Rhea (Belgium)

Health state utility values (HSUVs) are vital in cost-utility analyses (CUAs) that inform policymaking. However, suboptimal selection and application of HSUVs have been reported in areas such as cardiovascular disease and cancer. This study reviewed the methodological quality and appropriateness of HSUV in CUA use for interventions targeting infectious diseases in aging populations. A systematic search of the MEDLINE database was conducted to identify CUAs that evaluated interventions against six major infectious diseases from January 2000 to July 2025. Two reviewers independently screened the identified studies based on eligibility criteria. The two reviewers then assessed the included studies using a modified checklist that covered how HSUVs were selected, elicited, and applied. Findings are summarized by descriptive statistics across the entire period (January 2000 to July 2025) and three sub-periods (2000-2009, 2010-2019, and 2020 to July 2025). Among the 146 included CUA studies, only 10 (7%) relied exclusively on original sources for HSUVs, while 78% used economic data, either alone or in combination with other secondary sources or assumptions. Most studies (78-91%) did not provide sufficient rationale or descriptions for the population or how HSUVs were elicited, and 42% failed to report all utility components. Complete comparability between the CUAs and reference data for the diagnosis, severity, and country was observed in only 51-60% of studies. Notably, fewer than half of CUAs reported HSUVs that were consistent with their cited sources, and 80% did not discuss the limitations associated with HSUV use. Most criteria showed limited improvements, and in some cases declines, between January 2000 and July 2025. CUAs of infectious diseases in aging populations are frequently associated with suboptimal practices in how HSUVs are selected, elicited, and applied. These shortcomings highlight the need for cautious interpretation of CUA data and for greater methodological transparency. Improving the quality of economic evaluations will require systematic approaches to how HSUVs are selected and elicited, with increased investment in primary data collection and the creation of accessible utility databases.

Power distribution networks are designed to operate as balanced three-phase systems, but achieving and maintaining network balance is challenging, particularly with the increasing adoption of distributed energy resources (DERs). Phase unbalance introduces inefficiencies into the network, including increased energy losses and difficulties in maintaining voltage levels within acceptable limits. This paper proposes a computationally efficient methodology to optimize customer phase configurations in networks with high DER penetration. The approach focuses only on load unbalance, eliminating the need for power flow outputs and extensive smart meter (SM) installations across the network, typically required for voltage and current values. The methodology is validated using a real-world Belgian distribution network with high DER penetration. Results demonstrate improvements, including reduction in load unbalance, enhanced voltage profiles, and decreased line losses.

Sen2Cor is a Level-2A processor designed to correct Sentinel-2 Level-1C products from the effects of the atmosphere in order to deliver a Level-2A surface reflectance product. ESA has been using Sen2Cor for systematic Level-2A processing of Sentinel-2 acquisitions over Europe since June 2017. It has since then been successfully integrated into Sentinel-2 ground segment (PDGS) with a global production over the World started in December 2018. In this manuscript, the Level-2A product and algorithm are presented. The performance of this operational Level-2A product is described in terms of cloud screening accuracy and atmospheric correction accuracy. Finally, the on-going parallel developments aimed at improving the product quality at global scale in terms of cloud screening and atmospheric correction are discussed.

Introduction: Motherhood among women living with HIV/AIDS is considered perilous in most of the countries of Sub-Saharan Africa. Objectives: To analyse women’s compliance to biomedical norms recommended to reduce the risk of mother-tochild transmission of HIV during pregnancy and childbirth in the rural province of Maputo. Methodology: A qualitative study was performed, consisting of in-depth interviews and focus group discussions with women who had become mothers, in-depth interviews with community health workers and semi-structured interviews with mother and child health nurses. We used Bourdieu’s theory of practice as a guiding framework to analyse the data. Results: Our findings showed that participants complied with some recommended biomedical norms to reduce the risk of mother-to-child transmission of HIV, such as subsequent antenatal visits, adherence to antiretroviral therapy and childbirth at the health facility. However, they did not comply with the timing of the first antenatal care, use of modern health care system to treat illness episodes and use of condom during pregnancy. Conclusion: The study results suggest that compliance to the recommended prevention of mother-to-child transmission is the result of complex interactions in which participants rely on knowledge and resources within both the family and community and the modern health care system. Awareness among health care workers of pregnant women’s perspectives as well as an adequate education about the timing of the first antenatal care and the benefits of antenatal care in both the health facility and community could thus enable to improve prevention of mother-tochild transmission of HIV.