Peritoneal dialysis vs. hemodialysis among patients with end-stage renal disease in Iran: which is more cost-effective?

BACKGROUND: There is little economic evidence on different modalities among patients with end-stage renal disease (ESRD) in Iran. This study aimed to assess the cost-utility of peritoneal dialysis (PD) and hemodialysis (HD) among ESRD patients in Iran. METHODS: From the health system perspective and with a 10-year time horizon, we conducted a cost-utility analysis based on a Markov model to compare three strategies of PD and HD [the second scenario (30% PD, 70% HD), the third scenario (50% PD, 50% HD) and the fourth scenario (70% PD, 30% HD)] among ESRD patients with the current situation (PD, 3% vs. HD, 97%) as the basic scenario (the first scenario) in Iran. Cost data for PD, HD and kidney transplantation were extracted from the medical records of 720 patients in the Health Insurance Organization (HIO) database. The Iranian version of the EQ-5D-5 L questionnaire was filled out through direct interview with 518 patients with ESRD to obtain health utility values. Other variables such as transition probabilities and survival rates were extracted from the literature. To examine the uncertainty in all variables included in the study, a probabilistic sensitivity analysis (PSA) was performed. TreeAge Pro 2020 software was used for data analysis. FINDINGS: Our analysis indicated that the average 10-year costs associated with the first scenario (S1), the second scenario (S2), the third scenario (S3) and the fourth scenario (S4) were 4750.5, 4846.8, 4918.2, and 4989.6 million Iranian Rial (IRR), respectively. The corresponding average quality-adjusted life years (QALYs) per patient were 2.68, 2.72, 2.75 and 2.78, respectively. The ICER for S2, S3 and S4 scenarios was estimated at 2268.2, 2266.7 and 2266.7 per a QALY gained, respectively. The analysis showed that at a willingness-to-pay (WTP) threshold of 3,000,000,000 IRR (2.5 times the GDP per capita), the fourth scenario had a 63% probability of being cost-effective compared to the other scenarios. CONCLUSION: Our study demonstrated that the fourth scenario (70% PD vs. 30% HD) compared to the current situation (3% PD vs. 97% HD) among patients with ESKD is cost-effective at a threshold of 2.5 times the GDP per capita (US$4100 in 2022). Despite the high cost of PD, due to its greater effectiveness, it is recommended that policymakers pursue a strategy to increase the use of PD among ESRD patients.

Cost-effectiveness analysis of different screening strategies for helicobacter pylori infection in Iran: A model-based evaluation.

BACKGROUND: The World Health Organization recommends assessing screening for helicobacter pylori infection to lower gastric cancer (GC) rates. Therefore, we carried out a study to evaluate the cost-effectiveness of different H. pylori screening approaches in Iran. MATERIALS AND METHODS: We used a Markov model with a 50-year time horizon and health system perspective to compare four H. pylori screening strategies (endoscopy, serology, urea breath test [UBT], stool antigen test [SAT]) to no screening in the population aged 20 years and older in Iran. Model parameters were extracted from primary data and published studies. Cost data also came from medical records of 120 patients at different stages of GC. We calculated costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) for each strategy. Probabilistic sensitivity analysis (PSA) using Monte Carlo simulation tested the model's robustness. All analyses were done in TreeAge Pro 2020. RESULTS: All screening strategies provided more QALYs compared to no screening. Base-case analysis found the UBT strategy was the most cost-effective, with an ICER of 101,106,261.5 Iranian rial (IRR) per QALY gained, despite being more costly. No screening and endoscopy were dominated strategies, meaning they had higher costs but provided fewer effectiveness compared to other options. PSA showed at a willingness-to-pay (WTP) threshold of 316,112,349 IRR (Iran's GDP per capita) per QALY, UBT was the optimal strategy in 57.1% of iterations. CONCLUSION: This cost-effectiveness analysis found that screening for H. pylori may be cost-effective in Iran. Among the 4 screening strategies examined, UBT was the most cost-effective approach. Further studies should do cost-effectiveness analyses for specific age groups to optimize the benefits achieved with limited resources.

Financial burden of prostate cancer in the Iranian population: a cost of illness and financial risk protection analysis.

BACKGROUND: Prostate cancer is the second most common cancer in males worldwide and the third most common among Iran's male population. However, there is a lack of evidence regarding its direct and indirect costs in low and middle-income countries. This study intends to bridge the gap using a cost of illness approach, assessing the costs of prostate cancer from the perspectives of patients, society, and the insurance system. METHODS: Two hundred ninety seven patients were included in the study. Data for a 2-month period were obtained from patients registered at two hospitals (Tabriz, Tehran) in Iran in 2017. We applied a prevalence-based, bottom-up approach to assess the costs of the illness. We used the World Health Organization methods to measure the prevalence and investigate the determinants of catastrophic and impoverishing health expenditures. RESULTS: We determined the total costs of the disease for the patients to be IRR 68 million (PPP $ 5,244.44). Total costs of the disease from the perspective of the society amounted to IRR 700,000 million (PPP $ 54 million). Insurance companies expended IRR 20 million (PPP $ 1,558.80) per patient. Our findings show that 31% of the patients incurred catastrophic health expenditure due to the disease. Five point forty-four percent (5.44%) of the patients were impoverished due to the costs of this cancer. CONCLUSION: We found an alarmingly high prevalence of catastrophic health expenditures among prostate cancer patients. In addition, prostate cancer puts a substantial burden on both the patients and society.

Statistical modeling and optimization of dexamethasone adsorption from aqueous solution by Fe3O4@NH2-MIL88B nanorods: Isotherm, Kinetics, and Thermodynamic.

The presence of pharmaceutical compounds in the environment poses a significant threat to human and aquatic animal health. Dexamethasone (DEX), a synthetic steroid hormone with endocrine-disrupting effects, is one such compound that needs to be effectively removed before discharging into the environment. This research presents a novel approach utilizing magnetically recyclable Fe3O4@NH2-MIL88B NRs as an efficient adsorbent for the treatment of DEX from aqueous solutions. The synthesized adsorbent was characterized by X-ray diffraction (XRD), scanning microscopy (SEM), transmission electron microscopy (TEM), vibrating sample magnetometer (VSM), diffuse reflectance spectra (DRS), and Fourier transform infrared spectroscopy (FTIR). Response surface methodology based on central composite design (RSM-CCD) was employed to optimize DEX removal efficiency by determining the optimal conditions, including pH, adsorbent dose, time, and DEX concentration. Under the optimized conditions (pH: 5.53, adsorbent dose: 0.185 g/L, time: 16.068 min, and DEX concentration: 33.491 mg/L), Fe3O4@NH2-MIL88B NRs revealed remarkable DEX adsorption efficiency of 91 ± 1.34% and adsorption capacity of 180.01 mg/g. The Langmuir isotherm and pseudo-second-order kinetic model were found to fit well with the experimental data, indicating a monolayer and chemical adsorption process. Thermodynamic analysis revealed that the adsorption process was spontaneous and endothermic. The study also investigated the inhibitory effect of background ions on DEX removal by Fe3O4@NH2-MIL88B NRs. Magnesium exhibited superior competitive ability with dexamethasone to occupy the active sites of the adsorbent compared to other background ions. The reuse of the adsorbent over ten consecutive cycles resulted in a 39.46% decrease in removal efficiency. The Fe3O4@NH2-MIL88B NRs are surrounded by abundant amounts of functional groups and π-electrons bands that can play a key role in the adsorption and separation of DEX from aqueous environments. The promising results obtained under real conditions highlight the potential of Fe3O4@NH2-MIL88B NRs as a practical and efficient adsorbent for the removal of DEX and other similar corticosteroids from aqueous solutions.

Prevention and control of non-communicable diseases in iran: the case for Investment.

BACKGROUND: Non-communicable diseases are imposing a considerable burden on Iran. This study aims to assess the Return on Investment (ROI) for implementation of Non-communicable diseases (NCDs) prevention program in Iran. METHODS: Four disease groups including cardiovascular diseases, diabetes, cancer, and respiratory diseases were included in our ROI analysis. The study followed four steps: 1) Estimating the total economic burden of NCDs using the Cost-of-Illness approach. 2) Estimating the total costs of implementing clinical and preventive interventions using an ingredient based costing at delivering level and a program costing method at central level.3) Calculating health impacts and economic benefits of interventions using the impact measures of avoided incidence, avoided mortality, healthy life years (HLYs) gained, and avoided direct treatment costs. 4) Calculating the ROI for each intervention in 5- and 15- year time horizons. RESULTS: The total economic burden of NCDs to the Iranian economy was IRR 838.49 trillion per year (2018), which was equivalent to 5% of the country's annual Gross Domestic Product (GDP). The package of NCD will lead to 549 000 deaths averted and 2 370 000 healthy life years gained over 15 years, and, financially, Iranian economy will gain IRR 542.22 trillion over 15 years. The highest ROI was observed for the package of physical activity interventions, followed by the interventions addressing salt, tobacco package and clinical interventions. Conclusions NCDs in Iran are causing a surge in health care costs and are contributing to reduced productivity. Those actions to prevent NCDs in Iran, as well as yielding to a notable health impact, are giving a good economic return to the society. This study underscores an essential need for establishment of a national multi-sectorial NCD coordination mechanism to bring together and strengthen existing cross-agency initiatives on NCDs.

Association between heavy metals and colon cancer: an ecological study based on geographical information systems in North-Eastern Iran.

BACKGROUND: Colorectal cancer has increased in Middle Eastern countries and exposure to environmental pollutants such as heavy metals has been implicated. However, data linking them to this disease are generally lacking. This study aimed to explore the spatial pattern of age-standardized incidence rate (ASR) of colon cancer and its potential association with the exposure level of the amount of heavy metals existing in rice produced in north-eastern Iran. METHODS: Cancer data were drawn from the Iranian population-based cancer registry of Golestan Province, north-eastern Iran. Samples of 69 rice milling factories were analysed for the concentration levels of cadmium, nickel, cobalt, copper, selenium, lead and zinc. The inverse distance weighting (IDW) algorithm was used to interpolate the concentration of this kind of heavy metals on the surface of the study area. Exploratory regression analysis was conducted to build ordinary least squares (OLS) models including every possible combination of the candidate explanatory variables and chose the most useful ones to show the association between heavy metals and the ASR of colon cancer. RESULTS: The highest concentrations of heavy metals were found in the central part of the province and particularly counties with higher amount of cobalt were shown to be associated with higher ASR of men with colon cancer. In contrast, selenium concentrations were higher in areas with lower ASR of colon cancer in men. A significant regression equation for men with colon cancer was found (F(4,137) = 38.304, P < .000) with an adjusted R2 of 0.77. The predicted ASR of men colon cancer was - 58.36 with the coefficients for cobalt = 120.33; cadmium = 80.60; selenium = - 6.07; nickel = - 3.09; and zinc = - 0.41. The association of copper and lead with colon cancer in men was not significant. We did not find a significant outcome for colon cancer in women. CONCLUSION: Increased amounts of heavy metals in consumed rice may impact colon cancer incidence, both positively and negatively. While there were indications of an association between high cobalt concentrations and an increased risk for colon cancer, we found that high selenium concentrations might instead decrease the risk. Further investigations are needed to clarify if there are ecological or other reasons for these discrepancies. Regular monitoring of the amount of heavy metals in consumed rice is recommended.

Medicine storage, wastage, and associated determinants among urban households: a systematic review and meta-analysis of household surveys.

BACKGROUND: Irrational household storage of medicines is a world-wide problem, which triggers medicine wastage as well as its associated harms. This study aimed to include all available evidences from literature to perform a focused examination of the prevalence and factors associated with medicine storage and wastage among urban households. This systematic review and meta-analysis mapped the existing literature on the burden, outcomes, and affective socio-economic factors of medicine storage among urban households. In addition, this study estimated pooled effect sizes for storage and wastage rates. METHODS: Household surveys evaluating modality, size, costs, and affective factors of medicines storage at home were searched in PubMed, EMBASE, OVID, SCOPUS, ProQuest, and Google scholar databases in 2019. Random effect meta-analysis and subgroup analysis were used to pool effect sizes for medicine storage and wastage prevalence among different geographical regions. RESULTS: From the 2604 initial records, 20 studies were selected for systematic review and 16 articles were selected for meta-analysis. An overall pooled-prevalence of medicine storage and real wastage rate was 77 and 15%, respectively. In this regard, some significant differences were observed between geographical regions. Southwest Asia region had the highest storage and wastage rates. The most common classes of medicines found in households belonged to the Infective agents for systemic (17.4%) and the Nervous system (16.4%). Moreover, income, education, age, the presence of chronic illness, female gender, and insurance coverage were found to be associated with higher home storage. The most commonly used method of disposal was throwing them in the garbage. CONCLUSIONS: Factors beyond medical needs were also found to be associated with medicine storage, which urges effective strategies in the supply and demand side of the medicine consumption chain. The first necessary step to mitigate home storage is establishing an adequate legislation and strict enforcement of regulations on dispensing, prescription, and marketing of medicines. Patient's pressure on excessive prescription, irrational storage, and use of medicines deserve efficient community-centered programs, in order to increase awareness on these issues. So, hazardous consequences of inappropriate disposal should be mitigated by different take back programs, particularly in low and middle income countries.

Determinants of catastrophic health expenditures in Iran: a systematic review and meta-analysis.

BACKGROUND: Catastrophic health expenditures (CHE) are of concern to policy makers and can prevent individuals accessing effective health care services. The exposure of households to CHE is one of the indices used to evaluate and address the level of financial risk protection in health systems, which is a key priority in the global health policy agenda and an indicator of progress toward the UN Sustainable Development Goal for Universal Health Coverage. This study aims to assess the CHE at population and disease levels and its influencing factors in Iran. METHODS: This study is a systematic review and meta-analysis. The following keywords and their Persian equivalents were used for the review: Catastrophic Health Expenditures; Health Equity; Health System Equity; Financial Contribution; Health Expenditures; Financial Protection; Financial Catastrophe; and Health Financing Equity. These keywords were searched with no time limit until October 2019 in PubMed, Web of Science, Scopus, ProQuest, ScienceDirect, Embase, and the national databases of Iran. Studies that met a set of inclusion criteria formed part of the meta-analysis and results were analyzed using a random-effects model. RESULTS: The review identified 53 relevant studies, of which 40 are conducted at the population level and 13 are disease specific. At the population level, the rate of CHE is 4.7% (95% CI 4.1% to 5.3%, n = 52). Across diseases, the percentage of CHE is 25.3% (95% CI 11.7% to 46.5%, n = 13), among cancer patients, while people undergoing dialysis face the highest percentage of CHE (54.5%). The most important factors influencing the rate of CHE in these studies are health insurance status, having a household member aged 60-65 years or older, gender of the head of household, and the use of inpatient and outpatient services. CONCLUSION: The results suggest that catastrophic health spending in Iran has increased from 2001 to 2015 and has reached its highest levels in the last 5 years. It is therefore imperative to review and develop fair health financing policies to protect people against financial hardship. This review and meta-analysis provides evidence to help inform effective health financing strategies and policies to prioritise high-burden disease groups and address the determinants of CHE.

Assessment of groundwater quality around municipal solid waste landfill by using Water Quality Index for groundwater resources and multivariate statistical technique: a case study of the landfill site, Qaem Shahr City, Iran.

Groundwater is a precious natural water resource which can be considered as an available and safe source of water for domestic uses. In some cities in northern Iran, groundwater is being polluted due to various human activities. In this regard, the located municipal solid waste landfills close to these areas without the requested controls regarding the landfill leachate and gas emission are among the major sources of environmental pollution, which are deteriorating groundwater quality around landfill sites. In this context, the current study was aimed to assess the quality of collected groundwater samples around a landfill site using the modified Water Quality Index for groundwater resources (WQIG). Also, the water quality map has been prepared by using WQIG in GIS environment. Therefore, thirty-three groundwater samples were collected and analyzed around 11 water wells close to the landfill site. Variety of physicochemical parameters including nitrate (NO3), fecal coliform, sodium absorption ratio (SAR), electrical conductivity, biological oxygen demand (BOD5), phosphate (PO4), total dissolved solids, dissolved oxygen, pH were assessed in groundwater samples based on recommended standard methods by American Public Health Association (APHA). Geostatistics analysis including Kriging, semi-variogram, and variogram methods also was used to evaluate the spatial variations in the variables and to provide the necessary data for further interpolation. According to the results of WQIG, most of the groundwater wells (98.85%) are polluted due to the existing of the landfill site in the investigated area. Generally speaking, based on the WQIG the water samples were defined as not suitable for drinking applications. Also, the high concentrations of nitrate and hardness in the downstream wells (W1-W11) of the landfill were demonstrated by the results of Kriging assay which can be correlated with the penetration of leachate into these wells. Considering the SAR results, all wells in the studied area are classified as (C3S1) that means the groundwater of this area is suitable for agricultural approaches. Moreover, the reduction in the water quality from the south to the north and northeast was demonstrated by the results of spatial dispersion. Evaluation of the changes in water quality near landfill sites showed that 2149.56 m2 of total area had a relatively poor potential for the region's groundwater recharge.

Interim value set for the EQ-5D-5L in Iran using the Crosswalk method.

Background: The EuroQol five-dimensional 5 level (EQ-5D-5L) value set is not currently available for the Iranian general public, while the value set for EuroQol five-dimensional 3 level (EQ-5D-3L) is available. The present study aimed to generate an interim EQ-5D-5L value set for the context of Iran. Methods: The Iranian interim EQ-5D-5L value set was generated using the crosswalk method, which maps EQ-5D-3L and EQ-5D-5L responses. The EQ-5D-3L value set has previously been estimated by Time Trade-Off (TTO) method. The interim value set obtained for EQ-5D-5L was compared with the value set of EQ-5D-3L by using measures of mean, median, and skewness.The analysis was done using STATA version 15. Results: The mean and median scores of the Iranian interim value set were 0.499 and 0.451 for EQ-5D-5L and 0.455 and 0.459 for Iranian EQ-5D-3L, respectively. The range of value for both EQ-5D-3L and interim EQ-5D-5L was -0.113 to 0.919. Data skewness of EQ-5D-3L and interim EQ-5D-5L was-0.099 and -0.114, respectively. In addition, the figure of distribution of value sets for both data sets had a tail extended towards the left. The states of "good health"(i.e., states with value>0.8) for the EQ-5D-3L value set were proportionally more than the Iranian interim EQ-5D-5Lcrosswalk value set (2.47% vs. 0.448%). Conclusion: An EQ-5D-5L value set was generated using the crosswalk method for the Iranian general public, and now researchers and policy-makers can apply it to their economic and clinical analyses.

Distribution of fluoride contamination in drinking water resources and health risk assessment using geographic information system, northwest Iran.

This paper considers exposure to the concentration of fluoride in drinking water resources of Showt city in West Azerbaijan Province in, Iran, and its related potential health risk assessment issues to the resident populations. For this purpose, 88 drinking water samples were analyzed in 2016 by using the spectrophotometric method. Non-carcinogenic health risks due to F exposure through consumption of drinking water were assessed using the US EPA method. In addition, the associated zoning maps of the obtained results were presented using a geographic information system (GIS). The results indicated that fluoride concentration in drinking water ranged from 0.0 to 5.5 mg L-1 of the study area. Based on this research, 36.36% of the samples had a fluoride level higher than the permissible level, 13.63% had less than the permissible limit, and 50% of the samples had a level within the optimum limit of 0.5-1.5 mg L-1. The Hazard Quotient index (HQ) for children, teenager and adults had health hazards (HQ > 1) in 54.55%, 31.82%, and 22.73% of samples, respectively. Groundwater resources having a risk of more than one were located in the villages of Khilajajam, Kolos, and Shorboulagh. So, in these study areas, there are potential risks of dental and skeletal fluorosis.

Association of consumption of excess hard water, body mass index and waist circumference with risk of hypertension in individuals living in hard and soft water areas.

Chronic exposure to soft drinking water increases the risk of hypertension. We conducted a cross-sectional study in 2017 in two study areas in the Poldasht County to assess the relation of hardness, body mass index and waist circumference with risk of hypertension. Total water hardness was measured by gravimetric methods. Hardness of > 180 ppm was considered to be hard drinking water. The Shiblu and Gharghologh areas had a four times higher mean total hardness level in drinking water (968.69 mg/L as CaCO3) than the Sarisoo and Agh Otlogh (180 mg/L as CaCO3) areas. According to the results of the study, the prehypertension prevalence in areas with high and low water hardness was calculated as 23.15% (18.11-29.15) and 46.84% (37.61-57.64), respectively. Moreover, the result showed the prevalence of hypertension and prehypertension was higher in regions with low hardness than those with high hardness, which was statistically significant (P < 0.001). The results of logistic regression showed that age, body mass index, waist circumference and hardness of drinking water were significantly related to hypertension. Accordingly, hypertension was low in people of regions with high hardness (OR 0.26, 0.17-0.42). This report examined whether total hardness in drinking water was protective against hypertension. This is an important finding for the ministry of human health as well as for the water and sewage company.

An innovative swimming pool water quality index (SPWQI) to monitor and evaluate the pools: design and compilation of computational model.

This research aimed to develop an index known as swimming pool water quality index (SPWQI) for quantifying the water pollution potential. The index is a quantitative tool to show the data on the water quality of swimming pools consistently. It makes summarizing the complex data on water quality possible and paves the way for its communication to the general public and decision makers. In this study, the SPWQI has been formulated according to the literature review and Delphi method. According to literature review and the total judgment of the panelist (23 experts specialized in environmental health engineering), 13 physicochemical and biological parameters along with their weights were selected for inclusion in the SPWQI. The results indicated the possibility of calculating a single numerical value (i.e., SPWQI), which indicates the combined effect of significant selected parameters on water quality. In addition, biological composition (47%) had a strong preference weighting than physical and chemical parameters in evaluating the index. Next, it was attempted to implement a novel and user-friendly mathematical model for evaluating the SPWQI. Then, the model accuracy and performance was confirmed by a case study. Overall, it could be said that the assessment of SPWQI sheds light on the concurrent power of several pollutants and can help the authorities to decide upon water quality management and treatment approaches.

Telepsychiatry- Based Care for the Treatment Follow-Up of Iranian War Veterans with Post-Traumatic Stress Disorder: A Randomized Controlled Trial.

BACKGROUND: Physical limitations, distance, and time are major obstacles to access to mental health services for veterans and soldiers. This study was aimed at comparing the efficacy of telepsychiatry and face-to-face consultation as methods of treating post-traumatic stress disorder (PTSD). The comparison was based on treatment costs, access to health services, completion of therapy sessions, and patient satisfaction as variables. METHODS: This research was a double blinded clinical trial supported by Tabriz University of Medical Sciences and conducted in 2015 to 2016 in Tabriz, Iran. Totally, 60 patients were included in the study. Through simple randomization, the patients were divided into experimental and control groups, both of whom were treated through face-to-face consultations for the first 3 sessions. Six follow-up sessions were then held remotely with the experimental group and face to face with the control group. Data were collected using a self-designed and reliable questionnaire and entered in SPSS, version 16. Intergroup comparisons were performed using descriptive statistical measures. Finally, the results were tested using the t test method. RESULTS: A significant relationship was found between the use of information technology and increased patient satisfaction, completion of therapy sessions, and reduction in treatment costs; however, no significant difference was found between the groups in terms of reduction in waiting time and access to a psychiatrist. CONCLUSION: Telepsychiatry is an effective means of delivering mental health services to psychiatric outpatients living in remote areas with limited resources. The results provide preliminary support for the use of telepsychiatry in treating PTSD and improving access to care. Trial Registration Number: IRCT2016020826449N1.

Health risk assessment to fluoride in drinking water of rural residents living in the Poldasht city, Northwest of Iran.

This study analyzes the concentrations and health risks of fluoride in 112 drinking water samples collected from 28 villages of the Poldasht city, West Azerbaijan province in Iran. Results indicated that fluoride content in drinking water ranged from0.27 to 10.3mgL-1 (average 1.70mgL-1). The 57% of samples analyzed exceeded the limit set for fluoride in drinking water. Based on findings from health risk assessment this study, the highest fluoride exposure for different regions of Poldasht city was observed in young consumers, children and teenager's groups. Also, most of the rural residents suffered from fluoride contaminated drinking water. The calculated HQ value was > 1 for all groups of residents in Agh otlogh and Sari soo areas. Therefore, it is imperative to take measures to reduce fluoride concentration in drinking water and control of fluorosis. Action should be implemented to enhance monitoring of fluoride levels to avoid the potential risk to the population.

Adsorption of diazinon from aqueous solution using metal organic framework and functionalized graphene: Comparison of BBD, ANN models.

In the present study, metal organic frameworks (MOFs) and aminated graphitic carbonaceous structure (ACS-RGO) through chemical synthesis prepared by a simple precipitation method and used for diazinon removal. Several techniques such as XRD , FESEM and FTIR were applied for identification of MOF-5 and ACS-RGO. Also, response surface methodology (RSM) was employed in this work to look at the effectiveness of diazinon adsorption. To forecast pesticide removal, we applied artificial neural network (ANN) and Box-Behnken Design (BBD) models. For the ANN model, a sensitivity analysis was also performed. The effect of independent variables like solution pH, various concentrations of diazinon, MOFs and ACS-RGO adsorbent dose and contact time were assessed to find out the optimum conditions. Based on the model prediction, the optimal condition for adsorption ACS-RGO and MOF-5 were determined to be pH 6.6 and 6.6, adsorbent dose of 0.59 and 0.906 g/L, and mixing time of 52.15 and 36.96 min respectively. These conditions resulted in 96.69% and 80.62% diazinon removal using ACS-RGO and MOF-5, respectively. Isotherm studies proved the adsorption of ACS-RGO and MOF-5 following the Langmuir isotherm model for diazinon removal. Diazinon removal followed by the pseudo-second and Pseudo-first order kinetics model provides a better fit for analyzing the kinetic data associated with pesticide adsorption for ACS-RGO and MOF-5, respectively. Based on the obtained results, the predicted values for the efficiency of diazinon removal with the ANN and BBD were similar (R2=0.98). Therefore, two models were able to predict diazinon removal by ACS-RGO and MOF-5.

Photocatalytic degradation of ciprofloxacin using a novel carbohydrate-based nanocomposite from aqueous solutions.

Pharmaceutical substances in the ecosystem pose a notable hazard to human and aquatic organism well-being. The occurrence of ciprofloxacin (CIP) within water sources or the food chain can perturb plant biochemical processes and induce drug resistance in both humans and animals. Therefore, effective removal is imperative prior to environmental discharge. This study introduces a Novel Carbohydrate-Based Nanocomposite (Fe3O4/MOF/AmCs-Alg) as a proficient photocatalytic agent for degrading CIP in aqueous solutions. The fabricated nanocomposite underwent characterization using FTIR, XRD, FESEM, DRS, and VSM techniques. The analyses conducted verified the successful synthesis of the Fe3O4/MOF/AmCs-Alg nanocomposite. Utilizing the optimized parameters (pH = 5, nanocomposite dose = 0.4 g/L, CIP concentration = 10 mg/L, light intensity = 75 mW/cm2, and a duration of 45min), the Fe3O4/MOF/AmCs-Alg/Vis nanocomposite demonstrated an impressive CIP degradation efficiency of 95.85%. Under optimal experiment conditions, CIP removal efficiency in tap water and treated wastewater samples was 91.27% and 76.78%, respectively. Furthermore, the total organic carbon (TOC) analysis indicated a mineralization rate of 51.21% for CIP. Trapping studies demonstrated that the superoxide radical (O2°-) had a notable contribution to the breakdown of CIP. In summary, the Fe3O4/MOF/AmCs-Alg/Vis system offers numerous benefits, encompassing effective degradation capabilities, effortless catalyst retrieval, and remarkable nanocomposite reusability.

Nanocellulose: A comprehensive review investigating its potential as an innovative material for water remediation.

Rapid growth in industrialization sectors, the wastewater treatment plants become exhausted and potentially not able to give desirable discharge standards. Many industries discharge the untreated effluent into the water bodies which affects the aquatic diversity and human health. The effective disposal of industrial effluents thus has been an imperative requirement. For decades nanocellulose based materials gained immense attraction towards application in wastewater remediation and emerged out as a new biobased nanomaterial. It is light weighted, cost effective, mechanically strong and easily available. Large surface area, versatile surface functionality, biodegradability, high aspect ratio etc., make them suitable candidate in this field. Majorly cellulose based nanomaterials are used in the form of cellulose nanocrystals (CNCs), cellulose nanofibers (CNFs), or bacterial nanocellulose (BNC). This review specifically describes about a variety of extraction methods to produced nanocellulose and also discusses the modification of nanocellulose by adding functionalities in its surface chemistry. We majorly focus on the utilization of nanocellulose based materials in water remediation for the removal of different contaminants such as dyes, heavy metals, oil, microbial colony etc. This review mainly emphasizes in ray of hope towards nanocellulose materials to achieve more advancement in the water remediation fields.

Cost of Lung Cancer: A Systematic Review.

OBJECTIVES: We performed a systematic review of studies estimating the cost of illness of lung cancer to compare costs between studies and examine cost drivers, emphasizing generalizability and methodological choices. METHODS: A systematic search on studies published in English on cost of illness of lung cancer was performed in MEDLINE (PubMed), Embase, Web of Science, and Scopus. Databases were searched in January 2017, and records were screened based on eligibility criteria. The systematic search was updated on May 7, 2020. The quality of included studies was appraised using a modified Drummond checklist. RESULTS: Of the 4891 records screened, 19 records were included. Most of the studies were cross-sectional and retrospective and used a prevalence-based approach and a bottom-up approach. Direct medical costs ranged from 4484.13 US dollars purchasing power parity to 45 364.48 US dollars purchasing power parity. Total medical costs as a percentage of total gross domestic product (GDP) ranged from 0.00248 to 0.1326 (median 0.0217), and total medical costs as a percentage of total health expenditure ranged from 0.038 to 0.836 (median 0.209). CONCLUSIONS: There was considerable methodological heterogeneity that made it difficult to compare results between studies. The costs of lung cancer are substantial and impose a substantial economic burden on patients, healthcare systems, and societies. By comparing cancer costs with total health expenditures and GDP per capita, it can be concluded that lung cancer imposes a considerable economic burden on patients and healthcare systems in countries with lower GDP per capita and higher incidence rate.