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BACKGROUND AND OBJECTIVES: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) combined with computed tomography (CT) is a new imaging modality to detect the extra-prostatic spread of prostate cancer. PSMA PET/CT has a higher sensitivity and specificity than conventional imaging (CT ± whole body bone scan [WBBS]). This study conducted a cost-utility analysis of PSMA PET/CT compared with conventional imaging for patients with newly diagnosed, intermediate-risk or high-risk primary prostate cancer. PERSPECTIVE: Australian healthcare perspective. SETTING: Tertiary. METHODS: A decision-analytic Markov model combined data from a variety of sources. The time horizon was 35 years. The sensitivity and specificity of PSMA PET/CT and CT alone were based on meta-analyses and the test accuracy of CT+WBBS was based on a single randomised controlled trial. Health outcomes included cases detected, life-years, and quality-adjusted life-years. Costs related to other diagnostic tests, initial treatment, adverse events, and post-disease progression were included. All costs were reported in 2021 Australian Dollars (A$). RESULTS: The deterministic incremental cost-effectiveness ratio of PSMA PET/CT was estimated to be A $21,147/quality-adjusted life-year gained versus CT+WBBS, and A$36,231/quality-adjusted life-year gained versus CT alone. The results were most sensitive to the time horizon, and the initial treatments received by patients diagnosed with metastatic cancer. The probability of PSMA PET/CT being cost effective was estimated to be 91% versus CT+WBBS and 89% versus CT alone, using a threshold of AU$50,000/quality-adjusted life-year gained. CONCLUSIONS: PSMA PET/CT is likely to be more costly than CT+WBBS or CT alone in Australia; however, it is still likely to be considered cost effective compared with conventional imaging.

In the ever-increasing demand of construction and construction materials worldwide, concrete is the most extensively used material for construction purposes almost next to the water. Therefore, there is a dire need of clean, green and durable concrete. Recently, an environmentally friendly strategy has been employed to manufacture bio-concrete by the usage of microorganisms in the traditional concrete to enhance its durability and compressive strength. In this review, we discuss the role of microbes in influencing the various properties of concrete such as compressive strength, flexural strength and tensile strength by reducing the concrete porosity and diminishing water absorption. The mechanism of microbial-induced calcium carbonate precipitation (MICP) in the traditional concrete by the action of microbes which resulted in the formation of bio-concrete as an improved building material has also been discussed. Additionally, an in-depth comparative analysis of the performance of bio-concrete with the traditional concrete synthesized from various industrial wastes such as silica fume, rice husk ash and metakaolin in terms of different properties such as compressive strength, flexural strength and percentage water absorption has been presented. This review highlights the impact of usage of microbes in the conventional concrete to produce novel and eco-friendly bio-concrete in construction technology.

Inequity in healthcare utilization is typically measured as the unequal distribution of services by observable non-need indicators, such as income, after controlling for observable need indicators. However, important sources of unequal healthcare utilization are often unobserved. The unobserved element may reflect need factors, such as imperfectly measured severity of illness, that would predict greater utilization across different healthcare channels, but also based on choice, such as patient preferences to use a particular healthcare channel over an alternative one, which may differ in its effect between channels. Accounting for unobserved sources of utilization may, therefore, help to understand contradictory inequalities between different healthcare channels, such as pro-poor inequalities for general practitioner use and pro-rich inequalities for specialist visits. This paper uses survey data from the Household Income and Labour Dynamics in Australia and panel data methods to investigate if seemingly contradictory inequalities between different healthcare channels are explained by latent individual-level heterogeneity. Results show that unobserved individual-level heterogeneity affects inequities across different healthcare channels, providing indications that the unobserved element may primarily represent unobserved need.

A novel Fe-Cr-V-C plasma transformed arc (PTA) coating of 4 mm thickness was successfully deposited on a mild steel substrate, which constitutes a relatively smaller amount of carbide-forming elements such as Cr and V compared to previous studies. PTA coating was found to be free of any surface or transverse crack and porosity. A detailed phase analysis was performed using XRD, optical and SEM coupled with EPMA analysis. Thermodynamic calculations were also performed to determine the volume fraction and type of the carbide phases formed because of the coating and substrate interaction. Hardness variation along the coating thickness was related to the carbide fraction and size distribution. The improvement in wear resistance of the coating is reported and explained based on the carbide size and distribution.

Benzoxazolyl linked meta- and para-substituted new chemical entities (5a–5h) featuring thiazolidinedione, rhodanine, hydantoin, and thiohydantoin moieties were synthesized and characterized by 1H NMR, 13C NMR, FT-IR, and HRMS spectral studies. In addition, all compounds were screened for α-glucosidase inhibitory activity and further supported by molecular docking studies carried out at the active site of α-glucosidase (PDB code: 3TOP) in comparison to acarbose used as a standard drug. Out of eight tested compounds, 5d was found as the most active inhibitor of α-glucosidase (IC50 = 9.48 ± 0.36 µM), having rhodanine moiety substituted at meta-position of the phenyl ring.

With recent advances in the pharmacological management of type 2 diabetes mellitus (T2DM), there is a growing need to understand which patients optimally benefit from these novel therapies. Various clinical clustering methodologies have emerged that utilise data-agnostic strategies to categorise patients that have similar clinical characteristics and outcomes; broadly, this characterisation is termed phenotyping. In patients with T2DM, we aimed to describe patient characteristics from phenotype studies, their cardiovascular risk profiles and the impact of antihyperglycemic treatment. Numerous phenotypic studies have been undertaken that have utilised a combination of clinical, biochemical, imaging and genetic variables. Each of these has produced phenotypes that display a spectrum of cardiovascular risk. Studies that aimed to describe pathophysiological phenotypes generally identified five phenotypes: autoimmune phenotype, insulin-related phenotypes (including permutations of insulin deficiency and resistance), obesity phenotype, ageing phenotype, and a sex-related phenotype. Studies examining risk profiles have demonstrated that across such phenotypes there is a spectrum of risk for diabetic complications. Few studies have examined treatment effects across these phenotypes, and thus provide little insights towards making phenotype-guided treatment decisions Clustering analyses in patients with T2DM have identified distinct phenotypes with unique risk profiles. Further studies are needed that harness the use of clinical, biochemical, imaging and genetic data to explore therapeutic heterogeneity and response to antihyperglycemic treatment across the spectrum of patient phenotypes.

Objective To detail clinical profile and outcome in children infected with SARS-CoV-2. Methods This retrospective study was undertaken at a tertiary care pediatric teaching hospital in Northern India. The data on clinical characteristics and outcome of children ( 10 y of age with malnutrition and comorbid illness. Supplementary Information The online version contains supplementary material available at 10.1007/s12098-021-03822-5.

China is the largest producer and consumer of coal in the world. The extraction of coal is increasing intensively to meet the needs of the ever-increasing population and industries. However, coal mining has resulted in environmental changes, including deforestation, air, water, soil, and landform deterioration. This study investigates the impact of mining on the environment in Ruqigou coalfield by utilising in situ and remote sensing data. Field data collected include temperature, gas compositions, and water samples. Multi-temporal Landsat data of 1991, 2003, and 2019 were used in monitoring the impact of mining on different land covers, especially vegetation. A supervised classification was performed to assess the changes in land cover. In order to track the changes in vegetation, normalised difference vegetation index (NDVI) was employed. To study the changes in coal fire areas, thermal anomalies were extracted from the thermal infrared data using a dynamic thresholding technique. The results of in situ analyses show that water quality is unfit for domestic, industrial, and agricultural use. All the gas sampling sites emit noxious gases such as CO