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We examine how hospital cost efficiency can improve because of knowledge spillover effects, arising from the experiences of members of a healthcare system. We identify two types of functional technology networks—that we term repository-type and workflow-type networks—which are defined by the adoption patterns of different types of electronic health record (EHR) systems application functions by hospitals in a health system. Additionally, we examine how structural features of these two network types—namely, network centrality and interconnectedness—impact such knowledge spillover effects. By analyzing seven years of panel data for 1,420 U.S. hospitals across 216 health systems, and data obtained from surveys of healthcare experts, we found that greater centrality of nodes in repository-type networks enhances the influence of partners' experiences on cost efficiency but has the opposite effect in workflow-type networks, while greater interconnectedness of workflow-type networks enhances the influence of partners' experiences on cost efficiency. Interestingly, we found the opposite effect in repository-type networks, where greater interconnectedness diminishes the influence of partners' experiences on cost efficiency. We discuss reasons for this surprising and counterintuitive finding. Overall, our results demonstrate that at least in healthcare settings where information technologies enable knowledge-sharing networks to be formed, benefits can accrue through knowledge spillover effects; moreover, variations across functional categories of technologies adopted in a network context can result in different technology-network structures with differential impacts on hospital cost efficiency because of their influence on knowledge spillover at both the hospital and system levels. Not only can these results explain mixed findings in the literature that has been dominated by a focus on cost efficiency outcomes dependent solely on the EHR adoption choices of individual hospitals, but they also provide the basis for guidelines for a network-based perspective of technology adoption. We discuss other possible settings to which our empirical findings can be reasonably generalized, including supply chain technologies and the Internet of Things. [ABSTRACT FROM AUTHOR]

Background: SATURN (Systematic Accumulation of Treatment practices and Utilisation, Real world evidence, and Natural history data) for the rare condition osteogenesis imperfecta (OI) has the objective to create a common core dataset by utilising existing, well-established data sources to meet the needs of the various stakeholders (physicians, registry/dataset owners, patients and patient associations, OI community leaders, European [EU] policymakers, regulators, health technology assessments [HTA]s, and healthcare systems including payers). This paper describes the steps taken to assess the feasibility of one existing OI registry (i.e., the Registry of OI [ROI]) as a candidate for SATURN. The same methodology will be applied to other existing OI registries in the future and this same concept could be utilised for other rare disease registries. Methods: The approach to assessing the feasibility of the ROI registry consisted of three steps: (1) an assessment of the registry characteristics using the Registry Evaluation and Quality Standards Tool (REQueST); (2) a gap analysis comparing SATURN required Core Variables to those being captured in the registry's Case Report Form (CRF); and (3) a compliance check on the data exchange process following the Title 21 of Code of Federal Regulations (CFR) Part 11/EudraLex Annex 11 Compliance Checklist. The first registry that SATURN has assessed is the ROI database at the Istituto Ortopedico Rizzoli (IOR) in Italy. Results: The results from the ROI REQueST have demonstrated satisfactory complete responses in terms of methodology, essential standards, interpretability, and interoperability—readiness for data linkage, data sources, and ethics to meet the needs of data customers. However, the ROI data is from a tertiary referral centre which may limit the ability to understand the full patient journey. The gap analysis has revealed that an exact or logical match between SATURN requested variables and the ROI current variables exists for the following items: patient characteristics, treatment of OI (medical and surgical) and treatment of pain (with the exception of frequency of treatment and reasons for discontinuation), fracture history and bone density. However, data on safety was missing. The compliance check has implied that the ROI implemented appropriate controls for the web-based platform (i.e., Genotype–phenotype Data Integration Platform [GeDI]) that is involved in processing the electronic patient data, and GeDI is a validated/compliant application that follows relevant 21 CFR Part 11/EudraLex Annex 11 regulations. Conclusions: This robust feasibility process highlights potential limitations and opportunities to develop and to refine the collaboration with the ROI as the SATURN programme moves forward. It also ensures that the existing datasets in the rare condition OI are being maximised to respond to the needs of patients, data customers and decision-makers. This feasibility process has allowed SATURN to build a compliant methodology that aligns with the requirements from the European Medicines Agency (EMA) and HTAs. More data variables will continue to be developed and refined along the way with more registries participating in SATURN. As a result, SATURN will become a meaningful and truly collaborative core dataset, which will also contribute to advancing understanding of OI diagnosis, treatment, and care. [ABSTRACT FROM AUTHOR]

Previous reviews on the cost of illness (COI) of Parkinson's disease (PD) have often focused on health‐care costs due to PD, underestimating its effects on other sectors. This systematic review determines the COI of PD from a societal perspective. The protocol was registered in PROSPERO (ID: CRD42023428937). Embase, Medline, and EconLit were searched up to October 12, 2023, for studies determining the COI of PD from a societal perspective. From 2812 abstracts, 17 studies were included. The COI of PD averaged €20,911.37 per patient per year, increasing to almost €100,000 in the most severely affected patients. Health‐care costs accounted for 46.1% of total costs, followed by productivity loss (37.4%) and costs to patient and family (16.4%). The COI of PD strongly varied between different geographical regions, with costs in North America 3.6 times higher compared to Asia. This study is the first to identify the relative importance of different cost items. Most important were reduced employment, government benefits, informal care, medication, nursing homes, and hospital admission. There was strong variety in the cost items that were included, with 55.2% of cost items measured in fewer than half of articles. Our review shows that PD‐COI is high and appears in various cost sectors, with strong variety in the cost items included in different studies. Therefore, a guideline for the measurement of COI in PD should be developed to harmonize this. This article provides a first step toward the development of such a tool by identifying which cost items are most relevant. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. [ABSTRACT FROM AUTHOR]

To address the urgent demand for sustainable battery manufacturing, this review contrasts traditional wet process with emerging dry electrode technologies. Dry process stands out because of its reduced energy and environmental footprint, offering considerable economic benefits and facilitating the production of high‐energy‐density electrodes. We spotlight technological innovations that exemplify the paradigm shift towards eco‐friendliness and cost‐efficiency. This review synthesizes the latest developments in dry electrode production, comparing the techniques with conventional methods, and outlines future research for further optimization toward a higher technology readiness level. We suggest that the evolution of battery manufacturing hinges on the synergy between process innovation and materials science, which is crucial for meeting the dual goals of environmental sustainability and economic practicality. [ABSTRACT FROM AUTHOR]

The Health Technology Assessment (HTA) Working Group of the Emerging Technology Division of International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) aims to develop a methodological approach for producing structured HTA information for laboratory medicine technologies. This approach seeks to support decision-making processes at the country, regional, and/or hospital levels regarding the introduction of specific technologies. The focus of this model will primarily be on defining assessment elements within the domains of 'organizational aspects' and 'costs and economic evaluations', potentially differentiated by the type of diagnostic technology (e.g., genetic tests, molecular tests). To achieve this project's goal, a literature review and examination of websites of international HTA agencies have been conducted. The research aims to identify multidisciplinary methodological approaches used to assess laboratory diagnostic technologies and to pinpoint the domains and assessment elements utilized. We found 7 methodological articles describing methodological approaches adopted to assess laboratory diagnostic technologies. Among the HTA organizations considered, 23 reports were found, of which 7 were produced by the European Network of HTA (EUnetHTA), 4 by the National Institute for Health and Care Excellence Diagnostic Assessment Program (NICE DAP), and 12 by other HTA agencies. The EUnetHTA reports were rapid collaborative assessments covering various domains, while the NICE DAP reports focused on diagnostic guidances, including descriptions of technologies, clinical need and practice, diagnostic tests, accuracy, effectiveness, and cost-effectiveness. Finally, a survey targeting laboratory professionals will be conducted to introduce assessment elements, differentiated by the type of diagnostic technology, primarily for organizational and economic domains. [ABSTRACT FROM AUTHOR]

Mini-public participation procedures with random selection have a long tradition in parliamentary technology assessment and acceptance research. Less documented is their potential in the area of research-based development of technical innovations. This article marks a contribution to that area and discusses the application of planning cells for a citizens' report for the participatory development of a multisensory screening system that, in the context of a global health crisis, shall contactlessly detect characteristics of respiratory virus infections to protect critical hospital infrastructures. Randomly selected citizens and clinic personnel from the Homburg region in Saarland, Germany, deliberated on the framework conditions for the AI-based data processing and ethical aspects of the so-called VI-screen system. This evaluation demonstrates how the structural anchoring of the method in an early phase of the development process was conducive for the competent researchers to incorporate the knowledge – and discussion-based recommendations of the participants, potentially increasing the social connectivity, diffusion, and responsible application of the VI-screen system in the future. Based on a critical assessment, potential adjustments to the standard participation procedure are derived in order to increase its potential for future use in research-based technology development. [ABSTRACT FROM AUTHOR]

• More than two-thirds of the world's population are affected by the escalating issue of rising income inequality. This phenomenon is intensifying the risk of societal divisions, provoking protests in numerous countries, and impeding economic and social development. • BioTrade refers to products or services derived from biodiversity, which are commercialized and traded in a manner that upholds respect for both people and nature. • There exists a robust positive correlation between BioTrade and income inequality. However, the impact of BioTrade on inequality exhibits heterogeneity based on sub-regions and the distribution of income disparities. • The level of preparedness for advanced technologies serves as one pathway through which BioTrade influences global inequality. While empirical studies exploring the impacts of international trade on income inequality have continued to expand, yielding mixed results, less attention has been devoted to the effects of BioTrade on income redistribution. This article addresses this gap by examining the impact of BioTrade on income inequality, with a specific emphasis on the role of technological innovations. We employ a panel model encompassing 131 countries over the period 2010–2019, utilizing instrumental variable two-stage least squares and smoothed instrumental-variable quantile regression. Overall, the results indicate a strong positive link between BioTrade and income inequality, yet its effects remain heterogeneous across sub-regions and the distribution of income inequality. To elucidate this positive link, the article presents evidence of the crucial role of the level of readiness for advanced technologies. Consequently, technological innovations play a pivotal role in mitigating the accelerating effects of BioTrade on inequality. The results are robust to a battery of robustness tests, including variations in estimation methodologies, alternative measures of inequality and BioTrade, and the inclusion of control variables. These results call upon policymakers to champion technological innovations, such as Internet access and research and development, as crucial strategies for effectively and sustainably alleviating the aggravation of inequalities induced by BioTrade. [ABSTRACT FROM AUTHOR]

Objective: This study analyzes the potential cost-effectiveness of integrating an artificial intelligence (AI)–assisted system into the differentiation of incidental renal lesions as benign or malignant on MR images during follow-up. Materials and methods: For estimation of quality-adjusted life years (QALYs) and lifetime costs, a decision model was created, including the MRI strategy and MRI + AI strategy. Model input parameters were derived from recent literature. Willingness to pay (WTP) was set to $100,000/QALY. Costs of $0 for the AI were assumed in the base-case scenario. Model uncertainty and costs of the AI system were assessed using deterministic and probabilistic sensitivity analysis. Results: Average total costs were at $8054 for the MRI strategy and $7939 for additional use of an AI-based algorithm. The model yielded a cumulative effectiveness of 8.76 QALYs for the MRI strategy and of 8.77 for the MRI + AI strategy. The economically dominant strategy was MRI + AI. Deterministic and probabilistic sensitivity analysis showed high robustness of the model with the incremental cost-effectiveness ratio (ICER), which represents the incremental cost associated with one additional QALY gained, remaining below the WTP for variation of the input parameters. If increasing costs for the algorithm, the ICER of $0/QALY was exceeded at $115, and the defined WTP was exceeded at $667 for the use of the AI. Conclusions: This analysis, rooted in assumptions, suggests that the additional use of an AI-based algorithm may be a potentially cost-effective alternative in the differentiation of incidental renal lesions using MRI and needs to be confirmed in the future. Clinical relevance statement: These results hint at AI's the potential impact on diagnosing renal masses. While the current study urges careful interpretation, ongoing research is essential to confirm and seamlessly integrate AI into clinical practice, ensuring its efficacy in routine diagnostics. Key Points: • This is a model-based study using data from literature where AI has been applied in the diagnostic workup of incidental renal lesions. • MRI + AI has the potential to be a cost-effective alternative in the differentiation of incidental renal lesions. • The additional use of AI can reduce costs in the diagnostic workup of incidental renal lesions. [ABSTRACT FROM AUTHOR]

Low‐volume sampling devices offer the promise of lower discomfort and greater convenience for patients, potentially reducing patient burden and enabling decentralized clinical trials. In this study, we determined whether low‐volume sampling devices produce pharmacokinetic (PK) data comparable to conventional venipuncture for a diverse set of monoclonal antibodies (mAbs) and small molecules. We adopted an open‐label, non‐randomized, parallel‐group, single‐site study design, with four cohorts of 10 healthy subjects per arm. The study drugs, doses, and routes of administration included: crenezumab (15 mg/kg, intravenous infusion), etrolizumab (210 mg, subcutaneous), GDC‐X (oral), and hydroxychloroquine (HCQ, 200 mg, oral). Samples were collected after administration of a single dose of each drug using conventional venipuncture and three low‐volume capillary devices: TassoOne Plus for liquid blood, Tasso‐M20 for dry blood, both applied to the arm, and Neoteryx Mitra® for dry blood obtained from fingertips. Serum/plasma concentrations from venipuncture and TassoOne Plus samples overlapped and PK parameters were comparable for all drugs, except HCQ. After applying a baseline hematocrit value, the dry blood concentrations and PK parameters for the two monoclonal antibodies were comparable to those obtained from venipuncture. For the two small molecules, two bridging strategies were evaluated for converting dry blood concentrations to equivalent plasma concentrations. A baseline hematocrit correction and/or linear regression‐based correction was effective for GDC‐X, but not for HCQ. Additionally, the study evaluated the bioanalytical data quality and comparability from the various collection methods, as well as patient preference for the devices. [ABSTRACT FROM AUTHOR]

In the vast arena of human advancement, artificial intelligence serves as a transformational force offering boundless possibilities. This study determined the relationship between technology readiness and technology acceptance of artificial intelligence by accountancy students. The study used a descriptive-correlational research design and a complete enumeration technique. The data were gathered from one hundred twenty-five (125) students from the Bachelor of Science in Accountancy program. The technology readiness level of accountancy students in terms of optimism and insecurity is high, while innovativeness and discomfort are moderately high. Moreover, the level of technology acceptance of accountancy students in terms of usefulness and ease of use is also high. The study reveals a significant relationship between technology readiness and technology acceptance of artificial intelligence among accountancy students. With a comprehensive examination of accounting students' readiness and acceptance levels towards artificial intelligence, the study offers essential insights into accounting students' readiness for the seamless integration of artificial intelligence into their academic and professional endeavors. [ABSTRACT FROM AUTHOR]

Background: Undifferentiated shock is recognized as a criticality state that is transitional in immune-mediated topology for casual risk of lethal microcirculatory dysfunction. This was a sensitivity analysis of a drug (tetracosactide; TCS10) targeting melanocortin receptors (MCRs) in a phase 3 randomized controlled trial to improve cardiovascular surgical rescue outcome by reversing mortality and hemostatic disorders. Methods: Sensitivity analysis was based on a randomized, two-arm, multicenter, double-blind, controlled trial. The Naïve Bayes classifier was performed by density-based sensitivity index for principal strata as proportional hazard model of 30-day surgical risk mortality according to European System for Cardiac Operative Risk Evaluation inputs-outputs in 100 consecutive cases (from August to September 2013 from Emilia Romagna region, Italy). Patients included an agent-based TCS10 group (10 mg, single intravenous bolus before surgery; n = 56) and control group (n = 44) and the association with cytokines, lactate, and bleeding-blood transfusion episodes with the prior-risk log-odds for mortality rate in time-to-event was analyzed. Results: Thirty-day mortality was significantly improved in the TCS10 group vs. control group (0 vs. 8 deaths, P < 0.0001). Baseline levels of interleukin (IL)-6, IL-10, and lactate were associated with bleeding episodes, independent of TCS10 treatment [odds ratio (OR) = 1.90, 95% confidence interval (CI) 1.39–2.79; OR = 1.53, 95%CI 1.17–2.12; and OR = 2.92, 95%CI 1.40–6.66, respectively], while baseline level of Fms-like tyrosine kinase 3 ligand (Flt3L) was associated with lower bleeding rates in TCS10-treated patients (OR = 0.31, 95%CI 0.11–0.90, P = 0.03). For every 8 TCS10-treated patients, 1 bleeding case was avoided. Blood transfusion episodes were significantly reduced in the TCS10 group compared to the control group (OR = 0.32, 95%CI 0.14–0.73, P = 0.01). For every 4 TCS10-treated patients, 1 transfusion case was avoided. Conclusions: Sensitivity index underlines the quality target product profile of TCS10 in the runway of emergency casualty care. To introduce the technology readiness level in real-life critically ill patients, further large-scale studies are required. Trial registration: European Union Drug Regulating Authorities Clinical Trials Database (EudraCT Number: 2007-006445-41). [ABSTRACT FROM AUTHOR]

Ammonia is one of the most important industrial chemicals which is commonly used for producing fertilizers and cleaning solutions, as the refrigerant gas, and as the precursors for making various chemicals. With the goal of sustainable development, ammonia is also proposed as the clean fuel for decarbonized transportation. The current the Haber–Bosch process for ammonia synthesis has large footprint and operates under harsh conditions using fossil fuels as the feedstock, being recognized as the major carbon emission source. Accordingly, call for sustainable production of green ammonia using renewable energies is proposed. Ammonia synthesis assisted by nonthermal plasmas has emerged in recent years as a novel and mild electrified technology, which can potentially be coupled with intermittent renewable energies and green hydrogen. Although being promising, significant development is still needed to advance the technology towards practical applications at scales. Hence, this review comments the progression of key aspects of the plasma-assisted ammonia synthesis such as catalyst and reactor design, mechanistic understanding, and process parameters. The snapshot of the current developments and proposed perspectives hope to provide guidance for the future research efforts to drive the technology towards higher technology readiness levels. [ABSTRACT FROM AUTHOR]

Various models, frameworks, and systems have been established to support persons with disabilities in accessing assistive technology (AT). This paper highlights the commonalities and complementary aspects of these resources for the optimal selection of the most appropriate AT for a particular user. The selection process considers the user characteristics, abilities, needs, and environment. However, it does not provide a specific methodology for tailoring this technology to individual users. This study reports on the experience of an interdisciplinary team formed in 2001 to develop user-tailored AT. The team established a systematic methodology, detailed as a step-by-step protocol. A survey was conducted to validate the protocol’s effectiveness and assess the impact of user-tailored AT. Participants included users and stakeholders. Quantitative data were requested and complemented with qualitative information. Eighty-one participants were involved, with 92.6% reliant on augmentative and alternative communication (AAC) systems. A user-tailored AT was developed for this cohort, with a sustained usage rate of 56.4%. Quantitative analysis revealed a 40% reduction in reported difficulties, and Individually Prioritized Problem Assessment (IPPA) scores demonstrated a corresponding 40% improvement in overall effectiveness. The qualitative data corroborated these findings, highlighting positive user feedback and underlining the significance of family support and interdisciplinary collaboration. The proposed methodology offers a step-by-step protocol that complements current models and frameworks and aims to guide individuals and teams that develop user-tailored AT for persons with disabilities. Additionaly, this study reflects the importance of applying user-tailored AT to improve the quality of life of persons with disabilities. [ABSTRACT FROM AUTHOR]

Objectives: Estimates of minimally important differences (MID) can assist interpretation of data collected using patient-reported outcomes (PRO), but variability exists in the emphasis placed on MIDs in health technology assessment (HTA) guidelines. This study aimed to identify to what extent information on the MID of a commonly used PRO, the EQ-5D, is required and utilised by selected HTA agencies. Methods: Technology appraisal (TA) documents from HTA agencies in England, France, Germany, and the US between 2019 and 2021 were reviewed to identify documents which discussed MID of EQ-5D data as a clinical outcome assessment (COA) endpoint. Results: Of 151 TAs utilising EQ-5D as a COA endpoint, 58 (38%) discussed MID of EQ-5D data. Discussion of MID was most frequent in Germany, in 75% (n = 12/16) of Gemeinsamer Bundesausschuss (G-BA) and 44% (n = 34/78) of Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, (IQWiG) TAs. MID was predominantly applied to the EQ-VAS (n = 50), most frequently using a threshold of > 7 or > 10 points (n = 13). G-BA and IQWiG frequently criticised MID analyses, particularly the sources of MID thresholds for the EQ-VAS, as they were perceived as being unsuitable for assessing the validity of MID. Conclusion: MID of the EQ-5D was not frequently discussed outside of Germany, and this did not appear to negatively impact decision-making of these HTA agencies. While MID thresholds were often applied to EQ-VAS data in German TAs, analyses were frequently rejected in benefit assessments due to concerns with their validity. Companies should pre-specify analyses of continuous data in statistical analysis plans to be considered for treatment benefit assessment in Germany. [ABSTRACT FROM AUTHOR]

The transition to a hydrogen-based economy presents a promising solution to the challenges posed by unsustainable energy systems and reliance on fossil fuels. This comprehensive review explores various hydrogen production methods, emphasizing their technological advancements, sustainability implications, and future prospects. Beginning with an overview of hydrogen's significance as a clean energy carrier, the review examines key production methods such as Steam Methane Reforming, Electrolysis (Proton Exchange Membrane, alkaline, solid oxide), Biomass Gasification, Photoelectrochemical Water Splitting, and Thermochemical Processes. Each method is scrutinized for its efficiency, environmental impact, and scalability, providing valuable insights into their roles in advancing the hydrogen economy. The review highlights the transformative potential of hydrogen production to replace fossil fuels due to its ability to store renewable energy long-term and its zero emissions. It also discusses potential technological advancements, including high-efficiency solid-state electrolysis and advanced catalysts for water splitting, highlighting avenues for innovation in hydrogen production. Additionally, policy recommendations aimed at promoting the hydrogen economy and fostering collaboration between academia, industry, and governments are elucidated. Through a detailed analysis of hydrogen production technologies and future prospects, this review contributes to shaping the trajectory of sustainable energy systems, advancing the adoption of hydrogen as a key energy vector, and underscoring the importance of alternative and sustainable energy sources. • Hydrogen economy addresses unsustainable energy challenges. • Review covers key hydrogen production methods and technologies. • Examines efficiency, environmental impact, scalability of each method. • Highlights advances in catalysts and solid-state electrolysis. • Recommends policies for renewable integration, innovation, and collaboration. [ABSTRACT FROM AUTHOR]

This paper presents the first comprehensive study of a groundbreaking Vertically Mounted Bifacial Photovoltaic (VBPV) system, marking a significant innovation in solar energy technology. The VBPV system, characterized by its vertical orientation and the use of high-efficiency Heterojunction cells, introduces a novel concept diverging from traditional solar panel installations. Our empirical research, conducted over a full year at the University of York, UK, offers an inaugural assessment of this pioneering technology. The study reveals that the VBPV system significantly outperforms both a vertically mounted monofacial PV (VMPV) system and a conventional tilted monofacial PV (TMPV) system in energy output. Key findings include a daily power output increase of 7.12% and 10.12% over the VMPV system and an impressive 26.91% and 22.88% enhancement over the TMPV system during early morning and late afternoon hours, respectively. Seasonal analysis shows average power gains of 11.42% in spring, 8.13% in summer, 10.94% in autumn, and 12.45% in winter compared to the VMPV system. Against the TMPV system, these gains are even more substantial, peaking at 24.52% in winter. These results underscore the VBPV system's exceptional efficiency in harnessing solar energy across varied environmental conditions, establishing it as a promising and sustainable solution in solar energy technology. [ABSTRACT FROM AUTHOR]

There has been a transition from broad to more specific research questions in the practice of network meta‐analysis (NMA). Such convergence is also taking place in the context of individual registrational trials, following the recent introduction of the estimand framework, which is impacting the design, data collection strategy, analysis and interpretation of clinical trials. The language of estimands has much to offer to NMA, particularly given the “narrow” perspective of treatments and target populations taken in health technology assessment. [ABSTRACT FROM AUTHOR]

Carbon Capture, Storage and Utilization (CCS/CCU) is critical for achieving net-zero emissions. Although the recent surge in CCS/CCU projects announcement, there is a clear gap between announced capacity (around 400 Mt CO2 per year) and the Net Zero Emissions (NZE) scenario deployment target (around 1 Gt per year) by 2030. This review examines breakthroughs and advancements across both established and emerging CCS/CCU systems with different Technology Readiness Levels (TRLs) in various industrial sectors, emphasizing the necessity of prospective assessments for their acceleration and scalability. It examines the development and application of prospective Life Cycle Assessment (pLCA) and prospective Techno-Economic Assessment (pTEA), highlighting their limitations and importance of their outcomes in decision-making processes. Differences between the evolving dynamics of the technological systems (foreground) and the evolution of the overall socioeconomic system (background) are discussed. Incorporating scenario data from Integrated Assessment Models (lAMs) into pLCA and pTEA reveals an iterative relationship that significantly influences the outcome of both the environmental assessments and the economics of large- scale production of the CCS/CCU systems under study. This, in turn, could reshape investment strategies towards advanced technologies, necessitating their consideration within the evolving structure of lAMs. It is concluded that the inherent limitations of CCS/CCU technologies at an early stage of development require quantitative uncertainty analysis and demand robustness, interdisciplinary collaboration, policy intervention, and data transparency. The rigorous evaluative frameworks are key for developing economic, environmental and climate policies and enable well-informed decisions across rapidly evolving sectors. A framework is proposed in this review, outlining a multistep process that includes a series of databases and open-source tools to interface pTEA and pLCA with enhanced lAMs for CCS/CCU, demonstrating its potential to improve decision-making and policy development. [ABSTRACT FROM AUTHOR]

Objectives: Identify, through a systematic review, the main domains and methods to support health technology assessment of Medical Devices (MD) from the perspective of technological incorporation into healthcare systems. Methods: Performed structured searches in MEDLINE, Embase, BVS, Cochrane Library, and Web of Science for full studies published between 2017 and May 2023. Selection, extraction, and quality assessment were performed by two blinded reviewers, and discrepancies were resolved by a third reviewer. Results: A total of 5,790 studies were retrieved, of which 41 were included. We grouped the identified criteria into eight domains for the evaluations. Conclusion: Overall, studies discuss the need to establish specific methods for conducting HTA in MD. Due to the wide diversity of MD types, a single methodological guideline may not encompass all the specificities and intrinsic characteristics of the plurality of MD. Studies suggest using clustering criteria through technological characterization as a strategy to make the process as standardized as possible. [ABSTRACT FROM AUTHOR]

AbstractHigher education aims to educate diverse professionals to operate in an increasingly complex world. Yet, academic assessment practices still rely upon standardisation, namely, that all students should demonstrate their achievement in ways that are largely comparable, if not identical. In this study, we theorise assessment standardisation as a technology of normalisation upon student diversity and identities. Our study is located in one of the most complex learning settings in higher education: placements. We theorise how diverse students navigate the tensions arising from standardised assessment situations that assess highly personalised forms of learning in complex assessment settings. Our data material consists of longitudinal interviews with 16 disabled university students in Australia before, during, and after a placement. Our findings show that assessment suppresses and normalises students’ diverse identities, calling into question the inclusivity of such assessment practices. We discuss how assessment provides students with narrow ways of forming their professional identities. While this is the case for all students, the social consequences of assessment standardisation might be more crucial for those who do not fit the ‘norm’ set by assessment, such as disabled students in our case. [ABSTRACT FROM AUTHOR]

The transformation of fossil fuel-based power generation systems towards greenhouse gas-neutral ones based on renewable energy sources is one of the key challenges facing contemporary society. The temporal volatility that accompanies the integration of renewable energy (e.g. solar radiation and wind) must be compensated to ensure that at any given time, a sufficient supply of electrical energy for the demands of different sectors is available. Green hydrogen, which is produced using renewable energy sources via electrolysis, can be used to chemically store electrical energy on a seasonal basis. Reconversion technologies are needed to generate electricity from stored hydrogen during periods of low renewable electricity generation. This study presents a detailed techno-economic assessment of hydrogen gas turbines. These technologies are also superior to fuel cells due to their comparatively low investment costs, especially when it comes to covering the residual loads. As of today, hydrogen gas turbines are only available in laboratory or small-scale settings and have no market penetration or high technology readiness level. The primary focus of this study is to analyze the effects on gas turbine component costs when hydrogen is used instead of natural gas. Based on these findings, an economic analysis addressing the current state of these turbine components is conducted. A literature review on the subsystems is performed, considering statements from leading manufactures and researchers to derive the cost deviations and total cost per installed capacity (€/kW el). The results reveal that a hydrogen gas turbine power plant has an expected cost increase of 8.5% compared to a conventional gas turbine one. This leads to an average cost of 542.5 €/kW el for hydrogen gas turbines. For hydrogen combined cycle power plants, the expected cost increase corresponds to the cost of the gas turbine system, as the steam turbine subsystem remains unaffected by fuel switching. Additionally, power plant retrofit potentials were calculated and the respective costs in the case of an upgrade were estimated. For Germany as a case study for an industrialized country, the potential of a possible retrofit is between 2.7 and 11.4 GW resulting to a total investment between 0.3 and 1.1 billion €. • Detailed techno-economic assessment of hydrogen gas turbines. • Component analysis of gas turbine subsystems for using hydrogen. • Calculated literature-based cost increase of hydrogen gas turbines compared to conventional gas turbines (€/kW). • Case study of Germany for possible power plant retrofits and related cost. [ABSTRACT FROM AUTHOR]

To reduce carbon emissions, generation of electricity from combustion systems is being replaced by renewable resources. However, the most abundant renewable sources – solar and wind – are not dispatchable, vary diurnally and are subject to intermittency, and produce electricity at times in excess of demand (excess production). To manage this variability and capture the excess renewable energy, energy storage technologies are being developed and deployed such as battery energy storage (BES), hydrogen production with electrolyzers (ELY) paired with hydrogen energy storage (HES) and fuel cells (FCs), and renewable natural gas (RNG) production. While BES may be better suited for short duration storage, hydrogen is suited for long duration storage and RNG can decarbonize the natural gas system. California Senate Bill 100 (SB100) sets a goal that all retail electricity sold in the State must be sourced from renewable and zero-carbon resources by 2045, raising the questions of which set of technologies and in what proportion are required to meet the 2045 target in the required timeframe as well as the role of the natural gas infrastructure, if any. To address these questions, this study combines electric grid dispatch modeling and optimization to identify the energy storage and dispatchable technologies in 5-year increments from 2030 to 2045 required to transition from a 60% renewable electric grid in 2035 to a 100% renewable electric grid in 2045. The results show that, by utilizing the established natural gas system to store and transmit hydrogen and RNG, the deployment of battery energy storage is dramatically reduced. The required capacity for BES in 2045, for example, is 40 times lower by leveraging the natural gas infrastructure with a concomitant reduction in cost and associated challenges to transform the electric grid. • The transition to a hydrogen economy can benefit from systematic planning. • Natural gas power plants (NGPPs) facilitate a cost-effective transition. • A high penetration of renewable generation requires long duration storage. • NGPPs significantly reduce the required energy storage capacity. [ABSTRACT FROM AUTHOR]

Triacylglycerides (TAGs) produced via the syngas fermentation of biogenic residues and wastes were evaluated as a potential feedstock for advanced road transportation, aviation, and maritime drop-in fuels via hydroprocessing technology. Due to the limited availability of TAGs, a simulated feedstock (SM TAGs) was utilized by blending various commercial oils, simulating the fatty acid composition of TAGs. At first, the simulated feedstock and the real TAGs were hydrotreated on a TRL 4 (technology readiness level) pilot plant to evaluate the potential of the SM feedstock to simulate the TAGs based on product quality. The hydrotreatment technology was evaluated and optimized on a TRL 4 plant. The research was further extended to a TRL 5 hydrotreatment plant with the optimum operating window for scaling up the technology. The resulting product was fractionated on a batch fractionation unit under vacuum to separate the jet and diesel fractions. The produced fuels were analyzed and evaluated based on the aviation Jet A1, EN590, EN15940, and marine diesel DMA specifications. The results show that the TAG composition was successfully simulated via a blend of vegetable oils. In addition, the hydrotreatment of the real TAGs and simulated feedstock resulted in similar-quality liquid products. The technology was successfully scaled up on a TRL 5 unit, leading to advanced, high-quality aviation and diesel drop-in fuels from TAGs, while the reaction pathways of hydrotreating can be controlled via the operating parameters of pressure, temperature, and H2/oil ratio. The hydrotreatment process's optimum conditions were 13.8 MPa pressure, 643 K temperature, 1 h−1 liquid hourly space velocity (LHSV), and 5000 scfb hydrogen-to-oil ratio. Finally, a storage stability study of the hydrotreated liquid product showed that it can be stored for more than 6 months at ambient conditions without any noticeable changes to its properties. [ABSTRACT FROM AUTHOR]

Personal protective equipment (PPE) has been universally recognized for its role in protecting workers from injuries and illnesses. Smart PPE integrates Internet of Things (IoT) technologies to enable continuous monitoring of workers and their surrounding environment, preventing undesirable events, facilitating rapid emergency response, and informing rescuers of potential hazards. This work presents a smart PPE system with a sensor node architecture designed to monitor workers and their surroundings. The sensor node is equipped with various sensors and communication capabilities, enabling the monitoring of specific gases (VOC, CO2, CO, O2), particulate matter (PM), temperature, humidity, positional information, audio signals, and body gestures. The system utilizes artificial intelligence algorithms to recognize patterns in worker activity that could lead to risky situations. Gas tests were conducted in a special chamber, positioning capabilities were tested indoors and outdoors, and the remaining sensors were tested in a simulated laboratory environment. This paper presents the sensor node architecture and the results of tests on target risky scenarios. The sensor node performed well in all situations, correctly signaling all cases that could lead to risky situations. [ABSTRACT FROM AUTHOR]

Background: Recent publications underscore the need for updated recommendations addressing less radical surgery for <2 cm tumors, induction chemotherapy, or immunotherapy for locally advanced stages of cervical cancer, as well as for the systemic therapy for recurrent or metastatic cervical cancer. Aim: To summarize the current evidence for the diagnosis, treatment, and follow-up of cervical cancer and provide evidence-based clinical practice recommendations. Methods: Developed according to AGREE II standards, the guidelines classify scientific evidence based on the Agency for Health Technology Assessment and Tariff System criteria. Recommendations are graded by evidence strength and consensus level from the development group. Key Results: (1) Early-Stage Cancer: Stromal invasion and lymphovascular space involvement (LVSI) from pretreatment biopsy identify candidates for surgery, particularly for simple hysterectomy. (2) Surgical Approach: Minimally invasive surgery is not recommended, except for T1A, LVSI-negative tumors, due to a reduction in life expectancy. (3) Locally Advanced Cancer: concurrent chemoradiation (CCRT) followed by brachytherapy (BRT) is the cornerstone treatment. Low-risk patients (fewer than two metastatic nodes or FIGO IB2-II) may consider induction chemotherapy (ICT) followed by CCRT and BRT after 7 days. High-risk patients (two or more metastatic nodes or FIGO IIIA, IIIB, and IVA) benefit from pembrolizumab with CCRT and maintenance therapy. (4) Metastatic, Persistent, and Recurrent Cancer: A PD-L1 status from pretreatment biopsy identifies candidates for Pembrolizumab with available systemic treatment, while triplet therapy (Atezolizumab/Bevacizumab/chemotherapy) becomes a PD-L1-independent option. Conclusions: These evidence-based guidelines aim to improve clinical outcomes through precise treatment strategies based on individual risk factors, predictors, and disease stages. [ABSTRACT FROM AUTHOR]

Background/Objectives: Hypoglossal nerve stimulation (HNS) emerged as an alternative treatment for patients with obstructive sleep apnea (OSA) a decade ago. Long-term clinical trials and real-world data show that HNS treatment provides significant and sustained improvements in both OSA disease control and quality-of-life measures over time. Given the nature of HNS treatment, with the requirement of using an implantable neurostimulation system, patient safety is a critical domain in the assessment of this technology. The objective of this review was to evaluate adverse events (AEs) and complications with HNS therapy in a systematic review of published evidence. Methods: Medline, Cochrane, and Web of Science were systematically searched to identify randomized controlled and real-world observational studies reporting relevant outcomes with HNS therapy for treatment of OSA that included procedure-, device-, and treatment-related AEs. Results: Out of 418 articles screened, 27 were reviewed for eligibility, and 17 studies, the majority found to have low-to-moderate risk of bias, with data on 1962 patients were included for further analysis. Across included studies, reporting of AEs was heterogeneous with regard to the classifications used and the extent of reporting. Over an average follow-up duration of 17.5 ± 16.9 months, the pooled mortality rate was 0.01% (95% CI = 0.0 to 0.2%), with all reported deaths being unrelated to HNS treatment. The HNS system survival probability over the follow-up time of 60 months was 0.9834 (95% CI = 0.9768 to 0.9882), with infections and request for removal by patients being the most common indications. The pooled surgical revision rate was 0.08% (95% CI 0.0 to 0.2%). Most reported treatment-related side effects were transient stimulation-related discomfort (0.08%, 95% CI = 0.0 to 0.2%) and tongue abrasions (0.07%, 95% CI = 0.0 to 0.2%). Based on the systematic review, a standardized set of endpoints was defined, aiming to harmonize safety data relevant to HNS therapy. Conclusions: In this systematic review, HNS therapy for treatment of OSA is associated with a positive patient safety profile. AEs occur mainly at device implantation and during the treatment acclimatization period. Due to a lack of available evidence, partially implantable HNS systems are underrepresented in this review, which limits the generalizability of the results. Significant heterogeneity was found for adverse event reporting. A framework for reporting HNS outcomes that includes AEs and side effects is proposed to facilitate comparability of the reported data. [ABSTRACT FROM AUTHOR]

To illustrate the financial consequences of implementing different managed entry agreements (managed entry agreements for the Dutch healthcare system for autologous gene therapy atidarsagene autotemcel [Libmeldy]), while also providing a first systematic guidance on how to construct managed entry agreements to aid future reimbursement decision making and create patient access to high-cost, one-off potentially curative therapies. Three payment models were compared: (1) an arbitrary 60% price discount, (2) an outcome-based spread payment with discounts, and (3) an outcome-based spread payment linked to a willingness to pay model with discounts. Financial consequences were estimated for full responders (A), patients responding according to the predicted clinical pathway presented in health technology assessment reports (B), and unstable responders (C). The associated costs for an average patient during the time frame of the payment agreement, the total budget impact, and associated benefits expressed in quality-adjusted life-years of the patient population were calculated. When patients responded according to the predicted clinical pathway presented in health technology assessment reports (scenario B), implementing outcome-based reimbursement models (models 2 and 3) had lower associated budget impacts while gaining similar benefits compared with the discount (scenario 1, €8.9 million to €6.6 million vs €9.2 million). In the case of unstable responders (scenario C), costs for payers are lower in the outcome-based scenarios (€4.1 million and €3.0 million, scenario 2C and 3C, respectively) compared with implementing the discount (€9.2 million, scenario 1C). Outcome-based models can mitigate the financial risk of reimbursing atidarsagene autotemcel. This can be considerably beneficial over simple discounts when clinical performance was similar to or worse than predicted. • High-priced one-off gene therapies, such as atidarsagene autotemcel (AA, Libmeldy), are innovative treatments that often fulfill an unmet medical need. However, they represent a reimbursement challenge to many healthcare systems because of substantial upfront costs, which are often incurred all at once, with the claim of durability of effects. • More guidance is needed to inform decision makers and healthcare payers which type of reimbursement and payment model is suitable. Therefore, a framework and calculation tool were used to help decision makers weigh the different payment scenarios for AA and help them negotiate and implement an outcome-based spread payment model. • The results from this calculation tool demonstrated that for AA, outcome-based models could considerably mitigate the financial risks for the payer in cases when clinical performance was similar or worse than predicted. The exact outcomes of the calculations should be treated with caution as the discount rates used are arbitrary and should be updated with values from decision makers. [ABSTRACT FROM AUTHOR]

This study aims to review the National Institute of Health and Care Excellence (NICE) technology assessments to gain insights into the implementation of treatment effect (TE) waning, whereby the hazard or survival in an assessed technology converges to that of the comparator. This analysis aims to contribute to inform future guidance in this area. Technology appraisals published October 20, 2021 to September 20, 2023 were reviewed and data extracted on TE waning circumstances, methods, and rationale to compile a database based on 3 research questions: When are TE waning assumptions used? What methods are used? Why have the company/Evidence Assessment Group/committee preferred these methods? Both the evidence assessment group/company and the committee included TE waning assumptions in 28 appraisals. There was no pattern of waning assumptions between shorter (<20 years) and longer (>20 years) time horizons. The most prominent time point for applying waning assumptions was at 5 years, with 30 out of 59 (50.8%) of the methods applied used 5 years. Stopping rules were used in 21 out of 30 (70.1%) of the appraisals for which the committee included waning, and waning assumptions were used more in oncology. The most common reason given for including TE waning assumptions was precedent from prior appraisals. Considerable heterogeneity existed in both the methods used and justifications given for TE waning assumptions. This variability poses a risk of inconsistent decision making. Reliance on past appraisals emphasizes the necessity to advocate for evidence-driven approaches and underscores the demand for guidance on suitable methods for incorporating assumptions. • This study identified significant heterogeneity in how National Institute of Health and Care Excellence submissions address treatment effect waning. The methodologies used to incorporate waning efficacy into analyses varied considerably and notably, no submissions reference external guidance to justify the chosen method. • This article highlights the over-reliance on prior appraisal decisions within National Institute of Health and Care Excellence technology appraisals. A 5-year time point has been used in half of the methods to apply waning assumptions, with evaluation of this assumption in scenario analysis in most cases. There are strong links between treatment effect waning assumptions and stopping rules, but some explanations given by companies that did not implement waning where there is a stopping rule are counter intuitive. • Failure to account for uncertainty in the long-term effects of treatment appropriately may result in suboptimal funding decisions being made. This article highlights the clear need for guidance going forward and takes the first step in production of this guidance. [ABSTRACT FROM AUTHOR]

Multilevel network meta-regression (ML-NMR) leverages individual patient data (IPD) and aggregate data from a network of randomized controlled trials (RCTs) to assess the comparative efficacy of multiple treatments, while adjusting for between-study differences. We provide an overview of ML-NMR for time-to-event outcomes and apply it to an illustrative case study, including example R code. The case study evaluated the comparative efficacy of idecabtagene vicleucel (ide-cel), selinexor+dexamethasone (Sd), belantamab mafodotin (BM), and conventional care (CC) for patients with triple-class exposed relapsed/refractory multiple myeloma in terms of overall survival. Single-arm clinical trials and real-world data were naively combined to create an aggregate data artificial RCT (aRCT) (MAMMOTH-CC versus DREAMM-2-BM versus STORM-2-Sd) and an IPD aRCT (KarMMa-ide-cel versus KarMMa-RW-CC). With some assumptions, we incorporated continuous covariates with skewed distributions, reported as median and range. The ML-NMR models adjusted for number of prior lines, triple-class refractory status, and age and were compared using the leave-one-out information criterion. We summarized predicted hazard ratios and survival (95% credible intervals) in the IPD aRCT population. The Weibull ML-NMR model had the lowest leave-one-out information criterion. Ide-cel was more efficacious than Sd, BM, and CC in terms of overall survival. Effect modifiers had minimal impact on the model, and only triple-class refractory was a prognostic factor. We demonstrate an application of ML-NMR for time-to-event outcomes and introduce code that can be used to aid implementation. Given its benefits, we encourage practitioners to utilize ML-NMR when population adjustment is necessary for comparisons of multiple treatments. • Multilevel network meta-regression (ML-NMR) can leverage individual patient data and aggregate data when comparing multiple treatments in a network of any size, while adjusting for differences in populations between trials. • We demonstrate an application of ML-NMR for time-to-event outcomes and introduce code for implementation. • ML-NMR reflects an extension of standard network meta-analysis framework to help address challenges of existing alternative indirect treatment methods, which can be applied to time-to-event outcomes to compare multiple direct treatment comparisons simultaneously in health technology assessments. [ABSTRACT FROM AUTHOR]

We compared the Institute for Clinical and Economic Review's (ICER) ratings of comparative clinical effectiveness with the German Federal Joint Committee's (G-BA) added benefit ratings, and explored what factors may explain the disagreement between the 2 organizations. We included drugs if they were assessed by ICER under its 2020 to 2023 Value Assessment Framework and had a corresponding assessment by G-BA as of January 2024 for the same indication, patient population, and comparator drug. To compare assessments, we modified ICER's proposed crosswalk between G-BA and ICER benefit ratings to account for G-BA's certainty ratings. We also determined whether each pair was based on similar evidence. Assessment pairs exhibiting disagreement based on the modified crosswalk despite a similar evidence base were qualitatively analyzed to identify reasons for disagreement. Out of 15 drug assessment pairs matched on indication, patient subgroup, and comparator, none showed agreement in their assessments when based on similar evidence. Disagreement was attributed to differences in evidence evaluation, including evaluations of safety, generalizability, and study design, as well as G-BA's rejection of the available evidence in 4 cases as unsuitable. The findings demonstrate that even under conditions where populations and comparators are identical and the evidence base is consistent, different assessors may arrive at divergent conclusions about comparative effectiveness, thus underscoring the presence of value judgments within assessments of clinical effectiveness. To support initiatives that seek to facilitate the exchange of value assessments between countries, these value judgments should always be transparently presented and justified in assessment summaries. • Several studies have documented disagreement in the comparative effectiveness assessments of the same drugs by different national health technology assessment (HTA) bodies. However, we are not aware of any studies that compare Institute for Clinical and Economic Review's (ICER) comparative effectiveness assessments with those of other HTA bodies. Furthermore, existing studies have matched and compared comparative effectiveness assessments at the drug level or the indication and patient subgroup level only. • We identified 15 drug assessment pairs matched on indication, patient subgroup, and comparator treatment. Seven assessment pairs were based on similar evidence. Using a novel crosswalk to translate G-BA ratings into ICER ratings that accounts for G-BA's assessment of certainty, G-BA and ICER did not agree in their assessment for any of these 7 drugs. • The findings demonstrate that even when populations and comparators are identical and the evidence base is similar, different assessors may arrive at divergent conclusions about comparative effectiveness, thus underscoring the role of value judgments. To support initiatives seeking to facilitate exchange of value assessments between jurisdictions, value judgments should be transparently presented and justified in assessment summaries. A recently published framework is 1 tool HTA bodies could use to organize and justify value judgments. [ABSTRACT FROM AUTHOR]

This study aimed to systematically review evidence on the cost-effectiveness of chimeric antigen receptor T-cell (CAR-T) therapies for patients with cancer. Electronic databases were searched in October 2022 and updated in September 2023. Systematic reviews, health technology assessments, and economic evaluations that compared costs and effects of CAR-T therapy in patients with cancer were included. Two reviewers independently screened studies, extracted data, synthesized results, and critically appraised studies using the Philips checklist. Cost data were presented in 2022 US dollars. Our search yielded 1809 records, 47 of which were included. Most of included studies were cost-utility analysis, published between 2018 and 2023, and conducted in the United States. Tisagenlecleucel, axicabtagene ciloleucel, idecabtagene vicleucel, ciltacabtagene autoleucel, lisocabtagene maraleucel, brexucabtagene autoleucel, and relmacabtagene autoleucel were compared with various standard of care chemotherapies. The incremental cost-effectiveness ratio (ICER) for CAR-T therapies ranged from $9424 to $4 124 105 per quality-adjusted life-year (QALY) in adults and from $20 784 to $243 177 per QALY in pediatric patients. Incremental cost-effectiveness ratios were found to improve over longer time horizons or when an earlier cure point was assumed. Most studies failed to meet the Philips checklist due to a lack of head-to-head comparisons and uncertainty surrounding CAR-T costs and curative effects. CAR-T therapies were more expensive and generated more QALYs than comparators, but their cost-effectiveness was uncertain and dependent on patient population, cancer type, and model assumptions. This highlights the need for more nuanced economic evaluations and continued research to better understand the value of CAR-T therapies in diverse patient populations. • Chimeric antigen receptor T-cell (CAR-T) therapies are a group of novel cancer therapeutics that have shown significant promise in the treatment of patients whose disease has relapsed or become refractory to treatment. However, these come at a significantly higher price than existing therapies, raising questions of their value for money. • This systematic review provides a comprehensive summary and critical evaluation of the available evidence on the economic value of CAR-T therapies. It encompasses a review of 47 studies that compare 7 distinct CAR-T therapies against standard cancer care practices, covering both pediatric and adult patient populations. • The findings indicate that CAR-T therapies tend to be more costly, but also more effective than their comparator treatments. However, the cost-effectiveness estimates for these therapies are highly uncertain, influenced by a range of factors including patient demographics, specific cancer types being treated, and underlying assumptions of the economic models used. Given the evolving evidence on the safety and efficacy of CAR-T therapies, it is crucial to update estimates as new evidence becomes available. [ABSTRACT FROM AUTHOR]

Customers are looking for suppliers to deliver complex systems at faster rates, targeting three year cycle. This timeframe is challenging for low Technology Readiness Level (TRL) developments, increasing requirements engineering effort, leaving engineers little time and scope for innovation. Test and Evaluation (T&E) activities are often performed in Australia near the end of the process diminishing their value , compensating for a lack of modelling and simulation in early stages. Waterfall Project Management dominates where capability is hardware focused, leading to overruns and deliver capability that falls short of customer expectations in some areas. The Agile approach has been successfully used in software-focused developments. Project managers have been slow to adopt Agile for developments in areas like Defence where the safety is hardware dominant claiming the Agile process lacks necessary governance , increasing risk in the development. This paper examines the extant developmental process in a Defence context and proposes a Minimal Viable Product (MVP)-based framework using Agile to accelerate the development and mitigate risk escalation. [ABSTRACT FROM AUTHOR]

Representations of science and technology, embodied as imaginaries, visions, and expectations, have become a growing focus of analysis. These representations are of interest to normative approaches to science and technology, such as Hermeneutic Technology Assessment and Responsible Innovation, because of their ability to modulate understandings of science and technology and to influence scientific and technological development. This article analyses the culture of participation underlying the NanoKOMIK project and the representations and meanings of (nano)science and (nano)technology communicated in the two nano-fiction comic books created as part of the project: Dayanne and Murillo. The power of nanoscience (2016) and NanoKOMIK #2 (2017). The article argues that despite NanoKOMIK's efforts to engage the public with (nano)science and (nano)technology, it reproduces non-binding modes of public participation and transmits socio-technical meanings that are instrumental in the social legitimisation of (nano)technology. More specifically, the analysis shows that NanoKOMIK's comic books, in addition to not problematising the risks and conveying an eminently positive view of nanotechnology, also communicate certain 'myth-conceptions' of scientific activity and its products. For example, they convey an individualistic and linear vision of research and innovation and an instrumentalist and neutral (or 'value-free') view of technology. These findings highlight the importance of critically analysing the 'cultures of participation' that characterise and reproduce 'participatory' or 'collaborative' projects and the representations of (nano)science and (nano)technology that they perpetuate. [ABSTRACT FROM AUTHOR]

Project Orbis is a global initiative that aims to streamline regulatory review processes across international regulators in the USA, Canada, Australia, UK, Israel, Brazil, Singapore, and Switzerland to bring promising cancer drugs to patients earlier. We explored the clinical benefit, time to regulatory approval and health technology assessment recommendations, reimbursement outcomes, and monthly treatment prices of cancer drugs reviewed through this initiative. For this retrospective, comparative analysis, we identified cancer drug approvals reviewed through Project Orbis in the USA, Canada, and the UK between May 1, 2019, and Nov 1, 2023. Approvals of cancer drugs reviewed Project Orbis were extracted from the Food and Drug Administration (FDA) Oncology Centre of Excellence and all other FDA approvals from the Drugs@FDA database. The co-primary outcomes were time of regulatory review, time from regulatory approval to health technology assessment recommendation (England, Scotland, and Canada), reimbursement outcomes, clinical benefit (defined as median gains in progression-free survival and overall survival) between cancer drug approvals reviewed by Project Orbis and other FDA approval processes, and monthly treatment prices. The Wilcoxon rank-sum and Fisher's Exact tests were used to examine statistical significance between approvals reviewed through Project Orbis and other FDA approvals during the same period. Between May 1, 2019 and Nov 1, 2023, 81 (33%) of 244 cancer drugs approved by the FDA were reviewed through Project Orbis. The median overall survival gains were 4·1 months (IQR 3·3–5·1) compared with 2·7 months (2·1–3·9) for other FDA approvals. Similarly, progression-free survival gains were 2·6 months (IQR 1·7–4·9) for Project Orbis compared with 2·6 months (0·6–5·1) for other FDA approvals. Neither overall survival (p=0·11) nor progression-free survival (p=0·44) gains were significantly different between the two cohorts of approvals. Of the 14 UK Medicines and Healthcare products Regulatory Agency (MHRA) approvals reviewed by the Scottish Medicines Consortium (SMC), the agency gave positive recommendations for all 14 (100%). Of the 15 MHRA approvals reviewed by the National Institute for Health and Care Excellence (NICE), the agency gave positive recommendations for six (40%). Of the 49 approvals reviewed by the Canadian Agency for Drugs and Technologies in Health (CADTH), the agency conditionally recommended 44 (90%). The time between regulatory approval to NICE recommendation increased from a median of 137 days (IQR 102–172) in 2021 to 302 days (184–483) in 2023, SMC recommendation increased from 185 days (in 2021 for one drug only) to 368 days (IQR 313–476) in 2023, and CADTH decision increased from 97 days (in 2020 for one drug only) to 202 days (IQR 153–304) in 2023. The median monthly price of approvals reviewed through Project Orbis was US$20 000 per month (IQR 13 000–37 000). Clinical outcomes of Project Orbis were no different than other FDA approvals during the same time, and access, after a successful health technology assessment, was considerably delayed or absent, raising questions about whether Project Orbis participation translates into faster patient access to medicines with high clinical benefit and sustainable costs. Although future challenges might benefit from regulatory harmonisation, the advantages are currently unclear. None. [ABSTRACT FROM AUTHOR]

The marketing authorization of Advanced Therapy Medicinal Products (ATMPs) in Brazil is recent. The features of these therapies impose specialized regulatory action and are consequently challenging for developers. The goal of this study was to identify the industry's experience in clinical development, marketing authorization and access to ATMPs through the Unified Health System (SUS, acronym in Portuguese), from a regulatory perspective. A survey containing structured questions was conducted among research participants who work at companies that commercialize ATMPs. A descriptive analysis was performed. We invited 15 foreign pharmaceutical companies, of which 10 agreed to participate. Overall, participants assessed that Brazil has a well-established regulatory system, especially the sanitary registration by the National Health Surveillance Agency (Anvisa), which ensures the quality, safety, and efficacy of the products. The Agency's good interaction with the regulated sector, the harmonization of sanitary and ethical assessment systems with other countries, and the analysis time in the biosafety assessment of Genetically Modified Organisms (GMOs) stand out as positive in industry's evaluation. On the other hand, it is important to advance the pricing regulation for these products since Brazilian regulations do not establish specific criteria for ATMP. One of the biggest challenges is the difficulty for the SUS in reimbursing these very high-cost therapies, especially using current Health Technology Assessment (HTA) methods. Considering the increasing number of approvals of cell and gene therapies in Brazil in the coming years, a close dialogue between the industry and the public sector is recommended to advance regulatory improvements (pricing and HTA). Additionally, the construction of policies to promote the national Health Economic-Industrial Complex, based on a mission-oriented vision that encourages innovative models of financing, especially those that consider risk-sharing and co-financing technologies, will help provide the population with universal, equitable and sustainable access to ATMP in the SUS. [ABSTRACT FROM AUTHOR]

Augmented Reality (AR) could improve maritime collaboration by facilitating human factors like situation awareness and decision-making. However, it is not clear in which ways AR can be beneficial and for which maritime operations. This paper addresses the need for a systematic literature review of state-of-the-art ways AR can facilitate maritime collaboration. Following the PRISMA statement, we searched for the constructs "AR," "maritime operation," and "collaboration" in the Web of Science and IEEE Xplore databases. Out of 691 search results, we retained 32 publications for analysis. Ten publications from other sources were included. Our results provide a review of AR applications for the maritime operations of ship navigation, personal navigation, maritime construction, maritime maintenance and inspection, and other. We suggest that research focuses on bringing promising AR applications to higher technology readiness levels, learning from other industries, applying robust evaluation methods, and grounding more on human factors like decision-making, situation awareness, and communication. [ABSTRACT FROM AUTHOR]

The role of teaching, learning, and assessment with digital technology has become increasingly prominent in mathematics education. This survey paper provides an overview of how technology has been transforming teaching, learning, and assessment in mathematics education in the digital age and suggests how the field will evolve in the coming years. Based on several decades of research and educational practices, we discuss and anticipate the multifaceted impact of technology on mathematics education, thus laying the groundwork for the other papers in this issue. After a brief introduction discussing the motivations for this issue, we focus our attention on three lines of research: teaching mathematics with technology, learning mathematics with technology, and assessment with technology. We point to new research orientations that address the issue of teaching with technology, specifically describing attempts to conceptualise teachers' mathematical and digital competencies, perspectives that view teachers as designers of digital resources, and the design and evaluation of long-term initiatives to support teachers as they develop innovative teaching practices enhanced by digital technologies. Our examination shows that learning with technology is still marked by new conceptualizations raised by researchers that can further our understanding of this complex issue. These conceptualizations support the recognition that multiple resources, ranging from paper and pencil to augmented reality, participate in the learning process. Finally, assessment with technology, especially in the formative sense, offers new possibilities for offering individualised support for learners that can benefit from adaptive systems, though more tasks for conceptual understanding need to be developed. [ABSTRACT FROM AUTHOR]

We study the experts' practices developed with the support of digital technologies (DT), when they take aware in-the-moment decisions during classroom discussions to promote the development of effective formative assessment (FA) processes. In this investigation, we complement a macro-analysis of paradigmatic examples of classroom activities, focused on the functionalities of DT and on the implemented FA strategies, with a micro-analysis, developed with reference to a theoretical construct useful for interpreting and analysing expert teachers' roles during classroom discussions (the Model of Aware and Effective Attitudes and Behaviours, MAEAB). More specifically, we explore how the expert uses DT to empower these roles with the aim of promoting FA processes. This study has two implications: (1) at the theoretical level, the study will introduce a model aimed at characterising the ways in which the expert can promote FA during classroom discussions when they are mediated by the use of DT; (2) at the pragmatic level, the use of this model to analyse paradigmatic examples from teaching experiments will introduce potential guidelines for teacher professional development aimed at promoting teachers' autonomous use of DT to carry out effective FA practices. [ABSTRACT FROM AUTHOR]

The current university standards of research productivity focus on commercially adopted innovations in various industries. However, as a newly instated university in the Philippines, the Sorsogon State University’s research outputs in various disciplines are still lacking the necessary technology readiness level (TRL) that the industry requires. This descriptive method of research using correlation design utilized archival sources to determine the association between the faculty profile and the TRL of research outputs of the university. It was found that more than half of the 194 regular faculty members are specializing in soft sciences which resulted in the dominance of the basic type of research (250 out of 296) conducted from 2015 to 2020. Using the nine-point National Aeronautics and Space Administration (NASA) scale, the study revealed the right-skewed distribution of TRL assessment of faculty research outputs by area of specialization, almost all reaching TRL 1-4 and were not transferred to the intended beneficiaries. Factors such as academic rank, area of expertise, and highest educational attainment of faculty members were significantly associated with the TRL of their research outputs. Faculty members with the appropriate expertise and education preparation may be given the opportunity to collaborate with potential industry partners as part of the reengineering process of the university’s research function. [ABSTRACT FROM AUTHOR]

This article examines the healthcare crisis in Sri Lanka, which has been exacerbated by the country's economic downturn in 2022. Prior to the crisis, Sri Lanka had enjoyed a robust healthcare system and good health indicators. However, the current situation has led to shortages of essential medicines and medical devices, as well as a rise in out-of-pocket expenditures (OOPE) for healthcare. The article analyzes the root causes of the high OOPE, including inadequate public financing, inefficiencies in the healthcare system, and the lack of a national health insurance scheme. It also discusses the potential social and geopolitical implications of a strained healthcare system in Sri Lanka, such as the erosion of trust in the government, challenges in economic cooperation, and the potential for regional instability. The article concludes by suggesting potential solutions, including improving healthcare financing, implementing healthcare technology assessment, and fostering international cooperation to address the crisis. Addressing the healthcare challenges in Sri Lanka is crucial not only for the well-being of its population but also for regional peace and stability. [ABSTRACT FROM AUTHOR]

Introduction: Access to medicines is a shared goal across healthcare stakeholders. Since health technology assessment (HTA) informs funding decisions, it shapes access to medicines. Despite its wide implementation, significant access variations due to HTA are observed across Europe. This paper elicited the opinions of European stakeholders on how HTA can be improved to facilitate access. Methods: A scoping review identified HTA features that influence access to medicines within markets and areas for improvement, while three access dimensions were identified (availability, affordability, timeliness). Using the Delphi method, we elicited the opinions of European stakeholders to validate the literature findings. Results: Nineteen participants from 14 countries participated in the Delphi panel. Thirteen HTA features that could be improved to optimise access to medicines in Europe were identified. Of these, 11 recorded a positive impact on at least one of the three access dimensions. HTA features had mostly a positive impact on timeliness and a less clear impact on affordability. 'Early scientific advice' and 'clarity in evidentiary requirements' showed a positive impact on all access dimensions. 'Established ways to deal with uncertainty during HTA' could improve medicines' availability and timeliness, while more 'reliance on real-world evidence' could expedite time to market access. Conclusions: Our results reiterate that increased transparency during HTA and the decision-making processes is essential; the use of and reliance on new evidence generation such as real-world evidence can optimise the availability of medicines; and better collaborations between regulatory institutions within and between countries are paramount for better access to medicines. [ABSTRACT FROM AUTHOR]

Display technologies influence user experience, not only through the perception of product features but also due to their own usage properties. In this work, 12 functional, usable, pleasuring, and media usage properties were analysed for five display technologies: image rendering, 360° rotation, and augmented, immersive, and non-immersive virtual reality. The perception of their importance and their assessment for the chosen technologies were studied by taking two different household products. Two variables for studying decision and expectations were also considered. The results showed that 360° rotation was well-valued in various properties, mainly related to functionality and usability, while the immersive virtual technology stood out in media properties and also in the most important feature: realism. It was also seen that the results could depend on the displayed product. These results provide a deeper insight for user experience optimisation because they complement the information to choose the most appropriate display technology based on the properties to be prioritised. [ABSTRACT FROM AUTHOR]

Vaccine-preventable diseases continue to generate a substantial burden on health, healthcare systems, and societies, which is projected to increase with population ageing. There is a need to better understand the full value of adult immunisation programmes corresponding to the broader value of vaccine frameworks that are recommended for evidence-based decision-making. This review aims to summarise and map evidence for the value of selected adult immunisation programmes (seasonal influenza, pneumococcal disease, RSV, and HZ) in ten diverse countries. We conducted a structured literature review of evidence published from 2017 to 2023. An existing framework was used to structure the assessment, developing matrices demonstrating the elements of value evidenced for each vaccine and country of focus. Our analysis showed substantial evidence base on the value of adult immunisation programmes, but the availability of evidence varied by value element and by vaccine. The impact on the quality of life of the vaccinated individual was the most evidenced value element. Mortality benefits for vaccinated individuals and cost-offsets to healthcare systems were also well-evidenced. The availability of evidence for 'broader' societal value elements (such as transmission value, carer productivity and impact on social equity, and antimicrobial resistance prevention) varied. No evidence was identified relating to the broader value elements of macroeconomic effects, value to other interventions, or effects on the quality of life of caregivers. Robust evidence exists to show that adult immunisation programmes generate substantial value for population health and health systems, yet some elements of broader value remain underrepresented in the academic literature. Without such evidence, the full value of immunisation programmes is underestimated, risking suboptimal policy decisions. [ABSTRACT FROM AUTHOR]

Background: Spiritual health is a state which not only increases the meaning of life but also increases mental satisfaction and gist in life. It improves the verbal communication between physician and patients, which reflects future patient care by strengthening their relationship. Aims and Objectives: (1) The present study was planned to assess the spiritual health status of undergraduate medical students of Veer Surendra Sai Institute of Medical Sciences and Research, Burla, by use of the Spiritual Health Assessment Scale (SHAS) and coping orientation for problem experiences (COPE) score and (2) to find the association between sociodemographic variables and spiritual health status of the students. Materials and Methods: For this study, 750 undergraduate students of either sex were recruited between August 2023 and November 2023. The data were collected through "sociodemographic characteristic questionnaire's," "SHAS," and "cope score." Results: In our study, most of the students were female, i.e., 56.94%. Majority of students were having mean SHA score (96.83 ± 4.72). Regarding copping score, we found that 287 students have scored high score between 42 and 46 (38.26%). A significant association was found between SHAS and type of family (P = 0.001), ritual gathering (P = 0.000), father's education level (P = 0.009), and mother's education level (P = 0.003) at P < 0.05. Conclusion: This study concludes that the spiritual health is directly and indirectly associated with lifestyle modification of the MBBS students which help very easily to overcome from stress and anxiety. [ABSTRACT FROM AUTHOR]

The emergence of SARS-CoV-2 has meant that pandemic preparedness has become a major focus of the global scientific community. Gathered in the historic St Edmund Hall college in Oxford, the one-day LPMHealthcare conference on emerging viruses (6 September 2023) sought to review and learn from past pandemics—the current SARS-CoV-2 pandemic and the Mpox outbreak—and then look towards potential future pandemics. This includes an emphasis on monitoring the "traditional" reservoirs of viruses with zoonotic potential, as well as possible new sources of spillover events, e.g., bats, which we are coming into closer contact with due to climate change and the impacts of human activities on habitats. Continued vigilance and investment into creative scientific solutions is required for issues including the long-term physical and psychological effects of COVID-19, i.e., long COVID. The evaluation of current systems, including environmental monitoring, communication (with the public, regulatory authorities, and governments), and training; assessment of the effectiveness of the technologies/assays we have in place currently; and lobbying of the government and the public to work with scientists are all required in order to build trust moving forward. Overall, the SARS-CoV-2 pandemic has shown how many sectors can work together to achieve a global impact in times of crisis. [ABSTRACT FROM AUTHOR]

Recently, Ades and colleagues discussed the controversies and advancements in network meta‐analysis (NMA) over the past two decades, discussing its reliability, assumptions, novel approaches, and provided some useful recommendations for the conduction of NMAs. The present discussion paper builds on the insights by Ades and colleagues, providing a roadmap for NMA applications, advancements in software and tools, and approaches designed to facilitate the assessment and interpretation of NMA findings. It also discusses the impact of NMA across disciplines, particularly for policymakers and guideline developers. Despite 20 years of NMA history, challenges remain in understanding and assessing assumptions, communicating and interpreting findings, and applying common approaches like network meta‐regression and NMA involving non‐randomized studies in readily available software. NMA has proven particularly valuable in clinical decision‐making, which highlights the need for additional training and interdisciplinary collaboration of knowledge users, including patient engagement, to enhance its adoption and address real‐world problems. [ABSTRACT FROM AUTHOR]

We respond to some of the methodological issues raised in a recent review of network meta‐analysis (NMA). We also provide a health technology developer's perspective and consider the future application of NMA to health technology assessment. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has highlighted the importance of evidence-informed priority setting and situational analysis in pandemic preparedness and response. Health Technology Assessment (HTA) has been identified as an essential tool for evidence-informed decision-making in healthcare. However, the potential role of HTA in pandemic preparedness and response in Africa has yet to be explored. The objective of this scoping review is to ascertain the current understanding of the possible role of HTA in Africa to support future pandemic preparedness and response. Methods: We will conduct a scoping review of literature published between 2010 and 2024. Electronic databases like Embase, PubMed, Scopus, Web of Science, and Google Scholar will be utilized to perform the search. We will also search grey literature sources such as websites of relevant organizations and government agencies. The search will only include studies that were conducted in the English language. Two reviewers will evaluate the titles and abstracts of the publications independently to determine their eligibility using Covidence. Full-text articles will be reviewed for eligibility and data extraction. The data will be extracted using a standardized form. The extracted data will include information on the study design, objectives, methods, findings, and conclusions. The thematic analysis approach will guide the data analysis. Themes and sub-themes will be identified and reported. The review will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Discussion: This scoping review will identify the existing knowledge on the potential role of HTA in Africa to support future pandemic preparedness and response. The findings will aid in identifying deficiencies in knowledge and provide valuable insights for future study. Additionally, they will inform policy-makers and other stakeholders about the potential contribution of the Health Technology Assessment (HTA) in enhancing Africa's readiness and response to pandemics. [ABSTRACT FROM AUTHOR]

With the increasing pervasiveness of Information and Communication Technology (ICT) in the fabric of economic activities, the corporate digital divide has become a crucial issue for the assessment of Information Technology (IT) competencies and the digital gap between firms and territories. With little granular data available to measure the phenomenon, most studies have used survey data. To address this empirical gap, we scanned the homepages of 182,705 Italian companies and extracted ten characteristics related to their digital footprint to develop a new index for the corporate digital assessment. Our results show a significant digital divide between Italian companies according to size, sector and geographical location, opening new perspectives for monitoring and data-driven analysis. [ABSTRACT FROM AUTHOR]

Wireless capsule endoscopy (CE) has revolutionized gastrointestinal diagnostics, offering a non-invasive means to visualize and monitor the GI tract. This review traces the evolution of CE technology. Addressing the limitations of traditional white light (WL) CE, the paper explores non-WL technologies, integrating diverse sensing modalities and novel biomarkers to enhance diagnostic capabilities. Concluding with an assessment of Technology Readiness Levels, the paper emphasizes the transformative impact of non-WL colon CE devices on GI diagnostics, promising more precise, patient-centric, and accessible healthcare for GI disorders. [ABSTRACT FROM AUTHOR]