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2.
3.
Microb Biotechnol ; 17(3): e14436, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38465733

RESUMO

Microbes are powerful upgraders, able to convert simple substrates to nutritional metabolites at rates and yields surpassing those of higher organisms by a factor of 2 to 10. A summary table highlights the superior efficiencies of a whole array of microbes compared to conventionally farmed animals and insects, converting nitrogen and organics to food and feed. Aiming at the most resource-efficient class of microbial proteins, deploying the power of open microbial communities, coined here as 'symbiotic microbiomes' is promising. For instance, a production train of interest is to develop rumen-inspired technologies to upgrade fibre-rich substrates, increasingly available as residues from emerging bioeconomy initiatives. Such advancements offer promising perspectives, as currently only 5%-25% of the available cellulose is recovered by ruminant livestock systems. While safely producing food and feed with open cultures has a long-standing tradition, novel symbiotic fermentation routes are currently facing much higher market entrance barriers compared to axenic fermentation. Our global society is at a pivotal juncture, requiring a shift towards food production systems that not only embrace the environmental and economic sustainability but also uphold ethical standards. In this context, we propose to re-examine the place of spontaneous or natural microbial consortia for safe future food and feed biotech developments, and advocate for intelligent regulatory practices. We stress that reconsidering symbiotic microbiomes is key to achieve sustainable development goals and defend the need for microbial biotechnology literacy education.


Assuntos
Biotecnologia , Ruminantes , Animais , Fermentação , Ração Animal , Custos e Análise de Custo
5.
Front Public Health ; 12: 1263472, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38481843

RESUMO

Introduction: While biosimilar medicines can contribute to the sustainability of healthcare systems, their utilization rate varies across European countries. This study aims to identify and systematize policy measures and instruments used in European countries to increase biosimilar market share. Methods: A systematic review was conducted according to PRISMA 2020 recommendations. Medline-PubMed, Web of Science and ScienceDirect databases were searched using inclusion criteria that required full articles published in English between January 2006 and November 2023. Reviews, letters, reports, editorials and comments or opinion articles were excluded from this study. Results: Of the 1,137 articles, only 13 met the eligibility criteria for analysis, which covered a total of 28 European countries. Pricing regulation measures were found in 27 of these countries with tendering, price-linkage and internal reference price being the most used. Tendering was used by 27 countries to procure biosimilars in inpatient setting. Prescribing guidelines and recommendations were the widely used instrument. Some European countries adopted physician incentives, quotas, and prescription by international non-proprietary name. Conclusion: Automatic substitution was not commonly recommended or applied. Interchangeability and switching will become increasingly relevant issues. It is important that the positive results from some countries serve as an example for the future of these medicines in the European market. Systematic review registration: https://inplasy.com/, Identifier INPLASY2023120032.


Assuntos
Medicamentos Biossimilares , Medicamentos Biossimilares/uso terapêutico , Europa (Continente) , Custos e Análise de Custo , Políticas
6.
Trials ; 25(1): 176, 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38468293

RESUMO

INTRODUCTION: Chronic back pain is a widespread medical condition associated with high socioeconomic costs and increasing prevalence. Despite the advanced implementation of multidisciplinary approaches, providing a satisfactory treatment offer for those affected is often not possible. Exposure therapy (EXP) promises to be an effective and economical form of treatment and in a previous pilot study showed to be superior to cognitive behavioral therapy (CBT) in reducing perceived limitations of movement. The current study aims to further compare the efficacy of both treatment methods and identify those patient groups that particularly benefit from EXP. METHODS: The general objective of this randomized multicenter clinical trial (targeted N = 380) is to improve and expand the range of treatments available to patients with chronic back pain. As the primary objective of the study, two different psychological treatments (EXP and CBT) will be compared. The primary outcome measure is a clinically significant improvement in pain-related impairment, measured by the QPBDS, from baseline to 6-month follow-up. Secondary outcome measures are absolute changes and clinically significant improvements in variables coping, psychological flexibility, depressiveness, catastrophizing, exercise avoidance and fear of exercise, and intensity of pain. Participants are recruited in five psychological and medical centers in Germany and receive ten sessions of manualized therapy by trained licensed CBT therapists or clinical psychologists, who are currently in their post-gradual CBT training. Potential predictors of each treatment's efficacy will be explored with a focus on avoidance and coping behavior. CONCLUSION: This study will be the first RCT to compare CBT and EXP in chronic back pain in a large sample, including patients from different care structures due to psychological and medical recruitment centers. By identifying and exploring potential predictors of symptom improvement in each treatment group, this study will contribute to enable a more individualized assignment to treatment modalities and thus improves the care situation for chronic back pain and helps to create a customized treatment program for subgroups of pain patients. If our findings confirm EXP to be an efficacious and efficient treatment concept, it should gain more attention and be further disseminated. TRIAL REGISTRATION: ClinicalTrials.gov NCT05294081. Registered on 02 March 2022.


Assuntos
Dor Crônica , Terapia Cognitivo-Comportamental , Humanos , Projetos Piloto , Dor nas Costas/diagnóstico , Dor nas Costas/terapia , Dor nas Costas/psicologia , Terapia Cognitivo-Comportamental/métodos , Medo , Custos e Análise de Custo , Dor Crônica/diagnóstico , Dor Crônica/terapia , Dor Crônica/psicologia , Resultado do Tratamento , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Multicêntricos como Assunto
7.
Nutrients ; 16(5)2024 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-38474788

RESUMO

It is crucial to ensure healthy diets are affordable in low socioeconomic groups, such as welfare-dependent households, who experience higher rates of diet-related disease than others. This study assessed the cost of habitual (unhealthy) and recommended (healthy) diets in six welfare-dependent and six other, comparable Australian households, using either popular branded products or the cheapest available alternatives. It also assessed diet affordability in welfare-dependent households, before and after modest increases in government welfare payments introduced in early September 2023. Results confirmed that recommended diets were less expensive than habitual diets in all households unless the cheapest available products were included. This strategy reduced habitual diet costs by 35-37% and recommended diet costs by 30-32%. The lower cost differential could aid perceptions that healthy foods are more expensive than unhealthy foods. In April 2023, 23-37% of the income of welfare-dependent households with children was required to purchase recommended diets; this reduced only to 20-35% in September 2023. Hence, the increases in welfare payments were insufficient to meaningfully improve the affordability of healthy diets in the most vulnerable Australians. In the current cost-of-living crisis, there is an urgent need for more welfare support to help purchase healthy diets. Monitoring of diet cost and affordability is also required.


Assuntos
População Australasiana , Dieta , Alimentos , Criança , Humanos , Austrália , Custos e Análise de Custo
8.
J Vis Exp ; (204)2024 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-38465925

RESUMO

Transcriptomics allows to obtain comprehensive insights into cellular programs and their responses to perturbations. Despite a significant decrease in the costs of library production and sequencing in the last decade, applying these technologies at the scale necessary for drug screening remains prohibitively expensive, obstructing the immense potential of these methods. Our study presents a cost-effective system for transcriptome-based drug screening, combining miniaturized perturbation cultures with mini-bulk transcriptomics. The optimized mini-bulk protocol provides informative biological signals at cost-effective sequencing depth, enabling extensive screening of known drugs and new molecules. Depending on the chosen treatment and incubation time, this protocol will result in sequencing libraries within approximately 2 days. Due to several stopping points within this protocol, the library preparation, as well as the sequencing, can be performed time-independently. Processing simultaneously a high number of samples is possible; measurement of up to 384 samples was tested without loss of data quality. There are also no known limitations to the number of conditions and/or drugs, despite considering variability in optimal drug incubation times.


Assuntos
Perfilação da Expressão Gênica , Transcriptoma , Avaliação Pré-Clínica de Medicamentos , Biblioteca Gênica , Custos e Análise de Custo
9.
Am J Manag Care ; 30(3): 107-108, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38457817

RESUMO

Out-of-pocket costs of diabetes medications other than insulin can be quite high for individuals with employer-sponsored health insurance.


Assuntos
Diabetes Mellitus , Planos de Assistência de Saúde para Empregados , Humanos , Estados Unidos , Gastos em Saúde , Custos e Análise de Custo , Diabetes Mellitus/tratamento farmacológico , Insulina/uso terapêutico , Seguro Saúde
10.
Am J Manag Care ; 30(3): 133-138, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38457821

RESUMO

OBJECTIVES: This study evaluated a collaborative service model between the largest Medicaid managed care organization (MCO) in Texas, Superior HealthPlan, and the affordable housing provider Prospera Housing Community Services. STUDY DESIGN: Using a quasi-experimental 2-groups research design, we compared health care outcomes and costs between a sample of 104 participants served by the Prospera+Superior collaborative model and a group of 104 participants who had health care coverage through the Superior HealthPlan Medicaid MCO but did not live at Prospera properties (ie, Superior-only group). METHODS: Data from medical claims were analyzed to examine change in outcomes 12 months before and after implementation of the Prospera+Superior collaborative model in 2019. RESULTS: The Prospera+Superior group had a 56% lower rate of emergency department/urgent care visits and spent $2061 less in prescription costs than the Superior-only group after implementation. CONCLUSIONS: These findings provide needed evidence of the clinical and economic value of forming multisector collaborative models between MCOs and other community providers.


Assuntos
Cefalosporinas , Habitação , Programas de Assistência Gerenciada , Estados Unidos , Humanos , Custos e Análise de Custo , Medicaid
12.
PLoS One ; 19(3): e0300386, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38489340

RESUMO

The paper aims to conduct an analysis of pricing strategies in a dual channel supply chain under external uncertainty, utilizing Interval numbers theory and Game theory as the theoretical basis. The focus is on maximizing the expected profits of manufacturers and retailers. Four models are considered: centralized decision-making, manufacturer's Stackelberg, retailer's Stackelberg strategy, and vertical Nash model, with the decision variable being the product price. By solving the game model, the paper compares the optimal decisions under the four models and conducts sensitivity analysis to reflect the influence of key parameters and analyze their relationships. The ultimate goal is to optimize profits under various circumstances by adjusting market potential and price parameters to determine the best price level. The findings suggest that decision-maker's risk indicators have a greater impact on decision results when market demand is less sensitive to price, and that the size of the market has a negative correlation with the impact of decision-maker's risk indicators on decision results.


Assuntos
Comportamento do Consumidor , Teoria do Jogo , Incerteza , Custos e Análise de Custo , Comércio/métodos
13.
J Acquir Immune Defic Syndr ; 95(5): 417-423, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38489491

RESUMO

INTRODUCTION: Large proportions of people living with HIV (PLHIV) in sub-Saharan Africa are not linked to or retained in HIV care. There is a critical need for cost-effective interventions to improve engagement and retention in care and inform optimal allocation of resources. METHODS: We estimated costs associated with a short message service (SMS) plus peer navigation (SMS+PN) intervention; an SMS-only intervention; and standard of care (SOC), within the I-Care cluster-randomized trial to improve HIV care engagement for recently diagnosed PLHIV. We employed a uniform cost data-collection protocol to quantify resources used and associated costs for each intervention. RESULTS: Compared with SOC, the SMS+PN intervention cost $1284 ($828-$2859) more per additional patient linked to care within 30 days and $1904 ($1158-$5343) more per additional patient retained in care at 12 months, while improving linkage by 24% (95% CI: 11 to 36) and retention by 16% (95% CI: 6 to 26). By contrast, the SMS-only intervention cost $198 ($93-dominated) more per additional patient linked to care and $697 ($171-dominated) more per additional patient retained in care but was not significantly associated with improvements in linkage (12%; 95% CI: -1 to 25) or retention (3%; 95% CI: -7 to 14) compared with SOC. The efficiency of the SMS+PN intervention could be improved by 46%, to $690 more per additional patient linked and $1023 more per additional patient retained in care, if implemented within the Department of Health using more efficient distribution of staff resources. DISCUSSION: Findings suggest that scale-up of the SMS+PN intervention could benefit patients, improving care and health outcomes while being cost-effective.


Assuntos
Infecções por HIV , Envio de Mensagens de Texto , Adulto , Humanos , África do Sul , Infecções por HIV/diagnóstico , Custos e Análise de Custo , Coleta de Dados
15.
J Health Econ ; 94: 102868, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38447245

RESUMO

This paper shows that selection incentives in downstream markets distort upstream prices. It is possible for inputs to be priced above the value that the good has for final consumers. We apply this idea to pharmaceutical companies selling drugs to a health insurance market with selection problems. We specify the conditions under which drugs are sold at prices exceeding treatment value. Another feature of the model is an excessive private incentive to reduce market size, e.g. in the form of personalized medicine.


Assuntos
Custos de Medicamentos , Seguro Saúde , Humanos , Custos e Análise de Custo
16.
Health Place ; 86: 103223, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38479102

RESUMO

Japan's population has been aging steadily, evidenced by it spending JPY 11 trillion (USD 110 billion) on annual long-term care (LTC) costs in 2021. In this context, understanding the factors influencing LTC costs has become increasingly vital. Although studies have reported positive relationships between neighborhood environment and health outcomes, the connection between LTC costs and neighborhood environment remains unclear. To address this gap in the literature, this cohort study, conducted from 2010 to 2019 across seven Japanese municipalities and involving 34,982 older people, examined the relationship between eight neighborhood environment elements and the mean monthly cumulate costs (MMCC) of LTC. The results showed that older people who reported the presence of fresh food stores nearby and dangerous places for walking alone at night in the neighborhood had lower MMCC, by JPY 1,367.6 and 1,383.3 per month, respectively, than respondents who did not report the presence of these neighborhood elements. Meanwhile, older people whose neighborhoods had easily accessible facilities had higher MMCC of JPY 739.4. This study's key findings reveal significant relationships between neighborhood environment elements and LTC costs and can be used to support developments in urban design to support healthy aging and reduced LTC costs.


Assuntos
Assistência de Longa Duração , Meio Social , Humanos , Idoso , Estudos de Coortes , Japão , Custos e Análise de Custo
17.
PLoS One ; 19(3): e0300781, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38512872

RESUMO

The allocation of assets across different markets is a crucial element of investment strategy. In this regard, stocks and bonds are two significant assets that form the backbone of multi-asset allocation. Among publicly offered funds (The publicly offered funds in China correspond to the mutual funds in the United States, with different names and details in terms of legal form and sales channels), the stock-bond hybrid fund gives investors a return while minimizing the risk through capital flow between the stock and bond markets. Our research on China's financial market data from 2006 to 2022 reveals a cross-asset momentum between the stock and bond markets. We find that the momentum in the stock market negatively influences the bond market's return, while the momentum in the bond market positively influences the stock market's return. Portfolios that exploit cross-asset momentum have excess returns that other asset pricing factors cannot explain. Our analysis reveals that hybrid funds play an intermediary role in the transmission mechanism of cross-asset momentum. We observe that the more flexible the asset allocation ratio of the fund, the more crucial the intermediary role played by the fund. Hence, encouraging the development of hybrid funds and relaxing restrictions on asset allocation ratios could improve liquidity and pricing efficiency. These findings have significant implications for investors seeking to optimize their asset allocation across different markets and for policymakers seeking to enhance the efficiency of China's financial market.


Assuntos
Administração Financeira , Estados Unidos , Investimentos em Saúde , Comércio , China , Custos e Análise de Custo
18.
PLoS One ; 19(3): e0300738, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38512943

RESUMO

BACKGROUND: The role of hyperbaric oxygen therapy (HBOT) in necrotizing soft tissue infections (NSTI) is mainly based on small retrospective studies. A previous study using the 1998-2009 National Inpatient Sample (NIS) found HBOT to be associated with decreased mortality in NSTI. Given the argument of advancements in critical care, we aimed to investigate the continued role of HBOT in NSTI. METHODS: The 2012-2020 National Inpatient Sample (NIS) was queried for NSTI admissions who received surgery. 60,481 patients between 2012-2020 were included, 600 (<1%) underwent HBOT. Primary outcome was in-hospital mortality. Secondary outcomes included amputation, hospital length of stay, and costs. A multivariate model was constructed to account for baseline differences in groups. RESULTS: Age, gender, and comorbidities were similar between the two groups. On bivariate comparison, the HBOT group had lower mortality rate (<2% vs 5.9%, p<0.001) and lower amputation rate (11.8% vs 18.3%, p<0.001) however, longer lengths of stay (16.9 days vs 14.6 days, p<0.001) and higher costs ($54,000 vs $46,000, p<0.001). After multivariate analysis, HBOT was associated with decreased mortality (Adjusted Odds Ratio (AOR) 0.22, 95% CI 0.09-0.53, P<0.001) and lower risk of amputation (AOR 0.73, 95% CI 0.55-0.96, P = 0.03). HBO was associated with longer stays by 1.6 days (95% CI 0.4-2.7 days) and increased costs by $7,800 (95% CI $2,200-$13,300), they also had significantly lower risks of non-home discharges (AOR 0.79, 95%CI 0.65-0.96). CONCLUSIONS: After correction for differences, HBOT was associated with decreased mortality, amputations, and non-home discharges in NSTI with the tradeoff of increase to costs and length of stay.


Assuntos
Fasciite Necrosante , Oxigenoterapia Hiperbárica , Infecções dos Tecidos Moles , Humanos , Infecções dos Tecidos Moles/terapia , Estudos Retrospectivos , Hospitalização , Custos e Análise de Custo , Fasciite Necrosante/terapia
19.
Anal Chem ; 96(11): 4333-4342, 2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38459927

RESUMO

The rising threats to food security include several factors, such as population growth, low agricultural investment, and poor distribution systems. Consequently, food insecurity results from a confluence of issues, including diseases, processing limitations, and distribution deficiencies. Food insecurity usually occurs in vulnerable areas where certain technologies and traditional food safety testing are not a viable solution for foodborne disease detection. In this regard, 3D printing technologies and 3D printed sensors open the platform to produce portable, accurate, and low-cost sensors that address the gaps and challenges in food security. In this paper, we discuss the perspective role of 3D printed sensors in food security in terms of food safety and food quality monitoring to provide reliable access to nutritious, affordable food. In each section, we highlight the advantages of 3D printing technology in terms of cost-effectiveness, accuracy, accessibility, and reproducibility compared to traditional manufacturing methodologies. Recent developments in robotic technologies for mechanization, such as food handling with soft grippers, are also discussed. Lastly, we delve into the applications of advanced 3D printing technologies in agricultural monitoring, particularly the future of plant wearables, environmental sensing, and overall plant health monitoring.


Assuntos
Manipulação de Alimentos , Impressão Tridimensional , Reprodutibilidade dos Testes , Alimentos , Custos e Análise de Custo
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