cost-function to study changes in cost with variations in time, region, prices, skill-mix and other factors.
Patient-reported outcome measures (PROMs) are used in health technology assessment (HTA) to measure patient experiences with disease and treatment, allowing a deeper understanding of treatment impact beyond clinical endpoints. Developing and administering PROMs for rare diseases poses unique challenges because of small patient populations, disease heterogeneity, lack of natural history knowledge, and short-term studies.

This research aims to identify key factors to consider when using different types of PROMs in HTA for rare disease treatments (RDTs).

A scoping review of scientific and grey literature was conducted, with no date or publication type restrictions. Information on the advantages of and the challenges and potential solutions when using different types of PROMs for RDTs, including psychometric properties, was extracted and synthesized.

Of 79 records from PubMed, 32 were included, plus 12 records from the grey literature. PROMs for rare diseases face potential data collection and psychometric challenges resulting from small patient populations and disease heterogeneity. Generic PROMs are comparable across diseases but not sensitive to disease specificities. Disease-specific instruments are sensitive but do not exist for many rare diseases and rarely provide the utility values required by some HTA bodies. Creating new PROMs is time and resource intensive. Potential solutions include pooling data (multi-site/international data collection), using computer-assisted technology, or using generic and disease-specific PROMs in a complementary way.

PROMs are relevant in HTA for RDTs but pose a number of difficulties. A deeper understanding of the potential advantages of and the challenges and potential solutions for each can help manage these difficulties.
PROMs are relevant in HTA for RDTs but pose a number of difficulties. A deeper understanding of the potential advantages of and the challenges and potential solutions for each can help manage these difficulties.
The Mathematical and Economic Modelling for Vaccination and Immunisation Evaluation (MEMVIE) programme aimed to explore, capture and support the potential contribution of the public to mathematical and economic modelling, in order to identify the values that underpin public involvement (PI) in modelling and co-produce a framework that identifies the nature and type of PI in modelling and supports its implementation.

We established a PI Reference Group, who worked collaboratively with the academic contributors to create a deliberative knowledge space, which valued different forms of knowledge, expertise and evidence. Together, we explored the key steps of mathematical and economic methods in 21 meetings during 2015-2020. These deliberations generated rich discussion, through which we identified potential points of public contribution and the values that underpin PI in modelling. We iteratively developed a framework to guide future practice of PI in modelling.

We present the MEMVIE Public Involvement FramPI in modelling is in its infancy. The MEMVIE Framework is the first attempt to identify potential points of collaborative public contribution to modelling, but it requires further evaluation and refinement that we are undertaking in a subsequent study.We present the initial results of a neonatal screening program in part of the public health system in Honduras, that is, the Honduran Social Security Institute. The program design includes steps from neonatal bloodspot in the first newborn days to evaluation and treatment when necessary. In 2018 and 2019, 19,911 newborns were tested for hypothyroidism, cystic fibrosis, galactosemia, phenylketonuria, and adrenal hyperplasia. Abnormalities were identified in 18 newborns, corresponding to a prevalence of 910,000. Considering all births in Honduras, the estimated coverage of screening ranged between 4.4 and 5.7%. These results reinforce the need to expand and consolidate neonatal screening.Coagulum in the semen of some primates plays different roles, depending on the species. In the present study, we examined sperm motility in the coagulum and liquid portions of semen collected from captive individuals from two great ape species two adult Bornean orangutans (Pongo pygmaeus) (n = 27) and three adult chimpanzees (Pan troglodytes) (n = 14). The results revealed that orangutan sperm remained motile for significantly longer in the coagulum than in the liquid portion (> 18 h). By contrast, chimpanzee sperm motility did not differ significantly over time between the two portions of the semen, although motility was slightly higher in the liquid portion than in the coagulum. The evolution of the seminal coagulum is thought to be related to postcopulatory sperm competition; however, functions of seminal coagulum have not been completely elucidated. Our data from the orangutan semen suggest that in this species, seminal coagulum may strengthen own-sperm survival. This report is the first to provide evidence for this distinctive function of the seminal coagulum. This unique property of orangutan seminal coagulum might be attributable to their reproductive traits, e.g., difficulty in predicting ovulation due to a lack of genital swelling during estrus. The orangutan is a Critically Endangered species, and captive breeding, including artificial insemination (AI), is expected. However, worldwide, only one case of orangutan AI has been successful. Our findings may contribute to an understanding of their basic semen characteristics and help improve the AI method.Humans use regularities in the environment to facilitate learning, often without awareness or intent. How might such regularities distort long-term memory? Here, participants studied and reported the colors of objects in a long-term memory paradigm, uninformed that certain colors were sampled more frequently overall. When participants misreported an object's color, these errors were often centered around the average studied color (i.e., "Rich" color), demonstrating swap errors in long-term memory due to imposed statistical regularities. We observed such swap errors regardless of memory load, explicit knowledge, or the distance in color space between the correct color of the tested object and the Rich color. https://www.selleckchem.com/products/pha-848125.html An explicit guessing strategy where participants intentionally made swap errors when uncertain could not fully account for our results. We discuss other potential sources of observed swap errors such as false memory and implicit biased guessing. Although less robust than swap errors, evidence was also observed for subtle shift errors towards or away from the Rich color dependent on the color distance between the correct color and the Rich color. Together, these findings of swap and shift errors provide converging evidence for memory distortion mechanisms induced by a reference point, bridging a gap in the literature between how attention to regularities similarly influences visual working memory and visual long-term memory.Pervasive congruency effects characterize approximate number discrimination tasks. Performance is better on congruent (the more numerous stimulus consists of objects of larger size that occupy a larger area) than on incongruent (where the opposite holds) items. The congruency effects typically occur when controlling for nonnumeric variables such as cumulative area. Furthermore, only performance on incongruent stimuli seems to predict math abilities. Here, we present evidence for an attentional-bias induced by stimulus control (ABC) where preattentive features such as item size reflexively influence decisions, which can explain these congruency effects. In three experiments, we tested predictions derived from the ABC. In Experiment 1, as predicted, we found that manipulation of size introduced congruency effects and eliminated the correlation with math ability for congruent items. However, performance on incongruent items and neutral, nonmanipulated items were still predictive of math ability. A negative correlation between performance on congruent and incongruent items even indicated that they measure different underlying constructs. Experiment 2 demonstrated, in line with the ABC account, that increasing presentation time reduced congruency effects. By directly measuring overt attention using eye-tracking, Experiment 3 revealed that people direct their first gaze toward the array with items of larger individual size, biasing them towards these arrays. The ABC explains why the relation between performance on approximate number discrimination tasks and math achievement has been fragile and suggests that stimulus control manipulations have contaminated the results. We discuss the importance of using stimuli that are representative of the environment.Potato plants are often exposed to biotic and abiotic stresses that negatively impact their growth, development, and yield. Plants respond to different stresses by inducing large numbers of stress-responsive genes, which can be either functional or regulatory genes. Among regulatory genes, Dehydration Responsive Element Binding (DREB) genes are considered as one of the main groups of transcriptional regulators. The overexpression of these factors in several transgenic plants leads to enhancement of abiotic stress tolerance. However, a number of reports showed that the overexpression of DREB factors under control of constitutive promoter, affects their morphology and production. Therefore, it becomes interesting to evaluate the effect of the overexpression of this StDREB1 transcription factor on plant growth, morphology, yield and tuber composition under both greenhouse and field culture conditions. To our knowledge, there is no available data on the effect of DREBA-4 overexpression on potato plants morphology and yield. Indeed, most studies focused on DREB genes from A-1 and A-2 groups for other plant species. Our results showed that StDREB1, a A-4 group of DREB gene from potato (Solanum tuberosum L.), overexpressing plants did not show any growth retardation. On the contrary, they seem to be more vigorous, and produced higher tuber weight in greenhouse and field culture than the wild type (WT) plants. Moreover, the overexpression of StDREB1 transcription factor seemed to have an effect on tuber quality in terms of dry matter, starch contents and reducing sugars in comparison to the WT tubers. These data suggest that the StDREB1 gene from A-4 group of DREB subfamily can be a good candidate in potato breeding for stress tolerance.
Transforaminal lumbar interbody fusion (TLIF) represents a commonly performed spinal procedure that poses a significant financial burden on patients, hospitals and insurers. Reducing these costs, while maintaining efficacy, may be assisted by a new powered endplate preparation device, designed to shorten procedural time while offering positive impacts on other elements that contribute to the cost of care.

The aim of the study was to assess and compare the individual cost elements of TLIF procedures with and without the use of the device, to determine whether application of this technology translated into any material procedural savings.

The records of 208 single-level TLIF procedures in a single hospital were reviewed. Surgical time, length of hospital stay, blood loss, infection rate, and other parameters were compared for the cases where the device was used (device group; n = 143) and cases which used standard tools (control group; n = 65). The cost per unit of each element was derived from the literature, online resources, and the hospital's financial department.