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In service systems with delay-sensitive customers, customer decisions to join the queue or balk influence demand, impacting service provider profits. Studies show that customers can be risk-seeking for short waits and risk-averse when waits exceed expectations. Prior research on this mixed-risk attitude is limited, focussing on optimal pricing policies from a social welfare perspective. This study fills this gap by investigating the impact of this behaviour on customer joining strategies and the provider's pricing and capacity policies. We analyse a profit-maximising firm managing an unobservable queue where customers display mixed-risk behaviour towards delay parameterised by a risk-switching point and a degree of risk propensity. Customers join or balk based on expected utility, while the firm determines the service price and rate to maximise expected profit. We derive optimal strategies for both customers and the firm under scenarios with concave or convex capacity costs. Computational experiments show that optimal pricing, capacity, and profit peak at intermediate risk-switching points. For smaller points, optimal price and capacity rise with the customers' degree of risk propensity, while larger points have minimal impact. Numerical exploration emphasises the significance of capacity cost and the effectiveness of leveraging price over controlling capacity for maximising firm profitability. [ABSTRACT FROM AUTHOR]

Objectives: This study compares the demographics, diagnoses, re-admission rates, sick leaves, and prescribed medications of patients accessing digital general practitioner (GP) visits with those of patients opting for traditional face-to-face appointments in a primary health care setting. Design: The study adopted a retrospective analysis of patient record data collected in 2019, comparing visits to a digital primary health center with traditional health center visits. Setting: Primary health care. Participants: The data encompassed patients who utilized the digital clinic and those who visited public health centers for primary health care services. Main Outcome Measures: The study assessed demographics, health diagnoses, prescribed medications, sick leave recommendations, re-admission rates, and differences in costs between digital clinic and face-to-face visits. Secondary outcomes included a comparative analysis of medication categories, resolution rates for health problems, and potential impacts on health care utilization. Results: Digital clinic users were typically younger, more educated, and predominantly female compared with health centre users. Digital visits were well-suited for uncomplicated infections, while health centre appointments were associated with a higher prevalence of chronic conditions. Medication patterns differed between the two modalities, with digital clinic users receiving generic over-the-counter drugs and antibiotics, whereas health centre visits commonly involved cardiac and antihypertensive medications. Sick leave recommendations were slightly higher in the digital clinic, but the difference was not significant. Approximately 70% of health problems addressed in the digital clinic were successfully resolved, and the cost of digital visits was about 50,3% of face-to-face appointments. Conclusion: Digital health care services offer a cost-efficient alternative for specific health problems, appealing to younger, educated individuals, when compared to the users of public health center, and may enable improvement of cost-effectiveness combined with acceptable demand management and patient segmentation practices. The results highlight the potential benefits of digital clinics, particularly for uncomplicated cases, while also emphasizing the importance of suitable referral mechanisms for in-person consultations. [ABSTRACT FROM AUTHOR]

Background: To compare the effectiveness, cost, and safety of four regimens recommended by the World Health Organization (WHO) for rifampicin resistance/multidrug-resistance tuberculosis (RR/MDR-TB) Treatment in Eastern China. Methods: We performed a cohort study among patients with RR/MDR between 2020 and 2022 in Jiangsu Province. The treatment success rate, cost, and drug adverse reaction rate were compared. Results: Between 2020 and 2022, 253 RR/MDR-TB patients were enrolled in the study. 37 (14.62%), 76 (30.04%), 74 (29.25%), and 66 (26.09%) patients had the short-term regimens, the new long-term oral regimens, the new long-term injectable regimens, and the traditional long-term regimens, respectively. The treatment success rate was the highest among patients treated with the short-term regimen (75.68%) and was the lowest among patients treated with the traditional long-term regimens (60.61%). The estimated mean cost per favorable outcome was 142.61 thousand Chinese Yuan (CNY), and the short-term regimens showed the lowest cost in the four regimes (88.51 thousand CNY vs. 174.24 thousand CNY, 144.00 thousand CNY, and 134.98 thousand CNY). Incremental cost-effectiveness ratios of the short-term regimens, the new long-term oral regimen, and the new long-term injectable regimens were -3083.04, 6040.09, and 819.68 CNY compared to the traditional long-term regimens. Conclusions: For RR/MDR-TB patients in China who meet the criteria for short-term regimens, the short-term regimens were proven to be the most cost-effective of the four regimens recommended by WHO. For RR/MDR-TB patients in China who don't meet the criteria for short-term regimens, the new long-term injectable regimens are more cost-effective than the remaining two regimens. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to reexamine the concept of deinstitutionalization as applied to children’s services and to map the challenges and harm this concept has done to services for children. Originally raised in relation to the closing or reductions of asylums and mental hospitals in the 1930s, the concept was articulated by the Stockholm Declaration on Children’s Residential Care. Deinstitutionalization remains a prominent concept in many policy circles, but unfortunately, it is primarily framed and evaluated solely in terms of cost saving. The unintended consequences of deinstitutionalization include children and families being underserved in overburdened and undeveloped community-based services and increases in homeless and juvenile justice populations. It is in the best interest of the child, family, and community to provide effective care. Effective care is the right care, in the right setting, at the right time. This is best accomplished by including residential care in the service array available to children and families. [ABSTRACT FROM AUTHOR]

Objective: Western diet is associated with chronic disease risk, and degree of dietary acculturation can impact susceptibility. This study sought to understand the factors associated with changes in food consumption habits among international students at a large public university in the southern US. Participants: A convenience sample of 173 international students representing 41 countries at The University of Georgia participated in the survey. Methods: This cross-sectional online survey assessed dietary habits, perception of healthy eating, and level of acculturation using previously validated measures. Results: Highest number of participants were from China (19.2%), 89.0% were graduate students with an average age of 27.5 ± 4.83 years. The majority (62.0%) of participants were dietary acculturated with affordability and accessibility determining types of food consumption, as fewer whole foods and more processed foods were consumed in the U.S. Conclusions: Findings suggest dietary acculturation may be driven by economic factors, making the transition to Westernized food items a convenient and cost-effective choice among international students. [ABSTRACT FROM AUTHOR]

Zeolites are widely used in fields such as separation and catalysis due to their unique pore structure. However, the complexity of its crystallization process and growth mechanism presents challenges for the research and exploitation of novel zeolites. In order to achieve the development of new zeolites with specific structures and properties, this study delves into the key factors in zeolite synthesis and dealumination processes, as well as their impact on zeolite synthesis, from the perspective of changes in silicon and aluminum. It was found that selecting silicon and aluminum sources with high activity and high specific surface area could achieve the best dissolution effect, and the suitable alkalinity could help to enhance the solubility and reactivity of silicon and aluminum sources, which in turn could improve the crystallinity and yield of zeolite. Prolonging the crystallization time and increasing the crystallization temperature can accelerate the nucleation and growth of aluminosilicate gel and reduce the anticrystallization phenomenon. In addition, precise control of the pore structure of zeolite can be achieved by controlling the selection of template agents and the conditions of dealumination treatment, thereby improving the application performance of zeolite. In this study, we reveal the deep connection between influence factors, zeolite synthesis, and silicon-aluminum variations, which provides new perspectives and methods for the exploitation and application of novel zeolites. Meanwhile, through a deep understanding of the mechanism of influence factors on zeolite synthesis, it is able to target and regulate the synthesis conditions to achieve the desired zeolite structure and properties, which not only improves the efficiency and cost effectiveness of the synthesis, but also establishes a solid foundation for the further development and wide application of zeolites. Highlights: Clarified the migration and conversion of silica-aluminum in zeolite synthesis Summarized the dealumination of zeolite by different post-treatment methods Coupled synthesis and post-treatment to construct high-silica zeolite with hierarchical pore [ABSTRACT FROM AUTHOR]

An efficient, facile, and catalyst-free one-pot multicomponent green strategy under neat or aqueous conditions has been developed to synthesize a series of spiro compounds that contain two biologically active pharmacophores, benzochromenes/thio-chromenes and indan-1,3-dione, in a single molecular framework. The desired Spiroindene-1,3dione-benzochromene/thio-chromene derivatives were yielded through a one-pot, three-component reaction between ninhydrin, substituted 1,3-dicarbonyls, and 2-naphthol/2-naphthalene thiol via the Knoevenagel–Michael cascade. The advances of this strategy include high product yields (94–82%), the formation of a new asymmetric center, cost-effectiveness, atom economy, and a straightforward workup procedure that does not require any additional purification steps. [ABSTRACT FROM AUTHOR]

Polycondensation for PLA synthesis is widely used due to its cost-effectiveness, but it often leads to low molecular weight PLA. To address this limitation, researchers have explored different catalysts, with the stannous chloride and p-toluene sulfonic acid combination being a popular choice. However, this method typically yields PLA with a MW of no more than 35000 g/mol, which is unsuitable for commercial applications. In contrast, ring-opening polymerization is considered the most effective method for synthesizing high MW PLA, despite its complexity and cost. Industrial-scale production predominantly employs ROP due to its capability to produce high MW PLA. The use of stannous octoate as a catalyst for ROP has shown promise in synthesizing higher MW PLA. However, its sensitivity to water limits its use in polycondensation, where stannous chloride is commonly employed but is not capable of synthesizing high MW PLA. This study explores the use of stannous octoate for the synthesis of high MW PLA with higher yield. [ABSTRACT FROM AUTHOR]

The journey towards ending AIDS epidemic in Bangladesh by 2030 is ambitious yet achievable. Although Bangladesh has always had a low rate of HIV among its general population, it remains one of seven countries in Asia and the Pacific where new HIV cases are rising. This study evaluates the effectiveness of HIV programmatic strategies and investment scenarios using the AIDS Epidemic Model (AEM) from 2023 to 2030, focusing on optimizing resource allocation and interventions. The findings indicate that without improved program effectiveness, new HIV infections will increase to 1,382 by 2030, failing to meet the targets of the Global AIDS Strategy 2021–2026. If Bangladesh improves its HIV program effectiveness according to the Global AIDS Strategy 2021–2026, the NSP and Global AIDS Strategy targets could significantly lower new infections and AIDS-related deaths and increase treatment coverage to meet Ending AIDS targets. The NSP targets could reduce new HIV infections to under 275 annually and achieve treatment goals by 2030. The study reveals that NSP targets are the most cost-effective, offering the highest benefit-cost ratio, highlighting the urgent need to enhance HIV prevention program effectiveness, particularly among key populations, to achieve both public health and economic benefits. [ABSTRACT FROM AUTHOR]

Green burial is an emerging practice in Zimbabwe and is being encouraged as a strategy for enhancing sustainable land use. This study explores stakeholder perceptions towards green burial and its implications on environmental sustainability. Interview data was collected from a purposively selected sample of 26 participants drawn from Harare and Bulawayo, the major metropolitan cities in Zimbabwe. The results of the study showed that the most promising route to promote green burial is through religion by invoking the principles of spirituality and ecological faith. Green burial was also perceived to be more affordable suggesting that cost effectiveness may be used as a positioning strategy. Cultural beliefs and lack of green burial infrastructure were identified as the main inhibiting factors. The findings of this study point to the need for stakeholders to explore strategies to reconcile the conflict between green burial and cultural beliefs. The development of green burial legislation and supporting infrastructure is recommended as a way of promoting the mainstream adoption of the green burial practice. [ABSTRACT FROM AUTHOR]

Objectives: Despite growing interest, the cost-effectiveness of eHealth interventions for supporting quality of life of people with dementia and their caregivers remains unclear. This study evaluated the cost-effectiveness of the FindMyApps intervention, compared to digital care-as-usual. FindMyApps aims to help people with dementia and their caregivers find and learn to use tablet apps that may support social participation and self-management of people with dementia and sense of competence of caregivers. Method: A randomised controlled trial (Netherlands Trial Register NL8157) was conducted, including people with mild cognitive impairment (MCI) or mild dementia and their informal caregivers (FindMyApps n = 76, digital care-as-usual n = 74). Outcomes for people with MCI/dementia were Quality-Adjusted Life-Years (QALYs), calculated from EQ-5D-5L data and the Dutch tariff for utility scores, social participation (Maastricht Social Participation Profile) and quality of life (Adult Social Care Outcomes Toolkit), and for caregivers, QALYs and sense of competence (Short Sense of Competence Questionnaire). Societal costs were calculated using data collected with the RUD-lite instrument and the Dutch costing guideline. Multiple imputation was employed to fill in missing cost and effect data. Bootstrapped multilevel models were used to estimate incremental total societal costs and incremental effects between groups which were then used to calculate Incremental Cost-Effectiveness Ratios (ICERs). Cost-effectiveness acceptability curves were estimated. Results: In the FindMyApps group, caregiver SSCQ scores were significantly higher compared to care-as-usual, n = 150, mean difference = 0.75, 95% CI [0.14, 1.38]. Other outcomes did not significantly differ between groups. Total societal costs for people with dementia were not significantly different, n = 150, mean difference = €-774, 95%CI [–2.643,.,079]. Total societal costs for caregivers were significantly lower in the FindMyApps group compared to care-as-usual, n = 150, mean difference = € −392, 95% CI [−1.254, −26], largely due to lower supportive care costs, mean difference = €−252, 95% CI [−1.009, 42]. For all outcomes, the probability that FindMyApps was cost-effective at a willingness-to-pay threshold of €0 per point of improvement was 0.72 for people with dementia and 0.93 for caregivers. Conclusion: FindMyApps is a cost-effective intervention for supporting caregivers' sense of competence. Further implementation of FindMyApps is warranted. [ABSTRACT FROM AUTHOR]

Purpose: To explore the experiences of patients with chronic low back pain (CLBP) plus comorbid depressive symptoms who received a remote synchronous videoconference group form of Acceptance and Commitment Therapy (ACT) or Behavioral Activation Treatment for Depression (BATD). Methods: A qualitative study (IMPACT-Q) was nested within a randomized controlled trial (RCT) designed to assess the efficacy and the cost-utility/cost-effectiveness of two therapies in the management of CLBP and depression. Fifty-five patients with CLBP plus depression were selected from the RCT. Twelve focus group sessions, each approximately 60–90 min long, were audio-recorded, transcribed verbatim, and analyzed by six coders through a thematic analysis (deductive and inductive) based on a descriptive phenomenological approach. Results: Patients perceived behavioral, affective, and cognitive improvements after completing group sessions. Overall, psychotherapy was perceived as a safe and non-judgmental place to express emotions and feel understood. The main barriers reported were lack of human contact and loss of social interaction. In contrast, ease of access, flexibility in the ability to connect from anywhere, avoidance of the need to travel, and savings in time and money were key facilitators to increase attendance and adherence to therapy. Conclusion: This study provided support for the acceptability of videoconference-delivered ACT or BATD in patients with CLBP plus comorbid depressive symptoms. IMPLICATIONS FOR REHABILITATION: Overall, patients reported behavioral, affective, and cognitive improvements after Acceptance and Commitment Therapy and Behavioral Activation Treatment for Depression group sessions. Acceptance and Commitment Therapy and Behavioral Activation Treatment for Depression delivered via videoconference platform were perceived as a facilitator for therapy attendance rather than a barrier. The findings indicate that group therapy on videoconferencing is perceived favorably as an alternative for managing patients with chronic pain and comorbid depression. Technical and social aspects of implementing videoconferencing therapies should be improved, as well as guidelines for adequate support for patients and therapists should also be provided. [ABSTRACT FROM AUTHOR]

Recently, there has been significant research on plant-based meat as a substitute for animal meat. However, developing meat analogues with suitable techno-functional properties and a meat-like texture presents several challenges. In lieu of animal meat, plant-based meats offer a sustainable and healthy alternative. The nutritional and textural properties of meat analogues are mostly influenced by the specific type of proteins utilized and the various processing techniques implemented. Despite this, alternative proteins sourced from various plants such as legumes, pulses, and cereals, continue to be underutilized, with limited research done on their use in meat analogue development. The sustainability of production technologies and the selection of proteins can have a direct impact on both cost effectiveness and consumer of meat analogues. The challenges associated with the development of gluten-free meat analogues are currently being examined. Moreover, the extraction techniques employed in the isolation of plant proteins are of paramount importance, as they contribute to the organoleptic and textural attributes of meat analogues. By utilizing advanced technologies to sustainably utilize diverse plant proteins, it is feasible to conquer the challenges encountered in the production of plant-based meat products that are palatable to both consumers and the food industry. In this review we have discussed the functional roles of various ingredients and additives for enhancing nutritional and textural properties of meat analogues and current technologies used for texturizing plant-based meat analogues. Further we have discussed various analytical methods for testing the quality attributes of meat analogues and technological and consumer perception/acceptability-related challenges and opportunities. [ABSTRACT FROM AUTHOR]

There is limited evidence for the cost and impact of occupational therapy (OT) interventions in transitioning from mental health institutions to independent living. A longitudinal case study was conducted in Ireland to evaluate the impact of OT in transitioning to independent living. Cost, resource utilization and quality of life data were collected for two participants using the Client Sociodemographic and Service Receipt Inventory, EQ-5D-5L and AQoL-8D. Subjective quality of life improved and use and cost of health services reduced, saving $218K over three years. These findings suggest occupational therapy may lead to sustainable benefits for individuals and mental health services. [ABSTRACT FROM AUTHOR]

Background: Substance use amongst young people poses developmental and clinical challenges, necessitating early detection and treatment. Considering the widespread use of technology in young people, delivering interventions digitally may help to reduce and monitor their substance use. Aims: We conducted a systematic review and two meta-analyses to assess the effectiveness of digital interventions for reducing substance use (alcohol, smoking, and other substances) among young people aged 10 to 24 years old. Method: Embase, Global Health, Medline, PsychINFO, Web of Science and reference lists of relevant papers were searched in November 2020. Studies were included if they quantitatively evaluated the effectiveness of digital health technologies for treating substance use. A narrative synthesis and meta-analysis were conducted. Results: Forty-two studies were included in the systematic review and 18 in the meta-analyses. Digital interventions showed small, but statistically significant reductions in weekly alcohol consumption compared to controls (SMD= −0.12, 95% CI= −0.17 to −0.06, I2=0%), but no overall effect was seen on 30-day smoking abstinence (OR = 1.12, 95% CI = 0.70 to 1.80, I2=81%). The effectiveness of digital interventions for reducing substance use is generally weak, however, promising results such as reducing alcohol use were seen. Large-scale studies should investigate the viability of digital interventions, collect user feedback, and determine cost-effectiveness. Prisma/Prospero: This systematic review was conducted following Cochrane methodology PRISMA guidelines. The review was registered with PROSPERO in November 2020 (CRD42020218442). [ABSTRACT FROM AUTHOR]

The number of low back pain (LBP) cases is projected to increase to more than 800 million by 2050. To address the substantial burden of disease associated with this rise in prevalence, effective treatments are needed. While clinical practice guidelines (CPG) consistently recommend non-pharmacological therapies as first-line treatments, recommendations regarding manual therapy (MT) in treating low back pain vary. The goal of this narrative review was to critically summarize the available evidence for MT behind these recommendations, to scrutinize its mechanisms of action, and propose some actionable steps for clinicians on how this knowledge can be integrated into a person-centered approach. Despite disparate recommendations from CPG, MT is as effective as other available treatments and may be offered to patients with LBP, especially as part of a treatment package with exercise and education. Most of the effects of MT are not specific to the technique. MT and other interventions share several mechanisms of action that mediate treatment success. These mechanisms can encompass patients' expectations, prior experiences, beliefs and convictions, epistemic trust, and nonspecific contextual effects. Although MT is safer than opioids for patients with LBP, this alone is insufficient. Our goal is to encourage clinicians to shift away from outdated and refuted ideas in MT and embrace a person-centered approach rooted in a comprehensive biopsychosocial framework while incorporating patients' beliefs, addressing illness behaviors, and seeking to understand each patient's journey. [ABSTRACT FROM AUTHOR]

Purpose: To compare the 26-week cost-effectiveness of adalimumab-corticosteroids (ADA-CS) and cyclosporine-corticosteroids (CSA-CS) for Vogt-Koyanagi-Harada (VKH). Methods: A preplanned cost-effectiveness analysis based on the per-protocol population of a randomized-controlled trial. VKH subjects were randomized to receive either cyclosporine (100-200 mg daily) combined with corticosteroids or adalimumab (40 mg twice monthly) combined with corticosteroids. The primary outcome of this cost-effectiveness study was the incremental cost-effectiveness ratio (ICER). Costs and quality-adjusted life-years (QALYs) data were calculated by the medical records and health utility, respectively. Subgroup (early and late-phase VKH) analysis and sensitivity analyses were performed. Results: The ICER at 26 weeks was $62,425/QALY for the total participants. Compared to the CSA-CS group, costs in the ADA-CS group were more expensive (mean difference [ΔA-C]: $2,497) with more gains in QALYs (mean difference [ΔA-C]: 0.04). The probability of ADA-CS being cost-effective was 0.17 and 0.41 at willingness to pay (WTP) thresholds of $12,000/QALY and $36,000/QALY, respectively. Subgroup analysis and sensitivity analyses showed consistent findings with the primary analysis. Conclusions: Regardless of early or late-phase VKH, the CSA-CS strategy may be recommended as the preferred initial choice for the majority of VKH. [ABSTRACT FROM AUTHOR]

Background: Telehealth can extend the reach of specialist palliative care providers to ensure that patients can access specialist services closer to home. Aim: To examine the cost and consequences of the Specialist Palliative Rural Telehealth (SPaRTa) service compared to the traditional non-specialist general practice-based services for people requiring palliative care. Design: The costs and outcomes for SPaRTa were compared using cost-consequence analysis principles, with a focus on net benefit and return on investment. Costs were estimated from the perspective of the health service provider for the 2020/2021 financial year, and cost-offsets associated with change in location of death and change in hospital transfers. Setting/participants: Patients of the SPaRTa in Queensland Australia. Results: During study period 5472 consultations were conducted from four major metropolitan hub sites to regional, rural, and remote areas at a total cost of $4 426 644. When remuneration for consultations, change to location of death and reduction in ambulance transfers were taken into account, the net-benefit to the state health system was $1 244 060, giving a return on investment of $1.28 for every dollar spent. SPaRTa complimented existing local care services, and enabled access to specialist care into the home. Conclusions: SPaRTa resulted in potential cost savings for the health service by enabling more convenient access to palliative care services outside of hospital settings. Decisions regarding funding for telepalliative care should consider not only the costs, but also the potential benefits to both the service providers, and the patients and families receiving this care. [ABSTRACT FROM AUTHOR]

COVID-19 contributed to the largest student performance decline in mathematics since 1990. The nation needs cost-effective mathematic interventions to address this drop and improve students' mathematics performance. This study presents a cost-effectiveness analysis (CEA) of three algebraic technological applications, across four conditions: From Here to There (FH2T), Dragon Box 12+ (DragonBox), Immediate Feedback and Active Control. This CEA study uses impact measures from a student-level randomized control trial comparing student learning from the three treatment conditions to the Active Control condition with an analytic sample of 1,850 middle school students across 9 schools, 34 teachers, and 127 classes. The results from the CEA indicate FH2T costs $39 per student and produces an average effect of 0.135 on algebraic achievement resulting in a cost-effectiveness ratio of $291. DragonBox costs $55 per student and produces an average effect of 0.269 on algebraic achievement resulting in a cost-effectiveness ratio of $206. Overall, the current CEA study demonstrates the efficiency of FH2T and DragonBox as low-cost interventions for improving students' algebraic performance and addressing the nation's decline in mathematics. [ABSTRACT FROM AUTHOR]

The global validation for SMAP (Soil Moisture Active Passive) Level-4 surface soil moisture using well-established core validation sites does not comprehensively account for all landscapes on earth's surface due to the diverse nature of their intrinsic characteristics. Due to the inhibitive cost of implementing a standard validation site, this study presents an alternative sampling approach suitable for localized validation of SMAP data in non-complex terrains. It involves clustering a large heterogeneous study area to smaller units of non-complex terrains where landscape-defining characteristics are largely homogeneous, thus permitting the computation of areal soil moisture as a simple arithmetic mean of near-linear point measurements. This allows optimization of limited resources (a hand-held moisture sensor with site-specific calibrations) to balance the need for spatial representativeness of samples in the sampling unit and the need for temporal proximity of sampled measurements to the aggregation time of the satellite product being validated. For ease of movement, transect sampling is implemented along access roads that run across the sampling units to allow sufficient measurement replications within a reasonably short time. Validations with four different landscapes in Kenya show a good agreement between in situ measurements and SMAP with R2 of 0.76, 0.72, 0.80, and 0.82, and biases of −0.0246, +0.0113, 0.0004, and + 0.0035 m3 m−3, respectively for Mawego, Kuresoi, Sotik and Kapsuser sites. These results only marginally differ from those obtained with a spatially distributed sampling method, indicating the potential of the proposed sampling design for time and cost effectiveness in validations at non-complex terrains. An analysis of the temporal variability of SMAP soil moisture in the watershed is also presented, with an assessment of its significance in the selection of sampling sites for validation. Particularly, the concept of temporal stability of soil moisture as a basis for clustering validation sites is evaluated. [ABSTRACT FROM AUTHOR]

Objective: A study was undertaken to explore the portion size estimation accuracy of bean bags as low-cost volumetric portion size estimation aids for amorphous foods. Designs: Three observational, cross-sectional and three experimental/quasi-experimental developmental evaluation sub-studies were carried out. Settings: Observational, cross-sectional: one retirement village and four schools. Experimental/quasi-experimental: one South African university. Participants: Observational, cross-sectional: elderly persons, adult women (school educators), schoolchildren. Experimental/quasi-experimental: university students. In total N = 541; > 3 800 observations. Variables measured: Using a standardised set of bean bags (test object; volume range: 60–625 ml), volumes of different amorphous foods (reference objects: actual foods or representations) in varying portion sizes had to be estimated. Accuracy (outcome measure) was perfect if volumes of test and reference object were identical. Acceptable estimation accuracy allowed for misestimation by one bean bag size. Test–retest reproducibility was also assessed. Analysis: Descriptive statistics (proportions perfect and acceptable accuracy). Results: Across the sub-studies, perfect accuracy ranged from 22–65% depending on participants, reference food and portion size. Irrespective thereof, acceptable accuracy was noted in > 70% of observations. Reproducibility varied (range: 28–67% agreement). Conclusions and implications: Perfect portion size estimation of amorphous foods remains challenging. When misestimation by 60–125 ml still serves the purpose of a dietary assessment, bean bags show promise for cost-effective food volume quantification, especially on group level in resource-limited settings. [ABSTRACT FROM AUTHOR]

Introduction: Recent evidence indicates that Maternal Supplementation with Long-Chain n-3 Fatty Acids During Pregnancy Substantially Mitigates Offspring's Asthma. Adding information regarding its cost-utility will undoubtedly allow its adoption, or not, in clinical practice guidelines. This research aimed to determine the cost-utility of LCPUFA supplementation in the third trimester of pregnancy to reduce the risk of wheezing and asthma in infants in Colombia. Methods: A Markov model was formulated to estimate the cost and quality-adjusted life-years (QALYs) attributed to individuals with severe asthma in Colombia, with a time horizon of five years and a cycle length of two weeks. Probabilistic sensitivity analysis and a value of information (VOI) analysis were conducted to evaluate the uncertainties in the case base. Cost-utility was assessed at a willingness-to-pay (WTP) value of US$5180. All costs were adjusted to 2021 with a 5% annual discounting rate for cost and QALYs. Results: The mean incremental cost of LCPUFA supplementation versus no supplementation was US-43.65. The mean incremental benefit of LCPUFA supplementation versus no supplementation was 0.074 QALY. The incremental cost-utility ratio was estimated at US$590.68 per QALY. The outcomes derived from our primary analysis remained robust when subjected to variations in all underlying assumptions and parameter values. Conclusion: Supplementation strategy supplementation with long-chain n-3 fatty acids during pregnancy is cost-effective in reducing the risk of developing asthma during childhood in Colombia. [ABSTRACT FROM AUTHOR]

Nucleic acids, like DNA and RNA, serve as versatile recognition elements in electrochemical biosensors, demonstrating notable efficacy in detecting various cancer biomarkers with high sensitivity and selectivity. These biosensors offer advantages such as cost-effectiveness, rapid response, ease of operation, and minimal sample preparation. This review provides a comprehensive overview of recent developments in nucleic acid-based electrochemical biosensors for cancer diagnosis, comparing them with antibody-based counterparts. Specific examples targeting key cancer biomarkers, including prostate-specific antigen, microRNA-21, and carcinoembryonic antigen, are highlighted. The discussion delves into challenges and limitations, encompassing stability, reproducibility, interference, and standardization issues. The review suggests future research directions, exploring new nucleic acid recognition elements, innovative transducer materials and designs, novel signal amplification strategies, and integration with microfluidic devices or portable instruments. Evaluating these biosensors in clinical settings using actual samples from cancer patients or healthy donors is emphasized. These sensors are sensitive and specific at detecting non-communicable and communicable disease biomarkers. DNA and RNA's self-assembly, programmability, catalytic activity, and dynamic behavior enable adaptable sensing platforms. They can increase biosensor biocompatibility, stability, signal transduction, and amplification with nanomaterials. In conclusion, nucleic acids-based electrochemical biosensors hold significant potential to enhance cancer detection and treatment through early and accurate diagnosis. [ABSTRACT FROM AUTHOR]

SUMMARY: Poultry feed manufacturing refers to processing various raw materials to meet birds' nutrient requirements, based on knowledge of animal nutrition and mechanical engineering. Since the advent of feed mills, many technologies have been utilised to implement various feed manufacturing techniques, which are helpful to sustainably produce well-balanced, cost-effective and high-quality feed. Efforts have been made to further strengthen the environmental, social and economic sustainability of feed manufacturing via a variety of technological innovations over the years. The integration and application of new technologies will be helpful to further improve poultry feed manufacturing in the future as well. By increasing the precision and uniformity of the final feed, and reducing the risk of errors, these advancements will ultimately result in more efficient manufacturing of animal products, optimising both the nutrition supplied and the energy used. This paper will review recent advances in the feed industry for poultry, as well as envision new technologies. [ABSTRACT FROM AUTHOR]

AbstractThis study investigates the effectiveness of ultrasound-aided sorption using carbon–doped zinc oxide nanoparticles (C–ZnO NPs) for the removal of eosin yellow dye (EY) from wastewater. Raman spectroscopy was employed to confirm the successful carbon doping in the ZnO lattice, while field emission scanning electron microscopy (FESEM) was used to observe the morphology of the C–ZnO NPs, revealing uniform pseudo-spherical grains with diameters ranging from 20 to 35 nm. The impact of important parameters such as EY base concentration (50–200 mg/L), C–ZnO NPs dose (0.125–1.0 g/L), initial solution pH (2.0–10.0), and reaction time (1–30 minutes) on EY dye removal was investigated to assess the adsorptive potential of C–ZnO NPs. The highest sorption efficiency of 95.90 ± 0.96 % for EY dye was achieved within 20 minutes using C–ZnO NPs dose of 0.50 g/L, a solution pH of 4.0, and at an EY base concentration of 50 mg/L. The adsorption followed pseudo-second-order kinetics and Langmuir isotherm, with a sorption capacity of 232.59 ± 1.36 mg/g. Sono-assisted adsorption outperformed with a performance of 98.96% ± 0.85% as compared with conventional methods like magnetic stirring and overhead stirring, which had a performance of 73.24% ± 1.90% and 78.06% ± 2.0% respectively. C–ZnO is found to be a cost-effective adsorbent due to its low production cost of 31.0 $/kg and high reusability. As a result, this work emphasizes the prospective use of C–ZnO NPs as adsorbent for EY removal from wastewater on account of high sorption efficiency, superior adsorptive performance over ZnO NPs, and its cost effectiveness. [ABSTRACT FROM AUTHOR]

The link between imprisonment and adverse mental health is well established and linked to both recidivism and prison misconduct, with negative consequences for prisoners, the prison system and society. To help minimise these impacts, appropriate mental health interventions are required. However, owing to finite resources to deliver healthcare in prisons, interventions must be both clinically and cost-effective. A systematic literature search was conducted using various medical and economic databases. The search aimed to identify full economic evaluations (comparing costs and consequences of two or more interventions) of mental health interventions for adult prisoners during incarceration. Results were intended to identify evidence gaps and highlight areas for future research. Only one publication met all eligibility requirements, with several limitations identified. This finding highlighted a clear lack of cost-effectiveness evidence for use by decision makers within the prison setting. This emphasises the need for future research to incorporate economic evaluation during the early stages of research design. Research should aim to incorporate both intervention costs and wider healthcare resource use, which may be affected, and generic outcomes, such as quality-adjusted life years (QALYs), which enable comparison across various disease areas and against pre-determined thresholds. [ABSTRACT FROM AUTHOR]

Alcohol and other drug (AOD) use problems among college students continue to represent a public health epidemic. In 2019, historically high rates of binge-drinking and marijuana use were reported among college-age adults, and the detrimental effects of excessive AOD use in college, such as poorer academic performance, sexual assault, injury or overdoses, and a range of other negative consequences, have been well-documented. Thus, there is a continued need for effective implementation of evidence-based, cost-effective interventions aimed at reducing risks associated with collegiate AOD use. Guided Self Change (GSC) is a brief intervention involving motivational enhancement and cognitive-behavioral strategies and has demonstrated effectiveness in reducing AOD use problems. Its brevity, client-driven style, and concrete here-and-now focus are appealing to individuals struggling with mild to moderate AOD use problems. In order to successfully intervene with collegians with AOD use problems attending minority-serving institutions, GSC requires developmental and cultural tailoring. The current report describes the developmental and cultural tailoring of GSC for emerging adult Latinx collegians, as well as our consumer-driven addition of mindfulness content. Key components of our GSC program are documented through qualitative feedback, quantitative results, and case vignettes. [ABSTRACT FROM AUTHOR]

The FLT3 inhibitor quizartinib has been shown to improve overall survival when added to intensive induction chemotherapy ("7 + 3") in patients 18-75 years old with newly diagnosed AML harboring a FLT3-ITD mutation. However, the health economic implications of this approval are unknown. We evaluated the cost-effectiveness of quizartinib using a partitioned survival analysis model. One-way and probabilistic sensitivity analyses were conducted. In the base case scenario, the addition of quizartinib to 7 + 3 resulted in incremental costs of $289,932 compared with 7 + 3 alone. With an incremental gain of 0.84 quality-adjusted life years (QALYs) with quizartinib + 7 + 3 induction vs. 7 + 3 alone, the incremental cost-effectiveness ratio for the addition of quizartinib to standard 7 + 3 was $344,039/QALY. Only an 87% reduction in the average wholesale price of quizartinib or omitting quizartinib continuation therapy after completion of consolidation therapy and allogeneic hematopoietic cell transplant would make quizartinib a cost-effective option. [ABSTRACT FROM AUTHOR]

Brief Admission by self-referral (BA) is a crisis-management intervention standardized for individuals with self-harm at risk of suicide. We analyzed its health-economic consequences. BA plus treatment as usual (TAU) was compared with TAU alone in a 12-month randomized controlled trial with 117 participants regarding costs for hospital admissions, coercive measures, emergency care and health outcomes (quality-adjusted life years; QALYs). Participants were followed from 12 months before baseline to up to five years after. Over one year BA was associated with a mean annual cost reduction of 4800 or incremental cost of 4600 euros, depending on bed occupancy assumption. Cost-savings were greatest for individuals with >180 admission days in the year before baseline. In terms of health outcomes BA was associated with a QALY gain of 0.078. Uncertainty analyses indicated a significant QALY gain and ambiguity in costs, resulting in BA either dominating TAU or costing 59 000 euros per gained QALY. BA is likely to produce QALY gains for individuals living with self-harm and suicidality. Cost-effectiveness depends on targeting high-need individuals and comparable bed utilization between BA and other psychiatric admissions. Future research should elaborate the explanatory factors for individual variations in the usage and benefit of BA. [ABSTRACT FROM AUTHOR]

Indonesia is a rapidly growing county with over 262 million inhabitants, but among highly populated countries it has one of the lowest concentrations of eye care providers. This study evaluated the cost-effectiveness of a program implemented in South Sulawesi, Indonesia that trained school teachers to conduct vision screenings, organized in-school evaluations by opticians, and provided free eyeglasses to school children with refractive error (RE). Schoolteachers across 6 districts in South Sulawesi were trained to screen children with possible RE for subsequent evaluation by opticians. All costs associated with designing and implementing the program (administration, training personnel, labor, service delivery, etc.) were assessed. Expenditures and outcomes data were utilized to calculate the cost per disability-adjusted-life-year (DALY) averted using both 2010 and 2016 Global Burden of Disease (GBD) weights. 521 teachers screened 41,212 students across 172 schools in South Sulawesi. 4,506 (10.9%) students failed screening, 2,652 were seen by optometrists, and 2,038 received glasses. The total program cost was US$97,380, with glasses (39.6%) and labor (23.3%) accounting for the two biggest expenditures. In districts with school-based refraction services, the costs per student screened, refracted, and receiving glasses were $2.57, $31.33, and $41.40, respectively; costs were $2.04, $59.80, and $73.22 when district services were instead provided centrally. The estimated cost per DALY averted was US$89.04 based on GBD 2010 weights. Treating children with correctable RE in limited resource settings can be done cost-effectively through a school-based model. [ABSTRACT FROM AUTHOR]

This systematic review aims to critically evaluate and synthesize the economic outcomes of various therapeutic strategies employed to manage cachexia patients. A comprehensive search for randomized controlled trials and observational studies was conducted from January 1, 2000 to December 31, 2023, using PubMed, Google Scholar, Clinical Trials Registry, Cochrane Central Register of Controlled Trials, British Medical Journal, National Health Service Economic Evaluation Database, and ScienceDirect, following PRISMA guidelines. We assessed the quality of the included studies using the Consolidated Health Economic Evaluation Reporting Standards reporting guidelines. We identified six high to medium quality economic evaluations in four countries, focusing on cancer, chronic obstructive pulmonary disease, and HIV/AIDS-associated cachexia. The results indicate that combination management strategies, specifically the use of nutritional supplements and exercise, are more cost-effective than usual care for cachexia syndrome. Additionally, two studies showed that dietary supplements alone were more cost-effective than usual care, and pharmacotherapy alone was more cost-effective than a placebo. Combining several strategies, such as nutritional supplements and exercise, may be the most economically efficient method for managing cachexia compared to usual care or single treatment approaches. However, the restricted and diverse characteristics of the current research hinder the definitive conclusions. [ABSTRACT FROM AUTHOR]

Phenolics produced during xylooligosaccharide production might inhibit xylanases and enhance the antioxidant and antimicrobial activities of XOS. The effects of phenolic compounds on xylanases may depend on the type and concentration of the compound, the plant biomass used, and the enzyme used. Understanding the effects of phenolic compounds on xylanases and their impact on XOS is critical for developing viable bioconversion of lignocellulosic biomass to XOS. Understanding the complex relationship between phenolic compounds and xylanases can lead to the development of strategies that improve the efficiency and cost-effectiveness of XOS manufacturing processes and optimise enzyme performance. [ABSTRACT FROM AUTHOR]

Poor walking aid compliance and accessibility can put the user at an increased risk of falls. We explored the acceptability and accessibility of magnetic walking aids (MWAs) compared to standard walking aids (SWAs) in inpatients following joint replacement. A non-blinded pilot randomised controlled trial was conducted. Inpatients following hip or knee replacement were randomly allocated to the MWA group (n = 20) or the SWA group (n = 20). Primary outcomes were the acceptability and accessibility of the MWA compared to the SWA during their inpatient stay, assessed through made-to-measure patient and staff questionnaires. The secondary outcome was the number of times the walking aid came to rest on the floor, measured using logbooks kept by participants. The participants in the MWA group reported their aid was more easily accessible, and that they were more likely to use their aid in their room than participants in the SWA group. Participants in the MWA group dropped their aid less often, with a median of 0.3 walking aid drops per day in the MWA group and 1.1 drops per day in the SWA group (p = 0.002). The results of this pilot randomised trial suggest MWAs may be an acceptable and inexpensive intervention for improving walking aid accessibility and adherence and reducing walking aid drops when compared to SWAs. Magnetic walking aids may be a simple and cost effective way for improving walking aid compliance compared to standard walking aids. Walking aid adherence can be difficult to monitor within hospital and community settings. Magnetic walking aids may be safe to use in a controlled inpatient hospital environment with no adverse effects. Magnetic walking aids may reduce the number of instances a walking aid inadvertently comes to rest on the floor. This is of particular importance to patients post-operatively. For example, total hip replacements, where reaching to pick up an aid from the floor could lead to hip dislocation. [ABSTRACT FROM AUTHOR]

Mental health problems are highly prevalent among people living with HIV/AIDS (PLWHA), yet mental health care in African countries is scarce. There is growing interest in understanding the effect of group therapy delivery models and task-shifting to support mental health care in African settings. We conducted a scoping review following the PRISMA-ScR statement on group therapy in PLWHA in Africa. We searched PubMed/Medline, Embase, and Google Scholar for articles published before October 2023 on evidence for effectiveness and acceptance of group therapies in PLWHA, and evidence of task-shifting approaches. A narrative synthesis approach for data analysis was used. We included 17 studies, which comprised 26 different outcome measures across seven countries in sub-Sahara Africa. The majority (72%) of the assessed single outcomes demonstrated a positive impact of group therapy delivery models on outcome measures, particularly depression, alcohol use, overall functioning, and social support in sub-Sahara Africa. High acceptance was demonstrated by quantitative and qualitative approaches. Task shifting approaches generally were shown to be effective, cost-effective, and accepted, and may support burdened healthcare systems in rural settings. The current evidence, albeit scarce, supports the use of group therapy and task shifting in addressing mental health among PLWHA living in sub-Sahara Africa. [ABSTRACT FROM AUTHOR]

Rehabilitation outcomes are important for patients, professionals and policy makers. Most outcome measures (OMs) were developed for "Western" contexts and may be inadequate for low-resource and conflict settings, where the ability to demonstrate impact would be critical to strengthening the sector. This study aims to understand perspectives of physiotherapists from challenging environments regarding current practices, value, barriers, and facilitators of measuring rehabilitation outcomes. Focus group discussions were held in English with 35 physiotherapists from 18 countries. Audio recordings were transcribed verbatim, anonymised, and analysed using reflexive thematic analysis. Four themes emerged illustrating the levels at which outcomes and measures were discussed: User (patients, families), provider (physiotherapists, rehabilitation workers), application (OMs), and structure (management, health system). Participants discussed diversity in current practices and patient populations, utility of OMs and a neglected rehabilitation sector lacking investment. Barriers to progressing outcome measurement included lacking patient health literacy, rehabilitation provider training, valid OMs, and leadership. Participants suggested improved patient involvement, routine outcome measurement by using, developing, or adapting simple, context- and stakeholder-relevant OMs, and support from management. These insights illustrate the need of and provide robust recommendations for context-adapted development of rehabilitation outcome measurement in various challenging contexts. Rehabilitation outcomes are important to show impact in low-resource and conflict settings, but most outcome measures originate from "Western" contexts Experience of physiotherapists from low-resource and conflict settings reveals the barriers and facilitators to measuring rehabilitation outcomes in their workplaces Participants' suggest to use or develop simple scales that are contextualised and stakeholder-relevant for standard, routine measurement This study highlights the need to improve the measurement of rehabilitation outcomes in challenging contexts and provides guidance on how to do so [ABSTRACT FROM AUTHOR]

There is growing interest in intelligent assistive technologies (IATs) in the rehabilitation and support of older adults, however, the factors contributing to or preventing their use in practice are not well understood. This study aimed to develop an overview of current knowledge on barriers and facilitators to the use of smart technologies in rehabilitative practice with older adults. We undertook a scoping review following guidelines proposed by Arksey and O'Malley (2005) and Levac et al. (2010). A computerised literature search was conducted using the Scopus and Ovid databases, yielding 7995 citations. Of these, 94 studies met inclusion criteria. Analysis of extracted data identified themes which were explored in semi-structured interviews with a purposefully selected sample of seven clinical rehabilitation practitioners (three physical therapists, two occupational therapists, and two speech-language pathologists). Barriers and facilitators to using these technologies were associated with accessibility, reported effectiveness, usability, patient-centred considerations, and staff considerations. Collaborative efforts of policy-makers, researchers, manufacturers, rehabilitation professionals, and older persons are needed to improve the design of technologies, develop appropriate funding and reimbursement strategies, and minimise barriers to their appropriate use to support independence and quality of life. Any strategies to improve upon barriers to prescribing smart technologies for older people should leverage the expertise of rehabilitation professionals operating at the interface between older people; their health/mobility; their families; and technology-based solutions. There is growing interest in intelligent assistive technologies (IATs) in the rehabilitation of older adults, as well as barriers to their use in practice. Rehabilitation professionals can play a key role in enabling access to IATs by recommending or prescribing their use to their older clients. Strategies to address barriers to the use of IATs for older people should leverage the expertise of rehabilitation professionals operating at the interface between older people, their families, and technology-based solutions. Older people and their families require technical support to initiate and continue to use IATs for rehabilitation. While rehabilitation providers may be well-placed to offer this support, they may require time and organizational support to build and maintain expertise in the fast-advancing field of smart technologies for rehabilitation. Cost and usability are universal challenges across the types of smart technologies considered in this review. Participatory approaches to involving older people in the design and development of smart assistive technologies contribute to better usability of these technologies. Devices and interventions that leverage more readily available devices and lower-cost components may overcome cost barriers to accessibility. [ABSTRACT FROM AUTHOR]

We study a collaborative scheduling problem where the dominant manufacturer (DM) outsources several processes to collaborative manufacturers (CMs). We consider multiple types of products defined by different collaborative production networks which may share some common CMs. The DM assigns the orders to the CMs and coordinates the production scheduling among the CMs. We analyse a practical order-merging strategy which combines a subset of same-type orders throughout the production aming at the cost benefit by continuous processing. Such a strategy is easy to implement but may increase the scheduling cost because of increased deviation between the completion time and the required delivery window of some orders. To this end, a heuristic algorithm based on a learning mechanism and ant colony optimisation is proposed for solving the collaborative scheduling problem under the order-merging plans. Simulation case study was carried out to compare the costs under different merging options. We conclude that merging more orders could lead to a better cost in a few cases, and the overall system performance is more sensitive to the merging schemes when the network capacity is tighter due to disruption. Our study provides an effective solution approach and managerial insights for collaborative scheduling problems with practical order-merging strategies. [ABSTRACT FROM AUTHOR]

AbstractTo create effective policies for promoting Integrated Pest Management (IPM) it is crucial to comprehend farmers’ attitudes toward IPM. A survey of 306 rice farmers was conducted to assess the perceived advantages and disadvantages of IPM practices and explain variations in perceptions among different groups of farmers. Through factor analysis, the primary advantages and disadvantages of utilizing IPM in farm field were categorized into six factors, namely: low efficacy in pest control, personal drawbacks, weak technical and support services (as disadvantages of IPM), as well as health benefits, cost effectiveness, and social advantages (as advantages of IPM). The cumulative percentage of variance accounted for by these six factors was 71.052%, with 36.78% of the variance stemming from positive aspects and 34.28% from negative aspects of IPM practices. Educated farmers showed a preference for IPM advantages (p < .001), while affluent farmers leaned towards IPM disadvantages (p < .020). Farmers with high rice production prioritized IPM disadvantages (p < .001), with those perceiving pesticides as harmful showing less preference for IPM drawbacks (p < .001). Training recipients favored IPM benefits (p < .000) and less so the drawbacks (p < .013). Farmers at health risk due to pesticides prioritized IPM advantages (p < .030) and lessened emphasis on disadvantages (p < .041). Additionally, farmers implementing IPM practices valued IPM advantages more (p < .000013) and disadvantages less (p < .000004). Using the scale from this research, agricultural extension services can tailor education efforts to emphasize the benefits of IPM practices and how to address their drawbacks, promoting widespread adoption of IPM among farmers. [ABSTRACT FROM AUTHOR]

The application of STEM (Science, Technology, Engineering, and Math) education in solving real-world problems is challenging. To tackle this challenge, a project-based learning approach that integrates robots with cost-effective self-made toys to problem-solving was adopted to assist rural primary school students to apply STEM skills. The purpose of this study was to evaluate the effects of the project-based learning approach which includes lecturing and hands-on activities on primary school students' STEM learning outcomes and attitudes. An experiment was conducted with 25 primary school students who voluntarily participated in a STEM summer-camp programme. Students were asked to assemble a paper house equipped with an IoT control module and LED light switches, and write and edit robot scripts to produce a robot-based storytelling narrative using the paper house they made as a context. The results show that the project-based learning approach was an effective approach for cultivating primary school students' STEM knowledge and skills as evidenced from the post-written test. The relationships between the students' STEM learning outcomes and attitudes were also confirmed by a clustering analysis. Students who had higher learning attitudes also achieved higher STEM learning outcomes; the findings are also supported by the feedback from the open-ended questionnaire items. This study suggests that integrating low-cost self-made toys and robots in project-based learning activities is an effective and practical approach to enhance primary school students' learning outcomes and learning attitudes in STEM education. [ABSTRACT FROM AUTHOR]

Evidence derived from laboratory medicine plays a pivotal role in the diagnosis, treatment monitoring, and prognosis of various diseases. Reference intervals (RIs) are indispensable tools for assessing test results. The accuracy of clinical decision-making relies directly on the appropriateness of RIs. With the increase in real-world studies and advances in computational power, there has been increased interest in establishing RIs using big data. This approach has demonstrated cost-effectiveness and applicability across diverse scenarios, thereby enhancing the overall suitability of the RI to a certain extent. However, challenges persist when tests results are influenced by age and sex. Reliance on a single RI or a grouping of RIs based on age and sex can lead to erroneous interpretation of results with significant implications for clinical decision-making. To address this issue, the development of next generation of reference interval models has arisen at an historic moment. Such models establish a curve relationship to derive continuously changing reference intervals for test results across different age and sex categories. By automatically selecting appropriate RIs based on the age and sex of patients during result interpretation, this approach facilitates clinical decision-making and enhances disease diagnosis/treatment as well as health management practices. Development of next-generation reference interval models use direct or indirect sampling techniques to select reference individuals and then employed curve fitting methods such as splines, polynomial regression and others to establish continuous models. In light of these studies, several observations can be made: Firstly, to date, limited interest has been shown in developing next-generation reference interval models, with only a few models currently available. Secondly, there are a wide range of methods and algorithms for constructing such models, and their diversity may lead to confusion. Thirdly, the process of constructing next-generation reference interval models can be complex, particularly when employing indirect sampling techniques. At present, normative documents pertaining to the development of next-generation reference interval models are lacking. In summary, this review aims to provide an overview of the current state of development of next-generation reference interval models by defining them, highlighting inherent advantages, and addressing existing challenges. It also describes the process, advanced algorithms for model building, the tools required and the diagnosis and validation of models. Additionally, a discussion on the prospects of utilizing big data for developing next-generation reference interval models is presented. The ultimate objective is to equip clinical laboratories with the theoretical framework and practical tools necessary for developing and optimizing next-generation reference interval models to establish next-generation reference intervals while enhancing the use of medical data resources to facilitate precision medicine. [ABSTRACT FROM AUTHOR]

Ionic liquid functionalised egg residues were tested for their biosorption ability towards water soluble anionic 'orange G' dye. Egg residues after ionic liquid treatment were characterised via FTIR, SEM and TGA. Adsorption process was optimised by evaluating different experimental parameters including effect of adsorbent dose, contact time, agitation speed, temperature and pH. Modified egg shell membrane (MESM) exhibited higher efficiency for orange G dye adsorption followed by unmodified egg shell membrane (ESM) and powdered egg shell (PES). Equilibrium states were achieved in 1 hour for the different studied initial dye concentrations at acidic pH, 120 rpm and 30°C. Under optimum conditions >95% dye is removed with 27 mg/g adsorption capacity of MESM for 80 ppm dye solution. Study was further extended to find the best-fitted kinetic and isothermal model. It was found that the process follows pseudo-second-order kinetics and Langmuir isothermal model. Adsorbent was regenerated and reused without significant loss of efficiency. This research work presented that ionic liquid modified egg shell membrane is highly efficient with regard to its ecological perspective and cost effectiveness for the removal of toxic dye from wastewater. [ABSTRACT FROM AUTHOR]

Effective services along the HIV continuum of care from HIV testing and counseling to linkage, and from linkage to antiretroviral therapy (ART) initiation and retention, are key to improved health outcomes of persons living with HIV. A comprehensive analysis of the costs and outcomes of cascade services is needed to help allocate and prioritize resources to achieve UNAIDS targets. We evaluated the costs and population-level impact of a community-wide, integrated scale-up of testing, linkage, and defaulter-tracing programs implemented in Bukoba Municipal Council, Tanzania. Costs per identified HIV-positive client for provider-initiated, and home- and venue-based testing and counseling were $92.64 United States dollars (USD), $256.33 USD, and $281.57 USD, respectively. Costs per patient linked to HIV care and ART were $47.69 USD and $74.12 USD, respectively, during all ART-eligibility periods combined. Costs per defaulter traced and returned to HIV care were $47.56 USD and $206.77 USD, respectively. The provider-initiated testing and counseling was the most cost-effective modality. Testing approaches targeted to populations groups and geographic location with high testing positivity rates may improve the overall efficiency of testing services. The expansion of ART eligibility criteria and high linkage rate also result in efficiency gains and economies of scale of linkage services. [ABSTRACT FROM AUTHOR]

Indicator condition (IC)-guided HIV testing, i.e., testing when diagnosing a condition associated with HIV, is a feasible and cost-effective testing strategy to identify undiagnosed individuals. Assessing determinants for IC-guided testing may identify opportunities for improvement. A survey study based on the Theory of Planned Behaviour (TPB) was conducted among 163 hospital physicians from five specialties in Amsterdam, the Netherlands. Structural equation models were used to determine the association between the TPB domains (i.e., attitude, belief, norms, self-efficacy and behavioural control) and (1) the intention to test as a mediator for HIV testing behaviour (intentional model) and (2) actual HIV testing behaviour (direct model). Both models accounted for the effect of guideline recommendations. Behaviour scored lower than intention on a five-point scale (mean score of 2.8, SD = 1.6 versus 3.8, SD = 1.1; p<0.0001). The direct model had a better fit than the intentional model based on fit statistics. Discrepancies between the determinants most important for intention versus those for behaviour led to the following recommendations: interventions to improve IC-guided testing in hospitals should primarily focus on implementation of guideline recommendations, followed by improving physicians' attitude towards IC-guided HIV testing and self-efficacy, as these were the most important correlates of actual HIV testing behaviour. [ABSTRACT FROM AUTHOR]

This work was designed to assess the cost-effectiveness of front-line tislelizumab plus chemotherapy (TIS+Chemo) in advanced gastric cancer (GC) or gastroesophageal junction cancer (GEJC) with positive expression of programmed cell death ligand 1 (PD-L1) from the perspective of Chinese healthcare system. A 10-year partitioned survival model was undertaken utilizing clinical data from RATIONALE 305. Costs and utilities were both discounted at an annual rate of 5%. The primary outcome was incremental cost-effectiveness ratios (ICERs) and calculated as the cost per quality-adjusted life years (QALYs). The willingness-to-pay (WTP) threshold was set as $18,625/QALY. Only direct medical costs were considered. Sensitivity analyses and subgroup analyses were performed to evaluate the robustness of the model. In the base-case analysis, the incremental cost and effectiveness associated with TIS+Chemo vs Chemo was 7,361 and 0.38 QALYs, respectively, leading to an ICER of 19,371/QALY. At the WTP threshold of $18,625/QALY, the TIS+Chemo was not a cost-effective first-line treatment option. The model outcomes were robust. TIS+Chemo did not provide a cost-effective approach for PD-L1 positive advanced GC/GEJC in China setting. However, TIS+Chemo might be cost-effective in provinces with higher WTP threshold. RATIONALE 305, , identifier is NCT03777657. [ABSTRACT FROM AUTHOR]

Introduction of direct acting antivirals (DAA) has transformed treatment of chronic hepatitis C (HCV) and made the elimination of HCV an achievable goal set forward by World Health Organization by 2030. Multiple barriers need to be overcome for successful eradication of HCV. Availability of pan-genotypic HCV regimens has decreased the need for genotype testing but maintained high efficacy associated with DAAs. In this review, we will assess the cost-effectiveness of DAA treatment in patients with chronic HCV disease, with emphasis on general, cirrhosis, and vulnerable populations. Multiple barriers exist limiting eradication of HCV, including cost to treatment, access, simplified testing, and implementing policy to foster treatment for all groups of HCV patients. Clinically, DAAs have drastically changed the landscape of HCV, but focused targeting of vulnerable groups is needed. Public policy will continue to play a strong role in eliminating HCV. While we will focus on the cost-effectiveness of DAA, several other factors regarding HCV require on going attention, such as increasing public awareness and decreasing social stigma associated with HCV, offering universal screening followed by linkage to treatment and improving preventive interventions to decrease spread of HCV. [ABSTRACT FROM AUTHOR]

Budget constraints in health-care systems have led to the popularity of Cost Effectiveness Thresholds (CET) to achieve efficient allocation of resources. The capability approach has been hailed for its potentially richer evaluative capabilities compared to the QALY in terms of thresholds. Extensive research, however, is still limited. This study estimated the monetary value of a year in full capability (YFC) and compared it to monetary value of a QALY for the Hungarian population. Data was collected from a large, cross sectional, representative online survey on the adult Hungarian population. Applying the wellbeing valuation method, health, capability, and income were then regressed against wellbeing to estimate 'shadow prices' for one QALY and YFC controlling for gender, age, employment, education, marital and social support. To examine 'core' regression coefficients, a robustness check was conducted. Health (VAS) and capability (ICECAP-A) had a positive and significant effect on Subjective Well-Being. The monetary values of one QALY and one YFC were 39 459 EUR and 58 148 EUR respectively. These tools provide a systematic approach to determining 'compensating income' for certain illnesses, disabilities and levels of pain. The capability approach shown to be broader than the QALY. [ABSTRACT FROM AUTHOR]

Speech and language pathologists (SLPs) often rely on judgements of speech fluency for diagnosing or monitoring patients with aphasia. However, such subjective methods have been criticised for their lack of reliability and their clinical cost in terms of time. This study aims at assessing the relevance of a signal-processing algorithm, initially developed in the field of language acquisition, for the automatic measurement of speech fluency in people with aphasia (PWA). Twenty-nine PWA and five control participants were recruited via non-profit organizations and SLP networks. All participants were recorded while reading out loud a set of sentences taken from the French version of the Boston Diagnostic Aphasia Examination. Three trained SLPs assessed the fluency of each sentence on a five-point qualitative scale. A forward-backward divergence segmentation and a clustering algorithm were used to compute, for each sentence, four automatic predictors of speech fluency: pseudo-syllable rate, speech ratio, rate of silent breaks, and standard deviation of pseudo-syllable length. The four predictors were finally combined into multivariate regression models (a multiple linear regression — MLR, and two non-linear models) to predict the average SLP ratings of speech fluency, using a leave-one-speaker-out validation scheme. All models achieved accurate predictions of speech fluency ratings, with average root-mean-square errors as low as 0.5. The MLR yielded a correlation coefficient of 0.87 with reference ratings at the sentence level, and of 0.93 when aggregating the data for each participant. The inclusion of an additional predictor sensitive to repetitions improved further the predictions with a correlation coefficient of 0.91 at the sentence level, and of 0.96 at the participant level. The algorithms used in this study can constitute a cost-effective and reliable tool for the assessment of the speech fluency of patients with aphasia in read-aloud tasks. Perspectives for the assessment of spontaneous speech are discussed. [ABSTRACT FROM AUTHOR]

Flood routing is an important topic in engineering hydrology and an integral part of flood management and hydrodynamic modelling studies. Muskingum and Muskingum-Cunge methods are commonly used in flood routing studies. Here, we perform a systematic review of research on linear and non-linear Muskingum and Muskingum-Cunge flood routing methods to document how they have contributed to the development of flood science. Specifically, we document the evolution of publications involving Muskingum flood routing methods between 1938 and 2021. Research gaps progressively filled over time include the use of optimization algorithms, and tools for uncertainty and sensitivity analysis. In addition, we document various case studies that were conducted to improve flood routing performance. The chronological analysis reveals performance improvement of Muskingum and Muskingum-Cunge models in terms of cost effectiveness, user friendliness and ease of use. [ABSTRACT FROM AUTHOR]

The United States is facing a surge in the aging population, which will increase the demand for services and supports that allow older adults to age independently. This study assessed the size and value of the volunteer labor force in two home- and community-based programs funded under the Older Americans Act (OAA). Using publicly available program data for fiscal years 2015–2019, we calculated the annual contribution of volunteers, based on the total number of volunteer hours and share of labor effort, and estimated the economic value of volunteers in these OAA programs. In fiscal year 2019, volunteers contributed a total value of $1.7 billion in the OAA Title III program and $14.0 million in the Title VII long-term care ombudsman program. These results highlight the value of volunteers in OAA programs and the need for policies to support volunteers in the aging services network. [ABSTRACT FROM AUTHOR]

People with disability often require long-term care. Long-term care is changing with the availability and advances in cost and function of technologies, such as home automation. Home automation has the potential to reduce paid carer hours and can potentially offer many benefits to people with a disability. The aim of this scoping review is to identify the health, social and economic outcomes experienced by people living with a disability who use home automation. Two electronic databases were searched by title and abstract to identify international literature that describes home automation experiences from the perspectives of people with disability. A thematic approach was taken to synthesise the data to identify the key outcomes from home automation. The review identified 11 studies reporting home automation outcomes for people living with a disability. Seven outcomes were associated with home automation: independence, autonomy, participation in daily activities, social and community connectedness, safety, mental health, and paid care and informal care. Advances in technology and changes in funding to support people living with a disability have made access to home automation more readily available. Overall, the study findings showed that there is a range of potential benefits of home automation experienced by individuals living with a disability. A wide range of outcomes have been evaluated following the installation of home automation systems for people with disability. Key outcomes evaluated to date include independence, autonomy, participation, safety, mental health, and reduced need for paid carers. Outcomes of home automation appear to be connected; for example, improved participation may lead to improved mental health. [ABSTRACT FROM AUTHOR]