Objective:To evaluate the cost-effectiveness of annual trivalent inactivated influenza vaccine(IIV3)under the context of Zhejiang province.Methods:A state transition simulation model was constructed to estimate the he...Objective:To evaluate the cost-effectiveness of annual trivalent inactivated influenza vaccine(IIV3)under the context of Zhejiang province.Methods:A state transition simulation model was constructed to estimate the health and economic outcomes of IIV3 vaccination program compared to no vaccination for hypothetical cohorts of Zhejiang province stratified by age and risk status.Model input parameters were chosen based on published literatures and expert advices.The analysis used societal perspectives and a one-year time horizon,and permanent outcomes were also included.The primary outcome was the incremental cost-effectiveness ratio(ICER),with expression of US dollars per quality adjusted life years(QALYs)gained.Results:In subgroups not at high risk for influenza-related complications(non-high risk subgroup),ICER ranged from $6268/QALY(for adults aged 50-64 years)to $11260/QALY(for children aged from 6 months to 4 years).In subgroups at high risk for influenza-related complications(high risk subgroup),ICER ranged from cost-saving(adults aged≥65 years)to $5260/QALY(for children aged from 6 months to 4 years).ICER were most sensitive to changes in probability of influenza illness,cost of hospitalization,and probability of death for adults aged 18-49 years with non-high risk status.Conclusions:ICERs of annual influenza vaccination varied by age and risk status but were less than the Gross Domestic Product(GDP)per capita of Zhejiang province($17745 in 2023),which remained cost-effective for all-age and different risk status groups from a societal perspective.展开更多
BACKGROUND Robotic assistance is increasingly used for donor and recipient hepatectomy in liver transplantation,yet existing evidence is fragmented and variably indirect.AIM To evaluate clinical outcomes,surgical perf...BACKGROUND Robotic assistance is increasingly used for donor and recipient hepatectomy in liver transplantation,yet existing evidence is fragmented and variably indirect.AIM To evaluate clinical outcomes,surgical performance,and economic effects of robotic-assisted donor and recipient hepatectomy in the transplant pathway.METHODS Following Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 and a priori registration,systematic reviews were included with or without meta-analysis.Four databases were searched through July 2025.Methodological quality was appraised with a measurement tool to assess systematic reviews(AMSTAR 2),and certainty was graded with grading of recommendations assessment,development and evaluation(GRADE).Evidence overlap was calculated via a citation-matrix-based corrected covered area(CCA).Effect sizes were prespecified as risk ratios(RR)for dichotomous outcomes and mean differences for continuous outcomes.RESULTS Five reviews met the inclusion criteria,four with meta-analyses and one consensus review used only for context.Donor(direct)findings were more favorable for robotics in terms of estimated blood loss(≈-117 mL)and length of stay(≈-0.6 days),although with longer operative time(≈+105 minutes).Absolute risks for donor complications were not estimable from ratio-only data.Recipient(indirect)meta-analysis indicated robotics to be favorable in terms of conversion(RR≈0.41)and severe morbidity(RR≈0.81),with a trend toward lower overall morbidity(RR≈0.92)and no difference in 30-day mortality.Differences in length of stay and operative time were small and heterogeneous.Economic evidence(indirect,network meta-analysis)suggested higher procedural costs for robotic vs laparoscopic intervention,but lower hospitalization costs vs open intervention,with laparoscopy the least expensive overall.AMSTAR 2 ratings were moderate-to-high across the reviews,GRADE certainty was low for key donor continuous outcomes,and low-to-moderate for recipient and economic outcomes.Overlap was slight(graded-corpus CCA=0.0%;including a contextual non-transplant review increased CCA to≈1.25%).CONCLUSION Robotic donor hepatectomy confers perioperative advantages at the cost of longer operative time.Recipient and economic findings are indirect and considered hypothesis-generating.Transplant-specific,prospective comparisons using a minimum standardized dataset and uniform outcome definitions are needed to resolve remaining uncertainties and to clarify the cost-utility correlation.展开更多
As a novel class of purely organic fluores-cent materials,multiple resonance thermal-ly activated delayed fluorescence(MR-TADF)compounds hold significant promise for next-generation display technologies.The efficiency...As a novel class of purely organic fluores-cent materials,multiple resonance thermal-ly activated delayed fluorescence(MR-TADF)compounds hold significant promise for next-generation display technologies.The efficiency of exciton utilization and the overall performance of organic light-emit-ting devices are closely linked to the singlet-triplet energy gap(ΔE_(ST))of MR-TADF emitters.Identifying an economic and accu-rate theoretical approach to predictΔE_(ST)would be beneficial for high-throughput screening and facilitate the inverse design of MR-TADF molecules.In this study,we evaluated the S_(1)state energy(E(S_(1))),T_(1)state ener-gy(E(T_(1))),andΔE_(ST)using three different physical interpretations:adiabatic excitation ener-gy,vertical absorption energy,and vertical emission energy.We employed the time-depen-dent density functional theory(TDDFT)and delta self-consistent field(ΔSCF)methods to calculate E(S_(1)),E(T_(1)),andΔE_(ST)for 20 MR-TADF molecules reported in the literature.We compared these calculated values with experimental data obtained from fluorescence spec-troscopy at room-temperature(or 77 K)and phosphorescence spectroscopy conducted at 77 K.Our findings indicate that the vertical absorption energy at the S0 state minimum,deter-mined by theΔSCF method,accurately predicts the S_(1)state energy.Similarly,the vertical absorption energy at the S0 state minimum,calculated using the TDDFT method,effectively predicts the T_(1)state energy.TheΔE_(ST)derived from the difference between these two excita-tion energies exhibited the smallest mean absolute error of only 0.039 eV compared to the ex-perimental values.This combination represents the most accurate and cost-effective method reported to date for predicting theΔE_(ST)of MR-TADF molecules,and can be integrated into AI-driven inverse design workflows for new emitters.展开更多
Cost-effectiveness analysis（CEA） is increasingly important in health care decision making.Cost-effectiveness threshold is a critical parameter in the cost-effectiveness analysis.This review introduces the concept of...Cost-effectiveness analysis（CEA） is increasingly important in health care decision making.Cost-effectiveness threshold is a critical parameter in the cost-effectiveness analysis.This review introduces the concept of cost-effectiveness threshold, summarizes its determining methods,and classifies the existing methods into two kinds according to budget constraints,then analyzes the merit and demerit of every methods.When there is a flexible budget,the methods for determining the cost-effectiveness threshold include inferring the threshold from previous decisions,comparison with other health care technology or transfer from elsewhere in the public sector,social willingness-to-pay approach,GDP per capita criteria,and rule of thumb.When there is a fixed budget,the methods for determining the cost-effectiveness threshold include shadow price approach,opportunity cost approach,and ICER threshold-searcher model.Each approach to determining threshold has its strength and weakness.The aim of this article is to introduce the existing methods and discuss the features of each method.The background information,such as the definition of threshold,is also described.The basic theory of cost-effectiveness threshold is elaborated,and we recommend the establishment of a cost-effectiveness threshold in the Chinese health care.展开更多
The United States （U.S.） is facing a national opioid epidemic, and medical systems are in need of non- pharmacologic strategies that can be employed to decrease the public＇s opioid dependence. Acupuncture has emerg...The United States （U.S.） is facing a national opioid epidemic, and medical systems are in need of non- pharmacologic strategies that can be employed to decrease the public＇s opioid dependence. Acupuncture has emerged as a powerful, evidence-based, safe, cost-effective, and available treatment modality suitable to meeting this need. Acupuncture has been shown to be effective for the management of numerous types of pain conditions, and mechanisms of action for acupuncture have been described and are understandable from biomedical, physiologic perspectives. Further, acupuncture＇s cost-effectiveness can dramatically decrease health care expenditures, both from the standpoint of treating acute pain and through avoiding addiction to opioids that requires costly care, destroys quality of life, and can lead to fatal overdose. Numerous federal regulatory agencies have advised or mandated that healthcare systems and providers offer non-pharmacologic treatment options for pain. Acupuncture stands out as the most evidence-based, immediately available choice to fulfil these calls. Acupuncture can safely, easily, and cost-effectively be incorporated into hospital settings as diverse as the emergency department, labor and delivery suites, andneonatal intensive care units to treat a variety of commonly seen pain conditions. Acupuncture is already being successfully and meaningfully utilized by the Veterans Administration and various branches of the U.S. Military, in some studies demonstrably decreasing the volume of opioids prescribed when included in care.展开更多
Different dosage forms can significantly impact pharmacokinetics in vivo,leading to varied effects and potential adverse reactions.This study aimed to evaluate the efficacy,safety,and cost-effectiveness of isosorbide ...Different dosage forms can significantly impact pharmacokinetics in vivo,leading to varied effects and potential adverse reactions.This study aimed to evaluate the efficacy,safety,and cost-effectiveness of isosorbide mononitrate sustained-release capsules(IMSRC)combined with conventional treatments,compared to isosorbide mononitrate tablets(IMT)combined with conventional treatments,for managing angina pectoris in patients with coronary heart diseases.A network meta-analysis(NMA)was conducted to assess the efficacy and safety of IMSRC and IMT.Relevant literature was sourced from databases,including PubMed,Embase,Cochrane Library,ScienceDirect,Web of Science,CNKI,Wanfang,and VIP,covering publications up to July 2023.The cost-effectiveness analysis(CEA)was performed from the perspective of China’s healthcare system,utilizing inputs derived from the NMA.The analysis included 15 studies.The NMA results revealed no significant difference in efficacy and safety between IMSRC plus conventional treatments and IMT plus conventional treatments.However,both combinations were more effective than conventional treatments without isosorbide mononitrate.No differences in safety were observed among the three groups.The surface under the cumulative ranking(SUCRA)of the NMA indicated that IMT had a slight edge over IMSRC in the total effective rate of angina pectoris,whereas IMSRC showed higher probabilities for markedly effective rate and ECG effective rate compared to IMT.The incidence of adverse events was ranked as IMT>conventional preparation>IMSRC.The CEA results highlighted that the incremental cost-effectiveness ratios(ICERs)for the markedly effective and total effective rates of angina pectoris were-133.41 and-260.20,respectively.The ICERs for ECG effective rates were-83.34 and-234.24,respectively.In conclusion,while IMSRC combined with conventional treatments and IMT combined with conventional treatments were similar in efficacy and safety,IMSRC proved to be more economical.展开更多
Guangdong’s carbon emissions have surpassed the world’s 11th largest emitter.It is indispensable for this province to find a robust cost-effective strategy for reducing carbon emissions.This study employed the Low E...Guangdong’s carbon emissions have surpassed the world’s 11th largest emitter.It is indispensable for this province to find a robust cost-effective strategy for reducing carbon emissions.This study employed the Low Emissions Analysis Platform model,marginal cost curves,and Monte Carlo methods to simulate the energy consumption,carbon emissions,and economic benefits of emission reduction in Guangdong Province from 2020 to 2030 under the application of various structural optimization policies and energy-saving technologies.The main findings are as follows:In 2030,Guangdong Province is projected to achieve a carbon emission reduction of 273.6 to 304.6million t CO_(2eq),with a total reduction cost ranging from 1030.9 to 1452.2 billion yuan.Increasing the share of renewable energy,which still has significant growth potential,can lead to a 1.4 times greater reduction in carbon emissions compared to the application of energy-saving technologies,despite the latter yielding 2.3 times more energy savings.The emission reduction measures with net-cost can contribute 71.4%to the total carbon reduction of the province,being much larger than those with net benefits.The power sector plays a critical role in carbon emission reduction within Guangdong Province,with its various measures exerting the most substantial impact on emission reduction quantity and cost,contributing cumulative variance contributions of 90.1%and 84.3%,respectively.It has relatively large potential for emission reduction and relatively low cost of structural adjustment.展开更多
BACKGROUND Obesity impacts 42%of United States adults and results in an estimated economic burden of nearly 1.4 trillion dollars annually.Endoscopic sleeve gastroplasty(ESG)is a United States Food and Drug Administrat...BACKGROUND Obesity impacts 42%of United States adults and results in an estimated economic burden of nearly 1.4 trillion dollars annually.Endoscopic sleeve gastroplasty(ESG)is a United States Food and Drug Administration authorized procedure with an excellent safety,efficacy,and durability profile.The cost-effectiveness of ESG compared to lifestyle modification(LM)in real-world patients with class I-III obesity represents a critical knowledge gap.AIM To approximate the cost-effectiveness of ESG vs LM using a real-world dataset of 860 United States adults with class I-III obesity undergoing ESG.METHODS A 6-state Markov model was employed,including healthy weight,overweight,class I-III obesity,and death.The LM control group was built using transition states previously described in the literature,supplemented by expert opinion.Cycles lasted six-months in the model’s first year and twelve-months thereafter.Existing literature informed approximations of each health state utility,adverse event disutility,and incidence of obesity-associated comorbidities.One-way sensitivity and probabilistic sensitivity analyses were performed.RESULTS The base-case incremental cost-effectiveness ratio(ICER)for ESG vs LM was 5904 dollars per quality-adjusted life year(QALY).In a one-way sensitivity analysis,the utilities assigned to the three obesity classes most greatly influenced the ICER.Probabilistic sensitivity analysis estimated an increase in upper-bound ICER of 8038 dollars per QALY,well under the generally cited United States willingness to pay ratio of 100000 dollars per QALY.CONCLUSION The results of this model support that ESG is overwhelmingly cost-effective compared to LM across all obesity classes.Payors should consider expanding coverage for their members.展开更多
With the continuous application of new technologies in reconnaissance and attack, false camouflage plays a more important role in improving the survivability of targets, and the number of decoys plays a crucial role i...With the continuous application of new technologies in reconnaissance and attack, false camouflage plays a more important role in improving the survivability of targets, and the number of decoys plays a crucial role in the camouflaging effect. Based on the concept of cost-effectiveness ratio, according to the newly formulated Johnson criterion and the view of discovery and destruction, this paper proposes to take the identification probability as the probability of being destroyed and uses mathematical formulas to calculate the cost of a single use decoy. On this basis, a cost-effectiveness ratio model is established, with the product of the increase in the survival probability of the target and the cost of the target as the benefit, and the sum of the product of the probability of being destroyed and the cost of the decoy and the cost of a single use as the consumption cost. The model is calculated and analyzed, and the number of decoys that conform to the actual situation is obtained.展开更多
Objective This systematic review examines recent pharmacoeconomic literature on denosumab'cost-effectiveness for bone metastasis treatment,providing evidence-based insights to guide healthcare policy decisions.Met...Objective This systematic review examines recent pharmacoeconomic literature on denosumab'cost-effectiveness for bone metastasis treatment,providing evidence-based insights to guide healthcare policy decisions.Methods A comprehensive literature search was performed across Cochrane,PubMed,EMBASE(Ovid),CNKI,and Wanfang databases to identify original articles published between 2017 and 2023.Key words consisted of bone metastases,denosumab,and cost-effectiveness in the search strategy.The methodological quality of the included studies was assessed utilizing the revised Consolidated Health Economic Evaluation Reporting Standards(CHEERS 2022).Data was extracted regarding methodological characteristics and cost-effectiveness analyses.Results A total of 111 studies were retrieved,of which 6 met the inclusion criteria.All included studies were based on clinical trials and published literature data and exhibited high methodological quality.Up to 83%(5 out of 6)of comparisons demonstrated that denosumab was more cost-effective or dominant compared to zoledronic acid.The adjusted incremental cost-effectiveness ratios varied substantially by tumor type,ranging from CZK 436,339.09 to USD 136,234 per skeletal-related event avoided and from CZK 61,580.95 to USD 118,392.11 per quality-adjusted life year gained.Conclusions The majority of the included studies support denosumab as a more cost-effective treatment option for bone metastases in solid tumors compared to zoledronic acid.The application of CHEER(2022)enhances the reliability of pharmacoeconomic evaluations.展开更多
Objective To evaluate the cost-effectiveness of gadopentetate dimeglumine(Gd-DTPA)and gadobenate dimeglumine(Gd-BOPTA)magnetic resonance imaging(MRI)contrast agents for the early diagnosis of hepatocellular carcinoma(...Objective To evaluate the cost-effectiveness of gadopentetate dimeglumine(Gd-DTPA)and gadobenate dimeglumine(Gd-BOPTA)magnetic resonance imaging(MRI)contrast agents for the early diagnosis of hepatocellular carcinoma(HCC)from the perspective of China’s healthcare system.Methods A decision tree+partitioned survival model was constructed for early diagnosis of HCC based on literature data.Taking quality-adjusted life year(QALY)as the main health outcome measure for incremental cost-effectiveness ratio(ICER)analysis,the sensitivity analysis by Monte Carlo simulation was constructed to generate corresponding tornado diagram,incremental cost-effectiveness scatter plot,and cost-effectiveness acceptability curve.Results and Conclusion The basic analysis results showed that the ICER value of Gd-BOPTA diagnostic scheme compared with Gd-DTPA diagnostic scheme was 17302.46 yuan/QALY,which is less than 1 times of China’s gross domestic product(GDP)per capita.The sensitivity analysis results showed that the cost of delayed treatment and timely treatment had a significant impact on the results.When the willingness to pay(WTP)was 1 time of GDP per capita,the probability of cost-effectiveness advantage of Gd-BOPTA diagnostic scheme was 65.30%.When the WTP value is set at 1 times of GDP per capita,Gd-BOPTA MRI has cost-effectiveness advantages for the early diagnosis of HCC.展开更多
Objective Chronic hepatitis B(CHB),characterized by a significant global disease burden and substantial healthcare costs,remains a critical public health challenge.Although tenofovir amibufenamide(TMF)and tenofovir al...Objective Chronic hepatitis B(CHB),characterized by a significant global disease burden and substantial healthcare costs,remains a critical public health challenge.Although tenofovir amibufenamide(TMF)and tenofovir alafenamide(TAF),including formulations from centralized volume-based procurement(CVBP-TAF)and imported sources(I-TAF),are all recommended treatment regimens,comparative studies on the efficacy,safety,and cost-effectiveness of these three regimens remain relatively limited.This retrospective cohort study aims to systematically compare the application effects of these three regimens in the treatment of CHB.Methods We conducted a single-center retrospective cohort study at Tianjin University Central Hospital from September 2019 to September 2024.CHB patients who had received TMF,CVBP-TAF,or I-TAF for 48 weeks were enrolled.Efficacy endpoints included HBV-DNA negative conversion,HBeAg seroclearance,and alanine aminotransferase(ALT)normalization.Safety outcomes encompassed nephrotoxicity,hepatotoxicity,and lipid profile changes.Cost-effectiveness analysis was used to calculate the cost-effectiveness ratio(CER)per unit efficacy gain and incremental CER using a healthcare payer perspective.Results A total of 173 patients were included,with 58 in the TMF group,58 in the I-TAF group,and 57 in the CVBP-TAF group.TMF demonstrated superior efficacy to I-TAF and CVBP-TAF,as evidenced by significantly higher HBV-DNA negative conversion rate and ALT normalization rate.No significant differences in safety outcomes were observed among the three groups.Cost-effectiveness analysis showed that CVBP-TAF had the lowest CER(4.62 CNY/%),followed by TMF with an intermediate CER(60.45 CNY/%),while I-TAF had the highest CER(66.49 CNY/%).Conclusion TMF demonstrates stronger antiviral efficacy than both TAF formulations,with comparable safety profiles.Despite the cost advantages of CVBP-TAF resulting from procurement policies,the clinical benefits of TMF support its use.Future strategies should improve the affordability of TMF to expand its accessibility.展开更多
BACKGROUND: Targeted temperature management(TTM) is a common therapeutic intervention, yet its cost-effectiveness remains uncertain. This study aimed to evaluate the real-world cost-effectiveness of TTM compared with ...BACKGROUND: Targeted temperature management(TTM) is a common therapeutic intervention, yet its cost-effectiveness remains uncertain. This study aimed to evaluate the real-world cost-effectiveness of TTM compared with that of conventional care in adult out-of-hospital cardiac arrest(OHCA) survivors using clinical patient-level data.METHODS: We conducted a retrospective cohort study at an academic medical center in the USA to assess the cost-effectiveness of TTM in adult non-traumatic OHCA survivors between 1 January, 2019 and 30 June, 2023. The primary outcome was survival to hospital discharge. Incremental cost-effectiveness ratios(ICERs) were calculated and compared with various decision makers' willingness to pay. Cost-effectiveness acceptability curves were utilized to evaluate the economic attractiveness of TTM. Uncertainty about the incremental cost and effect was explored with a 95% confidence ellipse.RESULTS: Among 925 non-traumatic OHCA survivors, only 30(3%) received TTM. After adjusting for potential confounders, the TTM group did not demonstrate a significantly lower cost(delta cost-$5,141, 95% confidence interval [95% CI]: $-35,347 to $25,065, P=0.79) and higher survival to hospital discharge(delta effect 6%, 95% CI:-11% to 23%, P=0.41). Additionally, a 95% confidence ellipse indicated uncertainty reflected by evidence that the true value of the ICER could be in any of the quadrants of the cost-effectiveness plane.CONCLUSION: Although TTM did not demonstrate a clear survival benefit in this study, its potential cost-effectiveness warrants further investigation with larger sample sizes. These findings highlight the need for additional research to optimize TTM use in OHCA care and inform resource allocation decisions.展开更多
While silicon/carbon(Si/C)is considered one of the most promising anode materials for the next generation of high-energy lithium-ion batteries(LIBs),the industrialization of Si/C anodes is hampered by high-cost and lo...While silicon/carbon(Si/C)is considered one of the most promising anode materials for the next generation of high-energy lithium-ion batteries(LIBs),the industrialization of Si/C anodes is hampered by high-cost and low product yield.Herein,a high-yield strategy is developed in which photovoltaic waste silicon is converted to cost-effective graphitic Si/C composites(G-Si@C)for LIBs.The introduction of a binder improves the dispersion and compatibility of silicon and graphite,enhances particle sphericity,and significantly reduces the loss rate of the spray prilling process(from about 25%to 5%).As an LIB anode,the fabricated G-Si@C composites exhibit a capacity of 605 mAh g^(-1) after 1200 cycles.The cost of manufacturing Si/C anode materials has been reduced to approximately$7.47 kg^(-1),which is close to that of commercial graphite anode materials($5.0 kg^(-1)),and significantly lower than commercial Si/C materials(ca.$20.74 kg^(-1)).Moreover,the G-Si@C material provides approximately 81.0 Ah/$of capacity,which exceeds the current best commercial graphite anodes(70.0 Ah/$)and Si/C anodes(48.2 Ah/$).The successful implementation of this pathway will significantly promote the industrialization of high-energydensity Si/C anode materials.展开更多
BACKGROUND There has been a growing interest in noninvasive ventilation(NIV)in comparison to invasive mechanical ventilation(IMV)as a standard of care for acute respiratory failure(ARF),especially in the post-covid er...BACKGROUND There has been a growing interest in noninvasive ventilation(NIV)in comparison to invasive mechanical ventilation(IMV)as a standard of care for acute respiratory failure(ARF),especially in the post-covid era,but direct head-to-head cost comparisons between the two modalities are not available in literature.AIM To compare the cost along with the clinical effectiveness of NIV in comparison to IMV in ARF.METHODS A prospective observational single-center case control study including adult patients with ARF(PaO2/FiO2 ratio<300)admitted from January 1,2024 to December 31,2024 in medical intensive care unit(ICU)of a tertiary care hospital requiring either NIV or invasive ventilation.NIV and IMV groups were compared based on average length of ICU and hospital stay,mortality,net cost of ICU treatment,need for intubation and tracheostomy.RESULTS A total of 319 patients were included in the study(197 in NIV,122 in IMV group).Statistically significant difference in length of ICU stay(NIV group:5±3.25 days,IMV group:9±2.6 days;P<0.05)and mortality rate was seen(11%NIV vs 34%IMV;P<0.01).On multivariate analyses,mortality showed a stronger association with IMV[odds ratio(OR)=7.73;95%CI:3.12-19.18]as compared to ICU stay(OR=2.73;95%CI:2.15-3.48).A total of 33 patients(17%)in NIV group required intubation of which 3 were tracheostomized,while 14 patients(11%)in IMV group needed tracheostomy.The net average cost of ICU stay was₹83902 in NIV group while in IMV group,the net ICU cost was₹476216.The average cost of ICU stay was five times higher with IMV.CONCLUSION NIV has potential economic and clinical benefits as compared to invasive ventilation in ARF.展开更多
BACKGROUND Pancreatic exocrine insufficiency(PEI)leads to fat malabsorption and maldigestion and is most commonly treated with pancreatic enzyme replacement therapy(PERT).Patients suffering from PEI in China are more ...BACKGROUND Pancreatic exocrine insufficiency(PEI)leads to fat malabsorption and maldigestion and is most commonly treated with pancreatic enzyme replacement therapy(PERT).Patients suffering from PEI in China are more likely not to receive adequate treatment as this drug is not part of the Chinese national essential medicine list.AIM To examine the cost-effectiveness of PERT for patients suffering from PEI in China.METHODS A decision analytical Markov model was constructed to simulate the progress of patients with PEI in China.The population included in the analyses were patients suffering from PEI with advanced(non-resectable)pancreatic cancer,who have undergone surgery due to pancreatic cancer and who have undergone endoscopic treatment due to chronic pancreatitis.The cost-effectiveness analyses were undertaken from a Chinese societal perspective comparing PERT with no PERT.The incremental cost-effectiveness ratio in United States dollars per quality adjusted life year(QALY)gained is the main outcome.Input was informed by publicly available data supplemented with expert clinical advice.RESULTS The cost-effectiveness analyses estimated that PERT resulted in additional 0.45 to 2.93 QALYs at discounted costs of between 4315 dollars to 15193 dollars.This resulted in an incremental cost-effectiveness ratio of 5178 dollars to 9533 dollars per QALY.The one-way sensitivity analyses showed that the main drivers of the model were the cost of PERT and overall survival.CONCLUSION This study demonstrates that PERT is a cost-effective treatment for patients suffering from PEI in China.展开更多
Nonlinear Rossby waves are used to describe typical wave phenomena in large-scale atmosphere andocean.Owing to the nonlinearity of the involved problems,the weakly nonlinear method,ie the derivative ex-pansion method,...Nonlinear Rossby waves are used to describe typical wave phenomena in large-scale atmosphere andocean.Owing to the nonlinearity of the involved problems,the weakly nonlinear method,ie the derivative ex-pansion method,was mainly used to investigate Rossby waves under the combined effects of the generalizedβ-effect and the basic flow effect.The derivative expansion method has the advantage of capturing the multi-scalecharacteristics of wave processes simultaneously.In the case where the perturbation expansion is independentof secular terms,the nonlinear equations describing the amplitude evolution of nonlinear waves were derived,such as the Korteweg-de Vries equation,the Boussinesq equation and Zakharov-Kuznetsov equation.Both quali-tative and quantitative analyses indicate that the generalizedβ-effect is the key factor inducing the evolution ofRossby solitary waves.展开更多
SiC/Al-based composite foams were prepared by a two-step foaming method.The influence of the SiC content and its distribution uniformity on the foaming stability,cell structure,and mechanical properties of the aluminu...SiC/Al-based composite foams were prepared by a two-step foaming method.The influence of the SiC content and its distribution uniformity on the foaming stability,cell structure,and mechanical properties of the aluminum foams was investigated.The macro/micro-features of the aluminum foams were characterized and analyzed.Results demonstrate that an appropriate increase in SiC content and the uniform distribution of SiC can improve the foaming stability,optimize the cell diameter and cell wall thickness,ameliorate the cell distribution,and enhance the hardness and compressive strength of the aluminum foams.However,either insufficient or excessive SiC leads to uneven distribution of SiC particles,which is unfavorable to foaming stability and good cell structure formation.With 6wt%SiC,both the foaming stability and cell structure of the aluminum foam reach the optimal state,resulting in the highest compressive strength and optimal energy absorption capacity.展开更多
In this paper,we consider the maximal positive definite solution of the nonlinear matrix equation.By using the idea of Algorithm 2.1 in ZHANG(2013),a new inversion-free method with a stepsize parameter is proposed to ...In this paper,we consider the maximal positive definite solution of the nonlinear matrix equation.By using the idea of Algorithm 2.1 in ZHANG(2013),a new inversion-free method with a stepsize parameter is proposed to obtain the maximal positive definite solution of nonlinear matrix equation X+A^(*)X|^(-α)A=Q with the case 0<α≤1.Based on this method,a new iterative algorithm is developed,and its convergence proof is given.Finally,two numerical examples are provided to show the effectiveness of the proposed method.展开更多
This study presents an effective hybrid simulation approach for simulating broadband ground motion in complex near-fault locations.The approach utilizes a deterministic approach based on the spectral element method(SE...This study presents an effective hybrid simulation approach for simulating broadband ground motion in complex near-fault locations.The approach utilizes a deterministic approach based on the spectral element method(SEM),which is used to simulate low-frequency ground motion(f<1 Hz)by incorporating an innovative efficient discontinuous Galerkin(DG)method for grid division to accurately model basin sedimentary layers at reduced costs.It also introduces a comprehensive hybrid source model for high-frequency random scattering and a nonlinear analysis module for basin sedimentary layers.Deterministic outcomes are combined with modified three-dimensional stochastic finite fault method(3D-EXSIM)simulations of high-frequency ground motion(f>1 Hz).A fourth-order Butterworth filter with zero phase shift is employed for time-domain filtering of low-and high-frequency time series at a crossover frequency of 1 Hz,merging the low and high-frequency ground motions into a broadband time series.Taking an Ms 6.8 Luding earthquake,as an example,this hybrid method was used for a rapid and efficient simulation analysis of broadband ground motion in the region.The accuracy and efficiency of this hybrid method were verified through comparisons with actually observed station data and empirical attenuation curves.Deterministic method simulation results revealed the effects of mountainous topography,basin effects,nonlinear effects within the basin’s sedimentary layers,and a coupling interaction between the basin and the mountains.The findings are consistent with similar studies,showing that near-fault sedimentary basins significantly focus and amplify strong ground motion,and the soil’s nonlinear behavior in the basin influences ground motion to varying extents at different distances from the fault.The mountainous topography impacts the basin’s response to ground motion,leading to barrier effects.This research provides a scientific foundation for seismic zoning,urban planning,and seismic design in nearfault mountain basin regions.展开更多
基金funded by Medical and Health Science and Technology Project of Zhejiang province(Grant number:2023KY633).
文摘Objective:To evaluate the cost-effectiveness of annual trivalent inactivated influenza vaccine(IIV3)under the context of Zhejiang province.Methods:A state transition simulation model was constructed to estimate the health and economic outcomes of IIV3 vaccination program compared to no vaccination for hypothetical cohorts of Zhejiang province stratified by age and risk status.Model input parameters were chosen based on published literatures and expert advices.The analysis used societal perspectives and a one-year time horizon,and permanent outcomes were also included.The primary outcome was the incremental cost-effectiveness ratio(ICER),with expression of US dollars per quality adjusted life years(QALYs)gained.Results:In subgroups not at high risk for influenza-related complications(non-high risk subgroup),ICER ranged from $6268/QALY(for adults aged 50-64 years)to $11260/QALY(for children aged from 6 months to 4 years).In subgroups at high risk for influenza-related complications(high risk subgroup),ICER ranged from cost-saving(adults aged≥65 years)to $5260/QALY(for children aged from 6 months to 4 years).ICER were most sensitive to changes in probability of influenza illness,cost of hospitalization,and probability of death for adults aged 18-49 years with non-high risk status.Conclusions:ICERs of annual influenza vaccination varied by age and risk status but were less than the Gross Domestic Product(GDP)per capita of Zhejiang province($17745 in 2023),which remained cost-effective for all-age and different risk status groups from a societal perspective.
文摘BACKGROUND Robotic assistance is increasingly used for donor and recipient hepatectomy in liver transplantation,yet existing evidence is fragmented and variably indirect.AIM To evaluate clinical outcomes,surgical performance,and economic effects of robotic-assisted donor and recipient hepatectomy in the transplant pathway.METHODS Following Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 and a priori registration,systematic reviews were included with or without meta-analysis.Four databases were searched through July 2025.Methodological quality was appraised with a measurement tool to assess systematic reviews(AMSTAR 2),and certainty was graded with grading of recommendations assessment,development and evaluation(GRADE).Evidence overlap was calculated via a citation-matrix-based corrected covered area(CCA).Effect sizes were prespecified as risk ratios(RR)for dichotomous outcomes and mean differences for continuous outcomes.RESULTS Five reviews met the inclusion criteria,four with meta-analyses and one consensus review used only for context.Donor(direct)findings were more favorable for robotics in terms of estimated blood loss(≈-117 mL)and length of stay(≈-0.6 days),although with longer operative time(≈+105 minutes).Absolute risks for donor complications were not estimable from ratio-only data.Recipient(indirect)meta-analysis indicated robotics to be favorable in terms of conversion(RR≈0.41)and severe morbidity(RR≈0.81),with a trend toward lower overall morbidity(RR≈0.92)and no difference in 30-day mortality.Differences in length of stay and operative time were small and heterogeneous.Economic evidence(indirect,network meta-analysis)suggested higher procedural costs for robotic vs laparoscopic intervention,but lower hospitalization costs vs open intervention,with laparoscopy the least expensive overall.AMSTAR 2 ratings were moderate-to-high across the reviews,GRADE certainty was low for key donor continuous outcomes,and low-to-moderate for recipient and economic outcomes.Overlap was slight(graded-corpus CCA=0.0%;including a contextual non-transplant review increased CCA to≈1.25%).CONCLUSION Robotic donor hepatectomy confers perioperative advantages at the cost of longer operative time.Recipient and economic findings are indirect and considered hypothesis-generating.Transplant-specific,prospective comparisons using a minimum standardized dataset and uniform outcome definitions are needed to resolve remaining uncertainties and to clarify the cost-utility correlation.
基金support provided by the National Natural Science Foundation of China(No.22273043).
文摘As a novel class of purely organic fluores-cent materials,multiple resonance thermal-ly activated delayed fluorescence(MR-TADF)compounds hold significant promise for next-generation display technologies.The efficiency of exciton utilization and the overall performance of organic light-emit-ting devices are closely linked to the singlet-triplet energy gap(ΔE_(ST))of MR-TADF emitters.Identifying an economic and accu-rate theoretical approach to predictΔE_(ST)would be beneficial for high-throughput screening and facilitate the inverse design of MR-TADF molecules.In this study,we evaluated the S_(1)state energy(E(S_(1))),T_(1)state ener-gy(E(T_(1))),andΔE_(ST)using three different physical interpretations:adiabatic excitation ener-gy,vertical absorption energy,and vertical emission energy.We employed the time-depen-dent density functional theory(TDDFT)and delta self-consistent field(ΔSCF)methods to calculate E(S_(1)),E(T_(1)),andΔE_(ST)for 20 MR-TADF molecules reported in the literature.We compared these calculated values with experimental data obtained from fluorescence spec-troscopy at room-temperature(or 77 K)and phosphorescence spectroscopy conducted at 77 K.Our findings indicate that the vertical absorption energy at the S0 state minimum,deter-mined by theΔSCF method,accurately predicts the S_(1)state energy.Similarly,the vertical absorption energy at the S0 state minimum,calculated using the TDDFT method,effectively predicts the T_(1)state energy.TheΔE_(ST)derived from the difference between these two excita-tion energies exhibited the smallest mean absolute error of only 0.039 eV compared to the ex-perimental values.This combination represents the most accurate and cost-effective method reported to date for predicting theΔE_(ST)of MR-TADF molecules,and can be integrated into AI-driven inverse design workflows for new emitters.
文摘Cost-effectiveness analysis（CEA） is increasingly important in health care decision making.Cost-effectiveness threshold is a critical parameter in the cost-effectiveness analysis.This review introduces the concept of cost-effectiveness threshold, summarizes its determining methods,and classifies the existing methods into two kinds according to budget constraints,then analyzes the merit and demerit of every methods.When there is a flexible budget,the methods for determining the cost-effectiveness threshold include inferring the threshold from previous decisions,comparison with other health care technology or transfer from elsewhere in the public sector,social willingness-to-pay approach,GDP per capita criteria,and rule of thumb.When there is a fixed budget,the methods for determining the cost-effectiveness threshold include shadow price approach,opportunity cost approach,and ICER threshold-searcher model.Each approach to determining threshold has its strength and weakness.The aim of this article is to introduce the existing methods and discuss the features of each method.The background information,such as the definition of threshold,is also described.The basic theory of cost-effectiveness threshold is elaborated,and we recommend the establishment of a cost-effectiveness threshold in the Chinese health care.
文摘The United States （U.S.） is facing a national opioid epidemic, and medical systems are in need of non- pharmacologic strategies that can be employed to decrease the public＇s opioid dependence. Acupuncture has emerged as a powerful, evidence-based, safe, cost-effective, and available treatment modality suitable to meeting this need. Acupuncture has been shown to be effective for the management of numerous types of pain conditions, and mechanisms of action for acupuncture have been described and are understandable from biomedical, physiologic perspectives. Further, acupuncture＇s cost-effectiveness can dramatically decrease health care expenditures, both from the standpoint of treating acute pain and through avoiding addiction to opioids that requires costly care, destroys quality of life, and can lead to fatal overdose. Numerous federal regulatory agencies have advised or mandated that healthcare systems and providers offer non-pharmacologic treatment options for pain. Acupuncture stands out as the most evidence-based, immediately available choice to fulfil these calls. Acupuncture can safely, easily, and cost-effectively be incorporated into hospital settings as diverse as the emergency department, labor and delivery suites, andneonatal intensive care units to treat a variety of commonly seen pain conditions. Acupuncture is already being successfully and meaningfully utilized by the Veterans Administration and various branches of the U.S. Military, in some studies demonstrably decreasing the volume of opioids prescribed when included in care.
基金The 2022 Ministry of Education General Project for Humanities and Social Sciences Research(Grant No.22YJAZH147)the General Subject of Guangzhou Philosophy and Social Science Development“14th Five-Year Plan”in 2023(Grant No.2023GZYB68)+2 种基金China University Industry-Academia-Research Innovation Fund-Huatong Guokang Medical Research Special Project(Grant No.2023HT017)2024 Guangdong Province General Project for the Planning of Philosophy and Social Sciences(Grant No.GD24CGL29)the Innovation Team Project of Colleges and Universities in Guangdong Province(Grant No.2022WCXTD011).
文摘Different dosage forms can significantly impact pharmacokinetics in vivo,leading to varied effects and potential adverse reactions.This study aimed to evaluate the efficacy,safety,and cost-effectiveness of isosorbide mononitrate sustained-release capsules(IMSRC)combined with conventional treatments,compared to isosorbide mononitrate tablets(IMT)combined with conventional treatments,for managing angina pectoris in patients with coronary heart diseases.A network meta-analysis(NMA)was conducted to assess the efficacy and safety of IMSRC and IMT.Relevant literature was sourced from databases,including PubMed,Embase,Cochrane Library,ScienceDirect,Web of Science,CNKI,Wanfang,and VIP,covering publications up to July 2023.The cost-effectiveness analysis(CEA)was performed from the perspective of China’s healthcare system,utilizing inputs derived from the NMA.The analysis included 15 studies.The NMA results revealed no significant difference in efficacy and safety between IMSRC plus conventional treatments and IMT plus conventional treatments.However,both combinations were more effective than conventional treatments without isosorbide mononitrate.No differences in safety were observed among the three groups.The surface under the cumulative ranking(SUCRA)of the NMA indicated that IMT had a slight edge over IMSRC in the total effective rate of angina pectoris,whereas IMSRC showed higher probabilities for markedly effective rate and ECG effective rate compared to IMT.The incidence of adverse events was ranked as IMT>conventional preparation>IMSRC.The CEA results highlighted that the incremental cost-effectiveness ratios(ICERs)for the markedly effective and total effective rates of angina pectoris were-133.41 and-260.20,respectively.The ICERs for ECG effective rates were-83.34 and-234.24,respectively.In conclusion,while IMSRC combined with conventional treatments and IMT combined with conventional treatments were similar in efficacy and safety,IMSRC proved to be more economical.
基金supported by Hainan Provincial Natural Science Foundation of China(No.721RC525).
文摘Guangdong’s carbon emissions have surpassed the world’s 11th largest emitter.It is indispensable for this province to find a robust cost-effective strategy for reducing carbon emissions.This study employed the Low Emissions Analysis Platform model,marginal cost curves,and Monte Carlo methods to simulate the energy consumption,carbon emissions,and economic benefits of emission reduction in Guangdong Province from 2020 to 2030 under the application of various structural optimization policies and energy-saving technologies.The main findings are as follows:In 2030,Guangdong Province is projected to achieve a carbon emission reduction of 273.6 to 304.6million t CO_(2eq),with a total reduction cost ranging from 1030.9 to 1452.2 billion yuan.Increasing the share of renewable energy,which still has significant growth potential,can lead to a 1.4 times greater reduction in carbon emissions compared to the application of energy-saving technologies,despite the latter yielding 2.3 times more energy savings.The emission reduction measures with net-cost can contribute 71.4%to the total carbon reduction of the province,being much larger than those with net benefits.The power sector plays a critical role in carbon emission reduction within Guangdong Province,with its various measures exerting the most substantial impact on emission reduction quantity and cost,contributing cumulative variance contributions of 90.1%and 84.3%,respectively.It has relatively large potential for emission reduction and relatively low cost of structural adjustment.
文摘BACKGROUND Obesity impacts 42%of United States adults and results in an estimated economic burden of nearly 1.4 trillion dollars annually.Endoscopic sleeve gastroplasty(ESG)is a United States Food and Drug Administration authorized procedure with an excellent safety,efficacy,and durability profile.The cost-effectiveness of ESG compared to lifestyle modification(LM)in real-world patients with class I-III obesity represents a critical knowledge gap.AIM To approximate the cost-effectiveness of ESG vs LM using a real-world dataset of 860 United States adults with class I-III obesity undergoing ESG.METHODS A 6-state Markov model was employed,including healthy weight,overweight,class I-III obesity,and death.The LM control group was built using transition states previously described in the literature,supplemented by expert opinion.Cycles lasted six-months in the model’s first year and twelve-months thereafter.Existing literature informed approximations of each health state utility,adverse event disutility,and incidence of obesity-associated comorbidities.One-way sensitivity and probabilistic sensitivity analyses were performed.RESULTS The base-case incremental cost-effectiveness ratio(ICER)for ESG vs LM was 5904 dollars per quality-adjusted life year(QALY).In a one-way sensitivity analysis,the utilities assigned to the three obesity classes most greatly influenced the ICER.Probabilistic sensitivity analysis estimated an increase in upper-bound ICER of 8038 dollars per QALY,well under the generally cited United States willingness to pay ratio of 100000 dollars per QALY.CONCLUSION The results of this model support that ESG is overwhelmingly cost-effective compared to LM across all obesity classes.Payors should consider expanding coverage for their members.
文摘With the continuous application of new technologies in reconnaissance and attack, false camouflage plays a more important role in improving the survivability of targets, and the number of decoys plays a crucial role in the camouflaging effect. Based on the concept of cost-effectiveness ratio, according to the newly formulated Johnson criterion and the view of discovery and destruction, this paper proposes to take the identification probability as the probability of being destroyed and uses mathematical formulas to calculate the cost of a single use decoy. On this basis, a cost-effectiveness ratio model is established, with the product of the increase in the survival probability of the target and the cost of the target as the benefit, and the sum of the product of the probability of being destroyed and the cost of the decoy and the cost of a single use as the consumption cost. The model is calculated and analyzed, and the number of decoys that conform to the actual situation is obtained.
文摘Objective This systematic review examines recent pharmacoeconomic literature on denosumab'cost-effectiveness for bone metastasis treatment,providing evidence-based insights to guide healthcare policy decisions.Methods A comprehensive literature search was performed across Cochrane,PubMed,EMBASE(Ovid),CNKI,and Wanfang databases to identify original articles published between 2017 and 2023.Key words consisted of bone metastases,denosumab,and cost-effectiveness in the search strategy.The methodological quality of the included studies was assessed utilizing the revised Consolidated Health Economic Evaluation Reporting Standards(CHEERS 2022).Data was extracted regarding methodological characteristics and cost-effectiveness analyses.Results A total of 111 studies were retrieved,of which 6 met the inclusion criteria.All included studies were based on clinical trials and published literature data and exhibited high methodological quality.Up to 83%(5 out of 6)of comparisons demonstrated that denosumab was more cost-effective or dominant compared to zoledronic acid.The adjusted incremental cost-effectiveness ratios varied substantially by tumor type,ranging from CZK 436,339.09 to USD 136,234 per skeletal-related event avoided and from CZK 61,580.95 to USD 118,392.11 per quality-adjusted life year gained.Conclusions The majority of the included studies support denosumab as a more cost-effective treatment option for bone metastases in solid tumors compared to zoledronic acid.The application of CHEER(2022)enhances the reliability of pharmacoeconomic evaluations.
文摘Objective To evaluate the cost-effectiveness of gadopentetate dimeglumine(Gd-DTPA)and gadobenate dimeglumine(Gd-BOPTA)magnetic resonance imaging(MRI)contrast agents for the early diagnosis of hepatocellular carcinoma(HCC)from the perspective of China’s healthcare system.Methods A decision tree+partitioned survival model was constructed for early diagnosis of HCC based on literature data.Taking quality-adjusted life year(QALY)as the main health outcome measure for incremental cost-effectiveness ratio(ICER)analysis,the sensitivity analysis by Monte Carlo simulation was constructed to generate corresponding tornado diagram,incremental cost-effectiveness scatter plot,and cost-effectiveness acceptability curve.Results and Conclusion The basic analysis results showed that the ICER value of Gd-BOPTA diagnostic scheme compared with Gd-DTPA diagnostic scheme was 17302.46 yuan/QALY,which is less than 1 times of China’s gross domestic product(GDP)per capita.The sensitivity analysis results showed that the cost of delayed treatment and timely treatment had a significant impact on the results.When the willingness to pay(WTP)was 1 time of GDP per capita,the probability of cost-effectiveness advantage of Gd-BOPTA diagnostic scheme was 65.30%.When the WTP value is set at 1 times of GDP per capita,Gd-BOPTA MRI has cost-effectiveness advantages for the early diagnosis of HCC.
基金funded by the 2024 Tianjin Comprehensive Clinical Evaluation of Drugs Project(No.TZH-2024-002)the Pilot Study on the Standardization of Comprehensive Clinical Evaluation of Drugs(No.PJC202410)2023 Tianjin Pharmacy Young and Middle-aged Research Programs(No.TJYX2023-03).
文摘Objective Chronic hepatitis B(CHB),characterized by a significant global disease burden and substantial healthcare costs,remains a critical public health challenge.Although tenofovir amibufenamide(TMF)and tenofovir alafenamide(TAF),including formulations from centralized volume-based procurement(CVBP-TAF)and imported sources(I-TAF),are all recommended treatment regimens,comparative studies on the efficacy,safety,and cost-effectiveness of these three regimens remain relatively limited.This retrospective cohort study aims to systematically compare the application effects of these three regimens in the treatment of CHB.Methods We conducted a single-center retrospective cohort study at Tianjin University Central Hospital from September 2019 to September 2024.CHB patients who had received TMF,CVBP-TAF,or I-TAF for 48 weeks were enrolled.Efficacy endpoints included HBV-DNA negative conversion,HBeAg seroclearance,and alanine aminotransferase(ALT)normalization.Safety outcomes encompassed nephrotoxicity,hepatotoxicity,and lipid profile changes.Cost-effectiveness analysis was used to calculate the cost-effectiveness ratio(CER)per unit efficacy gain and incremental CER using a healthcare payer perspective.Results A total of 173 patients were included,with 58 in the TMF group,58 in the I-TAF group,and 57 in the CVBP-TAF group.TMF demonstrated superior efficacy to I-TAF and CVBP-TAF,as evidenced by significantly higher HBV-DNA negative conversion rate and ALT normalization rate.No significant differences in safety outcomes were observed among the three groups.Cost-effectiveness analysis showed that CVBP-TAF had the lowest CER(4.62 CNY/%),followed by TMF with an intermediate CER(60.45 CNY/%),while I-TAF had the highest CER(66.49 CNY/%).Conclusion TMF demonstrates stronger antiviral efficacy than both TAF formulations,with comparable safety profiles.Despite the cost advantages of CVBP-TAF resulting from procurement policies,the clinical benefits of TMF support its use.Future strategies should improve the affordability of TMF to expand its accessibility.
基金supported by Faculty of MedicineChiang Mai University+2 种基金supported by the National Center for Advancing Translational SciencesNational Institutes of Healththrough grant number UL1 TR001860. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH。
文摘BACKGROUND: Targeted temperature management(TTM) is a common therapeutic intervention, yet its cost-effectiveness remains uncertain. This study aimed to evaluate the real-world cost-effectiveness of TTM compared with that of conventional care in adult out-of-hospital cardiac arrest(OHCA) survivors using clinical patient-level data.METHODS: We conducted a retrospective cohort study at an academic medical center in the USA to assess the cost-effectiveness of TTM in adult non-traumatic OHCA survivors between 1 January, 2019 and 30 June, 2023. The primary outcome was survival to hospital discharge. Incremental cost-effectiveness ratios(ICERs) were calculated and compared with various decision makers' willingness to pay. Cost-effectiveness acceptability curves were utilized to evaluate the economic attractiveness of TTM. Uncertainty about the incremental cost and effect was explored with a 95% confidence ellipse.RESULTS: Among 925 non-traumatic OHCA survivors, only 30(3%) received TTM. After adjusting for potential confounders, the TTM group did not demonstrate a significantly lower cost(delta cost-$5,141, 95% confidence interval [95% CI]: $-35,347 to $25,065, P=0.79) and higher survival to hospital discharge(delta effect 6%, 95% CI:-11% to 23%, P=0.41). Additionally, a 95% confidence ellipse indicated uncertainty reflected by evidence that the true value of the ICER could be in any of the quadrants of the cost-effectiveness plane.CONCLUSION: Although TTM did not demonstrate a clear survival benefit in this study, its potential cost-effectiveness warrants further investigation with larger sample sizes. These findings highlight the need for additional research to optimize TTM use in OHCA care and inform resource allocation decisions.
基金supported by the Major Science and Technology Projects in Yunnan Province(Grant No.202402AF080005)National Natural Science Foundation of China(Grant Nos.52274408,22468029,52274412)+2 种基金Yunnan Fundamental Research Projects(Grant No.202201AW070014)the Program for Innovative Research Team in University of Ministry of Education of China(Grant No.IRT 17R48)the German Research Foundation(DFG,Project number 501766751).
文摘While silicon/carbon(Si/C)is considered one of the most promising anode materials for the next generation of high-energy lithium-ion batteries(LIBs),the industrialization of Si/C anodes is hampered by high-cost and low product yield.Herein,a high-yield strategy is developed in which photovoltaic waste silicon is converted to cost-effective graphitic Si/C composites(G-Si@C)for LIBs.The introduction of a binder improves the dispersion and compatibility of silicon and graphite,enhances particle sphericity,and significantly reduces the loss rate of the spray prilling process(from about 25%to 5%).As an LIB anode,the fabricated G-Si@C composites exhibit a capacity of 605 mAh g^(-1) after 1200 cycles.The cost of manufacturing Si/C anode materials has been reduced to approximately$7.47 kg^(-1),which is close to that of commercial graphite anode materials($5.0 kg^(-1)),and significantly lower than commercial Si/C materials(ca.$20.74 kg^(-1)).Moreover,the G-Si@C material provides approximately 81.0 Ah/$of capacity,which exceeds the current best commercial graphite anodes(70.0 Ah/$)and Si/C anodes(48.2 Ah/$).The successful implementation of this pathway will significantly promote the industrialization of high-energydensity Si/C anode materials.
文摘BACKGROUND There has been a growing interest in noninvasive ventilation(NIV)in comparison to invasive mechanical ventilation(IMV)as a standard of care for acute respiratory failure(ARF),especially in the post-covid era,but direct head-to-head cost comparisons between the two modalities are not available in literature.AIM To compare the cost along with the clinical effectiveness of NIV in comparison to IMV in ARF.METHODS A prospective observational single-center case control study including adult patients with ARF(PaO2/FiO2 ratio<300)admitted from January 1,2024 to December 31,2024 in medical intensive care unit(ICU)of a tertiary care hospital requiring either NIV or invasive ventilation.NIV and IMV groups were compared based on average length of ICU and hospital stay,mortality,net cost of ICU treatment,need for intubation and tracheostomy.RESULTS A total of 319 patients were included in the study(197 in NIV,122 in IMV group).Statistically significant difference in length of ICU stay(NIV group:5±3.25 days,IMV group:9±2.6 days;P<0.05)and mortality rate was seen(11%NIV vs 34%IMV;P<0.01).On multivariate analyses,mortality showed a stronger association with IMV[odds ratio(OR)=7.73;95%CI:3.12-19.18]as compared to ICU stay(OR=2.73;95%CI:2.15-3.48).A total of 33 patients(17%)in NIV group required intubation of which 3 were tracheostomized,while 14 patients(11%)in IMV group needed tracheostomy.The net average cost of ICU stay was₹83902 in NIV group while in IMV group,the net ICU cost was₹476216.The average cost of ICU stay was five times higher with IMV.CONCLUSION NIV has potential economic and clinical benefits as compared to invasive ventilation in ARF.
文摘BACKGROUND Pancreatic exocrine insufficiency(PEI)leads to fat malabsorption and maldigestion and is most commonly treated with pancreatic enzyme replacement therapy(PERT).Patients suffering from PEI in China are more likely not to receive adequate treatment as this drug is not part of the Chinese national essential medicine list.AIM To examine the cost-effectiveness of PERT for patients suffering from PEI in China.METHODS A decision analytical Markov model was constructed to simulate the progress of patients with PEI in China.The population included in the analyses were patients suffering from PEI with advanced(non-resectable)pancreatic cancer,who have undergone surgery due to pancreatic cancer and who have undergone endoscopic treatment due to chronic pancreatitis.The cost-effectiveness analyses were undertaken from a Chinese societal perspective comparing PERT with no PERT.The incremental cost-effectiveness ratio in United States dollars per quality adjusted life year(QALY)gained is the main outcome.Input was informed by publicly available data supplemented with expert clinical advice.RESULTS The cost-effectiveness analyses estimated that PERT resulted in additional 0.45 to 2.93 QALYs at discounted costs of between 4315 dollars to 15193 dollars.This resulted in an incremental cost-effectiveness ratio of 5178 dollars to 9533 dollars per QALY.The one-way sensitivity analyses showed that the main drivers of the model were the cost of PERT and overall survival.CONCLUSION This study demonstrates that PERT is a cost-effective treatment for patients suffering from PEI in China.
文摘Nonlinear Rossby waves are used to describe typical wave phenomena in large-scale atmosphere andocean.Owing to the nonlinearity of the involved problems,the weakly nonlinear method,ie the derivative ex-pansion method,was mainly used to investigate Rossby waves under the combined effects of the generalizedβ-effect and the basic flow effect.The derivative expansion method has the advantage of capturing the multi-scalecharacteristics of wave processes simultaneously.In the case where the perturbation expansion is independentof secular terms,the nonlinear equations describing the amplitude evolution of nonlinear waves were derived,such as the Korteweg-de Vries equation,the Boussinesq equation and Zakharov-Kuznetsov equation.Both quali-tative and quantitative analyses indicate that the generalizedβ-effect is the key factor inducing the evolution ofRossby solitary waves.
基金Doctoral Startup Fund(20192066,20212028)Laijin Excellent Doctoral Fund(20202021)+1 种基金Scientific and Technological Innovation of Colleges and Universities in Shanxi Province(2020L0342)Fundamental Research Program of Shanxi Province(202303021222178)。
文摘SiC/Al-based composite foams were prepared by a two-step foaming method.The influence of the SiC content and its distribution uniformity on the foaming stability,cell structure,and mechanical properties of the aluminum foams was investigated.The macro/micro-features of the aluminum foams were characterized and analyzed.Results demonstrate that an appropriate increase in SiC content and the uniform distribution of SiC can improve the foaming stability,optimize the cell diameter and cell wall thickness,ameliorate the cell distribution,and enhance the hardness and compressive strength of the aluminum foams.However,either insufficient or excessive SiC leads to uneven distribution of SiC particles,which is unfavorable to foaming stability and good cell structure formation.With 6wt%SiC,both the foaming stability and cell structure of the aluminum foam reach the optimal state,resulting in the highest compressive strength and optimal energy absorption capacity.
基金Supported in part by Natural Science Foundation of Guangxi(2023GXNSFAA026246)in part by the Central Government's Guide to Local Science and Technology Development Fund(GuikeZY23055044)in part by the National Natural Science Foundation of China(62363003)。
文摘In this paper,we consider the maximal positive definite solution of the nonlinear matrix equation.By using the idea of Algorithm 2.1 in ZHANG(2013),a new inversion-free method with a stepsize parameter is proposed to obtain the maximal positive definite solution of nonlinear matrix equation X+A^(*)X|^(-α)A=Q with the case 0<α≤1.Based on this method,a new iterative algorithm is developed,and its convergence proof is given.Finally,two numerical examples are provided to show the effectiveness of the proposed method.
基金National Natural Science Foundation of China under Grant Nos.U2139208 and 52278516Key Laboratory of Earthquake Engineering and Engineering Vibration,China Earthquake Administration under Grant No.2024D15Key Laboratory of Soft Soil Characteristic and Engineering Environment,Tianjin Chengjian University under Grant No.2022SCEEKL003。
文摘This study presents an effective hybrid simulation approach for simulating broadband ground motion in complex near-fault locations.The approach utilizes a deterministic approach based on the spectral element method(SEM),which is used to simulate low-frequency ground motion(f<1 Hz)by incorporating an innovative efficient discontinuous Galerkin(DG)method for grid division to accurately model basin sedimentary layers at reduced costs.It also introduces a comprehensive hybrid source model for high-frequency random scattering and a nonlinear analysis module for basin sedimentary layers.Deterministic outcomes are combined with modified three-dimensional stochastic finite fault method(3D-EXSIM)simulations of high-frequency ground motion(f>1 Hz).A fourth-order Butterworth filter with zero phase shift is employed for time-domain filtering of low-and high-frequency time series at a crossover frequency of 1 Hz,merging the low and high-frequency ground motions into a broadband time series.Taking an Ms 6.8 Luding earthquake,as an example,this hybrid method was used for a rapid and efficient simulation analysis of broadband ground motion in the region.The accuracy and efficiency of this hybrid method were verified through comparisons with actually observed station data and empirical attenuation curves.Deterministic method simulation results revealed the effects of mountainous topography,basin effects,nonlinear effects within the basin’s sedimentary layers,and a coupling interaction between the basin and the mountains.The findings are consistent with similar studies,showing that near-fault sedimentary basins significantly focus and amplify strong ground motion,and the soil’s nonlinear behavior in the basin influences ground motion to varying extents at different distances from the fault.The mountainous topography impacts the basin’s response to ground motion,leading to barrier effects.This research provides a scientific foundation for seismic zoning,urban planning,and seismic design in nearfault mountain basin regions.
