Economic Evaluation of Neoadjuvant Versus Adjuvant Chemotherapy in Cancer Treatment: A Systematic Review and Meta-Analysis.

OBJECTIVES: In the absence of evidence on whether neoadjuvant (NAC) or adjuvant chemotherapy (AC) is more beneficial for various tumor treatments, economic evaluation (EE) can assist medical decision making. There is limited evidence on their cost-effectiveness and their prospective evaluation is less likely in the future. Therefore, a systematic review and meta-analysis about EE for NAC versus AC in solid tumor help compare these therapies from various perspectives. METHODS: Various databases were searched for studies published from inception to 2021. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines and economic-specific guidelines. The data were pooled using a random effects model when possible. RESULTS: The retrieval identified 15 EE studies of NAC versus AC in 8 types of cancer. NAC is the dominant strategy for pancreatic, head and neck, rectal, prostate cancers and colorectal liver metastases. For ovarian cancer, NAC is cost-effective with a lower cost and higher or similar quality-adjusted life-year. There were no significant differences in cost and outcomes for lung cancer. For stage IV or high-risk patients with ovarian or prostate cancer, NAC was cost-effective but not for patients who were not high risk. CONCLUSIONS: The EEs results for NAC versus AC were inconsistent because of their different model structures, assumptions, cost inclusions, and a shortage of studies. There are multiple sources of heterogeneity across EEs evidence synthesis. More high-quality EE studies on NAC versus AC in initial cancer treatment are necessary.

The coevolutionary process of restaurant CSR in the time of mega disruption.

This study investigates how US foodservice conglomerates have embarked on corporate social responsibility (CSR) measures to circumvent dire situations during the COVID-19 pandemic. It explores the evolution of CSR practices from restaurant enterprises to rescue and salvage their stakeholders. By analyzing press releases from ten restaurant chains in three different crisis phases (incubation, acceleration, and climax) through corpus linguistics, we identify a CSR progression mechanism that coevolves with the aftermath of the crisis among their stakeholders. This study improvises the CSR- as-process view to highlight the time-variant dynamic nature of CSR development over the course of major disruption.

Adsorption behavior of the antibiotic levofloxacin on microplastics in the presence of different heavy metals in an aqueous solution.

In recent years, the composite pollution of microplastics with organic pollutants and heavy metal ions in the water environment, including their combined toxicity, has received increasing attention. However, the mechanism underlying the joint effect of antibiotics and heavy metals on the surface behavior of microplastics has not been reported. The primary purpose of this article was to analyze the adsorption of levofloxacin (OFL) onto polyvinyl chloride (PVC) in an aqueous solution. The adsorption behavior was studied using kinetics, thermodynamics, and isotherm models, and the effects of several environmental factors, such as ionic strength, fulvic acid, and heavy metals, were determined. The adsorption kinetics and isotherms models indicated that the whole adsorption process was controlled by both intraparticle and outer diffusion, as well as chemical adsorption, which was the dominant mechanism. Based on the results of the thermodynamic experiment, the adsorption process was a nonspontaneous and exothermic reaction process. Furthermore, the presence of Cu2+, Zn2+, and Cr3+ ions significantly promoted the adsorption of OFL, but the presence of Cd2+ and Pb2+ ions inhibited its adsorption. At the same time, the presence of the ionic strength and fulvic acid remarkably restricted the adsorption process. These findings confirmed that electrostatic interactions, ion exchange, intermolecular hydrogen bonds, and halogen bond cooperation were the main adsorption mechanisms. This paper mainly discusses the interaction between combinations of pollutants with microplastics, which provides theoretical guidance for the interface behavior, migration and transformation of marine microplastics in the actual environment.

Interfacial interaction between diverse microplastics and tetracycline by adsorption in an aqueous solution.

The accumulation of microplastics in offshore aquaculture waters has gradually become a threat to the survival of marine life, and the combined pollution of microplastics and other pollutants is attracting widespread attention. In this paper, tetracycline (TC) was selected as a typical antibiotic, and its adsorption behavior on the surface of diverse type and different sizes of microplastics was studied to explore their combined pollution in an aqueous solution. The results of isotherm fitting showed that the maximum adsorption capacity and coefficient of polyethylene (PE) were the largest, and the adsorption capacity of PE was the strongest among the three microplastics: polyethylene (PE), polystyrene (PS) and polyvinyl chloride (PVC). With increasing PE particle size, the maximum adsorption capacity and adsorption coefficient of TC showed a significant decreasing trend, with a slight fluctuation in the middle. The presence of Pb2+, Cr3+, Cd2+, and Zn2+ markedly enhanced the adsorption of TC to PE, and Cu2+ could reduce the adsorption of TC to PE. The presence of chloride ions did not affect the adsorption process, which indicated that the adsorption mechanism between TC and microplastics is mainly an ion exchange mechanism. These results showed that the surface properties of microplastics and the chemical properties of the aqueous solution played an important role in the adsorption of TC. This study provides important scientific guidance and a theoretical basis for the study of the interfacial behavior, migration and transformation of marine microplastics.