.3 m2), and the landward (median: 10−13 m2) sides of the coast. CoPerm provides input data for global coastal groundwater assessments and regional studies of submarine groundwater discharge or saltwater intrusion that can radiate into ecological and economic studies.

The clinical, economic, and humanistic burden of treatments for exocrine pancreatic insufficiency and cost-effectiveness of treatments: A systematic literature review.

To examine the burden of exocrine pancreatic insufficiency (EPI), specifically the clinical impact of EPI on patients, their quality of life (QoL) and the cost-effectiveness of existing treatments. A systematic literature review was conducted using key search terms for the clinical, economic, and humanistic burden. Databases were searched from 2010 to 2022, with articles screened independently by 2 reviewers at abstract and full-text stage against pre-defined eligibility criteria. Seventy-one publications were identified that reported relevant clinical, humanistic, and economic data. Prevalence and incidence of EPI varied across identified studies; EPI appears to be especially prevalent as a comorbid condition in patients with cystic fibrosis. EPI has a large impact on QoL, with lower QoL scores in patients with EPI compared with those without EPI. The instruments used to assess QoL, however, were inconsistent across studies. Where reported, economic burden studies highlighted that patients with EPI have higher healthcare resource utilization compared with those without, with costs increasing with disease severity. This systematic literature review highlights that patients with EPI have higher treatment costs and lower QoL scores than patients without EPI. The prevalence of EPI as a comorbid condition is high, particularly in patients with cystic fibrosis.

Estimated economic costs of dental implants among older South Korean adults, 2015-2018.

Dental implants are a considerable financial burden for elderly people and their caregivers. This study aimed to calculate the estimated economic costs of dental implants on the Korean older population. The economic costs of dental implants for adults aged 75 years and older were estimated from a societal perspective, considering both direct and indirect expenditures. We used data from the Korean National Health Insurance Service for the period 2015-2018 to estimate the medical costs. Noninsured medical costs were estimated from research on medical expenses by the National Health Insurance Review and Assessment Service. Indirect costs related to transportation fees and time loss were obtained. The Cochran Armitage trend test was performed to examine the trend of the economic burden of dental implants. The estimated economic costs showed from 2015 to 2018 (total costs: $26.54-55.66 million, total costs after discount: $17.11-39.56 million). Direct costs, including insured and noninsured medical costs, represented from $25.81 to $47.03 million. Indirect costs, including transportation and time costs, ranged from $0.73 to $1.63 million. The impact of the total dental implant costs was 0.0018%-0.0034% of the Korean annual gross domestic product and 1.03%-1.59% of the annual total costs of dental care benefits. The estimated economic burden of dental implants significantly increased from 2015 to 2018 in older South Korean adults. These results will provide a foundation and guidance for further health economic studies on the burden of dental implants in the elderly population.

Techno-economic assessment of bio-hythane upgrading processes based on ionic liquids

Hythane, the blending of hydrogen (H2) and methane (CH4), is attracting attention as it could accelerate the H2 economy. H2 and CH4 can be extracted from organic material by fermentation and anaerobic digestion, respectively, but this alternative bio-hythane also contains carbon dioxide (CO2) that must be removed. This work addresses the use of Aprotic N‑Heterocyclic Anion-based ionic liquids (AHA-ILs) for bio-hythane upgrading. Three AHA-ILs ([P2228][2-CNPyr], [P2228][3-IPyra], and [P2228][4-BrIm]) were evaluated at process scale by conducting rate-based COSMO-based/Aspen Plus simulations of the upgrading processes. A wide range of operating conditions were screened by modifying key process variables such as the absorption pressure and the desorption temperature, and the bio-hythane composition. Energy and AHA-IL consumptions were analyzed together with variable operating cost (VOC). Energy demand and VOC were used to identify the Pareto optimal for each case study using a Python code. In addition, a detailed economic study was performed for the best three systems. The proposed processes are very versatile and are capable of handling bio-hythane of different compositions, being 10 %mol H2, 60 %mol CH4, and 30 %mol CO2 the most suitable for better process performance. For this case, the energy demand is about 0.51–0.56 kWh/Nm3 and VOC is about 1 cent. $/Nm3. The AHA-IL [P2228][3-IPyra] exhibited the best results for both variables. The energy requirement is in line with the minimum energy required for amine scrubbing technology, while VOC can be reduced by up to 17–48 % compared with electricity-intensive water scrubbing, pressure swing adsorption or membranes. Although higher investment is necessary, the assessed bio-hythane upgrading processes have the potential to operate around 0.1 $/Nm3, with VOC contributing about 8 % to the total cost.

Flexibility exploitation in Net-Zero Energy Factories. A technical and economic study case for dairy systems located in Central and South Europe

The decarbonization of energy systems (electric, thermal, gas, and transportation) requires flexibility to integrate power generated by volatile and renewable energy sources (vRES). Industrial systems can contribute to exploiting the flexibility needed to integrate the electricity generated by vRES into energy systems. Designing industrial systems as Net-Zero Energy Factories (NZEF) offers the possibility of exploiting the flexibility that could be used internally to integrate the power generated by renewable energy sources. This study addresses, on one hand, the presentation of a methodology to identify and quantify the flexibility potential of continuous processes typical in dairy systems. On the other hand, it aims to demonstrate a methodology for designing additional flexibility options to operate dairy systems as NZEF. A model has been developed in which the energetic and material flows of conventional diary systems are simulated. The model allows for the design of conventional dairy systems as NZEF and the evaluation of their potential to exploit flexibility. Two different European climate zones have been investigated: Bari (Italy) and Magdeburg (Germany). This study is relevant for designers and facility managers who are following their decarbonization plans, aiming to operate their industrial facility as Net-Zero Energy. The results of this study show that for dairy systems designed as Net-Zero Energy Factories and located in southern Europe (Bari, Italy), the operational costs are much lower than those operating in central Europe (Magdeburg, Germany). Specifically, integrating an 800 kW PV system reduced operational costs by 16.3 % in Bari, compared to 3.8 % in Magdeburg. Additionally, achieving 97 % vRES integration in Bari requires a 1000 kWh thermal storage capacity, whereas in Magdeburg, a 500 kWh capacity is sufficient. These findings suggest that NZEF designs can be optimized based on regional climatic conditions to maximize cost efficiency and vRES integration. The analysis indicates that sensible heat storage systems should be preferred over electrochemical batteries when designing additional flexibility options, considering both technical and economic criteria.

Health-related quality of life and its association with disease activity/functional status in rheumatoid arthritis: A cross-sectional study from South India.

Rheumatoid arthritis (RA) is an autoimmune disease with chronic pain that gradually becomes incapacitating and negatively influences the health-related quality of life (HRQoL). This study estimates HRQoL in RA using the EuroQol five dimensions (EQ-5D) tool and its association with functional status and disease activity. RA patients (n = 320) aged above 18 years, visiting outpatient clinic at a tertiary care multispecialty hospital in south India were the study participants. Sociodemographic, clinical, and laboratory data were collected from them. EQ-5D-5L questionnaire and the EQ Global Health Visual Analogue Scale (EQ-VAS) were used to measure HRQoL. Disease activity was measured using Disease Activity Score-28 (DAS-28), and the Health Assessment Questionnaire (HAQ) was used to assess functional status. Pearson's correlation and multiple linear regression were used to measure association, and statistical significance was considered at p < 0.05. The EQ-5D utility score was 0.54 ± 0.36, pain and anxiety were the most affected domains, and the mean EQ-VAS was 63.05 ± 18.54%. A moderate to high disease activity was present in 85% (DAS-28 > 3.2), and a severe functional disability in 32.8% (HAQ > 1.5) of study participants. The mean EQ-5D scores for RA patients were 0.78 (0.65-0.90) for no disease activity, 0.73 (0.65-0.80) for mild, 0.53 (0.32-0.74) for moderate and 0.47 (0.32-0.62) for high disease activity. In multiple linear regression analysis, HAQ and age independently predicted EQ-5D. RA significantly impacts HRQoL, and interventions focussing on pain and anxiety management are essential. The study's EQ-5D values could help estimate Quality Adjusted Life Years (QALY) while conducting economic evaluation studies in RA within an Indian context.

The “Gibson Les Paul” Guitar—Conception, Prototype and Production: A Study Through Counterfactuals

ABSTRACT The use of counterfactuals (“what-ifs”) has been a recognized approach in some fields within the humanities, in particular military history, where alternate scenarios can be readily proposed. As an approach it has also been used in fields such as the study of economics, and—much less so—in art history. This article will consider the violin and the piano, and then concentrate on a more modern—and, as such, better documented—example of the Gibson “Les Paul” model electric guitar to assess whether various decisions have had a major bearing on the business success of the model.

Natural contra human sciences: the conflict between nomothetic and idiographic sciences, with special reference to S. J. Boëthius

ABSTRACT This article tackles issues central to most academic disciplines, including scientific boundary demarcation, the battle of the faculties, the theory of science, and the conflict between nomothetic and idiographic methodologies, that is, between the two main approaches to science. It does so through discovering and rethinking a Methodenstreit in Swedish political science, an academic dispute involving Professor Rudolf Kjellén, the father of geopolitics, and his greatest rival, Professor S. J. Boëthius. Shortly after retiring from the Johan Skytte Professorship at Uppsala University, S. J. Boëthius published a great but inaccessible work on state theory and its history entitled Om statslivet (On the life of the state, 1916). The book critiques the positivistic and nomothetic (law-searching) approaches of the burgeoning social sciences, which were emancipating themselves from their father, history, and becoming independent disciplines. Boëthius critiqued the nomothetic studies of history, economics, statistics, sociology, and geopolitics for overemphasizing the significance of historical, economic, statistical, sociological, and geographical environments and structures. Thus, the exponents of these new or changing disciplines were criticized for neglecting the most important driving force of human affairs in Boëthius’s mind, namely, the power of personality and individual free will.

Patient-reported outcome measures and health economics in regenerative periodontal therapy: A systematic review and meta-analysis.

Understanding patient responses to periodontal regeneration is crucial. This systematic review and meta-analysis addressed two key questions: (a) the impact of periodontal regeneration on patient-reported outcome measures (PROMs) for intrabony and furcation involvement and (b) the cost-effectiveness of periodontal regeneration for treating periodontal defects. Twenty-four studies were included, with 20 randomized clinical trials (RCTs) reporting patient-reported outcomes and five (three RCTs and two economic model-based studies) reporting cost-effectiveness outcomes. Results favored regeneration therapy over conventional flap surgery for intrabony defects, showing improvements in qualitative (i.e., amount of regenerated attachment apparatus) and quantitative parameters (i.e., probing and radiographic parameters). In terms of PROMs, regenerative treatments involving barrier membranes resulted in longer chair times and higher rates of complications (such as membrane exposure or edema) compared to flap with biologic agents or access flap alone. Despite this, oral health-related quality of life improved after both regenerative and extraction procedures. Economically, regeneration remained favorable compared to extraction and replacement or open flap debridement alone for periodontal defects. Single-flap variants in open flap debridement yielded similar outcomes to regenerative treatment, offering a potentially cost-effective option. Nevertheless, further discussion on the benefits of less-invasive flap designs is needed due to the lack of histological evaluation.