Search

ObjectivesEarly rescue surfactant therapy using less invasive surfactant administration (LISA) can reduce the need for mechanical ventilation and avoid complications in preterm infants with respiratory distress syndrome. The purpose of this study was to estimate the budget impact of LISA compared with management based on continuous positive airway pressure (CPAP) alone and rescue surfactant therapy in case of CPAP failure.MethodsA budget impact model was built comparing LISA with CPAP alone in order to estimate the potential resource consumption and budget impact from the perspective of the National Health Service in England. A literature review was conducted to populate the model. Deterministic and probabilistic sensitivity analyses were conducted to characterise the existing uncertainty and to explore the contribution of individual model parameters to the overall budget impact.ResultsEarly rescue with LISA is expected to reduce resource consumption and costs compared with conservative therapy based on CPAP alone for preterm infants born at 25–32 weeks gestation. Savings are higher for preterm infants of 25–28 weeks (expected budget impact −£5146 per case, 95% credible interval (CrI) −£22 403 to £13, probability of being cost saving 97.4%) than for preterm infants of 29–32 weeks (−£176, 95% CrI −£4279 to £339, probability of being cost saving 85%). The impact of bronchopulmonary dysplasia (BPD) and intraventricular haemorrhage on resource consumption and the expected reduction in the incidence of BPD with LISA are the most influential parameters on the budget.ConclusionsEarly rescue with LISA used in preterm infants with respiratory distress syndrome and fraction of inspired oxygen ≥0.3 is expected to be cost saving compared with management based on CPAP alone, particularly in those born at 25–28 weeks gestation.

By using a case-study on a fall-prediction device for elderly patients with orthostatic hypotension we aim to demonstrate how the MAFEIP tool, developed as part of the European Innovation Programme on Active and Healthy Ageing (EIP on AHA), can be used to inform manufacturers on their product development based on a cost-effectiveness criterion. Secondly, we critically appraise the tool and suggest further improvements that may be needed for a larger-scale adoption of MAFEIP within and beside the EIP on AHA initiative. The model was implemented using the MAFEIP tool. Within the tool one way sensitivity analyses were performed to assess the robustness of the model against the relative effectiveness of the fall-prevention device at different price levels. The MAFEIP tool was applied to a novel fall-prediction device and used to estimate the expected cost-effectiveness and perform threshold analysis. In our case study, the device produced estimated gains of 0.035 QALYs per patient and incremental costs of £ 518 (incremental cost-effectiveness ratio £14,719). Based on the one-way sensitivity analysis, the maximum achievable price at a willingness to pay threshold of £20,000 per QALY is estimated close to £900. The MAFEIP allows to quickly create early economic models, and to explore model uncertainty by performing deterministic sensitivity analysis for single parameters. However, the integration within the MAFEIP of common analytical tools such as probabilistic sensitivity analysis and Value of information would greatly contribute to its relevance for evaluating innovative technologies within and beside the EIP on AHA initiative.

•Payers increasingly use CED schemes to reduce decision uncertainty.•CED schemes are particularly relevant for medical devices.•Payers face many challenges when applying CED schemes for medical devices.•Challenges often relate to the unique characteristics of medical devices.•These challenges have to be addressed to improve a CED scheme's chance of success.

Water cleaning of paper leaves is a preliminary step in many customary deacidification treatments of ancient books in conservation workshops. Usually, the washing solutions are considered “waste waters” and they are thrown away. In this work, an analytical protocol for the analysis of wash waters for the assessment of the conservation state of ancient books is proposed. Wash waters of leaves under different conservation conditions of a 16th-century-printed book were investigated using UV-Vis, IR, Raman, NMR, EPR, XRF, ESI-MS, ICP-MS, CE-PDA and elemental microanalysis. Analysis of the wash water extracts allowed one to identify a large number of degradation by-products, ranging from low-molecular mass organic acids to cellulose oligomers. Reasons for the very different conservation conditions of the leaves emerged, indicating that wash water analysis provides a deep insight into the conservation state and composition of leaves as well as degradation reactions occurred on them.

The manuscripts depository of the Vatican Library is one of the best examples of preservation applied to ancient books. It was built about 25 years ago, without any windows and with an air conditioning system which ensure a constant temperature and relative humidity control. A quarter of century after, it needs improvements particularly in some structural features (opening of a security door, new floor, papyrus and acidic papers storage, supplementary stacks etc.) and in air filtration. During the three years closure (2007-2010) of the Vatican Library due to its general restructuring, it will be possible carry out requirements and procedures to perfect the preservation of more than 70 mile ancient manuscripts. [ABSTRACT FROM AUTHOR]

During the renovation works of the Teresiana Library of Mantua — started on March 2008 and ended with the reopening to the public in 2011 — we wanted to give special emphasis to issues of preservation of book materials. In this article, these aspects are briefly given account of. [ABSTRACT FROM AUTHOR]

The first part of the renewal of Mantua's Teresiana Municipal Library, built in 1780 by the empress Marie Therese, is close to be completed; it affects not only the technical components of the building, but also the remarkable wooden shelves of both the "Sale Teresiane" (Marie Therese Halls). The Sale Teresiane, designed by Paolo Pozzo, the architect of the former Jesuit College in the Palazzo degli Studi, were meant to host the Imperial Royal Public Library of Mantua, and are now used to hold the library book collections. Together with the conservation of the wooden structure and shelves, a preservation plan has been set. It's been specifically focused, in the first stage, on a study of the condition of Sale Teresiane volumes, on the safeguarding (through a check of the environmental parameters in the storerooms and reading rooms) and on the maintenance (through anoxic disinfection and dusting) of book and documents. [ABSTRACT FROM AUTHOR]