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Background De-implementation of low-value care can increase health care sustainability. We evaluated the reporting of direct costs of de-implementation and subsequent change (increase or decrease) in health care costs in randomized trials of de-implementation research. Methods We searched MEDLINE and Scopus databases without any language restrictions up to May 2021. We conducted study screening and data extraction independently and in duplicate. We extracted information related to study characteristics, types and characteristics of interventions, de-implementation costs, and impacts on health care costs. We assessed risk of bias using a modified Cochrane risk-of-bias tool. Results We screened 10,733 articles, with 227 studies meeting the inclusion criteria, of which 50 included information on direct cost of de-implementation or impact of de-implementation on health care costs. Studies were mostly conducted in North America (36%) or Europe (32%) and in the primary care context (70%). The most common practice of interest was reduction in the use of antibiotics or other medications (74%). Most studies used education strategies (meetings, materials) (64%). Studies used either a single strategy (52%) or were multifaceted (48%). Of the 227 eligible studies, 18 (8%) reported on direct costs of the used de-implementation strategy; of which, 13 reported total costs, and 12 reported per unit costs (7 reported both). The costs of de-implementation strategies varied considerably. Of the 227 eligible studies, 43 (19%) reported on impact of de-implementation on health care costs. Health care costs decreased in 27 studies (63%), increased in 2 (5%), and were unchanged in 14 (33%). Conclusion De-implementation randomized controlled trials typically did not report direct costs of the de-implementation strategies (92%) or the impacts of de-implementation on health care costs (81%). Lack of cost information may limit the value of de-implementation trials to decision-makers. Trial registration OSF (Open Science Framework): https://osf.io/ueq32 .

Reliable determination of binding kinetics and affinity of DNA hybridization and single-base mismatches plays an essential role in systems biology, personalized and precision medicine. The standard tools are optical-based sensors that are difficult to operate in low cost and to miniaturize for high-throughput measurement. Biosensors based on nanowire field-effect transistors have been developed, but reliable and cost-effective fabrication remains a challenge. Here, we demonstrate that a graphene single-crystal domain patterned into multiple channels can measure time- and concentration-dependent DNA hybridization kinetics and affinity reliably and sensitively, with a detection limit of 10 pM for DNA. It can distinguish single-base mutations quantitatively in real time. An analytical model is developed to estimate probe density, efficiency of hybridization and the maximum sensor response. The results suggest a promising future for cost-effective, high-throughput screening of drug candidates, genetic variations and disease biomarkers by using an integrated, miniaturized, all-electrical multiplexed, graphene-based DNA array. Monitoring DNA binding and single-base mismatches accurately in real time is difficult, especially for miniaturized devices. Here the authors report a graphene field-effect transistor array capable of reliably measuring DNA hybridization kinetics and affinity at the picomolar level.

Monitoring the dynamic chemical and thermal state of a cell during operation is crucial to making meaningful advancements in battery technology as safety and reliability cannot be compromised. Here we demonstrate the feasibility of incorporating optical fibre Bragg grating sensors into commercial 18650 cells. By adjusting fibre morphologies, wavelength changes associated with both temperature and pressure are decoupled with high accuracy, which allows tracking of chemical events such as solid electrolyte interphase formation and structural evolution. We also demonstrate how multiple sensors are used to determine the heat generated by the cell without resorting to microcalorimetry. Unlike with conventional isothermal calorimetry, the cell’s heat capacity contribution is readily assessed, allowing for full parametrization of the thermal model. Collectively, these findings offer a scalable solution for screening electrolyte additives, rapidly identifying the best formation processes of commercial cells and designing battery thermal management systems with enhanced safety. Tracking a battery’s chemical and thermal states during operation offers important information on its reliability and lifetime. Here the authors develop optical fibre sensors and decouple temperature and pressure variations in the measurements inside of batteries, allowing chemical and thermal events to be monitored with high accuracy.

The purpose of this study is to evaluate the temperature distribution, strength development, porosity, scanning electron microscopy observation, shrinkage, and surface properties of concrete in order to apply microwave heat curing to the precast method and to analyze the CO2 emissions and economic feasibility of microwave heat curing. The heating of a steel form by microwave heating enabled concrete to be efficiently cured at a temperature within a range of ±5 °C. After the curing, demolding strength could be cleared through the densification of the concrete by decreasing the porosity of the concrete. Microwave heat curing exhibited excellent performance compared to conventional steam curing in terms of efficient temperature control, occurrence of cracks due to shrinkage, surface condition of concrete after curing, economic efficiency, and CO2 emissions. However, verification and supplementation based on actual data are necessary so that environments applicable to the various sizes and shapes of forms can be prepared.

The economy of the Roman Empire was predominantly agrarian: Roman landowners, agricultural laborers, and small tenant farmers were highly dependent upon one another for assuring stability. By examining the property rights established by the Roman government, in particular the laws concerning land tenure and the contractual relationships between wealthy landowners and the tenant farmers to whom they leased their land, Dennis P. Kehoe is able to demonstrate how the state fostered economic development and who benefited the most. In this bold application of economic theory, Kehoe explores the relationship between Roman private law and the development of the Roman economy during a crucial period of the Roman Empire, from the second to the fourth century C.E. Kehoe is able to use the laws concerning land tenure, and the Roman government's enforcement of those laws, as a window through which to develop a more comprehensive view of the Roman economy. With its innovative application of the methodologies of law and economics and the New Institutional Economics Law and the Rural Economy in the Roman Empire is a groundbreaking addition to the study of the Roman economy.

A pronoia was a type of conditional grant from the emperor, often to soldiers, of various properties and privileges. In large measure the institution of pronoia characterized social and economic relations in later Byzantium, and its study is the study of later Byzantium. Filling the need for a comprehensive study of the institution, this book examines the origin, evolution and characteristics of pronoia, focusing particularly on the later thirteenth and fourteenth centuries. But the book is much more than a study of a single institution. With a broad chronological scope extending from the mid-tenth to the mid-fifteenth century, it incorporates the latest understanding of Byzantine agrarian relations, taxation, administration and the economy, as it deals with relations between the emperor, monastic and lay landholders, including soldiers and peasants. Particular attention is paid to the relation between the pronoia and Western European, Slavic and Middle Eastern institutions, especially the Ottoman timar.

Microsoft Power BI is a cloud-based service that helps you easily visualize and share insights from your organization's data. This book will get you started with Business Intelligence using the Power BI tool, covering essential concepts like installation, building basic dashboards and visualizations to make your data come to life.

Obwohl zum Plündern in der Merowingerzeit viele Quellenaussagen vorhanden sind, wurden diese in der deutschsprachigen Mediävistik bisher noch nicht systematisch untersucht.Ein Grund hierfür ist die Theoriebezogenheit der Forschung und die damit verbundene Terminologie: Sie prägte mit ihren Implikationen die Forschungsperspektiven stärker vor.

This history of land tenure under the Ptolemies explores the relationship between the new Ptolemaic state and the ancient traditions of landholding and tenure. Departing from the traditional emphasis on the Fayyum, it offers a coherent framework for understanding the structure of the Ptolemaic state, and thus of the economy as a whole. Drawing on both Greek and demotic papyri, as well as hieroglyphic inscriptions and theories taken from the social sciences, Professor Manning argues that the traditional central state 'despotic' model of the Egyptian economy is insufficient. The result is a subtler picture of the complex relationship between the demands of the new state and the ancient, locally organized social structure of Egypt. By revealing the dynamics between central and local power in Egypt, the book shows that Ptolemaic economic power ultimately shaped Roman Egyptian social and economic institutions.