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Showing papers on "Cost effectiveness published in 2020"


Journal ArticleDOI
TL;DR: The burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected.

2,370 citations


Journal ArticleDOI
TL;DR: This review discussed remediation of PTEs contaminated soils through immobilization techniques using different soil amendments with respect to type of element, soil, and amendment, immobilization efficiency, underlying mechanisms, and field applicability.

630 citations


Journal ArticleDOI
14 Oct 2020-Nature
TL;DR: It is found that restoring 15% of converted lands in priority areas could avoid 60% of expected extinctions while sequestering 299 gigatonnes of CO 2 —30% of the total CO 2 increase in the atmosphere since the Industrial Revolution.
Abstract: Extensive ecosystem restoration is increasingly seen as being central to conserving biodiversity and stabilizing the climate of the Earth. Although ambitious national and global targets have been set, global priority areas that account for spatial variation in benefits and costs have yet to be identified. Here we develop and apply a multicriteria optimization approach that identifies priority areas for restoration across all terrestrial biomes, and estimates their benefits and costs. We find that restoring 15% of converted lands in priority areas could avoid 60% of expected extinctions while sequestering 299 gigatonnes of CO2—30% of the total CO2 increase in the atmosphere since the Industrial Revolution. The inclusion of several biomes is key to achieving multiple benefits. Cost effectiveness can increase up to 13-fold when spatial allocation is optimized using our multicriteria approach, which highlights the importance of spatial planning. Our results confirm the vast potential contributions of restoration to addressing global challenges, while underscoring the necessity of pursuing these goals synergistically.

348 citations


Journal ArticleDOI
TL;DR: This review aims to concisely highlight recent state-of-the-art progress of g-C3N4-based catalysts in AOPs beyond photocatalytic oxidation and the effect of water chemistry including pH, water temperature, natural organic matter, inorganic anions and dissolved oxygen on the catalytic performance.

326 citations


Journal ArticleDOI
08 Jan 2020-Small
TL;DR: The recent advances in the design and synthesis of UOR catalysts for urea electrolysis, photoelectrochemical urea splitting, and direct urea fuel cells are reviewed here and particular attention is paid to those design concepts, which specifically target the characteristics of urea molecules.
Abstract: Urea oxidation reaction (UOR) is the underlying reaction that determines the performance of modern urea-based energy conversion technologies. These technologies include electrocatalytic and photoelectrochemical urea splitting for hydrogen production and direct urea fuel cells as power engines. They have demonstrated great potentials as alternatives to current water splitting and hydrogen fuel cell systems with more favorable operating conditions and cost effectiveness. At the moment, UOR performance is mainly limited by the 6-electron transfer process. In this case, various material design and synthesis strategies have recently been reported to produce highly efficient UOR catalysts. The performance of these advanced catalysts is optimized by the modification of their structural and chemical properties, including porosity development, heterostructure construction, defect engineering, surface functionalization, and electronic structure modulation. Considering the rich progress in this field, the recent advances in the design and synthesis of UOR catalysts for urea electrolysis, photoelectrochemical urea splitting, and direct urea fuel cells are reviewed here. Particular attention is paid to those design concepts, which specifically target the characteristics of urea molecules. Moreover, challenges and prospects for the future development of urea-based energy conversion technologies and corresponding catalysts are also discussed.

256 citations


Journal ArticleDOI
TL;DR: This work proposes EUAGame, a game-theoretic approach that formulates the EUA problem as a potential game and designs a novel decentralized algorithm for finding a Nash equilibrium in the game as a solution to theEUA problem.
Abstract: Edge Computing provides mobile and Internet-of-Things (IoT) app vendors with a new distributed computing paradigm which allows an app vendor to deploy its app at hired edge servers distributed near app users at the edge of the cloud. This way, app users can be allocated to hired edge servers nearby to minimize network latency and energy consumption. A cost-effective edge user allocation (EUA) requires maximum app users to be served with minimum overall system cost. Finding a centralized optimal solution to this EUA problem is NP-hard. Thus, we propose EUAGame, a game-theoretic approach that formulates the EUA problem as a potential game. We analyze the game and show that it admits a Nash equilibrium. Then, we design a novel decentralized algorithm for finding a Nash equilibrium in the game as a solution to the EUA problem. The performance of this algorithm is theoretically analyzed and experimentally evaluated. The results show that the EUA problem can be solved effectively and efficiently.

244 citations


Journal ArticleDOI
03 Apr 2020
TL;DR: In this article, the potential of 11 resources recoverable from municipal wastewater treatment plants to supply national resource consumption is investigated in academia and nine non-technical bottlenecks are identified in literature that have to be overcome to successfully implement these technologies into wastewater treatment process designs.
Abstract: In recent decades, academia has elaborated a wide range of technological solutions to recover water, energy, fertiliser and other products from municipal wastewater treatment plants. Drivers for this work range from low resource recovery potential and cost effectiveness, to the high energy demands and large environmental footprints of current treatment-plant designs. However, only a few technologies have been implemented and a shift from wastewater treatment plants towards water resource facilities still seems far away. This critical review aims to inform decision-makers in water management utilities about the vast technical possibilities and market supply potentials, as well as the bottlenecks, related to the design or redesign of a municipal wastewater treatment process from a resource recovery perspective. Information and data have been extracted from literature to provide a holistic overview of this growing research field. First, reviewed data is used to calculate the potential of 11 resources recoverable from municipal wastewater treatment plants to supply national resource consumption. Depending on the resource, the supply potential may vary greatly. Second, resource recovery technologies investigated in academia are reviewed comprehensively and critically. The third section of the review identifies nine non-technical bottlenecks mentioned in literature that have to be overcome to successfully implement these technologies into wastewater treatment process designs. The bottlenecks are related to economics and value chain development, environment and health, and society and policy issues. Considering market potentials, technological innovations, and addressing potential bottlenecks early in the planning and process design phase, may facilitate the design and integration of water resource facilities and contribute to more circular urban water management practices.

222 citations


Journal ArticleDOI
TL;DR: A new strategy is demonstrated to synthesize active and stable Pt-based electrocatalysts for hydrogen evolution by confining Pt clusters in hollow mesoporous carbon spheres (Pt5 /HMCS), leading to remarkable electrocatalyst performance for hydrogen production in both acidic and alkaline solutions.
Abstract: Electrochemical water splitting is considered as a promising approach to produce clean and sustainable hydrogen fuel. As a new class of nanomaterials with high ratio of surface atoms and tunable composition and electronic structure, metal clusters are promising candidates as catalysts. Here, a new strategy is demonstrated to synthesize active and stable Pt-based electrocatalysts for hydrogen evolution by confining Pt clusters in hollow mesoporous carbon spheres (Pt5 /HMCS). Such a structure would effectively stabilize the Pt clusters during the ligand removal process, leading to remarkable electrocatalytic performance for hydrogen production in both acidic and alkaline solutions. Particularly, the optimal Pt5 /HMCS electrocatalyst exhibits 12 times the mass activity of Pt in commercial Pt/C catalyst with similar Pt loading. This study exemplifies a simple yet effective approach to improve the cost effectiveness of precious-metal-based catalysts with stabilized metal clusters.

220 citations


Journal ArticleDOI
01 Oct 2020
TL;DR: This review is mainly focused on the developments in the generation of cellulose nanocomposites and their potential applications in the biomedical field.
Abstract: Cellulose is a linear biopolymer which is composed of nanofibrils, thus having a large surface area. This low-cost, low-density, high-specific-surface-area, easily processable polymer is found in nature in the form of plants, bacteria and tunicates. Cellulose has outstanding characteristics including low cytotoxicity, biocompatibility, good mechanical properties, high chemical stability, and cost effectiveness which make them suitable candidates for biomedical applications. The manipulation of cellulose at nanoscale resulted in nanocellulose having exceptional physicochemical properties. Therefore, cellulose nanocomposite is a fascinating area of research which has applications in biomedical fields like wound healing, bone tissue engineering, three dimensional printing, drug carriers, medical implants etc. This review is mainly focused on the developments in the generation of cellulose nanocomposites and their potential applications in the biomedical field.

220 citations


Journal ArticleDOI
TL;DR: This review covers the technical aspects of integrating CRISPR/Cas technology in miniaturized sensors for analysis on-site and discusses the challenges of point-of-careCRISPR sensing.

190 citations



Journal ArticleDOI
TL;DR: The main objective is to do an in-depth analysis of healthcare data breaches and draw inferences from them, thereby using the findings to improve healthcare data confidentiality, and employs the simple moving average method and the simple exponential soothing method of time series analysis to examine the trend of healthcareData breaches and their cost.

Journal ArticleDOI
TL;DR: Greater emphasis has been put on a population-based approach and on disease-specific interventions, avoiding re-interpretation of information already and previously considered.
Abstract: European guidelines on cardiovascular prevention in clinical practice were first published in 1994 and have been regularly updated, most recently in 2016, by the Sixth European Joint Task Force. Given the amount of new information that has become available since then, components from the task force and experts from the European Association of Preventive Cardiology of the European Society of Cardiology were invited to provide a summary and critical review of the most important new studies and evidence since the latest guidelines were published. The structure of the document follows that of the previous document and has six parts: Introduction (epidemiology and cost effectiveness); Cardiovascular risk; How to intervene at the population level; How to intervene at the individual level; Disease-specific interventions; and Settings: where to intervene? In fact, in keeping with the guidelines, greater emphasis has been put on a population-based approach and on disease-specific interventions, avoiding re-interpretation of information already and previously considered. Finally, the presence of several gaps in the knowledge is highlighted.

Journal ArticleDOI
TL;DR: This work is intended to summarize the versatile applications of CDI and highlight the representative achievements in each of the applications primarily covering water desalination, water purification, water disinfection, resource recovery and synergistic combination with other technologies.

Journal ArticleDOI
TL;DR: From this discussion, the main challenges that are faced when trying to take evidence from research and translating it into policy or practice recommendations are pulled out, and from there to actual implementation in terms of better treatment and care.

Journal ArticleDOI
TL;DR: In this paper, a 3-electrode configuration in 6-M KOH electrolyte was used to evaluate the performance of the pre-carbonization, acid washing, and KOH activation procedures.

Journal ArticleDOI
TL;DR: Treatment with tafamidis is projected to produce substantial clinical benefit but would greatly exceed conventional cost-effectiveness thresholds at the current US list price, and access to and uptake of this effective therapy may be limited unless there is a large reduction in drug costs.
Abstract: Background: In patients with transthyretin amyloid cardiomyopathy, tafamidis reduces all-cause mortality and cardiovascular hospitalizations and slows decline in quality of life compared with place...

Journal ArticleDOI
TL;DR: In this paper, the authors reviewed the current regulatory frameworks for WCO collection and recycling practices imposed by major WCO producing countries, followed by the overview of the progress in biodiesel conversion techniques, along with novel methods to improve the feasibility for upscaling.

Journal ArticleDOI
23 Jan 2020-Small
TL;DR: The synthesis of ZIF-8@ZIF-67 derived nitrogen-doped porous carbon confined CoP polyhedron architectures (NC@CoP/NC) to function as innovative KIB anode materials is reported and may offer an innovative and feasible route of emerging anode design toward high performance KIBs.
Abstract: Potassium ion batteries (KIB) have become a compelling energy-storage system owing to their cost effectiveness and the high abundance of potassium in comparison with lithium. However, its practical applications have been thwarted by a series of challenges, including marked volume expansion and sluggish reaction kinetics caused by the large radius of potassium ions. In line with this, the exploration of reliable anode materials affording high electrical conductivity, sufficient active sites, and structural robustness is the key. The synthesis of ZIF-8@ZIF-67 derived nitrogen-doped porous carbon confined CoP polyhedron architectures (NC@CoP/NC) to function as innovative KIB anode materials is reported. Such composites enable an outstanding rate performance to harvest a capacity of ≈200 mAh g-1 at 2000 mA g-1 . Additionally, a high cycling stability can be gained by maintaining a high capacity retention of 93% after 100 cycles at 100 mA g-1 . Furthermore, the potassium ion storage mechanism of the NC@CoP/NC anode is systematically probed through theoretical simulations and experimental characterization. This contribution may offer an innovative and feasible route of emerging anode design toward high performance KIBs.

Journal ArticleDOI
20 Oct 2020-BMJ
TL;DR: This practice pointer summarises the evidence on the use of video consultations in healthcare and offers practical recommendations for video consulting in primary care and outpatient settings.
Abstract: ### What you need to know Even before the covid-19 pandemic, virtual consultations (also called telemedicine consultations) were on the rise, with many healthcare systems advocating a digital-first approach.1234567 At the start of the pandemic, many GPs and specialists turned to video consultations to reduce patient flow through healthcare facilities and limit infectious exposures.8910111213141516 Video and telephone consultations also enable clinicians who are well but have to self-isolate, or who fall into high risk groups and require shielding, to continue providing medical care.171819 The scope for video consultations for long term conditions is wide and includes management of diabetes, hypertension, asthma, stroke, psychiatric illnesses, cancers, and chronic pain.202122 Video consultations can also be used for triage and management of a wide range of acute conditions, including, for example, emergency eye care triage.232425 This practice pointer summarises the evidence on the use of video consultations in healthcare and offers practical recommendations for video consulting in primary care and outpatient settings. Evidence about patient outcomes, cost effectiveness, safety, technical issues, impact of video consultations on healthcare delivery, and quality of consultations is mixed and mainly from small studies.2021232627282930 The few randomised trials that have been conducted focus on the use of video consultations in hospital outpatient clinics for patients with chronic conditions. They …

Journal ArticleDOI
TL;DR: The efficiency of adsorption technique was found up to 90% for DBP removal from the water, and several regulations have been specified by world authorities like WHO, USEPA and Bureau of Indian Standard to protect human health.

Journal ArticleDOI
TL;DR: In this article, the authors proposed a model-based approach for comprehensive techno-economic assessments of grid-integrated seasonal storage and explored the conditions (cost, storage duration, and efficiency) that encourage cost competitiveness for seasonal storage technologies.
Abstract: Energy storage at all timescales, including the seasonal scale, plays a pivotal role in enabling increased penetration levels of wind and solar photovoltaic energy sources in power systems. Grid-integrated seasonal energy storage can reshape seasonal fluctuations of variable and uncertain power generation by reducing energy curtailment, replacing peak generation capacity, and providing transmission benefits. Most current literature focuses on technology cost assessments and does not characterize the potential grid benefits of seasonal storage to capture the most cost-effective solutions. We propose a model-based approach for comprehensive techno-economic assessments of grid-integrated seasonal storage. The approach has two major advantages compared to those presented in the literature. First, we do not make assumptions about the operation of the storage device, including annual cycles, asset utilization or depth of discharge. Rather, a model is used to calculate optimal storage operation profiles. Second, the model-based approach accounts for avoided power system costs, which allows us to estimate the cost effectiveness of different types of storage devices. We assess the cost competitiveness of three specific storage technologies including pumped hydro, compressed air, and hydrogen seasonal storage and explore the conditions (cost, storage duration, and efficiency) that encourage cost competitiveness for seasonal storage technologies. This study considers the Western U.S. power system with 24% to 61% of variable renewable power sources on an annual energy basis (up to 83.5% of renewable energy including hydro, geothermal, and biomass power sources). Our results indicate that for the Western U.S. power system, pumped hydro and compressed air energy storage with 1 day of discharge duration are expected to be cost-competitive in the near future. In contrast, hydrogen storage with up to 1 week of discharge duration could be cost-effective in the near future if power and energy capacity capital costs are equal to or less than ∼US$1507 kW−1 and ∼US$1.8 kWh−1 by 2025, respectively. However, based on projected power and energy capacity capital costs for 2050, hydrogen storage with up to 2 weeks of discharge duration is expected to be cost-effective in future power systems. Moreover, storage systems with greater discharge duration could be cost-competitive in the near future if greater renewable penetration levels increase arbitrage or capacity value, significant energy capital cost reductions are achieved, or revenues from additional services and new markets—e.g., reliability and resiliency—are monetized.

Journal ArticleDOI
TL;DR: The deposition of MIL-96(Al) MOF thin films via the Langmuir-Blodgett (LB) method on the IDE chips showed an increase in the water selectivity and sensitivity, while those of methanol showed a huge decrease, which proves the feasibility of the LB technique for the fabrication of ordered MOf thin films onto IDE chips using very small MOF quantities.
Abstract: The successful development of modern gas sensing technologies requires high sensitivity and selectivity coupled to cost effectiveness, which implies the necessity to miniaturize devices while reducing the amount of sensing material. The appealing alternative of integrating nanoparticles of a porous metal-organic framework (MOF) onto capacitive sensors based on interdigitated electrode (IDE) chips is presented. We report the deposition of MIL-96(Al) MOF thin films via the Langmuir-Blodgett (LB) method on the IDE chips, which allowed the study of their gas/vapor sensing properties. First, sorption studies of several organic vapors like methanol, toluene, chloroform, etc. were conducted on bulk MOF. The sorption data revealed that MIL-96(Al) presents high affinity toward water and methanol. Later on, ordered LB monolayer films of MIL-96(Al) particles of ∼200 nm were successfully deposited onto IDE chips with homogeneous coverage of the surface in comparison to conventional thin film fabrication techniques such as drop-casting. The sensing tests showed that MOF LB films were selective for water and methanol, and short response/recovery times were achieved. Finally, chemical vapor deposition (CVD) of a porous thin film of Parylene C (thickness ∼250-300 nm) was performed on top of the MOF LB films to fabricate a thin selective layer. The sensing results showed an increase in the water selectivity and sensitivity, while those of methanol showed a huge decrease. These results prove the feasibility of the LB technique for the fabrication of ordered MOF thin films onto IDE chips using very small MOF quantities.

Journal ArticleDOI
TL;DR: In this article, the authors review the current status of carbon capture technologies including absorption, adsorption, membrane, biological capture and cryogenic separation, and compare their advantages and disadvantages.
Abstract: Climate change has become a worldwide concern with the rapid rise of the atmospheric CO2 concentration. To mitigate CO2 emissions, the research and development (R&D) efforts in CO2 capture and separation both from the stationary sources with high CO2 concentrations (e.g., coal-fired power plants flue gas) and directly from the atmosphere have grown significantly. Much progress has been achieved, especially within the last twenty years. In this perspective, we first briefly review the current status of carbon capture technologies including absorption, adsorption, membrane, biological capture and cryogenic separation, and compare their advantages and disadvantages. Then we focus mainly on the recent advances in the absorption, adsorption and membrane technologies. Even though numerous optimizations in materials and processes have been pursued, implementing a single separation process is still quite energy-intensive or costly. To address the challenges, we provide our perspectives on future directions of CO2 capture research and development, i.e., the combination of flue gas recycling and hybrid capture system, and one-step integrated CO2 capture and conversion system, as they have the potential to overcome the technical bottlenecks of single capture technologies, offering significant improvement in energy efficiency and cost effectiveness.

Journal ArticleDOI
13 Aug 2020-PLOS ONE
TL;DR: An umbrella review of systematic reviews finds that telemedicine interventions can improve glycemic control in diabetic patients; reduce mortality and hospitalization due to chronic heart failure; help patients manage pain and increase their physical activity; improve mental health, diet quality and nutrition; and reduce exacerbations associated with respiratory diseases like asthma.
Abstract: Introduction Patients and policy makers alike have high expectations for the use of digital technologies as tools to improve health care service quality at a sustainable cost. Many countries within the Organisation for Economic Co-operation and Development (OECD) are investing in telemedicine initiatives, and a large and growing body of peer-reviewed studies on the topic has developed, as a consequence. Nonetheless, telemedicine is still not used at scale within the OECD. Seeking to provide a snapshot of the evidence on the use of telemedicine in the OECD, this umbrella review of systematic reviews summarizes findings on four areas of policy relevance: clinical and cost-effectiveness, patient experience, and implementation. Methods This review followed a prior written, unregistered protocol. Four databases (PubMed/Medline, CRD, and Cochrane Library) were searched for systematic reviews or meta-analyses published between January 2014 and February 2019. Based on the inclusion criteria, 98 systematic reviews were selected for analysis. Due to substantial heterogeneity, a meta-analysis was not conducted. The quality of included reviews was assessed using the AMSTAR 2 tool. Results Most reviews (n = 53) focused on effectiveness, followed by cost-effectiveness (n = 18), implementation (n = 17) and patient experience (n = 15). Eighty-three percent of clinical effectiveness reviews found telemedicine at least as effective as face-to-face care, and thirty-nine percent of cost-effectivenss reviews found telemedicine to be cost saving or cost-effective. Patients reported high acceptance of telemedicine and the most common barriers to implementation were usability and lack of reimbursement. However, the methodological quality of most reviews was low to critically low which limits generalizability and applicability of findings. Conclusion This umbrella review finds that telemedicine interventions can improve glycemic control in diabetic patients; reduce mortality and hospitalization due to chronic heart failure; help patients manage pain and increase their physical activity; improve mental health, diet quality and nutrition; and reduce exacerbations associated with respiratory diseases like asthma. In certain disease and specialty areas, telemedicine may be a less effective way to deliver care. While there is evidence that telemedicine can be cost-effective, generalizability is hindered by poor quality and reporting standards. This umbrella review also finds that patients report high levels of acceptance and satisfaction with telemedicine interventions, but that important barriers to wider use remain.

Journal ArticleDOI
01 Mar 2020-Small
TL;DR: An efficient surface engineering strategy is proposed to significantly improve the electric conductivity, Zn ion diffusion rate, and cycling stability of the MoO3 cathode for ZIBs, thus drastically promoting its electrochemical properties.
Abstract: Aqueous Zn-ion batteries (ZIBs) have garnered the researchers' spotlight owing to its high safety, cost effectiveness, and high theoretical capacity of Zn anode. However, the availability of cathode materials for Zn ions storage is limited. With unique layered structure along the [010] direction, α-MoO3 holds great promise as a cathode material for ZIBs, but its intrinsically poor conductivity severely restricts the capacity and rate capability. To circumvent this issue, an efficient surface engineering strategy is proposed to significantly improve the electric conductivity, Zn ion diffusion rate, and cycling stability of the MoO3 cathode for ZIBs, thus drastically promoting its electrochemical properties. With the synergetic effect of Al2 O3 coating and phosphating process, the constructed Zn//P-MoO3-x @Al2 O3 battery delivers impressive capacity of 257.7 mAh g-1 at 1 A g-1 and superior rate capability (57% capacity retention at 20 A g-1 ), dramatically surpassing the pristine Zn//MoO3 battery (115.8 mAh g-1 ; 19.7%). More importantly, capitalized on polyvinyl alcohol gel electrolyte, an admirable capacity (19.2 mAh cm-3 ) as well as favorable energy density (14.4 mWh cm-3 ; 240 Wh kg-1 ) are both achieved by the fiber-shaped quasi-solid-state ZIB. This work may be a great motivation for further research on molybdenum or other layered structure materials for high-performance ZIBs.

Posted ContentDOI
14 Feb 2020-medRxiv
TL;DR: It is predicted that a CoVID-19 outbreak will peak 126 to 147 days after the start of person-to-person transmission in England and Wales in the absence of controls, assuming biological parameters remain unchanged, and the epidemic peak would occur in June.
Abstract: Background An outbreak of a novel coronavirus, named CoVID-19, was first reported in China on 31 December 2019. As of 9 February 2020, cases have been reported in 25 countries, including probable cases of human-to-human transmission in England. Methods We adapted an existing national-scale metapopulation model to capture the spread of CoVID-19 in England and Wales. We used 2011 census data to capture population sizes and population movement, together with parameter estimates from the current outbreak in China. Results We predict that a CoVID-19 outbreak will peak 126 to 147 days (∼4 months) after the start of person-to-person transmission in England and Wales in the absence of controls, assuming biological parameters remain unchanged. Therefore, if person-to-person transmission persists from February, we predict the epidemic peak would occur in June. The starting location has minimal impact on peak timing, and model stochasticity varies peak timing by 10 days. Incorporating realistic parameter uncertainty leads to estimates of peak time ranging from 78 days to 241 days after person-to-person transmission has been established. Seasonal changes in transmission rate substantially impact the timing and size of the epidemic peak, as well as the total attack rate. Discussion We provide initial estimates of the potential course of CoVID-19 in England and Wales in the absence of control measures. These results can be refined with improved estimates of epidemiological parameters, and permit investigation of control measures and cost effectiveness analyses. Seasonal changes in transmission rate could shift the timing of the peak into winter months, which will have important implications for health-care capacity planning.

Journal ArticleDOI
TL;DR: To estimate the cost‐effectiveness of dapagliflozin added to standard therapy, vs. standard therapy only, in patients with heart failure (HF) with reduced ejection fraction (HFrEF), from the perspective of UK, German, and Spanish payers.
Abstract: AIM:To estimate the cost-effectiveness of dapagliflozin added to standard therapy, versus standard therapy only, in patients with heart failure (HF) with reduced ejection fraction, from the perspective of UK, German, and Spanish payers. METHODS AND RESULTS:A lifetime Markov model was built to estimate outcomes in patients with HFrEF. Health states were defined by Kansas City Cardiomyopathy Total Symptom Score, type 2 diabetes and worsening HF events. The incidence of worsening HF and all-cause mortality was estimated using negative binomial regression models and parametric survival analysis, respectively. Direct healthcare costs (2019 British pounds/Euro) and patient-reported outcomes (EQ-5D) were sourced from the existing literature and the Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure trial (DAPA-HF), respectively; the median duration of follow-up in DAPA-HF was 18.2 months (range: 0-27.8). Future costs and effects were discounted at 3.0% for the Spanish and German analyses and 3.5% for the UK analysis. In the UK setting, treatment with dapagliflozin was estimated to increase life-years and quality-adjusted life-years (QALYs) from 5.62 to 6.20 (+0.58) and 4.13 to 4.61 (+0.48), respectively, and reduce lifetime hospitalisations for HF (925 and 820 events per 1,000 patients for placebo and dapagliflozin, respectively). Similar results were obtained for Germany and Spain. The incremental cost-effectiveness ratios were £5,822, €5,379 and €9,406/QALY in the UK, Germany and Spain, respectively. In probabilistic sensitivity analyses, more than 90% of simulations were cost-effective at a willingness-to-pay threshold of £20,000/QALY in UK and €20,000/QALY in Germany and Spain. CONCLUSION:Dapagliflozin is likely to be a cost-effective treatment for HFrEF in the UK, German and Spanish healthcare systems. This article is protected by copyright. All rights reserved.

Journal ArticleDOI
TL;DR: In this article, a fly ash-based alkali-activated mortars (AAM) was used to replace ground blast furnace slag (GBFS) for glass bottles waste Nano powder (BGWNP) by replacing ground blast furnaces with fly ash based alkali activated mortars.

Journal ArticleDOI
TL;DR: In this paper, the authors reviewed the current trends in catalyst development considering the aspects of supports, metals, and promoters as an effort to find possible solutions for the limitations of Ni-based catalysts.