Showing papers on "Cost effectiveness published in 2021"

Regulation methods for the Zn/electrolyte interphase and the effectiveness evaluation in aqueous Zn-ion batteries

Abstract: Aqueous Zn-ion batteries (ZIBs) have inspired an overwhelming number of literature studies due to their safety, cost effectiveness, and environmental benignity. Directly employing metallic Zn foil as an anode significantly simplifies battery manufacturing and simultaneously broadens the operating voltage window of aqueous batteries, benefiting from its high overpotential against electrolyte decomposition. Nevertheless, serious issues, such as dendrite growth and side reactions, occurring at the Zn/electrolyte interphase, make the Coulombic efficiency and lifespan of Zn metal electrodes far from satisfactory, which has also been motivating new research interest in interfacial engineering to solve these problems. Owing to the rapid evolution of this new area, it is highly desirable to provide current and timely updates of interfacial strategies and their effectiveness evaluation. From the two sides – the electrode and the electrolyte at the interphase – this review thoroughly summarizes our fundamental understanding of interfacial strategies, including designing mechanisms, creating new methods, and technical challenges. Importantly, this review also analyses the effectiveness evaluation techniques for interfacial strategies, including electrochemical methods, characterization measurements, and computational simulations, providing guidelines for the accurate evaluation and analysis of ZIBs in the future.

Fortified-Chain: A Blockchain-Based Framework for Security and Privacy-Assured Internet of Medical Things With Effective Access Control

Abstract: The rapid developments in the Internet of Medical Things (IoMT) help the smart healthcare systems to deliver more sophisticated real-time services. At the same time, IoMT also raises many privacy and security issues. Also, the heterogeneous nature of these devices makes it challenging to develop a common security standard solution. Furthermore, the existing cloud-centric IoMT healthcare systems depend on cloud computing for electrical health records (EHR) and medical services, which is not suggestible for a decentralized IoMT healthcare systems. In this article, we have proposed a blockchain-based novel architecture that provides a decentralized EHR and smart-contract-based service automation without compromising with the system security and privacy. In this architecture, we have introduced the hybrid computing paradigm with the blockchain-based distributed data storage system to overcome blockchain-based cloud-centric IoMT healthcare system drawbacks, such as high latency, high storage cost, and single point of failure. A decentralized selective ring-based access control mechanism is introduced along with device authentication and patient records anonymity algorithms to improve the proposed system’s security capabilities. We have evaluated the latency and cost effectiveness of data sharing on the proposed system using Blockchain. Also, we conducted a logical system analysis, which reveals that our architecture-based security and privacy mechanisms are capable of fulfilling the requirements of decentralized IoMT smart healthcare systems. Experimental analysis proves that our fortified-chain-based H-CPS needs insignificant storage and has a response time in the order of milliseconds as compared to traditional centralized H-CPS while providing decentralized automated access control, security, and privacy.

Cost-Effective App Data Distribution in Edge Computing

Abstract: Edge computing, as an extension of cloud computing, distributes computing and storage resources from centralized cloud to distributed edge servers, to power a variety of applications demanding low latency, e.g., IoT services, virtual reality, real-time navigation, etc. From an app vendor's perspective, app data needs to be transferred from the cloud to specific edge servers in an area to serve the app users in the area. However, according to the pay-as-you-go business model, distributing a large amount of data from the cloud to edge servers can be expensive. The optimal data distribution strategy must minimize the cost incurred, which includes two major components, the cost of data transmission between the cloud to edge servers and the cost of data transmission between edge servers. In the meantime, the delay constraint must be fulfilled - the data distribution must not take too long. In this article, we make the first attempt to formulate this Edge Data Distribution (EDD) problem as a constrained optimization problem from the app vendor's perspective and prove its $\mathcal {NP}$ NP -hardness. We propose an optimal approach named EDD-IP to solve this problem exactly with the Integer Programming technique. Then, we propose an $O(k)$ O ( k ) -approximation algorithm named EDD-A for finding approximate solutions to large-scale EDD problems efficiently. EDD-IP and EDD-A are evaluated on a real-world dataset and the results demonstrate that they significantly outperform three representative approaches.

An overview of factors influencing thermal conductivity of building insulation materials

Abstract: Solving the matter of traditional energy consumption and finding the proper alternative resources are vital keys to a sustainable development policy. In recent years, many different thermal insulation materials have been developed for better energy efficiency and less environment damage. These products have confirmed their usefulness in buildings due to their benefits such as low density, high thermal resistance , and cost effectiveness. The efficiency of thermal insulation depends on their thermal conductivity and their ability to maintain their thermal characteristics over a period of time. This study presents factors influencing the thermal conductivity coefficient of three main groups including conventional, alternative, and new advanced materials. The most common factors are moisture content, temperature difference, and bulk density. Other factors are explained in some dependent studies such as airflow velocity , thickness, pressure, and material aging. The relationship between the thermal conductivity values with the mean temperature, moisture content, and density which were obtained from experimental investigation has also been summarized. Finally, uncertainty about the thermal conductivity value of some common insulation materials is also reviewed as the basis of selecting or designing the products used in building envelopes.

Deployment of electric vehicles in China to meet the carbon neutral target by 2060: Provincial disparities in energy systems, CO2 emissions, and cost effectiveness

Abstract: Switching to electricity in the ground transport sector is considered a promising way to achieve the energy transition and CO2 emission reductions required to meet China's carbon neutral target by 2060. In this study, a transport energy model containing an elaborate transport demand model and a technology bottom-up model for detailed behavioral and technological representations was developed to investigate how electric vehicles (EVs) will penetrate the markets in the long-term and what impacts on energy consumption and emissions would emerge following EV adoption in China at the provincial level. A set of scenarios was created based on different policy interventions for the promotion of electric mobility. The results showed that subsidies for EV adoption would significantly boost the market share and foster a rapid transition away from fossil fuels, while the business-as-usual scenario would only generate a moderate influence on EV penetration. The regional differences in the emission reduction potential due to EV subsidies across the 31 provinces indicated that policy instruments for EV promotion would have significant positive effects in the developed provinces in both the capital metropolitan area and southeastern China. An economic cost analysis revealed a relatively low economic feasibility in northeastern and northwestern regions where the emission reduction potential is also lower than the national average, implying that the developing provinces in northeastern and northwestern China require greater financial assistance and the establishment of supportive policies for EV promotion.

Can we manage fisheries with the inherent uncertainty from eDNA

Abstract: Environmental (e)DNA, as a general approach in aquatic systems, seeks to connect the presence of species' genetic material in the water and hence to infer the species' physical presence. However, fisheries managers face making decisions with risk and uncertainty when eDNA indicates a fish is present but traditional methods fail to capture the fish. In comparison with traditional methods such as nets, electrofishing and piscicides, eDNA approaches have more sources of underlying error that could give rise to false positives. This has resulted in some managers to question whether eDNA can be used to make management decisions because there is no fish in hand. As a relatively new approach, the methods and techniques have quickly evolved to improve confidence in eDNA. By evaluating an eDNA based research programmes through the pattern of the eDNA signal, assay design, experimental design, quality assurance and quality control checks, data analyses and concurrent search for fish using traditional gears, the evidence for fish presence can be evaluated to build confidence in the eDNA approach. The benefits for fisheries management from adopting an eDNA approach are numerous but include cost effectiveness, broader geographic coverage of habitat occupancy, early detection of invasive species, non-lethal stock assessments, exploration of previously inaccessible aquatic environments and discovery of new species hidden beneath the water's surface. At a time when global freshwater and marine fisheries are facing growing threats from over-harvest, pollution and climate change, we anticipate that growing confidence in eDNA will overcome the inherent uncertainty of not having a fish in hand and will empower the informed management actions necessary to protect and restore our fisheries.

Comparative cost-effectiveness of SARS-CoV-2 testing strategies in the USA: a modelling study.

Abstract: Summary Background To mitigate the COVID-19 pandemic, countries worldwide have enacted unprecedented movement restrictions, physical distancing measures, and face mask requirements Until safe and efficacious vaccines or antiviral drugs become widely available, viral testing remains the primary mitigation measure for rapid identification and isolation of infected individuals We aimed to assess the economic trade-offs of expanding and accelerating testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) across the USA in different transmission scenarios Methods We used a multiscale model that incorporates SARS-CoV-2 transmission at the population level and daily viral load dynamics at the individual level to assess eight surveillance testing strategies that varied by testing frequency (from daily to monthly testing) and isolation period (1 or 2 weeks), compared with the status-quo strategy of symptom-based testing and isolation For each testing strategy, we first estimated the costs (incorporating costs of diagnostic testing and admissions to hospital, and salary lost while in isolation) and years of life lost (YLLs) prevented under rapid and low transmission scenarios We then assessed the testing strategies across a range of scenarios, each defined by effective reproduction number (Re), willingness to pay per YLL averted, and cost of a test, to estimate the probability that a particular strategy had the greatest net benefit Additionally, for a range of transmission scenarios (Re from 1·1 to 3), we estimated a threshold test price at which the status-quo strategy outperforms all testing strategies considered Findings Our modelling showed that daily testing combined with a 2-week isolation period was the most costly strategy considered, reflecting increased costs with greater test frequency and length of isolation period Assuming a societal willingness to pay of US$100 000 per YLL averted and a price of $5 per test, the strategy most likely to be cost-effective under a rapid transmission scenario (Re of 2·2) is weekly testing followed by a 2-week isolation period subsequent to a positive test result Under low transmission scenarios (Re of 1·2), monthly testing of the population followed by 1-week isolation rather than 2-week isolation is likely to be most cost-effective Expanded surveillance testing is more likely to be cost-effective than the status-quo testing strategy if the price per test is less than $75 across all transmission rates considered Interpretation Extensive expansion of SARS-CoV-2 testing programmes with more frequent and rapid tests across communities coupled with isolation of individuals with confirmed infection is essential for mitigating the COVID-19 pandemic Furthermore, resources recouped from shortened isolation duration could be cost-effectively allocated to more frequent testing Funding US National Institutes of Health, US Centers for Disease Control and Prevention, and Love, Tito's

Economic and Sustainability of Biodiesel Production — A Systematic Literature Review

Abstract: As Earth’s fossil energy resources are limited, there is a growing need for renewable resources such as biodiesel. That is the reason why the social, economic and environmental impacts of biofuels became an important research topic in the last decade. Depleted stocks of crude oil and the significant level of environmental pollution encourage researchers and professionals to seek and find solutions. The study aims to analyze the economic and sustainability issues of biodiesel production by a systematic literature review. During this process, 53 relevant studies were analyzed out of 13,069 identified articles. Every study agrees that there are several concerns about the first-generation technology; however, further generations cannot be price-competitive at this moment due to the immature technology and high production costs. However, there are promising alternatives, such as wastewater-based microalgae with up to 70% oil content, fat, oils and grease (FOG), when production cost is below 799 USD/gallon, and municipal solid waste-volatile fatty acids technology, where the raw material is free. Proper management of the co-products (mainly glycerol) is essential, especially at the currently low petroleum prices (0.29 USD/L), which can only be handled by the biorefineries. Sustainability is sometimes translated as cost efficiency, but the complex interpretation is becoming more common. Common elements of sustainability are environmental and social, as well as economic, issues.

Vanadium-based cathodes for aqueous zinc-ion batteries: from crystal structures, diffusion channels to storage mechanisms

Abstract: Aqueous zinc ion batteries employing metallic zinc anodes and aqueous electrolytes are highly attractive electrochemical energy storage devices owing to their cost effectiveness, intrinsic safety, elemental abundance and competitive gravimetric energy density. Compared with other cathode materials, vanadium-based compounds feature advantages such as higher capacity, higher power density and longer cycle life. Here, a comprehensive review is presented on recent advances of vanadium-based cathodes, focusing on the correlation between the structures and electrode performances as well as energy-storage mechanisms. The structure and electrochemical properties of vanadium-based cathode materials are discussed by categorizing Zn2+ diffusion channels including one-dimensional tunnels, two-dimensional planes, three-dimensional interpenetrating networks and zero-dimensional diffusion channels. Furthermore, the remaining issues of vanadium-based cathodes are highlighted and promising performance-enhancement strategies are overviewed from aspects such as lattice control, vacancy/defect engineering, and pre-intercalation of cations and/or molecules.

A critical review over the electrochemical disinfection of bacteria in synthetic and real wastewaters using a boron-doped diamond anode

Abstract: Inadequate access to clean water and sanitation are the most relevant problems afflicting developing and industrialized nations. Global water scarcity is expected to grow worse in the coming decades and this has motivated the scientific community to identify new, safe, and robust water disinfection technologies at lower cost and with less energy, diminishing the use of chemicals and impact on the environment. Usually, conventional methods of water treatment can solve this problem satisfactorily, such as chlorination, but, sometimes, they can be chemically, energetically, and operationally intensive. Therefore, the science and technology has encouraged the development of other alternative disinfection technologies. In this frame, electrochemical disinfection or electrodisinfection is currently experiencing a renaissance due to the tremendous contributions of novel electrocatalytic materials as well as the use of electric current as an inexpensive and suitable reagent to drive the inactivation of waterborne pathogens, avoiding conventional chemical oxidizers or reducing agents. Electrodisinfection has a significant technical impact, because it can be easily scaled up or design small–portable devices, benefiting from advantages such as versatility, environmental compatibility, automation, inherent safety, and potential cost effectiveness among others. Diamond films emerge as a novel and sustainable solution to electrogenerate powerful oxidants for effectively controlling waterborne pathogens in drinking water. The overarching goal of this critical review is to evidence the importance of diamond electrochemical methods as alternative for the eradication of waterborne infectious agents from public and drinking waters. The mechanisms of bacteria inactivation, and the fundamentals and applications of electrochemical oxidation with diamond to disinfect synthetic and real waters and wastewaters are exhaustively discussed. The use of hybrid and sequential processes involving electrochemical oxidation with other techniques, as well as endodontic and food control applications, are also analyzed. A section remarking the future challenges of electrodisinfection with diamond is finally presented.

Detection of Li-ion battery failure and venting with Carbon Dioxide sensors

Abstract: Li-ion battery thermal runaway is a critical safety issue for Electric Vehicles. The proposed global technical regulation No. 20 by the United Nations on Electric Vehicle Safety requires an advanced warning 5 minutes prior to the evolution of hazardous conditions caused by thermal runaway. To achieve this 5-min advanced warning, a robust and sensitive detection methodology is required. Gas venting is often a precursor of thermal runaway, and therefore the use of gas-based detection method was evaluated in this paper to explore its response and implementation within a battery pack. The composition of battery vent-gas during a thermal runaway event includes CO2, CO, H2 and volatile organic compounds (VOCs). Among these gas species, there is still some debate about which is most suitable for detection. To resolve this debate, the composition of vent-gas under different testing conditions is summarized from the literature and CO2 is proposed as the target gas species due to its significant presence and early occurrence in all venting events. After evaluating available sensors, the Non-Dispersive Infrared (NDIR) CO2 sensor is considered due to its robustness and cost effectiveness. To further clarify the responsiveness of the NDIR CO2 sensor, an overcharging experiment leading to cell venting was conducted with a prototype gas sensor suite. The measured CO2 concentrations of over 30,000 ppm were detected with the gas sensor. Lastly, we demonstrate how a representative venting experiment of a single cell can be used to guide and set the sensed CO2 threshold that will trigger an alarm in a battery pack volume.

Current technologies for recovery of metals from industrial wastes: An overview

Abstract: Fast industrialization has increased the demand for heavy metals, on the other hand, high-grade ore natural reserves are belittling. Therefore, alternative sources of heavy metals need to be investigated. Massive amounts of industrial wastes are being generated annually. The majority is sent to landfills or to incinerators, which eventually poses environmental challenges such as ecological contamination and health hazards to living beings. Such industrial wastes contain hazardous elements of various metals (Au, Ag, Ni, Mo, Co, Cu, Zn, and Cr), whose improper disposal leads to adverse effects to human being and the environment. As a result, methods for industrial waste management such as reuse, remanufacturing, and recycling have received much attention due to the fact that they improve cost effectiveness over time and enable the metal recovery businesses to thrive profitably. The present study provides a state of art review on the current technologies existing for the recovery of precious metals from industrial wastes streams to analyse the sustainability. Among the wastes, spent petroleum catalysts, medical waste, electronic scraps, battery wastes, metal finishing industry waste, and fly ash are some of the largest industrially-generated wastes. Various metal recovery processes involve physical, chemical, and thermal characteristics of waste streams and target metals for separation and extraction. The current challenges of pyrometallurgy, modification on the hydrometallurgy, physical and chemical methods and other advanced technologies are presented in this review. The hydrometallurgical method, which involves dissolving and leaching, is a proven and successful process for recovering metals from various raw materials. Several other recovery methods have been proposed and are currently being implemented; the problem is that most of them are only successful in retrieving certain metals based on specific properties of industrial waste. The recovered metal solutions are further concentrated and purified using adsorption, cementation, chemical precipitation, ion exchange, membrane filtration and ion flotation techniques, which can also be applied to other liquid waste streams. The recovery method only makes sense if the recovery cost is much less than the value of the precious metal. The limitations placed on waste disposal and stringent environmental legislation require environmental-friendly metal recovery technologies. This review paper provides critical information that enables researchers to identify a proper method for metal recovery from different industrial wastes, and also it benefits researchers and stakeholders in determining research directions and making waste management-related decisions.

A Chemical map of NaSiCON electrode materials for sodium-ion batteries

Abstract: Na-ion batteries are promising devices for smart grids and electric vehicles due to cost effectiveness arising from the overall abundance of sodium (Na) and its even geographical distribution. Among other factors, the energy density of Na-ion batteries is limited by the positive electrode chemistry. NaSICON-based positive electrode materials are known for their wide range of electrochemical potentials, high ionic conductivity, and most importantly their structural and thermal stabilities. Using first- principles calculations, we chart the chemical space of 3d transition metal-based NaSICON phosphates of formula NaxMM’(PO4)3 (with M and M’= Ti, V, Cr, Mn, Fe, Co and Ni), to analyze their thermodynamic stabilities and the intercalation voltages for Na+ ions. Specifically, we computed the Na insertion voltages and related properties of 28 distinct NaSICON compositions. We investigated the thermodynamic stability of Na-intercalation in previously unreported NaxMn2(PO4)3 and NaxVCo(PO4)3 . The calculated quaternary phase diagrams of the Na-P-O-Co and Na-P-O-Ni chemical systems explain the origin of the suspected instability of Ni and Co-based NaSICON compositions. From our analysis, we are also able to rationalize anomalies in previously reported experimental data in this diverse and important chemical space.

Fuzzy Integral-Based CNN Classifier Fusion for 3D Skeleton Action Recognition

Abstract: Action recognition based on skeleton key joints has gained popularity due to its cost effectiveness and low complexity. Existing Convolutional Neural Network (CNN) based models mostly fail to capture various aspects of the skeleton sequence. To this end, four feature representations, which capture complementary characteristics of the sequence of key joints, are extracted with novel contribution of features estimated from angular information, and kinematics of the human actions. Single channel grayscale images are used to encode these features for classification using four CNNs, with the complementary nature verified through Kullback-Leibler (KL) and Jensen-Shannon (JS) divergences. As opposed to straightforward classifier combination generally used in existing literature, fuzzy fusion through the Choquet integral leverages the degree of uncertainty of decision scores obtained from four CNNs. Experimental results support the efficacy of fuzzy combination of CNNs to adaptively generate final decision score based upon confidence of each information source. Impressive results on the challenging UTD-MHAD, HDM05, G3D, and NTU RGB+D 60 and 120 datasets demonstrate the effectiveness of the proposed method. The source code for our method is available at https://github.com/theavicaster/fuzzy-integral-cnn-fusion-3d-har

A nationwide survey of online teaching strategies in dental education in China

Abstract: Objectives Due to the time and cost effectiveness, online teaching has played a significant role in the provision of education and has been a well-accepted strategy for higher education in the world. The aim of this study was to survey the current online undergraduate education status in dental medicine in mainland China during the critical stage of the COVID-19 outbreak, as well to provide a better understanding of practicing this learning strategy for the improvement and development of dental education. Methods For the cross-sectional survey, recruitment emails regarding to the implementation of online education were sent to 42 dental colleges and universities in mainland China between March and April 2020. Results Ninety-seven percent of the respondents have opened online courses during COVID-19 pandemic in China, 74% of which chose live broadcast as the major teaching way. As compared with theoretical courses, fewer specialized practical curriculums were set up online with a lower satisfaction from students in most dental schools. For the general evaluation of online learning from students of different dental schools, the "online learning content" received the highest support, while the "interaction between teachers and students" showed the lowest satisfaction. Most schools reported that the difficulty in assurance of students' learning motivation was the main problem in online education. Conclusions Our findings indicate the necessity and efficacy of the overall online teaching for dental education during the epidemic that can be further improved with the education model and pedagogical means to boost the informationization of dental education for future reference.

Rituximab for the treatment of multiple sclerosis: a review

Abstract: In the last decades, evidence suggesting the direct or indirect involvement of B cells on multiple sclerosis (MS) pathogenesis has accumulated. The increased amount of data on the efficacy and safety of B-cell-depleting therapies from several studies has suggested the addition of these drugs as treatment options to the current armamentarium of disease modifying therapies (DMTs) for MS. Particularly, rituximab (RTX), a chimeric monoclonal antibody directed at CD20 positive B lymphocytes resulting in cell-mediated apoptosis, has been demonstrated to reduce inflammatory activity, incidence of relapses and new brain lesions on magnetic resonance imaging (MRI) in patients with relapsing-remitting MS (RRMS). Additional evidence also demonstrated that patients with progressive MS (PMS) may benefit from RTX, which also showed to be well tolerated, with acceptable safety risks and favorable cost-effectiveness profile.Despite these encouraging results, RTX is currently approved for non-Hodgkin's lymphoma, chronic lymphocytic leukemia, several forms of vasculitis and rheumatoid arthritis, while it can only be administered off-label for MS treatment. Between Northern European countries exist different rules for using not licensed drug for treating MS. The Sweden MS register reports a high rate (53.5%) of off-label RTX prescriptions in relation to other annually started DMTs to treat MS patients, while Danish and Norwegian neurologists have to use other anti-CD20 drugs, as ocrelizumab, in most of the cases.In this paper, we review the pharmacokinetics, pharmacodynamics, clinical efficacy, safety profile and cost effectiveness aspects of RTX for the treatment of MS. Particularly, with the approval of new anti-CD20 DMTs, the recent worldwide COVID-19 emergency and the possible increased risk of infection with this class of drugs, this review sheds light on the use of RTX as an alternative treatment option for MS management, while commenting the gaps of knowledge regarding this drug.

Cost-effectiveness of intensive care for hospitalized COVID-19 patients: experience from South Africa.

Abstract: Given projected shortages of critical care capacity in public hospitals during the COVID-19 pandemic, the South African government embarked on an initiative to purchase this capacity from private hospitals. In order to inform purchasing decisions, we assessed the cost-effectiveness of intensive care management for admitted COVID-19 patients across the public and private health systems in South Africa. Using a modelling framework and health system perspective, costs and health outcomes of inpatient management of severe and critical COVID-19 patients in (1) general ward and intensive care (GW + ICU) versus (2) general ward only (GW) were assessed. Disability adjusted life years (DALYs) were evaluated and the cost per admission in public and private sectors was determined. The model made use of four variables: mortality rates, utilisation of inpatient days for each management approach, disability weights associated with severity of disease, and the unit cost per general ward day and per ICU day in public and private hospitals. Unit costs were multiplied by utilisation estimates to determine the cost per admission. DALYs were calculated as the sum of years of life lost (YLL) and years lived with disability (YLD). An incremental cost-effectiveness ratio (ICER) - representing difference in costs and health outcomes of the two management strategies - was compared to a cost-effectiveness threshold to determine the value for money of expansion in ICU services during COVID-19 surges. A cost per admission of ZAR 75,127 was estimated for inpatient management of severe and critical COVID-19 patients in GW as opposed to ZAR 103,030 in GW + ICU. DALYs were 1.48 and 1.10 in GW versus GW + ICU, respectively. The ratio of difference in costs and health outcomes between the two management strategies produced an ICER of ZAR 73,091 per DALY averted, a value above the cost-effectiveness threshold of ZAR 38,465. Results indicated that purchasing ICU capacity from the private sector during COVID-19 surges may not be a cost-effective investment. The ‘real time’, rapid, pragmatic, and transparent nature of this analysis demonstrates an approach for evidence generation for decision making relating to the COVID-19 pandemic response and South Africa’s wider priority setting agenda.

The rising zinc anodes for high-energy aqueous batteries

Abstract: Aqueous zinc-metal batteries have gained widespread attention because of their high safety, large capacity, cost effectiveness, and environmental friendliness . However, zinc anodes have long encountered with dendrite formation, inferior cycle life and low coulombic efficiency, which severely hinder the practical application. Here, the latest advances of zinc metal anodes for aqueous zinc-metal batteries are reviewed. The merits of zinc metal anodes, the reaction mechanisms in different media, and the issues faced are firstly summarized. Then the prominent progresses of zinc anodes in aqueous media are highlighted, including electrolyte optimization, host construction, interface modification, anode structure design, and working model regulation. Finally, the remaining challenges of zinc anodes are fully discussed, and the future perspectives of pursing stable zinc metal anodes by integrating multi-strategies, conducting in situ study of zinc plating/stripping behavior, exploring advanced cathode materials , and developing smart devices are also provided.

Cost-effectiveness of Atezolizumab Plus Bevacizumab vs Sorafenib as First-Line Treatment of Unresectable Hepatocellular Carcinoma

Abstract: Importance Treatment with atezolizumab plus bevacizumab may prolong overall survival among patients with unresectable hepatocellular carcinoma. However, to our knowledge, the cost-effectiveness of using this high-priced therapy for this indication is currently unknown. Objective To evaluate the cost-effectiveness of atezolizumab plus bevacizumab to treat unresectable hepatocellular carcinoma from the US payer perspective. Design, Setting, and Participants This economic evaluation used a partitioned survival model consisting of 3 discrete health states to assess the cost-effectiveness of treatment of hepatocellular carcinoma with atezolizumab plus bevacizumab vs sorafenib. The characteristics of patients in the model were similar to patients in a phase 3, open-label randomized clinical trial (IMbrave150) who had unresectable hepatocellular carcinoma and had not previously received systemic treatment. Key clinical data were generated from the IMbrave150 trial conducted between March 15, 2018, and January 30, 2019, and cost and health preference data were collected from the literature. Main Outcomes and Measures Costs, quality-adjusted life-years (QALYs), incremental cost-utility ratios, incremental net health benefits, and incremental net monetary benefits were calculated for the 2 treatment strategies. Subgroup, 1-way sensitivity, and probabilistic sensitivity analyses were performed. Results Treatment of hepatocellular carcinoma with atezolizumab plus bevacizumab added 0.530 QALYs and resulted in an incremental cost of $89 807 compared with sorafenib therapy, which had an incremental cost-utility ratio of $169 223 per QALY gained. The incremental net health benefit was −0.068 QALYs, and the incremental net monetary benefit was −$10 202 at a willingness-to-pay threshold of $150 000/QALY. The probabilistic sensitivity analysis indicated that treatment with atezolizumab plus bevacizumab achieved a 35% probability of cost-effectiveness at a threshold of $150 000/QALY. One-way sensitivity analysis revealed that the results were most sensitive to the hazard ratio of overall survival. The subgroup analysis found that treatment with atezolizumab plus bevacizumab was associated with preferred incremental net health benefits in several subgroups, including patients with hepatitis B and C. Conclusions and Relevance Atezolizumab plus bevacizumab treatment is unlikely to be a cost-effective option compared with sorafenib for patients with unresectable hepatocellular carcinoma. Reducing the prices of atezolizumab and bevacizumab may improve cost-effectiveness. The economic outcomes also may be improved by tailoring treatments based on individual patient factors.

Learning effectiveness of 360° video: experiences from a controlled experiment in healthcare education

Abstract: Recent advances in virtual reality (VR) technologies provide new opportunities for e-learning by giving the students an increased sense of presence. One of the VR technologies recently introduced t...