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1دورية أكاديمية
المؤلفون: Pace, A., Faught, B. E., Law, M., Mateus, L., Roy, M., Sulowski, C., Khowaja, A.
المصدر: Frontiers in Health Services ; volume 3 ; ISSN 2813-0146
الوصف: Introduction The use of telemedicine in critical care is emerging, however, there is a paucity of information surrounding the costs relative to health gains in the pediatric population. This study aimed to estimate the cost-effectiveness of a pediatric tele-resuscitation (Peds-TECH) intervention compared to the usual care in five community hospital emergency departments (EDs). Using a decision tree analysis approach with secondary retrospective data from a 3-year time period, this cost-effectiveness analysis was completed. Methods A mixed methods quasi-experimental design was embedded in the economic evaluation of Peds-TECH intervention. Patients aged <18 years triaged as Canadian Triage and Acuity Scale 1 or 2 at EDs were eligible to receive the intervention. Qualitative interviews were conducted with parents/caregivers to explore the out-of-pocket (OOP) expenses. Patient-level health resource utilization was extracted from Niagara Health databases. The Peds-TECH budget calculated one-time technology and operational costs per patient. Base-case analyses determined the incremental cost per year of life lost (YLL) averted, and additional sensitivity analysis confirmed the robustness of the results. Results Odds ratio for mortality among cases was 0.498 (95% CI: 0.173, 1.43). The average cost of a patient receiving the Peds-TECH intervention was $2,032.73 compared to $317.45 in usual care. In total, 54 patients received the Peds-TECH intervention. Fewer children died in the intervention group resulting in 4.71 YLL. The probabilistic analysis revealed an incremental cost-effectiveness ratio of $64.61 per YLL averted. Conclusion Peds-TECH appears to be a cost-effective intervention for resuscitating infants/children in hospital emergency departments.
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2دورية أكاديمية
المصدر: Frontiers in Chemistry ; volume 10 ; ISSN 2296-2646
الوصف: The race for environmentally-safe pesticides and biocides has been showing solutions ranging from pest-pathologic microorganisms to safer botanical extracts that can be incorporated in several formulations. Often linked to high biological activities, fruit residues can be recovered from food processing factories to obtain complex extracts enriched with several bioactive chemicals. Mango ( Mangifera indica ) fruits are processed into food products in high volumes across the globe and generate a consistent residue that contains, among others, the xanthonoid mangiferin and the flavonoid hyperoside. Both compounds have been linked to several pharmacological and pesticidal activities, although not yet studied for algicidal applications, a current concern specially for antifouling and harmful algae blooms control products. The challenge lies, however, not only on the degree of activity of the natural compounds, but also on the processes necessary to separate, isolate and formulate the bioactive compounds in order to obtain an effective final product. The solvent choice plays an important part regarding the selectivity of the separation and isolation of the main bioactive compounds from the solid waste matrix. Ethanolic mixtures in water have been consolidated recently as a promising extraction medium for flavonoids and xanthonoids, although hindered by solubility limitations. In this paper, aqueous solutions of ionic liquids (ILs) were tested, screened and optimized using Box-Behnken design and Response Surface Methodology to obtain mangiferin and hyperoside-enriched extracts. Results showed a greater concentration of mangiferin and hyperoside with 1-octyl-3-methylimidazolium chloride ([C 8 MIm] Cl), when compared to choline acetate and ethanolic extracts using optimized parameters. In terms of sufficiency, solvent selection between ILs and ethanolic extraction media was discussed considering economic and environmental factors. Ethanol/water mango waste extracts were then studied for their activity against ...
