Deploying a spreadsheet tool for early economic value assessment of medical device innovations with healthcare decision makers

Early stage evaluation of medical device innovations is important for healthcare decision-makers as much as for manufacturers, meaning that a wider application of a basic cost-effectiveness analysis is becoming necessary outside the usual expert base of health technology assessment specialists. Resulting from an academic-industry-healthcare professional collaboration, a spreadsheet tool is described that was designed to be accessible both to professionals in healthcare delivery organisations and to innovators in the healthcare technology industry who are non-experts in the field of health economics. The tool enables a basic cost-effectiveness analysis to be carried out, using a simplified decision-tree model to compare costs and patient benefit for a new device-related procedure with that of standard care employing an incumbent device or other alternative. Such a tool is useful to healthcare professionals because it enables them to rapidly elucidate the cost-effectiveness of heterogeneous innovations by means of the standard quality adjusted life year (QALY) measure of clinical outcome, which is intended to be broadly comparable across treatments. For the innovator or manufacturer it helps them focus on what is required for future stages of development, in order to fill gaps in the input data and so further strengthen their case from a health economics perspective. Results are presented of first experiences from deploying the tool on three medical device exemplars, in face-to-face meetings of the NHS National Innovation Centre (NIC) along with the innovator or clinical champion. The results show that mapping of device-related innovations to the tool is achievable in a short meeting between the NIC and the innovator using expected costs, outcomes data from the literature and estimates of ranges for unknown input data. Whilst the result of a simplified analysis is not expected to be definitive, the process of reasoning is found to be illuminating for the parties involved, enabling innovators to articulate the benefits of their innovations and for all parties to highlight gaps in data and evidence that will be required to take the innovation forward. The partnership model of the authors’ organisation supports the kind of cooperative design approach that is necessary to produce the kind of tool described.---------------------------7dd39101208fa Content-Disposition: form-data; name="c14_creators_1_name_family" Crave

The Economic Feasibility of Using Georgia Biomass for Electrical Energy Production

This study investigates the potential for using biomass for the production of electricity in Georgia. The volume, important characteristics, and delivered costs per unit of energy are estimated for various locally produced biomass. Production of synthetic fuels using both pyrolysis and gasification technologies is investigated as potential means for converting biomass into electricity. Capital and operating costs for each of these two technologies are projected across three different scales of production. Estimated costs per unit of electricity generated are determined. It appears, under the conditions modeled, these technologies are not cost competitive with currently used technologies. Significant subsidies would be needed to induce the adoption of these technologies under current economic conditions.bio-electricity, bio-feedstocks, biomass, cost, electricity, Agribusiness, Resource /Energy Economics and Policy,

Multi-Factorial Stability Study of Metabolites

Previous research done on metabolites has found that high energy compounds like adenosine triphosphate(ATP), nicotinamide adenine dinucleotide phosphate reduced (NADPH) or nicotinamide adenine dinucleotide reduced (NADH) are unstable in cell extracts at relatively high temperature and acidic condition. The multifactorial stability study of metabolites enables us to verify the best condition of storage for these energy compounds and sugar phosphates, as well as to strengthen the understanding of metabolism in biological study. As the most solvents for high performance liquid chromatography (HPLC) are acidic and unfavorable for these energy compounds, it is necessary to perform a detailed study about degree of instability of samples before running real samples on HPLC. The research aims to conduct a stability study of energy compounds and sugar phosphates using LC-MS/MS, under varying time points, temperatures and pH conditions. In this work we performed a factorial analysis of compound stability looking at differences in pH (acidic vs. neutral), and temperatures (room temperature of 20°C and temperature at which the standards are generally stored of 4°C). The samples are analyzed under 0, 1, 7, 24, and 168 hours after preparation. The results are enabling us to determine how fast these high energy compounds degrade in different temperatures and environment with various pH values. Future experiments on other pH and temperature combinations could be conducted in order to apply to samples more broadly and generally

Economic Impacts of Ethanol Production in Georgia

Capital costs to construct a conventional ethanol plant producing 100 million gallons per year are $170.593 million. Average annual net returns average$59.216 million with a 1% chance of annual net returns less than $0. Ethanol production stimulates total economic output of$314.221 million in the Georgia economy. Wages and benefits total $20.181 million for 408 jobs in Georgia. State and local governments derive a total of$4.572 million in tax revenues from ethanol production.Resource /Energy Economics and Policy,

Sequential primed kinases create a damage-responsive phosphodegron on Eco1.

Sister-chromatid cohesion is established during S phase when Eco1 acetylates cohesin. In budding yeast, Eco1 activity falls after S phase due to Cdk1-dependent phosphorylation, which triggers ubiquitination by SCF(Cdc4). We show here that Eco1 degradation requires the sequential actions of Cdk1 and two additional kinases, Cdc7-Dbf4 and the GSK-3 homolog Mck1. These kinases recognize motifs primed by previous phosphorylation, resulting in an ordered sequence of three phosphorylation events on Eco1. Only the latter two phosphorylation sites are spaced correctly to bind Cdc4, resulting in strict discrimination between phosphates added by Cdk1 and by Cdc7. Inhibition of Cdc7 by the DNA damage response prevents Eco1 destruction, allowing establishment of cohesion after S phase. This elaborate regulatory system, involving three independent kinases and stringent substrate selection by a ubiquitin ligase, enables robust control of cohesion establishment during normal growth and after stress

Energy Density Functionals From the Strong-Coupling Limit Applied to the Anions of the He Isoelectronic Series

Anions and radicals are important for many applications including environmental chemistry, semiconductors, and charge transfer, but are poorly described by the available approximate energy density functionals. Here we test an approximate exchange-correlation functional based on the exact strong-coupling limit of the Hohenberg-Kohn functional on the prototypical case of the He isoelectronic series with varying nuclear charge $Z<2$, which includes weakly bound negative ions and a quantum phase transition at a critical value of $Z$, representing a big challenge for density functional theory. We use accurate wavefunction calculations to validate our results, comparing energies and Kohn-Sham potentials, thus also providing useful reference data close to and at the quantum phase transition. We show that our functional is able to bind H$^-$ and to capture in general the physics of loosely bound anions, with a tendency to strongly overbind that can be proven mathematically. We also include corrections based on the uniform electron gas which improve the results.Comment: Accepted for the JCP Special Topic Issue "Advances in DFT Methodology

Apoptosome activation, an important molecular instigator in 6-mercaptopurine induced Leydig cell death.

Leydig cells are crucial to the production of testosterone in males. It is unknown if the cancer chemotherapeutic drug, 6-mercaptopurine (6 MP), produces Leydig cell failure among adult survivors of childhood acute lymphoblastic leukemia. Moreover, it is not known whether Leydig cell failure is due to either a loss of cells or an impairment in their function. Herein, we show, in a subset of childhood cancer survivors, that Leydig cell failure is related to the dose of 6 MP. This was extended, in a murine model, to demonstrate that 6 MP exposure induced caspase 3 activation, and the loss of Leydig cells was independent of Bak and Bax activation. The death of these non-proliferating cells was triggered by 6 MP metabolism, requiring formation of both cytosolic reactive oxygen species and thiopurine nucleotide triphosphates. The thiopurine nucleotide triphosphates (with physiological amounts of dATP) uniquely activated the apoptosome. An ABC transporter (Abcc4/Mrp4) reduced the amount of thiopurines, thereby providing protection for Leydig cells. The studies reported here demonstrate that the apoptosome is uniquely activated by thiopurine nucleotides and suggest that 6 MP induced Leydig cell death is likely a cause of Leydig cell failure in some survivors of childhood cancer