OBJECTIVE: To examine the organisational (i.e., perceived organisational support and psychologically safe environment) and individual (i.e., value, belief and norm) antecedents that strengthen healthcare workers\' speaking-up behaviour in a developing economy.
METHODS: The study uses a cross-sectional design to gather the same data from healthcare workers within the Ashanti Region of Ghana.
METHODS: The data collection happened between 15 June and 30 August 2023. A sample of 380 healthcare workers was selected from 20 facilities in the Ashanti Region of Ghana. A configurational approach, a fussy-set qualitative comparative analysis, was used to identify the configurations that caused high and low speaking-up behaviour among the study sample.
RESULTS: The study results reveal that whereas four configurations generate high speaking-up behaviour, three configurations, by contrast, produce low speaking-up behaviour among healthcare workers.
CONCLUSIONS: Results suggest that in so far as organisational support systems which take the form of a psychologically safe environment and perceived organisational support are vital in relaxing the hierarchical boundaries in a healthcare setting to improve healthcare workers\' speaking-up behaviour, the individual value-based factors that take the form of values, beliefs and norms are indispensable as it provides the healthcare workers with the necessary inner drive to regard speaking-up behaviour on patient safety and care as a moral duty.
CONCLUSIONS: Healthcare workers\' speaking-up behaviour is better achieved when organisational support systems complement the individual norms, values and beliefs of the individual.
UNASSIGNED: Adhered to Strengthening Reporting of Observational Studies in Epidemiology guidelines.
UNASSIGNED: No patient or public contribution.

UNASSIGNED: Research relating to Total Hip Arthroplasty (THA) has found the anterior-based muscle-sparing (ABMS) approach improves both intraoperative and postoperative outcomes when compared to other THA approaches. This study compares the costs and outcomes of the ABMS approach and standard of care (SOC) to determine the relative cost-effectiveness.
UNASSIGNED: A decision-analytic model was utilized to estimate intraoperative outcomes (i.e. length of procedure, length of stay (LOS), and transfusion rates) and 90-day postoperative complications (deep infection, periprosthetic fracture, and dislocation). Data relating to postoperative complications, intraoperative outcomes, and costs (adjusted to 2023 USD) were obtained from the literature. Model results were presented as incremental costs and complications avoided using a willingness-to-pay threshold of $100,000. We conducted both one-way sensitivity analysis (OWSA), varying each parameter individually within a specific range, and probabilistic sensitivity analysis (PSA) where parameters were varied simultaneously. In scenario analysis, ABMS was also compared to the posterior approach (PA) and direct anterior approach (DAA) individually.
UNASSIGNED: ABMS THA was found to have superior results compared to SOC THA over a 90-day time horizon since it decreased major complications by 0.00186 per patient and cost by $3,851 per patient. The PSA found the ABMS approach dominates SOC and is cost-effective in approximately 98.29% and 100% of 10,000 iterations, respectively. Comparing ABMS with only PA procedures increased cost savings per patient to $4,766 while it decreased to $3,242 when comparing ABMS to only DAA procedures. Length of procedure, LOS, and discharge disposition were the main cost drivers.
UNASSIGNED: This analysis demonstrates the ABMS approach for THA is a cost-effective technique when compared to PA and DAA, which may provide an opportunity for cost savings to the healthcare system.

Shared market opinions and beliefs by market participants generate a set of constraints that mediate information through a not-so-unstable system of expected target prices. Price trajectories, within these sets of constraints, confirm or disprove the likelihood of participant expectations and cannot, de facto, be considered permutable, as literature has shown, since their inner structure is dynamically affected by their own progress, suggesting per se the presence of both heat and cycles. This study described and discussed how trajectories are built using different alphabets and suggests that prices follow an ergodic course within structurally similar tessellation classes. It is reported that the courses of price moves are self-similar due to their a priori structure, and they do not need to be complete in order to create the conditions, in resembling conditions, for the appearance of the well-known and commonly used Fibonacci ratios between price trajectories. To date, financial models and engineering are mostly based on the mathematics of randomness. If these theoretical findings need empirical validation, such a potential infrastructure of ratios would suggest the possibility for a superstructure to exist, in other words, the emergence of exploitable patterns.

Prior reward is a potent cue for attentional capture, but the underlying neurobiology is largely unknown. In a novel whisker touch detection task, we show that mice flexibly shift attention between specific whiskers on a trial-by-trial timescale, guided by the recent history of stimulus-reward association. Two-photon calcium imaging and spike recordings revealed a robust neurobiological correlate of attention in the somatosensory cortex (S1), boosting sensory responses to the attended whisker in L2/3 and L5, but not L4. Attentional boosting in L2/3 pyramidal cells was topographically precise and whisker-specific, and shifted receptive fields toward the attended whisker. L2/3 VIP interneurons were broadly activated by whisker stimuli, motion, and arousal but did not carry a whisker-specific attentional signal, and thus did not mediate spatially focused tactile attention. Together, these findings establish a new model of focal attention in the mouse whisker tactile system, showing that the history of stimuli and rewards in the recent past can dynamically engage local modulation in cortical sensory maps to guide flexible shifts in ongoing behavior.

In this study, the health impacts of improving access to treatment with axicabtagene ciloleucel (axi-cel) was assessed in patients with relapsed/refractory diffuse large B-cell lymphoma after ≥2 lines of therapy in Spain. A partitioned survival mixture cure model was used to estimate the lifetime accumulated life years gained (LYG) and quality-adjusted life years (QALYs) per patient treated with axi-cel versus chemotherapy. Efficacy data were extracted from the ZUMA-1 trial for axi-cel and from the SCHOLAR-1 study for chemotherapy. In the base case, the incremental outcomes of axi-cel versus chemotherapy were evaluated in a cohort of 187 patients treated with CAR T-cell therapies, as reported by the \"Spanish National Health System Plan for Advanced Therapies\", and in the alternative scenario in the full eligible population based on epidemiological estimates (n = 490). Taking those currently treated with axi-cel, compared with chemotherapy, axi-cel provided an additional 1341 LYGs and 1053 QALYs. However, when all eligible patients (n = 490) were treated, axi-cel provided an additional 3515 LYs and 2759 QALYs. Therefore, if all eligible patients were treated with axi-cel rather than those currently treated as per the registry (n = 187), there would have been an additional 303 patients treated, resulting in an additional 2173 LYGs and 1706 QALYs in total. The lack of access in Spain has led to a loss of a substantial number of LYGs and QALYs, and efforts should be made to improve access for all eligible patients.

This paper is the introduction to a topical collection on \"Changing Values and Energy Systems\" that consists of six contributions that examine instances of value change regarding the design, use and operation of energy systems. This introduction discusses the need to consider values in the energy transition. It examines conceptions of value and value change and how values can be addressed in the design of energy systems. Value change in the context of energy and energy systems is a topic that has recently gained traction. Current, and past, energy transitions often focus on a limited range of values, such as sustainability, while leaving other salient values, such as energy democracy, or energy justice, out of the picture. Furthermore, these values become entrenched in the design of these systems: it is hard for stakeholders to address new concerns and values in the use and operation of these systems, leading to further costly transitions and systems\' overhaul. To remedy this issue, value change in the context of energy systems needs to be better understood. We also need to think about further requirements for the governance, institutional and engineering design of energy systems to accommodate future value change. Openness, transparency, adaptiveness, flexibility and modularity emerge as new requirements within the current energy transition that need further exploration and scrutiny.

UNASSIGNED: The need for rehabilitation in South Africa has doubled between 1990 and 2017 and is expected to increase in the coming years. However, the rehabilitation needs of South Africans (and globally) remain largely unmet. Establishing a common understanding of the value of rehabilitation can inform clinical practice and policymaking to achieve Universal Health Coverage (UHC).
UNASSIGNED: This study aims to explore the value of rehabilitation services in South Africa\'s public healthcare sector by gathering perspectives from stakeholders. The goal is to inform policy decisions related to the implementation of National Health Insurance (NHI) in South Africa.
UNASSIGNED: The study used a phenomenological approach and interpretivist paradigm. Semi-structured interviews were conducted face-to-face, online, or telephonically with 12 stakeholders from various rehabilitation sectors. The value of rehabilitation was analysed and categorised into five main categories: context, service delivery, patient outcomes, economic and financial components, and collaboration within and between sectors.
UNASSIGNED: The value of rehabilitation was found to be multifaceted, because of the varying health, economic, and social challenges faced by many South Africans.
UNASSIGNED: The study identified components of value-based rehabilitation that should be prioritised in the proposed NHI of South Africa. Future research should explore all stakeholder perspectives, including patients, and provide empirical evidence of rehabilitation\'s economic and societal value.
UNASSIGNED: We highlight priority areas that are central to the value of rehabilitation in South Africa and other low- and middle-income countries (LMICs). Tailoring rehabilitation services to patient and community needs is crucial for achieving value-based care. Given South Africa\'s commitment to the United Nations Convention on the Rights of Persons with Disabilities, prioritising rehabilitation remains essential.

Interventional radiology (IR) is a unique specialty that incorporates a diverse set of skills ranging from imaging, procedures, consultation, and patient management. Understanding how IR generates value to the healthcare system is important to review from various perspectives. IR specialists need to understand how to meet demands from various stakeholders to expand their practice improving patient care. Thus, this review discusses the domains of value contributed to medical systems and outlines the parameters of success. IR benefits five distinct parties: patients, practitioners, payers, employers, and innovators. Value to patients and providers is delivered through a wide set of diagnostic and therapeutic interventions. Payers and hospital systems financially benefit from the reduced cost in medical management secondary to fast patient recovery, outpatient procedures, fewer complications, and the prestige of offering diverse expertise for complex patients. Lastly, IR is a field of rapid innovation implementing new procedural technology and techniques. Overall, IR must actively advocate for further growth and influence in the medical field as their value continues to expand in multiple domains. Despite being a nascent specialty, IR has become indispensable to modern medical practice.

OBJECTIVE: To segregate imaging expenditures from claims data by resource utilization bands (RUBs) and underlying conditions to create an \"expenditure map\" of pediatric imaging costs.
METHODS: A Claims data for children enrolled in a commercial value-based plan were categorized by RUB 0 non-user, 1 healthy user, 2 low morbidity, 3 moderate morbidity, 4 high morbidity, & 5 very high morbidity. The per member per year (PMPY) expense, total imaging spend, and imaging modality with the highest spend were assessed for each RUB. Diagnosis categories associated with high imaging costs were also evaluated.
RESULTS: There were 40,022 pediatric plan members. 14% had imaging-related claims accounting for approximately $2.8 million in expenditures. Member distribution and mean PMPY expenditure RUB was respectively: RUB 0 (3,037, $0), RUB 1 (6,604, $7), RUB 2 - 13,698, $27), RUB 3 - 13,341, $87), RUB 4 (2,810, $268), RUB 5 (532, $841). RUB 3 had the largest total imaging costs at $1,159,523. The imaging modality with the greatest mean PMPY expense varied by RUB with radiography highest in lower RUBs and MRI highest in higher RUBs. The top 3 diagnoses associated with the highest total imaging costs were developmental disorders ($443,980), asthma ($388,797), and congenital heart disease ($294,977) and greatest mean PMPY imaging expenditures malignancy/leukemia ($3,100), transplant ($2,639), and tracheostomy ($1,661).
CONCLUSIONS: Expense mapping using claims data allows for a better understanding of the distribution of imaging costs across a covered pediatric population. This tool may assist organizations in planning effective cost-reduction initiatives and learning how imaging utilization varies by patient complexity in their system.

Memories are not only stored for personal recall, but also to communicate knowledge to others in service of adaptive decision-making. Prior research shows that goals to share information can change which content is communicated in memory as well as the linguistic style embedded in this communication. Yet, little is known as to how communication-related alterations in memory narration drive differences of value processing in listeners. Here, we test how memory communication alters multi-featural recall for complex events and the downstream consequence on value estimations in naïve listeners. Participants recalled a memory of playing an exploratory videogame at a 24-h delay under instructions to either share (i.e., social condition) or recall (i.e., control condition) their memory. Sharing goals systematically altered the content and linguistic style of recall, such that narrators from the social condition were biased towards recall of non-episodic details and communicated their memories with more clout, less formality, and less authenticity. Across two independent samples of naïve listeners, these features differentially influenced value estimations of the video game. We found that greater clout was associated with greater enjoyment while listening to memories (hedonic value), and that greater inclusion of non-episodic details resulted in greater willingness to purchase the video game (motivational drive). These findings indicate that sharing an experience as a story can change the content and linguistic tone of memory recall, which in turn shape perceived value in naïve listeners.