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
Retaining walls are utilized to support the earth and prevent the soil from spreading with natural slope angles where there are differences in the elevation of ground surfaces.As the need for retaining structures incr...Retaining walls are utilized to support the earth and prevent the soil from spreading with natural slope angles where there are differences in the elevation of ground surfaces.As the need for retaining structures increases,the use of retaining walls is increasing.The retaining walls,which increase the stability of levels,are economical and meet existing adverse conditions.A considerable amount of retaining walls is made from steel-reinforced concrete.The construction of reinforced concrete retaining walls can be costly due to its components.For this reason,the optimum cost should be targeted in the design of retaining walls.This study presents an artificial neural network(ANN)model developed to predict the optimum dimensions of a retaining wall using soil properties,material properties,and external loading conditions.The dataset utilized to train the ANN model is generated with the Flower Pollination Algorithm.The target variables in the dataset are the length of the heel(y1),length of the toe(y2),thickness of the stem(top)(y3),thickness of the stem(bottom)(y4),foundation base thickness(y5)and cost(y6)and these are estimated by utilizing an ANN model based on the height of the wall(x1),material unit weight(x2),wall friction angle(x3),surcharge load(x4),concrete cost per m3(x5),steel cost per ton(x6)and the soil class(x7).The model is formulated and trained as a multi-output regression model,as all outputs are numeric and continuous.The training and evaluation of the model results in a high prediction performance(R20.99).In addition,the impacts of different input features on the model>predictions are revealed using the SHapley Additive exPlanations(SHAP)algorithm.The study demonstrates that when trained with a large dataset,ANN models perform very well by predicting the optimal cost with high performance.展开更多
Direct electrolysis of seawater to produce green hydrogen is a more environmentally friendly process than freshwater electrolysis.The renewable energy sector exhibits tremendous interest in practical seawater electrol...Direct electrolysis of seawater to produce green hydrogen is a more environmentally friendly process than freshwater electrolysis.The renewable energy sector exhibits tremendous interest in practical seawater electrolysis techniques due to its substantial capacity to mitigate the need for freshwater consumption.With the low catalytic efficiency of the current seawater splitting process and the poor reliability of its operation,the process suffers from severe corrosion caused by chloride ions,as well as anodic competition between oxygen evolution and chlorine oxidation reactions.This review provides an overview of the latest electrocatalyst developments for promoting selectivity and stability in seawater electrolysis.Using the characterization and simulation results,as well as active machine learning,advanced electrocatalytic materials can be designed and developed,a research direction that will become increasingly important in the future.A variety of strategies are discussed in detail for designing advanced electrocatalysts in seawater electrolysis,including the surface protective layer,structural regulation by heteroatom doping and vacancies,porous structure,core-shell construction,and 3D hetero-structure construction to hinder chlorine evolution reactions.Finally,future perspectives and challenges for green hydrogen production from seawater electrolysis are also described.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 and Objective: A multitude of large cohort studies have collected data on incidence and covariates/risk factors of various chronic diseases. However, approaches for utilization of these large data and trans...Background and Objective: A multitude of large cohort studies have collected data on incidence and covariates/risk factors of various chronic diseases. However, approaches for utilization of these large data and translation of the valuable results to inform and guide clinical disease prevention practice are not well developed. In this paper, we proposed, based on large cohort study data, a novel conceptual cost-effective disease prevention design strategy for a target group when it is not affordable to include everyone in the target group for intervention. Methods and Results: Data from American Indian participants (n = 3516;2056 women) aged 45 - 74 years in the Strong Heart Study, the diabetes risk prediction model from the study, a utility function, and regression models were used. A conceptual cost-effective disease prevention design strategy based on large cohort data was initiated. The application of the proposed strategy for diabetes prevention was illustrated. Discussion: The strategy may provide reasonable solutions to address cost-effective prevention design issues. These issues include complex associations of a disease with its significant risk factors, cost-effectively selecting individuals at high risk of developing disease to undergo intervention, individual differences in health conditions, choosing intervention risk factors and setting their appropriate, attainable, gradual and adaptive goal levels for different subgroups, and assessing effectiveness of the prevention program. Conclusions: The strategy and methods shown in the illustrative example can also be analogously adopted and applied to other diseases preventions. The proposed strategy provides a way to translate and apply epidemiological study results to clinical disease prevention practice.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
Against the backdrop of escalating global climate change and energy crises,the resource utilization of carbon dioxide(CO_(2)),a major greenhouse gas,has become a crucial pathway for achieving carbon peaking and carbon...Against the backdrop of escalating global climate change and energy crises,the resource utilization of carbon dioxide(CO_(2)),a major greenhouse gas,has become a crucial pathway for achieving carbon peaking and carbon neutrality goals.The hydrogenation of CO_(2)to methanol not only enables carbon sequestration and recycling,but also provides a route to produce high value-added fuels and basic chemical feedstocks,holding significant environmental and economic potential.However,this conversion process is thermodynamically and kinetically limited,and traditional catalyst systems(e.g.,Cu/ZnO/Al_(2)O_(3))exhibit inadequate activity,selectivity,and stability under mild conditions.Therefore,the development of novel high-performance catalysts with precisely tunable structures and functionalities is imperative.Metal-organic frameworks(MOFs),as crystalline porous materials with high surface area,tunable pore structures,and diverse metal-ligand compositions,have the great potential in CO_(2)hydrogenation catalysis.Their structural design flexibility allows for the construction of well-dispersed active sites,tailored electronic environments,and enhanced metal-support interactions.This review systematically summarizes the recent advances in MOF-based and MOF-derived catalysts for CO_(2)hydrogenation to methanol,focusing on four design strategies:(1)spatial confinement and in situ construction,(2)defect engineering and ion-exchange,(3)bimetallic synergy and hybrid structure design,and(4)MOF-derived nanomaterial synthesis.These approaches significantly improve CO_(2)conversion and methanol selectivity by optimizing metal dispersion,interfacial structures,and reaction pathways.The reaction mechanism is further explored by focusing on the three main reaction pathways:the formate pathway(HCOO*),the RWGS(Reverse Water Gas Shift reaction)+CO*hydrogenation pathway,and the trans-COOH pathway.In situ spectroscopic studies and density functional theory(DFT)calculations elucidate the formation and transformation of key intermediates,as well as the roles of active sites,metal-support interfaces,oxygen vacancies,and promoters.Additionally,representative catalytic performance data for MOFbased systems are compiled and compared,demonstrating their advantages over traditional catalysts in terms of CO_(2)conversion,methanol selectivity,and space-time yield.Future perspectives for MOF-based CO_(2)hydrogenation catalysts will prioritize two main directions:structural design and mechanistic understanding.The precise construction of active sites through multi-metallic synergy,defect engineering,and interfacial electronic modulation should be made to enhance catalyst selectivity and stability.In addition,advanced in situ characterization techniques combined with theoretical modeling are essential to unravel the detailed reaction mechanisms and intermediate behaviors,thereby guiding rational catalyst design.Moreover,to enable industrial application,challenges related to thermal/hydrothermal stability,catalyst recyclability,and cost-effective large-scale synthesis must be addressed.The development of green,scalable preparation methods and the integration of MOF catalysts into practical reaction systems(e.g.,flow reactors)will be crucial for bridging the gap between laboratory research and commercial deployment.Ultimately,multi-scale structure-performance optimization and catalytic system integration will be vital for accelerating the industrialization of MOF-based CO_(2)-to-methanol technologies.展开更多
The electrochemical oxidation of biomass-derived platform molecule 5-hydroxymethylfurfural(HMF)represents a crucial pathway for green transformation into high-value chemicals,yet its reaction pathway selectivity,effic...The electrochemical oxidation of biomass-derived platform molecule 5-hydroxymethylfurfural(HMF)represents a crucial pathway for green transformation into high-value chemicals,yet its reaction pathway selectivity,efficiency,and catalyst stability are strongly dependent on the electrolyte pH environment.Under alkaline conditions,high OH−concentration facilitates preferential aldehyde group oxidation and efficient deprotonation,enabling highly efficient synthesis of 2,5-furandicarboxylic acid,but simultaneously induces HMF self-degradation and complicates product separation.As pH decreases,the reaction mechanism shifts toward enhanced hydroxymethyl oxidation,leading to intermediate accumulation(such as 5-hydroxymethyl-2-furancarboxylic acid,2,5-diformylfuran,and 5-formyl-2-furancarboxylic acid)with challenging selectivity control and significantly slowed reaction kinetics.This review comprehensively examines the systematic differences in HMF oxidation pathways and surface catalytic mechanisms across the full pH range from alkaline to acidic conditions.Addressing the distinct reaction characteristics and core challenges in alkaline,near-neutral,and acidic media,we systematically evaluate design strategies for high-efficiency electrocatalysts and explore reactor design aspects.Future research should focus on process integration(with tailored reactor design)for energy consumption reduction in alkaline systems,targeted synthesis of diverse oxidation products in near-neutral systems,and innovative catalyst development for acidic systems,thereby advancing the efficiency,selectivity,and practical application of HMF electrooxidation technologies across the entire pH spectrum through synergistic optimization of catalyst,reactor,and process.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.
文摘Retaining walls are utilized to support the earth and prevent the soil from spreading with natural slope angles where there are differences in the elevation of ground surfaces.As the need for retaining structures increases,the use of retaining walls is increasing.The retaining walls,which increase the stability of levels,are economical and meet existing adverse conditions.A considerable amount of retaining walls is made from steel-reinforced concrete.The construction of reinforced concrete retaining walls can be costly due to its components.For this reason,the optimum cost should be targeted in the design of retaining walls.This study presents an artificial neural network(ANN)model developed to predict the optimum dimensions of a retaining wall using soil properties,material properties,and external loading conditions.The dataset utilized to train the ANN model is generated with the Flower Pollination Algorithm.The target variables in the dataset are the length of the heel(y1),length of the toe(y2),thickness of the stem(top)(y3),thickness of the stem(bottom)(y4),foundation base thickness(y5)and cost(y6)and these are estimated by utilizing an ANN model based on the height of the wall(x1),material unit weight(x2),wall friction angle(x3),surcharge load(x4),concrete cost per m3(x5),steel cost per ton(x6)and the soil class(x7).The model is formulated and trained as a multi-output regression model,as all outputs are numeric and continuous.The training and evaluation of the model results in a high prediction performance(R20.99).In addition,the impacts of different input features on the model>predictions are revealed using the SHapley Additive exPlanations(SHAP)algorithm.The study demonstrates that when trained with a large dataset,ANN models perform very well by predicting the optimal cost with high performance.
基金part of a research project, PIF 726175Alfaisal University and its Office of Research & Innovation for their continuous support throughout this study。
文摘Direct electrolysis of seawater to produce green hydrogen is a more environmentally friendly process than freshwater electrolysis.The renewable energy sector exhibits tremendous interest in practical seawater electrolysis techniques due to its substantial capacity to mitigate the need for freshwater consumption.With the low catalytic efficiency of the current seawater splitting process and the poor reliability of its operation,the process suffers from severe corrosion caused by chloride ions,as well as anodic competition between oxygen evolution and chlorine oxidation reactions.This review provides an overview of the latest electrocatalyst developments for promoting selectivity and stability in seawater electrolysis.Using the characterization and simulation results,as well as active machine learning,advanced electrocatalytic materials can be designed and developed,a research direction that will become increasingly important in the future.A variety of strategies are discussed in detail for designing advanced electrocatalysts in seawater electrolysis,including the surface protective layer,structural regulation by heteroatom doping and vacancies,porous structure,core-shell construction,and 3D hetero-structure construction to hinder chlorine evolution reactions.Finally,future perspectives and challenges for green hydrogen production from seawater electrolysis are also described.
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 and Objective: A multitude of large cohort studies have collected data on incidence and covariates/risk factors of various chronic diseases. However, approaches for utilization of these large data and translation of the valuable results to inform and guide clinical disease prevention practice are not well developed. In this paper, we proposed, based on large cohort study data, a novel conceptual cost-effective disease prevention design strategy for a target group when it is not affordable to include everyone in the target group for intervention. Methods and Results: Data from American Indian participants (n = 3516;2056 women) aged 45 - 74 years in the Strong Heart Study, the diabetes risk prediction model from the study, a utility function, and regression models were used. A conceptual cost-effective disease prevention design strategy based on large cohort data was initiated. The application of the proposed strategy for diabetes prevention was illustrated. Discussion: The strategy may provide reasonable solutions to address cost-effective prevention design issues. These issues include complex associations of a disease with its significant risk factors, cost-effectively selecting individuals at high risk of developing disease to undergo intervention, individual differences in health conditions, choosing intervention risk factors and setting their appropriate, attainable, gradual and adaptive goal levels for different subgroups, and assessing effectiveness of the prevention program. Conclusions: The strategy and methods shown in the illustrative example can also be analogously adopted and applied to other diseases preventions. The proposed strategy provides a way to translate and apply epidemiological study results to clinical disease prevention practice.
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.
基金Supported by the National Key Research and Development Program of China(2023YFB4104500,2023YFB4104502)the National Natural Science Foundation of China(22138013)the Taishan Scholar Project(ts201712020).
文摘Against the backdrop of escalating global climate change and energy crises,the resource utilization of carbon dioxide(CO_(2)),a major greenhouse gas,has become a crucial pathway for achieving carbon peaking and carbon neutrality goals.The hydrogenation of CO_(2)to methanol not only enables carbon sequestration and recycling,but also provides a route to produce high value-added fuels and basic chemical feedstocks,holding significant environmental and economic potential.However,this conversion process is thermodynamically and kinetically limited,and traditional catalyst systems(e.g.,Cu/ZnO/Al_(2)O_(3))exhibit inadequate activity,selectivity,and stability under mild conditions.Therefore,the development of novel high-performance catalysts with precisely tunable structures and functionalities is imperative.Metal-organic frameworks(MOFs),as crystalline porous materials with high surface area,tunable pore structures,and diverse metal-ligand compositions,have the great potential in CO_(2)hydrogenation catalysis.Their structural design flexibility allows for the construction of well-dispersed active sites,tailored electronic environments,and enhanced metal-support interactions.This review systematically summarizes the recent advances in MOF-based and MOF-derived catalysts for CO_(2)hydrogenation to methanol,focusing on four design strategies:(1)spatial confinement and in situ construction,(2)defect engineering and ion-exchange,(3)bimetallic synergy and hybrid structure design,and(4)MOF-derived nanomaterial synthesis.These approaches significantly improve CO_(2)conversion and methanol selectivity by optimizing metal dispersion,interfacial structures,and reaction pathways.The reaction mechanism is further explored by focusing on the three main reaction pathways:the formate pathway(HCOO*),the RWGS(Reverse Water Gas Shift reaction)+CO*hydrogenation pathway,and the trans-COOH pathway.In situ spectroscopic studies and density functional theory(DFT)calculations elucidate the formation and transformation of key intermediates,as well as the roles of active sites,metal-support interfaces,oxygen vacancies,and promoters.Additionally,representative catalytic performance data for MOFbased systems are compiled and compared,demonstrating their advantages over traditional catalysts in terms of CO_(2)conversion,methanol selectivity,and space-time yield.Future perspectives for MOF-based CO_(2)hydrogenation catalysts will prioritize two main directions:structural design and mechanistic understanding.The precise construction of active sites through multi-metallic synergy,defect engineering,and interfacial electronic modulation should be made to enhance catalyst selectivity and stability.In addition,advanced in situ characterization techniques combined with theoretical modeling are essential to unravel the detailed reaction mechanisms and intermediate behaviors,thereby guiding rational catalyst design.Moreover,to enable industrial application,challenges related to thermal/hydrothermal stability,catalyst recyclability,and cost-effective large-scale synthesis must be addressed.The development of green,scalable preparation methods and the integration of MOF catalysts into practical reaction systems(e.g.,flow reactors)will be crucial for bridging the gap between laboratory research and commercial deployment.Ultimately,multi-scale structure-performance optimization and catalytic system integration will be vital for accelerating the industrialization of MOF-based CO_(2)-to-methanol technologies.
基金supported by the National Key R&D Program of China(2023YFA1507400)the National Natural Science Foundation of China(Grant No.22325805,22441010,22408203)+2 种基金Beijing Natural Science Foundation(Grant No.JQ22003)the Haihe Laboratory of Sustainable Chemical Transformations(24HHWCSS00007)Tsinghua University Dushi Program,and Sinopec Group(PR20232572).
文摘The electrochemical oxidation of biomass-derived platform molecule 5-hydroxymethylfurfural(HMF)represents a crucial pathway for green transformation into high-value chemicals,yet its reaction pathway selectivity,efficiency,and catalyst stability are strongly dependent on the electrolyte pH environment.Under alkaline conditions,high OH−concentration facilitates preferential aldehyde group oxidation and efficient deprotonation,enabling highly efficient synthesis of 2,5-furandicarboxylic acid,but simultaneously induces HMF self-degradation and complicates product separation.As pH decreases,the reaction mechanism shifts toward enhanced hydroxymethyl oxidation,leading to intermediate accumulation(such as 5-hydroxymethyl-2-furancarboxylic acid,2,5-diformylfuran,and 5-formyl-2-furancarboxylic acid)with challenging selectivity control and significantly slowed reaction kinetics.This review comprehensively examines the systematic differences in HMF oxidation pathways and surface catalytic mechanisms across the full pH range from alkaline to acidic conditions.Addressing the distinct reaction characteristics and core challenges in alkaline,near-neutral,and acidic media,we systematically evaluate design strategies for high-efficiency electrocatalysts and explore reactor design aspects.Future research should focus on process integration(with tailored reactor design)for energy consumption reduction in alkaline systems,targeted synthesis of diverse oxidation products in near-neutral systems,and innovative catalyst development for acidic systems,thereby advancing the efficiency,selectivity,and practical application of HMF electrooxidation technologies across the entire pH spectrum through synergistic optimization of catalyst,reactor,and process.
