Productivity benefits of health technologies are ignored in typical economic evaluations from a health payer's perspective, risking undervaluation. We conduct a productivity-based cost-benefit ...analysis from a societal perspective and estimate indirect costs of adult pneumococcal disease, vaccination benefits from the adult 13-valent pneumococcal conjugate vaccine (PCV13 Adult), and rates of return to PCV13 Adult for a range of hypothetical vaccination costs. Our context is Turkey's funding PCV13 for the elderly and for non-elderly adults with select comorbidities within the Ministry of Health's National Immunization Program. We use a Markov model with one-year cycles. Indirect costs from death or disability equal the expected present discounted value of lifetime losses in the infected individual's paid and unpaid work and in caregivers' paid work. Vaccination benefits comprise averted indirect costs. Rates of return equal vaccination benefits divided by vaccination costs, minus one. Input parameters are from public data sources. We model comorbidities' effects by scalar multiplication of the parameters of the general population. Indirect costs per treatment episode of inpatient community-acquired pneumonia (CAP), bacteremia, and meningitis - but not for outpatient CAP - approach or exceed Turkish per capita gross domestic product. Vaccination benefits equal $207.02 per vaccination in 2017 US dollars. The rate of return is positive for all hypothetical costs below this. Results are sensitive to herd effects from pediatric vaccination and vaccine efficacy rates. For a wide range of hypothetical vaccination costs, the rate of return compares favorably with those of other global development interventions with well-established strong investment cases.
•A thermo-mechanical characterization of ABS 3D printed specimens at 77K is reported, which allows delimiting their use in cryogenic applications.•We present three different examples of ABS 3D ...printed objects providing specific solutions in different cryogenic areas:•(i) (SQUID inserts for angular magnetometry, (ii) a support for a metamaterial “magnetic concentrator”, and (iii) tools for in vitro techniques.
3D printing has become a common, inexpensive and rapid prototyping technique, enabling the ad hoc fabrication of complex shapes. In this paper, we demonstrate that 3D printed objects in ABS can be used at cryogenic temperatures, offering flexible solutions in different fields. Firstly, a thermo-mechanical characterization of ABS 3D printed specimens at 77K is reported, which allowed us to delimit the type of cryogenic uses where 3D printed pieces may be implemented. Secondly, we present three different examples where ABS 3D printed objects working at low temperatures have provided specific solutions: (i) SQUID inserts for angular magnetometry (low temperature material characterization field); (ii) a cage support for a metamaterial “magnetic concentrator” (superconductivity application), and (iii) dedicated tools for cryopreservation in assisted reproductive techniques (medicine field).
We discuss the need to make economic evaluations of vaccines antimicrobial resistance (AMR)-sensitive and ways to do so. Such AMR-sensitive evaluations can play a role in value-for-money comparisons ...of different vaccines within a national immunization program, or in comparisons of vaccine-centric and nonvaccine-centric technologies within an anti-AMR program. In general terms, incremental cost-effectiveness ratios and rates of return and their associated decision rules are unaltered by consideration of AMR-related value. The decision metrics need to have their various health, cost, and socioeconomic terms disaggregated into resistance-related subcategories, which in turn have to be measured carefully before they are reaggregated. The fundamental scientific challenges lie primarily in quantifying the causal impact of health technologies on resistance-related health outcomes, and secondarily in ascertaining the economic value of those outcomes. We emphasize the importance of evaluating vaccines in the context of other potentially complementary and substitutable nonvaccine technologies. Complementarity implies that optimal spending on each set of interventions is positive, and substitutability implies that the ratio of spending will depend on relative value for money. We exemplify this general point through a qualitative discussion of the complementarities and (especially the) substitutability between pneumococcal conjugate vaccines and antimicrobial stewardship and between research and development (R&D) of a gonorrhea vaccine versus R&D of a gonorrhea antibiotic. We propose a roadmap for future work, which includes quantifying the causal effects of vaccination and other health technologies on short-term and long-term resistance-related outcomes, measuring the health-sector costs and broader socioeconomic consequences of resistance-related mortality and morbidity, and evaluating vaccines in the context of nonvaccine complements and substitutes.
We report on the improvement of the infrared optical trapping efficiency of dielectric microspheres by the controlled adhesion of gold nanorods to their surface. When trapping wavelength was equal to ...the surface plasmon resonance wavelength of the gold nanorods (808 nm), a 7 times improvement in the optical force acting on the microspheres was obtained. Such a gold nanorod assisted enhancement of the optical trapping efficiency enabled the intracellular manipulation of the decorated dielectric microsphere by using a low power (22 mW) infrared optical trap.
In the original version of this Article the colour key for the amino acid enrichment score was inadvertently omitted from the lower panel of Figure 5b during the production process. This has now been ...corrected in the PDF and HTML versions of the Article.
The critically endangered mangrove finch is now limited to one small population on the west coast of Isabela Island in the Galápagos, but 100 years ago multiple populations were found on the islands ...of Isabela and Fernandina. By accessing genetic datasets through museum sampling, we are able to put current levels of genetic diversity and hybridization with congenerics into a historical context for enhanced conservation. In this study, we compared neutral genetic diversity of the now extinct Fernandina population to historical and current diversity of the Isabela population using 14 microsatellite markers. We found that current genetic diversity of the last remnant population (~80–100 individuals) is far below levels 100 years ago, with only about half of the allelic diversity retained. Current genetic diversity is close to levels in the Fernandina population that went extinct by the 1970s. Bottleneck analysis did not show a strong signature of recent decline, and instead implies that this species may have consistently had low population sizes with wide fluctuations. Hybridization with congeneric woodpecker finches was found in the modern Isabela population, implying that some individuals within the few remaining breeding pairs are finding mates with woodpecker finches. Within the context of historical low population sizes and wide fluctuations, current conservation efforts may help the mangrove finch face current extinction threats and avoid the fate of the Fernandina population. However, this historically small lineage will likely continue to face challenges associated with small specialist species surrounded by a widely-distributed sister lineage producing viable hybrids.
Conventional superelastic orthodontic wires are arch-shaped, have the same mechanical properties all along their length and are used to correct the position of teeth. The disadvantage of these ...archwires is that there are different types of teeth in the mouth and different forces are therefore needed to rectify their position. The aim of this work was to laser weld several types of NiTi orthodontic wires that had different chemical compositions and superelastic properties, in order to adjust their properties to different parts of the mouth. Microstructural changes, transformation stresses and temperatures, variations in corrosion behaviour and ion release were studied in the welded wires.
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