The Budget Impact of Oral Nutritional Supplements for Disease Related Malnutrition in Elderly in the Community Setting

A health economic analysis was performed to assess the economic impact on the national health care budget of using oral nutritional supplements (ONS), being a food for special medical purposes also known as medical nutrition, for the treatment of disease related malnutrition (DRM) in the community in the Netherlands. An economic model was developed to calculate the budget impact of using ONS in community dwelling elderly (>5 years) with DRM in the Netherlands. The model reflects the costs of DRM and the cost reductions resulting from improvement in DRM due to treatment with ONS. Using ONS for the treatment of DRM in community dwelling elderly, leads to a total annual cost savings of € 13 million (18.9% savings), when all eligible patients are treated. The additional costs of ONS (€ 57 million) are more than balanced by a reduction of other health care costs, e.g., re-/hospitalization (€ 70 million). Sensitivity analyses were performed on all parameters, including duration of treatment with ONS and the prevalence of DRM. This budget impact analysis shows that the use of ONS for treatment of DRM in elderly patients in the community may lead to cost savings in the Netherlands

Costs of managing adverse events in the treatment of first-line metastatic renal cell carcinoma: Bevacizumab in combination with interferon-α2a compared with sunitinib

Background: Bevacizumab plus interferon-α2a (IFN) prolongs progression-free survival to>10 months, which is comparable with sunitinib as first-line treatment of metastatic renal cell carcinoma (RCC). The two regimens have different tolerability profiles; therefore, costs for managing adverse events may be an important factor in selecting therapy.Methods: Costs of managing adverse events affecting patients with metastatic RCC eligible for treatment with bevacizumab plus IFN or sunitinib were evaluated using a linear decision analytical model. Management costs were calculated from the published incidence of adverse events and health-care costs for treating adverse events in the United Kingdom, Germany, France and Italy.Results: Adverse event management costs were higher for sunitinib than for bevacizumab plus IFN. The average cost per patient for the management of grade 3-4 adverse events was markedly lower with bevacizumab plus IFN compared with sunitinib in the United Kingdom (\[euro]1475 vs \[euro]804), Germany (\[euro]1785 vs \[euro]1367), France (\[euro]2590 vs \[euro]1618) and Italy (\[euro]891 vs \[euro]402). The main cost drivers were lymphopaenia, neutropaenia, thrombocytopaenia, leucopaenia and fatigue/asthaenia for sunitinib; and proteinuria, fatigue/asthaenia, bleeding, anaemia and gastrointestinal perforation for bevacizumab plus IFN.Conclusion: The costs of managing adverse events are lower for bevacizumab plus IFN than for sunitinib. The potential for cost savings should be considered when selecting treatments for RCC

Evidence for the Emergence of New Rice Types of Interspecific Hybrid Origin in West African Farmers' Fields

In West Africa two rice species (Oryza glaberrima Steud. and Oryza sativa L.) co-exist. Although originally it was thought that interspecific hybridization is impossible without biotechnological methods, progenies of hybridization appear to occur in farmer fields

The VIMOS VLT Deep Survey: The build-up of the colour-density relation

We investigate the redshift and luminosity evolution of the galaxy colour-density relation using the data from the First Epoch VIMOS-VLT Deep Survey (VVDS). The size (6582 galaxies), depth (I_AB<=24) and redshift sampling rate of the survey enable us to reconstruct the 3D galaxy environment on relatively local scales (R=5 Mpc) up to z~1.5. Particular attention has been devoted to calibrate a density reconstruction scheme, which factors out survey selection effects and reproduces in an unbiased way the underlying `real' galaxy environment. While at lower redshift we confirm the existence of a steep colour-density relation, with the fraction of the reddest(/bluest) galaxies of the same luminosity increasing(/decreasing) as a function of density, this trend progressively disappears in the highest redshift bins investigated. The rest frame u*-g' colour-magnitude diagram shows a bimodal pattern in both low and high density environments up to z~1.5. We find that the bimodal distribution is not universal but strongly depends upon environment: at lower redshifts the colour-magnitude diagrams in low and high density regions are significantly different while the progressive weakening of the colour-density relation causes the two bimodal distributions to nearly mirror each other in the highest redshift bin investigated. Both the colour-density and the colour-magnitude-density relations appear to be a transient, cumulative product of genetic and environmental factors operating over at least a period of 9 Gyr. These findings support an evolutionary scenario in which star formation/gas depletion processes are accelerated in more luminous objects and in high density environments: star formation activity is shifting with cosmic time towards lower luminosity (downsizing), and out of high density environments.Comment: 17 pages, 10 figures, figures added, accepted by A&

The LAGUNA design study- towards giant liquid based underground detectors for neutrino physics and astrophysics and proton decay searches

The feasibility of a next generation neutrino observatory in Europe is being considered within the LAGUNA design study. To accommodate giant neutrino detectors and shield them from cosmic rays, a new very large underground infrastructure is required. Seven potential candidate sites in different parts of Europe and at several distances from CERN are being studied: Boulby (UK), Canfranc (Spain), Fr\'ejus (France/Italy), Pyh\"asalmi (Finland), Polkowice-Sieroszowice (Poland), Slanic (Romania) and Umbria (Italy). The design study aims at the comprehensive and coordinated technical assessment of each site, at a coherent cost estimation, and at a prioritization of the sites within the summer 2010.Comment: 5 pages, contribution to the Workshop "European Strategy for Future Neutrino Physics", CERN, Oct. 200