Accessibility to cancer medicines in Europe:Towards equitable access and fair pricing

This dissertation explores disparities in access to novel cancer medicines across Europe from the perspectives of patients, healthcare providers, and national authorities. It addresses challenges related to accessibility, pricing, and the socioeconomic impact of cancer, with the aim of informing evidence-based policies to support fair and sustainable cancer care.In the first part, access disparities were assessed through surveys with hospital pharmacists and oncology specialists across several European countries. Findings revealed significant variation in time to access and availability of novel cancer medicines, influenced by hospital type, country-specific regulations, and medicine type. Combination therapies were generally less accessible than monotherapies, and access was often faster in specialized hospitals and countries with strong early access programs. The second part of the dissertation examined medicine pricing. We analyzed managed entry agreements (MEAs), revealing differences in how countries negotiate and report discounts. Although MEAs aim to reduce costs, confidentiality limits transparency and comparability. We also presented confidential hospital-level pricing data from nine countries, showing wide disparities and emphasizing the need for standardized reporting to strengthen negotiations and collaboration.The third part investigated the socioeconomic impact of cancer from the patient perspective through the SEC study, involving over 3,000 patients in 25 countries. High levels of financial toxicity were reported, particularly among younger, lower-income, self-employed, and less-educated patients. A sub-study on adolescents and young adults (AYAs) found that 79% experienced financial difficulties, with limited support tailored to their needs. Many healthcare professionals remained unaware of these challenges.The dissertation concludes with six key recommendations, including harmonized EU regulations for early access, improved use of real-world evidence, discontinuation of external reference pricing, and enhanced price transparency. It also calls for the development of validated tools to identify vulnerable patients and inform targeted, supportive policies across Europe

Super-Vth Standard Cells With Improved EDP:Design and Silicon Validation in 65nm LP CMOS

The ever-increasing computational load and shrinking power budget have accentuated the need for energy-efficient operation of edge devices. In this article, a combination of static CMOS logic and Hybrid Pass transistor logic with Static CMOS output (HPSC), which has no floating or weak nodes and is thus as robust to noise as static CMOS logic, is used for designing toolchain-compatible super-Vth standard cells. Optimized HPSC variants of a 2/3-input XOR cell, a 2/3-input XNR cell, a half adder cell, a full adder cell, and two variants of a 1-bit multiply-accumulate combinational cell are presented in a commercial 65nm Low-Power CMOS technology. Measurements of test structures based on ring oscillators and dummy path techniques show an average frequency and average energy-delay product improvement of up to 30.3% and 32.5% respectively at typical conditions. The proposed cells’ superior performance compared to the commercially available standard cells is also highlighted in terms of propagation delay, leakage, and dynamic power consumption. This shows a promising approach for foundries or other commercial entities to improve digital design performance to about half a technology node at no additional cost

Evaluating the ability to map the degree of informality within a city using a scalable, machine learning methodology in Nairobi, Kenya

Updatable and scalable maps of urban deprivation are needed to plan, upgrade, and monitor dynamic neighborhood-level changes within developing world cities, especially in Sub-Saharan Africa. Earth Observation data provides a promising solution for consistent, accurate high-resolution maps globally. However, most studies use very high spatial resolution images, which often cover only small areas and are cost prohibitive. Additionally, most of the previous work has only focused on distinguishing only between slums and formal areas. Our current work has started to look into moving beyond, slum-non slum dichotomy to look at the degree of deprivation within a city. Therefore, this work focuses on determining if we can expand our slum, non-slum, scalable machine learning approaches to represent this degree of deprivation. This is our first attempt to do this, and model results indicate moderate accuracy, but tend to over predict slum areas, especially in the areas where our on the ground data are captured. Future work should focus on understanding modeling uncertainty, expanding on the ground data locations, and the model inputs to determine our ability to scale up the degree of informality data

Microfluidic Thermal Flow Sensor with Extended Linear Range and Reduced Heat Dissipation Using a Shunt

This paper reports an inline microfluidic thermal flow sensor with extended linear range via a thermal shunt between the up- and downstream branch. The shunt is realised by refilling a 3 $\mu \mathrm{m}$ wide trench, such that the up-and downstream branch are thermally short-circuited. Additionally, the fabrication technology allows for the integration of highly-doped silicon heaters in the sidewalls of the freely-suspended microchannel. The sensor is characterised using nitrogen, isopropanol, and water. The shunt extends the linear range 30 times to 0.3 g/h. The heaters dissipate 3.5 mW of power resulting in a maximum temperature of 303 K, suitable for lab-on-a-chip applications. Furthermore, the fabrication technology is compatible with other inline sensors enabling further on-chip integration

Leveraging the critical incident technique for uncovering and training the OSCM competences of the future

PurposeThe purpose of this perspective article is twofold. First, it discusses how the critical incident technique (CIT) can serve as a method for identifying competences required in operations and supply chain management (OSCM) in combination with a systematic literature review (SLR) and Delphi approach. Second, it discusses how the CIT can be used for pedagogical purposes and can support the development of the resulting competences in teaching by using critical incidents (CIs) identified during the research process as a form of problem-based learning (PBL). Thus, we illustrate how CIT can drive competence-oriented research and educational advancements to address complex and dilemma-struck challenges in OSCM.Design/methodology/approachWe provide an overview of CIT in the context of research and education and illustrate CIT’s role in identifying competences and developing them through training. Based on previous use of CIT for the identification of sustainable sourcing competences and subsequent training, we highlight CIT’s broader applicability and extend the discussion to other areas in OSCM, such as supply chain resilience and leveraging new technologies.FindingsWe propose CIT as an effective tool for recognising and developing competences in OSCM. Both future research implications and pedagogical implications are offered. The strengths and limitations of CIT as a method in both research and educational settings are explored.Research limitations/implicationsThe illustration of CIT’s application is limited to research on identifying and training sustainable sourcing competences. Further research is recommended to extend CIT’s application to other OSCM areas.Practical implicationsFor OSCM researchers, educators and practitioners, CIT offers a structured approach to identifying and teaching needed competences, ultimately contributing to more effective training programs in complex supply chain environments.Social implicationsFor society at large and professional OSCM communities, the ability to adapt to new regulatory and economic realities and address the complex and dilemma-struck challenges in OSCM is highly desirable.Originality/valueWe position CIT as a dual-purpose tool for research and education in OSCM. CIT is useful for both identifying competences and training future OSCM leaders, offering a method that can be applied to various complex areas in the field, intended to inspire future research and teaching

Advanced packaging for SiC power modules

The PhD research focuses on exploring solutions to the interconnection challenges in packaging that hinder the exploitation of the full potential of SiC semiconductor power modules. These packaging solutions aim to enable SiC power devices to operate at higher power densities, switching speeds, efficiency, and reliability. To be more specific, a systematic study of topside interconnection and substrate attachment regarding design, materials, process, simulation, testing, and failure analysis for SiC power modules is conducted

Analyzing and formalising land indicators of LGAF, GLII and SDGs through LADM

Over the past fifteen years, LGAF, GLII, and SDGs frameworks have jointly shaped acomplementary global land governance monitoring system. However, challenges remain indata fragmentation and standardised indicator computation. This study explores how ISO19152 LADM provides a unified technical foundation to model and monitor global landindicators. It develops a standardised conceptual model with UML-based implementation andproposes a modular indicator computation architecture based on interface classes andreusable logic components. The proposed approach supports scalable reporting, enhancesindicator operationalisation, and bridges the gap between global policy frameworks andpractical land administration systems at the national level

Particle dynamics and dune formation in Rayleigh-Bénard convection:a particle-resolved simulation study

This paper presents numerical results for Rayleigh-Bénard convection with suspended particles at Rayleigh numbers (Formula presented) and (Formula presented), and unit Prandtl number. Accounting for their finite size makes it possible to investigate in detail the mechanism by which the particles, which are 10 % heavier than the fluid, get resuspended after settling, thus maintaining a two-phase circulating flow. It is shown that an essential component of this mechanism is the formation of particle accumulations, or ‘dunes’, on the bottom of the Rayleigh-Bénard cell. Ascending plumes become localised on these dunes. Particles are dragged up the dune slopes, and when they reach the top, are entrained into the rising plumes. Direct resuspension of particles from the cell bottom, if it happens at all, is very rare. For (Formula presented), aspect ratios (width/height) (Formula presented) are considered. It is found that in these and in the other cases simulated, at steady state, a single dune evolves, the largest linear dimension of which is comparable to the cell size. A remarkable consequence is that even at the low volume fraction considered here, 3.27 %, the particles are able to structure the flow and to determine the size and position of the largest ascending plumes. Their effect on the Nusselt number, however, remains small. This and other results are explained on the basis of the ratio of the cell-bottom viscous boundary-layer thickness to the particle diameter.</p