The cost-utility of Viagra® in The Netherlands

OBJECTIVE: Clinical trials suggest that sildenafil is an effective treatment for erectile dysfunction. Nevertheless, reimbursement is controversial: sildenafil is expected to be more effective than conservative therapy (papaverine/ phentolamine injections), but also more costly to society. Economic appraisal of sildenafil is of interest given the prevalence of the disorder. DESIGN: We analyzed the cost-effectiveness of a sildenafil scenario (allowing a switch to injection therapy) and the papaverine/ phentolamine scenario (conservative therapy, no switch allowed). Analyses were performed from the societal perspective. Values for health states of erectile dysfunction were collected using time trade-off. Using these values (N=169), we converted trial outcomes (Goldstein, 1998) into quality adjusted lif

Cost utility analysis of sildenafil compared with papaverine-phentolamine injections

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An autonomous robot for harvesting cucumbers in greenhouses

This paper describes the concept of an autonomous robot for harvesting cucumbers in greenhouses. A description is given of the working environment of the robot and the logistics of harvesting. It is stated that for a 2 ha Dutch nursery, 4 harvesting robots and one docking station are needed during the peak season. Based on these preliminaries, the design specifications of the harvest robot are defined. The main requirements is that a single harvest operation may take at most 10 s. Then, the paper focuses on the individual hardware and software components of the robot. These include, the autonomous vehicle, the manipulator, the end-effector, the two computer vision systems for detection and 3D imaging of the fruit and the environment and, finally, a control scheme that generates collision-free motions for the manipulator during harvesting. The manipulator has seven degrees-of-freedom (DOF). This is sufficient for the harvesting task. The end-effector is designed such that it handles the soft fruit without loss of quality. The thermal cutting device included in the end-effector prevents the spreading of viruses through the greenhouse. The computer vision system is able to detect more than 95␘f the cucumbers in a greenhouse. Using geometric models the ripeness of the cucumbers is determined. A motion planner based on the A*-search algorithm assures collision-free eye-hand co-ordination. In autumn 2001 system integration took place and the harvesting robot was tested in greenhouse. With a success rate of 80°field tests confirmed the ability of the robot to pick cucumbers without human interference. On average the robot needed 45 s to pick one cucumber. Future research focuses on hardware and software solutions to improve the picking speed and accuracy of the eye-hand co-ordination of the robot