Analyses of the return on investment of public health interventions: a scoping review and recommendations for future studies.

Return on investment (ROI) analysis is increasingly being used for evaluating the value for money of public health interventions. Given its potential role for informing health policies, it is important that there is a more comprehensive understanding of ROI analysis within the global health field. To address this gap in the literature, we conducted a scoping review of recent research articles reporting an ROI metric for a health intervention within the public sector in any country setting. The database search was limited to literature published in English and studies published between 1 January 2018 and 14 June 2021. Uses and settings where the ROI metric is being applied, key methodological features of the calculations and the types of economic benefits included were extracted. 118 relevant studies were included within this scoping review. We found that ROI analyses of health interventions differed between those that only included fiscal savings (such as prevented medical expenses) and those which incorporated a wider range of benefits (such as monetised health benefits). This highlights the variation in the definition of ROI analyses and supports the finding that ROI analyses are used for a range of different research questions/purposes within the healthcare sector. We also found that the methodologies used in ROI calculations were inconsistent and often poorly reported. This review demonstrates that there is notable variation in the methodology surrounding recent ROI calculations of healthcare interventions, as well as the definition of ROI analysis. We recommend that ROI metrics should be carefully interpreted before they are used to inform policy decisions regarding the allocation of healthcare resources. To improve the consistency of future studies, we also set out recommended use cases for ROI analysis and a reporting checklist.

Direct electric-field reconstruction of few-cycle mid-infrared pulses in the nanojoule energy range.

Amid the increasing potential of ultrafast mid-infrared (mid-IR) laser sources based on transition metal doped chalcogenides such as Cr:ZnS, Cr:ZnSe, and Fe:ZnSe lasers, there is a need for direct and sensitive characterization of mid-IR mode-locked laser pulses that work in the nanojoule energy range. We developed a two-dimensional spectral shearing interferometry (2DSI) setup to successfully demonstrate the direct electric-field reconstruction of Cr:ZnS mode-locked laser pulses with a central wavelength of 2.3 µm, temporal duration of 30.3 fs, and energies of 3 nJ. The reconstructed electric field is in reasonable agreement with an independently measured intensity autocorrelation trace, and the quantitative reliability of the 2DSI measurement is verified from a material dispersion evaluation. The presented implementation of 2DSI, including a choice of nonlinear crystal as well as the use of high-throughput dispersive elements and a high signal-to-noise ratio near-IR spectrometer, would benefit future development of ultrafast mid-IR lasers and their applications.

Gene and protein expression of cartilage oligomeric matrix protein associated with oncogenesis in canine tumors.

To investigate the expression of cartilage oligomeric matrix protein (COMP) associated with oncogenesis, samples of serum and tumor tissue were obtained from 25 dogs with tumors. The serum levels of COMP in dogs with tumors were significantly higher than in 38 normal controls and correlated with the concentrations of tumor tissue extracts. Positive bands to COMP antibody were detected on immunoblots of tumor extracts. Immunohistochemistry and in situ hybridization demonstrated positive signals of COMP and its mRNA in the cytoplasm of tumor cells from mammary gland tumors, but not in the normal mammary gland. Positive immunohistochemistry results were also obtained for COMP in mast cell tumor and melanoma cells. Oncogenesis might augment production of COMP and the serum level of COMP in dogs.

Interpreting gelatinase activity in tumor tissue and serum as a prognostic marker of naturally developing canine tumors.

To evaluate the clinical usefulness of tissue and serum gelatinase activity as a prognostic marker of canine tumors, tissue samples from 60 tumors and corresponding serum samples from the same animals were collected at the time of biopsy and surgery. On the basis of histopathology and clinical aggressiveness of metastasis and recurrence (MR), the cases were divided into 6 categories: non-inflammatory (Inf(-)) and inflammatory (Inf(+)) benign, and the Inf(-) MR(-), Inf(-) MR(+), Inf(+) MR(-), and Inf(+) MR(+) malignant. Gelatinase activity was determined semi-quantitatively using gelatin zymogram with a gelatinase standard from cultured canine peripheral blood mononuclear cells stimulated with lipopolysaccharide. No significant difference in gelatinase activities in tissue extracts was evident between the benign and malignant tumors. Inf(+) benign tumors, as well as Inf(-) MR(+), Inf(+) MR(-) and Inf(+) MR(+) malignant tumors, showed significantly higher tissue gelatinase activity than Inf(-) benign. The tissue activity in Inf(-) MR(-) malignant was significantly lower than in Inf(+) MR(-) and Inf(+) MR(+) malignant. The serum activity was significantly higher in the malignant cases than in the control and the benign. Inf(-) MR(+), Inf(+) MR(-) and Inf(+) MR(+) malignant tumors induced significantly higher gelatinase activity in serum than Inf(-) benign tumors. Gelatinase activity in serum was positively correlated with that in tumor extracts. Increased gelatinase in tumor tissue and serum may be correlated with inflammation as well as tumor aggressiveness, and thus should be used in combination with histopathology for predicting tumor metastasis or recurrence.