scholarly journals Evaluation of Current Therapies for COVID-19 Treatment

2020 ◽  
Vol 8 (8) ◽  
pp. 1097 ◽  
Author(s):  
Atin Sethi ◽  
Horacio Bach
Keyword(s):  
Lung Infection ◽  
Multiple Organ ◽  
Efficacy And Safety ◽  
Benefit Analysis ◽  
Efficacious Treatment ◽  
Current Therapies ◽  
Potential Benefits ◽  
Risk Benefit Analysis ◽  
Unproven Therapies

The virus SARS-CoV-2, the etiological agent of COVID-19, is responsible for more than 400,000 deaths worldwide as of 10 June 2020. As a result of its recent appearance (December 2019), an efficacious treatment is not yet available. Although considered a lung infection since its emergence, COVID-19 is now causing multiple organ failure, requiring a continuous adjustment in the procedures. In this review, we summarize the current literature surrounding unproven therapies for COVID-19. Analyses of the clinical trials were grouped as chemotherapy, serotherapy, anticoagulant, and the use of human recombinant soluble ACE2 therapies. We conclude that, while no agent has hit the threshold for quality of evidence to demonstrate efficacy and safety, preliminary data show potential benefits. Moreover, there is a possibility for harm with these unproven therapies, and the decision to treat should be based on a comprehensive risk–benefit analysis.

scholarly journals Sitting Position in Neurosurgery

2019 ◽  
Vol 07 (02) ◽  
pp. 077-083
Author(s):  
Shwetal Goraksha ◽  
Bhoomika Thakore ◽  
Joseph Monteiro
Keyword(s):  
Patient Safety ◽  
Cervical Spine ◽  
Cerebellopontine Angle ◽  
Pineal Region ◽  
Anesthetic Techniques ◽  
Sitting Position ◽  
Benefit Analysis ◽  
Monitoring Techniques ◽  
Potential Benefits ◽  
Risk Benefit Analysis

AbstractNeurosurgery in the sitting position is used for resection of tumors located in the cerebellopontine angle, pineal region, other technically difficult tumors in the infratentorial region, as well as surgeries of the cervical spine. Since its inception, the use of this particular position has been contentious due its risk-benefit analysis. With improved microsurgical equipment and surgical and anesthetic techniques, as well as advanced monitoring techniques to assure patient safety, many centers are revisiting the sitting position for its potential benefits.

Economic Analysis of Quality Innovation in Design and Manufacturing

1993 ◽  
Author(s):  
Hubert Vasseur ◽  
Thomas R. Kurfess ◽  
Jonathan Cagan
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Competitive Environment ◽  
Benefit Analysis ◽  
Industrial Output ◽  
Profit Margins ◽  
Design And Manufacturing ◽  
Potential Benefits ◽  
Corporate Profits

Abstract Due to several possible production modes, an industrial output may have different quality levels. Production processes and quality assurance plans are chosen and adjusted, generally as a lagged reaction to customers’ input and competitors’ strategy. Different techniques based on cost benefit analysis have existed to assess beforehand the overall benefits to society of such decisions; however, these techniques do not necessarily provide any insight as to the resulting influence on corporate profits. This paper reviews different perspectives on industrial quality and adopts a formalism in which social and corporate optimum can be compared from an engineering standpoint. The potential benefits for a manufacturer to improve the quality of its products are studied under several market conditions. The incentive is the strongest in a competitive environment where the benefits of quality innovation are twofold: quality innovation increases consumers’ demand and allows the manufacturer to keep more substantial profit margins.

scholarly journals Applying a Risk-benefit Analysis to Outcomes in Tuberculosis Clinical Trials

2019 ◽  
Vol 70 (4) ◽  
pp. 698-703 ◽  
Author(s):  
Sachiko Miyahara ◽  
Ritesh Ramchandani ◽  
Soyeon Kim ◽  
Scott R Evans ◽  
Amita Gupta ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Systematic Approach ◽  
Composite Outcome ◽  
Efficacy And Safety ◽  
Benefit Analysis ◽  
Prevention Study ◽  
Design Considerations ◽  
The Mean ◽  
Risk Benefit Analysis ◽  
Noninferiority Margin

Abstract Although it is common to analyze efficacy and safety separately in clinical trials, this could yield a misleading study conclusion if an increase in efficacy is accompanied by a decrease in safety. A risk-benefit analysis is a systematic approach to examine safety and efficacy jointly. Both the “rank-based” and “partial-credit” methods described in this paper allow researchers to create a single, composite outcome incorporating efficacy, safety, and other factors. The first approach compares the distribution of rankings between arms. In the second approach, a score can be assigned to each outcome category, considering its severity and comparing the mean or median scores of arms. The methods were applied to the A5279/Brief Rifapentine-Isoniazid Efficacy for TB Prevention study, and design considerations for future clinical trials are discussed, including the challenge of arriving at a consensus on rankings/scorings. If well designed, a risk-benefit analysis may allow for a superiority comparison and, therefore, avoid setting a noninferiority margin. Clinical Trials Registration. NCT01404312 (A5279).

scholarly journals Enhancing the effectiveness of community drug and alcohol teams working with opioid-dependent pregnant women: results of an audit

2012 ◽  
Vol 36 (11) ◽  
pp. 421-423
Author(s):  
Mani Sairam ◽  
Rakesh Magon ◽  
Christos Kouimtsidis
Keyword(s):  
Pregnant Women ◽  
Action Plan ◽  
National Standards ◽  
Quality Of Services ◽  
Clinical Implications ◽  
Substitution Treatment ◽  
Benefit Analysis ◽  
Drug And Alcohol ◽  
Risk Benefit Analysis

Aims and methodTo evaluate the quality of services offered by community drug and alcohol teams (CDATs) to pregnant women in substitution treatment. A full audit of the practice across all local CDATs against national standards was undertaken in 2008 and 2010.ResultsQuality of services improved and met three standards in 100% and the fourth standard in 96% of cases. There was good implementation of the recommendations arising out of the action plan of the first cycle, which resulted in significant improvements in interagency liaison and risk-benefit analysis documentation within the CDATs.Clinical implicationsManagement of pregnant women in substitution treatment can be improved by adhering to a multipronged approach as identified by this audit.

scholarly journals The Burden of COVID-19 in Children and Its Prevention by Vaccination: A Joint Statement of the Israeli Pediatric Association and the Israeli Society for Pediatric Infectious Diseases

Vaccines ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 81
Author(s):  
Michal Stein ◽  
Liat Ashkenazi-Hoffnung ◽  
David Greenberg ◽  
Ilan Dalal ◽  
Gilat Livni ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Safety Data ◽  
Epidemiological Data ◽  
Vaccine Safety ◽  
Clinical Aspects ◽  
Direct Effects ◽  
Efficacy And Safety ◽  
Benefit Analysis ◽  
Inflammatory Syndrome ◽  
Risk Benefit Analysis

As of October 2021, SARS-CoV-2 infections were reported among 512,613 children and adolescents in Israel (~33% of all COVID-19 cases). The 5–11-year age group accounted for about 43% (223,850) of affected children and adolescents. In light of the availability of the Pfizer-BioNTech BNT162b2 vaccine against COVID-19 for children aged 5–11 years, we aimed to write a position paper for pediatricians, policymakers and families regarding the clinical aspects of COVID-19 and the vaccination of children against COVID-19. The first objective of this review was to describe the diverse facets of the burden of COVID-19 in children, including the direct effects of hospitalization during the acute phase of the disease, multisystem inflammatory syndrome in children, long COVID and the indirect effects of social isolation and interruption in education. In addition, we aimed to provide an update regarding the efficacy and safety of childhood mRNA COVID-19 vaccination and to instill confidence in pediatricians regarding the benefits of vaccinating children against COVID-19. We reviewed up-to-date Israeli and international epidemiological data and literature regarding COVID-19 morbidity and its sequelae in children, vaccine efficacy in reducing COVID-19-related morbidity and SARS-CoV-2 transmission and vaccine safety data. We conducted a risk–benefit analysis regarding the vaccination of children and adolescents. We concluded that vaccines are safe and effective and are recommended for all children aged 5 to 11 years to protect them from COVID-19 and its complications and to reduce community transmissions. Based on these data, after weighing the benefits of vaccination versus the harm, the Israeli Ministry of Health decided to recommend vaccination for children aged 5–11 years.

Evolving Cuban-CARICOM relations : a comparative cost/benefit analysis

1995 ◽  
Vol 69 (1-2) ◽  
pp. 45-66 ◽  
Author(s):  
Michael Erisman
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Benefit Analysis ◽  
Comparative Cost ◽  
The Future ◽  
Potential Benefits ◽  
Developmental Dynamics ◽  
The Relationship ◽  
Risk Benefit Analysis ◽  
Cost Risk

Survey of the basic developmental dynamics involved in the evolving Cuban-CARICOM relationship. On the basis of a cost-risk/benefit analysis, the author provides some projections regarding the future of this relationship. He concludes that there appear sufficient potential benefits for both sides to deepen the relationship. Cuban-CARICOM integration, however, has no top priority for either partner.

scholarly journals Physicochemical Characterization Cascade of Nanoadjuvant–Antigen Systems for Improving Vaccines

Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 544
Author(s):  
Giuditta Guerrini ◽  
Antonio Vivi ◽  
Sabrina Gioria ◽  
Jessica Ponti ◽  
Davide Magrì ◽  
...  
Keyword(s):  
Immune Response ◽  
Protein Structure ◽  
Physicochemical Properties ◽  
Physicochemical Characterization ◽  
Protein Antigen ◽  
Efficacy And Safety

Adjuvants have been used for decades to enhance the immune response to vaccines, in particular for the subunit-based adjuvants. Physicochemical properties of the adjuvant-protein antigen complexes, such as size, morphology, protein structure and binding, influence the overall efficacy and safety of the vaccine. Here we show how to perform an accurate physicochemical characterization of the nanoaluminum–ovalbumin complex. Using a combination of existing techniques, we developed a multi-staged characterization strategy based on measurements of increased complexity. This characterization cascade has the advantage of being very flexible and easily adaptable to any adjuvant-protein antigen combinations. It will contribute to control the quality of antigen–adjuvant complexes and immunological outcomes, ultimately leading to improved vaccines.

Economic returns of family planning and fertility decline in India, 1991–2061

2021 ◽  
pp. 1-33
Author(s):  
Srinivas Goli ◽  
K. S. James ◽  
Devender Singh ◽  
Venkatesh Srinivasan ◽  
Rakesh Mishra ◽  
...  
Keyword(s):  
Family Planning ◽  
Return On Investment ◽  
Unmet Need ◽  
Economic Returns ◽  
Reproductive Health Care ◽  
The World ◽  
Potential Benefits ◽  
Education And Employment ◽  
Global Evidence

Abstract Investment in family planning (FP) provides returns through a lifetime. Global evidence shows that FP is the second-best buy in terms of return on investment after liberalizing trade. In this study, we estimate the cumulative benefits of FP investments for India from 1991 to 2016 and project them up to 2061 with four scenarios of fertility levels. The findings suggest that India will have greater elasticity of FP investments to lifetime economic returns compared to the world average (cost–revenue ratio of 1:120). We have taken four scenarios for the goalpost, viz., 2.1, 1.8, 1.6, and 1.4. Although different scenarios of total fertility rate (TFR) levels at the goalpost (i.e., the year 2061) offer varied lifetime returns from FP, scenario TFR < 1.8 will be counterproductive and will reduce the potential benefits. With a comprehensive approach, if the country focuses more on improving the quality of FP services and on reducing the unmet need for FP to enhance reproductive health care and expand maximum opportunities for education and employment for both women and men, it can improve its potential to reap more benefits.

scholarly journals International Perspectives on Management of Inflammatory Bowel Disease: Opinion Differences and Similarities Between Patients and Physicians From the IBD GAPPS Survey

2021 ◽  
Author(s):  
David T Rubin ◽  
Charles Sninsky ◽  
Britta Siegmund ◽  
Miquel Sans ◽  
Ailsa Hart ◽  
...  
Keyword(s):  
Unmet Need ◽  
Patient Survey ◽  
Complex Disorders ◽  
International Perspectives ◽  
Bowel Diseases ◽  
Life Impact ◽  
Current Therapies ◽  
Inflammatory Bowel ◽  
Patient Advocacy Groups

Abstract Background Inflammatory bowel diseases (IBD), including Crohn disease (CD) and ulcerative colitis (UC), are complex disorders with multiple comorbidities. We conducted international patient and physician surveys to evaluate current experiences and perceptions of patients with CD or UC and physicians who treat IBD. Methods The IBD Global Assessment of Patient and Physician Unmet Need Surveys comprised a patient survey and a physician survey, fielded in North America and Europe between August 16, 2019, and November 10, 2019. Adults with CD or UC (targeted 1:1 ratio) were recruited from physicians, patient advocacy groups, and recruitment panels; physicians were recruited by recruitment agencies and panels. Results In total, 2398 patients with IBD (1368 CD, 1030 UC) and 654 physicians completed surveys. Anxiety and depression were the most common comorbidities among patients with IBD. Patients and physicians were generally aligned on treatment goals and patient-physician communication. Patients with IBD reported high quality-of-life impact by rectal urgency and need to use the toilet, which were rated as lower-impact by physicians. Patients defined remission based on symptoms; physicians defined remission based primarily on clinical tests. Patients expected current treatments to control their disease for a longer duration than did physicians. Patients expressed more concern about corticosteroid use compared with physicians; many physicians reported prescribing corticosteroids for more than 4 months per year in some patients. Conclusions Patients could benefit from education about disease remission and expectations for current therapies. High corticosteroid use is concerning to patients, and physicians should minimize the use of corticosteroids for extended periods of time.

scholarly journals Efficacy and safety of Si-Jun-Zi-Tang-based therapies for functional (non-ulcer) dyspepsia: a meta-analysis of randomized controlled trials

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yaping Wang ◽  
Bin Liu ◽  
Xiuqiong Fu ◽  
Tiejun Tong ◽  
Zhiling Yu
Keyword(s):  
Relapse Rate ◽  
Large Scale ◽  
Primary Outcome ◽  
Response Rate ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Efficacy And Safety ◽  
History Of ◽  
Non Ulcer Dyspepsia

Abstract Background The traditional Chinese medicine formula Si-Jun-Zi-Tang (SJZT) has a long history of application in the treatment of functional dyspepsia (non-ulcer dyspepsia, FD)-like symptoms. SJZT-based therapies have been claimed to be beneficial in managing FD. This study aimed to assess the efficacy and safety of SJZT-based therapies in treating FD by meta-analysis. Methods Systematic searches for RCTs were conducted in seven databases (up to February 2019) without language restrictions. Data were analyzed using Cochrane RevMan software version 5.3.0 and Stata software version 13.1, and reported as relative risk (RR) or odds ratio (OR) with 95% confidence intervals (CIs). The primary outcome was response rate and the secondary outcomes were gastric emptying, quality of life, adverse effects and relapse rate. The quality of evidence was evaluated according to criteria from the Cochrane risk of bias. Results A total of 341 potentially relevant publications were identified, and 12 RCTs were eligible for inclusion. For the response rate, there was a statically significant benefit in favor of SJZT-based therapies (RR = 1.23; 95% CI 1.17 to 1.30). However, the benefit was limited to modified SJZT (MSJZT). The relapse rate of FD patients received SJZT-based therapies was lower than that of patients who received conventional medicines (OR = 0.23; 95% CI 0.10 to 0.51). No SJZT-based therapies-related adverse effect was reported. Conclusion SJZT-based prescriptions may be effective in treating FD and no serious side-effects were identified, but the effect on response rate appeared to be limited to MSJZT. The results should be interpreted with caution as all the included studies were considered at a high risk of bias. Standardized, large-scale and strictly designed RCTs are needed to further validate the benefits of SJZT-based therapies for FD management. Trial registration Systematic review registration: [PROSPERO registration: CRD42019139136].

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