BIOSIMILAR MEDICINE PRICE ANALYSIS IN BRAZIL: THE ANTIRHEUMATIC CASE

Objective: The introduction of biosimilar medicines in markets can bring savings to health systems, expanding the population’s access to various treatments. This study aims to analyze the price competition of biological agents and their biosimilars in Brazil within the scope of rheumatoid arthritis. Methods: Prices for 14 presentations of original and biosimilar medicines were analyzed from January 2003 to October 2019 in Brazil. Prices were taken from official lists and were noted since launch and during the later trading period. Prices were converted to United States dollars and adjusted for inflation for the 2003 base year. Results: In Brazil, during this review period, prices of biopharmaceuticals decreased in real values, reaching up to a 50% reduction. The introduction of biosimilars did not affect the price sharing of biological medicines. Conclusion: Biosimilar antirheumatics do not yet have a significant impact on the price of biologics marketed in Brazil. A change in this scenario is expected in the medium and long term

Economic Analyses of Respiratory Tract Infection Diagnostics:A Systematic Review

BACKGROUND: Diagnostic testing for respiratory tract infections is a tool to manage the current COVID-19 pandemic, as well as the rising incidence of antimicrobial resistance. At the same time, new European regulations for market entry of in vitro diagnostics, in the form of the in vitro diagnostic regulation, may lead to more clinical evidence supporting health-economic analyses. OBJECTIVE: The objective of this systematic review was to review the methods used in economic evaluations of applied diagnostic techniques, for all patients seeking care for infectious diseases of the respiratory tract (such as pneumonia, pulmonary tuberculosis, influenza, sinusitis, pharyngitis, sore throats and general respiratory tract infections). METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, articles from three large databases of scientific literature were included (Scopus, Web of Science and PubMed) for the period January 2000 to May 2020. RESULTS: A total of 70 economic analyses are included, most of which use decision tree modelling for diagnostic testing for respiratory tract infections in the community-care setting. Many studies do not incorporate a generally comparable clinical outcome in their cost-effectiveness analysis: fewer than half the studies (33/70) used generalisable outcomes such as quality-adjusted life-years. Other papers consider outcomes related to the accuracy of the test or outcomes related to the prescribed treatment. The time horizons of the studies generally are limited. CONCLUSIONS: The methods to economically assess diagnostic tests for respiratory tract infections vary and would benefit from clear recommendations from policy makers on the assessed time horizon and outcomes used. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40273-021-01054-1

Association among salivary alpha-amylase activity and working memory functioning in healthy children

Salivary Alpha-Amylase (sAA) shows a statistically significant association with levels of peripheral noradrenaline under acute psychosocial stress conditions in young and healthy participants. In this study, our aim was directed to examine the relation among sAA and cognitive performance in various executive tasks in an experimental sample composed by 69 healthy children although we only could obtain the complete set of data for 44 boys and girls for this battery. The cogni- tive tasks employed were: Digits, Letters & Numbers, Arithmetic and Visual Span subtests of WISC-V (this full set of subtests is employed to the assessment of verbal and visual working memory). Saliva samples were obtained at baseline (10 minutes before the start of neuropsychological assessment), one minute before the start, after the end of the verbal tasks, and one minute after the end of the visual span task. Our statistical analyses showed a significant association among sAA levels and some of the parameters employed to describe the perfor- mance of each participant in the subscales of Digits and Letters & Numbers after controlling the effect of BMI. Scores in Letters & Numbers and visual span were associated with levels of salivary flow rate. These results are coherent with the findings of a previous pilot study conducted in our laboratory and are interpreted in relation with those results which have suggested a main role of the Locus Coeruleus-Noradrenaline System (LC-NA System) in the regulation of the level of arousal and executive behaviors.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Aplicación método REBA en el área de poscosecha

Aplicar la encuesta sociodemográfica y nórdica, complementando con el Método de evaluación ergonómico REBA, para poder evaluar los riegos asociados a cada tarea que se realiza en la empresa de Flores Santa Luz Farms en el área de la poscosecha e identificar las causas que generan DME.Con el propósito de aplicar el Método REBA en el área de poscosecha de una organización, este trabajo se utilizó el Método Ergonómico REBA para evaluar los riegos asociados a cada tarea que se realiza en la empresa de Flores Santa Luz Farms, ubicada en la vereda de Puente Piedra del municipio de Madrid, Cundinamarca, en el área de la poscosecha e identificar las causas que generan DME. Para lograr esto se utiliza un método descriptivo cualitativo con el uso de una herramienta metodológica tipo encuesta nórdica y sociodemográfica para lograr una caracterización de los 30 sujetos participantes del estudio. El Método REBA fue aplicado sobre las áreas de corte, clasificación y boncheo. Gracias al trabajo de campo y el uso de la clasificación de los niveles de acción del Método REBA se logró determinar un nivel de riesgo bajo para la tarea de clasificación, lo que implica que una intervención puede ser necesaria; y riesgo medio para el área de corte y boncheo de lo que se deduce que la intervención es necesaria. El trabajo termina con unas recomendaciones generales y específicas para los trabajadores.With the purpose of applying the REBA Method in the post-harvest area of an organization, this work was used the REBA Ergonomic Method to assess the risks associated with each task performed at the Flores Santa Luz Farms company, located on the sidewalk of Stone bridge of the municipality of Madrid, Cundinamarca, in the post-harvest area and identify the causes that identify DME.. To achieve this, a qualitative descriptive method is used with the use of a Nordic and sociodemographic survey methodological tool to achieve a characterization of the 30 subjects participating in the study. The REBA Method was applied to the areas of cutting, sorting and boosting. Thanks to the fieldwork and the use of the classification of the action levels of the REBA Method, it was possible to determine a low level of risk for the classification task, which implies that an intervention may be necessary; and average risk for the area of court and boncheo from which it is deduced that the intervention is necessary. The work ends with general and specific recommendations for workers

Health-Economic Analyses of Diagnostics:Guidance on Design and Reporting

Cost-effectiveness analyses (CEAs) can be used to assess the value of diagnostics in clinical practice. Due to the introduction of the European in vitro diagnostic and medical devices regulations, more clinical data on new diagnostics may become available, which may improve the interest and feasibility of performing CEAs. We present eight recommendations on the reporting and design of CEAs of diagnostics. The symptoms patients experience, the clinical setting, locations of test sampling and analysis, and diagnostic algorithms should be clearly reported. The used time horizon should reflect the time horizon used to model the treatment after the diagnostic pathway. Quality-adjusted life-years (QALYs) or disability-adjusted life-years (DALYs) should be used as the clinical outcomes but may be combined with other relevant outcomes, such as real options value. If the number of tests using the same equipment can vary, the economy of scale should be considered. An understandable graphical representation of the various diagnostic algorithms should be provided to understand the results, such as an efficiency frontier. Finally, the budget impact and affordability should be considered. These recommendations can be used in addition to other, more general, recommendations, such as the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) or the reference case for economic evaluation by the international decision support initiative

Un impulso para el emprendimiento colombiano

El trabajo de nuevos creadores es apoyado por MADE IN_ Concept Store, una tienda que se enfoca en el valor del esfuerzo naciona

Light-induced strain and its correlation with the optical absorption at charged domain walls in polycrystalline ferroelectrics

Photostrictive materials have a growing interest because of their great potential as light-driven actuators, among other optomechanical applications. In this context, the optical control of macroscopic strain in ferroelectrics has recently attracted remarkable attention as an effective alternative to the conventional electric control of strain. Here, a clear correlation between optical absorption and light-induced strain in polycrystalline BaTiO3 is shown. Specifically, the grain size and the sample thickness dependence of optical absorption when the material is irradiated with energy photons lower than the band gap evidence that light absorption at charged domain walls is the core of the observed photo-response in ferroelectrics. The photoinduced electronic reconstruction phenomenon is proposed as the primary physical mechanism for light absorption at charged domain walls. Results open a new pathway to designing ferroelectric-based devices with new functionalities like thickness gradient-based photo-controlled nanoactuators.Postprint (published version

La Imagen y la Narrativa como Herramientas para el Abordaje Psicosocial en Escenarios de Violencia. Departamentos de Cundinamarca y Arauca

El conflicto armado en Colombia ha sido uno de los más grandes problemas políticos que ha experimentado el país, ya que por más de cinco décadas este se ha mantenido vigente, y hoy en día, pese a los acuerdos de paz firmados en la Habana Cuba en 2016, aún se mantienen algunas problemáticas psicosociales relacionadas con el mismo, siendo el desplazamiento forzado, las amenazas de muerte, la desvinculación territorial, el abandono político entre otras sus secuelas más significativas, en donde las diversas comunidades, de diferentes etnias, raza, culturas etc., tendrán que esperar pacientemente a que el estado y algunas instituciones les ayude a resolver dichas problemáticas. Respecto al caso Violencia y Esperanza, se evidencia el reconocimiento de la comunidad sobre los problemas, dificultades y fortalezas. En el relato se confirma también que es un riesgo denunciar sucesos producidos por la violencia política, ya que surgen las amenazas contra la integridad y la dignidad humana. Se describen los impactos psicosociales positivos y negativos, encontrando voces que revelan el posicionamiento subjetivo desde el lugar de víctima y sobreviviente. Sobre el caso de Peñas Coloradas, los emergentes psicosociales presentes en la actualidad, es el abandono de esta comodidad por parte del Estado, por lo que aún continúan con la misma dificultad. A continuación, se puede constatar a través de las técnicas de la narrativa y foto voz el sufrimiento propio de los pueblos, en donde el abandono, la estigmatización, la discriminación, y el miedo son protagonistas, los cuales han influido en la desestructuración del tejido social, la vulneración de los Derechos Humanos y la pérdida de identidad individual y colectiva de estas comunidades.The armed conflict in Colombia has been one of the greatest political problems that the country has experienced, since for more than five decades it has remained in force, and today, despite the peace agreements signed in Havana, Cuba in 2016, some psychosocial problems related to it still remain, being forced displacement, death threats, territorial disengagement, political abandonment among others, its most significant consequences, where the various communities, of different ethnicities, race, cultures etc., they will have to wait patiently for the state and some institutions to help them solve these problems. Regarding the Violence and Hope case, the community's recognition of the problems, difficulties and strengths is evident. The story also confirms that it is a risk to report events caused by political violence, since threats to human integrity and dignity arise. The positive and negative psychosocial impacts are described, finding voices that reveal the subjective positioning from the place of victim and survivor. Regarding the case of Peñas Coloradas, the psychosocial emerging present at present, it is the abandonment of this comfort by the State, for which the earthquake difficulties still continue. Next, it is possible to verify through the techniques of narrative and photo-voice the suffering of peoples, where abandonment, stigmatization, discrimination, and fear are protagonists, which have influenced the destructuring of the fabric social, the violation of Human Rights and the loss of individual and collective identity of these communities

Incidence of the tympanic foramen in the population of Northeast Brazil

The persistence of the tympanic foramen (or of Huschke) in individuals after second childhood constitutes a failure in the embryological development of the tympanic cavity. When present, it is on the anterior wall of the external acoustic meatus and is associated with important otological complications of the temporomandibular joint and external acoustic meatus. To report on the incidence of tympanic foramen in adult dry skulls, belonging to the population of the Northeast of Brazil, 87 adult skulls obtained from the Human Anatomy Laboratory of 4 universities of the Northeast of Brazil, without knowledge of gender, race and age were analyzed. The 174 temporal bones were examined for presence, morphology and measurements of the longitudinal and transverse diameter of the tympanic foramen. The incidence of tympanic foramen was 24.14%, found in 15 (17.24%) skulls on the right and 18 (20.68%) on the left side. Unilateral tympanic foramen was observed in 10 (11.50%) skulls, bilateral in 9 (10.34%) and multiple in 2 (2.30%). The form of tympanic foramen was mainly irregular. In conclusion, the higher prevalence of tympanic foramen found in the Northeast among other studies carried out in Brazil can be attributed to specific dietary habits in the region that could induce the later foramen occlusion

Highly active and stable OER electrocatalysts derived from Sr2MIrO6 for proton exchange membrane water electrolyzers

Proton exchange membrane water electrolysis is a promising technology to produce green hydrogen from renewables, as it can efficiently achieve high current densities. Lowering iridium amount in oxygen evolution reaction electrocatalysts is critical for achieving cost-effective production of green hydrogen. In this work, we develop catalysts from Ir double perovskites. Sr2CaIrO6 achieves 10 mA cm−2 at only 1.48 V. The surface of the perovskite reconstructs when immersed in an acidic electrolyte and during the first catalytic cycles, resulting in a stable surface conformed by short-range order edge-sharing IrO6 octahedra arranged in an open structure responsible for the high performance. A proton exchange membrane water electrolysis cell is developed with Sr2CaIrO6 as anode and low Ir loading (0.4 mgIr cm−2). The cell achieves 2.40 V at 6 A cm−2 (overload) and no loss in performance at a constant 2 A cm−2 (nominal load). Thus, reducing Ir use without compromising efficiency and lifetim