Production Losses Research Articles

Effectiveness of a Complementary Telehealth Education Program as a Preventive Treatment for Chronic Migraine: A Randomized Pilot Study

Background/Objectives: Chronic migraine (CM) is a neurological disorder that causes significant disability, loss of productivity, and economic burden. Preventive treatments, including pharmacological and educational interventions, are crucial for managing CM effectively. The aim of this study was to analyze whether adding a therapeutic telehealth education program (TTEP) to pharmacological treatment achieved a greater reduction in the number of headache days experienced by patients with CM. Methods: A randomized, double-blind, controlled pilot study with two parallel groups was performed. Patients with a diagnosis of CM and who were being treated with Botulinum Toxin were randomly assigned to either the EG (therapeutic education program about the neuroscience of pain, migraine, pain strategies, sleep habits, exercise, nutrition, postural habits, and relaxation strategies) or CG (general health recommendations with no specific content about migraine). The intervention lasted a total of eight weeks and was delivered via a telehealth application (APP). Headache frequency, migraine frequency, pain intensity, headache impact, allodynia, fear of movement, pain catastrophizing, chronic pain self-efficacy, anxiety and depression, sleep quality, and sedentary lifestyle were measured at baseline (M0), one month after the intervention started (M1), at the end of the intervention (M2), and one month after the intervention was completed for follow-up (M3). Results: In total, 48 patients participated. There were differences between the groups in the following outcomes in favor of EG for headache frequency at the one-month follow-up (p = 0.03; d = 0.681); chronic pain self-efficacy at post-treatment (p = 0.007; d = 0.885) and at the one-month follow-up (p < 0.001; d = 0.998); and sleep quality at post-treatment (p = 0.013; d = 0.786) and at the one-month follow-up (p < 0.001; d = 1.086). No differences existed between the groups for the other outcomes examined (p < 0.05). Conclusions: The use of TTEP reduced the number of headache days, improved sleep quality, and increased self-efficacy in managing pain. This pilot study suggests that the addition of a specialized TTPE to pharmacological treatments may be more effective than a general health recommendation program for migraine.

Isolation and identification of antifungal, antibacterial and nematocide agents from marine bacillus gottheilii MSB1

Abstract Pathogenic fungi employ numerous strategies to colonize plants, infect them, reduce crop yield and quality, and cause significant losses in agricultural production. The increasing use of chemical pesticides has led to various ecological and environmental issues, including the emergence of resistant weeds, soil compaction, and water pollution, all negatively impacting agricultural sustainability. Additionally, the extensive development of synthetic fungicides has adverse effects on animal and human health, prompting the exploration of alternative approaches and green strategies for phytopathogen control. Microorganisms living in sponges represent a promising source of novel bioactive secondary metabolites, potentially useful in developing new nematicidal and antimicrobial agents. This study focuses on extracting bioactive compounds from endosymbiotic bacteria associated with the marine sponge Hyrtios erect sp. (collected from NIOF Station, Hurghada, Red Sea, Egypt) using various organic solvents. Bacillus sp. was isolated and identified through 16 S rRNA gene sequencing. The biocidal activity of Bacillus gotheilii MSB1 extracts was screened against plant pathogenic bacteria, fungi, and nematodes. The n-butanol extract showed significant potential as a biological fungicide against Alternaria alternata and Fusarium oxysporum. Both n-hexane and ethyl acetate extracts exhibited negative impacts against the plant pathogenic bacteria Erwinia carotovora and Ralstonia solanacearum, whereas the n-butanol extract had a positive effect. Regarding nematicidal activity, ethyl acetate and n-butanol extracts demonstrated in-vitro activity against the root-knot nematode Meloidogyne incognita, which causes serious vegetable crop diseases, but the n-hexane extract showed no positive effects. The findings suggest that bioactive compounds from endosymbiotic bacteria associated with marine sponges, particularly B. gotheilii MSB1, hold significant potential as alternative biological control agents against plant pathogens. The n-butanol extract, in particular, displayed promising biocidal activities against various plant pathogenic fungi, bacteria, and nematodes. These results support further exploration and development of such bioactive compounds as sustainable, environmentally friendly alternatives to synthetic pesticides and fungicides in agricultural practices.

In Situ Synthesis of MoO3 by Surface Oxidation of Mo2C (MXene) for Stable Near‐Surface Reactions in Aqueous Aluminum‐Ion Battery

AbstractMolybdenum trioxide (MoO3) is a promising positive electrode material for aqueous aluminum‐ion batteries (AAIBs) due to its high theoretical capacity. However, MoO3 faces several challenges in an aqueous electrolyte, such as easy dissolution of reaction products, volume expansion, and low conductivity, which severely limit its application in aqueous batteries. In this work, we effectively increased the overall conductivity of the electrode by in situ growing MoO3 on the Mo2C MXene layer. MXene can effectively inhibit the dissolution and structural loss of MoO3 reaction products. Additionally, the coordination effect of Mo2C and MoO3 achieves a stable near‐surface reaction on the MXene laminates, resulting in the Mo2C/MoO3 composite exhibiting excellent aluminum storage properties (123.5 mAh/g after 200 cycles at 0.4 A/g). The energy storage mechanism of H+/Al3+ co‐insertion/extraction was elucidated through ex situ characterization, and the promotion effect of Mo2C on MoO3 reaction kinetics was verified by density functional theory (DFT) calculations. This work provides new insights into improving the stability of AAIBs cathodes and extends the application of Mo‐based MXene in aqueous batteries.

In Situ Synthesis of MoO3 by Surface Oxidation of Mo2C (MXene) for Stable Near-Surface Reactions in Aqueous Aluminum-Ion Battery.

Molybdenum trioxide (MoO3) is a promising positive electrode material for aqueous aluminum-ion batteries (AAIBs) due to its high theoretical capacity. However, MoO3 faces several challenges in an aqueous electrolyte, such as easy dissolution of reaction products, volume expansion, and low conductivity, which severely limit its application in aqueous batteries. In this work, we effectively increased the overall conductivity of the electrode by in situ growing MoO3 on the Mo2C MXene layer. MXene can effectively inhibit the dissolution and structural loss of MoO3 reaction products. Additionally, the coordination effect of Mo2C and MoO3 achieves a stable near-surface reaction on the MXene laminates, resulting in the Mo2C/MoO3 composite exhibiting excellent aluminum storage properties (123.5 mAh/g after 200 cycles at 0.4 A/g). The energy storage mechanism of H+/Al3+ co-insertion/extraction was elucidated through ex situ characterization, and the promotion effect of Mo2C on MoO3 reaction kinetics was verified by density functional theory (DFT) calculations. This work provides new insights into improving the stability of AAIBs cathodes and extends the application of Mo-based MXene in aqueous batteries.

Global, Regional, and Country-Level Economic Impacts of Oral Conditions in 2019

The recent World Health Organization (WHO) Oral Health Resolution and the subsequent WHO Global Oral Health Action Plan highlight the key relevance of providing information on the economic impacts of oral conditions. The purpose of this study was to provide updated estimates for the global, regional, and country-level economic impacts of oral conditions in 2019. Extending previously established methods, dental expenditures (costs for treatments) and productivity losses for 5 oral conditions (caries in deciduous and permanent teeth, periodontitis, edentulism, other oral diseases) were estimated for the year 2019. The estimated total worldwide economic impacts of oral conditions in 2019 were US $710B, of which US $387B (US $327B to US $404B) was due to direct costs and US $323B (US $186 to US $460) was due to productivity losses for the 5 main oral conditions. Low-income countries spent an average of US $0.52 (US $0.22 to US $0.96) per capita on dental care, while high-income countries spent an average of US $260 (US $257 to US $268) per capita—a 500-fold difference. These findings suggest that oral conditions continue to substantiate an enormous economic burden to individuals and society. The comprehensiveness of estimates supersedes that of previous work as the primary information on direct costs was identified for a larger number of countries. The need for more and better routine reporting and monitoring of the economic impact of oral conditions is emphasized. The relevance of such information is also highlighted by its inclusion in the first-ever WHO Global Oral Health Status Report and Global Strategy on Oral health 2023 to 2030. Given the persistently high economic burden of oral conditions, there is a key role for better prioritization of cost-efficient oral health programs as well as needs-responsive capacity planning.

Evaluation and Application of Machine Learning Techniques for Quality Improvement in Metal Product Manufacturing

This article presents a discussion of the application of machine learning methods to enhance the quality of drive shaft production, with a particular focus on the identification of critical quality issues, including cracks, scratches, and dimensional deviations, which have been observed in the final stages of machining. A variety of classification algorithms, including neural networks (NNs), bagged trees (BT), and support vector machines (SVMs), were employed to efficiently analyse and predict defects. The results show that neural networks achieved the highest accuracy (94.7%) and the fastest prediction time, thereby underscoring their efficiency in processing complex production data. The BT model demonstrated stability in its predictions with a slower prediction time, while the SVM model exhibited superior training speed, though with slightly lower accuracy. This article proposes that optimising key process parameters, such as temperature, machining speed, and the type of coolant used, can markedly reduce the prevalence of production defects. It also recommends integrating machine learning with traditional quality management techniques to create a more flexible and adaptive control system, which could help reduce production losses and enhance customer satisfaction.

A spatial assessment of agricultural vulnerability to climate change using multidimensional data in Maharashtra state of India

This study aims to examine district-level agricultural vulnerability in the semi-arid and drought-prone state of Maharashtra. Using a multidimensional approach, suitable indicators for 34 districts were selected under exposure, sensitivity and adaptive capacity, aligning with the IPCC 2007 framework for vulnerability assessment. The analysis used temperature and rainfall data spanning 50 years (1968–2017). It also incorporated area and yield data from 2011 to 2020, along with other indicators for the year 2019–20. The composite agricultural vulnerability index (CAVI) score was obtained using proper normalization and assigning weights. The study revealed that the Marathwada and Vidarbha regions reported higher potential crop losses. Among the districts, Sangali was the most exposed (0.57), while Jalgaon was the least exposed (0.31) to climate variations. Ahmednagar exhibited the highest sensitivity (0.70), while Nagpur showed the lowest sensitivity (0.34) to climate change. Regarding adaptive capacity, Pune demonstrated the highest resilience (0.57) and Sindhudurg displayed the lowest score (0.23). CAVI highlighted that the Konkan region, along with western Maharashtra and eastern parts of Vidarbha, exhibited relatively lower vulnerability to climate change, due to factors such as lower potential crop loss and better adaptive capacity. In contrast, Marathwada and western Vidarbha regions were more vulnerable, facing significant crop production losses and higher exposure to climate variability. Hence, to build resilience to climate change and reduce crop production losses, crop planning needs to be adjusted according to the climatic conditions in these regions.

Impact of Arable Land Abandonment on Crop Production Losses in Ukraine During the Armed Conflict

The outbreak of Russia-Ukraine conflict casted an impact on the global food market, which was believed to be attributed to that Ukraine has suffered significant production losses due to cropland abandonment. Nevertheless, recent outbreaks of farmer protests against Ukraine’s grain exports demonstrated that the production losses might not be as severe as previous estimates. By utilizing the adaptive threshold segmentation method to extract abandoned cropland from the Sentinel-2 high-resolution imagery and calibrating the spatial production allocation model’s gridded crop production data from Ukraine’s statistical data, this study explicitly evaluated Ukraine’s crop-specific production losses and the spatial heterogeneity. The results demonstrated that the estimated area of abandoned cropland in Ukraine ranges from 2.34 to 2.40 million hectares, constituting 7.14% to 7.30% of the total cropland. In Ukrainian-controlled zones, this area spans 1.44 to 1.48 million hectares, whereas in Russian-occupied areas, it varies from 0.90 to 0.92 million hectares. Additionally, the total production losses for wheat, maize, barley, and sunflower amount to 1.92, 1.67, 0.70, and 0.99 million tons, respectively, with corresponding loss ratios of 9.10%, 7.48%, 9.54%, and 8.67%. Furthermore, production losses of wheat, barley, and sunflower emerged in both the eastern and southern states adjacent to the conflict frontlines, while maize losses were concentrated in the western states. The findings imply that Ukraine ought to streamline the food transportation channels and maintain stable agricultural activities in regions with high crop production.

Abstract 4136932: Impact of Different Socioeconomic Metrics on Heart Failure-Related Admission and Short-Term Outcomes in Maryland

Introduction: Annually, over 500,000 Americans are hospitalized due to heart failure (HF), marking it as a major contributor to morbidity and mortality. It also poses a significant financial burden and leads to considerable losses in productivity. Objective: This study investigates the predictive accuracy of different socioeconomic metrics on the risk and outcomes of HF in Maryland. Methodology: A retrospective analysis of the Maryland State Inpatient Database (2016-2020) was conducted to assess the predictive accuracy of race/ethnicity, insurance status, household median income, and neighborhood poverty level (measured by the Distressed Communities Index) on the risk of heart failure-related hospital admissions and outcomes. Multivariate logistic regression models were also used to adjust for confounders. Result: During the study period, a total of 389,220 cases of HF were reported in the Maryland SID. The majority of these patients were white (56.8%) and female (51.1%), with a median age of 73 years (interquartile range [IQR] 62-82 years). The in-hospital mortality rate was 5.1%, while rates of atrial fibrillation, cardiac arrest and prolonged hospital stay were 34.4%, 0.3%, and 48.4%, respectively. Multivariate analysis revealed a substantial area under the ROC curve (AUC) indicating good model performance: 0.88 for predicting HF, 0.64 for atrial fibrillation, 0.64 for cardiac arrest 0.57 for prolonged hospital stays, 0.63 for mortality. Subgroup analyses showed variable predictiveness by race (AUC = 0.4378), payment method (AUC = 0.5754), income quartile (AUC = 0.5202), and deprivation composite score (AUC = 0.4751). Patients with private insurance had the highest risk of stress cardiomyopathy (odds ratio [OR] = 1.98; 95% confidence interval [CI] 1.70-2.29). Socioeconomic metrics, including neighborhood distress, showed varying predictive accuracy for the HF-related admissions and selected short-term outcomes, with the highest predictive accuracy for neighborhood distress on the risk of HF (AUC = 0.50, std: 0.006), atrial fibrillation (AUC = 0.48, std: 0.0007), cardiac arrest (AUC = 0.51, std: 0.007), and prolonged hospital stays (AUC = 0.53, std: 0.0005) and mortality (AUC = 0.50, std: 0.0015). Conclusion: Neighborhood poverty level demonstrates significant predictive power for assessing the risk of HF-related hospital admissions and the short-term outcomes among Maryland residents, exceeding factors like insurance and race/ethnicity.

Mitochondrial AOX1a and an H2O2 feed‐forward signalling loop regulate flooding tolerance in rice

SummaryFlooding is a widespread natural disaster that causes tremendous yield losses of global food production. Rice is the only cereal capable of growing in aquatic environments. Direct seeding by which seedlings grow underwater is an important cultivation method for reducing rice production cost. Hypoxic germination tolerance and root growth in waterlogged soil are key traits for rice adaptability to flooded environments. Alternative oxidase (AOX) is a non‐ATP‐producing terminal oxidase in the plant mitochondrial electron transport chain, but its role in hypoxia tolerance had been unclear. We have discovered that AOX1a is necessary and sufficient to promote germination/coleoptile elongation and root development in rice under flooding/hypoxia. Hypoxia enhances endogenous H2O2 accumulation, and H2O2 in turn activates an ensemble of regulatory genes including AOX1a to facilitate the conversion of deleterious reactive oxygen species to H2O2 in rice under hypoxia. We show that AOX1a and H2O2 act interdependently to coordinate three key downstream events, that is, glycolysis/fermentation for minimal ATP production, root aerenchyma development and lateral root emergence under hypoxia. Moreover, we reveal that ectopic AOX1a expression promotes vigorous root and plant growth, and increases grain yield under regular irrigation conditions. Our discoveries provide new insights into a unique sensor–second messenger pair in which AOX1a acts as the sensor perceiving low oxygen tension, while H2O2 accumulation serves as the second messenger triggering downstream root development in rice against hypoxia stress. This work also reveals AOX1a genetic manipulation and H2O2 pretreatment as potential targets for improving flooding tolerance in rice and other crops.

Innate Immunity in Rice: A Defense Against Bacterial Leaf Blight

Rice (Oryza sativa L.) is one of the major staple food crops of the world and sustainable rice production is important for ensuring global food security. Throughout the growing season, a variety of pathogens including fungi, bacteria, viruses, and nematodes, infect different parts of the crop resulting in yield loss. Bacterial leaf blight caused by Xanthomonas oryzae pv. oryzae (Xoo) is one of the major limiting factors in rice production. Being a vascular pathogen, X. oryzae pv. oryzae interferes with a range of physiological and biochemical exchange process in rice. The earlier the pathogen infection, more will be the loss and grain quality is also severely affected due to infection. The spread of the pathogen is too rapid in the favourable climatic conditions. The disease results in 20 to 30 per cent annual loss in rice production and under severe conditions, the yield loss goes up to 80 per cent. Plant pathogens employ different ways to attack host plants and impair plant growth and reproduction. Unlike vertebrates, plants lack mobile immune cells and an adaptive immune system. Plants mainly rely on two interconnected tiers of the innate immune system to perceive and respond to pathogen infection. This innate immune system or basal resistance mediated by a repertoire of Resistance or R genes in plants acts as the first line of pre-formed and inducible defenses that protect the host plants from large number of pathogens. Over the years, extensive investigation on the molecular interactions between rice and Xanthomonas oryzae pv. oryzae has made impressive progress in understanding the molecular basis of rice innate immunity against bacterial leaf blight. Improving plant immunity has been considered as one of the best choices available for achieving economical and sustainable management of bacterial leaf blight in a durable manner. In this review, we summarize the molecular basis of two tiered innate immune system including PAMP triggered immunity (PTI) and Effector triggered immunity (ETI) as well as R genes involved in rice - Xanthomonas oryzae pv. oryzae interaction.

Production losses caused by red leather leaf in hay and milling oats

Context Red leather leaf (RLL), caused by Neospermospora avenae, is a common foliar disease of oats in south-eastern Australia but its impact on hay and grain yield and quality is unknown. Aim We aimed to determine the effect of RLL on grain yield and quality of commercial milling oat varieties, and biomass and nutrition of hay oat varieties, with a range of host plant resistance responses by comparing fungicide and disease treatments. Methods A total of eight field experiments were conducted in 2019 and 2020; four experiments each investigated the effects of RLL on hay or milling oats. In each experiment, six or seven oat varieties were sown with a disease or fungicide imposed. RLL severity was estimated visually for each experiment. Biomass yield and quality traits at early milk development stage were measured for hay oat experiments; and grain yield and quality for the milling oat experiments. Key results RLL severity (% leaf area affected: 0–44% in hay oats and 2–61% in milling oats) varied with the season, varietal resistance, and treatments. RLL caused significant losses in most experiments, with reductions in biomass of up to 3.5 t/ha (22%) in hay oats and grain yield of up to 1.1 t/ha (21%) in milling oats. Conclusions RLL can be a severe foliar disease of oats in south-eastern Australia and cause significant losses in both hay and milling oat crops. Implications Growing varieties with resistance can effectively reduce potential loss due to RLL and growers are required to adapt fungicide strategies reflecting seasonal conditions and product type (grain or hay).

An Outbreak of Porcine Reproductive and Respiratory Syndrome Virus (PRRSV) in a German Boar Stud: A Retrospective Analysis of PRRSV Shedding in Boar Semen

The porcine reproductive and respiratory syndrome virus (PRRSV) causes high economical costs due to reduced productivity and losses in pig production. The virus can infect sow herds through various routes. One possible risk factor is the transmission of PRRSV through artificial insemination with infected boar semen. For these reasons, conventional boar studs should be closely monitored to detect an outbreak of PRRSV at an early stage. In the presented retrospective study, 2184 fresh semen samples from 336 boars were investigated (RT-qPCR) after an accidental PRRSV introduction to the herd. Hence, the different shedding profiles of PRRSV via semen resulted in 42.2% where no virus was detected, 2.0% intermittent shedding, and 8.4% permanent shedding. The duration of viral shedding varies from 2 days to 83 days post outbreak (on average 33 days). A significant impact of breed on PRRSV shedding duration could not be shown. Also, the distribution of the shedding profile does not follow a consistent mode, indicating that not every boar is shedding the virus via semen.

Antifungal Action of Metallic Nanoparticles Against Fungicide-Resistant Pathogens Causing Main Postharvest Lemon Diseases

Postharvest fungal diseases are the main cause of economic losses in lemon production. The continued use of synthetic fungicides to control the diseases favors the emergence of resistant strains, which encourages the search for alternatives. The aim of this study was to assess the efficacy of metallic nanoparticles (NPs) as antifungal agents against local isolates of Penicillium digitatum and Penicillium italicum, each of them in a fungicide-sensitive and -resistant version, and a Geotrichum citri-aurantii isolate. NPs of ZnO, CuO, and Ag were synthesized and characterized by spectroscopy and microscopy, presenting average sizes < 25 nm and spherical shapes. ZnO-NPs did not present antifungal activity at the assayed conditions, while the minimum fungicidal concentrations (MFCs) were 1000 and 10 µg mL−1 for CuO-NPs and Ag-NPs, respectively. The NPs’ antimicrobial action included conidial membrane permeability and strong intracellular disorganization. Moreover, the Ag-NPs reduced green mold incidence on inoculated lemons when applied to the fruit. Taken together, Ag-NPs were effective in inhibiting both fungicide-sensitive and -resistant isolates of the main lemon postharvest pathogens, suggesting their potential use as an alternative approach.

A Socio-Ecological Approach to Work Performance: A pilot study among Workers with Chronic Skin Diseases

Abstract Objectives Chronic skin diseases (CSD) may lead to productivity losses. This mixed-methods study investigated symptom severity, social challenges, need for workplace accommodation, sick leave and their association with perceived impaired work performance (IWP) among workers with CSD. Methods Data were collected from April to June 2023. Participants (n = 102) completed an online questionnaire sent from the Institute for Occupational Safety and Hygiene and almost 20% were interviewed. The analyses included logistic regression and structural equation models and a thematic analysis. Results Of participants, 72.3% reported perceived IWP. The need for workplace accommodation and sick leave duration were directly associated with IWP. These findings were integrated with common themes based on a socioecological approach. Conclusions By working together to address personal, interpersonal, organizational, and societal aspects associated with CSD, occupational physicians and stakeholders can alleviate perceived IWP.

QOL-06. OPTIMIZING NEUROFIBROMATOSIS CARE: A COMPREHENSIVE ECONOMIC EVALUATION OF A SPECIALIZED EXPERTISE CENTER’S IMPACT ON PATIENT OUTCOMES

Abstract Neurofibromatosis type 1 (NF1), NF2-related schwannomatosis (NF2) and other schwannomatoses represent a spectrum of genetic disorders characterized by the development of tumors on nerve tissues, profoundly impacting patients’ quality of life and posing complex challenges. Recognizing the imperative for comprehensive care delivery, we undertook to implement a Neurofibromatosis Expertise Center (CE) at the Centre hospitalier de l’Université de Montréal (CHUM), Quebec, Canada. Employing a robust analysis framework, we aimed to assess the economic viability of the CE by quantifying the Quality-Adjusted Life Years (QALYs) gained through centralized multidisciplinary neurofibromatosis care (cost-utility ratio = CAD/QALY gained). Leveraging data from validated questionnaires including the SF-6D, our preliminary analysis revealed significant enhancements in patients’ quality of life across diverse domains, including physical pain, visible cutaneous lesions, cognitive dysfunction, hearing loss, malignancies, psychiatric comorbidities, unemployment, physical disability, and social isolation. Notably, among the respondents (N = 115), patients receiving CE services reported a 12% increase in general health compared to a 25% decline among those without CE services. Moreover, 28% of CE patients reported improved overall health compared to 12% of those without CE services. Using the Work Productivity and Activity Impairment questionnaire (WPAI-GH), we found that cohorts followed in CE for ≥ 1 year (N = 45) experienced less work productivity losses compared to the most recent cohort (N = 32), which presented scores exceeding 6 on a 1-to-10 scale. We hypothesize that the establishment of the CE will yield profound improvements in patient health outcomes and alleviate financial strains on the Ministère de la Santé et des Services Sociaux du Québec (MSSS). Therefore, our next steps include discussing a strategy for funding application to the MSSS to ensure the accessibility of necessary care for patients. Continuing data collection and analysis will also provide a more comprehensive overview of patient characteristics and needs.

Public, Private and Public-Private Partnerships (PPP) to Implement a One Health Approach to Combat Antimicrobial Resistance in Colombia

Abstract The establishment of public-private partnerships (PPPs) within Colombia, Latin America, is a recent, innovative effort within the nation’s agricultural industry to tackle antimicrobial resistance (AMR) under a One Health approach. PPPs are a formal alliance between representatives from the public and private sectors that aim to promote cross-sectoral collaboration, stewardship and accountability. Members agree on shared objectives and responsibilities, resources and risks to establish monitoring, prevention and mitigation activities against AMR within the farming industry. Key learnings of this initiative within the context of Colombia include: maximisation of results when monitoring is assigned to the private sector, and this may apply to other lower-middle-income countries (LMICs); objectives are better achieved when they are pre-defined according to time, budget and human resource constraints of member institutions; and confidentiality agreements must be consistent with the sensitive nature of surveillance information. Barriers to implementation were also identified, such as frequent changes of government personnel at decision making levels that make governance planning and adaptation challenging, while legal formalities and bureaucracy hinder formalisation of agreements. The success of this PPP is a useful example for other LMICs to aid in the control and prevention of animal diseases, promotion of food safety and reduction in poor animal health which limit commerce, while at the same time, minimising production loss and ensuring the provision of a fair income for producers. Information © The Authors 2024

Loss of quality of life and increased societal costs in patients with hypertrophic cardiomyopathy: the AFFECT-HCM study

Abstract Introduction Hypertrophic cardiomyopathy (HCM) is the most prevalent inherited cardiac disease. The impact of HCM on quality of life (QoL) and societal costs remains poorly understood. This prospective multi-centre burden of disease study estimated QoL and societal costs of genotyped HCM patients and genotype-positive phenotype-negative (G+/P-) subjects. Methods Participants were categorized into three groups based on genotype and phenotype: 1) G+/P- (left ventricular (LV) wall thickness <13 mm), 2) non-obstructive HCM (nHCM, LV outflow tract (LVOT) gradient <30 mmHg), and 3) obstructive HCM (oHCM, LVOT gradient ≥30 mmHg). We assessed QoL with EQ-5D-5L and Kansas City Cardiomyopathy Questionnaires (KCCQ). Societal costs were measured using medical consumption (iMCQ) and productivity cost (iPCQ) questionnaires. We performed subanalyses within three age groups: <40, 40-59, and ≥60 years. Results From three Dutch hospitals, 506 subjects were enrolled (84 G+/P-, 313 nHCM, 109 oHCM; median age 59 years, 39% female). HCM (both nHCM and oHCM) patients reported reduced QoL vs G+/P- subjects (KCCQ: 88 vs 98, EQ-5D-5L: 0.88 vs 0.96; both p<0.001). oHCM patients reported lower KCCQ scores than nHCM patients (83 vs 89, p=0.036). Societal costs were significantly higher in HCM patients (€19,035/year vs €7,385/year) compared to G+/P- controls, mainly explained by higher healthcare costs and productivity losses. Being symptomatic and of younger age (<60 years) particularly led to decreased QoL and increased costs. Conclusion HCM is associated with decreased QoL and increased societal costs, especially in younger and symptomatic patients. oHCM patients were more frequently symptomatic than nHCM patients. This study highlights the substantial disease burden of HCM and can aid in assessing new therapy cost-effectiveness for HCM in the future.

NOISE POLLUTION AND ITS EFFECTS ON HUMAN HEALTH: A REVIEW

Noise pollution is a pervasive environmental issue with significant adverse effects on human health. This abstract explores the impact of noise pollution on both physical and mental well-being, emphasizing its role in increasing risks for cardiovascular diseases, hearing loss, sleep disturbances, and cognitive impairments. Vulnerable populations, including children and the elderly, are particularly affected by high noise levels, which exacerbate stress, anxiety, and depression, and impair cognitive development in children. The economic implications of noise pollution are considerable, with substantial costs associated with healthcare and productivity losses, as well as negative effects on community cohesion and quality of life. Effective noise management is essential, requiring robust regulations, improved urban planning, and heightened public awareness. Further research is needed to understand the long-term health impacts, refine noise reduction technologies, and assess effects on specific populations. Interdisciplinary studies will be crucial in developing comprehensive strategies to mitigate the health impacts of noise pollution. KEYWORDS: Noise Pollution; Health Impacts; Noise Reduction Technologies; Economic Costs; Interdisciplinary Research

Valuing the Societal Impact of Medicines and Other Health Technologies: A User Guide to Current Best Practices.

This study argues that value assessment conducted from a societal perspective should rely on the Generalized Cost-Effectiveness Analysis (GCEA) framework proposed herein. Recently developed value assessment inventories- such as the Second Panel on Cost-Effectiveness's "impact inventory" and International Society of Pharmacoeconomics Outcomes Research (ISPOR) "value flower"- aimed to more comprehensively capture the benefits and costs of new health technologies from a societal perspective. Nevertheless, application of broader value elements in practice has been limited in part because quantifying these elements can be complex, but also because there have been numerous methodological advances since these value inventories have been released (e.g. generalized and risk-adjusted cost effectiveness). To facilitate estimation of treatment value from a societal perspective, this paper provides an updated value inventory- called the GCEA value flower- and a user guide for implementing GCEAfor health economics researchers and practitioners. GCEA considers 15 broader value elements across four categories: (i)uncertainty, (ii) dynamics, (iii)beneficiary, and (iv) additional value components. The uncertainty category incorporates patient risk preferences into value assessment. The dynamics category petals account for the evolution of real-world treatment value (e.g. option value) and includes drug pricing trends (e.g. future genericization). The beneficiary category accounts for the fact health technologies can benefit others (e.g. caregivers) and also that society may care to whom health benefits accrue (e.g. equity). Finally, GCEA incorporates additional broader sources of value (e.g. community spillovers, productivity losses). This GCEA user guide aims to facilitate both the estimation of each of these value elements and the incorporation of these values into health technology assessment when conducted from a societal perspective.