Cost-effectiveness of implementing a digital psychosocial intervention for patients with psychotic spectrum disorders in low- and middle-income countries in Southeast Europe: Economic evaluation alongside a cluster randomised trial

BACKGROUND: DIALOG+ is a digital psychosocial intervention aimed at making routine meetings between patients and clinicians therapeutically effective. This study aimed to evaluate the cost-effectiveness of implementing DIALOG+ treatment for patients with psychotic disorders in five low- and middle-income countries in Southeast Europe alongside a cluster randomised trial. METHODS: Resource use and quality of life data were collected alongside the multi-country cluster randomised trial of 468 participants with psychotic disorders. Due to COVID-19 interruptions of the trial’s original 12-month intervention period, adjusted costs and quality-adjusted life years (QALYs) were estimated at the participant level using a mixed-effects model over the first 6 months only. We estimated the incremental cost-effectiveness ratio (ICER) with uncertainty presented using a cost-effectiveness plane and a cost-effectiveness acceptability curve. Seven sensitivity analyses were conducted to check the robustness of the findings. RESULTS: The average cost of delivering DIALOG+ was €91.11 per participant. DIALOG+ was associated with an incremental health gain of 0.0032 QALYs (95% CI –0.0015, 0.0079), incremental costs of €84.17 (95% CI –8.18, 176.52), and an estimated ICER of €26,347.61. The probability of DIALOG+ being cost-effective against three times the weighted gross domestic product (GDP) per capita for the five participating countries was 18.9%. CONCLUSION: Evidence from the cost-effectiveness analyses in this study suggested that DIALOG+ involved relatively low costs. However, it is not likely to be cost-effective in the five participating countries compared with standard care against a willingness-to-pay threshold of three times the weighted GDP per capita per QALY gained

Monitoring the Dusty S-Cluster Object (DSO/G2) on its Orbit towards the Galactic Center Black Hole

We analyse and report in detail new near-infrared (1.45 - 2.45 microns) observations of the Dusty S-cluster Object (DSO/G2) during its approach to the black hole at the center of the Galaxy that were carried out with ESO VLT/SINFONI between February and September 2014. Before May 2014 we detect spatially compact Br-gamma and Pa-alpha line emission from the DSO at about 40mas east of SgrA*. The velocity of the source, measured from the red-shifted emission, is 2700+-60 km/s. No blue-shifted emission above the noise level is detected at the position of SgrA* or upstream the presumed orbit. After May we find spatially compact Br-gamma blue-shifted line emission from the DSO at about 30mas west of SgrA* at a velocity of -3320+-60 km/s and no indication for significant red-shifted emission. We do not detect any significant extension of velocity gradient across the source. We find a Br-gamma-line full width at half maximum of 50+-10 Angstroem before and 15+-10 Angstroem after the peribothron transit, i.e. no significant line broadening with respect to last year is observed. Br-gamma line maps show that the bulk of the line emission originates from a region of less than 20mas diameter. This is consistent with a very compact source on an elliptical orbit with a peribothron time passage in 2014.39+-0.14. For the moment, the flaring activity of the black hole in the near-infrared regime has not shown any statistically significant increment. Increased accretion activity of SgrA* may still be upcoming. We discuss details of a source model according to which the DSO is rather a young accreting star than a coreless gas and dust cloud.Comment: 32 pages - 3 tables - 17 figure - accepted by Ap

Morphological Phase Diagram of Gadolinium Iodide Encapsulated in Carbon Nanotubes

The melt phase encapsulation of gadolinium iodide (GdI3) in small internal diameter carbon nanotubes (CNTs) was explored to understand how the tubular structure of the host could chemically stabilize a hygroscopic metal halide. However, given the distribution of diameters in the as-received CNTs, the final sample consisted of mixed encapsulation products. These varied from the monoelemental iodine chain to the atomic layer deposition of the binary halide. Supported by density functional theory calculations, these observations led to the proposition of a morphological phase diagram for GdI3 encapsulation in CNTs as a function of the host's internal diameter. Copyright © 2018 American Chemical Society

Guide for numerical electromagnetic analysis methods: application to surge phenomena and comparison with circuit theory-based approach

The aim of this document is to provide an extended description and application guide of methods belonging to the so-called Numerical Electromagnetic Analysis (NEA) applied to the calculation of electromagnetic transients in power systems. As known, the accurate computation of electromagnetic transients is a fundamental requirement of several studies in the area of power systems. Lightning and switching studies are, for instance, typical subjects where the accuracy of transient\u2019s computation has a direct influence to the proper sizing of components like insulators and breakers. Traditional approaches adopted since now were based on the combination of circuit and transmission lines theories. These approaches, analytically and numerically validated by numerous contributions to the literature, rely on specific assumptions that are inherently relaxed by NEA methods. Indeed, NEA methods mostly rely on the numerical solution of the full-wave Maxwell\u2019s equations and, in this respect, the assessment of their accuracy, as well as the description of the various numerical methodologies, have motivated the preparation of this Technical Brochure

eTRANSAFE: data science to empower translational safety assessment

Toxicolog

eTRANSAFE: data science to empower translational safety assessment

Thirteen pharmaceutical companies have shared and integrated preclinical and clinical data for creating computational resources that enhance translational drug safety assessment