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Aims: To develop a model to evaluate the cost-effectiveness of 4 mg dibotermin alfa/absorbable collagen sponge (ACS) versus iliac crest bone graft (ICBG) in patients with lumbar degenerative disc disease in the United Kingdom. Materials & methods: A Markov decision-analytic model was constructed to calculate costs and quality-adjusted life-years over a 4-year time horizon in each treatment group, from a United Kingdom National Health Service perspective. An individual patient data meta-analysis was undertaken to synthesize data from four randomized controlled trials and two single-arm studies concerning health-related quality of life and procedural resource use. Current cost data from the United Kingdom were then applied to determine the overall mean cost per patient in each group. One-way and probabilistic sensitivity analyses were undertaken to explore the impact of parameter uncertainty. Results: The model predicted 4-year discounted cost savings of £192 per patient treated with dibotermin alfa/ACS, compared with ICBG, and a gain of 0.0114 QALYs per patient over the same time period. Sensitivity analyses indicated that the results were most sensitive to variability in the differences in health-related quality of life and secondary surgery rate, with dibotermin alfa/ACS having a 60% probability of being cost-effective at a willingness-to-pay threshold of £20,000 per QALY gained. Limitations: There is uncertainty in the difference in cost and QALYs between the two groups. However, comprehensive sensitivity analyses were undertaken to explore this and present the results in a transparent manner. Conclusions: Our results provide an economic case for the use of 4 mg dibotermin alfa/ACS versus iliac crest bone graft, with additional health benefits predicted at reduced overall cost.

By combining information such as genomics, proteomics, and metabolomics data, multi-omics methodologies have the potential to reveal the otherwise invisible processes of carcinogenesis. Using these data, a new generation point-of-care (POC) devices may support patient care through rapid diagnosis involving accurate and simultaneous multi-omics measurements. In this work we present a proof-of-concept portable system capable of measuring a metabolite (glutamate) and a protein (proteolytically active prostate-specific antigen - aPSA) simultaneously on single device in a two-minute interval using on-chip optical methods. The device has the potential to improve the current diagnostic pathways of prostate cancer by reducing the high false-positive rate with the widely used total prostate-specific antigen test. We demonstrate simultaneous assay of glutamate and aPSA in buffer and synthetic urine. For the glutamate assay, the limit of detection (LOD) and resolution were found to be 0.9 μM and 2.7 μM. LOD and resolution for aPSA were 0.5 ng/ml and 2.0 ng/ml. The LOD and resolution achieved using this device are therefore in line with human physiological ranges. The platform is suitable for accommodating two independent optical assays therefore chemistry can be modified to measure different analytes regardless of their nature. This technological breakthrough has the potential to deliver an accurate multi-omics portable device for prostate cancer and may be extended to other diseases.

The detection of metabolites such as choline in blood are important in clinical care for patients with cancer and cardiovascular disease. Choline is only present in human blood at low concentrations hence accurate measurement in an affordable point-of-care format is extremely challenging. Integration of microfluidics on to complementary metal-oxide semiconductor (CMOS) technology has the potential to enable advanced sensing technologies with extremely low limit of detection that are well suited to multiple clinical metabolite measurements. Although CMOS and microfluidics are individually mature technologies, their integration has presented challenges that we overcome in a novel, cost-effective, single-step process. To demonstrate the process, we present the microfluidic integration of a metabolomics-on-CMOS point-of-care platform with four capillary microfluidic channels on top of a CMOS optical sensor array. The fabricated device was characterised to verify the required structural profile, mechanical strength, optical spectra, and fluid flow. As a proof of concept, we used the device for the in-vitro quantification of choline in human blood plasma with a limit of detection of 3.2 M and a resolution of 1.6 M.

No abstract available.

Epsilon-near-zero (ENZ) modes have attracted extensive interests due to its ultrasmall mode volume resulting in extremely strong light-matter interaction (LMI) for active optoelectronic devices. The ENZ modes can be electrically toggled between on and off states with a classic metal-insulator-semiconductor (MIS) configuration and therefore allow access to electro-absorption (E-A) modulation. Relying on the quantum confinement of charge-carriers in the doped semiconductor, the fundamental limitation of achieving high modulation efficiency with MIS junction is that only a nanometer-thin ENZ confinement layer can contribute to the strength of E-A. Further, for the ENZ based spatial light modulation, the requirement of resonant coupling inevitably leads to small absolute modulation depth and limited spectral bandwidth as restricted by the properties of the plasmonic or high-Q resonance systems. In this paper, we proposed and demonstrated a dual-ENZ mode scheme for spatial light modulation with a TCOs/dielectric/silicon nanotrench configuration for the first time. Such a SIS junction can build up two distinct ENZ layers arising from the induced charge-carriers of opposite polarities adjacent to both faces of the dielectric layer. The non-resonant and low-loss deep nanotrench framework allows the free space light to be modulated efficiently via interaction of dual ENZ modes in an elongated manner. Our theoretical and experimental studies reveal that the dual ENZ mode scheme in the SIS configuration leverages the large modulation depth, extended spectral bandwidth together with high speed switching, thus holding great promise for achieving electrically addressed spatial light modulation in near- to mid-infrared regions.

In this paper, we investigate the self-mixing effect of planar Gunn diode oscillators numerically and experimentally. The simulation shows a 4 μm long GaAs-based heterostructure planar Gunn diode can generate not only an oscillation frequency of 27.5 GHz but also a down-converted signal of 2.5 GHz when an external signal of 30 GHz is injected to the diode. The conversion loss varies between 14 dB and 20 dB depending on the biasing condition as well as the amplitude and frequency of the input signal. Experiments confirmed the simulation results. The self-mixing effect of planar Gunn oscillators show a great potential for simplifying RF frontends for millimeter-wave applications such as 5G and beyond communications, radar, and imaging systems.

The state of polarization (SoP) is a fundamental property of electromagnetic radiation that can carry a rich set of important information in light transmitted through a test sample. Despite a wide range of applications in material identification, (thin-film) characterization, and defect analysis, the SoP remains difficult to exploit—especially at terahertz frequencies since its measurement requires complex apparatuses with multiple moving parts. We have addressed these challenges by designing a metasurface polarimeter (MSP) that incorporates the entire functionality of a division of aperture polarimeter (DoAP) with high efficiency into a single silicon layer without the need for moving parts. Collective simulations are in perfect agreement with experimental data, both confirming the intended operation. Furthermore, we present an automated analysis algorithm that allows for the complete determination of the SoP from a single image with an experimental accuracy of 92.1% ± 4.2%, following an initial calibration. We anticipate that the presented MSP will find applications in polarimetric sensing and imaging for non-destructive evaluation at terahertz frequencies.

Introduction Alors que notre planète est de plus en plus dominée par les activités humaines et leurs conséquences, nous nous retrouvons à vivre dans un monde où les zones naturelles sont de plus en plus réduites. D’un autre côté, les avancées technologiques nous conduisent vers une connectivité accrue et créent de nouveaux liens entre les personnes, les écosystèmes et les paysages à travers le globe (Helping, 2013). Les conséque...

Introduction Les pâturages et savanes du monde, autrefois ouverts, sont de plus en plus enclavés par des limites qui démarquent des parcelles de plus en plus petites. Les changements qui en résultent dans les échelles de gestion de ces paysages ont des répercussions à la fois sur les processus écologiques et sociaux et, en définitive, sur la santé du système ainsi que sur la santé et le bien-être de l’homme. Une approche One Hea...

One Health, « Une seule santé », est une stratégie mondiale visant à développer les collaborations interdisciplinaires pour la santé humaine, animale et environnementale. Elle promeut une approche intégrée, systémique et unifiée de la santé aux échelles locale, nationale et mondiale, afin de mieux affronter les maladies émergentes à risque pandémique, mais aussi s'adapter aux impacts environnementaux présents et futurs. Bien que ce mouvement s’étende, la littérature en français reste rare. Traduit de l’anglais, coordonné par d’éminents épidémiologistes et s'appuyant sur un large panel d' approches scientifiques rarement réunies autour de la santé, cet ouvrage retrace les origines du concept et présente un contenu pratique sur les outils méthodologiques, la collecte de données, les techniques de surveillance et les plans d’étude. Il combine recherche et pratique en un seul volume et constitue un ouvrage de référence unique pour la santé mondiale.

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