6,622 research outputs found

    Cost-effectiveness of osimertinib versus standard EGFR-TKI as first-line treatment for locally advanced or metastatic EGFR mutation-positive non-small cell lung cancer in Australia.

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    Objectives: To assess the cost-effectiveness of osimertinib versus standard epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), gefitinib or erlotinib, as first-line treatment for patients with locally advanced or metastatic EGFR mutation-positive non-small cell lung cancer in Australia from a healthcare system perspective. Methods: A partitioned survival model comprising three mutually exclusive health states with a five-year time horizon was developed. Model inputs were sourced from the pivotal trial (FLAURA) and published literature. Incremental cost-effectiveness ratios (ICERs), in terms of cost per quality-adjusted life-year (QALY) gained and cost per life-year (LY) gained, were calculated. Uncertainty of the results was assessed using deterministic and probabilistic sensitivity analyses. Results: Compared with standard EGFR-TKIs, osimertinib was associated with a higher incremental cost of A118,502,andanincrementalbenefitof0.274QALYsand0.313LYs.TheICERwasestimatedtobeA118,502, and an incremental benefit of 0.274 QALYs and 0.313 LYs. The ICER was estimated to be A432,197/QALY gained and A378,157/LYgained.ThebasecaseICERwasmostsensitivetochangesincostoffirstlineosimertinib,timehorizon,andchoiceofoverallsurvivaldata(interimversusfinalanalysis).Conclusions:AtawillingnesstopaythresholdofA378,157/LY gained. The base-case ICER was most sensitive to changes in cost of first-line osimertinib, time horizon, and choice of overall survival data (interim versus final analysis). Conclusions: At a willingness-to-pay threshold of A50,000/QALY, first-line osimertinib is not cost-effective compared with standard EGFR-TKIs in Australia based on the current published price. To achieve acceptable cost-effectiveness, the cost of first-line osimertinib needs to be reduced by at least 68.4%

    Probing the gateway to superheavy nuclei in cranked relativistic Hartree-Bogoliubov theory

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    The cranked relativistic Hartree+Bogoliubov theory has been applied for a systematic study of the nuclei around 254No, the heaviest nuclei for which detailed spectroscopic data are available. The deformation, rotational response, pairing correlations, quasi-particle and other properties of these nuclei have been studied with different relativistic mean field (RMF) parametrizations. For the first time, the quasi-particle spectra of odd deformed nuclei have been calculated in a fully self-consistent way within the framework of the RMF theory. The energies of the spherical subshells, from which active deformed states of these nuclei emerge, are described with an accuracy better than 0.5 MeV for most of the subshells with the NL1 and NL3 parametrizations. However, for a few subshells the discrepancy reach 0.7-1.0 MeV. The implications of these results for the study of superheavy nuclei are discussed.Comment: 7 pages, 3 figures, Proceedings of the Conference on Frontiers of Nuclear Structure, Berkeley, California, July 29th - August 2nd, 2002, UC Berkeley, Clark Kerr Campus, in pres

    Lipase From Thermoalkalophilic Pseudomonas species as an Additive in Potential Laundry Detergent Formulations

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    Lipase isolated from a thermoalkalophilic Pseudomonas species was used as additive to improve the degree of olive oil removal from cotton fabric in the presence of surfactants. The lipase used in this study was found to be more effective with non ionic surfactants as compared to ionic surfactants. In terms of stability, there was no decrease in activity found in the presence of Tween 85, Span 80 and Span 20. Lipase from Pseudomonas species was most active in the presence of Tween 85, Span 80 and Span 20. The application of lipase from Pseudomonas species as an additive in the formulation containing Span 80 has improved oil removal by 36% using the washing system consisting 5 U/mL lipase, at 70 °C for 20 min and 0.8% of Span 80 as surfactant. Considering that lipase from Pseudomonas species is stable in high pH and temperatures in the presence of various surfactants, therefore it is suitable to be incorporated as additives in potential detergent formulations

    Time-dependent Nonlinear Optical Susceptibility of an Out-of-Equilibrium Soft Material

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    We investigate the time-dependent nonlinear optical absorption of a clay dispersion (Laponite) in organic dye (Rhodamine B) water solution displaying liquid-arrested state transition. Specifically, we determine the characteristic time τD\tau_D of the nonlinear susceptibility build-up due as to the Soret effect. By comparing τD\tau_D with the relaxation time provided by standard dynamic light scattering measurements we report on the decoupling of the two collective diffusion times at the two very different length scales during the aging of the out-of-equilibrium system. With this demonstration experiment we also show the potentiality of nonlinear optics measurements in the study of the late stage of arrest in soft materials

    How do Doctors Decide When to Prescribe Antibiotics in Upper Respiratory Tract Infections?

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    Purpose: To examine the predictive features which doctors use when prescribing antibiotics in upper respiratory tract infections (URTIs). Method: This is a cross sectional, prospective study done in a teaching university primary care centre in Kuala Lumpur from June to August 2000. Twelve primary care practitioners participated in the study. Each practitioner was asked to record clinical data and prescriptions given to twenty consecutive patients with URTIs using a structured questionnaire for each patient
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