Using a discrete choice experiment involving cost to value a classification system measuring the quality of life impact of self-management for diabetes

Objective: This paper describes the use of a novel approach in health valuation of a discrete choice experiment (DCE) including a cost attribute to value a recently developed classification system for measuring the quality of life impact (both health and treatment experience) of self-management for diabetes. Methods: A large online survey was conducted using DCE with cost on UK respondents from the general population (n=1,497) and individuals with diabetes (n=405). The data was modelled using a conditional logit model with robust standard errors. The marginal rate of substitution (MRS) was used to generate willingness to pay estimates for every state defined by the classification system. Robustness of results was assessed by including interaction effects for household income. Results: There were some logical inconsistencies and insignificant coefficients for the milder levels of some attributes. There were some differences in the rank ordering of different attributes for the general population and diabetes patients. The willingness to pay to avoid the most severe state was £1,118.53 per month for the general population and £2,356.02 per month for the diabetes patient population. The results were largely robust. Conclusion: Health and self-management can be valued in a single classification system using DCE with cost. The MRS for key attributes can be used to inform cost-benefit analysis of self-management interventions in diabetes using results from clinical studies where this new classification system has been applied. The method shows promise, but found large willingness to pay estimates exceeding the cost levels used in the survey

Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE).

Objective To compare the effectiveness of insulin pumps with multiple daily injections for adults with type 1 diabetes, with both groups receiving equivalent training in flexible insulin treatment.Design Pragmatic, multicentre, open label, parallel group, cluster randomised controlled trial (Relative Effectiveness of Pumps Over MDI and Structured Education (REPOSE) trial).Setting Eight secondary care centres in England and Scotland.Participants Adults with type 1 diabetes who were willing to undertake intensive insulin treatment, with no preference for pumps or multiple daily injections. Participants were allocated a place on established group training courses that taught flexible intensive insulin treatment ("dose adjustment for normal eating," DAFNE). The course groups (the clusters) were then randomly allocated in pairs to either pump or multiple daily injections.Interventions Participants attended training in flexible insulin treatment (using insulin analogues) structured around the use of pump or injections, followed for two years.Main outcome measures The primary outcomes were a change in glycated haemoglobin (HbA1c) values (%) at two years in participants with baseline HbA1c value of ≥7.5% (58 mmol/mol), and the proportion of participants achieving an HbA1c value of <7.5%. Secondary outcomes included body weight, insulin dose, and episodes of moderate and severe hypoglycaemia. Ancillary outcomes included quality of life and treatment satisfaction.Results 317 participants (46 courses) were randomised (156 pump and 161 injections). 267 attended courses and 260 were included in the intention to treat analysis, of which 235 (119 pump and 116 injection) had baseline HbA1c values of ≥7.5%. Glycaemic control and rates of severe hypoglycaemia improved in both groups. The mean change in HbA1c at two years was -0.85% with pump treatment and -0.42% with multiple daily injections. Adjusting for course, centre, age, sex, and accounting for missing values, the difference was -0.24% (-2.7 mmol/mol) in favour of pump users (95% confidence interval -0.53 to 0.05, P=0.10). Most psychosocial measures showed no difference, but pump users showed greater improvement in treatment satisfaction and some quality of life domains (dietary freedom and daily hassle) at 12 and 24 months.Conclusions Both groups showed clinically relevant and long lasting decreases in HbA1c, rates of severe hypoglycaemia, and improved psychological measures, although few participants achieved glucose levels currently recommended by national and international guidelines. Adding pump treatment to structured training in flexible intensive insulin treatment did not substantially enhance educational benefits on glycaemic control, hypoglycaemia, or psychosocial outcomes in adults with type 1 diabetes. These results do not support a policy of providing insulin pumps to adults with poor glycaemic control until the effects of training on participants' level of engagement in intensive self management have been determined.Trial registration Current Controlled Trials ISRCTN61215213.This research was funded by the UK Health Technology Assessment Programme (project No 08/107/01) and will be published in full in Health Technology Assessment. See the HTA programme website for further project information. (http://www.nets.nihr.ac.uk/). This report presents independent research commissioned by the National Institute for Health Research (NIHR). We also acknowledge financial support from the Research and Development Programmes of the Department of Health for England and the Scottish Health and Social Care Directorates who supported the costs of consumables, and of Medtronic UK, which provided the insulin pumps for the trial. These funders had no involvement in the design of the protocol; the collection, analysis, and interpretation of the data; the writing of this paper; or the decision to submit this article for publication. The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the HTA, NIHR, NHS, the Department of Health, or Medtronic UK

Transparent conductive electrode based on LBL deposition of graphene oxide and copper nanowires

Publisher Copyright: © 2021In this work, Graphene/Copper Nanowire (G/CuNW) based transparent conducting electrodes (TCEs) were prepared via spin-assisted layer-by-layer (LBL) deposition. 3-aminopropyltriethoxysilane (ɣ-APS) functionalized glass substrates were sequentially spin-coated with graphene oxide (GO) and CuNWs. Then, to enhance the electrical conductivity, the multilayer films were subjected to chemical reduction and thermal annealing. The ultimate films were characterized by a scanning electron microscope, UV–Vis spectrometer, and sheet resistance using a four-point probe method. 3-bilayer G/CuNWs films exhibited sheet resistance of 9 Ω/sq and optical transmittance of 67% (at 550 nm), which is comparable to commercial ITO electrode in terms of mainly sheet resistance.Peer reviewe

A comparison of optic nerve head topographic measurements by Stratus OCT in patients with macrodiscs and normal-sized healthy discs

PMID = 2424087

Risk of superior gluteal nerve and gluteus medius muscle injury during femoral nail insertion

PubMed: 17403807Background: Abduction weakness and limping is a well-recognized complication of closed antegrade insertion of femoral nails, latrogenic injuries to the superior gluteal nerve and the gluteus medius muscle are the most likely contributing factors. The purpose of this study of cadavers was to assess the risk of nerve and muscle injury with various lower-limb positions used during nail insertion. Methods: We studied thirteen hips of ten formalin-fixed adult cadavers. With the cadaver in the full lateral position, a 9-mm reamer was introduced in a retrograde fashion from the intercondylar notch and passed through the gluteus medius muscle. The distance between the point of entry of the reamer into the undersurface of this muscle and the inferior main branch of the superior gluteal nerve (the nerve-reamer distance) and the distance between the entry and exit points of the reamer in the gluteus medius muscle (the intramuscle distance) were measured in three different hip positions: 15° of flexion and 15° of adduction (Position 1), 30° of flexion and 30° of adduction (Position 2), and 60° of flexion and 30° of adduction (Position 3). Results: In Position 1, the average nerve-reamer distance was 7 mm and the average intramuscle distance was 24 mm. In three hips the reamer injured the nerve directly, and in two other hips the distance was ?5 mm. In Position 2, the average nerve-reamer distance was 21 mm and the average intramuscle distance was 18 mm. In Position 3, the average nerve-reamer distance was 33 mm and the average intramuscle distance was 11 mm. None of the reamers in this position came closer than 20 mm to the nerve. Conclusions: The risk of injury to the superior gluteal nerve and the gluteus medius muscle during closed antegrade insertion of a femoral nail is lessened by increasing the amount of hip flexion and adduction. Clinical Relevance: The risk of injury to both the superior gluteal nerve and the gluteus medius muscle is higher with limited degrees of hip flexion and adduction, such as are possible in the supine position on a fracture table, than it is with greater degrees of hip flexion and adduction, which are possible in the lateral position on a fracture table or in the so-called sloppy lateral position on an ordinary table. Therefore, insertion of a femoral nail with the hip in increased flexion and adduction might help to lower the risk of injuries to the superior gluteal nerve and the gluteus medius muscle. Copyright © 2007 by The Journal of Bone and Joint Surgery, Incorporated

Recent Rrogresses on Solution-Processed Silver Nanowire Based Transparent Conducting Electrodes for Organic Solar Cells

Organic photovoltaics (OPVs) are considered as a future alternative for conventional silicon based solar cells, owing to their low cost, ease of production and high-throughput. The transparent conducting electrode (TCE) is a fundamental component of OPVs. Traditionally, indium tin oxide (ITO) has been mainly utilized as a TCE in OPV applications due to its relatively high transparency and low sheet resistance. However, increasing demand for the optoelectronic devices has led to large fluctuations in ITO prices in the past decade and ITO is known to account more than 50% of the total cost of OPV devices. Thus, it is believed that development of solution-processable alternative materials is of great importance in reducing the cost of OPVs. Numerous materials, including silver nanowires, carbon nanotubes, graphene and conducting polymers, have been offered as replacements for ITO. This article reviews recent progress on fabrication of TCE via solution based coating techniques of silver nanowires (Ag NWs). In addition, performance of the Ag NWs based TCE in OPVs is summarized. Finally, we explore the future outlook for Ag NWs based TCE at the end of the review. © 2017 Elsevier LtdNational Research Foundation of Korea: NRF-2015R1C1A1A02036599 111M510The authors would like to acknowledge the financial support from T?BITAK, Turkey (Grant No: 111M510) and National Research Foundation of Korea, South Korea (NRF-2015R1C1A1A02036599)

Preparation of Transparent Conductive Electrode via Layer-By-Layer Deposition of Silver Nanowires and Its Application in Organic Photovoltaic Device (vol 10, 46, 2020)

Basarir, Fevzihan/0000-0003-0055-7151;WOS:000526090400097[No Abstract Available]National Research Foundation (NRF) [NRF-2018K2A9A1A06066082]; Technology Development Program to Solve Climate Changes of the National Research Foundation (NRF) - Ministry of Science, ICT & Future Planning [NRF-2016M1A2A2940914]; TUBITAKTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [113M772]; Pukyong National University Research Fund in 2017 [CD-2017-1504]The first two authors contributed equally to this work. This research was supported by the National Research Foundation (NRF) (NRF-2018K2A9A1A06066082) and the Technology Development Program to Solve Climate Changes of the National Research Foundation (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2016M1A2A2940914). The authors would like to acknowledge the financial support from TUBITAK (Grant No. 113M772). This work was also supported by the Pukyong National University Research Fund in 2017 (CD-2017-1504)

Preparation of Transparent Conductive Electrode via Layer-By-Layer Deposition of Silver Nanowires and Its Application in Organic Photovoltaic Device

Basarir, Fevzihan/0000-0003-0055-7151; Lee, Bo Ram/0000-0002-4670-6717; kosemen, arif/0000-0002-7572-7963WOS:000516825600046PubMed: 31878159Solution processed transparent conductive electrodes (TCEs) were fabricated via layer-by-layer (LBL) deposition of silver nanowires (AgNWs). First, the AgNWs were coated on (3-Mercaptopropyl)trimethoxysilane modified glass substrates. Then, multilayer AgNW films were obtained by using 1,3-propanedithiol as a linker via LBL deposition, which made it possible to control the optical transmittance and sheet resistance of multilayer thin films. Next, thermal annealing of AgNW films was performed in order to agent their electrical conductivity. AgNW monolayer films were characterized by UV-Vis spectrometer, field emission scanning electron microscopy, optical microscopy, atomic force microscopy and sheet resistance measurement by four-point probe method. The high performances were achieved with multilayer films, which provided sheet resistances of 9 Omega/sq, 11 Omega/sq with optical transmittances of 71%, 70% at 550 nm, which are comparable to commercial indium tin oxide (ITO) electrodes. Finally, an organic photovoltaic device was fabricated on the AgNW multilayer electrodes for demonstration purpose, which exhibited power conversion efficiency of 1.1%.National Research Foundation (NRF) [NRF-2018K2A9A1A06066082]; TUBITAKTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [113M772]; Pukyong National University Research Fund [CD-2017-1504]First two authors contributed equally to this work. This research was supported by the National Research Foundation (NRF) (NRF-2018K2A9A1A06066082). The authors would like to acknowledge the financial support from TUBITAK (Grant No: 113M772). This work was supported by the Pukyong National University Research Fund in 2017 (CD-2017-1504)