An Exploratory Analysis of Pharmaceutical Price Disparities and Their Implications Among Six Developed Nations

In our study of 43 drugs, prescription drug prices in several wealthy nations (Australia, Canada, France, Germany, and the U.K.) were much lower than in the U.S. on average, well below relative per capita GDP. There was relatively little difference among the five foreign nations. All this is consistent with previous research. After separating less-unique from more unique drugs, however, important new findings emerged. Relative prices for less-unique drugs, which are subject to strong competition, were at about half the U.S. level. We suggest that this reflects the exercise of monopsony power that does not exist in the U.S., where buyers as well as sellers compete. On the other hand, relative prices for highly unique drugs tended to be approximately proportional to per capita GDP or higher. Remarkably, biotech drugs were priced at or above U.S. levels in Canada and France

An Empirical Examination of Symptom Substitution Associated with Behavior Therapy for Tourette\u27s Disorder

Over the past six decades, behavior therapy has been a major contributor to the development of evidence-based psychotherapy treatments. However, a long-standing concern with behavior therapy among many nonbehavioral clinicians has been the potential risk for symptom substitution. Few studies have been conducted to evaluate symptom substitution in response to behavioral treatments, largely due to measurement and definitional challenges associated with treated psychiatric symptoms. Given the overt motor and vocal tics associated with Tourette’s disorder, it presents an excellent opportunity to empirically evaluate the potential risk for symptom substitution associated with behavior therapy. The present study examined the possible presence of symptom substitution using four methods: (a) the onset of new tic symptoms, (b) the occurrence of adverse events, (c) change in tic medications, and (d) worsening of co-occurring psychiatric symptoms. Two hundred twenty-eight participants with Tourette’s disorder or persistent motor or vocal tic disorders were randomly assigned to receive behavioral therapy or supportive therapy for tics. Both therapies consisted of eight sessions over 10 weeks. Results indicated that participants treated with behavior therapy were not more likely to have an onset of new tic symptoms, experience adverse events, increase tic medications, or have an exacerbation in co-occurring psychiatric symptoms relative to participants treated with supportive therapy. Further analysis suggested that the emergence of new tics was attributed with the normal waxing and waning nature of Tourette’s disorder. Findings provide empirical support to counter the long-standing concern of symptom substitution in response to behavior therapy for individuals with Tourette\u27s disorder

Effects of Brief Dry Cupping on Muscle Soreness in the Gastrocnemius Muscle and Flexibility of the Ankle

OBJECTIVES The purpose of this study was to analyze the effects of brief dry cupping on muscle soreness of the gastrocnemius muscle and range of motion (ROM) in the ankle. METHODS Thirty-six participants (age=29±10 yrs, ht=173.8±10.3 cm, wt=75.3±15.9 kg) were randomly assigned to three groups: A (no exercise), B (bilateral heel drops to exhaustion), and C (right unilateral heel drops to exhaustion). Dorsiflexion ROM was assessed bilaterally for all groups. All participants received the cupping protocol on the right gastrocnemius, but C also received it on the left. Dry cupping was applied using four two-inch cups in four quadrants on the calf for 90 seconds. Soreness was reported using a 10-point VAS scale at 24- and 48-hours. Repeated measures ANOVAs were used to examine the effects of cupping on soreness and range of motion, respectively. Alpha was set at 0.05 for all tests. RESULTS A significant difference in muscle soreness existed between right (3.58±1.31 VAS) and left (2.83±1.02 VAS) calves for group B at 24 hours (p = 0.029). No other significant differences existed between calves that were and were not cupped (p \u3e 0.05). No significant differences in ROM occurred between any conditions (p \u3e 0.05). CONCLUSION Ninety seconds of dry cupping on the calf may reduce 24-hr muscle soreness after performing heel drops to exhaustion, but has no effect on ROM

The Genes and Enzymes of Phosphonate Metabolism by Bacteria, and Their Distribution in the Marine Environment

Phosphonates are compounds that contain the chemically stable carbon–phosphorus (C–P) bond. They are widely distributed amongst more primitive life forms including many marine invertebrates and constitute a significant component of the dissolved organic phosphorus reservoir in the oceans. Virtually all biogenic C–P compounds are synthesized by a pathway in which the key step is the intramolecular rearrangement of phosphoenolpyruvate to phosphonopyruvate. However C–P bond cleavage by degradative microorganisms is catalyzed by a number of enzymes – C–P lyases, C–P hydrolases, and others of as-yet-uncharacterized mechanism. Expression of some of the pathways of phosphonate catabolism is controlled by ambient levels of inorganic P (Pi) but for others it is Pi-independent. In this report we review the enzymology of C–P bond metabolism in bacteria, and also present the results of an in silico investigation of the distribution of the genes that encode the pathways responsible, in both bacterial genomes and in marine metagenomic libraries, and their likely modes of regulation. Interrogation of currently available whole-genome bacterial sequences indicates that some 10% contain genes encoding putative pathways of phosphonate biosynthesis while ∼40% encode one or more pathways of phosphonate catabolism. Analysis of metagenomic data from the global ocean survey suggests that some 10 and 30%, respectively, of bacterial genomes across the sites sampled encode these pathways. Catabolic routes involving phosphonoacetate hydrolase, C–P lyase(s), and an uncharacterized 2-aminoethylphosphonate degradative sequence were predominant, and it is likely that both substrate-inducible and Pi-repressible mechanisms are involved in their regulation. The data we present indicate the likely importance of phosphonate-P in global biogeochemical P cycling, and by extension its role in marine productivity and in carbon and nitrogen dynamics in the oceans

Effects of Dry Cupping on Delayed Onset Muscle Soreness and Flexibility of the Gastrocnemius Muscle

Limited range of motion and muscle soreness effect many people throughout their lifetime and finding relief can elevate quality of life. For decades, many claim that dry cupping therapy provides relief to soreness, tight muscles, pain, inflammation, flexibility, and helps with relaxation and performance. PURPOSE: To analyze the effects of dry cupping on delayed onset muscle soreness (DOMS) and range of motion (ROM) of the gastrocnemius muscle. METHODS: Sixteen males and 16 females (age=29±9.8 yrs, ht=68.5±4.1 in, wt=166.2±35.2 lbs) were randomly assigned to three groups: A (no exercise), B (bilateral heel raises to exhaustion), and C (right unilateral heel raises to exhaustion). Dorsiflexion ROM was assessed bilaterally for all groups. All participants received the cupping protocol on the right gastrocnemius, but C also received it bilaterally. Cupping protocol applied four two-inch cups in each quadrant for 90 seconds. Participants reported soreness using a 10-point scale at 24- and 48-hours. Repeated measures ANOVAs were used to examine the effects of cupping on soreness and range of motion, respectively. Alpha was set at .05 for all tests. RESULTS: Significant differences for soreness existed at 24 and 48 hours between the calves that were and were not exercised for both the left and the right sides, regardless of cupping, p\u3c.05. No differences in ROM occurred between any condition, p\u3e.05. CONCLUSIONS: Dry cupping therapy does not impact DOMS or ROM of the gastrocnemius. While the heel raise protocol effectively caused soreness, dry cupping for 90 seconds after exercise does not reduce this effect

Horticultural technique for rearing and redistribution of the sessile biological control agent, Rhizaspidiotus donacis on its host plant, Arundo donax

Arundo donax, giant reed is an invasive weed in the riparian habitats of the Rio Grande Basin. A biological control program using specialist insects from the native range in Mediterranean Europe, including the arundo scale, Rhi-zaspidiotus donacis has been implemented. The arundo scale is a sessile insect that spends most of its life cycle affixed to its host plant, thus creating challenges for its rearing and redistribution to field sites. A horticultural technique was developed which allowed for rearing of the scale on small, potted A. donax microplants, which could later be transplanted to field sites. Female scale reach maturity on the microplants and produce mobile crawler scale, which move to adjacent uninfested A. donax plants. Arundo scale were established at 48 sites on the Rio Grande using microplants. This horticultural technique allows for movement of the arundo scale at any stage of its life cycle to field sites to conduct biological control programs for A. donax where it is invasive

On defining 'sustainability'. An impossible task?

Since its inception, the Sustainable Development Division (SDD) has run a track in the Institute of Industrial and Systems Engineering (IISE) Annual Conference. Different topics have been associated to this track. This indicates that a vast variety of ideas have been associated to the effort of developing sustainable Industrial and Systems Engineering (ISE) practices. These works have been revisited and categorized utilizing the Triple Bottom Line framework by topics and countries of origin, in an effort to recognize potential patterns. Findings suggest that establishing a unique definition for 'sustainability' in the context of IISE seems a futile enterprise. Increasing the variety of responses, rather than reducing it, appears to be a better strategy to disseminate principles, particularly those from the United Nations 2030 sustainable development goals among IISE professionals