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Cost-Effectiveness of PHMB & betaine wound bed preparation compared with standard care in venous leg ulcers: A cost-utility analysis in the United Kingdom

Cooper DM, Bojke C, Ghosh P

J Tissue Viability, 2023 Mar 16.
PMID: 36990897 DOI: 10.1016/j.jtv.2023.03.001

BACKGROUND: Wounds cost £8.3 billion per year in the United Kingdom (UK) annually. Venous leg ulcers (VLUs) account for 15% of wounds and can be complicated to heal, increasing nurse visits and resource costs. Recent wound bed preparation consensus recommends wound cleansing and biofilm disrupting agents. However, inert cleansers such as tap water or saline are inexpensive, an evaluation of evidence is required to justify the higher upfront costs of treatment with active cleansers. We undertook a cost-effectiveness analysis of the use of a biofilm disrupting and cleansing solution and gel, Prontosan® Solution and Gel X, (PSGX) (B Braun Medical), as compared to the standard practice of using saline solution, for treating VLUs.
METHODS: A Markov model was parameterised to one-year costs and health-related quality of life consequences of treating chronic VLUs with PSGX versus saline solution. Costs are viewed from a UK healthcare payer perspective, include routine care and management of complications. A systematic literature search was performed to inform the clinical parameters of the economic model. Deterministic univariate sensitivity analysis (DSA) and probabilistic sensitivity analysis (PSA) were undertaken.
RESULTS: For PSGX an Incremental Net Monetary Benefit (INMB) of £1,129.65 to £1,042.39 per patient (with a Maximum Willingness to Pay of £30k and £20k per QALY respectively), of which cost savings are £867.87 and 0.0087 quality-adjusted life years (QALYs) gain per patient. PSA indicates a 99.3% probability of PSGX being cost-effective over saline.
CONCLUSIONS: PSGX for the treatment of VLUs is dominant compared with saline solution in the UK with expected cost-savings within a year and improved patient outcomes.
The role of conductive nanoparticles in anaerobic digestion: Mechanism, current status and future perspectives

Kumar SS, Ghosh P, Kataria N, Kumar D, Thakur S, Pathania D, et al.

Chemosphere, 2021 Oct;280:130601.
PMID: 33945900 DOI: 10.1016/j.chemosphere.2021.130601

In the current scenario, alternative energy sources are the need of the hour. Organic wastes having a larger fraction of biodegradable constituents present a sustainable bioenergy source. It has been reported that the calorific value of biogas generated by anaerobic digestion (AD) is 21-25 MJ/m3 with the treatment which makes it an excellent replacement of natural gas and fossil fuels and can reduce more than 80% greenhouse gas emission to the surroundings. However, there are some limitations associated with the AD process for instance ammonia build-up at the first stage reduces the rate of hydrolysis of biomass, whereas, in the last stage it interferes with methane formation. Owing to special physicochemical properties such as high activity, high reactive surface area, and high specificity, tailor-made conductive nanoparticles can improve the performance of the AD process. In the AD process, H2 is used as an electron carrier, referred as mediated interspecies electron transfer (MIET). Due to the diffusion limitation of these electron carriers, the MIET efficiency is relatively low that limits the methanogenesis. Direct interspecies electron transfer (DIET), which enables direct cell-to-cell electron transport between bacteria and methanogen, has been considered an alternative efficient approach to MIET that creates metabolically favorable conditions and results in faster conversion of organic acids and alcohols into methane. This paper discusses in detail the application of conductive nanoparticles to enhance the AD process efficiency. Interaction between microbes in anaerobic conditions for electron transfer with the help of CNPs is discussed. Application of a variety of conductive nanomaterials as an additive is discussed with their potential biogas production and treatment enhancement in the anaerobic digestion process.
Enhanced biogas production from municipal solid waste via co-digestion with sewage sludge and metabolic pathway analysis

Ghosh P, Kumar M, Kapoor R, Kumar SS, Singh L, Vijay V, et al.

Bioresour Technol, 2020 Jan;296:122275.
PMID: 31683109 DOI: 10.1016/j.biortech.2019.122275

The present study intends to evaluate the potential of co-digestion for utilizing Organic fraction of Municipal Solid Waste (OFMSW) and sewage sludge (SS) for enhanced biogas production. Metagenomic analysis was performed to identify the dominant bacteria, archaea and fungi, changes in their communities with time and their functional roles during the course of anaerobic digestion (AD). The cumulative biogas yield of 586.2 mL biogas/gVS with the highest methane concentration of 69.5% was observed under an optimum ratio of OFMSW:SS (40:60 w/w). Bacteria and fungi were found to be majorly involved in hydrolysis and initial stages of AD. Probably, the most common archaea Methanosarsina sp. primarily followed the acetoclastic pathway. The hydrogenotrophic pathway was less followed as indicated by the reduction in abundance of syntrophic acetate oxidizers. An adequate understanding of microbial communities is important to manipulate and inoculate the specific microbial consortia to maximize CH4 production through AD.
Assessment of pan-Leishmania detection by recombinase polymerase amplification assay

Louizi C, Khan MAA, Faisal K, Chowdhury R, Ghosh P, Hossain F, et al.

Diagn Microbiol Infect Dis, 2023 Feb;105(2):115862.
PMID: 36493571 DOI: 10.1016/j.diagmicrobio.2022.115862

The spread of vector habitats along with increasing human mobility can introduce atypical Leishmania species and hence can challenge existing diagnostic practices for rapid detection of active infection with species outside the narrow target range. Here we assessed the pan-Leishmania detection ability of isothermal recombinase polymerase amplification (RPA) assays targeting 18S rRNA gene, cathepsin L-like cysteine proteinase B (Cpb) gene, and kinetoplast minicircle DNA (kDNA) regions. While the lowest limit of detection of the 18S rRNA-RPA and Cpb-RPA assays were estimated as 12 and 17 standard DNA molecules, respectively, both assays could amplify genomic DNA of 7 pathogenic Leishmania species. Evaluation of 18S rRNA-RPA and our previously developed kDNA-RPA assays on 70 real-time PCR-positive leishmaniasis samples of varying pathologies resulted in sensitivity rates of 35.71% and 88.57%, respectively, while the combined sensitivity was 98.57%. Combinatorial application of 18S rRNA-RPA and kDNA-RPA assays can be recommended for further diagnostic assessments.
Fulltext BOO-ST and CBCEC: two novel hybrid machine learning methods aim to reduce the mortality of heart failure patients

Sutradhar A, Al Rafi M, Shamrat FMJM, Ghosh P, Das S, Islam MA, et al.

Sci Rep, 2023 Dec 18;13(1):22874.
PMID: 38129433 DOI: 10.1038/s41598-023-48486-7

Heart failure (HF) is a leading cause of mortality worldwide. Machine learning (ML) approaches have shown potential as an early detection tool for improving patient outcomes. Enhancing the effectiveness and clinical applicability of the ML model necessitates training an efficient classifier with a diverse set of high-quality datasets. Hence, we proposed two novel hybrid ML methods ((a) consisting of Boosting, SMOTE, and Tomek links (BOO-ST); (b) combining the best-performing conventional classifier with ensemble classifiers (CBCEC)) to serve as an efficient early warning system for HF mortality. The BOO-ST was introduced to tackle the challenge of class imbalance, while CBCEC was responsible for training the processed and selected features derived from the Feature Importance (FI) and Information Gain (IG) feature selection techniques. We also conducted an explicit and intuitive comprehension to explore the impact of potential characteristics correlating with the fatality cases of HF. The experimental results demonstrated the proposed classifier CBCEC showcases a significant accuracy of 93.67% in terms of providing the early forecasting of HF mortality. Therefore, we can reveal that our proposed aspects (BOO-ST and CBCEC) can be able to play a crucial role in preventing the death rate of HF and reducing stress in the healthcare sector.