Economic Burden Research Articles

PREDICTORS AND COMPONENTS OF INPATIENT ASTHMA HOSPITAL COST: A CROSS SECTIONAL STUDY

Asthma, a chronic respiratory condition, continues to impose a significant economic burden on healthcare systems worldwide. Objective: The main objective of the study is to find the predictors and components of inpatient asthma hospital cost. Methods: This cross-sectional study was conducted at a tertiary care hospital from January 2024 to June 2024. Data were collected from 245 patients suffering from asthma. Patients were selected based on the International Classification of Diseases (ICD) codes related to asthma documented in their medical records. Patients aged >18 years with complete medical and billing records available were included in the study. Results: The results show that gender did not significantly affect hospital costs, with males averaging $7,400 and females $7,000 (p = 0.12). Age was a significant predictor, as older patients (65+ years) incurred higher costs ($9,800) compared to younger groups (p < 0.01). Socioeconomic status also impacted costs, with lower-income patients averaging $8,100 compared to $6,200 for higher-income patients (p < 0.05). Age (65+ years) increased costs by $1,800 in univariate analysis and by $1,500 in multivariate analysis (p < 0.01). Asthma severity had the strongest effect, with severe cases adding $5,500 in univariate analysis and $4,800 in multivariate analysis (p < 0.001). Comorbidities increased costs by $4,000 univariately and $3,500 in multivariate models (p < 0.01).Conclusion: It is concluded that asthma severity, comorbidities, and socioeconomic status are the primary predictors of inpatient asthma hospital costs.

Understanding the Risk Factors, Burden, and Interventions for Chronic Respiratory Diseases in Low- and Middle-Income Countries: A Scoping Review.

This scoping review aims to identify risk factors for COPD and asthma, examine the burden and intervention measures, and clarify the findings in the context of climate change, with a particular focus on LMICs. Following the PRISMA-ScR guidelines, we conducted a scoping review using PubMed, Embase, and Scopus, focusing on studies published from 2011 to 2024. Our review included 52 studies that encompassed 244,004 participants. Predominantly conducted in SSA (n = 43, 83%) and Asia (n = 16, 31%), they address indoor and ambient air pollution, occupational hazards, and environmental conditions. Climate change exacerbates risks, varying regionally. SSA faces severe household and occupational exposures, while other LMICs deal with industrial and urban pollution. Stigma, social exclusion and economic burden underscore the necessity for intervention strategies (e.g., educational programs, pulmonary rehabilitation, low-emission cookstoves). Our research shows a strong link between air pollution, occupational and environmental exposures, and the prevalence of COPD and asthma in LMICs. It suggests that targeted interventions are effective ways to mitigate these diseases and also highlights the significant impact of climate change on respiratory health.

The clinical potential of 1,5-anhydroglucitol as biomarker in diabetes mellitus.

A crucial measure of diabetes management is to monitor blood glucose, which often requires continuous blood collection, leading to economic burden and discomfort. Blood glucose and glycated hemoglobin A1c serve as traditional indicators of glucose monitoring. But now glycated albumin, fructosamine, and 1,5-anhydroglucitol (1,5-AG) have been gaining more attention. 1,5-AG is a chemically stable monosaccharide that exists in the human body. Its serum concentration remains stable when blood glucose levels are normal. However, it decreases when blood glucose exceeds the renal glucose threshold. Studies have shown that 1.5-AG reflects blood glucose changes in 1 to 2 weeks; therefore, decreased levels of serum 1,5-AG can serve as a clinical indicator of short-term blood glucose disturbances. Recent studies have shown that 1,5-AG can be used not only for the screening and managing of diabetes but also for predicting diabetes-related adverse events and islet β cell function in prediabetic patients. In addition, saliva 1,5-AG demonstrates potential value in the screening and diagnosis of diabetes. This review focuses on the biological characteristics, detection methods, and clinical application of 1,5-AG to promote understanding and applicable research of 1,5-AG in the future.

THE CLINICAL EFFECTIVENESS OF ADVANCED OR METASTATIC NON-SMALL CELL LUNG CANCER: A SYSTEMATIC REVIEW

Lung cancer presents a significant epidemiological and economic burden worldwide. This deadly type of cancer ranks second in incidence and first in mortality among all cancers. The rapid increase in new and expensive treatment options places a substantial financial strain on public healthcare systems. Given the limited healthcare resources, the economic evaluation of new cancer drugs is crucial for ensuring the sustainability of healthcare systems and improving patients' access to treatments. This study aims to systematically review health state utility values (HSUVs) associated with traditional chemotherapy and targeted therapies in the first-line treatment of advanced or metastatic non-small cell lung cancer (NSCLC). A search was conducted in PubMed, EMBASE, and BioMed databases to identify publications reporting HSUVs, and 10 studies were selected from 1319 based on predefined criteria. The study found that HSUVs for targeted therapies were consistently higher across all health states compared to traditional chemotherapy. The included publications provide a comprehensive framework of HSUVs applicable to this disease and highlight the need for more empirical research to obtain a broader range of HSUVs for NSCLC.

Investigating the metabolomic pathways in female reproductive endocrine disorders: a Mendelian randomization study.

Reproductive endocrine disorders (RED), including polycystic ovary syndrome (PCOS), endometriosis (EMs), and female infertility (FI), significantly affect women's health globally, with varying prevalence across different regions. These conditions can be addressed through medication, surgical interventions, and lifestyle modifications. However, the limited understanding of RED's etiology and the substantial economic burden of its treatment highlight the importance of investigating its pathogenesis. Metabolites play a critical role in metabolic processes and are potentially linked to the development of RED. Despite existing studies suggesting correlations between metabolites and RED, conclusive evidence remains scarce, primarily due to the observational nature of these studies, which are prone to confounding factors. This study utilized Mendelian Randomization (MR) to explore the causal relationship between metabolites and RED, leveraging genetic variants associated with metabolite levels as instrumental variables to minimize confounding and reverse causality. Data were obtained from the Metabolomics GWAS Server and the IEU OpenGWAS project. Instrumental variables were selected based on their association with the human gut microbiota composition, and the GWAS summary statistics for metabolites, PCOS, EMs, and FI were analyzed. The MR-Egger regression and random-effects inverse-variance weighted (IVW) methods were employed to validate the causal relationship. Cochran's Q test was employed to evaluate heterogeneity, sensitivity analysis was performed using leave-one-out analysis, and for pleiotropy analysis, the intercept term of MR-Egger's method was investigated. The MR analysis revealed significant associations between various metabolites and RED conditions. For instance, a positive association was found between 1-palmitoylglycerophosphocholine and PCOS, while a negative association was noted between phenylacetate and FI. The study identified several metabolites associated with an increased risk and others with protective effects against PCOS, EMs, and FI. These findings highlight the complex interplay between metabolites and RED, suggesting potential pathways through which these conditions could be influenced or treated. This MR study provides valuable insights into the causal relationship between metabolites and female reproductive endocrine disorders, suggesting that metabolic alterations play a significant role in the pathogenesis of PCOS, EMs, and FI, and offering a foundation for future research and therapeutic development.

Education and metabolic syndrome: a Mendelian randomization study.

The metabolic syndrome (MetS), a collection of conditions that heighten the risk of disease development and impose economic burdens on patients. However, the causal relationship between education and MetS was uncertain. In this study, the Mendelian randomization (MR) method was employed to elucidate the potential causal link between education and the MetS and its components. Single nucleotide polymorphisms (SNPs) associated with education, MetS, and its components were sourced from a public database, with the inverse variance-weighted (IVW) method utilized for analysis. Education demonstrated a significant negative correlation with the risk of MetS (OR = 0.55, 95% CI = 0.48-0.63, p = 2.18E-51), waist circumference(OR = 0.80, 95% CI = 0.76-0.83, p = 4.98E-33), hypertension (OR = 0.96, 95% CI = 0.95-0.97; p = 4.54E-10), Fasting blood glucose (OR = 0.94, 95% CI = 0.91-0.97, p = 7.58E-6) and triglycerides (OR = 0.83, 95% CI = 0.79-0.87, p = 7.87E-18) while showing a positive association with high-density lipoprotein cholesterol (OR = 1.22, 95% CI = 1.18-1.25, p = 1.45E-31). The findings of this study suggest that education can decrease the incidence of MetS.

Enriched marine oil supplements in pregnancy for the modulation of maternal inflammatory- associated causes of preterm delivery

Preterm birth is a major cause of perinatal complications and neonatal deaths. Furthermore, in the field of obstetrics many clinical entities like uterine contractions or the occurrence of pre- eclampsia remain to be serious complications during pregnancy and represent a major psychological, financial, and economic burden for society. Several published guidelines, studies and recommendations have highlighted the importance of supplementation of omega-3 long chain polyunsaturated fatty acids (PUFAs) during pregnancy. This narrative review aims at giving an overview on the modern perception of inflammatory processes and the role of specialized pro-resolving mediators (SPMs) in their resolution, especially in obstetrics. Additionally, we highlight the possible role of SPMs in the prevention of obstetric complications through oral supplementation using enriched marine oil nutritional’s. The intake of PUFAs may result in an overall improvement of pregnancy outcomes by contributing to fetal brain growth and neurological development but more importantly though modulation of inflammation-associated pathologies. Especially the use of SPMs represents a promising approach for the management of obstetric and perinatal complications. SPMs are monohydroxylates derived from enriched marine oil nutritional’s that involve certain pro-resolutive metabolites of omega-3 long chains PUFAs and may contribute to an attenuation of inflammatory diseases. This may be obtained through various mechanisms necessary for a proper resolution of inflammation such as the termination of neutrophil tissue infiltration, initiation of phagocytosis, downregulation of pro-inflammatory cytokines or tissue regeneration. In this way, acute and chronic inflammatory diseases associated with serious obstetrical complications can be modulated, which might contribute to an improved pregnancy outcome.

The economic burden of schizophrenia spectrum disorders: clinical and functional correlates and predictors of direct costs. A retrospective longitudinal study

The economic burden of schizophrenia amounts for 1.5-3 % of healthcare expenses in developed countries, and ∼50 % derives from direct costs: 81 % of these are due to hospitalization, residential facilities and semi-residential facilities. Therefore, a better characterization of variables that influence direct costs represents a relevant issue.A total of 276 individuals with schizophrenia spectrum disorders receiving treatment from the Community Mental Health Centers of Brescia (Italy) were included in the study: for each participant socio-demographic, clinical and functional characteristics were assessed, and data related to the use of services in 2022 (then converted to costs) were collected. Regression analyses were performed to identify predictors of costs.A direct healthcare expenditure of 16477.23 (±32856.47) € per patient per year was identified. The main cost predictor was the PSP total score (p=0.005), followed by age of onset (p=0.020), and PANSS total score (p=0.033). Including PANSS sub-scales scores and PSP single items as potential predictors, the main predictor was the “socially useful activities” PSP item (p=0.002), followed by age of onset (p=0.011), and PANSS negative scale score (p=0.027).Our findings underline the need to implement rehabilitative intervention focused on the improvement of psychosocial functioning and negative symptoms, also to reduce healthcare expenses.

Therapeutic potential of natural coumarins in autoimmune diseases with underlying mechanisms.

Autoimmune diseases encompass a wide range of disorders characterized by disturbed immunoregulation leading to the development of specific autoantibodies, which cause inflammation and multiple organ involvement. However, its pathogenesis remains unelucidated. Furthermore, the cumulative medical and economic burden of autoimmune diseases is on the rise, making these diseases a ubiquitous global phenomenon that is predicted to further increase in the coming decades. Coumarins, a class of aromatic natural products with benzene and alpha-pyrone as their basic structures, has good therapeutic effects on autoimmune diseases. In this review, we systematically highlighted the latest evidence on coumarins and autoimmune diseases data from clinical and animal studies. Coumarin acts on immune cells and cytokines and plays a role in the treatment of autoimmune diseases by regulating NF-κB, Keap1/Nrf2, MAPKs, JAK/STAT, Wnt/β-catenin, PI3K/AKT, Notch and TGF-β/Smad signaling pathways. This systematic review will provide insight into the interaction of coumarin and autoimmune diseases, and will lay a groundwork for the development of new drugs for autoimmune diseases.

Inpatient Falls: Epidemiology, Risk Assessment, and Prevention Measures. A Narrative Review.

Background Patient falls are a common inpatient dilemma and comprise the largest category of preventable adverse events in hospitalized patients. These events place a clinical burden on the patient, such as increased morbidity and reduced quality of life, in addition to an economic burden on the hospital system. Fall prevention strategies have the opportunity to decrease inpatient health care costs and length of stay. Several risk factors have been identified that contribute to inpatient falls and several strategies have been identified to minimize this risk. These risk factors are typically characterized as intrinsic and extrinsic factors. Intrinsic factors include characteristics such as age, gender, impaired mobility, and physiological factors (eg, co-morbidities, low muscular strength, visual impairment, poor reaction time, and movement disorders). Extrinsic factors are related to characteristics in the environment, such as slippery surfaces, footwear, bad lighting, and the influence of medications. Risk assessment tools, such as the Hendrich II Fall Risk Model, Morse Fall Scale, and STRATIFY, were developed to help identify those at risk. In utilizing these models and our understanding of predisposing risk factors, prevention strategies may be utilized to mitigate these risks. These strategies are often generalized actions including patient education; however, targeted interventions (ie, patient education) also improve outcomes by interrogating specific risk factors.

Combining single-cell RNA sequencing and network pharmacology to explore the target of cangfu daotan decoction in the treatment of obese polycystic ovary syndrome from an immune perspective.

Polycystic ovary syndrome (PCOS) is a heterogeneous gynecological endocrine disorder linked to immunity. Cangfu Daotan Decoction (CFDT), a classic Chinese medicine prescription, is particularly effective in treating PCOS, specifically in patients with obesity; however, its specific mechanism remains unclear. Part 1: Peripheral blood mononuclear cells were collected on egg retrieval day from obese and normal-weight patients with PCOS and healthy women undergoing in vitro fertilization (IVF)-embryo transfer. Next, scRNA-seq was performed to screen the key genes of bese patients with PCOS. Part 2: Active ingredients of CFDT and obesity-related PCOS targets were identified based on public databases, and the binding ability between the active ingredients and targets was analyzed. Part 3: This part was a monocentric, randomized controlled trial. The obese women with PCOS were randomized to CFDT (6 packets/day) or placebo, and the healthy women were included in the blank control group (43 cases per group). The clinical manifestations and laboratory outcomes among the three groups were compared. Based on the scRNA-seq data from Part 1, CYLD, ARPC3, CXCR4, RORA, JUN, FGL2, ZEB2, GNLY, FTL, SMAD3, IL7R, KIR2DL1, CTSD, BTG2, CCL5, HLA, RETN, CTSZ, and NCF2 were potential key genes associated with obese PCOS were identified. The proportions of T, B, and natural killer cells were higher in patients with PCOS compared to healthy women, with even higher proportions observed in obese patients with PCOS. Gene ontology and the Kyoto encyclopedia of genes and genomes analysis depicted that the differentially expressed genes were related to immune regulation pathways. Network pharmacology analysis identified that the key active components in CFDT were quercetin, carvacrol, β-sitosterol, cholesterol, and nobiletin, and TP53, AKT1, STAT3, JUN, SRC, etc. were the core targets. The core targets and their enrichment pathways overlapped with those in Part 1. Clinical trials in Part 3 found that CFDT reduced the dosage of gonadotropins use in patients with PCOS, increased the number of high-quality embryos, and improved the ongoing pregnancy rate. CFDT can improve the immune microenvironment of patients to some extent, reduce their economic burden, and enhance IVF outcomes. The improvement in the immune microenvironment in obese patients with PCOS may be linked to targets such as JUN and AKT.

Literature Review to Understand the Burden and Current Non-surgical Management of Moderate-Severe Pain Associated with Knee Osteoarthritis.

To conduct a literature review exploring the humanistic burden, costs, and guideline recommendations for non-surgical management of moderate-severe pain in knee osteoarthritis (KOA). Published studies (2018-25 April 2023) assessing the burden of moderate-severe pain in KOA were identified by searching Medline, Embase, EconLit, and Cochrane database, supplemented with grey literature hand searches and reference list snowballing. Treatment guidelines were also identified for key countries. This review included 106 publications and 37 treatment guidelines. Patients with moderate-severe pain were found to experience a low quality of life (QoL) and an impaired ability to perform daily tasks. The economic burden of KOA was substantial, including cost of medical visits, non-operative treatment (physical therapy and hyaluronic acid [HA] being key drivers) and productivity losses. Non-steroidal anti-inflammatory drugs (NSAIDs) were among the most frequently used pharmacological treatments, with intra-articular (IA) injections used to varying degrees. Opioid use was also frequently reported. Guidelines universally recommended NSAIDs, albeit with limited dose and duration for oral NSAIDs. IA-corticosteroids were conditionally/moderately recommended for short-term use by most guidelines, while IA-HA and opioids were rarely recommended. Guidelines are not specific to patients with moderate-severe pain and do not distinguish between different KOA phenotypes. KOA with moderate-severe pain is associated with substantial humanistic and economic burden. Real-world data suggest that some treatments are regularly used at high cost regardless of the lack of evidence-based recommendations. There remains a need for new treatment options that successfully relieve pain, improve QoL and delay the need for surgery. Graphical abstract available for this article.

Scaling the Food Mountain: Implications for Addressing the Determinants of Consumer Food Waste Practices

The growing food waste phenomenon is recognised as a global issue with significant social, economic, and environmental burdens. This is a major concern in developed nations, where consumers are the largest contributors to the total volume of food waste production. As a leading cause of food and water insecurity, economic inequality, and environmental degradation, preventing and minimising consumer food waste is a key objective for policymakers and practitioners. Due to the complex consumer behaviours and practices associated with food waste generation, current understandings of why food waste occurs remain scattered. The purpose of this review is therefore to map the history and development of consumer food waste research over time, highlighting key themes and inconsistencies within the existing literature. Adopting a narrative approach, the literature is organised into three distinct themes to explore and identify the various internal and external determinants of consumer food waste. Our analysis highlights consumer food waste as a complex and multi-faceted challenge which cannot be attributed to one single variable, but rather a combination of behaviours determined by various societal, individual, and behavioural factors. While previous research tends to frame food waste as mainly a consumer issue, this review identifies several collective actors who are central to the problem. These findings call for a holistic view across the food supply chain to help identify opportunities for multi-stakeholder actions that prevent and reduce food waste at the consumer level. Drawing upon these new insights, we provide practical recommendations to assist policymakers, retailers, and consumers in mitigating consumer-related food waste.

Molecular Insights and Pharmacotherapy of Diabetic Neuropathy

Background: Diabetes mellitus is a chronic disorder of energy metabolism caused by lack or decrease in the effectiveness of insulin, and is characterised by an abnormally elevated blood glucose concentrations and the development of macrovascular, microvascular and/or neuropathic complications. Diabetic neuropathy (DN) is one of the most debilitating outcomes of diabetes mellitus, and may cause pain, decreased mobility as well as amputation. Diabetes can damage the peripheral nervous system (PNS), through the induction of de-myelination in neurones, precipitated by chronic hyperglycaemia-induced oxidative stress, and causing a condition that involves the upper and lower limbs. Objective: The study discussed the risk factors for insulin resistance and pre-diabetes, type II diabetes mellitus and vascular complications, cellular and molecular basis of DN, physiopathological mechanisms, and the pharmacological treatment of DN. Method: The study examined journal articles and standard textbooks, as it relates to diabetes mellitus and its complications. Search for articles on DN was carried out in the literature. These were identified and reviewed for selection using chemical abstracts service, pubmed, google scholar, crossreference, web of science, pubmed central free article, and scopus. The key words used for search were: diabetic neuropathy; diabetic peripheral neuropathy; peripheral neuropathy; microvascular complications of diabetes mellitus; and neuromuscular complications of diabetes mellitus. Result & Discussion: Two hundred and fifty (250) articles and other works were identified, while ninety-seven (97) articles and non-journal materials were extracted and reviewed, taking into account the criteria for selection. Studies done in the last 4.5 decades were included, while works written on other languages, outside English were excluded. Findings indicate that DN is a complex disorder that affects the peripheral and/or cranial nerves, which is caused by unattended or poorly attended, long-term increase in blood glucose concentrations. It relatively manifests early, affecting a significant proportion of the micro-blood vessels in the middle-aged and elderly diabetic patients. DN causes numbness, loss of sensation, and sometimes pain in the feet, legs, arms or hands. Hyperglycaemia causes the activation and inhibition of several molecular pathways that are crucial for homeostasis in neuronal and neuroglial cells. Conclusion: DN is the commonest complication of diabetes mellitus. It has no known definitive therapy. Treatment is essentially symptomatic with huge economic and psychological burden, hence the rationale for a cost effective and targeted therapies. Achieving euglycaemia using anti-diabetic regimens (i.e., insulin and oral hypoglycaemic agents), foot care, changes in feeding habits and lifestyle modification are critical to holistically address the problem.

Designing persuasive communication models for vaccine acceptance in isolated communities: A mass communication approach

This study introduces the Persuasive Communication Model as a novel approach to address vaccine hesitancy in isolated U.S. communities, where infectious diseases such as measles and influenza continue to pose significant public health threats. By integrating mass communication theories like the Elaboration Likelihood Model (ELM) and Social Cognitive Theory (SCT), with AI-driven message personalization, the model effectively tailors health communication strategies to the cultural, cognitive, and socio-economic contexts of vaccine-hesitant populations. In a randomized controlled trial, the model increased vaccination uptake by over 20% compared to traditional methods, while also enhancing trust in healthcare systems. The model’s adaptive communication, utilizing both digital platforms and community leaders, was instrumental in overcoming barriers related to geographic isolation, religious beliefs, and cultural resistance. These findings are particularly relevant for enhancing national public health security and reducing the economic burden of vaccine-preventable diseases. The study highlights the model's superiority over static communication frameworks, offering scalable applications for broader public health interventions.

Chronic hepatitis B costs and healthcare resource utilization in a Japanese patient population: a retrospective cross-sectional analysis.

Data on the economic burden of chronic hepatitis B infection in Japan are lacking. This study investigated healthcare resource utilization and costs of chronic hepatitis B infection and liver complications in Japan. This non-interventional study used the Medical Data Vision database. For the first analysis, a population with prevalent chronic hepatitis B infection and absence of liver complications was identified and further stratified by nucleos(t)ide analog treatment history. In the second analysis, patients with prevalent chronic hepatitis B infection and incident liver complications were identified. Patients were followed for 1 year in the first analysis and 2 years in the second analysis. Numbers of all-cause outpatient, inpatient, emergency hospitalizations, medication use, and associated costs per person-year were described across patients without/with nucleos(t)ide analog treatment and in those without/with liver complications. For patients with chronic hepatitis B infection, 75,967 had no liver complications while 17,678 patients had liver complications. All-cause outpatient visits were the largest contributor to healthcare resource utilization and costs, for patients without and with liver complications, and were numerically higher for patients on nucleos(t)ide analog than not. Patients with liver complications had numerically higher all-cause healthcare resource utilization and total costs than patients without complications. Japan has a high economic burden of chronic hepatitis B infection, particularly in patients with liver complications. Optimizing treatment to prevent complications may reduce this burden.

Melanin Hydrogel Inverse Opal Microneedle Patches for Wound Healing.

Bacterial infected wounds bring an economic burden to the worldwide medical care field. A variety of bioactives-integrated hydrogel patches are developed in response to this challenge. Here, the melanin hydrogel inverse opal microneedle patches (MNs) with antioxidant and visual color sensing abilities for the management of bacterial infected wounds are proposed. The MNs are fabricated by applying melanin-loaded polyethylene glycol diacrylate (PEGDA) as the inverse opal hydrogel and using bacitracin-carried gelatin to fill those nanopores of hydrogel scaffold. Benefitting from the antioxidant capacity of melanin nanoparticles and the local antimicrobial ability of bacitracin, the resulting MNs possess the integrated functions of reactive oxygen species scavenging and antibacterial. Besides, the inverse opal structure endows the MNs with vivid structure color and detectable reflected wavelength, which can gradually shift with the release of the drug, thus allowing MNs to assess the drug delivery. Based on these characteristics, MNs perform excellent in in vitro drug delivery and monitoring, as well as the promotion of bacterial infected wound recovery in vivo, indicating the potential of MNs in the future wound management field.

Ex Vivo Intestinal Organoid Models: Current State-of-the-Art and Challenges in Disease Modelling and Therapeutic Testing for Colorectal Cancer.

Despite improvements in participation in population-based screening programme, colorectal cancer remains a major cause of cancer-related mortality worldwide. Targeted interventions are desirable to reduce the health and economic burden of this disease. Two-dimensional monolayers of colorectal cancer cell lines represent the traditional in vitro models for disease and are often used for diverse purposes, including the delineation of molecular pathways associated with disease aetiology or the gauging of drug efficacy. The lack of complexity in such models, chiefly the limited epithelial cell diversity and differentiation, attenuated mucus production, lack of microbial interactions and mechanical stresses, has driven interest in the development of more holistic and physiologically relevant in vitro model systems. In particular, established ex vivo patient-derived explant and patient-derived tumour xenograft models have been supplemented by progress in organoid and microfluidic organ-on-a-chip cultures. Here, we discuss the applicability of advanced culturing technologies, such as organoid systems, as models for colorectal cancer and for testing chemotherapeutic drug sensitivity and efficacy. We highlight current challenges associated with organoid technologies and discuss their future for more accurate disease modelling and personalized medicine.

Research Progress on Non-Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease worldwide. With the prevalence of overweight and obesity in the Chinese population, NAFLD is no longer a disease exclusive to Western developed countries, and has become one of the most common metabolic diseases in the world. The global prevalence of NAFLD is as high as 37.8%, and the prevalence of NAFLD in the Chinese population is 23.3%. In recent years, with the global epidemic of obesity and metabolic syndrome, the prevalence of NAFLD has gradually increased. The risk factors of NAFLD are closely related to obesity, diabetes, hypercholesterolemia, hypertriglyceridemia, hyperuricemia and other diseases. When NAFLD co-exists with these metabolic diseases, it often increases the risk of cirrhosis, liver cancer, and even death. At the same time, it can aggravate other chronic liver diseases, promote disease progression, and is closely related to the occurrence and development of atherosclerosis and type 2 diabetes. With the progression of NAFLD disease, the related clinical burden and economic burden of NAFLD and its impact on patients' quality of life are becoming more and more serious. Therefore, early identification, early diagnosis, early prevention, early treatment and standardized management of NAFLD are conducive to the control of the risk of cirrhosis, liver cancer and cardiovascular diseases. This article will review the epidemiology, hazards, and related risk factors of NAFLD.

Balancing Cost and Environmental Impact: A Linear Programming Approach to Sustainable Shopping

A linear programming model is devised for consumer purchasing decisions minimizing weighted cost and environmental impact using real-world data. Minor shifts towards environmental preferences can greatly reduce impact with minimal cost increase. Spending slightly more on the bundle than the cheapest option can cut environmental impact by a third. Conversely, less than 10% compromise in impact yields over 15% cost savings. Consumers can find efficient midpoints—cost-effective and environmentally sustainable options—through strategic decisions. Additionally, a synthetic dataset, modeling different societal dispositions through Beta distributions of cost-environment orientation parameters, simulates societal attitudes, showing that a 10% reduction in environmental impact is possible with a 23% higher economic burden, while 60% of this reduction can be achieved with only 3.1% increase in cost when maintaining a balanced societal disposition. This demonstrates the potential of optimization-based strategic purchasing decisions to achieve significant economic and environmental efficiencies when accompanied by increased environmental awareness.