Hasil untuk "Costs"

R. Baltussen, A. Taghreed, T. T. Torres et al.

R. Goetzel, S. Long, R. Ozminkowski et al.

Zhangwei Zheng, Mohd Hafizuddin Syah Bangaan Abdullah, Hafizah Omar Zaki et al.

Abstract Background Health insurance plays a vital role in reducing healthcare costs and promoting equitable access to medical services. However, coverage gaps persist in many regions, impeding progress toward universal health coverage as outlined in the UN Sustainable Development Goals. This study aims to comprehensively review recent research on health insurance purchasing, focusing on patterns, trends, methodologies, and key thematic areas. Methods A combination of bibliometric analysis and systematic review was employed to analyze health insurance purchasing literature. The Theory-Context-Methodology (TCM) framework guided the systematic review, with performance analysis conducted to evaluate publication trends and contribution patterns. Bibliographic coupling and co-occurrence analysis were used to identify the major themes and frontier topics. Results The study examined diverse theoretical perspectives and methodological approaches, with a focus on developed and emerging markets. The performance analysis revealed a steady increase in publications, with the United States and China emerging as leading contributors. Quantitative methods dominated in developed markets, while qualitative approaches were more prevalent in emerging markets. Key research themes included policy reforms and consumer behavior, with frontier topics such as cultural and financial factors and urban–rural insurance integration gaining prominence. Conclusions This study enhances the understanding of global health insurance purchasing research, particularly highlighting the need for further exploration in emerging markets. The findings provide valuable insights for future research, especially regarding evolving insurance systems and their impact on healthcare access and equity.

Angelo Arcuri, Lorenzo Giolli, Cosimo Magazzino

Addressing critical challenges such as climate change, environmental degradation, and resource depletion requires a swift transition to efficient and environmentally friendly energy solutions. Among these, geothermal energy is recognized for its dependability, low environmental impact, and versatility. This study investigates the role of geothermal energy in Italy’s business sector, examining its impact on companies and social perception. It specifically evaluates how communicating geological, hydrological, and atmospheric risks associated with geothermal projects influences firms’ likelihood of experiencing social acceptance challenges. Additionally, this research quantifies the impact of geothermal energy adoption on companies’ energy costs and CO₂ emissions. The analysis further explores the long-term implications of expanding the use of this renewable resource through sensitivity analysis, focusing on its effects on emissions and costs. The findings indicate that firms communicating geothermal-related risks are less likely to experience social acceptance challenges compared to those that do not. Moreover, this study shows that the use of geothermal energy positively impacts firms’ business and environmental performance by reducing energy costs and CO₂ emissions. Sensitivity analysis demonstrates that increasing the proportion of geothermal energy usage amplifies these benefits, thereby enhancing firms’ competitiveness. This research provides a comprehensive framework for promoting geothermal energy integration in business operations, offering valuable insights to support the global shift toward sustainable energy systems.

Ian C. Smith, Yasmin Abusetah, Homira Osman et al.

Abstract Introduction Neuromuscular diseases (NMDs) are rare multisystem, genetic or acquired disorders causing weakness and/or sensory loss. It is essential for governments, insurance providers, and broader society to have a better understanding of the burden of illness of NMDs. Our goal is to assess the social and economic burden of Canadians living with NMDs, encompassing schooling and education achievement, health-related quality-of-life, and labour force participation and productivity. Methods and analysis We will conduct a national, cross-sectional survey of individuals living with a NMD and their caregivers who are members of Muscular Dystrophy Canada and/or are patients within our national network of neuromuscular clinics. Surveys can be completed online or via telephone. The specific sub-sections of the questionnaire will differ based on respondent’s profile, whether they are 1) a minor living with a NMD, 2) an adult living with a NMD, 3) an adult who is a caregiver for someone living with a NMD, or 4) an adult who both lives with a NMD and is a caregiver for someone with a NMD. We will use descriptive statistics to describe distributions and ranges of the social and economic measures. Pearson correlations for continuous data and Spearman rho for rank data will be used to detect the strength of association of socio-demographic factors, disease characteristics, and social and economic impacts of NMDs. Ethics and dissemination The study protocol has been approved by the Ottawa Health Science Network Research Ethics Board (Protocol ID # 20210601-01H). This study will provide the overall impact of NMD on costs and health-related quality of life, disseminated via a series of manuscripts which will include both between- and within-NMD/NMD subtype comparisons. The data obtained will guide governmental policy development and inform patient organisation programs to deliver more effective supports to individuals and families affected by NMDs.

Kimberley Szeto, John Arnold, Carol Maher

Abstract Increasing physical activity in patients offers dual benefits, fostering improved patient health and recovery, while also bolstering healthcare system efficiency by minimizing costs related to extended hospital stays, complications, and readmissions. Wearable activity trackers offer valuable opportunities to enhance physical activity across various healthcare settings and among different patient groups. However, their integration into healthcare faces multiple implementation challenges related to the devices themselves, patients, clinicians, and systemic factors. This article presents the Wearable Activity Tracker Checklist for Healthcare (WATCH), which was recently developed through an international Delphi study. The WATCH provides a comprehensive framework for implementation and evaluation of wearable activity trackers in healthcare. It covers the purpose and setting for usage; patient, provider, and support personnel roles; selection of relevant metrics; device specifications; procedural steps for issuance and maintenance; data management; timelines; necessary adaptations for specific scenarios; and essential resources (such as education and training) for effective implementation. The WATCH is designed to support the implementation of wearable activity trackers across a wide range of healthcare populations and settings, and in those with varied levels of experience. The overarching goal is to support broader, sustained, and systematic use of wearable activity trackers in healthcare, therefore fostering enhanced physical activity promotion and improved patient outcomes.

Maciej Superson, Klaudia Wilk-Trytko, Katarzyna Szmyt et al.

Intruduction and purpose: Patients with severe asthma account for approximately 3% to 10% of all asthma patients. They have higher hospital utilization rates and treatment costs than patients with non-severe asthma. Previously, treatment options for these patients were limited due to unacceptable side effects. However, the advent of biologic therapies has provided promising targeted therapy for these patients. State of knowledge: Biologic therapies target inflammatory modulators that play a key role in the pathogenesis of asthma, particularly in patients with high T2 cells. These therapies have shown promising results in reducing asthma symptoms, improving lung function, decreasing the use of oral corticosteroids, and enhancing patients' quality of life. Conclusions: This article reviews the mechanism of action, efficacy, and indications of currently approved biologic drugs available in Poland, as well as potential therapeutic targets for the future.

Jesús Alberto Afonso Urich, Viktoria Marko, Katharina Boehm et al.

The development of analytical procedures, in line with the recent regulatory requirements ICH Q2 (R2) and ICH Q14, is progressing, and it must be able to manage the entire life cycle of the methodology. This is also applicable to and especially challenging for combinations of drug substances and dosage form. A reliable and efficient, stability-indicating, MS-compatible, reverse-phase ultra-performance liquid chromatographic (UPLC^®) method was developed for the determination of carvedilol and felodipine in a combination oral dosage form. The development of the method, performed using analytical quality by design (AQbD) principles, was in line with the future regulatory requirements. Furthermore, the fixed-dose combination dosage forms are a clear solution to the polypharmacy phenomenon in the elderly population. The main factors evaluated were the mobile phase buffer, organic modifier, column, flow, and column temperature. The optimum conditions were achieved with a Waters Acquity HSS T3 (100 × 2.1 mm i.d., 1.8 µm) column at 38 °C, using ammonium acetate buffer (5 mM, pH 4.5) (Solution A) and MeOH (Solution B) as mobile phases in gradient elution (t = 0 min, 10% B; t = 1.5 min, 10% B; t = 12.0 min, 90% B; t = 13.0 min, 10% B; t = 15.5 min, 10% B) at a flow rate of 0.2 mL/min and UV Detection of 240 and 362 nm for carvedilol (CAV) and felodipine (FLP), respectively. The linearity was demonstrated over concentration ranges of 30–650 µg/mL (R² = 0.9984) (CAV) and 32–260 µg/mL (R² = 0.9996) (FLP). Forced degradation studies were performed by subjecting the samples to hydrolytic (acid and base), oxidative, and thermal stress conditions. Standard solution stability was also performed. The proposed validated method was successfully used for the quantitative analysis of bulk, stability, and fixed-dose combination dosage form samples of the desired drug product. Using the AQbD principles, it is possible to generate methodologies with improved knowledge, leading to high-quality data, lower operation costs, and minimum regulatory risk. Furthermore, this work paves the way for providing a platform of robust analytical methods for the simultaneous quantification of innovative on-demand new dose combinations.

Josef Balák, Lucie Drábová, Vojtěch Ilko et al.

This study investigates the effect of pure yeast culture fermentation versus spontaneous fermentation on the volatile compound profile of industrially produced plum brandy. Using traditional distillation methods, the evolution of key volatile compounds is monitored at seven different moments during the distillation process. By integrating advanced analytical techniques such as GC-MS and sensory evaluation, significant differences in the composition of the distillates are highlighted, particularly in terms of ethyl esters and higher alcohols which are key to the sensory properties of the final product. Distillates produced with the addition of pure cultures gave higher concentrations of esters than those obtained by wild fermentation. The results of our industrial research show that the most critical step is to limit the storage of the input raw material, thereby reducing the subsequent risk of producing higher concentrations of 1-propanol. Furthermore, our results indicate that the heart of the distillate can only be removed up to an ethanol content of approximately 450 g/L and that the removal of additional ethanol results in only a 10% increase in the total volume of the distillate, which in turn results in an increase in boiler heating costs of approximately 30%.

Camilo Guzman, Salim Mattar, Nelson Alvis-Guzman et al.

Abstract: During the pandemic, Latin American countries suffered the collapse of their health systems. This was caused by the high demand for care of patients infected with SARS-CoV-2, which was added to the care of patients with other diseases. The significant increase in demand for health services caused medical and laboratory supplies to decline rapidly. The COVID-19 pandemic exacerbated a health crisis in several developing countries, mainly caused by insufficient systematic policies for integrating scientific knowledge. The current Colombian government must formulate a Biotechnological or Biosecurity Sovereignty Law that guarantees scientific autonomy, ensuring that Colombia is self-sufficient in Science, Technology, and Innovation. Colombian government should also focus on establishing and developing pharmaceutical chemical production by acquiring active chemical ingredients from other countries. This strategy could reduce the production costs and final prices of medicines, as well as generate high-level employment and wealth for the country. In this way, the Colombian government could prevent shortage of essential medicines and excessive price increases by commercial intermediation. In conclusion, the manuscript focuses on the lack of biotechnological sovereignty in Colombia. We propose a model of a Latin American Science and Technology ecosystem to achieve biotechnological sovereignty via state funding of research, strengthening universities, and fostering participation among private companies and Ministries of Science, Education, Trade, and Health. Scientific autonomy based on innovative processes that strengthen biotechnological independence can contribute to the economy by generating gross added value, creating high-quality employment, and facilitating the appropriation and social dissemination of knowledge, and cost reduction.

Graham Brooks

Krishnaraj Chadaga, Srikanth Prabhu, Niranjana Sampathila et al.

The human papillomavirus (HPV) is responsible for most cervical cancer cases worldwide. This gynecological carcinoma causes many deaths, even though it can be treated by removing malignant tissues at a preliminary stage. In many developing countries, patients do not undertake medical examinations due to the lack of awareness, hospital resources and high testing costs. Hence, it is vital to design a computer aided diagnostic method which can screen cervical cancer patients. In this research, we predict the probability risk of contracting this deadly disease using a custom stacked ensemble machine learning approach. The technique combines the results of several machine learning algorithms on multiple levels to produce reliable predictions. In the beginning, a deep exploratory analysis is conducted using univariate and multivariate statistics. Later, the one-way ANOVA, mutual information and Pearson’s correlation techniques are utilized for feature selection. Since the data was imbalanced, the Borderline-SMOTE technique was used to balance the data. The final stacked machine learning model obtained an accuracy, precision, recall, F1-score, area under curve (AUC) and average precision of 98%, 97%, 99%, 98%, 100% and 100%, respectively. To make the model explainable and interpretable to clinicians, explainable artificial intelligence algorithms such as Shapley additive values (SHAP), local interpretable model agnostic explanation (LIME), random forest and ELI5 have been effectively utilized. The optimistic results indicate the potential of automated frameworks to assist doctors and medical professionals in diagnosing and screening potential cervical cancer patients.

Thatohatsi Sefuthi, Lungiswa Nkonki

Abstract Objective The aims of this systematic review were to (1) identify primary- and model-based economic evaluations of cervical cancer screening methods and to (2) provide a contextual summary of valuation outcomes associated with three types of cervical cancer screening tests: visual inspection with acetic acid, human papillomavirus deoxyribonucleic acid, and Papanicolaou smear. Introduction Cervical cancer screening is an important public health priority with the potential to improve the detection of precancerous lesions in high-risk females for early intervention and disease prevention. Test performance and cost-effectiveness differ based on the specific screening method used across different platforms. There is a need to appraise existing economic evaluations of cervical cancer screening methods. Methods This review considered primary-based and model-based full economic evaluations of cervical cancer screening methods. The evaluation methods of interest included cost-effectiveness analysis, cost-utility analysis, cost-minimization analysis, cost–benefit analysis, and cost-consequence analysis. We searched Scopus, PubMed, National Health Economic Evaluation Database (NH EED), Cochrane, and the Health Economic Evaluation Database for full economic evaluations of cancer screening methods. No formal date restrictions were applied. Model-based and primary-based full economic evaluations were included. A critical appraisal of included studies was performed by the main investigator, while a second independent reviewer assessed critical appraisal findings for any inconsistencies. Data were extracted using a standardised data extraction tool for economic evaluations. The ultimate outcomes of costs, effectiveness, benefits, and utilities of cervical cancer screening modalities were extracted from included studies, analysed, and summarised. Results From a total of 671 screened studies, 44 studies met the study inclusion criteria. Forty-three studies were cost-effectiveness analyses, one study reported both cost-utility and cost-effectiveness outcomes, and another study reported cost utilities of cervical cancer screening methods only. Human papillomavirus (HPV) DNA testing was reported as a dominant stand-alone screening test by 14 studies, while five studies reported visual inspection with acetic acid (VIA) as a dominant stand-alone screening test. Primary HPV screening strategies were dominant in 21 studies, while three studies reported cytology-based screening strategies as the dominant screening method. Conclusions Existing evidence indicates that HPV-based and VIA testing strategies are cost-effective, but this is dependent on setting. Our review suggests the limited cost-effectiveness of cytology-based testing, which may be due in part to the need for specific infrastructures and human resources. Systematic review registration PROSPERO CRD42020212454 .

Dorit Segal, Anat Prior, Tamar H. Gollan

The current study examined the reliability and consistency of switching and mixing costs in the language and the color-shape tasks in three pre-existing data sets, to assess whether they are equally well suited for the study of individual differences. Specifically, we considered if the language task is as reliable as the color-shape task – an important question given the wide use of language switching tasks but little information available to address this question. Switching costs had low to moderate reliability and internal consistency, and these were similar for the language and the color-shape tasks. Mixing costs were more reliable in the language task than in the color-shape task when tested twice on the same day and trended in the same direction when tested a week apart. In addition, mixing costs were larger and more consistent than switching costs in all data sets and they were also were more reliable than switching costs in the language task when tested on the same day. These results reveal the language task to be as good as the color-shape task for measuring switching and mixing ability. Low variability of switching costs may decrease their reliability and consistency, in turn interfering with the chance of detecting cross task correlations. We advocate for exploring procedures to increase the variability of switching costs, which might increase reliability and consistency of these measures, and improve the ability to determine if bilingual language use relies on cognitive mechanisms that overlap with those underlying nonlinguistic multi-tasking.

J. C. A. Baker, L. Garcia-Carreras, M. Gloor et al.

<p>Water recycled through transpiring forests influences the spatial distribution of precipitation in the Amazon and has been shown to play a role in the initiation of the wet season. However, due to the challenges and costs associated with measuring evapotranspiration (ET) directly and high uncertainty in remote-sensing ET retrievals, the spatial and temporal patterns in Amazon ET remain poorly understood. In this study, we estimated ET over the Amazon and 10 sub-basins using a catchment-balance approach, whereby ET is calculated directly as the balance between precipitation, runoff, and change in groundwater storage. We compared our results with ET from remote-sensing datasets, reanalysis, models from Phase 5 and Phase 6 of the Coupled Model Intercomparison Projects (CMIP5 and CMIP6 respectively), and in situ flux tower measurements to provide a comprehensive overview of current understanding. Catchment-balance analysis revealed a gradient in ET from east to west/southwest across the Amazon Basin, a strong seasonal cycle in basin-mean ET primarily controlled by net incoming radiation, and no trend in ET over the past 2 decades. This approach has a degree of uncertainty, due to errors in each of the terms of the water budget; therefore, we conducted an error analysis to identify the range of likely values. Satellite datasets, reanalysis, and climate models all tended to overestimate the magnitude of ET relative to catchment-balance estimates, underestimate seasonal and interannual variability, and show conflicting positive and negative trends. Only two out of six satellite and model datasets analysed reproduced spatial and seasonal variation in Amazon ET, and captured the same controls on ET as indicated by catchment-balance analysis. CMIP5 and CMIP6 ET was inconsistent with catchment-balance estimates over all scales analysed. Overall, the discrepancies between data products and models revealed by our analysis demonstrate a need for more ground-based ET measurements in the Amazon as well as a need to substantially improve model representation of this fundamental component of the Amazon hydrological cycle.</p>

A. Deaton, J. Muellbauer

Xia PEI, Xiao WU, Peng GUO et al.

In order to solve the single machine scheduling problem, and improve the reliability and stability of the equipment, a single machine scheduling model considering piecewise linear deterioration and maintenance unavailability time was established according to the characteristics of continuous fault detection and discrete fault detection. Based on the system reliability theory, the single machine scheduling problem considering machine reliability was studied, and the advantages and disadvantages of maintenance strategy were compared by unified processing of decision conditions. The influence of related parameter changes on production scheduling optimization was determined by single factor and two factor adjustment analysis. The results show that the solution time of the model increases exponentially with the decreasing direction of unit delay cost, and the greater the unit delay cost, the faster the solution speed. The change of delay cost per unit time will not cause a significant change in maintenance cost, and the cost function does not have jumping nodes in flexible periodic maintenance, so it can not be adjusted adaptively. Ratio of preventive maintenance time to fault minor maintenance time has great influence on maintenance decision under discrete detection. The unified processing method of decision conditions can reduce the calculation time and detection cost, and better solve the problems of excessive maintenance or insufficient maintenance in discrete fault detection. These will help to reduce operating costs and improve economic benefits.

Önder Çınar, Mustafa Suat Bolat, Kemal Öztürk

Objective:Ureterorenoscopic stone surgery (USS) is the primary method of ureteral stone treatment. Double-J (JJ) stenting is an integral part of a USS, and most urologists prefer to use it without an extraction string. The probable reason for such preference could be the lack of reliable and sufficient data on JJ stent use with an extraction string.Materials and Methods:A total of 177 patients who underwent USS were divided into four groups: Group 1 men (JJ stent was manually removed), group 2 men (JJ stent was cystoscopically removed), group 3 women (JJ stent was manually removed), and group 4 women (JJ stent was cystoscopically removed). We investigated the impact of two different JJ stent removal techniques on pain perception, lower urinary tract symptoms (LUTS), depressive symptomatology, complications, and cost.Results:Compared to groups 1 and 3, the mean surgery times were higher in groups 2 and 4 (p=0.001). Preoperative LUTS scores were similar in all groups (p>0.05). Postoperative pain scores in groups 3 and 4 were similar (p=0.06), but they were lower in group 1 than in group 2 (p=0.004). Postoperative Beck depression inventory scores were lower in groups 1 and 3 (p<0.02). The total cost of USS was 28.5% higher in groups 2 and 4 compared to groups 1 and 3.Conclusion:It is concluded that JJ stent removal with an extraction string is a reliable method with low treatment costs that does not adversely affect surgical outcomes.

Wang Y, Song W, Cui Y et al.

Yang Wang,1 Wen Song,2 Yi Cui,3 Yang Zhang,1 Shenglin Mei,4 Qintao Wang1 1State Key Laboratory of Military Stomatology, Department of Periodontology, School of Stomatology, Air Force Medical University, Xi&rsquo;an, People&rsquo;s Republic of China; 2State Key Laboratory of Military Stomatology, Department of Prosthetic Dentistry, School of Stomatology, Air Force Medical University, Xi&rsquo;an, People&rsquo;s Republic of China; 3Equipment Department, Xijing Hospital, Air Force Medical University, Xi&rsquo;an, People&rsquo;s Republic of China; 4Department of Prosthodontics, College of Stomatology, Xi&rsquo;an Jiaotong University, Xi&rsquo;an, People&rsquo;s Republic of ChinaCorrespondence: Qintao WangDepartment of Periodontology, School of Stomatology, Air Force Medical University, No. 145 West Changle Road, Xi&rsquo;an 710032, People&rsquo;s Republic of ChinaTel +86 2984 776 096Fax +0086 2983 223 047Email yznmbk@fmmu.edu.cnPurpose: Reducing toxicity, immunogenicity, and costs of small interfering RNAs (siRNA) carrier materials are key goals for RNA interference (RNAi) technology transition from bench to bed. Recently, calcium ions (Ca2+) have garnered attention as a novel, alternative material for delivering siRNA to cells. However, the tolerance for Ca2+ concentration varies in different cell types, which has limited its applications in vivo. Bovine serum albumin (BSA) can bind to Ca2+ through chelation. Moreover, BSA is a favorable coating material for nanoparticles owing to its excellent biocompatibility. Therefore, we hypothesized that coating Ca2+-siRNA with BSA helps buffer Ca2+ toxicity in vivo.Methods: BSA-Ca2+-siRNA nanoparticles were prepared, and the size, shape, encapsulation, and release efficiency were characterized using atomic force microscopy, scanning electronic microcopy, and gel electrophoresis. Binding nanoparticles were evaluated using attenuated total reflection-Fourier-transform infrared spectroscopy. The cellular uptake, intracellular release, cytotoxicity, and gene knockdown of nanoparticles were evaluated in periodontal ligament stem cells (PDLSCs) using laser-scanning confocal microscope, flow cytometry, and real-time quantitative polymerase chain reaction.Results: BSA and Ca2+-siRNA could form a stable nano-scale complex (&sim; 140 nm in diameter). The nanocomplexes could maintain siRNA release for more than 1 week in neutral phosphate-buffered saline (PBS) and could induce accelerated degradation in acidic PBS (pH 5.0). The nanoparticles were taken up by the cells, primarily through macropinocytosis, and were then released intracellularly through the acidification of endosomes/lysosomes. Importantly, the BSA-Ca2+ carrier had high transfection efficiency and biocompatibility both in vitro and in vivo. To demonstrate the therapeutic potential of our BSA coating-optimized Ca2+-siRNA technology, we showed that BSA-Ca2+-siWWP1 complexes strongly enhanced the osteogenic differentiation of inflammatory PDLSCs.Conclusion: BSA-Ca2+ could potentially be used for siRNA delivery, which is not only highly efficient and cost-effective but also biocompatible to host tissues owing to the BSA coating.Keywords: bovine serum albumin, calcium ions, osteogenic differentiation, small interfering RNA

Tania Cerquitelli, Andrea Regalia, Emanuele Manfredi et al.

In a context of deep transformation of the entire automotive industry, starting from pervasive and native connectivity, commercial vehicles (heavy, light, and buses) are generating and transmitting much more data than passenger cars, with a much higher expected value, motivated by the higher costs of the vehicles and their added-value related businesses, such as logistics, freight, and transportation management. This paper presents a data-driven and unsupervised methodology to provide a descriptive model assessing the residual value estimates of heavy trucks subject to buy-back. A huge amount of telematics data characterizing the actual usage of commercial vehicles is jointly analyzed with different external conditions (e.g., altimetry), affecting the truck's performance to estimate the devaluation of the vehicle at the buy-back. The proposed approach has been evaluated on a large set of real-world heavy trucks to demonstrate its effectiveness in correctly assessing the real status of wear and residual value at the end of leasing contracts, to provide a few and quantitative insights through an informative, interactive and user-friendly dashboard to make a proper decision on the next business strategies to be adopted. The proposed solution has already been deployed by a private company within its data analytics services since (1) an interpretable descriptive model of the main factors/parameters and corresponding weights affecting the residual value is provided and (2) the experimental results confirmed the promising outcomes of the proposed data-driven methodology.