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Poly-gamma-glutamic acid (γ-PGA) is one of the most expensive biological macromolecules with multifarious applications in biomedical, environmental, and other sectors. One of the major challenges encountered during microbial fermentation process is the batch contamination which leads to economic losses, poor yield, and compromised quality of the desired product. Depending on the volume of the product being generated in an industrial setting, these loses maybe enormous. One strategy to tackle this issue is the fermentation under non-sterile conditions using osmophilic microbial strains. In this study, osmophilic Bacillus paralicheniformis (NCIM 5769) strain isolated from honey served as the chassis for the production of high amount of γ-PGA (dry weight of 284 g/L and productivity of 3.94 g/L/h) in batch fermentation using sucrose via non-sterile fermentation. The fermentation process design discussed in this study offers dual advantages such as hyper-osmotic stress–induced non-sterile fermentation and hyper-production of γ-PGA. Furthermore, a predictive pathway for the γ-PGA hyper-production was constructed based on the genome mining analysis which revealed the presence of sucrose utilization genes, osmotic stress–related genes, and γ-PGA biosynthesis genes. In summary, this novel non-sterilization approach will potentially reduce the cost associated with sterilization (an energy-efficient process), eventually leading to the cost-effective production of γ-PGA. Thus, our work serves as an energy-efficient platform, thereby solving the serious challenge of microbial contamination through indigenously developed non-sterile fermentation. [ABSTRACT FROM AUTHOR]

In cloud control systems, generating an efficient and economical workflow scheduling strategy for deadline-constrained workflow applications, especially in uncertain multi-workflow dynamic scheduling processes, is a crucial challenge. To optimize the total cost of workflow scheduling, the authors propose a cost-driven heuristic scheduling algorithm F-MWSA which consists of two phases: Fuzzy deadline distribution and fuzzy task scheduling. In the fuzzy deadline distribution phase, a new workflow deadline distribution strategy with fuzziness is designed to obtain the sub-deadline constraint of each task. The fuzzy task scheduling phase focuses on a cost-effective strategy to assign tasks to cloud resources, reducing multi-workflow scheduling costs. Performance evaluations on five real-world workflows demonstrate that the proposed F-MWSA outperforms the baseline policy in terms of total cost, success ratio, resource utilization, and makespan. [ABSTRACT FROM AUTHOR]

Background: Antipsychotic medications are the primary treatment for schizophrenia, with olanzapine being an effective medication for schizophrenia. The economic cost for each individual with schizophrenia is high, with antipsychotic medication being a major expense. This study aims to develop an economic decision model that compares different treatment options for schizophrenia patients, including olanzapine Orally Dispersible Tablets (ODT), olanzapine [ODT + Standard Oral Tablet (SOT)], risperidone (ODT + SOT), and aripiprazole (ODT + SOT), to determine their cost-effectiveness with an objective to optimize healthcare resource allocation in Morocco. Methods: The study used published medical literature and a clinical expert panel to develop a decision analytic model. This model was designed to capture parameters such as adherence levels, treatment discontinuation, relapse with and without hospitalization, quality-adjusted life years (QALYs), treatment-related adverse events, healthcare resource utilization, and associated costs. The main outcomes of interest included the total annual direct cost per treatment, QALYs, and incremental cost-effectiveness ratio (ICER) per 1 QALY gained. One-way and probabilistic sensitivity analyses were employed to account for parameter uncertainty. Results: According to the simulation model, the ODT and ODT + SOT as a group form of olanzapine was the most effective treatment option in terms of the lowest percentages of inpatient relapse, and patients who remained stable (11% and 79% respectively) than risperidone (19% and 62% respectively) and aripiprazole ODT (26% and 50% respectively) and ODT + SOT formulation groups. Olanzapine (ODT + SOT) therapy group was cost-effective when compared to the combined group of ODT + SOT forms of risperidone [ICER: Moroccan Dirham (MAD) 103,907], and aripiprazole (ICER: MAD 65,047). Additionally, olanzapine ODT was found to be cost-effective compared to olanzapine SOT with an ICER of MAD 3921, risperidone ODT with an ICER of MAD 1,02,298, risperidone SOT with an ICER of MAD 31,088, and aripiprazole ODT or SOT formulations. All the above ICERs fall under the willingness-to-pay threshold in Morocco of MAD 250,832.40. Sensitivity analyses confirmed the reliability of the findings. Conclusions: The model concluded that olanzapine ODT is the most cost-effective first-line treatment option for schizophrenia in Morocco when compared to other atypical antipsychotic medications in ODT and SOT formulations. [ABSTRACT FROM AUTHOR]

This study presents a novel approach to determining the soil's elastic modulus (E'), a critical parameter in geotechnical engineering, by employing derivative-based methodologies and one-dimensional consolidation test results. The main challenges of traditional methods, such as triaxial CD testing, include high costs, long duration, and complexity in data collection and analysis. This new approach addresses these challenges by applying derivative calculations at a specific reference stress point (Pref), resulting in a tangent equation that accurately represents the soil's compressive behavior. Utilizing the results from one-dimensional consolidation tests not only reduces dependence on costly triaxial CD tests but also ensures high accuracy in evaluating soil mechanical properties. The findings indicate that the E' value obtained from this new method is equivalent to that from triaxial CD tests, confirming the method's feasibility and effectiveness. The unique achievement of this research is the development of a fast, cost-effective, and efficient method for determining the soil's elastic modulus, opening new research directions in the field of geotechnical engineering. [ABSTRACT FROM AUTHOR]

The integration of robots into social environments necessitates their ability to interpret human intentions and anticipate potential outcomes accurately. This capability is particularly crucial for social robots designed for human care, as they may encounter situations that pose significant risks to individuals, such as undetected obstacles in their path. These hazards must be identified and mitigated promptly to ensure human safety. This paper delves into the artificial theory of mind (ATM) approach to inferring and interpreting human intentions within human–robot interaction. We propose a novel algorithm that detects potentially hazardous situations for humans and selects appropriate robotic actions to eliminate these dangers in real time. Our methodology employs a simulation-based approach to ATM, incorporating a "like-me" policy to assign intentions and actions to human subjects. This strategy enables the robot to detect risks and act with a high success rate, even under time-constrained circumstances. The algorithm was seamlessly integrated into an existing robotics cognitive architecture, enhancing its social interaction and risk mitigation capabilities. To evaluate the robustness, precision, and real-time responsiveness of our implementation, we conducted a series of three experiments: (i) A fully simulated scenario to assess the algorithm's performance in a controlled environment; (ii) A human-in-the-loop hybrid configuration to test the system's adaptability to real-time human input; and (iii) A real-world scenario to validate the algorithm's effectiveness in practical applications. These experiments provided comprehensive insights into the algorithm's performance across various conditions, demonstrating its potential for improving the safety and efficacy of social robots in human care settings. Our findings contribute to the growing research on social robotics and artificial intelligence, offering a promising approach to enhancing human–robot interaction in potentially hazardous environments. Future work may explore the scalability of this algorithm to more complex scenarios and its integration with other advanced robotic systems. [ABSTRACT FROM AUTHOR]

The mixing of N3 and N719 metal-complex dyes was investigated in this work to determine the effects of the combination of dyes on TiO2film for application in dye-sensitized solar cells (DSSCs). The dyes were mixed in a ratio of 1:1, and their performance in the DSSCs was measured using current–voltage curves and electrochemical impedance spectroscopy (EIS). The results indicated that the efficiency of the DSSCs increased to 7% with the addition of the N719 dye to the N3 dye. The surface morphology revealed a smooth and homogeneous distribution of TiO2 nanoparticles, and the mixed dyes showed broad absorption spectra in the visible region. The EIS results indicated a low electron recombination rate and long electron lifetime for the mixed dye-sensitized solar cells. Overall, the study demonstrated the potential for using a combination of N3 and N719 dyes to improve the efficiency of DSSCs. The employment of mixed dye as a photosensitizer in DSSCs may offer a promising approach for achieving high-performance and cost-effective DSSCs. [ABSTRACT FROM AUTHOR]

Background: Today, laparoscopy is frequently used in abdominal emergencies such as acute appendicitis. There are several techniques used to close the appendiceal stump during laparoscopic appendectomy. We aimed to compare the use of handmade loop and Hem-o-lok used to close the appendiceal stump in public hospitals where resources are limited, in terms of surgical outcomes and cost. Methods: Between January 2020 and December 2022, patients for whom handmade loops and Hem-o-loks were used to close the appendiceal stump during laparoscopic appendectomy in our clinic were included in the study. There were a total of 638 patients (mean age: 33 ± 13.5 years, 325 females and 313 males) in the patient cohort. Demographic and clinical data, duration of surgery, complications, hospital stay, pathology reports, mortality, and cost of supplies were compared between the two groups. Results: There were 308 patients in the handmade loop group (160 females, 148 males, mean age: 33.7 years, range: 18–85 years) and 330 patients in the Hem-o-lok group (166 females, 164 males, mean age: 32.5 years, range: 18–89 years). There was no significant difference between the two groups for American Society of Anesthesiologists score, duration of symptom, hospital stay, intensive care unit stay, preoperative laboratory values, histopathological results, mortality, and morbidity (P >.05). The mean operation time was 48.76 ± 16.16 minutes in the handmade loop group and 40.53 ± 11.63 minutes in the Hem-o-lok group (p = 0.001). In terms of cost, the cost per case of Hem-o-lok group was about 25.8 times as much as the group that used sutures ($31 versus $1.2). Conclusions: Both methods can be used safely in laparoscopic appendectomy. The use of Hem-o-lok has no advantage other than shortening the operation time. However, it is costlier. Especially in peripheral hospitals where resources are limited, closing the appendiceal stump using a handmade loop is an easy, safe, and cost-effective method. [ABSTRACT FROM AUTHOR]

Purpose: Environment-friendly pest management techniques are safer, sustainable over the years, better for ecosystem services, and more convenient with lower risks. Netting and or bagging is one of the most suitable tools for pest management. To develop environmentally friendly management techniques against the common cutworm (Spodoptera litura Fab.), we compared the cost-effectiveness of netting and bagging for the production of bell peppers in Bangladesh. Research Method: The study was undertaken in the field of Entomology, at Sylhet Agricultural University, Bangladesh, from October 2018 to April 2019. Netting and bagging significantly improved plant morphology, fruit quality, and yield and managed the insect pests. Findings: In this paper, we tried to bring forth different prospects of netting and bagging in bell peppers to manage the common cutworm. Superior-quality fruits were harvested from the netting/bagging treatment compared to the control. Netting and bagging treatment increased yield by more than 10-fold over control and decreased fruit infestation to 10.67%. The maximum marginal benefit-cost ratio (MBCR = 18.06) was achieved from the netting/bagging treatment, while the lowest MBCR (7.29) was obtained from bagging only. Superior-quality fruits were obtained using white paper bags compared to brown paper bags. The common cutworm first appeared in February and gradually increased with the progress of the season, indicating that netting and bagging need to be applied at the early fruiting stage of bell pepper. Research Limitations: The study focused on the environment-friendly management of common cutworms in bell peppers, revealing impressive results, but these need to be validated across the locations. Originality/Value: Albeit labor-intensive, combining nylon netting with fruit bagging is a cost-effective, eco-friendly management technique against the common cutworm of bell pepper. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the long-term cost-effectiveness of conventional care (CC) and seven first-line targeted therapies marketed in China for the treatment of patients with ankylosing spondylitis (AS)–namely secukinumab, ixekizumab, infliximab, etanercept, adalimumab and golimumab and tofacitinib–from the perspective of the Chinese health care system. Methods: The York model was structured as a 12-week decision tree leading into two Markov models. This study set 1 year as a recurring cycle and a lifetime timeframe for the model. Primary model outcomes included the costs in Chinese yuan (CNY), health outcomes in quality-adjusted life-years (QALYs) and the incremental cost-effectiveness ratio (ICER) under a willingness-to-pay threshold of ¥89,358 (equal to the per capita gross domestic product in China in 2023) per QALY. Parameters in the York model were captured from network meta-analyses and literature including treatment response, short-term disease progression, patient functioning and long-term structural disease progression. Utilities are dependent on indicators such as the BASDAI score, the BASFI score, gender and age. Drug prices were analysed using the median price of the Chinese market from YAOZH net in the basic analysis. Costs and outcomes were discounted at 5.0%. We performed deterministic and probabilistic sensitivity analyses to investigate the robustness of the results. The prices of original drugs and generic drugs were used in the scenario analysis. Results: Compared with CC, the ICER of golimumab was ¥104,217.4/QALY, which is between 1 and 3 times the GDP per capita, while the ICERs of the other six targeted therapies were less than ¥89,358/QALY. The specific economic rank of the targeted therapy was as follows: secukinumab > ixekizumab > tofacitinib > infliximab > etanercept > adalimumab > golimumab. Treatment response rates such as the BASDAI50, changes in the BASDAI/BASFI scores and the discounting rate were key model drivers. According to the scenario analysis, IL-17 inhibitors were still the most economical intervention when original drugs and generic drugs were used. Conclusion: Targeted therapies are cost-effective treatments for AS. Overall, IL-17 inhibitors were the dominant treatment. The choice of the brand-new prices or generic drug prices can greatly affect economics. [ABSTRACT FROM AUTHOR]

The collaborative care model (CCM) was created to improve the delivery of mental health care and is reported to improve access, enhance treatment outcomes, and reduce healthcare costs. To understand the impacts of the CCM on symptom management, diverse populations, and sustainability in healthcare systems, a systematic review was conducted. Several databases were searched for articles assessing the CCM. The inclusion criteria limited the studies to those (1) published between January 2008 and January 2024; (2) written in the English language; (3) analyzing adult patients; (4) analyzing symptom improvement in major depressive disorder, generalized anxiety disorder, or post-traumatic stress disorder; and (5) fitting the given definition of a CCM. We identified 9743 articles. Due to missing information or duplication, 4702 were excluded. The remaining articles were screened, yielding 468 articles for full-text analysis, of which 16 articles met the inclusion criteria. Of these articles, five primarily focused on individual patient outcomes, five focused on specific populations, and six reviewed system impacts; eleven articles studied US populations and five studied international populations. An analysis revealed that in 12 of the final articles, the CCM led to a statistically significant improvement in anxiety and depression symptoms with viable implementation and sustainability strategies. The CCM is an effective method for improving patient symptoms and can be potentially affordable in healthcare systems. [ABSTRACT FROM AUTHOR]

Background: Clostridioides difficile infection (CDI) represents a prevalent and potentially severe health concern linked to the usage of broad-spectrum antibiotics. The aim of this study was to evaluate a new lyophilized product based on human fecal microbiota for transplant, including cost–benefit analysis in the treatment of recurrent or refractory CDI. Methods: The product for fecal microbiota transplant was obtained from two donors. Microbiological, viability, and genomic analysis were evaluated. After validation, a clinical pilot study including recurrent or refractory CDI with 24 patients was performed. Clinical response and 4-week recurrence were the outcome. Cost–benefit analysis compared the fecal microbiota transplant with conventional retreatment with vancomycin or metronidazole. Results: The microbiota for transplant presented significant bacterial viability, with and adequate balance of Firmicutes and Bacteroidetes. The clinical response with the microbiota transplant was 92%. In financial terms, estimated expenditure for CDI solely related to recurrence, based on stochastic modeling, totals USD 222.8 million per year in Brazil. Conclusions: The lyophilized human fecal microbiota for transplant is safe and can be an important step for a new product with low cost, even with genomic sequencing. Fecal microbiota transplantation emerges as a more cost-effective alternative compared to antimicrobials in the retreatment of CDI. [ABSTRACT FROM AUTHOR]

Introduction: There has been a rapid proliferation of the robotic approach to inguinal hernia, mainly in the United States, as it has shown similar outcomes to the laparoscopic approach but with a significant increase in associated costs. Our objective is to conduct a cost analysis in our setting (Spanish National Health System). Materials and methods: A retrospective single-center comparative study on inguinal hernia repair using a robotic approach versus laparoscopic approach. Results: A total of 98 patients who underwent either robotic or laparoscopic TAPP inguinal hernia repair between October 2021 and July 2023 were analyzed. Out of these 98 patients, 20 (20.4%) were treated with the robotic approach, while 78 (79.6%) underwent the laparoscopic approach. When comparing both approaches, no significant differences were found in terms of complications, recurrences, or readmissions. However, the robotic group exhibited a longer surgical time (86 ± 33.07 min vs. 40 ± 14.46 min, p < 0.001), an extended hospital stays (1.6 ± 0.503 days vs. 1.13 ± 0.727 days, p < 0.007), as well as higher procedural costs (2318.63 ± 205.15 € vs. 356.81 ± 110.14 €, p < 0.001) and total hospitalization costs (3272.48 ± 408.49 € vs. 1048.61 ± 460.06 €, p < 0.001). These results were consistent when performing subgroup analysis for unilateral and bilateral hernias. Conclusions: The benefits observed in terms of recurrence rates and post-surgical complications do not justify the additional costs incurred by the robotic approach to inguinal hernia within the national public healthcare system. Nevertheless, it represents a simpler way to initiate the robotic learning curve, justifying its use in a training context. [ABSTRACT FROM AUTHOR]

Adeno-associated viruses (AAVs) have emerged as promising tools for gene therapy due to their safety and efficacy in delivering therapeutic genes or gene editing sequences to various tissues and organs. AAV serotype 9 (AAV9), among AAV serotypes, stands out for its ability to efficiently target multiple tissues, thus holding significant potential for clinical applications. However, existing methods for purifying AAVs are cumbersome, expensive, and often yield inconsistent results. In this study, we explore a novel purification strategy utilizing Dynabeads™ CaptureSelect™ magnetic beads. The AAV9 magnetic beads capture AAV9 with high specificity and recovery between 70 and 90%, whereas the AAVX magnetic beads did not bind to the AAV9. Through continuous interaction with AAVs in solution, these beads offer enhanced clearance of genomic DNA and plasmids even in the absence of endonuclease. The beads could be regenerated at least eight times, and the used beads could be stored for up to six months and reused without a significant reduction in recovery. The potency of the AAV9-purified vectors in vivo was comparable to that of iodixanol purified vectors. [ABSTRACT FROM AUTHOR]

This study investigates the influence of various parameters on the efficiency of cultivating and preserving Lemna aequinoctialis duckweed samples in vitro, with the aim of minimizing time, labor, and storage expenses. The method addresses the issue of limited space and the risk of sample loss by storing multiple duplicates (more than one tube or flask per sample) in a space-efficient and cost-effective container. Due to the practical implications and capacity to decrease operating expenses, our results are helpful for large-scale implementation. Using a single frond resulted in a longer preservation effect compared to sample densities of three and five fronds. Initial samples can be cultured in nutrient solution with or without sugar, stored in tap water or nutrient solution, kept at a stable temperature of 25 ± 2°C or room temperature. The test tubes with duckweed were not covered, or covered by black paper up to the solution surface or higher. The outcomes demonstrated that all three duckweed samples (HNP_005, HNP_026, and HNP_031), whether grown in SSM or SFM media, were best preserved if the tubes were covered by black paper higher than the solution surface (CH) and can be kept at room temperature for at least 9 mo. [ABSTRACT FROM AUTHOR]

Background: Improving the rate of genetic gain of cereal crop will rely on the accelerated crop breeding pipelines to allow rapid delivery of improved crop varieties. The laborious, time-consuming traditional breeding cycle, and the seasonal variations are the key factor restricting the breeder to develop new varieties. To address these issues, a revolutionized cost-effective speed breeding protocol for large-scale rice germplasm advancement is presented in the present study. The protocol emphasises on optimizing potting material, balancing the double-edged sword of limited nutritional dose, mode and stage of application, plant density, temperature, humidity, light spectrum, intensity, photoperiod, and hormonal regulation to accelerate rice growth and development. Results: The plant density of 700 plants/m2, cost-effective halogen tubes (B:G:R:FR-7.0:27.6:65.4:89.2) with an intensity of ∼ 750–800 µmol/m2/s and photoperiod of 13 h light and 11 h dark during seedling and vegetative stage and 8 h light and 16 h dark during reproductive stage had a significant effect (P < 0.05) on reducing the mean plant height, tillering, and inducing early flowering. Our results confirmed that one generation can be achieved within 68–75 days using the cost-effective SpeedyPaddy protocol resulting in 4–5 generations per year across different duration of rice varieties. The other applications include hybridization, trait-based phenotyping, and mapping of QTL/genes. The estimated cost to run one breeding cycle with plant capacity of 15,680 plants in SpeedyPaddy was $2941 including one-time miscellaneous cost which is much lower than the advanced controlled environment speed breeding facilities. Conclusion: The protocol offers a promising cost-effective solution with average saving of 2.0 to 2.6 months per breeding cycle with an integration of genomics-assisted selection, trait-based phenotyping, mapping of QTL/genes, marker development may accelerate the varietal development and release. This outstanding cost-effective break-through marks a significant leap in rice breeding addressing climate change and food security. [ABSTRACT FROM AUTHOR]

We propose a Bayesian model selection approach that allows medical practitioners to select among predictor variables while taking their respective costs into account. Medical procedures almost always incur costs in time and/or money. These costs might exceed their usefulness for modeling the outcome of interest. We develop Bayesian model selection that uses flexible model priors to penalize costly predictors a priori and select a subset of predictors useful relative to their costs. Our approach (i) gives the practitioner control over the magnitude of cost penalization, (ii) enables the prior to scale well with sample size, and (iii) enables the creation of our proposed inclusion path visualization, which can be used to make decisions about individual candidate predictors using both probabilistic and visual tools. We demonstrate the effectiveness of our inclusion path approach and the importance of being able to adjust the magnitude of the prior's cost penalization through a dataset pertaining to heart disease diagnosis in patients at the Cleveland Clinic Foundation, where several candidate predictors with various costs were recorded for patients, and through simulated data. [ABSTRACT FROM AUTHOR]

Peste des petits ruminants (PPRV), a highly contagious viral disease, causes significant economic losses concerning sheep and goats. Recently, PPR viruses (PPRVs), have adopted new hosts and lineage IV of PPRVs represents genetic diversity within the same lineage. 350 samples, including blood, swabs, and tissues from sheep/goats, were collected during the 2020–2021 disease outbreaks in Pakistan. These samples were analysed through RT-PCR and three isolates of PPRV with accession numbers, MW600920, MW600921, and MW600922, were submitted to GenBank, based on the partial N-gene sequencing. This analysis provides a better understanding of genetic characterizations and a targeted RT-PCR approach for rapid PPRV diagnosis. An IELISA test was developed using the semi-purified antigen MW600922 isolate grown in Vero cells. The PPRV isolates currently present high divergence with the Turkish strain; conversely, similarities equivalent to 99.73% were observed for isolates collected from Pakistan. The developed indirect ELISA (IELISA) test demonstrated antibody detection rates at dilutions of 1:200 for antibodies (serum) and 1:32 for antigens. In comparison to cELISA, high specificity (85.23%) and sensitivity (90.60%) rates were observed. In contrast to the virus neutralization test (VNT), IELISA was observed to be 100% specific and 82.14% sensitive in its results. Based on these results, serological surveys conducted for PPR antibodies using IELISA can be a more effective strategy on a larger scale. Furthermore, our results demonstrate a significant breakthrough in the research in terms of cost-effectiveness and storage efficiency, and the developed IELISA test is highly recommended for use in developing countries. Summary: Peste des petits ruminants (PPRV) is a transboundary, highly contagious, and economically significant viral disease affecting small ruminants and wildlife. PPRV, a disease that only targets animals, is the focus of the Global Eradication Programme (PPRV GEP), which aims to eradicate the disease by 2030. Following the completion of the first phase of the GEP (2017–2021), Pakistan has initiated the second phase: PPRV presence and the implementation of a control strategy. Rapid and accurate laboratory diagnosis is vital to the disease's effective control and eradication. In the present study, we have improved diagnosis by reverse transcriptase polymerase chain reaction (RT-PCR), which not only can detect low viral concentrations but also contributes to the genetic analysis of lineage-IV viruses. However, the development of cost-effective indirect ELISA (iELISA) may allow for the analysis of serum samples obtained from larger populations of small ruminants. [ABSTRACT FROM AUTHOR]

The management of wasting in Ethiopia is heavily reliant on the Community‐based Management of Acute Malnutrition (CMAM) programme that has been implemented in more than 18,000 service delivery points scattered across the country. Despite the full‐scale implementation of the CMAM, the number of child death averted, and the cost per child death averted remains unknown. This study aimed to estimate the cost and the number of child death averted by the CMAM programme between 2008 and 2020. Using data from routine monitoring of the CMAM programme, we estimated the excess mortality averted by the programme and estimated the cost per averted child death based on supply and labour. Over the past 13 years between 2008 and 2020, 3.6 million children under 5 years were admitted to the Ethiopian CMAM programme. The yearly average admission of 317,228 was achieved since 2011. On average, ~34,000 child deaths were averted yearly. The CMAM programme was estimated to have saved 437,654 (95% confidence interval [CI]: 320,161; 469,932) child deaths between 2008 and 2020, approximately 12% of the admitted cases. The average cost of the programme per adverted death was estimated at US$762/child death averted (95% CI = 639; 1001). The CMAM programme in Ethiopia is cost‐effective and has continued to avert a significant number of child death. Given the high short‐ and long‐term economic and health consequences of child wasting, concerted multi‐sectoral efforts are needed to accelerate progress not only in its treatment but also in its prevention. Key messages: A total of 3.6 million children were admitted between 2008 and 2020, increasing annually from 92,000 in 2008 to 390,000 in 2020 due to improvement in case findings and referral.Death rate in Community‐based Management of Acute Malnutrition (CMAM) programmes has decreased by sixfold between 2008 and 2020 from 1.23% to 0.22%During 13 years of implementation, the Ethiopian CMAM programme averted the death of >400 thousand children under five. [ABSTRACT FROM AUTHOR]

Summary: Osteoporosis treatment following arthroplasty for femoral neck fracture (FNF) is associated with lower rates of periprosthetic fracture (PPF). Our study evaluated the economic viability of treatment in patients following arthroplasty and demonstrates that treatment with oral bisphosphonates can be cost-effective in preventing PPF. Introduction: Osteoporosis treatment following arthroplasty for femoral neck fracture (FNF) is associated with lower rates of periprosthetic fracture (PPF). Although cost-effective in reducing the rate of secondary fragility fracture, the economic viability of osteoporosis treatment in preventing PPF has not been evaluated. Therefore, the purpose of this study is to use a break-even analysis to determine whether and which current osteoporosis medications are cost-effective in preventing PPF following arthroplasty for FNFs. Methods: Three-year average cost of osteoporosis medication (oral bisphosphonates, estrogen hormonal therapy, intravenous (IV) bisphosphonates, denosumab, teriparatide, and abaloparatide), costs of PPF care, and PPF rates in patients who underwent hip arthroplasty for FNFs without osteoporosis treatment were used to perform a break-even analysis. The absolute risk reduction (ARR) related to osteoporosis treatment and sensitivity analyses were used to evaluate the cost-effectiveness of this intervention and break-even PPF rates. Results: Oral bisphosphonate therapy following arthroplasty for hip fractures would be economically justified if it prevents one out of 56 PPFs (ARR, 1.8%). Given the current cost and incidence of PPF, overall treatment can only be economically viable for PPF prophylaxis if the 3-year costs of these agents are less than $1500. Conclusion: The utilization of lower cost osteoporosis medications such as oral bisphosphonates and estrogen hormonal therapy as PPF prophylaxis in this patient population would be economically viable if they reduce the PPF rate by 1.8% and 1.5%, respectively. For IV bisphosphonates and newer agents to be economically viable as PPF prophylaxis in the USA, their costs need to be significantly reduced. [ABSTRACT FROM AUTHOR]

The use of Global Navigation Satellite System (GNSS) in combination with real-time kinematic technique, known as differential GNSS (dGNSS), has increased in recent years for monitoring landslide displacements and detecting early signs of potential failure, enabling an earlier response for risk mitigation than traditional monitoring techniques. GNSS offers several advantages, including high accuracy and high-frequency data collection. Although more cost-effective, their affordability may still present challenges for public organizations managing multiple landslides in their territory. The SparkFun is a suite of components for GNSS assembly designed for topographic surveying, that integrates u-blox ZED-F9P or ZED-F9R modules. The system offers the benefits of dGNSS technology while being more affordable than other market options. It also avoids relying on phone signals for data storage on a cloud server. This paper presents the SparkFun system, its components, and how it can be assembled to create a dGNSS system for landslide monitoring. The deployment and testing at the Chin Coulee landslide in Alberta are discussed. Over the 6-month testing period, the system achieved millimeter accuracy (up to 14 mm), aligning with the manufacturer's specifications. Estimated system errors were found to be comparable to a commercially available dGNSS system (Ophelia Geocube). Additionally, the system exhibits displacement trends similar to the 2018 Geocube monitoring campaign; however, for future deployments, the robustness of the power supply system and the insulation of the equipment need to be enhanced. Overall, the SparkFun system appears to be a promising and cost-effective alternative for monitoring landslide displacements. [ABSTRACT FROM AUTHOR]

Simple Summary: Simple Summary: Hormonal treatment seems less effective than expected, and it is not a cost-efficient option for solving an anestrous problem in dairy cows under field conditions in tropical countries. To assess whether this evidence is correct, this retrospective study retrieved the clinical records of anestrous cows that received hormonal treatment before artificial insemination (AI) from the Veterinary Teaching Hospital. The results showed that pregnancy success was influenced by hormone treatment protocol, body condition score (BCS) upon hormone treatment, housing conditions, and season. The fixed-time AI (TAI) is the effective method for treating both cyclic and noncyclic anestrous dairy cows due to the high pregnancy risk (PR). However, the cost-efficiency analysis showed that the hormone treatment protocols with estrus detection before AI (EAI) were the most cost-efficient option for cyclic cows. In contrast, the TAI protocols were only appropriate for noncyclic cows. This study emphasized that hormonal treatment is still an effective technique for improving reproductive efficiency in anestrous cattle. However, farmers and veterinarians in tropical countries should be aware of the animal's health, environmental conditions, farm and management conditions, and the cost-efficiency of treatment protocols before making the treatment decision. This retrospective study aimed to evaluate the performance of hormone treatment protocols, determine the factors associated with pregnancy success after hormone treatment, and compare the cost-efficiencies of two types of hormone treatment among cyclic and noncyclic anestrous dairy cows. The clinical records of 279 anestrous cows that received hormone treatment for artificial insemination (AI) from 64 herds in the western region of Thailand were obtained from Kasetsart University Veterinary Teaching Hospital from January to August 2017. The performance of the hormone treatment protocols, fixed-time AI (TAI) and estrus detection before AI (EAI), showed that the pregnancy risk for the TAI protocol was higher than that for the EAI protocol, but pregnancy per AI did not differ significantly between the two protocols in cyclic and noncyclic cows. Multivariate logistic regression analysis showed that cows receiving the TAI protocol were more likely to be pregnant compared to those treated with the EAI protocol. Cows with a 3.00 body condition score (BCS) < 3.75 after treatment and loose-housed cows were more likely to become pregnant. Treatment during winter showed higher pregnancy success than that in the summer and rainy seasons. The cost-efficiency analysis showed that the TAI protocol was the most cost-efficient option for noncyclic cows, whereas the EAI protocol was the most cost-efficient option for cyclic cows. [ABSTRACT FROM AUTHOR]

To develop a cost-effective, high-viscosity asphalt for porous asphalt pavement, we utilized SBS, tackifier, and solubilizer as the main raw materials, identified the optimal composition through an orthogonal experiment of three factors and three levels, and prepared a low-cost high-viscosity asphalt. We compared its conventional and rheological properties against those of rubber asphalt, SBS modified asphalt, and matrix asphalt, employing fluorescence microscopy and Fourier transform infrared spectroscopy for microstructural analysis. The results indicate that the optimal formula composition for high-viscosity asphalt was 4–5% styrene-butadiene-styrene (SBS) + 1–2% tackifier +0–3% solubilizer +0.15% stabilizer. The components evenly dispersed and the performances were enhanced with chemical and physical modification. Compared with SBS modified asphalt, rubber asphalt, and matrix asphalt, the softening point, 5 °C ductility, and 60 °C dynamic viscosity of high-viscosity asphalt were significantly improved, while the 175 °C Brookfield viscosity was equivalent to SBS modified asphalt. In particular, the 60 °C dynamic viscosity reaches 383,180 Pa·s. Rheological tests indicate that the high- and low-temperature grade of high-viscosity asphalt reaches 88–18 °C, and that high-viscosity asphalt has the best high-temperature resistance to permanent deformation and low-temperature resistance to cracking. It can save about 30% cost compared to commercially available high-viscosity asphalt, which is conducive to the promotion and application of porous asphalt pavement. [ABSTRACT FROM AUTHOR]

With rapid urbanization sweeping through emerging nations, such as India, there has been a substantial increase in wastewater production, which poses a significant challenge in terms of its treatment and sustainable use. Conventional wastewater treatment methods, including the moving bed biofilm reactor (MBBR), up-flow anaerobic sludge blanket (UASB), membrane bioreactor (MBR), activated sludge process (ASP), sequencing batch reactors (SBR), and others, have demonstrated their effectiveness but come at a considerable cost. As these systems age, their operational and maintenance expenses escalate, rendering them less practical and sustainable. Despite the establishment of numerous wastewater treatment plants aimed at adhering to the regulations set forth by the Central Pollution Control Board of India (CPCB), high operating and maintenance costs have resulted in the abandonment of many of these facilities. There is a persistent need for sustainable, cost-effective, and environmentally friendly wastewater management technology to address this pressing issue. A solid immobilised biofilter (SIBF) system is currently under research as a potential solution because of its natural, cost-efficient, and sustainable characteristics. This study engages in a compelling comparative case study of two hospitals in Maharashtra, India. This contrasts the conventional wastewater treatment method (MBBR) with the natural treatment approach (SIBF). This study utilizes a 30-year life cycle cost analysis approach, which distinctly reveals that the MBBR system carries a higher life cycle cost. In contrast, the SIBF system has significantly lower costs because of its reduced energy consumption and operational costs. Four laboratory tests, namely biological oxygen demand, chemical oxygen demand, total suspended solids, and pH, were used to evaluate the quality of the treated wastewater. This research makes a significant contribution to the field of cost-effective wastewater management solutions by evaluating the feasibility of system implementation. [ABSTRACT FROM AUTHOR]

This study examined the extent of damage caused by Bemisia tabaci (Genn.) on brinjal and the effects of citrus extracts in managing the menace using randomized block design during the 2022 and 2023 cropping seasons. The variety examined was highly susceptible with plants in T3 being the most affected. Citrus extracts differed significantly (p<5%) with its essential oil (30 ml/ l) being the most effective. The extracts are recommended to be incorporated in B. tabaci management practicesof brinjal. [ABSTRACT FROM AUTHOR]

In recent years, numerous efforts have been made to synthesize new hole-transporting materials (HTMs) for perovskite solar cells (PSC) with the aim of replacing spiro-OMeTAD. However, to improve the conductivity and mobility of these materials, chemical additives are mostly used, which not only increase the cost but also reduce the stability and efficiency of perovskite solar cells in the long term due to the moisture sensitivity of perovskite crystals. Therefore, small organic molecules 2 and 6 were synthesized using cost-effective raw materials to improve the synthesis route, solubility, and morphology on the perovskite surface compared to spiro-OMeTAD for additive-free hole transport materials. The chemical properties, purity, and identification of these molecules were confirmed using electrochemical methods, UV-Vis spectroscopy, and NMR spectroscopy. In addition, thermal stability and robustness of new HTMs were measured and investigated by differential scanning calorimetric (DSC) and thermogravimetric analysis (TGA). Due to the donor-acceptor type π-system, the molecules used to increase the charge transfer mobility and thus reduce the use of chemical additives. The photovoltaic parameters of the solar cell made from HTMs 2 and 6 were determined by photovoltaic analysis, and the results showed that the performance of the device containing hole-transporting layer 6 was almost the same as of spiro-OMeTAD in additive-free conditions, with a current density of 14.68 mA/cm², an open-circuit voltage of 0.82 V, a fill factor of 0.65, and a power conversion efficiency of 7.88%. [ABSTRACT FROM AUTHOR]

Advancements in robotics and mapping technology have spotlighted the development of Simultaneous Localization and Mapping (SLAM) systems as a key research area. However, the high cost of advanced SLAM systems poses a significant barrier to research and development in the field, while many low-cost SLAM systems, operating under resource constraints, fail to achieve high-precision real-time mapping and localization, rendering them unsuitable for practical applications. This paper introduces a cost-effective SLAM system design that maintains high performance while significantly reducing costs. Our approach utilizes economical components and efficient algorithms, addressing the high-cost barrier in the field. First, we developed a robust robotic platform based on a traditional four-wheeled vehicle structure, enhancing flexibility and load capacity. Then, we adapted the SLAM algorithm using the LiDAR-inertial Odometry framework coupled with the Fast Iterative Closest Point (ICP) algorithm to balance accuracy and real-time performance. Finally, we integrated the 3D multi-goal Rapidly exploring Random Tree (RRT) algorithm with Nonlinear Model Predictive Control (NMPC) for autonomous exploration in complex environments. Comprehensive experimental results confirm the system's capability for real-time, autonomous navigation and mapping in intricate indoor settings, rivaling more expensive SLAM systems in accuracy and efficiency at a lower cost. Our research results are published as open access, facilitating greater accessibility and collaboration. [ABSTRACT FROM AUTHOR]

The integration of innovation into routine clinical practice is faced with many challenges. In 2007, we received the mandate to evaluate how the introduction of a robotic program in gynecologic oncology affected patient-centered care by studying its impact on clinical outcomes and hospital resource utilization. Here we summarize the history and experience of developing a robotic surgery program for gynecologic cancers over 16 years. Analysis of the data indicates that robotic surgery improved perioperative patient clinical parameters, decreased blood loss, complications, and hospital stay, maintained the oncologic outcome, and is cost-effective, resulting in it becoming the dominant surgical approach in gynecologic oncology in a tertiary cancer care institution. [ABSTRACT FROM AUTHOR]

Solar desalination using hydrogel evaporators is an eco‐friendly, highly efficient means with natural sunlight for sustainable freshwater production. However, it remains challenging to develop a cost‐effective and scalable method to prepare salt‐resistant hydrogel evaporators for stable desalination. Here, inspired by tree transpiration and hierarchical porous structure, a 3D‐printed bionic hydrogel evaporator (3DP‐BHE) is designed for long‐term solar desalination. Commercialized activated carbon (AC) is introduced into biomass starch skeleton as a solar light absorber to build 3DP‐BHE in a cost‐effective fashion ($10.14 m−2 of total materials cost). The bionic tree leaf layer for 94.01% light absorption and timely vapor diffusion. The bionic tree trunk layer with 3D printed bimodal porous structure for water transfer, thermal isolation, and salt ions convection and diffusion. With the unique bionic structure, the 3DP‐BHE achieves a stable evaporation rate of 2.13 kg m−2 h−1 at ≈90.5% energy efficiency under one sun (1 kW m−2). During the 7‐day desalination of 10 wt.% brine, a steady evaporation rate of 1.98 kg m−2 h−1 is maintained with a record‐high cost‐effectiveness (195.3 g h−1 $−1) manner. This 3DP‐BHE will open significant opportunities for affordable solar desalination systems on multiple scales, from individual households to off‐grid communities. [ABSTRACT FROM AUTHOR]

A cost-effective noninvasive 2.4 GHz microwave blood glucose sensor is designed and implemented in this study. The special feature of the system is that it can operate independently without any other equipment, and the system is small in size and easy to carry. When the system is powered on and the ring finger is placed on the sensor, the blood glucose level (BGL) can be determined. The system is easy to operate and can be used continuously. For the system, a special sensor element with metamaterial cells and a specific RF-DC rectifier circuit are designed and implemented. An algorithm that can calculate BGL from the sensing voltage generated by detecting the fingertip and programmed to run in the embedded system is developed. Compared with BGL detected by a commercially available invasive blood glucose sensor, the detection error of the proposed sensor is less than 2%. The proposed noninvasive 2.4 GHz microwave blood glucose sensor is very simple and inexpensive, and the measurement results are very close to those of commercially available sensors. [ABSTRACT FROM AUTHOR]

Blood, a ubiquitous and fundamental carbohydrate material composed of plasma, red blood cells, white blood cells, and platelets, has been playing an important role in biology, life science, history, and religious studies, while graphene has garnered significant attention due to its exceptional properties and extensive range of potential applications. Achieving environmentally friendly, cost-effective growth using hybrid precursors and obtaining high-quality graphene through a straightforward chemical vapor deposition process have been traditionally considered mutually exclusive. This study demonstrates that we can produce high-quality graphene domains with controlled thickness through a one-step growth process at atmospheric pressure using blood as a precursor. Raman spectroscopy confirms the uniformity of the blood-grown graphene films, and observing the half-integer quantum Hall effect in the measured devices highlights their outstanding electronic properties. This unprecedented approach opens possibilities for blood application, facilitating an unconventional route for graphene growth applications. [ABSTRACT FROM AUTHOR]

Introduction: SARS-COV-2 has created havoc during 2019-2021. Diagnosis and managing complications needed both laboratory investigations and imaging modalities. Aims and objectives: To find out the association between socio-demographic and clinical profiles of the study subjects with their different laboratory investigations and imaging modalities and to compare normal investigations with their gold-standard variants. Materials and Methods: During the first wave of COVID-19, a descriptive, observational, and cross-sectional study was carried out on 120 consecutive samples of mild to moderate COVID patients using a convenience sampling technique in a COVID indoor ward of Medical College, Kolkata. The semi-structured data collection form used in the study was predesigned, pretested, face and content validated. SPSS version 25 and Microsoft Excel version 19 was used for data analysis after coding. Ethical approval was taken. (Ref No. MC/KOL/IEC/ Non-Spon/842/11/2020). Results: Old age, uncontrolled diabetes and hypertension, presence of symptoms especially shortness of breath is significantly associated with low levels of SpO2, elevated C reactive protein (CRP) and D-dimer, abnormal Chest X-ray (CXR) and CT Thorax. A Kappa analysis suggested CRP and CXR can also be done instead of D-dimer and CT Thorax respectively, in a COVID patient for monitoring complications. Conclusion: CRP and CXR are cost-effective alternatives and can be used as diagnostic modalities for monitoring of complications of mild to moderate COVID-19 infections. [ABSTRACT FROM AUTHOR]

Engineered Geopolymer Composites (EGCs), known for their excellent tensile properties and lower carbon emissions, have gained widespread attention in the field of fiber-reinforced concrete. However, the high cost of high-performance synthetic fibers, a crucial component of EGCs, limits their practical engineering applications. In this study, by using low-cost PP fibers hybridized with PE fibers and adjusting the fly ash/ground granulated blast furnace slag (FA/GGBS) ratio, cost-effective, high-performing hybrid PE/PP-reinforced engineered geopolymer composites (H-EGCs) were developed. This study conducted axial compressive and tensile tests on H-EGCs with different FA/GGBS ratios (7:3, 6:4, and 5:5) and PP fiber replacement ratios (0%, 25%, 50%, 75%, and 100%), investigated the influence of FA/GGBS and PP fiber replacement ratio on static mechanical behavior, and evaluated the economic and environmental benefits based on mechanical performance indicators. The result indicated that the compressive strength of H-EGCs can reach 120 MPa when the FA/GGBS ratio is 5:5; however, an increase in FA/GGBS and PP fiber replacement ratio leads to a loss in compressive strength and elastic modulus. The incorporation of PP fibers in moderate amounts enhances ultimate tensile strain by reducing crack control ability, and the maximum tensile deformation capacity (7.82–9.66%) was obtained for H-EGCs with a PP fiber replacement ratio of 50%. The optimal economic and environmental benefits of H-EGCs are observed when the FA/GGBS ratio is 5:5 and the PP fiber replacement ratio is set at 50%. [ABSTRACT FROM AUTHOR]

The physicochemical behavior of polymer‐modified binders suggests suitability for rejuvenating aged pavements and meets base bitumen parameters. The strengthening effect is mainly due to their electronic structures, which interact with asphaltene via CH‐π interactions and crosslinkage reaction with S–H and O–H bonds of base bitumen, along with the virgin and waste polymers used. The functional groups in bitumen play a vital role in enhanced paving resistance after modification. This review aims to provide an overview of the current knowledge on the role of polymers in bitumen modification and to identify research gaps. It also discusses underutilized technologies, methods, and future research perspectives to implement more effective road networks for an environmentally sustainable development. [ABSTRACT FROM AUTHOR]

The droplet microfluidic device has become a widely used tool in fields such as physics, chemistry, and biology, but its complexity has limited its widespread application. This report introduces a modular and cost-effective droplet microfluidic device for the controlled production of complex emulsions, including oil and aqueous single emulsions, and double emulsions with varying numbers of encapsulated droplets. The droplet sizes can be precisely controlled by easily replacing flat needles and adjusting the needle position within an axially accelerated co-flow field. This modular device not only allows for easy repair and maintenance in case of device clogging or damage but can also be readily expanded to produce complex emulsions. The low-cost and user-friendly nature of the device greatly facilitates the widespread adoption and utilization of droplet microfluidics. [ABSTRACT FROM AUTHOR]

Nowadays, the rise of Internet of Things (IoT) devices is driving technological upgrades and transformations in the construction industry, the integration of IoT devices in buildings is crucial for both the buildings themselves and the intelligent cities. However, large-scale IoT devices increase energy consumption and bring higher operating costs to buildings. Therefore, harvesting the ambient cost-effective and clean energy sources is essential for the future development of intelligent buildings. In this work, we investigate the feasibility of integrating a typical triboelectric droplet energy harvester (DEH) into buildings. We demonstrate the energy harvesting capabilities of DEH on different sloped roof surfaces and complex curved building surfaces by simulating rainy weather with various rainfall intensities. The results indicate energy harvesting efficiency increases with larger tilt angles, which guides future smart architectural designs. This work is significant for the future integration of diversified, all-weather green energy collection and management systems, including raindrop energy, wind power generation, and solar energy, which will contribute to energy conservation and cost control in the next generation of smart buildings. [ABSTRACT FROM AUTHOR]

The production of hydrogen peroxide (H2O2) by 2-electron oxygen reduction reaction (ORR) in acidic electrolytes is a promising alternative to the existing anthraquinone process. However, the development of cost-effective catalysts with high activity for H2O2 electrosynthesis remains a great challenge. Here, we report a cobalt-nitrogen-carbon catalyst in which cobalt single atoms are supported on carbon black (Co-N-CB) for the electrosynthesis of H2O2 in an acid medium. The prepared Co-N-CB shows high activity for O2 reduction into H2O2 with an average selectivity of 80.6% over a wide potential range of 0.1–0.7 V vs. RHE in 0.1 M HClO4 electrolytes. We found that (i) the Co single atoms are the active sites of 2-electron ORR; (ii) a catalyst for efficient H2O2 production by O2 reduction should achieve a good balance between high ORR activity and H2O2 selectivity. Using Co-N-CB as a cathodic catalyst, the electrochemical device could electrosynthesize H2O2 directly from H2 and O2 with a high productivity of 291.0 mol kgcat−1 h−1. Our work provides a flexible way to prepare affordable catalysts for efficient H2O2 electrosynthesis. [ABSTRACT FROM AUTHOR]

Low‐cost ceramic microfiltration membranes were explored for immobilizing lipases. Expensive commercial ceramics (e.g., alumina, zirconia) have advantages like chemical robustness, but high sintering temperatures limit their usability. To overcome this, researchers used Fuller's earth clay with rice husk ash to create cost‐effective membranes. However, fewer reactive sites on ceramic surfaces hinder enzyme immobilization. To address this, 3‐aminopropyltriethoxysilane and glutaraldehyde activated the membrane for covalent lipase binding. The immobilized membrane retained activity for over five 1‐h reaction cycles with a minimal performance decline of around 60 %. After five cycles, it retained over 40 % of the initial activity. These results show promise for using low‐cost ceramic membranes in various industries, such as in food, beverages, pharmaceuticals, and chemical production. [ABSTRACT FROM AUTHOR]

Background: Annual screening through low-dose computed tomography (LDCT) is recommended for heavy smokers. However, it is questionable whether all individuals require annual screening given the potential harms of LDCT screening. This study examines the benefit–harm and cost-effectiveness of risk-based screening in heavy smokers and determines the optimal risk threshold for screening and risk-stratified screening intervals. Methods: We conducted a comparative cost-effectiveness analysis in China, using a cohort-based Markov model which simulated a lung cancer screening cohort of 19,146 heavy smokers aged 50 ~ 74 years old, who had a smoking history of at least 30 pack-years and were either current smokers or had quit for < 15 years. A total of 34 risk-based screening strategies, varying by different risk groups for screening eligibility and screening intervals (1-year, 2-year, 3-year, one-off, non-screening), were evaluated and were compared with annual screening for all heavy smokers (the status quo strategy). The analysis was undertaken from the health service perspective with a 30-year time horizon. The willingness-to-pay (WTP) threshold was adopted as three times the gross domestic product (GDP) of China in 2021 (CNY 242,928) per quality-adjusted life year (QALY) gained. Results: Compared with the status quo strategy, nine risk-based screening strategies were found to be cost-effective, with two of them even resulting in cost-saving. The most cost-effective strategy was the risk-based approach of annual screening for individuals with a 5-year risk threshold of ≥ 1.70%, biennial screening for individuals with a 5-year risk threshold of 1.03 ~ 1.69%, and triennial screening for individuals with a 5-year risk threshold of < 1.03%. This strategy had the highest incremental net monetary benefit (iNMB) of CNY 1032. All risk-based screening strategies were more efficient than the status quo strategy, requiring 129 ~ 656 fewer screenings per lung cancer death avoided, and 0.5 ~ 28 fewer screenings per life-year gained. The cost-effectiveness of risk-based screening was further improved when individual adherence to screening improved and individuals quit smoking after being screened. Conclusions: Risk-based screening strategies are more efficient in reducing lung cancer deaths and gaining life years compared to the status quo strategy. Risk-stratified screening intervals can potentially balance long-term benefit–harm trade-offs and improve the cost-effectiveness of lung cancer screenings. [ABSTRACT FROM AUTHOR]

Cassava (Manihot esculenta Crantz) is an essential crop with increasing importance for food supply and as raw material for industrial processing. The crop is vegetatively propagated through stem cuttings taken at the end of the growing cycle and its low multiplication rate and the high cost of stem transportation are detrimental to the increasing demand for high-quality cassava planting materials. Rapid multiplication of vegetative propagules of crops comprises tissue culture (TC) and semi-autotroph hydroponics (SAH) that provide cost-effective propagation of plant materials; however, they contrast the need for specific infrastructure, special media and substrates, and trained personnel. Traditional methods such as TC and SAH have shown promise in efficient plant material propagation. Nonetheless, these techniques necessitate specific infrastructure, specialized media and substrates, as well as trained personnel. Moreover, losses during the intermediate nursery and adaptation stages limit the overall effectiveness of these methods. Building upon an earlier report from Embrapa Brazil, which utilized mature buds from cassava for rapid propagation, we present a modified protocol that simplifies the process for wider adoption. Our method involves excising single nodes with attached leaves from immature (green) cassava stems at 2 months after planting (MAP). These nodes are then germinated in pure water, eliminating the need for specific growth substrates and additional treatments. After the initial phase, the rooted sprouts are transferred into soil within 1–8 weeks. The protocol demonstrates a high turnover rate at minimal costs. Due to its simplicity, cost-effectiveness, and robustness, this method holds significant promise as an efficient means of producing cassava planting materials to meet diverse agricultural needs. [ABSTRACT FROM AUTHOR]

Traditional methods of air pollution monitoring require substantial investment in equipment and infrastructure. However, efficient and cost-effective alternatives offer promising solutions for region-specific pollution assessments and understanding their impact on local populations. This review explores examples of low-cost monitoring methods, focusing on natural bioindicators, human interaction-based techniques, and the outcomes associated with air pollution exposure. Bioindicators such as spider webs, lichens, mosses, and Tradescantia pallida (T. pallida) are discussed as potential tools for air pollution monitoring. Human biomonitoring techniques, including the micronucleus assay and the assessment of pulmonary anthracosis, are examined for their ability to provide valuable insights into genotoxic effects and long-term exposure. The advantages and limitations of each method are highlighted. The review advocates for continued research and development to refine these approaches, with the aim of mitigating the adverse health impacts of air pollution on both individuals and communities. [ABSTRACT FROM AUTHOR]

Objective: To determine the most financially optimal surgical approach for testicular sperm retrieval for men with non‐obstructive azoospermia. Design: A decision tree was created examining five potential surgical approaches for men with non‐obstructive azoospermia pursuing one cycle of intracytoplasmic sperm injection. An expected financial net loss was determined for each surgical option based on couples' willingness to pay for one cycle of intracytoplasmic sperm injection resulting in pregnancy. The branch with the lowest expected net loss was defined as the most optimal financial decision (minimizing loss to a couple). Fresh testicular sperm extraction implied testicular sperm extraction was performed in conjunction with programmed ovulation induction. Frozen testicular sperm extraction implied testicular sperm extraction was performed initially, and ovulation induction/intracytoplasmic sperm injection was canceled if sperm retrieval failed. The surgical options included fresh conventional testicular sperm extraction, with and without "back‐up" sperm cryopreservation, fresh microsurgical testicular sperm extraction, with and without "back‐up" sperm cryopreservation, and frozen microsurgical testicular sperm extraction. Success was defined as pregnancy after one intracytoplasmic sperm injection cycle. Materials and methods: Probabilities of successful sperm retrieval with conventional testicular sperm extraction/microsurgical testicular sperm extraction, post‐thaw sperm cellular loss following frozen microsurgical testicular sperm extraction, ovulation induction/intracytoplasmic sperm injection cycle out‐of‐pocket costs, intracytoplasmic sperm injection pregnancy rates for men with non‐obstructive azoospermia, standard conventional testicular sperm extraction cost and average willingness to pay for intracytoplasmic sperm injection cycle were gathered from the systematic literature review. Costs were in USD and adjusted to inflation (as of April 2020). Two‐way sensitivity analysis was performed on varying couples' willingness to pay for one cycle of intracytoplasmic sperm injection and varying microsurgical testicular sperm extraction out‐of‐pocket costs. Results: According to our decision tree analysis (assuming minimum microsurgical testicular sperm extraction cost of $1,000 and willingness to pay of $8,000), the expected net loss for each branch was as follows: ‐$17,545 for fresh conventional testicular sperm extraction, ‐$17,523 for fresh microsurgical testicular sperm extraction, ‐$9,624 for frozen microsurgical testicular sperm extraction, ‐$17,991 for fresh conventional testicular sperm extraction with "backup", and ‐$18,210 for fresh microsurgical testicular sperm extraction with "backup". Two‐way sensitivity analysis with a variable willingness to pay values and microsurgical testicular sperm extraction and in‐vitro fertilization costs confirmed that frozen microsurgical testicular sperm extraction consistently presented the lowest net loss compared to other options. Interestingly, when directly comparing fresh microsurgical testicular sperm extraction and conventional testicular sperm extraction with "back‐up", scenarios with decreasing willingness to pay and lower microsurgical testicular sperm extraction costs demonstrated fresh conventional testicular sperm extraction with "back‐up" as more optimal than fresh microsurgical testicular sperm extraction with "back‐up". Conclusions: For those couples who must pay out of pocket, our study suggests that frozen microsurgical testicular sperm extraction is the most financially optimal decision for the surgical management of non‐obstructive azoospermia, regardless of microsurgical testicular sperm extraction cost and the couple's willingness to pay. [ABSTRACT FROM AUTHOR]

The continuous pharmacological advances in antiretroviral treatment (ART) and the increasing understanding of HIV drug resistance has led to a change in the paradigm of ART optimization in the setting of the viral suppression of treatment-experienced patients with the emerging evidence of the effectiveness and safety of dual therapies. The aim of this study is to determine the antiviral efficacy and safety of switching to Dolutegravir + Lamivudine in people living with HIV, and to analyze the rate of patients with virologic failure (VF). A total of 200 patients were included with a median age of 51 years, 189 cells/µL of nadir CD4+, 13 years on ART and four previous ART regimens. Among the 168 patients who completed a follow-up at 48 weeks, a total of five VFs occurred, resulting in a 2.98% (5/168) VF rate. The results of the intention-to-treat analysis were a VF rate of 2.54% (5/197), and the rate of patients/year with viral suppression was 98.3% (298/303) in the observed data analysis. We observed a significant improvement in mean CD4 lymphocytes, the CD4/CD8 ratio and lipid profiles. The optimization of ART to DTG plus 3TC is a cost-effective switch option for treatment-experienced HIV patients, and also improves their lipid profiles. [ABSTRACT FROM AUTHOR]

The zebrafish's ease of care and high reproductive rate have made them a popular animal model. It is routinely kept and maintained in commercial aquariums. However, the expense of a particular system was prohibitive for researchers with limited budgets or who worked in universities without zebrafish-rearing facilities. Thus, a simple custom-made aquaria system was developed. The recirculating opendesign aquaria system was cost-effective and may frequently be improved. This study has developed a distinctive aquaria system that can tackle the issues related to expanding research based on zebrafish. [ABSTRACT FROM AUTHOR]

Random execution of run sequences is employed in response surface designs to avoid bias in the response. Since the randomization of run sequences may induce frequent changes in the factor levels, which makes it difficult or expensive for the experimenter, especially when hard-to-change factors are involved in the experiment. Mostly, second order response surface designs (SORDs) are being used to explore the functional relationship between the response and the input variables. But when the lack of fit of the model becomes significant, it is desirable to explore the relationship with a polynomial model of order three. This requires third order rotatable designs (TORDs), which can be sequentially implemented by adding few more runs to the SORDs. In this paper, the construction of sequential TORDs with minimum level changes in the run sequences has been discussed. [ABSTRACT FROM AUTHOR]

The case studies are introduced in this study, highlighting freight transportation via road and road rail between satellite cities in Pakistan's Punjab and Sindh provinces. The case study analysis contributes to developing environmentally friendly and cost-effective transportation solutions and reducing nitrous oxide (N2O) and carbon dioxide (CO2) emissions associated with road and intermodal freight transit. We developed a mixed-integer linear programming (MILP) model to formulate the bi-objective problem, including real-life constraints, emissions at starting nodes, ending notes, and between the arc. In the mathematical model, the cost and emissions functions are developed to minimize the primary and secondary objective functions in the road and intermodal transportation. Furthermore, five distinct sets (locations, starting stations, ending stations, transport orders, and transport service) with parameters relating to container movement between the starting and ending nodes are a necessary part of the MILP formulation. The multiobjective optimization problem is solved by metaheuristic techniques such as the multiobjective genetic algorithm as the goal of applying a metaheuristic algorithm is to find the search space to search the near to optimized solutions. The Pareto front solutions are provided for balancing the costs and emissions of transporting supplies from Punjab to Sindh using the MATLAB solver toolbox. We gathered data from one of Pakistan's most well-known logistics service providers in the paper industry. According to the findings, intermodal transportation is 72% more cost-effective than road transportation. Additionally, by substituting intermodal transportation for road transportation, N2O, and CO2 emissions can be reduced by 74% and 57%, respectively. [ABSTRACT FROM AUTHOR]

Introduction: Telemedicine can alleviate the problems faced in rural settings in providing access to specialist stroke care. The evidence of the cost-effectiveness of this model of care outside high-income countries is limited. This study aimed to conduct: (a) a systematic review of economic evaluations of telestroke and (b) a cost–utility analysis of telestroke, using China as a case study. Methods: We systematically searched Embase, Medline Complete and Cochrane databases. Inclusion criteria: full economic evaluations of telemedicine/telestroke networks examining the use of thrombolysis in patients with acute ischaemic stroke, published in English. A cost–utility analysis was undertaken using a Markov model incorporating a decision tree to simulate the delivery of telestroke for acute ischaemic stroke in rural China, compared to no telestroke from a societal and healthcare perspective. One-way deterministic sensitivity analyses and probabilistic sensitivity analyses were performed to test the robustness of results. Results: Of 559 publications found, eight met the eligibility criteria and were included in the systematic review (two cost-effectiveness analyses and six cost–utility analyses, all performed in high-income countries). Telestroke was a cost-saving/cost-effective intervention in five out of the eight studies. In our modelled analysis for rural China, telestroke was the dominant strategy, with estimated cost savings of Chinese yuan 4,328 (US$627) and additional 0.0925 quality-adjusted life years per patient. Sensitivity analyses confirmed the base case results. Discussion: Consistent with published economic evaluations of telestroke in other jurisdictions, telestroke represents a cost-effective solution to enhance stroke care in rural China. [ABSTRACT FROM AUTHOR]

The reliability and availability of a Jet Unmanned Aerial Vehicle (JUAV) for balloon downing are evaluated in this third part of the paper. The paper delves into the challenges faced by traditional air defence systems in countering high-altitude balloons, leading to the proposal of substituting missiles with Unmanned Aerial Vehicles (UAVs), specifically the Jet Unmanned Aerial Vehicle (JUAV). The best solution found in the previous section is a derivation of the 1:6 scale RC model of the Lockheed F104C. This is designed for balloon downing, and the essay meticulously analyses its reliability, failure probabilities, and maintenance strategies for various subsystems. The engine is replaced with a more powerful micro-jet, and an 84 mm recoilless cannon is added at the base of the tail. The scaled-down model can use most data derived from the full-scale airplane flight manual, corrected for larger thrust-to-weight and lower wing-loading. Several adjustments and additions are made on sensors, autopilot, On-Line Diagnostic System, communication system, and firing system to increase the reliability of the system. Due to the relatively short design life of the RC model, the Time Between Overhaul (TBO) of the UAV is reduced to 25 h. Consequently, the study emphasizes the importance of simplicity, operational reliability, and adaptability in the development and assessment of modern missile defence systems. The reliability of the JUAVI is presented as 98.14% for 50 consecutive fully automatic missions, highlighting its potential significance in bolstering national security. [ABSTRACT FROM AUTHOR]

Techno-economic needs assessment for an automated solar panel production system is presented. Solar energy, a rapidly growing renewable energy source, has the potential to meet a significant portion of the world's energy needs. Solar panels, the key component of solar energy systems, there are produced in a major industry. Automated solar panel production systems offer the potential to increase production efficiency and reduce costs. The study outlines key factors necessary for successful establishment and operation of an automated solar panel production factory, including market analysis, financial projections, operational strategies, and sustainability initiatives. The market analysis through examination global trends in the solar energy market, identifying growth trends, potential competitors, and target customer segments. The study used a five-step methodology to assess needs, identifying major requirement such as the application of high-speed and precision manufacturing equipment, investment in reliable and efficient manufacturing processes, and development of costeffective manufacturing methods. The study's results highlight several key economic benefits of automated solar panel production, including increased production efficiency, reduced labor costs, and improved product quality. The findings are valuable to various stakeholders, including government officials, business leaders, and community members, informing decisions regarding solar industry development and new manufacturing facilities in specific regions. The paper recommends the use of eco-friendly manufacturing processes, utilization of recyclable materials, and adoption of energy-efficient automated technologies to minimize the carbon footprint of solar panel production. [ABSTRACT FROM AUTHOR]

Advancements in several industrial fields contribute to environmental pollution, predominantly after using essential heavy metals, organic compounds (including pharmaceuticals and dyes), and gaseous emissions such as carbon dioxide (CO2), often released into the environment without prior treatment. Consequently, it enriches the pollution of water resources and bacteria in the soil. Researchers are searching for cost-effective and innovative methods, including synthesizing harmless active compounds to minimize the toxic effects of discharged waste products. This article provides the synthesis and characterization of the Layered Silicate Na Magadiites (LSNaM.), which have a unique structure where each layer is interconnected with tetrahedra. The synthesized LSNaM is characterized by nitrogen adsorption, thermogravimetry, X-ray diffraction, and scanning electron microscopy, and it was applied to laboratory-prepared dye wastewater. Results showed that the LSNaM exhibited significantly higher adsorption capacities for the reactive active blue dye (RB) with slow adsorption kinetics, and equilibrium typically reached within 3 to 4 hours. Moreover, the data were best described by a pseudo-first-order kinetic model. Additionally, the impact of pH on the adsorption process was investigated at ambient temperature. The findings suggest that LSNaM has the potential to serve as an efficient and cost-effective material for removing organic contaminants, such as dyes and organic pharmaceutical waste discharged in soil and streams. [ABSTRACT FROM AUTHOR]