Effect of IGF-1 C472T, GH C2141G, and GHR T914A polymorphisms on growth performance and feed efficiency in young Kazakh white-headed cattle.

Background and Aim: Improving the feed efficiency of beef cattle is necessary to increase the profitability of meat production. Implementing marker-assisted selection breeding systems can improve the genetic potential of beef cattle for increased productivity. This research aimed to study the effects of insulin-like growth factor (IGF)-1 C472T, growth hormone (GH) C2141G, and GH receptor (GHR) T914A polymorphisms on growth performance and feed efficiency in young Kazakh white-headed cattle. Materials and Methods: Young Kazakh white-headed cattle (n = 50) were grouped after weaning according to sex (28 bulls and 22 heifers) and they were genotyped according to the IGF-1 C472T, GH C2141G, and GHR T914A polymorphisms. The test period was conducted from 8 to 15 months of age. The experimental animals were evaluated for live weight (LW) at the beginning and end of the test period. They were also assessed for average daily gain, hip height, metabolic mid-weight (MMWT), actual dry matter intake (DMI), and residual feed intake (RFI). Results: Significant differences in MMWT were found between the bulls with the IGF-1TT and IGF-1CT genotypes, which was a 2.2 kg increase in heterozygous cattle (p < 0.05). Heterozygous IGF-1CT bulls differed with a higher DMI of 0.087 kg/day (p < 0.05) compared to IGF-1TT homozygotes. Carriers of the IGF-1TT genotype had the greatest feed efficiency at 0.068 kg/day (p < 0.05). Heifers with the GHCC genotype differed in their maximum DMI with an increase of 1.17%-1.57% (p < 0.05) relative to the other genotypes. The G allele in the GH C2141G polymorphism was associated with better (p < 0.05) feed efficiency in the Kazakh white-headed breed. The minimum DMI and RFI in GHR T914A heterozygous heifers were significantly inferior (p < 0.05) to the other genotypes. Conclusion: Association studies of the IGF-1 C472T, GH C2141G, and GHR T914A polymorphisms indicate a relationship between growth, development, and feed efficiency with the genetic characteristics of young Kazakh white-headed cattle. A significant (p < 0.05) dominant effect was found in the IGF-1 gene in bulls and in the GHR gene in heifers, which should be considered when breeding with heterogeneous parental pairs. The negative effect of the allele substitution in the IGF-1 C472T polymorphism was observed in the LW of heifers (-3.25 kg) at the age of 8 months and bulls (-6.05 kg) at 15 months. The substitution in the GH C2141G polymorphism was associated with a significant reduction in DMI by 0.036 kg (p < 0.05) and an increase in feed efficiency by 0.023 kg (p < 0.05) during the rearing of heifers. These results can improve the production efficiency of mature herds of Kazakh white-headed cattle.

Budget cap and pay-back model to control spending on medicines: A case study of Bulgaria.

Central and Eastern European countries (CEEC) have among the highest rates of increase in healthcare expenditure. External reference pricing, generics and biologics price capping, regressive scale for price setting, health technology assessment (HTA), and positive drug lists for reimbursed medicines are among the variety of implemented cost-containment measures aimed at reducing and controlling the rising cost for pharmaceuticals. The aim of our study was to analyze the influence of a recently introduced measure in Bulgaria-budget capping in terms of overall budget expenditure. A secondary goal was to analyze current and extrapolate future trends in the healthcare and pharmaceutical budget based on data from 2016 to 2021. The study is a retrospective, observational and prognostic, macroeconomic analysis of the National Health Insurance Fund's (NHIF) budget before (2016-2018) and after (2019-2021) the introduction of the new budget cap model. Subgroups analysis for each of the three new budget groups of medicines (group A: medicines for outpatient treatment, prescribed after approval by a committee of 3 specialists; group B: all other medicines out of group A; and group C: oncology and life-saving medicines out of group A) was also performed, and the data were extrapolated for the next 3 years. The Kruskal-Wallis test was applied to establish statistically significant differences between the groups. During 2016-2021, healthcare services and pharmaceutical spending increased permanently, observing a growth of 82 and 80%, respectively. The overall healthcare budget increased from European €1.8 billion to 3.3 billion. The subgroup analysis showed a similar trend for all three groups, with similar growth between them. The highest spending was observed in group C, which outpaced the others mainly due to the particular antineoplastic (chemotherapy) medicines included in it. The rising overall healthcare cost in Bulgaria (from European €1.8 billion to 3.3 billion) reveals that implementation of a mechanism for budget predictability and sustainability is needed. The introduced budget cap is a relatively effective measure, but the high level of overspending and pay-back amount (from European €34 billion to 59 billion during 2019-2021) reveals that the market environmental risk factors are not well foreseen and practically implemented.

Effect of leptin C528T and leptin C73T polymorphisms and pregnancy on adipose tissue formation and carcass grade in Aberdeen Angus heifers and first-calf cows.

Background and Aim: The leptin (LEP) gene plays a role in the regulation of the activity required to obtain food, energy metabolism, and fat deposition and affects the body composition of animals. Lipogenesis is an ineffective process. A lot of energy from feed is expended on the synthesis of adipose tissue. This study aimed to determine the effect of LEP C528T and LEP C73T polymorphisms and pregnancy on adipose tissue formation and carcass grade in Aberdeen Angus heifers and first-calf cows. Materials and Methods: Heifers (n = 49) and first-calf cows (n = 30) were grouped according to their genotype for LEP C528T and LEP C73T polymorphisms at the age of 24 months. DNA samples were isolated from whole blood. Experimental animals were slaughtered at the age of 24 months, and a chemical analysis of samples of longissimus dorsi muscle and ground beef was performed. Results: The maximum internal fat weight, back-fat thickness, and fat content of the longissimus dorsi muscle and ground beef were determined in heifers heterozygous for both LEP C528T and LEP C73T polymorphisms. The ranking of genotypes in terms of adipose tissue formation did not change in first-calf cows compared to heifers carrying the same LEP gene variants. Pregnancy had a more significant (p < 0.05-0.001) effect on slaughter parameters and lipogenesis in animals of different genotypes than studied polymorphisms. Heterozygosity of the LEP gene was much more strongly expressed in the carcass grade of heifers. "Prime" grades were assigned to 66.7% of carcasses heterozygous for LEP C528T and "Top Choice" to 58.8% of carcasses with LEP C73T nucleotide substitutions. Conclusion: LEP C528T and LEP C73T polymorphisms were shown to affect the extent of fat formation in Aberdeen Angus heifers and first-calf cows. Animals with heterozygous genotypes exhibited the maximum development of internal fat, back-fat, and intramuscular fat. Pregnancy had a more significant effect on slaughter parameters and adipose tissue formation than studied polymorphisms. First-calf cows had a significantly lower fat content in carcasses than heifers. These results can aid in the production of efficient mature herds of Aberdeen Angus cattle.

Evaluation of the quality of life after implantation of light or standard polypropylene hernia meshes.

Abstract.

Analysis of Healthcare Expenditures in Bulgaria.

The growth of public expenditure worldwide has set the priority on assessment of trends and establishment of factors which generate the most significant public costs. The goal of the current study is to review the tendencies in public healthcare expenditures in Bulgaria and to analyze the influence of the demographic, economic, and healthcare system capacity indicators on expenditures dynamics. A retrospective, top-down, financial analysis of the healthcare system expenditures was performed. Datasets of the National Statistical Institute (NSI), National Health Insurance Fund (NHIF), and National Center of Public Health and Analysis (NCPHA) were retrospectively reviewed from2014-2019 to collect the information in absolute units of healthcare expenditures, healthcare system performance, demographics, and economic indicators. The research showed that increasing GDP led to higher healthcare costs, and it was the main factor affecting the cost growth in Bulgaria. The number of hospitalized patients and citizens in retirement age remained constant, confirming that their impact on healthcare costs was negligible. In conclusion, the population aging, average life expectancy, patient morbidity, and hospitalization rate altogether impacted healthcare costs mainly due to the multimorbidity of older people and the rising need for outpatient hospital services and medications.